Successfully embracing 40!

Let me tell you a story some 40ish years in the making.

This is the speech I recently gave at my 40th.

525459_4447412675705_1758526451_n 61577_10151369931132322_586094424_n

Some 46ish years ago a man met a woman in rather unusual circumstances. You see Kevin McLennan was a nurse with a talent for baking, and Patricia Wilde was a nurse with a working kitchen. Kevin liked to bake sponges, cakes, biscuits and all sorts of goodies that had lashings of cream and butter for his patients. As the story goes – apparently Patricia liked this talent in a man and together they began a romance over food and the passion for helping others in times of need.

On April 5, 1968 they were wed and soon after relocated from Sydney back to Kevin’s family area – a small remote village in the hinterland outside of Grafton – the village of Nymboida, with it’s rolling hills and fast running waters and quaint village and rural community – the perfect area to start a family.

Alas – despite wanting 8 children they were unable to have children of their own (despite trying over and over again – yes trust me throughout the years it has been somewhat awkward LOL) and so they began the process of adoption.

On April 12 1973 they received a phone call advising them that a baby boy had been born and was indeed to be theirs. So I – Scott Keith McLennan was born and now in a family.

But our family was by no means complete – on Sept 21, 1976 we received a call advising us that a beautiful baby girl would be completing our family. Erin was delivered not by a stork but by east west airlines and we collected her during the jacaranda festival – so to me Erin became my little jacaranda – my little flower. Someone for me to watch over, care for, mentor, and to love.

It is often said that families are born that families are of flesh and blood.

I wholeheartedly disagree with this. A family can definitely be gifted and can definitely be chosen. And for that I am exceptionally grateful.

It is from that foundation of love security and that families are what you make of them – which my life propelled forward… A sentiment that has me now surrounded by various families and various people who makeup my extended family – each of you and those that could not join us tonight. A motley crew – but isn’t that what families are….

My life thus far has been indeed a tapestry of wonder & colour, excitement & intrigue, fun & mystery. And one that I am exceptionally grateful to be experiencing –

And the through the wonder of social media so are all of you. Albeit a little edited from time to time.

School was interesting – starting with the smallest school 8 kids in 7 grades right up to the largest some 1300 boys in 6 grades. Nymboida Public, Coutts Crossing, St Aloysius, Parramatta Marist and Mt Maria Senior – my schools – each with their own challenges, and with their many stories. Yes I was bullied and picked on – and sometimes it was really bad. I got into trouble for laughing or challenging teachers about their skills. I lost, I won, I participated, and I survived.

Higher education saw me study at The Australian Catholic University and Sydney Uni and more recently Monash.

As an adult I have always worked in healthcare – helping others, being their, looking after my flock (its an Aries thing). From the multitude of specialties I have worked in – ICU, ED, Education, Home Care, Recruitment, right unto the last 15 years where Skin, wound care and Dermatology & Aesthetics have been where I found home. Whether it is with patients, or running a business on a global level, to helping smaller businesses to be successful – I am love it – and like to think I am making a difference.

Some of my highlights – Army, Healthcare, Allergan & Botox, Sanofi & Sculptra, and my most recent – The Rose & Face Forward in Perth.

It is not always about work (although many would disagree), work is a way of life – it is never just a job. But outside of work – One of my other passions is singing – and I have had the honor and privilege of singing with SLAGS the Sydney Philharmonia and of course door in the wall. And I have to say wow – I loved every minute – and look forward to reinvigorating that passion soon.

Another significant passion is of course you – my friends and indeed my family.

To the man I lived with for 12 years – thank you.

To all my friends from the various portions of my life – thank you

To the family – we are indeed a motley crew – thank you

And of course to my foundation – Mum, Dad and Erin and her family – thank you.

Don’t have regrets, don’t live your life wondering – with would’ve should’ve could’ve’s – live your life to the fullest.

It has been said –

  • Dance like no one is watching
  • Sing like no one is listening
  • Laugh like no one cares
  • And Love like it doesn’t hurt

But trust me it is so much better to do it all with my family and friends and in front of an audience.

And thank you for being you!

S

Sunscreen – Some myths explained!

Img_1061

 

So we are now in the height of summer and this is the when you are more likely to be applying sunscreen (you should be applying it all year round – but hey!), I thought I might just take a moment and chat about sunscreen and some of the myths surrounding them.

In todays information overload world there is a lot of information about, some slightly more truthful than others, and some more marketing than truth. So here are some of the common myths – explained.

Myth #1: Dark skin doesn’t burn, so they don’t need sunscreen.

Simply – all complexions can burn; Caucasian skin just shows it more quickly than people of colour!

Myth #2: The higher the SPF, the better the sunscreen.

In the US and in Europe some sunscreens claim up to 100+ SPF, in Australia you cannot claim anything above 30+ SPF. So you may believe that the Australians are cheating – actually the science behind the rating scales is just simplified in Australia. The ratio of sun protection above 30 is not directly related to the number. I.e.: SPF 15 gives you approximately 93% sun protection and SPF 30 gives you around 97% sun protection. SPF 100 cannot physically give you more than 100% protection.

Myth #3: A thin layer of sunscreen is all I need.

The more sunscreen you apply the better. Generally we only apply around 20% of the actual amount we need.

Myth #4: If I apply lots of sunscreen in the morning it will last all day!

Applying sunscreen frequently throughout the day allows the sunscreen to remain constantly active. Sunscreen wears off. This can be caused by sweat, water, evaporation, and absorption. So re-apply every 2-4 hrs.

Myth #5:  On cloudy days I don’t need sunscreen.

Unfortunately UVA rays (the sun’s ultraviolet rays) can pass through clouds and reflect off a multitude of surfaces (cars, water, buildings, snow, windows, concrete) onto our skin. This will still cause damage, and yes you can still burn.

Myth #6: I don’t go outside – I don’t need sunscreen.

You maybe surprised just how often we experience exposure to UV rays when we don’t go outside: Driving, hanging the washing, watering the plants etc. we also experience UV ray exposure from laptops, TV’s, fluorescent lights etc. So please just wear sunscreen.

Myth #7: I only use sunscreen in summer – so it should last.

Sunscreens have a life of around 2-3 years depending on the manufacturer, and how you store the products. Unfortunately they also start to loose their effectiveness over time once they are opened (oxidation, evaporation, extreme temperatures etc.). Always check the expiration date, or the date of manufacture and don’t use anything that is older than 2 years. It just won’t work.

So when it comes to skin protection and sun protection – get the maximum benefit from your investment – and look after yourself when having fun in the sun:

 Know your sunscreen is a broad spectrum (UVA and UVB),

Use SPF 30+ every 2-4 hours

Use sunscreen every day – even in-doors.

Check the expiry date of your sunscreen.

 

 

Scott

 

Treating skin of colour

Skin-colors-711079-sw

Recently, the National Geographic concluded in its Population 7 Billion series on the human race that the most common person today is a 28 yr. old male Han Chinese Man of which there are 900 million. Over the next 20 years the most typical person will probably reside in India, with the most common face on the planet being of Indian descent.

In multi-cutural countries where a mix of skin types are abundant, understanding skin of colour, pigmented skin and racial prototypically will be essential in all aesthetic clinics; especially if we are providing a comprehensive service to all our patients and addressing their specific concerns. If you are performing procedures and treatments on skin (first and foremost) you need to focus on skincare, not injectables. People with skin of colour are more concerned with pigmentation and scaring than lines and wrinkles, unlike Caucasian patients.

When injecting people with skin of colour, the more puncture sites and larger the puncture sites the greater the risk of post-inflammatory hyperpigmentation (PIH).

A misconception amongst many is that people with skin of colour do not require sun protection. This is definitely not true, and it is now being suggested that people with skin of colour may be more affected not by UVA and UVB light, but by simple plain light. With a recent study showing that pigmentation can occur in people with skin of colour with plain in-office light.

There are many causes of pigmentation or staining on skin and these need to be thoroughly investigated before initiating any form of treatment, along with appropriately counseling and working with the person to ensure compliance and risk minimization.

Some of the things that can cause pigmentation include:

  • Sunlight – direct and indirect
  • Light
  • Jewelry
  • Flowers
  • Henna
  •  Watches / Bangles
  •  Vascular disease
  • Dermatitis
  • Pregnancy
  • Permanent and Temporary tattoos
  • Some make-up and hair dye

 Some of the treatments available for pigmentation include:

  • Chemical Peels
  • Light based therapies – IPL, Laser
  • Topical treatments (hydroquinone, Vitamin K, Vitamin A, Retinols)
  • Home made remedies: Garlic Juice, Lemon Juice
  • Bleaching agents
  • Over the counter topical whitening products

Chemical peels can be used in people with skin of colour, however the deeper and stronger the peel the greater risk of PIH. So it is advised to take things slowly, carefully and considerately. Mind you that should be the mantra when appraching skin of colour with any of the above modailities.

As we move forward in understanding skin of colour, and its idiosyncratic behavior, working with patients to understand, prevent and treat pigmentation will become an increasing service that clinicians’ will need to grapple with in their practices moving forward.

Treating pigmentation and skin issues in people with skin of colour, like all things it is recommended to treat cautiously and conservatively, and ALWAYS start with SUNSCREEN!

 

 

Scott McLennan
Independent Consultant, Aesthetic Dermatology

+61 401120290
scott.mclennan@me.com


 

Cosmeceuticals – combining science and beauty

Photo

Consumers spend billions of dollars every year on creams, lotions and potions trying to address their concerns about ageing or their skin needs or issues. There is indeed a plethora of opinions, marketing dollars, rumours and old-wives-tales to certainly confuse the most thorough of researchers, however what about the majority of us. I find that people (patients, family and friends and the odd random person who asks me my opinion) just want simple, effective skin care that actually works, doesn’t have 1000 steps, and doesn’t cost their first born. So here are some of my thoughts and opinions about the effectiveness of cosmeceutical ingredients and the importance of product testing.

Lets get some simple facts straight first. Cosmeceuticals and beauty creams, lotions and potions are NOT subject to approval by government authorities (Med Safe, TGA, FDA etc.). The government regulatory agencies require vigorous testing and scientifically proven results for all their approved products.  This essentially means that beauty creams should not claim that they have a therapeutic effect that is similar to those or better than those of prescriptive medicines.  Beauty creams and their ingredients are not as powerful, or as effective as prescriptive medicines – or rather their claims cannot suggest that they are. Often you find beauty creams and their benefits are often not adequately tested nor are their ingredients tested – individually or collectively. Sometimes claims may be greatly exaggerated or deliberately suggestive to confuse the purchaser. 

The difference between Cosmeceuticals and beauty creams, are that generally Cosmeceuticals are products that have active ingredients, and whilst they may not have been approved by the government agencies, they are often thoroughly tested and clinically proven. Most often you will find these products are educated and sold within medical clinics because they are stronger than beauty creams, and their results can be tailored to suit individual patients needs, by clinical staff. Beauty creams that are sold over the counter are generally not active and can be sold without supervision.

Cosmeceuticals are divided into categories based on their active ingredients:

  • Antioxidants
    • These help in reducing the harmful effects of free radicals.
    • Free radicals are molecules that damage our skin’s normal cells, leading to inflammation, increased sun damage and exposure, and have been linked to the development of skin cancers
  • Peptides
    • Small proteins that stimulate the production of collagen and naturally thicken the skin.
  • Growth factors
    • These are compounds that help with new cell and blood vessel growth, stimulating collagen and elastin fibers and help with the generation of newer healthier skin.
  • The new trend in aesthetic dermatology and in using anti-ageing topical products is combination products. Essentially this is where we just put several active ingredients together in one tube/pot to help with convenience and reported efficacy. Some combination products can have; multiple vitamins, multiple antioxidants, retinol plus anti-oxidants, growth factors plus vitamin C, and other unique combinations.
  • Please note: Whilst many of these active ingredients are thoroughly tested and well documented in many scientific journals – many of the combination products aren’t – especially how they interact together. Understanding the differing effects of products when combined is still unknown and often only theorised.

Natural v’s Organic v’s Other’s

Every now and then everyone only wants Natural or Organic products, because what is natural is better for you. This is often a myth and there is no reputable scientific evidence to support this claim. It is a well-known fact that natural or organic skin care products are far less tested and measured than synthetic products and definitely far less than any pharmaceutical product.

Most naturally occurring ingredients and compounds used in skin care today need to be chemically altered. This is for texture, stability, usability, and smell to name a few reasons. As soon as a compound or ingredient has been chemically altered – they are no longer a “natural” product. Enhanced natural ingredients (chemically altered) tend to be more stable, penetrate better and have more long-lasting effects on the skin than true natural plant extracts. So beware the “natural”, it may not be that “natural”.

The best way of understanding the effectiveness of your cosmeceutical product is to understand the testing process and what, if any, testing your products have gone through.

  • Active ingredients are evaluated using a specific form of testing which is used to label the biologic activity and determine if the ingredient is an antioxidant or is anti-inflammatory.
  • Clinicians confirm a products’ efficacy and its ability by reviewing any clinical trials that have been undertaken. The best clinical trial scenario is the double blind, randomised multi-centre clinical trial.
  • Cosmetic companies have been known to test their products on their employees or friends & family using open-label evaluations. 9 out of 10 people agree that this product is the best etc
  • Aesthetic Specialists can often recommend active skin care products that have strong science behind them and have been proven safe and effective in human studies.

My top tips when purchasing your topical potion think of these:

  • What does the product claim to do? What studies have been performed on this product? How were the studies conducted?
  • If it sounds too good to be true, then it probably is.
  • Stick with products and brands that you know to be reputable. Well-known manufacturers have more money behind their active ingredients and product testing. They also have more money behind their marketing teams.
  • Everyone only ever publishes their best results – so just be careful when looking on websites many are biased even if they say they are objective.
  • During the day ALWAYS wear sunscreen and consider using products that contain antioxidants because they have sun-protection properties.
  •  At night, use products that contain retinoids, peptides, or growth factors for their repair properties. Nighttime is the best time to allow your skin time to recover and heal.

Top tips for using your topical solutions:

  • Simple is always best. The less steps and the less confusing the more you will actually use it.
  • Use a very good cleanser – lactic acid or glycolic acid cleanser. NOT SOAP!
  • Use your retinol at night. 
  • Always use a sunscreen during the day.
  • Use your vitamin C, B during the day.


Be open and honest with your clinician about your concerns with your skin, and they should be able to help you use a Simple, Effective and Efficient skin care regime that works!


 

Scott McLennan
Independent Consultant, Aesthetic Dermatology
Owner & Director – Lifestyle Aesthetics Australia

+61 401120290
scott.mclennan@me.com

Cutting through today’s aesthetic world

Img_1378

 

Honestly it can be very confusing out there today. There are literally hundereds of cosmetic procedures, treatments and solutions available to anyone and everyone, in what would seem to be anywhere. Ranging from at-home treatments and procedures, to some beauty therapy room procedures, to the more medical clinic treatments and procedures that should only should be performed or overseen by appropriately trained and experienced medical professionals.  

There are risks involved with all procedures – at home and in clinic – and often these risks are exacerbated when different combinations and different technologies are used simulataneously by the unsuspecting, inexperieenced or unaware. Here are some simple thoughts to consider when choosing what may be a good procedure for you and where to have them done. 

At-home treatments

  • Many of the at-home cosmetic treatments such as microdermabrasion kits and chemical peel solutions can be purchased over the internet or over the counter can be safe when they have been thoroughly tested for this type of self-use. 
  • Generally the concentration of the active ingredients in these products is much lower than those prescribed and used within clinics. Therefore, most at-home treatments do not produce results that are as dramatic or as long-lasting as the cosmetic procedures performed in medical aesthetic practices.
  • There still are safety concerns if these at-home treatments are used improperly or if any of the active ingredients cause an unforeseen skin reaction. That is why it is important that you consider any at-home cosmetic treatments to discuss these products with his or her clinical specialist.
    • For example, a person who is using a retinoid could be at risk for an adverse skin reaction from a chemical that is used in an at-home product that probably should not be used simultaneously.
  • There are now Do-it-yourself laser hair removal devices available and are becoming popular as an alternative to visiting a clinic to have unwanted hair permanently reduced. However, they can pose a safety concern for people who have a tan or who have darker skin.
    • The concern for people who use a home laser hair removal device or for those who opt to receive cosmetic treatments outside of an experienced medical practice, is that many factors can adversely affect the outcome of the procedure and these can have unforeseen long lasting side effects.
    • For example, the improper use of a laser hair-removal device on an individual who has darker skin or who has a tan could result in scarring or hyperpigmentation or hypopigmentation. Incidences of these are reported daily and are increasing.

 In-office cosmetic procedures 

  • There are new technologies, products, procedures and clinical applications entering the the relm cosmetic procedures that are always enhancing clinicians abilities to fine-tune treatments.
  • Advances in the use of lasers, wrinkle fillers and wrinkle relaxers, volumisers and collagen stimulators are allowing clinicians to refine and customise treatments based on each patient’s specific cosmetic needs.
    • Fractional resurfacing is one of the newer laser technologies that gives clinicians the option to safely treat patients with more extensive skin damage with less down time. The main benefits of this procedure are increased collagen production that creates more dramatic results to improve the appearance of skin texture and reduce the appearance of wrinkles and acne scars — with considerably less downtime than other invasive laser technologies.
    • Laser technologies used to treat vascular lesions — such as port-wine stains and other birthmarks — have greatly improved over the years. This has allowed more patients to benefit from treatment, especially infants, without injuring the surrounding skin.
    • A number of new injectable products have been introduced in recent years to replace lost skin texture, skin volume, deeper volume, contour and shape, and when used together can produce more natural results that are longer lasting.
  • New developments in wrinkle fillers allow clinicians to correct signs of ageing, from sunken cheeks to fine lines around the eyes and lips.
    • Botulinum toxin’s, most widely known for its ability to diminish wrinkles and other facial lines, is being used and further studied across many medical applications to help patients lead lives free of pain, inconvenience for use in an array of conditions. New manufacturers have introduced some different botulinum toxin formulations in recent years, helping to make accessability and pricing more competitive and affordable.

So when choosing your topical products, your laser/IPL/Light based therapy or your injectable products – talk to someone that understands the technologies, keeps abreast of the current trends and uses, and then work with them to work out what method may be best for you.

Be open and honest about what you are using at home, and then work with your specialist to devise a holisitic plan to address your individual needs.

Oh and beware – if it sounds too good to be true – it often is! 

 

 

Men v’s Women and Ageing

Don’t you just hate that dreaded question – how old are you? Followed closely by – well how old do you think I am.

Trust me working in Aesthetics i am always challenged with this question, because it is hard, you don’t want to say a number that is their age, and hey some people have had a little too much done, so guessing an age is really hard. Many of my contemporaries (women and men) are not as old as you think and then most are way younger than what you think due to a whole host of dermal challenges they have been indulging in.

According to an old wives tale: you can always tell a persons age by their neck and their hands. This is somewhat true because many people can’t do successful treatments for their necks and hands, but also because you always slap your goop on your face, not your neck, and your poor hands are always doing something.

A question often poised is: do man and women age differently? Is it that women are just more prone to caring about ageing than man. Do men have the same signs and sympotms of ageing than women? Is it genetics or something else? The simple answer is yes, we do age differently, but it can affect us blokes the same as women, and yes it is ok to care about your appearance and the effects of life on our skin.

So do men age different to women? The simple answer is – Yes. Albeit our skin ages less quickly, but like everything else it does age.

Generally men’s skin is different to women, our muscle tone is different, and our basic skeletal structure is different as well. Therefore – anatomically speaking we are different, and therefore we we age differently.

Our skin is thicker, tends to hold more oil than women and as a result helps us ward off or minimize the signs of early Ageing – such as small fine wrinkles. It is believed that this is because of our higher levels of testosterone than women, however it is significantly dependent on our lifestyle, our activities and of course what we do to help maintain ourselves.

Structurally speaking we do develop small signs and symptoms of Ageing similarly to that of women, but just not quite the same. Same same but different. For example: testosterone is good for our skin, but It is believed that if we have too much testosterone we tend to loose hair, and as such increase our signs of aging on our heads and necks faster, and increasing our susceptibility to pre-cancerous cells and other dermal challenges.

The fitter and healthier we are: ie all that outside running, sailing, surfing, sports, and activities in the elements, the more exposure our poor skin suffer and then the more signs and symptoms of Ageing appear.

Our facial fat diminishes also diminishes. We need fat on our faces – not around our girths, to give the face shape and contour and protection. Women tend to loose facial fat in their early 30’s as part of the natural Ageing process, men not until their 40’s.

The same can be said for our bone structure, eventually we do start to loose this as well. Women are more susceptible to bone loss than men and earlier than men, but men do suffer it as well, which reduces and changes our facial shape.

So at the end of the day, men’s skin does age, albeit differently to women, but it does age. What we out he skin through is often harsher than women, and we tend not to care or worry about our skin as much as women. But if we look after our skin (i.e.: wear sunscreen, and do a skin routine) we can always look younger and for longer, than our female contemporaries thanks in part to genetics, evolution and hey just lucky being born a bloke.

Be careful for what you wish for

Be_careful_what_you_wish_for_by_infu5ion-d3dq90u

The internet is an amazing place, where you can literally get lost for hours searching reviewing learning being grossed out or being entertain. On top of all of that you can also shop… It’s what you can shop for that should have many segments of the market a little more concerned than what is currently being portrayed… 

There is an increase on the number of people presenting into clinics across the world proudly showing products and treatments they have bought on line and demanding to have these injected or performed by their trusted local medical professionals. Now this poses several challenges for all parties concerned. 

·      For the patients:

o   you are offered really great products with amazing claims and have now bought these wonderfully cheap products on line. They look like what clinics are using (or what you have had injected previously. Their claims make them sound like the real pharmaceutical product, but can you be really sure that they are? Do they come from a qualified manufacturer that has been rigorously tested and approved, or are they brick dust? Often when these products arrive their labels often filled with spelling mistakes, or written in foreign languages how can patients know what they have bought is the real deal? 

·     For the clinicians:

 a patient has presented and demanded to have this random product injected that they are brandishing in front of you. What is it? Why have they got it in their hand? What is the product – it looks like something that is approved and used locally – but can you be sure? What if something goes wrong? Who is responsible? The product clearly hasn’t been tested or approved by the local authorities. What if I refuse? Will the patient go somewhere else? Or worse still: will they try and inject it themselves?

·     For the authorities:

purchasing counterfeit pharmaceutical products or medical devices online poses a real threat to the health and wellbeing for the citizens and public that they are trying to protect, and for those countries with nationalised healthcare systems, places an undue burden or risk upon the public funds used to support and correct adverse events from illegal products and devices. However controlling all products coming into the country is very difficult, and possibly infringes upon individuals basic right to freedom (I will leave that argument to the lawyers and activists).

·     For the companies:

Manufacturers and Distributors who take the time to develop, invest and then register their products – how are they responding? What are they doing to increase the consumer awareness about the risks? Are they allowed to educate the patient about their products (unfortunately in Australia companies are not allowed to educate the general public directly about their products – thus leaving it up to the physicians) Should they lobby harder for a full share of voice? Do they see it as part of their role and/or responsibility? 

Through my own eyes I have witnessed the number of people presenting to clinics with online purchased products and devices is increasing, and it’s not just in Asia. More and more patients are presenting in Australia, New Zealand, and Europe with these products and devices. Colleagues in the US have also stated similar occurances. So how do we respond? 

Some clinicians are taking the responsible tact of working with the patients about the products and about the regulatory system, the testing and the approval process, all designed with their safety in mind. Some patients a quite reasonable about this, but there are some that suggest that they don’t care, and are willing to take the risk. We have seen this voiced on numerous occasions, but when things did go wrong the patients all blamed the clinicians, not themselves for forcing their clinicians hand. Or worse still, when refused – do the patients attempt to inject themselves?

Some companies are now promoting directly to patients about making sure it is an approved product, with visual clue on what to look for. This works in some countries, but in Australia for example, a pharmaceutical company cannot advertise directly to the patient, so improving patient’s knowledge and understanding is left to the clinicians – which in itself is a challenge. 

There are stories coming out of India, Asia and Africa where cheaper products are sent or purchased by local health authorities or NGO’s and they either turn out to be brick dust (this was the case of HIV medications bring used in Africa shipped from China that weren’t working, it wasn’t until they were actually tested that they were proven to have nothing active in them at all); or they contain different amounts of the active ingredient thus reducing the efficacy (this was the case of an injectable product being sold as the real version, it wasn’t until closer inspection of the packaging and then formal testing showed it only had 10% of the active ingredient) – this was the case of several counterfeit products coming out of India and China being sold in the Medical Aesthetic Market space around Asia.

Unfortunately it is not only the patients purchasing these products. There are now reports of clinicians and local distributors purchasing these products and promoting them directly to the patients and clinicians as the either just like the “approved” versions or worse informing people that they are the approved versions.

So the moral of the story, pharmaceutical products and medical devices go through rigorous testing, trials and approval processes all designed with the patients’ safety and wellbeing in mind.

Risking disfigurement, permanent damage or worse, for the sake of a few dollars, or risking your reputation and livelihood for the sake of trying to make a few more dollars – is it really worth it? If it sounds too good to be true – it probably is.

    

 

Self-inflicted-enhancement


 

Be careful for what you wish for

Be_careful_what_you_wish_for_by_infu5ion-d3dq90u

The internet is an amazing place, where you can literally get lost for hours searching reviewing learning being grossed out or being entertain. On top of all of that you can also shop… It’s what you can shop for that should have many segments of the market a little more concerned than what is currently being portrayed… 

There is an increase on the number of people presenting into clinics across the world proudly showing products and treatments they have bought on line and demanding to have these injected or performed by their trusted local medical professionals. Now this poses several challenges for all parties concerned. 

·      For the patients:

o   you are offered really great products with amazing claims and have now bought these wonderfully cheap products on line. They look like what clinics are using (or what you have had injected previously. Their claims make them sound like the real pharmaceutical product, but can you be really sure that they are? Do they come from a qualified manufacturer that has been rigorously tested and approved, or are they brick dust? Often when these products arrive their labels often filled with spelling mistakes, or written in foreign languages how can patients know what they have bought is the real deal? 

·     For the clinicians:

 a patient has presented and demanded to have this random product injected that they are brandishing in front of you. What is it? Why have they got it in their hand? What is the product – it looks like something that is approved and used locally – but can you be sure? What if something goes wrong? Who is responsible? The product clearly hasn’t been tested or approved by the local authorities. What if I refuse? Will the patient go somewhere else? Or worse still: will they try and inject it themselves?

·     For the authorities:

purchasing counterfeit pharmaceutical products or medical devices online poses a real threat to the health and wellbeing for the citizens and public that they are trying to protect, and for those countries with nationalised healthcare systems, places an undue burden or risk upon the public funds used to support and correct adverse events from illegal products and devices. However controlling all products coming into the country is very difficult, and possibly infringes upon individuals basic right to freedom (I will leave that argument to the lawyers and activists).

·     For the companies:

Manufacturers and Distributors who take the time to develop, invest and then register their products – how are they responding? What are they doing to increase the consumer awareness about the risks? Are they allowed to educate the patient about their products (unfortunately in Australia companies are not allowed to educate the general public directly about their products – thus leaving it up to the physicians) Should they lobby harder for a full share of voice? Do they see it as part of their role and/or responsibility? 

Through my own eyes I have witnessed the number of people presenting to clinics with online purchased products and devices is increasing, and it’s not just in Asia. More and more patients are presenting in Australia, New Zealand, and Europe with these products and devices. Colleagues in the US have also stated similar occurances. So how do we respond? 

Some clinicians are taking the responsible tact of working with the patients about the products and about the regulatory system, the testing and the approval process, all designed with their safety in mind. Some patients a quite reasonable about this, but there are some that suggest that they don’t care, and are willing to take the risk. We have seen this voiced on numerous occasions, but when things did go wrong the patients all blamed the clinicians, not themselves for forcing their clinicians hand. Or worse still, when refused – do the patients attempt to inject themselves?

Some companies are now promoting directly to patients about making sure it is an approved product, with visual clue on what to look for. This works in some countries, but in Australia for example, a pharmaceutical company cannot advertise directly to the patient, so improving patient’s knowledge and understanding is left to the clinicians – which in itself is a challenge. 

There are stories coming out of India, Asia and Africa where cheaper products are sent or purchased by local health authorities or NGO’s and they either turn out to be brick dust (this was the case of HIV medications bring used in Africa shipped from China that weren’t working, it wasn’t until they were actually tested that they were proven to have nothing active in them at all); or they contain different amounts of the active ingredient thus reducing the efficacy (this was the case of an injectable product being sold as the real version, it wasn’t until closer inspection of the packaging and then formal testing showed it only had 10% of the active ingredient) – this was the case of several counterfeit products coming out of India and China being sold in the Medical Aesthetic Market space around Asia.

Unfortunately it is not only the patients purchasing these products. There are now reports of clinicians and local distributors purchasing these products and promoting them directly to the patients and clinicians as the either just like the “approved” versions or worse informing people that they are the approved versions.

So the moral of the story, pharmaceutical products and medical devices go through rigorous testing, trials and approval processes all designed with the patients’ safety and wellbeing in mind.

Risking disfigurement, permanent damage or worse, for the sake of a few dollars, or risking your reputation and livelihood for the sake of trying to make a few more dollars – is it really worth it? If it sounds too good to be true – it probably is.

    

 

Self-inflicted-enhancement


 

What do people really want?

Question-mark-backgrounds-wallpapers

What do people really want?

It’s a leading question definitely, but I will keep it to the aesthetic market place, and the wonderful world of anti-ageing.

Over time our understandings, our technologies, our products and our skills have changed, but the one desire to look younger, to feel better, to portray the image of who we feel on the inside on the outside hasn’t changed in centuries.

The ancients searched for the fountain of youth, ancient Greek, Roman, Aztec, Egyptians all looked for topical solutions to apply to help keep the younger… And in today’s world we aren’t very different.

The anti-Ageing market is a whopping  $60 billion dollar market where $25 billion is spent on procedures, $ 5 billion on spa treatments, $30 billion on over the counter (OTC) beauty products worldwide. There is an estimated 77,000 cosmetic injectors in the world (Plastic Surgeons, Dermatologists, Nurses, Cosmetic/Appearance medicine Physicians) and growing day by day.

Who is driving the market?

Essentially it is the baby boomer market, or rather the beauty boomer market. This group of People has the financial abilities, the knowledge sources and a definite willpower to overcome ageing…. Continuing to look young.

Google analytics states that this market is defined as the 46-65 year olds.

  • 76% are comfortable with their age
  • 52%feel younger than their actual age
  • 99% of boomer decisions are made using Google. 
  • TV is the trigger to research – so they see something on the TV and then they will research it on-line 
  • Boomers rely on search engines and manufacturers websites to provide them with the information they need about the various products/procedures. 
  • Videos are a huge aspect of meeting the knowledge quest for information and product/treatment reviews and stories relating to procedure. 
  • 85% of today’s patients are female, who are generally big brand lovers and are considered to be heavy social media users. 

But what do they really want?

Over the past 5 years several surveys have been undertaken to try and establish what patients really want when they are seeking out options. There are slight variations when it comes to different cultural requirements, but essentially the results have only strengthened the opinions and views posed 5 years ago. More recently I conducted a further survey with over 1000 respondents and the results are inline with the findings as well. 

  • People want to portray on the outside what they feel on the inside 
  • People want to look better
  • People want to look natural
  • People don’t want to look over done

The primary goal people have when looking at a cosmetic procedure is:

  • To feel better about their appearance   30.8%
  • To look better    23.1%
  • To look younger     15.4%
  • To look more refreshed    23.1%
  • To look less tired    7.7%

Top non-surgical procedures in 2011 as reported by the International Society of Aesthetic Plastic Surgeons

  1. Toxins
  2. Dermal injectables
  3. Chemical Peel
  4. Laser Hair removal
  5. Microdermabraision

Top surgical procedures in 2011 as reported by the International Society of Aesthetic Plastic Surgeons

  1. Breast augmentation
  2. Rhinoplasty
  3. Liposuction
  4. Blepharoplasty
  5. Facelift

People have highlighted the following as their most important concerns when considering a medical aesthetic procedure are?

  1. Looking natural   64.3%
  2. Potential complications   42.9% 
  3. Not looking natural    28.6%
  4. Cost   28.6%
  5. After care service   7.1% 

What makes good customer service for patients?

  • Over 80% of respondents want consistent practice and good results
  • Over 75% want professional and courteous staff
  • Versus 13% of people base their decisions on price

 

When a patient sits down in front of a clinician – providing a solution to these real needs can be a very complex and interesting dilemma that all clinicians face across the world, and one that gets more and more complex the more variables clinicians are faced with including but not limited to;

·       Trying to address what a patient thinks they need, versus what they actually want and can afford;

  • The technologies and their claims versus their abilities and real time clinical evidence;
  • The understandings the Ageing process, the racial and cultural differences;
  • The raft of trends published in the media and
  • Financial affordability of the procedure.

It is truly a complex minefield of possibilities.

As we march forward in what is an eternal and growing quest for youth (in its various forms) we must always remember that we didn’t age overnight, we didn’t become who we are today simply waking up one morning and looking in the mirror and scream – oh my god I’m old. There are a range of aspects and causes to our appearance that need to be understood and then addressed separately and as part of a holistic approach if we are to truly meet what today’s patient is demanding, and what the research has overwhelmingly underlined over the past 5 years at least.

Clinicians should approach the patient with reverence, with grace and poise, and with respect. Treat the cause of the wrinkles, the volume loss, the lines, rather than just the symptoms. Work with your patients so they can start to feel younger, feel more rejuvenated and ultimately address what the survey’s inform us of what they are looking for, not we want to give them.

Don’t just make people look pretty, help people to feel better about their appearance, help people to feel more confidence in themselves and then we help people achieve what they really want.  

 

Scott McLennan

 

Screen_shot_2012-06-16_at_3