The Harley Street Journal

Bi-monthly newspaper for the cosmetic and plastic surgery sector

cosmetic surgery

Expert Opinion

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10096026_xxlIt’s not only women who are opting for cosmetic procedures. Recent figures show that men are also going under the knife to look good. THSJ asked Dr Sanjay Rajpara

how SmartLipo Triplex can help men suffering with Gynecomastia.

Why should men be considering SmartLipo Triplex to treat Gynecomastia?

Up until now plastic surgery procedures or traditional liposuction have been the only available options for men. I believe men should explore new minimally invasive options as old surgical procedures are associated with more complications- and also they fail to tighten the skin causing irregularities and scarring.

As a minimally invasive technique, lasers have been used for treating Gynecomastia with encouraging results. SmartLipo Triplex is one step ahead as it has the ability to treat this condition with minimum invasion and down time and also ability to tighten the skin giving it the most desirable shape for the men’s chest.

What is SmartLipo Triplex and how does it work?

SmartLipo MPX is the first dual-wavelength laser system specifically designed for body sculpting and weight loss.  Unlike liposuction, which attacks solid fat, this safer alternative zaps fat cells with laser energy delivered through a cannula under the skin. The system’s proprietary pulsing format melts the fat tissue, which is then drained away as waste.

Cynosure’s FDA approved SmartLipo Triplex treatment is equipped with the ThermaGuide feature, which constantly measures the temperature under the skin and controls the output of energy. This ensures that the treatment area stays within a safe range so that it is hot enough to work efficiently, but not so hot as to cause the patient harm.

SmartLipo Triplex laser energy also coagulates the tissue reducing the bleeding; and has a unique ability to heat up the collagen. This results in new collagen formation with tightening of the skin. This in turn reduces the chances of having any loose skin left and sculpts the skin to the body’s contours. Gynecomastia treatment with SmartLipo Triplex causes fewer complications compared to standard surgery and lipolysis; with faster recovery and superior aesthetic results.

Availability: For more information visit www.cynsosure.com

Cosmetic Surgery Firm Directors That Go Bust To Avoid Payouts To Be Banned From Running New Clinics

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7251789_xxlBosses of cosmetic surgery firms that go bankrupt and leave patients helpless are to be barred from running new health clinics.

A Government crackdown will mean the directors of surgery firms that go bust, as well as those found guilty of providing poor care, will not be allowed to close then re-open weeks later under a new name.

In February the Department of Health announced the introduction of a ‘fit and proper person test’. For the first time, incompetent bosses will be refused a licence to run a health clinic by the regulator, the Care Quality Commission.

The rules will apply to those holding top jobs in both the NHS and private sector and will also mean that unfit directors can be removed from their job.

Care and Support Minister Norman Lamb said:

“This test will allow us to make sure that those leading health and care organisations are up to the job, and to remove those who are not- including those who have presided over poor care.”

Rise of Medical Tourism Shows Impact On Cosmetic Surgery Market

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8193012_xlA recent paper, by ASPS Member Surgeon Dr. Kevin C. Chung and Lauren E. Franzblau of the University of Michigan, discusses “the rise and transformation of the medical tourism industry, foreign and domestic forces that influence cosmetic surgical tourism, and the pros and cons for all involved parties.”

“The rapid globalisation of the industry also marks a fundamental shift in the world’s perception of elective procedures: patients are becoming consumers and these medical services are being viewed as commodities,” say Chung and Franzblau.

More ‘Medical Tourists’ Are Traveling for Cosmetic Surgery

Travelling for medical care is nothing new — but in the past, people were more likely to travel from poor countries to obtain higher-quality care in wealthier countries. Today, prompted by the ease and relatively low costs of travel, more patients from the United States and other western countries are travelling to the developing world to access less-costly medical and surgical procedures. Because cosmetic plastic surgery procedures aren’t covered by insurance, they make up a major part of the burgeoning medical tourism market.

Figures vary, but there’s a consensus that medical tourism is growing rapidly: India alone may have more than one million medical tourists per year. Other countries with growing medical tourism industries include Mexico, Dubai, South Africa, Thailand and Singapore.

Prices for cosmetic surgery in these countries are typically much lower than at home. For example, a breast augmentation procedure that would cost £4,000 in the U.S. can be done for £1,200 in India. Even after the costs of airfare are factored in, having an operation overseas can be much less expensive.

In many countries, governments are working actively to foster their medical tourism industry. Some destinations even market procedures performed in resort-like settings, encouraging patients to combine a vacation with cosmetic surgery. Travelling abroad also lets patients recuperate privately, without anyone at home knowing that they’ve had plastic surgery.

Raising Potential Concerns Over Safety and Quality

The growth of medical tourism may have a significant impact on the cosmetic surgery market in the U.S., but also raises concerns over physical safety and legal protection. Although destination countries promote the quality and safety of their procedures and facilities, there is often little evidence to support these claims.

“Because the practice of medical travel does not appear to be going away in the foreseeable future, plastic surgeons must understand the international market and learn to compete in it,” Chung and Franzblau write.

Since U.S. surgeons may find it hard to compete on price, effective strategies may include emphasising superior quality and safety of care, or developing “niche markets” of procedures that can be profitably performed at home.

The authors emphasise that medical tourism  “is not purely good or bad” – neither for patients nor the countries involved. Patients may be drawn by lower costs, but must consider the potential risks of undergoing surgery in a foreign country, as well as travelling after surgery.

Latin Americans Top For Plastic Surgery

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11955234_xxlAccording to the American Society of Plastic Surgeons (ASPS), there were 14.6 million cosmetic plastic surgery procedures performed in the U.S. alone in 2012, up 5% from the previous year.

Additionally, 5.6 million reconstructive plastic surgery procedures were performed last year, up 1 percent. While plastic surgeries have seen an increase, the procedures tend to be focused in certain countries.

According to the International Society of Aesthetic Plastic Surgery (ISAPS), Italy, Greece, and South Korea had the most aesthetic/cosmetic procedures per 1,000 people.

Latin Americans who have the highest percentage of procedures per 1,000 people were Colombia, Brazil, and Venezuela.

The top cosmetic minimally-invasive procedure was Botulinum toxin type A, with 6.1 million procedures, and the top cosmetic surgical procedure breast augmentation, with 286,000 procedures.

Breast Augmentations On The Up Due To Satisfactory Results, Say Surgeons

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According to US surgeons Dr. Jerome H. Liu and Dr. Tom S. Liu the consistent increase in popularity of breast augmentation is evidence of continued patient satisfaction with the results of the procedure.

The plastic surgeons say, when a woman increases her breast size, she can often gain a more youthful appearance. In addition, breast enlargement can improve the overall proportion/balance of a woman’s figure, as well as provide a more contoured, sensual look to the breasts. However, the surgeons say breast augmentation can not only dramatically change a woman’s appearance but also significantly impact and improve self-esteem.

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Many of the doctors’ breast augmentation patients are women who have lost some volume in their breasts due to pregnancy or breast-feeding, they say. Some of these women have experienced decreased levels of confidence and a lower self-image and seek to restore the breasts to their original size and shape.

At the same time, other patients consider the procedure because of simple dissatisfaction with the size of their breasts, or the desire to achieve fuller, more youthful breast contours. Overall, the doctors say breast augmentation can have both cosmetic and emotional benefits, helping patients add volume to the breasts and feel more confident about the way they look.

Faulty breast implant firm founder to serve four years

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iStock_000010195246_LargeA French court has sentenced Jean-Claude Mas, the founder of Poly Implant Prothèse (PIP), to four years in prison on aggravated fraud charges for selling breast implants filled with industrial-grade silicone that were prone to rupture to some 300,000 women in 65 countries.

Mas, 74, was also ordered to pay €75,000 in fines.

PIP’s former general manager Claude Couty was sentenced to three years in prison, two of them suspended, and ordered to pay €30,000 in fines.

Quality control director Hannelore Font and production director Loic Gossart were each sentenced to two years with one year suspended while research director Thierry Brinon was given an 18-month suspended sentence.

Prosecutors had called for the defendants to receive sentences ranging from six months to four years in prison. They also urged the Marseille court to impose a €100,000 ($137,000) fine on Mas, who they dubbed “the sorcerer’s apprentice of implants”, and to ban him from working in medical services or from heading a company.

More than 7,000 women have declared themselves civil plaintiffs in the case and hundreds packed the court during the April trial, which was moved to the Marseille convention centre.

Health risks disputed

The scandal first emerged in 2010 after doctors noticed that PIP’s implants had unusually high rupture rates. During a month-long trial, the defendants admitted using industrial-grade silicone but Mas denied the company’s implants posed any health risks.

More than 7,500 women have reported ruptures in the implants and 15,000 have had them replaced in France alone.

Health officials in France and other countries including the Britain have said the implants are not toxic and do not increase the risk of breast cancer but have nevertheless urged their removal.

The court will not rule on the question of whether the implants pose a risk, only whether the five managers defrauded their clients as well as German safety standards firm TUV, which approved the implants for the mass market and was last month found liable in a case tried in the French city of Toulon. The court ruled that the firm had “neglected its duties” by failing to properly vet the implants.

TUV was ordered to pay more than €50 million in compensation to six distributors and to more than 1,600 women fitted with the implants.

Mas, a one-time travelling salesman who got his start in the medical business by selling pharmaceuticals, founded PIP in 1991 to take advantage of the booming market for cosmetic implants.

He built the company into the third-largest global supplier of implants but came under scrutiny when plastic surgeons began reporting an unusual number of ruptures in his products.

Health authorities later discovered he was saving millions of Euros by using industrial-grade silicone gel in 75 percent of the implants. PIP implants were banned and the company was eventually liquidated.

PIP had exported more than 80 percent of its implants, with about half going to Latin America, about a third to other countries in Western Europe, about 10 percent to Eastern Europe and the rest to the Middle East and Asia.

The British Association of Aesthetic Plastic Surgeons warned in December that, although criminal behaviour cannot be prevented by regulation, the system ‘endangered’ the safety of women worldwide by failing to discover Mas’ illegal activities over ten years.

Consultant plastic surgeon and BAAPS President Rajiv Grover said:

“There can be no way of compensating the victims of PIP for the scale of this betrayal, and in that respect no sentencing can ever be adequate punishment. It’s appalling that it has been years since the PIP crisis first made headlines in the UK and despite the Government urging the private sector to replace the defective devices, thousands of women are still left with no support from their original providers.

“Whilst there is no way for regulation to prevent criminal behaviour, undoubtedly the system failed hundreds of thousands of women worldwide who, for all anyone knew, could have been walking around with implants filled with toothpaste. That such a dangerous situation was allowed to develop unchecked over the last ten years is totally unacceptable and we welcome the implementation of pragmatic changes that will protect patients in the future.”

More men over 50 are choosing cosmetic surgery to reduce ‘moobs’

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13746038_xxlBrent Tanner, consultant plastic surgeon and council member of the British Association of Aesthetic Plastic Surgeons, told Irish Mirror that most men want to avoid looking like their fathers.

“Men are increasingly aware of their looks, and many are seeking to take action to improve their appearance. The biggest change in recent years has been the number of men over 50 who are opting for plastic surgery,” he explained.

“Most of the men I see are regularly in the gym and eat sensibly. They’ve done their bit, and now want surgery to do the rest.  Most who are unhappy with their chests simply want their so-called man boobs reduced so they can feel confident on the beach,” he said.

Mr Tanner explained a smaller number of older men choose chest implants which can help them achieve a stronger, more defined appearance.

“The important thing for them to remember though is that if you do not keep up the exercise, it can look rather odd if your chest looks like it belongs to a 30-year-old and the rest of your body is flabby.”

As with any cosmetic procedure, it’s important patients review their expectations thoroughly before they decide to proceed. A lot of men I see tell me they simply want to avoid looking like their fathers,” he concluded.

First Government Recommendation from Cosmetic Surgery Review to be Implemented: Insurance for Patients

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11955166_xxlIn the wake of the findings from the Government enquiry into cosmetic surgery published in 2013, the British Association of Aesthetic Plastic Surgeons is first to announce the implementation of one of the report’s major recommendations: for patients to be protected through insurance. The only aesthetic surgical society to conduct a yearly audit of the procedures performed by its members, the BAAPS was able to work with the world’s leading specialist insurance market, Lloyd’s of London, to create a policy that will safeguard all patients of surgeons who are part of the Association.
The ‘Aesthetic Surgery Commitment’ or ‘ASC’ policy (www.asurgerycommitment.com) is groundbreaking in that not only does it cover corrective treatment of all the most common complications of surgery (such as infection or bleeding) but also – a world first – capsular contracture, an abnormal reaction of the body to breast implants.

According to consultant plastic surgeon and BAAPS President Rajiv Grover:

“In line with Sir Bruce Keogh’s recommendations for more safeguards in the aesthetic surgery sector, we are pleased to launch a truly innovative insurance package that will further protect our patients. No procedure is risk-free and ASC covers all common complications, so people undergoing surgery with BAAPS members can enjoy peace of mind that they will be looked after, in the unlikely event of any problems.”

Females hair transplant surgery up 82%

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12503410_xxlWomen have previously suffered with hair loss in silence, but it seems more are now aware of the possible solutions available to them and are opting to invest in a cosmetic procedure to rectify problems.

One London clinic has witnessed an 82% increase in the number of women undergoing hair transplants this year. The Private Clinic in London claims that not only are male patient numbers rising, but the number of women choosing to undergo hair transplants is on the rise too – with 39 the average age for treatment

Hair transplant surgeon Dr Raghu Reddy puts this down, in part, to a better awareness of the problem of hair loss and the possible remedies.

“I think women are more knowledgeable today than they were a few years ago about the viable solutions to hair loss,” says Dr Reddy.

“While high-profile male celebrities who have undergone hair transplants have undoubtedly helped make more men in the UK open to the possibility of a hair transplant, this has actually also encouraged more women to consider the option of investing in a transplant. Now, women are more informed and better placed to address the problem.”

Contrary to popular belief, the same hair transplant procedure can be delivered to women as it can to men; this is known as an FUE transplant (Follicular Unit Extraction).

The procedure is delivered under local anaesthetic and involves removing hairs from an area where the hair is plentiful and transplanting these into the areas on the woman’s head where the volume has been lost.

According to Dr Reddy there are a number of reasons why more and more women are seeking advice about hair loss. He said:

“Many of the women I see have worn extensions for many years, which have put a lot of traction on the existing hair, while in some cases glue applied to the roots to join extensions has also starved the hair of its own vital nutrients.”

“Over time this causes the hair to thin and if this is not addressed it can turn into a more concerning condition known as traction alopecia, something which means the hair will not grow back.”

“The same can occur with over-styling – the prolonged use of hair straighteners or heated curlers can weaken the hair and gradually cause bald patches to form.”

Keith Hobbs, Clinical Director of the Institute of Trichologists, added:

“Traction alopecia caused by extensions can cause temporary patchy hair loss. Long term use of extensions can in some cases cause permanent hair loss so using a product like Nioxin DiaBoost helps strengthen hair.”

Thousands Attend Reconstructive, Cosmetic and Non-Surgical Event

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9372668_xxlWith over fourteen days’ worth of educational and scientific content packed into two days of intense, focused activity, the first-ever Clinical Cosmetic & Reconstructive Expo (CCR) www.ccr-expo.com at London’s Olympia will not be soon forgotten by a medical sector which had never seen an event of its kind taking place in the UK.

Numbers of attendees which included aesthetic and reconstructive surgeons, cosmetic doctors and nurses clocked at 2,398 and 116% of the 1,170msq worth of stands sold this year has already been re-booked, with still a year to go before the next CCR Expo scheduled for 10-11 October, 2014 again at London Olympia.

The event, which saw over 120 exhibitors showcasing their wares was covered in high-profile mainstream media including the Times, Sunday Times, Mail on Sunday, Daily Mail and the Evening Standard as well as specialised trade press such as Independent Practitioner Today and Cosmetic News.

Three highly specialised conferences took place simultaneously, with lectures on a varied range of cutting-edge subjects; from hand transplants and separating conjoined twins, to discussions on cultural and societal beauty ideals, the correct proportions for breast augmentations and the latest in cosmetic injectables. Live demos of the newest technologies ran concurrently to the conferences, alongside animated and controversial debates which saw leading experts address the sector’s hottest topics.

Peter Jones, Chief Executive Officer for CCR Expo, said:

“We are thrilled with the reception given to this year’s programme – the feedback has been nothing less than fantastic and we are already full of exciting plans for next year; we will be offering double the demo area space, an additional theatre, double the free-of-charge workshop as well as injectables and dedicated cosmeceuticals education content. We have received confirmation from leading medical associations that wish to hold their annual scientific meetings at CCR – an amazing vote of confidence which will be fully justified as we roll out our 2014 strategies.”

Consultant plastic surgeon and Chairman of the Expo’s Medical Advisory Board Norman Waterhouse, who is also former President of the British Association of Aesthetic Plastic Surgeons (BAAPS), says;

“I couldn’t be more delighted with how the Expo panned out – our vision was to bring a fragmented sector together in one groundbreaking event; to learn from each other and help shape best practice for the profession and promote patient safety. Reviewing attendance numbers alongside the extraordinary feedback we have received, our objectives of sharing knowledge were successfully achieved, and we look forward to continuing to provide a positive platform to enhance dialogue and education for many years to come.”

With over fourteen days’ worth of educational and scientific content packed into two days of intense, focused activity, the first-ever Clinical Cosmetic & Reconstructive Expo (CCR) www.ccr-expo.com at London’s Olympia will not be soon forgotten by a medical sector which had never seen an event of its kind taking place in the UK.

Numbers of attendees which included aesthetic and reconstructive surgeons, cosmetic doctors and nurses clocked at 2,398 and 116% of the 1,170msq worth of stands sold this year has already been re-booked, with still a year to go before the next CCR Expo scheduled for 10-11 October, 2014 again at London Olympia. The event, which saw over 120 exhibitors showcasing their wares was covered in high-profile mainstream media including the Times, Sunday Times, Mail on Sunday, Daily Mail and the Evening Standard as well as specialised trade press such as Independent Practitioner Today and Cosmetic News.

Three highly specialised conferences took place simultaneously, with lectures on a varied range of cutting-edge subjects; from hand transplants and separating conjoined twins, to discussions on cultural and societal beauty ideals, the correct proportions for breast augmentations and the latest in cosmetic injectables. Live demos of the newest technologies ran concurrently to the conferences, alongside animated and controversial debates which saw leading experts address the sector’s hottest topics.

Peter Jones, Chief Executive Officer for CCR Expo, said:

“We are thrilled with the reception given to this year’s programme – the feedback has been nothing less than fantastic and we are already full of exciting plans for next year; we will be offering double the demo area space, an additional theatre, double the free-of-charge workshop as well as injectables and dedicated cosmeceuticals education content. We have received confirmation from leading medical associations that wish to hold their annual scientific meetings at CCR – an amazing vote of confidence which will be fully justified as we roll out our 2014 strategies.”

Consultant plastic surgeon and Chairman of the Expo’s Medical Advisory Board Norman Waterhouse, who is also former President of the British Association of Aesthetic Plastic Surgeons (BAAPS), says;

“I couldn’t be more delighted with how the Expo panned out – our vision was to bring a fragmented sector together in one groundbreaking event; to learn from each other and help shape best practice for the profession and promote patient safety. Reviewing attendance numbers alongside the extraordinary feedback we have received, our objectives of sharing knowledge were successfully achieved, and we look forward to continuing to provide a positive platform to enhance dialogue and education for many years to come.”