find us on twitter, facebook &...
TRANSCRIPT
[AQ: please supply an author image]
prime-journal.com | March/April 2014
❚ 3
It’s a typIcal busy Monday and Mrs Jones, a lovely 46 year old MarketIng executive has a 1:30 pm appointment to see you. she is a new patient to your office but has been happily having botox® to her upper face for the past 3 years on a regular basis and because of scheduling conflicts, was unable to see her regular dermatologist for treatment. It’s been nearly 4 months since her last treatment and she, ‘doesn’t want to let it go’. she heard you were great from her friend, who somehow has been looking better and
better over the past few years, although she hasn’t a clue what you’ve been doing to her. she’s in a bit of a rush though and it’s already 2:15 pm when you are finally able to examine her.
When you examine her you notice that indeed she has some movement in her upper face, the usual three areas where her doctor gives her botox, but few lines there. However, you do notice the volume loss in her temples that contributes to sagging of the lateral brow, that she’s had bone resorbtion in the chin and mid-face causing classic sagging and folds. Her mid-face fat volume loss and widening of her orbital sockets has caused the appearance of dark circles under her eyes. these conditions cause her to appear tired and older than she could optimally appear. she is energetic and engaging yet appears tired. there is no question in your mind that some filler or collagen stimulator to her mid-face and possibly lower face would give her greater facial balance and certainly more ‘bang for the buck’ than just treating her usual areas with botox cosmetic.
two syringes of Juvéderm voluMa™ to her mid-face might remove the tired look that she hasn’t even complained to you about. In fact, if you were going to use a neurotoxin, you’d like to bypass her forehead (where she’s asking for it), since it is very smooth compared with the rest of her face, add more neurotoxin to the lateral brow area to open the eyes and lift the brows, and
treat her depressor anguli oris and mentalis to improve her perioral area. you’ve made these calculations in your head in the first minute she’s been telling you about her prior treatments and her otherwise unremarkable medical history.
What do you do? do you give her the best upper face botox you can, perhaps suggesting to lift her brows a bit? do you spend time and explain the ageing process to her and do a facial analysis pointing out her folds, creases, areas of bone resorbtion (structural changes) and lipoatrophy so that you can suggest treating those areas today or at a future visit after she’s seen what you can do with botox? do you
suggest that she return to her other doctor for filler treatment? do you bring up the idea that neurotoxin might also be beneficial in her lower face and that there are other toxins on the market? perhaps if she is budget conscious, you might consider what ‘specials’ are available on the different toxins if you feel they are equally beneficial for her? Maybe she’s participated in brilliant distinctions, allergan’s points reward programme, and that might make her excited to try voluMa or conversely, maybe she’ll be in ‘sticker shock’ and suggest one vial of radiesse® instead, since you price that lower in your office. Meanwhile, she’s been allotted 15 minutes as a ‘botox new patient’ appointment.
Mrs Jones, of course could be any cosmetic patient in a medical or cosmetic practice, thinking she needs anything from blepharoplasty to restylane®. over the years there has been a cataclysmic change in the field of aesthetic medicine both in our knowledge of how we age and our tools for correction. I’d argue that even my ‘cosmetic surgery’ practice is mis-named as are most of the
Over the years there has been a cataclysmic change in the field of
aesthetic medicine both in our knowledge of how we age and our
tools for correction.
Our new and imprOved website is now live. visit prime-journal.com for weekly news and our article archive
| guest editOrial
Affiliated partners:
Follow us @PrimeJournal
FiNd us ON twitter, FacebOOk & liNkediN
Join PRIME’s editorial team for the latest updates in aesthetic and anti-ageing medicine, debates, and interaction with your peers and colleagues, conference information and special offers
Delicious
Slash Dot
Newsvine
Yahoo
Microsoft
App Store
Qik
Tumblr
Behance
Friendster
RSS
Flickr
MySpace
Mixx
FriendFeed
SlideShare
Yahoo Buzz
MSN
Amazon
Vimeo
WordPerss
Design Float
Bebo
StumbleUpon
Skype
YouTube
Netvibes
Apple
Last.fm
Viddler
Blogger
Deviant Art
Squidoo
Retweet
Digg
Technorati
Google Talk
AOL
MobileMe
Mister Wong
Virb
Posterous
Design Bump
Share This
Update #1
Update #2
Google Buzz
Ebay
Gowalla
Podcast
Button Red
Picasa
Feedburner
ICQ
Paypal
Button Blue
Button White
Bing
WordPress (blue)
Metacafe
Heart
Button Orange
Button Light Blue Button Yellow
Meetup
Drupal
Yelp
Star
Green
IconDock Foursquare
Identi.ca
Coro�ot Ember App
Hyves
Delicious
Slash Dot
Newsvine
Yahoo
Microsoft
App Store
Qik
Tumblr
Behance
Friendster
RSS
Flickr
MySpace
Mixx
FriendFeed
SlideShare
Yahoo Buzz
MSN
Amazon
Vimeo
WordPerss
Design Float
Bebo
StumbleUpon
Skype
YouTube
Netvibes
Apple
Last.fm
Viddler
Blogger
Deviant Art
Squidoo
Retweet
Digg
Technorati
Google Talk
AOL
MobileMe
Mister Wong
Virb
Posterous
Design Bump
Share This
Update #1
Update #2
Google Buzz
Ebay
Gowalla
Podcast
Button Red
Picasa
Feedburner
ICQ
Paypal
Button Blue
Button White
Bing
WordPress (blue)
Metacafe
Heart
Button Orange
Button Light Blue Button Yellow
Meetup
Drupal
Yelp
Star
Green
IconDock Foursquare
Identi.ca
Coro�ot Ember App
Hyves
Search for Prime Journal
Follow us @PrimeJournal
Delicious
Slash Dot
Newsvine
Yahoo
Microsoft
App Store
Qik
Tumblr
Behance
Friendster
RSS
Flickr
MySpace
Mixx
FriendFeed
SlideShare
Yahoo Buzz
MSN
Amazon
Vimeo
WordPerss
Design Float
Bebo
StumbleUpon
Skype
YouTube
Netvibes
Apple
Last.fm
Viddler
Blogger
Deviant Art
Squidoo
Retweet
Digg
Technorati
Google Talk
AOL
MobileMe
Mister Wong
Virb
Posterous
Design Bump
Share This
Update #1
Update #2
Google Buzz
Ebay
Gowalla
Podcast
Button Red
Picasa
Feedburner
ICQ
Paypal
Button Blue
Button White
Bing
WordPress (blue)
Metacafe
Heart
Button Orange
Button Light Blue Button Yellow
Meetup
Drupal
Yelp
Star
Green
IconDock Foursquare
Identi.ca
Coro�ot Ember App
Hyves
Search for Prime Journal
INTERNATIONAL JOURNAL OF AESTHETIC AND ANTI-AGEING MEDICINE
prim
e-jou
rnal.co
m
INT
ER
NA
TIO
NA
L JO
UR
NA
L O
F A
EST
HE
TIC
AN
D A
NT
I-AG
EIN
G M
ED
ICIN
E
Jan/Feb 2014
Volume 2 ❙ Issue 1
Legal Issues ❚ Skincare Diversion ❚ Industry News ❚ Facial Contouring ❚ EventsJan
/Feb 20
14 ❙ Vo
lum
e 2 ❙ Issue 1
ROUNDTAbLE
SUppLEMENT FIllers and ToxIns
TOpICAL
ANTIOxIDANTS
For skIn reJuVenaTIon
MICROCANNULAE
The PaTIenT’s PersPecTIVe
chemical peels
Skin therapies using
Co
ver
imag
e Sh
utt
erst
ock
Ret
ou
chin
g L
ind
a D
uo
ng
enevaDOUBLE GOLD MEDAL WINNERGENEVA INVENTION 2011BEST INGREDIENT INNOVATION& FORMULATION
a premium brand by
Organ-Specific
homologous molecules
that trigger renewal and
regeneration of
cells, tissue & organs
For oral or topical application in
five eco-ultrafiltrates
• Skin • Placenta
• Mesenchyme
and combination of
• Skin-Placenta-Mesenchyme-Collagen
• Skin-Collagen-Elastin
Only 3 nanometres small
Molecular weight ofless than 10 kDa
• Allergenic Free
• Chemical Free
• Pathogenic Free
SEE US AT:
Aesthetics Asia Exhibition and Congress
Abu Dhabi Medical Congress 2013
Cosmoprof Asia 201312th Asia Paci�c Conference & Expo on Anti-aging and Regenerative Medicine
The International Congress in Aesthetic, Anti-Ageing Medicine & Medical Spa.
12th - 14th of September 2013
SINGAPORE
18th - 20th October 2013
BALI
27th - 29th October 2013
ABU DHABI
13th - 15th November 2013
HONG KONG
6th - 7th December 2013
DUBAI
TherapySwiss Nanocell
22-year old female with burn scar on face after an accident
BEFORE AFTER 2 WEEKS*
* Results may vary according to individuals.
Level 7, Rue Blavignac 10, 1227 Carouge, Switzerland.t: +41 22 301 65 55 f: +41 22 301 65 57 e: [email protected]
Product enquiries and to order visit www.mf3-nano.comeneva
DOUBLE GOLD MEDAL WINNERGENEVA INVENTION 2011BEST INGREDIENT INNOVATION& FORMULATION
a premium brand by
Organ-Specific
homologous molecules
that trigger renewal and
regeneration of
cells, tissue & organs
For oral or topical application in
five eco-ultrafiltrates
• Skin • Placenta
• Mesenchyme
and combination of
• Skin-Placenta-Mesenchyme-Collagen
• Skin-Collagen-Elastin
Only 3 nanometres small
Molecular weight ofless than 10 kDa
• Allergenic Free
• Chemical Free
• Pathogenic Free
SEE US AT:
Aesthetics Asia Exhibition and Congress
Abu Dhabi Medical Congress 2013
Cosmoprof Asia 201312th Asia Paci�c Conference & Expo on Anti-aging and Regenerative Medicine
The International Congress in Aesthetic, Anti-Ageing Medicine & Medical Spa.
12th - 14th of September 2013
SINGAPORE
18th - 20th October 2013
BALI
27th - 29th October 2013
ABU DHABI
13th - 15th November 2013
HONG KONG
6th - 7th December 2013
DUBAI
TherapySwiss Nanocell
22-year old female with burn scar on face after an accident
BEFORE AFTER 2 WEEKS*
* Results may vary according to individuals.
Level 7, Rue Blavignac 10, 1227 Carouge, Switzerland.t: +41 22 301 65 55 f: +41 22 301 65 57 e: [email protected]
Product enquiries and to order visit www.mf3-nano.com
terms we use. patients may think they come in for dermal fillers, toxins or a face lift but, in fact, they come to you because they want to look better or to look their best.
In our office, we have so many tools at our disposal now that we can safely and effectively treat a much wider demographic to improve their looks and self esteem, often within budgets they can afford once they learn the value of the treatments. over the past 5 years my practice has become almost exclusively cosmetic in nature, so I’ve adopted the more time intensive, comprehensive approach: to educate the patient. I rely on a team of cosmetic consultants to help me with this process so that each patient is fully appraised of the options available to them and can consider their budget, long term aesthetic goals, immediate cosmetic desires, recovery time, and comfort level with both me and the procedures I’m recommending. While there is no reason to take a patient who comes in for a quick botox maintanance treatment and tell them they really ‘need’ a liquid face lift, full face neurotoxin, retin-a, and ulthera to their neck, but I decided early on not to simply be a botox injector; I’m a cosmetic medical and surgical expert and patients come to me for my knowledge and skill. My patients may pay more per unit than at the medi-spa around the corner but they are not getting a product, they are benefiting from a treatment tailored to make them look their best, safely and effectively.
Most of my patients are at the pinnacles of their careers and want to look youthful and refreshed. our challenge is to educate the patients who seek a specific procedure and educate them about the way we all age and how they can expect to age. together, we outline a rejuvenation programme that can begin at that first visit. educating them about the paradigm of full face evaluation, treatment, maintenance and prevention will allow them to set budgets for ‘wellness care’. However, the first step is educating your staff. stop them when they say, there is a ‘botox in room 3’ or ‘sculptra® in room 6’. teaching your staff how to look at an ageing face should be your first objective.
Mrs Jones had radiesse and botox cosmetic and returned for peri-orbital restylane. I recommended she have the filler with her previous doctor but she wanted treatment with me. I have a feeling that she will be a patient for many years and only hope that if I keep her waiting a long time during one of her future appointments, she recalls the extra time I spent with her on the day we met.
there is nothing more gratifying for me than to see the breadth of patients in my office, (young, old, male, female), many of whom have been coming for many years, and will hopefully come for years to come. together we view their medical photos and observe them looking younger and better over the years they’ve been coming for treatment.
My 95-year-old patient came in to see me and said emphatically: ‘you know I’m not vain in the least. I’m not trying to be a beauty and am not looking for a date. I’m an award winning novelist with a sharp mind. before I had surgery and filler, I felt invisible. people look through old people in this city. now I feel relevant and people listen to what I have to say.’
yes, the treatment options today are complex, the field increasingly competitive, and our patients are more demanding. It takes extra time and effort to remain at the forefront and to sift through the hype of some new devices, but we are blessed to be leading a revolution in the way we approach ageing. We profoundly improve people’s lives and for that we should be deeply grateful.
prime-journal.com | March/April 2014
❚ 5
| guest editOrial
Joseph eviataroculofacial plastic surgeon, new york
International Journal of Aesthetic and Anti-Ageing MedicineInforma, Christchurch Court, 10–15 Newgate Street, London, EC1A 7AZ, UKwww.prime-journal.comISSN 2325-9817 (print)ISSN 2325-9825 (online)
Managing Editor Rosalind Hill [email protected]
Sub-Editor Balraj Juttla [email protected]
Art Director David ‘Spike’ [email protected]
Publisher Mark Eaton [email protected] / +44(0)20 7017 4060
European Sales Manager Mat Eaton [email protected] / +44(0)20 7017 4315
Business Development Manager NA Meg McNeel [email protected] / +1 (212) 520 2745
Marketing Director Justin Bambridge [email protected]
Production Manager Jonathan Collard [email protected]
Graphic Designer Snehal Sanghani [email protected]
Director of Audience Development Nora Pastenkos [email protected]
Managing Director James Gareh [email protected]
Production & Ads Department [email protected]
Please send your manuscripts and press releases to: [email protected]
All submitted manuscripts are evaluated on the basis of scientific quality, originality, appropriateness, contribution to the field and style. Suitable manuscripts are subject to peer-review. Manuscripts and accompanying files should be prepared in accordance with our Author Guidelines, which are available via www.prime-journal.com. All content © 2014 Informa UK Ltd
Images © Shutterstock.com, unless otherwise stated
For address changes, please contact Nora Pastenkos: [email protected]
Board MeMBer SpecialiSM StateDr Ashraf Badawi Dermatologist OntarioDr William H. Beeson Plastic Surgeon IndianaDr Anthony Benedetto Cosmetic Dermatologist PennsylvaniaDr Valerie Callender Dermatologist MarylandDr Andrew Campbell Facial Plastic Surgeon WisconsinProf Wayne Carey Dermatologist QuebecDr Anoop Chaturvedi Anti-ageing Practitioner TexasDr Joel Cohen Dermatologic Surgeon ColoradoDr Lisa M. Donofrio Cosmetic Dermatologist New YorkDr Joseph Eviatar Oculofacial Plastic Surgeon New YorkDr Michael H. Gold Dermatologist TennesseeDr Steven B. Hopping Plastic Surgeon Washington, DC
Board MeMBer SpecialiSM StateDr Gustavo H. Leibaschoff Cosmetic Surgeon TexasWendy Lewis Industry Expert New YorkDr Z. Paul Lorenc Aesthetic Plastic Surgeon New YorkDr Ronald Mancini Oculoplastic and Orbital Surgeon TexasDr Neil Sadick Dermatologist New YorkDr Nazanin Saedi Dermatologist PennsylvaniaDr Hema Sundaram Dermatologist Maryland/VirginiaDr Amy Taub Dermatologist IllinoisDr S. Randolph Waldman Plastic Surgeon KentuckyDr Heidi A. Waldorf Dermatologist New YorkDr Susan Weinkle Dermatologist Florida
priMe journal NOrth america editOrial bOard
For the full list of our international board members, visit www.prime-journal.com/editorial-board