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Sun Exposure & Flying after Azzalure treatment: Advice for Your Patients

Question:
Dear Cosmetic Courses,
Can you go on holiday to a very hot country 4 days after receiving Azzalure treatment?

The product information says to avoid direct sunlight for a week: how necessary is this and do you have any reassuring advice or tips for patients?

Cosmetic Courses Answer:
Thank you for your really good question about whether you can use Azzalure and then the patient go off on holiday.

Our general advice is that it should be absolutely fine. At Cosmetic Courses, we do get asked questions about people going up in planes following Azzalure treatment but this isn’t really a problem: lots of air stewardess’ have Botox and Dermal Filler treatments.

Regarding sunshine exposure on the small incisions where the needle went in, again we would advise that this is fine but we would advise patients to wear a Clinical-strength sunblock (Cosmetic Courses recommend the Heliocare range for maximum protection) on their face, which they should be doing anyway if they are going to a warm country.

Overall, not a problem at all performing Azzalure on people that are going abroad 4 days later: it is quite commonly performed. Sunblock is a good idea but in the first 74 hours following Azzalure treatment we encourage them to refrain from anything that raises their blood pressure too much, so travelling immediately after the injection wouldn’t be ideal.

Thanks very much for for sending in such an interesting Frequently Asked Question.

The Cosmetic Courses Team

If you are a medical professional interested in training to treat patients in Azzalure, Cosmetic Courses are one of the top UK medical aesthetic training providers. Contact us on 0845 230 4110 to discuss your training with our helpful team.

Or, if YOU have a question you would like our team of experts to answer, why not call our 24/7 Sipgate Helpline on 0870 4907385 for a personalised answer like the one above!

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How do you Know you are Getting the Best?

Are Cosmetic Surgeons the Experts When it Comes to Botox & training?

There was a very interesting debate on the RealSelf forums recently (where you can go to ‘find, share and discuss the real story about any cosmetic surgery treatment’).

A forum user was asking whether they would be better to go and see a Cosmetic Surgeon or Dermatologist (Skin Problem Specialist) for their Botox® injections.

Some of the responses provided by resident forum experts were very interesting.

• It’s all about experience, with Botox® said one US Plastic Surgeon. The “most expert” Botox® specialist can be measured in terms of a Practitioner who has the most anatomical knowledge of the areas which they are treating; which amounts of product work to produce the best-looking, longest-lasting results; how regularly they themselves perform the treatment. He points out that Cosmetic Surgeons are, in a sense, artists and trained to have ‘a good eye’ for what looks natural and effective when performing Botox®…other Skin Care Experts may have a better developed eye for other areas, such as skin abnormalities. In terms of experience, many Board Registered Plastic Surgeons have simply been working in the area far longer and performed more procedures than your average Dermatologist. But he also provides a fantastic quote: “a very experienced Dermatologist would be a better choice than an inexperienced plastic surgeon”.
• Ask about their Allergan Account Level – the same Surgeon gave a great tip that you can guage how regularly a Surgeon (or Dermatologist) is practicing Botox by asking their Allergan account level. “Allergan is the manufacturer of Botox, and has various levels of accounts by doctor or by practice based on how much Botox they are purchasing. Levels include silver, gold, platinum, platinum plus, diamond and then black diamond is the highest, meaning they are in the top 1% of injectors nationwide.”
• Cosmetic Surgeons understand limitations of Botox® says another forum user from Montreal. They have ‘the experience to know when surgical correction is the best treatment in their armatorium of aesthetic tools’ which means they don’t believe Botox® is some magical cure-all. They are therefore more likely to manage patients’ expectations of the results, suggest possible alternative treatments and be realistic about the possibilities which can be achieved with each patient.
• What about Dermatologists? Of course there are those on the thread arguing the flipside. Dermatologist Mitchell Schwartz points out that both Cosmetic Surgeons and Dermatologists are skin specialists. In fact, he says, Botox® treatment was initially developed by a dermatologist and an ophthalmologist.

The big thing they all keep coming back to is experience, experience, experience.

And it got me to thinking…

This forum thread was from a patients’ perspective. But what about delegates: nurses, doctors and dentists interested in training in Botox®?

Is Botox® Training better with a Cosmetic Surgeon?
Surely the same principles apply…

Ideally, you want to train with a company who has team members with a range of experience: not just all cosmetic surgeons, or all doctors, all dentists, Aesthetic Nurses or all dermatologists. You want to take aspects of each of their knowledge and learn from what they can teach you. Unfortunately (probably due to the fact that “birds of a feather flock together”!) a lot of training providers are strongly skewed towards one “type” of team.

At Cosmetic Courses, our Training Team is a real eclectic mix. We have Cosmetic Surgeons, RGNs (Registered General Nurses), Doctors, Medical Aestheticians. The one thing they all have in common is that they are dedicated experts in the field of aesthetic medicine. And they are all headed by a renowned Cosmetic Surgeon: Mr Adrian Richards of Aurora Clinics.

The benefits of Cosmetic Surgeon-led training?

• Expert advice from Mr Adrian Richards, The Daily Mail’s ‘Home Counties Leading Plastic Surgeon’: over 12 years’ international specialist experience in aesthetic medicine with numerous procedures to draw on. Watch him on Youtube to see him in action…his reputation is second to none.
• Receive in-depth marketing and business advice on how to make it big.
• See the bigger picture: put non-surgical procedures like Botox® and dermal fillers into the context of cosmetic surgery as a whole and get advice on assessing your patients in terms of all the possibilities for improving them facially.
• Train in the surroundings of a renowned Cosmetic Surgery clinic with 4 fully-functioning and equipped Clinic rooms: this is our National Cosmetic Training Centre.
• Train at the very most professional level: our training is in no way intimidating (just check out our testimonials section to see all the comments about our friendly team!). But by coming to a Cosmetic Surgeon-led provider, you can rest assured that you will be amongst other doctors, nurses and dentists intent upon getting the very best start to their medical aesthetic career. Training with Mr Richards and his team is intense, comprehensive and, above all, inspirational.

To find out more about Cosmetic Courses’ great range of Cosmetic Surgeon-led training, call us today on 0845 230 4110 and find out why we are the outstanding choice for your medical aesthetic training.

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How do Muscles Cause Wrinkles and Frown Lines?

There is a one vertical Procerus muscle and two Corrugator muscles that cause wrinkles and frowning in the area between the eyebrows.

The frotanus muscle runs upwards from the bridge of the nose and inserts into the skin.

Muscle fibres run upwards along the muscle and, when they contract, this produces shortening of the muscle and a cross line transverse (horizontal line at the upper bridge of the nose).

The Corrugate muscles run upwards and sideways from the bone in the frown area to the skin above the inner aspect of the eyebrow.

When these muscles contract they pull the eyebrows inwards, downwards and cause either vertical or slightly slanted lines on either side of the frown areas.

The muscles run in different directions and therefore the contractions cause lines in different orientation. It is important to know which muscle is responsible for which line when treating the frown area with Botox in order to correctly target the right muscle. In future blog posts we’ll talk about variation in muscles between other people and tell-tale signs if someone has had Botox Therapy.

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Pain Relief & Dermal Fillers

Pain relief using local anaesthetic for dermal filler injections

Dermal filler injections are more uncomfortable for the patient than other treatments such as BOTOX® treatment.

This depends on the area treated, with the lips in particular being very uncomfortable because of their denser nerve endings in this area. Many patients are deterred from having dermal filler injections into their lips because of the discomfort of the procedure.

Traditionally, practitioners have used dental blocks blocking the infra-orbital and mental nerves in a similar fashion to that used for the dentist for dental treatment.

While this type of local anaesthetic is very effective at reducing discomfort from the lips during injections, making it almost completely pain free, it has the disadvantage that the local anaesthetic can also affect the muscle tone of the lips.
By reducing the muscle tone they decrease your patient’s ability to contract the muscle and produce the lines which you aim to treat.

At Cosmetic Courses we always advise our trainees to first of all mark the lines they wish to treat prior to inserting the dental blocks so that the landmarks are retained.

Although the marking technique does give indication as to the areas that require volume adjustment, due to a decreased subcutaneous tissue it is not as accurate as seeing the areas for yourself with the muscles contracted which is often not possible with dental blocks.

Whilst EMLA and other topical anaesthetics such as Ametop offer some pain relief this is not complete and, even if these are used, dermal fillers are uncomfortable.

With Juvederm®, the Allergan company introduced a product with local anaesthetic combined with the hyaluronic acid.
This has significant advantages in that, although the first injection is of normal tenderness, the local anaesthetic does permeate through the area and each subsequent injection becomes less painful.

We have found that, if dermal fillers which contain lignocaine are used correctly, the discomfort from dermal filler injections (even in the lips) is significantly reduced and is very tolerable for most of our patients.

Our current preference is to use a dermal filler containing local anaesthetics in the peri-oral area as this has the dual advantage of producing good pain relief for the patient and also preserving the muscle activity allowing you to accurately place the dermal fillers in the correct position.

If you would like to know more about these techniques with dermal fillers to reduce the discomfort for your patients please contact the Cosmetic Courses office on 08452 304 110 or via email at [email protected] to discuss your training needs.

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Facial Rejuvenation: Complimentary Surgical & Non-surgical Approaches

Latest developments in facial rejuvenation surgeryFacial Rejuvenation

Non-surgical skin treatments and surgical facial procedures often go hand-in-hand. The former, if begun early enough, can be a preventative to ward off the necessity for the latter until much later. Or, they can be used to compliment each other: there is little point a patient saving up and spending their hard-earned savings on that facelift only to reverse the effects by failing to pamper their skin.

Recent figures have shown a 50% increase in the number of people undergoing facial rejuvenation procedures during the last year. Why are more people considering these forms of treatment? Many people tell Cosmetic Courses’ founding Surgeon, Mr Adrian Richards, that they don’t like having their photograph taken and feel as if they would like to look fresher and less tired. Patients often tell him that they believe their face looks far older than they feel.

In the UK, most patients considering any form of treatment want to look as natural as possible. Treatments can realistically make you look as you did 8-10 years ago.

To achieve a natural fresh appearance it is important to address each of the following: The skin, active wrinkles caused by muscle contractions and gravity changes. For some people dramatic improvements can be achieved with skin treatments which involve minimal downtime and cost.

Skin treatments alone can make you look much fresher and brighter. These treatments may consist of Microdermabrasion, Genuine Dermaroller Therapy, or perhaps a light chemical peel. These all work in different ways to removes fine wrinkles, reduce pore size or cause mild skin contraction. Combined, they are highly effective to make the skin look fresher and more youthful.

Active wrinkles caused by muscle contraction are typically found between the eyebrows (frown lines), on the forehead and below the temple (crows feet). As these lines are caused by muscle contraction they are best treated by selectively reducing the overactive muscle activity in these areas. This best performed with small injections of botulinum toxin or dermal fillers into specific muscles.

Gravity changes include descent of the cheek region which causes deepening of the lines which come down from the nose to corner of the mouth. Other changes include loss of the jaw line and jowl formation. The neck skin can also loosen and the sharp angle between the neck and chin is lost.

Gravity changes are best treated with Surgery as the muscle layers of the face need to be repositioned in their previous position. In the forties and early fifties it is often best to have a Mini-face lift (MACS-lift). This elevates the cheek, jowl and neck regions and restores a more youthful face shape.

Most people in their mid to late fifties or older are more suited to more traditional face lift techniques (SMAS-lifts).

These techniques specifically tighten the neck and jowl regions.

Cosmetic Courses offer a Professional Development Section in conjunction with our sister company, Aurora Clinics. This aims to provide support and information about Surgical procedures to enhance the non-surgical training which you can gain with Cosmetic Courses.

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