Home' Spa and Clinic : Volume 59 November 2014 Contents MTAECANMAG02MAU1014
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vision of skin care
Transforming skin care practices worldwide, VISIA’s advanced technology provides
meaningful skin evaluations, on-screen and printed reports, and tracks treatment
progress. Increase compliance with quantitative values for skin features that
previously could only be evaluated subjectively.
• develop more targeted
• Communicate clearly using powerful
• Repeatable facial imaging
• Quantative analysis
• Track treatment progress and
outcomes effectively over time
• Improve patient satisfaction with
recommended skin care treatments
Call 1300 886 385 or visit
for more information.
In the beginning – the late 1990s, that is
– Australian aesthetics consumers had
a choice of collagen derived from cow
hide to fill lines and wrinkles and Botox to
freeze them to reverse the signs of ageing.
Over the ensuing years the playing field
has been transformed with a whole new
league of more effective and enduring
dermal fillers based on hyaluronic acid
(HA) that do not have the potential to
cause allergic reactions, as did collagen.
Also fillers that literally “grow on you” (the
bio-stimulant variety) and a wider choice of
According to Dr Joseph Hkeik, Sydney
cosmetic physician and Medical Dean of the
Australasian College of Cosmetic Surgery
(ACCS), Australians are now spending up to
$1 billion each year on aesthetic medicine,
“exceeding their American counterparts by
almost 40 per cent per capita.”
So as an aesthetics business operator
offering these ser vices to clients, albeit if you
are not the actual injector, it is important to
be aware of what these products are and what
they do. Clients will expect you to have this
fundamental knowledge ahead of booking
with your attending medical practitioner.
Other points you should be able to
convey to clients: Injectables are minimally
invasive procedures. References in some
media outlets to them being “cosmetic
surgery” are incorrect.
There is no downtime in the sense of
needing to take time off work. However,
there may be some swelling, redness and
bruising after wards – this depends on the
skill of the injector and the extent of the area
being treated as to how long it lasts; also the
susceptibility of the client to these factors.
HA is a naturally-occurring substance in
the body. High concentrations are found in
soft connective tissues, in fluid surrounding
the eyes, some cartilage and joint fluids and
in skin tissue.
The man-made version used in fillers
is not derived from animal sources. When
injected beneath the skin it acts like
a cushion to support facial structures
and tissues that may have lost volume or
elasticity due to normal ageing.
HA is also renowned for its ability to draw
in and retain up to 1000 times its own weight
in water, so it also helps hydrate the skin,
making it look fresher and more supple.
Brand names of HA fillers include
Princess, Esthélis, Hylaform, Juvéderm,
Perlane, and Restylane. They come in varying
v iscosities, each with different functions.
Denser consistencies can be used to
“resculpt” facial features, such as the mid-
cheek area that typically “deflates” with age,
thus restoring more youthful contours – or
creating them where nature didn’t bestow.
Thinner textures are used for filling
shallower lines and wrinkles and for areas of
the face where skin is thinner.
With brand names such as Radiesse
and Sculptra, these are more “global”
volumising fillers. They can prov ide
an immediate boost in treated areas
but subsequently work with the body to
stimulate production of its own natural
collagen for several months. Optimum
results are achieved in around six months.
In effect they create a “scaffold”
under the skin, providing structure for
the new collagen.
They are injectable liquids; Radiesse
comprised of calcium hydroxylapatite
(CaHA) microspheres and Sculptra poly-L -
lactic acid, both suspended in an aqueous gel
carrier. Again, these are synthetic versions of
substances that naturally occur in the body.
Over time, the gel is absorbed and the
body metabolises the active ingredients,
leaving behind the natural collagen.
They are used to create a soft, natural,
more youthful re-contouring of the face
without the “over stuffed” look that can
result with poor injecting techniques of
HA dermal fillers.
However, biostimulant and HA fillers are
increasingly used an adjuncts to each other
for better results.
A new player joined the anti-wrinkle
injection market in Australia this year in the
form of Xeomin, a botulinum toxin type A
and pronounced “zee-oh-min”.
It belongs to a family of medicines
called “peripheral muscle relaxants”. These
block the transmission of signals from
ner ves to the muscles by hindering the
production of neurotransmitters (signal-
relaying chemicals), allowing the muscles to
Xeomin is only the third botulinum
toxin approved for cosmetic use in Australia
since the late 1990s, the others being Botox
These products are officially approved for
the cosmetic treatment on adults of frown
lines between the eyebrows (glabellar lines)
but are widely used to resculpt areas of the
face with strategic injection points – eg. to
lift the brows or drooping mouth corners or
to refine jawlines that have “bulked up” as a
result of chronic teeth clenching.
Botulinum toxin type A is produced by a
bacteria first discovered in poorly prepared
sausages during the 18th century. It was
named after the Latin for sausage - botulus.
The quantities used for aesthetics
purposes are tiny - a few billionths of a
gram, dissolved in saline - meaning the risk
factor of use is low.
It was also used to address a number of
medical conditions for many years prior to
its ascendancy as an anti-wrinkle panacea;
from children with cerebral palsy to allow
for more limb movement, to treating the
abnormal head position and neck pain
associated with cer vical dystonia, abnormal
spasm of the eyelids, post-stroke spasticity
of the upper limbs, migraines, excessive
sweating and leaky bladders.
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