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The news is finally out. Botox maker Allergan and US drug giant Pfizer have announced they are to merge in a deal worth a staggering $160 billion.

Allergan LogoThe merger between the two former rivals creates a new pharmaceutical ‘supercompany’ which is set to be officially the world’s largest pharmaceutical company by sales.

There had long been talk about an Allergan buyout. Indeed, on our blog last year, we covered the unsuccessful takeover bid made by Valeant.

Now this new deal secures the long-term future of the company, and ushers in exciting new possibilities to research, discover and deliver more medicines and therapies.

The future for Allergan

The new company has a combined pipeline of more than 100 mid-to-late stage programmes currently in development.

And with dramatically increased resources to invest in R&D and manufacturing in future, we’re likely to see some incredible innovations in the cosmetic industry in the not-too-distant future.

As Brent Saunders, Chief Executive Officer of Allergan, says:

“The combination of Allergan and Pfizer is a highly strategic, value-enhancing transaction that brings together two biopharma powerhouses to change lives for the better. This bold action is the next chapter in the successful transformation of Allergan allowing us to operate with greater resources at a much bigger scale. Joining forces with Pfizer matches our leading products in seven high growth therapeutic areas and our robust R&D pipeline with Pfizer’s leading innovative and established businesses, vast global footprint and strength in discovery and development research to create a new biopharma leader.”

What does it mean for you?

This soon after the event, it’s difficult to say what – if any – impact the merger will have on you and your business in the coming months. 

But at Cosmetic Courses, we have a great relationship with Allergan and are in frequent close contact. As soon as we know about any changes that are likely to affect you, we’ll of course be sure to let you know as soon as we can. So do keep an eye out on our blog, newsletters and social media channels.

For the time being, it’s business as usual – albeit with some exciting new possibilities on the horizon.

 

 

 

 

 

 

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.

 

As the law stands, newly qualified consultants can walk straight into the operating theatre and perform the full repertoire of cosmetic surgery procedures for anyone who asks.  But in a recent survey, both doctors and patients have expressed their dissatisfaction with the status quo – and called for more specialist training for cosmetic surgeons to be made a legal requirement. The poll was conducted on 2,000 women and 500 doctors to coincide with the Clinical Cosmetic and Reconstructive Expo (the UK’s biggest plastic surgery conference), which takes place next month. 93% of the doctors surveyed said that they didn’t feel newly qualified surgeons were of the required standard to provide complex specialist surgeries like facelift and breast enlargement. Even though the law says otherwise, and NHS training is deemed to be sufficient.

Which leaves a vanishingly small one in 14 clinicians who felt things were fine the way they are, and no accredited training was necessary. Three-quarters of the patients surveyed also said they would feel more confident having cosmetic surgery if they knew their surgeon had undertaken further specialist training.

When asked about non-surgical cosmetic treatments, including injectables and laser treatment, both doctors and patients agreed that comprehensive specialist training was necessary. A minority of the doctors surveyed (around a third) thought medical professionals should have a minimum of three months’ training before being allowed to perform laser treatment.

Calls and campaigns to improve standards in the industry seem to be gathering momentum. This poll comes only days after Health Education England (HEE) released the first part of their review into training for non-surgical procedures.

And the organisation Save Face is currently creating a voluntary register of non-surgical cosmetic practitioners who have been thoroughly vetted by doctors before accreditation.

We will keep a close eye on any outcomes arising from this new scrutiny on what has hitherto been a largely unregulated industry. From our point of view as medical professionals, anything that improves patient safety and raises the standard for those entering the cosmetic arena can only be healthy for the industry – and improve its reputation beyond measure.

 

As an aesthetic practitioner it goes without saying that you want to deliver the best possible service to your clients. However there may be occasions when things go wrong and a claim is made against you. We know how distressing this can be for not only the patient but also the practitioner.

Eddie Hooker, CEO of Hamilton Fraser Cosmetic Insurance, recommends the following five steps that will help in the event of a claim being made against you:

1. Obtain full consent

Always ensure you obtain full consent from your client before the start of any treatment. Set out all the risks and benefits as well as any potential side effects and ensure your client has read and absorbed all of the information before they consent to the treatment they will be undergoing.

2. Keep detailed records

Always make sure you maintain a written record of all of the treatments you have provided, on the date you provided it. This should include machine settings together (where appropriate) with before and after photographs. You will need to keep your notes for 10 years in case a claim may arise in the future. You will also need to keep your equipment in good working order and up to date in accordance with manufacturers’ guidelines.

3. Stay up to date with your training

Ensure you can demonstrate you are fully trained and competent by undergoing initial training and also regular re-training throughout your career and retain all certificates.

4. Manage expectations

It is important to ensure the client has realistic expectations of the outcome of the treatment and whether (and when) any top up treatments may be necessary. Ensure that you allow sufficient time at consultation to cover this.

5. Medical due diligence

Make sure you get a full medical history from the client and explain full aftercare treatment and what they need to carry out themselves.

It is important to ensure that you have adequate insurance protection in case the worst happens. At Hamilton Fraser Cosmetic Insurance we have been insuring aesthetic practitioners for many years and understand the aesthetic industry, so please contact us on 0800 63 43 881 or email [email protected] for insurance advice and a free quotation.

After the publication of the long-awaited Keogh Report last year, Health Education England are working with regulators and royal colleges to review the qualifications required to carry out non-surgical cosmetic procedures in the Health Education Review . Their recommendations are expected at the end of April.

The outcome of the review could be a pivotal moment in the industry, both for professionals and patients. Our team have been following HEE’s research as closely as we can, including attending one of their recent workshops, to keep up to speed with any developments.

So what might the HEE review mean for professionals in the industry?

In our opinion, any measures to improve standards can only be good for the industry and benefit both patients and practitioners. We would absolutely welcome any reforms that mean our delegates can go out and practice the treatments they have learned with us as confidently and safely as possible.

Of course, while the outcomes of the review are as yet unknown, we currently don’t know whether HEE will suggest any changes. But if new recommendations are made, we will work with all our delegates, past and present, to ensure they meet the new standards.

We are dedicated to offering the highest quality aesthetic training in the UK, and best practice is always our aim. With that in mind, we will continue to keep abreast of any changes and be sure to keep you informed along the way.

Cosmetic Courses are one of the UK’s most established providers of medical aesthetic training, with over 10 years’ experience to date. Our expert team come from a variety of medical backgrounds, and diverse industries, and all make it their business to keep at the very forefront of developments in the industry. For more information on Cosmetic Courses or the training we offer, contact the team on 01844 390110 or email [email protected].

Winner of last year’s The Apprentice, Dr Leah Totton, this week launched the first of her cosmetic clinic ‘Dr. Leah’, joined by businesswoman and The Apprentice star Karren Brady. They will be offering various treatments, including cosmetic procedures such as Botox and liposuction.

Dr Totton came under fire with her business plan, which won her £250,000 of Lord Sugar’s investment, as she has not previously worked in aesthetic medicine, despite having trained in the techniques.

Her business idea came at the same time as the government-initiated Keogh review looked in to practices within the medical beauty sector, including who can administer such procedures and what medical and aesthetic training ought to be required. At the time previous BAAPS Chairman Nigel Mercer likened Dr Totton’s offering such procedures as putting “a hairdresser in charge of cosmetic surgery”.

Despite this controversy the planned clinics are going ahead, with the first on London’s Harley Street. Although Dr Totton, from Londonderry in Ireland, has decreed she will not administer Botox to the under-18s there are still question marks over how much publicity such clinics should receive, and whether services such as Botox and liposuction should be performed in a beauty therapy rather than in medical surroundings.

Runner up on the show, Luisa Zissman is currently appearing on Channel 5’s Celebrity Big Brother.

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.

For the first time ever, an attempt has been made to monitor and control places that provide Botox treatments and “filler” injections. With 5,000 clinics performing approximately 200,000 Botox treatments for wrinkles and filler treatments designed to plump lips and sagging skin each year in the United Kingdom, the industry is in dire need of regulation. Although there are plenty of legitimate practitioners working in the industry, there are also far too many rogue practitioners administering treatments they are not qualified to give. To combat this, only doctors, dentists and nurses will be invited to participate in this attempt at regulation, along with organizations that provide Botox and filler injections. Once accepted, these practitioners will receive certificates of approval proving the quality and safety of their service.

The main problem with this proposed system is that it is voluntary. The charity Action Against Medical Accidents declared that if the Government does not make this system statutory, many people will be left at risk because an industry cannot be trusted to regulate itself properly – especially an industry that is as large and prosperous as the cosmetic industry. The Government requires any major cosmetic surgery to be regulated, but as Botox and filler injections are relatively minor non-surgical procedures, they can be offered by just about any business. Peter Walsh, the chief executive of Action Against Medical Accidents declares that his charity will continue “using our experience and influence to make this scheme as robust as it can be.”

One of the best reasons to create a regulated cosmetic industry is to help reduce the amount of botched cosmetic procedures. The most high profile examples of cosmetic treatments gone wrong are usually celebrities. For example, in 2003, Leslie Ash, the star of the television show Men Behaving Badly, had filler injections on her lips. The procedure went wrong, resulting in a look known as the “trout pout.” It is hard to determine exactly how many people have suffered from cosmetic treatments gone wrong or adverse side effects since many people are extremely embarrassed as to what has happened to them and would prefer to keep it quiet rather than raise a national ruckus. Also, without strict guidelines, many practitioners may turn to shady and dangerous treatments. For instance, in 2005, two government reports were published detailing how several practitioners supplying filler injections were using material from both animal and human corpses – material that could have been infected with hepatitis and other deadly diseases.