2011 Autumn - Aesthetic and Anti-Aging Medicine Society of South

Transcription

1 ACC
ET R
HI ED
PE CS C ITE
D
R
IS PD FO
SU PO R
E* IN
T
DECISION MAKING
when expanding your practice
volume 4 Number 1
autumn edition 2011
Official journal of
laser
MUST-HAVES
entering the age of
EHR
EDITORS
note
The industry focuses on improving patient compliance and researching new formulations as the FDA final
Med Esthetics Southern Africa Editor: Dr Riekie Smit
sunscreen monograph remains in limbo. By Linda W. Lewis
The South African Aesthetic Medicine Industry:
there is still more to come…
The aesthetic medical industry in Southern Africa has grown
tremendously over the past 5 years. The amount of new
practitioners and specialists entering this field is very exciting.
A number of factors have contributed to the establishment
and growth of this industry. These include the increasing
number of companies entering the market, increasing
numbers of scientific papers and new development research
locally, annual congresses and growing societies, and then
also the alluring factor to practices under stress of medical aid
debt.
This is just the start of the growth. Compared to growth
statistics in other countries worldwide, we are just at the foot
of the mountain. So there is more to come.
With this growth comes more responsibilities, more regulatory
problems and a higher need for professional training. It is vital
that practitioners are involved and cooperative with societies,
regulatory bodies, indemnity cover companies, further
education and other authorities to ensure that these barriers
will not dampen the growth of individual practices. The good
news is that there are numerous discussions and meetings
taking place this year to address ethical and regulatory
factors unique to aesthetic practices. Until these factors are
resolved, practitioners and specialists should adhere to the
current regulatory and ethical guidelines set down by the
HPCSA to encourage a healthy cooperative relationship with
all authorities. This will also ensure that this industry earns
respect and support in its rapid growth.
After all, this rapid growth of aesthetic medicine and ‘new
hope’ has kept many doubtful practitioners in our country!
On a very positive note, both physicians and companies
are looking forward to South Africa hosting the 19th World
Congress of Aesthetic Medicine in 2013. This can only but
further boost the growth of South Africa’s aesthetic medical
industry. The interest from all over the world in this event
has been overwhelming. So mark your calendars for 14-16
February 2013 in Cape Town!
We hope that this issue of MedEsthetics, and also future
issues, will guide you to new adventures, and give insights
into business, ethics and scientific aspects of this industry to
ensure that you are up to date with the fast pace of evolution
in aesthetic medicine.
I hope you enjoy reading the informative articles, features and
new launches in this issue!
Riekie Smit
MedEsthetics Southern Africa Editor
President Aesthetic & Anti-aging Medicine Society of South Africa
MedEsthetics Volume 4 Number 1 Autumn Edition 2011
1
CONTENTS
Volume 4 Number 1 Autumn Edition 2011
1 ACC
ET R
HI ED
PE CS C ITE
D
R
IS PD FO
S U PO R
E* IN
T
entering the age of
EHR
DECISION MAKING
when expanding your practice
volume 3 Number 4
summer edition 2010
laser
MUST-HAVES
Official journal of
page
DISCLAIMER
This publication contains selected items originally
published under license from Creative Age Publications
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trademarks etc. in this publication does not imply, even
in the absence of a specifi c statement, that such names
are exempt for the relevant laws and regulations and
therefore free for general use.
Product liability: the publishers cannot guarantee the
accuracy of any information about the publication of
medications contained in this publication. In every
individual case, the user must check such information by
consulting the relevant literature.
ARTICLES
Entering the age of EHR
The Finishing Touch
Laser Must-haves
Decision Making
Emerging from the Storm
6
12
18
30
38
LEGAL ISSUE
Consumer Protection Act
23
AESTHETICS CALENDAR
26
BEST PRACTICES
32
INTRODUCTIONS
34
PRODUCT REVIEWS
37
NEWS & EVENTS
52
PUBLISHER
Reni Rouncilvell
MedSpec Publishing
PO Box 12973
Clubview · 0014
South Africa
Tel +27 (0) 12 661 3294
Mobile +27 (0) 82 441 6904
e-mail reni@medspec.co.za
SALES & ADVERTISING
Lelani Wearing
Tel +27 (0) 12 661 3294
Mobile +27 (0) 79 512 6990
e-mail lelani@medspec.co.za
Sue-Anne Smook
Tel +27 (0) 12 661 3294
Mobile +27 (0) 82 856 2813
e-mail sueanne@medspec.co.za
SUBSCRIPTION & ACCOUNTS
Elizabeth Versteeg
Mobile +27 (0) 72 189 8499
e-mail accounts@medspec.co.za
DESIGN & LAYOUT
Sonja van Niekerk
MedSpec Publishing
Mobile +27 (0) 82 444 0231
e-mail sonja@brightwhite.co.za
Aesthetic Medicine Congress of South Africa
2 - 4 June 2011, CSIR ICC, Pretoria
The AMCSA 2011 attracts numerous specialty doctors
annually to learn more and get updated on the latest
developments, research, devices and techniques in the field
of Aesthetic & Anti-aging Medicine. The congress starts on
Thursday afternoon 2 June 2011 with company workshops,
practical demonstrations and exhibitions. Friday 3 June and
Saturday 4 June features 3 parallel auditoriums with scientific
presentations on various topics ranging from Botulinum
Toxin therapy, dermal fillers, chemical peels, lasers and
light treatments, slimming, anti-aging medicine, hormonal
aging, skin rejuvenation, pigmentation, wound healing
and scars management. These will take place in the form of
presentations as well as live demonstrations to demonstrate
new techniques and revise existing techniques.The exhibition
area is open from 2 - 4 June and features over 40 company
exhibits. The leading companies in this industry showcases
new devices, products, research and trends. It is an ideal
business interaction environment. Precongress workshops
takes place form 1 - 2 June 2011 and includes Level 1 Botulinum
Toxin and Dermal Filler training, Expert training, Weight Loss
Clinic Training workshop, Vein Treatments workshop and an
Advanced Chemical Peel Workshop. This year, the Gala Dinner
will take place on Friday 3 June with fabulous entertainment,
socializing, good food and wine. After last year’s success, no
one wants to miss out on this action. The AMCSA organizing
committee welcomes you to this year’s congress!
For more information: www.aestheticcongress.co.za or amcsa@ackmain.com
3
COSMO PEEL
SPOT PEEL
MASK PEEL
Entering the age of
EHR
By Jeffrey Benabio, MD
The task of converting your practice to EHR is not enviable, but the move to a nationwide electronic
records system is inevitable.
My grandfather went blind from diabetes. His physicians didn’t
tell him he had diabetes until it was too late. My grandmother
died of a heart attack. She had high blood pressure for which
her physicians recommended she “relax more.” Medical
diagnosis and treatment has clearly changed for the better in
the last few decades. Physician practices, however, have not.
Physicians today have less autonomy, less respect and less
control than in decades past. Added to this is the mounting
pressure to move to electronic health records (EHR). The
change will happen only under duress for many practices,
but it need not be for yours. We may suffer under draconian
6
MedEsthetics Southern Africa
regulations and miserly health insurers
for the foreseeable future, but we needn’t
suffer from an office mired in 1970s technology
or Medicare penalties.
Imagine instead an office where all your charts are at your
fingertips, where your patients’ eyes widen when they see
you scroll through their records on an iPad, where lab work is
automatically entered and shared with the patient and alerts
you only when it needs your attention. Imagine that instead
of selecting an EHR system only when penalties start to occur,
ENTERING THE AGE OF EHR
you convert to an electronic system early and reap significant
incentives.
There are advantages to adopting an EHR system sooner
rather than later. What follows is a road map outlining
some of the risks and rewards for that change
to help you understand the process, the
regulations and the available resources.
of $44,000 as an incentive to covert your records to EHR. The
actual amount you’ll receive depends on the year you adopt
as shown in Table 1 (left). Medicaid
has similar incentives up to
a maximum of $63,750.
For the Medicaid
incentive, at
Risks and Rewards
Selecting and implementing an EHR for
your practice will entail a tremendous amount
of work. Like remodeling your kitchen, every
step is difficult: planning, selecting the right tools,
tearing up your current system, asking everyone to bear
with you while you rebuild and having more than one
moment when you wonder if it was all worth it. It will be.
One of the advantages of adopting EHR early is that the
incentives will help offset the costs of your new system. If you
start in 2011, you could collect up to $44,000 in incentives
over five years under Medicare,
or up to $63,750 over six years
least 30% of your patients must
through Medicaid. If, however, you
The incentives are not designed to be
be covered by Medicaid. You can
wait five or more years, it could
a down payment to purchase a system.
collect from either Medicare or
cost you up to 3% of your Medicare
They
are
intended…to
help
defray
the
cost
Medicaid, but not both.
reimbursements. There is never a
The incentives are not designed
good time to convert your practice
of your transition.
to be a down payment to purchase
to EHR, just as there is never a good
a system. They are intended to
time to remodel your kitchen. But
there is a bad time to do so, and that is in 2015 or later, which encourage you to change to EHR and to help defray the cost
of your transition. In changing to an EHR, the disruption to
will be here sooner than you’d like.
The Centers for Medicare and Medicaid Services will pay up your practice will be substantial. You will have to reduce
to 75% of your Medicare charges for the year to a maximum the number of patients you see and spend precious time
and energy ensuring that your
staff are trained and efficient
Table 1: Medicare’s Sliding Incentive Scale for Qualified EHR Use
in the system’s operation. Your
Adopt
Adopt
Adopt
Adopt
Adopt
Adopt
Adopt
patients will appreciate neither
2011
2012
2013
2014
2015
2016
2017
the added delay in getting an
appointment nor having to
Payment
$18,000
—
—
—
—
—
—
sit in your waiting room while
2011
you work out the kinks in your
Payment
system. They will appreciate you
$12,000 $18,000
—
—
—
—
—
2012
providing them with their own
personal health records, the
Payment
ability to make appointments
$8,000
$12,000 $15,000
—
—
—
—
2013
with you online and the
opportunity to interact with you
Payment
$4,000
$8,000
$12,000 $12,000
—
—
—
by email or secure messaging.
2014
They certainly will tell their
Payment
family and friends about how
$2,000
$4,000
$8,000
$8,000
-1%
-1%
-1%
2015
their doctor is on the cutting
edge of medicine and uses
Payment
$0
$2,000
$4,000
$4,000
$0
-2%
-2%
electronic records to protect
2016
them from errors and keep them
Payment
safe.
$0
$0
$0
$0
$0
$0
-3%
2017
7
•
•
•
•
•
Other potential benefits of EHR include:
Instant access to chart and health information
Ability to document lesions with photos mapped to specific anatomical
sites
Embedded before-and-after photos for procedures
Improved communication with referring physicians
Increased revenue from better documentation for evaluation and
management (E&M) coding
Planning the Change
The first step in changing to an EHR is to assess where your practice is on the
readiness spectrum. Some offices are replete with technology-savvy staff
nimble enough to implement an EHR with minimal difficulty. Other practices
are firmly entrenched in a pen-and-paper model: staff might have little or no
experience with computers, and buy-in from all of your office stakeholders
might be a monumental task. The beginning should be the hardest part. Involve
people—including office managers and staff—early to overcome resistance.
This will allow for a streamlined process later during implementation.
Once you assess your practice readiness, set measurable goals. A goal for
a slow-adopting office might be to start with e-prescribing and phase into
a total electronic system over months or even years. A fast-adopting office
might set a goal to transition entirely to an electronic system in one defined
period—essentially tearing down what you have, then rebuilding efficiently
and effectively. Office managers as well as nursing and support staff should be
involved early and completely and have some sense of control over their role
in the transition. Even a fast-adopting office should expect the transition to
take three to six months.
A goal for a slow-adopting practice might be
to start with e-prescribing and phase into a
Table 2: Stage 1 Core meaningful use
Objectives
(must complete all 15)
Record patient demographics
Record vital signs and chart changes
Maintain up-to-date problem list of
active diagnoses
Maintain active medication list
Maintain active allergy list
Record smoking status for patients
Provide patients with clinical summaries for office visits
Provide patients with an electronic
copy of their health information
Generate and transmit prescriptions
electronically
Computer order entry for medications
Implement drug-drug and drug-allergy
interaction checks
Choose system with capability to
electronically exchange key clinical
information
Implement systems to protect patient
privacy and secure data
Conduct a security risk analysis and
implement security update
Report clinical quality measures to
Centers for Medicare and Medicaid
Services (CMS)
total electronic system.
Navigating the Change
Once you have decided to convert your practice to EHR, you will not have any
difficulty sleeping. That’s because the reading you’ll need to do to understand
EHRs and federal rules and regulations governing EHR incentives will to put
you to sleep for a year. (The Center for Medicare and Medicaid’s final rule on
EHR incentives alone is 275 pages.) You’ll need to study two key areas: the
types of EHRs that are available and the requirements you must meet to be
eligible for the financial incentives.
Imagine EHR as purchasing a vehicle. You could purchase any make, model,
year or type; however, your business’s success depends on your choosing the
right one. Moreover, you have to choose the vehicle by committee, and the car
salesmen will nag you by repeatedly coming to your office. Choosing under
such conditions will be a nearly impossible task. Fortunately, there are things
you can do to improve the selection process.
Designate one person as the primary contact person for EHR vendors and
have her narrow the selection for the other stakeholders. It’s much easier
to choose from three or four EHRs than it is to choose from 30. Use all the
resources at your disposal to limit your search. Discuss different EHRs with
other practices. Look for products that are recommended by your specialty’s
society. See if your hospital or medical group is offering incentives or can assist
8
you with certain preferred products. Use
the Certification Commission for Health
Information Technology (CCHIT, cchit.
org), a nonprofit organization that is
the recognized certification body of the
United States government. Selecting
a vendor from its list will significantly
increase the likelihood that you will be
eligible for bonus incentives.
Although federal rewards for adopting
an EHR are substantial, the burden to
prove that you are using your system in
an approved fashion is also substantial.
In order to receive any incentive pay,
you must demonstrate that your EHR is
certified (see above) and that you are
using it in a meaningful way. The latter is
known as “meaningful use.”
Meaningful use requirements are
specific and time sensitive. Your practice
must meet all 15 of Stage 1 requirements
(see Table 2 on page 20) and five of 10
Results from doctors currently using
the NovaShape in South Africa
DR JJF VAN SCHOOR - SECUNDA
“Since we got the Ellipse I²PL and NovaShape, our aesthetic practice soared,
most definitely our best acquisition made”
PATIENT 1
Waist
Was 94cm
Hips
Were 103cm
Legs
Were 62 & 61cm
Now 87cm
Now 99cm
Now 60 & 59cm
Lost 7 cm
Lost 4 cm
Lost 4 cm
PATIENT 2
Waist
Was 88cm
Hips
Were 111cm
Buttock Were 114cm
Legs
Were 65 & 64cm
Arms
Were 33 & 34 cm
Now 81cm
Now 108cm
Now 113cm
Now 64 & 63 cm
Now 32 & 33 cm
Lost 7cm
Lost 3 cm
Lost 1 cm
Lost 2 cm
Lost 2 cm
DR R SMIT - PRETORIA
“The NovaShape treatment is a gentle & highly effective treatment
method eliminates fat cells both over large areas and selectively
as needed. Helping you to loose 3-6 cm in that area. It is a noninvasive treatment that permanently destroy fat cells by using
resonant ultrasound”
REDUCED FROM SIZE 38 TO SIZE 32
DR J VAN DER MERWE JOHANNESBURG
“We have had our NovaContour for the past three
months and have done 45 patients. We are planning
an active marketing campaign during March to create
an awareness of our wonderful machine to the broader public. Most
of the 45 patients are our existing patients but we have had a number
of queries from outside our patient database. The results so far are
very satisfying. Most patients say they can already feel the difference
when they put their clothes on after treatment. With this system we
have excellent results and client satisfaction which is very important for
any practice.”
The NovaContour has broadened my practice options and will definitely increase
in the future. I would recommend any practice to acquire this system for the
upgrade of your practice and treatment options”.
Stage 2 requirements (see Table 3 on this page) for you
to receive bonus monies. In Stage 2 you can select the
five of 10 that best fit your practice.
The meaningful use criteria are organized into five
categories:
1. To improve the quality, safety and efficiency of
care while reducing disparities. This includes using
computerized physician order entry and e-prescribing.
2. To engage patients and families in their care. This
includes providing patients with a clinical summary
of their visits and an electronic copy of their health
information (such as online access or downloaded to
a USB drive).
3. To promote public and population health. For
example, sharing information about reportable
diseases, such as syphilis.
4. To improve care coordination. An example would be
sharing key clinical information with a separate EHR
that can accept the data.
5. To promote the privacy and security of EHRs. This
includes performing security tests and updating
security to address vulnerable areas.
In order to comply, your EHR will have to be a complete
EHR: that is, it will have to include all the capabilities to
e-prescribe, communicate with other EHR systems and
record the necessary data for you to prove meaningful
use. EHR modules such as e-prescribing or electronic
charts may be step-wise products you employ, but they
are insufficient alone to qualify you for incentive monies.
Regarding meaningful use, Stage 1 objectives need
to be met right away, whereas you’ll have until 2013 to
comply with Stage 2 objectives. Additional stages will be
added after 2015. For now, you need only to attest that
you have met all 15 of the Stage 1 objectives. Specific
measures that you need to attest for each objective can
be found on the Health and Human Services website
(hhs.gov). Eventually, you will have to electronically
submit measures to demonstrate meaningful use. It is
Table 3: Stage 2 Elective meaningful use Objectives
(must complete five of 10)
important that you select an EHR that has the capability to collect,
store and transmit the necessary data that Medicare will require.
Not all systems are so equipped.
Don’t Go It Alone
There are ample resources to aid you in changing to EHR. The Office
of the National Coordinator of Health Information Technology has
comprehensive guides and documents at http://healthit.hhs.gov.
The American Academy of Dermatology also has extensive help
on its web portal under the Health Information Technology section
at http://www.aad.org/pm/hit/ including dEHRm, a step-by-step
guide to choosing, implementing and successfully adopting EHR.
You can also find helpful information and resources at the American
Medical Association’s website (ama-assn.org) in the section on
Health Information Technologies.
Changing your practice to EHR may be the largest undertaking
you ever make for your practice. Some physicians would rather
“close shop” than convert, and so they will. But for those of us who
have no intention to retire soon, the change to EHR is inevitable.
Taking control of the process early will allow you to make the most
of the transition and will lead to
significant advantages for you and
your practice.
Implement drug formulary checks
Incorporate laboratory test results into EHRs
Generate lists of patients sorted by specific conditions
Send reminders to patients for follow-up or prevention care
For more information contact
Mark Lainchbury
e-clinic mark@e-clinic.uk.com
Give patients electronic access to their health information
Use EHR technology to identify patient-specific education resources
Perform medication reconciliation among care settings
Provide a summary of care record for patients
Submit electronic immunization data to immunization registries
Submit electronic syndromic surveillance data to public health agencies
10
Jeffrey Benabio, MD, FAAD, is a board-certified
dermatologist with Kaiser Permanente;
founder of the thedermblog.com; and skincare
expert at Livestrong.com. He is also the author
of numerous scientific articles and abstracts.
Contact him at drbenabio@thedermblog.com.
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the
FINISHING touch
Makeup artists and high-quality cosmetics complement skin rejuvenation procedures and treatments for chronic
dermatologic concerns. By Linda W. Lewis
of different types of makeup,” says Jason Joel Emer, MD,
resident, department of dermatology, Mt. Sinai School of
Medicine in New York City.
“Having a trained esthetician on staff to show patients how to
hide temporary blemishes or minimize untreatable problems
helps me meet patient expectations,” says Mossi Salibian,
MD, FACS, of Aesthetic Plastic Surgery/Reconstructive
Microsurgery, Los Angeles.
“Some people have temporary conditions that they want
to hide, such as post-inflammatory hyperpigmentation from
acne or a transient patch of vitiligo. Others have permanent
lesions that they prefer to conceal, such as melanocytic
birthmarks, vascular birthmarks or vitiligo that has been
unresponsive to medical therapy,” says Victoria H. Barbosa,
MD, MPH, MBA, of Millennium Park Dermatology in Chicago.
All of these skin problems, as well as postprocedure
bruising and swelling, can cause psychological
pain as well as physical
discomfort. “Sometimes
a little makeup can be
the difference between
a patient leaving my office
feeling good about herself
rather
than
self-conscious
and depressed,” says Steven H.
Dayan, MD, FACS, True Skin
Care Center,
Chicago. “I
make sure
all of my
estheticians
are skilled in
applying makeup,
and everyone who
© Istockphoto.com
Dermatologists and plastic surgeons generally are not trained
in buying and using makeup, yet cosmetics are integral to
their practices. Whether employed to put the final touches
on skin rejuvenation procedures or to offer
camouflage for postprocedure bruising and
chronic skin concerns, professionally
applied cosmetics can boost patient
satisfaction rates. “We study skin
condition,
which
includes
texture and tone, but I find
it helpful to work with
someone who knows
the intricacies of
color and shading,
as well as the
properties
12
THE FINISHING TOUCH
Working Arrangements
Business arrangements between medical practices and makeup
artists or estheticians trained in makeup application vary.
“Some practices hire them as full-time or part-time employees.
Others contract with them as consultants. Some practices
have no financial relationship with a makeup artist, but make
referrals to those they know and trust,” says Dr. Barbosa. “The
best arrangement depends on several factors, including the
practice philosophy, budget, volume of patients interested in
the services of a makeup artist and the range of products that
Photo courtesy of Steven H. Dayan, MD
comes in for a procedure is directed to our
Touch-up Bar at the end of her treatment.
“Years ago patients would leave my treatment room
and go into the lavatory to apply makeup. It concerned
me that I didn’t know what they were putting on and what
they might be doing that would cause problems later. Since
we’ve been offering makeup touch-ups, we’ve had nothing but
positive feedback. I don’t see why other practices don’t offer
the service,” says Dr. Dayan.
When it comes to plastic surgery patients, makeup artists
may provide another important service—emotional support.
“Patients go into surgery expecting to look great when they
come out, but the recovery process often takes weeks or months.
Patients need to talk with someone who can reassure them that
things are proceeding normally, as well as show them how to
cover bruising and scarring so they can look better faster,” says
Marianne Morrison, a makeup artist and owner of Natural Style
Cosmetics, Huntington Station, New York.
Dr. Steven Dayan offers patients a “touch-up bar” stocked with highquality cosmetics where they can reapply makeup before leaving his
practice.
“Sometimes a little makeup can be the difference between a patient leaving my office feeling
a physician sells.
“A high-volume practice that carries a wide range of color
and corrective cosmetics might hire a makeup artist full time. A
practice with minimal involvement with color cosmetics might
invite a consulting makeup artist to participate in special events
or promotions only a few times a year,” Dr. Barbosa explains.
The location of your practice can also play a role. “Not having
a makeup artist in my New York practice is not a problem
because I can refer patients to lots of outside resources, but I
know a dermatologist in Nebraska who does everything within
his office because there are few outside specialists to rely on,”
says Dr. Emer.
Whether you are hiring a makeup artist or setting up a
referral relationship, you will need to make sure the person’s
skills are topnotch and that she is trained to work as a part of a
medical team.
“A makeup artist definitely needs to be versatile,” says Dr.
Emer. “She needs to be able to work with lots of skin types and
have a flexible repertoire of services that can cover all types of
14
blemishes from pigmentation problems to bruises and
scars.”
Expertise with color and style is essential, but people
skills are also a must. “We have estheticians trained in
makeup application and cosmetic tattoos. Good skills are
necessary, but their ability to form a bond with patients
is equally important. The trust factor is paramount,” says
Dr. Salibian.
Start with an experienced makeup artist who has a
well-developed eye for color and shading, then require her
to get certification on any service you offer. “Most makeup
artists need to be trained by a medical professional
before they begin offering services in a medical practice,”
cautions Dr. Emer. “That means dermatologists need to
get some training as well. First the doctor needs to learn
something about the products and then he can help train
the esthetician. An esthetician trained to work in a medical
practice can be an important member of the team.”
© Istockphoto.com
good about herself rather than self-conscious and depressed.”
THE FINISHING TOUCH
Stocking Makeup
Although selling products in a medical practice is still
controversial, almost all medical aesthetic practitioners
consider it an important adjunct of patient care.
“At Millennium Park Dermatology, we strive to provide
excellent dermatologic care to our patients first and
foremost,” says Dr. Barbosa. “We focus on products that we
believe are superior in quality to what patients can obtain in
nonmedical, commercial outlets and those that are available
elsewhere but can be difficult for our patients to find. Product
suggestions are made based on the trusted relationship we
have with our patients.”
At True Skin Care Center, the emphasis is on camouflage
makeup. “We carry a variety of cosmetics but mostly mineral
makeup,” notes Dr. Dayan. “We have used many lines over
the years, but DermaMinerals is our choice at present. We
want to make sure that any line we use has a high mineral
content and a high SPF. Clinical testing showing its efficacy
for specific indications certainly helps persuade me. We also
offer eye and lip products, but our largest stock is concealers
and foundations.”
“To serve patients well, an office needs a wide enough
range of products to address specific needs, including
shade selection, skin type and degree of coverage needed,”
advises Dr. Barbosa. “It can be helpful to start with a niche
and expand your cosmetic product sales as your business
grows. A practice may start with corrective cosmetics or
with cosmetic products for people with sensitive skin. Then,
once you have a good customer base you can expand your
offerings. It is important to bear in mind that patients will
expect superior quality products from an aesthetic medical
practice, and you should have some sense of the price point
that makes sense for your patient base.”
For practices with a diverse patient base, it is important
that the makeup line work for a wide variety of skin
types and indications. “That’s why we chose Cover
FX—its versatility,” says Dr. Emer. “Patients can
use it for an everyday natural look or
Long-Lasting Makeup
“As the population continues to age, we see more patients
complaining of lost eyebrows and disappearing lip lines.
Others can no longer see well enough to apply makeup.
They want permanent makeup services, and if we don’t
provide them, they will get them elsewhere,” says Gregory Allen, MD, medical director of the Desert Aesthetic &
Lifestyle Institute, Mesa, Arizona. “I find this frightening
because permanent makeup is virtually unregulated. We
offer a safe recourse. This service is especially helpful for
burn victims and patients with alopecia.”
Dr. Allen chose the Nouveau Contour Intelligent System
(nouveaucontourusa.com) to do eyebrows, eyeliner, lip
liner and even scar revision (needling without pigment).
The computerized device controls depth of needle penetration for precision, and the pigments are free of harmful dyes and heavy metals.
“Needles and pigment for a particular procedure come
in sealed packages which can be discarded after use,” says
Nicole Davis, esthetician and laser tech at Desert Aesthetic, “so there’s no risk of cross-contamination.”
“We do a lot of breast enhancement and reconstruction, and find it useful to have someone trained in micropigmentation on staff to do nipple tattoos,” says Los
Angeles plastic surgeon Mossi Salibian, MD, FACS. “We are
fortunate to have an RN who is also an esthetician and is
certified in permanent makeup application using Permark
(permark.com) equipment and inks.”
Dr. Allen advises doctors interested in adding permanent makeup to start with an experienced makeup artist
who has a well-developed eye for color and a thorough
understanding of makeup application. “Then make sure
she gets ample training on the system you choose. We
require certification and ask new hires to do test services
on family and friends before working with our patients,”
he adds.
15
THE FINISHING TOUCH
to cover bad scars or serious skin conditions.”
Most physicians rely heavily on their lead
esthetician/makeup artist to choose product lines
and decide which items to retail. “Before we chose
Youngblood [Mineral] Cosmetics, we looked at
many lines. I worked with my estheticians to find
out which products worked best for my patients and
then examined the choices for safety and efficacy in
specific situations,” notes Dr. Salibian.
Having knowledgeable estheticians on staff can
certainly improve product sales. “Selecting color
cosmetics or shades of corrective cosmetics is
Targeted Resources
Corrective makeup is available from a myriad
of sources. Here are a few brands often used
and sold in medical aesthetic practices.
Genop Healthcare
Dianne Rix
dianne@genophc.co.za
011 545 6631
Coverderm
David Cronje
nailmetics@vodamail.co.za
012 460 1220
challenging for many
patients,”
says
Dr.
Barbosa.
“Ultimately
patients are more
often satisfied with
their purchases if they
have had professional
help in choosing the
best products for their
needs.”
“Women don’t
After
like heavy makeup
that draws unwanted
attention,” says
Morrison. “We work
with them on using
the right moisturizer
and show them how
to cover blemishes
and use eye shadow,
blush and eyeliner to
draw attention away
from problem areas.
For instance, during
Offering corrective cosmetics and training with
recovery there is often
a professional makeup artist can boost your
puffiness. We show
patients’ confidence and satisfaction.
patients how to use
blush as a contour tool
to minimize the fullness.”
“Product is everything,” says Barbara Rutecki, a makeup artist
with Miss American Beauty in Atlantic City, New Jersey. “For
corrective makeup, I swear by Dermablend. It is effective, easy to
apply and has a website designed with physicians in mind. If I am
promoting a line, it has to work or my credibility is out the door.”
Vichy / Normaderm
gary@intamarket.co.za
Promoting Cosmetics
Certainly, having a good makeup artist as a part of your team helps
with your No. 1 practice-building priority—patient referrals—
but should you include makeup services and products in other
promotions?
“We don’t want to come across as selling cosmetics,” says Dr.
Salibian, whose makeup promotions are low-key, consisting
mostly of handouts to existing patients and information in email
newsletters. “We often include makeup demonstrations and
cosmetic products in promotional packages, such as our Night of
Beauty,” he says.
“We provide samples when possible or have testers available
so that people can see what they are buying,” adds Dr Barbosa.
“We sometimes bundle product sales with services as well, like
chemical peels, neurotoxins or fillers, to encourage patients to try
something new.”
011 444 0404
Linda W. Lewis is a contributing editor to MedEsthetics magazine.
Effie Tzetis
dtzetis@za.loreal.com
083 288 0256
Environ
Claire Taylor
Claire@environ.co.za
011 268 5711
Intamarket
Gary Wachsberger
16
Top: photo courtesy of CoverFx; Bottom: © Istockphoto.com
Before
IMPROVING PROFITABILITY
laser
MUST-HAVES
Physicians share the devices that are fundamental to their medical aesthetic practices. By Inga
Hansen
© Getty Images
Faced with a steady stream of new technologies entering the market and price tags that start in the tens of
thousands of dollars, practice owners routinely cite equipment-purchasing decisions as one of their biggest
business challenges. To help reduce the number of idle lasers taking up space in treatment rooms across the
country, we spoke with physicians in a variety of regions and asked them to share their go-to devices—the ones
that consistently deliver in terms of cost, downtime, results and bookings—and their strategies for evaluating
the promise of new technologies.
18
© Istockphoto.com
Intamarket Medical Technologies (Pty) Ltd
intamed
The Go-To Devices
Every laser practice has one or two core devices that receive the most
use and generate the highest number of referrals. Although equipment
choices vary based on each practice’s core patient base and subspecialty, there were a few technologies that stood out among all the
physicians with whom we spoke. “If you’re looking for core devices,
an IPL, fractional erbium laser and alexandrite or diode laser for hair
removal would be high on the list,” says David H. McDaniel, MD, FAAD,
director of the Institute of Anti-Aging Research in Virginia Beach,
Virginia, and assistant clinical professor of clinical dermatology, Eastern
Virginia Medical School. “Although you can use an IPL for hair removal,
I find that either an alexandrite or diode laser is more desirable, so if
you add one of these lasers to your IPL and fractional ablative laser, you
have a pretty good set up.”
At Grossman Dermatology—with locations in New York and Santa
Monica, California—dermatologist Karyn Grossman, MD, serves an
upper income patient
base that is “primarily 30to 70-year-old Caucasian
“Patients in climates with a
women and some men,”
she says. Her most-used
longer warm season may
laser/light device is the IPL,
have a stronger interest in
thanks to its wide range
of indications. “We use it
laser hair removal.”
for scars, broken vessels
and lentigines,” says Dr.
Grossman.
“IPL is one of the
core go-to devices for
photorejuvenation,” says
Dr.
McDaniel. “When
used
properly,
these
devices are very effective
for
photorejuvenation,
pigment
dyschromia,
telangiectasia and rosacea.
They can also be used—
with proper technique and
on appropriate, untanned,
lighter Fitzpatrick skin
types—on the décolleté,
arms and hands.” The lack
of consumables makes
IPL an affordable option
Intamed has been selected as distributor of choice by the
following highly respected companies:
Laser and Light Based Systems
Active Acne
Photo Therapy
Acne Scars
Pigmented Lesions
Alopecia Areata
Psoriasis
Anti-Aging
Vascular Lesions
Body Sculpting
Skin Rejuvenation
Cellulite Reduction
Skin Tightening
Endovenous Ablation
Tattoo Removal
Fat Reduction
Vascular Lesions
Hair Removal
Vitiligo
Laser Lipolysis
Wound Healing
PDT
Wrinkle Reduction
Skin Remodeling, Body and Facial Contouring Systems
Facial Contouring
Anti-Aging
Facial Tightening
Cellulite Reduction
Body Contouring
Skin Rejuvenation
Body Tightening
Skin Contouring
General
Surgical and General Products
Anti-Aging and cooling mask for face and
hands
Eyelash Conditioner for longer, thicker and
fuller eyelashes & eyebrows. New MD Hair
Restoration Kit for hair growth and restoration.
Dermatology, Plastic Surgery
General Surgical Instruments
Dual Radio Frequency System for cosmetic
facial and ENT procedures.
An Unmatched Aesthetic
Medicine Portfolio
intamed
Intamarket Medical Technologies (Pty) Ltd
Tel: 011 444 0404 Fax: 086 670 0063
gary@intamarket.co.za
www.intamed.co.za
LASER MUST-HAVES
Your patient demographics and regional climate help
dictate the best devices for your practice.
Resources
Following are some of the leading
suppliers of laser and light devices for
the medical aesthetics market.
Best Lasers - Sharon Best
012 998 9844 | info@bestlasers.co.za
Bester Medical - Hendrik Bester
021 599 7263 | bmed@telkomsa.net
Decade Marketing - Margie Thomas
021 683 8505 | decade@endermologie.co.za
Ergon - Mike Danvers
011 454 1876 | 082 576 1380 | ergon@iafrica.com
Hitech Lasers - Naomi Olivier
012 349 1250 | hitech@hitechlasers.co.za
Intamarket - Gary Wachsberger
011 444 0404 | gary@intamarket.co.za
MedSci - Pieter J v Rensburg
+27 (0) 82 452 5295 | pieter@medsci.co.za
Moscon Medical - Michelle Wilson
011 483 8056 | michelle@moscon.co.za
Radiant Healthcare
Jacques Pretorius
011 794 8253 | info@radianthealth.co.za
Sound Aesthetics - Duncan Hesketh
011 513 3142 | info@soundaesthetics.co.za
Stern Laser - Ro Ziervogel
086 11 78376 | ro@sternlaser.co.za
Technolase - Marita Op’t Hof
012 349 1750 | 083 379 3988
technola@mweb.co.za
20
for patients and the treatments can often be performed by nurses as well as
physicians.
At Cultura Dermatology Spa & Laser Center in Washington, DC, Eliot F. Battle
Jr., MD, serves a more diverse patient base. “My patients are 75% women of
color and 25% Caucasian,” he says. “We perform about 100 laser treatments
per day. We do laser hair removal, color blending, skin texture improvement
and antiaging treatments.” His go-to device is the 1064nm Nd:YAG laser. “The
Nd:YAG is my favorite wavelength. It is safer for darker skin types,” says Dr.
Battle. “I also prefer platforms that allow me to have various treatment heads
and wavelengths in one device—Cutera, Palomar Medical and Cynosure all
offer very good platforms.”
Dr. Grossman also praises platform devices. “I use the Lume [Lumenis] One
because it combines an IPL with an Nd:YAG laser,” she says.
Following IPL and Nd:YAG wavelengths, fractional lasers—both ablative and
nonablative—are experiencing steady use in a variety of cosmetic practices.
“My favorite device for treating dark spots in skin of color is the microsecond
Nd:YAG laser—either the Cutera Genesis or Cynosure Elite [MPX],” says Dr.
Battle. “My No. 2 device for dark spots in skin of color is the Palomar [Lux1540]
nonablative fractional laser.”
Both Neil Sadick, MD, Sadick Dermatology, New York, and clinical professor of
dermatology at Weill Cornell Medical College, and Dr. Grossman, cite fractional
CO2 as a top choice for facial rejuvenation. “I use the Lumenis UltraPulse CO2
mostly in the Active FX mode,” says Dr. Grossman. “It has a large spot size and
is more superficial. It works very well for periorbital lines and discoloration.” In
addition to facial rejuvenation, Dr. Grossman uses the Active FX on the hands
and chest. “I use the Deep FX mode to treat facial lines in older patients and in
combination with full CO2 resurfacing to treat deeper lines in older patients,”
she says.
Dr. Sadick uses the nonablative Fraxel dual system “for hyperpigmentation
and acne scarring, and the Fraxel CO2 for facial rejuvenation,” he says. “You
do need both nonablative and ablative [devices] for facial rejuvenation. The
ablative lasers allow you to treat more severe photodamage.”
Regional Considerations
In addition to patient demographics such as skin type, income level and age
group, your device needs will vary based on location and sub-specialty. “In
urban areas, where people are workaholics, nonablative devices are important
because patients can go back to work immediately after treatment,” says Dr.
Battle. “Washington, DC, is one of the most diverse cities in the world—on any
given day I will have patients from 25 different nationalities come through
my door, so I see every skin type and mix of nationalities imaginable. For
hair removal, for example, I can’t work without multiple wavelengths. I need
the alexandrite, diode and Nd:YAG wavelengths. Rural areas tend to be more
homogenous. That affects the number of devices you will need.”
“If you’re in a sunny area where you see very light skin types with lots of
photoaging then IPL and Thulium may be of more interest,” says Dr. McDaniel.
“Patients in climates with a longer warm season may also have a stronger
interest in laser hair removal, whereas a CO2 laser may be of more interest to a
surgeon who performs a lot of facelifts under anesthesia as there is a need to
resurface perioral and periorbital wrinkles to get a balanced result.”
Drs. Sadick and Grossman both practice in upper income, urban areas
and perform a lot of skin tightening. Dr. Sadick depends on his Thermage to
offer both body and facial skin tightening. While Dr. Grossman stands by two
tightening devices—the Thermage for 40- to 45-year-old patients “who are
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LASER MUST-HAVES
“For my niche I also need lasers
that can truly treat all skin types
and are stable enough to move
beginning to sag but not close to ready for a brow lift or facelift, and—because
of where we are—we also do a lot of Alma Accent treatments for cellulite and
post-baby belly shaping,” she says.
Evaluating New Technologies
With so many new and improved devices hitting the market each season, it
is a challenge to determine which piece of equipment will become the new
tried-and-true workhorse of your practice and which will find itself in the
corner collecting dust. One way to limit your exposure to poor investments
is to start with your sub-specialty and your specific patient base. “If you treat
a lot of acne, you might start with IPL. If it’s skin rejuvenation and antiaging,
a fractional device; for leg veins, a 1064nm Nd:YAG; or, if you have a lot of
requests for tattoo removal, a Q-switched laser,” says Dr. Sadick.
“You also have to look at who your patients are, what they’re asking for and
the predominant skin types you’re treating,” says Dr. Grossman. “For instance,
there are some great, new hair removal lasers out there right now, but we get
maybe three patients a year for laser hair removal so I’m not going to spend
$100,000 on a new hair removal system.”
When a new system catches Dr. Grossman’s attention she looks at “cost,
downtime and my patient’s expectations. If it’s a brand new concept, I also
look at whether this is something my patients will like and who’s making it—
my preference is to work with larger, well-established companies,” she says. If
you’re ready to start investing and are unsure what your patients will support,
“talk to them,” says Dr. Grossman. “ ‘We’re thinking of bringing in some new
lasers, what would you like us to be able to do?’ They’ll tell you, ‘I want to get
rid of these veins or I want laser hair removal.’ ” She advises against adopting
a new technology in hopes of attracting a new demographic of patients,
because it can take a significant amount of time to establish that base. Devices
that fill a need or want within your existing patient base offer a safer bet on
ROI.
Once you’ve decided on the type of device you’d like to add, “look at the
results of clinical studies at multiple sites and try to speak with one of the
clinical investigators,” says Dr. McDaniel.
Meetings and professional associations provide a rich opportunity
to survey other doctors on their experiences with different devices and
manufacturers, notes Dr. Battle, especially if the device you’re investigating
was approved under the 510(k) predicate device process or is being used offlabel. “I can ask a myriad of doctors their opinions and then bring in the laser
companies to get a feel for the device,” he says. “How does it feel ergonomically?
22
© Istockphoto.com
from room to room.”
How long will it take to get the laser back
up and running if it needs service? For my
niche I also need lasers that can truly treat
all skin types and are stable enough to
move from room-to-room without needing
recalibration.”
One of the final considerations as you
compare suppliers is, of course, cost. In
addition to the initial purchase price,
companies will vary in terms of their
warranties and service contracts. The cost
of consumables should also be factored in.
“One company now has a $25,000 transfer
fee if the owner tries to sell the device, and
that is a new concept that may be an issue,”
says Dr. McDaniel. He notes that some
companies offer free loaners if your laser
needs repair and “more education, so they
may put their fees higher, but there can
be considerable value for the practice in
having that support,” he says.
“The good news is that there are very
effective fifth and sixth generation devices
out there, and there has never been a
better time to buy new equipment,” says Dr.
Battle. The sluggish economy and increased
competition means laser manufacturers are
ready to make deals with serious buyers.
You can significantly lower the risk of new
equipment investments by taking the time
to survey your patients on their wants and
needs; researching technologies through
conferences, journals and professional
associations; and determining your price
range before making a purchasing decision.
Inga Hansen is the executive editor of MedEsthetics.
IMPLICATIONS FOR MEDICAL PRACTICE
(part 1 of 3)
CONSUMER
PROTECTION ACT
A new era in consumer protection law has dawned upon South Africa with the impending full implementation
of the Consumer Protection Act 68 of 2009 (CPA). The CPA was signed into law by the State President in 2009.
Aspects of the CPA relating to the establishment of the National Consumer Commission and empowering the
Minister of Trade and Industry to make regulations came into effect on 24 April 2010. All other provisions were
deferred by the Minister to 31 March 2011 . Draft Regulations have been published, but had not been finalised at
the date of writing this article.
The CPA places a number of onerous obligations on suppliers (this includes medical practitioners) and will have a significant
impact on the way businesses are conducted in SA in the future.
The primary purpose of the CPA is the prevention of exploitation or harm to and the
promotion of the social well-being of consumers. It will introduce general principles of
consumer protection and serve as an overarching governing statement on consumer
protection matters in South Africa.
The Consumer’s “Bill of Rights”:
• Right of Equality
• Right to Privacy
• Right to Choose
• Right to Disclosure and Information
• Right to Fair and Responsible Marketing
• Right to Fair and Honest Dealing
• Right to Fair, Just and Reasonable Terms and Conditions
• Right to Fair Value, Good Quality and Safety
LE RN
C
I
RT & EA INT
A
D
O
E
CP RIB PD P
SC S C UE
B
SU HIC R ISS
T
1 E PE
23
LEGAL ISSUE
Due to the number of provisions of the CPA that could
potentially apply to medical practitioners, they will be
reviewed in a three-part series. In this first article the various
definitions as well as the rights and obligations of consumers
and suppliers in relation to marketing practices are reviewed.
HOW WILL THE ACT APPLY TO MEDICAL PRACTITIONERS?
The CPA will apply to all transactions (agreements) in SA for
the supply of goods and the performance of services. Certain
transactions will be exempted such as:
•
•
•
•
•
Goods or services that are promoted or supplied to the
State;
Where consumers are juristic persons with asset values
or annual turnovers, which exceed the threshold value to
be determined by the Minister of Trade and Industry. The
proposed threshold amount is R3 million;
Any credit agreement under the National Credit Act (but
the goods and services in terms of these agreements are
covered under the CPA);
Transactions, which fall within an industry-wide exemption
granted by the Minister. The relevant regulatory authority
must apply for exemption e.g. the Health Professions
Council of SA (HPCSA) in the case of medical practitioners
; and
Services that are supplied under an employment contract.
The provision of goods and services by a trade union, a society
or an association (e.g. the SA Medical Association [SAMA]) to
their members will also be regarded as a transaction between
a supplier and a consumer within the meaning of the CPA.
CONSUMERS
Consumers as defined in the CPA are in essence persons:
•
•
•
•
Medical practitioners might in a number of instances qualify as
consumers when they are for example the recipients of goods
and services. However, since the CPA specifies that consumers
who are juristic persons with annual turnovers or asset values
greater than a specified threshold amount (proposed to be R3
million) would in general not be entitled to the protection as
consumers in terms of the CPA, a medical practice structured
as an incorporated company would therefore not receive all
the protections envisaged for consumers in the CPA, if its
annual turnover exceeds the threshold value when finalised.
Patients will qualify as consumers.
GOODS
Goods include:
•
•
•
•
The definition of consumers, suppliers, goods and services
are briefly reviewed below for a clearer understanding of the
CPA’s applicability to medical practitioners.
SUPPLIERS
Suppliers are persons who market goods and services and
include:
•
•
•
•
•
•
•
Individuals;
Juristic persons;
Partnerships;
Trusts;
Organs of state;
Entities owned, directed, contracted or licensed by the
state to offer or supply any goods or services and
Public-private partnerships.
•
Anything marketed for human consumption;
Any other tangible object including anything written or
saved to an electronic medium;
Any information, data, x-ray films, recordings, photographs,
other intangible products and/or the license to use such
products;
A legal interest in land and or other immovable property;
and
Electricity and Water.
All medicines, substances, devices, prosthesis or other goods
(e.g. lotions or creams) supplied by medical practitioners
would fall under the definition of goods.
SERVICES
Services include amongst others:
•
•
•
All medical practitioners will therefore qualify as suppliers in
terms of the Act.
To whom goods or services are marketed;
Who have entered into transactions (agreements) with
suppliers;
Who are users of particular goods; or
Who are beneficiaries of services (e.g. children or medical
scheme dependants).
•
Any work or undertaking performed by one person for the
direct or indirect benefit of another;
The provision of information, education, advice or
consultation (except advice that is subject to regulation in
terms of the Financial Advisory and Intermediary Services
Act 37 2002);
Any undertaking or assumption of any risk by one person
on behalf of another; and
Provision of accommodation.
All consultations, medical and aesthetic services and
procedures will therefore be regarded as services in terms of
the CPA.
24
LEGAL ISSUE
amongst others impermissible for a supplier to unfairly
MARKETING
Although the CPA will become the key piece of legislation
of how goods and services could be marketed in SA, other • Exclude any person or category of persons from accessing
any goods or services or granting any person or category
legislation could also regulate these activities and has to be
of persons exclusive access to any goods or services; or
observed such as directives from the HPCSA. In instances
where an inconsistency exists between the CPA and any • Assign priority supply, supply a different quality of or charge
different prices for any goods or services to any person or
other Act the provisions of both Acts will apply concurrently
category of persons on the basis of any of the grounds of
to the extent that it is possible and will comply with one of
unfair discrimination contemplated in the Constitution
the inconsistent provisions without contravening the second.
and the Promotion of
If this is not possible, the
Equality and Prevention
provision extending the
of Unfair Discrimination
greater protection to a
Practitioners
will
therefore
have
to
ensure
Act 4 of 2000. These unfair
consumer will prevail over
that all patients receive the same quality of services
discrimination
grounds
the alternative provision.
and no differentiation occurs
include race, age, gender,
on the basis of any unfair discrimination ground
disability
or
sexual
It will not be permissible
orientation.
for service providers (e.g.
medical practitioners) to
Persons may also not
market goods and services
in a manner that is misleading, fraudulent or deceptive in be treated directly or indirectly differently in a manner that
respect of amongst others the nature thereof, the conditions would constitute unfair discrimination when:
of supply, price or any other material aspect. Practitioners
will have to ensure that they neither verbally nor through • Assessing the ability of a person to pay the cost or comply
their conduct directly nor indirectly express or imply false,
with the obligation of the proposed agreement;
misleading or deceptive representation concerning any • Deciding whether to enter into an agreement e.g. accept a
material fact of the service to be rendered or the goods to
person as a patient;
be supplied. This would include a failure to correct any • Determining any aspect of the cost of an agreement to the
misapprehension on the part of the consumer e.g. regarding
consumer;
the performance characteristics of a medicine, the results • Providing any services to the consumer;
of any treatment, that a specific price advantage exists • Assessing or requiring compliance by the consumer with
or that a charge is levied for a specific purpose. The use
the terms of an agreement e.g. collection of an outstanding
of exaggeration, innuendo and ambiguity in respect of a
debt;
material fact would also be regarded as a prohibited false • Determining whether to continue, enforce, seek judgment
in respect of or terminate an agreement (e.g. refusal to
representation. Practitioners must therefore be particularly
treat a patient or collecting a debt); or
cautious with regard to for example representations made in
relation to treatment risk factors, side-effects of treatment or • Determining whether to report any personal information
of such person (e.g. to a medical scheme).
medication, ingredients of medicines and off-label usage of
medicines.
Practitioners will therefore have to ensure that all patients
receive the same quality of services and no differentiation
Protection is also afforded to consumers against
occurs on the basis of any unfair discrimination ground.
discriminatory marketing.
Decisions as to which persons to accept as patients and
This entails that
the level of fees charged should also not be based on
it will be
any discriminatory ground that would constitute unfair
discrimination. Providing for different waiting rooms for
different race groups would for example fall in the prohibited
categories of unfair discrimination. Certain differential
treatment based on an unfair discrimination ground would be
permitted in terms of the CPA on specific reasonable grounds
e.g. the provision of specific facilities for disabled persons and
separate washrooms for males and females.
Consumers will also be entitled to restrict unwanted
direct marketing from for example medical practices. The
consumer may require that the person responsible for the
25
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) amcsa@ackmain.com
9 MARCH 2011
PRP kit – clinical technology in advanced skincare
Co-Sponsor: DermaVpharmaceuticals - Presented by Dr J Snyman & Dr R Smit
Irene, Pretoria
AAMSSA – Mareli Jv Rensburg | info@aestheticdoctors.co.za | 012 548 7152
5 – 6 MARCH
Basic Botulinum Toxin and Dermal Filler course
Pretoria
Soy Secrets of youth | support@rejuice.co.za | 082 442 7000 | 015 291 2404
15 – 17 MARCH
LipomassageTM by Endermologie®
Cape Town
Decade Marketing | decade@endermologie.co.za | 021 683 8505
24 – 26 MARCH
9th Anti-Aging Medicine World Congress & MediSpa
Monte-Carlo, Monaco
amwc@euromedicom.com
29 – 31 MARCH
Johannesburg
6 APRIL 2011
Facial Anatomy Revision: Cadaver Dissection
Co-Sponsor: Glenmark - Presented: Dr V Jandera (Plastic surgeon)
WITS university, JHB
7 – 9 APRIL
19th World Congress on anti-aging medicine & Biomedical Technologies
Florida
event@a4m.com
12 – 14 APRIL
Cape Town
13 – 15 APRIL
Johannesburg
13 – 17 APRIL
American Academy of Aesthetic Medicine:
Level 2 – Diploma course in Aesthetic Medicine
Miami, Florida
Ellen Dahlin | ellen@aaamed.org | +1-310-944-1790
19 APRIL
Anti- Ageing – Minimize the effect of rapid ageing
Fairland
Sarien Kirstein | sarien@futurehealthsa.co.za | 082 257 5384
24 – 28 APRIL
Botox & Filler training - Beginners & Advance - By Dr Karin Semprini
Cape Town
The Bay Skin Care center | manager@thebayskincare.co.za | 021 438 9800
1 MAY
Congress of Dermatological Society of SA
CSIR ICC, Pretoria
Amanda Pyne-James | Amanda.rsvp@yebo.co.za | 011 463 4064
1 – 5 MAY
Johannesburg
7 – 8 MAY
Cape Town
10 MAY
Filorga Filler workshop - By Dr Riekie Smit
Pretoria - Filorga Laboratoreis
colette@filorgasouthafrica.co.za | 012 548 3943 | 082 494 7670
11 MAY
Filorga Product & Glykopeel Training
Pretoria - Filorga Laboratoreis
17 – 19 MAY
Cape Town
20 MAY
Filorga Filler workshop
By Dr R Beeton
Bloemfontein, Free State - Filorga Laboratoreis
24 – 26 MAY
Johannesburg
1 –JUNE 2011
AMCSA Pre-Congress
Level 1 & Advanced Botulinum Toxin & Dermal filler training workshops
CSIR ICC, Pretoria
AMCSA organizing committee
mareli@aestheticcongress.co.za | amcsa@ackmain.com
www.aestheticcongress.co.za | 012 548 7152
2 JUNE 2011
AMCSA Pre-Congress
Successful Weight loss clinic workshop
Vein Treatment workshop
2 – 4 JUNE 2011
Aesthetic Medicine Congress of SA (AMCSA)
16 – 20 JUNE
Cape Town
13 – 18 JUNE
Cape Town
21 – 23 JUNE
Johannesburg
26
CALENDAR OF EVENTS
4 JULY
Corrective product use | Co-Sponsor: Clinique
Midrand, JHB
13 – 17 JULY
New Orleans, Louisiana
15 – 17 JULY
Level 1 – Certificate course in Aesthetic Medicine
New Orleans, Louisiana
12 – 14 JULY
Cape Town
19 – 21 JULY
Johannesburg
29 JULY
Filorga Filler workshop, By Dr Albert Niemann
KZN, Durban
Filorga Laboratoreis | colette@filorgasouthafrica.co.za
012 548 3943 | 082 494 7670
16 – 18 AUGUST
Cape Town
17 AUGUST
Pretoria
012 548 3943 | 082 494 7670
18 AUGUST
Filorga Filler workshop, By Dr Riekie Smit
Pretoria
012 548 3943 | 082 494 7670
23 – 25 AUGUST
Johannesburg
27 – 31 AUGUST
Facial Aesthetic Boot camp
BTX and Filler techniques, Chemical peels, Mesotherapy, etc.
Pretoria
Soy Secrets of youth | support@rejuice.co.za | 082 442 7000| 015 291 2404
SEPTEMBER
Enrolment for Aesthetic Medicine Post Graduate diploma @ FPD
Lynnwood, Pretoria
Foundation of Professional Development
Danielle Daniels | danielled@foundation.co.za
www.foundation.co.za | 012 816 9000
14 – 16 SEPTEMBER
Johannesburg
021 683 8505
17 – 18 SEPTEMBER
Pretoria
11 – 13 OCTOBER
Cape Town
18 – 20 OCTOBER
Johannesburg
27 OCTOBER
Filorga Filler workshop, By Dr Albert Niemann
KZN, Durban
012 548 3943 | 082 494 7670
29 – 30 OCTOBER
Cape Town
2 – 6 NOVEMBER
Miami, Florida
4 – 6 NOVEMBER
Miami
Miami, Florida
15 – 17 NOVEMBER
Cape Town
16 NOVEMBER
Pretoria
012 548 3943 | 082 494 7670
17 NOVEMBER
Filorga Filler workshop, By Dr Riekie Smit
Pretoria
012 548 3943 | 082 494 7670
22 – 24 NOVEMBER
Cape Town
TRAINING PROVIDED ON REQUEST
SEPTEMBER
Anti-aging medicine, Co-Sponsor: Solal Technology
Midrand, Johannesburg
9 – 11 SEPTEMBER
Long Beach, California
13 – 15 SEPTEMBER
Cape Town
Sclerotherapy, Nutrition & Weightloss, Mesotherapy, Chemical Peeling,
Aesthetic practice management & staff training, etc.
Pretoria
Soy Secrets of youth
Winette | support@rejuice.co.za | 082 442 7000 | 015 291 2404
Microdermabrasion – all manufacturers and also on Synergie AMS systems
Anywhere
Stern Laser | Valerie van Zyl | www.sternlaser.co.za | 083 628 9946
Lasers, IPL’S, Slimming and Cellulite units training
Johannesburg
Radiant Healthcare | sales@radianthealth.co.za | 011 794 8253
27
LEGAL ISSUE
communication desists from any further communication.
For this purpose, draft Regulations provide for the
establishment of a Registry in which a person may register
a pre-emptive block, i.e. recording his/her decision not to
receive (block) any direct marketing material or approaches from
certain suppliers. Practitioners would have to check the Registry,
once established, to determine whether any of the potential recipients
of the marketing material has registered such a “pre-emptive block”. The
draft Regulations propose onerous provisions on practitioners in respect of the
Registry. It proposes to require amongst others that “direct marketers” need
to register with the Registry in order to be able to check the Registry for
these registered blocks. It is not clear from the draft Regulations who
would qualify as “direct marketers” and whether it would for example
include medical practitioners engaging in ad hoc
marketing activities. The draft Regulations also propose
that direct marketers should update their information
annually, comprehensive pre-emptive blocks must be
assumed unless the administrator of the Registry advises
otherwise and consumers may also register only certain details such as a mobile telephone number or e-mail address
on the Registry, which could make accurate verification of consumer details difficult for marketers of goods and services.
CONCLUSION
The far-reaching implications of the Consumer Protection Act for all businesses including medical
practices cannot be sufficiently emphasised. The rapidly approaching full implementation date means
that there is limited time for medical practitioners to align their business practices and systems to ensure
compliance with the CPA. It is therefore advisable that doctors should commence with the review of their
businesses to ensure compliance with the Act before the full implementation thereof on 31 March 2011.
Compiled By Esmé Prins-van den Berg (Director) and
Shakira Ramlakhan (Consultant)
Benguela Health (Pty) Ltd
February 2011
REFERENCES
1. Consumer Protection Act 68 of 2009.
2. Consumer Protection Act: I Know my Rights.
Do You Know Yours? A publication of the
Department of Trade and Industry.
3. Consumer Protection Act, 2009: Proposed
Consumer Protection Regulations. Notice No.
1099. Government Gazette No. 33818 of 29
November 2010.
28
1
2
3
4
5
REGISTRATION INSTRUCTIONS FOR YOUR
FREE ETHICS CPD POINT
Go to www.medspecpublishing.co.za
Click on the MedEsthetics CPD programme button.
Complete the registration form and click the submit
button.
You will be directed to your landing page, where the
questionnaires will be displayed.
Click on the questionnaire which you would like to
complete, once completed click submit.
Stitching the
aesthetic and medical
worlds together.
DMK Montague-King (DMK) can enhance and prolong the
result of fillers and injectables and minimise post surgery
downtime, to days not months.
DMK Pre and Post Operative Treatments work on the
premise that the healthier skin functions prior to surgery, the
faster it heals, and the better the result.
ÀYHGD\VSRVWVXUJHU\
DMK Skin Revision Protocols can offer you:

New clientele with high levels of client retention and satisfaction
A competitive advantage in an ever-changing market
Pre and Post Operative Treatments protocols for medical procedures
Alignment with medical practices
7KHEHQHÀWVRIKLJKUHWDLOPDUJLQV
International education and marketing support
GXULQJHQ]\PHWKHUDS\
QLQHGD\VSRVWVXUJHU\
For more information about DMK treatments contact DMK Montague-King
Tel: +27 (0)11 2626 120 l Fax: +27 (0)11 2626 125 l Email: info@dannemk.co.za
Address: Georgian Place, Block C, First floor, 18 Southway Rd, Kelvin, Sandton Johannesburg
DECISION
MAKING
when EXPANDING the
AESTHETIC PRACTICE
by adding devices
There are a few factors that one needs to consider before purchasing
a device for your Aesthetic Practice, namely
•
•
What is the demand in your area for Hair Removal, Skin Rejuvenation or both?
What amount of capital do you have available to invest?
In my opinion, the logical decision for any practice which has established itself with Botulinum Toxin; Fillers; Chemical
Peels, etc, is to start with an Imaging Device. Although the direct return on investment (ROI) is not high, it is an
essential record-keeping, diagnostic and marketing tool. I would then add a Skin Rejuvenation device. This would
augment the existing treatment menu and ensure improved synergistic results with combination treatments.
However, in certain areas, there would be more demand for Hair Removal or, if finances allow, both devices. According
to international statistics, a hair removal device would generate the most income. However, if there is no demand for
this within your existing practice, then one needs to consider alternatives.
The selection of which device to purchase is dependant on the following factors:•
•
•
•
•
30
Investigate which device is considered to be the best internationally.
Find the local distributor.
Ensure that the training, assistance with marketing and after sales service are commensurate with your expectations.
If there are any consumables, be aware of the need for constant availability, as well as the cost factor.
Investigate the turn around time by the supplier for faulty units. Do they carry the necessary stock for prompt
repairs, and do they have loan units available? Downtime equals income and opportunity lost, which most
practices can ill afford.
DECISION MAKING
•
•
Buy from a well known supplier who has many devices already installed successfully around the country.
Enquire about the frequency of servicing and the downtime and cost involved thereof.
As a reputable Aesthetic Practitioner, always buy a specific technology for a specific purpose. Certain suppliers of
devices may claim, for example, that Intense Pulsed Light can do hair removal, vascular reduction, skin tightening as
well as skin rejuvenation. Approach other practices with similar devices and ask whether they are satisfied with the
results obtained.
Therefore the steps that I would recommend for purchasing devices should be followed conservatively and are as
follows:•
•
•
•
•
•
Imaging device
IPL for skin rejuvenation
Microdermabrasion
Laser for hair reduction
Non-invasive skin tightening/cellulite/subcutaneous fat treatment
Fractional laser device
Ensure that you are confident in the use of each device before adding another. Strict financial controls
are important to monitor the real monetary success of each device within your practice. Start with the
more basic equipment and slowly build up to the more advanced devices.
31
BEST PRACTICES
01
02
01 Pre-Surgery Toning In an effort to provide patients with both safer and
more effective body sculpting procedures, Frank Ferrin, MD, plastic surgeon
and medical director of Elite Body Sculpting in Coral Gables, Florida, has
joined forces with his son, exercise physiologist and master trainer Chris
Ferrin. Prior to undergoing liposuction procedures, patients work with Chris
as part of a weight training and muscle building program. Once an agreed
upon level of fitness and shape has been achieved, Dr. Ferrin performs
surgical body contouring. “In order to sculpt around the muscle, there must
first be muscle in place,” says Dr. Ferrin, who notes that combining fitness
and nutrition strategies with body contouring surgery offers both a more
natural appearance and faster recovery times.
02 From the Patient’s Perspective Peter A. Adamson, MD, FRCSC, FACS, has
authored Fabulous Faces: From Motivation to Tranformation Through Facial
Plastic Surgery, a book that seeks both to address the love-hate relationship
that society has with the concept of cosmetic surgery and to give patients a
better idea of what to expect from these procedures. Fabulous Faces follows
the personal journey of several patients from the decision-making process
through surgery and recovery. “I feel it is important that people considering
surgical or nonsurgical cosmetic procedures make the best and most
well-informed decisions,” says Dr. Adamson. “This requires having a good
understanding of the results that might be achieved, both objectively and
psychologically.” In the book, Dr. Adamson also offers an explanation of the
different specialties of plastic surgery to help patients find the right doctor
for each type of procedure. The book is available at amazon.com.
03
03 Custom Merchandising Support Attractive merchandising can help
to increase retail sales. Keeping products clean, dust-free and displaying
them at eye level on uncluttered and well-lit shelving are some of the ways
to encourage both browsing and buying. Now you can create a peruseworthy merchandise display without spending a lot of money redesigning
your waiting room area. MicroPharmacy Corporation, a provider of pointof-sale software for medical environments, is offering custom, portable
lighted display systems for practices. Each unit includes a backlit lightbox
incorporating a custom logo or graphic and three illuminated shelves to
draw attention to your products. The unit also includes three locked storage
cabinets below for extra inventory.
For more information contact Lynette Schlebush-Mok, 082 451 6486,
www.nine-dot.co.za, Lynettesm@telkomsa.net
32
04 Science Log The use of the low pulse Q-switched 1064nm laser
for facial toning has been associated with mottled depigmentation in
Chinese patients. Researchers at the University of Hong Kong and the
Wellman Center for Photomedicine at Massachusetts General Hospital
assessed 14 Chinese patients, each of whom underwent laser toning
for either nonablative skin rejuvenation or melasma with a low fluence,
large spot size, multiple passed Q-switched Nd:YAG laser. In all cases,
UV photographic images demonstrated facial mottled depigmentation.
The study appeared in the October 2010 journal of Lasers in Surgery
and Medicine.
... Botox Cosmetic injections improve quality of life and self-esteem
according to a study by Steven H. Dayan, MD, FACS, that appeared in
the November 2010 issue of Dermatologic Surgery. In the double-blind,
randomized, placebo-controlled survey, 100 subjects were treated
with either Botox Cosmetic or saline placebo for facial wrinkles. All
participants completed a health outcomes survey prior to, two weeks
following and three months after injections. In patients treated with
Botox Cosmetic, statistically significant improvements were observed
in answers pertaining to quality of life, overall life satisfaction, selfworth, appearance and sense of well-being.
05
05 Cutting-Edge Skin Imaging Movie studios are not the only business
entities to benefit from new 3D technologies. Cosmetic practitioners
can now offer patients stereoscopic view technology—similar to that
used in movie theaters—to provide more realistic 3D simulations of
procedure outcomes. Canfield Imaging Systems’ new Vectra 3D Systems
employ VectraVision to provide images so realistic that you’ll want to
reach out and touch them. VectraVision is available with both new and
existing VECTRA X3, M3 and M1 installations. Additional features now
available for the VECTRA 3D systems include:
• Face and breast assessment utilities that aid in surgical planning,
including asymmetry measurements, left/right composite tools and
RBX visualization of vascularity and pigmentation
• A Patient Consent Checklist that helps to assure patient
understanding of existing conditions and expected outcomes
• An animation wizard to create video clips of simulated procedures
for websites and presentation
• New cropping and trimming tools, and whiteboard markers.
Software upgrades are provided at no cost to Canfield customers
with current service agreements.
INTRODUCTIONS
01
01 Improved Pulsed Light Palomar Medical Technologies
introduces the MaxG pulsed light handpiece for use with
the company’s Artisan and StarLux Systems. Designed
to rival the performance of single wavelength lasers, the
MaxG combines Palomar’s Dynamic Spectrum Shifting and
dual band filters—which increase the concentration of
near-infrared light in longer pulse widths to provide more
uniform heating across the entire diameter of larger vessels.
Additionally, in comparison to non-optimized pulsed light,
the MaxG offers more energy across all pulse durations. Plus,
greater peak power to address small vessels, and higher
fluences for mid-to-large resistant vessels.
Contact: 800.725.6627, palomarmedical.com.
02
03
04
02 Undereye Aging Defense Age Intervention Dark Circle Eye
Defense from Jan Marini Skin Research addresses three of the
most commonly cited periorbital cosmetic concerns—dark
undereye circles, undereye wrinkles and poor skin texture.
The cream features six primary ingredients: five to address the
five causes of dark circles—blood leakage, iron discoloration,
inflammation, thin and fragile skin, and pigmentation—and
one to improve delivery of actives. They include Chrysin, NHS
chelates, palmitoyl oligopeptide, palmitoyl tetrapeptide-7,
retinol and Microsponge Technology.
Contact: 800.347.2223, janmarini.com.
03 Help for Hypopigmentation Physicians have a new tool
available to address hypopigmentation associated with laser,
chemical and manual deep resurfacing. The Excilite-μ from
DEKA Medical is now available for use in the United States for
the treatment of leukoderma, psoriasis and vitiligo. The system’s
308nm monochromatic excimer light stimulates melancoytes
to restore color to depigmented areas and is cleared for use
on all parts of the body, including the hands, elbows and
knees. “Prior to the Excilite-μ, physicians had few options for
patients seeking improvement in their hypopigmentation,”
said Brian Biesman, MD, director of the Nashville Center for
Laser and Facial Surgery, Nashville. “I have seen improvement
in hypopigmentation caused by laser resurfacing, surgical
scars, cryotherapy and deep chemical peels.”
Contact: 877.844.5552, dekamedinc.com.
04 Faster Body Sculpting Reduce fat pockets in less time with
the new eZ App 8 applicator from ZELTIQ Aesthetics. The curved
cooling plates treat 2.5 times the amount of fat as the original
ZELTIQ CoolSculpting applicators in one hour. Additional
benefits include increased cooling capacity and additional
sensors for improved system monitoring. The eZ App 8 joins
the original eZ App 6.3 and eZ App 6.2 for petite patients.
“We are constantly striving to improve the CoolSculpting
34
INTRODUCTIONS
05
procedure...to increase both physician and patient satisfaction,”
said Gordie Nye, president and CEO of ZELTIQ. “The new eZ
App 8 applicator will give physicians the additional treatment
options they desire, while patients spend less time being treated
with added comfort.” Contact: 888.935.8471, coolsculpting.com.
05 Rapid Hair Removal The new SopranoXLi from Alma Lasers
features several upgrades to help physicians provide faster laser
hair removal and deep dermal heating. The system offers increased
power up to 20 J/cm2, an improved ergonomic design for operator
comfort, pre-programmed settings for all male and female face and
body parts, and a large 12” full-color, touch screen monitor with
interactive software. The diode module has an extra large 12mm x
10mm footprint and up to 10Hz repetition rate. For hair removal the
SopranoXLi uses the gold standard 810nm diode laser with gradual
heating and a contact cooling Sapphire tip as well as Alma’s InMotion sweeping technology to help physicians comprehensively
cover the treatment area. The device’s near infrared (NIR) module
addresses skin laxity with an 18cm2 spot size.
Contact: 866.414.2562, almalasers.com.
06
07
06 Upgradable and Easy to use The M22 is a tabletop modular
multi-application platform. This smart, simple and innovative
device features IPL and Nd:YAG with Lumenis’ proprietary Optimal
Pulse Technology (OPT™) and Multiple-Sequential Pulsing. This
new platform was designed to consistently produce superior
results and deliver predictable treatment outcomes for over 30
applications. “The M22 delivers everything one can expect form
a multi-application platform and takes performance to the next
level with accuracy, simplicity and expediency”, said dr. Matthew
Knight, Florida USA. “M22 provides maximum versatility and it’s
set up for expansion.” M22 allows for the treatment of multiple skin
conditions with one device and offers a great return on investment.
Contact: Hitech Lasers +27 12 349 1250 or
Email: hitech@hitechlasers.co.za
07 NEW ELLIPSE HR-L PLUS APPLICATOR An 8.64 cm² footprint
makes Ellipse HR-L+ the largest and fastest hair removal applicator
in the market, enhancing client throughput. The lager footprint
means fewer overlaps and skipped areas ensuring better results.
The Ellipse HR-L+ weights only 400 grams (33% lighter than the
Ellipse HR). Its low weight and innovative flexible cabling make
treatments much more comfortable for operators and clients.
The HR-L+ is currently available for the new Ellipse Light SPT,
I²PL PLUS and the Ellipse MicroLight. HR-L+ is also applicable for
the new Ellipse Light SPT and I²PL system after upgrade to PLUS
level. “The Ellipse HR-L+ applicator appears to be one of the best
hair removal applicators in the top segment of the market.” Peter
Bjerring M.D. Professor, Head of the Department of Dermatology,
Molholm Hospita, Vejle, Denmark. For more information regarding
the Ellipse HR-L+ applicator, contact Technolase cc @ 012 349 1750.
MedEsthetics Volume 3 Number 4 Summer Edition 2010
35
INTRODUCTIONS
08
09
10
08 Ancient Wisdom and Modern Science Conjure Liquid Gold As
the name suggests, Liquid Gold is one of the richest and most luxurious
indulgences you could wish for your skin. It’s a powerful resurfacing
and firming lotion that jump-starts the skin’s metabolism, refines
enlarged pores, evens skin tone and delivers a bright dewy radiance
to the skin. Licorice is renowned as an anti-irritant and for helping
to reduce acne and pigmentation in the skin. It contains Vitamin
E, B-complex, biotin, pantothenic acid, lecithin and manganese
– elements essential for the maintenance of strong, healthy skin.
Naturally derived from sugar cane, Glycolic Acid has a scientificallybacked reputation for improving skin texture; reducing acne, wrinkles,
lines and the size of pores; and minimising the signs of sun damage.
Glycolic Acid works by dissolving the ionic binds that hold dead skin
cells together, allowing them to be gently sloughed away to reveal
the new supple skin beneath. Combined in high concentrations in
Liquid Gold’s silky soft elixir, Licorice and Glycolic Acid are instantly
absorbed by cell membranes, restoring a golden glow to even the
most lack-lustre skin. No wonder we call it Liquid Gold!
For more information: Christina Bowman 079 527 1232,
info@alpha-h.co.za, www.alpha-h.co.za
09 Alpha-H A & E - 50/50 Serum (1.5%) Vitamins A and E are
combined in the Alpha-H A & E 1.5% Serum to produce a formidable
weapon against dryness, scarring, and wrinkles. Tissue regeneration
is boosted and cells repaired, whilst powerful antioxidants protect
against free radical attack. Alpha-H A & E 1.5% Serum is a powerful
repair serum that combines the natural regenerating properties of
Vitamin A and Vitamin E to offer a superior antioxidant, moisturizing,
scar inhabiting, wrinkle reducing, exfoliating and tissue regeneration
effects. Alpha A & E 1.5% Serum has an exceptional liposome delivery
system, that provide outstanding results without the excessive
irritation or unpredictable side effects, often seen in other forms of
Vitamin A. Clinical studies indicate that these essential Vitamins,
in conjunction with UVA and UVB protectants can play an essential
role in war against aging. Perfect for the following skin types: sun
damaged skin; mature, lined, wrinkled skin; oily/acne prone skin; skin
affected by Rosacea; skin affected by pigmentation; skin affected by
scaring; post-operative skin and menopausal skin.
For more information: Christina Bowman 079 527 1232,
info@alpha-h.co.za, www.alpha-h.co.za
10 The PRECISION you require with the VERSATILITY you need
The patented Surgitron® Dual RF Radiosurgery® energy source
represents advanced radiowave technology that provides
veterinarians unparalleled surgical PRECISION for cutting and
coagulating soft tissues. The high frequency of 4.0 MHz minimizes
heat dissipation and thus cellular alteration. The Surgitron® Dual RF™
system’s VERSATILITY enables use in a wide variety of procedures
such as biopsy, declaw, wet-field coagulation, sebaceous adenoma
and basic endoscopy. Radiosurgery® uses high-frequency energy to
make cosmetic-enhancing incisions. Radiosurgery® delicately seals
blood vessels, allowing for incredibly precise surgery with minimal
bleeding. Rapid, comfortable post-operative recuperation with little,
if any, bruising and swelling, facilitates a return to normal activities.
Cosmetic radiowave surgery patients heal quickly and start enjoying
their results immediately. Radiowave procedures are effective on
36
INTRODUCTIONS
many types of skin lesions, including: Age spots • Moles and raised
lesions • Skin tags • Small red facial veins • Warts • Skin surface
irregularities. For more information please contact Intamed:
0800 110 679, gary@intamarket.co.za, www.intamed.co.za
11
11 MD Lash Factor Eyelash & Eyebrow Conditioner, Hair Growth
and Restoration MD Lash Factor is an eyelash and eyebrow
conditioner that makes your own eyelashes grow longer, thicker and
fuller naturally. MD Lash Factor is peer reviewed by medical doctors
and published in medical journals confirming its effectiveness and
safety for long term use. The latest addition to the MD Range of
products is the MD Hair Restoration Kit for Hair Restoration and
growth. For more information please contact Intamed:
0800 110 679, gary@intamarket.co.za, www.intamed.co.za
PRODUCT REVIEWS
01
02
01 Radiant Healthcare once again visibly better! The FDA
approved Viora Trios™ IPL based system is a phototherapy system
that delivers the most sought after IPL applications in the aesthetic
beauty market for all skin types. Radiant Healthcare has negotiated
a package deal and better prices with one of our suppliers on the
Trios - Hair Removal and Skin Rejuvenation IPL.These prices never
seen before in South Africa . . . Trios with Hair Removal applicator
ex stock priced at R102 000.00 including Vat, training and delivery.
(Optional: Skin Rejuvenation and Acne Applicators)
Contact: Jacques or Melissa at on Tel: 011-794-8253
02 Filorga Neocica – Restorative Cream For Damaged Skin
Soothing care for damaged skin with hypersensitivities (useful
for use post-laser treatments, post-chemical peeling, post-skin
injection, or to treat severe sunburn or skin irritation). Neocica
is ideal for treating ALL skin sensitivities and for reducing skin
irritation and redness. 96 ingredients - 73% active ones. IT’S
MISSION: To accelerate the tissue repair process and appease
the sensitised skin cells irritated through aesthetic treatments.
THE MECHANISM: NCTF® and hyaluronic acid, with collaxyl and
the anti-inflammatory trio of skin-softening rhamnosoft , épaline
(corn), and inductylor (Artemia Brown seaweed). These all act
together to fight against the formation of cytokines, the mediators
of the inflammation. The rhamnosoft blocks the adhesion of
bacteria, limits the reception of the inflammatory messages and
lessens irritant reactions. Therefore, it helps repair damaged skin
and lessens the ageing consequences of the inflammation. To
summarise, NEOCICA appeases the inflammation and assures a
spectacular reconstruction of the epidermis while acting on the
regeneration processes of the cell. THE RESULT: Skin traumatised
by a peel, microdermabrasion, laser treatment, severe sunburn
or after aesthetic injections shows less redness, less irritation and
it recovers more rapidly. APPLICATION: Use 3 to 6 times a day
on affected areas, using a very light tapping motion to increase
penetration without harming the skin. PRICE: 20ml – R465.00. For
more information please contact G.A. Active Wholesalers ,
www.filorgasouthafrica.co.za
Colette Kotzé, 012 548 3943, colette@filorgasouthafrica.co.za
37
emerging from
THE STORM
Recovery tips to buoy your practice as the economy begins to rebuild. by J. Tol Broome Jr.
If you’ve been reading the business headlines of late, then you know that The Great Recession is officially over.
Consumer sentiment, manufacturing capacity utilization and business inventories—have been trending in a positive
direction. So why doesn’t it feel like the downturn is over? Your practice continues to struggle as revenues remain below
prerecession levels. And the headlines also report some negative economic stats, such as unemployment, a continued
slide in housing prices and record government deficits at all levels in the USA.
38
EMERGING FROM THE STORM
added benefit of service-quality excellence is the word-ofIT’S ALL RELATIVE
mouth advertising that will result, which is sure to bring more
Recessions are a lot like hurricanes. There’s a wide range in
prospective patients into your practice.
the level of severity. With a Category 1 storm, there is a lot
of wind and rain that comes with the squall, but the storm
is soon forgotten after a week or two of cleanup. As the · Consider replacing employees. If you have any employees
who are not getting the job done, now is the time to consider
storm strength moves up the Saffir-Simpson severity scale,
a change. With unemployment still high, the job market is
the challenges become more daunting. The worst storms are
flooded with capable and eager people
rated Category 5 and carry winds in excess
looking for steady employment. Many
of 155.4 mph.
Recessions are a lot
have extensive experience in medical
The best known modern-day Category
aesthetics and will be ready to hit the
5 storm is Hurricane Katrina. With these
like hurricanes.
ground running with minimal training.
terrible tempests, the storm itself is horrific
There’s a wide range in the It can be interpersonally uncomfortable
with life-threatening wind and rain as well
to have to terminate employees during
as devastating property destruction. The
level of severity.
high unemployment, but you will not
result is an overwhelming level of debris
maximize the potential of your business
that can take months—or even years—to
without the right people in place.
clean up. And they tend to have a life-changing impact on
those caught in their paths. The 2001-2002 recession was like
a Category 1 storm. During the few months of the very mild · Assess your business model. It is likely that over the past
several years you’ve focused primarily on survival. But you
economic downturn, some practice owners felt the pinch. But
need to resist the temptation to remain in that mode as the
after it came and went, most practices soon moved on to even
economic recovery ensues. Now is a great time to assess your
better results. In contrast, The Great Recession of 2007-2009
practice’s business model. Start with your location. If you are
has been akin to a Category 5 hurricane. The economic storm
near the end of your lease term, consider whether or not a
was very severe and lengthy. Many did not survive. And those
different location makes sense. There are some great deals
still standing are left with a daunting debris field.
for commerical space right now, and you might be surprised
So what should you do now to deal with the debris and take
by what you can now afford in upgrading your location.
part in the recovery? First, the fact that you are still in business
Second, even if your lease is not near its end and you like your
is no small feat and should be celebrated. The Great
location, you might be successful in renegotiating a
Recession debris field is littered with business closures,
lower rate in exchange for a longer term. (For more
yet your practice still has the lights on. Congratulations.
information on lease negotiations, see Business
What should you do next? Try to find the rainbow.
Consult on page 10.) Next, consider some other key
questions: Are you still meeting the needs of your
LOOK, LOOK, LOOK TO THE RAINBOW
patients? Do you have the right mix of treatment
The rainbow may seem elusive right now, but
options and price points relative to the market? Should
apply some of these tactics to your business,
you consider other revenue sources, such as retail
and you will greatly improve your chances of
or online sales? What should you be doing that
surviving and thriving during the period of
you are not doing? What should you
revitalization that is on the horizon.
stop doing? If you determine that you
need to make some business-model
· Focus on service quality. This is a
changes, map out a plan and a time line
great place to start because it is something
for implementation and follow it.
over which you have direct control. It
might be unclear how to bring more patients
· Take advantage of the challenges faced by competitors.
through your front door, but you can ensure
Realize that just as you have been dealing with a Category
that all who enter will have a great experience
5 economic storm over the past several years, so have your
in your practice. Service quality starts with the
owner.
competitors. And while it may be tempting to focus inward,
Maintain a positive attitude with your employees so that
it’s actually an excellent time to assess your competitive
they will want to come to work. And insist that they take
landscape and grab market share. While other practice
the same approach with patients. If any employee lacks
owners operate in a survival mode, focus on two or three
sufficient product or procedure knowledge, make sure she
things you can do to improve your competitive position
gets up to speed to help meet patient needs. An
39
EMERGING FROM THE STORM
creditors, you will have a much better chance of keeping
them off your back, allowing you to focus more on running
your practice. Keep your promises. Try to under-promise
and over-deliver. If you know you will be late, contact your
creditor and let him know that you might be 10 days late,
and then try to pay in five days. Ask for longer terms. A
supplier might be willing to give you a 45-day term instead
of 30. And your bank might be willing to extend your threeyear loan to five years. Rotate late payments: If you have 20
creditors and you can’t pay everybody
· Manage expenses closely. You’ve likely
on time right now, pay half of them
been in a hunkering-down mode with
on time this month and the other half
expenses throughout the recessionary
If you don’t already have strong on time next month. Keep essential
period. This is no less important during
a recovery. Managing expenses closely controls in place for ordering, this creditors current. Every business has
a few creditors that are essential to
will allow you to stock more inventory,
can be a great way to
keeping the doors open. If you can’t
offer special promotions to increase
keep them current, be sure to keep
bookings and keep loans current. If
reduce expenses.
them well informed. Avoid surprising
there are some areas that could still
your banker. He can deal with bad news
generate potential savings (such as
as long as he has forewarning. Consider
different staffing models, change in
cash-management services, such as a lockbox, computerhours or operation, etc.), consider implementing them now.
based balance reporting and funds transfer, automated
Additionally, you need to have control over ordering supplies
clearinghouse services and controlled disbursement. They
and inventory. Some practices allow most anybody to place
can significantly improve your cash flow.
orders, which can result in wasteful spending. If you don’t
already have strong controls in place for ordering, this can be
· Keep your personal credit clean. Most creditors view the small
a great way to reduce expenses.
business and the business owner as essentially one in the
same, so it’s imperative that you keep your personal credit
· Preserve working capital. Working capital is the investment
clean during an economic recovery, particularly if you think
you have in accounts receivable and inventory less accounts
you will need to borrow money once a sustained expansion
payable. You can generate a significant level of cash in your
period sets in. There are five key components of a personal
business by improving your working capital position. Take
credit rating, listed in order of importance: 1) timeliness of bill
a good look at your current retail inventory. If some of it is
payments, including tax liens, bankruptcies and judgments;
slow moving, mark it down, get rid of it and don’t replace
2) level of outstanding credit relative to lines available (i.e.,
it. Instead, invest those dollars in more of the
having a $15,000 credit card with $14,000 owed); 3)
inventory that moves faster, and your working
length of time your credit has been active;
capital position will improve.
4) types of credit; 5) acquisition of
new credit. There are three major
· Generate cash by collecting receivables
credit score sources: Equifax,
faster or paying creditors more
Experian and Trans-Union.
slowly. Start calling overdue
If you aren’t sure what your
accounts
and
continue
credit score is, visit the websites
calling every few days until
of one of these credit bureaus
you are paid. Likewise, don’t pay
and find out.
your creditors early. This ties
The Great Recession
up working capital, and that
has left a lot of damage
means less cash to run your
and debris in its wake, but
business.
the economic recovery has
begun. Follow these tips and
· Work closely with creditors.
you
will increase the likelihood of finding
Recessions can be brutal when it comes to meeting
new success as you seek to revitalize your
debt obligations. Revenues and cash levels fall,
medical aesthetic practice.
but debt payments don’t. If you find yourself
in a position where it is difficult to cover
J. Tol Broome Jr. is a Winston-Salem, NC-based
all debt obligations, don’t panic. Instead,
freelance writer with more than 20 years of commerciallending experience.
be proactive. If you communicate with
in your local market. These tactics might include introducing
new equipment or product lines, investigating different
local advertising venues or offering targeted discounts to
drive more traffic. While it may seem counter-intuitive, this
also could be the ideal time to buy out a competitor if you
have access to capital. Some of the best business purchases
are done at economic inflection points such as the one now
prevalent in the current commerce environment.
40
LABORATOIRES FILORGA - ADVERTORIAL
X-HA VOLUME®
THE VOLUMIZING IMPLANT
The X-HA Volume® is indicated for injection into the deep dermis, subcutis or supraperiosteally.
This filler is indicated to increase or restore volume of the face, remodel facial contours and to
correct deeper wrinkles and folds.
The X-HA Volume® benefits from a high purification technology allowing to obtain a pure cross-linked hyaluronic
acid, with the lowest proteins and endotoxins rates, which is much lower than required by the European
Pharmacopeia’s. X-HA® range therefore limits risks of hypersensitivity, inflammation and secondary reactions,
and offers perfect biocompatibility.
mPa s -1
It perfectly complete corrections made with X-HA³®, polyvalent filler for the treatment of medium and deep
wrinkles and lip enhancement.
1 025
Fo rce d ’i nj e c t i o n
Vi s co s i té à 0, 1s -1
557
B
30,4
13,3
888
A
20,3
1 038
X-HA
Volume
c
X-HA Volume® has a very high viscosity to resist to
deformations and create volume
12,9
X-HA
Volume
27G
A
21G
C
21G
B
27G
Easy Injection
Thanks to its high viscosity, X-HA Volume® can be easity
injected with a non traumatic needle.
Long-lasting remanence
Thanks to its high cross-linking, X-HA Volume® resist to
degradation factors of hyaluronic acid. Its remanence
into the tissues in longer than 12 months
Cross-linked hyaluronic acid volumizing implants: A: 22mg/ml – B: 25,5 mg/ml – C: 24mg/ml
The X-HA Volume® is packed in 2 x 1ml syringes
Concentration : 23 mg/ml
Molecular weight : 2,5 M Daltons
High Viscosity : 1 M mPa.s-1
Price: R2450 excl VAT
41
RADIANT HEALTHCARE - ADVERTORIAL
SYNERON
Unveils New Cutting-Edge Aesthetic Products at American Academy of
Dermatology Annual Meeting, Underscoring Science and Leadership
Breakthrough technologies give doctors a wider range of treatment advantages across a more diverse patient
base
February 3, 2011 – Today Syneron Medical Ltd. (NASDAQ: ELOS), www.syneron.com, the global leader in the medical aesthetic
device marketplace, announced that the company will be featuring an exciting new family of aesthetic treatments at the
American Academy of Dermatology (AAD) 69th Annual Meeting taking place in New Orleans, LA.
The newly-launched products include ePrime™ Energy-Based Dermal Volumizer™, CO2RE versatile Fractional CO2 Resurfacing
System and elure™ Advanced Skin Lightening Technology™. Additionally, the revolutionary eMatrix® complete Sublative
Rejuvenation® system will be the subject of several presentations at the conference, and will accompany the company’s full line
of devices at booth 3515.
“The top physicians in the world continue to look to Syneron for innovative solutions to the multitude of medical and aesthetic
challenges in improving patients’ skin quality,” said Louis P. Scafuri, Chief Executive Officer of Syneron. “The newest family
of products underscores the company’s commitment to science, results and trust, and our dedication to working with our
customers to develop technologies that will give physicians greater flexibility to treat a diverse patient base.”
Following are highlights of this exciting line of products which bring forth an entirely new and diverse range of treatment
categories – from wrinkle reduction to skin resurfacing and lightening:
•
ePrime Energy-Based Dermal Volumizer is yet another new and exciting innovation from Syneron and Candela. The first
minimally invasive aesthetic device to precisely target and deliver measured radio frequency (RF) energy directly into the
deep dermis, ePrime is proven to result in dramatic tone and volumetric improvements of the skin in a single treatment.
Andrea Willey, M.D., of Laser and Skin Surgery Center in Sacramento, CA, stated, “The improvement in skin tone resulting
from increased volume and new collagen production is unique to ePrime and a fascinating concept to bring to light.”
•
eMatrix Sublative Rejuvenation is the world’s first RF-only technology for energy-based facial rejuvenation, delivering highintensity dermal impact with less epidermal ablation with minimal patient downtime. eMatrix treats skin texture and tone
without skin color limitations.
About Syneron Medical Ltd.
Syneron Medical Ltd. – a company devoted to real technology, real science and real results – is the leading global aesthetic
device company with a comprehensive product portfolio and a global distribution footprint. The Company’s technology enables
physicians to provide advanced solutions for a broad range of medical-aesthetic applications including body contouring, hair
removal, wrinkle reduction, rejuvenation of the skin’s appearance through the treatment of superficial benign vascular and
pigmented lesions, and the treatment of acne, leg veins and cellulite.
Contact Radiant Healthcare for more information
Office
011 794 8252
Jacques
082 829 9300
Melissa
082 306 5138
Email
ales@radianthealth.co.za
Website
www.radianthealth.co.za
42
RADIANT HEALTHCARE - ADVERTORIAL
SYNERON ELŌS™
technology still tops the aesthetic market for client
satisfaction and clinical efficacy!
The eMax™ aesthetic system from Syneron is powered by revolutionary elōs™ (electro-optical synergy)
technology. The combination of these two energies is the key to safer and more effective aesthetic (or cosmetic)
treatments for a full spectrum of skin types (Fitzpatrick types i-iv).
This is what local Syneron owners have to say about the eMax:-
“Laser hair removal on the eMax system is safe on most skin
types, including Asian skins and it is highly efficient for all hair
colours, including white and blond hair.”
<< Dr. Natela Rekhviashvili, Vaal Triangle
“We have treated many patients with great results. It has
proven to be safe and efficient, and the radio frequency has
allowed us to treat darker skins. This was previously unheard
of!”
Dr. Stuart Meintjies, Cape Town >>
“Clinical results from the Syneron Emax system have proven
above my expectations and I found it to be very safe on all
skin types. It is in a class of its own!”
Dr. Maryke van Lelyveld, Vaal Triangle
<< Dr. Alek Nikolic, Cape Town
“In treatments of over 2000 patients, many of whom have
had prior IPL treatments with the FotoFacial RF procedure,
and in a split-face comparison study of the IPL FotoFacial and
FotoFacial RF, it has become clear that there are four major
advantages of this new technology over Intense Pulsed Light
(IPL)-only technologies: 1) better overall clinical results; 2)
patient preference for the FotoFacial RF procedure; 3) lower
incidence of complications and a greater margin of safety
in treating skin type iv and v patients and in slightly tanned
patients; 4) more rapid mastery of technique finesse with the
FotoFacial RF procedure.”
Contact Radiant Healthcare for more information
Office 011 794 8252 | Jacques 082 829 9300 | Melissa 082 306 5138
Email sales@radianthealth.co.za | Website www.radianthealth.co.za
43
TECHNOLASE - ADVERTORIAL
SENSATIONAL
BODY CONTOUR
THE FINAL SOLUTION
NovaShape is the logical elevation of cavitation systems
to low power used in medicine and aesthetics. Increase
results with HIFU techniques (Focused) and of course using
the technique osmolar is transforming the way to treat fat
deposits in medicine.
An innovative system, with more features that offers a real alternative to liposuction. With thee
technical environment of low osmolarity, we can provide almost immediate and permanentt
cosmetic results of liposuction without surgery, without post-treatment recovery and
d
discomfort for the patient.
PHYSIOLOGICAL ACTION
Cavitation fields generated by ultrasonic resonant high pressure and density, creating large bubbless
of vacuum (by the rapid oscillation of pressure changes in the interstitial fluid of aipose tissue to energyy
imploding enough to break the adipocyte membrane. The energy at which the fat cells are exposed is such
h
(100kg / cm²), which causes the separation of fatty nodules packages and perforated membranes or celll
walls.
NovaShape is a state of the art device built after years of research on variable low frequencies (forr
mechanical effects) rather than other devices working on high frequencies of 1Mhz to 2.4Mhz (for thermall
effects), on the non-invasive fat reduction & body contouring applications. The method of low frequenciess
applied
by the NovaShape system allows treatments to take place on mostt
a
parts of the body, were results are obtained after a single session only!!
After treatment (rupture of adipocytes) the released fat and
d
cellular debris are cleared via the body’s natural physiological and
d
metabolic pathways.
MULTI-FREQUENCY EMITTER FOR RESONANT EFFECT
In order to obtain a dynamic cavitation process, the ultrasound
d
emitter must be in concordance with the frequency absorbed by everyy
biological tissue at resonant level. This fact will depend on the density,,
its depth, and the shape of the cavity where the fat tissue is located.
HYPO-OSMOLAR SOLUTION
HY
Hidrolipoclasia,
NovaShape recovers, due to its ease of use, providess
Hid
l
a technique convenient in use and now with great results. Unlike previouss
44
TECHNOLASE - ADVERTORIAL
ultrasound equipment used, NovaShape uses much lower frequencies, greater
penetration, higher capacity
ca
and lower compression heating effect. Studies of
the Complutense Univ
University have shown that using a hypo-osmolar solution in
combination with cavitation,
cavit
offer similar results to liposuction surgery without
the drawbacks. In add
addition, improved skin tone, recorded slight increases in
after the session and days without fibrosis, or side
cholesterol and triglycerides
triglyce
effects or hospitalization.
hospitalizatio
FAT FREE BUBBLE – LARGER
LA
To increase the bubble size,
si the NovaShape has an equalizer function resonance
to the area and type of fatty tissue. (The larger the
sensor to adapt the technique
techn
bubble, more effective the results)
APPLICATION
The treatment area needs to be defined (approx. 10min of treatment per 10m²), select
the protocol parameters for each aarea and apply the conductive gel evenly over the area.
Unlike other systems that are w
working on fixed frequency, NovaShape software
sweeps constantly on low frequenc
frequencies to reach the specific frequency that is required
tissue location.
for the density/depth/shape of fat ti
CLINICAL RESULTS
Using the combined techniques of solution of low osmolarity and Resonant Cavitation, we obtain
results in a single session of perimeter reduc
reduction of between 3 and 6 cm in belly fat accumulation,
and 2 – 4 cm in thighs. The effects are visible in one session and it is recommended an average of three
treatments to achieve an equivalent treatment to surgical liposuction.
measurement to demonstrate the loss of adipose
The loss of perimeter is complemented with ultrasound
ultra
tissue thickness, as apposed to cosmetic results offered by other techniques. The real result is obtained
reabsorbed.
after 4 or 5 weeks, once all wastes are reabsorbed
ADVANTAGES OVER OTHER SYSTEMS
* Resonance Sensor with EQUALIZER function
* Cooled Head (more power in continuous mode with variable
frequency, more effectively without risk of burning)
lower
* Greater penetration, enhanced compression and low
thermal effect
* No consumables, low wear head per session
thickness or
* Can be applied in most of the body, regardless of th
density of area
NovaShape phone Technolase cc,
For more information regarding the NovaShap
www.technolase.co.za
Tel 012 349 1750 or visit the web www.tech
45
HITECH LASERS - ADVERTORIAL
CO2 LASER LIGHT
MAKES RIGHT …
CO2 Laser treatment – new hope for patients with burn scars,
traumatic injury scars and other skin abnormalities.
Carbon Dioxide, or CO2, lasers have been widely used since 1994 to eradicate wrinkles and sun damage.
Now the same CO2 laser with fractional technology is used in the treatment of severe burn scars, traumatic
injuries and skin abnormalities. A breakthrough was recently announced by Lumenis, a global developer
of light-based devices for Surgical, Aesthetic, and Ophthalmic application. Leading physicians and
organizations collaborate with Lumenis to find solutions for patients with burn scars, traumatic injury
scars and other skin abnormalities using their proprietary UltraPulse Fractional CO2 laser technology.
BEFORE
AFTER
BEFORE
AFTER
Chest and arms before and after Lumenis UltraPulse CO2 treatment. Courtesy of Jill Waibel, MD
Dr. Rox Anderson,
A
Professor and Dermatologist at Harvard Medical School, a world renowned
laser technology for more than two decades, and at the forefront of a global movement
leader of las
bringing new
ne hope and help to burn survivors, recently treated over 100 patients at the Vietnam
Anomalies Centre (VAC) and trained local physicians. “Our initial efforts focused on treating
Vascular Ano
hemangiomas and other skin abnormalities, but with the advent of UltraPulse fractional technology,
hemangiom
we quickly realized that there was an opportunity to treat burn victims, especially children, “ said Dr.
Anderson “our Mission at VAC is to offer help and hope to these children. The best way to do this is to
Anders
enable and train local physicians on the latest techniques so they can offer a service that was not
ena
possible in Vietnam, or anywhere else in the world, five years ago. With Lumenis’ technology and
pos
support, we are able to achieve this.” This marks the first such international effort for the laser
sup
treatment of scars of this magnitude. Lumenis helped to make the treatments and training
trea
possible through a donation of an UltraPulse laser system.
poss
“Recent medical advancements have enabled the survival of patients with burns covering 80%
“R
to 90% of their body. This has created a reconstruction situation that we haven’t seen before“ said
Dr. Jill
Jil Waibel a renowned private practice physician and an expert in burn scar treatment
in the USA. Dr Waibel also works together with Angle Faces an organization that provides
healing retreats and on-going support to adolescent girls with severe facial disfigurements.
heali
“UltraPulse has had a dramatic impact on the treatment of scars because it is the only laser that
“Ultr
46
UltraPulse® CO2
HITECH LASERS - ADVERTORIAL
BEFORE
AFTER
Face before and after Lumenis UltraPulse CO2 Treatment. Courtesy of Jill Waibel, MD
can reach the depths required to treat deep scars - Lumenis’ UltraPulse is
the only hope that these patients have.”
The US Armed Forces sector is also a significant benefactor of this
novel treatment modality. Lt. Col. Chad Hivnor, M.D., chief of pediatric
dermatology at Wilford Hall Medical Centre was the first to introduce
UltraPulse fractional laser treatment to wounded warriors. “I saw more
and more soldiers returning with severe burns and scars and there was
no treatment to offer them,” said Lt. Col. Hivnor. “I knew UltraPulse
worked well for acne scars, so it made sense that it would help this
scarring. We’ve seen a dramatic improvement in pliability and mobility.”
“The success of this treatment can be attributed to the support of the medical
community, especially these dermatologists and plastic surgeons who are so passionate
about this cause, “said Mr Robert Mann, Sr. VP and General Manager of Global
Aesthetics and Dermatology at Lumenis. “It is our privilege to support them with our
UltraPulse fractional technology.”
Through its collaborations with various international organisations and
individual laser technology leaders Lumenis has the most extensive experience in
the area of burn scars and traumatic injury scars in the industry. A South African
specialist together with Dr. Matteo Tretti-Clementoni of Milan, Italy is currently busy
with clinical trials to bring hope to the South African burn survivors and traumatic
injury victims.
AcuPulse™ CO2
During the recent AAD meeting in New Orleans Lumenis, with over forty years
of laser research and development, introduced the patented MultiMode scanning
technology for the Acu-Pulse CO2 laser, a mid-level version of the UltraPulse
fractional CO2 laser system. This is an exciting new development in ablative
fractional therapy because this unique feature will allow fractional treatments of
both superficial and deep structures using a single hand piece and an exceptionally
easy computer interface.
Hitech Lasers is the sole distributor of the Lumenis products in Southern Africa. For more information on
their range of Lasers, IPL systems and other aesthetic systems contact Hitech Lasers on
Tel: +27 12 349 1250 or E-mail: hitech@hitechlasers.co.za
MedEsthetics Volume 3 Number 4 Summer Edition 2010
47
ALPHA - H - ADVERTORIAL
Latest Advancement in skin care and professional solutions
NEW SKIN BEGINS WITH
The story of Alpha-H begins over 18 years ago, with a remarkable, life-changing story. Having suffered with a
demoralising skin condition for many years, Michelle Doherty’ owner of Alpha-H was introduced to Alpha-H,
consisting of a two-step programme of the Balancing Cleanser and Balancing Moisturiser. Michelle experienced
astounding effects resulting not only in a happy, healthy skin but a personal boost to self confidence and esteem.
Since then, Michelle’s mission has been simply to bring the very best skin care products and services to the world,
not only just for a season or a specific reason but for a lifetime.
Today, with 22 years of research and development, Alpha-H is an exceptionally high quality, results-driven, specialised
skincare range, with over 40 products, sold in prestigious clinics worldwide and in over 850 professional salons and spas in
Australia. Always destined to be more than just another ‘Dr’ brand, Alpha-H has given the beauty industry not one but several
“cult” classics: Liquid Gold, an innovative, exceptional night time resurfacing and firming lotion; Rejuvenating Cream, an awardwinning nourishing, firming cream loaded with minerals, anti-oxidants and collagen-boosting Vitamin C and The Liquid Gold
Smoothing and Perfecting Mask, a fundamental peeling treatment which brings new cells to the surface of the skin. Alpha-H
is now considered a leader in corrective and preventative skincare globally.
The success of Alpha-H has grown from a simple desire to exceed customer’s expectations in terms of their products
performance and results, and has quickly developed a cult following with people from all walks of life. They attribute their
success and growing popularity to their customers spreading the news word of mouth.
It is a responsibility and integrity, most of all, that the Alpha-H family share. Alpha-H was born from an aspiration and
enthusiasm to make a difference and “deliver the very best to every customer every day.” Michelle works closely with her team
of cosmetic scientists, researching ingredients and developing powerful formulations to ensure a consistently high standard
right across the range, bridging the gap between cosmetic surgery and the more traditional cosmetic brands, with nature and
science.
Endorsed by thousands of therapists and doctors worldwide, Alpha-H believes that exfoliation followed by nutrition,
hydration and fortification of the skin are necessary to maintain a clear, healthy and firm complexion. Designed to treat and
visibly improve a wide number of skin conditions such as fine lines and wrinkles, pigmentation and sun damage, clogged pores
and blemishes, acne and acne scarring, Dermatitis, Eczema and Psoriasis and tired, lifeless skin.
Alpha-H is primarily made up of ‘Salicylic acid’ a alpha hydroxy acid, which naturally occurs in sugar cane. Glycolic
acids work by dissolving the ionic bonds that hold the dead skin cells together. The cells can then very gently be sloughed off
to allow new healthy cells to the surface. What makes Alpha-H so distinctive and innovative, is their expansion to take scientific
skincare into a whole new dimension. By combining glycolic acid with a unique blend of other effective natural and botanical
ingredients such as green tea extract, Vitamin E, salicilic acid, ginseng, licorice and hibiscus flower extract and jojoba, Alpha-H
has mastered the art of treating a wide range of skin concerns with tremendous results.
Results with significant improvement can usually be seen within five to seven days of commencing an Alpha-H skin
management programme.
With Alpha-H, new skin truly begins
For more information or interested in becoming a stockist please contact:
Christina Bowman: Tel: +27 (0)79 527 1232, E-mail: info@alpha-h.co.za. www.alpha-h.co.za
48
INTAMED - ADVERTORIAL
USING PELLEVÉ ™
Radiowaves to Wipe Away Wrinkles
If you’re considering how to refresh your appearance without
surgery, the Pellevé Wrinkle Reduction System is right for
you. Pellevé is the newest innovation in skin tightening, FDAcleared to safely and effectively treats facial wrinkles with
virtually no pain, no anesthesia, and no downtime. With just
a single, one-hour treatment, you could be on your way to
firmer, tighter skin—with results that can last up to six months.
Pellevé delivers constant, gradual energy to the skin, causing
heat to build up where the skin and fat layer come together.
The increasing heat modifies the collagen bundles deep
inside the skin, causing them to contract and stimulate the
growth of new collagen over time. This results in firmer,
tighter skin. Many people see the result immediately after just
one treatment, with lasting improvement for months after as
the skin produces new collagen.
Unlike other skin tightening systems, Pellevé doesn’t require
anesthesia or skin cooling. Because the skin is not numb, you
can describe the depth of feeling to the practitioner, which
helps provide the best result in the area being treated. The
overall result is a noticeable improvement in skin quality and
appearance with minimal side effects and no recovery time, so
it fits easily into busy schedules.
Measurable and immediate improvement
• Visible and lasting effects in nearly all patients
• Better skin quality and reduction in skin laxity
Safe and effective
• Non-invasive
• No anesthetic required
• No skin cooling needed
• Minimal discomfort
• Minimal side effects
For More Information Contact Pellevé Exclusive Distributor:
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THE PRESERVATIVE WARS!
That the current controversy regarding preservatives in skin and body products
will have a huge backlash on the “Green Cosmetic” advocates is the main
concern of many private screening labs across the USA. These are independent
labs that all companies manufacturing cosmetics under FDA regulations must
use to validate the fact that their products are indeed safe for human use. While
many ingredients have come under fire as not organic or natural enough, thus
causing cancer or other life threatening anomalies (without one shred of valid
proof) probably the biggest “culprit” is the preservative methylparaben.
In addition to killing bacteria from gram positive and grand negative, fungus and molds, thus extending
the shelf life of a product up to the required 2 years, methylparaben has been a mainstay of the cosmetic
and personal care industry since the 1920’s. I will not go into the pros and con’s of this in this article as I
have covered the subject many times before. Needless to say many new alternatives have become available
in the market place which allows chemists to dispense with the Green Offensive preservative. It is of note
however, that many of the over-the-counter BIG cosmetic houses have not caved into this—preferring to
hedge their bets against department store and other retail clients getting some sort of bacterial or mold
attack from a topically applied “organic, natural” product.
Those of us in the private clinic or spa business have more of an opportunity to monitor our clients on an
ongoing treatment basis, so the “green movement” has targeted our market niche more than the public
retail arena.
And there is nothing wrong with using organic materials or active herbs AS
LONG AS THEY ARE PROTECTING OUR SKIN’S AGAINST MICROBACTERIAL OR
MOLD ATTACK!
And herein lays the quandary. A lot of micro-bacteriologists have worried about the new preservatives
breaking down eventually—in the hands of the consumer. People are not always careful at home about
50
DANNE MONTAGUE-KING - ADVERTORIAL
cross contamination when their fingers are dispensing a
product on their skin. Often times lids are left off containers,
sometimes just for a few minutes, ample time for airborne
bacteria to enter the product and proliferate.
But as it happens many times with discoveries—suddenly
someone will notice something special in the world of
chemists and scientists and another voice will pass on the
message!
business (and some Doctors) who like to appear as if they
discovered every new thing that comes down the Pike—and I
was not about to let that happen to this dedicated man. Alan
Lord discovered BIOSENCE over 9 years ago after suffering a
topical fungus infection in Hawaii. As corny as this seems, it
was some native Hawaiian folk medicine mixture that got rid
of the problem and got him to thinking.
He thought and researched by trial and error (and an abstract
point of view on things) and finally came up with EURIKA!
I AM PRIVILEGED TO BE ONE OF THOSE VOICES!
One of my chemist colleagues, Sarjula Sangvhi, a woman
wise in the nature of herbs and Asian chemistry was one of
the really concerned people about the longevity of the new
preservatives. During a conversation with a micro bacterial lab
where she sends products regularly for independent testing,
she was made aware, by a very excited lab technician, that a
new compound had come thru (for FDA testing) that seemed
nearly miraculous. Mainly because it was based upon ALL
organic ingredients, some fairly common!
The technician, at first suspicious of her
findings, ran every test known to man
including accelerated stability testing and
the compound came thru with flying colours
every time!
Oddly enough, the compound, named BIOCENSE ™ was being
used only for the medical field, in Doctor’s offices, surgeries
and hospitals. It was classed as a substance that prevents and
arrests the growth of microorganisms in ZERO (0) time! For
medical preparations it was applied to living tissue topically as
a botanical antiseptic system, but as a botanical preservative
it also kills in 0 time staphylococci including Methicillin
Resistant Staphylococcus Aureus (MRSA)
This was very apparent in the treatment of wounds, infection
prevention and infection transmission—all very vital to
modern hospitals today!
The lab tech immediately called up the man who discovered
this amazing compound and informed him of the huge
potential in the cosmetic industry.
A short time after that I was informed of this development (as
I was about ready to cave in and use the new “alternatives”
in my own formulations) and I asked for the inventor’s phone
number.
His name is Alan Lord, as like most creative innovators,
he was very shy and retiring on the phone—almost folksy! As
I am somewhat out spoken and have a very abstract way of
thinking, I immediately let him know that his story MUST be
told, as all such knowledge must be shared—not harbored as
a secret by a few. I also know a great many “ego’s” in the beauty
BIOSENSE is a globally approved paraben and formaldehyde
free preservative system that is compatible with almost all
personal care products; it is safe, non-toxic and non-irritating
with no evidence of ocular irritation or skin reactions.
Obviously there are those people on this planet who are
allergic to even the most body friendly foods and natural
ingredients, but that ratio is far and few between and not
enough to keep this remarkable preservative away from the
common herd!
To the compounding chemist, BIOSENCE is versatile, easy to
use, and highly stable and effect over a broad ph range—
including complex molecules such as proteins and surfactants.
It can also be incorporated into cosmetic phasing under a
wide range of temperatures.
In talking to this remarkable man, I had a sense of Déjà-vu there are so many times in one’s life when one has a chance
to come up with a first. I had that chance years ago when I
created a topical analgesic called Biofreeze -simply because
I wanted to help my Grandmother with her chronic arthritis
pains. Years later it became one of the top selling analgesics in
the world. I have no ownership of Biofreeze anymore, having
sold my formula and shares out to partners years ago—but
wherever I go on this planet, even in Russia and Tibet and see
Biofreeze advertized I have this small glow of achievement
of having done something for my fellow man. After listening
to Alan’s story of his early concerns of transmittable bacteria
running rampant in hospitals (his Father was a hospital
administrator) I understood his pride in the research he had
done strictly because something NEEDED to be done. In the
beginning I actually thought Biofreeze would never really sell.
I would like to add my voice to others in getting Alan Lord’s
discovery out there as well.
Not one time in our hour long conversation of loaded
questions coming from me, did he ever mention a commercial
aspect of his compound. Instead, we discussed what types of
treatments could be employed using BIOSESNCE and how it
could help the plastic surgeons for pre and post operation
procedure, the Dermatologists and the aesthetician. Also,
what various forms it could be included in for the most
effective results.
However if the cosmetic world is going to keep on worrying
about “all natural preservatives, BIOSENCE would be the one
to put their money into.
I know I am.
51
NEWS & EVENTS
01
01 Call for Abstracts
Last chance to submit! The Aesthetic Medicine Congress of South Africa 2011 is taking
place from 2 - 4 June 2011. The program is already filled with new and innovative
presentations and demonstrations by local and international experts. If you have new
techniques, research or developments that you want to share with a target audience,
ensure to submit your abstract before 30 March 2011. The scientific committee will take
all abstract submissions into consideration.
02
02 Melissa Eksteen, this last week, celebrated her 6th year with Radiant Healthcare. The
team at Radiant Healthcare would like to convey our appreciation for her exceptional
dedication to the company and our clients throughout the six years. At Radiant Healthcare
we believe that business is not just about providing equipment and service, but also in
building long term, loyal relationships.
03 Foundation for Professional Development – Post Graduate Aesthetic Medicine
Update The first group of doctors have completed there 1st year of this 2 year program
successfully. The 1st year was revising all the basic medical sciences and also covering
endocrinology, nutrition, anti-aging medicine. In the last classes an update on medical
emergencies management was an eye opener for many doctors again to the importance
of updating ones knowledge on managing such situations. Now comes the practical and
technique skills of specific aesthetic medical procedures as well as the research task. The
research tasks will will be very beneficial for the respect and development of aesthetic
medicine in South Africa. The FPD have started taking in new entrants for the next course
to start early next year.
For more information please contact Stacey Dias (StaceyD@foundation.co.za)
04 19Th World Congress of Aesthetic Medicine 2013in Cape Town This event is
coming to Cape Town! Taking place from 14-16 February 2013 at the CTICC and the
pre-congress workshops at Stellenbosch University, Tygerberg campus. Expert speakers
from around the world will present, train and demonstrate the latest trends, techniques,
research and developments in both Aesthetic & Anti-aging medicine. The scientific
committee includes local doctors as well as each of the presidents of the 27 countries
affiliated to the UIME. This diverse scientific input will ensure an unsurpassed program
to attend. International and local companies will be exhibiting and demonstrating new
products, techniques and devices. This international event of the International Union of
Aesthetic Medicine (UIME) will also include symposiums from other continents to update
the diverse audience of the unique trends of the various regions of the world. The precongress workshops with hands-on training on cadaver material and lead by international
experts will be an unforgettable experience. The Gala Dinner taking place at Moya, Spier
Wine Estate will be the ideal Valentine’s African Experience creating memories forever.
Spouses of delegates are welcome to enjoy the numerous South African Valentine’s
offers. Pre- and post congress tours, sight seeings and events will contribute to making
this your best congress ever! The 19th WCAM is the ideal environment for learning,
starting a new venture, business opportunities and updating your expert skills. All of
this taking place in a top ranked destination: nothing better than Cape Town! ABSTRACT
SUBMISSIONS – NOW OPEN! If you have experience, research or new developments that
you want to share with an international audience, then ensure to send us your abstract!
Online submissions available.
For more information about the 19th WCAM: www.wcam2013.co.za
52
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Contact 011 794-8252/3 | radiant@worldonline.co.za | www.radianthealth.co.za