On Saturday 8 and Sunday 9 March the medical aesthetics community came together in London for ACE 2014. We report on some of the many highlights.
The Aesthetics Conference and Exhibition, formerly Cosmetic News Expo, took place on the weekend of March 8 and 9 at the Business Design Centre in London. Over the weekend, more than 1600 visitors in total came to see more than 90 exhibitors and listen to a host of internationally acclaimed speakers.
The two days of seminars, masterclasses, clinical workshops, expert clinics and business workshops offered delegates the opportunity to discover new techniques and products, develop their learning and improve their businesses, with up to 59 CPD points available.
Sponsored by Sinclair IS Pharma and Syneron Candela, with Registration and Consumables partner Med-fx and Floorplan sponsor Allergan, the event attracted visitors from across the medical aesthetics profession. The largest groups were cosmetic doctors and nurses who made up 28% and 25% respectively of the total attendance, along with 19% dentists and 2% surgeons. Dermatologists, aestheticians and clinic managers made up the remaining percentage of visitors keen to see the latest in products, treatments and clinical research.
On Saturday, Dr Tracy Mountford opened the conference, chairing a session on the European Perspective, with nurse and Aesthetics editorial board member Sharon Bennett, who is UK Lead on the BSI/CEN Non-Surgical Medical Cosmetic Standard, discussing the on-going CEN review. Following this, indication specific filler treatments were discussed by internationally renowned dermatology specialist Dr Sabine Zenker. Next on the main agenda, ACE steering committee chair Dr Mike Comins introduced a session on Body and Hand Treatments featuring the new and revolutionary VelaShape III, and a seminar on hand rejuvenation by Dr Dennis Wolf. Concurrently, David Gower, Dr Elisabeth Dancey and Aesthetics editorial board member, Dr Sarah Tonks led a masterclass by Medical Aesthetics Group on the role of hyaluronic acid in intimate rejuvenation. Also on Saturday morning, Dr Hugo Kitchen for Galderma offered an entertaining and illuminating masterclass in mid-face rejuvenation with Emervel Deep, including plenty of tips on how to keep patients satisfied and loyal, such as occasionally offering free treatments to long- time customers.
Clinical workshops and expert clinics on the exhibition floor drew large, standing- room-only audiences watching demonstrations including the potential of Sculptra for a full-face rejuvenation, and a live lipolysis demonstration by Dr Martyn King using 3D Lipo. One of the most popular masterclasses was led by Dr Tapan Patel and Dr Raj Acquilla, showcasing the use of Botox, with its new licence for treating crow’s feet, together with the Vycross collection of fillers for total facial rejuvenation and beautification. Dr Acquilla gave an expert presentation on facial anatomy, pointing out that the science of understanding the true anatomical changes of ageing is fast evolving. It was only in 2012 that a study showed the effects of bone resorption on the eye socket. They spoke about the importance of injecting ‘exquisitely’, with the emphasis on small, subtle changes, placed exactly. “Beauty is in detail, not in volume,” said Dr Acquilla. They also recommended the use of a cannula to treat the jawline to avoid nerve injuries. They discussed the high level of tissue integration possible with the Vycross range, and the unique structure of cross- linked, short chain hyaluronic acid. Dr Comins chaired ‘Where Surgery and Medicine Meet’, where Dr Raina Zarb Adami discussed the value of combination treatments for the lower face and neck, and Professor Vishy Mahadevan and Mr Dalvi Humzah provided an informative lecture focusing on facial anatomy with reference to injectables. The vital importance of fully understanding the anatomy was reinforced in a session on Safety in Advanced Facial Techniques, which included a presentation by Julian De Silva, who advised on how to avoid severe adverse events such as necrosis. He pointed out that some treatments need particular care, such as injectables in the nose post- rhinoplasty.
Sinclair IS Pharma curated a panel of experts chaired by Dr Tracy Mountford, throwing a fresh perspective on collagen replenishing treatment Sculptra in their afternoon masterclass. As part of the session, Dr Linda Eve provided a remarkable glimpse into the facial volumising effects of Sculptra with a series of case study images. Dr Eve also detailed the use of cannulas to treat patients with Sculptra, using the newer CanuSculpt technique, of which the benefits include minimum entry points and no need for anaesthesia. International Sculptra trainer Dr Askari Townshend, celebrating 15 years of the product, went on to detail its history. Specialist nurse Sharron Brown brought a new dimension to the session by speaking on the use of Sculptra in patients with HIV-related facial lipoatrophy, and the way in which it allowed these patients to return to work and regain their confidence in everyday life. Later on Saturday afternoon, plastic surgeon and Aesthetics board member Mr Adrian Richards presented a lively expert clinic on lip augmentation, beginning with a series of image comparisons to assess the symmetry of well-known celebrity faces. Mr Richards maintained a high level of audience participation throughout, repeatedly asking the audience, “What would you do in this situation?”, sparking much discussion amongst both the seated and standing audience. One issue raised was the importance of creating an age-appropriate outcome for the patient, in this case by analysing the width of the lips compared with their height.
New for 2014, the business workshops proved popular throughout the weekend, with talks from Dr Jason Williams on patient retention and John Castro on digital strategy drawing particularly large audiences. The practice development focus complemented the clinical content of the programme, providing advice to delegates on how they could grow their business, ensure they were meeting legal and ethical standards and regulations, and improve service to their patients.
In the evening, after a champagne reception, delegates had the opportunity to attend a unique Question Time session, sponsored by 3D aesthetics and the 3D lipolite programme. The first of its kind for the medical aesthetics community, the discussion was led by Peter Sissons and a panel of leading industry figures, comprised of Dr Andrew Vallance- Owen, a member of Sir Bruce Keogh’s Cosmetic Interventions Review team, Dr Tracy Mountford, founder and medical director of The Cosmetic Skin Clinic, Mr Dalvi Humzah, a consultant plastic, reconstructive and aesthetic surgeon based at the Plastic Dermatological Surgery, Dr Mike Comins, president of the British College of Aesthetic Medicine, Sharon Bennett, vice-chair of the British Association of Cosmetic Nurses, Dr Martyn King, owner of the Cosmedic Skin Clinic and Dr Leah Totton, Apprentice winner and founder of the Dr Leah clinic.
The session proved extremely popular with delegates and allowed a full discussion of the issues affecting the medical aesthetics industry. The entire panel agreed it was essential that all those involved in aesthetic medicine work together to improve standards with Dr King saying he felt that, “We can’t rely on regulation from the government”. Dr Mountford suggested that only qualified medical practitioners should be performing injectable treatments, saying, “If you can’t deal with the complications you shouldn’t pick up the needle.” Dr Vallance- Owen gave an insight into the workings of the Keogh committee, saying that “Lack of data regarding complications was the real problem,” and that, “A registry to collect data is the only way to protect patients.” Other topics raised included the lack of a register of practitioners, the poor quality of many training courses, and the possibility of adding cosmetic medicine to the undergraduate curriculum.
However, Dr Totton claimed that an informed public would be the key to improved safety. “We can’t stop the hairdresser injectors,” she said. “So we must educate the public about the risks.” Asked about the future of aesthetic medicine, Mike Comins asked ‘Does anyone in the government really care about this industry?”, but Dr Vallance- Owen said he believed very strongly that the government would introduce legislation to make fillers prescription-only medical devices and would insist on supervision of non-medical injectors. Sharon Bennett said, “I am optimistic. Associations are already coming together to be stronger.” Dr Vallance- Owen called for practitioners to report complications, speak up about bad practice and lobby for a compulsory register. Mr Humzah left the audience considering what he called “The three Ps; your patient, your procedure and whether you are the right practitioner to be doing it – if not, pass it on.” Day two of the conference began with a session on Skin Health. After an introduction by Dr Tapan Patel and a presentation on chemical peels by Sharon King, dermatologist Dr Tamara Griffiths gave a fascinating overview of cosmeceutical ingredients, telling her audience, “You owe it to yourself and your customers to understand the science.” She presented vivid evidence of the extent to which the sun creates photoageing, comparing images of skin on the forearm to skin on the inner arm. She recommended antioxidants to boost the effect of sunscreen. Dr Daron Seukeran presented on rosacea, discussing alternative diagnoses, the use of vascular lasers, and the potential of Mirvaso gel.
Dermatologist Dr Stefanie Williams then spoke powerfully about treating adult acne. “Acne is not cosmetic, or a rite of passage,” she said, “It is a serious, disfiguring, scarring, skin disease.” She spoke of the importance of early medical treatment to avoid scarring, and said that patients should avoid oils and facials, which in one study worsened acne in 80% of cases. For scarring, she recommended medical needling, used in conjunction with a Clarisonic cleansing brush to make anaesthetic creams work more effectively on patients.
Also on Sunday morning was a masterclass presented by Dr Johanna Ward explaining both how to use Coolsculpting technology and how introducing it can benefit a clinic financially. Dr Kuldeep Minocha talked about the value of Restylane Skinboosters as a versatile treatment for a broad range of patients. Dr Britta Knoll presented an expert clinic on treating hair loss through the use of mesotherapy, stating that she sees 10 patients a day suffering from the condition. Dr Knoll, who was trained by mesotherapy founder Dr Michel Pistor, explained the scope of the technique, describing it as a locally targeted treatment in the correct skin layer by multiple microinjections. She emphasised that Dr Pistor’s mantra was “Medication, yes: but a small dose, rarely, and at the right place.” She stressed that mesotherapy succeeds in more than 90% of cases of hair loss; however, if hair bulbs have been destroyed by treatment such as chemotherapy, it can be very difficult to regenerate hair growth.