Inside Aesthetics

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Latest Episodes:

Ep 237 TriLift: Dynamic Muscle Stimulation for Facial Toning | Dr Saras Sundrum, Ashlee Middleton & Jessica Sluga Nov 30, 2023

Show notes

Episode 237 hosts Dr Saras Sundrum (Cosmetic Physician, Sydney), Ashlee Middleton (National Sales Manager - Lumenis ANZ) and Jessica Sluga (National Clinical Educator - Lumenis ANZ).

We discuss TriLift, a novel device made by Lumenis. According to Lumenis, Trilift can give 'a facelift-like result with no injections or surgery'. TriLift includes three modaliites of treatment: dynamic muscle stimulation, radiofrequency for skin rejuvenation and radiofrequency microneedling for skin texture improvement and resurfacing.

Our three guests give us their own insights on the device. We discuss it's clinical indications, the technology built into it and some important commercial aspects when buying a new device. Dr Saras shares her own journey of buying TriLift, her real life patient feedback and how she has succesfully integrated it into her practice.

This podcast was sponsored by Lumenis ANZ

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Ep 236 Ultherapy: Micro-focused Ultrasound Under Visualisation | Dr Stephen Lowe Nov 23, 2023

Show notes

Episode 236 hosts Dr Stephen Lowe (Cosmetic Physician based in Sydney, Australia)

Stephen has been in the aesthetics field for over 13 years and is a global KOL for Merz Aesthetics. He has been using Ultherapy since 2017 and is a leading practitioner in how to best use it.

We discuss what Ultherapy is, the technology involved and how this relates to treating specific signs of facial ageing. We specifically drill down into collagen loss, aging of the SMAS layer and how these structures impact on facial aesthetics.

We learn from Stephen about what patients make the best candidates for Ultherapy, contrast it with alternative modalities and treatments, discuss what the treatment journey looks like, downtime and the rare risk of complications.

This podcast was produced in partnership with Merz Aesthetics

The non-invasive Ultherapy® procedure is indicated for dermatological sculpting and lifting of the dermis on the upper face, lower face, neck, and décolletage though the deposition of micro-focused ultrasound energy. Ultherapy® should not be used on persons with open wounds, lesions, severe or cystic acne, or implants in the treated area. THIS PRODUCT IS NOT AVAILABLE FOR PURCHASE BY THE GENERAL PUBLIC. Always read the label and consult your Healthcare Professional for more information. This medical device must be administered by Healthcare Professional or trained personnel, under the supervision of a physician. If you are a Healthcare Professional, please review the Ultherapy® Instructions for Use before administering treatment, available from https://www.merzaustralia.com.au/products/

Copyright © 2023. Merz Australia Pty Ltd. All rights reserved. Ultherapy® is a registered trademark of Ulthera, Inc. Merz Aesthetics® and the Merz Aesthetics® logo are registered trademarks of Merz Pharma GmbH & Co. KGaA. For more information about how Merz handles personal data, please see Merz General Data Protection information notice at https://www.merz.com/fin/

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Ep 235 The Business Of Injecting (Chapter 11) | Kian Moini Nov 16, 2023

Show notes

Episode 235 hosts Kian Moini (Entrepreneur and the owner of 'Q-Tox' based in Sydney, Australia)

We hosted Kian way back in episode 143, almost two years ago to the day prior to his clinic opening. We re-visit what his goals were for his clinic and learn how he has navigated the challenges of the competitive Sydney aesthetic market. We learn about what worked, what needed tweaking and get an insight into how understanding your CRM data can drive your overall strategy.

In 'The Business of Injecting' episodes we host injectors and clinic owners to discuss all aspects of the business side of their clinic. We analyse their financial struggles and challenges, difficult decisions, friction points, staffing, hiring, firing and other topics relevant for aesthetic business owners.

00:00 Introduction 02:46 Meet our Guest Kian Moini 06:19 Data Driven Clinic Decisions 11:08 Defining Premium Mid Tier Model 13:45 Mall Clinics and Market Positioning 16:29 Launch Lessons and Walk In Growth 21:07 Improving Injectors With Metrics 23:13 Playing to Injector Strengths 28:25 Surviving the Scary Weeks 32:32 Why Numbers Matter in Tough Times 35:06 Gross Profit Over Revenue 37:11 Zero Based Budgeting 38:09 Why Costs Get Ignored 39:52 Marketing Is The Product 42:09 Know Your Margins Fast 43:16 Boom Times Won't Last 44:53 Small Clinics Win 50:16 Fitout Spend Strategy 51:36 Build Lessons And Layout 55:48 Staffing Without A Manager 60:29 Hiring Receptionists 61:55 Building The Injector Team 64:30 Rebooking And Ethical Sales 68:22 Educator Not Salesperson 68:49 Slow Down For Quality 69:44 Rapport And Patient Experience 70:33 Chain Clinic Menu Mentality 75:17 Pricing Strategy And Margins 79:28 Raising Prices Without Backlash 83:32 Negotiating Suppliers And Stock 86:31 Testing New Toxins And Technique 91:30 Marketing Mix And Acquisition Cost 92:51 Choosing The Right CRM 95:08 Opening A Second Clinic 98:22 When Is Enough 100:04 Final Wrap And Where To Follow

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Ep 234 Disasters & Solutions (Chapter 3): Vascular Occlusion of the Tongue | Julie Bass Kaplan Nov 09, 2023

Show notes

Episode 234 hosts Julie Bass Kaplan (Nurse Practitioner based in California, USA)

This is the 3rd chapter in our mini-series called 'Disasters & Solutions'. Here we look at some of the unusual, difficult or outright disasterous outcomes for patients caused by injectables. We speak to the injectors who managed the case and go through what happened, step by step. We'll learn about what might have been done to prevent the problem and what injectors can do in their own practice to be safer practitioners.

In Chapter 3 we discuss a case concerning a patient who was treated with chin filler. They immediately developed a significant and rare vascular occlusion that affected one side of their tongue. We hear about what was done to salvage the situation and drill down into some fundamental learning points for all injectors.

00:00 Introduction 01:01 Disasters Series Returns 02:48 Case Background Chin Filler 06:04 Consent and Risk Talk 09:04 Technique and Ultrasound Error 18:47 Training Lessons on Ultrasound 20:45 Harlequin Tongue Recognition 23:06 Emergency Protocol and Drills 27:19 Patient Support and Timeline 32:07 Hyaluronidase Dosing and Stock 39:44 Adjuncts Hyperbaric and EO2 43:51 Next Steps Patient and Injector 44:49 Turning Complication Into Paper 46:38 Injector Growth And Confidence 48:20 Patient Care And Communication 58:01 Undiagnosed Occlusions Debate 62:29 Median Canal Anatomy Explained 66:22 Fishing For Red Technique 72:10 VO Mechanisms And Risk Factors 73:38 Emergency Kit And Training 76:37 Refunds Apologies And Support 80:05 Medicolegal Protocols And Notes 85:16 Wrap Up And Where To Learn

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Ep 233 Safety Manoeuvres When Injecting | Dr Alexander Rivkin Nov 02, 2023

Show notes

Episode 233 hosts Dr Alexander Rivkin (ENT surgeon based in California, USA)

For years injectors have argued bitterly about the pros and cons of theoretical safety manoeuvres performed when injecting fillers. These techniques include aspiration, small or larger movements of the needle tip or even aspiration and moving combined.

We explore the rationale proposed for these procedures and try to understand the merits and limitations of what they might offers us.

00:00 Introduction 01:35 Meet Dr Alexander Rivkin 02:34 From ENT to Aesthetics 04:55 Early Days and Marketing 08:05 Learning to Inject 10:16 Complications and Risk 13:31 Safety Versus Efficacy 16:50 Needle Motion Paper Debate 20:10 Critiquing the Model 27:33 Aspiration Explained 35:02 Bolus Versus Moving Technique 44:54 Teaching Safety to Beginners 47:05 Why Aspiration Feels Safer 47:25 Training Risks and False Confidence 48:15 Patient Comfort and Needle Motion 48:55 Legal Standards and Expert Battles 50:07 What Moving the Needle Means 52:11 Vasospasm and Early Ischemia 56:59 Ultrasound Promise and Pushback 64:15 Dissolving Filler and Integration Myth 67:48 Evidence Gaps and Practical Rules 71:11 Nose Occlusions and Management Steps 76:28 Why Keep Doing Nose Jobs 80:00 Origin of Nonsurgical Rhinoplasty 82:01 Wrap Up and Resources

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Ep 232 Normal: A Plastic Surgeon's Letter to His Daughters about Body Image | Dr Pouria Moradi Oct 26, 2023

Show notes

Episode 232 hosts Dr Pouria Moradi (Plastic Surgeon & Reconstructive Surgeon based in Sydney, Australia)

Pouria recently published his first book entitled 'Normal - A Plastic Surgeon's letter to his daughter about body image'. He first got the idea for the book as he watched his seven year old daughter participating in a swimming carnival. She seemed so proud of herself and completely unaware of how she looked in her cute swimming costume.

But it dawned on him juggling his role as a father and Plastic Surgeon - how long would this innocence would last? Might she soon start asking questions about her body? And if so, what should a father who offers cosmetic surgery every day to other women say?

This is a deep conversation about body image, parenting, ethics and ultimately, we try to understand what is 'normal'?

00:00 Introduction 01:03 Sunday Catch Up 01:26 Meet Dr Pouria Moradi 02:46 Why He Wrote Normal 06:25 Kids and Body Image 09:25 Defining Normal in Surgery 10:39 Parenting and Social Media 12:08 Talking Cosmetic Work at Home 14:35 Reading the Letter 19:11 Ethics and Saying No 25:00 Otoplasty and Medicare Rules 28:56 Book Structure and Resources 31:45 Screening Patients and Red Flags 34:18 Dopamine and Going Bigger 36:37 Reconstructive Roots vs Cosmetic 39:23 Where Surgeons Draw the Line 40:17 Setting Realistic Results 42:08 Aligning Expectations 44:24 3D Imaging Pitfalls 46:06 Depression and BDD 47:57 Social Media Dysphoria 52:59 Surgeon Bias and Referrals 55:43 Patients Versus Clients 61:28 How to Say No 63:24 Transgender Care Basics 67:50 Defending Cosmetic Surgery 71:48 New Cosmetic Guidelines 79:09 Book and Wrap Up

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Ep 231 The Risks of Illegal Injectable Products & How to Protect Yourself | Ian Carroll & Jahan Kalantar Oct 19, 2023

Show notes

Episode 231 hosts Ian Carroll (Founder and Managing Director of EnVogue Skin) & Jahan Kalantar (Criminal Lawyer & the principal of 'Executive Law Group')

We discuss the consequences surrounding the alleged actions of a new aesthetic distributor based in Australia.

00:00 Introduction 01:46 Meet our Guests: Ian Carroll & Jahan Kalantar 03:25 Rumors of Unapproved Filler 05:42 How TGA Approval Works 07:38 Risks for Injectors and Clinics 11:31 Legal and Insurance Fallout 17:23 Due Diligence Using ARTG 19:58 Alleged Fake TGA Documents 22:54 What Happens Next 25:30 How This Could Happen 29:56 Bigger Industry Lessons 33:11 Personal Use Import Rules 34:11 Special Access Pathways 36:56 Dodgy DMs and Grey Market 38:07 Counterfeit Risks in Familiar Brands 39:55 Industry Reputation and Regulation 43:36 Verification Tech and QR Codes 45:27 Long Term Complications and Support 47:24 Clinic Crisis Response Playbook 50:29 Legal Triage and Potential Offences 53:39 Market Size and Consumer Danger 55:31 Reporting Suppliers and Staying Cautious 57:32 Key Takeaways and Wrap Up

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Ep 230 The Tox Talks (Chapter 7): We've Been Doing Toxins Wrong for the Past 35 Years | Dr John Joseph Oct 12, 2023

Show notes

Episode 230 hosts Dr John Joseph (Plastic Surgeon from California, USA)

In this mini series 'The Tox Talks', we feature expert injectors who have significant experience in using botulinum toxins. These episodes explore our guests experiences using particular brands, the evolution of their injecting techniques and we get special insights into the subtle nuances of getting the best out of toxins.

In chapter 7 John shares his experiences as a lead clinical study investigator and tells us why he believes we've been doing toxins wrong for the past 35 years. We dangle the possibilities of longer lasting results, less complications, increased patient satisfaction, more time and how to revolutionise the world of toxin treatments.

00:00 Introduction 01:04 Miami Conference Teaser 02:02 Meet Dr John Joseph 02:20 Early Botox Adoption 07:51 Building a Botox Practice 09:00 Why 2.5 mL Became Standard 11:15 Inside Clinical Trials 15:55 On Label vs Off Label 19:20 Eureka on Dose Duration 23:44 Galderma Study and Bias 28:41 How Longer Duration Works 32:28 Measuring Duration and FDA 40:22 Why He Pushed the Science 45:32 Allergan Plateau Findings 46:56 Why Duration Plateaus 47:51 Trial Design and Patient Expectations 50:28 Safety and Field of Effect 52:54 Concentrate to Extend Duration 56:34 Cold Versus Old Data 61:50 90 Units in the Lip 66:06 AccuTox Syringe Prototype 72:04 Running Multiple Dilutions 77:11 Pricing and Practice Economics 81:29 Which Toxin to Stock 83:22 Future Adoption and Consumer Pull 84:54 Resistance and Type E Antidote 90:43 Wrap Up and Next Steps

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Ep 229 The Injector Diaries (Chapter 16) | Julie Bass Kaplan Oct 05, 2023

Show notes

Episode 229 hosts Julie Bass Kaplan (Nurse Practitioner based in California, USA)

Julie joins us in the 16th Chapter of our series called 'The Injector Diaries'. These episodes feature in depth conversations, stories and experiences from injectors around the globe.

Each injector brings their own unique take on things and we showcase every level of type of injector, from newbies to masters. We'll explore how and why they chose to inject, why they favour using certain products, look under the hoods of their clinics and aim to inspire our injector listeners.

00:00 Introduction 01:03 Catching Up With Julie 02:15 Shoe Closet Studio 03:53 Julie Origin Story 07:55 Starting a Business 11:25 Finding Your Voice 18:12 Handling Trolls Online 22:16 Early Injecting Days 24:47 First Vascular Occlusion 31:15 Recovery and Lessons 33:28 Practice Changed Forever 34:58 Cannula Discovery 36:25 Can Cannulas Occlude 37:52 Ultrasound Changes Everything 39:00 Spasm vs Occlusion 44:04 Quiet Zone Doppler 45:48 Life as an Educator 50:59 Purpose and Beauty 57:14 Regenerative Medicine Buzz 59:51 Mentors and Pioneers 63:56 Training with Pharma 66:13 Teaching Without Constant Travel 67:16 Inside Advanced Injector Training 68:59 When Trainees Are Ready 71:36 Why Weekend Courses Fail 74:29 Hiring and Training Philosophy 78:19 Mistakes and No Degree Shaming 81:52 Trainer Pay Inequality 88:35 What Patreon Is and Safety 93:00 Rapid Fire Favorites 95:43 Workshops That Shaped Her 97:03 Wrap Up and Where to Follow

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Ep 228 The Business of Injecting (Chapter 10) | Jamie Yerales Sep 28, 2023

Show notes

Episode 228 hosts Jamie Yerales (Registered Nurse based in Terrigal, Australia)

Jamie first trained as a Beauty Therapist before graduating as a Registered Nurse in 2012. She worked a cosmetic injector in a number of clinics in Sydney before deciding to build her own clinic, 'The Cosmetic Couture'.

In 'The Business of Injecting' episodes we host injectors to discuss all aspects of the business side of their clinic. We analyse their financial struggles and challenges, difficult decisions, friction points, staffing, hiring, firing and other topics relevant for aesthetic business owners.

00:00 Introduction 01:03 Singapore Cadaver Lab Lessons 03:08 Meet Jamie Yerales 04:25 Jamie's Path to Injecting 06:51 From Subcontractor to Owner 09:18 Central Coast Clinic Rebrand 11:53 Marketing and SEO Reality 15:35 Why Open Cosmetic Couture 17:40 Funding the Fit Out 28:42 Clinic Design and Patient Flow 32:44 Consultation Psychology 37:24 Scaling With Assistants 40:28 Choosing Profitable Devices 43:41 Skin Devices Boost Results 44:10 Body Devices And Costs 45:38 Marketing Body Treatments 47:42 True Cost And Opportunity 49:49 Finance Versus Buy Outright 51:50 Learn Business Basics 55:22 Managing Staff And Culture 57:36 Keeping Injectors Long Term 63:23 Trends Versus Timeless 70:30 Pricing Botox And Filler 74:12 Becoming A Tox Expert 79:09 Next Stage Business Growth 86:34 Final Advice And Wrap Up

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