The Harley Street Journal

Bi-monthly newspaper for the cosmetic and plastic surgery sector

cosmetic treatments

Allergan Launches New Periorbital Treatment Protocol

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12794953_xxlAllergan have unveiled a new treatment protocol for periorbital revitalisation which incorporates a portfolio combination approach of both BOTOX® and the VYCROSS™ Collection of dermal filler treatments.

Developed in consultation with twelve European expert medical aesthetics practitioners, the latest guidance describes an approach for treating this challenging facial region which is holistic, individualised and stepwise.

As part of Allergan’s ongoing commitment to excellence in medical education, the new treatment protocol will be launched to over 15,000 medical practitioners across Europe as part of an extensive $6 million training programme, which is led by one of the leading global surgeons, Dr Mauricio De Maio.

Market trends and insights continue to underline the high importance of this facial region for patients, as it often represents one of the first areas considered for a cosmetic injectable treatment. Recent market research shows that crow’s feet lines are the most desired area for a facial injectable treatment, with under-eye bags and glabellar lines following closely behind in the top six areas of ageing concern.

Latest results from a new European survey also show that people are least happy with their eye area (versus other facial zones) – this unhappiness is more prevalent among women and peaks around the age of 40.

The top ageing concerns for the eye area were identified as dark circles, wrinkles and under-eye bags.

 

However, the periorbital region can represent a treatment challenge due to the complex anatomy and the need for advanced injection techniques. With this in mind, and based on feedback from the clinical community, Allergan supported the development of a new treatment protocol which provides expert guidance on periorbital anatomy, patient assessment and a stepwise approach to achieving optimal treatment outcomes using Allergan’s portfolio combination of BOTOX® and the VYCROSS™ Collection.

Mr Kambiz Golchin, a Consultant ENT and Facial Plastic Surgeon, says in his clinical practice, he sees high numbers of patients who want to refresh their eye area and address key ageing concerns like eye bags and crow’s feet lines, but who are concerned about maintaining a natural looking result and keeping their expressions.

“This is where Allergan’s new periorbital treatment protocol can play a role in guiding physicians through the treatment options now available for this complex area, in order to deliver results which reflect patients’ unique characteristics, ethnicity and personal treatment goals,” he explains.

“Expert training is key to ensuring these treatments are used correctly to deliver optimal results for patients.”

Allergan is a multi‐specialty health care company established more than 60 years ago with a commitment to uncover the best of science and develop and deliver innovative treatments and an evolving portfolio of pharmaceuticals, biologics, medical devices and over‐the‐counter consumer products.

BAPRAS React To Independent Medical Devices Review

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9922155_xxlBAPRAS has responded to recommendations from the independent review led by Professor Terence Stephenson into how medical devices are handled within the MHRA.

Graeme Perks, BAPRAS President and Consultant Plastic Surgeon, said the organisation was strongly supportive of the ‘useful and practical recommendations’ which they believe, if funded and implemented, will be an important step in improving patient safety and driving standards.

“A key recommendation put forward in the report is that patient records should be used to track what medical devices are given to patients,” Mr Perks explained.

“BAPRAS has continually pushed for the creation of a compulsory register for medical devices and as well as being part of the International Collaboration of Breast Registry Activities (ICOBRA), our Association is already working on a UK specific database pilot with Clinical Practice Research Datalink (CPRD), a research service jointly funded by the NHS National Institute for Health Research (NIHR) and the MHRA,” he said.

As cosmetic dermal fillers are classed as medical devices this is potentially a significant step in the right direction to improving this part of cosmetic practice also.

“The review recommends that the MHRA needs to communicate more effectively with the public and patients; simplifying communication and involving the public more in active reporting of adverse incidents and decision making,” Mr Perks explained.

“We believe this is critical and would mirror our own focus on patient outcome reporting and standard setting,” he said.

Another key recommendation points to the MHRA making information available on the safety and effectiveness of medical devices more widely, in order to support professionals in their choice of the appropriate device for their patient.

“BAPRAS would strongly welcome this move because, as the PIP implant crisis brought to light, practitioners are often influenced by marketing pressures in their decision making and we would like to see this process better informed through reliable information from the MHRA instead,” Mr Perks concluded.

The report also advises that the MHRA plays a leading role in Europe to ensure that regulations are fit for purpose and help meet the needs of patients. BAPRAS and the British Association of Aesthetic Plastic Surgeons (BAAPS) continue to be at the centre of the debate on regulation of Aesthetic Services and devices in Europe through the British Standards Institution (BSI).

A further recommendation puts forward that devices should be as important as medicines and that the MHRA should set up a new group of experts to advise it, called the Devices Expert Advisory Committee.

Follow BAPRAS on Twitter at @BAPRASvoice

Rejuvenating The Face Without Surgery

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Rejuvenating The Face Without Surgery 

 

APSARAS1Cosmetic treatments have come on in leaps and bounds over the past decade. So much so that today you don’t have to undergo cosmetic surgery to truly rejuvenate your face. With advanced non-surgical procedures, you can improve your appearance without a single scalpel in sight.

Not only is it possible to soften lines and wrinkles and refine your skin surface, but also to recreate youthful apple cheeks, gently plump your lips, straighten your nose, slim your face and give your jaw line a more defined look. However, with infinite possibilities these days, it becomes more difficult for the consumer to know which procedures are most suitable for their concern, and most importantly which are safest.

When thinking about non-surgical procedures I always evaluate my patient’s face methodically using the ‘rule of 3’ approach, as all of the three main problem areas of the ageing face need addressing to achieve a harmonious facial rejuvenation.

Lines & Wrinkles

The traditional key areas to look at when trying to turn back the clock are lines and wrinkles. Not all lines and wrinkles are created equally though. In order to decide on an appropriate treatment we have to divide this group into ‘dynamic’ and ‘static’ lines. Dynamic lines are those generated by repeated movement of underlying mimic muscles – think frown lines between the eyebrows, worry lines on the forehead and crow’s feet around the eyes.

To soften dynamic lines it is important to address their underlying cause (i.e. over-movement of mimic muscles). So the first step should be a botulinum toxin, like BOTOX. The newest trend goes towards using this on wider areas of the face, but in lower doses, in order to avoid the undesirable ‘frozen face’ appearance.

For static lines on the other hand, which are independent of mimic movement (e.g. nose-to-mouth lines), a filler is a good choice to gently plump up the grove from underneath. Hyaluronic acid fillers have now become the gold standard in this area.

Facial contour & volume

While ironing out wrinkles seemed to be the main aim of cosmetic treatments up until about five years ago, we have since realised that it’s actually another change that makes us look older, namely loss of facial volume and contour. While a young face displays a heart shape with plump cheeks and a firm, slim jaw line, this cheek volume is one of the first fat pads to go when we get older.

Flat cheeks and heavy jowls will then flip around the ‘inverted triangle of youth’ and leave our face appearing older – more than lines and wrinkles ever could. The good news is that we can correct this without surgery, by injecting a more viscous filler (‘volumiser’) into the cheeks. Hyaluronic acid volumisers offer the best benefit-risk ratio in my opinion.

Skin surface & texture

The last key area to look at is the skin surface and texture (‘skin quality’). Loss of elasticity, crepeyness, and irregular pigmentation are all important factors of ageing skin. Studies have even shown that irregular pigmentation not only makes you look older and less attractive to others, but people will also judge you as less healthy. Remedies to improve skin surface factors are, for example, cosmeceuticals, laser treatments, and medical needling.

Getting the best out of non-surgical treatments 

Why don’t you take an old photo of yourself and compare this to your face in a mirror, before seeing an aesthetic practitioner. Try accessing your face as objectively as possible using the ‘rule of 3’ approach. This will greatly help you in your subsequent consultation with the cosmetic doctor.

BOX OUT//

For more information on non-surgical treatments with Dr Thevendra at the APSARAS Clinic visit www.apsaras.co.uk

Reducing Needlestick Injuries In The Clinical Environment

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10967686_xxlA small but still troubling number of healthcare workers develop a potentially life-threatening disease as a result of sharps injury. In the UK approximately 10,000 needle-stick injuries occur each year.

When you then consider the risk of infection following a needle-stick injury is estimated to be 1 in 3 for HBV, 1 in 30 for HCV and 1 in 300 for HIV, it is vital that safety procedures are put in place in all aesthetic clinics.

Following the introduction of The Health & Safety (Sharps Instruments in Healthcare) Regulations 2013 in May last year, all healthcare facilities need to assess the risk of exposure to blood-borne infections from sharps injuries, identify how to eliminate this and where exposure cannot be eliminated, put into place extensive prevention methods.

The new legislation also requires a framework for the occurrence of a sharps injury and the need for employers to revise their reporting procedures with health and safety representatives.

The health and safety law has always placed general responsibilities on the employer to provide their staff with a healthy working environment. However, this new legislation is putting further emphasis on prevention.

In reality it would be difficult, if not impossible to remove all sharps from a healthcare practice, so the next best thing is to assess the risk correctly, use devices which limit the risk of injury and dispose of all sharps in a safe manner.

Key tips all clinical staff should do to help reduce needle-stick injuries are:

  • Cease recapping of needles
  • Ensure the correct type & size of sharps disposal unit is in place
  • Make sure your sharps disposal units are assembled & closed correctly
  • Place all sharps disposal units in a safe, secure location
  • Dispose of your sharps at point of use
  • Report all sharps injuries immediately
  • In the case of a needle-stick injury follow your H&S protocol immediately

It’s important to remember that when it comes to hazardous and infectious waste, such as syringes and other sharps at a clinical practice the cradle-to-grave rule applies. The producer of waste will always be held responsible for the safe and legal disposal of it, even after it has been passed onto the waste carrier collecting it.

This is why it’s important to work with comprehensively trained sharps waste disposal experts who will safely and securely dispose of it and advise on the correct products which comply with both the UK and EU legislation.  Health and safety law is criminal law and healthcare organisations can be subject to enforcement action if they fail to comply with the legal requirements. There is also always a threat of civil law action if an employee is injured due to insufficient practices and technologies being in place.

Everyone has a role to play in the prevention of sharps injuries. From those working in patient-facing roles through to managers and owners who will hold legal overall responsibility for the well-being of their staff.

About Initial Medical

Initial Medical is an expert in healthcare waste management, providing a complete collection, disposal and recycling service for hazardous and non-hazardous waste and offensive waste produced by businesses and organisations within the UK. The safe management of healthcare waste is vital to ensure your activities are not a risk to human health.  Initial Medical’s healthcare waste services ensure that all of your waste is stringently handled in compliance with legislation and in accordance with Safe Management of Healthcare Waste V2 best practice guidelines, providing you with the peace of mind that you are adhering to current legislation.

By Rebecca Allen of Initial Medical. For further information please visit www.initalmedical.co.uk or call 0870 850 4045

Creative Insiders: Using PR To Promote Your Cosmetic Practice

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6521616_xxlAs a consultant, or someone on the business side of an aesthetic clinic, you may be keen to promote your practice to generate greater awareness of the work that you do, but may be unsure of how to do this. The Harley Street Journal asked Holly Broadway and Sarah Bakker from Merchant Healthcare Marketing to explain how PR can help build your cosmetic practice. 

“At Merchant Healthcare Marketing, we are specialists at working with private hospitals and clinics, to help them promote their services and consultants through public relations (PR) and other marketing channels,” Sarah explains.

The specialists agree it’s important to understand what PR is and how it can help grow your business, especially in terms of positive public awareness.

“Public relations involves working with the media to create positive public awareness of a brand or person,” Holly says.

“At Merchant Healthcare Marketing, we talk to consultants and directors on a daily basis. One thing they often ask is what the difference is between advertising and PR. Quite simply, with advertising you pay for the space the ad sits on, which means you have control over the content and often where it is placed. With PR, although you will pay for the service, you are not paying for the space directly, so you will have less control over content and all decisions are all at the discretion of the journalist and editor,” Holly points out.

However, they explain, the bonus of PR is that articles generated through this method, as editorial, hold more value than an advertisement as they carry an endorsement from a third party (the media).

“As you may be aware, providing content for consumer media, which target the general public, such as national newspapers, glossy magazines, television and radio, will help you speak to potential patients,” Sarah explains.

However, achieving substantial coverage in the national newspapers is not straight forward or easy. To get around this Holly says you need to understand what the media requires.

“Firstly, you need to ensure to build a relationship with the media and prove you are a credible source of information and someone that will get back to them within their specified deadline,” she says.

“One of the main reasons journalists ask to speak with consultants is that they often require medical professionals to comment on a story to make it clinically credible. When talking to consumer media, ,you need to avoid using clinical jargon and explain yourself in a way the layperson can understand,” Holly concludes.

Patient case studies are a major way in which coverage is gained for consultants and practitioners. Sarah reveals these are stories about a patient you may have who has an interesting story to tell about their treatment.

“Perhaps they were the first to have a certain treatment in the UK, or they have had a treatment that has dramatically changed their life in some way,” she says.

“By using real people examples, the media creates stories that their readers can relate to,” Sarah concludes.

Placing an interesting case study in the national media that credits you and/or your clinic will generate beneficial credibility and awareness. Below are some key points Holly and Sarah say you need to bear in mind when choosing a patient case study:

  • Are they a happy customer?

You want your patient to speak to the media and have nothing but positive things to say about their treatment.

  • Is your patient willing to be identified?

Unfortunately, the consumer media are only interested in patients who are happy to be named and photographed.

  • Has your patient given consent?

We always encourage patients to sign a consent form to ensure they are happy to be a case study and understand what is required of them.

  • Is the treatment new?

If the treatment is a UK first, or even a world first, the media want to know about it.

  • Is the treatment relevant?

The media will be more interested if you have a treatment that is relevant to a health awareness date, or something that is being heavily featured in the press at this time.

So what advice do the experts offer clinic owners and practitioners that may be apprehensive about speaking to the press?

“We encounter various consultants and clinics that are nervous about putting themselves out there to the national media,” Holly says.

“Many have had bad experiences and feel that journalists only want to catch them out and write negative stories. Although this can happen, it is generally an inaccurate view and the vast majority of journalists do not work like this,” she explains.

It can be daunting when you receive a call from a journalist, and this is where a PR agency can help you identify which opportunities are of most value to your business. If you do decide to talk directly to media, ensure you ask all the right questions and feel comfortable you understand what they want from you and the angle of their story.

Merchant Healthcare Marketing is an integrated marketing & PR agency that specialises in healthcare

Web:  www.merchanthealthcaremarketing.com 

Phone: 023 8022 5478

Email: sarah@merchantmarketinggroup.com  

BAD Announce Sun Awareness Week

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8928573_xxlThe British Association of Dermatologists (BAD) has announced the dates of their 2014 Sun Awareness Week.

This national campaign, overseen by the BAD’s Skin Cancer Prevention Committee and comprised of leading medical professionals with expertise in skin cancer, vitamin D and public health messaging, will run from 5th to 11th May.

The campaign is two-pronged and combines prevention and detection advice. The first aim is to encourage people to regularly self-examine for skin cancer. The second is to teach people about the dangers of sunburn and excessive tanning, and to discourage people from using sunbeds, in light of the associated risks of skin cancer.

In addition to public education about the dangers of sunbed use, the BAD has also been involved in campaigning for legislation to regulate the sunbed industry and is continuing to push towards further and improved regulation.

A spokesperson for SKCIN, a national charitable organisation targeting skin cancer in the UK, said education and raising awareness on the subject of sun safety and the early detection of skin cancers is vital to saving lives.

“Detecting skin cancers early save lives, particularly in the case of Melanoma, the deadliest form of the disease. It is important to check your skin regularly for signs of change, and consult your doctor immediately if you detect any changes particularly with moles, or are unsure of any unusual marks, patches, sores or spots, no matter how small they are.”

More information can be found at www.bad.org.uk

Surgeons ‘Concerned’ About Young People Undergoing Cosmetic Procedures

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11374948_xlAccording to BAAPS, plastic surgeons are worried about the number of young people who want cosmetic procedures.

The British Association of Aesthetic Plastic Surgeons claims younger patients can be vulnerable and often have self-esteem issues.

It is warning procedures can’t always help people overcome problems with their body image.

BAAPS says its surgeons carried out 50,122 cosmetic procedures in 2013, a 17% increase on 2012.

There is no age breakdown, but President Elect Michael Cadier claims they are seeing more young people who want cosmetic procedures.

“They’re still immature, vulnerable and it’s too big an operation with too many potential life-long implications,” he said.

“There are potentially other avenues they should be exploring.”

The cosmetic interventions industry was worth £720m in 2005, £2.3bn in 2010 and it’s estimated it will rise to £3.6bn by 2015, a review commissioned by the Department of Health found.

In February 2014, the government outlined its response to a review of the industry. Their plans were criticised by surgeons, who said the decision not to classify dermal fillers as prescription only has been labelled a “missed opportunity”.

They accused the industry of acting like “cowboys” and selling products “like double glazing”.

The Harley Street Journal previously revealed (Issue 2: March/April ’14) research suggesting most women in the UK who undergo cosmetic procedures opt to have them by the time they turn 21.

Pictured: Mr Michael Cadier

Knowing Cause of Hyperpigmentation Is Essential to Treatment, Say Plastic Surgeons

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11948059_xxlAccording to a plastic surgery group, correcting hyperpigmentation is often a complex process, and it should always begin with an in-depth consultation to understand the cause before treatment.

Surgeons and skin care professionals at LIPSG treat a variety of patient concerns, but among the more difficult to address is hyperpigmentation.

To get the most out of skin pigmentation treatment, the LIPSG doctors say patients must first undergo a comprehensive skin evaluation. By doing so, skin care professionals can assess potential causes of the dark skin discoloration and whether it was influenced by genetics, medical history, or other lifestyle factors. The LIPSG team notes that each of these can play a role in skin cell function, and by relating hyperpigmentation to a specific cause, the most effective method of treatment can often be identified.

Most treatment options for the skin condition utilise heat, light, chemicals, or lasers, and the LIPSG doctors emphasise the need for a thorough skin analysis to determine if the patient’s condition is treatable.

Common procedures performed for these patients include chemical peels, IPL therapy, microdermabrasion, and laser skin resurfacing. In addition, the aesthetic professionals at the Aesthetic Center can also recommend camouflage makeup for the temporary concealment of dark spots.

Overall, the surgeons and aestheticians at LIPSG believe successful treatment of hyperpigmentation relies on a thorough skin analysis. For patients who wish to address their uneven skin tone, they recommend seeking a qualified professional who understands how various factors affects skin and how potential treatment methods will affect the condition.

Top surgeon opens High tech clinic in Cheltenham

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15941575_xxlA new clinic has opened in Cheltenham, offering surgical and non-surgical procedures, carried out by top consultant Robert Warr.

Look Amazing was launched nine months ago, bringing specialist skin and laser treatment to Cheltenham. The clinic boasts the latest technology to deal with lines, wrinkles, unwanted hair and other skin issues.

Although he covers all cosmetic surgery, he specialises in breast reconstruction and skin cancers, including reconstructive surgery following operations.

“I also do a lot of non-surgical treatments such as Botox, lasers and fillers, which are incredibly popular these days,” said Robert, 47.

“Following the review regulations are being tightened up for non-surgical procedures, which is good for us as our unique selling point is that people will be having treatments performed by a consultant plastic surgeon,” he concluded.

Botulinum Toxin A Tops US Non-Surgical Cosmetic Procedure List

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11329948_xlInjection of botulinum toxin type A continues to be the most popular form of minimally invasive cosmetic surgery, with a total of more than 6.3 million procedures performed in 2013, the American Society of Plastic Surgeons reported.

Overall, botulinum toxins such as Botox and Dysport accounted for 47% of the market for minimally invasive procedures, which totalled 13.4 million procedures in 2013, according to the ASPS.

The second most popular surgery was injection of soft tissue fillers, with 2.2 million procedures performed, followed by chemical peels (1.2 million procedures), laser hair removal (1.1 million), and microdermabrasion (970,000), the ASPS said.

The total number of minimally invasive procedures increased by 3% from 2012, as did the number of botulinum injections. The largest increase for a single type of procedure was seen for the soft tissue fillers, with hyaluronic acid injections up 18% from 2012 to 2013, the ASPS noted.

The estimates for 2013 are based on data from a national database and survey responses from 800 dermatologists, ENTs, and plastic surgeons.