Clinical excellence

What were the key takeaways from AM London’s injectables masterclasses?

Our popular injectables masterclasses returned this year to explore the latest techniques and innovations shaking up the sector. During a series of live demonstrations and discussions, experienced practitioners revealed firsthand the techniques and approaches they adopt in their clinics.

Using their brands-of-choice to treat patients in real-time, leaders in their field came together to share the groundbreaking new innovations taking the world of injectables and toxins by storm – with diverse subjects ranging from treating prejuvenation, treating mature patients, individualising injectables treatments and approaches to lip enhancement on Friday to managing complications, periorbital rejuvenation, combination treatments and injection techniques and innovations on Saturday.

Also, among the topics up for discussion were proactive ageing – ethical injectable treatments for 20s and 30s, respecting ethnic features, the management of aesthetic complications with ultrasound and PRP, and toxins for erectile dysfunction. Experts also shared their ethical concerns surrounding patient safety, potential risks, and unfavourable outcomes. Questions put to the experts included concerns surrounding problems with pre-injection skin sterilisation as well as the pros and cons of using different injection devices.

Another topic of discussion was the importance of taking the time to have lengthy and detailed consultations with every patient to establish both their immediate and long-term aesthetic goals. This is also about realistically managing their expectations to ensure everyone is satisfied with the outcome and daring to say ‘no’.

Of course, we all know that injectables are the bread and butter of most aesthetic clinics. As this fast-moving industry continues to evolve, so has the huge breadth of techniques available to help medically qualified practitioners administer them.

In the early days, treatments tended to focus more on the nasolabial folds and lips, but times have changed. Knowledge of anatomy and techniques has evolved significantly since then. Now, there is a vast range of non-surgical injectable solutions that have become popular among patients of all ages. The injectables masterclasses gave delegates a chance to get up to date with the brands shaping and advancing aesthetics and hear how to stay at the forefront of the latest emerging trends.

HOLISTIC APPROACH

During a masterclass devoted to treating the mature patient, Dr Manav Bawa, medical director of Time Clinic in London, said he takes a holistic approach no matter the patient’s age: “The most common complaint I hear is sagging,” he said. “But it’s not simply about adding more and more filler. For harmonious, balanced results, we want our patients to be the best versions of themselves. What we don’t want is patients whose friends and family say they’ve had too much work done.

“It all comes back to the consultation – if I spend 45 minutes plus with a patient, I can understand what’s really going on, why do they want treatment? I can understand their background, and what other medical conditions they’ve got going on.

“The good physician treats the disease; the great physician treats the patient who has the disease,” he added. “Take the time to understand your patient more.”

Julie Scott, a registered nurse with more than 30 years of experience, agreed with Dr Bawa about ageing. She said: “So many people say, ‘I’ve started the menopause and feel like I’ve aged overnight.’

“We need to catch them before these things happen. I often think about the ageing landscape as a valley. It’s for us to understand and unpick the peaks and troughs that will determine which tools we use when treating our patients.

“Always start with the canvas. We can’t fix everything with a syringe.”

Medics reflected that another problem with some fillers in the early days was that the substances were tricky to use, and that is another reason why it is now crucial to take the time to discuss in detail how a product might look instead of focusing simply on how long it might last. While a particular product or treatment might technically satisfy the medical aim, it might not quite work, aesthetically speaking, and could potentially leave the patient looking worse.

SAFER PRODUCTS

Most products used today are temporary in nature and can be dissolved, but practitioners should still be concerned about the anatomical structures lying underneath the skin. Injecting product into a blood vessel can cause vascular and tissue damage, warned Alexandra Mills, who chaired a session called Approaches to Lip Enhancement. Alex also gave a brief talk about Approaches to Peri-Oral Rejuvenation and how important it is to tread carefully: “I always look at a patient’s bone structure, fat loss and the quality of their skin as it tells you so, so much.

“We must better understand the underlying physiological changes which occur in the peri-oral region due to ageing. This will allow us to create bespoke treatment plans which allow us to produce more natural aesthetic outcomes in this area.”

Mills was followed on stage by Amy Bird, director of KAST Medical Aesthetics in Cheshire. Bird discussed the advent of the new ‘lip flip’ treatment and how she deals with a steady stream of loyal patients begging her to ensure they do not end up with a dreaded trout pout.

Bird, who currently sees regulars up to the age of 82, said: “They are progressive, socially liberal, aware, and willing to spend. Lip fillers are my top requested treatment.

“The newest trend has to be the lip flip as the community turns to more natural and subdued styles. The idea of the lip flip actually came from a patient. They requested it from me. It was driven via social media from fear, but I had already stopped injecting the upper lip with toxins.”

Bird firmly believes a natural and subtle rejuvenation should be the desired endpoint, and when asked if the lip flip is suitable for everyone, she said: “Anatomy and what you’re walking in with plays a big part, but I have found a 100% satisfaction rate, zero complications and zero adverse reports with my technique and product. I want people to be able to talk, suck a straw and smile properly. Downtime is less than 60 minutes, and within 24 hours, they are seeing results.