NEWS AND ANALYSIS

AM Live going ahead as planned

Following the Government’s announcement that it is to push back the easing of remaining coronavirus restrictions in England, Aesthetic Medicine Live will continue as planned on 8-9 July 2021. The show will follow the guidelines for events in Roadmap Step 3 released on Monday, 17 May 2021. Step 3 allows business events with 1,000 visitors or 50% of a venue’s capacity to take place. For the first time, Aesthetic Medicine Live will take place in the National Hall at Olympia London. This is a fantastic new venue for the show which will allow for more space around the exhibition floor, ensuring a comfortable visit. In addition to a larger space, there will be much wider aisles on the exhibition show floor, temperature checks outside the venue, mandatory wearing of face masks inside the venue at all times, and socially distanced seating within the conference, Business Workshops and Demo Theatre. We look forward to welcoming the industry back together under one roof.

German PIP safety body found liable in landmark case, must award victims compensation

A French appeal court has ruled that thousands of victims of the PIP breast implant scandal are to be compensated.

10 years after the TUV1 case was brought, German safety body TUV Rheinland, which issued safety certificates for the faulty breast implants manufactured by French company Poly Implant Prothèse (PIP), has been found liable and will now have to fully compensate the victims involved in the case. This includes 540 British women, some of which still have the implants in place because they can’t afford to have them removed or replaced. The court also upheld an earlier judgement of negligence by TUV.

It emerged in 2010 that the faulty implants were filled with industrial-grade silicone that was not safe or cleared for human use. PIP was then liquidated, but the faulty implants had been in manufacture since 2001. Many of the implants ruptured, causing the silicone to leak into the body and cause often debilitating side effects and illnesses. Up to 400,000 women worldwide are thought to have received the implants.

BAAPS (British Association of Aesthetic Plastic Surgeons) president Mary O’ Brien said to the BBC: “The human cost and distress to many women and their families following surgery involving PIP implants is sobering.” The Association supported the development of the International Collaboration of Breast Registry Activities (ICOBRA), which provides guidance for national registries and which the NHS Breast and Cosmetic Implant Registry is part of.

First ready–to–use toxin recieves European approval

Alluzience, a new BoNT-A neuromodulator from Galderma, has become the first readyto-use toxin approved for use in Europe. National approval processes will now take place for the product after it received a positive decision from its European approval procedure.

Unlike all other BoNT-A wrinkle relaxants currently approved in Europe that come in powder form and require reconstitution with sodium chloride before use, Alluzience is a ready-to-use formulation. Galderma says this avoids any calculations and allows for more precision, meaning that the product has the potential to improve safety and dosing accuracy compared with powderform BoNT-A preperations.

Alluzience is intended for the treatment of frown lines. The European authorisation is based on the data from two trials including one study in which more than 50% of patients demonstrated effects within two to three days. 1 An effect was demonstrated for up to six months. One month after injection, 85.2% of patients were either “satisfied” or “very satisfied” compared to 9% for placebo patients.

“At Galderma we pride ourselves on developing innovative products that meet today’s needs, which is underpinned by our longstanding knowledge and heritage in dermatology,” said Alexandre Brennan, head of Galderma’s global business unit for aesthetics. “We know how advantageous it is for doctors to have access to a ready-to-use liquid formulation in Alluzience. It’s for this reason that [this] is an important milestone for both patients and healthcare professionals.”

1. Ascher B, Rzany B, Kestemont P, et al. Liquid Formulation of AbobotulinumtoxinA: A 6-Month, Phase 3, Double-Blind, Randomized, Placebo Controlled Study of a Single Treatment, Ready-to Use Toxin for Moderate-to-Severe Glabellar Lines. Aesthet Surg J. 2020;40(1):93–104.

Younger patients spending more on aesthetic treatments

Patients aged under 40 are contributing more to aesthetic treatment sales in 2021 compared to those aged over 60, found data from Guidepoint Qsight. In March and April 2021, spending by patients aged under 40 increased by 70% compared to the same months in 2019 (as a pre-pandemic baseline). Conversely, treatment sales by patients over 60 decreased by 6%.

The data company has collected point-of-sale and survey data from hundreds of clinics in the US since 2007 and gives insight into nearreal-time data. Overall, treatment sales grew 27% in March and 14% in April compared to the same months in 2019, with non-surgical skin tightening and toxin injections experiencing the highest increases, at 36% and 32% respectively.

Sun safety knowledge worryingly lacking in the US

A third of Americans failed a basic quiz on sun exposure, with young adults faring the worst. The survey, from the American Academy of Dermatology (AAD), was designed to measure the level of sun-safety knowledge of the population.

Generation Z (those born after 1996) demonstrated the lowest level of awareness about the dangers of sun exposure. 42% were unaware that tanning can cause skin cancer, while 41% didn’t know that ultraviolet rays are reflected by snow, water and sand. 33% didn’t think they could get sunburn on a cloudy day.

Millennials (those born between 1981 and 1996) didn’t do much better. 37% didn’t know that tanning can cause skin cancer, and 23% didn’t believe that sunburn increases the risk of developing skin cancer. More than half of the entire survey population (1,000 adults) didn’t know that shade can protect them from the sun’s harmful rays, 35% believed that tanning is safe as long as you don’t burn; and 47% either believed or were unsure as to whether having a “base tan” prevents burning in the sun.

“These are striking results when it comes to younger generations’ knowledge about basic sun exposure,” said Dr Kenneth Tomecki, president of AAD. “Gen Z and Millennials have a lifetime of potential damaging sun exposure ahead of them, so now is the time to close the knowledge gap and ensure they are aware of how easy it is to practice sun-safe behaviour.”

More than half of UK men use partners’ skincare products

More than half of men in the UK admit to using their partner’s skincare products without them knowing, revealed a new study by skincare brand Clarins. In the recent survey of 1,000 men in the UK, 56% said they were guilty of “stealing” their partner’s products to help with their skincare concerns, while more than one in ten (14%) owned up to using their other half’s products every day, and 19% admitted that they use their partner’s products “often”.

When asked about their own skincare routines, the survey revealed that men are most likely to use moisturiser, cleanser, eye cream and spot treatment. In addition, it was discovered that 90% of men have at least one skincare insecurity, with the top five biggest concerns dry skin (41%), dark circles under the eyes (35%), acne/acne scars (27%), ageing/fine lines (26%) and blackheads/enlarged pores (26%).

For the men that regularly use their own skincare products, almost 50% said the amount of time and money they spend on their routine has increased over the past five years. Four in five men (82%) say they spend up to £50 a month on specialist skincare products.

Psychotherapist Sarah Lee, who worked with Clarins on the survey, said: “Traditionally, ‘masculinity’ has had a very narrow, heteronormative definition. For some men, secretly using their partner’s moisturiser is a lot easier than recognising, challenging and deconstructing societal norms. Men’s ability to express their identity (or emotions) freely is generally helpful, however it becomes problematic when it’s based on unrealistic expectations such as filtered images or feeling the need to conform to certain body types or looks. We need diverse role models, and we need to practice being less judgmental towards our bodies.”

Aesthetic practitioners send open response to JCCP regarding its 10–Point Plan THE JCCP’S 10 POINT PLAN

A group of over 100 doctors, nurses and dentists from the field of aesthetics have come together to issue a response to the JCCP (Joint Council for Cosmetic Practitioners) in reference to its 10-Point Plan, released in March. The Plan is a framework of recommended actions towards regulation and a monitored, safer environment for the practise of nonsurgical aesthetic procedures, including hair restoration. (See infographic opposite for the 10-Point Plan in brief).

Represented by Dr Steven Land, director of Novellus Aesthetics, Ness Griffiths, aesthetic nurse practitioner at Novellus Aesthetics; and Dr Tapan Patel, director of Phi Aesthetics, the response addresses each point individually and summarises “the general feelings about this plan from those operating within the sector”. The main body of the letter reads as follows:

1. Statutory regulation: 

“We would start out by pointing out that those we feel should be injecting – doctors, dentists and nurses – are already mandated to be on a statutory register. Entry onto these registers compels them to ‘follow best practice guidance’; ‘comply with standards of proficiency’; ‘provide treatments safely’ and ‘possess (any) insurance cover’. It is our belief that legislation restricting practice to the aforementioned groups would solve many of these problems in one go and thus this point does not actually go far enough.

“Lobbying and exerting political influence to this end would be a more useful effort than trying to set up another compulsory register when it is not needed and would, in fact, be a huge leap forward in making the whole industry safer. Working with these regulatory bodies – NMC, GMC and GDC – to encourage them to take aesthetic medicine more seriously as a speciality and develop their own guidelines and policies would be welcomed by everyone in the sector.”

2. Mandatory education and training standards:

“Much in this point is to be applauded – working to raise the training and educational standards within aesthetic medicine is paramount. We would point out that restricting the practice of aesthetic medicine to doctors, dentists and nurses would solve a lot of the issues around maintaining competence and being registered on a PSA register would add the proposal of working with these registers to ban their members from training those unqualified to undertake medical procedures.”

3. Clear, transparent information:

 “Again, much to be recommended in this point – and again all of this would be covered under the duties expected by the relevant registering bodies of doctors, dentists and nurses. Restrict practice to these groups, work with their registering bodies for clear guidance on aesthetic medicine for their members, and a regulatory framework to prevent poor practice already exists.”

4. Definition of medical and cosmetic treatments:

“This is a point that we have issue with. We would contest that any procedure using a prescription-only medicine or a class-three implantable medical device is medical. It may also be cosmetic as the two are not mutually exclusive, and to try and set such distinction is unfair (as a comparison, we would point out that the majority of breast augmentation surgery (using an implantable medical device) is for cosmetic reasons but is also selfevidently medical).

“The recently published WHO ICD-11 classifies everything we treat with botulinum toxin and dermal filler to be a disease. Aesthetic medicine is considered a medical speciality in its own right in other countries and restricted to medical practitioners – and it should be so in this country, too.”

5. Safe and ethical prescribing: 

“Again, much to be commended in this point – particularly the objectives of publishing details of practitioners’ prescribers (perhaps as part of the licensing scheme mentioned in Point 9) and the proposal that all prescribing professionals are allowed to obtain stock for emergency purposes – both of which would increase safety for our patients.

“We would also add that working with the GMC, GDC and NMC to adopt the 2019 GPharmC guidance on not prescribing for non-medical professionals in the field of aesthetic medicine would be welcomed by advocates of patient safety.”

6. More regulated advertising and social media:

“Again, nothing here to argue with, suffice to say that current rules and regulations need to be more strictly enforced to ensure a level playing field. As fillers are considered a medical treatment by their regulatory bodies, medical practitioners are not allowed to do any sort of offer, whereas non-medical practitioners are free to do what they will (again, restricting aesthetic medicine to medics would solve this problem).”

7. National complications reporting:

 “We agree that making dermal fillers prescription-only devices should lead to an increase in complication reporting, especially if this is made easier with an online reporting form or app. Pushing for regulation around medical devices (which have notoriously poor vigilance) may be easier as it removes the requirement for reclassification and would improve the safety of medicine as a whole.”

8. Adequate insurance cover:

 “Another laudable aim, entirely covered by making aesthetic medicine practice-able only by medics. Membership of our respective mandatory registers makes us compelled to have adequate insurance for the fields within which we practice.”

9. Licensing of premises, treatments and practitioners:

“This point and its objectives go a long way toward making the field of aesthetic medicine more regulated and safer for the patient. Licensing of premises to ensure they meet basic requirements, details of the treatments carried out and the details of the practitioners working there, and their regulatory bodies, prescribers and qualifications would seem so obvious that we suspect most members of the public would be surprised to find out it doesn’t already happen.”

10. Raising customer awareness: 

“Any proposal to raise public awareness of aesthetic medicine, its benefits and its risks is to be applauded. The availability of reliable information is key to safe decision making by our patients – knowing what procedures are available, safe and well-evidenced, and which practitioners can be relied upon to do right by them, is paramount to the safety of our patients and the continued success and growth of aesthetic medicine as a speciality.”

The authors added: “As general points we would like to say we have issues with the impartiality of the APPG for beauty, aesthetics and wellness. It is funded by the beauty industry and previous public meetings have shown they have little understanding of the medical aesthetics field and the complexities contained therein. We believe that closer ties with the current regulatory bodies for doctors, dentists and nurses are key relationships for moving the safety of aesthetic medicine forward – many of the points covered in this document should be being regulated by these bodies for their members yet are seemingly ignored, even when concerns are reported.”