For those of you that have attended our Foundation and Advanced Botox and Dermal Fillers courses, you will be aware that dermal fillers are used to introduce volume back into areas of the face that have lost volume during the ageing process. When it comes to dermal filler training, there’s a lot to cover, do you know your Juvederm Ultra 2 from your Ultra 4? And what about knowing your marionette lines from your tear troughs?

Where can dermal fillers be used?

Dermal fillers have a wide multitude of uses from the obvious to the not so obvious. If you have a patient that is interested in having dermal filler, we advise that you get them to attend an initial skin consultation with you before having the treatment. This will allow you to find out more about the patient’s medical history, and the look that they are hoping to achieve.

Tear troughs Cosmetic Courses;Picture showing Tear Trough Treatment Before & After

These are the lines under your eyes that make your eyes look tired. A loss of volume in the area, a loss of tissue elasticity or a mild reduction in bone density could all be causes of concern. By using an advanced technique, dermal fillers can be placed in either the tear trough itself, slightly lower in the cheek area, or indeed a combination of both to achieve brighter, more rejuvenated eyes.

Naso-labial folds
Commonly known as the smile or laughter lines, these are the two skin folds that run from each side of the nose to the corners of the mouth. If you are bothered by your nasolabial folds, and wonder what to do to improve the area then filler is perfect to fill out these folds, and partnered with cheek filler the face will appear much younger looking.

Mouth corners

Sometimes the corners of your mouth can droop leaving you looking unhappy. Dermal filler can be placed below the corners of the mouth with a small amount directly into the corners of the lips.

Marionette lines
Marionette lines run between the corners of the lips down towards the chin and jaw giving a puppet-like effect. As we age, our facial bones become smaller resulting in lines like these appearing. Dermal filler is great for filling in these lines making them less prominent.


As you age you lose an amount of subcutaneous fat which can result in a loss of volume and elasticity to the face. This in turn highlights hollow cheek bones, and the presence of excess skin resulting in sunken cheeks. This can cause someone to appear gaunt and tired-looking. Dermal fillers can be injected into this area to plump out the face with natural volume and a gentle lift. This is an advanced technique and is offered at one of our specialist training days.

Lips & vermillion borderCosmetic Courses; Image showing Lip Fillere treatment before & after

A celebrity favourite and probably the most well-known use of filler. The lips can be injected with dermal filler either in the body of the lip to boost fullness or the border of the lips to increase definition. This treatment is ideal for correcting thin lips but can also help solve problems with a downward smile and the need to lengthen the mouth.

Chin augmentation

A perfect alternative to a surgical chin implant, is a non-surgical chin augmentation which is achieved with dermal fillers. Fillers will help define your jaw line and although only a temporary solution it is a great way to see what can be achieved surgically if you are unsure.

Smoker’s lines

These are the vertical lines above the lip that appear when you pout. They are mostly caused by regular lip movements but are also called smokers lines, because regular smoking means pressing the lips together.  If your lines are deep enough then they can be drastically reduced with a small amount of injectable filler to achieve a smoother appearance.

Have you heard of the lunchtime nose job? Dermal fillers can now be used to straighten out any lumps or bumps in your nose without the need for any surgical downtime. Fillers are injected into the nose to smooth out slight bumps in the bridge of the nose, or rectify a crooked line of the nose (particularly in profile view) and even cartilage irregularities at the tip of the nose all in less than 15 minutes! This is another advanced course available for those that have been practicing in dermal filler for a while.


Hands are a new use for fillers, patients have found that the use of the fillers in their face is great for concealing their real age, but then it is often their hands that give it away. Ageing hands lose volume and the skin appears thinner. Having filler injected into the skin on the back of the hands can make them appear plumper and less veiny.

So now you know your areas, let’s look at the product that we use on our training days at Cosmetic Courses:

Juvaderm®  Vycross Range

The Juvaderm® Vycross range is a smoother gel which means you get a comfortable treatment. The risk of bruising and swelling is reduced as is any discomfort as anesthetic is added into the formulation of the filler. The Vycross range provides subtle and natural outcomes due to the smoothness of the gel making it easier to inject with precision.

The Vycross range has 3 different forumulas;

Juvederm® Voluma 

Juvederm® Voluma is a much thicker hyaluronic acid gel which has been made by altering the cross-linking technique used in Ultra to create a more viscous result. Voluma can be used for recontouring and restoring the face in the case of age-related volume loss. Designed for deep volume restoration to re-contour the face in areas such as the cheek bone and chin regions.

The effects of Juvéderm® Voluma® last for approximately up to 18 months.

Juvederm® Volbella
Launched in Paris Juvederm® Volbella® is specifically designed to enhance lip volume and define lip contours, with a completely natural look and feel.  The filler has a smooth, liquid consistency for a smoother look and the addition of lidocaine anaesthetic makes the treatment even more comfortable in an otherwise uncomfortable area.

The effects of Juvederm® Volbella® last for approximately up to 12 months

Juvederm® Volift®
This revolutionary dermal filler is produced using VYCROSS™ technology. This creates an ultra-smooth gel for natural appearance with minimal swelling and bruising. It is best used for smoothing nasolabial folds and facial contours.

The effects of Juvederm® last for approximately up to 15 months.

Juvederm® Hydrate Cosmetic Courses; image showing dermal filler product Juverderm Hydrate

The Juvederm Hydrate is used to improve skin hydration and restore elasticity which is lost through ageing. It works by replacing hyaluronic acid but unlike traditional filler it acts as a hydrating agent attracting and keeping moisture within the skin to achieve that healthy natural glow. Juvéderm® Hydrate is most commonly used for very fine lines and wrinkles associated with ageing. It has also been recommended as an early treatment for crow’s feet and fine lines around the mouth.

The effects of Juvéderm® Hydrate last for approximately four to 6 months

Juvederm® Ultra is our most common dermal filler. The filler contains non-animal hyaluronic acid with the addition of 0.3% lidocaine which is a local anaesthetic to make you feel comfortable both during and after the treatment.
There are actually four different formulations for Juvéderm® ULTRA available;

Juvederm® Ultra 2 is a highly cross-linked formulation which is used for the subtle correction of medium facial lines, in particular those around the corners of the eyes and those very close to the surface of the skin. It can also be used to around the lips to enhance natural lip contour.

Juvederm® Ultra 3 Cosmetic Courses; image showing dermal filler product range Juverderm Ultra 3

Ultra 3 is another highly cross-linked formulation but is instead used for more versatility in contouring and volumising anything from moderate to medium facial lines and skin depressions, in areas such as the nasolabial folds. It can be used subtly in lips to enhance lip contour, increase volume and maintain a youthful smile.

Juvederm® Ultra 4 [image]

Ultra 4 is a highly cross-linked robust formulation used for volumising and correction of medium to deep folds and wrinkles, including adding volume in the cheeks and chin improving contour to the face.

Juvederm® Ultra SmileCosmetic Courses; image showing dermal filler product range Juverderm Smile

The newest arrival to the Juvéderm® ULTRA family the Juvéderm® Ultra Smile is based on the Ultra 3 product but it is specifically targeted for use in the lips. It works by providing fuller but softer and natural looking lips and smooths fine lines to fully enhance the mouth area for a fresh new look.

The effects of Juvéderm® Ultra Smile lasts approximately up to 18 months

If you would like to find out  more about our Advanced Dermal Filler Training Course and the product range that we use, you can call the team on 01844 390110 or email [email protected]

Male and Female Ageing

As technology has advanced, it has become more apparent that in society we are more obsessed with how we look. Mobile phones, iPads and tablets, make capturing the moment even easier with the rise in ‘selfies’ and social media sharing. Within the aesthetic industry, there has also been a shift. Over 90% of procedures performed in the UK in 2015 were non-surgical, and approximately 800,000 of those treatments were for Botox and filler treatments. Many clinics are also reporting that they have seen an increase in the volume of male patients that they are now Image showing Peter Andretreating with in their clinic, showing that it is not just woman that are interested in anti-ageing treatments. This could be due to more male celebrities admitting to having treatments, such as Peter Andre and Shane Warne having a little ‘Brotox’ here and there.

One of the questions that we at Cosmetic Courses have been asked by our delegates over the past few months is; are there any differences between the male and female ageing process?

In essence, the ageing process itself is more or less the same, but it is worth noting that there are significant differences between both sexes anatomy, and care should therefore be taken when carrying out aesthetic treatments to ensure a natural and harmonious look is achieved to suit both sexes.

The areas that we believe need to be treated differently for Males and Females are the following:

  • Forehead
  • Eyebrow
  • Cheek
  • Nose
  • Jawline and chin
  • Peri Oral Area

The Forehead

Picture showing the difference between male and famle supraorbital ridgeThis is one of the most important areas for rejuvenation, but there are noticeable differences between the sexes. Anthropologists use the forehead as an indicator to determine the sex of the skull. It has been observed that a female skull has more of a flat supraorbital ridge, with a smooth convexity up to the hairline, whereas the male skull has a more pronounced supraorbital ridge with some concavity before the forehead becomes flatter towards the hairline. This skeletal structure is what influences the soft tissues and the overall position of the eyebrows.


The male eyebrow is flat and tends to sit along the supraorbital ridge whereas the female brow arches at a 10 -2- degree angle with a tail that is more superior to the head.

The aim of aesthetic treatments is to restore a more youthful and natural looking appearance. To treat this area for a female it may require forehead re-volumisation and a bit of brow lifting to maintaining that feminine look, but applying the same technique for males, it could result in over feminising, and portray an unnatural. To stay respectful of the male gender, it is advised to not lift above the supraorbital and to only elevate the ptotic brow to ensure the most natural look is achieved.


Male and Female AgeingThis is an area that is extensively covered in female rejuvenation, but it does come with limited descriptions when it comes to males. Females have a rounder and fuller cheek due to having a thicker fat compartment in the medial area compared to the lateral area. In regards to female ageing, a fuller cheek gives a more youthful look, referring back to the triangle of youth – everything is more pert and smoother. Male cheeks tend to be flatter and more angular due to a thinner layer of subcutaneous fat. The technique used to treat this area have slight differences, and the volume of product used needs to vary. To keep the ‘flatter’ cheek look for male patients, product should only be used to replace the volume loss. Females can have slightly more product used, and this can be replaced more often to maintain the fuller cheek look.


Image showing Naso LabialThere are more subtle differences between the sexes in this area. There are 2 angles that are used to determine the ideal nose shape: Naso-labial Angle and Naso-frontal angle.

Naso Labial is the angle between a line drawn from the lip border to the base of the columella to the nasel tip. This angle is slightly more obtuse and slightly upturned for females, and it’s also necessary to consider your patients cultural and ethnic differences when treating this area.

Image showing the Naso Frontal AngleNaso Frontal is the angle at the radix, the lowest point of the nasal bridge formed by a line running from the radix to the glabella and from the radix along the dorsum of the nose. This position of the radix is important between males and females. Females are normally in line with the lash line whereas males are at the level of the tarsal fold.

Jawline and Chin

Both masculinisation and feminisation techniques can be used within this area. Toxins can be used to narrow down the masseter or curve the chin, and Dermal Fillers can widen the jawline, increase definition or add a sharper gonial angles as well as flatten or enlarge the chin area.  Different cultures and ethnicities have different representations of what they believe is an attractive jawline, so it is useful to be aware of this when treating patients. The Hollywood ideal is a defined as a strong wide jaw for males whereas females have a softer narrower pointier chin.

Perioral Area

Treating this area is a more common request in females rather than males. Male skin within this area is thicker than in females, who tend to suffer more with smokers lines and wrinkling. This area benefits from toxin, filler and skin resurfacing treatments for both sexes. If treating a male patient, we suggest you treat with caution.

Male and Female AgeingWhen treating both the female and male face for any aesthetic treatment, it is important to book them in for a full consultation, to undertake a facial analysis. Within this consultation, grade the upper, mid and lower face in terms of structure, proportion and symmetry. Within our training, we advise that you take photos of all your patients and keep these as a record to show before and after treatment– it also helps to show the patient how far they have come on their treatments with you.

At Cosmetic Courses, we offer an advanced Botox and Dermal Filler training Course which offers more advanced techniques. If you would like to find out more about the course, or have any questions, please call the team on 01844 390110 or email [email protected]

Buckinghamshire Plastic Surgeon Recognized as Top Social Influencer in Cosmetic Surgery.

Clinical director of Cosmetic Courses, Mr Adrian Richards is one of 500 doctors in the nation to receive the prestigious RealSelf 500 Award, out of nearly 13,000 board certified specialists with a presence on RealSelf—the leading online community helping people make confident choices in elective cosmetic procedures.

RealSelf top 500 LogoIn a time when 1 in 4 U.S. adults share their health experiences on social media channels, the medical professionals that made the 2015 RealSelf 500 are recognized both for having an outstanding record of consumer feedback and for providing credible, valuable insights in response to consumer questions about elective cosmetic treatments, plastic surgery, dentistry and more.

Mr. Richards qualified as a Doctor in 1988 and for 12 years specialised in plastic surgery. He is a member of both the British Association of Plastic and Reconstructive Surgeons (BAPRAS) and the British Association of Aesthetic Plastic Surgeons (BAAPS). He now has private clinics based at premier locations, including the Northampton, Milton Keynes, Buckinghamshire and London. Mr. Richards recognises that his patients demand excellence from plastic surgeons; consequently he continuously collaborates with other plastic surgeons worldwide to bring new surgical and non-surgical innovations to his practice for the benefit of his patients. As a respected figure in the industry, Adrian is often invited to speak at events and conferences, and has made several appearances on national radio and television, including Channel 4’s ‘How Not to Get Old’ and ‘Bodyshockers’.

“In 2015, these 500 doctors collectively impacted tens of millions of consumers, with nearly 30% of our total doctor content posted by this relatively small group,” said Tom Seery, RealSelf founder and CEO. “When I started RealSelf, many doctors questioned why they should ‘give away’ their expertise ‘for free’ on the web. Now, eight years later — and with over one million doctor answers on our platform — we are proud of the standard this select group has set. They’re leading the way by empowering millions of consumers to gain access to the information they need to make smart and confident health and beauty decisions.”

Image Showing Realself Star RatingsMr Richards is an expert contributor to RealSelf, and to date has posted 558 answers to questions on RealSelf. Each month people from all over world ask important aesthetic-related questions, such as “massaging a rippling implant?” or “Possible infection in BA stitches?”  Mr Richards also maintains a patient star rating of five out of five stars in RealSelf reviews. For more information on Mr Richards, please visit and for the full list of RealSelf 500 Award winners, visit

About RealSelf

Since its founding in 2006, RealSelf has created the world’s largest community for learning and sharing information about cosmetic surgery, dermatology, dentistry, and other elective treatments.

With patients researching practitioners and Plastic Surgeons, having an online presence on trusted resource sites for reviews has never been more important. With RealSelf’s extensive collections of reviews, photos, videos and Q&A’s, it has become one of the most trusted resources for those who are looking for help beyond the beauty counter.

If you would like to join RealSelf and start your online reviews and presence, you can sign up by visiting

Cosmetic Courses banne showing, Male trends

Independent Pharmacist Shailesh Patel chats about the increase in cosmetic procedures in men over the past year.

The male market has been steadily growing over the years as male consumers increasingly seek out treatments to support their lifestyle choices.

Although a small segment of the aesthetic market, recent data from the British Association of Aesthetic Plastic Surgeons (BAAPS) has shown Cosmetic Courses; picture showing close up of man with facial markingsthat male clients made up 9% of the total number of those undergoing cosmetic surgery operations in the UK. These numbers have nearly doubled over the past decade (from 2,440 procedures in 2005 to 4,614 in 2015). However, treatments for men tend to be less invasive than for female clients.

This trend could be driven by the subgroup of the millennials known as young urban males  (Yummies). These individuals tend to focus more on personal grooming and health than other age groups. This age group tends to marry later, meaning that they can invest in themselves and their appearance for longer than other age groups.

It is also important to remember that men are unique both physiologically and behaviourally. Having an in-depth knowledge of the male anatomy and suitable training is important to meet the needs of male clients 3.

You should have a separate marketing strategy to target males. Options include; advertising to men through your female clients (husbands, boyfriends, sons, etc.), having specific areas for male clients in your clinic and sections on your website and social media activities focusing on male clients.

Cosmetic Courses have also seen an increase in enquiries for male models. By having a diverse range of sexes, this gives our delegates the best experience in understanding the differences between the sexes, and the techniques that would work best when treating male and female faces.

If you would like to become a model for Cosmetic Courses, please call the team on 01844 390110 or fill in our Contact form

About Pharmacyspace

Pharmacyspace, based in Aylesbury, Buckinghamshire, provides cost effective medical products and consumables for your clinic. Feel free to talk to us about how we can support you with both your male and female clients.

Anyone interested in better time management would do well to have a chat with Adrian Richards. As well as being a busy surgeon, aesthetic trainer, bass player, father of four, sometime marathon runner and Clinical Director of both Aurora Clinics and Cosmetic Courses, Adrian has also found time to write a book.

He has just finished the second edition of his best-selling textbook, ‘Key Notes on Plastic Surgery’, a concise reference guide for surgeons in training, along with co-author Hywel Dafydd. We sat down with Adrian for five minutes to talk about the book.

Hi Adrian, why did you write the first edition of Key Notes?

When I was doing my final exams in Plastic Surgery, I really felt a need for this type of book. As it didn’t exist, I decided to write it myself. I’m delighted that most Plastic Surgeons doing their final exams now have a copy with them.

How would you describe the style of the book?

George Orwell felt that sparse writing was the best. While I can’t claim to write like him, I tried to live by this principle – using the shortest word that would convey meaning and keeping the text and sentences as concise as possible.

Who do you think will read the book?

Anyone who buys it I suppose! But most people who have it are either junior Plastic Surgeons preparing for their major Plastic Surgery exam or experienced surgeons who want to keep up with the latest information.

Is Key Notes in Plastic Surgery suitable for members of the general public?

The book is quite technical but it’s designed to be easily understood. We’ve broken up the information using bullet points, so anyone with an interest in Plastic Surgery will be able to dip into it.

Why might a member of the general public read the book?

Perhaps if they were researching a particular aspect of Plastic Surgery the book might be a good reference for them.

Why have you published a second edition of Key Notes in Plastic Surgery?

The first edition was really popular but times and techniques change. Plastic Surgery is a rapidly evolving speciality and the book has been updated to reflect this.

What are the differences between the 1st and 2nd Editions?

The second edition is slightly longer and has many more diagrams to bring it to life and help the reader understand what is a very visual speciality.

Why have you recruited a co-author?

When I wrote the first edition back in 1999 I was a young Plastic Surgeon with an up-to-date knowledge of the breadth of Plastic Surgery. Like all Plastic Surgeons, I now focus on specific types of surgery. For this reason, Hywel Dafydd has been responsible for the majority of the updated content in the 2nd edition.

What is Mr Dafydd’s background?

Hywel reminds me of a younger version of myself. He has just passed his final Plastic Surgical exams and is travelling the world learning the latest Plastic Surgical techniques before starting his Consultant post in Swansea. Having studied for the exams for the last 3 years Hywel has an excellent and broad understanding of the current state of Plastic Surgery.

Will there be a 3rd edition of Key Notes?

I would like to see a new edition of Key Notes published every 10 years – ideally updated and improved by a new generation of Plastic Surgeons finishing their training and at their peak of understanding the wide scope of Plastic Surgery.

‘Key Notes on Plastic Surgery (Second Edition)’ is published on 21 November 2014 and available to pre-order now from all good book shops, including Amazon.


This is a bit of a side-line from our usual medical aesthetic non-surgical topics here at Cosmetic Courses UK.

However, we know that many of our delegates are GPs. With the current PIP Implants crisis affecting so many in the UK and many GPs having to give advice to worried patients, we thought that you might appreciate some clarification from our partner company, Aurora Clinics. As you may know, Cosmetic Courses is led by expert Plastic Surgeons so this team (including Cosmetic Courses director, renowned Plastic Surgeon Mr. Adrian Richards) are ideally placed to offer some guidance on dealing with PIP Implants patients. We hope you find this useful.

Backgound to the PIP Implants Situation:

  • French brand PIP implants used between 2001 and the spring of 2010 are reported to be faulty
  • In the spring of 2010, PIP’s Chief Engineer reported his concerns to the French authorities
  • Between 30,000-40,000 women in the UK have these implants
  • Between 2,000 and 3,000 of these implants were used by the NHS
  • The majority of the remainder were used by the major Cosmetic Surgery Groups (including the Harley Medical Group, Transform and The Hospital Group)
  • Aurora Clinics (Cosmetic Courses’ partner company) has never used these implants
  • The PIP company has now gone into liquidation


What is wrong with PIP implants?

  • In an effort to reduce production costs,  the PIP implants company appear to have cut corners during the manufacturing process
  • Investigations into the exact problems with each separate batch of PIP implants is ongoing

However, the recurring problems with PIP implants appear to involve:

  • The implant shell

The shell of every silicone implant is made through a separate dipping and drying process. In PIPs, it appears that the numbers of dips was reduced; in particular the most expensive layer, which seals the shell from the internal silicone, may have been omitted entirely.  This means that the implant is permeable to the internal silicone, resulting in “bleed” of the internal silicone through the shell.

In addition, the shell appears to be more fragile than other implant brands, with a higher rupture rate.

  • The implant content

Medical grade silicone is expensive and has been tested internally on humans.  Industrial grade silicone is less expensive and has not been tested on humans.  It appears that, to reduce costs, a mixture of both types of silicone was used in PIP implants.

Ongoing toxicology studies are being performed on this silicone but we do not have any definitive data on this at present.


One of the reasons why definitive data is lacking on PIP issues is that there is no national registry of these implants.  A registry did exist but the government withdrew funding for this in the mid 2000’s.

Because of this, we do not know exactly how many PIP implants were used in the UK or which women have them.  The Government is now calling for the breast implant registry to be re-established.

Aurora Clinics Surgeons are working with major professional bodies, BAAPS and BAPRAS, to record data on the PIP implants we remove.

Our findings to date indicate that, of the PIP implants that we have removed:

  • 30% are severely ruptured
  • 60% have significant silicone gel-bleed on their surfaces
  • 10% are in a similar condition to other implant brands when removed

Further analysis of the performance of particular batches of PIP implants is ongoing.  Many of the implants that have ruptured have only been inserted within the last 4 years.


Because of these findings, we feel that all women with PIP implants should consider having them removed.

If women with PIP implants do not have information on their implant manufacturer they should request this from the surgeon or company who inserted them.  This should be provided promptly and efficiently.

The requested information should include the:

  1. Size in cc’s
  2. Type (high, ultrahigh (UH) etc.)
  3. The batch and lot number. The batch number is a 5 digit number and the lot number a 3 digit number


Many of the patients we have seen with PIP implants report generalized symptoms of fatigue, hair loss and joint pains.  These are difficult to attribute to PIP implants and there is no guarantee whether their symptoms will resolve if the implants are removed or exchanged.

Approximately 50% of our patients report symptoms in their breasts, necks, axilla or arms.  These range from generalized aches and tenderness to parathesesia.  Again, these are difficult to attribute solely to the PIP implants.


In most cases, it is not possible to determine whether the PIP implants are intact by examination alone.  A significant number of our patients have silent ruptures.

Indications that the implants may be ruptured include:

  • Distortion in the shape of the breast
  • Softness of the breast with a lack of palpability of the rim of the implants (particularly in slim patients)
  • Axillary or neck lymphadenopathy


The majority of the women that we see are – understandably – extremely anxious about their PIP implants.  In most cases, they are very well informed about the issues with these implants from support groups and forums on the Internet.

Some hospital groups, including BMI, have offered to pay for the removal and replacement of any PIP implants they have inserted.

Some of the other major Cosmetic Surgery companies have offered to remove and replace PIP implants which they have inserted. This is only the case, however, if they have been shown to be ruptured by Ultrasound or MRI scans. 

Management recommendations

At present, both the government and the private medical groups are recommending that women with PIP implants seek advice from their GP’s.

From our experience, we would recommend:

  • If the PIP implants have been inserted by the NHS, refer patients to your local breast unit
  • If there is definite evidence of implant rupture, refer to the NHS, the surgeon or private group which inserted them.  The treatment for these patients should be free of charge.
  • If there is no evidence of rupture clinically, implant removal without replacement is permitted in some cases under the care of the NHS
  • If your patient would like further investigation, most NHS units will offer to assess the integrity of the PIP implant

In most cases, radiological investigations will demonstrate implant rupture but not gel bleed.

If there is no clinical or radiological evidence of implant rupture the patient can:

  • Choose to have the PIP implant retained and undergo regular clinical and radiological surveillance until more definite data on the performance of each batch of the implants and the toxicology of the silicone gel is known
  • Choose to have the implants removed or replaced

Unfortunately, at present, neither the NHS nor some of the private providers are offering free PIP replacement unless there is definite evidence of implant rupture.

Many women are reluctant to wait for this data and are choosing to either have their PIP implants removed or replaced with high quality Allergan or Nagor implants.

Aurora Clinics are offering a cost price package deal for PIP implants patients, in partnership with BMI. If you are interested in referring your PIP implants patients to Aurora or would like more information on what this cost price deal entails, please contact [email protected] or 0800 328 5743 . You can also watch videos about our removal and replacement surgery plus support packages via this link.

As the medical aesthetic industry comes under scrutiny, Cosmetic Courses supports calls for higher competency levels.

Botox and Dermal Filler Providers Under Fire

Not only the Surgical sector of the cosmetic treatment industry has come under scrutiny recently following the PIP breast implants fiasco. The Non-Surgical cosmetic injectables market is now also being heavily criticized for lack of regulation and the ease with which products / procedures can launch or professionals can become qualified.

The UK has been described as “an open goal when it comes to cosmetic injections”, with companies starting up and disappearing at the first sign of trouble and a “terrible…lack of training” (Dr. Mike Comins, president of the British Association of Cosmetic Doctors).

Dr. Comins has particularly stressed the importance of competence and for “only medical doctors, their assistants or supervised nurses [to] be allowed to carry out injections of Botox and fillers”.

Cosmetic Courses support Competency & Training for Medical Professionals

These are views which leading UK medical aesthetic training provider, Cosmetic Courses, has long upheld. Even before the PIP scandal hit the media, we were championing rigorous standards within cosmetic injectables training and had a strict policy of only accepting currently qualified medical professionals onto our courses.

Test the Water: then Commit to Competency

We understand that branching into a career in medical aesthetics can be a big commitment, so we do believe that delegates should be given opportunity for ‘taster’ training sessions where they do not have to invest so much money or long-term career aspirations up-front: some people do literally start aesthetic injecting and decide then and there it’s not for them.

Bespoke 1-1 for Competency Certification
But, if a delegate does then decide that they want to pursue a career in cosmetic injectables, we strongly encourage all training with Cosmetic Courses to continue to Bespoke 1-1 level which is the stage where you can be certified in competency. This is in line with the recommendation by the BACD and Mike Comins.

Training DOESN’T end with Competency
Furthermore, Cosmetic Courses always say that your training is a journey. Even having received Competency Certification, many delegates do decide to continue to Advanced Level and we positively encourage this. As Dr. Comins continues: BACD members ‘also have to attend a certain number of conferences and training sessions to maintain their membership’. Our own Cosmetic Courses trainers frequently do this, attending regular events, training sessions and conferences to keep up-to-date with all the latest products and techniques.

Keeping up-to-date is vital in this fast paced industry. This is why Cosmetic Courses believe that Competency Certification and Refresher Training go hand-in-hand. Although many delegates may have already been competency certified, this may have been years ago any they might not have done anything with it ever since. In that time, techniques and products will have moved on. The best practitioners keep up to date with regular training and activity: and Cosmetic Courses encourage all our delegates to be the best.

Our Commitment to You
As Cosmetic Courses’ manager recognized, we do not only expect our delegates to be the best they can be but we also expect the same from ourselves. As part of this ‘we are offering more courses and expanding our packages on an ongoing basis to ensure not just that you keep up but that we keep up’.

Cosmetic Courses also offer a support program so that all delegates are never essentially ‘alone’ after graduating from Cosmetic Courses. Despite being certified competent, if you ever need support or advice after having trained with Cosmetic Courses there is ongoing mentor support via telephone or email.

In all these ways we hope to be able to help do our part to regulate the standards within the industry.

When patients are looking for wrinkle and age spot reduction, they often look at fractional laser resurfacing and other skin invasive skin tightening techniques. Facial fillers, or dermal fillers, can often replace laser and surgical treatments. A variety of facial fillers are now available, and patients should speak with a qualified dermatologist or physician about which is best for them.

Dr. Tahl Humes is the owner and medical director of VITAHL Medical Aesthetics in Denver, Colorado. Dr. Humes, who performes both surgical procedures and facial fillers, says that she prefers Juvederm because her patients have less swelling and bruising than with other varieties. Juvederm is a smooth gel non-animal dermal filler with the highest concentration of hyaluronic acid available. Dr. Humes says that she prefers Juvederm, but uses Restylane on a rare occasion as well.

As the body ages, it’s normal to see a decrease in the volume appearance of the cheeks because of either fat loss in the face or because of reabsorbtion of bone. This often causes a hollow appearance in the cheeks. Dr. Humes prefers Radiesse or Sculptra for this larger area because these products are better for larger areas. Radiesse and Sculptra are both non-hyaluronic acid based fillers used in recontouring the face. To get the most out of facial fillers, patients often combine large area treatments with individual line treatements.

Dr. Humes recommends Sculptra treatments to her patients who want to keep their filler treatments under wraps. Sculptra treatments done over a period of three months offer a more gradual change. As a bonus, Sculptra stimulates natural collagen slowly and helps to keep a more natural look. With this type of treatment, others won’t quickly notice that the patient has had treatments.

With the many options available with fillers, doctors are now able to meet the needs of almost every patient. Facial fillers are a temporary solutions, though. Some may only last six months while others may last as long as two years. Patients interested in facial contouring, resurfacing, or lifting should speak with their doctor about facial fillers to see if this choice is right for them.

Many people are fighting to reverse the effects of aging. Now with an alternative to plastic surgery, less invasive facial treatments are being sought after. Some of theseFace Lift include, laser treatments, injections of Botox and dermal fillers.

These treatments are great for those aging employees who are trying to stay younger looking so as to stay competitive in the job market. There are also professions where you want to look younger, like the others to fit in. You don’t want the age to start showing on your face. With the economy being so fragile, these treatments are a lot less expensive to obtain.

New dermal fillers are an excellent way to correct sagging cheeks and laugh lines. These fillers are made of a complex sugar that is found in many tissues in the body called hyaluronic acid. The most popular treatment is one an injection to treat expression lines between the brows and on the forehead. This popular treatment is called injectable botulinim toxin.

These less invasive treatments are being chosen over plastic surgery because they are only a fraction of the cost with much less recovery time. These treatments can cost anywhere from $400 to $1000 with a few hours recovery time, some injections can even be done on your lunch break, while a facelift can cost anywhere from $6,000 to $15,000 and take weeks to recover. The only downside is that people are spending thousands of dollars getting treatments repeated for maximum results which can end up costing you more than the facelift would have.

Many plastic surgeons have turned their businesses to offering these fillers and injections, as their surgery business is declining. However, there are some issues that fillers and injections will not correct, so plastic surgery is required. It has been estimated that plastic surgeons are accumulating over 50% of their income from fillers and injections, like Restylane and Dysport.

There is a growing concern among experts that people will be on the bandwagon to try any new thing that becomes available. This can put their health at risk and it is best to stick with the methods that are proven to help, rather than gamble on a new, untested method.

Individuals have always been trying to unearth ways to keep youthful and hold back the “sands of time.” Attain promising results from one of the latest non-surgical rejuvenator, Pelleve. This product is slated to diminish maturing facial skin and lessen the signs of aging without undergoing the knife, annoying injections or telltale blotching effects.

What is Pellvue?

Pellvue received clearance in May 2009 from the FDA. The deep layers of the skin are heated which in turn helps encourage the manufacture of new collagen. The added bonus is the existing collagen begins to tighten and shrink down the appearance of wrinkles.


Application is painless and easy. The entire procedure is done as an out-patient in a doctor’s office. The doctor will touch the designated area with the Pelleve “wand” or handpiece. Once applied to the targeted zones, it will produce a warm massage-like sensation to the patient, while heating the internal deep layers of the skin. The wand uses an advanced radiowave technology, supported through a generator without damaging or scaring the epidermis. As the heat moves through the skin, it pinpoints the collagens rich layer underneath the surface of the skin (aka dermis) and awakens it.

Time required

Receiving better results than most other non-invasive procedures, the patient requires no recovery time, no anesthesia, and will notice with just one treatment firmer, tighter skin. The patient can back to their normal daily timetable immediately. Depending the amount of treatment and areas deemed necessary by the doctor, the entire treatment will generally take only 45 minutes to an hour. The doctor will recommend the number of treatments that would be most beneficial for each individual patient. Even up to a month later, the application continues its working process on results of improving the skin´s exterior even more.


Pelleve works on all skin types, including people of color. Pelleve can be treated to all age groups, but those individuals in their in their late 40s to early 50s, searching for that fresh and vibrant appearance gain results the most. Individuals seeking to diminish the fine lines, lift sagging cheeks or jowls and overall tightening of the facial muscles, including the upper eye lids, should discuss Pellvue as a treatment of choice with their physician. It may be incorporated with other treatments to compliment the best results for you.

Results are noticeable after just one treatment. The period of longevity to maintain the outcome can vary, as the skin continues to produce new collagen. Dependent on the precise targeted area and individual, Pellvue has been known to last several years on some patients.