op_CosmeticNewsNovember2011

of

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

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W

elcome to the November issue of Cosmetic News. Over the last few weeks people have been logging on to www.cosmeticnewsuk.com to cast their votes in the inaugural Aesthetic Awards. With almost 4,000 votes made online, the response has been amazing and we now know who will be taking home a coveted award on the night. Although the winners will not be revealed until the glamorous James Bond themed dinner at Sopwell House on December 1, I would just like to take this opportunity to congratulate all the finalists and thank everyone who has entered or voted as part of our first ever awards. I would also like to thank our sponsors Q-Med and Silderm for their support. On to this month’s issue…

Skin tightening procedures for both the face and body have grown in popularity in recent years with the emergence of minimally invasive but efficacious methods of addressing the problem.

Caused by ageing, weight loss and pregnancy, among other things, lax, saggy skin is a concern for thousands of men and women in the UK. As part of this month’s Special Feature we examine some of the most effective treatments for this indication (p21-24). We also look at the newest treatment for cellulite Cellulaze (p33-34) and discuss the ethics of Groupon offers (p44-46).

I hope you enjoy this issue and look forward to celebrating with everyone who is attending the Aesthetic Awards next month.

the AwArds night for your industry

AAwards esthetic 2011 12 p l At i n u m

in AssociAtion with

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cosmetic news

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Cosmetic news

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November

04 EDITOR’S CHOICE Vicky Eldridge tries out the Red + MRS Fine Titanium Derma Roller

06 INDUSTRY NEWS We round up the latest industry news

11 NEWS SPECIAL We report on the launch of the British Association Of Cosmetic Doctors Launch Independent Sector Medical Appraisal Pilot

12 COSMETIC NEWS EXPO 2012 Be the first to find out what the 2012 Cosmetic News Expo has in store

Red + MRS Fine Titanium Derma Roller One treatment I have always wanted to try but I have not had a chance to, until recently, is dermal rollering. But last month I finally got the opportunity to sample what has undoubtedly become one of the most popular lowdowntime treatments to emerge in recent years.

Aesthetic nurse Frances Furlong

14 ON THE SCENE

performed the treatment for me using

We report on the British Association Of Cosmetic Doctors’ autumn meeting and the UK launch of ArqueDerma™

Roller. She also used a cocktail of

1 6 T H E B I G D E B AT E VAT on cosmetic procedures

18 PEOPLE IN PROFILE We chat to the glamorous Dr Beatriz Molina

2 1 - 2 4 S P E C I A L F E AT U R E – S K I N TIGHTENING We take a look at skin tightening and examine some of the best treatments on the market

28 CLINICAL STUDY We summarise the results of a split face clinical study comparing the Soprano ® XL and the LightSheer ™ for hair removal

3 3 T R E AT M E N T S P OT L I G H T The newly launched Cellulaze laser cellulite reduction treatment

c h o i c e

the Red + MRS Fine Titanium Derma mesotherapy products in combination with the dermal rollering to enhance my results as the needling helps aid penetration of active ingredients.

I was a little anxious about whether or not the treatment would be painful, however, after 20 minutes wearing local anaesthetic cream on my face I need not have worried.

Although I felt a sensation of heat and a mild amount of discomfort, I was pleasantly surprised at how non-invasive a treatment that involves having needles run allover you skin actually was.

Immediately post treatment my skin was quite red and had the appearance of sunburn but after Frances applied a tinted SPF I left the clinic without any make-up on and went out for lunch! Over the next few days the appearance of my skin definitely improved, especially around the chin where I had a few spots. I am booked in for a second treatment in six weeks time and would definitely recommend this to anyone hoping to improve the appearance of their skin.

The Red + MRS Fine Titanium Derma Rollers have just been introduced to the UK market

36 PRODUCT FOCUS

by Inspira Med and include both in-clinic and at-home devices ranging in sizes from

The Intact product range in combinations with OXYJet

0.20 mm-0.30mm for home use and 0.50mm-3.00mm for professional use. All rollers are

38 PRODUCT NEWS

delivered in individual sealed sterile envelopes and plastic cases.

We round up the latest product news

42 ABSTRACTS We round up the latest clinical studies

For more information on the Red + MRS Fine Titanium Derma Roller contact Hilary McNamara on m.hilary@tiscali.co.uk or 07900 490280.

44 BEST PRACTICE Ron Myers debates the ethics and viability of Groupon deals for medical aesthetics clinics

48 MARKETING Zoe Davitt on branding

50 BUSINESS FOCUS Norman Rea on the implications of the Bribery Act 2010

5 2 D AT E S F O R T H E D I A RY Training course, conference and meeting dates

54 DIRECTORY Our guide to the manufacturers, suppliers and business services featured in this month’s issue

Meet the Cosmetic News team Charlotte Body Publisher 01268 754 897 charlotte@creativemedialtd.co.uk

Peter Johnson, Art Director 01268 754 897 peter.johnson@creativemedialtd.co.uk

Vicky Eldridge Editor 01268 754 897 M: 07940 083 677 vicky@creativemedialtd.co.uk

Loraine Winter Designer 01268 754 897 loraine@creativemedialtd.co.uk

Emilia Cops Associate Publisher 01268 754 897 emilia@creativemedialtd.co.uk

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

Hollie-Jane Dunwell Account Manager 01268 754 897 hollie.jane@creativemedialtd.co.uk DISCLAIMER The editor and the publishers do not necessarily agree with the views expressed by contributors and advertisers nor do they accept responsibility for any errors in the transmission of the subject matter in this publication. In all matters the editor’s decision is final.

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News - Industry News

Dr Ahmed Al-Qahtani gives exclusive one-day seminar to explore stem cell and growth factor technology in cosmetics Dr Ahmed Al-Qahtani will be coming to London to give an

Dr Al-Qahtani is a professor of immunology and the innovator

exclusive one-day seminar on ‘Stem Cell and Growth Factor

for the latest growth factor technology with US patents pending

Technology in Cosmetics – The Future’.

as of 2010. He is a longstanding member of the American Association of Immunologists, a member of the American Society for

The event will take place on Wednesday November 9 at the

Clinical Pharmacology and Therapeutics and is accredited with

Melia White House Hotel near Regent’s Park and will include a

numerous scientific publications.

live teaching session on the ‘Recovery Complex Procedure with

The event is being organised by Skin Geeks. Limited places

Dermastamp’.

available and there is a £40 registration fee.

SilDerm sponsor awards

AAwards esthetic 2011 12 Aesthetic Awards 2011 12 the AwArds night for your industry

-

BACN announces bursaries for nurse prescribing courses The British Association of Cosmetic nurses is offering bursaries totaling £10,000 to help members undertake the V300 Nurse Prescribing Course at their chosen universi-

in AssociAtion with cosmetic news SilDerm Ltd has on•board as 1 december 2011 •come sopwell house hertfordshire

ties. Following completion of the V300 Independent Nurse Prescribing Course cosmetic

the Gold Sponsor of the Aesthetic

lowing a face-to-face consultation with patients. Without it, they need to obtain prescrip-

st

nurses are able to prescribe drugs within their specialty, including botulinum A toxins, fol-

Awards in association with Cosmetic

tions from doctors. BACN members can apply for bursaries now in preparation for January

News. SilDerm provides clinically

2012. The first awards will be made on Monday December 5. There will be further awarding

proven treatments in AssociAtionfor withaesthetic cosmetic news

dates next year or until all the money has been allocated.

-

conditions and has focussed its product range on stretch marks, skin lightening

“Sponsors of the association have generously given money for educational purposes and

and anti-ageing. SilDerm’s products are backed by clinical studies to prove their

we feel this is a good use of funds,” explained BACN president, Liz Bardolph, who will also

effectiveness and include: SilDerm™ Stretch Mark Repair Cream, which delivers a

chair the awarding panel. The other panel members are David Hicks, chairman of Wigmore

72% improvement in indentation of the stretch mark, a 34% improvement in the

Medical, and BACN members Dawn Attwell and Sharron Brown. The V300 courses cost

length of the stretch mark and a 25% reduction in colour versus placebo, accord-

between £1,000 and £1,500, although some are more. The BACN is offering £800 per

ing to studies; SilDerm™ Stretch Mark Prevention Oil which delivers a reduced

member towards the full prescribing course and £200 towards a pre-assessment course.

the risk of getting stretch marks and the severity by up to 40% versus placebo in

Applicants can opt for one or the other, but not both. Payments will be made directly

a randomised trial with 80 pregnant women and Lumixyl™ Topical Brightening

to the universities involved. Full details and application forms can be obtained from the

System, a breakthrough in skin brightening technology which has been proven

website www.cosmeticnurses.org.

in clinical studies to be as effective as hydroquinone but without the negative

The organisation has also announced that its 2012 annual conference will be held in

side effects of killing skin cells or making the skin grey.

London on Saturday October 6 at a venue to be confirmed.

Cosmetic News calendar keeps you up to date

MAG appoints new business development manager

Cosmetic News is creating a handy 2012 desk calendar, which will be given

Ajay Shah has been appointed as Medical Aesthetic Group’s business development

to all of our readers for free along with our January 2012 issue.

manager in order to concentrate and manage the growth in demand for its dermal

The calendar will include important industry dates including conferences,

filler product Stylage® Stylage® is an intradermal filler containing the antioxidant man-

exhibitions and association

nitol, which makes it one of the longest lasting fillers on the market. Since its launch at FACE

meetings. If you have any dates

in June 2011, Stylage® has increased rapidly in sales because of its performance and cost ef-

you would like to include in

fective positioning in the aesthetic market. Ajay will also work with Dermasculpt Cannulas

the calendar or are interested

and DCL Skincare products and Rennova Filler for DC Medica Ltd.

in advertising, please contact

Ajay has a wealth of experience in the medical supply business and aesthetics. He has

Hollie Dunwell on 01268 754 897

worked with Sanofi-Aventis, selling Newfill to NHS Hospitals for HIV treatment and Sculptra

or e-mail hollie.jane@creativeme-

to aesthetic clinics. He has also worked with Merz where he exceeded company sales

dialtd.co.uk

targets for Radiesse and Belotero.

Cosmetic News launches e-newsletter Cosmetic News has launched a new monthly e-newsletter in order to keep you

and suppliers. Subscribing is easy, simply visit www.cosmeticnewsuk.com. With

even more up to date on what’s going on in the industry.

4,000 people already subscribed, the e-newsletter is a fantastic way to tell people

The newsletters will feature information about Creative Media’s events, including

about your business. If you are interested in advertising contact Hollie Dunwell on

the Aesthetic Awards and Cosmetic News Expo, as well as updates on the latest

01268 754 897 or e-mail hollie.jane@creativemedialtd.co.uk. A 250 word advertorial

products and treatments on the market and exclusive offers from manufacturers

costs £190 +VAT, a button costs £95+VAT and a banner ad is £130+VAT.

6

cosmeticnewsuk.com

News - Industry News

Cutting prices means cutting corners, warn surgeons The British Association of

become common to bundle together the practice of aesthetic plastic surgery such

Aesthetic Plastic Surgeons issued

as face-lifts and breast augmentation alongside beauty treatments such as facials,

a stark warning at its annual

lasers and injectable fillers under the term ‘cosmetic industry’. This blurring of

scientific meeting about the

lines has encouraged blatantly unethical marketing tactics, which trivialise serious

way serious surgical procedures

surgery - driven by greed and with very little concern for the public’s safety.”

are sold, singling out specific practices which it felt were

According to consultant plastic surgeon and former BAAPS president Nigel

endangering the public.

Mercer, “Let’s be clear: surgery cannot be an industry where profit trumps safety.

This year has seen some of the

As surgeons, we are legally and ethically bound to put the safety of the patient and

most extreme marketing tactics to date in cosmetic surgery, including breast ops

what is right for them above considerations of profit. An aromatherapy massage,

raffled at a nightclub, unproven procedures promoted as innocuous non-surgical

a hot air balloon ride and a nose job may all sound like a fun day out to some – but

treatments on morning chat shows and discount coupons for nose jobs listed

these promotions, generally couched in the language and hyperbole of sales and

alongside offers for cat food and falconry lessons, according to the group.

marketing, must not be sold with discount coupons as if they were white goods.”

A presentation given at the meeting focussed on a study comparing the way UK cosmetic surgery clinics market to the public versus their American counterparts. It

The study which evaluated the top 50 websites offering surgery in London versus

revealed that clinics in Britain are more than twice as likely (26% v. 12%) than those

New York – also revealed that whilst nearly all (94%) of websites in the US listed the

in the US to offer financial incentives such as prize draws, BOGOFs, multi-procedure

surgeons’ accreditation, for example Board certification, only 64% of UK sites did

discounts and ‘rewards’ for booking surgery such as studio photos shoots.

so. This left well over a third (36%) of providers whose practitioners didn’t include

According to consultant plastic surgeon and BAAPS president Fazel Fatah, “It has

qualifications, were not on the specialist register or even listed on the GMC.

MAG’S online ordering is a hit with customers

New preservation service turns fat cells into a healthy asset

Medical Aesthetic Supplies Ltd has introduced a secure online ordering

UK-based Future Health BIOBANK is

facility to its website. The new resource will enable busy clinics to place their

expanding its stem cell storage services to

orders 24 hours a day seven days a week for next working day delivery. Orders

include the banking of adipose-derived

placed online for mainland UK delivery automatically receive a 5% discount so

stem cells or lipo stem cells. Routinely

customers save time and money. Only current customers can use the service,

discarded following liposuction, these

which is password protected. For more information visit www.magroup.co.uk.

stem cells can now be extracted and frozen

Innomed Training Launches Cosmetic Course for Beauty Therapists, Dental Nurses and Hygienists

under strict GMP conditions for future

Innomed Training, in conjunction with Sally Durant Training and

Director, Dr Julia Irving, spoke to delegates

Consultancy, has developed a hands-on two-day course for beauty

about the use of stem cells in all fields of medicine, including cosmetic surgery.

therapists (level 3), dental nurses and hygienists to provide them with

Interest in the medical applications for adult stem cells has been steadily increasing over

a high level of knowledge on a number of topics including skin science,

the last decade but it is only recently that scientific attention has started to look at the

physiology of skin dysfunction, the correction of skin disorders and the

potential of cells contained in fat tissue. Dr Irving said, “The concentration of such stem cells

maintenance of skin health. Practical training is also provided in a range of

in adipose tissue is 500 times higher than bone marrow. However, until recently, no-one

skin corrective treatments, including light dermal roller skin needling, skin

had the technology to separate these cells from the fat and then prepare them for future

peeling and mesotherapy. Sally Durant commented, “I am very excited to be

medical use. As a perfect match for the donor there is no problem with rejection but, just as

working with award-winning Innomed Training so that we can offer specialised

importantly, lipoaspirate also contains blood vessel forming cells which will enable a new

cosmetic training to a wider variety of key clinic professionals. These treatments

blood supply to form naturally around a transplant area. Now that we have the expertise to

provide a great opportunity to learn new skills, increase client choice and grow a

isolate and store these cells, I believe there will be increasing interest from those wanting

salon, clinic or dental practice income through the addition of new treatments.”

to develop medical applications, including plastic surgeons who are constantly looking for

Dr Xavier Goodarzian of Innomed Training explained, “We are constantly looking

ways to reduce rejection and improve engraftment.”

for ways to help practitioners grow their teams’ skills and knowledge and this

Future Health’s new Lipo Stem Cell Service will cost £1,695 including all processing, 25

course is designed to deliver real benefits to clinics and practices by filling the gap

years’ storage and the provision of a special Lipo Collection Kit. During the liposuction

between beauty and medical treatments”

the surgeon will place at least 50ml of the extracted fat tissue in a special, sterile adipose

The first courses will take place in central London on November 22 and

container provided in the kit. This sample, along with a blood sample from the patient and

December 5. For more information contact 023 80 67 67 33 or visit www.

a completed simple health questionnaire, is then returned to Future Health’s laboratories

innomedtraining.co.uk

via an approved medical courier within 48 hours of the procedure.

8

cosmeticnewsuk.com

use in regenerative medicine or cosmetic reconstruction procedures.

The Queen’s Award-winning company announced the launch of the new lipo stem cell service at the annual conference of the British Association of Aesthetic Plastic Surgeons in Birmingham, where Future Health Scientific

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NeW Revolutionary ‘In-Motion’ i-Pixel technology

5 th – 6 th NOVEMBE R 2011

After

Before and after ONE i-Pixel treatment

Facial and Body Contouring using Ultrasound and RF by Dr. Fernando Urdiales

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

After

After

Pixel Laser

Photos courtesy: Bhupendra Patel, MD

Before

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

After

Before

After

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

News - Industry News

Laser Active slams hair removal ‘cowboys’ Laser Active is warning women about unqualified hair removal clinics that

It costs a lot of money to buy the specialist medical equipment needed to operate

disregard health and safety rules and use ‘cheap devices’ bought on the internet.

professionally and put the patient at the forefront of safety.”

The ethical hair removal organisation says the Government’s move to abolish regulatory controls in the laser market has opened the floodgates for anyone to set

Gill, whose company is currently being franchised across the country in a bid to stamp

up in business. “Since controls effectively disappeared we’ve seen an explosion of

out the cowboys, added, “As the Government appears to have abandoned any official

amateurs setting up as hair removal experts,” said Laser Active founder Gill Leeden, a

regulatory control over these dangerous practices, then we have to offer people a

qualified nurse. One slip with a laser and permanent damage can be done to eyes if

safe and ethical alternative.” Laser Active’s franchises will only be available to qualified

no safety glasses are worn, yet many of these amateurs totally disregard the dangers.

nurses who agree to undertake proper training.

At-home skincare devices: the next billiondollar market A new report from Kline & Company has revealed key findings on the booming market for power-operated devices designed for acne elimination, anti-ageing treatment, and daily cleansing.

In At-home Skin Care Devices 2011: US Market Analysis and Opportunities, Kline pegs the market at close to $1 billion at the retail level for 2011, with exceptional growth expected for the next five years. Kline’s report is the first of its kind to take an in-depth look at

Terina Denny joins Skin Geeks

the market for this emerging class of products. “We knew this market was really taking off, but

Terina Denny has joined the team at Skin Geeks Ltd as

products at Kline. “Clearly, these devices are finding a very receptive and growing audience

senior account manager and educator after leaving

of savvy consumers looking to save time and money by avoiding regular trips to the

Body Language Journal, FACE Ltd part of the Wigmore

doctor for those in-office procedures that were once commonplace in more robust

Medical Ltd portfolio. She brings many years of medical

economic times.” While sonic cleansing products, led by market leader Clarisonic, top

aesthetic industry knowledge and contacts to the role and

the list as the highest growth segment, acne treatment devices are the fastest

is very excited to be working with the results-driven Image

growing. Meanwhile, anti-ageing devices are expected to grow by a very

Skincare range, which is only available through licensed

healthy 50% this year alone, benefiting from consumers’ demand for products

physicians and other professional skincare specialists.

to reduce the appearance of fine lines, wrinkles, and age spots.

even we were shocked by its sheer size,” said Karen Doskow, industry manager for consumer

All Med Pro moves into aesthetic insurance market A new specialist insurance brokerage has been set up in collaboration with a long standing commercial brokers in Swindon with the goal of providing business insurance to medical professionals including dentists and medical costmestics practitioners.

All Med Pro offers a wide range of insurance products and services such as practice/ surgery insurance, practice overheads insurance, medical malpractice insurance, hands and eyes insurance and engineering inspection cover.

The company’s experience was initially in providing insurance to dental professionals and decided to expand its coverage after noticing how many of its customers were extending their services to include various non-surgical cosmetic procedures.

Monday 14th noveMber The causes, Development and Management of Acne – London

Monday 21st noveMber The Ageing Process and Skin Regeneration Practices - London

Monday 28th noveMber Director Thomas Chaston, who runs the business alongside fellow dirctor Adam O’Keeffe, said, “From dealing primarily with dentists word has got around that we are able to offer professional indemnity insurance to professionals within the cosmetic industry and we have recently found ourselves quoting for businesses whose practice is solely in this area. We have found that our professional indemnity insurance premiums have been highly competitive in this market with a good level of cover to match.

Most specialised insurance brokers have arrangements with a single insurer product or scheme and therefore they may not search the market thoroughly for their clients.

We believe that it is the broker’s job to offer a broking service to their clients and therefore we search the market for our clients at quotation and renewal stage.”

10

cosmeticnewsuk.com

nutrition and the Skin - London

Monday 16th January Advanced Skin Science - birmingham

Featu r cour ed ses

£225 incl VA T

tuesday 17th January investigative consultation ad Advanced Skin Assessment - birmingham

Monday 30th January laser Hair Removal – core Knowledge for the Aesthetic Therapist - London

Monday 13th February The Art of Skin Peeling - London

Full details oF all course agendas are available on our website

News special

P ilot scheme

Control the pain of cosmetic injections

We find out about a new initiative between the British Association Of Cosmetic Doctors, Independent Healthcare Advisory and the IDF to deliver the revalidation support team medical appraisal pilot

INSTANTLY with a clinically proven topical anaesthetic

The British Association of Cosmetic Doctors, under the management of the Independent Healthcare Advisory services, has teamed up with the Independent Doctors Federation (IDF) to become involved with the independent sector medical appraisal pilot. The pilot as a whole will deliver 150 appraisals with BACD delivering 50 appraisals to BACD doctors and will provide the RST with evaluations of the appraisal experience for doctors who work in ‘unmanaged care’ environments and more isolated areas of practice. Working with IHAS and the IDF on this important pilot is another landmark in the BACD’s campaign to make cosmetic medicine a recognised medical speciality.

The IHAS has formed an effective partnership with the IDF and the BACD in order to fully engage with a diverse range of doctors working in isolated environments within the medical community to ensure a validation system that is effective and streamlined Nick Lyons, programme director for testing and piloting at the NHS

A fast, safe and effective way to help control the pain associated with cosmetic needle procedures

revalidation support team said, “The pilot has made excellent progress to date, reflecting the enthusiasm of each organisation. The feedback that these doctors provide will be invaluable in shaping the medical appraisal process for revalidation, ensuring it is right for all doctors, regardless of their speciality or the context in which they practise” The BACD appraisal process within the pilot is specifically designed for doctors practising cosmetic medicine. All appraisers trained are members of the BACD and are practising cosmetic doctors who understand the specific challenges and problems that cosmetic doctors face In addition members who take part in the pilot

For further details and pricing information call

will benefit from substantial cost savings Dr Paul Myers is the clinical lead for BACD working with the IHAS pilot lead. He is

0845 130 4949

important for ensuring the BACD work within the Medical Appraisal Guidelines during the pilot appraisals. He said: “The BACD strongly believes that our involvement with this medical appraisal pilot is an excellent opportunity for selected doctors to have an appraisal, specifically by a fellow cosmetic doctor, in a format that will contribute to the final MAG in March 2012. The MAG will ensure a consistent approach for all doctors for revalidation of which the appraisal is at the centre of revalidation” Appraisals will take place between October and December 2011 so that medical appraisals can be completed by the end of the year. Doctors that currently practice within the NHS, even for a small number of sessions, can be appraised through their local NHS appraisal arrangements and will have a prescribed link to the responsible

EUROMEDICAL

officer in that NHS organisation. For more information please contact the BACD office 0800 328 3613: info@cosmeticdoctors.co.uk and www.independenthealthcare.org.uk

SYSTEMS LIMITED

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Cosmetic News Expo 2012

Cosmetic n ews E www.cosmeticnewsuk.com

xpo 2012 29th - 30th april 2012 | business design centre, islington, london

s i lv e r s p o n s o r

They say the early bird catches the worm and that is why there is no better time to book your place at the Cosmetic News Expo 2012.

Following the success of our 2010 and 2011 events, preparations for next year are already well underway. The Expo will once again take place at the Business Design Centre in Islington and will be held on Sunday April 29 and Monday April 30 2012.

The Cosmetic News Expo is the UK’s largest aesthetic conference and exhibition, bringing together more aesthetic practitioners under one roof than any other meeting. With more than 40 exhibitors already signed up for 2012 and with Syneron/Candela on board as our Silver Sponsor this is one opportunity you can’t afford to miss.

The event offers aesthetic professionals the chance to gain CPD accredited education at the same time as networking and exchanging information with their peers and finding out about the latest technologies and products on the market, all under one roof.

Entry to the exhibition and workshops, as always, is free but, due to demand, we will be introducing a small charge for the conference, which will include lunch. See our early bird offers (right) for prices.

12

cosmeticnewsuk.com

Why you should book now for the UK’s largest aesthetic exhibition and conference

1. Take advantage of our early bird offer We are offering all those who book their place at the Cosmetic News Expo 2012 conference before December 30 a 10% discount on the price of their ticket. Due to the demand there will be a small charge of £45 per day for the 2012 conference or £80 if you book for both days if you book in advance or £75 per day/£150 for both days if you pay on the day. A complimentary lunch will be incorporated into the delegate package, with refreshments provided throughout the conference breaks. Delegates will also receive a complimentary VIP invite to the post show party, which is a fantastic opportunity network with speakers and exhibitors and let your hair down after the show. Tickets for non-delegates and guests for the party will cost £10. To book your place visit www.cosmeticnewsuk.com or call 01268 754 897.

2. Get CPD accredited education The Cosmetic News Expo conference is an excellent opportunity to see the very best UK and international speakers, discussing the latest topics and demonstrating the most up-to-date techniques, at the fraction of the cost of other industry events. Key topics for 2012 include: • • • • • •

TREATING MENOPAUSAL CLIENTS ADVANCED LASER WORKSHOP BEGINNERS LASER WORKSHOP CLINICAL PHOTOGRAPHY WORKSHOP INJECTION TECHNIQUES TREATING BLACK AND ASIAN SKIN

• • • •

TREATING MALE CLIENTS POST PREGNANCY TREATMENTS ADVANCED INJECTORS MASTERCLASS BEGINNERS INJECTORS MASTERCLASS

3. CATCH UP WITH ALL YOUR SUPPLIERS UNDER ONE ROOF The Cosmetic News Expo brings together more aesthetics suppliers than any other event in the UK. Our exhibitors are made up of the key manufactures and suppliers in the industry, making the Cosmetic News Expo a must visit for those who are new to the industry who are trying to source suppliers as well as busy practitioners who want to be able to see all their reps under one roof. And because our exhibitors are keen to attract practitioners to their stands, many often offer exclusive show deals. In tough trading times these are the kind of deals that can really help your business to boom.

4. NETWORK WITH OTHER AESTHETIC PRACTITIONERS From doctors, nurses and dentists to dermatologists, plastic surgeons and aestheticians, the Cosmetic News Expo attracts a wide range of aesthetic practitioners keen to network and share ideas. Networking can be a great technique to help your business, not only to build useful relationships but also to learn things about the market or companies that you wouldn’t normally find out while being stuck in your clinic. Perhaps you want to refer patients to a specialist or share ideas and information with your peers, the Cosmetic News Expo is the ideal place to make contacts and get your face out in the industry.

5. STAY AHEAD OF THE COMPETITION If you want to keep your practice at the cutting edge then finding out about the latest developments and newest products on the market is key. The Cosmetic News Expo is a great platform for companies to introduce new products to the market and as such many of our exhibitors will be showcasing their newest innovations. Our educational programme will also keep you up to date on what’s hot in aesthetics for 2011.

Calling all manufacturers and suppliers The Cosmetic News Expo gives you the perfect opportunity to promote your products and services to hundreds of aesthetic practitioners as well as catching up with existing customers. Stands for our 2012 event are selling fast so if you are an astute business and are looking to either expand your ranges or you are looking for broader customer appeal with new brands, book your stand now to make sure you don’t miss out. Our stand spaces are competitively priced and offer outstanding value, which ensures you not only control your costs but also achieve an even higher return on your investment. Contact Hollie Dunwell on 01268 754897 or email: hollie.jane@creativemedialtd.co.uk.

www.skinbrands.co.uk • 44 (0)560 314 1956

on the scene

A Nice time

We report on the British Association of Cosmetic Doctors’ autumn meeting in Nice Members of the British Association of Cosmetic Doctors jetted off to Nice for their annual autumn conference last month. The event combined an educational programme, exhibition and dinner at the luxurious Palais de la Méditerranée, hotel on the Promenade des Anglais, overlooking the picturesque Dr Harryono Judodihardjo, Dr Jayesh Patel,, Gita Patel and Southern French Susan Judodihardjo coastline.

Standards of Practice’.

While the annual jolly, which was once again held abroad after two years

conference continued with Dr Peter Prendergast presenting on ‘What

on UK soil, was undoubtedly a chance for members and their partners to

All Doctors Need to Know About the Approach to VASER’, Dr Alison

wind down and catch up with their peers the focus of the event remained

Burton on ‘Medical Ethics’ and Dr Martyn King on the Nordson Assisted

After a short break for afternoon tea, when most members took the opportunity to soak up some sun on the hotel’s sea-view terrace, the afternoon’s session

Dr Ravi Jain and Dr Rupert Gabriel

kicked off to a dramatic start after one delegate collapsed outside the conference and the only French speaking doctor, Dr Herve Raspaldo, had to leave the podium to assist in translation. Thankfully the doctor in question was ok. The

on education.

Injection System.

The event kicked

The members meeting

off with a

then took place before

leisurely brunch

the conference came to an

before delegates

explosive end with a heated

took their seats to listen to the

Dr Barbara Kubicka, Mr Rajiv Grover and BACD company secretary Sharon Turner-Fry

first speaker

Hollie Dunwell, Emma Miller, Kelly Tobin, Vicky Eldridge, Dr David Eccleston, Mary-Kay Sheehy and Jemma Cooke

members debated about the ethics surrounding remote consultations.

of the day, Mr Rajiv Grover,

As always the event was supported by manufacturers and

who was welcomed by the BACD’s newly elected president, Dr Samantha

suppliers including: Allergan, Candela/Syneron, Galderma/Q-Med,

Gammell, and chair of the morning session, Dr Xavier Goodarzian. Mr

HealthXchange, Nordson, Sound Surgical and Wigmore Medical.

Grover gave a presentation on ‘Understanding Anatomy to Enhance Your

In the evening

Yobana Iturbe and Jen Pain (Galderma) with Dr Mark Harrison

Treatment and Improve

exhibitors and

Safety’ and was followed by

delegates came

Dr Bea Brookes on ‘Nerve

together to enjoy

Blocks to the Hands’; Dr

a champagne

Barbara Kubicka on ‘Skin

reception on La

Revitalisation’ and Dr

Terrasse followed

Mark Palmer on ‘Injection

by a three-course

Lipolysis for Facial and

meal at the Salon

Body Contouring: The

Madisson.

Latest Evidence Based

David Hicks (Wigmore Medical ), Dr Beatriz Molina and Frank Ward (Galderma)

ArqueDerma™ Artistic Restoration Lift™ UK Launch, Lancashire The ArqueDerma™ Artistic Restoration

as Juvederm®, Restylane®, and Perlane®. Leslie

Lift™ was officially launched into the UK

developed this revolutionary technique while working

last month. The patent-pending technique

with thousands of patients over the last 10 years in her

originates from the United States where

practice as an aesthetic nurse injector, as well as in her

there are currently more than 200 licensed

work as an aesthetic injection trainer.

practitioners.

A pilot course was held to mark the launch,

ArqueDerma™ Artistic Restoration Lift™ provides

hosted by Christine Blackburn, founder of

natural, more dramatic results not achievable by using the conventional filler techniques,

Angle Face Medical and one of only five

according to Leslie. Using precepts found in physics and architectural engineering,

licensed ArqueDerma™ Trainers worldwide. The class was conducted by Leslie Fletcher,

the ArqueDerma™ technique utilises 40% less filler to achieve unprecedented, longer

the innovator behind ArqueDerma™, with Christine as co-trainer.

lasting results (up to six months longer than conventional methods of dermal filling).

The delegates, who hailed from Yorkshire and Scotland, are now licensed ArqueDerma™

ArqueDerma™ courses are offered to advanced injectors who desire to expand their

practitioners and are listed on the official ArqueDerma™ website. ArqueDerma™

current skill set to the highest level of advanced injecting. Future ArqueDerma™ training

Artistic Restoration Lift™ is a patent-pending methodology to deliver dermal fillers such

sessions conducted by Christine have now begun and will continue into 2012.

14

cosmeticnewsuk.com

• Designed to assist with injection placement, speed and volume • Simplifies the injection process by using air pressure instead of thumb pressure • Provides ease of use with less hand fatigue • Allows smaller guage needles

the big debate

Following the recent British Association of Aesthetic Plastic Surgeons meeting, the organisation has called for a debate on the impending VAT taxation of ‘cosmetic procedures’, we find out their views and the views of the BACD

The aesthetics sector has been rocked by the prospect of the Government imposing VAT on cosmetic procedures, a decision which could have huge financial implications for the industry.

BAAPS agrees that procedures which are deemed to be purely ‘cosmetic’ such as injectables and lasers should be taxed with VAT as proposed by the Government, however the organisation says that bundling surgery such as breast reductions, tummy tucks and children’s bat-ear ops under this umbrella term will present an ethical minefield and leave the public vulnerable.

HMRC guidance to health professions states that services are only exempt of VAT if the purpose is to ‘protect, maintain or restore

The Government says there is no reason for aesthetic surgery

the health of the person concerned’. The BAAPS argues this

to be VAT-free and that applying the tax will raise around

subjective approach places a value judgment on treatment, fails to

£500 million a year for the Treasury. Surgeons and cosmetic

recognise the extensive scope and purpose of most plastic surgery

doctors were previously advised by accountants not to

procedures and does not provide enough clarification in terms of

register for VAT but HMRC officials insist VAT should always

medical, psychological and social welfare of the patient. It will also

have been paid on cosmetic ops and say they are now simply

require general finance/accounting and audit staff – unqualified to

‘clarifying’ existing rules.

determine what could be ‘medical’ need – to have access to patient records in order to validate criteria.

Under the proposal, cosmetic practitioners would have to register for VAT and pass the charge on to patients, meaning

Consultant plastic surgeon and former BAAPS President

there would be a 20% increase in the cost of treatments.

Douglas McGeorge comments, “Less than one in 10 patients in the ‘cosmetic’ market is actually having real surgery.

But while some procedures are performed purely for cosmetic

Non-surgicals represent, in fact, over three-quarters (75%)

reasons, there are psychological and medical reasons for some

of the monies spent in this area. A whole array of individuals

of these treatments, so where do we draw the line between

including plastic surgeons offer non-surgical treatments – from

what is purely vanity and what is ‘essential’ for patient health and

dermatologists and GPs, through dentists and beauty therapists.

wellbeing? This was one of the questions posed at the recent

Apart from a few techniques used for medical purposes, no

British Association of Aesthetic Plastic Surgeons meeting, where

one could argue that these are not performed purely for

members called for a debate to halt the initiative to impose a tax

beautification reasons, particularly since the treatments are

on cosmetic procedures, claiming that some surgeries should not

totally unregulated. Surgery, however, is very different. It is

be categorised under this umbrella.

performed in regulated hospitals and done to help maintain or restore the health of the patient and their quality of life. Any

“When Patients seek out care from doctors they expect to be treated without judgement or prejudice, putting the maintenance of their health as our primary concern” 16

cosmeticnewsuk.com

justification to HMRC of our decisions to impose or not impose VAT will be impossible unless patient confidentiality is breached.”

BAAPS President Fazel Fatah adds, “At the start of the recession, well over a quarter of BAAPS surgeons had already noticed an alarming increase in patients presenting with problems from cut-price surgery deals abroad. Taxing private plastic surgery in the UK will only aggravate this situation. Moreover, using blanket terminology such as ‘free choice rather than medical necessity’ and ‘purely for aesthetic purposes’ without engaging in any kind of public debate or formal consultations as to specific definitions of what is therapeutic, places a value judgment on treatment

“psychological wellbeing is just as important as the physical. The subjective proposals being put forward by HMRC will potentially harm large numbers of patients”

and compromises the doctor-patient relationship.”

Douglas McGeorge adds, “Many of these operations have been excluded or rationed in the NHS – the postcode lottery denies treatment in certain parts of the country

MICRODERMABRASION SPECIALISTS

whilst allowing surgery in others. For example, a recent study revealed that only 62% of PCTs carry out tummy tucks, and rules governing who is eligible are arbitrary and sometimes contradictory. Some exclude women who’ve had problems after pregnancy, and others exclude those who’ve undergone stomach stapling.

Many of these procedures have major functional as well as psychological benefit and they must have at some point been deemed medical or the state wouldn’t have offered them. The option of having all our patients ‘rubber-stamped’ by a clinical psychologist on a daily basis is simply unrealistic. Are all children who have their

DIAMOND PEELING

teeth straightened to be taxed? There is certainly no functional need for the vast majority. Should prominent ear correction be taxed; an operation performed on young children to prevent them being bullied and developing psychological problems? What level of asymmetry or abnormality is required to justify breast surgery? When do large breasts create enough of a physical problem to allow treatment? Large noses will kill no one on their own but can create major problems in life that prevent individuals contributing to society and, indeed, have been

FULL TRAINING

known to result in self-harming. At what level is treatment acceptable with drooping eyelids that impair vision and should their treatment be extended to allow harmony in facial features or be restricted to just the immediate problem, perhaps leaving the patient looking odd? Our role is to make sure patient needs justify treatment, not VAT exemption.”

Fazel Fatah says, “Treatments carried out by plastic surgeons do improve the psychological as well as the physical

C R Y S TA L PEELING

wellbeing of patients. For many it is impossible to ascertain which aspect is the most important, but, as enshrined in the World Health Authority, psychological wellbeing is just as important as the physical. The subjective proposals being put forward by HMRC will potentially harm large numbers of patients. They imply that, by definition, any procedure that corrects appearance rather than function is not a medical need. There has been no meaningful discussion with the professional bodies involved. We can only hope that common ground can be found that protects the wellbeing of patients whilst balancing the obvious need to increase tax revenues. With surgery, we are quite literally, dealing with human lives.

“The reasons for undertaking aesthetic plastic surgery vary widely and from patient to patient – the same condition can affect each person in a different way. Some may experience side effects, others it can affect their ability to work, or they could suffer serious psychological impact. It is simply not possible to generalise about the reasons for treatment.”

The non-surgical sector however would argue that the same is true of many non-invasive procedures where

GREAT VERSATILITY

people are seeking treatment for medical or psychological reasons and that this part of the sector too should be

PROVEN EFFICACY

exempt from VAT when the treatments are being ‘prescribed’ by a medical professional.

Dr Samantha Gammell, President Elect of the British Association of Cosmetic Doctors, is concerned that the aggressive stance taken by HMRC will discriminate against vulnerable women, certain ethic groups and those who have been left with disfiguring dermatological conditions such as acne scarring. “When Patients seek out care from doctors they expect to be treated without judgement or prejudice, putting the maintenance of their health as our primary concern. We are appalled that HMRC inspectors in Wales are demanding to review

RESULTS DRIVEN TREATMENTS HIGH RETURN ON INVESTMENT 5 YEAR WARRANTY AFFORDABLE QUALITY

confidential patient records for proof of their medical needs. It is an obscene invasion of privacy based on a ridiculous premise that a doctor, having taken on a duty of care, could do otherwise than protect the health of their patient. The public should not be put off seeking the help that they need. There is simply no legal basis for the HMRC’s approach and we will continue to fight for patients’ rights.”

Give us your views?

What do you think of the Government’s decision to impose VAT on cosmetic procedures? Do you think non-surgical treatments should also be exempt and if so why? Let us know your views by emailing vicky@creativemedialtd.co.uk

01903 768 380 info@thecarltongroup.co.uk

www.thecarltongroup.co.uk

people in profile

I don’t know how she does it We speak to the glamorous Dr Beatriz Molina When Sarah Jessica Parker recently starred in the movie ‘I Don’t Know How She Does It’, the role resonated with many women who juggle a successful career with being a mum, all at the same time as looking effortlessly glamorous, and no one in the aesthetics industry embodies that more than Dr Beatriz Molina.

U

ndoubtedly a role model for many of her patients, Beatriz

are dealing with people who

always looks impeccable, runs a hugely successful and

are ill it can be very stressful

award-winning practice, is a speaker, trainer and KOL for

and emotional. Occasionally

some of the industry’s leading manufacturers and suppliers

you give good news, yes,

and is a devoted wife and mum. Spanish born Beatriz graduated from the

but most people are battling

University of Malaga, before completing her training as a doctor in the

illness. This business is

UK where she qualified as a GP with a special interest in dermatology,

fantastic, everyone is happy,

minor ops and cosmetic medicine. Beatriz originally wanted to be a plastic

they want something to

surgeon but after five years doing surgical rotations she decided to go

make them look and feel

into general practice instead, however, it was not until she discovered

better and, because of the

aesthetics in 2004 that she found her true niche. “I did originally want

nature of the business, you can actually give them that. They feel so much

to be a plastic surgeon but it was a very competitive market being female

better and they are confident and happy.”

and it was very hard to get up the ladder”, she says. “I suppose I got to a

Beatriz started working as a full time aesthetic practitioner in 2005 and

point where I thought ‘I don’t know if I want to do this anymore’ and I

opened her first clinic, Medikas, in Somerset, in 2007. A year later the

went into general practice but, after the challenges of surgery, I didn’t find

clinic was given the accolade of Clinic of the Year (three rooms or less) at

it as stimulating. I first used botulinum toxin for hyperhidrosis and from

the Aesthetic Medicine Awards to the surprise and delight of Beatriz and

there it just spiraled. I went on to study botulinum toxin for lines and

her team. “When we had a phone call to say we were shortlisted I was

wrinkles and dermal fillers and immediately I just felt so passionate about

delighted - for me that was as good as winning! We were so happy and

the whole thing. After a few months I thought: this is it, I really want to

were excited about going to the event but we didn’t think we would win

do this.”

it because the competition was so high. Of course when the night came and we won it I just couldn’t believe it! I think it is important in this

Aesthetics reignited Beatriz’s passion for her work and she quickly decided

business at the moment to have these sorts of things because it brings

to make it her full time career. She says, “I couldn’t get enough! I did so

out the best in everyone - even if you don’t win it just to be recognised if

many training courses, I went to all the conferences, I was studying and

you do well.”

reading all the books - I was just like a sponge. I spent a long time doing all of this and doing treatments on friends and family without charging

B ath time

and when I felt I was prepared, I went for it. I originally went into it part time but it was so absorbing that I wanted more so I decided to

With a flourishing and successful practice under her belt, Beatriz decided

completely leave general practice and go full time. I love it - I just don’t

to expand her business by opening another clinic in a less secluded area.

regret it at all!” One of the things that Beatriz liked most about aesthetics

After months of searching she finally found a property in Bath and

was how happy the treatments made the paitents. She says, “When you

opened her new clinic Medikas Medi-Spa in September this year. She says, “Somerset is beautiful but it is very quiet and we are in the middle of nowhere and access is difficult because it is very rural.

We have a nice catchment area and we are very well known and respected in the area but there is a limit to how much further you can go. My husband works locally , my daughter goes to school locally and we like the area so we did not want to go too far away. That is why we started looking at Bath. We wanted to give more of a boutique

18

cosmeticnewsuk.com

type of service with this

maximum results with whatever product you are using to accommodate

clinic and Bath is perfect

different skins and ages, and that is not an easy thing to accomplish”,

for that - it’s a pretty

she says.

town and the access is a lot easier. We get a lot of

Beatriz is a big fan of Radiesse and this is one of the products she has

requests from people in

lectured on, she says, “I have used Radiesse since I first started injecting

London or further away

in 2005 and it only came to the UK in 2004, so it was pretty new. It

who want to come to us,

was FDA improved in 2006, which was quite a nice safety net. For

so it is easier for them to

me it is the lifting capacity of the product which is far superior to any

go somewhere like Bath.

other product on the market. You can achieve a really nice contouring

We started looking quite

and lifting with this product and it is very safe.” Beatriz has also been

a while ago and it was

working with Galderma’s new HA filler Emervel and is impressed

really challenging to find

with the results so far. She explains, “The HAs are now moving on

the right premises because there are a lot of listed buildings, but we finally got

dramatically and I have to say I am very impressed with some of the

a small place that fits in with the idea of providing a very personalised service.

new products, particularly with Emervel. I have been working with

It is a very relaxing atmosphere there – it is really lovely.”

some of the clinical trials and studies with the product and that is what made me realise that actually there is something very new and different

The new clinic has three treatment rooms as well as a manicure and pedicure

with it. At first I was thinking ‘not another HA’ but the technology is

area and has sleek and elegant design. Beatriz is there two or three days a

really moving on and the companies are spending a lot of time and input

week at the moment, spending the rest of her time at the Somerset clinic

and money to develop these products and actually explain why they

where she is currently doing a clinical trial on Azzalure. “The Somerset clinic

are different or better than others. I think everyone should try different

is much more clinical and the Bath clinic more like the American concept of

products and get their own experience to decide why they like one over

a medi-spa, combining beauty and aesthetics under one roof. Everybody says

the other. They can all do the job but if you understand the reason why

it is really nice and welcoming and we have had really good feedback, which

you choose one product over another then that is great. Anyone who

is excellent.”

wants to do a good job in any area needs a number of tools.

T he art of filling

putting paitents first

One of the things Beatriz has become most well known for is dermal

Despite her success, like many doctors Beatriz initially found it difficult

fillers. She says, “My main passion is dermal fillers. I love skin

going from treating patients to dealing with money-spending clients and

rejuvenation from all different angles - I am interested in anything that

running her own business. She says, `’At the beginning it was a nightmare

will improve the skin and make it look younger. It is a combination of

I had no idea how to run a business and it felt embarrassing as a doctor

techniques, of course, that allow you to achieve that, but what I find

to ask for money, but you get used to it with time. I always think, if I was

most challenging and rewarding is dermal fillers, because you see the

not making money from this, as a doctor, what would I recommend? It’s

instant result.

hard because I always think of them as patients because I am a doctor.

“In the last few years the whole shift towards volumising and

I know they are clients, because they are paying for a service, but to me

contouring has made it even more exciting too. What I love about it

they are still patients so if I have to say ‘no’ because I don’t think it is the

is the fact you can sculpt someone’s face of any age – you can treat

best treatment for them, then I will, and I think they respect me for that

someone in their 20s and give them higher cheek bones or you can treat

because they trust me. I will always be truthful, of course it is a business,

someone of 60-70 and give them a face-lift. I do think it is an art form.

you have to make money, but that is not my priority, it is the safety and

I think some of it comes down to natural ability – obviously you can

well-being of my patients. If you listen to what they want and don’t over

learn techniques from different injectors when you do your training, but

sell it and do a really thorough consultation with them, they know what

for me there has always been some inner thing that tells me if I inject

they are expecting and they are really happy.”

this way, or from this angle, I am going to get a better result.”

It is this passion for dermal fillers that has made Beatriz one of the rising stars on the conference circuit and has seen her working as a KOL and trainer for some of the UK’s leading manufacturers and suppliers,

recruitment

including Merz and Galderma.

“I work mainly with two companies and I do a different range of products and techniques, which makes it more interesting”, she says. “I really love the teaching part, it is great, it brings you out of your normal daily practice.”

Beatriz took on her first training role after excelling during her own training to use Evolence bovine collagen. She said, “When they asked me to become a trainer for the product I didn’t realise I was doing anything different from anyone else because you still think you are learning and you still think everyone does the same. It was only when I started doing training that I realised actually not everyone does inject the same. There are so many different ways to get from A to B and there are a lot of different techniques and as long as you get a good result and it is safe for the patient it is fine.”

So what is it that Beatriz thinks makes a good injector? “It is a

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Cosmetic News November 2011

Special Feature - Skin tightening

T ightening up We take a look at skin tightening treatments

One of the things that is so exciting about the aesthetics industry is how quickly technologies develop offering practitioners new and dynamic treatment options.

Even a decade ago the only real solution to lax, saggy skin was surgical intervention, however, the emergence of minimally invasive techniques utilising radio-frequency, laser and infrared technologies has offered patients an alternative to going under the knife and widened the scope of skin tightening procedures.

L

oose skin can be caused by a number of factors including ageing, pregnancy or weight loss and, as such, is a major concern for many people. As we age, the skin loses its elasticity and stretches. Sometimes this can be rectified by increasing the volume under the skin using dermal fillers, however if the skin has stretched too much it needs to be tightened.

Until recently the only method of dealing with loose skin was surgery i.e. a face-lift or

tummy tuck. While this remains the gold standard for excessive excess skin, practitioners can now treat milder cases of skin laxity non-surgically using various different technologies such as infrared lasers or radio-frequency.

These technologies are being harnessed in a variety of devices, which deliver the energy to a targeted area of the skin, causing heating of the underlying tissues. The heat generated causes the collagen within the skin to be damaged, in a controlled way, which in turn makes it tighten and kick starts the body’s healing process to produce fresh, new collagen. Over a period of months this process continues with the skin progressively becoming tighter, smoother and more youthful in appearance. These methods of non-surgically tightening the skin have been one of the most revolutionary developments in the aesthetic and cosmetic world in recent years. Minimally invasive and with very little down time they can be used to address saggy skin on the face, neck, dÊcolletage, arms or abdomen caused by ageing, pregnancy or weight loss.

Infrared laser skin tightening Infrared laser skin tightening uses a broadband spectrum of infrared light which heats up the water content in the skin, causing the surrounding collagen to contract and tighten. The body’s own natural healing process then starts producing new collagen to further tighten the overall appearance of the skin over several months.

It is not designed to treat large areas of loose or redundant skin, such as after massive weight-loss, which may be better suited to surgical approaches; but is suitable for treating small areas of lax and redundant skin on the abdomen (e.g. post pregnancy tummy), thighs and underarms and to tone, lift and tighten skin on the face and neck.

Radio-Frequency For people with loose or sagging skin who do not want to go under the knife, radio-frequency offers a noninvasive alternative with minimal downtime. It is safe for all skin types and can be used to treat the forehead, under the eyes, the cheeks, mid-face, jaw line, and the neck.

Radio-frequency (RF) treatments utilise radio-frequency energy to penetrate the skin without damaging it.

cosmeticnewsuk.com

21

Special Feature - Skin tightening

They can be used to improve skin tone and elasticity on

There are two main types of delivery used by RF systems:

Side effects of treatment are usually minimal and can

the face and body. Unlike the surgical applications of RF,

Monopolar and Biopolar. Monopolar or Unipolar, refers to

include swelling, redness and, in some cases, blisters.

where the energy is used to ablate or coagulate tissue,

a device that has a single pole or electrode. A grounding

However most of these side effects are short lived and

the use of radio-frequency in this field is non-ablative and

pad is quite often used with these types of devices to

will disappear within a few days. There are very few

used to heat the deeper, sub-dermal layers of the skin

provide a low resistance path for the current to flow

contraindications to treatment with RF, however, as with

to affect change, without damaging the skin’s surface

back to the machine. Biopolar devices have two poles or

any cosmetic treatment, pregnant women are advised

or epidermis. This is where RF differs from other types

electrodes. With bipolar devices, the current flows only

to wait until after they have given birth before having

of similarly indicated cosmetic treatments such as laser

through the tissue which is between the two electrodes

treatment. RF treatment is also not advisable for anyone

and light where the energy tends to get absorbed in the

on the hand-piece and therefore no grounding or return

fitted with a pacemaker or other electrical device or

upper layers of the skin.

pad is needed.

anyone who has artificial metal implants.

S kin tightening

devices

ACCENT

P ellev é Accent uses two separate hand-pieces to

Pellevé is the newest innovation in RF skin tightening. It is FDA-cleared to

deliver different types of RF energy into the

safely and effectively treat facial wrinkles with virtually no pain, no anesthesia,

deep tissue lasers (2mm to 6mm depth under

and no downtime. With just a single, one-hour treatment, patients can

the skin). Its biopolar hand-piece is designed

achieve firmer, tighter skin—with results that can last up to six months.

to tighten the skin while its monopolar hand-piece reduces cellulite and fat. Patients have described the treatment as feeling like a warm massage. The treatment takes less than an hour and requires no recovery time. As the dermis is heated, a natural reaction occurs that promotes the creation of new collagen, while also releasing toxins in the fat, draining retained fluids and improving skin texture.

The treatment works by using controlled heating of the tissue to break down cellulite; releasing and flushing away toxins and fatty deposits; draining excess fluid; and boosting collagen production to improve the skin’s appearance. It targets key areas of fat that are resistant to diet and exercise, while simultaneously improving the texture and tone of the skin.

Pellevé delivers constant, gradual energy to the skin, causing heat to build

R e F irme

up where the skin and fat layer come together. The increasing heat modifies

The ReFirme system from Syneron combines broadband infrared light and

the collagen bundles deep inside the skin, causing them to contract and

biopolar radio-frequency energy for the non-ablative treatment of skin laxity

stimulate the growth of new collagen over time. This results in firmer, tighter

and mild to moderate rhytides. Clinical studies have shown that the system

skin. Many people see the result immediately after just one treatment, with

is safe and effective. A study of 31 patients showed that the combination

lasting improvement for months after as the skin produces new collagen.

of broadband infrared (700-2,000nm) and bipolar RF energies is a safe and

Unlike other skin tightening systems, Pellevé doesn’t require anesthesia or

effective treatment modality for improving laxity of the face and was more

skin cooling. Because the skin is not numb, the patient can describe the depth

effective at lower energies than RF alone.

of feeling to the practitioner, which helps provide the best result in the area being treated. The overall result is a noticeable improvement in skin quality

C avi S culpt

and appearance with minimal side effects and no recovery time, so it fits easily

The CaviSculpt uses radio-frequency and diode laser to tighten the skin by

into busy schedules.

improving elasticity and reducing fine lines and wrinkles. The system also The CaviSculpt Combi and the CaviSculpt Pinnacle professional models

T ri L ipo by P ollogen ( L ifestyle A esthetics )

allow both ultrasound cavitation and radio-frequency to be administered

The TriLipo by Pollogen reshapes the body by reducing localised fat and

simultaneously via one treatment head. In addition, the Pinnacle has a Tripolar

tightening the skin. The system releases liquid fat from subcutaneous

radio-frequency treatment head to penetrate deeper into the skin to tackle

tissue and removes the released fat via DMA patented lymphatic drainage

deeper wrinkles. The CaviSculpt Define professional model emits not only the

mechanism. TriLipo Technology combines two effective technologies, TriLipo

standard 40htz frequency but also has the ability to pulse between the two,

RF and TriLipo Dynamic Muscle Activation (DMA). Working simultaneously

which is particularly useful when tackling stubborn fatty deposits.

they create a synergistic effect that delivers non-invasive fat removal and

uses ultrasound cavitation to reduce fat and the appearance of cellulite.

22

cosmeticnewsuk.com

Profit Now From Ultrasonic Body Sculpting

CaviSculpt Define The Non-invasive Body Sculpting System The Cavisculpt Define is our ground breaking and best selling professional ultrasound cavitation machine. It incorporates both the standard 40MHtz Frequency Emitter but also 28MHz horizontal wave and the ability to pulse between the two.

For a limited period we are also offering a FREE second lipolysis treatment head. This emits a more gentle 1MHz which combined with Diode Laser not only lifts the face but also stimulates collagen growth in order to increase the elasticity of the skin and smooth fine lines and wrinkles.

Results are often immediate but can be dramatically increased if the client does 20 minutes vibration plate training directly after each CaviSculpt treatment.

• Professional marketing material and support available • High return on investment • 2 year warranty • Free comprehensive training with every purchase • Demonstrations available upon request

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Contact: 0845 226 0067 sales@ultim8fitness.co.uk

Special Feature - Skin tightening

lymphatic drainage, as well as skin tightening. TriLipo treatments are

larger areas such as the arms, legs and abdomen in a faster time. It also

easy to perform in an in-office setting. With a simple ‘walk-in, walk-out’

has an extended tip for an unobstructed view of the skin`s surface.

treatment plan, patients can immediately resume their daily activities and benefit from immediate and long-lasting results.

T hermage C P T ™ The Thermage CPT™ is the flagship model from Thermage (Solta

V elashape

Medical) and was developed as many patients found its predecessor,

The Velashape features the revolutionary ELOS combination of bipolar

the Thermage NXT system, quite painful. This led them to introduce

radio-frequency and infrared light energies, plus negative pressure and

their proprietary Comfort Pulse Technology™ to this system and a

mechanical tissue manipulation. The combination of the infrared light

vibrating handpiece for more comfortable treatments. The Comfort

and the conducted RF increase the oxygen intracellular diffusion by

Pulse Technology™ is a new method of energy delivery for the device

heating the skin. The vacuum and specially designed rollers manipulate

which interweaves pulsed radiofrequency delivery with cooling bursts

and smooth out the skin to facilitate safe and efficient energy delivery.

mimicking that found with Transcutaneous Electrical Nerve Stimulation

The net result increases the metabolism of stored energies, it increases

or TENS therapy, often used for alleviating joint and muscle pain or labour

the lymphatic drainage and reduces the size of the fat chamber. The

pains. It disrupts the brain`s neural response and thus is aimed at

Velashape is the first medical device FDA cleared for circumferential

improving comfort during the Thermage treatment. The manufacturers

reduction and the first Class 11 system FDA cleared for the reduction of

have also redesigned the treatment tips so that they deliver better,

cellulite. Clients can already see visible results after the fourth treatment.

uniform heat distribution, which leads to improved volumetric heating in

The Velashape is a very safe and comfortable treatment and clients don’t

terms of results for a treated area, i.e. a greater volume of tissue is heated

need to wear any body stockings during the duration of the treatment.

to the target temperature, and greater comfort as the heating is more

The safety and effectiveness of the Velashape has been demonstrated

evenly distributed across the treatment area.

in both multi-center clinical trials and in more than three million independent treatments performed on clients around the world.

V iora R eaction ( A Z T E C S ervices )

Reaction™, Viora’s leading RF skin tightening and body contouring device, utilises CORE™ technology (three different RF frequency modes, and a fourth mode channeling all three frequencies into one pulse). During treatments for face and small body areas, the ST applicator is used, directly heating the skin’s underlying network of collagen and elastin fibers. This action causes the fibers to shrink,

T itan ™

breaking rigid collagen cross links and ultimately strengthen the

The Titan™ (Cutera) heats the dermis to a depth of 1-2mm with light energy to cause immediate collagen contraction, (or skin tightening), whilst protecting the epidermis with a continuous in-built cooling system. It also stimulates long-term collagen rebuilding, leading to younger looking skin. Titan™ uses infrared light wavelengths delivered in pulses to the target area, which are preferentially absorbed by the water content of the skin; the energy delivered heats up the water causing uniform heating of the treated area. This heat acts on the existing collagen, causing it to immediately contract and tighten. It also stimulates the fibroblasts in the skin to produce new collagen,

24

cosmeticnewsuk.com

thus creating further tightening over time. The surface layer of the skin

skin’s elasticity. Thanks to the versatility of CORE™ technology,

(epidermis) is kept cool by a continuous contact cooling system built into

Viora has also developed a special skin tightening protocol named

the Titan™ hand-piece, which gives pre-, during and post-cooling direct

ReFit, which treats larger areas like the abdomen and buttocks.

to the outer skin layers. Depending on the area being treated, there is

This concept incorporates the BC and FC applicators, which include

a choice of Titan™ hand pieces: Titan™ V and Titan™ XL. Titan™ V has an

vacuum therapy with the CORE™ technology. The use of vacuum

extended tip for an unobstructed view of the skin`s surface, making it

in the treatment allows deeper heat penetration, improved blood

ideal for treating delicate areas around the eyes and nose. Titan™ XL has

circulation and promotion of lymphatic drainage, thereby improving

a treatment tip twice as large as the Titan™ V, making it ideal for treating

the quality of skin tone.

5th – 6th NOVEMBER 2011

Facial and Body Contouring using Ultrasound and RF by Dr. Fernando Urdiales

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Clinical Study - Laser hair removal

S plitting hairs

We summarise the results of a split face clinical study published in the Journal of Cosmetic and Laser Therapy comparing the Soprano ® XL and the LightSheer ™ for hair removal

In recent years laser hair removal has established itself as a popular and accepted method of permanently reducing unwanted hair. It is one of the most searched for aesthetic treatments on Google and one of the most common procedures performed by both beauty therapists and aesthetic practitioners. The Soprano has undoubtedly been one of the most talked about hair removal lasers on the market, claiming to offer ‘pain free’ treatment and now being approved by the FDA to treat all skin types, including tanned skin. A study was recently published in the Journal of Cosmetic and Laser

Therapy comparing the Soprano ® XL (Alma Lasers Ltd, Caesarea, Israel) and the LightSheer ™ (Lumenis, Inc., Santa Clara, CA, USA) for hair removal. Here we take a look at the study and find out what conclusions the authors drew from it...

Abstract Background: This study was designed to

The study started by discussing the different variety of lasers and IPLs that

evaluate the hypothesis that low-level fluences

have been intorduced to the market in recent years for hair removal including

done repetitively on a hair follicle will produce

the Q-switched Nd:YAG laser (1064nm), which they said showed minimal

permanent hair removal with less discomfort and

effectiveness for long-term hair removal; the longpulsed ruby laser (694nm),

fewer side effects than a single high-fluence pulse.

the longpulsed alexandrite laser (755nm), the diode laser (800nm), and a

Objective: To compare the safety and efficacy of

variety of filtered, flashlamp pulsed-dye lasers, all of which use melanin as the

a low-fluence, high-repetition rate versus a high-

chromophore for selective photothermolysis and show more positive results.

fluence, low-repetition rate 810nm diode laser for permanent hair reduction in patients with facial

They noted that high-fluence diode lasers with contact cooling have been

hirsutism.

considered to be the ‘gold standard’ to remove unwanted hair. However, they

Methods: Forty-two female patients with

acknowledged that laser hair removal can be painful for patients and can

confirmed polycystic ovaries by ultrasonography

cause hypopigmentation or post-inflamatory hyperpigmentation, especially

with facial hirsutism were subjected to the low-

in dark skin tones . It makes sense therefore that lowering the energy should

fluence, high-repetition Soprano® XL laser in SHR

result in less pain and fewer potential adverse events, but could theoretically

mode and the LightSheer™ laser on each side of

affect the efficacy of the therapy? This was the questions being posed.

the face using preset parameters once a month for six sessions. Hair counts were done at the end of

The purpose of the study was to compare the efficacy, safety and treatment

the sixth session using a ‘Hi Quality Hair Analysis

speed of a new low-fluence, rapidpulse, with multiple passes, 810nm diode

Program System’ and the pain score was recorded

laser (the Soprano® XL) with a traditional high-powered, single-pass, 810nm

by a visual analog scale.

diode laser system (the LightSheer™). The authors (Ganesh Pai, Pavritha

Results: The overall median reduction of hair was

Bhat, Hema Mallya and Michael Gold) noted that ‘the approach of using low

90.5% with the Soprano® XL and 85% with the

fluencies with repetitive millisecond pulses to achieve heat stacking in the

LightSheer™, with a standard deviation of 7 and

hair bulb and bulge represents a paradigm shift in laser hair removal’.

8.5 respectively. Discussion: This new technology,

Materials and methods

cosmeticnewsuk.com

statistically insignificant increase in hair reduction

The open-label, single-centre, prospective clinical study included a total of 42

compared to the Light-Sheer, but did show a

female patients above the age of 18 years with facial hirsutism (excess hair)

significant reduction in hair thickness and a low

with Fitzpatrick skin types IV and V and who had polycystic ovaries confirmed

pain score.

by ultrasonography. Patients with obvious skin disease or a history of chronic

28

with low fluence and high repetition, showed a

skin disease other than moderate facial acne vulgaris; keloidal or hypertrophic scar tendency; skin types I, II, III, and VI; severe photosensitivity; and pregnant patients were excluded from the study.

Using the manufacturer-recommended methods and settings, one side of the face of each patient (randomly determined) was treated with the Soprano® XL in SHR mode using a technique of maintaining the handpiece in constant motion, with a fluence up to 10 J/cm 2 , 10 Hz, and a 20-ms pulse duration as recommended by the manufacturers.

The authors achieved their desired results with

Figure 1: Graph comparing the overall median hair removal percentages for

fluences which ranged from 5 to 8 J/cm2. The area

Soprano ® XL (90.5%) and LightSheer™ (85%).

to be treated was first shaved and a cool ultrasound gel applied. The other side of the face was treated

However, on analysing the hair width (mm) (measured using a hair analysis system), a

with the LightSheer ™ usinga conventional single-

much more striking observation was noted as the median hair width was reduced to

pass fluence to tolerance (25-35J/cm2), 2Hz, and a

0.02 mm with the Soprano ® XL and 0.05 mm with the LightSheer ™ (Figure 2).

30ms pulse duration (which was the pulse width found safest in our patient population based on past experiences on skin types IV and V).

The subjects were treated six times at intervals of four to six weeks with each device to permit hair re-growth and mimic real-life laser hair removal. Baseline hair density and final hair counts after the sixth session were made within a predetermined square-shaped area (2 x 2 cm2 area from the tip of the ear lobule to the jaw line) by using the hair analysis system SIF-1 for accuracy.

Pain during the treatment was measured subjectively by patients on a 0 – 10 visual analog scale (0 = no pain, 10 = unbearable pain) and recorded by evaluation for each side of the face after each

Figure 2 . Graph comparing the overall median hair width reduction for Soprano

treatment session.

® XL (0.02 mm) and LightSheer™ (0.05 mm).

Results

This was statistically different with a p –value of <0.0005. We observed that the

All the data was analysed using appropriate statistical

median pain scores of the Soprano ® XL and the LightSheer ™ were two and six,

tests at the end of six sessions of treatment, which

respectively (Figure 3), as measured on a 0 -10 visual analog scale (0 = no pain, 10 =

included the paired t -test. Statistical significance was

unbearable pain) over the six treatment sessions. The difference between median

considered to be p<0.05.

overall pain scores was four, which is statistically very significant (p<0.0005)

Based on hair density recorded at the beginning and

Figure 3. Graph comparing

the end of the treatment session, the study found

the overall median pain

that the overall median reduction of hair was 90.5%

scores for Soprano ® XL (2)

with the Soprano ® XL in SHR mode and 85% with the

and LightSheer ™ (6).

LightSheer ™, with a standard deviation of 7 and 8.5 respectively (Figure 1). Comparing the hair removal

There were no adverse

percentages between these two lasers using the

events noted during the

paired t -test, they found that these differences were

course of the study.

not statistically significant (p<0.063).

cosmeticnewsuk.com

29

Clinical Study - Laser hair removal

Discussion

did show a significant reduction of hair thickness when the

This study showed that using low energy, high-repetition

remaining hairs were measured. This was subjectively felt by

diode laser pulses with the Soprano® XL in SHR mode gave

the patients in the study and confirmed by measurement of

comparable results to the traditional high-fluence, single

the hair shaft. The reduced level of pain with the low-frequency

pass technique using the LightSheer™ laser. The Soprano® XL

modality laser increased patient compliance with the procedure.

system uses a sapphire contact cooling system in its handpiece

All patients who underwent laser hair removal with the Soprano®

to protect the epidermis. Describing how the system works,

XL were calm and relaxed during the procedure; however, with

the athors wrote, “The system does not target melanin as the

the LightSheer™ diode patients moved, by reflex, away from the

principle target chromophore, instead it focuses on raising the

handpiece owing to pain and physical discomfort.

temperature of the sub-dermal layer of the skin progressively to at least to 45°C, and to less than the thermal destruction

Patients who subjectively wished to treat other parts of the

temperature of the hair follicle without heating the epidermis

body opted for this less painful laser. Further, all 42 patients who

of the skin region. Although the fluence of each pulse delivered

were enrolled completed the study. In a similar study by Braun,

to the skin is relatively low, the rapidly delivered pulses

similar observations for pain score and hair reduction were seen.

effectively heat the dermis.”

A significant difference was that this study was conducted on androgen-dependent facial hair in contrast to leg hairs in the

The study also highlighted what it believed were the advantages

Braun study. The authors were also able to quantify hair loss

of using the Soprano® XL in SHR mode over traditional high-

and the thickness of the remaining hairs with the help of a hair

fluence treatments. These included: less pain and, theoretically,

scanner device.

a lower incidence of adverse effects, especially in dark skinned individuals. They alikened the motion used with the treatment

Conclusion

as being similar to what you do when you are ironing i.e. the

The study concluded that low-level fluencies performed

laser handpiece never remains stationary in one spot, but is

repetitively on a hair follicle will produce permanent hair

always moving in the treatment area. This means the skin is

reduction with less discomfort and fewer side effects than a

never subjected to a single diode laser pulse greater than 10 J/

single, high-fluence pass. Both devices produced hair reduction

cm2 . Since this is below the threshold of burning, the incidence

counts in excess of 80% six months following the first treatment;

of adverse effects is lower, as well as the sensation of discomfort,

however, treatment with the Soprano® XL produced a more

which is directly related to fluence. The authors had a median

signifcant reduction in hair thickness in subsequent sessions as

pain score of 2/10 for the Soprano® XL, verses 6/10 for the

compared with the LightSheer™. Overall, the authors concluded

LightSheer™ which they found to be statistically significant.

that the concept of this new technology has translated into

Although the new technology showed a statistically insignificant

greater acceptance by patients in terms of finer recalcitrant hairs

increase in hair reduction compared to the LightSheer™, it

and less pain during the procedure.

“All patients who underwent laser hair removal with the Soprano® XL were calm and relaxed during the procedure” R eferences

1. Hamzavi I, Tan E, Shapico J, Lui H. A randomized bilateral vehicle controlled study of efl ornithine cream combined with laser treatment alone for facial hirsutism in women. J Am Acad Dermatol. 2007;45:52-56.

2. Dover JS, Arndt KS. Illustrated cutaneous laser surgery: A practitioner ’ s guide.

Norwalk, CT: Appleton & Lange; 1990. p. 45-48.

3. Olsen EA. Methods of hair removal. J Am Acad Dermatol. 1999;40:143-155.

4. Goldberg DJ. Various mechanisms of hair removal. Cosmet Dermatol. 1997;10:3638.

5. Nanni CA, Alster TS. Optimizing treatment parameters for hair removal using a topical carbon-based solution and 1064nm Q-switched neodynium:YAG laser energy. Arch Dermatol. 1997;133:1546-1549.

6. Grossman MC, Dierickx C, Farinelli W, Flotte T, Anderson RR. Damage to hair follicles by normal-mode ruby laser pulses. J Am Acad Dermatol. 1996;35: 889 – 894.

7. Dierickx CC, Grossman MC, Farinelli WA, Anderson RR. Permanent hair removal by normal-mode ruby laser. Arch Dermatol. 1998;134:837-842.

8. Finkel B, Eliezri YD, Waldman A, Slatkine M. Pulsed alexandrite laser technology

30

cosmeticnewsuk.com

for non-invasive hair removal. J Clin Laser Med Surg. 1997;15:225-229.

9. Dierickx CC, Grossman MC, Farinelli WA, Anderson RR. Hair removal by a pulsed, infrared laser system. Lasers Surg Med. 1998;(suppl 10):198.

10. Grossman MC, Dierickx CC, Quintana A, Geronemus R, Anderson RR. Removal of excess body hair with an 800nm pulsed diode laser. Lasers Surg Med. 1998;(suppl 10):201.

11. Smith SR, Goldman MP, Fitzpatrick RE. Long term results of hair photo-epilation.

Lasers Surg Med. 1998;(suppl 10):205.

12. Weiss RA, Weiss MA, Marwaha S, Harrington AC. Hair removal with a non-coherent filtered flashlamp intense pulsed light source. Lasers Surg Med. 1999;24:128 – 132.

13. Anderson RR, Parrish JA. Selective photothermolysis: Precise microsurgery by selective absorption of pulsed radiation. Science. 1983;220:524 – 527.

14. Braun M. Permanent laser hair removal with low fluence high repetition rate versus high fl uence low repetition rate 810nm diode laser — A split leg comparison study. J Drugs Dermatol. 2009;8:14 – 17.

15. Patil UA, Dhami LD. Overview of lasers. Indian J Plast Surg. 2008;41:101 – 113.

5th – 6th NOVEMBER 2011

Facial and Body Contouring using Ultrasound and RF by Dr. Fernando Urdiales

Results Results you can rely on esults youon canBLUE rely you can rely Results ou can rely on BLUE you can Results rely on BLUE Results BLUE you can rely on Results you can rely on you can rely on BLU Results

BLUE

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XLi unique 810-nm diode laser platform offers effective Pain-Free XLi XLi chest + abdomen infor under 20min!

Alma Lasers revolutionary Soprano hairlong reduction Hair-Free™ treatments for permanent all skin types all year • Intelligent interactive interface on a 12’’ color screenXLi and topical dermal heating standout in the industry.

Soprano • No consumables • Pain-Free laser hair removaleffective Pain-Free unique 810-nm diode laser offers • New!platform Pain Free skin tightening XLi Extremely effective Hair-Free results Hair-Free™ treatments• for all skin types all year long.

XLi • Effectively treats all skinSoprano types including skin type 6hair reduction Alma Lasers revolutionary for permanent • Year round treatments and topical dermal heating standout in the industry. SopranoXLi XLi “Soprano hastorevolutionized photoepilation, longer lasting and results “I am SHR happy thatmedical the Soprano Haircontributing Removal beenbetter veryPain-Free well compared • confirm Fastest coverage the industry atoffers 10Hzhas pulse repetition rate. unique 810-nm diodeinXL laser platformsystem effective to conventional technologies. ‘IN-Motion’ treatment, applying low fluences at high repetition rates, enables us to provide received by our patients and that theyXLiin have allallbeen truly amazed that itlong is a pain free Hair-Free™ treatments for skin types all year chest + abdomen under 20min! customized photoepilation for each patient. Soprano works with all skin and hair types, all year round, with consistent, safe, treatment.

TheSoprano have the laser system very easy and safecolor to use andadvantages we have XLi • staff Intelligent interactive interface onproviding a 12’’ screen SHRfound is an essential tool for aesthetic practices, more patient than any reliable results. Today very pleased withconsumables the service we have received from ABC Lasers.” of itsbeen competitors” Pain-Free laserand hairsupport removal • No dr rita rakus Founder of theresults BaCd, Clinic in Extremely effective • mBBs New! Pain Free member skinHair-Free tightening Dr. Fernando Urdiales, MD ,Director of Miramar Medical Institute, Malaga, Spain.

• Effectively treats all skin Lip types including skin type 6 Knightsbridge.

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M E D I C A L

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sanofi-aventis, One Onslow Street, Guildford, Surrey GU1 4YS. Date of preparation: FEBRUARY 2011. GB.POL.11.02.02.

Treatment Spotlight - Cellulaze

The cellulite solution We find out about the first surgical laser treatment to target cellulite – Cellulaze

Cellulite is one of the four holy grails of cosmetic surgery1. More than 85% of women over the age of 20 are affected by the ‘orange peel’ effect2, and treatment options have traditionally been non-invasive, temporary and generally unsuccessful. However Cynosure has recently launched the world’s first surgical treatment for cellulite, to solve one of the most talked about body concerns for women in decades.

Cellulite is a structural problem below the skin. It consists of fat deposits, which get trapped between stiffened fibrous bands that connect the skin’s tissues. The bands squeeze the fat under the skin, resulting in a lumpy texture. Yet many cellulite treatments focus on treating fat from above the skin.

Cellulaze uses Cynosure’s proprietary SideLight side-firing fiber technology, which allows for more precise tissue targeting. The Cellulaze mechanism of action uses a 1440nm Nd:YAG wavelength exclusively and occurs in three ways: • • • •

Target Bulging pockets of fat – SideLight fiber is reoriented to target pockets of herniated fat Thermal subcision of fibrous septae – Using the SideLight laser fiber, fibrotic septae are thermally subcised Tissue tightening – Energy is delivered to the hypo dermal junction to thicken skin and increase skin elasticity

The system also uses ThermaGuide™ Intelligent Delivery System, which helps to precisely determine your endpoint with integrated temperature sensing to achieve more uniform results.

System Type

Nd:YAG

Wavelength

1440nm

Pulse Width (Max)

1000μs

Power Output Options

15W

Benefits of Cellulaze

Max Rep Rate

25Hz

• Only treatment that attacks the very structure of cellulite • One simple treatment • Proven to reduce the appearance of cellulite • Treatment that lasts • Produces healthier looking skin • Lose the cover-ups for good • 93% patient satisfaction as proven by clinical studies

Aming Beam

Red

Electrical Requirements

230 VAC/16A

Size

HxWxD) 37.4” x 19.7” x 25.6” (95cm x 50cm x 65cm)

Weight

220 lbs (100kg)

Unlike other non-invasive cellulite treatments, Cellulaze directly attacks this fat tissue, cutting through the brittle structural bands beneath the skin that are the real cause of cellulite’s dimpled appearance to release them and even out the skin’s surface, in one treatment.

How does Cellulaze work?

Cynosure’s Cellulaze treatment uses a 1440nm Nd:YAG wavelength and unique side-firing laser, to attack the fat tissue in three simple steps. Inserted through small incisions in the skin, the laser is first placed just underneath the top layer and pointed down to melt excess fat lying beneath the epidermis. Next it is pointed horizontal to cut through the stiffened fibrous bands, releasing the valleys that cause the orange peel effect. Finally, the laser is placed in the up position to thicken and elasticise the top layer of skin, smoothing out the surface for tight and toned skin.

Who are the right candidates for Cellulaze?

Cellulaze delivers the best results for women who are not significantly overweight but have mild to moderate cellulite on their thighs.

What does the procedure feel like for patients ?

Because the area is numbed with local anesthesia, there is minimal discomfort during the procedure. Patients may feel a light pressure. Following a Cellulaze treatment, and may cosmeticnewsuk.com

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Treatment Spotlight - Cellulaze

experience some soreness, but they will be able to return to normal activities in a day or two.

How long do the results last?

Patients will some improvement right away with optimal results apparent between three to six months. Since new collagen is formed in the areas treated with Cellulaze and the structures under the skin are altered, results are long lasting.

Clinical studies have shown results can last for one year or more. However, it is important for patients to maintain a healthy diet and exercise regimen to continue to enjoy the results.

Clinical study

Cellulaze is backed by two years of clinical research. Studies have shown that it increases the thickness of the skin by 22% and the elasticity of the skin by 32% – significant claims that haven’t been made by any other treatments. Thicker and more elastic skin can help flatten and smooth the skin’s surface to improve the appearance of cellulite. A study carried out by leading US plastic surgeon Barry E DiBernardo also demonstrated that a single treatment with the Cellulaze 1440nm pulsed laser improved the appearance of cellulite, with results dramatically increasing up to one year later.

Topical treatments, massage and other various non-invasive techniques offer a temporary solution3.

“Cellulaze is supported by two years of clinical research that has led to the development of a revolutionary approach, shown to reduce cellulite for 12 months or longer,” said Cynosure president and chief executive officer Michael Davin.

“We are extremely excited with the introduction of Cellulaze as patient satisfaction has far exceeded our expectations,” added Neil Wolfenden, managing director for Cynosure UK. “Together with the new non-invasive SmoothShapes system, we are working on educating cellulite sufferers about Cynosure’s temporary and permanent treatments for cellulite.For the first time the UK is at the forefront of cosmetic surgery, with Cynosure’s global approach to Cellulaze.”

“For the first time the UK is at the forefront of cosmetic surgery” Barry E. DiBernardo. Treatment of Cellulite Using a 1440nm Pulsed Laser With One-Year Follow-Up. Aesthetic Surgery Journal 2011 31: 328 Abstract Background: Cellulite is characterised by a thickened hypodermal fat layer, along with hypodermal fat lobules that extend upward into the dermis, expanding and stretching the fibrous septae that separate the fat lobules. Eventually, the septae sclerose, contract, and harden, holding the skin at an inflexible length while the surrounding tissue continues to expand.

Objectives: The author evaluates the efficacy, safety, and duration of clinical benefit associated with a pulsed laser that delivers 1440nm energy to the dermalhypodermal interface for the treatment of cellulite. The changes in the dermal structure that affect the appearance of cellulite are also examined.

Methods: Ten healthy women with cellulite on their thighs enrolled in a prospective Institutional Review Board–approved study conducted in the author’s private plastic surgery clinic. Patients received a single treatment with a 1440nm pulsed laser. Energy was delivered to the subdermal tissue through a fiber that was designed for side firing and enclosed in a cannula. Treatment addressed the thickened hypodermal fat layer, hypodermal fat lobules that extended upward into the dermis, and fibrous septae by thermal subcision.

Results: The mean age of the patients was 47 years ± 5.4 years. Mean skin thickness (as shown by ultrasound) and skin elasticity were shown by objective measurements to increase significantly at one, three, six, and 12 months.

Subjective physician and subject evaluations indicated improvement, high subject satisfaction, and minimal adverse effects.

Conclusions: In this study, a single treatment with the 1440nm pulsed laser improved the appearance of cellulite, an improvement that persisted through at least one year of follow-up with minimal adverse effects.

[REFERENCES]

(1) Rawlings, A.V. Cellulite and its treatment. Int. J. Cosmet. Sci. 28, 175–190 (2006) (2) Introduction to Cellulite http://www.cellulite.co.uk/what-is-cellulite (3) Cellulite treatments on trial http://women.timesonline.co.uk/tol/life_and_style/women/beauty/article6592516.ece (4) DiBernardo, MD Treatment of Cellulite Using a 1440-nm Pulsed Laser With One-Year Follow-Up, Aesthetic Surgery Journal (2011) (5) www.cynosureuk.com

34

cosmeticnewsuk.com

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Product Focus

T he I N TA C T principle We take a look at the Intact range and its use in combination with OXYjet

A few years ago the gap between beauty salons and medical aesthetics clinics was vast, but now many clinics are realising the added value of offering less invasive, more pampering treatments to their menu.

•

Pigmentation

•

Weakening of the natural skin protection system

One of the key ingredients is Commiphora Mukul, a myrrh plant, which is mainly found in India, that contains a resin, which has been an important part of traditional Ayurvedic medicine for many centuries.

Although statistics have shown that consumers are continuing to

An extract of this resin is able to stimulate Lipogenesis (fatty

spend money on looking and feeling good, despite the current global

acid synthesis) and at the same time inhibits lipolysis (fatty acid

economic climate, many clinics are still feeling the pinch with clients

degradation). Triglycerides are formed as a result, which store the

coming back less regularly for treatments such as botox and fillers or

adipocytes of the skin (in vitro). The adipocytes increase and plump up

holding off on having more expensive procedures. While the medical

the skin to the depth of its’ youth.

aesthetics industry is feeling this less than the cosmetic surgery industry it is still vital, in times like these, to set your clinic apart from the

Other key ingredients include:

opposition and keep your clients coming back time and again. When

•

Syn-Coll – a peptide that is able to stimulate tissue growth factor

times are tough, there is nothing that makes people feel better than a bit

(TGF). TGF is the key to synthesis of collagen and increases its

of pampering and so it makes sense that to help your clinic stand out

new formation in the skin. This allows the dermis to store more moisture and the skin this is moisturised and streamlined.

from the crowd you need to be offering consumers treatments that fit this mould.

•

Syn-Hycan – a Tripeptide, which works on the

One such treatment is the Intact Oxygen Facial. The treatment uses the

Glucosaminoglycan Hyaluronan. This sugar-like molecule

Intact product range from Nora Bode alongside OXYjet.

binds up to 1,000 times its weight in water and is thus crucially

OXYjet is a non-invasive anti-ageing treatment that works by using

involved in the strength and firmness of the skin. Syn-Hycan

pure oxygen under pressure to pump a collagen stimulating serum,

increases the synthesis of Hyalurons in the skin, which can store

free radical correctors, vitamins A, C and E and a form of hyaluronic acid deep into the skin. This special cocktail of cosmetics contains

more water.

•

Syn-Ake – a synthetic Tripeptide (Dipeptides Diaminobutyroyl

substances naturally found in the skin of your youth, and thus the

benzyl amides Diacetates) that mimics the effect of ‘snake-bite’.

body biologically accepts it, filling wrinkles and plumping the skin.

The Temple Viper paralyzes the muscles of its victims, so that

This luxurious procedure means that lines are smoothed away, the lip

they can no longer move. SYN-ake doesn’t paralyze muscles,

contour area is defined and the skin is rejuvenated and appears more

but gently relaxes them, which effectively reduce expression lines

youthful.

especially around the eyes and forehead area. In vivo tests show a reduction in the depth of wrinkles by up to 52%, after continued

The INTACT range includes:

36

cosmeticnewsuk.com

regular use over a period of 28 days.

•

Eryngium Maritimum (Sea Holly) – a plant that grows in

•

Perfect skin volume cream

•

Perfect skin volume fluid

an extremely barren and sophisticated environment, and it has

•

Perfect eye zone concentrate

therefore developed special protection qualities over the years. It

•

Perfect lip filler concentrate and

has natural strengths against various environmental influences

•

Perfect skin volume concentrate

(dehydration, light, UV rays and salt) and is rich in proteins,

lipids, carbohydrates and minerals.This combination promotes

The products contain various active ingredients to combat the key

the regeneration of the skin and gives it new strength and energy.

factors of ageing.

This in turn slows down the ageing of the skin.

•

Loss of subcutaneous fatty tissue

•

Depletion of collagen and hyaluronic acid

OXYjet has also now launched a brand new range of Leo

•

Expression lines

Machines, incorporating the OXYclear and OXYtone procedures,

•

Reduced performance of micro-capillaries

red and blue light technology, cryo technology and diamond head

•

Sebaceous gland function

microdermabrasion, further enhancing the treatment’s capabilities.

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Oxygen is essential to life and to keeping the skin looking young and healthy.

Through his research and product analysis, Dr Peter T Pugliese found that the amount of Oxygen delivered to the skin by many current available treatments could not be determined.

The circadian Oxygen Rx System is formulated to deliver a measured and controlled amount of oxygen to skin, ensuring the oxygen delivered to the skin will be maximally beneficial while minimizing risk of free radical damage.

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Product News BLEMISH + AGE SKIN THERAPY TREATMENT SkinCeuticals has launched a new treatment for adults suffering from Grade I-III acne which incorporates its Blemish + Age product range.

SkinCeuticals Blemish + Age Skin Therapy Treatment is designed to dramatically improve the appearance of blemished skin and fight lines and wrinkles. The treatment incorporates the new Blemish + Age product line featuring a powerful solution of a first-to-market acid combination containing dioic acid, salicylic acid (including capryloyl salicylic acid), glycolic acid and citric acids. These blemish-fighting and age-fighting dynamic actives provide targeted modes of action in the skin. The 125 minute Acne Grade I and II treatment is ideal for those with acneic or

SkinGeeks launches AQ Active Serum SkinGeeks has introduced a new growth factor-based product to the UK market.

AQ® Active Serum contains high concentrations of multiple growth factors that are found in healthy, young skin. The serum also contains several plant-based ingredients that support the repair of DNA damage as well as Chaperone proteins to protect the active ingredients and help them penetrate deeper into the skin layers.

The product’s FDA-registered manufacturer only uses premium sources for its growth factor ingredients and scientifically advanced methods of production and filtration ensure highly stable, pure, concentrated products. Unlike some other growth factor based skincare lines on the market, AQ Active serum has a pleasant aroma that increases client usage, and is easily absorbed into the skin. Results can be noticed within a few weeks of using the serum.

seborrheic skin. There is also a 45-60 minute Acne Grade III treatment, which can also be carried out on Grade IV acne with a GP or dermatologist referral.

INTRAcel RF microneedling device to launch in UK SmartMed, the newly formed division of Healthxchange Pharmacy, will be launching the INTRAcel monopolar/bipolar RF microneedling device into the UK. The system has been recognised as a revolution in skin rejuvenation and is the first device of its kind currently available on the market. Effective for a wide range of cosmetic indications including tightening of the neck and jowls plus dramatic improvement of acne scarring, this device offers a complete skin rejuvenation solution from a single system with little or no down time. Launch events are due to take place in London during December 2011 and January 2012. For more information contact Donna Ofsofke on 0845 689 0090.

DermaQuest launches new skin screensaver Award-winning chemist, Sam Dhatt, has created a new instant-acting

DermaQuest ZinClear Tinted Nude SPF 30 is silky on application, concealing

sun protecting tinted moisturiser – DermaQuest ZinClear Tinted Nude

peel-induced redness while smoothing the skin with a subtle wash of healthy,

SPF 30 . The skin perfecting all-in-one contains broad spectrum UVA/B

matte colour. Suitable for the English rose complexion, DermaQuest ZinClear

SPF while acting as an anti-ageing healing cream.

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Award for elure Advanced Skin Lightening™ Products Syneron’s elure Advanced Skin Lightening™ Lotion and Advanced Lightening™ Night Cream have been named ‘The Big Breakthrough in Beauty’ by Allure magazine for 2011.

our physician partners’ high standards.”

strategy focused on bringing complete aesthetic solutions to our customers and

“We are extremely delighted and honored to receive this prestigious award from

to consumers. elure is the next generation in skin lightening products with an

Allure, a publication we hold in the highest regard,” said Louis P Scafuri, chief

outstanding efficacy and safety profile proven in extended clinical trials.”

executive officer of Syneron. “elure further instills our commitment in pioneering

Dr Shimon Eckhouse, chairman of the board of Syneron commented, “elure is an excellent example of Syneron’s technology and product development

innovative aesthetic applications for the face and body and puts us at the

The two elure products featured in the October issue of Allure magazine, with a

forefront of exciting technological advancements that aim to meet and exceed

circulation over one million readers.

38

cosmeticnewsuk.com

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Christmas offers

Stocking fillers We round up some of the best Christmas offers for you to retail to your clients this festive season

Susan Posnick Christmas SkinCeuticals giveaway Christmas Gift Box Purchase just five items from the Susan Posnick range

during the month of December and receive one of these

SkinCeuticals is launching a Christmas gift box

gorgeous little sets, which fits perfectly into any girl’s

comprising some of its signature products. The

handbag. The mini brush set contains a Kabuki brush and a

gift box costs at £120 and contains Phloretin

little pot of either Susan Posnick’s Shimmer Colorflo or Susan

CF, Retexturing Activator and Sheer Mineral UV

Posnick’s Bronzer Colorflo. The pot dispenses just the smallest

Defense SPF50 and is a fantastic retail item for

amount of product through the tiny perforations. Kabuki

clients. For more information e-mail

brushes are a must-have accessory for anyone’s make-up kit

info@skinbrands.co.uk

providing a light to full coverage to ensure a flawless finish.

For more information contact Skinbrands – www.skinbrands. co.uk, call + 44 (0) 5603 141956 or e-mail info@skinbrands.co.uk

Obagi gives you more

Give your patients some ‘get up and glow’ this party season with the new Blue Peel RADIANCE. It’s simple, easy to use and instantly effective. This in-clinic, nurse-led application takes mere minutes to put on, has little or no patient down-time and gives them a fantastic glow so they can shine at any festive party. Healthxchange Pharmacy has a special offer for a limited time only on Blue Peel RADIANCE, including a free kit with every six Nu-Derm starter sets ordered before November 30, so contact your territory manager or call the pharmacy direct on 01481 736837.

Give the gift of healthy skin with Clarasonic this Christmas Clarisonic is a sonic skin cleansing system that creates a sonic micro massage that works with

Boston Medical Group Ltd launches new serum in time for festive season If your clients are looking to give their skin a boost for the

the skins natural elasticity to provide effective gentle cleansing. Clarisonic utilises Patented

festive season then the new SR Serum from Boston Medical

Sonic Technology and moves at over 300 movements per second. Clarisonic’s gentle sonic action

Group could be just

works to loosen sebum and dirt, while cleansing, clarifying and stimulating the skin, deeply

what they are looking

cleansing, unclogging pores, and removing make-up, dirt and oil and is twice as effective as

for. The product can

manual cleansing. Clinical studies have shown that Clarisonic can be used as part of daily skincare

be used either as a

routine and leaves the skin feeling and looking smoother and softer, removes up to 6x more make up than

mesotherapy treatment

manual cleansing, and improves product absorption by up to 61%, making the sonically cleansed skin

for the face by injecting

more receptive to skincare ingredients. It also helps to reduce the appearance of fine lines, wrinkles and

it directly into the skin

pore size, while also helping to reduce blemishes, redness, dry patches and excess sebum. The Clarisonic is

or before and after the

gentle enough for all skin types, including skin affected by complex conditions, and that is why physicians

Dermal Roller SR treatment to boost its efficiency.

recommend it as an adjunct to treatments for seborrhoeic dermatitis, rosacea and acne. Pre-procedural

The wonder serum contains 56 skin-boosting ingredients, including

cleansing with Clarisonic is incorporated in many professional practices as thorough skin cleansing assures

cytokines, coenzymes, vitamins, minerals, antioxidants, amino acids

procedures are performed on skin free of impediments and can help increase the treatment outcome.

and hyaluronic acid, which are delivered to the dermis helping to

Clarisonic is ideal for clinic-based treatments, such as microdermabrasion, AHA peels, intense pulsed light

target the underlying factors causing ageing while also treating

(IPL) treatments, laser hair removal, laser

the skin at the surface. When combined, the Dermal Roller SR™ and

resurfacing and photodynamic treatment.

SR Serum can offer clients effective skin rejuvenation on the face,

It is also ideal as part of in-spa facials and

hands, neck and décolleté. The results include the reduction of fine

other cosmetic treatments. For more

lines and wrinkles, indented scars, acne scaring, enlarged pores and

information call 0800 988 4864,

hyperpigmentation as well as a glowing and even complexion with

e-mail uksales@clarisonic.com or visit

plumper, firmer skin. Training is an integral part of the company’s

website www.clarisonic.co.uk

philosophy and as such it provides full, recognised training for its products, either at its training facility in London or at the client’s clinic/practice.

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cosmeticnewsuk.com

w w w. c o s m e t i c - i n s u r a n c e . c o m / c o s m e t i c n e w s

Laser Support Services

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abstracts

Abstracts

We summarise some of the most recent studies you may have missed Title: Acne scars in ethnic skin treated with both non-ablative fractional 1,550 nm and ablative fractional CO2 lasers: comparative retrospective analysis with recommended guidelines Authors: Abdulmajeed M. Alajlan MD, Sami N. Alsuwaidan MD Published: Lasers in Surgery and Medicine Volume 43, Issue 8, pages 787–791, September 2011

Abstract Background: Fractional technology has changed the dermatologists view in how to treat acne scars in ethnic skin as a result of its favorable safety profile.

Objectives: To evaluate the safety and efficacy of non-ablative fractional (NAF) 1,550 nm and ablative fractional (AF) CO2 Lasers in the treatment of acne scars in ethnic skin.

Methodology: In this retrospective analysis patients with acne scars who were treated with NAF 1,550 nm or AF CO2 lasers from January 2008 until July 2009 were included. Evaluation was made through comparing preand post-photographs and physician global assessment.

Patients’ satisfaction rate was also recorded. Assessment of improvement was based on a quartile grading scale.

Bleaching creams and oral antibiotics were routinely given after each session. Adverse effects were recorded.

Follow up visits were scheduled at weeks 1 and 4 of each session and 12 weeks post-last session.

Results: A total of 82 patients were recruited in the study. Forty-five patients treated with NAF 1,550 nm laser and 37 patients with AF CO2 laser. Skin phototype was mainly type IV (III–V). An overall patient satisfaction was 71% for NAF 1,550 nm laser group and 65% for AF CO2 laser group. Thirty-five percent and 37% of patients attained more than 50% improvement with NAF 1,550 nm and AF CO2 lasers, respectively. Patients treated with NAF 1,550 nm laser had less down time.

Transient post-inflammatory hyperpigmentation (PIH) was noted in 17% of patients treated with NAF 1,550 nm laser compared to 14% with AF CO2.

Conclusion: Both NAF 1,550 nm and AF CO2 lasers are effective in treating acne scars in ethnic skin with good patient satisfaction rate and high safety profile. PIH decreased with routine use of prophylactic bleaching creams. Fractional laser resurfacing open a wide horizon for treating acne scars in ethnic skin.

Title: Percutaneous Selective Radiofrequency Nerve Ablation for Glabellar Frown Lines Authors: Jun Hyung Kim, Jin Wook Jeong, Daegu Son, Kihwan Han, So Young Lee, Tae Hyun Choi, David W Chang Published: Aesthetic Surgery Journal September 2011 31: 747-755,

Abstract Background: The dynamic muscles of the glabellar region can be overactive, giving patients a “scowling” look and making them appear angry, worried, or stressed.

42

cosmeticnewsuk.com

Objective: The authors describe percutaneous selective nerve ablation, a minimally invasive procedure for treatment of glabellar frown lines, and report results from a series of patients treated with the technique.

Methods: From November 2007 to December 2009, 27 patients (22 women and five men) underwent percutaneous selective nerve ablation to improve glabellar frown lines. Initially, the surface pathway of the nerve to the corrugator supercilii and procerus was checked with a peripheral nerve stimulator. For percutaneous localisation, a 22-gauge monopolar electrode was introduced into the lateral brow and cheek skin without incision. Short electrical stimulation (0.3-0.5 mA) was delivered to identify the proper lesion sites. Synchronous contraction of corrugator supercilii was elicited and radiofrequency nerve ablation performed (85°C, 70 seconds). In all patients, the frontal branch of the facial nerve and angular nerve were treated bilaterally. The improvement was evaluated with the Wrinkle Assessment Scale.

Results: Mean patient age was 54.5 years, and mean follow-up time was 18 months (range, 12-26 months).

One patient had superficial second-degree burns to the brow skin, which healed with conservative treatment.

Two patients had temporary paresthesia that completely resolved in a few weeks without sequelae. The Wrinkle Assessment Scale indicated a statistically significant improvement in the glabellar frown lines (preoperative vs postoperative mean, 3.7 vs 1.8; P < .05).

Conclusion: Although long-term studies are necessary to determine the ideal amount of energy delivery for maximum efficacy and time for treatment of glabellar frown lines, the study lends support for the safety and efficacy of percutaneous selective nerve ablation.

Title: Measuring Quality of Life and Patient Satisfaction After Body Contouring: A Systematic Review of Patient-Reported Outcome Measures Authors: Patrick L. Reavey, Anne F. Klassen, Stefan J. Cano, Colleen McCarthy, Amie Scott, J. Peter Rubin, Michele Shermak, and Andrea L. Pusic Published: Aesthetic Surgery Journal September 2011 31: 807-813,

Abstract Evidence-Based Background: In both cosmetic and postbariatric body contouring populations, the primary determinants of success are patient satisfaction and quality of life (QOL). These patientreported outcomes (PRO) are ideally measured with specially-designed, procedure- or condition-specific questionnaires.

Objective: The authors identify and appraise all patient-reported outcome (PRO) measures (questionnaires) developed for patients undergoing body contouring surgery.

Methods: Evidence Based Medicine databases were searched from the inception of each database through August 2010. Articles included in the study described

the development and/or psychometric evaluation of a PRO measure developed for body contouring patients.

Each measure was then appraised for adherence to internationally-recommended guidelines for item generation, item reduction, and psychometric evaluation.

Results: The following five PRO questionnaires were identified by our search: one liposuction (the Freiburg Questionnaire on Aesthetic Dermatology and Cosmetic Surgery, FQAD), one general plastic surgery (Derriford Appearance Scale, DAS-59/24), and three breast reduction measures (the Breast Reduction Assessed Severity Scale Questionnaire, BRASSQ; Breast Related Symptoms questionnaire, BRS; and the BREAST-Q reduction module. Detailed examination of these measures revealed that the FQAD, DAS-59, and BRS are limited by both their content range and psychometric properties. The BRASSQ and BREAST-Q both have strong psychometric properties, and the BREAST-Q is unique in its inclusion of items covering specific postoperative issues such as scarring.

Conclusions: While instruments are available for measuring outcomes in breast reduction patients, reliable, valid, and responsive PRO measures are lacking for the majority of body contouring procedures. To demonstrate the unique outcomes of body contouring surgery, future research to rigorously develop and validate new PRO measures in this population is necessary.

Title: Strategies for assessing the degree of photodamage to skin: a systematic review of the literature Authors: L. Baillie, D. Askew, N. Douglas and H.P. Soyer Published: British Journal of Dermatology Volume 165, Issue 4, pages 735–742, October 2011

Abstract As our understanding of the role of ultraviolet (UV) radiation exposure in causing skin cancer continues to be enhanced, it is important that clinicians and researchers are familiar with the various methods for assessing photodamage to skin. This paper provides a systematic review of the published literature on invasive and noninvasive methods used to quantify lifetime UV exposure (‘photo-ageing’). Clinical examination, histopathology, immunohistochemistry, skin surface topography and ultrasound, in addition to newer technologies such as reflectance confocal microscopy, optical coherence tomography and multiphoton tomography, are reviewed. It is concluded that histopathological solar elastosis alone should not be viewed as a ‘gold standard’ diagnostic test and that there is no single method available to give accurate quantification of the degenerative changes associated with photodamage. Although additional research into sensitivity and specificity is still needed, skin surface topography currently has the most support in the literature as a valid and reliable noninvasive tool for the assessment of photo-ageing.

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best practice - Groupon Ethics

ToorGnrootutpoon pon?

Grou

Ron Myers on the ethics surrounding Groupon offers Publicity, profit and the possibility of attracting a lifelong customer – all reasonable answers about why a number of clinics are choosing to advertise cut price cosmetic treatments on discount site Groupon.

However, with Groupon taking a minimum 50% of the profits whilst stipulating the cost of the services/goods being advertised must be reduced by at least 50% and only 66% of advertisers saying they made a clear cut profit using the site – is it worth it?

G

roupon appeals to a nation

Originally catering to businesses with excess

of bargain hunter consumers,

products or used to drum up publicity for

so is the idea of upselling the

new businesses, their appearance within

customer onto more expensive

the aesthetic industry has been a quick and

treatments/products or the guarantee of

when it offered breast implants and facelift for only £1,999.

Pictured below, is the most expensive Groupon cosmetic surgery deal we’ve ever

highly controversial endeavour.

repeat business in the future realistic?

It seems their foothold in the aesthetic

seen for one specific treatment... a whopping

Below are two perspectives on the Groupon

industry marketplace is well and truly

£1,400!

phenomenon - from the availability of

cemented with the emergence of a string

seriously discounted cosmetic treatments,

of deals rising to above £1,000 for a

Other pricey deals include Lasik eye surgery

to two examples of unhappy customers

variety of cosmetic procedures – is this

for £1,295, IPL treatment for £999 and a

who wrote to the Consulting Room after

the best strategy to appeal to the discount

hair transplant for £999.

purchasing Groupon vouchers cosmetic

hunting clients Groupon typically attracts?

treatments.

Previously, Groupon had mostly catered

Whilst, these prices fall below the average

to the (arguably) more trivial beauty side

amount charged in clinics nationwide, it

Are these the most expensive treatments

of the cosmetic marketplace concentrating

begs the question of advertising standards,

ever on Groupon?

on laser hair removal, microdermabrasion,

or the lack thereof, in the industry –

laser teeth whitening etc. However, a

especially in a high pressure situation where

Like many in the industry, I tend to keep

recent deal branched into a more serious

the clock is literally counting down at the

an eye on deal website Groupon with a

range of medical procedures such as

side of your screen, it’s hardly the most

mixture of fascination and suspicion. On

Bodytite, eye surgery and a hair transplant.

conducive forum for rational thinking and

the one hand its effectiveness in drumming up business is to be applauded; however, I

44

thorough research into the treatment being Early this year the site caused controversy

advertised.

can’t help noting its

I don’t know about you but the description

moral and ethical

of this deal doesn’t fill me with confidence,

pitfalls, especially

whilst the surgery’s location in relation to

when it comes

public transport links may be important

to responsible

does it really deserve so much attention?

Cosmetic Surgery

Would any other forum offer such

advertising.

trivialisation of a medical procedure like the

cosmeticnewsuk.com

description seen here: “When the constituents of

why is this so? But Groupon, with its reputation

the human body throw a big party it’s a team effort,

for quick-draw bargains doesn’t induce this line of

with finger food, assorted tissues and haemogolo-

thinking.

sticks, apart from the fats that won’t move a

BAAPS (the British Association of Associated Plastic

muscle. Give insipid lipids the boot.”? In any other

Surgeons) have warned against Groupon with

situation a serious reduction on average price such

Former BAAPS President Adam Searle saying: “This

as this would make a consumer pause and question

is a practice I unreservedly and utterly condemn.”

Groupon – The Consumer Perspective

customers as possible, clinics may often skip important procedures.

(This is the warning from hair specialist website www.hairgoodbye. co.uk.) One of these procedures is the patch test, which is compulsory

Bargains, bargains, bargains! It’s easy to understand why the public

for people undergoing laser or IPL hair removal treatment. The idea

loves Groupon but is it all as black and white as the public would like

of this test is that a small area on your body must be treated before the

to think? Here, we examine one of the most reoccurring treatments on

main hair removal treatment. It is usually carried out about three or

Groupon and the negative press that has surrounded previous laser hair

four days before starting the treatment.

removal deals.

Buyer Beware - the danger of cheap laser hair removal

In other cases, due to the busy schedules, clinics may leave gaps of two months or more between the patch test and the main treatments. This

The recent surge in popularity

way, new customers can easily fail to notice problems with their skin

of discount voucher sites, most

after the patch test.

notably Groupon, has made

However, an expert

laser and IPL hair removal

would not miss these

cheaper and easier than ever

signs shortly after

to get. However, consumers

the patch test.

should beware of these sounds-too-good-to-be-true

One very confusing

deals, they may be cutting the price of the treatment but are they also

Groupon Ad

cutting corners? Six sessions is the minimum number recommended

from early 2011

for permanent hair reduction and regular deals offer six sessions that

advertised the

vary between £99 and £150. For about £800 for women and £1,000

following “Bread

for men, you can also buy a pass for unlimited hair removal sessions

brain agreement, not

in a number of beauty salons. Incidentally, whilst writing this a new

to be confused with

Groupon deal (pictured) for six IPL treatments in Birmingham has

thread vein treatment, is the tentative approval of certain undesirable

landed in my inbox!

elements of the mind’s dough, including rye wit and kneady behaviour.

Get under the crust of unwanted extras with today’s Groupon” –

During the recent summer

erm.... what?! This deal eventually went on to sell out!

holidays these deals have proved to be extremely popular (even

HairGoodbye have also reported that clinics are hiring personnel

though the real time to start

who are not trained to the required standards. One client on the

treatment is after the summer

Hair Goodbye website complained that a clinic they visited through

to avoid problems with tanned

Groupon hired predominantly Eastern European workers who did not

skin) and participating salons

have the correct qualifications or experience. IPL and Laser settings

have sold large numbers of

vary on the customer’s skin and hair colour so without the necessary

vouchers through discount

training, therapists will underset the IPL which will not remove the

websites. However, by

hair. However, oversetting the machine and other misuse can lead to

accommodating as many

permanent skin damage, which may include:

best practice - Groupon Ethics

•

•

•

•

Burns – These painful consequences can occur regardless of your

Another Groupon user has also told The Consulting Room how they were

practitioner’s training however, they are more commonly the results

taken in by the sites misleading advertising: “I recently bought a Groupon

of less experienced technicians.

voucher for this clinic for my sister as a birthday present. The deal was

Skin discolouration - A non painful permanent lightening of the

clearly for 6 IPL sessions on three areas worth £1,320 for £109. When I

skin can occur on the treated area. A laser is designed to target the

rang up to book an appointment for her I was told that the consultation

darker coloured hair pigment but it can sometimes affect darker

was counted as part of the six sessions. When I queried this, I was told

coloured skin as well.

that the consultation would include a test patch but they would do a

Scarring – Over-treatment due to a lack of training can lead to skin

‘larger test patch’ to make it into a session - surely this negates the test

scarring, however this may also rarely arise when treated with a

patch and I would say akin to negligence if anything went wrong in this

qualified practitioner.

‘large test patch’ area. I was also told that the six sessions on three areas

Skin anomalies – Clinics who may be under pressure to book in a

I had paid for was actually only two sessions on each area because ‘you

lot of clients due to a deal may restrict treatment times. This may

wouldn’t get 18 sessions for £109’. The point is I might have paid £109

cause inattention when it comes to skin anomalies such as spots,

but the value of the voucher is £1,320. They completely missed the point.

moles, scars, skin tags etc as areas darker than your natural skin colour should not be treated but covered due to risk of burning.

“I was then cheerily told that a half leg (which my sister said she wanted) would count as two separate sessions (front and back), so that effectively

We think that consumers should beware of misinformation and the

used up four sessions on one leg. Now she only has one session left

likelihood of the poorer service that can be associated with clinics offering

(discounting the consultation and one leg). What on earth is she supposed

these deals.

to do with one session?

One angry Groupon customer told The Consulting Room: “I bought a

“The clinic completely misled people who have bought this deal and they

voucher from Groupon for laser hair removal last year (2010). Booking

turned what I thought would be a nice 25th birthday present for my sister

the first consultation appointment was a nightmare. After that I was told

into a feeling of being ripped-off”

that they were still recruiting laser therapists so most of the appointments

The consumer may then start to question why that particular clinic is

were not yet available! In terms of the laser...on their website they claim

using discount deals in the first place – are they a new business? If so,

to use ND Yag laser - which is not true. They use IPL on all the skin

do they have the amount of qualified staff to deal with the demand the

tones! To add to all this, there have been five separate occasions where

discount will produce or will you be waiting for an appointment for a

their laser machine has “BROKEN” so they have had to cancel all my

long time? If you pay in advance for a yearlong treatment and the salon

appointments. They still have not managed to fix it for more than two

goes out of business then the whole notion of discount treatment is

months on each occasion and keep ignoring my phone calls.”

rendered useless.

So what are the major points to consider when advertising / buying on Groupon?

Ron Myers

1.

experience in the pharmaceutical

The industry’s leading groups and organisations are calling for

Ron Myers has more than 13 years

Groupon/treatment regulation

industry in a variety of sales and

2.

Is the promise of profit, repeat revenue and upselling realistic?

marketing, sales management

3.

Does the coupling of your clinic and Groupon appeal to the right

and business development

consumer and give consumers an accurate vision of your clinic?

roles working for Smith Kline

4.

Should it really be integrated into your permanent marketing strategy?

Beecham, Novartis, and Allergan

5.

The possibility of consumer / industry backlash

Pharmaceuticals. Ron was involved in the launch of

So, as members of the aesthetic industry (some of you may even have advertised on Groupon yourself) do the positives outweigh the negatives?

Does Groupon denigrate your clinic’s image as a serious medical practice?

Groupon –

Botox® and M.D. Forté® glycolic peels into the UK market place in 1994. He set up a specialist consultancy service in 2002 with business partner Martyn Roe. Since then they have been busy working on a variety of high profile projects in the aesthetics industry, including the development of Wigmore Medical’s concept as

revolutionary new

a specialist aesthetic distributor; the launch of the

marketing technique

Facial Aesthetic Conference and Exhibition (F.A.C.E.)

or irresponsible

– now the UK’s largest non-surgical medical aesthetic

depreciation of

conference; business development projects with

cosmetic surgery?

individual medical aesthetic clinics and website design and development – including e-commerce sites and the launch and management of MediZen – a non-surgical medical aesthetic clinic - in conjunction with Dr David Eccleston. In addition Ron and Martyn developed www. consultingroom.com – launched in 2003, and now the largest specialist aesthetic information website in the UK, and winner of “Best Aesthetic Patient Information Website” at the 2008 Aesthetic Medicine Awards.

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cosmeticnewsuk.com

marketing - Branding

Building a Zoe Davitt gives us the lowdown on branding

A successful brand lives in the minds and hearts of your customers. It is all of the things they think of when they imagine your company or your product.

Are you clear in your mind what branding is and what

Brands have become an integral part of modern life and we

makes a brand successful? There is much mystery

use them as an extension of ourselves. The choices that we

surrounding marketing and in particular branding. This

make say a lot about who we are as individuals. The best

article’s here to lift the lid on this critical topic and help

brands create a special relationship with customers based on

provide you with a quick, easy to digest overview.

intangible qualities that evoke strong emotional responses – Apple is a great example of this.

What is a brand?

Branding comes from the term used where farmers literally

What makes a good, strong brand?

branded their cattle to establish ownership. Today, we use

A successful brand:

the word to describe a name, term, logo, symbol, sign or

•

Clearly and consistently delivers a clear message

design that is used to identify one sellers good and/or services

•

Affirms and confirms your credibility

from those of others.

•

Makes an emotional connection with your target

Horizons. She has a strong background in

As a concept, Philip Kotler, often referred to as the

•

Creates a motivation for the buyer

marketing and customer service, giving

Godfather of marketing, offers the following definition:

•

Establishes, encourages and maintains loyalty

prospects

Zoe Davitt is managing director of Blue

“Brands were founded in response to consumers’ desire

her a perfect combination of skills and expertise. Her many business-orientated

“A brand is a promise to your customers, the totality

for predictability and above-all protection. Brands are

qualifications include ones from the CIM

of perceptions about a product, service or business, the

‘trustmarks’ that embody for consumers a commitment

(Chartered Institute of Marketing), and she

relationship customers have with it based on passed

to quality, value for money and reliability” Paul Jackson,

has a wealth of experience across many

experiences, present associations and future expectations….

Media Smart®

sectors including medicine, dentistry,

brand reality is always defined by the customer’s view.”

Brand = Promise

recruitment, tourism, hotel management and facilities management.

In today’s ever increasingly competitive market it is vital

Your brand is the source of a promise to your clients/

for your success to be able to differentiate yourself from

customers and demonstrates your business’ entire philosophy

the competition. As consumers, our expectations are high

about what you can do for them.

and we expect a lot. As Marketers say “you need to sell the

It should start with defining who your target market is as

sizzle”. As a self-confessed Starbucks addict, I know that it

your brand position resides more in their hearts and minds

isn’t just the coffee that makes me a fan it’s far more ethereal

than it does yours. It is your prospects/clients/customers’

than that – it is the brand that has done its job by making me

experience of your brand and how they perceive you to be

feel somehow connected and part of something. I am willing

that counts. What you want to do is persuade, and then

to pay an extortionate amount for a cup of coffee because I

reaffirm that by choosing you they have made the right

somehow feel it’s worth it!

choice.

You have to be client centric in your approach. Everything

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“A great brand raises the bar -- it adds a greater sense of

else should feed to and from this. Constantly ask yourself

purpose to the experience, whether it’s the challenge to do

“what do my clients’ want? What do they need? What do

your best in sports and fitness, or the affirmation that the

they expect? What is their perception of the value of what I

cup of coffee you’re drinking really matters.” – Howard

provide? How can I do better?”

Schultz, CEO, and chairman of Starbucks

Within the field of facial aesthetics, your brand is

“In order to build your brand, all of your marketing communications must reflect what is trying to be portrayed” particularly important. When providing clients with laser treatment, fillers and peels you are not selling them an ‘off the shelf’ product, you are selling them an experience, you are selling them a better, younger-looking, smoother-skinned

Medical Microdermabrasion From MATTIOLI ENGINEERING

version of themselves. You are providing them self-confidence which is a hugely powerful commodity.

Unique Customer Benefits

As featured on

So, why should a client decide to come to your clinic for their treatment and not your competitors? What can you offer your clients?

The market is not defined by what do you but what your customer wants. So, instead of thinking about USPs, look at the UCBs – unique customer benefits. what someone will get from using your clinic, your service, rather than just a list of features. This will help you make a connection.

Consistency You will often hear marketers harping on about the importance of integration and consistency and this is for a very good reason. In order to build your brand, all of your marketing communications must reflect what is trying to be portrayed as this is how new prospects will judge your abilities as a practitioner and will persuade them to make an appointment and not just an enquiry. It also reaffirms to existing clients that they have made the right choice.

The quality of the marketing material is perceived by prospects and clients to match the quality of care and treatment they will get from your practice and what they are willing to pay. So, if you want to charge top-end prices your website and marketing material need to be top-end too.

Are you ‘on brand’ in all that do?

So, do you think your business has the right brand? Are you getting the right message across to your target market? Take time out to cast a critical eye over the following: •

Your visual identity and marketing communications including social media

•

You and your entire team – don’t underestimate the importance of good personnel. You need everyone to be a brand ambassador.

•

The prospect/client journey. Literally ensure that every touch point of your business is ‘on brand’. This is the brand experience

You can get your unique brand’s personality across through bespoke

needle free Mesotherapy for the delivery of active substances.

photography and video and the use of real testimonials and real people. Make sure you’re standing out from the crowd and giving your customers something they’re proud to be associated with. By building and strengthening your brand you‘re looking to achieve awareness, recognition, interaction and engagement and ultimately, loyalty.

So the next time you purchase your favourite product or experience your chosen brand’s particular service, think to yourself, what makes them special and why have I chosen to buy from them.

Tel: 01234 841536 www.polarismedicallasers.co.uk

business focus

A question of law Norman Rea of Sydney Mitchell LLP outlines the implications of the Bribery Act 2010 The Bribery Act finally came into force, after some delay, on the July 1 2011.

‘So What?’ you may be asking. Some of you glancing at this article may feel that it doesn’t affect you or your business. Unfortunately the Act, and possible prosecution under it, potentially affects all of us in our working lives and I urge you to read on. The Act modernised outdated criminal law relating to bribery and other similar offences and impacts on commercial and employment law issues for individuals and organisations.

PENALTIES – MAXIMUM IMPRISONMENT 10 YEARS – UNLIMITED FINES I don’t want to scaremonger but now that I’ve got your attention I’ll continue….

Four new offences 1. Offering, promising or giving a bribe 2. Requesting, receiving or accepting a bribe 3. Bribing a foreign public official 4. ‘Corporate bribery’ whereby a company or organisation (both UK and non UK based) fails to prevent bribery by a person associated with it.

NORMAN REA Norman is an award winning employment lawyer and experienced tribunal advocate.

He has written many articles for the legal and national press. He is a member of the Employment Lawyers Association and Birmingham Law Society’s Education & Training Committee.

The last of these offences is likely to cause most concern to employers owing to its broad scope. There are far reaching consequences for those organisations that turn a blind eye to ‘facilitation’ payments and it is therefore essential that organisations take action now to ensure they know of their legal obligations and can take steps to avoid future difficulties with staff and other businesses. Unfortunately ‘facilitation’ or ‘grease’ payments are the expected ‘norm’ in some countries.

Clearly these will not be tolerated under the Act. The Act is far stricter than its American counterpart – the Foreign Corrupt Practices Act (FCPA).

Background Some of you may remember much publicised prosecutions and heavy fines imposed even before the advent of the Act. In January 2009 the Financial Services Authority (FSA) fined insurer AON £5.25 million for failing to take reasonable care to establish and maintain effective systems and controls for countering the risks of bribery and corruption.

In September 2009 the first prosecution was brought in the UK against a company for corruption abroad following a Serious Fraud Office enquiry when Mabey Johnson Limited, a manufacturer of bridge equipment, admitted paying bribes to win contracts abroad. They were fined nearly £6.5 million.

That case came after the £2.25 million fine imposed on Balfour Beatty to settle allegations of bribery, a settlement that was widely criticised for being too lenient.

Adequate Procedures Defence In relation to the offence of “failure to prevent a bribe being paid’” you can present a complete defence if you can show that you have adequate procedures in place. ‘Adequate procedures’ need only be proportionate to the size and nature of your business. Whilst major multinationals must exercise greater

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due diligence and have more detailed compliance procedures in place, such as a Reporting Officer, verbal communication may suffice for a small company so long as there is periodic staff briefing and it is made clear that you have a ‘zero tolerance’ attitude to bribery.

If there is very little risk of bribery being encountered by members of a small organisation, or agents acting on its behalf ‘associated person’, no specific and detailed bribery policy will be required.

Corporate Entertaining – Don’t cancel the tickets!

Before the Act came into force there was much concern over the question of corporate hospitality. The Government has published a Guidance on the Act, which makes clear that reasonable hospitality to ‘meet, network and get to know your clients’ will not fall foul of the new legislation. The Guide states: “Bona fide hospitality and promotional, or other business expenditure which seeks to improve the image of a commercial organisation, better to present products and services, or establish cordial relations, is recognised as an established and important part of doing business and it is not the intention of the Act to criminalise such behaviour” You will no doubt be relieved that there is now no need to cancel Twickenham, that box at Wimbledon, seats at the Grand Prix or tickets for the Olympics!

First Prosecution The Crown Prosecution Service has decided that a court employee is to be the first person to be prosecuted under the Act. You couldn’t make it up could you? An administrative clerk has pleaded guilty to a charge under S2 of the Act for requesting and receiving a bribe intending to improperly perform his functions. It is alleged that he promised an individual summonsed for a motoring offence that he could influence the course of criminal proceedings in exchange for £500. He will be sentenced later this month at Southwark Crown Court.

The published Guidance on the Act offers reassurance to small businesses that “combating bribery is about common sense, not bureaucracy”. That said however it is clear that the Bribery Act will have far reaching consequences for any organisation that turns a blind eye to it. In my opinion it would be best practice to have some form of ‘paper trail’ showing a mission statement of zero tolerance and clear guidance set out in a simple policy enabling staff to report to a single person in authority any activities which they consider dodgy.

I n t e r n a t i o n a l

I n t e r n a t i o n a l

M a s t e r

M a s t e r

C o u r s e

C o u r s e

14th Annual Congress

o n

o n

A g i n g

S k i n

A g i n g

S k i n

STAY CONNECTED!

COURSE DIRECTOR Benjamin ASCHER, Plastic Surgeon, France COURSE COORDINATORS David GOLDBERG, Dermatologist, USA Bernard MOLE, Plastic Surgeon, France Bernard ROSSI, Dermatologist, France

Y RK O U

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COURSE SCIENTIFIC SECRETARIES Olivier GERBAULT, Plastic Surgeon, France Anne LE PILLOUER PROST, Dermatologist, France Serge MORDON, PHD - Research, France

ENDA

Be inspired with two stunning events

PALAIS DES CONGRÈS

•••

The IMCAS Incubator

Do you have an idea, a technique that you would like the industry to invest in? Seize this unique opportunity to present it to R&D executives of world leading aesthetic dermatology and plastic surgery companies!

Submit your incubator idea through www.imcas.com/en/imcas2012/abstract

La Nuit des IMCAS Awards

A jury of medical experts, totally independant of the industry and of the scientific committee of IMCAS, will select the 8 most creative and promisingly useful innovative studies of the year. Winners will be granted with a 2 000 € prize each.

Submit your study through www.imcas.com/en/imcas2012/abstract

PARIS JANUARY

26-2 9

2012

Download the updated PROGRAM, submit your ABSTRACTS, and more on WWW.IMCAS.COM 8, rue Foucault 75116 Paris - France +33 (0)1 40 73 82 82 +33 (0)1 40 70 09 09

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follow us on Twitter twitter.com/imcascongress

Dates for the Diary

november

diary

bioptica Laser Safety Consultants Bioptica: Laser Core of Knowledge course given at YOUR clinic on a date that suits YOU. Visit www.bioptica.co.uk for more information or call 07766 591 085.

1-2 Medik8 Training, London, www.SkinBrands.co.uk 5 Wigmore Medical Training, Microsclerotherapy and Facial Telangiectasia, London, training@wigmoremedical.com 6 Cosmetology Advanced Facial Aesthetics, Glasgow, www.cosmetologyuk.com 7 Obagi Workshop, Manchester, www.healthxchange.com 7-8 Sterex Advanced Electrolysis, www.sterex.com 7-11 The SPM Academy Certificate of Expertise in Micropigmentation, Birmingham, www.spmacademy.com 8-9 SkinCeuticals Training, Cheshire, www.SkinBrands.co.uk 9 Stem Cell and Growth Factor Technology in Cosmetics – The Future with Dr Ahmed Al-Qahtani, Melia Whte House Hotel, London, www.skingeeks.co.uk/contact.php 9 Wigmore Medical Training, Introduction to Skincare and Chemical Peels, London, training@wigmoremedical.com 9 Dr Bob Khanna Training Institute, Botulinum Toxin Beginners, www.drbobkhanna.com 10 Dr Bob Khanna Training Institute, Botulinum Toxin Advanced, www.drbobkhanna.com 10 Wigmore Medical Training, Introduction to Boutlinum Toxin Type A, London, training@wigmoremedical.com 11 Obagi Workshop, London, www.healthxchange.com 11 Dr Bob Khanna Training Institute, Dermal Fillers – Beginners, www.drbobkhanna.com 11 Wigmore Medical Training, Introduction to Dermal Fillers, London, training@wigmoremedical.com 12 Wigmore Medical Training, Advanced Toxins and Fillers, Newcastle, training@wigmoremedical.com 12 Dermis Deep Microsclerotherapy Course, Birmingham, www.dermisdeep.com 12 Cosmetic Courses Foundation Botulinum Toxin and Dermal Fillers, www.cosmeticcourses.co.uk

december 1 The Aesthetic Awards in Association with Cosmetic News, Sopwell House, St Albans, www.cosmeticnewsuk.com 1-2 SkinCeuticals Training, Cheshire, www.

SkinBrands.co.uk 2 Genuine Dermaroller™ Medical Device Training, The Glass House Clinic, London SW, www.genuinedermaroller.co.uk 3 Dermis Deep Advanced Botox Course, Central London, www.dermisdeep.com 3 Dermis Deep Superficial and Medium Chemical Peels, Manchester, www.dermisdeep.com 3 Cosmetic Courses Foundation Botulinum Toxin and Dermal Fillers, www.cosmeticcourses.co.uk 3 Cosmetology Botox Vistabel Foundation, Glasgow, www.cosmetologyuk.com 4 Cosmetology Dermal Fillers Foundation, Glasgow, www.cosmetologyuk.com 5 Medik8 Training, Cheshire, www.SkinBrands.co.uk 5 Dr Bob Khanna Training Institute, Botulinum Toxin - Beginners, www.drbobkhanna.com 6 Dr Bob Khanna Training Institute, Botulinum Toxin - Advanced, www.drbobkhanna.com

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12 Wigmore Medical Training, Microsclerotherapy and Facial Telangiectasia, London, training@wigmoremedical.com 12 Cosmetology Botox Vistabel Foundation, London, www.cosmetologyuk.com 13 Cosmetology Dermal Fillers Foundation, London, www.cosmetologyuk.com 14 Sally Durant Training and Consultancy, The Causes, Development and Management of Acne, London, 01527 919 880 14 Genuine Dermaroller™ Medical Device Training, The Clinik, Brighouse, Yorkshire, www.genuinedermaroller.co.uk 14 Genuine Dermaroller™ Medical Device Training, The Glass House Clinic, London, www.genuinedermaroller.co.uk 14-18 The SPM Academy Certificate of Expertise in Micropigmentation, Birmingham, www.spmacademy.com 15 Laser/IPL Core of Knowledge Training, www.lasersafe.co.uk 15 Medik8 Training, Cheshire, www.SkinBrands.co.uk 16 SkinMedica Training, Cheshire, www.SkinBrands.co.uk 16 Foundation level Botulinum Toxin and Dermal Filler Training Course, Glasgow, www.inspiredcosmetictraining.com 17 Genuine Dermaroller™ Medical Device Training, Horrington Clinic, South Horrington Village, Somerset, www.genuinedermaroller.co.uk 18 Wigmore Medical Training, CPR and Anaphylaxis, London, training@wigmoremedical.com 18 Minor Surgery Update, Guildford, www.theclinicalexchange.com 19 Dermis Deep Botox Course, Manchester, www.dermisdeep.com 19 Dermis Deep Dermal Filler Course, Manchester, www.dermisdeep.com 19 Cosmetology Botox Vistabel Foundation, Birmingham, www.cosmetologyuk.com 20 Cosmetology Dermal Fillers Foundation, Birmingham, www.cosmetologyuk.com

6 SkinMedica Training, Cheshire, www.SkinBrands.co.uk 6-7 Medik8 Training, London, www.SkinBrands.co.uk 6 Genuine Dermaroller™ Medical Device Training, The Clinic, Brighouse, Yorkshire www.genuinedermaroller.co.uk 7 Genuine Dermaroller™ Medical Device Training, The Ashleigh Clinic, Leicester, www.genuinedermaroller.co.uk 7 Dr Bob Khanna Training Institute, Dermal Fillers – Beginners, www.drbobkhanna.com 7 Wigmore Medical Training, GloMinerals Workshop, London, training@wigmoremedical.com 9 Wigmore Medical Training, CPR and Anaphylaxis, London, training@ wigmoremedical.com 9 Microsclerotherapy, Guildford, www. theclinicalexchange.com 10 Meeting of the Society of Cosmetic Physicians and Surgeons (SCPS), London, www.scps-uk.org 10 Dermis Deep Botox Course, Central London, www.dermisdeep.com 10 Dermis Deep Dermal Filler Course, Central London, www.dermisdeep.com 10 Wigmore Medical Training, Microsclerotherapy and Facial Telangiectasia,

We round up upcoming events, training courses and meetings

21 Sally Durant Training and Consultancy, The Ageing Process and Skin Regeneration Practices, London, 01527 919 880 21-22 LCS Academy BTEC Medical Laser/IPL Part 2, www.lcsacademy.co.uk 21-22 Sterex Advanced Cosmetic Procedures, Birmingham, www.sterex.com 21-25 The SPM Academy Certificate of Expertise in Micropigmentation Birmingham, www.spmacademy.com 23 Wigmore Medical Training, Dermal Rollers, London, training@wigmoremedical.com 24 Wigmore Medical Training, Advanced Toxins and Fillers, London, training@wigmoremedical.com 24-26 Microsclerotherapy for Thread Veins of the Leg, www.theclinicalexchange.com 25-26 International Congress in Aesthetic and Anti-ageing Medicine, Dubai, www.euromedicom.com 26 Dermis Deep Botox Course, Belfast, www.dermisdeep.com 26 Dermis Deep Dermal Filler Course, Belfast, www.dermisdeep.com 26 Wigmore Medical Training, Microsclerotherapy and Facial Telangiectasia, London, training@wigmoremedical.com 26 Cosmetology Botox Vistabel Foundation, Manchester, www.cosmetologyuk.com 27 Cosmetology Dermal Fillers Foundation, Manchester, www.cosmetologyuk.com 28 Sally Durant Training and Consultancy, Nutrition and the Skin, London, 01527 919880 28-29 SkinCeuticals Training, London, www.SkinBrands.co.uk 29 Wigmore Medical Training, Introduction to Skincare and Chemical Peels, London, training@wigmoremedical.com 29 Marketing Your Facial Aesthetic Business for Profit, Glasgow, www.inspiredcosmetictraining.com 30 Laser Sweat Ablation, Guildford, www.theclinicalexchange.com

London, training@wigmoremedical.com 12 Genuine Dermaroller™ Medical Device Training, The Glass House Clinic, London SW, www.genuinedermaroller.co.uk 12 Obagi Workshop, London, www.healthxchange.com 13-14 SkinCeuticals Training, London, www.SkinBrands.co.uk 14 Wigmore Medical Training, Introduction to Skincare and Chemical Peels, London, training@wigmoremedical.com 14 Foundation level Botulinum Toxin and Dermal Filler Training Course, Glasgow, www.inspiredcosmetictraining.com 15 Wigmore Medical Training, Introduction to Boutlinum Toxin Type A, London, training@wigmoremedical.com 16 Wigmore Medical Training, Introduction to Dermal Fillers, London, training@wigmoremedical.com

17 Sally Durant Training and Consultancy, Investigative Consultation ad Advanced Skin Assessment, Birmingham, 01527 919 880 18 Dr Bob Khanna Training Institute, Botulinum Toxin - Beginners, www.drbobkhanna.com 19 Dr Bob Khanna Training Institute, Botulinum Toxin - Advanced, www.drbobkhanna.com 20 Dr Bob Khanna Training Institute, Dermal Fillers – Beginners, www.drbobkhanna.com 21 Cosemtic Courses Foundation Botulinum Toxin and Dermal Fillers, www. cosmeticcourses.co.uk 30 Sally Durant Training and Consultancy, Laser Hair Removal – Core Knowledge for the Aesthetic Therapist, London, 01527 919 880

January

2 Premed Taster Course, Guildford, www.theclinicalexchange.com 13 Sally Durant Training and Consultancy, The Art of Skin Peeling, London, 01527 919 880 6 Dr Bob Khanna Training Institute, Botulinum Toxin - Beginners, www.drbobkhanna.com

February

13 Obagi Workshop, Manchester, www.healthxchange.com 16 Obagi Workshop, London, www.healthxchange.com 16 Sally Durant Training and Consultancy, Advanced Skin Science, Birmingham, 01527 919 880

COSMETIC NEWS EXPO 2012, THE BUSINESS DESIGN CENTRE, ISLINGTON, APRIL 29-30 2012, WWW.COSMETICNEWSUK.COM

CosmetiC n ews E the uk’s only free of charge aesthetiCs exhibition

s i lv e r s p o n s o r

www.CosmetiCnewsuk.Com

xpo 2012 29th - 30th april 2012 | business design Centre, islington, london

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

directory

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ABC Laser Contact: Guy Gouldsmit T: 08451 707 788 E: info@a-b-c-uk.com W: www.abclasers.co.uk

Candela UK Ltd Contact: Michaela Barker T: +44 08455210698 E: alex@alexsilver.co.uk W: www.candelalaser.co.uk

Aesthetic Academy + Training Contact: Chantalle Coombes T: 0845 519 4823 W: www.aestheticstraining.co.uk E: training@aestheticacademy.co.uk

Chromogenex Service: Laser System Manufacturer Contact: Lauren Roberts T 01554 755444 E: lroberts@chromogenex.com W: www.chromogenex.com

Allergan Contact: Customer Service T: 01628 494444 W: www.juvedermultra.co.uk

Beehive Medical Solutions Contact: Kevin Rendell T: 020 8550 9108 E: enquiries@beehive-solutions.co.uk W: http: //www.beehive-solutions.co.uk/ catalog

Cosmetic Courses Contact: Morag Hague T: 0845 230 4110 E: info@cosmeticcourses.co.uk W: www.cosmeticcourses.co.uk

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Betheny Workwear Service: Uniforms Contact: Siju Jacob T: 01516 776 777 W: www.betheny.co.uk E: enquiries@betheny.co.uk

Bioptica Contact: Roy Henderson T: 07766 591 085 E: roy@biotica.co.uk W: www.bioptica.co.uk Blue Horizons Marketing T: 01242 236600 E: info@bluehorizonsmarketing.co.uk W: www.bluehorizonsmarketing.co.uk Services: Websites, patient literature, referral literature, brand image, advertising, e-marketing and more.

Boston Medical Group LTD Contact: Iveta Vinklerova T: 0207 727 1110 E: info@boston-medical-group.co.uk W: www.boston-medical-group.co.uk

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Cutera (Europe) Contact: Stephen Ritchie T: 07969993296 E: sritchie@cutera.com W: www.cutera.com

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MACOM Compression Garments Contact: MACOM Customer Services T: 020 7386 0011 E: info@macom-medical.com W: www.macom-medical.com

Morning Star Surgical S.A. (Pty) Ltd Contact: Brian Nielsen T: +27 (82) 667 2506 E: brian@morningstar-medical.com W: www.morningstarsurgical.co.za

Galderma Contact: Azzallure Sales Team T: 01923 208950 E: info.uk@galderma.com W: www.galderma.co.uk

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Polaris Lasers Contact: Neil Calder T: 01234841536 E: njc@polaris-laser.com W: www.polaris-laser.com

Rosactive Phytoceutical U.K. Contact: Mr. Naci Gulsan T: 020 85090907 E: hunalp@hunalp.co.uk W: www.rosactive.co.uk www.hunalp.co.uk Sanofi Aventis Contact: Customer Service T: 01483 554 809 W: www.sanofi-aventis.co.uk

Specialist Make-Up Services Ltd Contact: Mike Lawrence T: 0845 2302021 E: enquiries@permanent-makeup.com W: www.permanent-makeup.com Services: Permanent Make-Up

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My Cells/Scandinavian UST Ltd Contact: John Tucker T: +35361 312979 E: info@mycells.ie W: www.my-cells.net Pronokal Service: Medically supervised weight loss programme E: info@pronokal.co.uk T: 0845 604 8834 W: www.pronokal.co.uk

RECOVA COMPRESSION GARMENTS Contact: Eva Sanchez-Smith E: eva.sanchez@recovapostsurgery.com W: www.recovapostsurgery.com T: 0207 000 1044

Skin Geeks Ltd Contact: Trishna Shah T: +44 (0)1865 338046 E: trishna@skingeeks.co.uk W: www.skingeeks.co.uk

Medical Aesthetic Group Contact: David Gower T: 02380 676733 E: info@magroup.co.uk W: www.magroup.co.uk Merz Aesthetics Contact: Merz Aesthetics Customer Services T: 0333 200 4140 E: info@merzaesthetics.co.uk

Qutis Contact: Marea Brennan Thorns T: 01844 213007 E: info@qutisclinics.co.uk W: www.qutisclinics.co

Skin brands Contact: Tracey Beesley T: +44 (0) 2089978541 E: tracey@skinbrands.co.uk W: www.skinbrands.co.uk

Med-fx Contact: Faye Price T: 01376 532800E: sales@medfx.co.uk W: www.medfx.co.uk

Euromedical Systems Ltd. Contact: Phillip Richardson T: 0845 130 4949 W: www.euromedicalsystems.co.uk E: info@euromedicalsystems.co.uk

Harley Aesthetics Contact: Dr Mark Harrison T: 02074872772 E: enquiries@harleyaesthetics.com W: www.harleyaesthetics.com Services: Training

Lifestyle Aesthetics Contact: Sue Wales T: 0845 0701 782 E: info@lifestyleaestheics.com W: www.lifestyleaesthetics.com

Mayfair Medical Contact: Mike Filapiuak T: +44 02076296269 E: mike@ericson-laboratoire.co.uk W: www.ericson-laboratoire.com

E-Clinic Contact: Mark Lainchbury T: 01274 530 505 E: info@e-clinic.uk.com W: www.e-clinic.uk.com

Hamilton Fraser Contact: Wai Chan T: 0845 3106 300 E: cosmetic@hamiltonfraser.co.uk W: www.hamiltonfraser.co.uk

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Mapperley Park Training www.mapperleypark.co.uk/training Email: training@mapperleypark.co.uk Tel: 01159 690 111

DermaFx Micropigmentation Service: Permanent Make Up Contact: Evie Adams T : 08703002078 E: dermafx@evieadams.com W: www.evieadams.com

Energist Contact: Andrew Snoddon T: 01792 798768 E: enquiries@energist-international.com W: www.energist-international.com

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Lynton Contact: Customer Services T: 0845 6121545 E: info@lynton.co.uk W: www.lynton.co.uk

Eden Aesthetics Contact: Anna Perry T: 01245 227 752 E: info@edenaesthetics.com W: www.edenaesthetics.com

BioActiveBeauty Hydropeptide...the next generation of Anti-Ageing Skincare .. using peptides at clinical levels.

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Q-MED Contact: Customer Service T: 0207 796 3290 E: info.uk@q-med.com W: www.q-medpractitioner.com/uk

Health xchange Contact: Customer Service T: +44 1481 736832 E: orders@healthxchange.com W: www.healthxchange.com

LCS Academy Contact: Dr Elizabeth Raymond Brown T: 0845 0037315 E: admin@lcsacademy.co.uk W: www.lcsacademy.co.uk

Cordcourt Limited Service: Uniform Supplier Contact: Gina Unsworth T: 0161 724 6009 E: sales@cordcourt.co.uk W: www.cordcourt.co.uk

AZTEC Services Service: Exclusive UK distributor for Viora product range Contact: Anthony Zacharek T: 07747 865600 E: sales@aztecservices.uk.com W: www.aztecservices.uk.com Barnes Roffe LLP Service: Chartered Accountants, Business and Tax Advisors Contact: Shen Yap T: 020 8988 6100 E: s.yap@barnesroffe.com W: www.barnesroffe.com

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Clinical Exchange, The Contact: Matt Jago T: 0845 644 0244 E: info@theclinicalexchange.com W: www.theclinicalexchange.com

Aesthetox Academy Service: Training Contact: Lisa Tyrer T: 0870 0801746 E: treatments@aesthetox.co.uk W: www.aesthetox.co.uk

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Cosmetic news DIRECTORY

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BOCOUTURE does not require a cold chain. ®

Transport and storage does not require refrigeration prior to reconstitution.

Unopened BOCOUTURE® vials can be stored at controlled room temperature ( 25°C) for up to 3 years.

Botulinum toxin type A free from complexing proteins

BOCOUTURE® 50 Abbreviated Prescribing Information Please refer to the Summary of Product Characteristics (SmPC) before prescribing. Presentation 50 LD50 units of Botulinum toxin type A (150 kD), free from complexing proteins as a powder for solution for injection. Indications Temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown (glabellar frown lines) in adults under 65 years of age when the severity of these lines has an important psychological impact for the patient. Dosage and administration Unit doses recommended for BOCOUTURE are not interchangeable with those for other preparations of Botulinum toxin.

Reconstitution with 0.9% sodium chloride unpreserved for intramuscular injection (50 units/1.25 ml).

Standard dosing is 20 units; 0.1 ml (4 units) injected into each of the 5 injection sites: 2 injections in each corrugator muscle and 1x procerus muscle. May be increased to up to 30 units. Use a thin sterile needle (e.g. 30 gauge). Intervals between treatments at least 3 months. Not recommended for use in patients over 65 years or under 18 years of age. Use immediately after reconstitution. Superior and medial alignment of the needle should be maintained during the injection. Injections near the levator palpebrae superioris and into the cranial portion of the orbicularis oculi should be avoided.

Injections into the corrugator muscle should be done in the medial portion of the muscle, and in the central portion of the muscle belly. Contraindications Hypersensitivity to Botulinum neurotoxin type A or to any of the excipients. Generalised disorders of muscle activity (e.g. myasthenia gravis, Lambert-Eaton syndrome). Presence of infection or inflammation at the proposed injection site.

Special warnings and precautions BOCOUTURE should only be used for one patient for one session.

Should not be injected into a blood vessel. Patients may experience exaggerated muscle weakness.

Not recommended for patients with a history of dysphagia and aspiration. Seek immediate medical care if swallowing, speech or respiratory disorders arise. Adrenaline and other medical aids for treating anaphylaxis should be available. Caution if bleeding disorders of any type occur. Caution in patients receiving anticoagulant therapy or taking other substances in anticoagulant doses. Caution in patients suffering from amyotrophic lateral sclerosis or other diseases which result in peripheral neuromuscular dysfunction. Caution in targeted muscles which display pronounced weakness or atrophy. Too frequent or too high dosing of Botulinum toxin type A may increase the risk of antibodies forming. Should not be used during pregnancy unless clearly necessary. Use during lactation cannot be recommended.

Has a minor or moderate influence on the ability to drive and use machines. Interactions No interaction studies have been performed. Theoretically Botulinum neurotoxin may be potentiated by aminoglycoside antibiotics or other medicinal products that interfere with neuromuscular transmission e.g. tubocurarine-type muscle relaxants. Concomitant use with aminoglycosides or spectinomycin requires special care. Peripheral muscle relaxants should be used with caution. 4-aminoquinolines may reduce the effect. Undesirable effects Usually, undesirable effects are observed within the first week after treatment and are temporary in nature. Localised muscle weakness, blepharoptosis,

localised pain, tenderness, itching, swelling and/or haematoma can occur in conjunction with the injection. Temporary vasovagal reactions associated with pre-injection anxiety, such as syncope, circulatory problems, nausea or tinnitus, may occur. Frequency defined as follows: very common (≥ 1/10); common (≥ 1/100, < 1/10); uncommon (≥ 1/1000, < 1/100); rare (≥ 1/10,000, < 1/1000); very rare (< 1/10,000). Infections and infestations; Uncommon: bronchitis, nasopharyngitis, influenza infection.

Psychiatric disorders; Uncommon: depression, insomnia Nervous system disorders; Common: headache. Uncommon: facial paresis (brow ptosis), vasovagal syncope, paraesthesia, dizziness. Eye disorders; Uncommon: eyelid oedema, eyelid ptosis, blurred vision, eye disorder, blepharitis, eye pain.

Ear and Labyrinth disorders; Uncommon: tinnitus. Gastrointestinal disorders; Uncommon: nausea, dry mouth. Skin and subcutaneous tissue disorders; Uncommon: pruritus, skin nodule, photosensitivity, dry skin. Musculoskeletal and connective tissue disorders; Common: muscle disorders (elevation of eyebrow), sensation of heaviness; Uncommon: muscle twitching, muscle cramps. General disorders and administration site conditions Uncommon: injection site reactions (bruising, pruritis), tenderness, Influenza like illness, fatigue (tiredness). General; In rare cases, localised allergic reactions; such as swelling, oedema, erythema, pruritus or rash, have been reported after treating vertical lines between the eyebrows (glabellar frown lines) and other indications. Overdose Increased doses of Botulinum neurotoxin type A may result in pronounced neuromuscular paralysis distant from the injection site. Symptoms of overdose are not immediately apparent post-injection and may include general weakness, ptosis, diplopia, speech difficulties, paralysis of the respiratory muscles and swallowing difficulties which may result in an aspiration pneumonia. BOCOUTURE may only be used by physicians with suitable qualifications and proven experience in the application of Botulinum toxin.

Prescriber should consult the SmPC for full information regarding side effects. Legal Category: POM. Basic NHS Price 50 U/vial £72.00 Product Licence Number: PL 29978/0002 Marketing Authorisation Holder: Merz Pharmaceuticals GmbH, Eckenheimer Landstraße 100, 60318 Frankfurt/Main, Germany.

Date of revision of text: June 2010. Full prescribing information and further information is available from Merz Pharma UK Ltd., 260 Centennial Park, Elstree Hill South, Elstree, Hertfordshire WD6 3SR. Tel: +44 (0) 333 200 4143 Adverse events should be reported. Reporting forms and information can be found at www.yellowcard.gov.uk. Adverse events should also be reported to Merz Pharma UK Ltd at the address above or by email to medical.information@merz.com or on +44 (0) 333 200 4143.

1047/BOC/JAN/2011/JH. Date of preparation: Jan 2011.

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

C

onfidence is...

Her happiness.

Your expertise.

Our experience.

Vistabel® is licensed for the treatment of moderate to severe glabellar lines Delivers lasting patient satisfaction, time after time1,2 Trusted with over 1 million cosmetic procedures across Europe3* The world’s first and most studied botulinum toxin4†

Satisfaction that shows

Vistabel® (botulinum toxin type A) Abbreviated Prescribing Information Presentation: Botulinum toxin type A (from clostridium botulinum), 50 Allergan Units/vial.

Indications: Temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown, in adults <65 years, when the severity of these lines has an important psychological impact for the patient.

Dosage and Administration: See Summary of Product Characteristics for full information.

Do not inject into blood vessels. Doses of botulinum toxin are not interchangeable between products. Not recommended for patients <18 or >65 years. Use for one patient treatment only during a single session. Reconstitute vial with 1.25ml of 0.9% preservative free sodium chloride for injection (4U/0.1ml). The recommended injection volume per muscle site is 0.1ml (4U). Five injection sites: 2 in each corrugator muscle and 1 in the procerus muscle: total dose 20U. Contra-indications: Known hypersensitivity to any constituent. Myasthenia gravis, Eaton Lambert syndrome. Infection at proposed injection sites. Pregnancy or lactation.

Warnings/Precautions: Use for one patient treatment only during a single session.

Relevant anatomy and changes due to prior surgical procedures must be understood prior to administration. Product contains less than 1mmol sodium (23mg) per dose. Do not exceed recommended dosages and frequency of administration. Epinephrine (adrenaline) or any other anti-anaphylactic measures should be available. Very rare reports of adverse reactions possibly related to spread of toxin distant from site of injection. Therapeutic doses may cause exaggerated muscle weakness. Caution in patients with history of dysphagia and aspiration. Patients or caregivers should seek immediate medical care if swallowing, speech or respiratory disorders arise. Too frequent or excessive dosing can result in risk of antibody formation, which may lead to treatment failure. Caution in the presence of inflammation at the proposed injection site(s) or when excessive muscle weakness or atrophy is present. Caution when used in patients with amyotrophic lateral sclerosis or with peripheral neuromuscular disorders. Effects of administering different botulinum toxin stereotypes simultaneously, or within several months of each other, is unknown and may cause exacerbation of excessive neuromuscular weakness.

Interactions: Theoretically, effect may be potentiated by aminoglycoside antibiotics or other drugs that interfere with neuromuscular transmission.

Adverse Effects: See Summary of Product Characteristics for full information on side effects. Based on controlled clinical trial data, the proportion of patients that would be expected to experience an adverse reaction after treatment is 23.5% (placebo: 19.2%).

These adverse reactions may be related to treatment, injection technique or both. In general, reactions occur within the first few days following injection and are transient and of mild to moderate severity. Pain/burning/stinging, oedema and/or bruising may be associated with the injection. Frequency By Indication: Defined as follows: Very Common (≥1/10), Common (≥1/100, <1/10), Uncommon (≥1/1,000, <1/100), Rare (≥1/10,000, <1/1,000), Very Rare (<1/10,000). Infections and infestations. Uncommon: Infection.

Psychiatric disorders. Uncommon: Anxiety. Nervous system disorders. Common: Headache. Uncommon: Paresthesia, dizziness. Eye disorders. Common: Eyelid ptosis.

Uncommon: Blepharitis, eye pain, visual disturbance. Gastrointestinal disorders.

Uncommon: Nausea, oral dryness. Skin and subcutaneous tissue disorders. Common: Erythema, Uncommon: Skin tightness, oedema (face, eyelid, periorbital), photosensitivity reaction, pruritus, dry skin. Musculoskeletal and connective tissue disorders. Common: Localised muscle weakness, Uncommon: Muscle twitching. General disorders and administration site conditions. Common: Face pain, Uncommon: Flu syndrome, asthenia, fever. The following have been reported rarely for glabellar lines and other indications: rash, urticaria, pruritus, erythema multiforme, psoriasiform eruption, anaphylactic reaction (angiodema, bronchospasm), alopecia, madarosis, tinnitus and hypoacousia. Adverse reactions possibly related to spread of toxin distant from injection site have been reported very rarely (muscle weakness, dysphagia, or aspiration pneumonia which can be fatal).

Price: £85.00 per vial.

Marketing Authorization Number: PL 05179/0010 Marketing Authorization Holder: Allergan Pharmaceuticals (Ireland) Ltd., Westport, Co. Mayo, Ireland.

Legal Category: POM. Date of preparation: December 2008.

Adverse events should be reported.

Reporting forms and information can be found at www.yellowcard.gov.uk Adverse events should also be reported to Allergan Ltd. UK_Medinfo@allergan.com or 01628 494026 References: 1. Stotland MA et al. Plast Reconstr Surg, 2007;120:1386-1393.

2. Carruthers A et al. Journal of Clinical Research, 2004;7:1-20. 3. Allergan Data on File (DoF) VIS/003/DEC 2010. 4. Allergan Data on File (DoF) VIS/005/MAR 2011. *Given in 5 key EU countries since VISTABEL® launch. Data taken from UK, France, Spain, Italy and Germany.

Global figures. Launched in 1989 in the U.S. Search strategy conducted using; Medline, Embase, Embal, Biosis, SciSearc, Pascal, HCAPlus, IPA. Search applied to Allergan, Ipsen & Merz botulinum toxin type A presentations (cosmetic indication).

†

Date of search: February 2011.

UK/0101/2011 Date of Preparation: March 2011