Botulinum Toxin revolution!

Botulinum Toxin - thoughts on the new kids on the block: Alluzience, Letybo, Botox, Azzalure, Bocouture. How will it affect aesthetic practice and patient choice.

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Dealing with FAT!

Excessive weight is not only detrimental to overall health, but can have a devastating effect on self esteem and confidence. When dealing with weight management, addressing underlying psychological factors are pivotal in achieving and maintaining results.

Different options are available depending on the patients presentation. Products such as Aqualyx or Celluform “melt away” stubborn areas of fat which remain despite weight loss. Saxenda assist in obtaining a goal weight by affecting appetite and other factors involved in weight management.

SAXENDA:

Saxenda is an injectable prescription medicine used for adults with excess weight (BMI ≥27) who also have weight-related medical problems or obesity (BMI ≥30), and children aged 12-17 years with a body weight above 132 pounds (60 kg) and obesity to help them lose weight and keep the weight off. Saxenda® should be used with a reduced calorie diet and increased physical activity.

When you attend for a weight management consultation the focus should not only be on the physical measurements and setting realistic goals, but also to identify underlying psychological factors pivotal in your weight gain. Of late more and more emphasis is being placed on the addictive nature of weight problems. A detailed consultation will exclude contraindications to the treatment, help to set realistic goals and explore dietary and physical activity guidance.

From a personal viewpoint Saxenda offers a novel approach to weigh loss. The safe reduction in appetite with resulting reduction in portion sizes allows seamless integration with modern life!

CELLUFORM and AQUALYX:

These products contain Deoxycholic Acid involved with fat emulsion (dissolving) in the body. Celluform contains Phosphatidyl Choline and Deoxycholic Acid, extremely effective against cellulite, water retention and localised fat.

The products are administered via special injection techniques directly into the affected area and is usually repeated (2 to 4 weekly) until the desired result is achieved. Areas of localised fat under the chin, on the stomach and the thigh area are most often treated.

Most patients report little discomfort during the procedure and there is no “down time”.

Celluform Plus for Chin fat, submental fat pad
Celluform body fat

Bio Stimulators vs Dermal Fillers

The basic difference is that a “bio-stimulator” product such as PLLA stimulate your own collagen formation rather than injecting Hyaloronic acid as with most filler products. The product is injected with a specialised technique and increases collagen - leading to subtle volume increase and improvement of lines and wrinkles. The product itself dissolves after a few days and the results are due to natural collagen production. It is often referred to as a liquid face lift being able to address the whole face rather that just specific areas. The effect sets on over 2 to 3 months and can be repeated until a satisfactory result is achieved. The result last for 2 to 3 years and it is a safe procedure that has been available for decades.

There are different bio-stimulator products on the market such as Sculptra and Lanluma.

Dermal fillers used these days are all mostly Hyaloronic Acid based. They restore loss of volume and improves overlaying skin quality. Each brand of filler has developed different products for different uses. “Thicker” fillers add more volume and are used for areas such as the cheeks. “Thinner” fillers are for more superficial use such as in the lips or for fine lines and wrinkles. The “thicker” products tend to have a longer lasting result of up to 16 or 18 months for some. Fillers are in general safe to use when administered by qualified medical practitioners.

Different brands or fillers include Juvederm, Restylane, Belotero and many others. Care have to be taken when choosing the brand of filler as poor quality fillers inevitably have a less desirable result!

HOW TO CHOOSE?

Your practitioner will be best placed to advised you on the most appropriate product for you unique presentation. When there is wide spread significant loss of volume my preference would be to consider a bio-stimulator and to achieve a complete “liquid face lift”. When there are only specific areas of concern, the use of dermal fillers is usually the best way forward. Overall there is however no definite recommendation and an in depth consultation and specific aims of the person would dictate the most appropriate procedure to use.

IMPORTANT FACTORS TO CONSIDER:

  • Always ask about the practitioners qualifications and experience. In my opinion these treatments should only be performed by a qualified professional - either a doctor or independent prescribing nurse at least. There are serious possible long term complications with these products which the practitioner must be able to 1. Prevent from happening 2. Identify and diagnose the problem 3. Be able to manage the complication which often require prescription medication 4. Must be regulated by a professional body such as the GMC (general medical council) on NMC (nursing midwifery council) to ensure professional standards.

  • Look at pictures of results. Practicing aesthetic medicine is an art form. Make sure the results of the practitioner is what you are aiming for. My personal preference is for a natural look and to avoid the “overdone” look at all cost! Treatments should restore natural beauty, occasionally correct undesired aspects of appearance. Unfortunately many people now have a “generic” appearance due to practitioners blindly following techniques taught in stead of treating each individual based on consultation.

  • Ask about the specific brand of filler and which product in that brand is being used. The practitioner must be able to provide you with the “lot number” and expiry date of the product. Make sure that the product is supplied from a reputable UK source and not a fake imported product!

  • Establish the exact cost of the procedure. The cost is not only related to the product, but also the qualifications and experience of the practitioner. When enquiring about a treatment, the points raised above should take priority over the price of the procedure. The price should not be your first question when considering a treatment nor should respectable professional lure people by advertising based on price.

  • Ensure clear aftercare instructions are provided following the treatment to assure the best results and minimise complications.