When we look at NHS prescribing we constantly hear “prescribe generically” so that the pharmacist can choose to dispense the most competitively priced medicine.  Patients have their favourite and will probably continue to ask for their favourite medicinal product rather than allow the budget to decide what they should take.

Is it true for products in aesthetic medicine? Botulinum toxins are the most commonly used prescription only medicine within the aesthetics industry. If you were to show this picture to the general public they would probably all state it was an injection of Botox.

Allergan have cashed in on the use of the word Botox and whilst there are other toxins, Dysport and Xeomin on the market, are we right to still call them all Botox? Dypsort, manufactured by Ipsen, has been given unfair reports of how it spreads more and leads to unnecessary ptosis. What controls the amount of spread is the amount of diluent that is used; as the more diluent used to mix the toxin with, the greater the volume that is injected and the greater the spread of the product around the injection site.

So what does lead aesthetic practitioners to use the toxin that they use?  Is it marketing support from the manufacturer, incentives by the company reps, keeping to the toxin that they trained in or just simply down to the pricing structure?  Practitioners want to offer a safe product, one that will achieve the results and be safe to use but also one that will offer an acceptable profit margin.

According to the BNF, toxin prices range from £64 to £154 although discounts can be applied to multiple purchases. Price matching is also available through various pharmacies such as Wigmore price matching against Church Pharmacy for the purchase of Azzalure. In short, in the private sector, medical professionals can choose to prescribe by brand to favour one toxin over another, patient preference should be considered however, but often the brand of toxin used may be down to injector preference and they may call the toxin that they use Botox even though it may be Dysport or Xeomin that is used.

1. Prevent infection – clean the skin effectively to remove all traces of makeup and the daily grime that our skin is exposed to.  Heavy makeup can be removed with a baby wipe, some practitioners prefer to use a savlon spray with gauze whereas other injectors prefer to use alcohol wipes.  Alcohol can denature Botox therefore, it is imperative to allow all vapours to evaporate before the chosen area is treated.
2. Assess what your patient’s preferences are –  The number of patients in my clinic that are astounded when I ask if they want a natural look with some movement, a brow lift or a frozen look with no movement.  I have heard reports of them visiting other injectors and just being injected, sometimes without even signing a consent form.  When assessing your patient’s preferences, you will be able to ascertain how much toxin to use to help achieve the desired look.
3. Photographs – before and after pictures are sometimes now mandatory for insurance companies and they allow you to show your patient what they were like before their treatment and allow you to compare the result gained from your treatment.
4. Dosage – when injecting the glabella, look and feel the muscle mass, in doing so you will gauge how many toxin units will be needed and it will serve to identify the bulk, location and width of the muscle.
5. Anatomy – have an awareness of the surrounding anatomical structures to ensure you do not allow the toxin to affect an area that you do not want to treat. Ensure that a non dominant finger or thumb protects the orbital rim.
6. Consent – full informed consent should be obtained, it is not necessary to obtain written consent however, it may be easier to prove your patient has been informed of the potential side effects of a Botox injection if they have signed the consent form.
7. Review your clients to make sure their treatment outcome is as expected.  As a new injector it is essential to be able to see the results of your treatments.
8. Document what you have injected and where you have placed the units.  If you then need to do a ‘top up’ you can alter their next treatment to include the additional dosage injected at the review appointment.

After four weeks of renovation, our premises in Mossley Hill, Liverpool is finally completed. Cosmetica Training was established in October 2007, training medical professionals in the administration of certain cosmetic procedures. Around this time, our courses taught by our highly experienced tutors, were held in business suites and conference rooms in luxury hotels, but due to the progressive growth over four years and a strong need for a clinical environment we decided to open a purpose built training centre.

After finding a large building complex on Allerton Road, we began work to update the interior from a dated set of offices to a modern clinical environment. The renovation varied from painting ceilings to relaying floors to moving walls, all of which contributed to a newer, fresher look throughout our premises.

Now that all of our construction has been completed, the grand opening of our dedicated training centre will occur on 6^th September 2011, although our Botox, Dermal Filler and Dermaroller courses will run monthly from 23^rd July.

If you partake in one of our highly acknowledged courses, you will be trained in the administration of products produced by Allergan, Galderma and Aestheticare to name a few; you will receive our promotional materials, be able to access our ‘Business in a Box’, which gives you all the consumables and products you need to treat new clients, allowing you to earn a minimum of £550; you will be safe in the knowledge that our teaching is one of the fully approved courses recommended by the medical insurance company Hamillton Fraser and you will also receive CPD accreditation.

Places on our cosmetic courses fill up quickly, so if you have the appropriate qualifications and are keen to attend Botox courses, Dermal Fillers courses to administer fillers such as Juvederm, or train to do Chemical Peels, Dermaroller or LNI, please reserve your place today. For further information, see our booking page .

As a medical professional you may wish to enter the aesthetics industry to be able to administer a wide range of non surgical treatments.  You will have spent time googling which company to go for to make sure it meets your needs before, during and after completion of your training. If a professional, indepth course that allows you a vast amount of injection experience is your top priority then look no further than us, Cosmetica Training.

We cater for both foundation and advanced botox training courses and dermal filler courses as well as other aesthetic courses that can improve the texture of the skin to enable you to holistically treat your future patients.

Our location is based in a fully equipped and dedicated clinical training centre and is easily accessible from the all over the UK. It has also been reported today that Liverpool is listed second as the city that offers visitors value for money.  The research factored in accommodation in a 4* hotel, food, drink and local transportation.

You can not only start your aesthetics career in a purpose built clinical training centre but also enjoy Liverpool’s culture and vibrant nightlife at a competitive cost too for those wishing to stay overnight.  We are able to source local accommodation and arrange transfers for delegates who request this at the time of booking, all associated charges will be billed to the delegate.

At Cosmetica Training we pride ourselves in offering the most practical experience than any other course currently offered by another training company. With Botox training the only way you can become competent is by having hands on practice.  Can you realistically be competent after injecting just one person with Botulinum toxin type A?  We believe that you cannot, yet courses that only allow their delegates to inject one model seem to be highly sought after.

Traditionally, Botox courses are ran by undertaking the theory during the morning and the practical session only commences in the afternoon.  Some courses being offered allow only 2 hours of injection training throughout the day, others allow for 4 hours of practical, however, these 4 hours are often shared with 10 – 15 other delegates.  

To change the way aesthetic courses are run we introduced e-learning, this enables you to spend a minimum of 2 weeks studying the theory, which we provide to you in written format and on a DVD.  During this time you get full tutor support and any queries you have are answered within 24 hours of your e-mail being sent to us.  On your practical training day you benefit from 7 hours of practical administration.  At the end of your Botox course you will be fully competent and be able to set up a clinic offering aesthetic treatments.

Attendance of a Botox training course ran by Cosmetica guarantees that you will be completely satisfied with the experience you have with us that we have a satisfaction guarantee.  If you feel that you are not fully competent with your injection technique, tell us before you leave and we will invite you back for a further practical session.

Full aftercare packages are available to all our delegates upon successful completion of our courses to range from e-mail support to full clinic visits to assist in setting up and running your first sessions.

When you train with Cosmetica we can put into place everything to help you to succeed.

Chemical skin peels are a highly sought after treatment and any practitioner wishing to undertake them need to ensure they book on the right training course.  You need to ascertain which type of peels you wish to do and what sort of down time the patient is going to go through following the treatment.

There are superficial salicylic acids, glycolic acids and the more popular trichloroacetic acid. Dr Philippe Deprez is the man behind the Easy TCA Skin Tech range which is used by many practitioners world wide, it is easy to use and achieves the desired results with different protocols available for varying conditions.

Taking America and many other countries by storm is the prescription strength products from Dr Zein Obagi.  With a 15 % and 20 % TCA, their Blue peel achieves controlled penetration to either a superficial depth or penetrating deeper to the papillary or reticular dermis.  The Obagi line is not matched by any other medical range we have seen and is reflected in the price tag.

The blue peel allows for 3 clinical end points as a guide to show the depth the peel has reached, 2 of which are frosting and epidermal sliding. A papillary peel will mean a down time of around 5 – 7 days duration following a 6 week skin preparation course.  The active ingredients of Obagi Nu Derm should be stopped around 4 days prior to having the blue peel and should be gradually introduced following the blue peel application.

The risk of post inflammatory pigmentation is reduced with the blue peel due to the preparation and continual use of the Obagi range, making this peel suitable for any skin type.

Our new Cosmetica clinic sees the launch of the Obagi blue peel which is available from our trained medical staff. For prices and further information please contact us on 0845 467 7732.

Throughout the years we have seen systems come and go that are supposed to make our lives as an aesthetic injector easy, but we are yet to use a system that delivers the ease, speed and comfort that we can achieve in daily clinics using expertise and topical or local anaesthetic.

We remained sceptical when we heard of the new Artiste system by Nordson Micromedics.  We were approached to see if we were interested in utilising this system during our botox and dermal filler training courses, our initial thoughts were that we could not see it fit into our company although it may be of interest to our tutors.

Upon delivery of the system, it was easy to assemble and to use with fool proof instructions.  The old Juvederm Ultra syringes do not fit the hand pieces, however all other syringes can be accommodated by the different hand pieces that are available.

The pressure gauge is easily changed to adjust to the different thickness of dermal fillers that are to be injected and the higher the pressure the faster the flow.  The system would be suitable for use by all although great care and skill is still required to ensure the right injection depth is gained.  it is also suitable to those practitioners that prefer to inject quickly or at a slower pace.

Booked into our Cosmetica clinic today we had lip augmentations, peri oral lines, oral commissures and liquid face lifts.  50 % of the patients were injected manually and the remaining patients were injected using the Artiste system.  All patients had topical anaesthetic applied for 30 minutes prior to treatment and were asked to score the treatmetn on a pain scale of 1 – 10, the lower the number equating to a pain free treatment.

Those patients injected manually assessed their pain scale as 6 – 7 whereas the patients injected with the Artiste system stated their pain scale was around a 3. All patients had been injected previously and the Artiste group had previously been inejcted manually and made a comparison of the manual inejction being a pain scale of an average of 6 out of 10.

As well as the comfort scale we noted that each syringe of dermal filler lasted longer than we would normally expect when using manual skills yet achieved the same results.

The positives of using the system are the economisation of the product and the comfort of the patient but does this outweigh the negatives?  We could only really find 2, firstly the price £3000 + VAT and the treatment time was extended reducing the profit margin that can be expected.  In time you may be able to shorten the injection time and we will monitor this throughout the next few weeks.

We do not think it would be a system we could use on our basic courses in view of the fact that new aesthetic practitioners may not be able to justify the price tag.  However, it is something that we would use in clinic, in our advanced courses and we would recommend that all injectors trial this sytem.

The media love to cover how celebrities are having fillers, botox and face lifts trying to highlight when possible where it has “gone wrong”.  Photographs of unnatural looking lips, swollen faces and tell tale bruising are adorned across the pages of gossip magazines, sometimes suggesting that natural is better.  However, they also imply that we should try to achieve perfection; that we, as men and women of today, should aspire to have flawless skin, a radiant smile and look forever youthful.  They portray that no matter what age, people should always look younger and try to prevent the ageing process.

In a ‘news’ page of a weekly magazine, two well known age defying stars, were featured looking less taut than they normally do. Said celebrities, both around the 50 year age mark, are known for holding back the tell tale signs of their age, are more often than not, are praised for their youthful appearance. They will not deny any rumours of cosmetic surgery or beauty enhancing treatments, but  unfortunately, they are also subjected to criticisms stating that they should focus less on maintaining their young looks. Nevertheless, when these stars go out without makeup on, with faint wrinkles in view, they become a theme of gossip.  A 50 year old non-celeb is free to walk around au naturale and be free of judgemental  glances, but the famous are criticized for their lines, that are often the result of genetics.

Over time, as the media and entertainment world increases in size, A Listers have become one of the main topics of conversation in our everyday life.  Everywhere we look, there are magazines that feature celebrities on the covers. But more often than not, the cover stories are based on their appearance. Why is it that our society today appears to care more for how actors look then the films they appear in? If it was not for their talent, we would not be aware of these icons, so why do we choose to discuss their looks, and more specifically their ageing?