cosmetic news | feb 2013

A l o p e c i A K e o g h R e v i e w : l A t e s t R e t A i l i n g s K i n c A R e

also in the february issue of CosmetiC news...

The UK’s leading Trade TiTle for medical aesTheTic professionals

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INJECTABLES special WE ExpLorE ThE WorLd of CoSmETIC INJECTABLES

®

W I T H L I D O C A I N E

ThE ShApE of ThINGS To ComE

it’s Here! CoSmETIC NEWS Expo ANd

AESThETICS CoNfErENCE 2013 ShoW ISSUE

Before After

No other system offers this advanced combination of technologies designed to target fat removal, cellulite

and skin tightening without the need to exercise

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

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

Skin Tightening

Cellu

lite

Fat R

educ

tion

For further information or a demonstrationcall: 01788 550 440

www.3d-lipo.comwww.3d-skintech.com

Why choose 3D-lipo?

What the experts say...

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

scientifically based and fit in with our ethos of holistic care for our clients.

3D-Lipo has delivered this to us’ Dr Mohamed Dewji – GP & Medical Director

LasaDerm Ltd (Milton Keynes)

Radio Frequency Skin Tightening Focus Fractional RF is the 3rd generation of RF technology. It utilises

three or more pole/electrodes to deliver the RF energy under the

skin. This energy is controlled and limited to the treatment area. Key

advantages of this technology are high treatment efficacy, no pain

as less energy is required, shorter treatment services and variable

depths of penetration.

CavitationCavitation is a natural phenomenon based on low frequency

ultrasound. The Ultrasound produces a strong wave of pressure

to fat cell membranes. A fat cell membrane cannot withstand this

pressure and therefore disintegrates into a liquid state. The result is

natural, permanent fat loss.

Cryolipolysis Using the unique combination of electro and cryo therapy 20-40% of

the fat cells in the treated area die in a natural way and dissolve over

the course of several months.

3D Dermology Combines pulsed variable vacuum and skin rolling for the effective

treatment of cellulite.

A Powerful Three Dimensional Alternative to Liposuction

The three day advanced and certificated intense laser hair removal course covers all aspects needed, to give you the knowledge to carry out treatments in confidence. Advance training is located in Belfast, London and Dublin.

The course will include the following topics:

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Patient consultation and communication•

Consent forms - everything you need to know.•

Regulatory issues and government requirements •

Types of medical and hair removal lasers - • How to

choose the right laser

Skin and hair biology•

Skin typing and laser settings•

Laser parameters (wavelength, chromophore, pulse •

duration, repetition rate, spot size, energy setting) and

their effect upon results.

Laser safety issues for the •

patient and the operator

Extensive hands-on •

practice on laser systems

Marketing your laser •

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k n o w l e d g e i s p o w e r . r e g i s t e r n o w !

cosmetic news expo is sponsored by:silver sponsorgold sponsor hosp ital ity sponsorbronze sponsor

S P E C I A L I S T S I N A E S T H E T I C T E C H N O L O G I E S

k n o w l e d g e i s p o w e r . r e g i s t e r n o w !

d o n t m i s s y o u r c h a n c e t o at t e n d t h e u k ’ s p r e m i e r t r a d e

e x h i b i t i o n a n d c o n f e r e n c e att h e b u s i n e s s d e s i g n c e n t r e ,

i s l i n g t o n , l o n d o n .

i t ’ s n o t t o o l a t e t o r e g i s t e rw w w. c o s m e t i c n e w s u k . c o m

call the t icket hotl ine 01268 754 897

gain valuable cpd pointscontinued professional growth and updating of skills is key to the development of any specialty, especially in one so dynamic and ever changing as aesthetic medicine. by attending the aesthetics conference you can gain valuable cpd points.

catch up with all your suppliers under one rooFthe cosmetic news expo brings together more key aesthetics manufacturers and suppliers under one roof than any other event in the uk and best of all entry to the exhibition is completely free.

network with over 1,000 visitorsFrom doctors, nurses and dentists to dermatologists, plastic surgeons and aestheticians, as the uk”s largest aesthetic meeting, the cosmetic news expo attracts a wide range of aesthetic practitioners keen to network and share ideas. this is the ideal place to make contacts and get your face out in the industry.

learn From some oF the industry’s leading Figuresas a delegate you can strengthen your knowledge of the latest developments in the industry and hear from key opinion leaders from the uk, europe and the us at both the aesthetics conference and as part of our free exhibitor workshops.

hear about new launchesif you want to keep your practice at the cutting edge then finding out about the latest developments and newest products on the market is key. as the first major event in the uk aesthetics calendar, the cosmetic news expo will see the official uk launch of a number of new and exciting brands. see them here first and stay ahead of the competition.

attend eXhibitor and business workshops as well as our conference programme in the main auditorium we will be running a series of exhibitor and business workshops on the exhibition floor. our exhibitors are dedicated to offering continued education and training to professionals working within this exciting and expanding sector and what better way to showcase you their products and services than through a dedicated workshop.

take advantage oF show oFFers a great thing about the cosmetic news expo is that exhibitors are keen to attract practitioners to them and many often offer exclusive show deals. these are the type of deals that can give you great margins and that you wouldn’t necessarily get if you didn’t attend. in tough trading times these are the kind of deals that can really help your business to boom, so make sure you take advantage.

recharge your enthusiasmbusiness can be tough, especially in these hard economic times. by visiting the cosmetic news expo you can recharge your enthusiasm by hearing about the latest developments and technologies, sharing ideas and concerns with your peers and being inspired by our exciting and dynamic speakers.

advance bookings

£49 - 1 Day £85 - 2 Day on the door

£75 - 1 Day £150 - 2 Day

Please contact us at PSR Insurance Brokers, 24 Creechurch Lane London EC3A 5JX

Contact Jacquie Ford Phone 0207 469 4985, Fax 0207 816 0029 Email [email protected] www.psrib.com

A simple solution for your Insurance requirements as a

CosmetiC PraCtitionerWhether you are an individual practitioner, a franchisee or operate an extensive chain, we can provide insurance solutions. All policies are competitively priced and in most instances can be paid over 12 months at no additional cost.

Benefit from a professional and personal service and many years of industry expertise.•Free quotation with no obligation to buy. •Policies tailored to reflect the exposures of your particular profession.•

“Aesthetic Medical Malpractice policies can be difficult to understand and it goes without saying that we must be satisfied that we have the right level of cover to meet our requirements. Jackie Ford, who handled the policy renewals, clearly knows her ‘stuff’, is professional and provides excellent customer service. We will continue to work with PSR for all our insurance needs.”Clinic Hertfordshire

“Jacquie delivers an efficient and thorough service in a warm and personable manner. She has always been easy and friendly to talk to and will go to great lengths to secure the best and most appropriate policy. The contrast to other insurance companies is great and it is the personal touch which makes all the difference. I only wish that all my dealings with insurance companies were the same.”Dr surrey

a e s t h e t i c s c o n f e r e n c e p r o g r a m m e 2 0 1 3 s a t u r d a y F e b r u a r y 1 6

MORNING SESSION - Chaired by Mr Dalvi Humzah

Managing the Versatility of Dermal Fillers – Dr Kate Goldie This session will analyse the facial indications for

fillers as well as looking at treatment plans and key

matrices for dermal fillers.

New Trends in Fillers Including Facial Volumising and Lip Shaping and Live Demonstration – Dr Raj Acquilla and Miss Jonquille Chantrey

New techniques are being developed all the time. This

masterclass session will focus on the latest treatments with

emphasis on anatomical placement and risk management using

the most effective products and techniques.

11.30am-12pm Coffee Break

How to Treat the Tear Trough Area: From Injection Techniques to Managing Complications (Including Live Demonstration) – Dr Patrick Trevidic The eye area has always been notoriously difficult to

treat. This session will cover treatment and management of this

delicate anatomical area using dermal fillers.

1pm-3pm Lunch Break/Exhibition Viewing

AFTERNOON SESSION – Chaired by Dr Tracy Mountford

Treatment and Maintenance of Redness and Inflammation - Dr Stefanie Williams and Mr Chris InglefieldA presentation of a study based around

rosacea/redness and the effects it has on skin ageing. To

include new findings around triggers, symptoms and treatments

for the skin condition to ensure correct diagnosis and

treatments for sufferers.

A Topical Approach To Wrinkles – Dr Barbara KubickaConfused by cosmeceutical ingredients?

With patients seeking advice for an array of differing

conditions, from the ravages of photoaging through

dermatological conditions and hyperpigmentation to simple

dry skin conditions, understanding and differentiating the

ingredients and products available is critical to successful skin

care. Covering both well established and novel ingredients this

session will provide you with all the facts you need to make

informed choices about cosmeceutical skin care that will meet

your patients’ needs.

The Impact of the Menopause on Ageing Skin – Dr Tracy Mountford and Dr Nick PanayDuring the menopause the skin undergoes

significant changes due to the hormonal

imbalance. The collaboration of gynaecologist and skin

specialist is an exciting partnership to improve care for this

group of women.

9.45am - 10.20am

10.20am -11.30am

12.00pm -1.00pm

3.00pm -3.40pm

3.40pm -4.20pm

4.20pm - 5.10pm

AesthetiCare®: EndyMedProTM3DEEP® - The New Wave in Performance and PredictabilityAn informative and interactive workshop highlighting the clinical and business advantages of the unique EndyMed™ 3DEEP® radio-frequency machine. EndyMed™ 3DEEP® is a patented and unique new wave in radio-frequency

technology, providing the latest, most advanced skin tightening and fractional skin resurfacing treatments to your patients. By overcoming the limitations of alternative systems, EndyMed™ 3DEEP® delivers non-invasive procedures that maximise performance, predictability, patient comfort and safety. See first hand the impact that EndyMed™ 3DEEP® can have on your business at the live demonstration and hear from current users of the system about their experiences and successes and how EndyMed™ 3DEEP® could make a difference to your clinical business and patients.

Boston Medical Group: It is Time to Introduce Revanesse® to Your ClientsBoston Medical Group Ltd will introduce the whole range of Prollenium products including mesotherapy range for face, body and hair. The Revanesse® line of fillers employs Thixofix™ Technology - one of the most advanced methods

of cross-linking available- thereby ensuring long lasting results. This patented process also ensures that the products remain easy to inject while not sacrificing viscosity. Additionally, Revanesse® fillers exclusively use HA with a high molecular weight to achieve maximum durability and longevity. Prollenium exports to over 80 countries in the world, and is currently working on further developments for the global market - Lidocaine range, Revanesse Contour specially designed for volumising, to name a few.

Sinclair IS Pharma - Sculptra – Ask The ExpertSculptra returns to the UK market. Come and meet Dr Danny Vleggaar and find the answers to the questions you always wanted to know regarding the return to the market of this popular product. Sculptra® works differently from traditional fillers. It’s a unique collagen replenishing treatment that helps to gradually and

subtly reduce lines, wrinkles and folds. By helping to replenish your own facial collagen and restore lost volume, it can give you a fuller, more natural look that can last for up to 25 months. The main ingredient of Sculptra® is poly-l-lactic acid, which has been successfully used in surgical operations for more than 25 years. Sculptra® was specially developed to repair facial scars and contour defects. Sculptra® is long lasting, biocompatible, and biodegradable.

Silhouette Soft™ Silhoutte Soft is a new minimally invasive suture treatment which is based on proven Silhouette Lift absorbable cone sutures technology. Soft is designed to be minimally invasive with no incisions being required and to be fully absorbable while providing lift and counteracting the effects of volume

loss. Soft offers immediate natural results, from a 30 minute treatment with an Immediate return to work and social life after treatment. Silhouette Soft™ Sutures are manufactured in Michigan, USA under ISO 13485 standards, and have been developed based upon six years of experience in suspension sutures with absorbable cones, with the highest quality and care.

Ellansé a Touch of Youth - Advanced techniquesAdvanced techniques demonstrated for rejuvenation in facial aestheticsEllansé™, the Unique and Innovative dermal filler, combines the benefits of both immediate correction of wrinkles and folds as well as stimulating the generation of the body’s own collagen. Ellansé™, longer lasting results for a beautiful, fresh

and natural look you’ll love.

Clinogen: Oxypeel Advanced Medical Aesthetics – Using Biological Exfoliation and Oxygen Delivery Sujata Jolly, medical director at Clinogen Laboratories, will talk about why she advocates the “Treat, Heal and Re-educate™”philosophy, and how a rounded approach to treat various skin conditions will produce superior long term results.

She will demonstrate the importance of using a logical methodology in treating skin problems, including acne, scarring, pigmentation and rosacea.

Energist: Portrait NeoGen Plasma Skin Regeneration – Live Treatment DemonstrationPortrait NeoGen is a unique device delivering controlled pulses of nitrogen plasma energy to skin. Portrait is a non-ablative treatment supported by numerous clinical studies, which provides demonstrable improvement to skin

texture, deep wrinkles and acne scarring. It has been noted that Portrait delivers treatment outcomes akin to those seen after full CO2 resurfacing, but with significantly reduced downtime. See a live demonstration of this unique and impressive treatment.

11.00am 11.30am

1.00pm -1.30pm

1.30pm -2.00pm

2.00pm -2.30pm

2.30pm - 3.00pm

11.45pm 12.30pm

12.30pm 1.00pm

free of charge business workshops

1 6 t h a n d 1 7 t h f e b r u a r ye x h i b i t i o n a n d c o n f e r e n c e

the uk’s largest trade aesthetics exhibition and conference

cosmetic newsexpo

book today! call the ticket hotline 01268 754 897

www.cosmeticnewsuk.com

advance bookings

£49 - 1 Day £85 - 2 Day on the door

£75 - 1 Day £150 - 2 Day

a e s t h e t i c s c o n f e r e n c e p r o g r a m m e 2 0 1 3 get cpd

pointss u n d ay F e b r u a r y 1 7

Presented by MR Jan Stanek and hosted by BTL, titled “ADVANCED BODY SHAPING

& SKIN TIGHTENING” or for a free demonstration contact [email protected].

BTL Industries Ltd, Unit 83, Greenway Business Centre Harlow Business Park Harlow, Essex CM19 5QE

Tel: +44 866-285-1656 Fax: +44 888-499-2502 Phone: +44 7508 621607 www.exilis.com www.btlaesthetics.co.uk [email protected]

EXILIS...the award winning system for ADVANCED BODY SHAPING & SKIN TIGHTENING...

...voted “The Best Skin Tightening Device Award TAS 2012”, Las Vegas

Register for our Workshop on 4th NOV at www.bodyconference.co.uk

Exilis...best in class

BTL-Exilis_210x297mm _2012_UK.indd 1 2.10.2012 10:54:31

MORNING SESSION – Chaired by Mr Chris Inglefield

Introduction to Lasers in Cosmetic Practice

Multi-Application Lasers – Dr Ariel Haus This session will explain the value of a multi-application laser and how it can benefit your bottom line while offering your patients the best results with the least downtime.

11am-11.30am Coffee Break

New Innovations and Advancements in Platform Technology - Dr Robin StonesThis session will look at the latest combination of light and laser based technologies that provide total anti ageing and

skin rejuvenation solutions for all skin types

Using Fractional CO2 to Repair Damage in Skin – Dr Tapan PatelCO2 Lasers have come a long way over the last ten years and the antiaging breakthrough of the decade, according

to many doctors, is skin-resurfacing with CO2 fractional laser therapy. Combining the effectiveness of traditional carbon dioxide lasers -- long thought to be the gold standard in wrinkle removal -- with a new application technique, it delivers powerful results without the traditionally harsh side effects.

Advanced Body Shaping and Skin Tightening: Obtaining the Best Results Using Radio-Frequency and Ultrasound Technology. – Mr Jan StanekThere is much new technology for skin tightening and body

shaping - but do these devices work? This session will present the findings of clinical practice.

1pm-3pm Lunch Break/Exhibition Viewing

AFTERNOON SESSION - Chaired by Dr Tapan Patel

Medical Devices for Intradermal Injections and the Use of Mesotherapy Techniques for Rejuvenation – Dr Galcerán MontalMesotherapy has been used widely in Southern Europe but with little uptake in the UK. Now, as techniques and results

improve, we are seeing an upsurge in treatments. Dr Galceràn Montal is an expert in his field and this session will focus on the treatment of the hands and neck as well as other problem areas that have previously been very difficult to treat.

Mesotherapy with Biomimetic Nano-Peptides: A New, Quick, Injectable Treatment for a Wide Variety of Indications - Dr Gabriela MercikFind out how the latest cutting-edge mesotherapy

technology can enable quick, non-invasive solutions for many different indications including skin brightening, hair restoration, rejuvenation, and lipolysis.

9.45am - 10.15

10.15am -11.00am

11.30am - 11.55am

11.55am - 12.15pm

12.15pm -1.00pm

3.00pm -4.00pm

4.00pm -5.00pm

AesthetiCare®: Genuine Dermaroller™ presents the e-Dermastamp™ – Bringing Electronic Microneedling On PointA workshop designed to demonstrate the efficacy and precision of the most advanced electronic micro-needling system available.

Manufactured in Germany to the same exacting standards as all Genuine Dermaroller™ devices, the NEW e-Dermastamp™ is a fully certified CE medical device providing you with the procedures you want, and the quality you need at a cost which will enable a profitable revenue and rapid ROI. See, hear and explore how the exciting NEW e-Dermastamp™ from Genuine Dermaroller™ and AesthetiCare® can benefit your clinical business and your patients.

11.30am to 12 - Luminary

Sinclair IS Pharma - Sculptra – Ask The ExpertSculptra returns to the UK market. Come and meet Dr Danny Vleggaar and find the answers to the questions you always wanted to know regarding the return to the market of this popular product. Sculptra® works differently from traditional fillers. It’s a

unique collagen replenishing treatment that helps to gradually and subtly reduce lines, wrinkles and folds. By helping to replenish your own facial collagen and restore lost volume, it can give you a fuller, more natural look that can last for up to 25 months. The main ingredient of Sculptra® is poly-l-lactic acid, which has been successfully used in surgical operations for more than 25 years. Sculptra® was specially developed to repair facial scars and contour defects. Sculptra® is long lasting, biocompatible, and biodegradable.

Harley Street Beauty: Building A BrandIn this workshop Harley Street Beauty will explore how to build your brand including aspects of marketing, PR, online media and market challenges from brands.

Clinogen: Revitale – A Non-Surgical Product Driven Approach to Facial Skin TighteningSujata Jolly, medical director at Clinogen Laboratories, will talk about the advantages of a non-surgical approach to facial skin tightening. She will address key questions including – why it is essential to target the skin as a whole rather than discrete

areas, how increasing the microcirculation will lead to long term improvement in skin tone, and why the timing of treatments is key in sustained results.

Advancements in Automated Dermal Needling - New techniques, New clinical trial data on Operation and other Scars, Combination therapy and New Pen ModelsOver the last year many have pioneered automated dermal needling with the DermaPen, with great success. In the US, UK and elsewhere,

new learning’s and technique have been tested and utilised. This master class involving Professor Tony Chu (the first clinical users of dermal needling and now Dermapen in the UK) looks at the latest stunning clinical trial work on operation and burn scars (including hypertrophic scars) being carried out in London. This is part of an on-going clinical research programme funded and supported by Dermapen who have the reputation as the company that seeks clinical proof above anecdotes.Dermapen, the only pen designed specifically for the purpose from drawing board to the clinic. A pen that can glide as well as stamp.

Tattoo Removal - Wavelength Selection for Maximum Results - Lynton LasersThe workshop will focus on how to remove tattoos using the latest technology, with specific focus on the correct wavelengths to be used. Lynton is the UK’s leading supplier of aesthetic

equipment to the medical, cosmetic, and beauty industries and has been recognized by winning Aesthetic Medicine’s inaugural equipment Brand of the Year award for 2008. The company mission ‘To become the supplier of choice for aesthetic equipment in the UK’ has always been strongly endorsed by customers throughout the UK.

11.00am 11.30am

12.30pm 1.00pm

1.00pm 1.30pm

1.30pm 2.00pm

2.00pm 2.30pm

2.30pm 3.00pm

free of charge business workshops



cosmetic newsexpo

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For more information, please contact Merz Aesthetics Customer Services

Phone: 0333 200 4140, Fax: 0208 236 3526 [email protected], www.radiesse.com

■ Immediate result due to elastic gel-matrix

■ Prolonged effectiveness due to CaHA-induced collagen production

Comprehensive studies confirm a robust safety profile

The EffectVolume enhancementfor a youthful appearance

Gold Standard Customer Servicesvoted as The Best by our customers in 2011 and 2012

Welcome to the February issue of Cosmetic News.

Editor’s Letter



cosmetic newsexpo

16 th a n d 17 th f e b r u a r y

see us at

stand 74

e x h i b i t i o n a n d c o n f e r e n c e


cosmetic newsexpo

This month sees our annual conference and exhibition, the Cosmetic News

Expo and Aesthetics Conference, take place in London. The Expo is the

UK’s largest event for the aesthetics industry and we are really looking

forward to welcoming everyone through the doors of the Business Design

Centre, London, on February 16 and 17.

We have a fantastic educational programme taking place over the two days where you can see leading

lights from the UK, US and Europe speaking about the hottest topics in aesthetic medicine. Once again we

have also received a phenomenal response from the industry with the key manufacturers and suppliers

exhibiting at the show. See our fold out cover for all the information you need. There is still time to book

your place, simply visit www.cosmeticnewsuk.com to register for your free tickets to the exhibition or call

our booking hotline on 01268 754 897 to reserve your place at the conference or workshops.

This month is also our Injectables Special (p18-36). As part of this we will bring you an exclusive on the

latest product from Allergan, JUVÉDERM® VOLBELLA® with Lidocaine, which will be having its UK

launch at the Cosmetic News Expo (p18-19). We also speak to Dr Linda Eve about her experience using

Sculptra (p36) and Dr Joanna Ward shares her insights on combining skinboosters with dermal rollering

(p24-26). We also give you the latest on the Sir Bruce Keogh Review (p12-14). I hope you enjoy this issue

and look forward to seeing you at the Cosmetic News Expo 2013 at the Business Design Centre, London on

February 16 and 17.

The Cosmetic News Expo takes

place in London this month and one

product that will be seeing its UK

launch at the event is the Dermalux™

Tri-Wave LED phototherapy system.

Utilising clinically proven Light Emitting Diode technology the Dermalux™

Tri-Wave will, like its predecessor, deliver excellent outcomes for a wide

range of common skin concerns including ageing, acne and pigmentation.

It also provides a significant development in the treatment of specialist and

problematic conditions such as rosacea, scarring and inflammatory disorders

such as eczema and psoriasis.

Designed and manufactured in the United Kingdom the Tri-Wave features the

three key wavelengths: RED light at 633nm, Blue at 415nm and Near Infra-Red

at 830nm. These are the medically proven and accepted wavelengths that

guarantee successful outcomes for a wide range of skin conditions and concerns.

A unique feature of Dermalux™ Tri-Wave is that all three wavelengths can be

delivered either as individual LED treatments or concurrently in any selected

combination providing stimulation at a sub-cellular, cellular and tissue level to

target multiple concerns in one session for accelerated results.

Unlike more invasive procedures, LED phototherapy does not use heat or

chemicals to promote change in the skin and therefore offers one of the

safest modalities to treat all skin types (I to VI) without incidence of thermal

damage, trauma or downtime. Furthermore, LED phototherapy can be used

in conjunction with most medication and enables the effective treatment of

compromised, reactive and sensitive skin conditions.

LED phototherapy is also an excellent adjunctive procedure and can be

combined with any existing skin treatment and product range to enhance

clinical outcomes. The Tri-Wave can be applied post treatment to reduce

redness and inflammation, help to prevent infection and breakouts and improve

healing time. It is also effective to prepare and strengthen the skin in advance of

invasive procedures which may result in inflammation or trauma.

Treatment times are short and the visible effects are immediate. Dermalux™

instantly revives a tired and dull complexion. After just one treatment skin

is incredibly hydrated, smooth and radiant and redness and irritation are

calmed. A course of treatments offers corrective and lasting improvement in the

appearance and health of the skin.

Dermalux™ is an affordable option for clients and due to growing awareness

of the benefits, is rapidly becoming a highly sought after treatment. LED

phototherapy also promotes a feeling of relaxation and wellbeing, helping to

relieve the stresses and strains of everyday life!

Dermalux™ offer “taster” events for potential purchasers and their clients

to demonstrate the benefits of the system. Offering onsite training, bespoke

protocols, client launch events, marketing and on-going support, Dermalux™

is a must have for aesthetic practitioners and clinics who want to make the

difference for their clients.

Dermalux™ Tri-Wave

Editor’schoice

DISCLAIMERThe editor and the publishers do not necessarily agree with the views expressed by contributors and advertisers nor do they accept responsibility

for any errors in the transmission of the subject matter in this publication. In all matters the editor’s decision is final.

Charlotte Body [email protected]

Kevin Hogg Publications [email protected]

Peter Johnson, Art [email protected]

Sean Rice Senior [email protected]

Vicky Eldridge EditorM: 07940 083 677 [email protected] Winkworth Operations Manager [email protected]

Sophie Belcher Events/[email protected]

Carly Mcfarlane Sales and Events Assistant [email protected]

contact the cosmetic news team on 01268 754 897

ContentsContentsindustrY insider

4 editor’s choiceVicky Eldridge on the Dermalux™ Tri-Wav

6 industrY neWsWe round up the latest industry news 12 neWs speciaLAs Sir Bruce Keogh and his expert panel reveal the summary of the response to the call for evidence, we report on what this means for the industry

16 on the scene Out and about in the industry this month

16 peopLe in profiLe We chat to mesotherapy expert Dr Glaaceran Montal about his career and passion for aesthetics

cLinicaL practice

18-34 [inJectabLes speciaL] We take a look at the world of cosmetic injectables

18 neW product focus We get the exclusive on Allergan’s new product: JUVÉDERM® VOLBELLA® with Lidocaine

21 cLinicaL studY We summarise the results of a clinical study published in the Journal of Cosmetic and Laser Therapy on the benefits of adding lidocaine to the hyaluronic acid filler Stylage®

24 combination treatments Dr Jo Ward explores skin boosters, their efficacy and combination applications

30 techniQueLeslie Fletcher tells us how she developed the patented ArqueDerma® Artistic Restoration Lift®

32 book extractWe summarise a chapter from a new book by Eric Finzi entitled The Face of Emotion: How Botox Affects Our Mood and Relationships looking at the importance of the eyebrows when conveying emotion

34 Q&a We speak to Dr Linda Eve MBBS, MD of Evenlines Clinic, Bournemouth, about her experience using Sculptra®

36 [skin neeLding]Lorna Jackson on the ‘nitty gritty’ of medical micro-needling dermal rollers and whether you know what you are you really buying?

41 treatment spotLight Geraldine Flynn on using micropgimentation for alopecia patients

product revieWs

36 product focus We find out how the latest launch from 3D-Lipo, 3D-Skintech, is offering clinics four cutting edge technologies in one piece of equipment

44 product neWsWe round up the latest product news

50 advertoriaL SkinCeuticals Redness Neutralizer in business

52 business focus Ed Beardsell on the endless opportunities offered by those 140 little characters on Twitter

54 retaiL Tayyab Akhlaq on how to get more from high-end retail products

56 a daY in the Life of…Antonia Mariconda finds out what a typical Day in the Life has in store for plastic surgeon Adrian Richards

58 training neWs and dates for the diarY The latest training news and dates for your diary

18-34 [inJectabLes speciaL] We take a look at the world of cosmetic injectables

Before After

No other system offers this advanced combination of technologies designed to target fat removal, cellulite

and skin tightening without the need to exercise

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

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

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For further information or a demonstrationcall: 01788 550 440

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Why choose 3D-lipo?

What the experts say...

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

scientifically based and fit in with our ethos of holistic care for our clients.

3D-Lipo has delivered this to us’ Dr Mohamed Dewji – GP & Medical Director

LasaDerm Ltd (Milton Keynes)

Radio Frequency Skin Tightening Focus Fractional RF is the 3rd generation of RF technology. It utilises

three or more pole/electrodes to deliver the RF energy under the

skin. This energy is controlled and limited to the treatment area. Key

advantages of this technology are high treatment efficacy, no pain

as less energy is required, shorter treatment services and variable

depths of penetration.

CavitationCavitation is a natural phenomenon based on low frequency

ultrasound. The Ultrasound produces a strong wave of pressure

to fat cell membranes. A fat cell membrane cannot withstand this

pressure and therefore disintegrates into a liquid state. The result is

natural, permanent fat loss.

Cryolipolysis Using the unique combination of electro and cryo therapy 20-40% of

the fat cells in the treated area die in a natural way and dissolve over

the course of several months.

3D Dermology Combines pulsed variable vacuum and skin rolling for the effective

treatment of cellulite.

A Powerful Three Dimensional Alternative to Liposuction


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ThermaVein™

syneron candela

acne e-book

Major Distribution Deal for ThermaVein™ Announced Tekno-Surgical, a division of SISK Healthcare, has secured the

exclusive UK and Ireland distribution rights to ThermaVein™.

The deal was secured after a tender process involving a

number of interested parties. ThermaVein™ technology was

only made available to the aesthetic market in late 2012 after

being widely used within the medical Industry for many years.

Mark Hawthorn, director of ThermaVein™ said, “We entered into a

tender process with a number of large operators who had shown

an interest late last year. As we progressed it became clear that

Tekno-Surgical have the infrastructure, staff and experience to fulfil

the potential of ThermaVein™. We have exclusive Worldwide rights

for the product and are already operational in the US. In addition

we are in talks with a number of other interested territories and

look forward to entering new and exciting markets. We will also

be looking to expand our product range across 2013 and have

substantial funds available”.

Janette McGovern, sales manager at Tekno Surgical said, “Our

aesthetic division is growing rapidly with the UK a major focus

area for us. When we saw ThermaVein™ being used in a treatment

we knew we had to move quickly. Our group has a turnover well

in excess of £80m and we expect ThermaVein™ to contribute

significantly to growing this number. We are very excited to be

involved with this product and are already experiencing strong

demand in both the UK and Ireland”.

Free adult acne e-book released by Court House Clinics Medical experts at Court House Clinics have teamed up with freelance

writer Laura Jane Williams to release a free e-book. The witty and

entertaining guide is designed as part prevention, part cure, and advice

for adults suffering with bad skin.

The free guide gives men and women practical advice with a no-nonsense

attitude. Chapters include oft-neglected topics such as acne during pregnancy,

acne and stress, and diet. The full e-book is available to download from http://

www.courthouseclinics.com/treatments/acne-treatment-guide/

baaps

BAAPS release results of annual auditAudit figures from the British Association of Aesthetic Plastic Surgeons have

revealed that, although the number of overall procedures remained static

and barely changed at all over the last year, facial rejuvenation treatments

in particular are the nation’s favourites with eyelid surgery, fat transfer, brow

and face-lifts all experiencing a double-digit rise.

The most impressive percentage increase was in male brow lifts, which

rose by 19%. Eyelid surgery and fat transfer also proved popular with both

genders, showing a rise of 13%, as did face-lifts, up 14%, compared with

abdominoplasty (tummy tucks) and liposuction tumbling in demand by 12% and

14% respectively. In all likelihood a result of the ongoing PIP implants crisis,

demand for breast augmentation dipped as expected but only slightly by 1.6%,

and continued to maintain its place as the most popular aesthetic surgery. On

the whole, the number of surgical procedures showed a barely-perceptible rise

of 0.2% from 2011 to a total of 43,172, and their order of popularity remained

largely unchanged.

According to Rajiv Grover, consultant plastic surgeon and president of the BAAPS,

“Every week there are reports of new ‘lunchtime’ or ‘Hollywood craze’ treatments

that are here today, gone tomorrow. The growth rates for surgical face-lifting and

other anti-ageing procedures showed a double digit rise, despite a double dip

recession. Perhaps because of turbulent financial times, patients are looking

for tried-and-tested procedures that deliver a reliable, long-lasting result and

which have a proven safety record. Whilst there is an undeniable rise in demand

for non-surgical treatments of the face; for example Botox® and fillers; once

there is actual loose skin in the neck or jowling, only surgery is likely to make a

significant improvement and the public seem to be increasingly aware of this.”

Paul Simmonds joins Syneron Candela sales teamSyneron Candela service engineer Paul Simmonds has now joined the company’s sales team. Paul has been visiting clinics across the UK for a number of years as part of the company’s technical and engineering team and will now be a regular point of contact for clinics across the Midlands and further afield. Paul’s in-depth knowledge of the Syneron Candela machines made him the perfect candidate for the role. He says, “I am very excited about the prospect of a new career path in the Syneron Candela team and taking time to help customers choose the right machine for their business.”

INDUSTRy NewS book Your ticket for the cosmetic neWs expo 2013

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aesthetic awards 2012-13, triple win for aBc lasersEquipmEnt Brand of thE YEaraBc lasers

trEatmEnt of thE YEar (BodY)soprano pain free hair removal (aBc lasers)

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Contact us on: Tel: 0845 [email protected], www.abclasers.co.uk

Aesthetic Medical Treatment System

12 www.cosmeticnewsuk.com

The consulTing room™

The wrighT iniTiaTiVe

eurocom healThcare

microneedling book

abc lasers

ABC LASERS WELCOMES NEW TEAM MEMBERABC Lasers has welcomed Fiona Doherty to

its growing team as London sales and training

director. Fiona is an experienced nurse prescriber

who has been working in the aesthetics industry

for more than seven years. Her work as a lead

nurse in a central London clinic has provided her

with a unique understanding of how to run a

successful clinical business and her training and

teaching background, make her a strong addition

to the ABC Lasers team. She said, “My past

experience has involved the training and mentoring of therapists, nurses

and doctors on cosmetic and medical procedures. I believe that the key to

finding the best clinical solutions for patients comes from a knowledgeable

and confident practitioner who is trained to a high standard. I am looking

forward to starting my role with ABC Lasers due to their excellent reputation

within the aesthetic industry and the phenomenal brand awareness and

demand from patients for Soprano™ pain free Laser, Harmony™ with

ClearLift™ and more. I am proud to join the only laser company voted

Equipment Brand of the Year gold winner and Treatment of the Year gold

winner for two years running at the Aesthetic Awards. This is a very exciting

time to join such a dynamic company!”

Holistic Microneedling book published November has seen the release of the new book

by Anthony Kingston. Holistic Microneedling: A Natural Approach to Skin Needling provides a

detailed account of how to perform microneedling

in a holistic and less invasive way. It focuses on the

techniques for treating a variety of conditions and

analyses different products that can be applied in

different situations. In addition, a thorough study of the history and science

behind microneedling is provided and demonstrated through 37 colour

photos and diagrams. Anthony began studying skin needling in the form of

acupuncture in Australia before continuing to study a wide variety of cosmetic

techniques throughout Asia and the west. Together with his wife he founded

the first specialist cosmetic skin needling clinic in the southern hemisphere.

The book is available through White Lotus Anti Aging and retails at £34.99 for

the soft cover book or £19.99 for the e-book.

New initiative offers patients pre- and post-procedure support A new initiative has been set up to offer people undergoing

cosmetic or aesthetic procedures support.

The Wright Initiative has developed the PaPPS Initiative, a

consumer driven programme addressing the emotional, relational

and psychological wellbeing of people who are considering or

having elective surgical or aesthetic procedures. PaPPS has been

pioneered to support both the patient and surgeon ensuring that

every aspect has been addressed.

Alongside supporting the patients, The Wright Initiative, headed by

respected psychotherapist Norman Wright, works with surgeons to

ensure that their patients are prepared, mentally and physically, for

the changes they will experience after surgery.

The specially-devised programme takes the form of focal sessions

that are held at TWI’s Nottingham and Harley Street clinics. During

the course of a 60-minute assessment, the patient will attain the

peace of mind that comes from knowing that their emotional welfare

has been addressed by them and their surgeon thus providing an

integrated support programme.

Syrinx Za International appoints Eurocom Healthcare Communications as its skincare distributor Eurocom Healthcare Communications has been appointed by Syrinx Za

International to handle its range of skincare products. Commenting on

appointing Eurocom, Ashley Metcalfe, chief executive at Syrinx Za International

said, “As a new business launching into the very competitive UK pharmacy

market the Eurocom team has given us the opportunity to punch above our

weight with innovative and creative designs that show a real understanding

of our business, our aims and our aspirations. They have delivered on time,

on strategy and most importantly at a budget we can afford.” Tony Chant,

managing director at Eurocom said, “The Syrinx Za range is based on pure,

natural ingredients, the main one being Zander. It is a truly unique range,

which will be welcomed by sufferers of various acute and chronic skin

conditions everywhere. We are delighted to be working with Ashley and the

team and look forward to developing both print and online digital initiatives for

them, to achieve a greater awareness of the Syrinx Za brand.”

INDUSTRy NewS book Your ticket for the cosmetic neWs expo 2013

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cosmetic newsexpo

The Consulting Room™ releases 2012 Website Traffic Statistics The Consulting Room™ has released its 2012 website statistics

giving an insight into what the average consumer is researching.

From January 1 to December 31 2012 just over one million unique

visitors came to www.consultingroom.com. In total, just under 700,000

of the annual site visitors viewed the Treatment and Product FAQ

information on the website.The most popular pages viewed in order

were: laser and IPL hair removal; radio-frequency for facial rejuvenation;

penile augmentation surgery; laser tattoo removal; dermal fillers;vaginal

surgery; fractional laser skin resurfacing; microdermabrasion; ultrasonic

body contouring; specialist skin cream; laser and IPL skin rejuvenation;

chemical peels; radio-frequency for cellulite and fat; medical skin

needling and umbilicoplasty (belly button surgery). The top ten

most popular Product FAQs were: Pixel; Teosyal®; Restylane® Vital;

Belotero; Accent; Dermaceutic Peel; Thermage CPT; Juvederm® Ultra;

Eurosilicone Breast Implants and Restylane® (Perlane & SubQ).

aesthetic awards 2012-13, triple win for aBc lasers

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Unlimited Options. One Easy Choice.The Leader in Medical Aesthetics

Alma Lasers offers the most advanced technologies for today’s most in-demand aesthetic procedures.

HarmonyXL is a multi-application platform featuring over 70 FDA cleared aesthetic treatments, including

ClearChoice for Onychomycosis (nail fungus), the popular Laser360iQ rejuvenation and anti-aging protocol, and

iTED, a revolution in ultrasound trans-epidermal delivery. Clinically PROVEN to safely treat ALL skin types. True

Breakthrough in treating the most in-demand indications: Stretch Marks, Melasma, Scars, Acne Scars and many more.

Contact us on: Tel: 0845 1707788,[email protected], www.abclasers.co.uk

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oVer 60’s cosmeTic TreaTmenT rise

skin cancer

cosmeceuTical markeT growTh

Cosmeceutical market grows, according to new report The global population grows older while increasing social pressures drive individuals to look

younger, and consumer awareness has risen for cosmeceutical products which offer a way to

keep up appearances without going under the knife, says a new report by market experts GBI

Research. The new report Cosmeceuticals Market to 2018 - Technological Advances and Consumer Awareness Boost Commercial Potential for Innovative and Premium-priced Products states that the market for cosmeceuticals represents the fastest growing segment of today’s personal care industry. Demand is spiraling, driven mainly by anti-ageing products, which offer an alternate to cosmetic surgical procedures, which promise more dramatic results but at a higher cost in terms of time, money and safety. The cosmeceuticals markets in the US, the UK, France, Germany, Italy, Spain and Japan were estimated to be worth $30.9 billion collectively in 2011, with the combined markets expected to reach $42.4 billion by 2018, following growth at a CAGR of 4.6%. Presently, cosmeceutical companies rely on developed nations, but increasing wealth in emerging markets such as Latin America, China and India is expected to see products reach out to an even wider audience in the future.

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A boom in divorcing over 60s has seen a massive rise in older women and men booking cosmetic beauty treatments

and buying anti-ageing products. The female ‘silver separators’ are seeking to emulate still-got-it older stars like

Dame Helen Mirren, 67, and Susan Sarandon, 66, as they get back out dating. And men may be trying to ape

silver foxes like Pretty Woman star Richard Gere, 63, or Taken legend Liam Neesen, 60. There has been a huge

58% increase in women in their 60s and 70s getting divorced. Many of these women have chosen to leave

an unhappy marriage and have sought out cosmetic treatments to improve their image before looking for a

new partner. As a result the ‘silver separators’ market has become the fastest growing demographic group for

aesthetic clinical treatments and the LoveLite clinic in Harley Street has seen a 250% increase in women of that

age seeking treatments. There has also been a significant increase of 160% in treatments for men of the same

age. LoveLite clinical director Donnamarie McBride said, “A year or so ago we had very few clients over the age

of 60, a handful in a year at most. But recently there has been a massive increase in demand and we’ve seen

as many in the past month as we would have done in nearly half a year previously. The over 60s age group is

without a doubt the fastest growing area in the non-invasive cosmetic treatment market at the moment. Almost

all of the women that come to us have just become separated or divorced, and they are wanting to improve their

appearance and get back to their more youthful figure. The Lipoglaze treatment is especially useful because the

older you get, the harder it is to shift the fatty areas with gym work and good diet alone.”

Over 60s spark rise in demand for cosmetic treatments and anti-ageing products

Leading Consultant Dermatologist On Mission To Raise Awareness Of Mohs Treatment For Skin CancerA leading consultant dermatologist is on a mission to raise awareness of Mohs surgical

treatment for non-melanoma skin cancer, which he believes is the most effective

treatment available today. Dr Walayat Hussain, who works at Spire Leeds Hospital, is

one of only a few doctors in the country trained in the highly specialised technique.

He is also the only Mohs surgeon in Yorkshire to be accredited by the world’s

leading Mohs institution, the American College of Mohs Surgery. “Mohs surgery, also

known as ‘Mohs micrographic surgery’, is one of the most effective and advanced

treatments for non-melanoma facial skin cancer today yet most doctors know very little about it’, said

Dr Hussain. “When dealing with skin cancer, what you see on the skin can be just the tip of the iceberg.

Mohs surgery enables all the roots of the skin cancer to be very precisely removed and by only removing

cancerous tissue and sparing normal skin, it can often offer an improved cosmetic result and may work

where other treatments have failed. Mohs surgery is considered the ‘gold-standard’ treatment for non-

melanoma skin cancers when it is felt there is a high risk of the cancer returning and especially when

the skin cancer is on the face as it allows the hole to be kept as small as possible. This is particularly

important around the eyes, ears, nose and mouth. Take the lips for example, it’s vital that a patient’s

ability to open their mouth, eat, smile and speak are not affected.”

Call Merz Aesthetics Customer Services now to find out more or place your orders: Tel: +44(0) 333 200 4140 Fax: +44(0) 208 236 3526 Email: [email protected]

www.belotero.uk.com

Merz Pharma Uk Ltd 260 Centennial Park, Elstree Hill South Elstree, Hertfordshire, WD6 3SR Tel: +44(0) 333 200 4140

1 Histological examination of human skin (eyelid dermis layer). Courtesy Dr. J. Reinmüller, Wiesbaden, Germany 2 Prager W, Steinkraus V. A prospective, rater-blind, randomized comparison of the effectiveness and tolerability of Belotero Basic versus Restylane for correction of nasolabial folds. Eur J Dermatol 2010;20 (6):748-52. 3 Taufig A, et al. A new strategy to detect intradermal reactions after injection of resorbable dermal fillers. J Ästhetische Chirurgie 2009; 2: 29-36 4 Reinmüller J et al. Poster presented at the 21 World Congress of Dermatology, Buenos Aires, Argentina, Sept 30 – Oct 5, 2007. Thereafter published as a supplement to Dermatology News: Kammerer S. Dermatology News 2007; 11: 2-3.

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2012 was a dark year for the aesthetics

industry as the safety and regulation

of cosmetic procedures came under

fire in the wake of the PIP scandal. The

widespread media coverage of the incident

stretched far beyond the world of implants

and brought non-surgical procedures, in

particular dermal fillers, under scrutiny

as well. This led to the Health Secretary,

Andrew Lansley, calling for a major review of the sector to be carried out.

The review, led by NHS medical director Sir Bruce Keogh (pictured left), saw

an expert panel being formed and, in August 2012, a Call for Evidence was

launched, running until October 15, 2012.

The Call for Evidence was issued to enable the public, industry and patient groups

to give their comments to Sir Bruce and the expert panel before they publish their

review and recommendations for the future of the industry in March 2013. The

key areas that were being considered by the panel were:

The regulation and safety of products used in cosmetic interventions;•

How best to ensure that the people who carry out procedures have the •

necessary skills and qualifications;

How to ensure that organisations have the systems in place to look after •

their patients both during their treatment and afterwards;

How to ensure that people considering cosmetic surgery and procedures •

are given the information, advice and time for reflection to make an

informed choice; and

What improvements are needed in dealing with complaints so they are •

listened to and acted upon.

On New Year’s Eve, December 31, 2012, a summary of the responses to the Call

for Evidence was released, outlining what the feeling in the industry and public

at large was and giving the industry, for the first time, an insight into what the

ramifications of the review may be.

The review will be pivotal for the future of the industry and could at last bring

in some tighter regulations that many have been calling for. But there is also

undoubtedly an air of concern spreading throughout the industry over how it could

impact the way in which medical aesthetics is practised.

In a foreword Sir Bruce stated that the expert panel had had a huge number

of responses from the public, practitioners, providers and the industry. 63% of

these were classified as ‘individuals’ (either professionals working in the sector

or members of the public); 10% were industry bodies, 6% were professional

bodies, 4% were charities, 4% were private providers, 4% were regulators, 3%

were insurers, 2% were devolved administration, 2% were manufacturers, 1%

were lawyers and 1% were membership. [Source: www.consultingroom.com]He

highlighted that it was important to acknowledge that people undergoing cosmetic

interventions are not only consumers but also patients and said that the current

regulatory framework doesn’t do enough to support consumer rights or patient

safety. He also reminded people that the summary of responses is not intended

to present an indication of the review committee’s emerging recommendations.

He said, “The responses to the Call for Evidence send a clear message that the

current regulatory framework doesn’t do enough to support consumer rights or

patient safety. The supply and demand for procedures in this fast-growing sector

has outgrown the existing legislation around the products used, the people

providing treatments and the information and advice available to the public.

“Over the next few months we’ll be using information gathered from the

Call for Evidence alongside our engagement with the sector to formulate

our recommendations. I hope what we propose will deliver a cosmetic

interventions industry that will lead the world in terms of patient care

without stifling consumer choice.”

According to the report the key messages that emerged from respondents were:

The current regulatory framework was inconsistent and did not reflect •

the many changes and innovations in such a fast-growing and dynamic

sector;

Training requirements were felt by many to be disproportionately weak •

compared to the potential risks of a procedure and more specialised

training was welcomed;

Dermal fillers and Intense Pulsed Light and laser procedures were •

highlighted by many as areas where there was insufficient legislation to

protect the public

As Sir Bruce Keogh and his expert panel reveal the summary of the responses to the Call for Evidence, we report on what this means for the industry

A glimpse oF WhAT’s To Come

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Dermal fillers and Intense Pulsed Light and laser procedures were highlighted by many as areas •

where there was insufficient legislation to protect the public

Respondents were concerned about the lack of data being collected on implants, procedures, •

adverse incidents and outcomes

The review was timely and an important part of restoring public trust in the cosmetic interventions •

sector following the issues with PIP breast implants

Suggestions that respondents wanted to see implemented came under five key categories:

Information, consent and advertising

There was very strong support for the banning of financial inducements, two-for-one type offers or time

limited deals promoting the sale of cosmetic interventions. It was also felt that it was not appropriate to offer

these procedures as competition prizes and that there should be tighter restrictions around advertising as

well as clearer advertising guidelines. Respondents indicated that consultations should be with the person

performing the procedure and not a sales advisor and that free consultations for cosmetic surgery should be

banned so that people don’t feel obliged to go through with surgical procedures. The possibility of a two stage

consent process, so people have time to reflect before making a decision, was also discussed.

Regulation of Practitioners

Training requirements were felt by many to be disproportionately weak compared to the potential risks of a

procedure and more specialised training was welcomed. The issue of whether non-healthcare professionals

should be able to administer injectables was split, but the majority of respondents felt that the key issue

was training, for both healthcare and non-healthcare professionals. It was felt that local authorities using the

Council Special Treatment License scheme would provide an effective way of policing the non-surgical side of

the industry.

Regulation of Providers

Respondents felt that providers should be keeping records of all devices and implants they use and

should be required to audit their processes and ensure their practitioners take part in clinical audits.

Most responses said that performing laser and light treatments didn’t need to be restricted to medical

professionals only, however, these procedures, along with other procedures, such as cosmetic injectables,

should not be administered outside healthcare settings.

Medical devices, implants and other products

The current regulation of fillers was felt to be inadequate. Many felt that all implants and fillers should be

classified as devices. Greater regulation of lasers and light treatments was needed given the potential risks

to consumers.

Data and registries

Improving data collection and the reporting of adverse incidents should be a priority. Device registries were

widely supported and most respondents felt that manufacturers and providers should share the cost of these

and they should be extended to all devices and implants, inclusive of fillers.

The full report is available at:

www.dh.gov.uk/health/files/2012/12/Review-of-the-regulation-of-cosmetic-intervention1.pdf

The review panel will report its recommendations in March.

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cosmetic newsexpo

oN The SceNe | oUT aND aboUT IN The INDUSTRy ThIS moNTh

oN The scene clinical skin specialist Joanne goodman keeps anne hathaway’s skin Fresh while Filming les miserables

She is the movie star of the moment after her critically acclaimed performance in the big screen adaptation of Victor Hugo’s classic novel, Les Miserables, and

so it is no surprise that Anne Hathaway wants to look her best.

The porcelain skinned beauty kept up with her

skincare regime by visiting clinical skin specialist Joanne

Goodman in Harley Street for her facials while in the

UK for six months filming for the musical blockbuster at

Pinewood Studios.

Tipped for Oscar and BAFTA success for her sensational

role as Fantine in the hit production, Hathaway uses the

Epicuren range, as recommended by her dermatologist.

The US enzyme based skincare range has been described by

Vogue as having “American Beauty Aficionado’s hooked”.

Joanne is head of distribution for the range in the UK and

uses it on her clients in both Harley Street and Hampshire.

s_bukley / shutterstock.com

snowberry lane clinic celebrates 10th anniversary

cheltenham cosmetic surgeon backs nurse led clinic For patients

Cheltenham cosmetic surgeon Dalvi Humzah has joined forces with Nuffield Health Cheltenham Hospital to launch its first dedicated nurse led clinic.

Led by registered nurse and independent nurse prescriber Anna Baker, the new clinic offers a range of non-surgical treatments including wrinkle relaxing injections and skincare treatments for patients.

At the opening event, consultant cosmetic surgeon Mr Humzah introduced Miss Baker to patients at Nuffield Health Cheltenham Hospital. The event highlighted the latest treatments for facial rejuvenation from Mr Humzah combining surgical and non-surgical techniques, as well as non-surgical cosmetic procedures available with Miss Baker.

Mr Humzah’s private practice - Plastic and Dermatological Surgery (PDS) – has been based within the Nuffield Health organisation for over 10 years. He said, “This is great news for patients in terms of safety and choice. It offers much more choice for men and women seeking surgical and non-surgical treatments at Nuffield Health Cheltenham Hospital. It also means patients will be secure in the knowledge that cosmetic treatments are being offered within the framework of the Nuffield Health clinical governance. Importantly, patients can now see a consultant or nurse for cosmetic treatment. Anna and I will work together to refer patients to suit their individual requirements. For example, patients who want to undergo surgical procedures will be referred to my clinic and patients looking for wrinkle reduction treatments can be referred to Anna’s clinic if they prefer.”

Miss Baker added, “With a dedicated non-surgical consulting clinic, we can encourage patients to seek treatment in a hospital environment to avoid unnecessary risks others face when visiting non-clinical set-ups.”

This year sees the Snowberry Lane Clinic in Melksham, Wiltshire celebrate its 10th anniversary. This is a major landmark and tremendous

achievement for Dr Rupert Gabriel, his wife Ann Gabriel RGN and their experienced and professional team.

Over the last 10 years Dr Gabriel and his team have built up and expanded a highly respected and successful cosmetic clinic which is now at the forefront of modern laser technology and cosmetic surgery. Treatments on offer include a full range of non-surgical treatments to minimally invasive body contouring procedures.

Dr Gabriel is registered with the BCAM, GMC and CQC and is a well-

known and respected cosmetic professional.One of the companies Dr Gabriel has worked closely with during that time

is Carleton Medical. He recently obtained the new Asclepion NeXT diode laser for hair removal which includes the SmoothPulse mode for super fast hair removal with the extra benefits of working on all skin types and being virtually pain free.

Ann Gabriel RGN says, “Our laser hair removal client feedback has been very positive and results are excellent. We are very happy with the new NeXT diode laser and the service from Carleton over the last 10-years”.

Nick J Fitrzyk from Carleton Medical said, “The team at Carleton Medical would like to congratulate the whole team at Snowberry Lane and wish them every success for the next 10 years!”

mr dalvi humzah and anna baker at nuffield health cheltenham hospital open event


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cosmetic newsexpo

A s c l e p i o n n e X T D i o D e : Pa i n F r e e L a s e r H a i r r e m o va L !

A s c l e p i o n TAT T o o s TA r : TaT T o o r e m o va L L a s e r F o r a L L i n K s , i n c L u d i n g g r e e n !

carleton Medical formerly known as


INjecTableS SpecIaljUvÉDeRm® volbella™ wITh lIDocaINe

We get the exclusive on the latest shape-shifting product from Allergan that looks set to change the way aesthetic practitioners view lip enhancement

ThE shApE of ThiNgs To ComE

Since their introduction into the fledgling

aesthetic market, you could say dermal

fillers have evolved more than any other

product on the market. From the advent

of biocompatible, resorbable HA fillers

to wide-ranging product viscosities

and the introduction of lidocaine, the past

few years have seen the fillers market

become far more diverse than anyone could

have imagined in the early days of collagen.

One other area in which fillers have also

seen huge advances is in the way they are

injected, with a move away from simple

‘filling’ to the more artistic and subtle

techniques of facial sculpting, volumising

and shaping.

One company who has always been ahead

of the game when it comes to innovations

in dermal fillers is Allergan.

Since the company took on the

JUVÉDERM® range back in 2006 it has

propelled the product to new heights,

becoming the first to add lidocaine to its

formulas and becoming a market leader

in this highly competitive field.

It is no surprise then that when Allergan

announced it was to be unveiling a new

addition to the JUVÉDERM® line at the

IMCAS meeting in Paris in January that

the industry sat up and took note. The

product is JUVÉDERM® VOLBELLA™

with Lidocaine, a new treatment for the

lips and peri-oral area that is designed

not only for gently restoring natural

looking lip volume, but also for defining

lip contours, treating oral commissures,

smoothing fine ‘barcode’ lines around

the lips and supporting the ‘marionette’

lines down to the chin.

CLiNiCAL STuDy AbSTRACT

Title: David Eccleston, Diane K

Murphy, Juvéderm® Volbella™ in the

perioral area: a 12-month prospective,

multicenter, open-label study, Clinical, Cosmetic and Investigational Dermatology, October 2012

background: Hyaluronic acid

dermal fillers are frequently used for

lip augmentation, and a new filler has

been developed with characteristics

especially suited for the lips.

Methods: Four European sites treated

60 subjects with Juvéderm® Volbella™

injectable gel in the perioral area, and

subjects returned to the clinic at 1,

3, 6, 9, and 12 months for follow-up.

The primary effectiveness endpoint

established a priori was a month 3

responder rate on the 4-point Lip

Fullness Scale (LFS) of ≥ 40% and

statistically > 0%, where responders

improved ≥ 1 point from baseline on

the investigator’s assessment of LFS.

At follow-up, subjects assessed lip

fullness goal achievement, the look and

feel of their lips, and their satisfaction

with the effects of treatment.

Results: The month 3 LFS responder

rate was 93.2% (P < 0.0001), so the

primary endpoint was met, and clinical

effectiveness was demonstrated. The

responder rate over time showed that

78.0% of subjects still had improved

lip fullness at month 9 and 48.3% at

month 12. After treatment 98.3% of

subjects reported that their lip fullness

goal had been achieved, and this was

maintained at 86.4% at month 9 and

56.9% at month 12. At month 1, 81.0%

of subjects reported that their lips felt

smooth, and 91.4% reported that their

lips looked natural (scores of 7–10

on an 11-point scale, where 0 was an

unfavourable outcome and 10 was a

favourable outcome). Similarly, 96.6%

of subjects reported being satisfied

(scores between 7 and 10 on an

11-point scale where 0 = very

dissatisfied, 10 = very satisfied) at

month 1, and by month 12 more

than 80% of subjects were still

satisfied. There were no severe

adverse events related to treatment.

Conclusion: Juvéderm® Volbella™

injectable gel is well tolerated and

has been demonstrated to provide

a smooth and natural improvement in

lip fullness that lasts for up to 1 year.

www.cosmeticnewsuk.com 23

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see us at

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cosmetic newsexpo

What makes it different from other lip

products on the market is its composition

and viscosity making it ideal for lip

shaping and taking natural looking lip

enhancement to the next level.

Developed using Allergan’s proprietary

VYCROSS technology, JUVÉDERM®

VOLBELLA™ with Lidocaine is the only

hyaluronic acid dermal filler proven to

last up to 12 months in the lips with

a single treatment.1It is formulated

with an innovative combination of low

and high molecular weight technology,

which improves the cross-linking

efficiency of HA chains. This more

effective cross-linking allows for

a lower concentration of HA to be

used, which results in less swelling.

The VYCROSS technology also delivers

an ultra-smooth gel, which results

in a natural look and feel2, as well

as improved duration3 and because

of its unique viscosity it requires

far less extrusion force, making

injection easier for practitioners.

A study published in Clinical, Cosmetic & Investigational Dermatology showed

that JUVÉDERM® VOLBELLA™ with

Lidocaine is well tolerated and has

been demonstrated to provide a smooth

and natural improvement in lip fullness

that lasts for up to one year. In addition,

the treatment is associated with high

patient satisfaction, with 86% of

patients reporting maintained

improvement in the look and feel

of their lips after nine months and 57%

of patients still reporting maintained

improvement after one year.

Dr David Eccleston, clinical director

of MediZen and one of the lead authors

on the paper says, “JUVÉDERM®

VOLBELLA™ with Lidocaine has been

uniquely designed for a natural look,

with less swelling compared to other lip

fillers enabling my patients to return to

everyday life more quickly. In addition,

this is the only dermal filler clinically

proven4

to last up to 12 months in the

lips with a single treatment1, so it

gives a long-lasting effect. I look

forward to including it in my portfolio

of dermal fillers.”

Rajkumar Narayanan, VP and commercial

head for medical EAME at Allergan

adds, “Recent media trends have shown

increasing consumer reservations about

cosmetic injectable treatments, with

a key barrier to treatment being

concerns about an unnatural look.

Leading medical aesthetic practitioners

in Europe are now looking for treatment

options, which give their patients natural

looking results with a tailored, individual

treatment approach. At Allergan, we

are delighted that we’ve been able to

respond to this desire through the

launch of this innovative new product”.

References

1 Single treatment defined as initial injection with optional top-up after 14 days

2 Allergan Data of File (DoF) (In-Lab)

3 Raspaldo H. J Cosmet & Laser Ther, 2008; 10:134-142

4 Eccleston D, Murphy DK - Clin Cos Investig Derm 2012; 5: 167-172

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As they are biocompatible, mesohyal™ active substances are highly tolerable and minimise side effects.


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cosmetic newsexpo

Although the benefits of adding lidocaine are recognised in terms of relieving the pain experienced upon injection (2,6,7), there are still relatively few studies comparing the effectiveness of adding lidocaine to a given product in a given patient or its impact on potential side effects and on the remanence of the

product. Initial comparative studies of this kind carried out in recent years (5-7) generally conclude that the two alternatives produce the same results in terms of tolerance and effectiveness, both immediately after treatment and six months later.

It would appear beneficial to establish the impact of lidocaine within the Stylage® range, the only one to incorporate both an anaesthetic (lidocaine) and an anti-oxidant in the form of mannitol in its cross-linked gel of HA.

In a study published in the Journal of Cosmetic and Laser Therapy, Bernard Mole and Lyliane Gozlan of the Centre Tourville, Paris, wanted to address the following questions:

1. Does this addition offer a real benefit in relation to the basic gel?2. Could it be the cause of other incidents directly linked to lidocaine?3. Could it have an impact on the durability of the result?

The single-blind post-CE Marking clinical study included 10 other practitioners. The triple objectives of the study were:

1. To highlight the benefits of adding lidocaine in terms of pain experienced by the patient and for all commonly injected areas of the face;2. To compare the tolerance of the two products;3. To compare the degree of aesthetic satisfaction achieved by the cross-linked gel with and without anaesthetic six to eight months after treatment.

p r o t o c o lThe clinical follow-up was carried out at 11 centres over a period of six to eight months and involved 84 patients aged between 27 and 75 years (with an average age of 50). 96% of them were women. An assessment of the thickness of the skin revealed that 58% of patients had normal skin, 25% had delicate skin and 16% had thick skin.The injected areas had to be symmetrically aligned on each side of the face for purpose of having comparable areas to assess. Any areas commonly treated with hyaluronic acid-based fillers could be injected. The injector was aware of the product type, i.e. with or without lidocaine, and arbitrarily chose which side to inject, the patient remaining unaware of the distribution of the products,The assessment was based on three criteria:• Patient comfort both upon administration of the injection and during the

appropriate recommended post-injection massage (on a pain scale of one to 10)• Any immediate and delayed side effects (oedema, erythema, redness, bruising, etc.) and the intensity thereof (slight, moderate or severe)•The aesthetic satisfaction achieved after injection: immediately after the injection, five weeks (+ /- one week) later and finally six to eight months later. This satisfaction criterion was assessed on a scale of one to 10, on one hand by the patient himself and on the other hand by the doctor. The practitioner also assessed the ease of injection.

r e s u l t sThe outcome of the study are as follows:

A total of seven different areas were injected among the 84 patients. Unsurprisingly, the distribution of injected areas shows the predominance of nasolabial folds and marionette lines (66% of indications).

Stylage® M Lidocaine was just as easy to inject as Stylage® M, confirming that the gel has equivalent physico-chemical properties. The very slight difference observed when using the lidocaine version (90% as opposed to 85% classed as “very easy”) was explained by a reaction specific to some patients who, in just a few seconds after the initial injections, experienced local anaesthesia in the injected areas. The injections, which had been now rendered painless, were more comfortable for the patient and therefore easier for the doctor.

The immediate side effects (experienced a few minutes to a few hours after treatment) were primarily limited to the usual redness or erythema in one third of the cases in both groups, as well as oedemas observed simultaneously. Some indurations were also observed (4-6% of the treated patients). All these side effects were resolved within a maximum of 72 hours after the injection. Bruising, which was more likely to occur when using a gel containing lidocaine, a vasodilator, was nevertheless limited (1 %, or just one patient) and no bruising was observed in the group treated with lidocaine-free Stylage® M.

Haematomas were also found in an almost equivalent percentage for both products (14% for Stylage® M Lidocaine and 18% for Stylage® M), which can be explained by the origin of these undesirable effects: rupture of venules and not due to the product itself. An overview of all side effects experienced shows that in 57% of cases without lidocaine and 60% of cases with lidocaine patients suffered no side effects. Consequently, no significant difference was noticed between the products with and without lidocaine in terms of post-injection side effects.The reported intensity of secondary reactions was low (level 1) in the vast majority of cases (intensities: 1=slight, 2 =moderate, 3 = severe), with only redness being reported as having an intensity of 3 in three patients (two of which had been treated with the lidocaine product and one without),

THE LATEST STYLAGE®

We summarise the results of a clinical study published in the

Journal of Cosmetic and Laser Therapy on the benefits of

adding lidocaine to the hyaluronic acid filler Stylage®

INjecTableS SpecIalclINIcal STUDy


INjecTableS SpecIalclINIcal STUDy

resolved in the hour following the injection, as well as one

case of a severe haematoma with Stylage® M. It is also

interesting to note that the vast majority of haematomas

observed were of low intensity for both products, which

tends to confirm the lack of impact of the vasodilatory action

of the 0.3% lidocaine in the Stylage® product, as was feared

by some. The average intensity of secondary reactions was

therefore lower in the lidocaine group.

Finally, no delayed undesirable effects (such as nodules,

inflammatory granulomas, hypersensitivity, etc.) were

reported, even up to 12-14 months of follow-up.

The products are therefore equivalent in terms of tolerance,

demonstrating only the usual side effects experienced when

receiving filler injections, for a combination of cross-linked

hyaluronic acid and mannitol, with or without lidocaine.

More significant was the assessment of the level of pain

experienced. This was self-assessed by the patient on a scale

of 1 to 10 and was, unsurprisingly, far lower in the lidocaine

group, both at the time of injection, with an average scoring

of 3.2 as opposed to 5.7, and during the post-injection

massage, with an average scoring of 1.8 as opposed to 4. For

the purposes of clearer comparison, the results have been

organized by ‘level of pain’ with the following hypotheses:

Very low level of pain =scores 1-3

Average level of pain = scores 4-6

high level of pain = scores 7-10

These results show that 60% of patients claimed to have

experienced a “very low” level of pain with Stylage M

Lidocaine as opposed to only 19% with Stylage® M.

Likewise, an analysis of the levels of pain experienced

with injections to the lips only, which accounted for 11%

of the areas injected, highlights the greatest effect of the

anaesthetic when treating this particularly sensitive area;

the average level of pain experienced during the injection is

6.7 with Stylage®M as opposed to 3.2 with lidocaine, with

respective levels of 4.6 and 1.7 experienced during massage.

With regards to the degree of immediate satisfaction

experienced this was comparable in both groups and

identical for both the patient and the doctor administering

the injection. The difference, albeit minor, in favour of

lidocaine

(where 81 % were very satisfied as opposed to 72%) for

patients could, perhaps, be explained by the lower level of

pain and the more ‘relaxed’ feeling of the treated area. No

asymmetry of correction was reported by either the doctor

or the patient, thus confirming that the physico-chemical

and volumizing properties of both products are equivalent.

The overall aesthetic satisfaction remains very high six

to eight months after the injection (average aesthetic

satisfaction score of 9 for doctors and 9.1 for patients),

with no asymmetry reported between areas treated with

lidocaine and those treated without. In answer to the

question “Is there a difference between the two sides

treated?”, as was the case five weeks after the injection,

the response was “no” in 95% of cases, with one doctor

claiming that the difference noted was due to the difficulty

of balancing the two sides of the face as a result of the

patient’s morphology. This confirms that both products

are equivalent in terms of immediate post-injection filling

effectiveness and remanence. So, adding lidocaine does not

constitute a guarantee of remanence nor indeed of worse

results, as some are inclined to think.

c o n c l u s i o nThis study shows that adding lidocaine to a cross-linked

hyaluronic acid gel:

1. Does not bring about any increased risk of

blood extravasation;

2. Affects neither the quality nor the durability

of the result.

However, patient comfort during the injection means that

generally-speaking, no nerve block is required, even when

treating the lips, an area which is generally much-dreaded

as it is extremely sensitive. Although the few seconds it

takes to initially insert the product may be uncomfortable,

the rest of the injection is far more tolerable. The correction

can therefore be refined under much better conditions. This

increased comfort throughout the injection process confirms

the notion that the addition of lidocaine is still a key step

forward in putting the patient at ease and should be applied

without limit to all fillers, particularly as real allergies to

lidocaine are currently more of a historical nature than a

clinical one.

[References]

1.Mole, Bernard and Gozian, Lyliane, Centre Tourville, Paris, France, Benefits of adding lidocaine to a hyaluronic gel - Stylage® M, Journal of

Cosmetic and Laser Therapy 2011; 13: 249-254

2. Wahl Gj. European evaluation of a new hyaluronic acid filler incorporating lidocaine. CosmeL DermaL 2008;7(4):298-303.

3. Lanigan S. An observational study of a 24 mglmL hyaluronic acid with pre-incorporated lidocaine for lip definition and enhancement. J

Cosmet Dermatol. 2011;10(1):11-4.

4. Monheit GD, Baumann LS, Gold MH, Goldberg DJ, Goldman MP, arins RS, Bachtell, Garcia E, Kablik J, Gershkovich J, Burkholder D. Novel

hyaluronic acid dermal filler: dermal gel extra physical properties and clinical outcomes. Dermatol Surg. 20 10;36(Suppl 3): 1833-41.

5. Lupo MP, Swetman G,WallerW. The effect of lidocaine when mixed with large gel particle hyaluronic acid filler tolerability and longevity: a

six-month trial. J Drugs Dermatol. 20 I0; 9(9):1097-100.

6. Levy PM, De Boulle K, Raspaldo H. Comparison of injection comfort of a new category of cohesive hyaluronic acid filler with preincorporated

lidocaine and a hyaluronic acid filler alone. Dermatol Surg. 2009;35(Suppl 1):332-6; discussion 337.

7. Brandt F, Bank D, Cross SL, Weiss R. A lidocaine-containing formulation of large-gel particle hyaluronic acid alleviates pain. Dermatol Surg.

2010;36(Suppl 3): 1876-85.



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cosmetic newsexpo

what are skin boosters?

Traditionally skin boosting has referred to

mesotherapy, a technique invented by French

physician Dr Michel Pistor in 1952. Dr Pistor to this

day is seen as the founding father of mesotherapy.

Mesotherapy refers to the practice of injecting

medicine into the mesoderm or middle layer of

the skin. Dr Pistor initially used mesotherapy for

pain management and rheumatology. Modern day

applications of mesotherapy use microinjections of

ingredients scientifically designed to stimulate skin

rejuvenation, hydration, collagen stimulation, fat

breakdown, cellulite reduction and hair regrowth.

To this day mesotherapy is commonly practised

in France where it is taught in medical school

and is recognised as a distinct medical specialty

by the French National Academy of Medicine.

Mesotherapy is practised by an estimated 18,000

physicians worldwide and is especially popular in

France and South America.

Mesotherapy has, to date, typically involved non-

standardised and variable blends of vitamins,

minerals, low-grade hyaluronic acid, amino acids,

plant extracts, homeopathic remedies and collagen

stimulating ingredients. There has been some

concern in the past about exactly what people use

as ‘mesotherapy’ and concern about exactly what is

being put into the treatment syringe. This concern

over its efficacy resulted in The American Society

for Dermatologic Surgery announcing in 2005 that

‘further study is warranted before this technique can

be endorsed’.(1)

Claims for mesotherapy have often been anecdotal

and not always based on well-conducted clinical

trials or empirical evidence. Clinical improvements

with mesotherapy have been difficult to quantify

Dr Jo Ward explores skin boosters, their efficacy and combination applications

Dr Jo Ward is a GP with a special interest in dermatology, minor surgery and cosmetic medicine. She is the medical director of The Skin Clinic Sevenoaks and its sister clinic

The Skin Clinic Brentwood. Dr Ward is passionate about dermatology and raising dermatology standards in the aesthetics industry and was awarded a distinction in the Diploma in Clinical Dermatology from Queen Mary’s University London. She is also a Hamilton Fraser approved trainer in cosmetic injectables.

B o o s T i N g y o u r

r e s u l t s

Skin boosting is a new and modern concept that gives us the tools to improve the skin’s texture, elasticity, hydration and surface tone. Skin boosters can be synergistically combined with other aesthetic treatments (advanced skincare, micro-needling, toxins, light treatments) to maximise the anti-ageing and collagen stimulating effect. This article explores the current evidence for skin boosters, their various uses and how they can be used to maximise aesthetic and cosmetic results.

INjecTableS SpecIalSkIN booSTeRS


and can be hard to capture on camera with an objective

before and after. Some studies have suggested that

mesotherapy provides ‘little improvement in histology,

mucin and elastin stains in post mesotherapy biopsies’. (2)

Modern day skin boosters however are a new and scientifically

proven approach to the idea of mesotherapy or injections of

medicines into the skin. The lack of empirical evidence that has

slightly tarred the reputation of conventional mesotherapy has

been erased with the advent of products such as Restylane®

Vital, where numerous studies have now cited clear, objective

and statistically significant evidence for improvements in skin

elasticity, surface texture, hydration and skin surface roughness

(3,4). Sutherland and colleagues have demonstrated that one

gram of HA can bind up to six litres of water. A testament to the

hydrating qualities of hyaluronic acids. (5)

Commercially available skin boosters include Restylane®

Vital, Restylane® Vital Light, Juvederm® Hydrate, Teosyal®

Mesotherapy and Teosyal® Redensity. They are all a

scientifically improved variation of traditional mesotherapy

and are made with a customised and standardised hyaluronic

acid base. Restylane Vital has cross-linked, stabilized

nonanimal HA of 20mg/ml, Teosyal® Meso is a non-

stabilized, nonanimal HA of 15mg/ml and Juvederm Hydrate

is 13.5mg/ml non-stabilized HA with 0.9% mannitol.

Skin boosters are injected in micro droplets into the superficial

(Teosyal®) or mid-dermis (Restylane®) as per manufacturer

recommendations. Best results will be seen with a minimum

of three treatments placed two to four weeks apart. Clinical

studies on skin boosters have mainly involved a minimum of

three treatments (6). They can be used generally over the lower

face, in the upper and lower lip to address smokers lines, to the

décolletage area, to the dorsum of the hands and more recently

they have been used in other areas such as the abdomen and

the upper arms (7). Vital comes in a 2ml injector pen to ensure

that standardised micro droplet amounts are delivered to each

injection area. Juvederm® Hydrate and Teosyal® Meso come

in prepackaged syringes of 1ml.

The key clinical difference in these skin-boosting products

is whether the hyaluronic acid is stabilized or not. The

stabilisation process of hyaluronic acid means that the

native polysaccharide is made more resistant against natural

degradation through a means of chemical cross-linking of a

small proportion of the polysaccharide chain. This technology

is unique to the Restylane® range of skin boosters and is

patented under the NASHA technology. Restylane® has two

stabilized, nonanimal skin boosters in its range: Restylane®

Vital and Restylane® Vital light.

Both stabilized and non-stabilized hyaluronic acid skin

boosters have been shown to clinically improve the elasticity

and hydration of the skin, helping to minimise the appearance

of fine lines and wrinkles and reduce skin surface roughness

(8). The difference is that stabilized HA’s have been found to

produce a statistically significant improvement in all of these

parameters, whereas non-stabilized HA’s show a trend for

improvement but this is not statistically significant.

Stabilized HA skin boosters have been shown in a study by

Dr Stefanie Williams to produce superior and longer lasting

results in the skin compared to non stabilized HA skin

boosters. In the study Restylane® Vital was injected into the

dorsum of the hands and was shown to increase ‘cutaneous

elasticity and stratum corneum hydration while reducing

skin surface roughness and TEWL’. In this study ‘stabilized

HA seemed to exhibit a longer duration of effect and was

found to be superior to non-stablised HA according to all

parameters at week 12’. Dr Williams chose Restylane´®

Vital as the stabilized HA in the study and Teosyal® Meso as

the non-stabilized HA as these are two of the most popular

commercially available skin booster brands.

combination treatments

Skin boosters play a vital role in improving the

hydrobalance, elasticity and texture of ageing skin and can

be used in combination with other aesthetic treatments

to great effect. Combining skin booster treatments with

active skin care, micro-needling, toxins and pigmentation

treatments can boost the desired results and dramatically

improve areas of cosmetic concern. Perhaps one of the most

exciting areas is the combination of skin boosters and micro-

needling, a new technique dubbed ‘Gel Needle Lifting’. Both

techniques are clinically proven to improve the appearance

of the skin and pose an exciting new direction for skin

rejuvenation.

skin boosters and topical treatments

Although creams and lotions can help rehydrate and

moisturise the skin, there is a limit to how much the

skin’s texture and quality can be improved with topical

preparations alone. Topical hyaluronic acid is not cross-

linked and has a short half-life limiting its longevity. As

Hannah John and Richard Price note in their recent paper

on HA fillers, ‘in the superficial epidermis (HAs) act as a

humectant contributing to (improved) moisture content

and reducing transepidermal water loss’ (9). In the deeper


dermis hyaluronic acid acts to increase

turgidity. Non cross linked hyaluronic acids

have a short half life so need to be applied

continuously and frequently if the plumping

and hydration effects are to be seen. In order

to get around this and to achieve a deeper and

more lasting dermal hydration within the skin,

we can place the HA deeper within the skin with skin

boosters. Combining skin boosters with daily topical

application of a hyaluronic acid based product will

maximize the skin’s hydration and improve the skin’s

texture, fine lines and wrinkles.

skin boosters and toXins

Toxins are one of the most popular aesthetic

treatments on the market with an estimated 12 million

people using them globally. Toxins complement

skin booster treatments as they extend the cosmetic

response of the hyaluronic acid through muscle

relaxation. This can be used to good effect in the

glabellar, crowsfeet, smoker’s lines and neck regions.

skin boosters and micro-needling

Micro-needling is a relatively new technique that

can be done with or without introducing products

transdermally (dry vs wet). Micro-needles are

Class 1 medical devices that do not have to be FDA

approved. It is therefore advisable to use good

quality micro-needles for the best the cosmetic

results. There are a number of poor quality imitation

roller devices that have inundated the market

recently and these have been associated with needle

breakages in the skin and unnecessary skin trauma.

Micro-needling and skin boosting combined can

give dramatic effects on the overall skin outcome.

It is a practice that is being used more and more in

clinics and anecdotally gives superior results than

one treatment modality alone, rather like 1 + 1 =

3. To date there is very little empirical evidence

for combination treatments of micro-needling

and skin boosters as few clinical studies have been

conducted. But both treatments are known to have

good clinical outcomes individually and simple

clinical observation shows the two treatments work

synergistically and enhance one another.

Techniques used include using Restylane® Vital

2ml injector pen 15 minutes prior to a micro-needle

treatment. The immediate benefit of this is that the

Vital contains lidocaine and helps reduce micro-

needle discomfort. Other practitioners will place

the HA gel over the skin and then roll the booster

into the skin rather than inject it prior. This allows

transdermal delivery of the skin booster via the

roller needles in a mesotherapy like technique.

Three simultaneous treatments of a skin booster

and micro-needling are thought to be deliver

the best clinical results. This new combination

treatment has been coined ‘Gel Needle Lifting’ and

is being used with Restylane® Vital, Juvederm®

Hydrate and Teosyal® Meso.

Clinicians are citing dramatic results as the skin

boosters help achieve dermal hydration and

plumping whilst the micro-needle treatment

stimulates collagen and skin resurfacing. Use of a

topical vitamin C and vitamin A will super boost

the results as vitamin C is an important cofactor for

vitamin A for new collagen production.

Optimum needle length has been something of a

debate recently but it is generally accepted now

that 1-1.5mm is the ideal depth for micro-needling

the face as it allows penetration into the papillary

dermis to stimulate neocollagenesis but doesn’t

over traumatize the skin. Apart from erythema

there are few other side effects. The micro trauma

holes close almost immediately so post procedure

infections do not occur.

With all of these treatments it is important to be

aware that the better your client’s overall health,

hormonal and nutritional state, the better the

outcome from any of these therapeutic procedures.

General lifestyle and skincare advice should always

form part of the initial consultation and will ensure

that suitable patients are being chosen for these

rejuvenating techniques.

[ r e F e r e n c e s ](1). Matarasso et al ‘Techonology Report: Mesotherapy’; American Society for Dermatological Surgery; January 2006(2). Amin S, Phelps R, Goldberg; ‘Mesotherapy for facial rejuvenation: a clinical, histologic and electron microscope evaluation’; Dermatol Surg 2006 Dec 32 (12) 1467-1472(3). Martina Kerscher, Julia Bayrhammer, Tilmann Reuther; ‘Rejuvenating Influence of a stabilized Hyaluronic acid based gel of non animal origin on facial skin ageing’; Dermatol Surg 2008: 34: 1-7(4). Dr Stefanie Williams; Changes in skin physiology and clinical appearance after micro droplet placement of hyaluronic acid in ageing hands’; European Dermatology London; 2009(5). Sutherland I ‘Novel and established applications of microbial polysaccahrides.’ Trend Biotechnol, 1988:16:41-46(6). Kerscher and Williams studies(7). Fenanda Distante et al ‘Stabilised Hyaluronic acid of non animal origin for rejuvenating the skin of the upper arm’ Dermatol Surg 2009(8). Dr Stepahnie Williams et al ‘Changes in skin physiology and clinical appearance after micro droplet placement of hyaluronic acid in aging hands’; European Dermatology London; 2009(9). Hannah John and Richard Price ‘Perspectives in the selection of hyaluronic acid fillers for facial wrinkles and aging skin’ Department of Plastic and reconstructive Surgery, Addenbrooks, Cambridge; July 2009



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INjecTableS SpecIalaRqUeDeRma® aRTISTIc ReSToRaTIoN lIfT®

As the ArqueDerma® Artistic Restoration Lift® receives its patent, the pioneering nurse behind the methodology, Leslie fletcher, tells us in her own words about how she developed the technique that has revolutionized the way we think about injecting dermal fillers

pATENT is A ViRTUE

Leslie Fletcher is the pioneer of the ArqueDerma® Artistic Restoration Lift®. Leslie developed this revolutionary patented technique for delivering dermal fillers while working with thousands of patients over the last 10 years in her practice as an aesthetic nurse injector, as well as an aesthetic injection trainer.

“On April 6, 2009, I applied for a

provisional patent for a procedure that

later became referred to as ArqueDerma®,

Artistic Restoration Lift®. On August

14, 2012 this 13-page document, which

included research of other related arts,

six figure schematics, as well as a detailed

description of the invention itself, became

the first non-provisional utility patent

for dermal filler use ever to be issued

in the United States.

I started working as an aesthetic nurse in

2001 and began my career as an aesthetic

injection trainer in 2007. Since then, I

have seen and researched many different

techniques for administering dermal fillers.

What initiated my quest for a different

approach, was the dissatisfaction I had

with the production outcomes that current

treatment modalities were offering at

the time. The conventional methods of

administering dermal fillers seemed to

simply put a band-aid on the wrinkle,

fold or overhang, or even worse, overstuff

the face in an attempt to eradicate any

wrinkles. In addition to dissatisfaction,

I felt a need to respond to my patients’

requests. Patients I had been treating for

years wanted more than just a ‘fill,’ they

wanted a ‘lift.’ These requests inspired

my curiosity to look outside the box to fix

this gravitational problem. I wanted to be

able to offer my patients what they needed

in a non-surgical way. Similar to most

inventions, ArqueDerma® was born out of

a necessity.

I’m told every inventor has an “aha”

moment, and mine came while observing a

scene on the side of a freeway. I noticed that

a wall was being supported by strategically

placed perpendicular beams. The obvious

came to my mind: “If those few beams can

hold up an entire wall, surely a few beams

could hold up a little hanging skin!”

Immediately I tested my theories on family

and friends, which produced incredible

results using markedly less product. As an

educator for several national pharmaceutical

companies, I demonstrated this new

technique during courses and it often

dominated the instruction for the remainder

of the class. Several respected colleagues on

multiple occasions advised me that what I

had “created” was an entire new category

for the delivery of dermal fillers. More than

one physician advised me to file a patent for

this innovative process. Although patenting

a medical technique was the farthest thing

from my mind at the time, I was given a

referral to an excellent patent attorney who

specialised in method patents. I learned that

this process could indeed qualify for a utility

patent. The requirement for utility patents

in the USA is as follows:

Under US patent law, a utility patent

protects “any new and useful process,

machine, article of manufacture, or

composition of matter, or any new and

useful improvement thereof”. (United States

Patent and Trademark Office- USPTO)

A “process” is defined by law as an act or

method, and primarily includes industrial

or technical processes. (A process is the

way an invention performs rather than

the way it is structured).

A utility patent must fulfill these three requirements: • Must be novel (I had to apply for the

non-provisional patent within one year

of invention. I also had to prove there

was nothing else in the industry like

this technique.)

• Must not be obvious (to a person

having skill in the area of technology

related to your invention)

• Must be useful (serve a useful purpose)

Additionally, I had to provide the USPTO

with a complete description of the actual

working invention, as well as descriptions

of current techniques used in the relevant

industry. These would later be examined,

and passed or declined by someone having

skill in this field of technology.

Once this time-sensitive task was safely

in the works, I applied for a copyright of

authorship for my training materials, as well

as national and international trademarks

to protect the brand used to identify and

distinguish this service from all other

types of aesthetic services. During the

next four years, my educational company,

InjectAbility® Institute, brought on national

and international expert trainers in order

to purely deliver the ArqueDerma® concept

to a wider audience. We now offer training

in Canada, United States, United Kingdom,

Australia, and potentially soon in Asia. To

date, InjectAbility® Institute has licensed this

patented technique to nearly 400 medical

practitioners in seven

different countries. Conceivably, nearly

two million patients have been treated

using the ArqueDerma® technique since

the procedure was introduced to the

medical aesthetic community in 2009.

In addition InjectAbility® Institute brought

on marketing and publicity specialists to

offer wider exposure of the technique to

practitioners who want to provide this

treatment to their patients. We have also

initiated very successful consumer-driven

campaigns to inform potential patients of the

newly patented technique. Answering their

need for a non-surgical “lift instead of a fill”.

The procuring of the patent has only

solidified what I have observed first

hand from seasoned injectors in several

countries over the years after taking the

licensing course. Many trained injectors

agree that they have never seen anything

similar (novel), more innovative (non-

obvious), or more effective (useful) than

the ArqueDerma® technique. Hence the

qualifications were met for all three patent

categories. In order to maintain the validity

of a patent, patent holders are required

to pay maintenance fees throughout the

duration of the patents life span.

Medical technique patents, although

uncommon, are important. They identify

a marked position of invention, validate

credit for intellectual property, and assign

ownership to an individual, or company of an

idea that was created, developed, and finally

submitted to the medical community.

About ArqueDerma®

ArqueDerma® Artistic Restoration Lift® is

a revolutionary way of delivering dermal

fillers to artistically address the three basic

signs of facial aging: loss of volume, lax skin,

and skin deterioration. This is accomplished

using a novel technique that corrects more

areas, effectively extends the use of filler

product by 40% and lasts significantly

longer than conventional methods of filling.

Unlike conventional volume replacement

procedures, the ArqueDerma technique

utilises dermal fillers like Juvederm®,

Restylane®and Perlane® as a stabilizer to

redirect sagging skin toward hollows that

have formed, anchoring it in place while

newly created collagen forms to sustain

the results. ArqueDerma® encompasses an

entirely new concept of “blanketing” thin

strands of hyaluronic acid dermal filler

product, placed in strategic multi- directional

vectors, to create an artistic lift of the lax

tissues. In this technique, dermal fillers

are administered applying a deliberate,

controlled force on the tissues stimulating

the fibroblasts and causing them to stretch.

Based on the controlled injury theory in

which type I and type III collagen production

occur at accelerated rates post trauma, this

mechanical stretching leads to an increase

of collagen production. This desired side

effect translates into longer-lasting results,

and leaves a hydrating effect on the skin’s

texture in the treated areas. Using the

needle to create a modest subcuticular

undermining effect, ArqueDerma®

is postulated to disrupt fragmented

collagen strands and replace them with purposeful, vectored strands of promoted

neocollagenesis. This effect results in

sustaining the desired lift longer than

conventional methods of filling. A major

advantage of being able to lift and redirect

the patient’s now separated tissue is the

ability to use the patient’s own lax skin

and reposition it upward, lifting it back

to its point of origin. ArqueDerma® opens

a world of possibilities for difficult to treat

areas such as the jowls and marionette

lines of the lower face.

During treatment, FDA/ medically approved

dermal fillers are administered with a

deliberate tension using the needle in multi-

directional curves, specific to the patient’s

needs, beneath the skin’s surface to disrupt

and remove damaged, fragmented collagen

strands and replace them with healthy new

collagen. This creates a hydrating effect,

enhancing the skin’s texture with hyaluronic

acid, as well as collagen in the areas treated.

Based on the clinically proven controlled

injury theory wherein collagen production

occurs at accelerated rates post trauma,

neocollagenesis begins.

Unlike conventional methods that use

dermal fillers to “fill” a crease or fold,

ArqueDerma uses dermal fillers as an

adhesive agent to sustain the lifted tissue

back in place until new collagen forms

(neocollagenesis). This newly formed

collagen stabilizes the effects, resulting

in the correction lasting longer than

conventional methods. Because collagen

production continues for many months

as part of the healing process, results

will continue to improve over time. This

increased collagen stimulation, coupled

with improved duration of dermal fillers,

result in longer-lasting results (18-24

months on average).

To learn more about the technique please visit www.ArqueDerma.com

Before & After



The world is a looking-glass, and gives back to every man the reflection of his own face.

Frown at it, and it will in turn look sourly upon you; laugh at it and with it, and it is a

jolly kind companion; and so let all young persons take their choice.

—William makepeace Thackeray

Why do we frown? At first glance, this may seem like an easy question to answer, but as soon

as you study frowning in depth, you realize just how complex it can be. First, we frown for

many different reasons. Most of the time we frown when we are communicating our emotions

to others. We frown when we’re worried, we’re concerned, and we don’t know what to do. But

we also frown when we are frustrated or just struggling to understand something. And we

clearly frown when we are angry or sad.

Second, there are different types of frowns depending on what other muscles in our faces are

activated at the same time. The meaning of your frown depends, in part, on how the other

facial muscles are recruited to form a facial expression. If the inner part of your eyebrows

point upward while frowning, you look sad; if they are drawn together and down while

frowning, you look angry. And all of this activity happens so seamlessly, without a hiccup, day

after day. Just as your voice carries your emotions as you speak, your facial muscles cooperate

to give others an idea of your emotions and feelings.

The intensity of facial expressions usually

correlates with the intensity of the emotion felt.

If you are in a rage, your brow will most likely

be tightly contracted—if you are only annoyed,

a fleeting and subtle frown may pass over your

brow. The frown is an amazingly versatile and

subtle form of expression.

The frown is naturally like a good director,

controlling the movement of lighting and scenery, marking transitions, changing mood and

feeling, giving tempo to our conversations. All of this activity that is happening around our

eyebrows is not recognized in a conscious way. Most of it happens so quickly (in seconds) and

so fleetingly that we do not remember it. However, in spite of the unconscious and involuntary

nature of these emotional signals, our brains are taking it all in, assessing the meaning of the

facial expressions of others, and responding in turn with our own facial expressions.

Charles Darwin was the first to note that the frown starts early in infancy. Observing his own

children, he was able to deduce that a frown came over his child’s brow whenever anything

difficult presented itself. He described how, with his own infant, “little frowns . . . may be seen

incessantly passing like shadows over its face” when something displeasing happened to him.

Darwin noted how his eight-week-old could easily express his annoyance at being fed not

straight from the breast, but with cold milk. Clearly, at an early stage in human life, we acquire

the ability to frown, suggesting how important this expression must be for our survival. Long

before his baby cried, a little frown alerted the caregiver that babies prefer warm milk.

The frown is naturally like a good director, controlling the movement of lighting and scenery, marking transitions, changing mood and feeling, giving tempo to our conversations

We summarise a chapter from a new book by Eric Finzi entitled The Face of Emotion: How Botox Affects Our Mood and Relationships

WRINKLER ABOVE THE EYE

We all instinctively recognise the different ways in which people can express

emotion. Body posture and movement are important and the human voice,

with its dramatic range of timbre and tonality, can project the ebullience of

joy as easily as the depths of despair. It is easier to hide the emotions carried

by your voice or body posture but it is much harder for most of us to hide

our emotions from our faces. It all happens so quickly—different emotions

display themselves on our faces in a second or less—before we are aware of

what our faces are doing. Unless you have a lot of training, it will be difficult

for you to hide the feelings that your face shows to others. The face thus

assumes greater importance in your emotional interactions with others.

In addition, the face, with its complex and dynamic interwoven muscle skin

layer, can convey a more complex range of our emotions than either the

contortion of our bodies or the sound of our voices.

The main muscle involved in the facial expressions of sadness and anger

is called the corrugator supercilii. The two Latin words that make up the

name literally mean “the wrinkler above the eye.” The corrugator muscle, the

frown muscle, helps draw the eyebrows together to create a frown.

Frowning is a facial expression that usually represents negative emotional

feelings. If our smiles tell others that all is good, our frowns do the reverse.

With fear, the entire brow is lifted, and the brows are often drawn together.

In the frown of sadness, the inside corners of the brow are tilted up, and the

upper eyelids are arched up. Each of these frowns carries a distinct meaning,

and the intensity of the frown alerts us to the intensity of the emotion.

The frown muscle is not the only facial muscle activated in the expression of

sadness, fear, or anger. For example, in anger the eyelids are tensed and the

teeth may be bared.

In sadness, the lower eyelid may be raised while the corners of the mouth

are drawn down. But just as the smile muscle helps pull the corners of our

mouths up and out, and is most associated with smiling and happiness, so

the muscle in the eyebrow remains the strongest means of expressing anger

or sadness.

These two muscles—the frown and smile muscles—represent the yin and

yang of facial expressions.The tension and position of frown versus smile

groups will help show others what you are feeling inside. That is common

sense to most of us. But the relative contractions of each muscle will not

only tell others your emotional state—they will inform you, the wearer of

the expression, what you are feeling. And not only do these muscles silently

speak to you—they help to create the state of your conscious mind. We shall

see many examples of how the face you make influences your decisions and

preferences.

Your face helps you to both optimally sense and express your emotions, and

the balance between the activity of these two muscles helps determine how

you feel about the world outside and inside of you.

From The Face of Emotion by Eric Finzi, MD. Copyright © 2013 by the

author and reprinted by permission of Palgrave Macmillan, a division of

Macmillan Publishers Ltd.

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Cosmetic News: How long have you been using Sculptra®?

Dr Linda Eve: I have been using Sculptra® for seven years and have carried out approximately 1,200 individual treatments.

CN: What is the difference between Sculptra® and dermal fillers?

LE: Sculptra® is entirely different to dermal fillers. It is a long lasting collagen stimulator called poly L-lactic acid (PLLA) first used in the NHS in 2004 for repairing severe distressing facial lipo-atrophy often suffered by HIV patients. Since then it has also been very successfully used in the private cosmetic sector for treating all ages of patients with facial volume loss.

CN: What are the indications for treatment and who are the ideal candidates?

LE: Sculptra® is the ideal treatment for using in patients who require general volume increase in the face such as in the temple, cheeks, lower face and chin areas. It is not advisable to use it in or above the lips nor across the forehead.

Sculptra® is suitable for any patient who has suffered volume loss from as young as mid 20s to even the over 80s. I have successfully treated a wide age range of patients and achieved excellent results even in the elderly. It is particularly useful for treating patients with thin skin and volume loss where a surgical face-lift could leave them looking gaunt and dermal fillers might end up being visible. In these difficult patients the Sculptra® will give back soft volume and lift to the face, which will look very natural.

CN: What are the contraindications?

LE: The contraindications to Sculptra® are similar to dermal fillers with caution in patients with a history of auto-immune disease, anaphylaxis, keloid scarring or active skin disease.

CN: How does the product work?

LE: Sculptra® (poly L lactic acid) is a unique product that stimulates the fibroblasts in the dermis to create new collagen cells. A course of treatments is normally required over a two to three month period using a total of two to seven vials. The number of vials used depends on whether just the cheeks are being treated or the whole face.

CN: What kind of results can be achieved and how long does it take for patients to see a result?

LE: Results are consistently excellent with tremendous patient satisfaction. The gradual growth of collagen gives optimum results after 10 months following the last set of injections but with early changes showing at around three months. The effects of Sculptra® last on average around two years when a smaller re-stimulation treatment is required to maintain the collagen lift. If no further treatments are given then the results achieved will be lost by about three years.

CN: How technique dependent are results with Sculptra® and what technique(s) do you recommend for injecting?

LE: The techniques used to inject Sculptra® have changed over the years and also between practitioners who will find their favourite method, each of which will give good results. The Sculptra® is mixed with sterile water and lidocaine 2% several days prior to treatment.

Injections are placed in the deep dermis or subcutaneous area in order to stimulate the fibroblasts and injections must not be injected superficially. I have, over the last 18 months, successfully developed the use of cannulas with Sculptra® instead of needles as this has allowed me to safely treat a much wider area of the face. Although the cannula technique is more demanding I consider it a safer technique, which also has huge benefits to the patients. It rarely causes any bruising or swelling and allows the patient to return to work or normal non-strenuous activities immediately.

CN: What do you like about this treatment?

LE: I consider that Sculptra® is the only product currently available that can give the most natural rejuvenation in lift and volume to the face. It is not a product for chasing lines but an amazing product that re-grows the patients own skin with long lasting and extremely satisfying results. My Sculptra® patients stay with me for years to ensure that their repeat treatments are carried out by myself. It is not a treatment that patients ‘shop around’ for because once they see the results they will always trust you with their future treatments.

CN: What other treatments does it work well in combination with?

LE: I use Sculptra® as my main volume replacement treatment in my clinic but I do combine it with dermal fillers for peri-oral lip lines and lip augmentation, plus Botox treatments if they are also required. I also encourage all my Sculptra® patients to consider skin conditioning treatments such as micro-dermabrasion, peels, Dermaroller and topical application of maybe Obagi Nu-derm, anti-oxidants and Tretinoin creams in order to improve their overall skin tone.

CN: What advice would you give to anyone thinking of adding the treatment to their clinic menu?

LE: If you are considering incorporating Sculptra® into your clinic I would advise an official training course with an expert injector. They will be able to teach, guide and support you with the various techniques used and help you gain the best results possible with your patients.

Once you have mastered the techniques of Sculptra® and seen the results for yourself in your own patients you will wonder how you ever managed to run a clinic without it!

INjecTableS SpecIalq&a

We speak to Dr Linda Eve mBBs, mD of Evenlines Clinic, Bournemouth, about her experience using sculptra®

Q& A

(Left) 57 yr old lady before (Right) 57 yr old lady 10 months after five Sculptra® vials (plus Botox®, lip augmentation and peri-oral dermal fillers)

Sculptra®

THE EFFECTIVECOLLAGEN STIMULATOR

For a gradual and natural deep tissue regeneration lastingover 2 years*

Actual Sculptra® Patient

*Clinical trial ended at 25 months. Narins et al. JAAD. March 2010.

INJECTABLE POLY-L-LACTIC ACID

•bache sculptra GB 170x240_Mise en page 1 17/01/13 17:30 Page1

SPC available on request Sinclair IS Pharma, Whitfield Court,

30-32 Whitfield St, London,W1T 2RQ

0207 467 6920 [email protected] www.sinclairispharma.com16 th a n d 17 th

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As more and more clinicians are embarking on offering skin needling to their clients, both in-clinic and at-home, so a myriad of devices has been launched to the UK marketplace. So what we really need to know, is the ‘nitty gritty’ of the difference between the devices, how are they made, what’s good, what’s bad and what do you, as an aesthetic practitioner need to consider when buying rollers to use on your patients.

Design, Manufacture & Quality

This is the foundation of a micro-needling device, like anything you buy, a poorly designed and made product, using cheap materials will both not do the intended ‘job’ to the levels that you might expect, but in the worst case scenario could cause harm. Whilst there is no specific definition of a micro-needle, they are generally fine needles with a shaft diameter of between 0.1mm and 0.25mm. Properly designed micro-needling devices require medical engineering, from the materials used to the number of needles created.

There are currently two main methods of manufacture; grinding and stamping.

Despite their application, micro- needles should in-fact be atraumatic, so a fully validated grinding and construction process is preferred over either a stamping or cutting production in the best quality rollers. Unfortunately we are unable to ascertain the exact needle processes used by each of the individual brands sold to the UK market, however generally it is thought that most needles produced globally are done so by mechanical pressing or stamping, with only a few key brands adopting the grinding method.

Grinding of the needles normally requires the stainless steel to go through a tempering/hardening process to enable each needle to be ground to an incredibly fine point, about 2-3μm tip radius, in order to conserve tissue and minimise “tearing” or ripping of the tissue as they enter and leave it when the device is rolled over the skin.

Needles used in the needle disk system (such as in the DTS/GENOSYS roller) are stamped from metal sheets approximately 0.16-0.25mm thick. Essentially these are not needles but better described as spikes like those on a cog. The manufacturer makes the claim that the tip of the spike has a “mosquito” diamond shape that enhances penetration but a counter argument is that the fact

that they are stamped and do not go through a secondary hardening and sharpening process means that the points are not considered to be sharp, plus they are also felt to be too close together.

This combined with the number of needles (more information on this below), means that their action on the skin is more traumatic as too much pressure is required in application, rather than the less traumatic performance of a ground micro-needle produced system. Testing of needle disk systems by Dermaroller GmbH shows that the metal is softer and bends more easily than the steel used for grinding. Pangaea Laboratories also noted that there have been no trials using this system and that they have concerns over the safety of this device. The needle lengths range from 0.8 to 3.0mm. The cutting edges of such needles can measure 0.16mm plus. This is 50 times wider than the 0.003mm tip radius of a ground, precision micro-needle as illustrated in this image.

In many of the imported devices from the Far East, the finish tends to be quite rough and so the needles are often coated or plated and/or polished. This gives a smoother, shinier finish but will give a blunting effect to the needles. There is also uncertainty about the materials used, which can include copper and nickel, which is used to avoid corrosion. Most needles used in the wide range of generic rollers produced in China and India are more like industrial pins than needles. See example images below, for typical examples of rollers manufactured in China and India, which clearly show irregularities in the needle shafts.

Below: (left) Image of a disk from a Disk Needle

Therapy System (DTS roller); (right) Stamped versus

ground needle

Rollwith itLorna Jackson on the ‘nitty gritty’ of medical micro-needling dermal rollers and whether you know what you are you really buying?

Lorna Jackson Lorna has been Editor of The

Consulting Room™, the UK’s largest aesthetic information website, for a decade. She has become an industry commentator on a number of different areas related to the aesthetic industry, collating and evaluating statistics and writing feature articles, blogs, newsletters and reports for The Consulting Room™ and various consumer and trade publications, including Aesthetic Medicine, Cosmetic News and Aesthetic Dentistry Today.

clINIcalSkIN NeeDlINg

Above: A brand from India called DERMAL

ROLLER.

Number of needles

Contrary to popular belief, having a greater number of

needles in a medical skin roller is not beneficial. Having more needles actually requires a greater force to be applied to penetrate the skin; meaning the procedure will be more painful and/or proper needle penetration will be difficult to achieve. It also means that there are a greater number of needles trying to enter and exit the skin at any one time which increases the risk of tearing or shearing of the skin tissues. The main dermaroller brands available on the market do display a variety of different needle configurations but popular layouts include 192 needles, those manufactured from disks tend to have more. It is also critical that every needle is the same length; a lack of uniformity in the length of the needles could lead to an inconsistency in the penetration and a reduction in the efficacy of the treatment. Assessment of a variety of rollers by Dermaroller GmbH has shown that needle length is not always consistent.

Angle of needles

The optimum angle to have between each needle on a micro-needling device is between 15 and 20 degrees (for example, the Genuine Dermaroller™ brand has an angle of 20 degrees and the DTS/GENOSYS device declares an angle of six degrees on their website). At the optimum angle range, minimum penetration force is required as only one needle will be entering the skin at any one time, as shown in the image below.

The picture on the left hand side is a visual representation of a roller with a larger number of needles and consequently with a lower angle of separation between the needles. This angle will require greater force to be applied in order to get all of the needles into the skin. So essentially the greater the angle between the needles and the fewer there are (within reason) the better, as this requires the least pressure to apply treatment and will minimise any potential excessive trauma to the skin.

Materials, construction and quality control

All skin needling devices have similar components; a plastic roller and micro-needles, which depending on the method of manufacture are either glued in place or embedded directly into the plastic roller. The preferred solution would be the embedded option as this method is believed to be more secure, in that there

is less chance of the needles becoming loose. Rollers manufactured using the needle disk system separate each of the stamped metal disks with a small disk of plastic.High quality stainless steel is the appropriate material for micro-medical skin needles – alloying elements of chromium, nickel, molybdenum and titanium. The chromium enables the metal to maintain its scratch and corrosion resistant surface and the molybdenum and titanium increases the hardness of the metal and helps to maintain a cutting edge.

Chromium and nickel are the primary alloys in the majority of corrosion and heat resistant stainless steels. The nickel is required to stabilise the structure and add to the material’s strength, it is effectively locked in to the structure of the metal so that in most stainless steels there is virtually no risk of nickel allergy. (Care does need to be taken if a needle is “coated” and assurance that this does not contain nickel should be sought.) The molybdenum adds to the hardness primarily as it increases it’s durability under high temperatures which are often required in the tempering/hardening process. When titanium is used as an alloying agent it is typically less than 1% (0.25 - 0.6%) and enhances the effect of the chromium and therefore corrosion resistance of the stainless steel.

This type of steel is ideal for medical instruments as it is strong, easy to sterilise and is resistant to corrosion. In terms of marketing claims, be aware that there is no such thing, from a legal standpoint, as ‘medical grade stainless steel’. Various stainless steel ‘recipes’ have been created and have been used in medical equipment for many years, thus proving their long term safety, but there is no singular steel alloy claimed as medical grade. Any new proprietary formulas must satisfy various standards authorities before being granted a clearance for use in medical applications. The steel needs to go through a strengthening and tempering process to provide the strength needed to enable them to be ground and processed to the required sharpness. This also means that they stay sharp and are not compromised during the procedure.

Titanium is stronger than some steels and approximately 45% lighter. Due to its biocompatible nature it is used in a range of surgical tools and surgical implants. Often mixed or alloyed with other metals, these alloys are very strong and tough even at high temperatures. The high cost of the raw materials and their processing make them prohibitive for many applications and industries and also increases the brittle nature of this metal if too much is used. Traders from China often claim that their devices are made from titanium. There is no evidence to prove this and it would seem highly unlikely as the material cost would be far too expensive and very difficult to tool due to breakages. Some products do contain a small percentage of titanium as part of the stainless steel alloy however, but levels do vary.

The plastic roller or barrel are made from a number of differing plastics such as ABS and MABS plastic or resin, with the cheaper Chinese or Indian imported rollers using inferior plastic compounds. Many of the higher quality brands use Lexan®. Lexan is the brand name for polycarbonate sheet and resin in a wide range of grades. Lexan is mainly used in things like space and sports helmets, clear high-performance windshields and aircraft canopies, motor vehicle headlight lenses, and bullet-resistant windows! The

Lexan grade of plastic allows for irradiation and other forms of sterilisation without degrading or discolouration so is favoured by leading brands. MABS is widely used in medical and diagnostic products and is also capable of sterilisation by irradiation

Sterility

The credibility of claims regarding sterility also needs considering and it is wise to understand and be clear about the difference between cleaning, disinfecting and sterilising. A sterile product is one that is free of viable microorganisms, including spores. The level/dose of the particular process used must be sufficient to eradicate all viable microorganisms and render the item sterile. This should be a validated process in which the known starting bio-burden has been rigorously tested at the process level/dose. The dose would need to also have been tested in the packaging and the format in which it is processed; this is normally done through dose mapping. The packaging seal/closure system around the device also needs to have been tested and validated, as should the claimed shelf life. Once validated, the starting bio-burden, the required dosing throughout the process and the packing configuration should be tested and approved for each batch/lot of production.

There are four main methods of sterilisation; irradiation, heat, gas and chemical.

The responsible way to perform these treatments, if the roller cannot be re-cleaned by a validated procedure such as cold sterilisation or autoclaving which would mean that the same roller could be reused on the same patient, is in a clinical setting with a sterile, single use medical device by a suitably qualified, experienced and trained practitioner.

Home use rollers cause other issues with hygiene as many come with an often untested, proprietary sanitising solution, or offer no solution and suggest consumers use baby sterilising solution. The problem with the latter is that the roller has not been tested with baby sterilising products to ensure either proper cleaning or compatibility. It is widely known that baby bottle sterilising solutions use chemicals which are highly corrosive to metals while being gentle on the plastic of the typical baby bottle. It should be noted that home use roller should be specifically designed for that use and not penetrate beyond the epidermis and thus make contact with dermal tissue or blood supply, needles that are longer than 0.2-0.3mm will do this. Devices that are sold for home use greater than this length and make claims for re-sterilisation at home should be avoided.

Medical device classification and general product safety

According to the European Union Medical Devices Directive; ‘medical device’ means any instrument, apparatus, appliance, software, material or other article, whether used alone or in combination, including the software intended by its manufacturer to be used specifically for diagnostic and/or therapeutic purposes and necessary for its proper application, intended by the manufacturer to be used for human beings for the purpose of:

1. Diagnosis, prevention, monitoring, treatment or alleviation of disease


2. Diagnosis, monitoring, treatment, alleviation of or compensation for an injury or handicap

3. Investigation, replacement or modification of the anatomy or of a physiological process

4. Control of contraception

and which does not achieve its principal intended action in or on the human body by pharmacological, immunological or metabolic means, but which may be assisted in its function by such means.

Medical devices are regulated under the provisions of a number of EU directives, covering different categories of medical device. The 4 categories are:

1. Class I = a plaster, a pair of glasses

2. Class IIa = disposable contact lenses, syringes, micro-needling devices

3. Class IIb = dermal fillers, gastric bands, lasers

4. Class III = breast implants, hip joints

A manufacturer of Class I devices can self certify their compliance to the EU directives. All other classes of device need assessment by an independent third-party organisation known as a notified body. A notified body is a private company regulated by the member states competent authority, in the UK the competent authority is the MHRA. With the CE marking on a product, the manufacturer declares that the product conforms to the essential requirements of the applicable EU directives. When certified by a notified body, the notified body’s number will be displayed alongside the CE mark. Medical devices have to comply with ‘essential requirements’. They must be safe and must function in a medical-technical way as described in the manufacturer’s ‘intended purpose’. CE marking is a validated process that documents how a product is manufactured. It also provides batch/lot traceability and ensures consistency across a batch. Having a CE mark should mean that the process of sterilisation and manufacture has been validated by the notified body.

Whilst CE marking is a good starting point when looking for a medical device it is neither a definitive solution nor a guarantee of quality. CE marking should assure sterility of the device and consistency through the manufacturing process but it unfortunately does not necessarily determine how good or effective a device or the method of manufacture is. The CE mark is designed to give consumers the absolute assurance of medical quality. Ironically, while the principal of one standard for all of Europe is signified by the CE mark, there is regrettably a variance in standards of the various notified bodies. Some are more lax than others. We have seen recently, failures in the monitoring and surveillance by the notified body and competent authorities with the PIP breast implant scandal. Unlike with medicines, notified bodies or certifying bodies are one step removed from the competent authority in a given country. The MHRA conducts periodic audits of notified bodies; it does not conduct its own assessment of data on safety and effectiveness of devices.

Experience has shown that the MHRA essentially takes the position that it has no jurisdiction or control over

devices used for ‘cosmetic indications’. This would not be the case for a medicine, which would be classified as such by its ingredients, mode of action and safety and raises questions over how well the supply of devices into the aesthetics industry is policed and how the reliability of suppliers can be guaranteed. If we return to the specifics of skin needling, the MHRA have made it clear they have no interest or jurisdiction if the device is used for ‘cosmetic indications’ regardless of the fact that it is attempting to achieve a physiological and anatomical change to the human body and is thus deemed by many to be ‘medical’. Currently any person can perform a procedure and any device, which does not make a medical claim, can be sold outside of any medical regulatory control. Thus this then falls under General Product Safety Regulations 2005, which requires that a producer does not place a product on the market, supply a product or offer or agree to do so for another entity unless the product is a safe product. This level of general regulation is much harder to police and validate. If we look at the procedure, in-clinic needling requires; surface anaesthesia using a pharmaceutical product, multiple needle penetrations into the dermis, clinical end points including pin point bleeding, a pre-treatment consultation regarding patient suitability and contra-indications and potential management of complications. The treatment goal is collagen stimulation and regeneration, angiogenesis and extra-cellular matrix regeneration.

Surely a responsible position is that these activities should be carried out in a clinical setting with a medical device and by a suitably qualified, experienced and trained practitioner. We do however have to remember CE marking is only a starting point and is open to, on occasion, fraudulent or misleading claims. For those that do not carry legitimate CE mark medical device classification there is virtually no policing of claims made by manufacturers. Broad technical and methodological claims can be made without verification. General Product Safety regulation falls under the remit of local authorities and Trading Standards, many argue that it is very questionable as to whether they are appropriate bodies to investigate or monitor these issues. Examples to justify this point of view would be claims regarding the materials of manufacture, the sterility, the methods of use, e.g., which needle lengths are appropriate for home use/professional use, re-use (with or without validated cleaning and sterilisation processes and proof of product quality maintenance), who can use them, as well as the management of potential adverse events and complications. It’s easy to see that this could well be a task too far for Trading Standards.

Interestingly, as a comparison, according to the Canadian equivalent of our MHRA regulator, Health Canada, dermal rollers make health claims about what their products do, so that places them in the same class as a medical device requiring a license. They do not consider them to be cosmetic. Thus, a roller without a license from them cannot legally be sold.

The UK market provides a broad range of products to the aesthetic clinician, all with varying degrees of unique claims and presentation. Trusted brands who can demonstrate quality and safety to you when asked and who provide appropriate and adequate levels of training and support should always be favoured over those with vague or unsubstantiated claims. I would urge all aesthetic practitioners to steer clear of cheap Far Eastern imports if you want to keep both your clients and your reputation.

To read the full version of this article, including a detailed summary of the main skin roller brands currently available in the UK, as well as new launches for 2013, please register for full membership with The Consulting Room by visiting www.consultingroom.com. Use referral code CNUK2013 for one month’s free membership (new members only, valid until 1st March 2013).

clINIcalSkIN NeeDlINg

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clINIcalTReaTmeNT SpoTlIghT

It involves implanting hypoallergenic coloured

pigments into the upper reticular part of the dermal

layer of the skin. The procedure is completely safe

and effective and used for a variety of semi permanent

cosmetic enhancements including eyebrows, eyeliner

and lip liners.

The procedure is completed in two steps four to eight

weeks apart after an initial patch test. The colour

remains visible for several years, however in order to

keep the look fresh and natural, a colour retouch is

advisable every 12-18 months.

Semi-permanent make-up is a fabulous treatment for

all for enhancing facial features but more so for ladies

suffering from alopecia. After several years in the semi

permanent make-up industry I have treated numerous

ladies suffering from different strains of alopecia.

Living with hair loss can be hard especially if you lose

your brows and or lashes, it takes away from your

features and you can feel you have a vacant look.

Alopecia is an autoimmune disorder. It has been

estimated that approximately two million people have

some form of alopecia.

The disease attacks the hair follicles. The cause is not

known. Scientists believe that a person’s genes may

play a role. For people whose genes put them at risk for

the disease, some type of trigger starts the attack on the

hair follicles. The triggers may be a virus or something

in the person’s environment. In some cases, hair loss

may be due to a vitamin A overdose, iron deficiency

anaemia, a malfunctioning thyroid gland, fever, or

pregnancy.

I have noticed it is usually after the first pregnancy as

opposed to during pregnancy or in later pregnancies

that it seems to be more common.There is a slightly

increased risk of having the disease if you have a close

family member with the disease therefore it can be

considered hereditary.

Other factors that cause hair loss can include allergies,

irritants, toxins, burns, injuries, and infections. We

also know that certain medications (especially anabolic

steroids), chronic kidney failure, radiation, and

chemotherapy can cause hair to fall out. It is safe to

have semi permanent make-up whilst battling cancer

Geraldine Flynn on using micropgimentation for alopecia patients

mak ing a m a r k

Semi-permanent make-up, also known as micropigmentation, is an advanced technique that should enhance the natural beauty and give the features shape and definition as opposed to giving you a dramatic, false “scouse brow” or artificial looking lips as often seen in the media.

“Semi-permanent make-up is a fabulous treatment for all for enhancing facial features but more so for ladies suffering from alopecia... Living with hair loss can be hard especially if you lose your brows and or lashes”


growth areas in the beauty industry recently but

it is an established treatment which is both safe

and medically approved, when carried out by our

experienced and competent technicians.

Permanent make-up dates back at least to the start

of the 20th century, though its nature was often

concealed in its early days.

The tattooist George Burchett, a major developer

of the technique when it become fashionable in

the 1930s, described in his memoirs how beauty

salons tattooed many women without their

knowledge, offering it as a “complexion treatment

... of injecting vegetable dyes under the top layer

of the skin.

Facial tattooing has been practised for centuries in

many cultures, particularly in Asia. The indigenous

people of Japan traditionally had facial tattoos.

More commonly seen today in Taiwan, North

Africa, Northern Nigeria, the Kurdish people in

East-Turkey, and the Maori of New Zealand .

think beFore you ink After some research I chose to train with Finishing

Touches who are the most respected in the industry

and who provide ongoing training and support.

Many technicians may not be registered with their

local city council, anyone offering semi-permanent

skin colouring, and the premises they work from,

must be registered with their local council under

the Local Government (Miscellaneous Provisions)

Order 1985.

I use only Finishing Touches EU certified approved

products supplied directly from them which

have been rigorously tested and have individual

lot numbers, expiry date and guaranteed sterile

needles.

Precision plus technology digital machine is the

most up to date state of the art technology. Using

a sterile cartridge system for better implantation

with less discomfort and more accurate results.

With a penetration range of 50-150 insertions

per second this system allows steady comfortable

treatments whilst causing minimal trauma to the

skin.

Treating my alopecia clients has been so very

rewarding and I look forward to continuing to

highlight this superb treatment.

References: Industry Profile Study: Vision

2009

“It is safe to have semi permanent make-up whilst battling cancer once your oncology nurse states your blood count is high enough. The difference this can make to a client in easing the loss of their hair is invaluable.”

test imonials“I have suffered from full alopecia for the last 7-8 years and as anyone with this will know it is a very hard thing to deal with. When it happened to me I completely lost all confidence in myself but through great wigs I managed to scrape a small piece of this back but I was always very aware of how strange I looked without eyebrows!. I had considered semi-permanent make up for many years but was always afraid and put off by the many horror stories that your hear about. It was only this year that I plucked up the courage to ring Geraldine and my only regret is that I didn’t do it sooner, she was amazing from start to finish and after meeting her for the first time within a few minutes I had complete confidence that she was going to make me look and feel wonderful again. I have now had both sessions done and I am completely overwhelmed with how well they look and how it has given me all my confidence back in such a short space of time. I cannot

thank Geraldine enough for how much she has helped me and I would very highly recommend her to anyone.” C Philips, September 2010

“Having just had my eyebrows done by Geraldine I now want to encourage anyone thinking about this procedure to go for it. I cannot stress enough the difference it has made to my life. I am much more confident and no longer shy away from eye contact with others. The difference eyebrows make to your face really is amazing!! Geraldine did a fantastic job, she knew exactly what shape and colour would suit my face and I trusted her completely. From start to finish I felt totally at ease. Geraldine’s professional, caring approach was much appreciated and at no time did I feel embarrassed or self conscious. My only regret is that I didn’t do it years ago...the painless, procedure was worth every penny. Thanks Geraldine.” H Wright, October 2010



Charlotteafter 28 weeks ofAlizonne Therapyweight loss 7st 1lbs

Alizonne...transforming lives!

Alizonne Therapy is a revolutionary medicallysupervised treatment program that combines weightloss with body contouring. Designed by our medicaldoctors, Alizonne Therapy can dramatically improveappearance and long term health. The treatmentcomprises of four essential elements - ultrasoundtherapy, connective tissue therapy, medical diet and stabilisation.Alizonne was first launched in the UK by Dr MarkPalmer from his Leeds clinic in 2006 and now consistsof two wholly owned successful clinics, one jointventure clinic and a total of 11 indepenant partnerclinics with 6 further clinics coming on board in 2013,all licensed by Alizonne UK and managed to ourspecific uniform standards and protocols.

We are currently recruiting carefully selected independent partner clinics around the U.K. to provide Alizonne therapy®.

If you are an independent clinic and would like further information please contactAnne Welford, Executive [email protected]

If you would like to be a part of the Alizonne Success Story

Having seen the incredible results our Alizonnepatients were achieving I couldn’t help but beimpressed. Patient feedback is incredible as manyreceive results they could not have dreamed of.We believed that weight loss and body contouringwould be one of the largest growth sectors in ourindustry and we couldn’t see any other weight lossproducts with either the same results or medicalsupervision. We have now expanded to 6 Alizonneclinics including 2 recent additions in Watford &Bournemouth where we have great hopes for2013. The treatments fit nicely along with ourother therapist business and have allowed us toextend our opening hours and benefit ourcosmetic business as well. From my experience Alizonne not only changesyour patients' lives but your clinic's finances as well!

I became interested in Alizonne when I wasconsidering what next to add to our treatmentrepertoire. Having made the decision to take onAlizonne I do not think I would have ever managedif it had not been for the constant support, adviceand guidance that I came to rely upon fromAlizonne UK.Alizonne is certainly not an add on, it has becomea major part of our core business. An addedbenefit from providing Alizonne treatment is thatthe majority of clients learn about the otherfacilities and treatments available from the clinicwhen they have lost weight and started to enjoytheir appearance. They are then more inclined toconsider aesthetic treatments and clearly, havingdeveloped a trusting relationship with us, do notlook elsewhere for these treatments!

I became aware of Alizonne when a long timefriend and client underwent the therapy and lostover 7 stone in just 20 weeks. He was soimpressed he decided he wanted to open his ownclinic and asked me to help him put a business plantogether. Alizonne UK, were fantastic. They tookus behind the scenes, provided in depth financialinformation, shared marketing ideas, materialsand costs and gave our clinic the flying startdreams are made of. The clinic has been opennearly eighteen months and turnover has grownconsistently month on month. We currently haveover 100 clients on our books and continue toreceive the full and active support of Alizonne UK .

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medical aestheticstemple

Paul Wilkinson.CEO. Courthouse Clinics

Chris MatthewsManaging Director. Silverlink Clinics

Dr Sam Robson. Medical Director. Temple Medical Aesthetics

www.alizonne.co.uk tel: 0844 800 1209

Be part of the

Success Story!

cosmetic news advert 210x297 b 17/1/13 14:52 Page 1


Combination treatments, targeting multiple concerns simultaneously have become part and parcel of everyday modern aesthetic practice. The one-size-fits all approach no longer exists thanks to the plethora of products, treatments and technologies on the market. However, while the value of combining different treatment modalities to achieve the best outcome for your patients/clients is well established, the cost of incorporating a broad range of treatments into your clinic can be significant, especially where equipment is involved.

In hard economic times the business savvy clinic

needs to think about how it can offer best value to

its clients, without compromising on results and

without breaking the bank. Step up a new wave of

multi-technology machines, which offer a range of

different treatments in one piece of equipment giving

you the ability to not only tailor your treatments to

each individual client’s needs and concerns, but also

allowing you to offer more than one cutting edge

technology with only one capital outlay.

The latest of this new breed of machine is

3D-Skintech from the same company that brought

you 3D-Lipo. The sleek, modern and ergonomically

designed multi-functional aesthetic device was

developed specifically for the face. It has four

individual treatments incorporated in one piece of

kit, including microdermabrasion, messotherapy,

radio-frequency and LED and can address a wide

range of common aesthetic concerns from anti-

ageing and pigmentation to acne.

The product has been under development for the

last 12 months and 3D-Lipo managing director Roy

Cowley has been closely watching the trends in

the market during that time so that the machine’s

capabilities mirrors demand from consumers and

practitioners alike.

The rotational diamond peel microdermabrasion

function of the machine is designed to bring greater

comfort and results to peeling, while tri-polar radio-

frequency technology means skin can be tightened

with lower energy, so less discomfort, than mono- or

bi-polar devices.

Mesotherapy removes the need for needles when

delivering active ingredients deep into the skin, and

full-canopy LED technology, with red, blue, yellow and

green wavelengths, can be tailored to treat a range

of concerns.

Another factor that will appeal to both clinics and their

patients is how time-effective as well as cost-effective

the treatment is. A typical treatment using 3D-Skintech

would last around an hour: 15 minutes each of

microdermabrasion followed by mesotherapy, radio-

frequency and then LED light therapy, far quicker than if

you did each of these individual treatments separately.

Despite the fact that 3D-Skintech combines four

technologies in one, Cowley is keen to stress that the

efficacy of each individual technology has not been

compromised and is of the highest standard available

on the market, in its own right. He says: “We haven’t just

stuck in a bonus handful of LED lights. Each application

is as good as or better than what’s available on the

market as a separate unit.”

The technology is also being launched in line with

a range of medical-grade peels and cosmeceutical

skincare products, designed to compliment the

procedure or to be used as stand alone in clinic or at

home regimes.

Products include the Moisturising Sun Shield, which

hydrates the skin while fighting free radicals and offering

SPF 30+ protection; Time Defense Cream which fights

environmental and stress-related ageing factors and a

collection of cleansers and toners. There is also a line of

AHA and BHA peels offering lightening, skin clearing and

anti-ageing properties.

This means that you can offer a comprehensive and prescriptive approach to your client’s needs covering;

• Preventative approach (cosmeceutical skincare with

actives for the effective treatment of acne/pigmentation

and anti-ageing)

• Preventative curative approach (peels combined with

cosmeceutical skincare to intensify the treatments

above)

• Curative approach (combines multiple technologies

to accelerate the effects on anti-ageing, acne and

pigmentation)

• Curative + approach (the ultimate result driven

approach which combines multiple technologies in

conjunction with the relevant peels and skincare)

It is this mulit-factorial approach that makes this

piece of equipment such excellent value for money

and when times are tough economics are equally as

important as results.

pRoDUcT focUS 3D-SkINTech

geTT iNg skintech -N iCAlWe find out how the latest launch from 3D-Lipo, 3D-Skintech, is offering clinics four cutting edge technologies in one piece of equipment

f o u r - i n - o n e

Radio-FrequencyThe Focus Fractional RF energy penetrates

the skin layers to selectively heat the skin

tissue and the extra cellular matrix where the

collagen fibres are embedded. The local heating causes

an immediate contraction of collagen fibres, and at the

same time increases the metabolism of the fibroblasts

thereby accelerating the production of new collagen and

elastin fibres. The concentration of collagen fibres and the

regeneration of the collagen and elastin deposits, tighten

the skin layers creating a smoother, healthier and younger

looking skin.

No needle MesotherapyHailed as the next generation following dermal

rollers electro mesotherapy breaks down the cell

wall to enable ingredients to be delivered into the

cell where they are needed most.

Full canopy LEDFull canopy LED ensures rapid and effective

treatment unlike a few LED lights on a handset,

which cannot deliver an effective outcome. Each

colour has a specific weight, temperature, wavelength,

density and energy level to stimulate or minimize various

metabolic functions. The different colours give off different

frequencies, which have varied effects on physical and

psychological functions.

Rotational Diamond Peel MicrodermabrasionThis latest technology combines the latest

in adjustable, rotational control with variable

vacuum to ensure a precise yet comfortable service without

the downtime issues commonly associated with crystal

microdermabrasion.

is set to create a revolution in the non-surgical Aesthetic skincare market. Following the success of the award winning 3D-lipo which combines technologies for the effective treatment of fat, cellulite and skin-tightening we are set to launch a phenomenal new multi-functional device for the face. Here are just some of the reasons why 3D-skintech will become the brand of choice in 2013

• Complete treatment portfolio for anti-ageing, pigmentation and acne• 4 technologies ensure a prescriptive & total approach to your clients needs • Used in conjunction with medical peel and cosmeceutical skin care line• Unsurpassed results ensures maximum client loyalty• Highly profitable with a multitude of services to offer• Provides you with a competitive edge in your area• Affordable as package price is under £10,000 with a product starter pack worth £1,000• Available on 3 Years interest FREE finance for the first 50 machines sold

A New Dimension in Non-Surgical Technology

A revolution in the non-surgical aesthetic skincare market...

For more information or a demonstration please call 01788 550 440

www.3d-skintech.comwww.3d-lipo.com

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

Mesotherapy Non-invasive mesotherapy ensures that the active ingredients are delivered where they are needed most without the need for needles.

Rotational Diamond Peel Microdermabrasion Utilising the latest technology available you can work in conjunction with topical skincare to ensure that hydration and comfort are not compromised whilst delivering excellent peeling results.

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

Radio Frequency Tri-polar Radio Frequency is the most advanced technology available for skin-tightening ensuring excellent results without the discomfort associated with mono or bi – polar devices.

IT’S ALL YOU WILL EVER NEED…


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Stylage® now avaialbe with lidocianeStylage® is now available with lidocaine. Stylage® is the first

product on the market which contains cross-linked HA (patented

IPN-Like Technology), the anti-oxidant mannitol, which provides

less swelling and extended longevity, and lidocaine for comfort

and safety for both for patients and physicians. A clinical study

conducted by French plastic surgeon Dr Bernard Mole confirmed that

the effectiveness of the HA was not compromised by the addition of

lidociane and that the performance and filling capacity or “volumising

effect” of gels with Stylage® lidocaine are the same as those without.

The study that was carried out on 84 patients with a clinical follow up

over a period of six to eight months, concluded that the product does

not bring about any increased risk of blood extravasation and affects

neither the quality or the durability of the results (see pages 21-22).

Alma Lasers Receives FDA Clearance for Pixel RF

Alma Lasers, is pleased to

announce the introduction of

the new Pixel RF fractionated

skin resurfacing module for

its Accent family of products.

Distributed in the UK by ABC

Lasers, the Pixel RF uses

proprietary InMotion Refractive

Radio-frequency Micro Plasma™

Technology, which both ablates and heats the skin through controlled,

focused delivery of energy without using disposables. Healthy skin around

the treated area helps to accelerate the healing process thus improving

results and reducing patient down time by allowing the need for just the

targeted tissue to heal and collagen to strengthen. With its high-energy

output, the Pixel RF can achieve in as little as one session what would

require multiple sessions with other RF technologies. Not only is it highly

effective to use on all skin types (Fitzpatrick I–VI) but treatments can be

administered year-round with no seasonal restrictions. The Pixel RF causes

evaporation, mechanical damage and thermal damage deep beneath

the epidermis surface providing significant dermal impact with minimal

epidermal disruption.

Carleton Medical launch QuadroStarCarleton Medical will be launching the latest offering from Asclepion,

QuadroStar, to the UK aesthetics market next month. The system is the

World’s first diode yellow light with a 577nm wavelength, which is the highest

absorbency wavelength for oxy and deoxyhemoglobin, meaning it is ideal

for vascular treatements. In addition to the 577nm wavelngth it also has

532nm, 940 or 980nm wavelengths. The small, compact and light table top

device has an iPad interface and a choice of hand pieces as well as a built in

scanner and skin cooling for easy handling without cables and there are no

running costs.

Applications include vascular lesions; pigmented lesions; laser assisted

liposuction; endovascular treatments and surgery. It is due to be launched in

March 2013.

Healthxchange introduce Obagi® Hydrate™The latest product from skincare

pioneers Obagi is now available

form Healthxchange. Obagi®

Hydrate™ is a new facial hydrator

that features an innovative

technology called Hydromanil

which captures and assimilates

water into the skin both

immediately and lastingly due to

an advanced multi-capillary process, creating a 2-in-1 response.

Clinical results are instant and long-lasting hydration, which helps to enhance

skin smoothness, while providing immediate and lasting effects on skin

barrier function. In recent clinical trials, the test results reported a 51%

improvement in water loss after eight hours and a 92% improvement in the

skin’s hydration within two hours (OMP Inc, data on file).

pRoDUcT NewS

sTylage®

alma lasers carleTon medical

healThxchange



AQTIS MEDICAL™ WORKSHOP

Saturday 16th February 1.30pm - 2pm:

Ellansé™ a Touch of Youth Advanced techniques

Presented by Sharon King NIP

www.ellanse.com

NEWHANDS

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For Full & Volumized

Hands

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Mesoneddling roller arrives in UK Euromedical Systems Ltd. will be distributing the latest development from Filgora

Laboratories, the Mesoneedling roller system, to the UK.

The system has been engineered specifically to work in conjunction with Filorga’s

mesotherapy products, NCTF 135 and NCTF 135 HA, allowing not only for an

easy treatment from the practitioner’s perspective, but also providing much less

intimidating alternative to traditional needle injected mesotherapy.

Additional benefits include: reduced chair time for larger areas and an improved

outcome (the micro punctures are proven to stimulate collagen production). The

Mesoneedle is a true class IIB medical device.

Clinogen Laboratories unveils new eye productClinogen Laboratories has unveiled its newest

product, Ionic Cellular Repair Eye Crème. Based

on naturally derived botanicals the product offers

an effective programme to control the visible

signs of ageing by improving lymph drainage;

stimulating microcirculation; nourishing and

strengthening delicate skin; increasing oxygen

supply to the dermal and epidermal levels and

revitalising the skin’s elasticity. The result is

a visible reduction in puffiness and dark circles,

and softening fine lines. It is the ideal homecare

treatment to lift, smooth and hydrate the fine

delicate skin around the eyes. Fine lines and

wrinkles around the eyes will appear smoother and

the skin brighter.

clinogen aqTis medical™

euromedical sysTems lTd

AQTIS Medical™ launches Ellansé™ HandsAQTIS Medical™ UK has launched a new filler product

designed specifically for hand rejuvenation.

Ellansé™ is a polycaprolactone-based biostimulatory filler,

which is available in four different longevity options (S, M, L

and E), ranging from 12 months up to four years.

Ellansé™ Hands has the same particle characteristics as the

other products in the Ellansé range, however the viscoelastic

characteristics of Ellansé™ Hands have been specifically

designed for ease of injectability, moldability and optimal

immediate results for this indication.

The range supports safe and cost-effective aesthetic treatments

through immediate and sustained performance, tunable

longevity and total bioresorbability (STAT Technology™). Ellansé™

is a biostimulator, inducing a natural neocollagenesis response

leading to longer-lasting volumisation. As all products have

identical injection characteristics, physicians choose between

the four products options based on the desired longevity.

Ellansé™ Hands is available in two versions, Ellansé™ Hands S

and Ellansé™ Hands M.

pRoDUcT NewS

Leading dermatologist joins forces with Concept HealthcareConsultant dermatologist Dr Russell Emerson has joined forces with Concept Healthcare to bring a potent anti-ageing duo - Prototype Anti-Wrinkle, Anti-Age Cream and Prototype Softgel Capsules - to the British market. Prototype Softgel Capsules contain resveratrol (which is clinically proven to have an anti-oxidant effect that is 17 times greater than Coenzyme Q) as well as vitamin C and B complex. The capsules provide anti-oxidant protection which is proven to enhance skin texture, reduce wrinkles, age spots and redness whilst supporting new collagen production. One capsule per day when used in combination with PROTOTYPE Anti-wrinkle Anti-age cream will achieve maximum effects.Prototype Anti-Wrinkle Anti-Age Cream combines hyaluronic acid, retinol, Q10 and vitamin E to provide short term rapid tightening of the skin, plus long-term strengthening of the skin’s connective tissue. The efficacy of the product range is backed up with evidence and extensive clinical data. Results can be seen in four to six weeks.

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Visit stand 90 at the Cosmetic News Expo; chance to win a FREE ‘Clinic Marketing Makeover’*

Half page Advert v2.indd 1 28/01/2013 16:57:22


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cosmetic newsexpo

C o D eaDveRToRIalSkINceUTIcalS ReDNeSS NeUTRalIZeR

The colour red has many different connotations from

love to danger but when it comes to the skin, redness

is generally seen as a bad thing. There are many causes

of skin redness or inflammation from environmental

factors to foods, stress and medications. As pioneers

in the field of cosmeceuticals, SkinCeuticals is always

striving to develop and bring to market new, innovative

products to target common skin concerns. Redness

Neutralizer is its latest.

Launched in January 2013, Redness Neutralizer is

proven to help prevent and correct the onset of skin

redness and flushing by up to 30% from patients

suffering from any specific redness inflammation. This

includes severe clinical conditions such as rosacea

through to advanced aesthetic skin treatments. Redness

Neutralizer is a superior cosmeceutical product with

high levels of active ingredients. It works effectively on

the skin to combat the associated signs and symptoms

of skin redness, whilst also being suitable for the most

sensitive of skin types.

Redness Neutralizer works by helping to protect the

skin against environmental triggers, which stimulate

the sensory nerve endings, causing the onset of

flushing, burning and discomfort for redness sufferers.

These environmental aggressors can also impair the

skin’s barrier function, leaving the skin feeling rough,

tight and irritated and more susceptible to redness.

The most common environmental trigger for the onset

of redness and flushing is the weather, in particular

UV exposure. Other specific triggers include alcohol,

spicy foods and stress. Redness can also be prevalent

following specific anti-ageing aesthetic treatments

including medical needling, non-ablative lasers,

microdermabrasion and chemical peels.

Prescription drugs for rosacea often address breakouts

and pustules, but in doing so, can overly strip the

skin’s barrier, without addressing the redness of the

skin. SkinCeuticals subsequently developed Redness

Neutralizer to specifically tackle the appearance

of skin redness, whilst providing a comforting and

soothing product for twice-daily use. Formulated with

patent-pending NeuroMed Complex, an innovative

combination of biomimetic peptides and natural

actives, SkinCeuticals Redness Neutralizer helps to

protect against the appearance of redness whilst helping

to protect the skin’s barrier.

We find out about the latest product launch from skincare pioneers skinCeuticals – Redness Neutralizer

r e D

ObSERVATiONAL STuDiES by MR CHRiSTOPHER iNGLEFiELD

bSC, MbbS, FRCS (PLAST)

Mr Christopher Inglefield undertook his own observational studies with 9 patients

over a period of 6 months. Using The Visia Complexion Analysis Machine - an

advanced skin analysis tool, he was able to qualitatively assess each client’s skin

and compare the results to their peer group for numerous skin concerns including

UV damage, skin evenness, wrinkle depth and redness. He was also able to

scientifically quantify the impact Redness Neutralizer had had on his patients’ level

of redness. Results include a redness level of 2% (severe) decreasing to a redness

level of 21%, which is a 19% improvement and a UV damage level of 33% to 56%,

which is an improvement of 23%.

Mr Inglefield says: “When I was first introduced to Redness Neutralizer earlier

this year, I had an immediate patient who I knew I wanted to trial this on. She has

been a regular patient for more than 5 years and has tried many products to treat

her redness, with very little success. Within 3 weeks, Redness Neutralizer had

proven impactful on her condition, with her commenting, ‘my skin has never felt

so calm’. This patient testimonial was the stimulator for me to conduct a small UK

observational study to further evaluate the efficacy of the product.”

SuiTAbLE FOR SENSiTiVE SKiN Redness Neutralizer offers a high performance

formulation, suitable for sensitive skin types.

It contains no alcohol, dyes, parabens or

silicones; is formulated in a light texture that’s

hydrating but without leaving an oily finish and

is dispended in a pump to be sanitary.

It is ideal as part of a sensitive skin care regime

from SkinCeuticals comprising of Gentle

Cleanser, C E Ferulic and Sheer Mineral UV

Defense SPF 50.

POST PROCEDuRE Redness Neutralizer can also be used post-

procedure to help soothe and calm the skin,

making it an ideal after-care product for non-

ablative fractionated laser and chemical peels.

SuiTAbLE FOR OTHER iNFLAMMATORy CONDiTiONS Redness Neutralizer has proven to be effective

at reducing the appearance of redness for

inflammatory conditions such as acne lesions,

scars, red stretch marks and superficial burns.

CLiNiCAL TRiALS In a 12-week clinical trial of 48

subjects, conducted by a board-certified

dermatologist, Redness Neutralizer provided

significant reduction in redness and flushing

on mild to moderate sufferers of skin

redness. In 12 weeks, the appearance of

redness and flushing was reduced by 30%

and skin radiance improved by 30% with

skin smoothness improving by over 55%. In

addition, 96% of users reported immediate

overall satisfaction and recognised that skin

immediately felt smoothed. 98% of users

stated that skin felt smoother immediately

after application and 87% of users reported a

reduction in the appearance of their redness

in just 12 weeks.


www.highgatehospital.co.uk | Contact us: 020 8341 4182 oremail: [email protected]

Highgate Private Hospital is part of Aspen Healthcare Ltd

Announcing the New Highgate Private Hospital

for 2013.The Highgate Private Hospital has invested £13 million in an extensive redevelopment and expansion project, allowing one of the UK’s largest private hospital providers for Cosmetic Surgery to further it’s ability to provide aftercare and peace of mind to the thousands of Plastic Surgeons and Medical Aesthetic Professionals throughout the UK.

As part of our investment we are delighted to announce the launch of the new Highgate Cosmetic Clinic which will include Cosmetic Surgery, Weight Management, Vascular Surgery, Non-Surgical Clinic and now VASER 2.0 which features improved technology that is excellent for fat transfer procedures as well as improved body sculpting efficiency.

Established over 25 years, we are renowned as one of London’s leading cosmetic surgery centres but also offer everything you would expect from a private hospital including outpatient clinics and treatment in most medical specialties, diagnostic imaging, physiotherapy and more. We pride ourselves on our high standards of nursing care, friendly atmosphere and exceptional customer service.

£13 million redevelopment and expansion project.

Consulting Rooms: 6 to15•Bedrooms: 28 to 43 (all en-suite)•Operating Theatres: 3 to 4•Phase 1 - High Dependency Unit•Phase 2 - State of the Art •Diagnostics Suite including: MRI, CT, Ultrasound scanners and X-Ray

Offer your patients more withVaser® Lipo at Highgate Private Hospital

Call us today to see how Highgate Private Hospital can enhance your patient offering.

We’re consistently bombarded with people telling us to get your clinic or business on whatever social media outlet becomes flavour of the month but when you get there you’re often left wondering what value it really brings to your business. The truth is that to establish yourself online and use it to your advantage takes a heck of a lot of groundwork, dedication and perseverance. The pay-off is that the rewards that can come from puncturing the white noise of the social media stream with your unique voice can be massive and it’s getting easier and easier to manage these channels and work them in to your daily routine.

Why Take The Plunge?When I started out working for my website Clinic Compare we had

barely scratched the surface of social media as we naively thought that nobody wanted to talk about cosmetic concerns online let alone in a public space. How wrong we were. More than 500 followers later we now consider this mass of chatter to be an invaluable part of our marketing strategy and tend to our channels daily.With Twitter, much like any marketing channel, you only get back what you put in to it but the rewards of opening up your brand and getting stuck in to conversation can be endless.

engage The CommuniTyGet stuck in and start connecting with some of the leading bodies and

people at the forefront of the cosmetic industry in the UK. Through following and engaging the

right people on Twitter it could lead to such opportunities as:Guest posting on other websites, a valuable means of boosting your site’s credibility as well as promoting your brand.Receiving offers to provide opinions, comments and blogs posts for our company pages bringing with them a new audience of followers to your site.

CreaTe a VoiCe For your BrandWhen patients are looking for

reassurance that a procedure is right for them or seeking advice about a cosmetic treatment then they won’t gravitate towards the faceless logo constantly tweeting self-promotion. Give your clinic a voice and let your personality shine through. People want to know they are talking to a human at the end of the day and not some automated tweet generator.

moniTor For menTionsReputation management is becoming increasingly important as more

and more patients take to Twitter to vent their frustration or sing your praise. By creating a dedicated stream looking out for mentions of your brand/clinic with a Twitter management tool such as Tweetdeck you can make sure you catch every opportunity to react.

handling FeedBaCkLet’s face it, we work within an industry that divides opinion and not

every bit of contact and feedback you receive through Twitter is going to be a golden review singing your clinic’s praises. Twitter gives you an amazing opportunity to handle issues in a public forum and let your clinic be a shining beacon of customer service and response.

Be a ForCe For goodAnyone considering undergoing a cosmetic procedure is more than

likely going to have a number of questions even before they consider stepping foot inside a consultant’s office. Twitter is the perfect medium for helping people by answering their questions directly (if qualified to do so) or point them in the direction of a source of information that will. By setting up Twilert to pick up question driven keywords in your area of expertise you can receive a daily burst of questions that you can help answer. Be a force for good in your industry by giving up a few minutes to answer questions each day, it’s a quick and easy way of building your brand and one good deed often leads to another.

Whether it’s the guilty procrastination of a quick peek at your Facebook timeline to the couple of cheeky tweets you slip in between appointments slowly but surely social media is creeping into our working life.

The tweet smell oF suCCessEd beardsell on the endless opportunities offered by those 140 little characters on Twitter

Ed Beardsell is the Marketing Manager for www.cliniccompare.co.uk, the online clinic comparison service.

my twitter toolboxManaging your Twitter account doesn’t have to be a daily grind, here’s my top applications which anyone who’s considering marketing through Twitter should use to get the most out of the their daily efforts.twilert: This free application allows you quickly and easily set up daily alerts when your brand, a specific keyword or hashtag is mentioned on Twitter.tweetdeck: Although there’s a number of Twitter management tools out there (Hootsuite, Seemic, Sproutsocial etc.) I find the clean and intuitive design of Tweetdeck allows me to set up personalised feeds with ease and manage the flow of information so that I can easily sift the important stuff from the noise.buffer: This handy little application allows users to line-up and time tweets to be posted automatically. An absolutely essential bit of kit however be careful not to turn your account in to a completely automated stream of posts as people will soon lose interest.

by setting up Twilert to pick up question driven keywords in your area of expertise you can receive a daily burst of questions that you can help answer.

IN bUSINeSS bUSINeSS focUS


NEW FOR LIPS AND PERI-ORAL AREA

The only HA dermal lip filler using Allergan’s proprietary

VYCROSS™ technology.

Designed for minimal swelling and a smooth, natural look that lasts.

®


Allergan’s newest innovation is designed for the lips and peri-oral area. It combines the soft and visibly smooth consistency

of the JUVÉDERM® range with less swelling and up to 12 months’ duration in the lips with just a single treatment.1

Ask your local Allergan Representative for more information about JUVÉDERM® VOLBELLA® with Lidocaine today.

Reference: 1. Eccleston D, Murphy D. Clinical, Cosmetic and Investigational Dermatology 2012:5 1–6.

Allergan, Marlow International, 1st Floor, The Parkway Marlow, Buckinghamshire SL7 1YL, UK | January 2013 UK/1296/2012

13457 UK Volbella Trade Ad.indd 1 10/01/2013 13:02


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So, what can beauty professionals do to identify, manage and reduce the risks and overheads of unsold stock? In order to ensure that supply chains maintain their value from beginning to end, it’s certainly worthwhile considering online marketplaces. There are many spas and clinics out there that don’t think it’s for them. However, fast-selling sites, such as eBay and Amazon, have the potential to yield vast profits for sellers, so it’s important not to dismiss these channels outright. It’s worthwhile pointing out that the majority of sellers on eBay are businesses selling to consumers, as opposed to consumers selling to other consumers. Indeed, over 65 per cent of items are ‘buy it now’ products not, as many would think, second-hand goods being sold via auctions. This means it’s a viable route for medi spas and private clinics that have stock and don’t know what to do with it. In terms of maximising your spending, it’s important to take the time to research the market, particularly with regards to pricing. You might think that online marketplaces mean you have to cut your costs, however, that’s not always the case. Look at the prices of similar goods and check you’re not underselling yourself, before taking the plunge.Pictures go a long way in online marketplaces. You wouldn’t go into a spa and expect to part

with your hard-earned cash, if they displayed bland pictures. People want to look, touch and feel, and it’s the same with online selling. Spend time investing in your photography – it will go a long way to boosting prices. A question we often get asked is: how do you manage products and still maintain control of your brand? This is particularly important in the world of professional beauty as the products are perceived to be luxurious and aspirational. People think that if they start selling on eBay then they are somehow letting go and that’s difficult for many businesses to do. However, it’s possible to create an online store front that can mimic not only the look and feel of a website, but also the company’s core values. This way, the essence of the brand can be retained and even enhanced. Selling through this channel means you’re adding another step on your sales journey, which is no bad thing in the current economic climate. Online marketplaces can also help to dispel negative attitudes to unwanted goods. People using sites, like eBay and Amazon, will often have a product in mind before they go shopping. Indeed, a recent statistic has shown that 90 per cent of sales come from direct search, rather than browsing. In this respect, changing people’s minds about goods isn’t a priority.

More focus should be placed on showing the products you have in the best possible light – clear shop fronts and compelling photography should be optimised to get your products in front of interested buyers. Selling through marketplaces is a great way of freeing up capital to invest in future inventory and get more value from your existing goods. A key benefit is that it has a very low barrier to entry. If you were to open up a spa you would have to look into renting a property, getting it fit for business and employing new staff. However, you could have five products and still be able to open your own eBay store. Indeed, you only have to pay when you sell a product – which means upfront costs aren’t an issue.If you’re using this method to get rid of end of line stock, it’s an easy mechanic for boosting your supply chain! For anyone who is looking to maximise their return on investment, online marketplaces are an attractive proposition. Simply do your research, enhance your shop front and invest in photography, and you could be on to a winner.

Tayyab Akhlaq on how to get more from high-end retail products

The eND oF The l iNe

Selling prescription-ready treatments and clinical beauty products is a lucrative way of boosting sales in the world of professional beauty. However, as trends change and tastes evolve, end of lines can literally choke a spa or clinic. Products have to be stored, tracked on a monthly basis, and protected, just like the rest of your inventory. However, if they’re not making you any money, there’s no point in keeping unwanted products in stock – particularly those that can command a high price tag. The beauty trade is a fast moving beast – with new products coming on the market as quickly as possible – meaning it’s important to turn around goods as quickly as possible.

Tayyab Akhlaq is the founder and managing director of Genie and the Geek – a leading ecommerce business, which specialises in online marketplaces.

IN bUSINeSS ReTaIl


PATIENT & PRACTITIONER PROTECTION

w: www.laserphysics.co.uk e: [email protected] t: 01829773155

Laser Physics specialise in providing safety and treatment products for

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cosmetic newsexpo

“Home is a small village outside Thame in Oxfordshire. I’m married with four children, eight siblings and 25 nephews and nieces! Phew! (imagine the Christmas card list). I live with my wife, four children and a dog of mixed race called Maisie. I will usually be up at 6am although this varies if it is an operating day. I tend to have nothing for breakfast other than a cup of tea.

Four years ago when he came over to visit me from America, my father, in his infinite wisdom, told me I was fat and unhealthy and needed to see a personal trainer! Since then, I see a personal trainer twice a week, play squash, run and have recently completed the Florence Marathon. I tend to do one marathon a year, ideally in an exotic location. Work is split between the Paddocks Hospital in Princes Risborough, the Gatehouse Clinic in Northampton, Harley Street, Milton Keynes and the Shelburne Hospital in High Wycombe. My commute to work tends to vary but is never more than an hour, and is often to our local clinic in Princes Risborough which takes me approximately 10 minutes to get to. I usually listen to podcasts and music in the car, when not using it as a mobile office and talking to people.

A typical morning would involve getting to the office before everyone else – like Alex Ferguson, to try and set a good example – followed by an hour and a half of videoing with our video editor. I tend to find this is the best time to do the videoing, when we are fresh. We are highly active in the video field and developing talk show type videos discussing plastic surgery and cosmetic surgery in the New Year.

Following this, I have hour meetings with our marketing team, operations team and non-surgical team until 12pm when my clinics start. I do not tend to stop for lunch and, as I’m giving up bread, I try and eat a salad whilst checking e-mails. A typical afternoon would involve seeing patients with my two nurse specialists at one of our

Aurora Clinics. This typically takes me until 6pm, when I normally have child taxiing duties, taking the children to a mixture of karate, cubs and tennis.

I always knew I wanted to be a surgeon, and decided to be a plastic surgeon the first time I ever saw a plastic surgical procedure performed. The attention to detail inspired me and after seeing a very simple skin graft procedure, I determined that I would be a plastic surgeon. I have a number of mentors, the greatest of which is Mr Brent Tanner who is a plastic surgeon who is very well known in the Brighton and Sussex area. Brent shares many of my ideals, both medically and in his personal life.

I’m a very sociable person and my work involves talking and interacting with people all day, whether it is our staff or patients. They say an average man says 2,000 words a day, and an average woman 7,000 words a day but I think my word count would be way above this on most days. Even during operations we do tend to talk almost continuously. The staff helping me with operations I would classify as personal friends and I enjoy the operation days learning and discussing topics with them.

Setting up Aurora Clinics and Cosmetic Courses have made me very proud and particularly when members of the staff do perform beyond my expectations as we do try and build a family

atmosphere in both businesses. We are working on large amounts of exciting projects ranging from online TV to developing national and international branches of Aurora Clinics. I work very closely with my business manager, who thinks many of my ideas are off the wall and tries to bring me down to earth. We work very well as a team and we are trying to focus on one exciting project at a time rather than one exciting project a day.

I think we need more regulation in the industry, particularly in the area of non-surgical treatments, although this is a very contentious and dangerous issue. I think we should be working towards this.

I have a varied interest in music and play bass guitar in a band, which is one of my main forms of relaxation. We are currently putting together a Commitments line up of songs to perform at my imminent 50th birthday party. We’re also planning to perform regularly in other events. I am also a keen squash player and very interested in making films, and have made a number of short feature films with a friend. I am also the chairman of a local medium-sized festival that attracts 15,000 people a year.

I often end my day by taking my dog for a walk to the pub 100 yards from my house to have a quick pint with my friends. Before I go to bed, I tend to play my guitar, which I try to do every day, and do try and read - usually non-fiction inspirational books. Generally I try to be happy and positive and my motto would be “Enjoy yourself, it’s later than you think”.

My final thought of the day? If you have enough energy, focus and drive, and if you have a dream you should aim for the skies.”

IN bUSINeSS a Day IN The lIfe

As part of this month’s Day in the Life, Antonia Mariconda talks to plastic surgeon Adrian Richards

The secret diar y of Adr ian richards

Adrian Richards, is one of the UK’s much loved consultant plastic surgeons. The surgical director of Aurora Clinics and Cosmetic Courses and senior lecturer at Anglia Ruskin University, talks here about a typcial day in his life.

Antonia Mariconda also known as ‘The Cosmedic Coach’ is a health and beauty writer, and author of four books. She is quoted in national and consumer press such as the BBC, Times, Top Santé, The Evening Standard, Daily Mail, and Metro, for her knowledge on beauty and aesthetics, and cosmetic surgery. Antonia also independently advises clients both from the UK and around the world on where and where not to shop safely for cosmetic surgery, beauty, aesthetic medicine, and anti-ageing treatments. Her client list includes A-list celebrities, Royalty and VIPs.Follow Antonia on Twitter @CosmedicCoach or join Antonia on Facebook where you will be updated about events and happenings in the world of health and beauty. www.thecosmediccoach.com


intraceuticalsi t ’ s i n t h e s k i n

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The Intraceuticals range complements all of our non-surgical treatments •and is a huge hit

Skin is glowing and hydrated; • clientscannotbelievetheresultsfor such a relaxing, no downtime treatment”

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Dr. Scott Gerrish is one of the most experienced and respected doctors in the DC metro area. As Medical Director of Bellini, Dr. Gerrish leads a team of professionals in his full-service medical spa. He is the founder of the revolutionary Fraxel® Boost concept which delivers the anti-aging properties of Fraxel® with no down-time.

Since 1996, Dr. Gerrish leads the way in offering the most comprehensive collection of anti-aging medically directed cosmetic procedures and is one of the most sought after physicians in the area. As one of the first medical spa doctors in Virginia, he has trained dozens of medical practitioners including doctors, physician assistants, nurses and estheticians in the art and science of medical esthetics.

What other people are saying about Intraceuticals

Dr. Scott GerrishMedical DirectorUSA

Dr.scottgerrish,MedicalDirector“The addition of the Intraceuticals Infusion to our Fraxel™ resurfacing protocols has increased our patient rebooking and retention. Anyone who does a laser resurfacing treatment would never do it again without including an Intraceuticals oxygen delivered treatment.”

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see us at

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cosmetic newsexpo

Intraceuticals oxygen delivered treatments combine hyperbaric oxygen with professional grade HA acid & a range of bespoke vitamins and anti-oxidants for instant results.

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HAIR VOLUME

l Thicker/stronger hair l Improved coverage

GloPRP, the next big thing in non-surgical facelifts and skin rejuvenation.Producing high quality PRP has been an expensive or complicated business, until now….Our no-compromise, patented, easy-to-use, GloPRP system gives the highest quality PRP at an affordable price, giving great results and a very short payback time.

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GloPRP, the next big thing in non-surgical facelifts and skin rejuvenation. Producing high quality PRP has been an expensive or complicated business, until now…. Our no-compromise, patented, easy-to-use, GloPRP system gives the highest quality PRP at an affordable price, giving great results and a very short payback time.

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SKIN REGENERATION

Recovery/Preservation of skin tension •Bright and younger skin appearance •Smoothing of wrinkles and acne scars •Wound healing•Improves the outcome of other •conventional therapies such as mesotherapy and autologous fat injection

HAIR VOLUME

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cosmetic newsexpo


FEBRUARY•2 Aesthetox Foundation Botox and Fillers, Birmingham,

www.aesthetox.co.uk

2 Aesthetox Masterclass Botox and Fillers, Birmingham,

www.aesthetox.co.uk

4-5 Ultrasonic Lipo-cavitation The non-invasive alternative to

Liposuction, Cawood House, Sutton, Ely, Cambs, 01353777303/07747696815

5 Level 2 Advanced Toxin: Lower Face, Medex House, Loughborough, Leicestershire, www.

aesthetictrainingcourses.com or 01509 239696

5 Level 2A Advanced Toxin: Easy Switching Between Toxins,

Medex House, Loughborough, Leicestershire,

www.aesthetictrainingcourses.com or 01509 239696

[email protected],

www.academyofadvancedbeauty.com

6 Ultrasound for Skin Rejuvenation and Wrinkle Reduction,

01353 777303/07747 696815, barbara@academyofadvancedbeauty.

com, www.academyofadvancedbeauty.com

7 Diamond Microdermabrasion for Face and Body,

01353777303/07747696815, barbara@academyofadvancedbeauty.


8 Advanced Facial Treatment, 01353777303/07747696815,

[email protected],


9 Innomed Training Chemical Peeling Systems: Comprehensive Course for New Users, Central

London, www.innomedtraining.co.uk

9 Innomed Training Advanced Botulinum Toxin: Lower Face, Neck,

Under-Arm Hyperhidrosis, Southampton, www.innomedtraining.co.uk

10 Innomed Training Advanced Dermal Fillers: Facial Contours, Lip Filler, Skin-Hydration,

Southampton, www.innomedtraining.co.uk

10 Innomed Training Mesotherapy for Fat, Cellulite and Skin

Rejuvenation: New Users, Central London, www.innomedtraining.co.uk

10 Aesthetox Foundation Botox and Fillers,

London, www.aesthetox.co.uk

11 Micro-needling, Boston International Training Academy Ltd, Bayswater,

London, 0207 727 1110; www.boston-medical-group.co.uk

13 Neostrata Training Day Harley Street, London, 01234 313 130;

www.aestheticsource.com

16 Aesthetox Foundation Botox and Fillers, Birmingham,

www.aesthetox.co.uk

16 Innomed Training Botulinum Toxin in Facial Aesthetics: New Users

BACN RUNS BUSINESS SKILLS WORKSHOP The British Association of Cosmetic Nurses is hosting a business skills workshop. The event will take place on Monday March 11 at The Royal College of Obstetricians and Gynaecologists, in Sussex Place, Regents Park, London and costs £60 for BACN members or £90 for non-members, including refreshments and lunch. The event will include top tips and golden nuggets to move your clinic up a level and to guide you in the aesthetics business. Contact the BACN office for more details.

ROYAL SOCIETY OF MEDICINE’S INTERVENTIONAL COSMETICS GROUP HOLDS 5TH INTERNATIONAL MULTIDISCIPLINARY ANNUAL MEETING The Royal Society of Medicine’s Interventional Cosmetics Group will hold its 5th International Multidisciplinary Annual Meeting at the RSM in Wimpole Street on Monday February 25. The meeting will explore Interventional Cosmetics: New and Controversial Treatments and will feature lectures on New Cosmetic Applications for Botulinum Toxin, Botulinum Misconceptions, Fillers within the Orbital Rim, Blindness and Worse after Filler Injections and Mini-liposuction & Mini-lipofilling of the Face. On Saturday and Sunday, February 23-24, at the same venue The 2nd EADV/ESCAD Fostering Course in Interventional Cosmetics for Trainees/Residents Practical Hands-on Workshop on Botulinum & Fillers for Beginners will also take place.

NEW ONLINE COURSES PROVIDE HIGH LEVEL SKINCARE TRAINING

A range of online skincare courses aimed at medical practitioners and professional beauty therapists is being launched by Sally Durant Training & Consultancy. The courses give medical professionals such as doctors, dentists and aesthetic nurses - specific training in clinical cosmetic dermatology which they will not have received as part of their general medical training. The courses also take beauty therapy training beyond

its usual NVQ 3 level and provide the higher level training that will enable therapists to build and develop their business. The portfolio includes 13 ‘knowledge based’ courses which are completed fully online. In addition, there are three practical courses in advanced beauty and aesthetic procedures, with the majority of the background study delivered online and supporting practical sessions held either at the client’s premises or at a number of satellite centres conveniently located throughout the country. The courses are certified by the International Institute of Skin, Health and Clinical Aesthetics (IISHCA), and validated by the international awarding body, IQ Industry Qualifications. They are written to achieve full CPD accreditation and accepted by all relevant professional indemnity insurers.

HABIA ANNOUNCES HSA LASER AND LHR COURSES FOR 2013

The Habia Skills Academy (HSA) had announced another series of Laser and Light Hair Removal courses. The intensive courses, which are delivered at Level 4, begin this April with further courses available up until October 2013. All courses take place at The

Spa Leamington in Leamington, Warwickshire. Each course lasts four non-consecutive days (two groups of two days) and covers the expert knowledge required for those looking to teach advanced laser and laser hair removal skills to others. The courses, which are being supported by Lynton Lasers and Polaris Medical, will be delivered by Barbara Green and Gill Herrick. Gill said, “The new qualification in Laser and Light systems require educators to be knowledgeable and up to date. This HSA course achieves just this as it revisits the basic principles as well as looking at the treatments from a training perspective.”

date s for th e d iary

we round up upcoming events, training courses and meetings



cosmetic newsexpo

incorporating

DaTeS foR The DIaRyTRaININg NewS

(incl. all major brands), Central London, www.innomedtraining.co.uk

16-17 Cosmetic News Expo and Aesthetics Conference 2013, The Business

Design Centre, Islington, London, www.cosmeticnewsuk.com

17 Innomed Training Dermal Fillers in Facial Aesthetics: New Users to

Hyaluronic Acid Fillers, Central London, www.innomedtraining.co.uk

21 Microsclerotherapy, Medex House, Loughborough, Leicestershire,


22 Cosmetic Courses Business, Marketing and Managing

Complications Seminar, www.cosmeticcourses.co.uk

23 Cosmetic Courses Foundation Botulinum Toxin and Dermal Fillers,

www.cosmeticcourses.co.uk

25 Obagi Workshop, London, www.healthxchange.com

25 Innomed Training Sculptra Beginners: Day 2 (Day 1 on January 21) Southampton, www.

innomedtraining.co.uk

26 Level 3 Toxin Masterclass: Neck, Jawline and Nefertiti Lift,



28 Cosmetic Courses Dermaroller, www.cosmeticcourses.co.uk

MARCH•1 Cosmetic Courses Chemical Peel and Microdermabrasion,

www.cosmeticcourses.co.uk

2 Aesthetox Foundation Botox and Fillers, Birmingham,

www.aesthetox.co.uk

2 Aesthetox Microsclerotherapy, Birmingham, www.aesthetox.co.uk

3-4 Dermal Fillers and Botulinum Toxin Foundation Course, Boston

International Training Academy Ltd, Bayswater, London,

0207 727 1110; www.boston-medical-group.co.uk

4 Obagi Workshop, Manchester, www.healthxchange.com

4-5 Ultrasonic Lipo-cavitation The non-invasive alternative to

Liposuction, Cawood House, Sutton, Ely, Cambs, 01353777303/

07747696815, [email protected],


5 Level 2 Advanced HA Dermal Filler: Lower Face Shaping,



6 Ultrasound for Skin Rejuvenation and Wrinkle Reduction,



7 Diamond Microdermabrasion for Face and Body,



7 Glyderm Skincare and Glycolic Acid Peels, Medex House, Loughborough, Leicestershire,

www.aesthetictrainingcourses.com

or 01509 239696

8 Pressotherapy for Lymphatic Drainage and Cellulite

Reduction, 01353777303/07747696815,

[email protected],


obagi blue peel Workshop, (14 may), glasgow, www.healthxchange.com

obagi blue peel Workshop, (14 June), london, www.healthxchange.com

the dates for the diary section is now a paid for section of the magazine and is a chance for you to advertise your training courses to our readers both in the

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Laser Support Services Ltd. School Drive - Ovenstone - Fife - KY10 2RR

Tel: 01333-311938 Fax 01333-312703 www.laser-support.co.uk — Email [email protected]





Mouthguards


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Patient protective eyewear •Laser safety eyewear •Disposable Laser, IPL and LED •eyewear Mouthguards •Laser surgical instruments •Safety signage •Safety interlocks •Laser safety curtains•

Laser Support Services has been supplying laser products since 1990. All supplies conform to

current EC safety standards

Laser Support Services Ltd.School Drive - Ovenstone - Fife - KY10 2RR

Tel: 01333-311938 Fax: 01333-312703www.laser-support.co.uk —

Email [email protected]


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cosmetic newsexpo

ABC Laser Contact: Guy GouldsmitT: 08451 707 788E: [email protected] W: www.abclasers.co.uk

Aesthetic Source Contact: Sharon MorrisT: 01234 313 130 E: [email protected]: NeoStrata and Exuviance - Innovation in Aesthetics delivered to you.

Aesthetox Academy - Contact: Lisa Tyrer Service: TrainingT: 0870 0801746E: [email protected]: www.aesthetox.co.uk

Allergan - Contact: Customer ServiceT: 0808 2381500W: www.juvedermultra.co.uk

AZTEC Services - Contact: Anthony Zacharek Service: Exclusive UK distributor for Viora product rangeT: 07747 865600 E: [email protected] W: www.aztecservices.uk.com

Bioptica Laser AestheticsContact: Mike ReganT: +44 (0)7917 573466E: [email protected] W: www.bla-online.co.uk Services: Core of Knowledge Training and Laser Protection Adviser (LPA) Services.

Boston Medical Group LTDContact: Iveta VinklerovaT: 0207 727 1110E: [email protected]: www.boston-medical-group.co.uk

Candela UK LtdContact: Michaela BarkerT: 0845 521 0698E: [email protected]: www.syneron-candela.co.uk

Carleton Medical LtdContact: Nick FitrzykT: 01633 838 081E: [email protected]: www.carletonmedical.co.ukServices: UK distributor of Asclepion Lasers

ChromogenexService: Laser System Manufacturer Contact: Lauren Roberts T 01554 755444 E: [email protected] W: www.chromogenex.com

Eden Aesthetics - Contact: Anna PerryT: 01245 227 752 E: [email protected]: www.edenaesthetics.com

Energist - Contact: Andrew SnoddonT: 01792 798768E: [email protected] W: www.energist-international.com

Galderma - Contact: Azzalure Sales TeamT: 01923 208950E: [email protected] W: www.galderma.co.uk

Hamilton Fraser - Contact: Wai ChanT: 0845 3106 300E: [email protected] W: hamiltonfraser.co.uk

Healthxchange PharmacyContact: Steve JoyceT: +44 (0)1481 736837 F: +44 (0)1481 736677E: [email protected]: www.healthxchange.comW: www.obagi.uk.com

Laser PhysicsContact: Customer ServicesT: 01829773155E: [email protected]: www.laserphysics.co.uk

Lifestyle Aesthetics- Contact: Sue WalesT: 0845 0701 782 E: [email protected]: www.lifestyleaesthetics.com

Lynton - Contact: Customer ServicesT: 0845 6121545 E: [email protected]: www.lynton.co.uk

Med-fxContact: Faye Price T: 01376 532800E: [email protected]: www.medfx.co.uk

Medical Aesthetic GroupContact: David GowerT: 02380 676733 E: [email protected]: www.magroup.co.uk

Merz AestheticsContact: Merz Aesthetics Customer ServicesT: 0333 200 4140E: [email protected]

Mesoestetic UK - Contact: Adam BirtwistleT: 01746 718123E: [email protected]: www.mesoestetic.co.ukServices: Cosmeceutical Skincare Treatment Solutions. Cosmelan. Antiagaing, Depigmentation, Anti Acne, Dermamelan.

Polaris LasersContact: Neil CalderT: 01234841536 E: [email protected]: www.polaris-laser.com

Q-Med, a Galderma DivisionContact: Customer ServiceT: 01923 208950E: [email protected]: www.q-medpractitioner.com/uk

SkinBrandsContact: Tracey BeesleyT: 0289 983 739E: [email protected] W: www.skinbrands.co.uk

Skin Geeks LtdContact: Customer ServicesT: +44 (0)1865 338046E: [email protected]: www.skingeeks.co.uk

Sound Surgical (UK) LTDContact: Raj JainT: +44 7971 686114E: [email protected]: www.SoundSurgical.co.uk

Zanco ModelsContacts: Mr Ricky ZancoT: 08453076191E: [email protected]: www.zancomodels.co.uk

DIRecToRy

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for the delivery of activesubstances.

Tel: 01234 841536 www.polarismedicallasers.co.uk

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≤ 25°C

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

(≥ 1/10,000, < 1/1000); very rare (< 1/10,000). Infections and infestations; Uncommon: bronchitis, nasopharyngitis, influenza infection. Psychiatric disorders; Uncommon: depression, insomnia. Nervous system disorders; Common: headache; Uncommon: facial paresis (brow ptosis), vasovagal syncope, paraesthesia, dizziness. Eye disorders; Uncommon: eyelid oedema, eyelid ptosis, blurred vision, eye disorder, blepharitis, eye pain. Ear and Labyrinth disorders; Uncommon: tinnitus. Gastrointestinal disorders; Uncommon: nausea, dry mouth. Skin and subcutaneous tissue disorders; Uncommon: pruritus, skin nodule, photosensitivity, dry skin. Musculoskeletal and connective tissue disorders; Common: muscle disorders (elevation of eyebrow), sensation of heaviness; Uncommon: muscle twitching, muscle cramps. General disorders and administration site conditions; Uncommon: injection site reactions (bruising, pruritis), tenderness, Influenza like illness, fatigue (tiredness). General; In rare cases, localised allergic reactions; such as swelling, oedema, erythema, pruritus or rash, have been reported after treating vertical lines between the eyebrows (glabellar frown lines) and other indications. Overdose May result in pronounced neuromuscular paralysis distant from the injection site. Symptoms are not immediately apparent post-injection. Bocouture® may only be used by physicians with suitable qualifications and proven experience in the application of Botulinum toxin. Legal Category POM. List Price 50 U/vial £72.00. Product Licence Number PL 29978/0002. Marketing Authorisation Holder Merz Pharmaceuticals GmbH, Eckenheimer Landstraße 100, 60318 Frankfurt/Main, Germany. Date of revision of text FEB 2012. Full prescribing information and further information is available from Merz Pharma UK Ltd., 260 Centennial Park, Elstree Hill South, Elstree, Hertfordshire WD6 3SR. Tel: +44 (0) 333 200 4143

Adverse events should be reported. Reporting forms and information can be found at yellowcard.mhra.gov.uk. Adverse events should also be reported to Merz Pharma UK Ltd at the address above or by email to [email protected] or on +44 (0) 333 200 4143.

1084/BOC/JUN/2012/JH Date of preparation June 2012Bocouture® is a registered trademark of Merz Pharma GmbH & Co, KGaA.

BOTOX® is licensed for the treatment of moderate to severe glabellar lines

Delivers long-lasting patient satisfaction, time after time2,3

Has been used for over 20 years in over 26 million treatment sessions worldwide6

Is the world’s first and most studied botulinum toxin*7

UK/0008/2013 Date of Preparation: January 2013

Botox® (botulinum toxin type A) Abbreviated Prescribing InformationPresentation: Botulinum toxin type A (from clostridium botulinum), 50 or 100 or 200 Allergan Units/vial. Indications: Temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown (glabellar lines), in adults <65 years, when the severity of these lines has an important psychological impact for the patient. Dosage and Administration: See Summary of Product Characteristics for full information. Do not inject into blood vessels. Doses of botulinum toxin are not interchangeable between products. Not recommended for patients <18 or >65 years. Use for one patient treatment only during a single session. Reconstitute vial with 1.25ml of 0.9% preservative free sodium chloride for injection (4U/0.1ml). The recommended injection volume per muscle site is 0.1ml (4U). Five injection sites: 2 in each corrugator muscle and 1 in the procerus muscle: total dose 20U. Contraindications: Known hypersensitivity to any constituent. Infection at proposed injection site(s). Warnings/Precautions: Relevant anatomy and changes due to prior surgical procedures must be understood prior to administration. Serious adverse events including fatal outcomes have been reported in patients who had received off-label injections directly into salivary glands, the oro-lingual-pharyngeal region, oesophagus and stomach. Do not exceed recommended dosages and frequency of administration. Adrenaline and other anti-anaphylactic measures should be available. Reports of side effects related to spread of toxin distant from injection site, sometimes resulting in death. Therapeutic doses may cause exaggerated muscle weakness. Caution in patients with underlying neurological disorder and history of dysphagia and aspiration. Patients should seek medical help if swallowing, speech or respiratory disorders arise. Clinical fluctuations may occur during repeated use. Too frequent or excessive dosing can lead to antibody formation and treatment resistance. The previously sedentary patient should resume activities gradually. Caution in the presence of inflammation at injection site(s) or when excessive weakness/atrophy is present in target muscle. Caution when used for treatment of patients with peripheral motor neuropathic disease. Use with extreme caution and close supervision in patients with defective neuromuscular transmission (myasthenia gravis, Eaton Lambert Syndrome). Contains human serum albumin. Procedure related injury could occur. Pneumothorax associated with injection procedure has been reported. Interactions: No interaction studies have been performed. No interactions of clinical significance have been reported. Theoretically, the effect may be potentiated by aminoglycoside antibiotics or other drugs that interfere with neuromuscular transmission. Effects of administering different botulinum toxin stereotypes simultaneously, or within several months of each other, is unknown and may cause exacerbation of excessive neuromuscular weakness. Pregnancy: BoTox® should not be used during pregnancy unless clearly necessary. Lactation: Use during lactation cannot be recommended. Adverse Effects: See Summary of Product Characteristics for full information on side effects. Based on controlled clinical trial data, the proportion of patients that would be expected to experience an adverse reaction after treatment is 23.5% (placebo: 19.2%). In general, reactions occur within the first few days following injection and are transient. Pain/

burning/stinging, oedema and/or bruising may be associated with the injection. Frequency By Indication: Defined as follows: Very Common (> 1/10); Common (>1/100 to <1/10); Uncommon (>1/1,000 to <1/100); Rare (>1/10,000 to <1/1,000); Very Rare (<1/10,000). Infections and infestations. Uncommon: Infection. Psychiatric disorders. Uncommon: Anxiety. Nervous system disorders. Common: Headache. Uncommon: Paresthesia, dizziness. Eye disorders. Common: Eyelid ptosis. Uncommon: Blepharitis, eye pain, visual disturbance. Gastrointestinal disorders. Uncommon: Nausea, oral dryness. Skin and subcutaneous tissue disorders. Common: Erythema, Uncommon: Skin tightness, oedema (face, eyelid, periorbital), photosensitivity reaction, pruritus, dry skin. Musculoskeletal and connective tissue disorders. Common: Localised muscle weakness, Uncommon: Muscle twitching. General disorders and administration site conditions. Common: Face pain, Uncommon: Flu syndrome, asthenia, fever. Adverse reactions possibly related to spread of toxin distant from injection site have been reported very rarely (exaggerated muscle weakness, dysphagia, constipation or aspiration pneumonia which can be fatal). Rare reports of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Rare reports of serious and/or immediate hypersensitivity (including anaphylaxis, serum sickness, urticaria, soft tissue oedema and dyspnoea) associated with BoTox use alone or in conjunction with other agents known to cause similar reaction. Very rare reports of angle closure glaucoma following treatment for blepharospasm. New onset or recurrent seizure occurred rarely in predisposed patients, however relationship to botulinum toxin has not been established. Needle related pain and/or anxiety may result in vasovagal response. NHS Price: 50 Units: £77.50, 100 Units: £138.20, 200 Units £276.40. Marketing Authorization Number: PL 00426/0074 Marketing Authorization Holder: Allergan Pharmaceuticals (Ireland) Ltd., Westport, Co. Mayo, Ireland. Legal Category: PoM. Date of preparation: December 2012.

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard

Adverse events should also be reported to Allergan Ltd. [email protected] or 01628 494026.

References: 1. De Almeida A et al. Dermatologic Surgery 2007;33:S37–43. 2. Carruthers A et al. J Clin Res, 2004;7:1–20. 3. Stotland MA et al. Plast Reconstr Surg, 2007;120:1386–1393. 4. Beer KR et al. J Drugs Dermatol, 2011;10(1) :39–44. 5. Lowe et al. Am Acad Dermatol, 2006;55:975-980. 6. Allergan data on file. BoTGL/001/SEP 2011 7. Allergan Data on FileVIS/006/JUL2011.*Allergan botulinum toxin type A. Global figures. Launched in 1989 in the US.

onfidence isC Reliable1,2

Rewarding3

Performance4,5

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