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See our latest articles in Aesthetics Journal

Our Clinical Director Adrian Richards recently joined the editorial board of Aesthetics Journal, the specialist monthly publication for medical aesthetics professionals.

As part of his work with the magazine, he’ll regularly be contributing expert articles on a variety of subjects. If you don’t subscribe to the magazine, or didn’t catch the latest couple of issues, you can read Adrian’s latest contributions here.

In this article, Adrian offers advice on the most appropriate treatments for each area of the face, based on what your patients are looking to achieve. He covers each area of the face in turn, from the forehead down to the neck, giving his thoughts on whether surgical or non-surgical treatments would produce the best aesthetic results. Click on the link above to read the full article.

Adrian wrote this article in collaboration with Cosmetic Courses trainer and Aurora Skin Clinics Clinical Lead Mel Recchia. They discuss two recent cases treated at Aurora. Both female patients had received dermal fillers to the upper face region at other clinics, and experienced significant late-onset peri-orbital swelling some time afterwards. Both were successfully treated with Hyaluronidase. The article looks at both the causes of Hyaluronic Acid dermal filler associated peri-orbital swelling, and its management. Click on the link above to read the full article.

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Are you a medical professional considering a move into the aesthetics industry? Or do you already have an aesthetic practice and would like to broaden your repertoire of treatments?

Cosmetic Courses offer a wide range of medical aesthetic training courses to help equip you with all the skills you need to build a successful aesthetic business. As the industry develops and new treatments become available, we are regularly adding new training courses to our programme.

Our newly launched Cosmetic Courses website includes plenty of support to help you carve out your new career, from podcasts and videos to downloadable materials and a jobs board.

For more information on any of our aesthetic training courses, our trainers or our training venues, please contact the team on 01844 390110 or email [email protected].

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Q&A: Using Hyaluronidase to Dissolve Dermal Filler

Question :

Dear Cosmetic Courses,

I have a patient with the following Dermal Fillers query and wondered whether you could advise? At the beginning of December, she had Juvederm Dermal Filler injected into an area under her cheekbone. Initially the region was tender and sore. After about a week the pain increased and her face became swollen on one side with a round hard solid lump in this area.

She went away on holiday shortly after and, whilst away, phoned her GP who advised her to take antibiotics. She has since been on a seven day course of amoxyllin and a five day course of augmentin 625mg. On returning she visited the same GP who advised her to see a specialist as he was not sure if an abscess had formed or a haematoma .

I have now examined the area, however, and feel that this is not an abscess as it is a hard mass and therefore, could maybe be a haematoma, or the filler with an infection around it?  Her own GP back home seems to agree as he has taken her off the augmentin and put her on a course of cefuroxime 250mg.

Do you think Hyaluronidase might dissolve the filler and how long after the infection has healed can this be done (providing that the lump is the filler! )

Answer :

Unfortunately, it does sound as though your patient has an infection in her cheek area which the GP was right to treat with antibiotics.

When the infection has settled down it may be possible to treat her with Hyalase but this is certainly not recommended whilst infection is still prevailant.

We may be able to provide further advice and information if you send a photograph of her to: [email protected]

Should there be further problems, our expert surgical team at Aurora Clinics would be happy to see her for a free consultation.

Best Wishes,

The Cosmetic Courses Team

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Temporary Dermal Fillers

As a person ages, the skin of the cheeks and lower portion of the face loses it’s elasticity. Wrinkles begin to form, and the lips lose their volume. Lips and skin can regain that volume by injecting dermal fillers. Dermal fillers are components that are injected directly into the skin to address these ageing issues. There are several types of dermal fillers. Some are comprised of human or animal tissue, while others are made of a synthetic material. Dermal fillers can either be temporary, permanent, or semi-permanent.

Depending on the situation, one dermal filler might be better than another. Temporary hyaluronic acid fillers are the most popular variety of dermal fillers. This type has been proven to be safe and efficient. The skin naturally contains hyaluronic acid, but in a matter of days it’s broken down by the body and is replaced. Temporary hyaluronic acid fillers are made so these particular molecules are better balanced in order to slow down the rate that they break down. The results of using a temporary hyaluronic acid filler can last anywhere from a couple of months to up to two years, depending on how the filler is applied. There’s no need to worry about improper placement of the product or lumpiness. A component called hyaluronidase is able to dissolve the temporary hyaluronic acid filler.

In Australia, a few brands of this type of dermal filler are Restylane, Jevederm, and Esthelis. These products come in various sized syringes. While some products merge with surrounding tissue when they’re injected, others will stay exactly where they’re placed. Because of this, certain products will work better on one spot of the face than they will on another spot.

The product Esthelis, for example, is soft and is able to be injected near the surface of the skin to clear up superficial wrinkles. Products that are thicker can cause over-correction or lumpiness. A thicker product like Jevederm Ultra Plus is useful in treating nasolabial lines as well as the marionette area of the face. Cheek augmentations can be achieved through using Juvederm Voluma, which is an even thicker substance than Juvederm Ultra Plus. Products that are thicker have a tendency to last longer than those that aren’t as thick.

As a person ages, it’s normal to change dermal filler products to best suit the needs of the patient. It’s always best to consult a doctor before using any type of filler product.

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Collagen, Hyaluronic Acid and Elastin

When fine lines develop around the forehead, crow’s feet around the eyes and wrinkles around the mouth, it is a sign of aging that is more obvious than a change in hair colour and density or a change in body posture.

Skin, consisting of bonded layers, begins to sag and become lumpy as a person ages. What is basically happening is that the skin loses its elasticity. This is usually a result of a depletion of three proteins common in skin: collagen, elastin, and hyaluronic acid.

Collagen is a fibrous protein found in skin, bone, cartilage, muscles, and tendons. It works to connect body tissue. It makes up 25 percent of the protein in the human body, and it is even found in teeth. Like a glue, it holds the tissues of the body together, including the layers of the skin.

Elastin is a protein that pulls back the skin when it is stretched. In addition to keeping the skin elastic and flexible, it keeps the skin smooth. This is why your mouth returns back to its normal shape after using the muscles of your face when talking.

The third essential protein for a youthful, healthy skin is hyaluronic acid. The more of this protein that is lost, the more aged a person begins to look. Fortunately, apart from cosmetics, it is also possible to take nutritional supplements to restore levels of hyaluronic acid. Moisture is lost because of lower amounts of hyaluronic acid. Diets rich in kelp, seaweed, and fish help maintain hyaluronic acid. People with Mediterranean or Asian diets appear to age slower with “plumper skin” than those people who live in cultures where refined foods filled with additives have become the norm. In cultures with poor diets, an enzyme called hyaluronidase begins to work against hyaluronic acid. Part of the process of restoring hyaluronic acid is to reduce the hyaluronidase enzyme.

Depletion of these three skin proteins is exacerbated by indulging in poor health habits like smoking, drinking alcohol, not drinking enough water, not eating nutritious food, not exercising, and getting an excessive sunburn. While taking care of your health by reversing all these conditions will go a long way to restoring your youthful appearance, you can also get relatively quick results by using lotions that provide the skin with what it needs to maintain its elasticity. Most anti-aging skin care programs work on restoring collagen, elastin, and hyaluronic acid.

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