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.


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.

Full, curvaceous lips instantly light up one’s smile, making it so much more alluring and charming. Most certainly, a provocative pout exudes an air of confidence and sex appeal, making it the object of envy and desire.

Today, lip enhancement surgery is probably one of the most popular procedures in the field of aesthetic plastic surgery.

Despite the recent rise in demand for it, lip enhancement surgery is not a new invention. It has dated back to ancient times, when women have used plant dyes and coloured clays to enhance the appearance of their lips. In the 1980s, collagen injection was introduced, which soon became popular and widely adopted by practising surgeons all over the world.

Now a new graft technique in lip surgery has been recently discovered that can certainly bring a smile to those who seek a simple and safe procedure that can produce a more prolonged result and look.

A team of plastic surgeons from the Aesthetic Surgery Centre in Naples, Florida recently discovered the new breakthrough that involves the use of muscle tissues along the patient’s neck. To date, the team has successfully carried out the surgery on 25 patients.

According to findings which were published in the Archives of Facial Plastic Surgery, the lip graft can be carried out simultaneously with a facelift surgery. This new technique adds fullness and shape to the appearance of one’s lips and reduces any signs of aging around the area of one’s mouth.

Renowned cosmetic surgeon, Dr Anurag Agarwal and his colleagues have employed this latest technique on many of their patients by using segments of the sternocleidomastoid muscles along the sides of the neck as well as their connective tissues to add fullness to their patients’ lips.

Dr Anurag and team are confident that this new surgical advancement produces a more prolonged result, which can last for at least two years. The procedure is also straightforward with quick uncomplicated recovery. As soon as the swelling subsides in a few weeks, the patient gains the luscious full lips she desires.

The new technique has fared well with all its patients who think that it produces a more natural feel than using artificial filler or implant. Even though they are optimistic about its results, they also acknowledge that the technique is not perfect and cannot altogether eliminate the signs of aging.

According to cosmetic surgeon and past president of the British Association of Aesthetic Plastic Surgeons, Mr Douglas McGeorge, this new technique produces a far more permanent result.

He said that this technique certainly pose the same risks as in all surgery procedures however slight the risk may be. He also warned that if a patient has not performed facelift simultaneous to the lip enhancement, the removal of the neck muscle tissue may leave a minor scar along the hairline.

There are all sorts of theories on why women desire fuller lips, ranging from having the sex appeal of movie actresses to simply looking more desirable. Lip augmentation providing a go to procedure in order to produce the desired look. 

While thin lips betray age, full lips cover it up. Since lip augmentation, creates smooth, full lips and reduces the fine lines around the entire mouth, this type of procedure enhances beauty and appears to reverse aging.

In fact, the irresistible appeal of beauty and anti-aging has created all sorts of solutions, including the following:

*Injections of collagen, primarily collagen derived from cows, bovine collagen. The effects last for up to 4 months before requiring repeated treatment.

*Injections of Hylaform and Restylane, derived from hyaluronic acid that is similar to that naturally found in humans. The effects of Hylaform last for up to four months and the effects of Restylane last for about six months before requiring repeated treatment.

*Injections of Radiance, microscopic spheres of calcium in a water-based gel that stimulates collagen production and regenerates tissue. The effects last for about one or two years.

*Injections of autologous fat, derived from the patient’s own body. However, the fat is reabsorbed, although results last longer than collagen.  While this may seem like an ideal solution, there are side effects: lumps and scars form and different areas of the body have to be harvested with each treatment.

* Other injected substances include alloderm, derived from cadaver tissue, autologen, derived from the patient’s skin, fascia, derived from donated white connective tissue, gore-tex, derived from a synthetic material, and verafil, derived from saline implants.

Besides injections of various materials that the body does not reject, but which require repeated treatments, there are also surgical procedures like the V-Y lip-plasty, where internal incisions are made then sewn back to roll the lips outward to appear fuller. In addition, there is laser lip rejuvenation, where the lips are lifted and smoothed, thus tightening them because of the underlying support from elastin and collagen

However, there is now a new procedure that has been reported in Archives of Facial Plastic Surgery (AFPS), a medical journal. It uses the sternocleidomastoid muscles, the neck muscles, for grafts. These muscles, also known as SCM, turn the head and pull it to the chest. The AFPS study reported that after an average of two years, head movement remained unaffected. The new procedure appears to provide positive long-term results.

For those of you suffering from heightening degrees of acne, there is a good chance that you have some scarring to indicate past blemishes. Scars from outbreaks tend to be unsightly and make your skin feel rough. They can even add years to your appearance, though no one wants to the look older than they really are.

Thankfully, there are ways in which you can alleviate your face from the scars left by acne. The method of treatment you can choose will depend on the severity of the flaws, as well as how you want to effectively remove the scars. The most common two routes for treatment involves natural methods or cosmetic surgery.

Natural Scar Treatments

If your acne scars are not severe, you may opt to give natural treatments a try. There are a few over the counter ointments and creams available for this technique. They contain all natural ingredients that will not further harm your skin. Natural exfoliant creams can also be purchased. They help to remove the outermost layers of skin to let new, healthier looking layers shine through.

There are some home remedies recipes for acne scars as well. Apple cidar vinegar, when combined with warm water, can act as a natural exfoliant. Apply the mixture a couple of times daily to the scars to remove the flawed skin.

Cosmetic Surgery for Acne Scars

Some scarring is too severe to be treated with natural methods. These may require the assistance of a cosmetic surgeon, particulary one that specializes in the face.

A number of surgical options are offered to those wishing to remove acne scars. These include:

Injections – Collagen can be inserted into the scars, filling them out to make them less noticeable. Collagen is a substance found naturally in the skin that helps to deal with elasticity and firmness. Adding more to the skin can help tone and tighten.

Microdermabrasion can be performed to remove the outer layers of your skin. It works similiar to that of a natural exfoliant, though it can be stronger and sometimes more effective in removing acne scars than home remedies.

Depending on the condition of your acne scarring, you may wish to start treatment using the natural strategies mentioned. If those fail to work for you, consider the cosmetic surgery options.

There’s almost nothing more satisfying for patients that undergo cosmetic procedures than an immediate correction in scars, skin texture and appearance. Dermal fillers today can provide this, instantly filling in hollow areas and smoothing the skin’s surface. Bovine collagen was the first FDA-approved dermal filler in the United States and remained the only option for almost a decade after it’s introduction in 1981. This type of dermal filler quickly became very popular and was sold under the name Zyderm I, with effective results that lasted around three months.

Of course, Zyderm I had its shortcomings. It was able to give fair results with marionette lines, moderate rhytides and deep nasolabial folds, although it had many disadvantages. Zyderm I provided a potential for allergy and required a skin test before use. The results only lasted three months or less and results were often disappointing for moderate to severe lines and scars.

In a very short time, Zyderm II and Zyplast were approved by the FDA and introduced to the public, addressing many of the problems with Zyderm I. These new types of dermal fillers significantly improved results and remained the only dermal fillers approved for use by the FDA for almost a decade. Still, there were many needs left unanswered. These products had many limitations and the full potential of facial dermal fillers wasn’t seen for some time.

The ideal dermal filler is safe, painless, hypoallergenic, inexpensive and provides results that last a long time. Today, dermal fillers have come a long way to fulfill this promise. With an increasingly large population reaching middle age, the demand for effective and safe dermal fillers is only growing. For this reason, facial filler products are the fastest growing area of cosmetic surgery and will continue to develop.

Dermal fillers are products that are injected into the dermis. After a treatment with dermal fillers, patients must not manipulate or touch the treated area to prevent product shift. If you’re interested in a treatment with facial fillers, typical costs range between £200 and £600 per session, depending on the formula you select. Today, results can last for six months or longer and greatly improve the appearance of even deeply set-in lines. You can even select fillers in the United States that are subdermal fillers, which are injected under the dermis in the subcutis area. Dermal fillers are only for use by trained professionals so you’ll need to schedule an appointment with a medical spa or cosmetic surgeon for each session. If you’re ready to see the difference a facial dermal filler can make, try scheduling a session today. You’ll find new fillers can erase years from your face while improving the overall texture and evenness of your skin.