Aesthetic Medicine November 2017 PDF

NOVEMBER 2017 www.aestheticmed.co.
uk
ISSUE 37
M ED I CI N E
FAST WORK LED THERE BE LIGHT BLIND SPOT

NOVEMBER 2017
he benefits o asting L ED D ossier B lindness as a complication
• INSPIRING BEST PRACTICE IN MEDICAL AESTHETICS •
OFC AM NOV17.indd All Pages 27/10/2017 16:05

AES_Advert_DPS_ProfessionalBeauty.qxp_Layout 1 15/08/2017 15:08 Page 1
THE UK’S LEADING LASER

AND AESTHETIC SUPPLIER
JUST GOT EVEN BETTER
The worlds most powerful Alexandrite and Diode Laser for rapid hair removal results.
Nd:YAG blended laser with a 30mm spot size. Three wavelengths, 755, 808 and 1064nm.
AES is the UK’s leading distributor of the most advanced laser and
aesthetic platforms for use in medical and cosmetic procedures.
Within our portfolio we offer some of the most ground breaking
technologies such as the most powerful Alexandrite/Nd:YAG
blended laser treating a full body in 31 minutes, the most advance
multiplatform laser that enables to grow with your business, the
award winning Lipofirm brand that is the celebrities and
professionals choice.
If you are looking to take your business to a new dimension with
technology that will give you the point of difference with some of
the best unique selling points then call the team at AES for a
demonstration.
AES, THE AWARD WINNING BRAND

THAT DELIVERS RESULTS
The most advanced multiplatform
laser with up to 6 hand pieces , Nd:YAG, Q-Switch, IPL,
AWARD WINNING PRODUCTS Er:YAG, Er:Glass and IR.
6051 AES with Stand.indd 2 30/10/2017 10:12

The Award Winning Lipofirm Pro, Inch Loss, MED TriLipo, TriPollar, DMA TriFractional and
Body Contouring, Cellulite, Facial and Body Skin Tightening. VoluDerm, the complete facial and body contouring platform.
The complete aesthetic facial platform The 4 in 1 Super Facial, exfoliation, infusion,
incorporating VoluDerm, TriFractional and TriPollar with oxygenation and TriPollar radio frequency.
Dynamic Muscle Activation.
For further information call 02920 231228 Advanced Esthetics Solutions Ltd
or email sales@advancedesthetics.co.uk 8 Churchill Way
www.advancedestheticssolutions.co.uk @aesolutionsuk Cardiff CF10 2DX
6051 AES with Stand.indd 3 30/10/2017 10:11

The VENUS VERSA
“A multi-platform workstation that
puts the most in-demand aesthetic
treatments in your hands.
Powered by Intense Pulsed Light
and Radio Frequency using
SmartpulseTM technology”
ACNE SCARS
PIGMENTED, VASCULAR LESIONS
HAIR REMOVAL
REDUCTION OF WRINKLES, RHYTIDES
One workstation puts all the most in-demand SKIN TIGHTENING & REJUVENATION
aesthetic treatments in your hands
Before After
IPL Handpiece with 7 applications NanoFractional RF™ with

Venus Concept is a progressive thinking company driven by our passion
SmartScan™ Handpiece
to create cutting edge technologies and products. While resting on strong
ethical morals, we push boundaries in order to create new standards in
the industry.
We offer a superior partnership with an unmatched customer service, full
marketing support and ongoing training with a superior warranty program.
FDA approved / Medically CE Certified
With over 3 million Venus Concept treatments performed every year
across the globe, patients worldwide are raving about their effectiveness
and safety – call now to book an in salon demonstration
Diamond-Polar ™ Handpiece Octi-Polar™ Handpiece

Telephone: 0208 748 2221
email info.uk@venusconcept.com www.venusconcept.com

WINNER FINALIST
USEF UL INF O R M A T IO N
www.aestheticmed.co.uk
Contents
NOVEMBER
0 6 NEWS AND ANALYSIS BUSINESS

6 NEWS 22 TALKING TO
The latest news from the We chat to Matthew Rundle,
industry director of Mayfair Aesthetics
Laser & Skin Clinics
16 NEWS SPECIAL REPORT
Level 7 – the facts 24 BUSINESS MINDSET
Dr Harry Singh writes
EDITORIAL 20 AESTHETIC MEDICINE about Passion, Purpose
Vicky Eldridge NORTH
and Proposition
E: vicky@aestheticmed.co.uk We tell you what went on at
T: +44 (0) 203 841 7362 Aesthetic Medicine North 2017
30 VIDEO MARKETING
Jon Mowat on how to press
ADVERTISING 16 play on your video strategy
Charles Mostyn
E: charles@aestheticmed.co.uk 32 CONTENT MARKETING
Mark Masters explains why
T: +44 (0) 207 349 4792
you shouldn’t put all your
Steve James eggs in the Facebook basket
E: steve@aestheticmed.co.uk
T: +44 (0) 207 349 4792 36 DATA PROTECTION
GDPR – stop worrying,
CLASSIFIED get a plan and get moving
Nur Suleyman
38 EMPLOYMENT
E: nur@aestheticmed.co.uk
Should your aesthetic
T: +44 (0) 207 349 4796
clinicians be self-employed
or company employees? >
MARKETING
Chloe Skilton
E: chloe@aestheticmed.co.uk 32
T: +44 (0) 207 351 0536
2 0
PUBLISHER
Mark Moloney
E: mark@aestheticmed.co.uk
T: +44 (0) 207 351 0536
DESIGN AND PRODUCTION

ICD, www.icd.gb.com
PRINTING
Headley Brothers
www.headley.co.uk
30
SUBSCRIBE
Annual print subscription UK: £49.00;
Europe: £59.50; outside Europe: £67.30
To receive your copy of Aesthetic Medicine every
month call 01371 851875 or see
www.escosubs.co.uk/aestheticmedicine
The publisher accepts no responsibility for any 46

advertiser whose advertisement is published in
Aesthetic Medicine. Anyone dealing with advertisers
must make their own enquiries.
M 2 Media
Unit 1.17 The Plaza
535 Kings Road
London
SW10 0SZ
Aesthetic Medicine • November 2017 3
003-004 AM NOV17 Contents.indd 3 30/10/2017 13:00

C O NT ENT S
IN THIS ISSUE... www.aestheticmed.co.uk
68 7 2 7 8
SKIN INJECTABLES NUTRITION PSYCHOLOGY 80 TREATMENT FOCUS

We find out about the
40 A-Z 54 MANAGING 62 FASTING 68 BODY DYSMORPHIA Duetto MT from Lynton
Dr Johanna Ward gives an COMPLICATIONS Nutritionist Kim Pearson BDD in aesthetic
overview of viral warts The Aesthetic on the benefits of fasting practitioners 84 DEVICES NEWS
Complications Expert The latest device based
42 SKINCARE SPY Group updates its 64 COLLAGEN DEVICES products and treatments
We take a peek inside guidance on blindness Dr Johanna Ward asks,
the bathroom cabinet of as a complication is collagen the new 72 DOSSIER 86 OUT AND ABOUT
aesthetic professionals from fillers superfood? LED devices Out and about in the
industry this month
44 TRIED AND TESTED 60 EDITOR’S CHOICE 78 CLINIC PROFILE
Jo Martin reviews Vicky Eldridge tries We visit The Doctors
Endocare CELLPRO out Profhilo Laser Clinic in Norwich
46 ANATOMY
Dr Sotirios Foutsizoglou
writes about the 64
65
anatomy of scars
50 SKIN NEWS
New products and
treatments for the skin
Welcome
to the November issue
of Aesthetic Medicine.
Body Dysmorphic Disorder (BDD) is something aesthetic practitioners may
encounter regularly within their clinics. BDD is a serious mental health disorder
where patients become obsessed with a minor or non-existent flaw to the extent
that they become severely depressed and suicidal. Around 75% of people with
BDD seek aesthetic treatments, however, only 2% benefit with most tending to be
dissatisfied with the results and experience a worsening of their BDD symptoms.
5 4 It’s important for aesthetic practitioners to be vigilant around BDD in patients but
also in themselves. To ascertain how prevalent BDD or disordered thinking around
appearance was among practitioners, Dr Steven Harris and Dr Neetu Johnson carried
out a first-of-its-kind survey at some recent conferences. In this month’s issue, they
present their findings. The article makes for interesting reading and sheds some
light on an important, little-talked-about problem. Turn to pages 68-70 to read
the outcome of this insightful study.
I hope you enjoy this month’s magazine and as always welcome
your feedback and suggestions.
Vicky Eldridge - Editor
4 Aesthetic Medicine • November 2017
003-004 AM NOV17 Contents.indd 4 30/10/2017 13:02

DUETTO MT EVO
Using the latest

laser hair removal
technology?
Upgrade to ‘Mixed Technology’ for Simultaneous Delivery
of a TRUE Alexandrite (755nm) & Nd:YAG (1064nm)
Find out more at

lynton.co.uk/duetto-mt
Call Lynton today on 01477 536 977

or visit lynton.co.uk
Untitled-9 1 26/10/2017 15:11

NEW S A ND A NA L Y SIS
INDUSTRY NEWS www.aestheticmed.co.uk
F irst O fq ual-regulated
evel qualifications
for cosmetic
inj ectables aw arded
Industry Qualifications (IQ) has announced the award of based examination, undertake a series of eight practical
the first Ofqual-regulated qualifications for Injectables examinations in a simulated environment and to observe
in Aesthetic Medicine at Level 7 (post graduate level). Dr 10 and undertake 10 treatments using botulinum toxin and
Emily Macgregor, Dr Harriet Bradley and Dr Kim Booysen dermal fillers.
achieved their qualifications at Harley Academy. According to Raymond Clarke, chief executive of IQ,
The IQ qualification was developed following guidelines “The qualification is demanding, even for those that have
published by Health Education England in November 2015 been medically trained, and sets a new benchmark for
and the General Medical Council in April 2016. professionals working in the sector. I would particularly
The qualification requires students to study a like to acknowledge the work of the Harley Academy
collection of subjects including relevant ethical and legal and in particular Dr Tristan Mehta for his support in the
requirements, key treatment principles, the necessity of development of this qualification”.
client-centred care, the role of psychology within aesthetic IQ has reported that five centres are now approved
medicine, key principles of dermatology and the actions, to offer the qualification, details of which are available
risks and management options associated with botulinum from IQ. Some 100 people are currently registered on the
toxin and/or dermal filler administration. programme and IQ is expecting a significant increase as the
Candidates are required to pass a challenging essay- launch of the JCCP registers nears.
H ackers target L ondon B ridge P lastic Surgery

London Bridge Plastic Surgery has been targeted by cyber-
criminals who stole sensitive data from the clinic and hacked
their social media channels.
The clinic, which not only has numerous celebrity clients
but does a lot of work with transgender patients, said it was
“horrified” that its patients had been targeted in the cyber-
attack, which is now being investigated by police. At the time of
going to print, no arrests had been made.
The group behind the attack has been described as “highly
sophisticated” and is said to be well known to international
law enforcement agencies, having targeted large US medical
providers and corporations over the past year.
W omen suffering w ith facial burns after

buying cheap skin peels on eB ay
Experts are warning consumers about the dangers of
buying cheap skin peels on eBay after reports of people
suffering facial burns.
The products, being sold by rogue manufacturers for as little
as £11, were being advertised as medical-grade chemical peels
but contained up to 100% pure acid and UK banned substances
like trichoroacetic acid (TCA). The seller advertised the peel
as “great for skin lightening” and said it could improve skin
conditions such as acne, age spots and fine lines.
Hannah Smith from Wiltshire told The Daily Mail she was
left “in agony” after using a TCA product bought on eBay.
She was told by her doctor that she was lucky not to need can cause as “tantamount to an acid attack”.
surgery. An eBay spokesperson said that “this type of item A spokesperson for the Department of Business
is prohibited on our UK platform” and has since removed it. commented, “The use of trichloroacetic acid is banned
Campaign group Safety in Beauty received 27 reports for use in cosmetic products and Trading Standards have
of chemical peels gone wrong in the past year. Founder powers to take action where a product is found to be unsafe
Antonia Mariconda described the potential damage they or otherwise unlawful.”
006-012 AM NOV17 News.indd 6 30/10/2017 15:36

www.aestheticmed.co.uk INDUSTRY NEWS
Rise in male treatments

leads to dev elopment
o se -specific protocols
for lasers and dev ices
A study examining the use of lasers and energy-based
devices in men has concluded that operators should use
sex-specific treatment approaches to get the best results
for their male clients.
The paper, published in the journal Dermatological
Surgery, claimed that, while the demand for cosmetic
treatments with devices had increased among men, there seek cosmetic treatment, which include photo-damage, actinic
was a “dearth of literature that addresses the approach and damage, acne scarring, rhinophyma, hair removal, axillary
treatment of cosmetic male patients.” hyperhidrosis, and loose neck/submental skin.
The authors reviewed sex-specific treatment Cosmetic issues touched on, but whose approaches or
recommendations regarding the use of lasers and energy- considerations vary less in men compared with women, were
based devices for the conditions for which men most commonly hyperpigmentation, vascular lesions, and facial rejuvenation.
Correctiv e treatments on
the rise, according to surv ey
of aesthetic professionals
Almost three quarters (72%) of UK aesthetic professionals
have had to correct the work of another practitioner,
according to a new study by CCR Expo, with 77% saying they
have had to perform a corrective treatment in the past year.
Respondents suggested a key problem is that too few
people ask to see someone’s qualifications or examples of
their previous work before having a treatment, with 74%
saying not enough checking is done. A further 84% also
argued that the lack of regulation of non-surgical beauty
treatments is part of the problem, resulting in far too many
untrained people providing them.
H ealthcare I mprov ement Scotland publishes updated

Enforcement P olicy as national regulation tightens up
Healthcare Improvement Scotland (HIS), the regulator for independent
healthcare services in Scotland, published an updated version of its
Enforcement Policy last month.
It became law for private independent clinics with practising doctors,
nurses or dentists to register with the body in April 2017. However, a significant
number are still yet to register. Enforcement action will begin in the next few
months against those clinics that continue to avoid registration. This could
lead to criminal proceedings being actioned against them and could result in a
fine of up to £5,000 or even a prison sentence for those found guilty.
HIS is now urging clinics that think they should be registered to contact
them to avoid prosecution.
Enforcement action may also be taken against clinics that are
registered with HIS but that do not operate to an appropriate standard.
Those that are not up to par may have their registration revoked unless
significant improvement is demonstrated within a specific timescale.
To read the Enforcement Policy, visit the HIS website
healthcareimprovementscotland.org.
006-012 AM NOV17 News.indd 7 30/10/2017 15:48

NEW S IN BR IEF
FDA APPROVES BOTOX COSMETIC
FOR FOREHEAD LINES
Allergan has announced the FDA approval of
Botox Cosmetic for the temporary improvement
in the appearance of moderate to severe
forehead lines associated with frontalis muscle
activity in adults. This approval makes the brand
the first neurotoxin indicated for three facial
treatment areas – forehead lines, crow’s feet
lines and glabellar lines. Botox is also the only
neurotoxin brand to receive approval of aesthetic
indications beyond glabellar lines in the US.
Study examines the role of anxiety
SCHUCO INTERNATIONAL
CELEBRATES 60-YEAR ANNIVERSARY in stress-related skin disease
Last month saw the 60th anniversary of Schuco
A study published in the British Journal of Dermatology has given insight into the
International as a supplier of dermatology, surgical
psychological factors affecting skin disease, by examining the role of anxiety
and aesthetic products in the UK. Paul Huttrer,
chief executive at Schuco International, said, “We
sensitivity (AS) social concerns in relation to stress and skin disease quality of
are immensely proud of Schuco’s achievements life (QOL).
over the last 60 years – working closely with The study entitled ‘Stress and Skin Disease Quality of Life: The Moderating
the medical community to help improve patient Role of Anxiety Sensitivity Social Concerns’ noted that while stress is
experiences through innovative technology. widely acknowledged as an important factor in the onset, exacerbation, and
By keeping our core values at the heart of our reoccurrence of many skin diseases, little is known about psychological risk
business, we will continue to expand the support, factors that impact the association between stress and dermatologic conditions.
expertise and training we offer our customers.” 237 people with active skin disease symptoms were recruited for the study
online and completed questionnaires assessing stress, AS social concerns, skin
OFAA ANNOUNCES PERI-ORBITAL disease QOL, and global skin disease symptom severity.
AND PERI-ORAL ANATOMY COURSES The research found that AS social concerns moderated the association between
The Oculo-Facial Aesthetic Academy (OFAA) stress and skin-related emotional and social functioning in adults with skin disease.
is launching a new course on restoration and
Stress was linked to skin disease-related emotional and functional impairment
rejuvenation of the peri-orbital and peri-oral
among individuals with high AS social concerns. These results highlight the potential
areas using non-surgical injectable treatments.
The course will be held on December 9 at Guy’s for AS reduction interventions to break the vicious cycle of stress and skin disease
Campus, King’s College London. Delegates symptoms and to improve psychosocial well-being in dermatology patients.
will get a comprehensive understanding of
facial anatomical layers using fresh cadavers
and prosections. The “wet-lab” will cover safe
reproducible filler injection techniques. They
RCSEd launches campaign to target
will also learn how to avoid complications.
bullying epidemic among surgeons
RECORD RISE IN REVISIONS FOR In the first UK study of its kind published in its journal The Surgeon, the Royal
BOTCHED SURGERY SAYS BAAPS College of Surgeons of Edinburgh has revealed that a staggering one in six
In an internal survey of members of The British surgical trainees suffer from Post-Traumatic Stress Disorder (PTSD) and that
Association of Plastic Surgeons , 80% said
aspiring surgeons are three times more likely to be victims of bullying than
they had witnessed an alarming increase
anyone else in the NHS.
in requests from patients to correct failed
cosmetic procedures during the last five years, Both can have serious implications for patient safety, with healthcare
with some members counting as much as a third professionals attributing disruptive behaviour in the perioperative area alone to
of their own practice as fixing other people’s 67% of adverse events, 71% of medical errors, and 27% of perioperative deaths.
mistakes. Members identified patients being In addition to the human cost, it has been estimated that this issue costs the
incorrectly selected for the initial surgery, NHS £13.75billion annually.
the original procedure being carried out by In response, the Royal College of
someone with inadequate training and going Surgeons of Edinburgh has launched an
abroad for procedures as the main causes. Undermining and Bullying initiative, to
encourage healthcare professionals to
ADULT BURN SUPPORT UK WEBSITE speak up and stamp out bullying. It is also
GOES LIVE campaigning for the General Medical
Dan’s Fund for Burns, a registered UK charity
Council to introduce compulsory training
offering practical support to adult burn
on bullying, including medical education
survivors, has announced a new adult burn
support website adultburnsupportuk.org. The
(CPD) credits for all foundation-year
site brings together helpful resources and doctors and processes introduced, so
information for burned adults, families and individuals who bully and undermine have
friends and burns practitioners. their training responsibilities removed.
006-012 AM NOV17 News.indd 8 30/10/2017 15:40

DON’T MISS OUT ON SUCCESS
By overwhelming client demand...
SOPRANO© PLATINUM™
Nothing else!
3 lasers in a single pulse for unbeatable results and unparalleled safety.
Multi award winning laser Best treatment of the year Best treatment innovation Best clinical breakthrough
abclasers.co.uk info@abclasers.co.uk 0845 170 7788
SopranoPlatinumAdvertPrintReady v2.indd 1 10/08/2017 10:19

N ew rules proposed for

plastic surgeons posting
surgery on social media
Guidelines for how surgeons should behave on social media
have been published in the Plastic and Reconstructive
Surgery Journal in a bid to address what has been described
as “circus”-like behavior from some practitioners.
Streaming or posting on social media during live surgery has
become an increasingly popular trend but there has been
no regulation or direction regarding what is appropriate
or allowed. Surgeons are already required to obtain consent before
Examples cited in the paper included a plastic surgeon posting identifying videos and photos of patients, but the
cradling fat removed from a tummy-tuck in his arms like a authors question the validity of the consent due to the power
baby and then putting a baby face on it using a Snapchat filter. dynamics in patient-doctor relationships.
Other doctors dressed in costumes, danced and flaunted “There is increasingly vulgar content by a growing number
removed body tissue on camera. of plastic surgeons,” said senior author Dr Clark Schierle, a
Proposed guidelines include obtaining written consent faculty member of Northwestern University Feinberg School
from patients before posting their operations on social of Medicine. “We want to create guidelines that balance the
media channels and informing patients that they have the need for plastic surgeons to post on social media, but we also
right to refuse or change their mind regarding online posts. want to maintain some element of professionalism.”
Capsular contracture rates hav e more than doubled since 2 0 1 3

The number of women experiencing capsular contracture
after breast augmentation has more than doubled in three
years, figures show.
In 2013 there were 148 reported cases of capsular
contracture — scar tissue forming around the implant which
feels solid to touch — but this figured had risen to 377 by 2016.
The complaints are logged by the Medicines and Healthcare
Products Regulatory Agency as “adverse reactions”. However
Caroline Payne, a spokesperson for the British Association of
Aesthetic Plastic Surgeons, said the figures were “slightly
skewed” as more implants are staying in for longer before
they are changed.
According to BAAPS figures, more than 7,000 women had
breast implants in the UK in the last year.
I nj ection techniq ue inspired by

make-up artistry outlined in j ournal
A paper has been published in the Aesthetic Plastic Surgery
Journal outlining a new approach to cheek volume restoration
that has been inspired by make-up artistry.
The paper, entitled ‘A Novel and More Aesthetic Injection
Pattern for Malar Cheek Volume Restoration’, described a new
injection pattern for restoring facial contours with hyaluronic
acid dermal fillers, which includes greater superolateral
positioning of injection sites.
The technique is said to help injectors avoid creating an
excess of volume in the anterior portion of the malar complex.
Contributing authors and injectors, who now use this technique
exclusively, claim it has provided optimal aesthetic results for
hundreds of patients with no observables complications.
The malar cheek contributes much to the aesthetic curvature
of the face and the authors say the new technique helps achieve
a greater aesthetic outcome in the correction of midface contour
deficiencies, which consistently results in high patient satisfaction.
006-012 AM NOV17 News.indd 10 30/10/2017 15:40

Harmony XL PRO TM
Spectrum
Get the celebrity of Solutions
treatment
AWARD WINNING LASER PLATFORM 70+ FDA APPROVED TREATMENT INDICATIONS

TM TM
&
HOME TO: ‘Hollywood Facelift’ the

world’s most advanced anti-
Perfecting problematic
complexions with a
ageing laser with no pain & cooling, vacuum-assisted
no downtime. laser.
Skin Remodelling Vascular Lesions Pigmented Lesions Tone & Texture Hair Removal Acne
abclasers.co.uk 0845 170 7788
HarmonyXLAdvert.indd 1 04/10/2017 09:22

NEW S IN BR IEF
RARE CANCER LINKED WITH
TEXTURED IMPLANTS UNDER REPORTED
A rare cancer in patients with breast implants may be
on the rise, but not all patients and physicians may be
aware of the risks, according to a group of Penn State
College of Medicine researchers. Breast implant-
associated anaplastic large cell lymphoma (or BIA-
Platelet-rich plasma plus hyaluronic
ALCL) is a rare peripheral T-cell lymphoma that
may develop in patients with breast implants. The
acid improves skin rejuvenation
researchers said the cancer is likely underreported, Autologous platelet-rich plasma (PRP) combined with hyaluronic acid (HA) improves
and although it appears to be linked with a certain
skin firmness and elasticity, according to a research letter published in the Journal
type of implant, more research is needed to identify
of the American Academy of Dermatology.
the specific cause. The results were published in a
research review in JAMA Surgery last month.
Dr Barbara Hersant and colleagues from the Henri Mondor Hospital in Paris,
conducted a prospective study to examine the clinical benefit of combining PRP
CONCERN OVER USE OF EMOJIS FOR and HA effectors. Outcomes were assessed at baseline, before injection, and at
PROMOTING COSMETIC SURGERY one, three, and six months after the last injection session. Thirty-one patients were
The Cadogan Clinic, based in Chelsea, London, is recruited and included in the trial. They observed significant improvement at six
calling for more awareness of the impact of social months versus baseline in the validated subjective scale. Significant improvement
media on self-image. Surgeons also highlighted was also seen in biophysical measurements for the net elasticity parameter.
concerns over social media accounts of clinics
sharing ‘sad’ emojis on pictures of pre-op patients
and then happy emojis on post-surgery images. They
described this form of promotion on platforms such
as Instagram as “irresponsible”. The Advertising
Standards Authority (ASA) does not prohibit the
use of emojis, however, it requires clinics to be
responsible in their advertising on social media.
SAVE FACE ANNOUNCES CONSENTZ

AS PREFERRED SOFTWARE PARTNER
Save Face has announced Consentz as its
preferred software partner. The collaboration
aims to promote shared safety standards in the
aesthetics specialty. Clinical director of Save
Face Emma Davies said, “Save Face has selected
Study finds link between cosmetic
Consentz as it supports practitioners in keeping
good electronic records, which are necessary to
surgery and quitting smoking
be compliant with data protection requirements. The results of a long-term follow-up study published in Plastic and Reconstructive
Surgery has shown that patients undergoing cosmetic surgery who have been
BAHRS DEVELOPS INSPECTION GUIDE advised to quit before their procedure will stop smoking, or at least smoke less,
WITH CQC TO IMPROVE PATIENT SAFETY in the years after their op.
The British Association of Hair Restoration Surgery
The study included 85 patients who were smokers when evaluated for
(BAHRS) has partnered with the Care Quality
Commission (CQC) to create an inspection guide cosmetic surgery. Patients were advised to refrain from smoking for at least two
to promote safety for patients undergoing hair weeks before elective procedures. Five years after cosmetic surgery, 47 patients
restoration surgery. The aim is to aid CQC advisors in responded to a follow-up survey. After exclusion of five “social” smokers, the
making correct assessments when inspecting clinics study included 42 patients who were daily smokers before cosmetic surgery.
that do hair restoration surgery. BAHRS believes In the follow-up survey, about 40% said they no longer smoked cigarettes on a daily
there’s been an increase in unethical advertising in basis. Nearly one-fourth had not smoked at all since their cosmetic surgery procedure.
the sector and will be working with the Advertising Most patients said they had reduced their cigarette intake and 70% agreed that
Standards Authority (ASA) to ensure marketers of discussing their increased surgical risks with the plastic surgeon influenced their
hair transplant surgery comply with regulations. ability to quit or reduce smoking.
NEW S IN P IC T UR ES
EF Medispa directors Theo and Rudi Fieldgrass have been out on the golf course raising money
for Great Ormond Street Hospital’s children’s charity (GOSH). Teams competed under the
leadership of rowing legend Sir Matthew Pinsent CBE and former England pro Jason Leonard
OBE at Stoke Park Golf Club. Last year, the day raised £80,000 to fund an enclosed isolation
recovery bay at Great Ormond Street Hospital. The new bay will allow the hospital’s young
patients the opportunity to recover in a safe environment after major and life-saving surgery.
006-012 AM NOV17 News.indd 12 30/10/2017 15:41

Your one
Your one
stop shop
stop shop
for all your
for all your
aesthetic
aesthetic
needs
supplies.
Preferred pharmacy
Preferred for many
pharmacy forleading
many brands.
leading brands.
PROU D SPONSOR OF
TH E AESTHETICS AWARDS 20 1 7
BEST CLINIC MIDLANDS & WALES
Cosmedic Pharmacy Tel: 0845 388 3880

Sherwood House Fax: 0845 388 3881
2 Albert Road, Tamworth Email: info@cosmedicpharmacy.co.uk
Staffordshire, B79 7JN. Web: |www.cosmedicpharmacy.co.uk
www.cosmedicpharmacy.co.uk | info@cosmedicpharmacy.co.uk T: 0845 388 3880 | F: 0845 388 3881
Cosmedic Pharmacy, Sherwood House, 2 Albert Road, Tamworth, Staffordshire, B79 7JN
Follow Us:
#AMLive
@AestheticMLive
/aestheticmedicinelive VISIT: www.aestheticmed.co.uk
4526_AMLIVE17_DPS NOV.indd 2 27/10/2017 15:11

YOUR PARTNER IN EVOLVING
YOUR AESTHETICS PRACTICE
EXHIBITION - The biggest names and most influential
brands showcase their latest product and treatment launches
CPD-ACCREDITED CONFERENCE - A 2 day, 2 agenda conference

featuring sessions from leading clinicians from across the globe
CPD-ACCREDITED BUSINESS WORKSHOPS - Expert advice on

running a successful aesthetic practice and keeping ahead
of emerging industry trends
LIVE DEMONSTRATIONS - Showcasing the newest treatments,

techniques and equipment on the market
BAHRS CONFERENCE - Highlighting the growing popularity

of Hair Restoration Surgery
UKAAPS SURGEONS’ DAY - The UK Association of Plastic

Surgeons host their annual conference
REGISTER HERE:
www.aestheticmed.co.uk/booktickets
HEADLINE SPONSOR CONFERENCE SPONSOR
4526_AMLIVE17_DPS NOV.indd 3 27/10/2017 15:11

N E W S A N D A N A LY S I S
NEWS SPECIAL REPORT www.aestheticmed.co.uk
On
the level
Industry Qualifications give some clarification around level 7
and what it actually means
I
t is often the case that impending regulation or indeed JCCP REQUIREMENTS
self-regulation can lead to well-intentioned people making The Joint Council for Cosmetic Procedures was formed with
decisions that they later regret. The absence of information the support of the Department of Health, following the
from those charged with developing the regulatory/self- Keogh Review and subsequent study conducted by Health
regulatory scheme as they finalise arrangement, can create a Education England (HEE). Since 2016, the JCCP Education
void in which the ill-informed or less well-intentioned can flourish. and Training Group, which has a wide range of practitioner
This is the case with level 7 qualifications for injectables. and stakeholder interests, has been working on defining
On the demand side, the desire to be JCCP-ready has the educational requirements for the five modalities
inevitably led to people spending considerable sums to considered by HEE:
achieve a level 7 qualification. On the supply side, we have i. Botulinum and toxins
seen the emergence of those that are willing to take money ii. Dermal fillers
for fake qualifications, and courses that will not be JCCP iii. Chemical peel and skin rejuvenation
compliant. The sums that have been spent are considerable iv. Laser, IPL and LED treatments
and while much of the problem is outside of the medical v. Hair restoration surgery
sector, the sector itself is not immune. In the coming months the JCCP will publish its
This article has been written to explain the characteristics requirements for training providers wishing to be included
of a regulated level 7 qualification, and provide a number of on the training providers register and details of the
easy steps to ensure that those wishing to be included on the practitioners register.
JCCP register invest in programmes that can deliver on the Of the five modalities, it is perhaps the issues surrounding
objective. We will start with the JCCP requirement. injectables and dermal fillers that has elicited the most

www.aestheticmed.co.uk NEWS SPECIAL REPORT
Ofqual is not responsible for programmes or post graduate

qualifications offered by the university sector.
To be recognised as a regulated qualification, the
qualification must be issued by a regulated awarding
organisation. The qualification itself will have the following
characteristics:
i. It will have a published specification outlining
entry requirements, qualification content and
associated delivery and assessment conditions. This
specification is different to a course programme in
that it will describe what a person needs to know or do
to gain a qualification, and how that knowledge, skill or
competence will be assessed. This specification will
be accessible via the awarding organisation’s website.
The IQ specification for the level 7 injectables can be
found at industryqualifications.org.uk/qualifications/
database/iq-level-7-certificate-in-injectables-for-
aesthetic-medicine
ii. The qualification specification will reference a
construct known as TQT (Total Qualification Time).
The average time (hours) a candidate will typically take
to achieve and demonstrate the level of attainment
necessary for the award of the qualification. In other
words, time taken to complete the full qualification.
The stated value will match or represent the demands
of the qualification content.
iii. The stated TQT value will also link to the title in terms
of the following terminology: award/certificate/
diploma. To the lay person, it may appear that
these constructs relate to qualification complexity.
However, their application is instead driven by the
duration of the qualification.
-Award indicates a small-sized qualification (i.e. a
qualification that has a TQT value of 120 hours or less);
- Certificate to indicate a medium-sized qualification
A regulated (i.e. a qualification that has a TQT value in the range
121-369 hours);
qualification is a - Diploma to indicate a large-sized qualification (i.e. a
qualification that has qualification with a TQT value of 370 hours or more)
been approved by a UK It is clearly not possible for a certificate or diploma to
be delivered across a weekend.
qualifications regulator.
iv. A regulated awarding organisation is required to
In England, that “level” all regulated qualifications. Level is driven by
regulator is Ofqual debate and emotion, and the demands of each assessment criteria. All of the
it is this modality which assessment criteria associated with a qualification
is considered in this article. can be located within the unit tables of the qualification
Without pre-empting the specification. An awarding organisation is required to
detail of the JCCP requirements, it is use the following levelling guide or reference chart to
evident in the HEE report and widely understood that the deduce the level of each assessment criteria. gov.uk/
JCCP will require training centres to be either: government/uploads/system/uploads/attachment_
i. A Higher Education Institute approved by the JCCP or; data/file/461637/qualification-and-component-
ii.
A training company/organisation or college to levels.pdf (pages 5-9).
be approved to offer regulated qualifications for
injectables at level 7. IDENTIFYING REGULATED LEVEL 7
But how can you tell if the qualification offered by a QUALIFICATIONS FOR INJECTABLES
training centre is regulated? Ofqual is the qualifications regulator in England, with
Scotland coming under the auspices of the Scottish
WHAT IS A REGULATED LEVEL 7 QUALIFICATION Qualifications Authority and Wales, Qualifications Wales.
A regulated qualification is a qualification that has been Currently, the focus of the JCCP has been on England
approved by a UK qualifications regulator. In England, that and consequently, awarding organisations regulated
regulator is Ofqual, which oversees school examinations by Ofqual. The first step in ensuring that you are investing in
(GCSE’s and A Levels) as well as vocational and some a training programme leading to a regulated qualification is
professional qualifications. It should be noted however that to check whether the organisation providing the certificate >

NEWS SPECIAL REPORT www.aestheticmed.co.uk
numerous developments within the

cosmetic sector and the introduction
of the Level 7 qualification has been an
encouraging movement towards the
regulation of a common high standard
throughout aesthetic education”.
Dr Tristan Mehta from Harley
academy highlighted that “the initial
failure rate among medics was higher
than expected and those involved now
recognised that even for doctors, work
is required to achieve the qualification”.
The JCCP has announced that the
Harley Academy will be the pilot centre
for injectables for the training provider
register using the IQ qualification.
is regulated by Ofqual. This can be done by searching at Lee Cottrill of SkinViva Training, part of the project group
register.ofqual.gov.uk/. If an organisation is Ofqual regulated said, “SkinViva Training has welcomed the opportunity to
it will appear in the search results and the status will work alongside IQ and the other centres to refine
be listed as “recognised”. the programmes and assessment during 2017.
However, just because an organisation Those involved are now extremely well
is a regulated awarding Organisation, placed to support those seeking early
it does not mean that it is regulated There is clearly considerable inclusion on the JCCP register”.
for the sector, or offers a regulated
qualification. To verify that the
confusion within the market WARNING: SPOTTING
qualification is a legitimate regulated with training companies THE DUDS
qualification, use the same website running short courses which are There is clearly considerable
and search on the qualification title. If promoted as level 7, accredited confusion within the market with
a qualification is regulated by Ofqual, training companies running short
it will appear in the search results and
by bogus certification courses which are promoted as level
the qualification status will be listed as organisations or associations 7, accredited by bogus certification
“available to learners”. organisations or associations. If it is
Currently, the only awarding not a JCCP approved HEI, or a regulated
organisation providing a regulated level 7 awarding organisation with the level 7 listed
qualification in Injectables to HEE and JCCP on the Ofqual website, save your money or rent a
requirements is Industry Qualifications. supercar for the weekend – at least you would gain some
While this is likely to change over time, currently it is very enjoyment from that!
easy to find a centre offering a regulated level 7 qualification Also be aware of programmes that have been endorsed by
– it will be offering the IQ Level 7 Certificate in Injectables regulated awarding organisations. Whilst the training may be
for Aesthetic Medicine (601/8963/0). There are six centres good, this is not the same as a course leading to a regulated
currently approved by IQ: qualification. Some regulated awarding organisations lend
Acquisition Aesthetics: 0203 3895611 their logo to training companies by offering an endorsement
Cosmetic Courses: 01844 318404 service. Confusing, yes, misleading, possibly, but check the
Derma Medical: 020 38737610 Ofqual website to find the real thing.
Harley Academy: 0203 8597958 Finally, unless you are a registered health care
SkinViva Training: 0161 8502491 professional, there are currently no pathways open to you
Save: 01495 239261 as the level 5 and 6 bridging arrangements have not been
established or agreed by the JCCP. AM
WORKING IN AN INFORMED PARTNERSHIP
Work on the IQ Level 7 in Injectables and Dermal Fillers
commenced in the early spring of 2016, prior to the
formation of the JCCP, following an approach from the
Harley Academy. As the qualification has developed,
there has been significant input from Cosmetic Courses
and SkinViva Training in particular, as the content and
assessment materials have been tested and refined. The
first regulated level 7 qualifications were achieved by
candidates of the Harley Academy in September, and our
other centres will follow shortly.
The programme is demanding – 278 hours with 59 contact
hours, encompassing examination – OSCE’s and practicals.
Acknowledging this, Dr Adrian Richards of Cosmetic Courses
said, “During my 16 years with Cosmetic Courses, I have seen

A M NO R T H 2 0 1 7
Nor ther n
h ig h lig h t s
We give you the lowdown on what went on at our second
annual event in Manchester – Aesthetic Medicine North 2017
O
ctober 22-23 saw Aesthetic Medicine North in the month. What makes this more surprising is that we
take place at Manchester Central for the second did this with half the staff and a quarter of the total spend
year running. that CCR cost us. The whole process of set up and
With most of the UK’s key breakdown was also so much easier than at any
aesthetic events taking of the London-based shows.”
place in London, Aesthetic Medicine Sam Keene, marketing manager for
launched the Aesthetic Medicine “We were very impressed Lynton said, “Aesthetic Medicine North
North meeting in 2016 to cater 2017 was another hugely successful
for practitioners working in the with our first day exhibiting at conference for Lynton. The logistics
Midlands, North and Scotland. AM North and received the same of attending both a beauty and
As well as a CPD-accredited medical aesthetics show at one
conference and business
number of enquiries of comparable location over two days, is ideal.
workshop programme, the quality as we received at CCR The quality of delegate was the
event included a dedicated highest we have seen at any other
exhibition showcasing the
London, earlier in the month” medical conference across the UK”.
UK’s leading aesthetic products John Culbert, Samantha Summerfield from
and brands. Cambridge Stratum Alumier, who were Gold Sponsors,
The event was sponsored by commented, “This was our second year
Church Pharmacy and attended by exhibiting at Aesthetic Medicine North
more than 800 delegates and visitors. and we were very pleased with the quality of
John Culbert, CEO of Cambridge delegates that attended. The conference was well
Stratum commented, “We were very organised and, as always, the team were very helpful. We
impressed with our first day exhibiting at Aesthetic had a good response from the delegates who attended and
Medicine North and received the same number of enquiries a lot of interest generated around our brand. Thank you to
of comparable quality as we received at CCR London, earlier the team.”
2 0 Aesthetic Medicine • November 2017
020-021 AM NOV17 AMNorth Review.indd 20 30/10/2017 16:08

A M NO R T H 2 0 1 7
EDUCATIONAL PROGRAMME marketing to running a business and navigating the

Education is at the heart of our events and VAT minefield. There were also workshops on
Aesthetic Medicine North saw both a CPD- websites and being an employer as well as
accredited clinical agenda, chaired by David a JCCP regulation panel where audience
Hicks, and business workshop programme “We had a good members got a chance to ask questions
take place across the two days. response from the of Paul Burgess, Sally Taber, Rachel
Topics covered on the main clinical Goddard and Mike Regan.
agenda included: PRP, Threads, delegates who attended and Other speakers included Alan
Fillers and Toxin – Standalone or in a lot of interest generated Adams, Naomi Di-Scala, Jacqueline
Combination Therapy; Advanced Naeini, Russell Turner, Veronica
Injection Techniques; Medical Legal
around our brand” Donnelly, Mark Bugg, Mr Taimur Shoaib,
Considerations in Aesthetic Medicine; Samantha Summerfield, Jemma Edwards, Dr Harry Singh, Ruth
Complications – to Avoid and Treat Alumier Duggal, Dr Nestor Demosthenous, Julia
Them and The Diagnosis and Repair of Kendrick and Martin Swann.
Damaged Skin. Conference chairman David Hicks
Chairs included Dr Simon Ravichandran and commented, “As conference chair it was a genuine
Dr Emma Ravichandran, Constance Campion, pleasure and privilege to work with such a fantastic
Naomi Di-Scala, Dr Ash Dutta, Dr Anna Hemming, Anna Baker, faculty and receptive interactive group of delegates. A
Dr Martyn King and Sharon King, while the speaker faculty standout conference for me in my 20+ years of involvement.”
featured Mr Ansar Mahmood, Helena Collier, Dr Nestor Dr Anna Hemming commented, “The conference was full
Demosthenous, Dr Alex Karkhi, Martin Swann, Mike Regan, of interesting presentations and intelligent discussion.
Victoria Hiscock, Dr Aamer Khan, Lorna Bowes and Nik Kane. The speakers were knowledgeable and informative and
Over on the business stage, day one was chaired by Richard raised good discussion about treatment options, product
Crawford-Small, with Pam Underdown leading proceedings selection, complications and mixing combinations of
on day two. Topics ranged from social media and digital treatments.” AM
Aesthetic Medicine • November 2017 2 1
020-021 AM NOV17 AMNorth Review.indd 21 30/10/2017 16:09

BUSINESS
TALKING TO www.aestheticmed.co.uk
T a l k i ng t o . . .
We chat to Matthew Rundle from Mayfair Aesthetics Laser & Skin Clinics
Aesthetic Medicine: Tell us about your background before huge growth in demand and an incredible improvement in
you moved into the aesthetics industry? the quality and safety of the laser systems available. Just as I
was ready to open my own company, the Soprano Ice
Matthew Rundle: I started in the hair and beauty industry in Platinum system was launching. My clinic was one of the first
1996 as a junior receptionist with Toni&Guy and worked my in London to offer this system which helped a great deal
way up to managing my first salon in Knightsbridge in 2000. In with our launch.
the early part of my career there was always a beauty
therapist within the salon and it was having facials that first AM: Tell us about your business model and why you chose this?
got me hooked on the beauty and aesthetics side of the
industry. My first facial was a Guinot Cathioderme treatment MR: My business model is for small clinics, with a first class,
and, at the time, I had no idea that using electric currents to friendly, professional service. The treatment we do mostly
bolster the efficacy of the products used was actually a thing. is laser hair removal but we also have a team of doctors and
specialists who offer the usual anti-ageing injectables, as
AM: What attracted you to the aesthetics industry? well as semi-permanent make-up, reflexology and
hypnotherapy. We invest in regular training to ensure
MR: After more than 20 years in the hair and beauty industry treatments are always carried out perfectly and book
I was ready for a change. For the last 10 years I’ve been enough time to always perform laser treatments correctly.
working with IPL and lasers within my salons and I’ve seen a Delivering what you promise works.
AM: What were the main challenges you faced when

opening your first clinic?
MR: The first Mayfair Aesthetics Laser & Skin Clinic was
actually my seventh new salon/clinic opening. From my
previous openings, I have created a very thorough to do list
covering literally everything required to open a new location.
It took only five days from beginning my initial location
search to signing contracts on my first clinic in Angel and it
was only seven weeks later that we were open for business.
AM: How did you decide what equipment you were going to use?
MR: I visited a few trade shows and had a long look at other
laser models on the market, then went incognito to eight clinics
around London and had a patch test with these different laser
systems. Some of these systems were actually traumatic in
022-023 AM Nov17 Talking to.indd 22 27/10/2017 16:18

BUSINESS
www.aestheticmed.co.uk TALKING TO
how painful they were and I was offered numbing cream at staff and I hope that coming to us for a laser treatment can
several clinics, which I think increases the risk of complications actually be a pleasant experience.
when having laser treatments.
Having worked with Soprano Ice at AM: What is the most enjoyable part of your job?
my previous clinic, I knew this was
a fantastic treatment and virtually MR: I do love the whole process of searching for
pain free. With the new Platinum We offer a and opening a new location.
model just launching, timing great service and
featured heavily in my decision, but I AM: Any plans for the future you can share with us?
also wanted to offer a system we don’t rush
suitable for all skin types that was a treatments MR: I’m on the look-out for a location for clinic
pain free option. four. In my monthly newsletter to our client base, I
asked for suggestions for our next location and got
AM: The business has grown and a huge number of requests for a part of London not
expanded rapidly what would you currently served by a lot of good quality laser clinics. Watch
attribute this to? this space.
I’m also hoping to open future clinics outside London and
MR: We offer a great service and we don’t rush treatments, the South East that do not tend to be as well served with the
which is a huge problem in a lot of laser clinics. We have great latest laser technology. AM
022-023 AM Nov17 Talking to.indd 23 27/10/2017 16:18

BUSINESS
BUSINESS MINDSET www.aestheticmed.co.uk
F i nd y o u r p u r p o s e
Dr Harry Singh on passion, purpose and proposition in the aesthetics business
“If you have a strong purpose in life, you don’t have to be pushed.
Your passion will drive you there”
Roy T. Bennett, The Light in the Heart
W
hy do some people achieve success in both their No one can make you motivated. I’ve been to many
personal and business lives and others don’t? personal development workshops and they pump you up, get
You may think it’s about strategies, networking you excited, get you motivated and then when you go back
and business knowledge. I agree that does to your daily grind, the motivation is loss. Motivation is like
play a part, but the overwhelming traits that taking a shower; you just don’t do it once, you have to keep
successful people have are their passions and purpose. doing it every day. Where people go wrong is that they look
at external sources to get motivated – courses, motivational
PASSION posts, motivational videos, books, etc. Motivation comes
“We have two lives, and the second begins when we from within, and the only way to have constant motivation is
realise we only have one” Confucius to follow your passion.
Are you spending every day doing what you love? Are you We have all heard that following your passion is the key
seeing the patients you love to serve? Are you excited to being happy. But will it make you successful? Let’s say I
about your life? If not, why not? Life is short – it’s not a am a professional athlete and am following my passion, but
dress rehearsal. another passion of mine is eating pizzas. If I were to follow
024-028 AM Nov17 Passion.indd 24 27/10/2017 16:20

BUSINESS
www.aestheticmed.co.uk BUSINESS MINDSET
the latter passion, it would impact on my ability to perform excited and content. It’s hard because you will have to give up
at my best for my athletic endeavours. Therefore, we need on what society thinks is normal. When you are pursuing these
targeted passion that helps us achieve our personal and principles, you are going to have to let go of the non-serving
business goals. principles. I know from personal experience what this feels
You and your business need to be in alignment like and how difficult it is to undertake. When I gave
with your core passions. So, how do you find your up dentistry, because it was not a core passion,
core passions and how can you dig into your I had a lot of negative reactions from others.
patients’ passions to serve them even better?
Motivation One tip that worked for me was to
The confused mind takes no action, is like taking a network and hang around people with the
so we only want to work out our top shower; you just don’t same passion as me. This will make it a
five passions. The following list is not lot easier for you to follow your passion
exhaustive, but pick five things you love do it once, you have to with the support of others on the same
doing and are important to you: learning, keep doing it every journey as you. For example, when I
fun, health, career, family, teaching, travel, decided to cut down my drinking and get
achievement, partner, creativity, fame,
day fitter, I stopped hanging around people that
wealth, business, sport, control, environment, invited me to parties and the pub on a regular
spirit, community, arts, relaxation, productivity, basis and searched for new friends that went to the
friends, connection, intellect, leadership, gym regularly and didn’t drink. Also, by hanging around the
awareness, balance, religion, freedom. same passionate circle I gained lots of information, tips and
How do you know which five to pick? Here are some tricks from them to allow me to follow my passion.
questions to think about when choosing from the list; Now let’s look at how you can take your personal passions
What was your dream as a child? into a business. That is only if a business was one of your
What gets you excited? core passions! Who are the patients that you feel passionate
If you were the keynote speaker at a conference, what about serving? You will have some patients you love seeing
would you speak about? and some who when you see them in your appointment book
What do you get asked most often for help? your heart sinks. You want to target and concentrate only
If you could do anything for a month, what would you do? on those patients that you enjoy working with. What makes
Once you have picked your top five, then write a short them so enjoyable and a pleasure to work with. Once you find
sentence as to why that is one of your passions. that out, you can create targeted promotions and marketing
For example, here are my top five: activities to attract more of the same type.
1. Business – I operate profitable businesses and serve my The same applies to our industry suppliers. Work and
customers support only those that have the same passions as you and
2. Learning – I constantly improve my knowledge in subjects ones that you feel passionate about working with.
that interest me
3. Health – I am working towards a healthy lifestyle so that I PURPOSE
can be a role model for my children Your purpose is the roadmap of your life and business. It’s the
4. Fun – I laugh a lot and at every opportunity possible ‘why’ you do anything. Simon Sinek’s book Start with the Why
5. Family – I am spending quality time with my loved ones emphasises this is the starting point of all success followed
Next, the simple part is to design your personal and business by ‘how’ and then ‘what’.
life around these core principles. I say it’s simple, but it’s not Why is this so important? I know many people that, upon
easy. It’s simple because you know deep down if you lived your first impressions, look successful either in business or their
life according to these core principles you would be happy, personal life but they have no purpose. This means they just

BUSINESS
Climate action
Life below water
Life on land
Peace, justice and strong institutions
Partnerships for the goals
I partner up with Buy1Give1 (B1G1), where a certain
percentage of every delegate’s workshop fee goes to this
great cause. The reason I chose B1G1 is you can choose the
project/s you want to fund, and these projects do cover the
majority of the 17 UN Goals.
I am getting a double benefit of running my business. One
is the more value I offer to my delegates the more money I
make and the more money I make, the larger the percentage
that is given to my purpose (B1G1). Do you think I will be more
passionate, more determined and more motivated to make
sure my business is successful as possible?
This is where passion and purpose work together to a
achieve exponential results. We are not talking about the
multiplication of results but more about the magnification of
carry on with what they are going, getting richer but have > results. Would this give you a reason to get out of bed and feel
no fulfilment in their lives. In Maslow’s Hierarchy of Needs, compelled to make the most of it?
once we have met our basic needs of surviving and security One way to define and remind yourself and your team about
we move onto our psychological needs. These include the purpose is to have a mission statement. We have all seen
relationships, friends and accomplishment. I truly believe those mission statements that go on for pages and only talk
that accomplishment is measured not by what you get, but about how great that business is. Your mission statement
what you give. needs to be short and memorable, so all team members and
your patients can understand it. It will include the impact you
“We make a living by what we get, but we make a want your business to have on your patients and your purpose.
life by what we give” Winston Churchill For example, Stone and Virtue is an online fashion shopping
site in the United States. Their mission statement is: “Like
a verse inscribed into stone, we want you to write your own
individual story. We hope to inspire and empower women to
fulfil their goals and dreams while giving back to our global
community in a meaningful way.”
Their ‘why’ is: “Stone and Virtue is a fashion company
featuring jewellery and clothing with socially conscious
branding and philanthropic messages. Each purchase made
with us will benefit a socially conscious cause enabling you to
visualise your impact.”
Similarly Patagonia’s (clothes for adventure sports)
mission statement: “Build the best product, cause no
unnecessary harm, use business to inspire and implement
solutions to the environmental crisis.”
Your support of your purpose doesn’t have to be financial;
it can be sharing your skillset and knowledge to society.
This is true for your patients and team members. If you have I have given numerous talks on motivation and personal
a clear and compelling purpose for your life and business, you development to less privileged people such as teenagers
will attract your ideal patients and have a very self-motivated excluded from school. You can give your time volunteering to
team willing to put in that extra mile. your purpose.
What is your purpose? A good starting point is to look at
the 17 UN Sustainable Development Goals. How to keep on track
No poverty Regular monitoring and scoring of certain statements will
Zero hunger hold you accountable to your purpose. You may want to ask
Good health and well-being yourself some of the following:
Quality education I am clear on my purpose
Gender equality My team are clear on the purpose
Clean water and sanitation I am committed to my purpose
Affordable and clean energy I impact others regularly
Decent work and economic growth
Industry, innovation and infrastructure Tony Robbins talks about the six human needs, and one
Reduced inequalities is contribution. How are you contributing? Whenever I’m
Sustainable cities and communities struggling or not progressing in life or business, the first
Responsible consumption and production thing I’ll do is reconnect with my purpose.

Enhancing the effects of laser
treatment for female facial hair1
When she turns to you,

give her an adVANtage
Laser Hair Removal plus VANIQA® Available from

Healthxchange Ph
armacy
Me dical Ltd
A faster, more effective combination than laser alone* an d Wi gm ore
Please visit vaniqa.co.uk for more information

VANIQA® is licensed for the treatment of Female Facial Hirsutism
Prescribing Information (Please consult the Summary of Product Characteristics (SmPC) before prescribing). medical treatment of patients who might be prescribed Vaniqa. For cutaneous use only. Contact with eyes or mucous
Vaniqa 11.5% Cream eflornithine Active Ingredient: eflornithine 115 mg per gram (as hydrochloride monohydrate). membranes (e.g. nose or mouth) should be avoided. Transient stinging may occur if applied to abraded or broken skin.
Excipients with known effect: Each gram of cream contains 47.2 mg of cetostearyl alcohol, 14.2 mg of stearyl alcohol, If skin irritation or intolerance develops, the frequency of application should be reduced temporarily to once a day. If
0.8 mg of methyl parahydroxybenzoate and 0.32mg of propyl parahydroxybenzoate Indication: Treatment of facial irritation continues, treatment should be discontinued and the physician consulted. Contains cetostearyl alcohol and
hirsutism in women. Dosage and Administration: Should be applied to the affected area twice daily, at least eight stearyl alcohol which may cause local skin reactions (e.g. contact dermatitis) as well as methyl parahydroxybenzoate
hours apart. Application should be limited to the face and under the chin. Maximal applied doses used safely in and propylparahydroxy-benzoate which may cause allergic reactions (possibly delayed). Interactions: No interaction
clinical trials were up to 30 grams per month. Improvement in the condition may be noticed within eight weeks and studies have been performed. Fertility, Pregnancy and lactation: Women should not use Vaniqa whilst pregnant or
continued treatment may result in further improvement and is necessary to maintain beneficial effects. Discontinue breastfeeding. Ability to drive and use machines: Vaniqa has no or negligible effects on the ability to drive and use
if no beneficial effects are noticed within four months of commencing therapy. Patients may need to continue to machines. Undesirable Effects: These are ranked under heading of frequency using the following convention: very
use hair removal methods (e.g. shaving or plucking) in conjunction with Vaniqa. Application of Vaniqa should be no common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very
sooner than 5 minutes after use of other hair removal method, as increased stinging or burning may occur. A thin rare (<1/10,000). Very common: acne. Common: pseudofolliculitis barbae, alopecia, stinging skin, burning skin, dry
layer of the cream should be applied to clean and dry affected areas. The cream should be rubbed in thoroughly. The skin, pruritus, erythema, tingling skin, irritated skin, rash, folliculitis. Uncommon: bleeding skin, furunculosis. Rare:
medicinal product should be applied such that no visual residual product remains on the treated areas after rub-in. rosacea, skin neoplasm, skin cysts, vesiculobullous rash. Consult SmPC in relation to other adverse effects. Legal
Hands should be washed after applying this medicinal product. For maximal efficacy, the treated area should not be Category: POM Marketing Authorisation Number(s): EU/1/01/173/003 NHS Cost: (excluding VAT) Tube containing
cleansed within four hours of application. Cosmetics (including sunscreens) can be applied over the treated areas, but 60g - £56.87 Marketing Authorisation Holder: Almirall, S.A. Ronda General Mitre, 151 08022 Barcelona Spain. Further
no sooner than five minutes after application. The condition should improve within eight weeks of starting treatment. information is available from: Almirall Limited, Harman House, 1 George Street, Uxbridge, Middlesex, UB8 1QQ, UK.
Paediatric populations: The safety and efficacy of Vaniqa in children 0-18 years has not been established. Hepatic /renal Tel: 0800 0087 399. Email: almirall@professionalinformation.co.uk Date of Revision: 08/2017 Item code: UKEFL3336(1)
impairment: caution should be used when prescribing Vaniqa. Consult SmPC for further information. Contraindications,
Warnings, etc: Contraindications: Hypersensitivity to eflornithine or to any of the excipients. Warnings & Precautions:
Excessive hair growth can result from serious underlying disorders (e.g. polycystic ovary syndrome, androgen secreting Adverse events should be reported. Reporting forms and information can be found at
neoplasm) or certain active substances (e.g. cyclosporin, glucocorticoids, minoxidil, phenobarbitone, phenytoin, www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Almirall Ltd.
combined oestrogen-androgen hormone replacement therapy). These factors should be considered in the overall
*Complete or almost complete hair removal was achieved in 93.5% (29/31 subjects)
in eflornithine-laser treated sites vs 67.9% (21/31 subjects) in placebo-laser treated sites.1
Date of preparation: October 2017. UKEFL3769d Reference: 1. Hamzavi I et al. J Am Acad Dermatol 2007; 57(1): 54-59.
Vaniqa A4_Red Head Lady OCT 2017 UKEFL3769d_new logo.indd 1 19/10/2017 10:21
BUSINESS
PROPOSITION (VALUE) Your value proposition needs to be short, easily explained

“A value proposition is a promise of value to be and specific. The more specific you are, the more value you
delivered, communicated, and acknowledged. offer. For example, a specialist surgeon who carries out heart
It is also a belief from the customer about how surgery is going to offer more value, hence make more money
value (benefit) will be delivered, experienced and than a general practitioner.
acquired” Wikipedia Where to start with your value proposition? You need to look
It all starts with looking inside yourself and digging down at how you are solving your patients’ problems, what benefits
into your values. There are no right or wrong answers; values you are delivering and how you can improve their current
are unique to the individual. For example, my top five alues situation. The value proposition takes them from where they
are; Impact, Growth, Success, Passion, Ambition. If you don’t are now, to where they want to be via your offering.
meet your values, then you won’t be happy. In certain services, it is easier to communicate this.
The next question is what needs to happen in your For example, if you are a digital company offering
personal and business life to satisfy your values. Facebook marketing services. If you can show and
Reflect on how much every day do you demonstrate that for every £100 one of your
experience your top five values. customers spends with you results in £600
If one of your values is freedom, then of business, you have a value proposition
being tied down to your business seven If you don’t meet your x6. Given these results, you won’t have too
days a week, 24 hours a day, is going to much problem gaining new business.
make you a very unhappy person. But if values, then you won’t But how can this work in the aesthetics
one of your values is ambition, then you be happy industry? We cant say you will look six
won’t mind ‘hustling’ because that is what times younger! We, therefore, need to go
you value. back to how you are solving your patients’
Now let’s look at the value proposition problems, what benefits you are delivering and
your business offers your patients and how to how you can improve their current situation.
convey this. Value can begin even before a money exchange
Many business owners think high fees can has occurred. Free consultations with impartial advice,
be an obstacle for patients. But, it’s the value you offer that free educational resources such as a report on how to look
patients will pay for. We can get from to A to B via many after your skin in the summer and/or free samples of skin
transportation methods, ranging from walking, public products for the patient to take away.
transport, private transport from cars to private jets. They Value can then occur during any treatments by giving
all have varying costs, but we still have people paying at all the patient more than they expected. Often patients are
these different price points. Why? People will pay for what coming to you because they feel/look older than they are.
they value. The benefits of your services could be quick, comfortable,
The value controls the speed of money flowing in your affordable and temporary. We are improving their mood,
business. If your patients perceive what you offer is of self-esteem and self-confidence. This will all form part of
greater value to them than the fee you are charging, money your value proposition. Remember, patients do not buy
will be exchanged, or to put it another way, if the patient the product or the treatment, but what the product or
perceives the problem larger than the cost of solving it, then treatment does for them.
there will be a sale. Therefore, business is very simple, offer The patient’s value will often be determined by their
more value than what the patients pay you, and you will have a actions and what they say. Listen very carefully regarding
queue of patients willing to hand over their hard-earned cash. their concerns and expectations of any particular
If you can demonstrate and show the value of your business treatment(s), this will give you vital clues. Post-treatment
to your patients, you will be on the road to success. value can be achieved with post-treatment calls, thank you
We can’t guess this, and different patients have different cards and/or free reviews. Put simply, give your patients
perceptions of value. We need to ask those patients already their money’s worth!
spending money with us, what they value. Then we can look
at increasing this value offering. SUMMARY
Patients, and all of us, have ‘anticipated’ value perception, Please don’t let this be one of the articles you read, comment
for example, we would all expect to pay more for a meal to yourself that it is was interesting and makes sense but
in a fancy restaurant, with posh tables and chairs and then do nothing about it. This article is an activity-based
candlelights compared to the local takeaway with plastic article. You need to sit down in a quiet room and work through
chairs and electric lightning. But they are selling the same for your personal and business goals and discover what your
service…food. passion, purpose and value propositions are. Good luck! AM
>> Dr Harry Singh BChD MFGDP has been carrying out facial aesthetics since 2002 and has treated more than
3,000 cases. He is not only a skillful facial aesthetician but also a keen marketer, which he feels is vital to
attract and retain patients requesting facial aesthetic services. He has published numerous articles on the
clinical and non-clinical aspects of facial aesthetics and spoken at dental and facial aesthetics conferences
on these topics. He was shortlisted at the Private Dentistry Awards in 2012 and 2013 in the Best Facial
Aesthetic Clinic category and a finalist in 2012 at MyFaceMyBody for the Best Aesthetics Clinic. Download
his video “Getting Started in Facial Aesthetics” for free at botoxtrainingclub.co.uk

SATISFACTION
GUARANTEED
with the fastest, quietest and most
cost-efficient system on the market
The Sirius by Ellipse

Choose your Sirius for Hair Removal only,
safely treating skin types 1-6 or a
complete platform device to include
hair removal and vascular treatments.
HAIR REMOVAL
VASCULAR LESIONS
FACIAL THREAD VEINS
ACNE CLEARANCE
MORE THAN LIGHT
020 8741 1111

info@ellipseUK.com
Selective Waveband Technology (SWT®)
Recommended for Clinics, Beauty Salons and Individuals ellipseUK.com
BUSINESS
VIDEO MARKETING www.aestheticmed.co.uk
P la y t h e t a p e f o r w a r d
Jon Mowat tells you how to press play on your video strategy
A
re you planning to use the power of video relationship status, what they do for a living, where they
content to promote your business? We hope so live, how they spend their spare time, how they find beauty
because video is increasingly superseding the salons, what they expect from a treatment, and so on.
written word. By 2020, globally IP video traffic These ideal consumers are called buyer personas, and can
will be 82% of all consumer internet traffic, up help you to identify with your target market in order to create
from 70% in 2015. (Cisco VNI Forecast and Methodology relevant content for them. Use all the data you have to hand
2015-2020). If that isn’t enough, Facebook with its 1.86 to do this – website and social media stats, your database of
billion global users is going for a video-first strategy; customers, client feedback, and surveys.
Mark Zuckerberg predicts that video will account for the
majority of what his audience consumes online within only EMOTIONAL DRIVERS OF THE AUDIENCE
five years. Now you have a picture of the ideal audience, move on to
In short, business owners who do not tell their story through their motivations. What are your customers’ pain points and,
video will lose out to the competition. However, as a busy more importantly, how can you solve them? For instance,
salon owner or manager, it can be difficult to find the time to why would a customer book a facial? They want their skin to
get to grips with how video fits into your marketing plan. look better but it’s more than that; you’re selling a treat and
In this article, I’ll help you take your first steps into video an experience, and also what they can achieve when they
marketing – and the good news is that if you do less, you’ll look and feel great.
actually achieve more. As you create your key messages, think about your
audience rather than just listing your services. What’s in
WHO DO YOU WANT TO REACH? it for them? How will your content make them feel? As the
From printed flyers to website copy, it’s vital to always put poet, Maya Angelou said: “People will forget what you said,
your audience first in all your communications. A really people will forget what you did, but people will never forget
useful exercise is to imagine who your audience is; age, how you made them feel.”
030-031 AM Nov17 Video Marketing.indd 30 27/10/2017 16:24

BUSINESS
VIDEO MARKETING
is searching for and then answer their questions with video

content; for instance, “how to get flawless skin” or “how to
look younger than your age”.
USER GENERATED CONTENT

Why not tap into user generated content, and encourage your
customers to create content for you? We’re sure that they
will love to share how great they look on their Instagram or
Facebook accounts. Curate the best content and share via
your business social channels with a brand hashtag.
HIRING A VIDEO AGENCY

With a limited marketing budget, you have to make decisions
about hiring a professional firm to help you produce the
WHICH VIDEOS WILL SHOW YOUR BEST SIDE? content. We’d certainly advise creating a brand video with
What do you want to achieve with your video? Is it increased an agency in order that your business appears professional;
awareness of your brand locally? Are you introducing a new lo-fi content can work on social media, but it could have a
service? Once you’ve settled on your objectives, ensure that you negative effect on the homepage of your website.
are able to identify how well the video has worked. Are you going
to track video views, how long people stay on your SHARE YOUR VIDEO ONLINE
website, or how many times your video is shared? An amazing video is not enough on its own, it
Now you know what you want to achieve needs to be seen by the right people. Upload
it’s time to think about the kind of content. your content to YouTube (the second
It is possible for small business owners An amazing video largest search engine) and share through
to create videos without a huge budget. is not enough on its your networks, email newsletter, and
Here’s some inspiration to kickstart social media channels. It’s certainly
your video campaign: own, it needs to be worth allocating a budget for YouTube or
seen by the right Facebook advertising as a cost-effective
BRAND VIDEO way to extend your reach.
This is a top-level video showing your
people To recap, understand your audience,
audience what you’re all about, and why clarify your objectives, know what success
they should choose you, reinforcing your looks like for you, and focus on doing less - but
key messages. Remember to start with the doing it well.
emotional drivers you’ve identified, and then back We hope your business is now ready for its close-up. AM
these up with factual arguments, and end on a call to action.
CUSTOMER TESTIMONIALS
Video testimonials are one of the most powerful ways of
marketing your small business. Written case studies are of
course valuable, but actually seeing a third person advocate
your salon on the screen makes it so much more believable.
SHOW CUSTOMERS WHAT THEY CAN EXPECT

It can be useful to give potential customers a video tour of
your salon and introduce viewers to your staff through a
360 degree video, or simply a piece to camera, describing
what customers can expect from your various treatments.
HELPFUL CONTENT
Your potential customers are searching online for beauty
tips, and if you’re there to help them out, they’re more
likely to trust your services. With ‘help’, content, marketers
examine what their audience is searching for online and
then they create content that perfectly meets those needs.
There are tools available, such as Google Keyword Tool or
YouTube Trends, to help you find what your target audience
>> Jon Mowat is the founder and MD of Hurricane, an award-winning video marketing agency helping businesses
to tell their brand stories with the right video strategy. With decades of experience in the industry, Jon has
just written a book (out in March 2018), “Video Marketing Strategy: Harness the Power of Online Video to Drive
Brand Growth” filled with tips and strategies for incorporating video into your wider marketing plan. If you’re
looking for more video tips, get in touch via Twitter @jon_hurricane or email info@hurricanemedia.co.uk
030-031 AM Nov17 Video Marketing.indd 31 27/10/2017 16:24

BUSINESS
CONTENT MARKETING www.aestheticmed.co.uk
T he on l y way
i s n’ t F a c e b o o k
Mark Masters on why you shouldn’t put all your eggs in one basket when it comes
to digital marketing
I
f you’re used to doing something one way, getting out of are on Facebook ads and driving revenue, surely it’s time to
the habit is a hard thing to do. But you can’t relentlessly pack up, throw in the towel and live happily ever after? If we
treat the way that you communicate your business as one are now spending nearly an hour a day on Facebook (Mark
ongoing campaign. The Holy Grail of a single-source for Zuckerberg, Facebook’s co-founder said 50 minutes), isn’t
customer acquisition doesn’t exist because this centres this the safe bet?
everything on your product, not what you believe in. Facebook has helped millions of businesses, by making it
For many businesses, there is an over reliance on easier than ever to target customers and to attract people to
Facebook ads to promote their company when it comes buy. The platform announced during the summer they now
to customer acquisition and this makes complete sense. If have two billion monthly users and that’s more than 25% of
someone is getting results, why should they look beyond the world’s population. However, if the results are looking
what is in front of them? If your product/service messages great for the short-term, how does the long-term look?
032-034 AM NOV17 Content Marketing.indd 32 27/10/2017 16:27

BUSINESS
www.aestheticmed.co.uk CONTENT MARKETING
THE GOOSE THAT LAID THE GOLDEN EGG PRODUCING CONTENT AROUND A CAMPAIGN
The, “our business is getting results from Facebook” angle The Facebook brush is pretty one sided. When you come
reminds me of the goose that laid the golden egg. from a pure company perspective, you produce content
The story is of a farmer who was struggling to make ends around a campaign. If you come from the perspective of
meet. To ease his problems he was given a goose. The goose your audience, you come from a different position, which
laid one golden egg every day. is centred on delivering worthwhile experiences on a
The farmer managed to sell an egg each day and, over consistent basis, over a long period of time.
time, he became rich, however, he believed that if he could When your message revolves around products, all you
get inside the goose there would be a barn of golden eggs. want other people to see is what you want them to like, click
He would then become the richest man in the village. He through and to get that warm achievement of building web
grabbed a knife and cut the stomach of the goose to get to traffic. The reality is when all you can bang on about is what
all the eggs. He lost any ability to have more eggs and you are looking for someone to download/sign-up/buy,
the goose too. there is no room to build a dialogue. If something
The message being, when you stick is bad, no one wants to engage with it, let
resolutely to one medium as your source For many alone read it. If you can’t deliver something
of income, you’ll be more inclined to look that someone wants to get to know a bit
for faster ways for a quicker return. businesses, there better, then somebody else will provide
is over reliance on the value they need.
PLAYING TO SOMEONE Facebook ads to promote You can’t live a full life where you look
ELSE’S RULES to squash people into a pipeline and call
When you stick wholeheartedly to one their company when it them leads. No matter how much money
game plan on someone else’s turf i.e comes to customer you throw at it.
Facebook, the objective is always to see
what you can take, in this case to make the acquisition WHAT ABOUT YOU?
people who consume on that space spend When you start to look at everyone as just
money with you. a pound sign, you detract from looking to build
This means that you are in a continuous loop an audience and become over reliant on the hand that
of living in a campaign mode, which inevitably means you are currently feeds you.
continually paying someone else for the privilege and have While there is a sense of reward saying, “Our Facebook
no means of building your own media asset. ads works, why should we look at other alternatives when
When it comes to being in constant campaign mode, one ill- it gets people to buy our products?” Let’s start looking at
thought ad can bring a brand that has built a strong message the longer-term implications if you are thinking about a
to one where a reputation is in tatters. This is what personal strategy that revolves predominately around Facebook:
care brand Dove did during October by releasing a Facebook Are you prepared to spend a sizeable budget, in one place
ad that was a GIF showing a black woman turning white after for a long time, to see a return?
using the soap. Anger certainly generates a higher rate You spend on Facebook ads, you get ads back and so does
of viral content. The hard work on championing women’s everybody else. If we have now reached two billion users,
diversity has currently been put way down the agenda. that certainly is a space that is currently being bombarded. >

BUSINESS
CONTENT MARKETING www.aestheticmed.co.uk
“You could, via exceptional customer service, brand

building and positioning, build word-of-mouth awareness
that delivers zero-cost advertising and ramps up your
revenues.
“Nine times out of 10, however, this does not happen.
Instead we dabble and hope. That’s not a good way to run an
online (or offline) business.”
WHAT’S THE ALTERNATIVE?

When you live in a walled garden, you get to see the world
on somebody else’s terms. For instance, when you’re on
Facebook’s mobile app, that is where the internet is and
where you tend to spend most of your time, in a beautifully
crafted space that wants you to become comfortable.
It is like starting a new school and the only crowd that will
have you are the cool kids. Over time, they are the ones who
slowly manipulate you to do what they want you to do to and
then toss you aside when they are finished. Or in a business
sense, when you have spent all your budget and can’t
manoeuvre anymore.
Facebook and Google now control 60% of all A more robust, longer term view is to actually
digital revenue (according to eMarketer). Sitting back get to know your audience and the people
The real winners of advertising online you are targeting, rather than the safety
are not your business, but Facebook
and thinking that of the thumbs up and the click throughs.
and Google. conversion and customer As an aside, the man who invented the
If all we are seeing more adverts Facebook like button has recently
that have no editorial control – i.e.
acquisition is answered by deleted the app from his phone. If
you pay, you have a presence – this spending money on one you can observe and be part of the
means more bad content that we channel is a naive and interactions in your own garden, you can
start to become immune to. We now contribute to the development of your
live in a fact free shouting match arena wrong approach to own audience development strategy.
for other people to hopefully listen. make The audience that you build, by being
The space becomes flooded with similar customer driven, grows when you dedicate
messages, over time it becomes less effective. everything on the audience and demonstrate
If the marketplace is currently limited to your knowledge and beliefs within an area that you can
one person having the freedom to spend and be targeted break through and deliver value.
with advertising to see a return then that is a fortunate You can drive the value of your audience by having
place to be. As the market becomes saturated, that once something that you can truly put a stamp on and look to
sizeable return won’t plateau, it will decline as more increase the value over time.
competition become comfortable in the same space.
Over time, if this becomes the sole source of marketing LET’S ROUND UP
spend, nothing is no longer new, exciting or provides a fresh Sitting back and thinking that conversion and customer
dynamic to the business. acquisition is answered by spending money on one channel
Ian Rhodes, ecommerce growth consultant, highlights is a naive and the wrong approach to make.
what you need to consider by not just concentrating all your It has to be a part of a much wider scope where the focus
efforts on one paid channel. Rhodes says, “You could run is on the people who want to interact with you and not
your store or business with Facebook as your single source treating everyone as though they are ducks and geese on a
for paid acquisition. force-feeding frenzy for the greatest serving of foie gras.
“You could have a defined business model where a When you get to know your audience a bit better and tune
programme of lifecycle marketing means that your acquisition into their side, you can start to monetise in different ways,
costs are based upon the lifetime value of your customer. rather than treat everything as a sprint for a prompt return.
“You could have in place continual optimisation processes You create better customers when you move from living
to learn and understand your customers’ buying habits to in a universe that revolves around a product, to one that
boost revenue per visitor figures through your website and revolves around other people and the role they play within
email marketing. your world. AM
>> Mark Masters is the owner of The ID Group, a content marketing consultancy helping businesses own
their spaces to build a subscribed audience. Visit youarethemedia.co.uk for a dedicated conference on
making an owned media approach work on May 24, 2018, in Bournemouth. Speakers include author of
Known, Mark Schaefer.

cosmelan
®
depigmenting solution
by mesoestetic ®
trust the leader*

the world’s leading professional
depigmentation method
before after before after***

**
cosmelan® method efficacy has been demonstrated in numerous studies under medical supervision. More than
www.mesoestetic.co.uk
1 million patients treated worldwide, in any skin phototype (I-VI) and in all ethnicities.
* Considering international distribution. ** Images courtesy of Dr Reddy. Long term results obtained after 24 weeks demonstrates method’s
efficacy on reappearance control. *** Short term results obtained 2 weeks after the method started.
Untitled-16 1 12/05/2017 12:55

BUSINESS
DATA PROTECTION www.aestheticmed.co.uk
P r o t e c t io np r e p a r a t io n
Data protection advisor Paula Tighe on how to start planning for the arrival of GDPR
W
ith the General Data Protection Regulation Also known as the ‘Data Register’, this record details the
(GDPR) just around the corner, businesses personal data you currently hold, your reason for holding
are facing a race against the clock to achieve it and where the data originated from. The accountability
compliance in time for its arrival in May. principles of GDPR require you to have a complete record
Companies must take the of your data – adopting new procedures and
new changes seriously and work quickly to processes to streamline functions.
understand the new regulation and what Compliance is not about preventing
action is needed from them. you from doing things – instead,
The basic principles will be the same for it helps improve standards
every business, starting with a plan that
If your data is captured, by questioning your reasons
is devised by the individuals responsible processed or used in the and motives. Make sure you
for pushing through change within EU, you are obligated to review your processes for
your organisation. searching for, capturing and
Remember, if your data is captured, comply – the UK’s decision recording personal data, including
processed or used in the EU, you are to leave the EU has no effect how you obtained consent from
obligated to comply – the UK’s decision the individuals concerned.
to leave the EU has no effect on the
on the new regulation Also review your existing digital
new regulation. and hard copy format privacy notices
and policies - are they concise, written
RAISE AWARENESS AND REGISTER IT in clear language, easy to understand and
First, it is important that key decision makers easily found?
understand the importance of compliance, and Finally, look closer at the way these policies and notices
that failing to meet requirements could result in costly legal are currently communicated to your data subjects. Your
proceedings. Recording the compliance process is an effective reasons for using their personal data should be clearly
way of showing your willingness to meet regulation rules, and explained, as should the complaints process if they feel
could save you unnecessary trouble later down the line. dissatisfied with your service.
036-037 AM Nov17 GDPR.indd 36 27/10/2017 16:30

BUSINESS
www.aestheticmed.co.uk DATA PROTECTION
NEVER ASSUME YOU HAVE CONSENT

One of the trickier areas of the new regulations is obtaining
consent for personal data to be captured and used for more
than just contact.
Individuals must give clear consent for their data to be used,
but must be allowed to revoke consent easily, at any time. If
you change the way you want to use their data, you must obtain
a new consent.
Consent must be implicit and your attempts to obtain or
confirm consent will help mitigate any future problems at the
hands of the regulator.
KEEP REVIEWING AND KEEP RECORDING

Under the GDPR and when you are obtaining and processing
personal and sensitive categories of data, you need to record
how this data will be retained and under what condition; for
example, is the retention period required for legal, regulation
and/or organisational purposes.
The new regulations bring a requirement for
all businesses affected by the GDPR to not
Individuals must only have a retention (data minimisation)
policy and schedule, but to carry out
give clear consent for mandatory Privacy Impact Assessments
their data to be used, (PIA) if they want to process personal data
as part of normal business practices, if it is
but must be allowed to to be processed on a new technological or
revoke consent easily, information society system, or if it contains
at any time sensitive categories of data.
RIGHTS OF THE INDIVIDUAL These assessments will help you decide
GDPR aims to give individuals greater control what are the likely effects on the individual,
over their personal data. For this reason, it is mitigate any risk and help you build in “privacy
crucial that existing procedures for dealing with personal data by design” in how you obtain and process individuals’
are reviewed and amended where necessary. data. Ensure you have a robust process for making the
Data subjects now have the right to request their data be assessments and then record it, along with the outcome – a
edited or erased, and it is up to your organisation to ensure PIA is a simple step towards compliance, with the emphasis
procedures are in place to deal with such requests. on what you do, rather than what you say you will do.
Perhaps one of the key drivers for the changes is the right
for an individual to prevent their data being used for direct MAKE SOMEONE RESPONSIBLE AND KEEP IT UP
marketing purposes, as is the right to challenge and prevent If you deal with personal data on a regular basis, then it may
automated decision making and profiling. be worth employing a dedicated Data Protection Officer
Regardless of complaints or investigations, adopting who can oversee procedures, ensuring your organisation is
transparent procedures will help mitigate any future fully compliant at all times.
problems with the regulator. If your organisation already It’s not just electronically held data that can pose a
takes care handling personal data under the existing laws, problem; you also need to consider written records, which
then the transition to GDPR should not be a cause for concern. are covered by the regulations – ensure all your staff are
trained on the correct handling of personal data.
PREPARE FOR PERSONAL REQUESTS Remember, track all your progress using your Data
If an individual makes a subject access request, you must Register, as it will be those organisations without proof of
comply within a month. You can refuse to comply if you think their willingness to comply that will suffer the consequences
the request has no merit – but you must tell them why and once GDPR has been introduced.
explain that they can complain to the regulator. Even if you are not fully compliant come May, those
For SMEs, it will be more important to show a willingness organisations that can prove they have made an active effort
to comply by trying to implement all the necessary steps and to meet requirements may receive a lesser punishment than
creating a data register, than to be fully compliant in May. those who have completely disregarded the new changes. AM
>> Paula Tighe is a qualified data protection professional and leads the trusted advisor information
governance service. Experienced in working with small, medium and large private and public bodies,
Tighe advises on a range of data protection issues, including training design and delivery, marketing,
housing, project management and ICT security.
036-037 AM Nov17 GDPR.indd 37 27/10/2017 16:31

BUSINESS
EMPLOYMENT www.aestheticmed.co.uk
T o PA Y E o r
n ot to P A Y E
Victoria Vilas asks, should your aesthetic clinicians be self-employed
or company employees?
Y
ou may be opening a new aesthetic clinic, or YOUR RESPONSIBILITIES FOR EMPLOYEES
perhaps you’re thinking of adding more doctor- AND FOR FREELANCERS
or nurse-led treatments to your laser clinic or As an employer, your responsibilities will depend on the
medi-spa. Either way, if you’re looking to take on employment status of your staff members, as classified by
a medical professional, you need to consider the HMRC. Full- and part-time workers who have employment
contract or employment agreement you’ll offer, not just the contracts with your business will have different employment
list of duties you need your new clinician to perform. rights to freelancers, and you will have different responsibilities
As an aesthetic business owner, you will be responsible in terms of tax and National Insurance contributions.
for staying in line with employment laws when taking on You will have more responsibility for contracted workers
clinicians, and your staffing decisions could be crucial to who have been hired as permanent employees. They should
the success of your business. If you are working out be added to your company payroll, and you will have to notify
whether you need a self-employed freelancer, or a HMRC of their employment status, and make PAYE (Pay As You
permanent, contracted employee, you need to look into Earn) payments to HMRC on their behalf, after deducting tax
the different types of employment status, as defined and National Insurance from their wages. Self-employed
by HM Revenue & Customs, and you need to think about clinicians should invoice the business for their work, and will
what is likely to work both for your business and for your be responsible for preparing their own tax returns and
new clinician. making their own National Insurance contributions.
038-039 AM NOV17 Employment.indd 38 27/10/2017 16:33

BUSINESS
www.aestheticmed.co.uk EMPLOYMENT
have to take them on as an employee, as HMRC will have

enough evidence to class them as a freelancer. If your
practitioner has not yet registered as self-employed, and the
work at your clinic is the only freelance work that they plan to
do, then HMRC may question whether they are, in fact, a part-
time employee rather than a self-employed person.
If you provide dermal fillers for a freelance clinician to use,
it is fair to argue that all practitioners injecting at your clinic
need to use the same stock as advertised on your treatment
menu, and stock you know has been purchased from your
chosen supplier. However, if you provide injectable products,
Your employees will be eligible for Statutory Sick Pay, and you train a clinician to use all of your clinic’s devices and
maternity or paternity leave, a minimum notice period, equipment, which they then use in practice on a daily or
protection against unfair dismissal, the statutory minimum weekly basis, they could be seen as more of an employee.
for paid holiday and more. Certain employment laws will not
apply to self-employed contractors, as they are in effect THE ADVANTAGES AND DISADVANTAGES OF
their own boss, but you will still be responsible for providing SELF-EMPLOYED PRACTITIONERS
a place of work that meets health and safety standards. It may seem like a good idea to take on freelancers in certain
situations. For example, when your business is new and
WHAT HMRC CONSIDERS TO BE AN “EMPLOYEE” you’re not yet sure of the demand for certain services, it may
It isn’t always easy to define what status your staff member seem wise to get help without having to commit long-term,
should have, especially if they work part-time hours or to a full-time role and salary. You may wish to add
or their schedule changes from week to week. injectable treatments to your laser clinic’s menu,
HMRC offers an online guide to employment Full- and but you do not yet have a regular client base
status at gov.uk/employment-status, or you for these treatments.
can contact them for guidance. In brief: part-time workers However, remember that certain
who have employment clauses work both ways. You may have
An employee is someone who: the chance to cut a self-employed
Has a full employment contract and
contracts with your practitioner’s working hours easily
is paid for time worked business will have if there is not enough work for them,
Is required to complete a regular different employment but this clinician could also leave your
number of hours per week/month business at short notice, without giving
Works only at the employer’s workplace rights to freelancers you enough time for you to find adequate
or a place specified by the employer cover. This doesn’t mean that all freelancers
Has essential materials and equipment will be disloyal, but it does mean you cannot
provided by their employer make the same demands of them as you can
Has a supervisor or boss, and the company an employee.
disciplinary process applies to them
Is not doing the work for their own company CONSIDER WHAT YOUR CLINICIAN WILL PREFER
Has to turn up, even if they don’t feel like working. Practitioners who have already been working as freelancers,
or have set up their own company and have been running
A freelancer or self-employed person is someone who: their own clinics, are unlikely to want to go back on the PAYE
Has their own business and is responsible for its success payroll, unless their own business has taken a downturn. A
or failure clinician with their own practice and a roster of loyal patients
Can decide what work to do and when is likely to have had the freedom and uncapped earning
Can subcontract or hire someone else to do the work potential that comes with being your own boss, so may see it
Is responsible for buying their own materials and as a step backwards to become an employee once again.
equipment and covering running costs. Practitioners who have not established their own
business, and those who are still honing their advanced
You may look at HMRC’s points and still wonder how a treating skills, may prefer to have the security of an
part-time aesthetic doctor would be classified, especially if employment contract and a guaranteed monthly income.
they meet criteria for both freelancers and employees. For The best thing you can do is keep your mind open, and
example, if you have an aesthetic doctor at your clinic two discuss further details with your chosen practitioner before
days every week, and you provide the dermal fillers they use you finalise employment agreements or contracts. AM
to inject your clinic patients, how are they best classified?
If your chosen clinician is already registered as self- REFERENCES
employed with HMRC, and they have undertaken freelance Employment status [UK: Gov.uk, 2017] <https://www.gov.uk/employment-status>
work with other businesses, then it is unlikely that you will
>> Victoria Vilas is marketing and operations manager at ARC, the aesthetics recruitment consultancy.
The ARC team help organisations within the industry grow their businesses by hiring the most talented
aesthetic professionals in the UK.
038-039 AM NOV17 Employment.indd 39 27/10/2017 16:33

SK IN/ D ER M A T O L O G Y
OF DERMATOLOGY
As part of her series on the A-Z of dermatology
Dr Johanna Ward gives an overview of viral warts
Viral warts are widespread benign skin infections. They occur in the
general population at a rate of 7-13% and at a higher rate in children
where it is estimated to be about 20%.
VIRAL WARTS
Definition: Viral warts are extremely common and benign Pathophysiology:
skin infections affecting all age groups but especially children. Warts have characteristic
They occur after inoculation with human papilloma virus thickening of the stratum corneum
(HPV), a DNA virus. (hyperkeratosis), thickening of the
Types: There are hundreds of different types of warts, from plane stratum spinosum (acanthosis),
warts and verrucas to filiform and mucosal warts. All are caused by thickening of the stratum
different strains of HPV. More than 130 different HPV strains are granulosum, rete ridge elongation
known. HPV 2,3,4,27,29 and 57 are the most common subtypes. and large blood vessels at the
Description: Viral warts are small papules that have a thickened, dermoepidermal junction.
hyperkeratotic surface and rough texture. They can range in shape Diagnosis: Diagnosis is straight forward in most cases
and size from 1 mm to larger than 1 cm. They often have a small black and can be done on clinical appearance and history. Biopsy is
dot in the centre which is due to a thrombosed blood capillary. rarely necessary.
Distribution: Common places for warts to occur are on the Treatment options: Many people choose to leave warts alone
hands and fingers, on the toes and around the nails. These are as they cause no harm and will often regress when left alone in
common places for trauma and auto-innoculation with the six to 24 months. If they are unsightly and bothersome then
virus. They do not normally cause pain except when they occur various salicylic acid topical lotions can be purchased OTC or
on the bottom of the feet as verrucas. prescribed. Duct tape and silver nitrate pens can be helpful as
Affects: home remedies.
Viral warts are extremely common. Particularly at risk groups are: In office cryotherapy and laser (usually pulsed dye or CO2)
Children (10-20% ) are both options for large warts or those that are resistant
Eczema sufferers (due to defective skin barrier function and to other treatment options. Cytotoxic treatments with
auto-inoculation) podophylin can be used although they are traditionally used
Immune deficiency states e.g. HIV sufferers more in the treatment of genital warts. AM
>> Dr Johanna Ward is the medical director of the award-winning Skin Clinic in Sevenoaks and Brentwood. She has
a special interest in dermatology and minor surgery and is the founder of ZENii, a premium vitamin and skincare
brand. Dr Ward won the MyFaceMyBody Award for Journalist or Beauty Blogger of the Year in 2016.
040 AM NOV17 AtoZ.indd 40 27/10/2017 16:36

Enhancing the effects of laser
treatment for female facial hair1
When she turns to you,

give her an adVANtage
Laser Hair Removal plus VANIQA® Available from

Healthxchange Ph
armacy
Me dical Ltd
A faster, more effective combination than laser alone* an d Wi gm ore
Please visit vaniqa.co.uk for more information

VANIQA® is licensed for the treatment of Female Facial Hirsutism
Prescribing Information (Please consult the Summary of Product Characteristics (SmPC) before prescribing). medical treatment of patients who might be prescribed Vaniqa. For cutaneous use only. Contact with eyes or mucous
Vaniqa 11.5% Cream eflornithine Active Ingredient: eflornithine 115 mg per gram (as hydrochloride monohydrate). membranes (e.g. nose or mouth) should be avoided. Transient stinging may occur if applied to abraded or broken skin.
Excipients with known effect: Each gram of cream contains 47.2 mg of cetostearyl alcohol, 14.2 mg of stearyl alcohol, If skin irritation or intolerance develops, the frequency of application should be reduced temporarily to once a day. If
0.8 mg of methyl parahydroxybenzoate and 0.32mg of propyl parahydroxybenzoate Indication: Treatment of facial irritation continues, treatment should be discontinued and the physician consulted. Contains cetostearyl alcohol and
hirsutism in women. Dosage and Administration: Should be applied to the affected area twice daily, at least eight stearyl alcohol which may cause local skin reactions (e.g. contact dermatitis) as well as methyl parahydroxybenzoate
hours apart. Application should be limited to the face and under the chin. Maximal applied doses used safely in and propylparahydroxy-benzoate which may cause allergic reactions (possibly delayed). Interactions: No interaction
clinical trials were up to 30 grams per month. Improvement in the condition may be noticed within eight weeks and studies have been performed. Fertility, Pregnancy and lactation: Women should not use Vaniqa whilst pregnant or
continued treatment may result in further improvement and is necessary to maintain beneficial effects. Discontinue breastfeeding. Ability to drive and use machines: Vaniqa has no or negligible effects on the ability to drive and use
if no beneficial effects are noticed within four months of commencing therapy. Patients may need to continue to machines. Undesirable Effects: These are ranked under heading of frequency using the following convention: very
use hair removal methods (e.g. shaving or plucking) in conjunction with Vaniqa. Application of Vaniqa should be no common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very
sooner than 5 minutes after use of other hair removal method, as increased stinging or burning may occur. A thin rare (<1/10,000). Very common: acne. Common: pseudofolliculitis barbae, alopecia, stinging skin, burning skin, dry
layer of the cream should be applied to clean and dry affected areas. The cream should be rubbed in thoroughly. The skin, pruritus, erythema, tingling skin, irritated skin, rash, folliculitis. Uncommon: bleeding skin, furunculosis. Rare:
medicinal product should be applied such that no visual residual product remains on the treated areas after rub-in. rosacea, skin neoplasm, skin cysts, vesiculobullous rash. Consult SmPC in relation to other adverse effects. Legal
Hands should be washed after applying this medicinal product. For maximal efficacy, the treated area should not be Category: POM Marketing Authorisation Number(s): EU/1/01/173/003 NHS Cost: (excluding VAT) Tube containing
cleansed within four hours of application. Cosmetics (including sunscreens) can be applied over the treated areas, but 60g - £56.87 Marketing Authorisation Holder: Almirall, S.A. Ronda General Mitre, 151 08022 Barcelona Spain. Further
no sooner than five minutes after application. The condition should improve within eight weeks of starting treatment. information is available from: Almirall Limited, Harman House, 1 George Street, Uxbridge, Middlesex, UB8 1QQ, UK.
Paediatric populations: The safety and efficacy of Vaniqa in children 0-18 years has not been established. Hepatic /renal Tel: 0800 0087 399. Email: almirall@professionalinformation.co.uk Date of Revision: 08/2017 Item code: UKEFL3336(1)
impairment: caution should be used when prescribing Vaniqa. Consult SmPC for further information. Contraindications,
Warnings, etc: Contraindications: Hypersensitivity to eflornithine or to any of the excipients. Warnings & Precautions:
Excessive hair growth can result from serious underlying disorders (e.g. polycystic ovary syndrome, androgen secreting Adverse events should be reported. Reporting forms and information can be found at
neoplasm) or certain active substances (e.g. cyclosporin, glucocorticoids, minoxidil, phenobarbitone, phenytoin, www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Almirall Ltd.
combined oestrogen-androgen hormone replacement therapy). These factors should be considered in the overall
*Complete or almost complete hair removal was achieved in 93.5% (29/31 subjects)
in eflornithine-laser treated sites vs 67.9% (21/31 subjects) in placebo-laser treated sites.1
Date of preparation: October 2017. UKEFL3769b Reference: 1. Hamzavi I et al. J Am Acad Dermatol 2007; 57(1): 54-59.
Vaniqa A4_Middle Eastern OCT 2017 UKEFL3769b_new logo.indd 1 19/10/2017 10:15

SKINCARE SPY www.aestheticmed.co.uk
S k i nc a r e Spy
We take a peek inside the bathroom cabinets of
industry professionals to see if they are practising what
they preach and what their cosmeceutical staples are
“Like many women,

I have tried a wide range of
skincare products over the years in the
hope of finding something that did what it said on the packet.
I finally got there with Elemis and Skinceuticals. My top choice is
the Elemis Pro-Collagen Marine Cream, which is light enough for the
summer and heavy enough for the winter.
I also love Elemis Pro-Radiance illuminating eye balm. This amazing product
contains fatigue-fighting ingredients and reduces the appearance
of fine lines and dark circles, leaving the eye area refreshed, revitalised
and radiant.
Exfoliation is an important part of my skincare regime. I highly recommend the
Papaya Enzyme Peel, which smells wonderful, is easy to apply and leaves your skin
purified and smooth.
Dr Maryam Osmani, Regents Park Aesthetics, London I absolutely adore Skinceuticals’ Phloretin CF and brightening UV defence
Dr Maryam Osmani qualified as a medical doctor in 2010 and SPF 30 for correction of pigmentation and protection against sun damage.
since then has been practising in the field of surgery within For summer sun, however, the Heliocare SPF 50 range provides
the NHS. During her training she developed a particular excellent cover. I use these products on my own patients after skin
interest in aesthetic medicine and now works at Regents treatments. Combine these products with a healthy diet
Park Aesthetics performing a range of treatments.
and exercise for healthy rejuvenated skin.”
“Having tried a lot of cleansers over

the yeras, but Exuviance Gentle Cleansing
Creme really hits the nail on the head. It’s gentle,
meaning that you can use it around the eye area
without irritation, and leaves the skin feeling refreshed
and smooth. Exuviance Triple Microdermabrasion is one
of my all-time favourites. It has the ability to eradicate dead skin cells,
brightening the skin and leaving it feeling super soft. I use this product
2/3 times a week and believe it aids smoother make-up application.
I recommend Exuviance Bionic Oxygen Facial to my clients, friends
and family, as it gives immediate results. I couldn’t be without
Exuviance Hydrafirm, it’s my essential, skin tonic! It smells divine
and certainly makes my skin feel nourished after application.
I also have a regular peels using the Neostrata range.
Following a peel, my skin is rejuvenated and I know
that I am keeping it healthy and youthful.” Tammie Rowe,, Prescents Salon, Southampton
Tammie Rowe has been a beauty therapist for more than
20 years and took over the Prescents Health and Beauty
Salon two and a half years ago. AM
042 AM NOV17 Skincare Spy.indd 42 27/10/2017 16:38

A NEW DIMENSION
IN BODY SCULPTING
Decrease circumference.
Diminish fat.
A non-invasive RF system
optimized to deliver Targeted,
Repeatable and Uniform
sculpting of problem areas for
a TRU 3D result.
Nothing protects Featuring
your skin like Super

anti-oxidant
Fernblock FC
Heliocare 360˚
The only daily-use, clinically proven
Before After One tx sun and anti-oxidant skin protection
range that combines:
Fernblock FC:
powerful anti-oxidant complex
UVA & UVB protection
Before After One tx

High-energy visible light protection
Infrared-A protection
DNA repair enzymes
Contact us to find out

more and request your
Before After One tx

FREE
SAMPLES
More information
e: info.uk@cutera.com
p: 0800 689 0437
aestheticare.co.uk
email info@aestheticare.co.uk
or call FREE on 0800 0195 322
Photos courtesy of A. Taub, M.D.

©2017. Cutera, Inc. All rights reserved.
© Ferndale Pharmaceuticals Ltd® 2017
043 adverts.indd 1 27/10/2017 15:47

TRIED AND TESTED www.aestheticmed.co.uk
I nt e l l i g e nt
skin car e
Jo Martin gives her review
of Endocare CELLPRO
I
can still recall being eight years old and finding my
mother’s pot of “vanishing cream” and being amazed at
the whole prospect of what it promised. Having liberally
covered my hands in this slimy, perfumed gloop I realised
that I had been duped – both hands were still clearly
visible. However, the double disappointment of failure
and the serious retribution for wasting my mother’s cream
began to teach me the lesson I needed to learn!
Many years on I am still fascinated by the often outrageous
promises manufacturers make for their products. Thankfully
the Trades Description Act put a stop to claims such as
“removes all wrinkles”, which is now diluted down to “may
reduce the appearance of fine lines and wrinkles”, which
of course brands can say, simply because pretty much any
hydrating cream which hyper hydrates the epidermis will
reduce the appearance of fine lines – for a few hours anyway.
In the face of all this “fake news” in the aesthetics
arena how is a sensible person with a sensible budget
supposed to find genuinely effective products?
I ran a busy skin clinic for 23 years and, in that time,
I sold thousands of skincare products ranging from the
very expensive to the moderately priced. All my choices
for both the retail side of my business, as well as for my own
personal use, were based on sound research and proven
facts. My personal favourite was the Endocare range in
which I virtually bathed on a daily basis and
044-045 AM NOV Tried & Tested.indd 44 27/10/2017 16:39

www.aestheticmed.co.uk TRIED AND TESTED
and scientists looking at the effects of CELLPRO use have

taken skin biopsies and observed new collagen production
at 90 days and beyond. So, these are not “quick fix” products
but long-term anti-ageing tools which continue to improve
the skin as time goes on.
Of course, this does not mean that you will need to
slice out sections of your skin to check for improvement,
because, if you follow the simple regime as I did, the results
will be clear in the mirror.
I was unsure at first about simply applying one eye cream
twice a day and either a gelcream plus Heliocare 360˚ SPF
in the morning and cream only in the evening, because I
normally layer a number of products on top of each other.
I didn’t need to worry though because, despite using a lot
less cream of various types, my skin has not suffered from
dryness at all but quite the reverse. It is bright and has a
glow to it that I always associate with healthy skin.
Having let my Botox and fillers wear off completely I am
now solely reliant on using the Newa RF home use device
never failed to be happy with the health of my skin as a result. and the CELLPRO products and, as I am no spring chicken at
These modestly priced products were a delight to my clients 63, this is quite a big ask.
as well and I never had anybody express disappointment Having said that, I feel that my skin is looking as healthy
with their results. as it ever has and the mimetic (or movement) lines on
Based on extensive clinical research, and originally my forehead, which reappeared in the absence of Botox, are
employed in the medical arena, it became known that the nowhere near as deep as they were when I was in my forties.
Crytomphalus Aspersa snail could produce significant skin I will continue with these products without a doubt, as for
healing effects that involved some pretty serious levels of me they represent my favourites but with extra benefits.
regeneration. And what does skin require increasingly as it And the cost of these clever products? Just £54.99 per
ages? Regeneration of course! item which equates to many OTC products which promise a
Consequently, I was very interested when the company lot but deliver so little by comparison.
asked me if I would like to try their latest range of products – As for the modern day vanishing cream equivalents? I’ll
EndocareCELLPRO.ThelatestversioncontainsCAFBioAction leave those to the light weights – if you are serious about
technology, which is actually the correct terminology for skin health you need snail power! AM
snail derived stem cell activators. So why is this exciting? Aestheticare is offering readers of Aesthetic Medicine a free
Because as we age, our fibroblasts, or collagen factories, sample of CELLPRO. To get yours aestheticare.co.uk/cellpro-
become less productive and decrease in numbers which sample, email hello@aestheticare.co.uk or phone 0800 0195 322.
leads to skin thinning and laxity. The stem cell activators in
CELLPRO can revive and re-energise our own stem cells and
encourage them to turn into new fibroblasts. This means
more collagen and elastin in the deeper layers and therefore
firmer and tighter skin in the longer term.
The inclusion of vitamin A ingredients
also improves surface skin by increasing
skin cell turnover and renewal, leading
to smoother and brighter looking skin,
thereby starting to reverse another part
of the skin ageing process.
An advanced moisturising system and
vitamin C and E complexes complete this
impressive all-rounder and make it a real
advancement in anti-ageing skincare.
I started using the products in June,
so you might wonder why I am only
just writing about them now but there
is a very good reason for that. Actual
collagen production in skin takes
approximately three months to achieve
>> Jo Martin is an aesthetic consultant at Martin-Stapleton Consulting. She founded the first private
laser clinic in the East Midlands in 1993 and has 22 years of laser experience. She is former lecturer on
Mapperley Park Training Courses and is an ex NHS physiotherapist.
044-045 AM NOV Tried & Tested.indd 45 27/10/2017 16:40

ANATOMY www.aestheticmed.co.uk
Scar ov er
Dr Sotirios Foutsizoglou discusses the physiological
factors affecting the final appearance of a scar
046-048 AM NOV17 Anatomy.indd 46 30/10/2017 15:42

www.aestheticmed.co.uk ANATOMY
E
ven the most intelligent patients ask this question: body parts grow, the scars become proportionately larger.
“will there be a scar?” When an injury occurs to the skin The direction of a laceration or excision also determines the
involving most of the dermis or an incision is made, there eventual appearance of the scar. Elective incisions or the excision
is always a scar. The question should be, why some people of lesions are usually planned to be parallel to the relaxed skin
develop a fine inconspicuous scar whereas others tend to tension lines. Maximal contraction occurs when a scar crosses
develop unsightly scars, even in favourable anatomical locations. the lines of minimal tension at a right angle. Wrinkle lines are
Following my previous article on collagen synthesis in wound generally the same as the relaxed skin tension lines (RSTLs) and lie
healing, this issue’s article will address the factors affecting the perpendicular to the long axis of the underlying muscles (Fig. 1).
final appearance of a scar. Remember that skin scars are the The shape of the wound also affects the ultimate appearance.
sequelae of the wound healing process following a breach in the The“trapdoor”scarresultsfromacurvilinearincisionorlaceration
epidermis and dermis. Interestingly, the same incision or wound in that,afterhealingandcontracture,appearsasadepressedgroove
two different patients will produce scars that differ in quality and with bulging skin on the inside of the curve.
aesthetics. For example, oily and dark skin produces less attractive Local conditions, such as crush injury, or systemic conditions
scars than thin, pale (Fitzpatrick I and II), older, and dry skin. Rules such as vascular disease, also affect the scar. Extreme malnutrition
are made to be broken, however, and an occasional patient will of vitamin deficiency may be a factor in scar formation.1
develop a scar that is not characteristic of his or her skin type.1 Atraumatic technique of approximation of the skin edges,
debridement of necrotic tissue or foreign material, and a tension-
OBTAINING A FINE-LINE SCAR free closure are the first steps in obtaining a fine-line scar. When
The final appearance of a scar is dependent on many factors, sutures are used, consideration should be given to choosing the
including the following: a) differences between individual appropriate material. The skin edges should be approximated
patients that we do not. yet understand and, therefore, cannot in an everted fashion as everted wound closures are always
predict; b) the type of skin and location of the body, such as associated with a better looking scar. In addition, placement of
chest or shoulder scars tend to widen or become hypertrophic. sutures that are not excessively tight and are removed promptly
Conversely, eyelid incisions almost always heal with a fine-line are two technical factors of definite importance in increasing the
scar; c) the tension on the closure; d) the direction and size of likelihood of a “good” scar. Ultimately, however, scar formation is
the wound and its anatomical boundaries; e) other local and unpredictable even with meticulous technique.1
systemic conditions, such as infection or malnutrition; and
lastly, f) the suturing or surgical technique. SYMPTOMATIC SCARS
At the end of the proliferative phase of wound healing, the
collagen deposition and resorption is at equilibrium and the wound
Descriptive Classification of Scars
strength is approximately 50% of normal. From this point on, as
Scars may be flat, thin, wide or stretched- the scar remodels, it should gradually soften, becoming pale and
out, depressed, trap-door, contracted, asymptomatic, leaving a fine scar at 12-18 months after injury.
In excessive cutaneous scar formation, wounds heal with
hyper- or hypopigmented, raised, an over-proliferative response, producing excessive cells
hypertrophic, or keloid. and extracellular matrix components including collagen and
ground substance. The collagen is predominantly immature
type III and disorganised. There are higher levels of soluble
Skin loses its elasticity with age. Stretched-out skin, collagen and collagenase indicating a greater wound
combined with changes in the subcutaneous tissue, turnover. 2 Excessive scar formation can be classified as
produces wrinkling, which makes scars less obvious and less either hypertrophic scarring or keloid formation. Both are
prone to widening in older individuals. Children, on the other manifestations of overexuberant scarring, although the
hand, may heal faster but their elastic skin and abundance of upstream aetiology is probably different.3
collagen may lead to a thicker and wider scar. In addition, as
KELOID SCARS
Keloids are less common and have a genetic component that
limits them to < 6% of the population, primarily the young
black and Asian populations < 30 years of age.
Macroscopically, these scars are thickened and elevated,
extending beyond the borders of the original wound.
Histologically, keloids are characterised by the overgrowth of
dense fibrous tissue with large, thick
collagen fibrils laid down in an irregular
pattern with less evidence of cross-
linking than in normal scars. There is
also an increase in vascularity.
These scars can occur up to a
year after trauma or with no defined
injury. They reach a specific size
and remain at that size for many
years without regression. Keloids
Fig.1. RSTLs are perpendicular to the underlying muscles of the face. most commonly occur on the face,
Ageing tends to accentuate the appearance of RSTLs. earlobes, and anterior chest (Fig. 2). > Fig. 2. Keloid scar on earlobe

ANATOMY www.aestheticmed.co.uk
HYPERTROPHIC SCARS collagenase due to reduction in wound α2-macroglobulin

Hypertrophic scars are also characterised by the formation of content or reduced collagen deposition due to a reduction
dense collagen fibres following injury but, in contrast to keloids, in fibroblast activity. Steroids also reduce inflammation.
do not extend beyond the original wound margins. They are Topical retinoic acid and vitamin E inhibit fibroblast
more prone to forming disabling contractures and are a near- production and reduce fibroblast numbers respectively.
universal outcome following extensive deep burn injury. 5-Fluorouracil (5-FU), a thymidylate synthase (TS) inhibitor,
The scars usually become more evident one to two interferes with DNA replication and cell division. Other
weeks after epithelial closure. They are more responsive to drugs such as penicillamine, colchicine, interferon and
treatment than keloid scars. cyclosporin A have also been used with variable results.
Hypertrophic scarring can occur at any age but mainly Laser can reduce pigmentation and shortens the inflammatory
< 20 years, and there is a familial inheritance. Males and phase of wound healing. The prolonged secretion of
females are equally affected. inflammatory cytokines has been shown to induce fibrosis.
The aetiology can be idiopathic Surgery (e.g. serial excision, realignment of the scar
or secondary to wound infection, along RSTLs to reduce tension, flaps, or grafts) should be
dehiscence, or tension. Wounds with a reserved until the scar has matured, unless it is causing a
higher risk of becoming hypertrophic contracture. The patient should be warned that surgery may
include chronic wounds or those with result in a worse scar. Recurrence rates and outcome can be
an increased inflammatory phase, significantly improved by combining surgery with adjunctive
wounds not in RSTLs, wounds in areas treatments such as external beam irradiation and steroids.
of high tension such as the anterior
chest, shoulders, and anterior neck, CONCLUSION
and wounds that heal by secondary Wound healing is one of the most complex physiological processes.
intention (Fig. 3). Fig. 3. Hypertrophic scars During the progression from an injury to a stable scar, the intrinsic and
of the anterior chest extrinsic clotting system is activated; there is an acute inflammatory
MANAGEMENT OF response; neovascularisation proceeds through angiogenesis and
ABNORMAL SCARS vasculogenesis; cells proliferate, divide, and undergo apoptosis;
The exact aetiology and pathophysiology of and extracellular matrix (ECM) is deposited and
excessive scar formation remains unknown. remodelled. These occur simultaneously and also
Many theories have been proposed to interact and influence each other at the level of
account for the fibroproliferation observed Scar formation gene transcription and protein translation in a
in hypertrophic scar and keloid formation, dynamic and continuous fashion. Thus, it is
including mechanical strain, inflammation, and the response to not surprising that scar formation and the
bacterial colonisation, and foreign body injury are still poorly response to injury are still poorly understood
reaction. Unfortunately, investigation by scientists and clinicians alike, except at a
of the mechanisms underlying these
understood by scientists purely descriptive or empirical level. The sheer
diseases has been hindered by the and clinicians alike number of commercially available products of
absence of animal models that reproduce unproven efficacy is a testament to the lack of
the characteristics of human overscarring. mechanistic understanding of wound healing
Modalities employed to reduce the unsightly and scar formation. Several stem cell populations
appearance of excessive scarring include: have been identified in the skin and are increasingly
Pressure therapy (e.g. silicone sheeting, studied as potential therapies for wound repair without scarring.
elasticated compression garments) may have a These progenitor populations include epidermal stem cells, hair
mechanomodulatory action increasing the collagenase follicle stem cells, and adipose-derived stem cells that have the
activity and decreasing the wound metabolism, leading to capacity to restore almost all skin compartments.4,5 The question
an early maturation of the scar. Ideally, the pressure should for the researchers is how to exploit these powerful cell populations
exceed normal capillary pressure (24 mmHg). Pressure to promote cutaneous repair in disease states or following injury. AM
applications are applied when the wound is fully healed and
need to be worn for 18-24 hours a day to show some effect.2
REFERENCES
Silicone gel may exert its therapeutic action either by a 1. Thorne CH et al. Grabb and Smith’s Plastic Surgery. 7th Ed. Lippincott and
direct chemical effect or by causing wound hypoxia and Williams and Wilkins, 2014.
2. Giele H. and Cassell O. Plastic and Reconstructive Surgery. Oxford University
increased hydration with success rates of more than Press, 2008.
80% for hypertrophic and 35% for keloid scars. Other 3. Kose O. and Waseem A. Keloids and hypertrophic scars: are they two different
occlusive materials such as hydrogels have been trialled sides of the same coin? Dermtol Surg. 2008;34:336-346.
4. Cha J. and Falanga V. Stem cells in cutaneous wound healing. Clin Dermatol.
with similar success rates to silicone. 2007;25:73-78.
Corticosteroids (intralesional triamcinolone) reduce 5. Blapain C, Fuchs E. Epidermal stem cells of the skin. Annu Rev Cell Dev Biol.
2006;22:339-373.
collagen levels either by increased activity of
>> Dr Sotirios Foutsizoglou developed a particular interest in anatomy during his time working in plastic and
reconstructive surgery in the NHS. He became heavily involved in teaching anatomy and physiology to medical
students and junior doctors and has worked as an anatomy demonstrator for Imperial College. He is currently
completing his last year of training in Plastic and Reconstructive Surgery at Evangelismos General Hospital
of Athens. Since 2012, in his role as the lead trainer of KT Medical Aesthetics Group, he has been training
practitioners in facial anatomy and advanced non-surgical treatments and procedures. He has written and
lectured on facial anatomy and complications associated with injectables both nationally and internationally.

new
CLINICAL • SAFETY
CLINISEPT+ PREP & PROCEDURE
CLINISEPT+ AFTERCARE
Effective skin cleansing is arguably the most

important aspect of any aesthetic procedure,
but there have been few meaningful
developments in this field for many years –
until now.
Clinisept+ is a ground-breaking technology
which brings significant benefits over existing
medical skin disinfectants and pre-procedure
cleansers.
Ultimate skin Complete skin

disinfection compatibility
+ Bactericidal + Skin neutral pH
Manufactured to ISO13485 Medical Standards of quality reliability and assurance

+ Fungicidal + Dermatologically tested
+ Virucidal + No alcohol, parabens, fragrances Clinisept+ has been
+ Sporicidal + Non-cytotoxic to re-growing skin comprehensively
tested by independent
laboratories to prove
The Clinisept+ products deliver a unique combination of greater protection its efficacy and safety.
against infection before, during and after aesthetic procedures, as well as
far better skin compatibility than existing medical cleansers - providing an Highly effective
ideal environment for the skin to recover. antimicrobial cleansing:
∙ BS EN 1040 ∙ BS EN 1275
∙ BS EN 1276 ∙ BS EN 13727
∙ BS EN 1650 ∙ BS EN 13704
Clinisept+ represents a new standard of ‘best practice’ safety, that,
combined with the additional benefits that Clinisept+ brings to Proven skin safety:
patient outcomes, makes this a step change product that should be ∙ Non-toxic
adopted by all professional clinics. ∙ Non-irritant to skin
∙ Non-irritant to eyes
∙ Non cytotoxic.
Meeting the needs of your business,

delivering high satisfaction to your patients
Call us on 01234 313130 | info@aestheticsource.com
www.aestheticsource.com
SKIN NEWS www.aestheticmed.co.uk
I mage Skincare introduces medical only range

Image Skincare has launched a new range of products for
medical clinics only.
Containing 13 products, the Image MD range has been
formulated by plastic surgeons and includes retinols, AHAs,
lighteners, peptides, ADT and plant-derived stem cell
technology.
Among the products is Image MD AHA/BHA daily cleanser
and a restoring post treatment masque. There is also a
retinol booster, which contains omega 3 and 6 oil infused
with retinol to hydrate skin. Also featured is a collagen
eye gel, which targets wrinkles, puffiness and dark circles,
alongside a post-treatment scar gel, which aims to reduce
the thickness and roughness of scars.
Skinbrands unv eils L imited

Edition Christmas Collections M A G announces monthly
from Rev itaL ash O xygenetix competition
RevitaLash Cosmetics has Medical Aesthetics Group (MAG) is holding
created two Perfecting Gift an Oxygenetix giveaway worth £350 for
Collections complete with clinics this month.
lash and brow regimens To enter the competition, you simply
and packaged in a premium need to send an image or video capturing
window box for Christmas. your best before and after transformation
The Lash Perfecting using the award-winning foundation.
Gift Collection includes MAG is offering the winner a full set of 12
RevitaLash Advanced Oxygenetix Foundations, a display unit and
Eyelash Conditioner, Defining a 'Clinic of the Month' feature across the
Liner Eyeliner, Volumizing Oxygenetix social media channels, reaching
Primer and Volumizing Mascara (RRP £104). thousands of potential new customers.
The Brow Perfecting Gift Collection features the best- The competition opens on November 1 and
selling RevitaBrow Advanced Eyebrow Conditioner and entries must be submitted by November 20.
all new RevitaLash Tweezers to achieve the ultimate Bold Send your entries to info@emmabw.com.
Brow designed to contour, define and enhance brows. It also
includes Hi-Def Tinted Brow Gel (RRP £99).
M edik8 createskitcollection A w ards for

Medik8 has unveiled a new collection of kits in time for Christmas.
Each kit contains travel-size bottles and has been carefully-curated to
Skinade
address common skincare concerns. Skinade was presented with
The Age Renew Starter Kit features Medik8’s most coveted anti-ageing two awards at the Aesthetic
products: poreCleanse Gel, Replenish: Hydr8, C-Tetra, Retinol 3 TR, Eyelift Everything Diamond Crystal
andPhysicalSunscreenSPF30,whiletheSmartRecoverySkincareSystem Awards ceremony, earning the
is designed to return compromised, post-procedure skin to its optimum title of Top Breakout Company
state of health. It includes: Red Alert Cleanse, C-Tetra, Retinol 3 TR, and Top Nutraceutical.
Ultimate Recovery and Physical Sunscreen SPF 30. Louise Marchesin, Head of
Other collections include the Blemish Control Kit, a comprehensive Marketing at Skinade said,
four-step regime that “We are incredibly proud of our
combats oily skin; the awards as it reflects the amazing
Gentle Repair Skincare response we have been getting
System, a restorative since launching in the US a
skincare system to soothe year ago.
and replenish sensitised "Being acknowledged by our
skin and breakouts; and the peers allows us to really solidify
White Balance Kit, a no-fuss just how far we have come.
solution for a healthy, even Skinade is pioneering the inside-
and glowing complexion. out approach and is here to stay.”
050 AM NOV17 Skin News.indd 50 27/10/2017 16:41

“TWO TREATMENTS
AND ONE NATURAL LOOK”
HA FILLER
&
PDO THREADS
CPD CERTIFIED
TRAINING COURSES AVAILABLE
FOR FURTHER INFORMATION PLEASE CONTACT

EVENTS@INTRALINE.COM OR CALL 0203 841 8000
OR VISIT SHOP.INTRALINE.COM
Untitled-28 1 15/09/2017 14:53

PB DPS.indd 2 10/02/2017 11:45
1.3cm
1.3cm
PB DPS.indd 3 10/02/2017 11:45

I NJ EC T A B L ES
MANAGING COMPLICATIONS www.aestheticmed.co.uk
054-060 AM NOV17 Managing complications.indd 54 27/10/2017 16:43

I NJ EC T A B L ES
www.aestheticmed.co.uk MANAGING COMPLICATIONS
Bl in d s p o t
The Aesthetic Complications Expert Group updates its guidance
on visual loss secondary to cosmetic filler injection
Definition:
“Any impairment or loss of vision (temporary or permanent) secondary
to central retinal or retinal branch artery occlusion occurring as a direct
consequence of percutaneous injection for aesthetic treatment1.”
B
lindness after facial injection is extremely rare Type I – Blindness without ophthalmoplegia (paralysis or
and was first reported by von Bahr more than 50 weakness of ocular muscles) and ptosis
years ago after scalp injection of a hydrocortisone Type II – Blindness with ptosis but without ophthalmoplegia
suspension to treat alopecia. 2 The first cases after Type III – Blindness with ophthalmoplegia but without ptosis
aesthetic filler treatments were reported in the Type IV – Blindness with ophthalmoplegia and ptosis
1980s (four cases) and rose to at least 16 reported cases in Based on previously reported case studies, improvement
between 2000-2010, presumably related to the increase in of visual acuity in patients with vascular occlusion after filler
the number of treatments being performed.1 injection is extremely rare. By contrast, periocular symptoms
Depending on which artery is occluded, vision loss can be such as ptosis and ophthalmoplegia recovered dramatically.6
classified into six subtypes3,4,5 :
1. Ophthalmic artery occlusion (OAO) MECHANISM
2. Generalised posterior ciliary artery occlusion with Terminal branches of the ophthalmic
relative central retinal artery sparing (PCAO) artery, namely the supraorbital
3. Central retinal artery occlusion (CRAO) and supratrochlear, supply Improvement
4. Branch retinal artery occlusion (BRAO) the medial forehead and of visual acuity in
5. Anterior ischaemic optic neuropathy (AION) anastomoses between these
6. Posterior ischaemic optic neuropathy (PION) vessels and the terminal patients with vascular
There are also four subtypes of periocular complications branches of the angular occlusion after
associated with blindness following cosmetic filler injection6: artery are well documented.7 >
filler injection is
extremely rare
Supraorbital Ophthalmic
Supratrochlear Posterior ciliary
artery artery
artery artery
Dorsal nasal
artery
Angular
artery
Lacrimal
artery
Internal cartoid
Anterior ciliary artery
artery Central retinal
artery
Laberal nasal
artery

I NJ EC T A B L ES
Visual loss following emboliaation of dermal filler typically

occurs within seconds of injection7 although visual loss has
been reported seven hours post-treatment in the case of a
posterior ciliary artery occlusion.14 Complete loss of vision is
the normal presentation although there may be visual field
defects. Visual loss is often accompanied by sudden onset
of severe pain (ocular, facial, headache or any combination)
although central retinal and retinal branch artery occlusions
may present without ocular pain. Other symptoms include
ophthalmoplegia (paralysis or weakness of ocular muscles),
Similarly, anastomoses with the superficial temporal arteries ptosis, enophthalmos (posterior displacement of the eye)
and the orbit has also been demonstrated.8 Injection of filler and horizontal strabismus (abnormal alignment of the eyes).
material into one of these vessels may lead to retrograde flow These symptoms accompany blindness due to disturbed
to beyond the point of the origin of the ophthalmic artery and flow to the superior and inferior branches which supply the
when pressure from the plunger is released, systolic pressure extraocular muscles.6
drives the product forward and to enter the ophthalmic artery Many cases with visual loss and periocular symptoms also
or central retinal artery resulting in visual loss. subsequently developed enophthalmos and surgery could
The requirements for blindness to occur include the be considered in patients demonstrating greater than 2mm
retrograde and subsequent anterograde passage of descent within six weeks of the injury.15
material, injection pressure exceeding systolic pressure Other symptoms and signs include7 corneal oedema,
and sufficient amount of material within the lumen of the anterior chamber inflammation, nausea, headache, pupillary
vessel. Findings indicate that the average entire volume of abnormality, iris atrophy, phthisis bulbi and livedo reticularis.
the supratrochlear artery from the glabella to the orbital Cerebral infarction can accompany retinal artery occlusion
apex is 0.085ml (range 0.04-0.12ml)9 and injection volume and therefore signs and symptoms of this may also be
should not exceed this volume in critical injection points. present such as aphasia or even contralateral hemiparesis.
Central nervous complications were seen in 23.5%12 to 39%5
INCIDENCE of cases where vision was affected. An MRI scan should be
Globally, at least 98 cases of visual loss after aesthetic facial performed in all patients who suffer visual loss or ocular pain
injection have been reported prior to 2015.1,10,11,12 A review as a result of filler injections.10
of the world literature by Belezany12 identified 98 cases
of vision change. High risk areas were glabella (38.8%), AREAS OF CAUTION
nasal region (25.5%), nasolabial fold (13.3%), and forehead Injections into the nose and glabella form the vast majority
(12.2%). Autologous fat was responsible for most of the of reported cases of blindness7 although moderate risk sites
complications (47.9%) followed by hyaluronic acid (23.5%) 12 included the nasolabial folds, forehead, periocular region,
and the outcome was worse in cases when autologous fat temple and cheek. Uncommon sites were the eyelid, lips and
had been injected.5,10 chin. Due to the complex vascularity of the face, any region
In 2012, the UK reported its first case (after injection to of the face has the potential to cause this complication.4
the temple with Poly-L-Lactic Acid, the first report with this
product).13 In 2013, the first two cases of bilateral blindness were MINIMISING THE RISK
reported (calcium hydroxyapatite to the nose and hyaluronic The key preventative strategies are listed below 6:
acid to the glabella, which also led to cerebral infarction).11 The 1. Know the location and depth of facial vessels and the
exact incidence of this devastating adverse event remains to be common variations.7 Injectors should understand the
determined due to the heterogeneity of data.7 appropriate depth and plane of injection at different sites.
Due to the seriousness of this complication, significant 2. Inject slowly and with minimal pressure.1,4,11
visual loss should be explained to the patient as a possible 3. Inject in small increments1,7 so that any filler injected into
rare complication as part of the consent process.11 the artery can be flushed peripherally before the next
incremental injection. This prevents a column of filler
SIGNS AND SYMPTOMS traveling retrograde and subsequently anterograde. No more
Pain (ocular, facial, headache or a combination) than 0.1 mL of filler should be injected with each increment.
Nausea 4. Move the needle tip while injecting4, so as not to deliver
Vision loss a large deposit in one location.
Paralysis or weakness of ocular muscles 5. Always aspirate before injection.1,4,7 This recommendation
Ptosis is controversial as it may not be possible to get flashback
Posterior displacement of the eye into a syringe through fine needles with thick gels. In
Strabismus (misalignment of the eyes when looking at an addition, the small size and collapsibility of facial vessels
object) limit the efficacy.
Corneal oedema 6. Use a small-diameter needle.1,7 A smaller needle
Pupillary abnormality necessitates slower injection and is less likely to occlude the
Iris atrophy vessel. If a sharp needle is being used then a perpendicular
Anterior chamber inflammation injection directly in contact with the bone is recommended;
Phthisis bulbi (shrunken, non-functional eye) injecting into a deeper plane may avoid vessels.7
Livedo reticularis (a mottled, reticulated vascular pattern 7. Smaller syringes4 are preferred to larger ones as a
of the skin) large syringe may make it more challenging to control

I NJ EC T A B L ES
www.aestheticmed.co.uk MANAGING COMPLICATIONS
the volume and increases the probability of injecting a REDUCE INTRAOCULAR PRESSURE7
larger bolus. Administer Timolol4,7 0.5% one to two drops in the affected
8. Consider using a cannula (minimum size 25G), as they eye only. This beta-adrenergic antagonist will aim to reduce
are less likely to pierce a blood vessel.1,7 Some authors intraocular pressure by reducing aqueous humor production.
recommend use of the cannula in the medial cheek, tear The patient should be encouraged to ‘rebreathe’ in a paper
trough, and nasolabial fold. bag. The aim is to increase CO2 levels within the blood which
9. Use extreme caution when injecting a patient who has will cause retinal arteries to vasodilate and could help dislodge
undergone trauma or a previous surgical procedure in blockage. An alternative to rebreathing through a paper bag is
the area.4 the inhalation of carbogen (95% oxygen, 5% carbon dioxide).4
10. Ensure that you are adequately trained, using an Oral acetazolamide4,7,14 may be considered although
appropriate product and are competent in the area intravenous administration in hospital is likely to be of
in which you are treating as well as competent of the greater benefit.
management of complications. Give the patient 300 mg of aspirin to prevent blood
11. A technique to possibly prevent embolism of filler is clotting.14
digital compression of the inferior-medial orbital rim
and the side of the nose7 whilst injecting. DISLODGE THE EMBOLUS TO A MORE
Sometimes the ophthalmic artery does not arise normally PERIPHERAL POSITION
from the internal carotid artery, but from the middle Massage the globe with repeated increasing pressure.
meningeal artery, which originates from the Prolonged ocular massage attempts to dislodge
external carotid artery. Furthermore, the emboli by rapidly changing intraocular
zygomatic-orbital artery raised from pressure4 thereby changing the pressure
the superficial temporal artery has an and flow in the retinal arteries.
anastomosis with branches of the The use of hyaluronidase Increasing the intraocular pressure
ophthalmic artery, and may be a has been shown to be also causes a reflexive dilation of
retrograde arterial embolic route.14 the retinal arterioles and dropping
Facial anatomy can be diverse and
ineffective at recanalising it suddenly increases the volume of
the facial artery originated from the retinal artery occlusion or flow significantly.
a single arterial trunk in 86% of improving the visual outcome Ocular massage is performed with
specimens and branching patterns the patient looking straight ahead
were only symmetrical in 53% of after four hours after onset with eyes closed. Gentle pressure is
cases.16 In conclusion, there is no of blindness 3 applied over the sclera with a finger,
absolute safe area of the face to inject.1 indenting the globe by a few millimetres
and then releasing at a frequency of
TREATMENT OF BLINDNESS two to three times a second.19 This should
AFTER FACIAL INJECTION be continued until advised otherwise by staff
Once the retinal artery has been occluded at the eye hospital. Commonly, firm ocular massage is
there is a window of 60-90 minutes before blindness is advised for several seconds and repeated only a few times.
irreversible.7 It is advisable to transfer the patient to the nearest The alternative advice originates from two case studies
specialist eye hospital via blue light ambulance as quickly as where embolised retinal arteries were directly visualised
possible.4 Transfer to a non-specialist emergency department during the massage process. This showed that even when the
may lead to inordinate delay and worse outcome.7 Ensure that emboli were dislodged, more would occlude the vessel when
you know which your closest specialist eye department is and massage stopped. Prolonged high frequency massage (up to
contact the on-call team as soon as possible to inform them three hours) had a better clearing effect.19
of the situation. Give medical staff as much information as
possible about the product, area and volume of injection. ADMINISTER HYALURONIDASE
Although there is no generally agreed treatment If hyaluronic acid has been used, administer hyaluronidase
regimen17, there are actions that may help. Prado18 suggests to the treatment area according to ACE Group guideline
a six-step therapy protocol with a ‘blindness safety kit’ that “The Use of Hyaluronidase in Aesthetic Practice”.
may be used in a clinical setting then continued into hospital. Retrobulbar injection of hyaluronidase has been
The protocol was adapted from Lazzeri et al.1 advocated by many plastic surgeons as emergency
treatment, however an evaluation by Zhu et al3 failed
TREATMENT OF BLINDNESS AFTER FACIAL to show any improvement in visual loss following 1,500-
INJECTION 3,000 units of hyaluronidase injected into the retrobulbar
Indications for treatment are sudden onset ocular pain and/or loss space in four patients. Consensus from ophthalmologists
of vision. The goal is to quickly reduce the intraocular pressure to when consulted on the topic of retrobulbar hyaluronidase
allow for the emboli to dislodge downstream and improve retinal injections by aesthetic practitioners is that it is a technically
perfusion1. Treatment must start within 90 minutes. difficult procedure even to a competent ophthalmological
Stop treatment immediately surgeon and the scope for causing more harm means the
Place patient in supine position7 risks outweigh any benefit.
Call 999 and prepare to transfer patient to hospital However, Chestnut20 recently reported in Dermatologic
setting as soon as possible. Surgery full restoration of vision after blindness was
Do not let any of the below delay referral to a specialist eye reported in a patient receiving hyaluronic acid fillers in the
hospital. midface. Vision was restored following three retrobulbar >

I NJ EC T A B L ES
REFERENCES
1. Lazzeri D, Agonstini T, Figus M, Nardi M, Pantaloni M, Lazzeri
S. Blindness following cosmetic injections of the face. Plastic
Reconstructive Surgery, 2012 April; 129(4):995-1012
2. von Bahr G. Multiple embolisms in the fundus of an eye after an

injection in the scalp. Acta Ophthalmol (Copenh.) 963;41:85–91
3. Zhu GZ, Sun ZS, Liao WX, Cai B, Chen CL, Zheng HH, Zeng L, Luo
SK. Efficacy of Retrobulbar Hyaluronidase Injection for Vision Loss
Resulting from Hyaluronic Acid Filler Embolization. Aesthetic Surg J
2017,1-11
4. Szantyr A, Orski M, Marchewka I, Orska M, Zapala J. Ocular

Complications Following Autologous Fat Injections Into Facial Area:
Case Report of a Recovery from Visual loss After Ophthalmic Artery
Occlusion and a Review of the Literature. Aesthetic Plast Surg.2017
Jun; 41(3) 580-584
5. Park KH, Kim YK, Woo SJ. Iatrogenic Occlusion of the

Ophthalmic Artery After Cosmetic Facial Filler Injections. JAMA
Ophthalmol.2014;132(6):714-723
6. Yujin M, Sangjun Y, et al. The Classification and Prognosis of Periocular

Complications Related to Blindness following Cosmetic Filler Injection.
Plastic and Recon surg: July 2017;140(1):61-64
hyaluronidase injections and aspirin. A total of 750 units 7. Loh KTD, Chua JJ. Prevention and management of vision loss relating to
were administered, 450 units as retrobulbar injections facial filler injections. Singapore Med J 2016. 57(8):438-443
and 300 units to surround the supraorbital and infraorbital 8. Tansatit T1, Moon HJ, Apinuntrum P, Phetudom T. Verification of
foramina. Retrobulbar injections should only be considered Embolic Channel Causing Blindness Following Filler Injection. Aesthetic
Plast Surg. 2015 Feb;39(1):154-61
by practitioners competent in this procedure in a specialist
eye unit. 9. Khan TT, Colon-Acevedo B, Mettu P, DeLorenzi C, Woodward JA. An
Anatomical Analysis of the Supratrochlear Artery: Considerations
Injection of hyaluronidase into the supratrochlear or in Facial Filler Injections and Preventing Vision Loss. Aesthetic Surg
supraorbital arteries to reach the embolus seems a more J.2017 Feb;37(2):203-208
sensible approach. 10. Woo SJ, Park SW, Park KH, Huh JW, Jung C, Kwon OK. Iatrogenic retinal
The use of hyaluronidase has been shown to be ineffective artery occlusion caused by cosmetic facial filler injections. American
Journal of Ophthalmology, 2012 Oct; 154(4):653-662
at recanalising the retinal artery occlusion or improving the
11. Carle MV, Roe R, Novack R, Boyer DS. Cosmetic Facial Fillers and Severe
visual outcome after four hours after onset of blindness.3 Vision Loss. JAMA Ophthalmol. Published online March 06, 2014.
doi:10.1001/jamaophthalmol.2014.498
SPECIALIST TREATMENT 12. Belezany K, Carruthers JDA, Humphrey S, Jones DJ. Avoiding and
Once the patient has been transferred to the hospital Treating Blindness From Fillers: A Review of the World Literature.
Dermatologic Surg 2015;41:1097-1117
setting, the aim is to further reduce intraocular pressure,
remove/reverse central retinal ischaemia and increase 13. Townshend, A. Blindness after facial injection. Journal of Clinical and
Aesthetic Dermatology.Published online December 2016. doi: 763416-
blood flow to the retina. dec-2016/60
Injection of 500mg IV Acetazolamide. This should increase 14. Hu XZ, Hu JY. Posterior Ciliary Artery Occlusion Caused by Hyaluronic
retinal blood flow and reduce intraocular pressure. Acid Injections Into the Forehead. Medicine;95(11): March 2016
Consider the use Enoxaparin subcutaneously or IV 15. Hazani R, Yaremchuk MJ. Correction of posttraumatic enophthalmos.
Heparin for anticoagulation.7 If the patient is having signs Arch Plast Surg. 2012;39:11–17
or symptoms of cerebral infarction, defer this step until a 16. Lohn JW, Penn JW, Norton J, Butler PE. The course and variation of the
Neurologist has assessed the patient. facial artery and vein: implications for facial transplantation and facial
surgery. Ann Plast Surg. 2011 Aug;67(2):184-8
Intravenous infusion of mannitol 20% (100ml over 30
17. Fraser SG, Adams W. Interventions for acute non-arteritic central
minutes).4,7 retinal artery occlusion. Cochrane Database Syst Rev. 2009 Jan
Consider injection of hyaluronidase via the transorbital 21;(1):CD001989. doi: 0.1002/14651858.CD001989.pub2.
approach into the more prominent and tortuous 18. Prado G, Rodriguez-Feliz J. Ocular Pain and Impending Blindness During
postseptal ophthalmic artery. 21 Facial Cosmetic Injections: Is Your Office Prepared? Aesth Plast surg
2017;41:199-203
Other supportive therapies include18: 19. Baker DL. Gentle, prolonged ocular massage can restore vision after
retinal artery occlusion. Ocular Surgery News U.S. Edition, July 1, 2004
Anterior chamber paracentesis7,11 to immediately lower
20. Chestnut C. Restoration of Visual Loss With Retrobulbar Hyaluronidase
intraocular pressure. Injection After Hyaluronic Acid Filler. Dermatol Surg. 2017;0:1-3
Steroid administration7, intravenous dexamethasone.4,14
21. Tansatit T1, Apinuntrum P, Phetudom T. An anatomic basis for treatment
Judicious use of antibiotics for suspected infection.7 of retinal artery occlusions caused by hyaluronic acid injections: a
Hyperbaric oxygen may salvage vulnerable retinal cadaveric study. Aesthetic Plast Surg. 2014 Dec;38(6):1131-7
damage.7,11,14 Practitioners should familiarise themselves

with their nearest hyperbaric oxygen chamber.
Authors Expert Group Consensus Group
Intravenous prostaglandin E14 to increase blood flow to
Dr Lee Walker Dr Martyn King Constance Campion
the retina and decrease activation of thrombocytes and Dr Martyn King Emma Davies Helena Collier
neutrophils. AM Sharon King Dr Ben Coyle
Dr Cormac Convery Dr Harryono
The ACE Group now has 700 registered members and Dr Lee Walker Judodihardjo
Dr Sam Robson
465 practitioners on their forum. Visit www.acegroup. Mr Taimur Shoaib
online to join the ACE Group.

aesthetic M ED I CI N E
CALL FOR ARTICLES
Are you interested in becoming a contributor

to Aesthetic Medicine magazine?
Do you have any articles you would like to write or any thoughts, treatment tips
or techniques you would like to share? Then we want to hear from you.
Whether it’s writing about running an aesthetics business or sharing your case studies
and clinical expertise, then get in touch and let us know your ideas by emailing
info@aestheticmed.co.uk or calling 0207 351 0536.
/AestheticMedicineMagazine @AestheticMedMag
www.aestheticmed.co.uk/magazine
4195 SPS Call for papers AM Advert A4.indd 1 27/10/2017 10:03
I NJ EC T A B L ES
EDITOR’S CHOICE www.aestheticmed.co.uk
P r o f h ilo
Vicky Eldridge tries out Profhilo
T
here has been a lot of excitement around Profhilo Profhilo is a BDDE-free, thermally-linked product and it
since it launched in the UK in 2016. provides a slow and long-lasting release of both high and
Every practitioner I speak to who uses it raves low molecular weight HA. Although it is based on hyaluronic
about it and, after visiting the IBSA Pharma factory acid technology, Profhilo is described as a “bio-remodelling
in Milan earlier this year with the UK distributor HA product” rather than a filler. The product utilises IBSA’s
Derma, my interest was definitely piqued. proprietary HydroLift® Action and is used to remodel and
Despite having worked in the aesthetics industry for 13 stimulate rather than to create immediate volumisation
years, I am still very cautious about injectables. I’ve had or augmentation. It contains both high (HMW) and low
botulinum toxin happily in the past, the last time being about molecular weight (LMW) HA which generates a dual action,
three years ago, but fillers are something I’ve always been incorporating hydration and tissue stimulation.
nervous about. My major concern being unnatural results Profhilo also involves fewer injection points, making
that I would then be stuck with for six to nine months. treatments fast and very comfortable, as the unique
I will shortly be turning 39 and have recently lost a lot of characteristics of the product mean that there is no need
weight and, as such, I was becoming increasingly aware of for a local anaesthetic ingredient, such as lidocaine, as there
some of those telltale signs of ageing – in particular volume is no resistance within the tissue when it is injected.
degradation, fine lines and wrinkles (especially around my On top of this the product claims to have reduced adverse
eyes) and a general dulling of my complexion. effects and limited side effects typically associated
What I liked about Profhilo is how natural the results with HA injections, and the results are long lasting and
looked from all the before and afters I’d seen. I also like the sustained. It also requires fewer top-up sessions than other
fact that, although it is an HA, it’s not a filler. biostimulators.
I had my treatment done with nurse independent
prescriber Wendy Preston from Fine Features, who has
been using Profhilo since it was first introduced into the
UK. Wendy is a big fan of the treatment and her pictures
put my mind at ease that I wouldn’t look like I’d “had
something done”.
She says, “I love the natural results from Profhilo and the
ease of the treatment and my patients have been loving
the results too. I have switched a lot of my clients who were
on Sculptra onto Profhilo and I have completely stopped
using skin boosters. It really does work like an amazing
moisturiser from within.”
Before After
I had two treatments based four weeks apart. The
treatment was quick and really didn’t hurt at all. I didn’t
really notice a difference after my first treatment and after
my second there was no sudden “wow” moment, however,
people increasingly started to tell me how well I was looking
and when I looked in the mirror I felt like something was
definitely different and definitely better, but it was so
natural that even I couldn’t put my finger on exactly what.
This was the perfect outcome for me. I just felt like a fresher
version of myself and, for that reason, I would definitely
have this treatment again. I know many practitioners
also combine Profhilo with other injectables treatments,
particularly where there is significant volume loss, but for
me this treatment on its own was enough to give me a result
Before After
I couldn’t be happier with. AM
060 AM NOV17 052 AM NOV17 Editors Choice .indd 60 27/10/2017 16:49

Untitled-11 1 20/09/2017 14:53
NUT R IT IO N
FASTING www.aestheticmed.co.uk
F ast f o r w a r d
Nutirtionist Kim Pearson explores the trend of fasting
New research into fasting is turning traditional nutrition and 11am, consume only water. Some individuals choose to
advice on its head. Recommendations to always have skip either breakfast or dinner, eating just two substantial
breakfast, eat little and often and never go hungry are being meals per day. Others consume three meals per day within
strongly challenged by leading experts in diet and health. a shorter timeframe than usual. This style of fasting is
We’re now learning that going for extended periods of designed to be practiced daily, on an on-going basis.
time without food can provide a wide range of benefits, Research has demonstrated time restricted eating to
including promoting health and longevity by reducing be clinically relevant for preventing and treating obesity
numerous disease risk factors and promoting cellular and metabolic disorders, including type 2 diabetes. In one
regeneration. When carried out in the right way, fasting study overweight individuals with >14 hour eating duration
will not automatically result in a reduced metabolic rate or who ate for only 10–11 hours daily for 16 weeks reduced body
rebound weight gain as once believed. weight and reported being energetic with improved sleep.
In this article I will discuss some of the different approaches Time restricted eating doesn’t require calorie restriction
to fasting. and it particularly suits individuals who don’t have a natural
desire to eat breakfast. Those who are used to eating
TIME RESTRICTED EATING breakfast may experience hunger initially, if they choose to
Time restricted eating involves restricting food intake to a delay eating in the morning, and it can take some adapting to
limited period of time during the day, typically eight hours. for those who graze throughout the day. Timeframes can be
For example eat between 11am and 7pm, then between 7pm adapted to suit the individual.
062-063 AM NOV17 Fasting.indd 62 30/10/2017 15:12

NUT R IT IO N
www.aestheticmed.co.uk FASTING
INTERMITTENT FASTING every day whilst you’re fasting, but space this out over the
Intermittent fasting involves alternating 24 hour periods of day. Avoid strenuous exercise.
fasting with periods of eating normally. Fast days typically
involve either consuming water only, or significant calorie FASTING MIMICKING DIETS
restriction. Studies have found that intermittent fasting is A concept developed by Professor Valter Longo and
as effective as continuous calorie restriction for improving researchers at the University of Southern California who
weight loss, insulin sensitivity and other health biomarkers. have carried out extensive research into periodic fasting.
There are two primary methods of intermittent fasting. Fasting mimicking diets (FMDs) provide the benefits of
One method involves fasting completely, consuming nothing water only fasting but with a specially designed, plant based
except water for 24-hours, on one or two non-consecutive diet plan that does not trigger nutrient sensing pathways.
days a week. The most common method is the 5:2 diet FMDs are the result of two decades of research and
approach. This involves consuming only 500 calories for millions of dollars of Federal funding. In studies, FMDs
women, or 600 calories for men calories per day, on two non- reduced risk factors for ageing and diseases including
consecutive days per week. There is no restriction on food diabetes, cardiovascular disease and cancer. Benefits
intake for the remaining days of the week. include reduced visceral fat and levels of systemic
If adopting the 5:2 diet, the person fasting inflammation, stem cell generation and autophagy.
needs to understand the calorific values of Fasting mimicking diets provide the health and
the foods they are consuming, which often cellular regeneration benefits of periodic fasting
positively influences food choices on but without having to give up food altogether.
non-fasting days. Individuals can New research For many individuals, a programme which
choose which days to fast in order to allows food can seem less daunting
awork around their lifestyle.
into fasting is compared with consuming water alone
When restricting food intake, turning traditional for several days. Compared with periodic
you’re also limiting the opportunity nutrition advice water only fasting there is reduced risk of
to consume essential nutrients such certain contraindications. The provision
as vitamins, minerals, antioxidants, on its head of specifically designed plant based meals
essential fats and fibre. It’s important to means that the body still receives essential
ensure that the general diet is as nutrient nutrients whilst remaining in a fasted state.
dense as possible. Supplementation may As with water only fasting, it’s important to make
also be considered. sure that the individual has no medical contraindications.
FMDs cannot be done by individuals who are allergic to the
PERIODIC FASTING ingredients in the programme which include nuts and soya.
Periodic fasting involves consuming nothing but water for a For healthy individuals it is recommended that three FMD
period of several days. Leading experts in the field believe that, cycles are completed over three months initially, with 25
in order to experience the full range of health benefits, prolonged days off in-between cycles. After the initial three cycles, it is
fasts should be carried out for more than three to four days. recommended that three cycles are completed per year on an
Prolonged fasting has been shown to induce autophagy, on-going basis. ProLon is the world’s first fasting mimicking
a process that helps to maintain healthy cellular function. diet. The five day diet plan comes simply packaged, including
During autophagy cells repair, regenerate and rid themselves plant-based energy bars, soups and a variety of snacks,
of debris. Prolonged fasts also promote stem cell generation. drinks and supplements. These are all carefully chosen to be
Water only fasts induce ketosis, a state where the body convenient and have minimal disruption on daily life.
switches over from using glucose (from carbohydrates) as a
primary energy source, to burning stored body fat. This can CLINICAL CONSIDERATIONS
be a very effective way to reduce excess fat and reduce risk Fasting is not right for everyone. Prior to recommending
factors associated with being overweight. fasting to clients and patients, take a full medical history
There are potential contraindications with medical to rule out contraindications including active infections,
conditions such as diabetes and heart conditions. Fasting diseases, use of certain medications, history of syncope
for long periods of time carries the risk of low blood (fainting) and pregnancy. Fasting is not recommend for
sugar and fainting. It’s not uncommon for individuals to anyone with an eating disorder.
experience side effects such as headaches. In summary, fasting can promote health and longevity
Extended water only fasts should be carried out under via a number of scientifically proven mechanisms. Fasting
expert supervision, as they can cause harm if done provides cells the opportunity to rest, regenerate, clear
incorrectly. Ideally blood tests should be run in order to rule out waste and move from storing fat to burning it. It is
out any underlying health issues. If fasting for longer the important to ensure that fasting strategies are tailored
five days this should then be supervised by an experienced to the individual’s needs based on their state of health,
professional. Plan on drinking two to three litres of water medical history, lifestyle and their desired outcomes. AM
>> Kim Pearson qualified as a nutritionist in 2008. Her areas of speciality are weight loss, skin health and healthy
ageing. She writes articles and provides professional comments for a range of magazines and newspapers and
hasappeared on national radio and television. Pearson speaks regularly at conferences and is a key opinion leader
for leading nutrition companies. She is a full member of the Complimentary and Natural Healthcare Council,
British Association of Applied Nutrition and Nutritional Therapy and the Guild of Health Writers.
062-063 AM NOV17 Fasting.indd 63 30/10/2017 15:13

NUT R IT IO N
COLLAGEN www.aestheticmed.co.uk
Skin
fo o d
Dr Johanna Ward on the benefits of oral collagen
T
he skin is the largest organ in the body and is Collagen V and VI: Both are typically found alongside Type I.
highly proliferative and dynamic. It has a constant Collagen VII: Is crucial for skin integrity even though it’s
physiological turnover and exists in a state of present at very low amounts (0.001%.) Collagen VII is a
continual replenishment with a huge need for component of the anchoring fibrils (acts as an anchor)
micronutritional support. between the layers of the dermal-epidermal junction.
We know that what we eat has a direct impact on the skin, Collagen plays a pivotal role in the structure and integrity of the
with micronutrient deficits affecting its quality, hydration and skin. As we age we lose our ability to produce collagen and
appearance. We also know that topical skin creams can only do experience a decline in collagen due to fibroblast ageing and
so much and that they cannot possibly substitute for what the reduced collagen synthesis.1 This results in skin sagging, wrinkles
blood supply can bring to the skin in terms of vitamins, minerals and loss of firmness. Research indicates that by the age of 40 the
and fatty acids. But can collagen, specifically oral collagen, be body’s ability to produce collagen decreases by 25%. By age 60, it
helpful to the skin and this constant renewal process? This article has decreased by over 50%. So being able to replace our collagen
will examine new evidence for oral collagen supplementation loss, or at the very least being able to support its native production,
and see how it can be used to benefit skin health. We will look at would be a great thing in terms of anti-ageing and skin health.
how oral collagen is prepared, how it is absorbed and how it can Abundant and healthy collagen is important for virtually
positively impact the skin. every tissue in our body; the hair, skin, nails, joints, bone,
cartilage and blood vessels all depend on collagen for their
COLLAGEN structure and integrity. Type I collagen is fundamental to the
Collagen is the major insoluble fibrous protein found in the health of all of these tissues.
extracellular matrix of the skin, together with elastin and In recent years many commercial collagen products
hyaluronic acid. The collagen family consist of 28 different have come onto the market. Due to the internet and the
types of collagen that account for 25-35% of the total protein anonymity that it provides for sellers, all kinds of collagen and
mass of humans. pseudo-collagen products have appeared on the market. It is
The important types of collagen for the skin are: becomingly increasingly difficult for the consumer to know
Collagen I: This is the commonest form of collagen in the which brands can be trusted. Many consumer reviews for
human body and accounts for 90% of human collagen. example may not even be reviewing genuine products but may
Type I is considered the key matrix building protein in our be reviewing counterfeit or poorly manufactured products.
skin which gives it structure and firmness. It is also the end
product when skin heals and repairs. SKIN CREAMS
Collagen III: Babies and children have a lot of this type of Collagen in skin creams is poorly regarded by the scientific
collagen. It is also found in fast growing tissue, especially in community because collagen is too large a molecule to penetrate
early stages of wound healing. It’s replaced later by Type I. into the skin and therefore cannot have an impact on the skin’s actual
064-066 AM NOV17 Collagen.indd 64 30/10/2017 12:31

NUT R IT IO N
www.aestheticmed.co.uk COLLAGEN
Placebo Peptan®
p =0.001
collagen integrity. What collagen skin creams can do is moisturise p <0.001
and hydrate the skin (by reducing water loss or by binding water) and 65
they seem to do this well. But there is no scientific evidence to show
63
that they have any effect on actual collagen quality or quantity.
61
Corneometric units
ORAL COLLAGEN 59
Many oral collagen products have come on to the market 57
recently. The important thing to consider with collagen 55
supplements is quality. As with all things poor manufacturing + 28 %
51
techniques will affect end results and outcomes.
49
Oral collagen supplements need to be dose appropriate,
prepared properly (hydrolysed) and well manufactured to 47
have positive benefits on the skin. Below I will outline how oral 45
collagen supplements work and the latest clinical evidence for WO W4 W8 WO W4 W8
supplementation with collagen for anti-ageing and skin health. Skin moisture level increase - Corneometer® measurement
WHAT IS ‘HYDROLYSED’ COLLAGEN? Placebo Peptan®

Hydrolysis is the process where collagen is processed and 115
broken down into small chain peptides or amino acids that
110 108 109
the body can then utilise. Hydrolysed collagen consists
+ 9%
of small peptides with low molecular weight (0.3 - 8 kDa) 105 103
enriched in specific amino acids: glycine, proline and 100 100 100
100
hydroxyproline taken from native collagen of animals –
%
generally fish, cows and pigs. The quality of hydrolysed 95

collagen is largely dependent on its molecular size, which
90
can vary greatly due to the hydrolysis methodology used.
The process of hydrolysis makes it highly digestible and means 85
the body can effectively utilise it. Hydrolysed collagen is thought
80
to be the only kind of collagen that can impact the skin positively WO W4 W12 WO W4 W12
and is what the clinical trails and data to date support.
Collagen density (relative change) assessed by
echography, at week 0, 4, and 12
HOW DO ORAL SUPPLEMENTS WORK?
In order to be active in the deeper layer of the skin,
Placebo Peptan® F
hydrolysed collagen must cross the intestinal barrier and be
120
absorbed into the blood stream. Studies by Osser et Al, Iwai
110 108 106
et al and Ohara et al have all shown that collagen peptides
are absorbed through intestinal membrane epithelial cells 100 100
100
- 31 %
and into the blood stream. 2,3,4 They are absorbed in the form 90
of small collagen peptides and free amino acids.5 They then 82
80
%
travel all around the body to the various target tissues, which 69
in the case of collagen is everything including the skin, hair, 70
nails, joints, bones and blood vessels. 60
Watanabe and Kamiyama have conducted in vivo studies 50
on the distribution of collagen in the body and have shown
40
that 14C labelled proline or collagen peptides have activity WO W4 W12 WO W4 W12
in the skin as quickly as two hours after ingestion and this
Collagen fragmentation (relative change) assessed by
remains high for up to 14 days.6 confocal laser after intake of Peptan®F at week 0,4 and 12
Once it reaches the dermis the hydrolysed collagen
peptides and amino acids have a dual action. Firstly, the
25
free amino acids provide building blocks for the formation
+ 745 %
of new collagen fibres , and secondly the collagen peptides
act as ligands and bind to fibroblast receptors to stimulate 20
the production of new collagen, elastin (minor effect) and
hyaluronic acid. The following actions of collagen peptides
15
Surface %
have been evidenced in clinical trials:

1) Stimulation and proliferation of fibroblasts
2) Increase in collagen fibre density and diameter in the dermis 10
3) Increase in dermal hyaluronic acid production
4) Increase in GAG percentage
5
5) Activate protection against UV radiation
In 2015 a double-blind, randomised, placebo-controlled
clinical trial was carried out in Japan on 33 women aged 40- 0
59 years with normal to dry skin. The results showed a 28% > T P1 P2 P3

NUT R IT IO N
COLLAGEN www.aestheticmed.co.uk
increase in skin hydration by taking 10g of hydrolysed Peptan

collagen. (Peptan is the world’s leading collagen manufacturer.)
In another study a double-blind, randomised, placebo-
controlled clinical trial was carried out in France on 47 women
aged 35-55 years with normal to dry skin. They were given oral
collagen. The positive outcome group showed a 30% decrease
in the formation of deep wrinkles, after supplementation of
10g of hydrolysed collagen for 12 weeks. Collagen density
of the dermis was measured by high-frequency real-time
ultrasound of the skin with a Dermcup® device and the
fragmentation of collagen in the reticular dermis was assessed
by reflectance confocal microscopy using a Vivascope3000®
device.7 Collagen fragmentation in the deep dermis was also
studied and found to be reduced by 31% after 12 weeks of
ingestion of oral collagen.
An ex vivo study8 examining glycosaminoglycans (GAGs)
showed that oral collagen significantly increased the amount
of acidic GAGs present in the epidermis by up to 745% in a
dose dependent manner, which represents hyaluronic acid
increase. The study’s conclusion was that collagen helps
increase the skin’s moisture by increasing the amount of
water binding hyaluronic acid in the epidermis.
HOW MUCH?
Daily doses vary from 400mg to 10,000mg per day depending
on the brand of collagen used. Most studies suggest a dose of
4,000-10,000mg is the ideal dose for skin health & anti-ageing,
brand dependent.
LIQUID, CAPSULES OR POWDER?

It really is a matter of preference and knowing what daily
dose you want to achieve. Capsules are designed to break
apart and release their powder in the small intestine where
absorption takes place. Powders and liquids have the benefit
REFERENCES
of not needing to go through this process and generally
1. James Varani, Michael Dame et al. Decreased Collagen Production in
deliver higher doses than capsules.
Chronologically Aged Skin’. American Journal of Pathology. June 2006.
2. Oesser S, Adam M, Babel W, Seifert J. Oral administration of (14)C

SIDE EFFECTS labeled gelatin hydrolysate leads to an accumulation of radioactivity in
There are few reported problems with high quality collagen cartilage of mice (C57/BL). J Nutr 1999; 129(10): 1891-5
supplementation. Very high doses can potentially cause 3. Iwai K, Hasegawa T, Taguchi Y, et al. Identification of food- derived
hypercalcaemia due to accumulation of the amino acid collagen peptides in human blood after oral ingestion of gelatin
hydrolysates. J Agric Food Chem 2005; 53(16): 6531-6.
hydroxyproline, so patients with a complex medical history
4. Ohara H, Matsumoto H, Ito K, Iwai K, Sato K. Comparison of quantity
are advised to check with their doctor before starting and structures of hydroxyproline-containing peptides in human blood
supplementation. But the FDA, WHO and European after oral ingestion of gelatin hydrolysates from different sources. J
Commission for Health and Consumer Protection have all Agric Food Chem 2007; 55(4): 1532-5.
confirmed that oral collagen is safe. 5. Sarah Sibbila, Martin Godfrey et al. An overview of the beneficial
effects of Hydrolysed Collagen as a nutraceutical on skin properties.
The Open Nutraceuticals Journal 2015: 8; 29-42
SUMMARY
6. Watanabe-Kamiyama et al. Absorption and Effectiveness of Orally
There is increasing clinical data to suggest that Administered Low Molecular Weight Collagen Hydrolysate in Rats. J
supplementation with hydrolysed collagen can indeed Agric & Food Chem 2010:58:835-841
have a positive impact on the skin. Collagen fragmentation 7. Jerome Asserin, Elian Lati, Toshiaki Shioya. The effect of oral
rates, skin hydration and wrinkle depth can all be positively collagen peptide supplementation on skin moisture and the dermal
collagen network: evidence from an ex vivo model and randomized,
affected with supplementation of high strength, well placebo-controlled clinical trials. Journal of Cosmetic Dermatology.
manufactured hydrolysed collagen. The clinical studies and September 2015
trials have small numbers, so ideally more studies will be 8. Asserin J et al. The effect of oral Collagen supplementation on skin
conducted in the future. The consumer needs to be aware moisture and the dermal collagen network: An ex vivo model and
randomised placebo controlled trial. Journal of Cosmetic Dermatology
that not all collagens are created equal and that positive 14:291-301
results are dose and brand dependent. AM
>> Dr Johanna Ward is medical director of the award-winning Skin Clinic in Sevenoaks and Brentwood. She has a
special interest in dermatology and minor surgery and is the founder of ZENii, a premium vitamin and skincare
brand. Dr Ward won the MyFaceMyBody Award for Journalist or Beauty Blogger of the Year in 2016.

Healthy skin starts within...
Introducing our
ProCollagen
Supplement Range
Cutting edge, clinically
proven, cosmeceutical
skincare at an
affordable price...
Collagen is the most abundant As part of the ZENii Skincare range, we now offer a range of Collagen
structural protein in our bodies. supplements in both tablet and powder form to boost your clients’ beauty &
Abundant & healthy collagen is skincare regimes.
important for virtually every tissue ZENii ProCollagen Capsules are a clinically proven Type 1 Marine
in our body: the hair, skin, nails, Collagen and Vitamin C formula. Taken daily it can help boost your beauty &
joints, bone, cartilage and blood skincare regime.
vessels all depend on collagen
for their structure and integrity. ProCollagen+ Powder is a high strength (10,000mg) marine collagen
powder ideal for adding into juices and smoothies to enhance your daily
Type 1 Collagen is fundamental
beauty regime. It contains Type 1 & Type 3 Marine collagen which helps
to the health of all of these
boost skin, hair, nail, joint & bone health.
tissues.
As we age we lose collagen at With an attractive trade price from £20 for 3 months’ supply, ZENii
a rate of about 1%. Collagen ProCollagen is the perfect complement to your clients’ existing skincare
loss causes skin wrinkling, skin products.
sagging, nail thinning, hair For more information about ProCollagen and other products
weakening, hair loss and joint in ZENii Supplements, including Probiotics, Vitamin D3 and
weakness. Omegas and more, contact us today!
Why ZENii? )% )%
ZENii was created and formulated by multi award-winning
Dr. Johanna Ward, one of the UK’s leading skin doctors. Lead by
her, our team of doctors, cosmetic scientists and nutritionists have
created a cutting-edge skincare and supplements range.
Each product has been meticulously formulated to deliver the very
best in clinically proven ingredients and micronutrients to optimise
skin health. We believe in nourishing the skin from without and
within. This is the future of anti-ageing, wellness and living a long
and healthy life.
!"#$%"#&$'(!"#%)*'"($)+",*$*-&$.&(//$#)(0&1$2"(*)2*$,3$*"4)5
!"#$$%&##%'&(%%)%%*+,--./0,1234-,560078/0829%%)%%:::8;<=--8/0829
P SY C H O L O G Y
BODY DYSMORPHIA www.aestheticmed.co.uk
D y s m o r p h ic
p r actition er s
Dr Steven Harris and Dr Neetu Johnson on BDD in the aesthetic practitioner
I
n last month’s edition of Aesthetic Medicine, we explored increasing focus on aesthetic patients with the disorder, very
Body Dysmorphic Disorder (BDD) in aesthetic patients. little is known about the practitioners. The thought patterns
BDD is a serious mental health disorder where patients and suggestions of aesthetic practitioners are important
become obsessed with a minor, or nonexistent flaw to when addressing our patients, as often our internal values
the extent that they become severely depressed and and ideas are projected during this consultation process,
suicidal. Around 75% of people with BDD seek aesthetic even at an unintentional subconscious level.
treatments, however, only 2% benefit. Most tend to be A first of its kind survey was conducted to study the
dissatisfied with the results and experience a worsening prevalence of BDD among aesthetic practitioners.
of their BDD symptoms; this may account for the higher
than normal suicide rate among aesthetic patients. MATERIALS AND METHODS
The role of the aesthetic practitioner is then not to treat,
but to prepare the patient for referral to specialist care. Study design and subjects
The disorder is treatable with combinations of Cognitive A practitioner survey was distributed among 200 aesthetic
Behaviour Therapy (CBT) and high doses of Selective practitioners during two separate aesthetic conferences
Serotonin Reuptake Inhibitors (SSRIs). There are studies to set two weeks apart in September and October 2017.
show that pharmacological augmentation, combination The first involved aesthetic doctors at the British College
and switching strategies may be useful in treatment- of Aesthetic Medicine (BCAM) and the second involved
resistant cases.1 aesthetic practitioners at the Clinical Cosmetic and
BDD is relatively common at around 2% of the Reconstructive Expo (CCR Expo). In total, 51 surveys were
general population but is much more common at 9-15% completed, 36 at BCAM’s conference and 15 at CCR Expo.
of aesthetic dermatology patients and up to half of those The respondents included 30 women, 20 men and one
seeking surgical rhinoplasties. 2 While there has been non-disclosure, with a percentage of age ranges (Figure 1).
068-070 AM NOV17 BBD.indd 68 30/10/2017 16:17

P SY C H O L O G Y
www.aestheticmed.co.uk BODY DYSMORPHIA
2% RESULTS
2% Figure 1. The results of the surveys were assessed independently by the
20% authors who are experts in the fields of aesthetic medicine and
20% 20-29 mental health. The rate of response at the BCAM conference
30-39 was 28% (36 out of 130 surveys) versus CCR Expo at 21%
(15 out of 70 surveys). In total (from both conferences), one
40-49
quarter (51 surveys) were returned fully completed.
25% 50-59
31% From these, eight respondents (16%) had a score of 19 or
60-69 above; they included three males and four females, with one
Unknown gender non-disclosed with an average age range between 30-
59 years old (Figure 4).
Assessment
(27) (34)
The practitioner survey was designed to record the following M40-49 F 30-39
information from the respondents: age, gender, age range and Nurse Doctor
the AAI (Figure 2). The latter is a self-report scale to help assess (33) (?) (33)
symptoms of BDD and has been found to have good reliability M 40-49 F 50-59
and validity.3 The possible range of scores is 0-40, where a Doctor Nurse
score of 19 or above indicates the likely presence of the BDD.
(21) (20)
M 50-49 F 50-59
Doctor Doctor
(19) (28)
M 40-49 F 40-49
Figure 4. Doctor Doctor
The results were reported

according to the recorded scores
in the individual questions on
the BBD survey. Appearance
check and comparison: a
The prevalence rate
significantly large number of BDD amongst
of respondents (96%) practitioners is higher
did not engage or rarely
checked their appearance than that found amongst
or compared aspects of aesthetic patients
their appearance to others.
Not engaging in avoidance
behaviour of situations or
reflections was also high in
practitioners (76%).
Figure 2. The Practitioner Survey Actual attempts of camouflaging and altering of
appearance sometimes, often and all the time was reported
in 29% of respondents. For the BDD questions involving
Dentists rumination and focus on feelings, 20% of respondents
reported having thoughts either sometimes or all the times.
Aesthetic When analysing the results per profession, BDD was most
Doctors
common among aesthetic nurses at 50%, who also had the
Plastic highest average score of 30, followed by aesthetic doctors at
Surgeons
16% with an average score of 26 (Figure 4). Of note, prevalence
Nurses
of BDD symptoms was lowest within the dental profession.
Other
0 5 10 15 20 DISCUSSION
To our knowledge, this survey is the first of its kind to study
Males Females Unknown
BDD in the aesthetic practitioner population. The authors
Figure 3. The demographic ratio of male to female practitioners recognise that there are limitations to this study. A larger
consisted of the following: group size would have provided more statistical power for
37 aesthetic doctors (16 males, 20 females and 1 non-disclosure of gender) more robust conclusions.
3 plastic surgeons (3 males and 0 females) It is known that people with BDD tend to be embarrassed
4 nurses (1 male and 3 females) or ashamed by their condition to the extent that some may
4 dentists (1 male and 3 females) have decided not to respond. As there is a stigma related to
1 female pharmacist
1 female beauty therapist
the condition, practitioners may not have felt comfortable in
1 female non-disclosure of profession. disclosing their thoughts relating to their own appearance. >
068-070 AM NOV17 BBD.indd 69 30/10/2017 13:19

P SY C H O L O G Y
BODY DYSMORPHIA www.aestheticmed.co.uk
with their potential complications. Our patients look up

to us as medical professionals for guidance and if the
consultation process is carried out with a therapeutic
framework in place, the relationship and ideology of
the practitioner can become quite powerful. This could
lead to psychological damage if the patient is young and
impressionable or is not mentally stable.
There are further implications for aesthetic patients
being treated by practitioners with BDD; the latter
have been found to have greater left-sided brain
activity when it comes to processing facial
detail and, therefore, may have a tendency to
It is time we realise focus on certain areas rather than treating
that BDD is a part of the face as a whole. A variant of BDD,
Other reasons for the poor response rate named Body Dysmorphic Disorder by proxy
may be that no specific time was allocated
our industry, we can no (BDDBP), may also be prevalent among
to the surveys; practitioners were asked longer afford to ignore as aesthetic practitioners and requires further
to complete them during the course of it affects us all research. Here, the primary preoccupation
the conferences and return at their leisure; involves perceived imperfections with the
some may have simply forgotten, while others appearance of others.
may have not given the survey much significance
despite the encouraging introduction. SUMMARY
The setting of the conferences with close It is time we realise that BDD is a part of our industry
proximity to colleagues may have introduced a we can no longer afford to ignore as it affects us all, either
respondent bias to conform to “normality”. As insight into BDD directly by those with the disorder or indirectly by its
can often be limited and poor, the chances of practitioners consequences. To this end we need to psychoeducate
overlooking the importance of this request may have been ourselves as well as our patients.
present on receiving the survey. As practitioners, we should regularly screen all our
Notwithstanding these limitations, the results of this patients with the diagnostic screening tools that have been
survey found that the prevalence rate of BDD among discussed in the first part of this BDD series and ensure
practitioners is higher than that found among aesthetic that patients are referred on to the appropriate pathways.
patients (16% versus 9-15%). The disorder was proportionally We must also find a way to identify and help colleagues with
most common in aesthetic nurses who also had the highest the disorder as remaining undiagnosed and untreated may
average score on the AAI, followed by aesthetic doctors. potentially lead to inappropriate and unsafe practice.
In general, aesthetic practitioners have more access to Without a doubt, BDD is the single greatest challenge
aesthetic products and procedures, either performed by facing our work as aesthetic practitioners and the integrity
colleagues or performed by themselves (on themselves). of our industry. We hope that by initiating this study we
As the psycho-social drivers for cosmetic procedures have have at the very least created a platform for dialogue about
increased in more recent years, pressures to defy the natural this disabling condition. AM
process of ageing seem clear within the industry itself.
Indeed it is the authors’ observations that an increasing
number of practitioners are appearing with exaggerated REFERENCES
facial features (usually involving botulinum toxin and dermal 1. Phillips, K.A., et al. Pharmacotherapy relapse prevention in body dysmorphic
disorder: A double blind, placebo controlled trial. The American Journal of
fillers) at various aesthetic meetings and conferences.
Psychiatry, April 2016 (Online)
It is important to remember that we not only have a
2. Harris, S. Body Dysmorphic Disorder. Aesthetic Medicine. 2007; 2: 20-22
duty of care to our patients, but our medical responsibility 3. Veale, D., et al. The Appearance Anxiety Inventory: Validation of a process
of “non nocere” is highly relevant here and specifically in measure in the treatment of body dysmorphic disorder. Journal of Behavioural
this industry where both patients and practitioners are and Cognitive Psychotherapy. 2014; 42(5): 605-616
vulnerable and at risk of having unnecessary procedures
>> Dr Steven Harris MB BCh, MSc, MBCAM, completed his medical studies in Johannesburg in 1997. He has
been practising aesthetic medicine at his clinic in North London since 2004 and has gained a reputation
for producing entirely natural looking results. Dr Harris also completed an MSc in Cognitive Behaviour
Therapy in 2005 and specialises in the management of patients with Body Dysmorphic Disorder. He
publishes and lectures regularly in both areas of aesthetic medicine and clinical psychology
>> Dr Neetu Johnson BSc(HONS) MBBS MRCPsych, is a London-based Consultant Psychiatrist and Aesthetic
Medicine Doctor with expertise in Neurodevelopmental disorders such as Autism and ADHD. She is a
member of the prestigious Royal College of Psychiatrists and the Royal Society of Medicine. Dr Johnson
has a specialist interest in the modality of Psychodermatology; a new subspecialty encompassing the
management of patients with primary skin conditions (such as acne) with an element of psychiatric or
psychological morbidity (such as depression or anxiety).
068-070 AM NOV17 BBD.indd 70 30/10/2017 13:20

*an average reduction of 35%: DermatestGmbh, Independent, split face study under specialist clinical dermatological assessment
Reduce fine lines and wrinkles by

35%* with rejuvenating micro-channelling
patches and specifically formulated HA serum
Available Nationwide
Visit radara.co.uk to find your nearest stockist.
QUALIT Y IS IN THE DETAIL
VEINAWAY ™ SYSTEM
THE LATEST
27.12 MHZ
RADIO FREQUENCY
TECHNOLOGY CONTROLLED
FOR PRECISION, TREATMENT
ACCURACY AND TIMES AND
COMFORT
DESIGNED TO TREAT THREAD/ QUICK VISIBLE
RESULTS
SPIDER VEINS, SKIN TAGS AND

OTHER MINOR SKIN PROBLEMS SAFE
TREATMENTS
WITH NO
SCARRING
“The ultimate
treatment for thread
and spider veins.” APPLICABLE
Endorsed by Dr Brian ON ALL PARTS
Newman, Europe’s OF THE BODY
leading vascular surgeon INCLUDING
SENSITIVE AREAS
SUCH AS FACE,
ANKLES AND EASY TO USE,
FREE KNEES SOFT TOUCH,

UPGRADEABLE
KEYBOARD,
ONSITE AUTO MODE
TRAINING WITH NO NEED
FOR FOOT
INCLUDED
WITH PACKAGE PEDAL
AUTO AND
THERMOPLEX/
Visit our website to view THERMOFLASH™
PATENTED
demo videos and to arrange TREATMENT
MODES
LOW RUNNING
COSTS AND
a free demonstration ONGOING
MAINTENANCE.
FAST RETURN ON
0333 358 3904

INVESTMENT
PATENTED
MODES WITH
LEASE
TEFLON IDEAL TO
TREAT SPIDER TO BUY
info@naturastudios.co.uk FILAMENT
VEINS, THREAD FROM
£60
VEINS, WARTS,
naturastudios.co.uk
+VAT
SKIN TAGS,
MOLES AND
*Subject to full company terms and conditions. Figures are based on a 5 year lease.
MANY MORE PER WEEK
Figures may vary depending on individual credit rating and subject to funders.
Vein Away™ is a European brand of Physioskin system.
Untitled-22 1 20/10/2017 11:35
071 adverts.indd 1 27/10/2017 15:35

D EV IC ES
DOSSIER www.aestheticmed.co.uk
072-076 AM NOV17 LED Dossier.indd 72 30/10/2017 16:05

D EV IC ES
www.aestheticmed.co.uk DOSSIER
L ED t h e r e b e l i g h t
In this month’s dossier we take a look at the best LED devices on the market
L
ight emitting diodes (LEDs) are the ultimate in non- equipment portfolio for non-invasive, non-abrasive and zero
invasive rejuvenation. Often used as an adjunct downtime treatments. The Cube LED Light can be used for the
to other treatments, LED phototherapy is much face, scalp and body, with an adjustable back, and is ideal for
more than simply a relaxing add on. Clinically lines and wrinkles, exfoliation, lymph drainage, deep cleansing,
proven to be effective for a number of applications, open pores, stretch marks, scars, chin and décolleté, breasts,
most noteably for its regenerative and anti-inflammatory arms, thighs and hands. For the ultimate facial rejuvenation,
properties, it is effective as a standalone solution for acne, Naturastudios recommend using the Cube LED Light with the
anti-ageing and inflammation as well as to enhance results Dermapen™.
and accelerate healing post-treatment. This combination maximises collagen production and
LED phototherapy meets the rising demand for no- decreases healing time. This means clients see quicker and
downtime, results-driven treatments within aesthetic clinics more effective results, whilst still retaining a natural look.
and, as such, there are now a number of devices on the
market utilising this technology. Here we round up the best
systems to help you decide which to use in your clinic.
CUBE LED LIGHT – NATURASTUDIOS

Naturastudios’ Cube LED Light offers
both infrared and laser diode technology "I love my
with four wavelengths of light. Red Dermalux
light provides a penetration rate of
1-6mm and is effective at treating – it’s a little unsung
acne scarring, atopic conditions and hero. I use it for just about
psoriasis.
Blue light provides a penetration
everything in my clinic"
rate of 1mm, and can sterilise acne Aly Graham-Gage,
germs and supress sebaceous glands. Beauty Rediscovered
Green light provides a penetration DERMALUX - AESTHETICARE
rate of 1-2mm and combats sun damage, The name Dermalux is
discolouration, hyperpigmentation and synonymous with high-end
uneven skin tones. LED phototherapy. The
Yellow light provides multi-award winning brand
a penetration rate of was the first to popularise
1-2mm and provides the treatment and, as such,
relief from rosacea and has built a strong reputation
pigmentation. These within the market, not
wavelengths can be just in the UK but at an
combined into one international level.
treatment to target Designed and
multiple layers of the manufactured in
skin for more complex the UK, Dermalux
conditions. systems are currently in more than 900
Infrared works by heating the epidermis, allowing for deeper aesthetic clinics, salons and medi-spas
penetration of the LED light and laser diode technology aids around the world.
the regeneration of hair, making the Cube Light a versatile The Dermalux Tri-Wave systems have
investment. pre-set treatment programmes for a
The demand for non-invasive range of skin-specific concerns,
treatments which will combination treatments and
effectively tighten and post-treatment protocols
rejuvenate their skin, within one device. Each
without impairing programme delivers
their expression, a specific combination
has made the wavelength protocol targeted to the individual condition.
Cube LED Light a There is also a custom programme setting for bespoke
popular addition protocols. Delivering concurrent wavelength treatments is
to Naturastudios' proven to increase efficacy and accelerates results. >

D EV IC ES
Dermalux uses blue 415nm, red 633nm and near infrared on a break. It’s the perfect way to round off an aggressive
830nm, internationally recognised and clinically-evidenced procedure, whether or not that is peels, micro-needling,
wavelengths for LED phototherapy. It is also the only system dermaplaning, or invasive needle work, hence why it’s so
capable of delivering all three wavelengths simultaneously. popular.”
This unique ability is proven to increase efficacy and A course of 12 sessions is generally recommended for all
accelerate results. indications at a frequency of one to three sessions per week.
Blue 415nm light destroys the bacteria which causes Maintenance treatments are advised on a monthly basis.
spots and helps in the prevention of breakouts. Applied in Aly Graham-Gage (RGN NIP), from Beauty Rediscovered, in
combination with red and near infrared light, the Dermalux Dorset, said, “I love my Dermalux – it’s a little unsung hero.
Tri-Wave treatment offers enhanced anti-blemish results and I use if for just about everything in my clinic – before and
is excellent as a post-treatment procedure to help minimise after treatments, as a standalone treatment and as a ‘cheer
breakouts and reduce redness. up’ treatment for those who just need an extra little treat.
Red 633nm light accelerates cell renewal and repair, "Skin looks and feels amazing after a Dermalux session.
boosting collagen and elastin synthesis for smoother, firmer I have great results with acne and skin conditions such
skin. Red light offers immediate visible results with the skin as psoriasis but most importantly clients feel relaxed,
feeling hydrated and plump with restored radiance. rejuvenated and cared for.”
Repairing near infrared 830nm light is the most Sharon Bennett (RGN NIP), from Harrogate Aesthetics
deeply absorbed wavelength. It triggers the skin's anti- commented, “Incorporating Dermalux has enabled us to
inflammatory processes to accelerate repair and reduce offer treatment for a wider range of skin concerns. Our
irritation and redness. It is also clinically effective in patients love it for rejuvenation or post-procedure to calm
the treatment of age spots and hyperpigmentation, the skin and it enables us to treat problem and sensitive
and works synergistically with red light for optimum skins knowing that they will see great results.”
rejuvenation results. Donna Glazer, from Face It Skin Clinic, London, added,
Dr Beatriz Molina, from the Medikas Clinic in Bristol, said, “Since we took on the Dermalux it has changed our whole
“The joy of Dermalux is that you can lie/sit down for 20 understanding of the effectiveness of using an LED in a
minutes and get up and go back to work. skin clinic, so much so we now have three machines and all
"It’s one of the few treatments that you genuinely can do within a couple of years.”

D EV IC ES
www.aestheticmed.co.uk DOSSIER
DÉESSE – HARPAR GRACE Marea Brennan-Thorns from MBNS, Thame,

Déesse is distributed in the UK by Harpar commented, "We are getting great feedback
Grace. It uses very safe low-level light therapy from clients about our Dèesse LED mask. We
(LLLT) by way of 770 surface-mounted, light are using it for discomfort relief pre cosmetic
emitting diodes (LED’s) to expose the skin injection and are ‘stopping’ bruises by using it
toclinicallyprovenwavelengthsoflight,delivered post-treatment too. It is very exciting.
at safe therapeutic doses, to stimulate natural "We are also using it on a client who has
cellular responses. facial and brain trauma. I did some research
These responses lead to skin rejuvenation on brain injury and light and, based on that
and the improvement of common problematic research, the patient is using the blue light
skin conditions. for 30 minutes. This will not only improve her
The procedure is pain-free, non-invasive skin but also improve her cortisol levels and
and is completely safe, requiring no downtime. the 'cortisol awakening response', which was
Treatments are typically programmed for 30 damaged in the brain injury. She is also using Mode
minutes but this can be adjusted to suit client 7 in the early evening as red light can help with sleep."
needs. Karidis Clinic senior nurse, Suzi Noble says, "Déesse
Fantastic for all-round skin health, the LED is a great standalone LED light facial but also a great
lights stimulate sensors within the skin which boost
cell activity and trigger the production of naturally
occurring chemicals. The brand has recently
launched the Déesse Pro LED phototherapy mask,
which includes eight treatment modes incorporating
five wavelengths of red light (630nm); blue light
(415nm); yellow light (580nm); green light (520nm)
and infrared light (830nm), especially for the
professional market.
Mode 1 is for anti-ageing and combines near
infrared and red light. Mode 2 is for acne and
combines near infrared and blue light. Mode 3 is
for toxin elimination and combines yellow light
with near infrared. Mode 4 is for pigmentation and
combines green light and near infrared. Mode 5
is for healing and combines blue and red light
with near infrared. Mode 6 is for soothing
and combines blue and green light with 20-minute add-on to compliment our
near infrared. Mode 7 is for congested current menu of treatments at Karidis.
acne and combines both modes 2 and "Our clients can even enjoy the
3 and Mode 8 is for inflammatory acne benefit of using the Déesse mask
combining modes 2 and 4. There are when having body treatments like
also two light intensity settings Coolsculpting. Within our Signature K Facial
to boost treatments. it plays a key part in calming and healing post-
Treatments can be set for We offer our inflammation following the dermaroller section
10, 20 or 30 minutes and surgical patients of the protocol. Furthermore, we offer our surgical
can be used in isolation for patients the detoxifying and healing mode during
specific skin conditions
the detoxifying and their recovery process, when they return to the clinic
or synergistically with healing mode during for check-ups, which we welcome to our menu as our
other brands and device- their recovery 'Karidis Beauty Sleep'."
led treatments to create
bespoke treatment Suzi Noble, LIGHTFUSION – SKINBRANDS
protocols ideally matched Karidis Clinic Lightfusion is a modular LED device developed in the UK,
to your client’s skincare needs. that is being used by doctors to reduce the swelling, bruising
Harpar Grace also reports a rise and erythema associated with injectables, microneedling
in the use of the mask as part and laser treatments. In addition, it has also been used to
of an express treatment concept within clinics and has speed up the wound-healing response associated
designed a marketing and PR starter kit to ensure that the with surgery.
machine is optimised from the moment it is placed in clinic. Lightfusion combines the power of proven wavelengths
Clients can see a difference in radiance after just one of light which energise cellular functions within the body.
treatment, with treatment packages – and top ups – Phototherapy creates biochemical reactions that are
recommended for optimum results. clinically-proven to stimulate the wound-healing processes.
Déesse has become a favourite among celebrities including Research shows that the primary effect of light is targeted on
Madonna, Kim Kardashian West and Kate Hudson, and has cellular mitochondria, causing a cascade of secondary reactions
appeared across a multitude of social media channels. that include increased cell proliferation and migration, >

D EV IC ES
Lightfusion is
fantastic as it targets a
range of concerns
Dr Kasia Brennan,
Courthouse Clinics
increased blood flow and tissue oxygenation and modulation "I often have clients wanting something to help boost the
of key cellular growth factors. general condition of their skin and Lightfusion is fantastic
As well as being used as a standalone facial treatment, as it targets a range of concerns from ageing, visible pores,
Lightfusion can be used before and after non-surgical and dehydration and poor skin texture", says Dr Kasia Brennan from
minor surgical procedures to shorten healing time and Courthouse Clinics. "It is safe, relaxing and completely painless.
reduce erythema and pigmentation. In addition, it’s an ideal My clients love the instant healthy glow and plumpness it gives
way to offer long-term collagen improvements alongside their skin. There is no redness or peeling after the procedure
botulinum toxin and dermal fillers, as well as to enhance the so it can be done before a special event or be part of a course
effects of microneedling and peels. of treatments to really give collagen production a big boost.
The device has a simple user interface with inbuilt timer. Everyone can benefit from this treatment and having had it
Divided into three modular treatment areas, the modular heads done myself and seeing the results, I can highly recommend it."
offer the user the ability to treat any part of the body including
the cheeks, forehead, hairline, periorbital region or alternatively GENO-LED
the chest area or even the lips. Users have reported utilising Geno-LED is a dome-shaped device that offers a therapeutic
the modular design to treat post-op incisions including breast distance from the face, making it a safe post-treatment
augmentation, blepharoplasty and face-lifts. These heads have option. Five light variations are available; red, blue, green,
direct contact with the skin and are designed to reduce light yellow and red/blue alternating, which is excellent for
scattering, which improves treatment efficacy by maximising inflamed acne. A fan is installed for additional skin cooling.
light dose. The treatment delivers 10 minute of optimised red The device is lightweight and fully portable, making it an
and near infrared light simultaneously. ideal add-on to aesthetic treatments.
Lightfusion has been designed with the help and Victoria Perry RGN said, “I have recently purchased the
experience of British designers and experts in light emitting Genosys Geno-LED light after attending my microneedling
diode technology. The technology uses a patented design training in June. I had previously undertaken research
to deliver therapeutic light directly to the skin. Unlike into the different units on the market and decided on the
other phototherapy devices this close proximity allows Geno-LED. I can honestly report that I am thrilled with the
clinically proven wavelengths of light to be easily absorbed results and more importantly my clients love it. The Geno-
by the target cells, therefore maximising the treatment LED has transformed the way I offer my facial treatments,
effect. Historically other LED devices have proven to be the results really do speak for themselves. I love the look,
too expensive for physicians to consider them solely for features, versatility and most of the all the wonderful
adjunctive therapy. The device is at a price point that allows results I have achieved so far!" AM
the physician to add the benefits of low level light therapy to
their armamentarium.
In addition, Lightfusion has been clinically proven to
reduce the appearance of fine lines and wrinkles and
pigmentation when combined with its proprietary hydrogel
mask in a four-week treatment course.

DeesseAJADVERTFullPage.pdf 1 11/09/2017 14:05
NEW
PRO EDITION
THE ORIGINAL LED PHOTOTHERAPY MASK
N A Y PROVEN AVE EN T
TREAT ENT O E
ANTI-AGEING
ACNE
HYPERPIGMENTATION
POST PROCEDURE
C
ROSACEA
M
CM
MY
CY
CMY
HIGH ROI
COVER COSTS IN AS LITTLE AS 1 MONTH
£1800 + VAT (STANDARD WHOLESALE PRICE)
SPECIAL LIMITED TIME OFFER
£250 OFF INCLUDES

MARKETING
& PR
UOTE AE T ET E NE NOV STARTER
KIT
OFFER VALID UNTIL T NOV
CALL 0845 1166242 OR EMAIL DEESSE@HARPARGRACE.COM
WWW.DEESSEPRO.COM
D EV IC ES
CLINIC PROFILE www.aestheticmed.co.uk
W o r k i ng i n h a r m o ny
Vicky Eldridge visits The Doctors Laser Clinic in Norwich and finds out
why having a happy team has been key to its success
W
alking into The Doctors Laser Clinic in business. As someone walking into the clinic this is palpable
Norwich I’m instantly struck by how and undoubtedly one of the reasons patients and staff
warm and friendly it is and how alike remain loyal to the business.
genuinely happy the team Before setting up The Doctors Laser Clinic
are. The atmosphere is so in 2010, Dr Willis worked as a family doctor
welcoming that you can feel it in the air. in Norwich for 28 years and jokes that his
Having been to many aesthetic clinics Quite often clinics motivation for the change of direction
in my time, this is not something you fall down because was his own ageing appearance.
can manufacturer or just put on for “I got into aesthetics because at age 50
the cameras. they lose their valuable having grown up in the tropics I looked like
Part of the reason for this is that Dr trained staff a 95-year-old farmer”, he says with a wry
Malcom Willis who founded the clinic and smile. “I went to a colleague who tortured
runs it alongside two other doctors – Dr me with his lasers and his IPL machines but
Kathy Kestin and Dr Mini Nelson – really does it was a miracle – I looked like I’d lost 25 years
value and look after his team. In fact, he doesn’t off my face.
think that hierarchies work and believes they “At the time, I was teaching dermatology at the
are the reason for so much workplace stress and discord. university but people really knew nothing about it. It was
At The Doctors Laser Clinic there is a real sense that about 10 years ago now that I really started going to courses
everyone from front of house to the laser technicians and and attending conferences and developing more of an
nurses are treated with the same respect and valued as interest in aesthetics.”
having equal importance to the successful running of the Dr Willis decided that it was laser he wanted to start
his clinic with and so he began looking for the right device
to launch his aesthetics business. He chose the Soprano
from ABC Lasers. He explains, “We started off in one room
upstairs in our GP surgery with two nurses, two doctors and
a healthcare assistant.
“We got three of the companies to loan us their
lasers and then took 40 of my NHS patients and did one
side with one laser and one side with the other. It was
obvious within a couple of months that the Soprano was far
superior. We decided to go with the Soprano and have never
looked back.”
078-079 AM NOV17 Clinic profile.indd 78 30/10/2017 16:19

D EV IC ES
www.aestheticmed.co.uk CLINIC PROFILE
it. He took a punt on us as a small business and that made it.

Now we’ve taken off.”
SMELLS LIKE TEAM SPIRIT

A happy team is at the heart of the clinic’s ethos and one
of the things that underpinned the business strategy from
the beginning was to give all of the team a 20% share of
everything they did.
In fact, Dr Willis feels so strongly about this philosophy
that before joining every potential new team member
has to watch a nine-minute YouTube video by American
neuroendocrinologist Robert Sapolsky on his studies of
baboons and the effects of hierarchy in society (we were
shown it too).
“Hierarchies are unhealthy places. I read a book by a
guy called Charles Handy called The Empty Raincoat and
it’s about what goes wrong in large organisations and why
the salary slave is increasingly an outdated concept in the
working environment.
“The companies that are thriving offer their staff an
opportunity to get involved in the profits. There are two
elements to that: the current profit, so that’s the 20% of
their own treatments, and the capital profit, so actually
being able to give the staff shares. If they stay with you and
work with you and are loyal to you then they are benefitting
from it. It encourages them to have a long-term view. Quite
often clinics fall down because they lose their valuable
trained staff.”
And this philosophy seems to be working. The clinic is
going from strength to strength and the team seems like
one big family.
MOVING PREMISES “We often say that our only rule here is that there
Three years ago, when the lease ran out on the building they are no rules”, says Dr Willis. “The only thing we ask is to do
were occupying, Dr Willis decided it was make or break time your best, be nice, be kind and look after each other. If you
and retired as a GP to focus on aesthetics full time. He says, “We do not have an open heart then this place is probably not for
had a choice at that stage to either close the business down as you.” AM
it had been or move forward and make this big investment”.
Now set in the aptly named “The Old Surgery”, the building
underwent an extensive £200,000 overhaul to transform
it into a seven treatment room, CQC-regulated laser and
aesthetic clinic.
Dr Willis also kitted the new clinic out with additional
equipment including the Harmony Platform and FemiLift
from ABC Lasers who he was keen to continue working with
as their equipment supplier after their success with Soprano.
“The versatility of the Harmony is extraordinary”, Dr Willis
says. “It’s got IPL, erbium, fractional, ablative, Q-Switch –
everything you need on one machine and its reliable.
“We have had one break down with the Harmony because I
fused it but it was repaired same day. I blew it in the morning
and it was fixed by 5pm. Likewise with Soprano.
“We have had the Soprano for seven and a half years. We
have had three breakdowns in that time, one of which was
over a bank holiday weekend where we had a lot of patients
booked in. I phoned ABC lasers and Guy Goudsmit [managing
director of ABC Lasers] turned up with a screwdriver
himself on Easter Saturday and fixed it so that on Easter
Sunday and Monday we could earn money.
“Guy was always really good to us when we were starting
out. He used to call us a ‘kebab shop’ when we were just
doing laser hair removal and would say ‘you’ve got to have
a full a la carte menu’. I said that I couldn’t afford it but he
sat me down and helped me work out a way we could afford
078-079 AM NOV17 Clinic profile.indd 79 30/10/2017 16:19

D EV IC ES
TREATMENT FOUCS www.aestheticmed.co.uk
I n the m i x
We find out about the advantages of the Duetto MT
Evo system from Lynton for hair removal
E
xcess hair is routinely reported as having a The Duetto MT Evo is no
major effect on quality of life, with many people one-trick pony however,
embroiled in protracted and elaborate daily the multi-application
“hair routines”. Laser and IPL hair removal is device is not just for hair
considered the treatment of choice for long term removal but can be used
reduction of unwanted hair. It is widely used in clinical for deep and superficial
practices and is a safe and effective alternative to other vascular lesions, skin
methods of hair removal. rejuvenation, sun damage,
The Duetto MT EVO from Lynton Lasers is a world’s first pigmentation and skin
in that it combines two gold standard wavelengths – tightening too.
Alexandrite 755nm and Nd:YAG 1064nm – in one emission
known as “Mixed Technology”. CLINIC EXPERIENCE
The Alexandrite laser at 755nm is well established as the – MEDIZEN
most effective laser for hair removal in skin types I to IV due The MediZen clinic in Sutton Coldfield has been using the
to its high melanin absorption characteristics. The increased device since April 2016 and it was its dual capabilities that
affinity for melanin means this wavelength excels at treating attracted them to the device, having trialled a number of
thin, fine and light coloured hairs. other lasers.
Nd:YAG laser at 1064nm is considered the gold standard Zoe Myers form the clinic comments, “The main
laser for safe use on a skin type VI. The lower melanin reason we chose the Duetto MT Evo was down
absorption at this wavelength makes it the to the duel wavelength capabilities,
ideal laser for treating skin types IV to VI. meaning it was safe to use on all
In addition, the Mixed Technology skin types effectively, as we have
mode enables safer and more “Having worked with many different ethnicities in
effectivetreatmentsofproblematic the Birmingham area.
cases, such as fine hair on darker
many hair removal systems “A large concern with many
skins and tanned skin. over the years we feel that the of our Asian clients is the
UK-based manufacturer Duetto MT Evo stands out head and fluffy dark downy hair on
Lynton has invested heavily their facial area. By using
in extensive research of shoulders above the rest. Our clients have the mixed modality method
treatment of fine and fair been delighted with how quick and we get the safety of the
facial hairs and say that this Nd:YAG combined with the
unique ability to combine true
comfortable the treatments are and the power of the Alexandrite to
independent primary lasers results have been fantastic even on give an incredibly effective
will help users overcome the key stubborn, fine hairs” treatment.
clinical restrictions of single and/or “As an operator, I find it easy
MediZen
characterised laser wavelengths (e.g. and enjoyable to use. This is a
treating fine and fair coloured hairs). great piece of kit.” AM
080 AM NOV17 Treatment Focus Lynton.indd 80 30/10/2017 15:10

dermamelan
®
depigmenting solution
by mesoestetic ®
A NE W ERA IN
S K IN REVITALIZATION
PI CO G e n e s is ™ s h at te rs the
co nve n t io n a l w is d o m of
s k in to n in g p ro ce d u re s by
in t ro d u c in g a n o n - t h e rmal
trust the leader*

way to s k in rev it a liz ati on by
co m b in in g d u a l wave l e ngths
the world’s leading professional
depigmentation method w it h u lt ra - s h o r t p u ls es to
s a fe ly a c h ieve d ra m at i c sk i n
im p rove m e n t in m u c h fewe r
t re at m e n t s .
before after** Baseline Post 3 txs
Baseline Post 2 txs
More information
before after**
e: info.uk@cutera.com
dermamelan® method efficacy has been demonstrated in numerous p: 0800 689 0437
studies under medical supervision. More than , patients treated
worldwide, in any skin phototype (I-VI) and in all ethnicities.
www.mesoestetic.co.uk
* Considering international distribution. ** Long term results obtained after 12 weeks demonstrate
method’s efficacy on pigmentation reappearance control.
Photos courtesy of J. Kaufman, M.D., J. Lezaic, D.O.

©2016. Cutera, Inc. All rights reserved.
081 adverts.indd 1 CUTERAUK_Ad_PicoGenesis_102017.indd 1 27/10/2017 15:43PM

10/12/2017 2:49:21
C O M M ER C IA L F EA T UR E
BTL AESTHETICS www.aestheticmed.co.uk
B T L A e s t h e t i c s p r o u d l y u nw r a p s
B T L Exilis U ltra F emme 3 6 0 °
B
TL Aesthetics has announced the launch of its True to the BTL Aesthetics
innovative BTL Exilis Ultra Femme 360° – the existing brand portfolio, Dr Shirin
new industry procedure with state of the art this treatment is also non- Lakhani
technology for extremely fast, non-invasive invasive and requires no
treatment of female intimate parts. downtime. ELITE AESTHETICS
Dr Shirin Lakhani from Elite Aesthetics has noted “BTL Ultra Femme is a
“Vaginal laxity, stress incontinence and
an overwhelming demand for feminine rejuvenation breakthrough in feminine
post-menopausal atrophy are conditions
treatments within the industry. “Vulvo-vaginal rejuvenation rejuvenation” comments
that can cause a great deal of distress
is increasingly being sought by women and this trend is being BTL Aesthetics managing
for many women. All of these can be
seen in both the surgical and non-surgical sectors”, she said. director Lee Boulderstone.
addressed by the Ultra Femme 360°,
“There are both aesthetic and functional reasons for seeking “It’s quick and simple to
without the need for surgery or
treatment and the development and availability of non- perform with no downtime
medication”
surgical techniques is certainly increasing the demand. at all.
“The BTL Exilis Ultra Femme 360° treatment is fantastic for “The demand for these
improving the vaginal function in a quick, easy, pain-free way. types of procedures has been
Vaginal laxity, stress incontinence and post-menopausal overwhelming, and women are
atrophy are conditions that can cause a great deal of distress grateful to finally have non-invasive options to treat
for many women. All of these can be addressed by the Ultra intimate health issues, as up until now, the options, and the
Femme 360°, without the need for surgery or medication. results, have been very limited,”
“Additionally, many women are so affected by the The Ultra Femme 360° degree technology is offered as
appearance of their genitalia that it prevents them part of the BTL Exilis Ultra 360° platform – a new upgrade
undertaking normal activities. Changes associated with to the industry’s current gold standard in shaping and
childbirth and menopause also impact us and by improving tightening, BTL Exilis.
the physical appearance and tissue quality of the labia, in The new Exilis Ultra 360° is the first and only applicator to
conjunction with restoring the health of the vaginal canal, simultaneously use ultrasound and radio frequency energy,
one can restore a woman’s self-confidence.” while the embedded 360° technology makes the device
the most versatile on the market, offering over twenty
A 360° SOLUTION treatment areas, further shortening treatment times and
BTL Ultra Femme 360° offers the shortest radiofrequency improving patient outcomes. AM
treatment time available for women’s intimate health and
wellness procedures. Utilising 360° volumetric heating and
groundbreaking EFCTM system with integrated impedance
intelligence, the treatment ensures the most effective and
uniform tissue heating, allowing physicians to treat at high
energy levels without compromising patient comfort.
449 BTL Advertorial.indd 80 31/10/2017 09:18

SUBSCRIBE TO
aesthetic M ED I CI N E
FOR JUST £34.50 AND RECIEVE A
FREE GIFT WORTH £70
YOUR FREE GIFT!
ALUMIER
RECOVERY
BALM
Say hello to happy
skin, say hello to
Recovery Balm.
Specifically formulated
for post-procedure
recovery.
Packed with soothing
antioxidant ingredients,
this moisturiser relieves
and calms skin.
Hinokitiol and sea whip
relieve redness. Aloe,
honey and boswellia
soothe, sodium
hyaluronate hydrates
Subscribe for just £34.50 and

and copper peptide
rehabilitates the
FREE
receive 10 printed issues
look of the skin.
GIFT WORTH
delivered direct to your door.
Download the app to receive a
digital edition at your fingertips.
Suitable for all
skin types.
£70
TO SUBSCRIBE, VISIT
www.aestheticmed.co.uk/magazine
and quote promo code AMNO to receive your free gift
TERMS AND CONDITIONS: Offer is subject to availability.
/AestheticMedicineMagazine @AestheticMedMag
The gifts will be issued on a first-come, first-served basis.
4487 AM Subs ad FP 210x297 SEPT.indd 1 27/10/2017 17:10

D EV IC ES
DEVICES NEWS www.aestheticmed.co.uk
Estewor l d M edical G r oup

p ar tn er s with A l ma in UK
Global plastic surgery and health
group Esteworld Medical Group has
introduced Soprano ICE Platinum and
Harmony PRO into its UK clinics as part
of a drive to offer cutting edge non-
surgical treatments to its patients.
“The Alma products have been
extremely successful in Turkey and
we wanted to bring this success
to the UK,” said managing director
Sam Cinkir. “We have selected
Soprano and Harmony because
both platforms offer comfortable
treatments with results that patients
love, recommend to others and return
to have.
“We will be switching all our current
laser technology to Alma. Within two
weeks of buying our first Soprano,
we have already placed an order for
another machine to meet the demand
and more will follow.”
The group also has clinics in Turkey,
Saudi Arabia, Qatar and the UAE.
In v asix an n oun ces
UK l aun ch of V otiv a
Q M edical l aun ches V Scul p t P r o Invasix will be launching Votiva in to
the UK market. Designed to improve
feminine health concerns, Votiva
includes two handpieces – FormaV and
FractoraV – to provide internal and
external treatment, with a resurfacing
and/or non-invasive option.
FormaV uses uniform RF to address
all areas of labial hypertrophy and
vaginal laxity. The versatility of the
FormaV allows the operator to provide
a customised solution to address
the variety of feminine health concerns
that occur due to ageing, hormonal
Q Medical is to distribute the vSculpt the body’s reaction to mechanical changes, or physical damage. Patients
Pro intravaginal device for postpartum stress by stimulating a higher often see results immediately,
women suffering from stress production of tenascin and collagen with continued results over the
incontinence and sexual function issues. enabling tissue repair. following weeks.
vSculpt Pro tones, tightens and In a clinical evaluation of the device FractoraV uses customised
restores the pelvic floor area for in women suffering from stress fractional RF energy to improve
improved bladder control, less vaginal incontinence and sexual function issues, superficial skin tone problems
dryness and better sexual function. 90% of patients saw improvement and (skin texture) and deep concerns
By using photobiomodulation, 55% said the vSculpt Pro successfully (deep heating and tightening)
vSculpt’s red light and near-infrared eliminated leakage altogether. through resurfacing. The bi-polar
light optimise cellular healing, When it came to pelvic floor RF treatment allows clinicians to
increasing circulation and reducing muscle strength, 82% of women accurately treat a targeted zone for a
vaginal inflammation and pain. saw improvement and 91% saw an precise non-invasive treatment. The
vSculpt Pro also utilises gentle heat improvement in sexual dysfunction. full depth heating can improve elastin
to increase microcirculation and blood vSculpt Pro is available exclusively and collagen remodelling to positively
flow, helping the body natural repair from medical and aesthetic impact women’s feminine health and
itself. Lastly, sonic vibration harnesses practitioners. quality of life.
084 AM NOV17 Devices News.indd 84 30/10/2017 13:22

®
CFU® Center Focused Ultrasound and CTR® Cool Touch Radiofrequency

technologies which safely and gently heat the epidermis, dermis,
superficial adipose layer, SMAS and deep fat layer.
CFU® EASYZOOM CTR® COOL TOUCH RF EXCLUSIVE DESIGN HIGH SPEED PULSES
Delivers Center Focused Ultrasound Bipolar radiofrequency creates Slim handpiece design offers EASYFLOW® technology allows
energy precisely in the skin where an even heating at superficial wide field of view, enhances fast pulses delivery to selected
is needed, according to the depth level, hence stimulating treatment precision and allows treatment area achieving
desired, generating more than contraction and regeneration of uniform and easy operation on desired heat level for high
65°C coagulation point. collagen fibers. all skin contours. speed procedure.
CERTIFIED
O UT A ND A BO UT
YUVA Medi-Spa
opening, Cheshire
YUVA Medi-Spa hosted a stylish press event to mark
its recent opening in Cheshire.
Founded by Dr Raj Acquilla, the clinic will offer a full
range of aesthetic treatments.
The word Yuva means “youth” in Sanskrit and the
name was chosen to reflect the clinic’s philosophy.
Dr Acquilla said, “Our philosophy is to make our
patients not only look but feel better about themselves
through proven, safe and effective procedures. We
pride ourselves on listening to their needs so that we
can tailor and deliver a treatment plan that suits their
individual goals. We understand the emotions that are
attached to age-related changes in appearance and
endeavour to make all our patients’ experience and
journey with us a memorable and positive one.”
Ou t a nd about
Out and about in the industry this month
BC A M C O NF ER ENC E, L O ND O N
The British College of Aesthetic Medicine (BCAM) held its annual
conference once again at the Church House Conference Centre,
Westminster, London.
An intense academic programme, with top speakers and informal chat
sessions with the experts were on offer. With a clinical and business
packed agenda, the main aims of the event were to keep members
informed of the latest treatments and techniques. It also included a
business agenda which provided delegates with the latest medico- legal
updates and general data protection regulations.
The conference also included support from 21 sponsors who showcased
their wide range of services.
Following the conference, a drinks and canapes reception, sponsored Paul Charlson
by Wigmore Medical, was held.
Conference director Dr Ruth Harker said, “It’s been high quality,
stimulating and what’s more a friendly, fun day!”
BCAM president, Paul Charlson said, “It’s been an exciting year. BCAM is
growing in its influence with a bigger conference and larger membership.
The dentists are joining us now and we have set up the BCAM Academy
for new aesthetic doctors”.
Next year’s conference will take place on Saturday September 22, 2018
at the Church House Conference Centre.
Ruth Harker
086-088 AM NOV17 Out and About.indd 86 27/10/2017 16:56

Book a free demo with
SPHEROFILL 3D at your clinic!
PolyCaprolacton threads with patented

bi-directional barbs, absorbed after 12-15 months.
Results last 3-5 years!
Book a one-on-one training day

at your clinic
with Dr Ragni Funner
Email us at post@amedica.co.uk
Call us at: 07566 210500
www.amedica.co.uk
aesthetic add june.indd 1 19/05/17 17:33
Untitled-135 1 21/08/2017 10:09

O UT A ND A BO UT
IAPCAM conference, London

The International Association for Prevention of Complications in Aesthetic Medicine (IAPCAM)
hosted its first symposium in London.
The organisation was set up by Dr Beatriz Molina who felt there was a need for more discussion
around complications.
Held at the Church House Conference Centre in Westminster, the meeting was attended by
125 delegates and included lectures on anatomy, protocols for managing complications, common
complications caused by dermal fillers, how to safely inject and manage complications in the
periocular area, delayed hypersensitivity due to dermal fillers and body dysmorphic disorder.
Speakers included Dr Simon Ravichandran, Dr Sandeep Cliff, Mr Phillippe Berros, Dr Tahera
Bhojani-Lynch, Dr Max Malik and Dr Martyn King. Dr Patrick Tracey also discussed his HELPIR
technique to restore tissue after vascular occlusion.
Ethical business development and issues surrounding insurance and legalities were also
discussed with speakers including Richard Crawford-Small and Martin Swann. While Andrew
Rankin provided an update to delegates on the new Joint Council of Cosmetic Practitioners (JCCP).
The day concluded with a wine tasting provided by David McDonnell from Aesthetic Source.
The next IAPCAM symposium will be held on Friday September 21, 2018 once again at the
Church House Conference Centre in Westminster.
Ou t a nd about
Out and about in the industry this month
A EST H ET IC G Y NA EC O L O G Y
A C A D EM Y C O NF ER ENC E 2 0 1 7 , L O ND O N
The 1st Annual AGA Conference London (Aesthetic Gynaecology Academy) saw
Influential academics, medics and doctors from around the globe come together for the
first time to discuss aesthetic gynaecology, share best practice and educate women on
the subject, openly.
The event was held at Kensington Town Hall and was organised by owner of HB
Health of Knightsbridge, Heather Bird. She said “I wanted to organise an event bringing
together, under one roof, leading aesthetic gynaecology medics that I have worked
alongside at my clinic and women across the UK, to educate and share best practice on
vaginal rejuvenation. With increased knowledge comes power, the power for women
to talk more openly about their insecurities or problems and importantly discuss the
solutions directly with leading gynaecologists”
Amongst the lecturers were Dr Fouad Ghaly, Dr Sherif Wakil and Dr Gail King.
M esoestetic cosmel an ev en t,
R oy al Society of M edicin e, L on don
Aesthetic pharmaceutical company Mesoestetic held a CPD session led by Dr Lori Nigro
to discuss the treatment of pigmentation using the cosmelan treatment method. The
event took place at the Royal Society of Medicine.
Dr Lori began by discussing the problem of pigmentation and the benefits of using
peels instead of laser to treat the issue, in particular using cosmelan.
She went on to talk about the careful skin analysis that is required by the professional
prior to choosing the right treatment method.
086-088 AM NOV17 Out and About.indd 88 27/10/2017 16:57

Untitled-8 1
Untitled-4 13/09/2017 11:55
13/10/2017 11:06
Not a prescriber?
Not a problem.
PARTNER
PRESCRIBING
Connecting non-prescribing HCPs
with their partner prescribers
Through Partner Prescribing on DigitRx, non-

prescribing healthcare professionals can now
ﬂexibly process their orders for payment and
delivery after their partnered prescribers have
created online prescriptions following
a consultation.
Find out more at

www.churchpharmacy.co.uk/partnerprescribing

Aesthetic Medicine November 2017 PDF

Uploaded by

Copyright:

Available Formats

You might also like

Aesthetic Medicine November 2017 PDF

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Aesthetic Medicine November 2017 PDF

Uploaded by

Copyright:

Available Formats

NOVEMBER 2017 www.aestheticmed.co.

FAST WORK LED THERE BE LIGHT BLIND SPOT

he benefits o asting L ED D ossier B lindness as a complication

• INSPIRING BEST PRACTICE IN MEDICAL AESTHETICS •

OFC AM NOV17.indd All Pages 27/10/2017 16:05

THE UK’S LEADING LASER

AES, THE AWARD WINNING BRAND

6051 AES with Stand.indd 2 30/10/2017 10:12

6051 AES with Stand.indd 3 30/10/2017 10:11

IPL Handpiece with 7 applications NanoFractional RF™ with

Diamond-Polar ™ Handpiece Octi-Polar™ Handpiece

email info.uk@venusconcept.com www.venusconcept.com

0 6 NEWS AND ANALYSIS BUSINESS

DESIGN AND PRODUCTION

The publisher accepts no responsibility for any 46

Aesthetic Medicine • November 2017 3

003-004 AM NOV17 Contents.indd 3 30/10/2017 13:00

IN THIS ISSUE... www.aestheticmed.co.uk

SKIN INJECTABLES NUTRITION PSYCHOLOGY 80 TREATMENT FOCUS

Vicky Eldridge - Editor

4 Aesthetic Medicine • November 2017

003-004 AM NOV17 Contents.indd 4 30/10/2017 13:02

Using the latest

Find out more at

Call Lynton today on 01477 536 977

Untitled-9 1 26/10/2017 15:11

INDUSTRY NEWS www.aestheticmed.co.uk

H ackers target L ondon B ridge P lastic Surgery

W omen suffering w ith facial burns after

6 Aesthetic Medicine • November 2017

006-012 AM NOV17 News.indd 6 30/10/2017 15:36

www.aestheticmed.co.uk INDUSTRY NEWS

Rise in male treatments

H ealthcare I mprov ement Scotland publishes updated

Aesthetic Medicine • November 2017 7

006-012 AM NOV17 News.indd 7 30/10/2017 15:48

INDUSTRY NEWS www.aestheticmed.co.uk

8 Aesthetic Medicine • November 2017

006-012 AM NOV17 News.indd 8 30/10/2017 15:40

3 lasers in a single pulse for unbeatable results and unparalleled safety.

abclasers.co.uk info@abclasers.co.uk 0845 170 7788

SopranoPlatinumAdvertPrintReady v2.indd 1 10/08/2017 10:19

INDUSTRY NEWS www.aestheticmed.co.uk

N ew rules proposed for

Capsular contracture rates hav e more than doubled since 2 0 1 3

I nj ection techniq ue inspired by

10 Aesthetic Medicine • November 2017

006-012 AM NOV17 News.indd 10 30/10/2017 15:40

AWARD WINNING LASER PLATFORM 70+ FDA APPROVED TREATMENT INDICATIONS

HOME TO: ‘Hollywood Facelift’ the

abclasers.co.uk 0845 170 7788

HarmonyXLAdvert.indd 1 04/10/2017 09:22

INDUSTRY NEWS www.aestheticmed.co.uk

SAVE FACE ANNOUNCES CONSENTZ

12 Aesthetic Medicine • November 2017

006-012 AM NOV17 News.indd 12 30/10/2017 15:41

BEST CLINIC MIDLANDS & WALES

Cosmedic Pharmacy Tel: 0845 388 3880