With recent ‘cowboy’ practitioners making major headlines over the past few weeks, it’s no wonder that the aesthetic industry is back in the spotlight.  It has become apparent that there is a slight ‘grey’ area in standards for practitioners and the level of care given to patients, both pre and post treatments, for both surgical and non-surgical. In this blog we explore the 7 essential standards when providing cosmetic procedures by the General Medical Council.

Establishments such as SaveFace and the Safety in Beauty Awards, are working hard to ensure reputable practitioners and clinics are recognised for their contribution to following best practice and industry standards. They have been campaigning for standards within this industry to be tightened up and enforced to ensure patients who put their faith in what they believe is a trusted practitioner to not be disappointed with their results. These concerns were initially raised by Professor Sir Bruce Keoghs in his 2013 Cosmetic Industry Review, as well as the Scottish Cosmetic Interventions Expert Group over the years.

It appears that their cries are finally being heard, and action is being taken. As from the 1st June 2016, the General Medical Council (GMC) are setting out 7 essential standards that need to be adhered to by any Doctor who offers surgical or non-surgical treatments to patients.

The standards will be set out within a guidance document, detailing ethical obligations and standards that practitioners will need to meet, as well as advising the best way to meet these standards.

The 7 essential standards when providing cosmetic procedures advice to be included will be along the lines of the following:

  • Seeking your patients consent – It will be your responsibility as a practitioner to discuss the cosmetic procedure with the patient giving them all the information that they require to make an informed decision. This cannot be delegated to another member of staff, and it is best practice to offer all your patients a consultation period before booking any treatment.
  • Give your patients reflection time – Patients must have enough time to reflect and assess  if their chosen procedure is the right choice for them. This is why a consultation period and break before the treatment is advised.
  • Consider your patients psychological needs – consider your patients vulnerabilities and be certain that they are going into having the procedure voluntarily and have not been forced.
  • Work within your competency levels – recognising your limits, asking for advice or referring the patient to a colleague with the correct skill set will ensure no repercussion in the future post treatment.
  • Up to date training – ensure that you are up to date with the latest techniques and undertake any relevant training courses.
  • Providing all information to your patient – this includes written information, support networks and aftercare advice.
  • Marketing your services – no promotional tactics will be able to be used to entice patients to make drastic decisions. Any advertising must be clear and factual.

Fiona Website profileRegarding the above guidance standards, our Aesthetic Trainer, Dr Fiona Durban thinks this is a step in the right direction “The GMC has simply defined standards of practice we should all currently be following. Practitioners should be self-directed in their learning in order that they are up to date with current best practice for procedures they perform. This also needs to be demonstrated for part of appraisal and revalidation. We should all be offering an initial consultation where treatments with our patients can be planned, their suitability assessed (including any psychological vulnerability) and information given. Consent should never be delegated to others.  This guidance I hope is another step towards the profession demanding high standards of care and best practice”

Cosmetic Courses is able to offer you any training requirements that you may need, as well as advice and support in ensuring that you are ready for these standards coming into force on 1st June 2016.

If you would like any advice on the 7 essential standards when providing cosmetic procedures, or refresher training, drop us an email to [email protected] or call the team on 01844 390110.

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.


With the advent of plastic surgery, and alternative procedures that do not involve surgery, wealthy women started the war against aging. As time has progressed however, technology has gotten much better, and as a result, these procedures have become safer, more appealing, and more affordable. As such, more and more people have turned to new procedures such as face-lifts and Botox injections.

Though some use cosmetic procedures just to enhance their own image and try to look better, people are starting to use it to turn 50 into the new 30. Recent studies and new polls suggest that the amount of women approaching old age, and seeking cosmetic procedures to delay aging, has come close to doubling in recent years. These studies also suggest that with more advances in the cosmetic field, these numbers will only continue to rise.

Many celebrities that have fallen from their pinnacle of beauty, are also now seeking these cosmetic treatments. Although not an intended effect of their procedures, due to their high amounts of public exposure, these celebrities serve as walking advertisements for the cosmetic surgery industry. Many people that idolize either these people, or beauty, may seek out these treatments solely because the people they look up to find them to be fine.

Some people may question why a women would want to change her natural body in the first place, but the answer is actually pretty obvious. Where sees 50 years ago, aging was tolerated as a natural part of life, the modern media now portrays aging as something bad and ugly. As women get older and experience menopause, their bodies start changing in ways that are now considered to be unattractive. They then seek out these cosmetic procedures, not only to make themselves look more attractive in society’s eyes, but also to improve their own self-esteem.

Though many question the ethics and morals of plastic and cosmetic surgeries, their benefits to society are obvious. With many famous figures acquiring new looks through these measures, they provide inspiration for common people to go out and get them to. Because of society’s misconstrued views of aging, plastic surgery is as psychological as it is physical, helping older women both look better, and improve their confidence in themselves. As these procedures become safer and more affordable, there is no doubt that the number of people seeking them will only continue to rise, and their benefits to society will be enjoyed by more and more people.

In recent years, plastic surgery has slowly been on decline in the United States. However, botox shots and other wrinkle softening beauty treatments are on the rise in Europe. German citizens in particular are taking advantage of advances in cosmetic surgery, according to the Düsseldorf based Gesellschaft für Ästhetische Chirurgie Deutschland (GÄCD).

Studies and polling data show that 171,000 German citizens have undergone cosmetic procedures in the last year, a rise of twenty percent. Comparatively, cosmetic surgery in the United States is down two percent from the previous year. The most substantial increase was seen in the use of wrinkle filling agents such as Botox. Approximately 100,000 patients used botox in 2008, a number which leaped to 146,000 in 2009 according to a survey done by the GÄCD.

GÄCD general secretary Matthias Gensior cites affordability as the primary reason for the rise in botox injections, mentioning that the economic crisis as a potential catalyst. While botox injections are still relatively expensive, they are generally cheaper than more invasive surgeries.

Most female patients sought Botox treatment in order to diminish the appearance of frown lines and crow’s feet. Male patients favoured laser treatments, according to the statistics released by the organisation. In total 130,000 women underwent Botox or needle related treatments, compared to just 14,000 for men. Meanwhile 43,000 men underwent laser surgery to even skin and smooth lines. Women, on the other hand, logged only 38,000 of these treatments. According to the GÄCD, a plurality of patients were new to cosmetic surgery. Moreover, the median age of these patients had also decreased significantly from previous years.

Non-facial related surgeries also remained popular. Liposuction remained a popular treatment for overweight women, with close to 17,000 surgeries performed last year. Corrective rhinoplasty was popular among men, with approximately 3,500 surgeries logged by doctors. Other popular cosmetic surgeries included tattoo removal and eye lifts. According to Gensior, men were far less likely to undergo more drastic surgeries due to the stigma often associated with plastic surgery. Women, he noted, undergo treatment not only for cosmetic reasons but practical ones as well. Droopy eyes, for example, make it difficult to apply make-up.

The amount of women who decide to get Botox injections, collagen injections, and other similar procedures has risen fifteen percent over last year’s figures, meaning that for the first time over a million women are undergoing these types of procedures. There is no shortage of information available about some of the risks of Botox injections. They can have unwanted results, including resulting in a face lacking in emotional flexibility. Regardless of this, Botox is now being viewed by many as a normal part of women’s lives as they grow older.

Men are not immune to these changes either. Research conducted by Mintel predicts that as many as nineteen million women and men would undergo such procedures if they could afford the bill. Of the cosmetic options that do not require surgery, Botox is by far the most desired option. Botox is used to paralyze the movement of muscles in the face, which causes wrinkles to be smoothed out. And despite some of the high profile mistakes made on people who receive collagen injections and other lip enhancing procedures, there is a very large market for them as well. As an example, the actress Lesley Ash was left with a disfigured face when a lip enhancement procedure failed.

Another growing industry is the market for face lift procedures that do not require surgery. These dubiously called “organic face lifts” have become popular enough that the Duchess of Cornwall was recently discovered to have been receiving them. The specifics of the procedure are not known at this point, but it involves using bee venom as a replacement for Botox. According to the research conducted by Mintel, “With high profile celebrities – and now even royalty – choosing to help nature with fillers and lifts, non-surgical procedures have never been so popular, as numbers have passed the one million barrier for the first time in 2009.”

In addition to the non surgical options, plastic surgery itself grew by nine percent from 2008 to 2010. The most popular of these options is breast enhancement, a procedure in which saline bags are placed inside women’s breasts. Eyebag removal came in second, followed by surgery to the neck and face, the stomach, liposuction, nose jobs, and eyebrow lifts.

As a whole, the cosmetic treatment industry grew by seventeen percent over the past two years, reaching two point three billion pounds. The non surgical segment of the market has seen especially high growth. The main factor is thought to be the increased accessibility of such treatments. Mintel also discovered that only a third of the population feels like they don’t need plastic surgery.

If you have tried more wrinkle cream and treatments than you have wrinkles on your face, it is easy to get frustrated with a lack of results. Some creams are gentle on your skin but show no real results. Other treatments are so abrasive and have so many bad side effects that it is not even worth the risk. But before you give up hope, consider trying a proven product used by dermatologists worldwide: Juvederm. Juvederm gives you younger looking skin instantly and lasts for up to a year, but it is still gentle and safe. Other products claim results, but Juverderm’s clients show them.

Juvederm is an injectable clear, water-based gel containing hyaluronic acid, a type of chemical found naturally in the body. There are no animal components involved in the manufacturing of the drug, so you do not need to worry about allergies. Juvederm increases the elasticity and smoothness of your skin while revitalizing the skin’s cells. It is a natural product that will not give you a “plastic surgery” look!

Using a very fine needle, the gel is injected into the mid to deep dermis layer of your facial tissue to add volume. The injection is performed slowly and only requires a small amount of the product, and then the skin is massage to distribute the gel evenly. In total, the procedure takes around 15 minutes, and you can see instant results.

Juvederm is an FDA-approved drug with a low risk of side effects (less than 1% of people tested showed side effects). You may experience slight redness, pain, itching, or swelling at the injection site. In addition to your face, you can use this product as a filler for wrinkles around your cheeks, forehead, hands, and mouth. The drug is easily available online or through an extensive network of professional providers.

The Juvederm results last up to a year, and the process can be repeated. Why spend money and time on facelifts or microdermabrasion therapies when they can cause you risk and discomfort? Fill out your wrinkles and go back in time to a younger you!

Lip augmentation can be risky. If done correctly, treatment therapies that give you firmer, fuller lips can make you look dramatic and stunning. But after seeing pictures of so many cases gone wrong, resulting in taut and comically large lips, you may be nervous to give it a try. If you’re looking for a natural and safe alternative way to increase your lip size, don’t turn to injections – give implants a try!

Life implants are a new trend in plastic surgery showing promising results. SurgiSil ™, a Texas medical device manufacturing company, recently introduced the Perma Facial Implant™. The product’s innovation is causing quite a buzz.

The Perma Facial Implant is a silicone implant designed for the lips, but with the capability for implantation into the cheeks, nose, and chin. It was approved by the FDA in 2007, and there are over 100 surgeons in the United States offering Perma Facial Implants. Unlike silicone injections, Perma Facial Implants consist of two solid elastomer pieces inserted into the lips. They come in different sizes, and can be easily removed if there are problems or you are unsatisfied. They look and feel smooth and natural. Because they are solid, they will not break or leak, nor will they develop scar tissue around the implant sight.

Although the cost of Perma Facial Implants is higher than injectable fillers, the procedure only has to be performed once or permanent results (unlike injections, which may be needed every few months). Following the surgery, you may experience side effects including swelling, bruising, and pain. You may be prescribed medication to help with these issues.

Although Perma implants are known to be safe an effective, there are other synthetic implants avialble. These include products like AlloDerm®, which is derived from human cadaver tissue. Although this product feels natural, it only lasts between six and 12 months. SoftForm, GORE-TEX® and Ultrasoft are other brands that rely on expanded polytetrafluoroethylene, a non-biodegradable synthetic polymer.

Meeting with a board-certified plastic surgeon is the most important step in determining which procedure is the best fit for you. Any procedure of this sort should be conducted by a trained specialist. No matter what, the doctor can make a huge difference between making your lips look full and just awkwardly swollen.

Plastic surgery usually makes people think about some of the more obvious and traditional procedures, including breast implants, face lifts,Collagen Dermal Fillers liposuction, and Botox injections. But you may be surprised to hear that, lately, women have been focusing on plastic surgery on another area of their bodies: their feet. But it is not all about appearance this time. More and more plastic surgeons are implanting collagen dermal fillers into the balls of women’s feet to help make the pain of wearing high heels just a little more bearable.

Women who are into wearing trendy stiletto heels are often burdened with the less-trendy foot pain that they cause. High heel shoes transfer weight into the toes and balls of the feet, focusing constant pressure on a part of the foot with a relatively small surface area. Over time, the fat in the balls of the feet deteriorates, and when this is combined with ageing, shoes can become quite uncomfortable and even painful.

The procedure required to implant dermal fillers is relatively cheap and painless, and you can recover quickly. The collagen contained in the implants is a natural protein found in skin tissue, so it breaks down over time and dissolves in the body naturally. That means, however, that the procedure must be repeated about every two to three months. Some women have chosen to undergo the procedure only every so often as needed. Cosmetic surgery clinics have seen a spike of interest in the procedure around the holiday season in particular, presumably due to holiday parties and more time spent in high-heeled shoes.

In 2009, sales in foot implants in the UK jumped five times the prior rate, and the number is expected to grow as the economy improves. Even celebrities are getting in on the trend. Last November, Victoria Beckham mentioned that she, too, was considering having work done on her feet to remove bunions formed from years of wearing heels. It was also said that she expressed interest in dermal fillers.

The trend in high heeled shoes does not seem to being changing anytime soon, and designers continue to challenge their clients with taller and more extreme footwear. Plastic surgery may seem to be an extreme decision, but if you’re on your feet often in heels, it could be a cheap and simple option to prevent more permanent damage!

A beautiful smile makes an indelible impression in the social world. Women of all eras have sought to acquire the full-lipped pout of actresses and models. Because of this, modern cosmetic surgeons never lack for business. Lip augmentation gives women the full lips they desire and it boosts their confidence in ways never thought possible. The technical aspects of lip augmentation are left to scientists and cosmetic surgeons, but they are fascinating even to the untrained population.

Three types of lip enhancing procedures are the most popular choices of dentists. Injectable fillers produce a temporary effect that lasts 6 weeks to 18 months, depending on the person who receives the treatment and the variety of product injected. Collagen, hylaform, perlane, and rofilan are typical products of lip augmentation with variable durations of effectiveness.

A more permanent solution is accomplished with fillers such as dermalive, alloderm, soft form, and aquamide. Depending on the area that needs to be injected, the treatment can last longer than its typical 3 to 10 minute duration. After the injections, a patient can expect swelling and, in some cases, discoloration. The discoloration goes away after a few days and the permanent effect of the fillers sets in, giving the patient beautiful, sensuous lips that will be with her always. A normal routine is resumed shortly after this procedure, leaving patients free to return to work or household duties.

In the majority of cases, Bio Alcamide is the choice of filler for this type of procedure. Its strengths are that allergic reactions are almost non-existent in its history. Discomfort is minimal. It consists of hydrogel. Its usefulness extends beyond lip augmentation and has been used to fill scars, wrinkles, and cavities in the skin.

A third procedure is conducted through plastic surgery. This, too, is a permanent procedure. There is no possible way to reverse it, so serious consideration should be given before undergoing this procedure. Gum lift and lip enhancement techniques are described in-depth on several sites, and it is wise to research the topics before scheduling a consultation. It is the most complex of the three procedures.

A cosmetic surgeon can examine your lips and discuss your medical history to determine what procedure and filler will work best for you. If you are suffering from low self-esteem due to small lips and desire the full, beautiful lips of actresses and models, it’s as easy as scheduling an appointment with a cosmetic surgeon or aesthetic dentist. Within weeks you can have your desires fulfilled and be happier and more fulfilled.

The possibilities with Aesthetic Dentistry are endless. See Laser whitening London for more ideas about dentists in the medical aesthetics industry.

Soft tissue augmentation for aesthetic purposes has been around for over a hundred years. We can trace this field of medicine back to a German plastic surgeon who published a paper about adipose grafts that are transplanted to fix soft tissue defects on the face. This shows that fat grafts are the oldest known facial dermal fillers used in the plastic surgery field. Of course, the past 100 years have been spent improving techniques and finding better materials and devices to use to help patients cosmetically improve the appearance of soft tissue deficiencies. Facial dermal fillers are now one of the most popular ways people use to create a more aesthetically pleasing improvement to their face with the least invasive procedure possible.

Unfortunately, smoking, sunlight, aging and gravity take a toll on the elastic collagen of the face, causing wrinkles to appear. Aging-related changes include downturned corners of the mouth and atrophy of the lower and upper lips. Plastic surgery makes it possible to rejuvenate these areas with minor improvements. Facial dermal fillers are used to rebuild and refresh the areas near the mouth, helping the patient regain a more youthful appearance. Dermal fillers can also treat aging near the naso-labial folds of the face, a common and early sign of facial aging.

So why do people love facial dermal fillers to such a degree? One reason is the popularity of Botox, which has been shown to have amazing anti-aging on upper facial areas. With Botox injections, the anti-aging effects on the upper face have also created a need for better procedures to address the lower area of the face. Novel filler technology has also increased facial dermal fillers’ popularity with the general public. When Botox is used for the upper face together with dermal fillers on the lower face, an unbelievable age-reversing result is achieved that offers a rejuvenated appearance with minimally invasive procedures.

Today, many people will agree that a face should have prominence and depressions that are symmetrical. This belief is yet another reason people seem drawn to the field of soft tissue augmentation, particularly facial dermal fillers. Lip enhancement is now one of the most popular procedures and draws both the young and old. Because of the minimally invasive nature of these procedures, paired with their ability to deliver unmatched results, it’s no wonder people are eager to use facial dermal fillers to improve their appearance.