Inside Aesthetics

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Latest Episodes:

Ep 167 Treatments & Regions Uncovered - Chapter 3: Lip fillers & Peri-oral Treatments | Dr Steven Harris & Julie Horne Apr 21, 2022

Show notes

Episode 167 hosts Dr Steven Harris (Cosmetic Physician based in London) & Julie Horne (Registered Nurse and Global Speaker based in Johannesberg, South Africa).

In this mini-series called 'Treatments & Regions Uncovered', we drill down into how to approach specific areas of the face, what techniques can be used and what our guests have changed over time as they've mastered their techniques. Dr Jake also give his own insights into how he treats these areas too.

In the 3rd chapter of the series we explore lip fillers and peri-oral treatments. Dr Harris and Julie Horne are both globally known for their contrasting styles when it comes to the lip region and we get a better understanding of how each of them approach this area of the face.

We'll also explore the patient perspective and get an understanding of their needs and complaints, as well as discussing any alternative treatment options that might be considered.

00:00 Introduction 00:45 Meet our Guests: Dr Steven Harris & Julie Horne 01:55 Julie And Steven Backgrounds 03:55 Different Aesthetic Philosophies 05:20 What Patients Want 10:50 Male Lips Approach 17:00 Easing Male Patient Anxiety 22:15 Perioral Concerns Assessment 27:35 Teeth Bite Asymmetry Factors 35:40 Instagram Photos And Context 40:30 Who Not To Treat 43:30 Dissolving Policy 45:50 Consultation Red Flags 49:05 Assessment Framework 50:50 Technique Name Change 51:55 Julie Method 55:20 Product Selection Guide 59:50 Steven Cubicle Approach 01:07:40 Russian Lips Debate 01:13:50 Dissolving Aftermath 01:16:40 Hyaluronidase Methods 01:18:45 Ultrasound in Practice 01:21:25 Occlusion Risk Talk 01:27:00 Ultrasound Reality Check 01:28:05 When Lips Need Surgery 01:30:35 Philtral Columns Debate 01:33:05 Gummy Smiles and Lip Flips 01:37:40 Lip Photos and Gloss 01:40:45 Accordion Lines Strategy 01:44:20 Listener Q and A Rapid Fire 01:51:55 Migration and Overfilling Risks 01:54:55 Teaching Plans and Wrap Up

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Ep 166 Why Do Patients Have Injectables & How Do They Choose Their Injector? | Dr Cara McDonald Apr 14, 2022

Show notes

Episode 166 hosts Dr Cara Mcdonald (Dermatologist based in Melbourne, Australia)

Cara is a leading dermatologist who specialises in managing skin cancer, rosacea, acne & cosmetic injectables. She's an international speaker for Allergan Aesthetics and an ambassador for La Roche Posay.

Over the last four years, she's conducted a survey on injectable patients that focusses on an very important question - why do patients like their injector and what drives their decision to stay with them or not?

00:00 Introduction 01:03 Dr Cara McDonald 04:55 Why Study the Patient Experience in Aesthetics 10:59 Designing the Survey and Research Process 18:27 What Drives Patient Satisfaction With Injectables 26:25 Trust Versus Results in Patient Loyalty 33:29 Functional Versus Technical Quality Explained 41:37 Building Rapport Through Communication and Time 48:53 Why Cost Is Not the Main Decision Factor 52:09 Recognizing Red Flag Patients and Expectations 61:45 Understanding Body Image and Self Perception 68:49 Managing Perfectionism and Unrealistic Goals 76:38 How to Say No and Protect Patient Outcomes 80:09 Consultation Framework for Safer Decision Making 86:34 Long Term Relationships and Patient Retention 90:43 Final Thoughts on Trust and Patient Experience

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Ep 165 The Injector Diaries (Chapter 6) | Anusha Dahan Apr 07, 2022

Show notes

Episode 165 hosts Anusha Dahan (Nurse practitioner based in Los Angeles, USA) Anusha joins us in the 6th Chapter of our mini-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'll showcase every level 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 businesses and aim to learn from and inspire our injector listeners.

00:00 Introduction 01:03 Meet Anusha Dahan 04:55 Discovering Botox and Early Injecting Days 10:59 Learning Aesthetics Without Formal Training 18:27 Building a Clinic From Scratch 26:25 Marketing the Early Practice and Finding Patients 33:29 Transition From Anti Aging to Beautification 41:37 Consultation Skills and Facial Assessment Approach 48:53 Staging Treatments Over Multiple Visits 52:09 Pricing Strategy and Attracting the Right Patients 61:45 Saying No to Patients and Setting Boundaries 68:49 Handling Complaints and Online Reviews 76:38 Social Media, Branding and Patient Selection 80:09 Staffing, Delegation and Workflow Systems 86:34 Finding the Ideal Schedule and Work Life Balance 90:43 Final Lessons for Long Term Success in Aesthetics

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Ep 164 Disasters & Solutions (Chapter 1) - Unregulated Botulinum Toxin Complications | Dr Cormac Convery Mar 31, 2022

Show notes

Episode 164 hosts Dr Cormac Convery (GP & Cosmetic Physician based in Ayrshire, Scotland)

In this new mini-series called 'Disasters & Solutions', we'll be looking at some of the unusual, difficult or outright disasterous outcomes for patients caused by injectables.

We'll speak to the injectors who managed a difficult 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 1, we discuss a case concerning a patient who was treated and injured by a non-medical injector with a likely imported and unregulated botulinum toxin. As the story unfolds, we learn she was one of at least nine similarly injured patients by the same injector.

00:00 Introduction 01:03 Meet Dr Cormac Convery 04:55 Founding CMAC and the Role of Complication Networks 10:59 Why Prevention Matters as Much as Treatment 18:27 Case Introduction Severe Reaction After Toxin Injection 26:25 When Multiple Patients Present With the Same Problem 33:29 Suspected Counterfeit or Unregulated Products 41:37 Why Testing and Biopsy Are Critical for Diagnosis 48:53 Understanding Granulomas and Foreign Body Reactions 52:09 Treatment Strategy Using Intralesional Steroids 61:45 Managing Patient Anxiety During Long Recovery 68:49 Restoring Contour With Laser and Filler 76:38 Who Pays for Complication Care and Legal Risks 80:09 The Problem With Unregulated Injectors 86:34 Why Complications Often Go Unreported 90:43 Lessons for Safer Practice and Patient Protection

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Ep 163 Compliance & Regulations in Injectable Clinics | Dr Jake Sloane & David Segal Mar 24, 2022

Show notes

Episode 163 showcases our hosts Dr Jake Sloane & David Segal

On the back of our discussion with Jahan Kalantar (episode 160), we look at the numerous compliance issues within injectable clinics from an injector and business owners perspective. We discuss:

- The background to why compliance and regulations in Australia are so topical

- Who makes the rules

- Clinical notes for injectors

- Stock checks and receiving stock in clinic

- What to do when stock goes missing or is damaged

- Drug storage and fridge requirements

- The role of clinical audits in injectable clinic

- Room cleanliness

- The dynamic of sharing rooms between multiple injectors

- The problem with compounded drugs

- The issue with friends and family in the injecting room

- The role of 'Secret Shoppers'

00:00 Introduction 04:55 Why Regulation in Aesthetics Is Increasing 10:59 Understanding Your Legal and Professional Responsibilities 18:27 Common Compliance Risks in Everyday Practice 26:25 Importance of Accurate Clinical Notes and Documentation 33:29 When Audits Happen and What Inspectors Look For 41:37 Managing Stock, Drug Books and Inventory Control 48:53 Safe Storage, Fridge Monitoring and Expiry Checks 52:09 Handling Adverse Events and Patient Complaints 61:45 Why Clear Protocols Protect Clinics and Staff 68:49 Training Teams and Setting Operational Standards 76:38 Preventing Errors With Communication and Systems 80:09 Lessons From Real Clinic Incidents and Mistakes 86:34 Building a Culture of Safety and Accountability 90:43 Key Takeaways for Running a Compliant Clinic

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Ep 162 Dissolving Fillers & Hyaluronidase | Gillian Murray Mar 17, 2022

Show notes

Episode 162 hosts Gillian Murray (Prescribing pharmacist, clinical researcher and pharmacist injector based in London, UK)

Gillian has over 16 years experience working within the National Health Service and is the directorate pharmacist. In this role she consults on pharmacy education strategies at a local as well as national level. She is a senior lecturer in clinical pharmacokinetics at Kings College University.

Passionate about using medicines safely, Gillian set up 'Medicine in Aesthetics' to support aesthetic practitioners. She is also the Secretary for Complication in Medical Aesthetics Collaborative (CMAC). Gillian has a particular interest in hypersensitivity reactions, filler gel chemistry, rheology and is currently undertaking post-graduate research in this field.

We explore:

How we came across Gillian's work
Her background as a pharmacist and what a prescribing pharmacist is
The dynamic of being a pharmacist injector in the UK
What hyaluronic acid is and what it looks like structurally
What the difference between natural and filler hyaluronic acid is
What crosslinking is and what BDDE is
The circumstances where we need to dissolve HA
What hyaluronidase is
How hyalase differs from hylanex
On label uses of hyaluronidase vs off label uses
The history of using hyalonidase to dissolve fillers
What the incidence of allergic reactions is when using hyaluronidase
Whether we should do patch testing with hyaluronidase or not
Protocols for using hyalase - both emergency and elective
The concept of 'dissolving clinics' and patients requesting their fillers to be removed
The use of ultrasound guided hyaluronidase injections - is it the gold standard?

00:00 Introduction 01:03 Meet Gillian Murray 04:55 Role of CMAC and Managing Complications 10:59 What Hyaluronidase Is and How It Works 18:27 When and Why We Use Filler Dissolving 26:25 History of Hyaluronidase in Medicine 33:29 Different Brands and Purity of Hyaluronidase 41:37 Emergency Protocols for Vascular Occlusion 48:53 Pain, Swelling and Patient Reactions Explained 52:09 Allergy Risk, Bee Stings and Skin Testing Debate 61:45 Does Hyaluronidase Affect Natural Tissue 68:49 Risks of Overusing Dissolving Treatments 76:38 Elective Dissolving and Patient Expectations 80:09 Why Good Injecting Reduces the Need to Dissolve 86:34 Common Complications Seen in Practice 90:43 Final Safety Lessons for Responsible Use

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Ep 161 The Injector Diaries (Chapter 5) | Lori Robertson Mar 10, 2022

Show notes

Episode 161 hosts Lori Robertson (Family nurse practitioner based in California, USA)

Lori joins us in the 5th Chapter of our mini-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'll showcase every level 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 businesses and aim to learn from and inspire our injector listeners.

00:00 Introduction 01:03 Meet Lori Robertson 04:55 From ICU Nursing to Aesthetic Medicine 10:59 Discovering Aesthetics and Early Training Challenges 18:27 Why Continuous Education Matters in Injecting 26:25 Becoming a Trainer and Teaching Safe Techniques 33:29 The Problem With Short Courses and Limited Experience 41:37 Building a Comprehensive Training Program 48:53 Hands On Mentorship and Time on Tissue 52:09 When New Injectors Are Ready to Practice 61:45 The Importance of Patient Selection and Ethics 68:49 Managing Expectations and Avoiding Overtreatment 76:38 Why Saying No Builds Trust and Reputation 80:09 Balancing Business Growth With Patient Safety 86:34 Mentorship, Community and Ongoing Learning 90:43 Final Advice for Safe and Sustainable Practice

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Ep 160 Medicolegal Issues for Injectors from a Criminal Lawyer's Perspective | Jahan Kalantar Mar 03, 2022

Show notes

Episode 160 hosts Jahan Kalantar (Criminal Lawyer based in Sydney, Australia)

Jahan also has an incredibly popular TikTok account where he provides entertaining and concise explanations about legal concepts.

Having discussed some of the legal principles that injectors need to be aware of in previous episodes (episodes 51, 66 & 114), we now explore things from a prosecuting solicitor's perspective.

Disclaimer: The information in this podcast is general in nature should not be taken as legal advice. Governing laws between countries, states and cities can vary greatly. You should seek your own independent advice before making decisions of a legal nature.

We explore:

- Jahan's career to date and how he became interested in the law of cosmetic medicine

- Why he changed from working as a barrister to working as a solicitor

- The reasons why patients usually sue cosmetic practitioners

- What constitutes a 'bad' outcome?

- Why poor communication is usually at the root of medicolegal complaints

- What exactly happen and what the main steps when a patient sues

- What exactly is 'informed consent' from a legal perspective?

- Consent forms and how to use them properly

- How and why can patients can still successfully take legal action, despite signing these forms which communicate the possible risks/complications associated with both surgical and non-surgical treatments?

- The crucial importance of excellent note taking and the perils of not doing them at the time of the treatments

- Why you should take clinical photography seriously

- The legal implications of registered nurses using remote prescribing doctors

- Terminating difficult consultations before they become a bigger problem

- Responsible and professional behavior - how solicitors can use your social media to build a case against you

00:00 Introduction 01:03 Meet Jahan Kalantar 04:55 Understanding Medical Negligence and Litigation 10:59 Why Patients Decide to Sue Practitioners 18:27 Communication Breakdowns and Expectation Management 26:25 Real Case Example Poor Outcome and Escalation 33:29 The Importance of Professional Boundaries With Patients 41:37 Responding to Complaints and Handling Conflict Early 48:53 Saying Sorry Without Admitting Legal Liability 52:09 The Legal Process From Complaint to Settlement 61:45 Why Detailed Clinical Notes Are Critical Protection 68:49 Documentation Mistakes That Create Legal Risk 76:38 Photography, Consent and Medical Records Standards 80:09 Identifying High Risk Patients and Red Flags 86:34 Protecting Your Practice With Systems and Protocols 90:43 Final Advice for Reducing Legal Risk in Aesthetics

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Ep 159 Laser Hair Removal & the Soprano Titanium Device | Sia Hendry & Tiarnna Smith Feb 24, 2022

Show notes

Episode 159 hosts Sia Hendry (Skin & laser therapist) & Tiarnna Smith (Clinical Application Specialist for Alma Lasers) from Sydney, Australia

Sia has been at the forefront of skin and laser treatments in Australia for over 15 years and is the owner of 'You by Sia' in Bondi Junction. Sia was one of the first clinics in Australia to offer laser hair removal and has seen first hand how the technology has changed over time.

Tiarnna's background is in medical engineering and she is one of Alma's clinical specialists. In this role she supports Alma's customers in all aspects of training and education when using their devices.

In this episode we focus on laser hair removal - the most popular cosmetic treatment performed in Australia today. We first reflect on how this came to be and contrast it to other countries where laser hair removal is often less available and far less affordable.

We then compare and contrast older laser hair removal technology with Alma's newest device the 'Soprano Titanium'.

We cover:

How laser hair removal actually works?
We re-cap on the basic physics of lasers & wavelengths including 755nm, 810nm & 1064nm
Sia's early experience with older laser hair removal technology and the disadvantages it had
Why older technology created significant pain and how the Soprano Titanium has improved on this
How painful treatments can lead to poorer compliance (particularly in the male demographic) and a less efficient business model
The use of separate skin cooling devices in traditional laser hair removal vs how the Soprano Titanium cools the skin from within the handpiece
Why regardless of the laser used, you will always need multiple treatments to achieve permanent hair reduction
Reducing the risk of serious adverse events when using laser hair removal devices - how automated settings have reduced human error
Treating skin of colour – how the Soprano Titanium device has solved one of the most significant limitations of older laser hair removal technology
Whether we can also treat patients with fake tan or sun tanned skin with the Soprano Titanium?
Hair colour limitations - can we now treat blond and red hair?
Medications - what patients need to tell their therapist before having laser hair removal
How upgrading technology has improved Sia's business, revenue and staff satisfaction
Alma's services including supporting clinics to trade in their older laser hair removal device

00:00 Introduction 01:04 Meet our Guests: Sia Hendry & Tiarnna Smith 04:55 Early Challenges in Laser Hair Removal 10:59 How Laser Hair Removal Technology Has Evolved 18:27 Safety Risks and Common Treatment Complications 26:25 How New Technology Improves Comfort and Efficiency 33:29 Understanding Pain Reduction and Cooling Systems 41:37 Treating Tanned and Darker Skin Types Safely 48:53 Blonde, Red and Difficult Hair Types Explained 52:09 Managing Contraindications and Patient Selection 61:45 Permanent Hair Reduction and Maintenance Treatments 68:49 Training Staff and Adopting New Technology 76:38 Business Benefits Faster Treatments and Higher Capacity 80:09 Cost Savings Without Consumables and Maintenance 86:34 Adverse Events, Safety Protocols and Risk Reduction 90:43 Final Advice for Clinics Considering New Devices

This episode was brought to you in partnership with Alma Lasers

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Ep 158 The Tox Talks (Chapter 1): Xeomin & Boucouture | Dr Niamh Corduff Feb 17, 2022

Show notes

Episode 158 hosts Dr Niamh Corduff (Plastic Surgeon & Merz KOL based in Geelong, Australia)

In this new 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 1 we focus on the brand known as Xeomin or Boucouture (Incobotulinum toxin A) distributed by Merz Aesthetics.

00:00 Introduction 01:03 Meet Dr Niamh Corduff 04:55 Early Adoption of Toxin in Clinical Practice 10:59 Why Non Surgical Treatments Expanded So Quickly 18:27 Learning Injection Technique Beyond Textbook Anatomy 26:25 The Art Versus Science of Aesthetic Injecting 33:29 Training Challenges and the Need for Better Standards 41:37 Understanding Different Toxin Brands and Manufacturing 48:53 Technique Adjustments Between Products 52:09 Precision, Spread and Injection Strategy 61:45 Longevity, Dosing and Patient Expectations 68:49 Risk of Resistance With Long Term High Dose Use 76:38 Storage, Stability and Practical Clinic Considerations 80:09 Choosing the Right Product for the Right Patient 86:34 Key Lessons for Safe and Effective Toxin Practice

This is a non-sponsored episode and does not replace training in any way. Our guest speaks from her own experiences and we do not promote or endorse any brand of product.

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