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MedEsthetics | Southern Africa

Conversations between aesthetic doctors are lately focused on the question of whether everybody is feeling the pinch due to the economic turmoil.

A report in Modern Medicine (January 2009) regarding the economic impact in the USA mentioned a decline in the amount of cosmetic procedures, but especially surgical cosmetic procedures. They also noted that instead of getting facelifts, patients are gravitating to Botox (botulinum toxin A, Allergan) and especially fillers, because they’re a fraction of the price. Though, even with these procedures patients are stretching out visits and follow up treatments.

In South Africa the use of Botulinum Toxin and fillers has not declined in the past few months. The usage has remained stable and constant. A decline was surely expected, but it is explained by some experts as a ‘comforter’ during turmoil and that this could be the reason for the consistency in the usage of Botulinum Toxin and Fillers in South Africa. When stress levels increase people need wellness treatments all the more. Though, the use of fillers remains low in South Africa compared to rates versus Botulinum Toxin usage in other countries.

A number of aesthetic practices locally have not felt any change in the amount of bookings, but report that patients tend to ‘budget’ a bit more and carefully select the type and amount of procedures.

During this current economic climate being proactive and flexible is the best way to avoid or minimize the negative impact on an aesthetic practice. One can offer more flexibility with payment plans but with absolute caution to not negatively impact on the already bad debt situation of patients. This should actually be quite a personal selection and it is difficult to put specific guidelines down for this.

Personally, I think that the one technique that could help aesthetic practices to maintain a constant income throughout the year is to give your patients a treatment plan for the forthcoming 12 months. After an analysis of their facial features and skin, the doctor can recommend the type of treatments, their costs and the amount of sessions with their frequency for the rest of the year. This will ensure that your patients make this part of their budget for the year. This strategy can often serve as a motivation for patients to increase their targets at work ‘in order to afford their cosmetic treatments’. Treatment plans serve as an excellent tool to retain existing patients and assisting them to plan ahead for their aesthetic procedures. It also serves as an accurate guidance to the correct procedures for the specific individual.

This year might teach us some more creativity and planning skills, which is actually a necessity. Good Readings,

Dr Riekie SmitMedEsthetics Southern Africa Editor

note from the editoreconomic turmoil & aesthitic procedures

MedEsthetics | Southern Africa�

MedEstheticsSouthern Africa

PUBLISHER

Reni RouncilvellMedSpec Publishing

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DISCLAIMER This publication contains selected items originally published under license from

Creative Age Publications in the USA.

This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights for translation, reprinting reuse of illustrations, broadcasting, reproduction of CD-Rom, microfilm, online publication, or in

any other way, and storage in data banks.

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consulting the relevant literature.

contents...

COLUMnS

6 BUSINESS CONSULTANT recession: proof your practice

- 8 strategies

9 DETAILS injectable thread lift

13 LEGAL ISSUE setting up an aesthetic practice

22 NEWS & EVENTS

47 BEST PRACTICES

13 24

autumn edition �009FEAtURES

4 tracking patients

18 roundtable: neurotoxins

& alternatives

24 why choose just one?

26 calendar of aesthetic / anti

aging medical events

30 laser eye protection

34 maximum exposure

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KEY FEATURE

Time to pull out all the stops when it comes to customer service. Are the records you use helping your providers take the best care of your patients?

Many spas choose to use a travel card or daily ticket

that is computer-generated at each visit. This offers

your staff complete client information, allowing them

to take customer service to the next level.

Daily tickets aid staff members in their consults, retail

recommendations, rebooking and many other tasks.

In a spa setting, the esthetician is responsible for

helping the front desk gather pertinent information,

such as email addresses and phone numbers. Daily

tickets show frequency of services and visits, allowing

your staff to suggest more frequent services when

appropriate or to contact a patient who has not

been in for several months. They help track purchases

and allow the service provider to formulate proper

regimens based on past use and discussions.

One of the goals of a technician is to suggest other

appropriate services—the more services performed,

the better the retention rates. When you have a history

of services right at your fingertips, it allows you to look

at past services that may not have been rebooked and

identify appropriate services the patient may not have

experienced. Providing your patients the best service

means always being one step ahead of them. They will

appreciate you for it and they will return!

Lisa Marie Arnold, Salon and Spa Solutions,

[email protected].

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proof your practice- 8 strategies

recessionBUSINESS CONSULTANT


When the economy is tight, patients

expect more for their money

By Cheryl Whitman


A tough economy doesn’t have to wreck your bottom line. With ingenuity, you can cut costs and expand your base without sacrificing quality or patient care.

How are you weathering the current economy? Being in an industry that is driven more by

want than need could put your practice in a precarious position. To keep damage to your

bottom line to a minimum and protect the long-term health of your practice, you’ll need to

take action now. Here are eight strategies to consider.

1. Be flexible. Despite economic concerns, your target market is still investigating new

products and services. The more you offer, the more patients you will be able to attract.

To address both tighter budgets and local competition, consider repositioning your

products and marketing them to a new clientele. For existing patients you can bundle

your current services (i.e., Botox Cosmetic, filler, a peel and a tightening procedure)

into a promotional package for a single cost. You may even market some treatments as

a “purchase three, get one free” package to entice budget-conscious prospects. Take

a close look at the demographic you are trying to reach and set your prices for their

budgets. Do what you can to further accommodate a range of incomes in your market

by offering financing options that allow patients to pay for high-ticket treatments over

time.

Autumn Edition | MedEsthetics ��

2. Be open to new opportunities. It may sound shocking but

difficult economic times can provide attractive opportunities to

expand your business. This may be a good time to evaluate the

acquisition of an existing medical spa/practice that is not able or

willing to withstand an economic downturn. Make sure that you

do your due diligence and review the profit and loss statements

with your accountant.

3. Cut costs. Take a close look at your expenses and assess which

variable costs and fixed expenses can be reduced or eliminated.

Focus on core markets and spend money in those areas, as you cut

back in areas that haven’t been as profitable. Lower debt levels,

especially debt incurred for nonproductive purposes. Consider

reducing expenses by:

• Eliminating unnecessary purchases.

• Reducing essential expenses, such as insurance, by shopping for a

better deal. Review marketing expenditures to determine whether

the processes you’re using are reaching your target market or

bringing in valid leads.

• Turning off lights in empty rooms, turning off computers, removing

chargers overnight or even eliminating an extra phone line.

• Hiring part-time rather than full-time employees. Develop more

creative compensation programs with incentives for full-time

employees to boost productivity so they can earn more. Your staff

may make less per hour, but they will have the opportunity to earn

more on a solid commission and bonus structure.

• Gathering money-saving suggestions from your staff members.

• Renegotiating contracts and leases as they come up for renewal.

• Increasing cash on hand by asking suppliers to extend your

payment period, while you work to collect any outstanding

receipts.

• Tightening inventory so you don’t have excess product on the

shelves.

4. Intensify your marketing. As P.T. Barnum said, “Without promotion,

something terrible happens—NOTHING!” You may be tempted

to cut back on marketing, but this is not the time. You still have

a considerable target market, and if you don’t reach out to them,

someone else will. During sluggish economic times, begin by

focusing on your internal database and existing patients. With

a relationship already established, they are worth much more to

you than new customers.

Aforementioned bundled promotions such as lunchtime or

Friday afternoon specials that combine several treatments like

Botox Cosmetic, fillers and skin rejuvenation into one package

at a special rate can bring patients back and increase bookings

among your regulars. Create a loyalty or VIP program to reward

and retain existing patients.

Examine low- or no-cost avenues of attracting new patients.

Free directories, online forums and local/community networking

groups can help you get the word out to new prospects, as can

seminars and speaking engagements at local women’s groups

and country clubs. “I’ve started doing patient education ‘soirees’

about once a month, which always result in increased bookings,”

says Roxanne Guy, MD, FACS, of Brevard Plastic Surgery & Skin

Treatment Center, Melbourne, Florida, and immediate past

president of ASPS. “The overriding theme I use is ‘Beauty for Life.’

I involve the whole staff and speak about the team approach.

We introduce the treatments offered by my estheticians, nurse

and nurse practitioner and explain the role of our patient care

coordinator and ancillary staff. We do drawings for facials and

skincare treatments, and we make sure attendees have the

opportunity to book appointments right then and there. For a

reasonably small investment of time and money, our soirees have

been extremely effective, especially for patients who have been

‘on the fence’ and for those who feel more comfortable booking

a procedure once they’ve met the doctor and the staff.”

To promote your events and new treatment packages, focus

on public relations versus paid advertising. Contact your local

newspapers, television stations and radio stations and provide

press releases for all upcoming seminars and new products and

services. It costs little to write a press release, which can be

emailed to your local news contacts. Concentrate on a 5- to 10-

mile radius for best results (rural practices may need to extend to

30 miles).

Finally, don’t forget to update your database of past clients,

existing clients and new leads. Invite them to upcoming seminars,

or to visit your website and blog for news about your practice.

recession, proof your practice BUSINESS CONSULTANT

recession

Create a loyalty or VIP program to reward and retain existing patients


5. Focus on service. When the economy is tight, patients expect more for

their money. Providing an experience that exceeds their expectations is the

best way to build and maintain trust, loyalty and patient satisfaction. This

is one of the best ways to add value without incurring cost. Ask current

clients to complete a satisfaction survey to make sure their needs are being

met and to find out what services or products are on their wish lists. Their

suggestions may lead to new and profitable product and/or service lines.

Continue to monitor for new market opportunities and understand that

as the economic climate shifts, your target market will move with it. Most

importantly, maintain your focus on customer service to retain the clients

you have worked so hard to attract. One way to do this is to step up

your involvement in patient consults, meet and greet as many patients as

possible and follow up with patients to check in on their recovery. “In good

or bad economic times the focus should always be on providing superlative

service to the patient,” says Julio F. Gallo, MD, FACS, medical director of The

Miami Institute for Age Management and Intervention, Miami. “This will

keep clients coming back throughout economic cycles. These are also the

times when you have to show more appreciation. Hosting special events or

gatherings can be one way of saying, ‘Thanks for staying with us through

the good and the bad.’ "

6. Invest in your staff. When the going gets tough, it is your team that will

make the difference for your practice. For that reason, it’s important to

avoid layoffs. Because most economic downturns are temporary, keeping

the staff you have worked so hard to train and encouraging productivity

can do more for your bottom line than you might at first expect. First, you

have the benefit of high morale that comes with job security in tough

times. Second, you can increase your bottom line by offering low-cost

incentives (i.e., days off, gift certificates, cash bonuses, etc.) for higher

productivity in product and service sales. Use any free staff members you

may have to execute promotions and improve patient services. If you are

innovative and adaptable, you can even take this opportunity to build your

staff by hiring some of the very talented, highly trained professionals who

have been laid off by other practices.

BUSINESS CONSULTANT recession, proof your practice

7. Look for ways to improve. Just as you regularly

assess your business and marketing plans, you

should also be evaluating practice policies, pricing

and employee performance. You may need to

adjust your hours of operation to better meet the

needs of those individuals who can only come

in on evenings or weekends. You may need to

train or retrain staff to improve efficiency or add

sought-after new treatments. Invite vendors,

pharmaceutical and equipment representatives to

provide additional training to your staff. This boosts

their excitement about the services and products

you’re offering. In addition, stay on top of cutting-

edge technologies and determine which to invest

in so you can stay ahead of the competition.

8. Stay focused. Success is closely tied to the

attention you pay to both short- and long-term

goals. Regardless of the present economy, you

must keep in mind that every decision you make

today will affect the future. Dropping prices, laying

off employees and cutting out improvements are

shortsighted ways of making it through tough

times. Do what you must to keep your credit

rating solid, but don’t discount your products and

services to make a quick buck. You do not want to

come out of a recession with a diluted brand and

reputation.

There is no doubt we will all face challenges as we

weather this economic shift. However, being proactive

and maintaining a strong focus on your goals

and objectives while using these challenges as an

opportunity to refine your services will put you ahead

of the competition and first in the minds of those in

your target market.

Cheryl Whitman is the founder and CEO of Beautiful

Forever Spa Business Consulting. Contact her at www.

medicalspaconsultant.com or www.medicalspasuccess.

com.

Autumn Edition | MedEsthetics 9

shows insertion

points

short needlelong needle

DIAgRAM 1

By Leslie Fletcher, Rn, MEP-C

Give nasolabial folds an extreme makeover with

this innovative dermal filler injection technique.

The Injectable Thread Lift literally lifts the skin and tacks it back, anchoring

it away from the dreaded weight of the folds.

DETAILS

injectablethread lift

If injected correctly, dermal fillers can push out nasolabial folds and alleviate the shadows

that draw the face down. If injected incorrectly, they can make your patient look as if she

forgot to swallow those two pieces of breakfast sausage and is storing them for a long

winter. I’ve developed a technique designed to offer a more aesthetically pleasing option

for your patients. Called the Injectable Thread Lift, it incorporates placing product medial

and lateral to the fold in a horizontal pattern. My inspiration came from the well-docu-

mented Fern Pattern technique (“A novel method to inject hyaluronic acid: the Fern Pattern

technique,” Tom van Eijk, MD, and Martin Braun, MD, J Drugs in Derm, August 2007), but

the Injectable Thread Lift offers many advantages over the Fern Pattern technique. When

placed in the fashion described below, the product fills the nasolabial fold; adds volume

and lifts the cheeks; turns out the lips, making them appear fuller; and supports the tear

troughs. It can do all of this while using the same amount of product as the traditional

method with fewer injections. It literally lifts the skin and tacks it back, anchoring it away

from the dreaded weight of the folds.

It may seem counterintuitive to inject filler on the full side of the fold, but the direction

of placement is critical. The effect is much like laying down structural support beams to

reinforce the sagging folds. Think of the columns of filler as working much like the threads

in a barbed suture face-lift.

PAtIEnt SELECtIOn AnD PREPThis technique is appropriate for any patient who has sagging skin that needs to be re-

directed, whether it is nasolabial folds, oral commissures, upper lip overhangs or jowling.

Contraindications would be the same as for any dermal filler procedure, including making

MedEsthetics | Southern Africa10

DETAILS injectable thread lift

sure the patient has not been using anticoagulants for at least one week before treat-

ment and has signed the consent form for the injectable filler you are using.

Proper anesthesia for this procedure depends on the area you are treating; follow the

same protocol with this technique as you would for any other filler procedure. If you are

filling only the nasolabial folds, topical numbing cream may be sufficient. If you are add-

ing oral commissures, you might want to consider a nerve block. In this case, you may

want to mark the patient before putting in the block, which can distort the tissue. Next

choose the appropriate needle length for the facial area of correction. A longer needle

works well on some faces, because you have more surface area to pull away from, giving

more of the appearance of a midface contour lift by involving the lateral malar eminence.

However, with the long needle you have to remember to use enough product to make it

supportive. No tiny threads here. These are structural cylinders.

A shorter needle (1/2 inch to 3/4 inch) works great too—maybe even better—because it

is easier to control, and you have a better perspective of the plane you are in. When you

use a small needle, you can gather the skin “accordion style” to make the short length

work longer for you. In other words, when you reach the hub of the needle, continue

pushing. You’ll be able to bunch up the skin to gain more distance with your short needle.

(See photo 1.)

Finally, disinfect the skin with alcohol, waiting for it to evaporate before injecting.

PROCEDUREDiagram 1 on page 12 should help you visualize the technique, but tailor it according to

your patient’s needs. Just keep following down the shadow of the fold until the correc-

tion is optimal. The dots represent approximate needle insertion points. Each should be

approximately 1cm lateral and superior to the fold. The main thing is to make sure your

needle extends at least 1/2 cm past the fold. The right side of the diagram shows what it

might look like if you used a short needle. The left side shows what it might look like if

you used a long needle.

The insertion point must be superior, not inferior, to the fold. When you are laying down

the “thread” of product, it should feel as if you are pulling the skin in the direction you

want it to go, mainly in an upward vector. (See photo 2.) You may actually have to get

behind and above your patient to access the area you need. It would seem ergonomically

easier to do this from below, but I honestly can’t see it working as well.

Insert the needle into the appropriate depth for the filler you are using. Radiesse would

be in the deep reticular/subcutaneous junction. Hyaluronic acid would be in the mid to

upper reticular dermis. This is because you will end up bearing down on the needle a bit

while injecting and placing the material a little deeper than your initial needle place-

ment.

You are going to “cross the line” or pass the fold by at least 1/2 cm and lay down a con-

tinuous line of filler as you withdraw the needle. You will end up placing a little more of

your filler on the other side of the fold and tapering off as you ascend, remembering to

stop short of the tip. Place the threads 1cm to 2cm apart, depending on what is needed

for optimal correction.

As you lay down each thread, push the needle down against the skin—the opposite

of tenting against the skin—and arc upward, tugging as you ascend to the end of the

needle, finishing with the end of your syringe at a 60- to 75-degree angle. (See photo 3.)

This helps to tether the skin as you redirect it upward. The words that come to mind to

describe this idea, while far from medical, are effective: Picture yourself “scooping” and

“gathering” as if to redirect the loose skin and “staple” it into place. While injecting in

this manner, you may actually feel some “crunching” as the dermal attachments release.

the lifting technique fills the nasolabial folds, adds volume to the cheeks and

turns out the lips.

AFtER

BEFORE

1

2

3

lidocaine 25mg & prilocaine 25mg

availablefrom pharmacies without a prescription

why should looking good

be a painful experience?

www.emla.co.za

At this time, you will see the product fill beautifully in the

pockets you have just formed with your needle, creating a

structure that lifts the skin upward. After you have com-

pleted your supportive columns, resist the urge to massage

them. Remember, they are supportive rods. If you smash

them, you end up with non-supportive blobs.

If you have failed to “stop short,” you might see small nod-

ules at some of the injection points. Press on the bumps

only with a cotton-tipped applicator to soften them. If you

were overzealous while filling, you may end up with a rip-

pling effect or a ledge superior to the insertion points. If this

happens, simply add injections to more or less “connect the

dots” (or all of the insertion points) in an arcing fashion.

FOLLOW-UP AnD RESULtSFollow up with your patient one to two weeks after the

procedure to ensure that your injections are symmetrical

and to check for any complications. Possible complications

with this technique are the same as with other types of filler

injections, but because of the multiple puncture sites, there

may be a greater tendency to bruise.

The best thing about this technique is that, when the patient

animates, such as by smiling, the nasolabial fold doesn’t

have the opportunity to “get into the groove” because the

support beams obstruct the way. With the traditional way

of filling these folds, the carefully placed product could shift

into the groove and would look rope-like upon animation.

This Injectable Thread Lift also works well for oral commis-

sures, marionette lines, separation of the malar fat pad,

lateral malar laxity, brow elevation, lower face jowling and

fine lines to the lower cheeks. I’ve even seen it work in

extremely dense mouth frowns, where the smile is in the

shape of an upside down “U.” This technique can be used

any time there is an overhang of skin to redirect upward.

No area is exempt when it comes to lifting up the skin and

going perpendicular to the wrinkle or fold. Any area that

needs to be lifted can benefit from an Injectable Thread Lift.

Be creative when it comes to this technique, remembering

that aesthetic injecting is as much an art as it is a science.

Leslie Fletcher, RN, an aesthetic nurse specialist for eight

years, works with several physicians in the Los Angeles

area, including plastic surgeon Michael Newman, MD, and

dermatologist Ava Shamban, MD. As a national educator

for Aesthetic Advancements Incorporated, she is recognized

for her expertise with sculpting and contouring using der-

mal fillers and Botox Cosmetic. Contact her at www.ede-

nestheticnursing.com.


ADVERTORIAL

emla® has been shown to be an effective dermal anaesthetic when treating

port wine stains (naevus flammeus) with pulsed dye lasers (Lanigan, 1987).

In a cinical study emla® reduced mean pain scores by 66% and made the

treatment pain free in 40% of cases (Sherwood, 1993). emla® has been shown

not to influence the efficacy (effectiveness) of the treatment (Ashinoff, 1990).

Taking into consideration the vasocontrictive effect if applied for less than 60

minutes, emla® can offer another advantage when vasocontriction is preferred.

This effect will assist with laser hair removal where the laser or light spectrum

should be focused on the hair follicle and not the vein. If you are using emla® for

pain reduction when treating veins with lasers or lights, ensure that the emla®

is applied for longer than 60 minutes to ensure that no vasoconstriction occurs.

This will not affect the efficacy of the treatment. This should be considered with

all vascular treatments. The vasoconstrictive effect of emla® has shown to not

affect the ease of venous cannulation at all.

The vasoconstrictive effect can be used to one’s advantage when performing

dermal filler injections or mesotherapy as this could reduce the risk of bruising

and bleeding as an additive effect to the reduced pain effect.

emla® has been studied for the depth of analgesia during a study with 2

groups of patients undergoing various depths of skin biopsies after 60 and 120

minutes of emla® application (Wahlgren & Quiding, 2000). The mean insertion

depths with acceptable pain were 2.9 and 4.5 mm respectively. After 3 to 4

hours of application, 6-mm deep insertions were made with acceptable pain

in all 5 subjects.

A study on the use of emla® for laser resurfacing demonstrated the usefulness

for pain relief without anaesthesia (Murison & Tucker, 2007). The authors

concluded that a cooling device in combination with emla® cream provided

a level of anaesthesia sufficient to allow laser resurfacing without the use of

local anaesthetic injections or intravenous agents.

emla® has sufficient data to show its effectiveness and usefulness in aesthetic

practices. It is important that doctors should make use of this data to reduce

pain during aesthetic procedures to improve the patient’s comfort level and

improve the overall experience of the specific aesthetic procedure.

added benefitesof emla® in aesthetic procedures

A eutectic mixture of local anaesthetics (EMLA) is commonly used to provide topical anaesthesia for needle procedures. Now, emla® is proving to be very useful in aesthetic medical procedures to improve your patient’s comfort and enhance the overall experience of the patient coming to such a clinic.

emla® cream is a mixture of equal parts of 2.5%

lidocaine and 2.5% prilocaine and is applied to

the skin, then covered with an occlusive dressing

and left in place for at least 60 minutes. The

peak action for emla® occurs at 2 hours and

lasts for as long as 4 to 5 hours. emla® has a

vasoconstrictive effect on the area applied, but

this effect is reduced if the cream remains in

place for longer than the minimum 60 minutes

(Moureau & Zonderman, 2000; Häfner et al.

2003). The rare side effects of emla® include

local minor skin reactions, such as itching or

erythema, which quickly disappears when emla®

and the occlusive dressing are removed. Allergic

reactions to emla® are extremely rare, but mild

systemic reactions have appeared in a small

percentage of patients with known allergies to

lidocaine.

1�

LOCAL ARTICLE - LEGAL ISSUE

aesthetic practicesetting up an

The Health Professions Council of SA (HPCSA) has very specific rules in respect of practice structures, collaboration amongst health care practitioners and the sharing of facilities. Since an “aesthetic medical practice” is in essence a “medical practice”, all these provisions are applicable to such practices. The relevant provisions are briefly reviewed in this article.

1 PRACtICE MODELS

A medical practice may be conducted as a single owner business (solus practice), a partnership, an

incorporated company or in an association.

The main features of the different vehicles of practice are the following:

• SOLUS PRACtICES

A single owner business is operated with full personal risk for the owner whose estate is liable for all the

commitments of his business. In this instance the medical practitioners practise under their own names

as single practitioners. They are still entitled to employ other practitioners such as professional assistants

and locum tenentes (locums) in their practices.


Esmé Prins

Attorney, notary and

Conveyancer of the High

Court of SA, Healthcare

Consultant.

BLC (Cum laude) (1986),

LLB (Cum laude) (1988)

and LLM (Cum laude)

(1997) (University of

Pretoria) Attorney,

notary and Conveyancer

of the High Court of SA

Healthcare Consultant.

CPD ARTICLE

SUBSCRIBE & EARN

1 ETHICS CPD POINT

PER ISSUE

SUBSCRIPtIOn InStRUCtIOnS1. Go to www.medspecpublishing.co.za 2. Click on the MedEsthetics CPD programme button.

3. Complete the registration form and click the submit button. 4. You will be directed to your landing page,

where the questionnaires will be displayed. 5. Click on the questionnaire which you would like to complete,

once completed click submit.

• PARtnERSHIPS

A partnership is a group of persons who unite with a profit motive.

A partnership is limited to a minimum of 2 and a maximum of 20

members. The Minister of Trade and Industry has exempted the

medical profession from this restriction. This means that medical

practitioners may form partnerships of up to 50 partners.

The partners in a partnership are jointly and severally liable for

the debts and liabilities of the partnership, but only to the extent

that such liabilities cannot be met out of the partnership assets.

• InCORPORAtED COMPAnIES

Since 1994 medical practitioners and other health care

practitioners registered with the HPCSA are permitted to practise

their professions as juristic persons in incorporated companies.

Incorporated companies must comply with the requirements of

the Companies Act 61 of 1973 as well as the following provisions

that were published in the Government Gazette:

• The Memorandum or Articles of Association must provide for the

joint and several liability of all past and present directors together

with the company for the debts and liabilities of the company

contracted during their period of office. Incorporated companies

must therefore be constituted with unlimited liability. This

implies that individual health care practitioners remain personally

accountable for their professional and clinical responsibilities and

cannot be afforded the protection of the legal entity in the case

of negligence or professional misconduct;

• Only natural persons registered in terms of the Health Professions

Act and who practise the profession of a medical practitioner,

dentist, psychologist or supplementary health service profession

(practitioners) may be shareholders of the company and have an

interest in its shares;

• Another incorporated company, all the directors and shareholders

of which are practitioners, may hold shares in the company up to

a maximum of 24% of the issued share capital;

• Only registered practitioners may be directors of the company;

• Each shareholder may only practise the profession in respect of

which he is registered;

• If a shareholder of the company or a person with an interest

in the shares dies or ceases to comply with the requirements,

the estate or person concerned may for a period of 6 months

or such a longer period as approved by the HPCSA continue

to hold the shares. These shares will have no voting rights and

the shareholders may not act as directors, receive any director’s

remuneration or share in the income or profit of the company;

• Only an authorised agent who is a shareholder of the company

may speak or vote on behalf of a shareholder at a meeting of a

company;

• Each shareholder remains personally subject to the provisions of

the Health Professions Act and the disciplinary authority of the

HPCSA;

• Neither a natural nor a juristic person may directly or indirectly

share in the profits or income of the company or have an interest

therein unless he/she is a shareholder of the company; and

• If the company neglects or fails to comply with these provisions,

such neglect or omission shall constitute conduct on the part of

the directors or shareholders in respect of which the HPCSA may

take disciplinary steps.

• ASSOCIAtIOnS

An association is a practice where certain expenses such as

facilities are shared but each health care practitioner practises in

his/her individual capacity for his/her own account. Agreements

can be verbal or in writing. A written agreement is recommended

for purposes of clarity and to minimise disputes during the

existence and dissolution of the association.

All the practitioners registered with the HPCSA are allowed to

conduct private medical practices together with the exclusion of

pathologists and radiologists1 in respect of whom restrictions

exist. ”Practising together” could mean to work together in an

employment relationship, as partners in a partnership or as directors

and shareholders of an incorporated company. Practitioners excluded

from practising together with medical practitioners are those that

are unregistered (e.g. beauty therapists) or practitioners who register

with other statutory councils (e.g. nurses, pharmacists, homoeopaths

and beauty therapists). Nurses may, however, be employed by medical

practitioners to assist them in their practices.

Ethical Rule 8 pertaining to partnerships and juristic persons was

recently amended and provide as follows:

LEGAL ISSUE - LOCAL ARTICLE

MedEsthetics | Southern Africa1�

Autumn Edition | MedEsthetics

LOCAL ARTICLE - LEGAL ISSUE

(1) A practitioner may practise in partnership or association with

or employ only a practitioner who is registered under the Act,

and who is not prohibited under any of the annexures to these

rules or any ethical rulings from entering into such partnership

or association or being so employed: Provided that, in the case

of employment, the practitioner so employed either provides a

supportive health care service to complete or supplement the

employing practitioner’s health care or treatment intervention

or is in the same professional category as the employing

practitioner.

(2) A practitioner shall practise in or as a juristic person who is

exempted from registration in terms of section 54A of the Act

only if such juristic person complies with the conditions of such

exemption.

(3) A practitioner shall practise in a partnership, association or as a

juristic person only within the scope of the profession in respect

of which he or she is registered under the Act.

(4) A practitioner shall not practise in any other form of practice

which has inherent requirements or conditions that violate or

potentially may violate one or more of these rules or an annexure

to these rules.

In terms of this amended rule an employed practitioner (e.g.

professional assistant) must provide a supportive health care service

to complete or supplement the employer’s health care treatment or

interventions (e.g. a radiographer supporting a radiologist) or be in

the same professional category2 as the employing practitioner.

Ethical Rule 9 should also be noted in respect of the employment of

professional assistants and locums and the collaboration between

the different health practitioners. It provides as follows:

(1) A practitioner shall employ as a professional assistant or locum

tenens or in any other contractual professional capacity and, in

the case of locum tenens for a period not exceeding six months,

only a person

(a) Who is registered under the Act to practise in independent

practice;

(b) Whose name currently appears on a register kept by the

registrar under section 18 of the Act; and

(c) Who is not suspended from practising his or her profession.

(2) A practitioner shall help or support only a person registered

under the Act, the Pharmacy Act, 1974 (Act No. 53 of 1974),

the Nursing Act, 1978 (Act No. 50 of 1978), the Social Service

Professions Act, 1978 (Act No. 110 of 1978), the Dental

Technicians Act, 1979 (Act No. 19 of 1979), or the Allied Health

Professions Act, 1982 (Act No. 63 of 1982), if the professional

practice or conduct of such person is legal and within the scope

of his or her profession.

In terms of the ethical rulings of the HPCSA locums can only support

a practice for a period of up to 6 months. A locum can therefore not

“conduct” a practice on behalf of another practitioner for any period

exceeding 6 months.

A person employed as a professional assistant or locum must also be

registered in the category “independent practice”, his/her name must

appear on the register and may not be suspended from practising

his/her profession. A practitioner employed by the government

could therefore for example not act as a locum unless he/she is

also registered in the category of “independent practice” and has

obtained the necessary permission from his/her fulltime employer,

e.g. the state, to do so.

Furthermore, a medical practitioner may only help or support another

registered practitioner provided that such person’s practice or conduct

is legal and within the scope of his/her profession.

2 MAnAgEMEnt EntItIES

Practitioners may form entities to manage and administer their

practices and/or to own assets used by the practice. These

entities would be engaged in the rendering of non-patient

related services such as the renting of rooms, leasing of vehicles

and office equipment, payment of staff salaries, maintenance of

buildings and billing services. Practitioners would then effectively

purchase the required support services from such an entity.

Billing must, however, still occur in the name of the professional

practice. There is no restriction on the legal form of such an entity.

It could for instance be structured as a close corporation or a

trust provided that it is separate from the professional practice.

3 nAMES OF PRACtICES

The name of one or more of the practitioners in the practice must

appear in the name of that practice. Partnerships and incorporated

companies are only allowed to include the surnames of the

shareholders or partners in the name of the practice. It is not

15


required that all the relevant surnames must be used. Business

names are not allowed such as “Aesthetic Medical Practice Inc”.

Should the person whose name has been used in the name of a

partnership or incorporated company leave the practice, it is not

required to change the name of the practice provided that all the

parties agree that their names could be retained even whilst no

longer being associated with that practice.

A private practice may also not include in its name the expression “hospital”, “clinic” or “institute” or any other special term, which could create the impression that the practice forms part or is in association with a hospital, clinic or similar facility.

A building from where practitioners practise could be called a

“medical centre” provided that at least 2 independent medical

practices are situated in that building.

4 SHARIng OF ROOMSEthical Rule 8A provides that:

A practitioner shall not share his or her rooms with a person or entity not registered in terms of the Act.

According to the Ethical Rules “rooms” refer to a physical structure

where a practitioner conducts his/her practice

• With an exclusive entrance; and

• Walled all round for the

• Privacy of patients;

• Preservation of their confidentiality; and

• Safe-keeping of records.

This definition should be understood to include for example the

waiting room and not only the space (cubicle) where the patient

is examined. It should also be read with Ethical Rule 21 that

provides that a practitioner may only perform professional acts

under proper conditions and in appropriate surroundings (except

in emergencies).

Practitioners registered at the HPCSA may therefore not share

rooms with any practitioner registered at any other statutory

council (e.g. homeopath, chiropractor or traditional healer) or an

unregistered person (e.g. beauty therapist)3.

5 COnCLUSIOn The establishment of aesthetic medical practices is fairly recent.

Although specific needs exist in these practices to for example

employ beauty therapists to assist with non-invasive therapies, it

should be noted that such conduct is neither authorised by the

Health Professions Act nor the Ethical Rules at present.

The HPCSA may conduct an enquiry into the professional conduct

of any medical practitioner that transgresses any of the Rules

of Conduct (Ethical Rules) and upon a finding of guilt, impose

an appropriate penalty on such a practitioner. In addition, if a

patient suffers harm as a result of the treatment or care offered

by an unauthorised person in a practice, the medical practitioner

in charge of that medical practice may be held liable for such

harm.

References:

1. Exemption of Juristic Persons from the Operation

of Certain Provisions of the Medical, Dental and

Supplementary Health Service Professions Act 56

of 1974. Government Notice R706 Government

Gazette 15627 of 15 April 1994

2. GNR. 717 of 4 August 2006: Ethical Rules of

Conduct for Practitioners registered under the Health

Professions Act, 1974 as amended by No. R. 68 of 2

February 2009

3. Health Professions Act 56 of 1974

4. Medical and Dental Professions Board of the HPCSA.

Guidelines for Making Professional Services Known.

Booklet 5. July 2001

5. Policy Document on Undesirable Business Practices.

HPCSA. 22 September 2005

1 The establishment of incorporated practices

and partnerships are only permissible between

pathologists and medical technologists in the case of

pathology and between radiologists, radiographers

and specialists in nuclear medicine in the case of

radiology.

2 It is not clear what the “same professional category”

means and consequently results in interpretational

problems. It could either be interpreted to mean “the

same discipline” or “the category of independent

practice”.

3 An exception exists in respect of physiotherapists

who may with the permission of their Professional

Board for example have their rooms in a gym.

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C M Y CM MY CY CMY K

neurotoxinsalternativesBy Wendy Lewis

KEY FEATURE

&With several novel neurotoxins currently undergoing investigational trials or awaiting FDA approval, including some that are topically applied, the market is poised to explode in the next few years.

One of these, Reloxin (Medicis), has been in use in Europe under the name Dysport

for years. Many expect it to be the first U.S. competitor of Botox Cosmetic (Allergan).

Some analysts predict FDA approval of Reloxin early in 2009. Another potential Botox

Cosmetic rival, PurTox (Mentor), is in clinical trials, and Merz Pharmaceuticals is planning

to introduce its own botulinum toxin type A product into the United States after its

success in Europe with Xeomin. At the same time, there is a wave of new technologies

entering the market that offer expression-line relief without the need for continuing

injections. The GFX System (BioForm Medical), a device that uses minimally invasive

bipolar radiofrequency energy to selectively weaken nerve signal transduction, is

currently FDA cleared via a 510(k) to create heat lesions in nerve tissue. BioForm, which

purchased the device from Advanced Cosmetic Intervention in April, intends to apply

for FDA clearance to market the product, also known as Relaxed Expressions, for the

treatment of frown lines. We asked five luminaries in dermatology and plastic surgery

to give us their thoughts on these developments.

Q: What do you believe are some of the advantages Reloxin may offer your pa-tients?

Dr. Sadick: One could be better diffusion which may be helpful around the eyes or for hyperhydrosis. Dr. Weiss: Rapid onset of action, possibly longer duration of action, and possibly fewer injections per treatment.


ROUNDTABLE

neurotoxins & alternatives KEY FEATURE


LEFt tO RIgHt James newman MD, FACS, clinical assistant professor, Stanford University Medical Center, San Mateo, California Robert A. Weiss MD, president-elect, American Society for Dermatologic Surgery; director, Maryland Laser Skin & vein Insti-

tute, Hunt valley, MarylandJoel Schlessinger MD, FAAD, FAACS, board-certified dermatologist and general cosmetic surgeon, Omaha,

nebraska; immediate past president, American Society of Cosmetic Dermatology and Aesthetic Surgeryneil Sadick MD, FACP, FAACS, FACPh, dermatologic surgeon, new York CityAnthony Sclafani MD, FACS, director of facial plastic surgery, the new York Eye & Ear Infirmary, new York City

Dr. Sclafani: With high-quality products, choice is always an advan-tage. While the mechanism of action is the same as Botox Cosmetic, Reloxin may have a shorter onset of action and give a more immedi-ate result. Dr. newman: In particular areas of the face, such as in the crow’s feet area, greater diffusion or spreading of neurotoxin could produce a good result with fewer injection sites, thus reducing the risk of bruising in this area.Dr. Schlessinger: So far, the data on Reloxin is very compelling. While it has many of the same characteristics as Botox Cosmetic, it seems to be quicker in onset. If the treatment is a last-minute one, Reloxin may be a good option. It may also be an option for people who have become resistant to Botox Cosmetic, but that remains to be seen. Lastly, it seems to spread more smoothly, creating a more even appearance. I will continue to use Botox Cosmetic for many patients—and there are some who will insist upon it based on pref-erence. For those who are interested in something different, Reloxin may prove to be an eye-opening experience. We are also working on other products from Mentor and Merz. Without a doubt, the science is expanding in this arena, and that is exciting.

Q: For patients who maintain lingering doubts about the long-term safety of botulinum toxin type A injections, what are some of the alternative treatments you offer?

Dr. Sadick: We use fillers for forehead lines, radiofrequency and broadband light sources for skin tightening, and iontophoresis for hyperhydrosis.Dr. Weiss: We offer Thermage for brow elevation and smoothing the skin around the eyes.Dr. Sclafani: Injectable soft tissue fillers and neurotoxins address similar areas in unique ways. Often these treatments are comple-mentary. For the neurotoxin-phobic patient, treatment of the same area with appropriate soft tissue fillers can help relieve the patient’s anxiety and still demonstrate, at least partially, the effect cosmetic treatments can achieve. For example, treating glabellar furrows with a hyaluronic acid filler in a patient concerned about neurotoxins will demonstrate the positive effect. Most patients will agree to adding neurotoxin treatment when they realize that it may enhance and pro-long the beneficial effect of fillers. New technology, such as selective nerve ablation devices, may eliminate any concerns, especially in the glabella. Ancillary procedures such as light-based and chemical skin

resurfacing can help reduce signs of facial aging caused by muscle hypertonicity. It is important to point out to patients that neurotoxin type A has demonstrated an excellent safety profile for more than two decades when administered by appropriately trained injectors.Dr. newman: Our No. 1 alternative is the Relaxed Expressions treat-ment using clinically proven selective radiofrequency energy to create relaxation of the frowning muscles by creating specific nerve blocks. This procedure takes the “toxin” perception out of the equation and lets patients significantly reduce frown lines while maintaining a natural expression. Patients like the natural results they achieve with the procedure, including some aesthetically pleasing brow elevation. There are no diffusion effects as seen with neurotoxins and the physi-cian has complete control of the therapeutic energy delivery.Dr. Schlessinger: We’ve worked on many studies over the past several years and the conclusions all seem to point to this: Neuro-toxins such as Botox Cosmetic and its second and third generations are safe. While bad press still continues to emerge about botulinum toxin injections, much of it is misleading and based on huge amounts of commercial-grade product injected into odd areas in techniques more consistent with neurologic than dermatologic use. There are many new topicals that have been developed, but none touch the type of dramatic improvement that Botox Cosmetic offers.

Q: Among the technologies offering alternatives to neurotoxin injec-tions, which do you believe are backed by compelling scientific data and which are you excited about using in your practice?

Dr. newman: Having participated in a multicenter trial of the Re-laxed Expressions system with five physicians producing efficacy greater than 80%, I find the data for this system very compelling. Because the radiofrequency energy used in Relaxed Expressions has treated thousands of patients in cardiology and neurology, it is one of the most well-known and safest treatments used in medicine today.

Q: What pearls can you offer on introducing other neurotoxins and related products and technologies into a cosmetic practice?

Dr. Sadick: I would recommend that they be used in conjunction with fillers and light sources.Dr. Weiss: The best way is to have patients understand that neuro-toxins can actually prevent the progression of wrinkles and reverse most wrinkles on the forehead or around the eyes. The safety has

neurotoxins

MedEsthetics | Southern Africa�0

KEY FEATURE neurotoxins & alternatives

now been established for almost 20 years! Neurotoxins are by far the easi-est way to perform noninvasive reju-venation, and I believe they reduce the need for brow-lifts if maintained.Dr. Sclafani: Start simple, with “home run” procedures. Crow’s feet are an excellent place to begin; once patients are comfortable with the process and pleased with the results, suggest ad-ditional treatment areas as needed. I often add Botox Cosmetic to the lat-eral superior orbicularis oculi muscle to enhance the natural brow arch and let patients see how neurotoxins can be used to contour the brow. Dr. newman: Other neurotoxins will need to be differentiated and offered when a physician can determine a specific benefit to the patient against established risks. Many physicians will rely on clinical trials until their own experience builds up. Because Relaxed Expressions is a new concept in aesthetic treatments, many physicians will need to refresh their knowledge on more specific neuroanatomy. When considering the implementation of Relaxed Expressions in your prac-tice, identify groups of patients who have been searching for a good alternative to neurotoxins. The results will surprise many doctors and bring in a new group of patients who may otherwise not seek treat-ment. It is important to be able to offer patients choices ranging from neurotoxins to more permanent eyelid and brow-lift surgery. The Re-laxed Expressions treatment fits between those two options.Dr. Schlessinger: These products will be something to offer to the consumer who may, for some reason, have become disenchanted with Botox Cosmetic. Many times, this is simply a factor of wanting something new, so it will be great to have another option once new forms become available.

Q: In your practice, how will you price these treatments? Is it per unit, per region or per treatment? How will having other products available influence your pricing structure?

Dr. Sadick: Per unit, but it depends on the cost of the product. Dr. Weiss: We price per unit. When Reloxin becomes available, we will price at equivalent units; for example, if it is a 3:1 ratio for units, we can price at one-third the cost per unit. If the pricing structure is reduced to us, we will pass that along to patients.Dr. Sclafani: For neurotoxin procedures, I typically price by treat-ment area; I find this is more appropriate than pricing by unit, as there will always be an incentive to use less. The most expensive option is to undertreat and thus underwhelm your patient. Dr. newman: We price per unit but always put it in context of the area we are treating so that patients have an education as to what their dosing may be. Other neurotoxins will most likely be priced in a similar fashion as they try to compete with the market leader. The Relaxed Expressions treatment does more than a neurotoxin, producing relaxed frowns and adding an aesthetic lift. As such, it is priced similarly to an upper-lid blepharoplasty in most practices.

Dr. Schlessinger: We do a combi-nation of per treatment and per unit, and I hope that competition created by new products will offer us a cost savings.

Q: Do you think the arrival of effec-tive alternatives to Botox Cosmetic will bring new patients into the mar-ket? If so, why?

Dr. Sadick: Yes, topical Botox-like products and GFX will draw in new patients.Dr. Weiss: Typically, as more aware-ness is created by different brands, new patients enter the market. We saw this with fillers. It will be in-teresting to see what happens on Google and other search engines

when someone searches for “Botox” once competitive products are introduced.Dr. Sclafani: Botox Cosmetic has be-

come a routine part of life in American society, and there is little or no resistance to it among my patients. However, there are some patients who have not sought care because of prejudices against neurotoxins as “unnatural.” Nerve ablation may fill a role in addressing the con-cerns of these potential patients. Dr. newman: I feel strongly that the introduction of alternative treatments such as Relaxed Expressions will bring in patients who

Phot

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Dr. Joel Schlessinger noted these results 17 days after treatment with Botox Cosmetic and

Restylane.

AFtER BEFORE

The results will surprise

many doctors and bring in a new group of patients.

Dr. Joel Schlessinger used Botox Cosmetic in the forehead and periorbital area and Restylane for the

nasolabial folds.

Phot

o co

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r. Sc

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AFtER BEFORE

Phot

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r. n

ewm

an

Dr. newman treated this patient with Relaxed Expres-sions. Photos show results pretreatment and at four

months after treatment.

BEFORE AFtER

have been reluctant to seek treatment because of percep-tions about toxins and their temporary effects. When patients learn there is an alternative with the potential to last longer that will allow them to avoid neurotoxins and give them a lift at the same time, this will provide them with a powerful reason to seek more information from aesthetic specialists.Dr. Schlessinger: There is no doubt that alternatives will bring in more patients. This happened very noticeably when Juvéderm (Allergan) came to market. We saw our filler num-bers go much higher. People feel more comfortable when a second product becomes available. It happens in other mar-kets as well. For example, when the first flat-screen televi-sions came to market, there were some early adopters, but most consumers waited until more options were available.

Q: In the near future, do you foresee having multiple neu-rotoxins in your practice for different indications, similar to what we are seeing now with dermal fillers?

Dr. Sadick: No, I do not.Dr. Sclafani: Unless the mechanism of action, onset of action, duration of action, shelf life, ease of use or safety profiles are significantly different, I don’t think neurotoxins will find particular niches. Instead, individual injectors will have their personal preferences for one over another.Dr. newman: Whereas the fillers have undergone years of differentiation with regard to placement, injection technique and biocompatibility, neurotoxins are all targeting the same area. I see most practices using two at most. Fillers are used for volume correction, and because we are dealing with dif-ferent layers, there is the need for more than one type of filler. The neurotoxins are singular in mode of action, and physicians will seek out the one or two with the best safety profiles and duration of effect.Dr. Weiss: We will definitely be carrying multiple neurotoxins as we learn and become more experienced with their par-ticular strengths and weaknesses. Onset of action and per-sistence will have subtle benefits for different regions and applications.Dr. Schlessinger: Absolutely! Research is planned for mul-tiple uses of these products, and as research delineates more opportunities to use these products, patient satisfaction rates and the patient base will only increase.

Wendy Lewis is president of Wendy Lewis & Co. (www.wl-beauty.com), an international consultancy specializing in aesthetic medicine and cosmeceuticals, and author of nine books.

Onset of action and persistence will have subtle

benefits for different regions and applications.

NEWS & EVENTS

MedEsthetics | Southern Africa��

PHOtOMEDEx ACQUIRES PHOtO tHERAPEUtICSPhotoMedex, a leader in the development of proprietary excimer

laser and fiber optic systems, announced in early August that it

has acquired Photo Therapeutics Limited for $13 million in cash

at closing, and up to an additional $7 million if certain profit

milestones are met. Photo Therapeutics, based in Carlsbad,

California, develops nonlaser light devices and skincare

products. Jeff O’Donnell, president and CEO of Montgomeryville,

Pennsylvania-based PhotoMedex said of, “This proposed

acquisition would be a transforming event for PhotoMedex

and underscore our strong strategic focus on dermatology. We

believe that the combined company will offer even greater value

to dermatologists by providing a proven platform for treating

a wide range of skin conditions, as well as effective pre- and

postprocedure treatment products that generate recurring

revenue and an opportunity to improve practice profitability.”

Contact: Ian Ziervogel, www.sternlaser.co.za, 082 551 5938

EUROPEAn ExPAnSIOnThe Hair Loss Control

Clinic has expanded

its reach overseas,

opening new clinics

in Sweden, Norway,

Cyprus, Israel, Ireland

and England. HLCC,

a world leader and

pioneer in laser hair

loss treatment, has

local offices in Latham and Saratoga in New York, and is affiliated

with 78 clinics in 18 countries. In September, the company launched

new lasers and hair loss products at the European Congress on

Anti-Aging in Dusseldorf, Germany. Bill Platter, president of HLCC,

and Nancy Belard, vice-president of sales, presented the new

product line. “There is much opportunity in Europe,” Platter said.

“We already have a distributor in Germany and we hope to open

several clinics there.” Contact: www.enhancehair.co.za,

[email protected], 011 319 7227

A DOnE DEALStiefel Laboratories, the world’s largest independent

pharmaceutical company specializing in dermatology, announced

in September that it has completed its acquisition of Barrier

Therapeutics, based in Princeton, New Jersey. Barrier’s acquisition

broadens Stiefel’s already extensive product offering with three

premium prescription products. Barrier currently markets Xolegel,

Vusion and Solage. “Barrier’s innovative products are a valuable

addition to Stiefel,” said Charles W. Stiefel, chairman and CEO of

Stiefel Laboratories. “The acquisition reinforces Stiefel’s promise

to provide novel, high-quality, safe and effective products for the

treatment of skin diseases and our continued commitment to

advancing the field of dermatology.” In addition, the acquisition

provides more opportunities for Stiefel to leverage its global

footprint for the newly acquired portfolio. Stiefel’s global

headquarters will remain in Coral Gables, Florida, while the

marketing and sales headquarters will remain in Duluth, Georgia.

For more details, visit www.stiefel.com.

RELIAnt JOInS FORCES WItH PHILIPSReliant Technologies has partnered with Philips to develop

skincare technologies for home use. The collaboration will

combine Reliant’s expertise in innovative skin rejuvenation laser

treatments with Philips’ design, marketing and global distribution

capabilities. “We are excited to team up with Philips - a company

with a globally recognized consumer brand and a commitment to

offer consumers advanced, easy-to-use products,” said Eric Stang,

president and CEO of Reliant. “This exclusive partnership will

allow us to leverage Reliant’s unique fractional laser technology

and enter the growing aesthetic market for home use with

innovative products that use the Philips and Fraxel brands.”

According to the American Society of Aesthetic Plastic Surgeons,

laser skin resurfacing is one of the fastest growing segments of

the cosmetics industry, having increased 230% from 1997 to

2007. In addition, more consumers have expressed interest in

aesthetic treatments for home use.” For more information, call

888.437.2937 or go to www.fraxel.com.

MADE In tHE USASound Surgical Technologies has brought back its disposable

product manufacturing to the United States. The Louisville,

Colorado-based company, which developed the VASER Lipo

System, has partnered with two local companies, IPAX and Front

Range Tooling, to produce the new VASER systems and canister

products. “We are thrilled to bring the disposables business and

associated manufacturing jobs back to Colorado and look forward

to a successful partnership with our new domestic vendors,” said

Dan Goldberger, CEO of Sound Surgical Technologies.

IPAX is an FDA-registered and ISO-certified manufacturing and

packaging firm that designs and assembles a variety of medical

components. It has designed and produced new infusion and

section tubing to complement the Vaser Lipo System. Front

Autumn Edition | MedEsthetics �3

Range Tooling is a mold-making company that has created the

new precision canister mold and now manufactures canisters for

Sound Surgical. For more information, go to www.vaser.com.

EnERgY COStSRecognizing economic challenges in the

market, Syneron has developed a pay-as-

you-go program for physicians interested in

offering their patients laser-assisted lipolysis

but reluctant to make the major investment

purchasing such equipment demands. The

LipoLite Energy Access Program lets U.S.

physicians purchase a one-year subscription

that includes enough fat-destruction power

to perform between 15 and 30 procedures. If

demand is higher than expected, physicians

can purchase additional energy packets as

needed. At the end of the year, they have

the option of extending the subscription,

purchasing the device or returning the

system. Contact: [email protected]

www.radianthealthcare.co.za, 011794 8253

SYnEROn ACQUIRES InLIgHt CORP.Syneron Medical, an innovator in the development, marketing and

sales of combined-energy medical aesthetic devices, has signed

an agreement to acquire San Diego-based Inlight Corporation, a

laser technology development and research firm. As part of the

agreement, Inlight president and cofounder Shlomo Assa will join

the Syneron management team. Assa has worked with several

laser companies including Laser Industries and holds multiple

United States patents for laser-based technologies. “With the

expertise offered by Inlight, we have assembled a powerful team

for enhancing the capabilities, applications and success of laser

technology for our customers and partners,” said Doron Gerstel,

CEO of Syneron. “This acquisition represents an important expan-

sion of our product development presence in the U.S. and serves

as a foundation for our commitment to improve and continue to

diversify our product offerings.” Contact: radiant@worldonline.

co.za www.radianthealthcare.co.za, 011794 8253

ISOLAgEn COMPLEtES PHASE III StUDIESIsolagen has presented an analysis of results from the completed

pivotal phase III double-blind, placebo-controlled studies IT-R-005

and IT-R-006 of Isolagen Therapy for the treatment of nasolabial

folds. Both studies, conducted under the United States Food and

Drug Administration (FDA) Special Protocol Assessment (SPA),

showed statistically significant results compared to placebo.

Under the SPA, a two-point improvement on both scales was

required to demonstrate the efficacy of Isolagen as compared

to placebo. The subject response rates for the modified intent to

treat (MITT) populations, those subjects who received at least

one of three treatments, were 68.7% (Isolagen Therapy) versus

33.7% (placebo) and 51% (Isolagen Therapy) versus 19.2%

(placebo) in IT-R-005 and IT-R-006 respectively. The occurrence of

local adverse reactions was low and events reported were mostly

mild in nature and of short duration. Adverse events reported

were similar to those seen in the placebo group. “The full analysis

of data from these pivotal studies is very exciting and further

supports the potential of Isolagen Therapy as an innovative and

well-tolerated treatment for wrinkles,” said Stacy R. Smith, MD,

study investigator and assistant clinical professor, division of

dermatology, University of California, San Diego.

Contact www.bolandcell.co.za

SAggIng BREAStS nOt FROM BREASt-FEEDIngA study published in the Aesthetic Surgery Journal (September/

October 2008) suggests that, contrary to popular belief, breast-

feeding is not a likely cause of post-pregnancy breast drooping

or ptosis. Using data from 93 patients who sought aesthetic

breast surgery between 1998 and 2006, plastic surgeon and

lead author Brian Rinker, MD, determined that older age, larger

pregnancy cup size, higher body mass index and a history of

smoking were significant risk factors for post-pregnancy ptosis,

while breast-feeding was not. All patients had a history of at

least one pregnancy, and 54 patients (58%) had a history of

breast-feeding. “Patients need to be armed with objective data

rather than broad assumptions when making important health

decisions,” said Alan H. Gold, MD, president of the American

Society for Aesthetic Plastic Surgery (ASAPS). “While further study

in a larger number of patients is necessary to assess the effects of

breast-feeding on the breasts versus other factors, this study is a

good start in providing information for those who are concerned

about the potential aesthetic effect of breast-feeding.”

NEWS & EVENTS

Since the first Ruby laser was introduced

in the 1960s, new wave-lengths and delivery systems

have proliferated in the medical market and beyond. In cosmetics, these technologies are now joined by radiofrequency and ultrasound, each offering additional benefits to pa-tient care. Keeping up to date with the latest equipment without blowing your budget has become the challenge of cosmetic practitioners. Enter the aesthetic platform. These multifunction devices incorporate a variety of wavelengths and, in some cases, a variety of technologies to help you provide patients with the best tools for their concerns - and stay ahead of the competition.

KEY FEATURE

By Inga Hansen


whychoose

just

one?


One of the key benefits of multifunction platforms is their ability to

harness the power of multiple technologies that allow you to provide

the best results to a wide cross-section of patients. “Lasers are so

specific in their targets that the majority of patients require treat-

ment with more than one wavelength to address their concerns,”

says Douglas J. Key, MD, The Key Laser Institute for Aesthetic Medi-

cine and a Center for Body Contouring, Portland, Oregon. “We need

to combine multiple modalities and wavelengths to get the best re-

sults, which is part of why aesthetic platforms are becoming more

popular.’”

MULtIPLE tREAtMEntS, OnE tREAtMEnt ROOMFacial rejuvenation can encompass everything from reducing red-

ness and wrinkles to tightening lax skin. Practices with standalone

devices may need to shift patients from one treatment room to an-

other to treat skin laxity, pigmentation problems and overall texture

concerns.

“A platform like the Revlite with multiple wavelengths—532nm,

585nm, 650nm and 1064nm—allows you to penetrate to a variety

of depths with one system so you can treat pigmented lesions, acne

scarring, wrinkles and more in one treatment room with one piece of

equipment,” says Tim Gehlmann, president/CEO, HOYA Conbio, mak-

ers of the RevLite and MedLite platforms, Fremont, California.

“I love platform systems for facial rejuvenation because I can look at

the whole face,” says John Shieh, MD, owner of RejuvaYou Medical

Spas with three locations in Southern California. “I can perform an

IPL and if I notice some problems around the lips and eyes, I can

switch over to the fractionated handpiece without rescheduling or

moving the patient.”

The ability to attack multiple targets with one device is what led Will

Kirby, MD, a board-certified dermatologist in Beverly Hills, California,

to bring the Revlite to his practice, Dr. Tattoff, which specializes in

tattoo removal. “Different colors respond to different wavelengths,”

he says. “The 1064nm wavelength targets black ink while a 532nm

laser targets red ink, for example, so the Revlite is great for tattoo

removal. I don’t have to switch from one laser to another. I just push

a button to move from one wavelength to the next.”

The majority of platform systems offer two to three base wavelengths

and pulsed light ranges that you can toggle between with the use of

the system software. In some systems, handpieces can be purchased

individually to filter specific wavelength ranges. Some practitioners,

like Shieh, use their systems with additional upgrades to cover most

or all of their light, laser-based and radiofrequency treatments. Oth-

eMax, Syneronwww.syneron.com Technologies: 810nm diode laser; bipolar radiofrequency; 400nm–980nm pulsed lightDimensions: 35kg(77lb); 18" x 17" x 40"FDA-approved Indications: Skin tightening, acne, leg veins, vascular lesions, pigmented lesions, telangiectasia, permanent hair reduction.The eMax system is a configurable platform that allows you to perform skin rejuvenation, ReFirme Skin Tightening, Matrix IR nonablative fractional skin treatments, MatrixRF ablative fractional skin resurfacing plus hair removal and acne treatments.

CoolLipo trio, Cooltouchwww.cooltouch.com Technologies: 1320nm laserDimensions: 160lb; 18" x 21" x 31"FDA-approved Indications: fat ablation, leg veins, fine lines, acne, acne scarring.The CoolLipo Trio allows you to perform CoolBreeze nonablative skin rejuvenation, CoolLipo laser-assisted lipolysis and CoolTouch CTEV ablation of varicose veins.

StarLux 500, Palomar Medical Technologieswww.palomarmedical.com Technologies: 1064nm laser; 525nm–1200nm pulsed light.Dimensions: 149lb; 23.5" x 17.8" x 42"FDA-approved Indications: permanent hair reduction, vascular lesions, acne, leg veins, soft tissue coagulation, pigmented and vascular lesions. The StarLux 500 can be configured for your practice to include the Lux2940 for fractional ablative skin resurfacing; Lux1540 for nonablative skin resurfacing; LuxDeepIR fractional infrared for skin tightening; LuxY, LuxR and LuxG pulsed light handpieces for hair removal, telangiectasia and pigmentation concerns; and the LuxV for acne.

why choose just one KEY FEATURE


25-27 FEBRUARY Endermologie training

Johannesburg

[email protected]

0216838505

2 MARCH Restylane Advanced Course

Johannesburg

[email protected]

0117062518

2 MARCH Lipomassage

Johannesburg

[email protected]

0216838505

3 MARCH Basic Botox

(Upper Face) Cape Town

[email protected]

0214389800

4 MARCH Advanced Botox / Fillers

(Lower Face) Cape town

[email protected]

0214389800

4 MARCH Mesotherapy training

Pretoria

[email protected]

0125486374

11-13 MARCH Endermologie training

Cape Town

[email protected]

0216838505

17 MARCH Basic Botox

(Upper Face) Johannesburg

[email protected]

0214389800

18 MARCH Advanced Botox / Fillers

(Lower Face) Johannesburg

[email protected]

0214389800

20 MARCH ALC Lasers training

Cape Town

[email protected]

0722267660

19-21 MARCH AMWC

Monte Carlo

www.euromedicom.com

25-27 MARCH Endermologie training

Johannesburg

[email protected]

0216838505

28 MARCH Solal technologies

Laboratories evaluation

Johannesburg

[email protected]

0117833939

7 APRIL Basic Botox


[email protected]

0214389800

8 APRIL Advanced Botox / Fillers

(Lower Face) Cape town

[email protected]

0214389800

15-17 APRIL Endermologie training

Cape Town

[email protected]

0216838505

20 APRIL Restylane Full Facial Balance

Johannesburg

[email protected]

0117062518

21 APRIL Basic Botox


[email protected]

0214389800

22 APRIL Advanced Botox / Fillers


[email protected]

0214389800

20-22 APRIL AMWC

Monte Carlo · France

21 APRIL Chemical Peel training

Pretoria

[email protected]

0125486374

22-24 APRIL Endermologie training

Johannesburg

[email protected]

0216838505

23- 26 APRIL Dermatology Congress

5 MAY Filorga Product training

Pretoria

[email protected]

5 MAY Basic Botox

(Upper Face) Durban

[email protected]

0214389800

6 MAY Advanced Botox / Fillers

(Lower Face) Durban

[email protected]

0214389800

11 MAY Restylane Introductory Course

Johannesburg

[email protected]

0117062518

13-15 MAY Endermologie training

Cape Town

[email protected]

0216838505

19 MAY Mesotherapy training

Pretoria

[email protected]

0125486374

19 MAY Basic Botox


[email protected]

0214389800

20 MAY Advanced Botox / Fillers


[email protected]

0214389800

22 MAY ALC Lasers training

Pretoria

[email protected]

0722267660

27-29 MAY Endermologie training

Johannesburg

[email protected]

0216838505

2 JUnEBasic Botox


[email protected]

0214389800

3 JUnEAdvanced Botox / Fillers

(Lower Face) Cape Town

[email protected]

0214389800

8 JUnERestylane Advanced Course

Johannesburg

[email protected]

0117062518

17-19 JUnE

Endermologie training

Cape Town

[email protected]

0216838505

CALENDAR OF EVENTS

Calendar of Aesthetic/ Anti-Aging Medical Events Supplied as a service by the Aesthetic and Anti-aging Medicine Society of South Africa

(AAMSSA) [email protected]


CALENDAR OF EVENTS

21 JUnEBasic Botox


[email protected]

0214389800

22 JUnEAdvanced Botox / Fillers


[email protected]

0214389800

23 JUnEChemical Peel training

Pretoria

[email protected]

0125486374

24-26 JUnE


Johannesburg

[email protected]

0216838505

6 JULYRestylane Full Facial Balance

Johannesburg

[email protected]

0117062518

15-17 JULY Endermologie training

Cape Town

[email protected]

0216838505

24-26 JUnE


Johannesburg

[email protected]

0216838505

17-19 JULYCanada World Congress

www.aestheticmedicine2009.com

Canada

[email protected]

3 AUgUStRestylane Introductory Course

Johannesburg

[email protected]

0117062518

4 AUgUStBasic Botox


[email protected]

0214389800

5 AUgUStAdvanced Botox / Fillers


[email protected]

0214389800

18 AUgUStBasic Botox


[email protected]

0214389800

19 AUgUSt Advanced Botox / Fillers


[email protected]

0214389800

19-20 AUgUSt


Cape Town

[email protected]

0216838505

26-28 AUgUSt


Johannesburg

[email protected]

0216838505

2-3 SEPtEMBERAMCSA

Pre-congress beginners & advanced

training workshops

4-5 SEPtEMBERAMCSA

Aesthetic Medicine Congress

of South Africa

www.aestheticcongress.co.za

CSIR ICC

Pretoria

[email protected]

0125486374

8 SEPtEMBER Basic Botox


[email protected]

0214389800

9 SEPtEMBERAdvanced Botox / Fillers


[email protected]

0214389800

14 SEPtEMBER

Restylane Advanced Course

Johannesburg

[email protected]

0117062518

16-18 SEPtEMBER Endermologie training

Cape Town

[email protected]

0216838505

25-26 SEPtEMBERSFME – Aesthetic Medicine

Congress of the French Society of

Aesthetic Medicine

Paris, France

[email protected]

30- 2 OCtOBER Endermologie training

Johannesburg

[email protected]

0216838505

7 OCtOBER Basic Botox

(Upper Face) Durban

[email protected]

0214389800

8 OCtOBER Advanced Botox / Fillers

(Lower Face) Durban

[email protected]

0214389800

12 OCtOBER Restylane Full Facial Balance

Johannesburg

[email protected]

0117062518

14-16 OCtOBER Endermologie training

Cape Town

[email protected]

0216838505

27 OCtOBERBasic Botox


[email protected]

0214389800

28 OCtOBERAdvanced Botox / Fillers


[email protected]

0214389800

18-30 OCtOBER Endermologie training

Johannesburg

[email protected]

0216838505

2 nOvEMBER Restylane Introductory Course

Johannesburg

[email protected]

0117062518

10 nOvEMBERBasic Botox


[email protected]

0214389800

11 nOvEMBERAdvanced Botox / Fillers


[email protected]

0214389800

17 nOvEMBERBasic Botox


[email protected]

0214389800

18 nOvEMBERAdvanced Botox / Fillers


[email protected]

0214389800

18-20 nOvEMBER Endermologie Training

Cape Town

[email protected]

0216838505

25-27 nOvEMBER Endermologie Training

Johannesburg

[email protected]

0216838505


KEY FEATURE why choose just one

ers find that certain combinations of technologies offer a better result

within certain indications.

The Kovak Laser Institute in Elmhurst, Illinois, features a wide variety

of both standalone and modular laser and light systems. “I’ve always

liked the 755nm and the 1064nm wavelengths for hair removal,

which made the Candela GentleMax system, which includes both of

these wavelengths, very attractive to me,” says owner and director

Stanley Kovak, MD. “We use both wavelengths, depending on the

patient’s hair color and skin tone. The 1064nm tends to be more

effective and safer for darker hair and skin tones while the 755nm

works well for lighter hair.”

WIDER OFFERIngS FOR A SMALLER InvESt-MEntIn addition to offering multiple modalities in one treatment, aesthetic

platforms are a popular choice for new practices that don’t have the

budget and/or the space to bring in multiple devices.

When Shieh made the decision to incorporate laser treatments

into his practice in 2002, he chose the Syneron eMax

platform, a configurable modular system that allows

you to custom- build your initial platform and add

new modules as needed. It was a good fit for his

f l e d g l i n g practice because he could offer

multiple technologies in a relatively small footprint, and the system

allowed him to grow his offerings along with his patient base as his

practice expanded. “I started with hair removal and skin resurfacing.

I soon realized that leg vein treatments would be a good addition to

my practice,” he says. “The system let me add what I needed at the

moment and then branch out as my practice grew and I pinpointed

my patient base. And it’s cost effective because I don’t have to invest

in a whole new laser or radiofrequency device as newer technologies

become available.”

Palo Alto, California-based Sciton was one of the first companies to

offer a custom, configurable aesthetics platform. Its Profile device

offers up to six modules for everything from hair removal to nonabla-

tive and fractional skin resurfacing. “The power supply and computer

software are shared, which is what helps reduce the cost of add-

ing new modules,” says Robert Ruck, vice president of worldwide

marketing. “Even with a wide range of price points on the market,

you save a lot by buying additional modules versus buying multiple

standalone devices.”

Like other devices, the system’s tend to include a warranty of one

to three years plus additional maintenance contracts that you pur-

chase with the system. In the case of the Profile, the cost of the

maintenance contract is dependent upon the number of modules in-

cluded. “The more modules one buys, the more the service contract

Profile Platform, Sciton

www.sciton.com Technologies: 2940nm Er:YAG, 1064nm Nd:YAG and 1319nm Nd:YAG lasers; 410nm–1400nm pulsed light.Dimensions: 200lb; 15" x 32" x 43"FDA-approved Indications: Port wine stains, acne/acne scars, scar revision, telangiectasia, pigmented lesions, wrinkles, hair removal, skin tightening and more.The Profile is an upgradable and configurable platform that includes up to five laser and light modules with no consumable components.

Quantum, Lumenis

www.lumenis.com Technologies: 1064nm Q-switched Nd: YAG laser, 560nm–1200nm pulsed lightDimensions: 16" x 16" x 39"FDA-approved Indications: Rosacea, telangiectasia, vascular lesions, hemangiomas, port wine stains, leg veins, solar lentigines, pigmented lesions, permanent hair reduction, tattoo removal.The Quantum platform can be configured to include the DL 1064nm Nd:YAG laser, QS 1064nm Q-switched Nd: YAG laser and HR pulsed light handpiece for hair removal.

Harmony xL, Alma Lasers

www.almalasers.com Technologies: 2940nm Er:YAG; 1064nm and 1320nm Nd:YAG lasers; 515nm–950nm pulsed lightDimensions: 133lb; 15.7" x 21.7" x 48.5"FDA-approved Indications: Acne, vascular lesions, pigmented lesions, permanent hair reduction, leg veins and more.The Harmony XL is an upgradable platform with more than 60 indications.


gentleMax Workstation, Candelawww.candelalaser.comTechnologies: 1064nm Nd: YAG laser, 755nm alexandrite laser Dimensions: 342lb; 45" x 26.5" x 38"FDA-approvedIndications: Permanent hair reduction, wrinkle reduction, reduction of diffuse redness and pigmentation, facial telangiectasia, leg veins, sun spots, age spots, melasma and more.The GentleMax 1064nm Nd:YAG and 755nm alexandrite laser system can be upgraded to include the SmoothPeel low-power erbium laser and additional light-based technologies.

RevLite, HOYA ConBiowww.conbio.com Technologies: 532nm, 585nm, 650nm and 1064nm Q-switched Nd:YAG laserDimensions: 154lb; 28.5" x 12" x 31.8" FDA-approved Indications: Wrinkle reduction, acne scars, tattoo removal, pigmented lesions, vascular lesions, hair removal and dermal lesions.The RevLite features PhotoAcoustic Technology Pulse, which allows for 60% more power output than the company’s previous MedLite platform.

Affirm Anti-Aging Workstation, Cynosurewww.cynosure.comTechnologies include: 1440nm and1320nm lasers; 560nm–950nm pulsed lightDimensions: 210lb; 45.2" x 18.7"x 29.3"FDA-approved Indications: Wrinkle reduction, pigmentation and redness reduction, coagulation of tissue and age spots.The Affirm Anti-Aging Workstation features Multiplex technology that allows for sequential emission of two laser wavelengths in one fiber delivery.

MultiFlex, Ellipsewww.ellipse.orgTechnologies: 1064nm Nd:YAG laser and 400nm–950nm pulsed lightDimensions: 154lb; 24.4" x 29.5" x 55.1"FDA-approved Indications: Hair reduction, pigmentation, port wine stains,telangiectasias, acne and more.The MultiFlex is an upgradable platform that features Dual Mode filtering to lower the risk of adverse outcomes.

will cost,” notes Ruck. You may also want to discuss repair options

as you investigate devices. In the case of modular systems or those

offering additional handpieces, ask your supplier if you can repair

components individually when problems occur.

The decision to invest in a multifunction system versus standalone

devices often hinges on volume. “Buying three separate devices can

be cost prohibitive if you’re offering only a few treatments per month

with each device,” says Key. “But if I’m performing 20 to 30 IPL treat-

ments each month, for example, or 20 Cool Breeze facial rejuvena-

tion treatments, then I want a dedicated laser to perform each of

these treatments.”

Kovak has found that even with the option of additional handpieces,

he prefers to use his GentleMax Workstation as a dedicated hair re-

moval device. “I only use it for hair removal because it offers the best

results,” he says. “My patients like it, and I like it. The system is also

good for veins, but it requires you to change handpieces, and I al-

ready have a dedicated laser for vein treatments. Dedicated lasers do

have some pluses. They’re a little faster and a little more aggressive,

but they don’t offer the versatility of the platform systems.”

They also don’t offer the compact footprint that can be attractive to

some practices. “If space is at a premium, you can’t beat the modular

systems,” says Shieh. “When I opened my second location, I could

actually pack the eMax in the back of my car and transport it to the

other facility for treatments until I was ready to invest in a second

system.”

Inga Hansen is the managing editor of MedEsthetics magazine.

why choose just one KEY FEATURE

KEY FEATURE

“The same laser that can remove a tattoo or kill a hair follicle can immediately cause permanent damage if it comes in contact with the retina,” says David Bothner, director of marketing at NoIR Laser in South Lyon, Michigan. The high-energy, focused rays emitted by these devices can cause serious eye damage. With the stakes so high, laser eyewear is no place to cut corners in your practice. The good news is that most laser manufacturers include three or four pairs of protective eyewear with each machine. But if that original eyewear gets damaged or isn’t comfortable to work in, you’ll need to purchase your own eye protection. Here’s what you need to know to be sure that you, your staff and your patients are all protected.

By Darcy Lewis

protectionlaser eye

MedEsthetics | Southern Africa30

The protective eyewear you will need depends on the wavelengths

you use in your practice. “The wavelength of your eyewear must

correspond to that of the laser you are using, or the laser could

destroy your eye without leaving even a mark on the lens,” says Mark

McLear, director of sales at Sperian Laser Products in Smithfield,

Rhode Island. “There’s a video on the Internet (www.youtube.com/

watch?v=iukFVUiN_rU) that shows a red balloon inside a clear one.

The laser beam pops the red one, leaving the clear one untouched.

Exactly the same thing can happen to an eye with the wrong

protection.”

You also need to know how much energy your laser produces to

calculate the level of optical density (OD) required to provide adequate

protection. “The answer is based on both the wavelength and power

of the laser since the eye is more sensitive to some wavelengths than

others,” says McLear. “You need to set the energy of your laser to

a safe level that won’t hurt your eye if it comes in contact with the

beam.”

“The eyewear you choose should be based on the worst-case

scenario, accidental exposure at the maximum output of the laser,”

says Bill Janssen, laser safety product manager at Laservision USA

in St. Paul, Minnesota. “Doctors often assume the majority of laser

light is absorbed by the patient’s tissue, but the exact percentage of

diffusely reflected light cannot be determined. Medical staff working

around Class IV lasers must be provided with eyewear that weakens

laser light to levels below maximum permissible exposure (MPE)

levels.”

gLASS OR POLYCARBOnAtE?Laser protective eyewear is made of either glass or polycarbonate

plastic. The choice is largely a matter of personal preference. Each

material offers its own set of positives and negatives, and each uses

different technology to protect the eye.

With polycarbonate, dyes within the plastic offer the protection. “We

make a polymer lens with absorptive dye molded into the plastic.

If a laser hits the lens, the dye absorbs the energy and transfers it

through the material,” says Bothner. “These dyed glasses do have

a tint to them, but they’re also lightweight and can be molded into

comfortable shapes and frame styles.”

McLear notes that improved dyes means that the tint of newer lenses

is not as dark as it was in past models. “The color is now a lime green

instead of a dark green, for example,” he says. Plastic lenses are also

less expensive, but they tend to scratch more easily than glass and,

therefore, may need to be replaced more often.

Glass goggles are heavier and more expensive, but they offer an

important plus: improved visible light transmission (VLT). “Weight is

definitely a factor, but given the detailed and exact nature of laser

work, most of our customers prefer glass because it offers a higher

VLT,” says Tom Barrows, owner of Innovative Optics in Maple Grove,

Minnesota. “Polycarbonate is a good choice for peripheral personnel,

who don’t need to see as clearly as the doctor.”

Hybrid lenses are also available. “These are lenses that use reflective

coatings on absorptive filters. The goal is to cover multiple wavelengths

so the user can be protected against multiple lasers with a single pair

of lenses,” says Bothner. “They are significantly more expensive, but

many think they’re worth the price. Polymer lenses would have to be

very dark to work under these circumstances, but coated glass offers

a higher VLT.” Other popular features include dielectric (so-called thin

film) coatings that give greater VLT in ambient light, antifog coatings,

prescription inserts and protective options for clinicians who use

loupes.

Another innovative option involves eye protection for IPLs. While they

are technically not lasers, IPLs also require eye protection due to the

device’s flash lamp. “In normal light, our IPL glasses are clear, but as

soon as the light pulses, the lenses darken and create the protection,”

says Daniel A. Buscaglia, DO, FAOCD, president and medical director

of the Cosmetic Vein & Laser Center in Amherst, New York. “The

glasses ‘see’ the light before our eyes do.”

Reusable metal eyeshields must be sterilized between patients, but for a high volume practice, they can be a more cost-effective choice

than disposables.


laser eye protection KEY FEATURE

protection

31

FRAME StYLESOnce you wade through the intricacies of wavelength, OD, VLT

and lens material, choosing a frame is rather straightforward: You

simply pick what you like. And, for most people, what they like is

synonymous with what feels comfortable. “You need a very specific

filter for protection but the frame is where personal preference comes

in,” says Janssen. “Frequently, the laser manufacturer provides all-

purpose, utilitarian goggles with its device, but many physicians

prefer a more contemporary frame style.”

Choosing comfortable eyewear offers important safety benefits:

“People are far more likely to wear glasses or goggles that fit well

and look good,” says Bothner. “Plus, if the frame doesn’t fit well or

doesn’t offer the correct angular coverage, you have a chance of

injury.”

PAtIEnt PROtECtIOnIn addition to protecting yourself and your staff, you need to provide

proper eye protection for your patients. Just like options for clinicians,

patients’ laser-protective eyewear has come a long way. “Twenty

years ago, doctors would cut the handles off regular spoons and

tape them over patients’ eyes with gauze pads,” says Barrows. “The

spoons worked, but the solution was cumbersome.”

Today, you have three main choices for patient eye protection: the

same laser glasses or goggles you use, reusable metal eye shields or

disposable eye shields, which consist of a thin piece of metal with

an adhesive bandage. Each type of protection offers advantages and

disadvantages.

Offering patients the same kind of eye protection you wear is the

most convenient. You can simply pull an additional pair of glasses

or goggles out of the drawer before beginning treatment. But given

the difference in angle between an upright clinician and a reclining

patient, laser glasses and goggles might not provide sufficient

protection for facial procedures, and they’re not an option when you

are working around the eyes.

Reusable metal eye shields, which offer maximum protection, cost

$100 or more and must be sterilized between patients. Still, in a

high-volume practice the overall cost may be less than for single-

use disposable eye shields. With the disposables, there are no fit,

hygiene or ease-of-use issues. “From the technician’s standpoint,

the disposables are much easier because they have the adhesive so

you don’t need to keep refitting them while you work,” says McLear.

There is also no need for sterilization (see “Note of Caution” on this

page).

Melanie Grossman, MD, offers both metal shields and goggles in

her New York-based dermatology practice. “Some patients will freak

out at the idea of having their eyes covered,” she says. “For these

patients I always have transparent, wavelength-protective goggles

or glasses available so they can see during the procedure unless I’m

treating the eye area and opaque shields are essential. I’ve noticed

that, when patients wear the protective glasses, however, they want

to treat them like sunglasses and lift them up when I’m not firing

the laser. The metal eye shields set the tone that this is a medical

procedure and the shields need to stay on for the entire session.”

REPLACEMEnt RULESOnce you ensure that everyone in the treatment room is wearing

proper laser-protective eyewear, you’re all set, right? Well, yes, until

that eyewear gets scratched or wears out. “If the glasses are properly

cared for and stored, they can last as long as your favorite sunglasses

or eyeglasses,” says Janssen, “provided their laser protection

properties remain clearly legible on the eyewear.” Loss of labels and

confusion among staff can be a good impetus to reexamine your eye

protection needs.

“I made the decision to upgrade all of my laser eyewear when I

KEY FEATURE laser eye protection


Disposable eyeshields, like these offered by Sperian, feature adhesive bandages over a metal plate so the shields won’t slip out of place

during treatments.

If the glasses are properly cared for

and stored, they can last as long as

your favorite sunglasses or eyeglasses


realized my newer staff members couldn’t decipher which glasses

went with which machine,” says Dr. Buscaglia. “We had eight pairs

of glasses for the tattoo removal laser, and they all looked different,

which increased the likelihood that someone could get hurt.”

Dr. Buscaglia spent a Saturday morning going through all of the

glasses for his 14 lasers. “It became clear to me that we needed

all-new eyewear. Many were cracked or damaged or looked like old

ski goggles,” he says. “I gave a complete list of my lasers to my

eyewear manufacturer, then got together with my staff and we tried

on glasses. We agreed on a frame style and bought three pairs for

each device, plus one pair of goggles to accommodate corrective

lenses.”

For a laser center with multiple devices, buying new eyewear for

everyone carries a substantial pricetag, but Dr. Buscaglia has no

regrets. “At about $160 to $280 per pair, I spent $8,000 for all the

glasses,” he says. “I knew this was going to be a bit of an upfront

cost but you really can’t put a price on safety.”

Darcy Lewis is an award-winning freelance writer in Chicago who

specializes in healthcare topics.

RECOURCES

American Society for Laser Medicine and Surgery

715.845.9283, www.aslms.org

Laser Institute of America · 800.345.2737, www.laserinstitute.org

Innovative Optics · 800.990.1455, www.innovativeoptics.com

Kentek · 800.432.2323, www.kenteklaserstore.com

Laservision USA · 800.393.5565, www.lasersafety.com

NoIR Laser · 800.521.9746, www.noirlaser.com

Oculo-Plastik · 888.381.3292, www.oculoplastik.com

Sperian Laser Products · 800.343.3411, www.sperianprotection.com/us

NOTE OF CAUTION Placing plastic or metal eye shields in sterilizing

solution can result in serious corneal abrasions, reported Amy F. Taub,

MD, and Erin C. DaVita of Advanced Dermatology and SkinQRI, Lin-

colnshire, Illinois, at the April 2008 annual meeting of the American

Society for Laser Medicine and Surgery. They reported on two pa-

tients who suffered corneal abrasions attributable to eye shields used

in two different laser procedures. They determined that the problem

was the result of immersing the shields in sterilizing solution, even

though the shields were rinsed after the immersion and then auto-

claved. To avoid similar problems, they recommended against plac-

ing eye shields in any sterilizing solution. Simply wash and autoclave

them.


laser eye protection KEY FEATURE

“Twenty years ago, doctors would cut the handles off regular spoons and tape them over patients’ eyes with gauze pads,”says Barrows.

“The spoons worked, but the solution was cumbersome.”

KEY FEATURE


One of the quickest ways to raise your company’s profile among the local and national media is to create a killer press center on your

website. Posting press releases, along with contact information and downloadable images of your practice and its key players is a great start. But

you can ratchet up your press pages with various forms of digital catnip that will make you and your practice virtually impossible for editors and reporters to ignore.

maximumexposure

By Joe Dysart


While a page of text including quotes and contact information is a

good start for a press release, you’ll get better play if you optimize it

for the Web. This means embedding relevant keywords that can be

found by search engines in the press release headline as well as in

the text. Offering formats with cut-and-paste portability will make

it easier for reporters on the go to pick up quotes and information.

Press releases posted on site in simple Web page format are easy to

cut and paste. Adobe .PDFs, while great for retaining an unchanged,

official record of your press release online, are often difficult to cut

and paste.

Editors and reporters are always hungry for story ideas, so you can

never offer too much content on your press center. The over-arching

guideline here is to clearly state that editors and reporters are wel-

come to directly quote information provided in your press releases.

This little permission can save the press five days of phone tag with

your practice and mean the difference between getting covered and

being passed over in favor of a more press-friendly practice.

Specific content ideal for launching press coverage includes quotes

from you and your staff on recent industry news, legislation or studies,

and short articles on new treatments you’re bringing into your prac-

tice. The press also loves transcripts of seminars or presentations they

can quote (always include a name and title), transcripts of recent we-

bcasts, case studies, survey results and patient testimonials. If you’ve

already enjoyed media coverage, offer links on your site to news stories

that have been written or aired about your practice, like

Dermatology Consultants (www.dallasderm.com/About/Press- Cen-

ter.html) and Forever Young (www.foreveryoung-inc.com/-practice-

media.html).

PROvIDE MEDIA SOURCESIf you establish yourself or your practice members as media authori-

ties, you’ll find yourself at the top of reporter’s lists when industry

news arises. Blogs are one of the quickest ways for a professional

to loom large before the press, but only if the blog is interesting and

insightful. Consider writing a major chore? Think about hiring a good

ghost blogger for your practice.

Meanwhile, you can gain additional authority with the media

by publicizing yourself in the various “expert stables” on the

Web—places where experts can present their experience, ex-

pertise and credentials to the press. Some of the more prominent

ones include Profnet (www.profnet.com), and Yearbook.com

(www.expertclick.com).

Your press releases should offer contact information including name,

title, phone and email for any media contacts. Providing the same

contact information in your press center for physicians who are avail-

able for interviews is even better. A promise, and a practice, to turn-

around all media requests within 24 hours will win you friends in the

press for life. And a stated openness to quickly respond to a media

“email interview” will inspire reporters to wonder if they’ve died and

gone to heaven.

Simply put, a reporter racing against deadline at three in the morning

will never forget the kindness of a quick, email interview. Moreover,

email interviews offer hidden advantages. They allow you to think

through your responses to the reporter and, given that your respons-

es are in writing, you’re less likely to be misquoted.

ADD RICH MEDIA UPgRADESOnce you’ve integrated the basics of an effective press center, you

can build out your content with a variety of multimedia tools. One

thing we’ve learned from the success of YouTube (www.youtube.

com) is that Web users, including the press, love sound and pictures.

Besides posting procedure videos on YouTube, you can also embed a

YouTube video player on your own website for free. Essentially, once

you post your completed video to the YouTube site, you can cut and

paste a snippet of YouTube-provided code that will create a YouTube

player on your own website in seconds. Such players can be dropped

beside your press releases in your press center, next to your blog or in

virtually any other sector of your website.

You have the option of posting the YouTube player “as is,” with its

familiar chrome border and YouTube logo or customizing it with your

company logo, as well as a look and feel that’s distinctive to your

brand. (With either option, a faint YouTube watermark appears in

the right-hand corner.) Sites that are currently using this technol-

ogy include The Reed Center for Plastic Surgery (www.thereedcenter.

com/rc-press.html) and Anil R. Shah, MD (www.shahfacialplastics.

com/media.html).

For video on how to add the YouTube player to your website, check

out www.youtube.com/youtubeonyoursite. There’s also a separate in-

structional video on how to customize your player at www.youtube.

com/watch?v=uTwWEtVtu58.

One caveat: You may want to have your attorney look at YouTube’s

fine print if you’re using the video strictly for advertising purposes. As

with many Web-related legal issues, this area is still very gray.

AttRACt AttEntIOnOne of the great equalizers of the Web is that a tiny, nimble compa-

ny can leap ahead of a lumbering goliath with the right promotion.

You can start promoting your press center with a sign-up box that

encourages visitors to join your email list for press releases and the

company e-newsletter. You can offer RSS (Really Simple Syndication)

While a page of text including quotes and contact information is a good start for a press release, you’ll get better play if you optimize it for the Web.

maximum exposure KEY FEATURE

maximum

Evolve Medical group’s site offers potential patients video, current news, newsletters and profile listings.

KEY FEATURE maximum exposure

feeds for reporters who like their news delivered this way through free

services like IceRocket (http://rss.icerocket.com) that make your pages

RSS-friendly.

During the past few years, Google has released a number of free tools

designed to help your press center get the best play on the Google search

engine. The idea is that if you use these tools, your site will appear higher

in Google search returns for the keywords highlighted on your site. Sign

up for a free Google Webmaster’s account (www.google.com/webmas-

ters) for tools, tips and tricks to optimize your press center domain for

the Google search engine. Once your press center is search-friendly for

Google, you’ll also be optimized for most other major search engines.

Other tactics that help direct media professionals to you and vice versa

include professional press release distribution services that, for a fee, dis-

tribute your press materials to media contacts worldwide. PRNewswire

(www.prnewswire.com) is one of the largest press release distribution

services. To find free services, you can search under the keywords “free

press release distribution.” “Press releases often lead to personal inter-

views, which can make you and your website very popular,” says Thomas

Wong, author of 101 Ways to Boost Your Web Traffic (Intesync).

With all of the new technologies available, it’s extremely important to

ensure that your press center downloads fast. The easiest way to lose an

editor or reporter is to serve up a press center site that takes forever to

download. For optimization tips, check out Andrew B. King’s book, Speed

Up Your Site (New Riders). King is the founder of Web Site Optimization,

LLC, which offers a free tool to analyze the download speed of your site

(www.websiteoptimization.com/services/analyze/).

MEASURE YOUR SUCCESSUpgrading your press center requires an investment of both time and

money, and you want to make sure your investment is paying off. Google

Analytics (www.google.com/analytics) allows you to measure not only

traffic to your press center, but the ways the press is interacting with

your site as well. This online service is a breeze to use—just cut and

paste a snippet of Google-provided code on every page of your press

center—and you’ll be able to analyze all sorts of press visits and activity

on your site with easy-to-understand reports. Google regularly enhances

this service. And the price is hard to beat: It’s free.

Once editors, reporters and bloggers start talking about your practice

on the Web, you’ll want to keep an eye on what they’re saying. The im-

portance of such reputation monitoring cannot be underestimated, says

Bruce Arnold, founder of Caslon Analytics (www.caslon.com.au), a Web

marketing firm that counsels clients on managing reputations online.

Specific reputation monitoring providers you’ll want to evaluate include

Factiva Insight (www.factiva.com/factivainsight/repu tation), Nielsen On-

line (www.nielsen-online.com/) and BlogSquirrel (www.cyberalert.com/-

blogmonitoring.html). z

Joe Dysart is an Internet speaker and business consultant based in

Thousand Oaks, California. Contact him at [email protected],

www.joedysart.com.


Anil M. Shah, MD, and the Reed Center for Plastic Surgery employ Youtube players as part of their press centers.

Dermatology Consultants provides clips on its website of recent television and print media coverage.

the ASAPS offers news releases that can be cut and pasted by media professionals. Contact information is printed clearly at the top of each release.

SUNLIFE - SENSITIVE CAREA Sun life Series for Sensitive, Allergy Prone and Damaging Skin

All products have been Dermatologically tested, UV - tested, Photo Stable, andFree of Allergy Causing Perfumes

Sun Life Sensitive Allergy Care SPF 12Sun Life Sensitive Age Stop SPF 25Sun Life Sensitive Body Lotion SPF 30Sun Life Sensitive Stop SPF 50Sun Life Sensitive After Sun Gel for Face & BodySun Life Sensitive Pre Tan LotionSun Life Sensitive Self Tan Lotion

SUNLIFE & SUNLIFE SENSITIVE

BY KLAPP

CELL AND SUN PROTECTORA breakthrough in SUNLIFE Products containing ECTOIN® that envelopes the individual

cells like a mantle and thus acts as a UV and Cell protector

SUNLIFE – CELL PROTECTORSun Life Protection Lotion SPF 8 200 mlECTOIN® - cell protectorCOPPER – stimulates melanin synthesis and strengthens the immune systemCell revitalizer, against free radicals, anti-inflammatory, anti-aging effectSun Life High Protection Lotion SPF 18 200mlECTOIN® - cell protectorCOPPER – stimulates melanin synthesis and strengthens the immune systemCell revitalizer, against free radicals, anti-inflammatory, anti-aging effectSun Life Pre Tan Lotion 200mlTanning activator for face ad body which stimulates melanin synthesisSun Life Tanning Lotion 200mlSelf tanning lotion giving the face and body a natural tanSun Life Cool Repair Lotion 200mlCooling after sun lotion with repair function

Optimum Esthetic SystemsTel : 012 362 6571/2/3Fax : 012 362 [email protected]

Klapp beauty wellness.indd 1 1/11/08 10:26:50 AM

Liquid Ice CosMedicals AG • Zugerbergstrasse 86 • 6314 Unterägeri • SwitzerlandTel. +41 41 750 89 89 • E-Fax +41 44 355 34 49 • E-Mail [email protected] • www.icemask.com

Aesthetic Buyer’s GuideSept 2008

ADVERTORIAL


ice maskcosMedical deliversperfect cooling after facial procedures

Celebrate A Year of Body Shaping In the year since VelaShape first entered the global spotlight, it has reshaped the way practitioners and patients think about non-invasive body contouring results!

Proven Clinical Results

What VelaShape Customers Are Saying

Practitioner Survey Highlights Include:

Clinical studies also report that patients can comfortably and safely achieve a toned, contoured and well shaped body in as few as 4 treatment sessions.

“VelaShape has also brought in new patients to the office – often friends and relatives of our existing patients come in just for VelaShape.”Mark Winter, M.D. – Orange Coast Women’s Medical Group, California

“We get consistent results with VelaShape. In fact, I guarantee my patients will see results whether it’s smoothing of the skin or circumferential reduction.”John Shieh, M.D. – RejuvaYou Medical Spas, California

97% of practitioners report an average of 3 - 10 centimeters reduction • in circumference of the treated areas for their patients. 87% of practitioners report that they treat at least 1 and up to 10 • VelaShape patients per week.78% of practitioners report seeing a significant reduction in the • appearance of cellulite on their patients.

“We see a lot of people who don’t want to go to the operating room but want to make a change in their body. VelaShape is certainly a way to achieve the results they are seeking with a non-invasive procedure.”Talmage Raine, M.D. – Hinsdale Center for Plastic Surgery, Illinois

1 Year Anniversary!

Perfectly Positioned for Today’s Economy

Aesthetics Buyers Guide July/August 2008Minimally Invasive Procedures Sustain Growth in Declining Economy

“As big ticket surgical items become financially out of reach for more consumers, several physicians and analysts pointed to a ‘trading down’ phenomenon whereby consumers are foregoing expensive surgical procedures for lower cost, often more minimally invasive alternatives.”

© 2009. All rights reserved. Syneron, the Syneron logo, VelaShape and elōs are trademarks of Syneron Medical Ltd. and may be registered in certain jurisdictions. elōs (electro-optical synergy) is a proprietary technology of Syneron Medical. LipoLite is a trademark of SpaMedica.* Temporary reduction of thigh circumference. PB71451

For an innovative approach to offering your patients effective, minimally invasive body contouring with great results and a fast recovery, use the VelaShape in combination with Syneron’s LipoLite Laser LipoSculpture system.

Body Contouring

Post 5 treatments.Photos courtesy of Longevity Medical Clinic

Before After

Cellulite Reduction

Post 4 treatments.Photos courtesy of Gerald Boey, M.D.

Before After

VelaShape™ treats both deeper tissue and the upper layers of the skin by offering a measurable reduction in fat layers, circumference and cellulite. Powered by the revolutionary elos™ technology, VelaShape is CE marked for body contouring and cellulite reduction and FDA cleared for circumferential* and cellulite reduction.

Better Together!

The Ultimate Body Contouring Treatment

&

For more information: www.velashape.com, www.syneron.com, [email protected]


ADVERTORIAL

The NovaShape is a-state-of-the-art system manufactured in Switzerland (Ultra Med Ltd) for fat reduction and body con-touring.

Years of research went into the manufacturing of the NovaShape. It uses low frequencies ultrasound (25Khz – 150Khz) which results in the

mechanical destruction of the adipose tissue - in contrast to similar ultrasound devices currently on the market which uses high frequencies

(1MHZ – 2.4Mhz) causing a thermal effect of adipose destruction. The NovaShape’s mechanical process results in a much safer and effective

treatment.

non-invasiveNovaShape

body contouringNEW FROM TECHNOLASE CC

tHE tECHnOLOgY On WHICH It IS BASED

The destruction of the adipose tissue or fat cells is caused is by a

process called Cavitation at Resonant Level.

The low frequency ultrasound causes a variation in pressure within

the tissue resulting in a large number of micro-bubbles to be formed

within the tissue. Due to the variation in pressure (the pressure

exceeds 50Kg per cm2) the bubbles explode and implode. This me-

chanical effect of exploding and imploding is strong enough to break

down the adipose membranes. It is a selective process – only the

adipocytes are ruptured –the surrounding tissue is not affected.

The rupturing of the adipose membranes (cell walls) destroys the fat

cells. The released fat and cellulite debris – triglycerides - are cleared

via the body’s natural physiological and metabolic pathways.

A SPECIALIzED HAnDPIECE

The NovaShape uses a piezoelectric emitter in the hand piece. It

houses a strong cooling mechanism. This unique refrigeration allows

the high power emitter to work continuously without over heating,

for optimal effectiveness and maximum comfort to the patient.

SPECIAL FEAtURES

• Permanent and Visible results from the first treatment

• Can be used over entire body

• No need for anesthesia or shaving

• Very comfortable due to cooling head.

• Extremely easy to use.

• Continuous research – therefore future upgrades.

• Low running cost

The NovaShape is Fully portable and weighs 65 Kg.


ADVERTORIAL

SUPER HIGH TECH COSMETIC POWERoptimum esthetic systems

Experience the Quality“Innovation Yesterday-Today and also Tomorrow”

Optimum Esthetic Systems is the

exclusive distributor of the KLAPP

COSMETICS range in southern Africa.

This includes the Klapp Professional,

Klapp Beauty Specialist, Klapp Wellness

and the GK Medical Cosmetics ranges.

KLAPP COSMETICS was founded in

1980 by Mr. Gerhard Klapp. KLAPP

develops and produces skin care

products and body lines that include a

variety of innovative professional and

home care ranges.

Gerhard Klapp, Anti-Aging-Specialist, alternative practitioner, Advocate of TCM, owner of the

KLAPP GROUP and Author has been dedicated to the research and development of effective

beauty-products for the preservation of beauty for over 25 years.

KLAPP has always been one of the trendsetters in the Beauty Market. To name only some of his

innovations, , Bio Cell therapies, Retinol (Vit A) series, Hyaluronic acid, Vit C, BX - Argireline®,

DMAE, DHEA, Collagen, Liposome’s, Peptides, Micro Silver, Gold, Ectoin®, Normasept®, Rona

care VTA® and DNA and Glycolic, Salicylic and Alfa Hydroxy Acids & Vit C series.

Klapp and GK products are NOT tested on animals and natural ingredients are used whenever

possible. All products are approved by the different National FDA’s. The company had its

international breakthrough with the massage technique CHI YANG and is currently exporting to

over 40 countries all over the world and is now available in South Africa.

GK COSMETICS GmbH, a division of Klapp Cosmetics, was founded in 2005 in order to develop

the market in the field of Medical Cosmetics. GK COSMETICS uses medical technology methods

and applies them for cosmetic use.

Technologies such as Impulse Light, Ultra Sound and High Voltage are used to penetrate the

upper layers of the skin and to enable active ingredients to be transported into the required areas,

connective tissue and the deeper skin layers.

The company has been awarded twice the sought-after German BEAUTY AWARD for Innovation, Products and Service

tREAtIng, PAMPERIng, RECOMMEnDIngKLAPP’S POSt LASER CARE SYStEMS

After being exposed to laser treatment

the skin needs extra care. Therefore it is

even more important now to support the

skin with the right choice of products.

KLAPP Cosmetics have developed specially

formulated products and treatments to

support the need of post-laser skin.

KLAPP Aloe Ferox gel – which

contains high concentration of naturally

ripened ingredients, harvested only

every three years .Alloe Ferox is used

immediately after the laser treatment

for its healing, moisturizing, astringent,

softening, regenerating and protective

properties. It also protects effectively

against UV rays and stress through

oxidation. It strengthens the collagen

and elastin fibres .Its disinfection action

prevents impurities and calms irritations.

Aloe Ferox Gel contains rich sources of

minerals and trace elements such as

magnesium, calcium, iron and zinc.

For the best results KLAPP recommends

keeping the Alloe Ferrox in the fridge to

enhance its cooling effect so important

after the laser procedure .The treatment

with Alloe Ferrox should continue for the

few first days after the laser .

Ideally immediately after the laser

treatment KLAPP Algen Aktiv Mask can

be used to improve moisture content

and elasticity and for additional cooling

effect.

OPTIMUM ESTHETIC SYSTEMS Tel: 012 362 6571/2/3 Fax : 012 362 6570 www.clubwellness.co.za [email protected]

ONLY

R6630.00Professional

use only

The GK 4 combines three technologies, which have been most successfully been used in medicine and cosmetic usage:• Ultrasound• Far Infrared• Ionization

Gk 4 offers Maximum Results• Moisture checking function• Skin regeneration• Deep activation of skin tissue and its metabolism• Increased permeability and open transport channels• Deep cleansing mode• Whitening mode• Wrinkle care mode • Massage mode• Nutrition mode• Lifting mode• Body care mode to improve body

shape by stimulating and exercising cellulites & fatty tissue

with MOISTURE CHECKING FUNCTION

ULTRASONIC & ION SKIN CARE MASSAGER

Beautiko GK.indd 1 26/2/08 12:04:06


Filorga® extends its range of anti-ageing chemical peelsFilorga Laboratories has been leader in the superficial chemical peel market with its advanced formulation GlyKopeel®, giving superior results

with no recovery period or social eviction. Last year, the new formulation of GlyKopeels was launched providing even lower pH with still no

skin flaking and need for social or sport eviction. This process of lower pH and less skin irritation were made possible after numerous years of

research and multiple experts from various countries.

tHE UnIQUE PH vARIAtIOn PROCESSThe sequential variation of pH during the GlyKopeel® procedure remains unique and is one of the major contributing factors reducing the risk

of side effects and improving visible results on skin appearance. Traditional peelings lower and increase the skin’s pH in a very sudden way.

GlyKopeel® is the first chemical superficial dermatological peeling in 4 steps, with sequential pH variations. By associating a first, preliminary

step (Prepeel with a pH of 4.5) with a final repairing phase (isotonic mist with a pH of 6.5) it allows a gentle treatment that provides an

immediate, visible result with no need for social eviction.

pH 4.5

pH 0.8 - 2

StEP 1 StEP 2 StEP 3 StEP 4pH

PREPEEL

PEELIng

POStPEELBRUME

pH 6.5

pH 8

Preparation Exfoliation neutralisaton Reparation

gLYKOPEEL * Is the first peeling with sequential variation of pH in 4 steps

4

6.5

4.5

1.6

UnIQUE IngREDIEntSThe new formula contains 18 ingredients improving the range of indications of skin imperfections. Results are visible immediately (brightness and softness) as well as progressive improvement (antiwrinkle and brown spots). Immediate results are ensured by the exfoliating action of glycolic acid combines with the antiradical, anti-inflammtory and hydrating action of the white mulberry, brown algae and glycerine. Progressively improving results on wrinkles and brown spots are due to the stimulating action of Vitamin A, C and E combined with the depigmenting action of Kojic acid and bearberry.

The peeling comes in 3 different glycolic acid concentrations and with 4 pH levels: 70 % with a pH of 0.8 and 1.6 / 50 % with a pH of 1.8 / 20 % with a pH of 2. Choice of peeling is made according to the skin type indication: Glykopeel® 20% is reserved to hyper-sensitive skins and can be performed by a medical assistant. Glykopeel® 50% is specifically indicated for sensitive skins or to be used in first sessions.

Glykopeel® 70% enables a higher efficiency level on more tolerant skin or skin used to peelings.

nEW!For an intensive treatment and a radical result, FILORGA® laboratories have developed the new Glykopeel® max, composed of 70% glycolic acid buffered at pH 0.8.

2009 marks the launch of numerous new innovations from the leading laboratory, the first in this year being the GlyKopeel 70% Max. This extends the indications of GlyKopeel® to also treat acne scars and deep dermal imperfections including pigmentary imperfections. The next breaktrough innovation to be launched in March at the Anti-ageing Medicine World Congress in Monte Carlo is the first of the X-peel range from Filorga. This range completes the chemical peel range in 3 formulations offering a ‘superficial – medium’ depth peel, a medium depth peel and deep peel formulation. An amazing composition of various acids makes this a new innovative peel offering more than any peel worldwide could ever offer. More information will be supplied after its launch in March.

For more information: www.filorgasouthafrica.co.za 012 548 3943 [email protected]

GlyKopeel® is recommended to treat wrinkles, loss of suppleness, dull complexion, hyperpigmentation, microcystic acne and skin imperfections.

ADVERTORIAL


ADVERTORIAL

Derma C, from the Filorga Professional range,

and Meso C, from the Cosmesotherapie range,

offers pure L-ascorbic acid delivered in its most active version thanks to its

ingenious packaging. Derma C is packaged in 3

vials needing activation instantly before use to

ensure optimal stability.

Each vial will be able to deliver the pure and active

form of Vitamin C for up to 7 days. This package

of 3 vials for 7 dya use of each vial, gives your

patients a 21 day cell renewal cycle with the most

active and pure benefits that one can ever expect

from Vitamin C combined with moisturizing

polysaccharides.

pure vitamin Coptimal benefits from

in its most active form

Vitamin C in its active form has numerous studies confirming its valid effects as an anti-oxidant, photoprotector, collagen stimulator and

depigmenting agent (by inhibiting melanin synthesis).

Derma C combines 100% of pure vitamin C with biosaccharides. These ingredients give it remarkable properties, having the effect of:

stimulating the cutaneous cellular metabolism, reinforcing the anti-oxidant power, hydrating and improving the skin’s tone.

BEnEFItS- Smooths lines and wrinkles with first use.

- Fades and lightens sun spots and age spots.

- Creates a new, more beautiful facial complexion.

- Enhances elasticity, firmness and skin texture.

- Restores radiance, smoothes, rebuilds collagen.

- Removes dull skin cells, reduces wrinkles and smoothes roughness due to excess dryness, acne and other problem skin conditions.

Derma C has received the PRICE OF INNOVATION in Europe already 8 years ago and has ever since become a vital part of prescription

following aesthetic consultations.

For more information and clinical trials contact gA Active Wholesalers 012 548 3943 or www.filorgasouthafrica.co.za or [email protected].

5493 Med Aesthetics ad NEWRR 3/6/09 12:55 PM Page 1

Composite

C M Y CM MY CY CMY K


BEST PRACTICES

CAnFIELD MODELIng SOFtWARESurgeons offering breast augmentation can save time, deliver

more realistic consultations and improve patient satisfaction by

adding the new Breast Sculptor surgical modeling software to

the Canfield VECTRA 3D imaging platform. The software pro-

vides 3D comparisons of different implant scenarios to help

patients select the type of augmentation they want quickly

and precisely. Unlike two-dimensional simulation tools, Breast

Sculptor presents an augmentation outcome that can be ro-

tated to show an almost infinite number of views. The VECTRA

3D platform for Breast Sculptor produces fast, accurate three-

dimensional surface imaging and precise measurement tools

for volume, area, circumference and distance. The surgeon can

also automatically calculate volume to provide an objective in-

dication of the amount of asymmetry prior to surgery. “Breast

Sculptor is a tremendous tool for developing a common under-

standing between me and my patients prior to surgery,” states

Nolan Karp, MD, of New York City. “This results in more satis-

fied patients and additional referrals.” For more information,

www.genophealthcare.co.za, [email protected]

CAnFIELD MODELIng SOFtWARE MAtRIx RF RECEIvES CLEARAnCEIn late September, Syneron Medical announced that its Matrix RF

applicator received FDA clearance for use in dermatologic proce-

dures requiring ablation and resurfacing of the skin. The Matrix RF

applicator is the first bipolar RF nonlaser and nonlight-based aes-

thetic device capable of creating tunable ablation/resurfacing im-

pact, simulating the effects of common ablative/coagulative lasers

used for a range of aesthetic applications. It is the first bipolar RF

device able to treat skin in a method similar to fractional laser or

light-based devices, heating discrete columns of skin while leaving

the surrounding tissue intact.

“In my trials, I have found that the Matrix RF produces a unique

combination of skin rejuvenation, wrinkle reduction, skin tighten-

ing and even lifting with less downtime than found with traditional

skin rejuvenating treatments,” reports dermatologist Amy Taub, MD,

who participated in the clinical studies of the Matrix RF. Matrix RF

will be sold as an applicator add-on to all exisiting eLight, eLaser

and eMax platforms. For more information, radiant@worldonline.

co.za, 011 794 8253

FDA APPROVED

Cour

tesy

Pal

omar

AFtER BEFORE

FDA APPROvEDPalomar Medical Technologies, a leader in the development of light-

based systems for cosmetic treatments, announced FDA clearance

for the treatment of scars with the Palomar Lux 1540 Fractional

Non-Ablative Laser Handpiece. The Lux 1540 has been shown to be

effective in treating both atrophic and hypertrophic scars by creating

micro-columns of coagulated tissue in the skin. This process results

in significant improvement in the appearance of scars, offers short

recovery times and allows doctors to tailor the treatment for each

patient’s individual type of skin and scar. “Treatment with the Palo-

mar Lux 1540 fractional technology has the potential to become the

gold standard for scar treatment,” said David B. Vasily, MD, medical

director of the Aesthetica Cosmetic and Laser Center in Bethlehem,

Pennsylvania. For more information, www.genophealthcare.co.za,

[email protected]


FIvE-POIntED StARSFive is the winning number if you want to become a media relations star, says Richard Virgilio,

managing director of PayPerClip public relations (www.payperclip.com). Becoming a media-

recognized industry expert has never been more important and Virgilio has found that keep-

ing these “fives” in mind can keep reporters and broadcasters coming back to you:

Five seconds is the optimal length for a newsworthy sound bite.

Five words is the limit for a business title. Think dermatologist specializing in

medical aesthetics instead of medical director of Bronzky, North and

York Dermatology Group.

Five points is ample content. Keep messages concise. If you try to say more,

you will be rushed and scattered, giving the impression that you are

unsure of your message.

Five sentences is all it should take to answer a reporter’s question on a specific

topic. Be direct.

Five deep breaths before an interview is the most important preparation after content.

If you are not composed, alert and focused, the interviewer may

sense your tension as lack of confidence and lose interest.

SCEnt OF SKIn CAnCERHuman skin produces numerous airborne chemical molecules known as

volatile organic compounds, many of which are odorous. In findings pre-

sented at the 236th meeting of the American Chemical Society in August,

researchers suggest that these scents might be used to detect basal cell

carcinoma and other forms of skin cancer. Using gas chromatography-

mass spectrometry techniques, scientists at the Monell Chemical Senses

Center (www.monell.org), a nonprofit basic research institute based in

Philadelphia, sampled air above basal cell tumors in 11 patients and found

a different profile of chemical compounds compared to skin located at the

same sites in 11 healthy control subjects. “Our findings may someday al-

low doctors to screen for and diagnose skin cancers at very early stages,”

said Michelle Gallagher, PhD.

In-OFFICE ADS WItH IMPACtDo patients pay any attention to the brochures and videos in your waiting room? A recent

Health Media Network (www.hmnads.com) study by Arbitron says that 86% of those

exposed to advertising in healthcare facilities could recall at least one advertisement

they had seen during their visits. HMN advertisements were in the form of framed wall

posters or broadcast over widescreen digital television monitors in waiting rooms or

treatment areas of the facilities.

If your in-office advertising is relegated to a few brochures on a crowded counter or

tabletop, it might be worth considering adding a sign unit like the one shown here

from Walls + Forms (www.wallsforms.com). The Lights Alive backlit floor stand lets

you highlight a premier service in the lighted portion of the sign and provides pockets

underneath for brochures.

BEST PRACTICES


vASER LIMItS BLOOD LOSSVaser-assisted lipoplasty should be recommended over

traditional suction-assisted lipoplasty for patients undergoing

large-volume liposuction procedures or treatments in very

fibrous areas of the body where increased blood loss is

expected, according to the findings of a study published

in the July/August 2008 issue of Aesthetic Surgery Journal.

The 57-patient study comparing traditional liposuction

(27 patients) with Vaser Lipo treatments (30 patients) was

conducted by Onelio Garcia Jr., MD, and Nirmal Nathan. The

findings showed that traditional liposuction results in 7.5

times more blood loss than in Vaser Lipo procedures.

“Vaser Lipo already has several well-documented clinical

advantages, but this particular scientific study adds new

levels of credibility to the benefits of Vaser technology over

traditional methods,” says Dan Goldberger, CEO of Sound

Surgical Technologies, the manufacturer of the Vaser Lipo

System. For more about Vaser Lipo, [email protected],

011 444 0404, [email protected], 011 794 8253

ADvAnCED WHItEnIngThe BEYOND WhiteSpa Select system is the new generation

in teeth whitening, offering a high

quality, specially-formulated whitening

gel. The system is a comprehensive,

turnkey product that comes with

the original teeth whitening

accelerator, free materials for

your first 10 treatments and

other promotional products

for your practice. Contact:

866.695.6452,

www.beyondwhitespa.com


BEST PRACTICES

50

tWO-In-OnE The eCO2 system from Lutronic is the first multifunctional fractional laser system that combines

both Static and Dynamic operation modes. Users can stamp an area up to 14mm by 14mm

and feather the treatment edges, thereby reducing the “checkerboard” appearance that is

common with currently available eCO2 devices. “The eCO2 has the ability to perform incisional

surgery, traditional ablative resurfacing and ablative microfractional photothermolysis,”

says J. David Holcomb, MD, immediate past president of the Florida Society of Facial Plastic

Surgeons. Contact: 609.275.1565, www.lutronic.com.

RESURFACIng BREAKtHROUgHAlma Lasers introduces the Pixel CO2, the company’s latest fractional, ablative CO2 solution.

The FDA-cleared system combines the effectiveness of an ablative approach with the comfort

level and convenience of a nonablative solution. Another plus is the shortened healing time-

the Pixel CO2 takes downtime from 30 days to approximately three. It also comes with a

lower risk of complications as compared to traditional laser skin resurfacing. Contact: www.

squabb.co.za, 012 667 5304, [email protected]

SKIn REnEWALSmooth deep wrinkles and firm skin

in as little as one session with the Af-

firm CO2 from Cynosure. Adjustable

power, pulse length and spot pacing

allow you to customize treatments

for skin resurfacing and collagen

rejuvenation. Contact: www.sternla-

ser.co.za, 082 551 5938

InCREASED vERSAtILItYPerform skin tightening, skin rejuvenation, hair

removal and more with one device. The Cutera

XEO is a customizable and upgradable platform

featuring 2790nm wavelength laser, 520nm to

1800nm pulsed light technologies and the Cool

Glide 1064 nm Nd:YAG laser. Contact:

www.ergonmedical.co.za, [email protected],

011 454 1876


FAStER FRACtIOnAL RESURFACIngReliant Technologies has received FDA 510(k) clearance for the new Fraxel re:pair 600micron

handpiece. The handpiece allows you to perform superficial fractionated procedures both on

and off the face, including the neck, hands and chest, with more uniform results and faster re-

covery times. Developed to treat fine lines, age spots and sun spots, the 600micron handpiece

works up to four times faster than other ablative technologies and offers additional collagen

remodeling capabilities. “The Fraxel re:pair’s 600micron handpiece is a significant advance-

ment for my practice,” says David H. McDaniel, MD. “Treatment is comparable to a series of IPL

treatments plus a series of microdermabrasion sessions, with the added benefit of increased,

long-term collagen production.” Contact: www.laserderm.co.za, 011 476 1228

tHREE DIMEnSIOnAL IMAgIngYou can help your patients visualize potential outcomes with Face Sculptor three dimensional

surgical modeling software from Canfield Imaging. The easy-to-learn software offers pictorial

icons and slide bars that allow you to sculpt facial images to the desired appearance. During

consultations, patients can see the results of rhinoplasty, chin augmentation and more, all

through three-dimensional, high resolution images that can be rotated and viewed from any

angle. The VECTRA 3D images are saved in the software’s Mirror database. The Face Sculptor

also allows you to capture two-dimensional before-and-after images, which can be printed into

photo quality reports for your medical files. www.genophealthcare.co.za, Dianne@genophc.

co.za

WAtER-ASSIStED LIPOSUCtIOnBody-Jet from Eclipsemed simultaneously irrigates and aspirates fat tissue during liposuction

to reduce bruising, swelling and collateral tissue damage. The Body-Jet uses only 25% of the

infiltration fluid normally required in traditional liposuction, which allows for less swollen mass

and improved patient comfort. The flushing action of the system helps protect surrounding

nerves and vessels. The Body-Jet also assists in fat transfer. When immediately filtered with

appropriate accessories, the fat does not require a lengthy centrifuge process to reduce water

volume prior to transfer. Contact: 800.759.6876, www.eclipsemed.com.

BEST PRACTICES

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›› Image processing via normal light image, polarised light and UV light images.

›› 3D display of each area ›› History and comparisson analysis›› Printed output of above

FaciaL aNaLYsis sYsteM -Janus

Observation & Measurement of› Pores› Wrinkles› Spots› Sebum› Porphyrin› SkinColour&Tone

*setting up an aesthetic recessiON · Unlike focused ﬁ xed frequency Unlike focused ﬁ xed...

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