This was held in Sydney over the weekend and featured a number of very interesting presentations. There is some great work being done with Stem Cells and Platelet Rich Plasma in both cosmetic and musculoskeletal medicine. We are looking to incorporate these into our practice. In contrast to most of our current methods of facial rejuvenation, which work via damaging tissue and initiating a healing response, there is no trauma (hence minimal discomfort), only regeneration.
Also of interest was Dr Paul Weaver’s talk on the development for a ‘glue’ to close varicose veins. This probably won’t be available in Australia for a few years, but promises to supercede our current thermal methods of ablation.
One of the more common problems we deal with is spider veins on legs. These can be caused by weight gain, sedentary lifestyle, prolonged standing, pregnancy or local trauma. As well as being unsightly they can sometimes cause pain or itch. An important part of the assessment of spider veins is ruling out underlying varicose veins. If these are present they will need to be dealt with first, otherwise spider vein treatment will be less effective.
The aberrant vessels are treated by injecting with a sclerosant solution via a very fine needle (Microsclerotherapy). Polidocanol, Sodium Tetradecyl Sulphate and Hypertonic Saline are common sclerosants. They act by irritating the lining of the vein, causing it to collapse on itself.
Because the needle is so fine and the injection so superficial the pain experienced is minimal. It has been described as equivalent to a mosquito bite.
Once the sclerotherapy is complete, compression stockings are worn to maximise the effect of the procedure.
We’ve had an influx of patients recently seeking treatment for varicose veins. All our vein treatments require compression stockings to be worn for 2 weeks, so now is the time to get those veins done – before the warmer weather makes it more uncomfortable.
Microsclerotherapy is a procedure involving the injection of small veins with a sclerosing solution. A very fine needle is used so it feels something like a mosquito bite. Ultrasound Guided Foam Sclerotherapy is used for larger veins. A sclerosant solution is mixed with air to form a detergent like foam. This allows us to treat a greater area of vein with a given volume of sclerosant. It is useful as an adjunct or alternative to Endovenous Radiofrequency Ablation.
Call us now to make an appointment. All initial consultations are bulk billed (no cost to patient).
Australian Doctor’s seminar Dermatology on Saturday was a good series of updates on a variety of topics. Non-melanoma skin cancer, Acne and Melanoma were particularly well covered. The presentation Cosmetic Dermatology in 2013 was slightly disappointing as the sections on botulinum toxin and endovenous thermal ablation of varicose veins contained some inaccuracies.
However, it was noted in the section on Lasers that fractional treatments produced a significant improvement when the skin was examined histologically. In addition, actinic (solar) keratoses could be eliminated.
More reasons to come and experience the restorative benefits of our Palomar 1540 Fractional Laser!
On Tuesday night we attended a talk by Dr Francisco de Melo, a Portuguese plastic surgeon practicing in Dubai. Ellanse is a dermal filler that has been on the market here for about a year. Most currently used fillers are hyaluronic acid polymers and act by occupying space in the tissues. In this way we can restore lost volume, enhance lips, etc. Ellanse has a different mode of action. It contains Polycaprolactone microspheres and has a ‘biostimulatory’ action. It induces a slight inflammatory response that results in collagenesis – the increased production of collagen in tissues. Studies have shown volume increases around 1.5 times that originally injected.
Ellanse comes in S, M, L and E, that last for 1, 2, 3 and 4 years respectively. Dr de Melo showed how he has used Ellanse for cheeks, temples, nasolabial folds, marionette lines and pre-jowl sulci. It is not suitable for lips. It looks like being a very useful addition to our range of volumising products.
We are getting into the cooler months and interest in vein treatment is rising. Many patients are aware that compression stockings need to be worn after most procedures to veins, and this can be uncomfortable in the middle of summer.
Whether the problem is large varicose veins or small spider vessels we have a solution. If there is a combination it is important to treat the large veins first. If spider and reticular vessels are being fed by larger varicosities their removal will be less effective. If larger veins are suspected we will do an ultrasound examination of the area to determine if these are incompetent. If this is the case we will recommend these be treated first. Once the large varicosities are eliminated the small veins can be addressed at a later date.
On Saturday I attended what was essentially a re-launch of Sculptra. Sculptra is a facial filler that exerts its effect differently to conventional fillers which mainly just replace volume. The action of Sculptra is to stimulate collagen production. Although there is some initial volume enhancement, the water that goes with the product is soon absorbed and the initial effect lost. Because collagen in the tissues takes time to build up, so the end result takes time to achieve. Add to this the need for Sculptra to be administered over 3 or 4 sessions a few weeks apart, one has to have some faith in the product and clinician. This is not an overnight fix, but certainly would seem to have a place in certain patients and situations.
The address was given by Dr Danny Vleggaar, a very experienced Swiss cosmetic physician. His demonstration of injection technique was useful, but even more interesting was his discussion of facial ageing. The face doesn’t age just because skin gets saggy and wrinkly. Changes occur at all levels – cutaneous tissues, fat, muscle and probably most importantly bony involution. Dr Vleggaar had some good photos and animations of live patients and cadaver dissections to demonstrate this.
It again highlights the need for us clinicians to educate our patients in this regard. Mitigating the effects of ageing can’t be achieved through toxins and skin care alone. It is vital to also address some of the volume changes that occur constantly after the age of about 25. At this stage we can only do this through the careful placement of fillers.
At Sydney Cosmetic Medical Centres we have a range of products to help achieve this.
Light based treatments (laser and IPL) allow us to target pigmented lesions in the skin and remove them. The light is absorbed by melanin, heats up and is destroyed. We have been getting great results with our Palomar Icon MaxG system with unwanted freckles, age spots, etc.