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Syneron - Candela UK September Newsletter Edition 5
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In This Month’s Syneron – Candela Newsletter....
• Latest News – We have been nominated for multiple awards at the Cosmetic News Awards and the MyFaceMyBody Awards.
• Treatment of the Month – Electro-optical Synergy in Aesthetic Medicine: Novel Technology, Multiple Applications.
• Clinical Papers – Skin Rejuvenation and Wrinkle Reduction Using a Fractional Radiofrequency System plus, A Study Evaluating the Safety and Efficacy of the Velasmooth System in the Treatment of Cellulite.
Edi t i on 5
September 2012
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Welcome to the September Edition of the Syneron – Candela Industry Newsletter
Michaela Barker UK General Manager Syneron – Candela
UK Ltd
Latest News Page 3
PR and Marketing Page 10
Exhibitions and Events Page 12
Training Page 16
Consumer Information Page 18
Clinical Papers Page 19
Treatment of the Month Page 21
Syneron – Candela Global News Page 26
Did You Know... Page 27
Contact Us Page 28
Welcome once again to the fifth edition of the Syneron – Candela e-newsletter. We have been nominated at the Cosmetic News Awards – you can vote for us by clicking on the logo on the right. After an exciting run up to the Olympics, in which we we’re standing proudly besides the British Olympic Synchronised Swimming Team as their sponsors, we watched in awe as they came 6th overall. The event was their first ever team final and we will continue to cheer them on in their future events. The surge in British Team Spirit must have rubbed off on us this summer and the Syneron-Candela team joined up with Ron Myers, Danielle Lowe, Dan Huxley and Danny Large from the Consulting Room™ to cycle from Coast to Coast to raise money for Chester Childbirth Appeal. Michaela Barker
UK General Manager Syneron-Candela
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Vote For Syneron – Candela at the Cosmetic News
Awards 2012 On December 1, 2012 Cosmetic News will be hosting its second annual Aesthetic Awards at The Grand Connaught Rooms in Covent Garden. The Aesthetic Awards, sponsored by Syneron - Candela brings together the cream of the aesthetics industry crop to acknowledge the success stories of the past year and reward those who are excelling. 30 awards categories have been designed to recognise those who have gone above and beyond in their dedication and service to the industry from the clinics and practitioners who are leading the way to the manufacturers and suppliers who have developed and brought to market the most innovative and inspiring products and treatments. Last year the awards had a staggering 7,000 entries and nominations and the organisers are expecting 2012 to have even more of a phenomenal response. The awards create a real buzz and excitement in the industry as well as raising awareness about high standards and achieving excellence. Syneron-Candela UK won the Silver Award for Equipment Brand of the Year at The Aesthetic Awards 2011. Participating in the Aesthetic Awards could not be easier. The voting process is open until Monday 15th October so you still have plenty of time to vote for us. Simply visit Cosmetic News Voting Form and vote for who you think are deserving winners as well as nominating the products and treatments that you think come out on top this year.
Join Syneron Candela at the Awards on 1st December For 8 of our lucky customers we will be giving tickets to join us for the event at the Industry awards dinner simply cast your Vote via the link on the right and we will draw 4 people at random and send a pair of tickets to join our tables at the awards ceremony - just to say Thankyou! Vote for Syneron – Candela in the Awards for Manufacturers and Suppliers Best Newcomer (Product or Treatment) - eLase Motif laser hair removal Treatment of the Year (Face) - e2 Sublime and Sublative (Syneron/Candela) Treatment of the Year (Body) - Velashape (Syneron/Candela) Equipment Brand of the Year - Syneron/Candela Sales Representative of the Year - Martyn Roe – Syneron/Candela Best Customer Service by a Manufacturer/Supplier - Syneron/Candela Best Advertising Campaign by a Manufacturer/Supplier - Syneron/Candela Re-branding
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We Have Also Been Nominated in the
MyFaceMyBody Awards Our patented elos™ technology has been shortlisted in the ‘Skin Tightening Treatment’ category at the inaugural MyFaceMyBody Awards, which are taking place on 30th November 2012 at The Landmark Hotel, London. The Awards will recognise and reward brands for their product innovation and popularity. The event will be attended by leading health and beauty professionals, journalists and celebrities. They will be voted on by the consumer and will feature a panel of experts; all are leaders within the health and beauty industry. Chaired by Stephen Handisides, the judges will study all entries and compile a shortlist which the consumers will then vote on. Click on the Video below to hear Syneron – Candela VP of Sales Erik Dowel discussing the benefits of elos™ technology. Don’t forget to vote for Syneron – Candela elos™ in the “Best Skin Tightening” Treatment Category by visiting - http://www.myfacemybody.com/awards_b/Vote/
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We Did it! Charity Bike Ride from Coast to Coast Raises over £1500.
Syneron – Candela team members Martyn Roe, Paul Simmonds and Gary Barker (Husband of Michaela Barker UK General Manager) in co-operation with The Consulting Room™ Team Ron Myers and Danielle Lowe (who chose to do it on a tandem bike!), Dan Huxley and Danny Large completed the gruelling 140 mile Coast to Coast (C2C) cycling challenge and raised over £1500 for the Chester Childbirth Appeal.
The team tackled the C2C over two days, riding through the Northern Lakes and over the Pennines. From the start in Whitehaven on the East Coast, the team faced high peaks such as the 1000foot Whinlatter Pass to Keswick and the nearly 2000foot juggernaut of Hartside Pass. After a well needed break at Alston, the 77 mile halfway point, they set off bright and early the next day where the first 18 miles were steep mountain climbs taking them through Northumberland and County Durham. The challenge was completed when the entire team made it to Tynemouth where amid the celebrations they found time to take a quick dip in the North Sea!
Team member Danielle Lowe says: “I would like to say it was easy but it wasn’t by any stretch of the imagination! It took a lot of hard work and we can’t say thank you enough to Paul Simmonds for his support - he really was the backbone of the team, Gary ‘the machine’ Barker for his continual motivation, cycling tips and for putting up with us amateurs for 147 miles! And Michaela Barker and her daughter Laura who were there to cheer us on every step of the way as well as providing much needed and much appreciated energy drinks.”
On behalf of the team Dan Huxley wishes to say a huge thank you to everyone who supported the challenge as he explained why they chose to cycle in aid of the Chester Childbirth Trust, a charity close to his heart:
“Last year my baby daughter became ill. After taking her into hospital with a temperature of over 42 degrees she was diagnosed with pneumonia. She couldn't breathe without oxygen, wouldn't eat anything and was hardly moving. After 4 days of drips, oxygen masks and a mother that never left her side she started to get better. I will never forget how helpful the nurses, doctors and staff were and without the Chester Childbirth Appeal Molly's stay would have been a lot worse.”
The Chester Childbirth Appeal has providing facilities and amenities over and above those afforded by the NHS. Only with the help of fund-raisers, volunteers and the great generosity of our supporters of the Childbirth Appeal have we been able to raise money to finance these improvements.
We would like to say once again a massive thank you to everyone who supported us.
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Starting Point: Whitehaven:147 miles to go.... Conquering the First Hurdle: Whinlatter
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Meet the Syneron – Candela Team: Jonathan Hunt
Regional Sales manager [email protected] Mobile 07703 612110 Jonathan is primarily responsible for the Northern territory in the UK and has had a varied career with 7 experience working in the laser field. Jonathan has excellent technical knowledge and is also a valued training resource.
He has a great deal of working knowledge on all aspects of the medical laser sector and works closely with the NHS. He has also developed a great skill set to offer private clinics help and advice when setting up. Outside of work Jonathan enjoys sport – well watching Manchester City!
Sir Bruce Keogh`s Review of the UK Cosmetic Surgery Industry Gets Underway
By Lorna Jackson, editor of The Consulting Room™
At the end of January 2012, following the fall-out from the PIP breast implant scandal which brought the cosmetic surgery industry to the forefront of public awareness and concerns, the Health Secretary Andrew Lansley asked the Department of Health to investigate the whole industry. This job was given to NHS Medical Director, Professor Sir Bruce Keogh along with an expert panel, and their Scope of Practice was laid down.
“I am working with experts from the plastic surgery field to look at what we can do to make sure people who choose to have cosmetic surgery and other cosmetic procedures are safe”; said Sir Keogh at the time of the announcement of the plan for a review.
As of 15th August 2012 the review, which will likely see the industry under heavier scrutiny than past Department of Health/Care Standards authority reviews, has now been officially launched with a ‘call for evidence’ to include experiences and views from both the industry and patients in order to assist the inquiry.
The call for evidence is asking for people’s views on regulation and safety of products used in cosmetic interventions, how best to ensure that the people who carry out procedures have the necessary skills and qualifications, how to ensure that organisations have the systems in place to look after their patients both during their treatment and afterwards, how to ensure that people considering cosmetic surgery and procedures are given the information, advice and time for reflection to make an informed choice and what improvements are needed in dealing with complaints so they are listened to and acted upon.
Commenting on the request for public input to the review, Sir Keogh said; “Many questions have been raised, particularly around the regulation of clinics, whether all practitioners are adequately qualified, how well people are advised when money is changing hands, aggressive marketing techniques, and what protection is available when things go wrong.” It’s hoped that tighter restrictions on those operating within the cosmetic surgery and non-surgical markets will result from the findings.
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To help highlight the need for this review, the Department of Health also commission a survey which was conducted by ComRes who interviewed 1,762 adults in England between 3rd and 5th August 2012 who had or who would consider having cosmetic procedures. People were asked the following questions:
1. Thinking of cosmetic surgery, such as a nose job, breast enlargement or reduction, facelift, eyelid lift, tummy tuck or liposuction, which three of the following, if any, would be factors in your decision about whether or not to have the surgery?
2. Thinking of cosmetic treatments such as Botox injection, dermal filler, chemical peel or laser hair removal, which three of the following, if any, would be main factors in your decision about whether or not to have the treatment?
The results showed an overwhelming concern for those involved in the industry in that most people factor cost above anything else, including the qualification of a practitioner and their quality of aftercare, despite the medical nature of cosmetic interventions.
In a statement from the Royal College of Surgeons (RCS), their President, Professor Norman Williams said;
“I am concerned by the results of the survey which show that people consider the cost of the surgery more important than the qualifications of the people doing it.”
Tim Goodacre, Head of Professional Standards at the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and a leading Consultant Plastic Surgeon, said:
“We hope that this review leads to a wholesale change of practice for the cosmetic surgery industry. We would like to see the robust implementation of a code of practice that will include higher standards of training and practice for surgeons whose work includes cosmetic procedures. We urge that institutions which deliver such operations should have the highest standard of management throughout and following interventions, and bear greater responsibility for the surgeons who work within them. We also hope that the review will address irresponsible advertising which seeks to do more than inform and instead persuade to have procedures which are widely trivialized. A compulsory code of advertising practice should be statutory and swift action taken against those who break the rules. This would protect people against mis-selling, unrealistic expectations and the lure of cosmetic surgery ‘deals’, as well as cutting out irresponsible advertising targeted at a very vulnerable group in the population.”
“We want to ensure that people considering cosmetic surgery and procedures are given the highest standard of unbiased information, with advice and time for reflection to make an informed choice. We have some scepticism that industry can deliver such non-conflicted information, and believe there is a clear role for authoritative professional organisations such as BAPRAS and the Royal Colleges of Surgeons to support such patient information. We continue to work closely with the Government to provide guidance on ensuring the highest standards of plastic surgery safety and care, including developing training, standard setting, ongoing education, and research into better practice.”
The expert panel and Sir Bruce Keogh will make their recommendations to the government by March 2013.
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“Move over face-lifts there’s a new player in town!”
- The Beauty Shop on Evolastin™
“We’re getting to a layer of the skin we haven’t reached before -
the skin is producing its own natural filler.”
- New You on ePrime™
“Until now, everything we were doing for skin
tightening and wrinkle reduction was guesswork”
- Elle Magzine on ePrime™
“Rejuvenated skin without the telltale signs of
surgery: we consider this the great equalizer in modern dermatology.”
- NY Times Article “Man-Friendly Procedure” on Ematrix™
“I saw results with the facial
wash alone!”
- Style Goes Strong on elure™
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“Facelift without the Scalpel”
Click Video Below to Watch
View more videos on our YouTube™ Page –
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EMAA, Paris
Date: Sunday 14th October – Monday 15th October 2012
Place: Palais des Congrès de Paris
This progressive multidisciplinary meeting is designed to bring an update on aesthetic and anti-aging treatments, products and new technologies in a very practical and interactive format that will provide an unparalleled weekend educational experience. It includes the hottest new procedures, training sessions, live demonstrations workshops, run by a world class faculty of opinion leaders in anti-aging medicine, aesthetic dermatology and surgery. The EMAA will shed the light on all new trends in cosmetology as well. The scientific programs of both parts of the convention, The Anti-Aging part and the Aesthetic part, have a wide variety of subjects treated in plenary sessions and very interesting live demonstrations and practical workshops with high educational interest. Visit http://www.euromedicom.com/emaa-2012/index.html for more details of the programme.
Professional Beauty North
Date: Sunday 14th October – Monday 15th October 2012
Place: Manchester Central Convention Complex Professional Beauty Manchester is one of the biggest shows of its kind which will be held in the North and will have large number of beauty care as well as spa products on display. This event will be organised on a large scale and will bring together a large number of national, as well as, international exhibitors. Being a part of this show will allow exhibitors to not only showcase their merchandise but they can also take advantage of this mega platform to launch new services. Visit www.professionalbeauty.co.uk for more information. ISDS (International Society for Dermatologic Surgery)
Date: Thursday 18th October – Saturday 20th October 2012
Place: Hotel Palace, Lucerne, Switzerland The 33rd Annual Meeting of the ISDS will have European CME Accreditation awarded by the UEMS/EACCME in Brussels. UEMS accreditation includes a charter with the American Medical Association. The ISDS brings dermatologic surgeons together so they may exchange innovative techniques and work for standardisation and improvement of training programs in dermatologic surgery. Visit http://www.isdsworld.com/ for more information.
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New Innovations – New Ideas Workshop
Date: Wednesday 24th October – Thursday 25th October 2012
Place: St Juliens, Malta Our Team of experts presents an engaging look at what is new in the industry and also run some advanced workshops looking at our existing products already used on the island. Visit http://www.syneron-candela.co.uk/content/new-innovations-new-ideas-0 for more information and to register. The Dermatologic & Aesthetic Surgery International League
Date: Wednesday 31st October – Sunday 4th October 2012
Place: The Westin Dragonara Resort, St Julian’s, Malta
The DASIL 1st annual conference will take place in the beautiful surrounds of the 5* Westin Dragonara resort in Malta. DASIL is a U.S. based non-profit organisation, it is the love of dermatology, dermatologic surgery, and aesthetic cosmetic surgery that has brought this group conference to fruition. We will be working with our plastic surgical and other core specialty like-minded physicians to make sure that we all work as one that we teach with the best teachers available; that we have contributions from all the core specialties; and that we stay true to our mission at all times. Visit www.thedasil.org or view the full brochure here - DASIL Agenda BODY Conference and Exhibition Date: Saturday 3rd November – Sunday 4th November 2012
Place: The Royal Society of Medicine, London
The conference offers choice and value for delegates with the inclusion of two separate parallel agendas running alongside our traditional non-surgical agenda. These include a Hair Removal Workshop and a focussed Cosmetic Surgery agenda related to BODY Aesthetics providing a unique opportunity for both Surgeons and Non-Surgeons to meet in one scientific forum. BODY provides a congress where practitioners of different specialities, and clinic owners, can learn more about all aspects of the BODY aesthetic market providing a forum for debate and discussion around controversial scientific, ethical and regulatory issues affecting our industry. Visit www.bodyconference.com for more information
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Body Work –
Exclusive Invitation to the Body Conference Workshops
Syneron – Candela the global leader in Aesthetic Devices Marketplace invites you to two workshops and a Day Pass to the Body Conference exhibition area, London
Future trends in the Dynamic Body Shaping Arena
With Mr Christopher Inglefield BSc,MBBS,FRCS(Plast)
Date: Saturday 3rd November 2012
Time: 11.30
Mr Chris Inglefield is an internationally recognised lecturer, trainer and specialist in cosmetic and plastic surgery, he has developed methods and techniques in none invasive body contouring at his own clinic London Bridge Plastic Surgery Clinic - he will share his extensive knowledge on what can and, perhaps more importantly, what can not be a achieved without surgery using the tools available on today’s market. A candid overview of the Body shaping market and some Myths and Truths about technologies such as Radio Frequency, light and Ultrasound.
Investigating Advances in Laser Hair Removal 2012 With Dr Pablo Naranjo
Date: Saturday 3rd November 2012
Time: 12.15
Dr Pablo Naranjo, University Lecturer for Masters Degree’s In Aesthetic Medicine and owner of a prestigious clinic in Madrid talks openly about his own experiences in a busy laser clinic sharing his knowledge of technology and experience with most current light based systems. Well known in the industry for his knowledge and expertise in laser treatments in Spain here he discusses some of the issues we all face with laser hair removal in clinics today. Looking at none responders, side effects and expectations Dr Naranjo discusses the opportunities this brings up to become a real expert getting the optimal results in this busy treatment category
Due to limited space contact [email protected] to reserve your place or call 0845 5210699
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Cosmoprof Asia Date: Wednesday 14th November – Friday 16th November 2012
Place: Hong Kong Convention Centre Cosmoprof Asia – the leading business-to-business beauty trade show event in Asia! All exhibits are divided into five themed sectors that cover the entire spectrum of the beauty industry. Visit the Cosmetics & Toiletries (perfumery, cosmetics and toiletries), Pack & OEM (packaging solutions), Beauty Salon, Hair Salon and Natural Health to find the latest trends and products from within all segments of the beauty and wellness industry. Strong international participation is confirmed by the presence of national and group pavilions give you the global perspective on emerging trends. See existing business contacts and friends or network to make new connections during the numerous special events planned over the course of the three days. Visit http://www.cosmoprof-asia.com/ for more information Cosmetic News Conference Date: Saturday 16th February – Sunday 17th February 2013
Place: Business Design Centre, Islington, London. Cosmetic News is proud to announce the dates for the fourth annual Cosmetic News Expo, taking place at The Business Design Centre, Islington, London on February 16-17 2013. As our previous events have shown, the Cosmetic News Expo brings together the highest quality exhibitors from across the aesthetics industry, enabling visitors to see all the key manufacturers and suppliers under one roof. The value for money conference which runs alongside the Expo will see cutting edge topics and leading UK and international speakers while our enhanced Business Workshops will educate and inspire. Entry to the exhibition and Business Workshops will once again be completely free of charge, making the Cosmetic News Expo a must visit event for all discerning aesthetic practitioners. As Sponsors we will once again be bringing our range of skin tightening, rejuvenation systems and hair removal lasers to the Cosmetic News Expo. In 2012 we launched some exciting new product ranges including the eTwo Sublime and the Motif (eLase). Syneron - Candela's presence at the Cosmetic News Expo 2013 promises to be just as exciting Visit www.cosmeticnewsuk.com for more information
Did you know...
Syneron – Candela markets, services and supports our products in over 86 countries worldwide!
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Webinar Title: Maximise the Body Contouring Opportunity with the VelaShape II System
Speaker: Dr. Lori Brightman
Dr. Brightman regularly lectures nationally and publishes widely about advances in cutaneous oncology, laser surgery and cosmetic
dermatology. Her current research involves the use of laser and light devices in the treatment of medical and cosmetic conditions. Her service to the community includes lectures and skin cancer screenings for many community based programs as well as major corporations
Register for the event here: Maximise the Body Contouring Opportunity with Velashape II
Advanced Training
Opportunities Available Throughout the UK
We hold regular advanced training and educational opportunities throughout the UK. We will be bringing you information on all upcoming summer training dates. Please contact us for more information Contact: [email protected]
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Core of Knowledge Laser / IPL Training When: Tuesday 13th November 2012 - London Saturday 3rd November – London Tuesday 8th January 2013 – Nottingham Monday 14th January 2013 - Nottingham This is the essential course for all laser/ILS practitioners. It is ideal for those new to laser/intense light sources (ILS) technologies, experienced practitioners, beauty therapists and clinical scientists. This one day course covers topics from the medicines and healthcare regulatory agency guidance document (MHRA 2008(03), Characteristic Features of Light from Lasers/ILS Sources, Hazards from Device Malfunction, Equipment Management, Effects of Light on the Eye, Skin and Body Tissues, Safety Management, including Local Rules and Controlled Areas, Introduction to Risk Assessment and means to minimise risks, plus actions required in the event of an incident. Who should sit the course? • Anyone new to laser/ILS technologies and applications. • Experienced practitioners wishing to update continual professional development (CPD). • Clinic owners and management who require background training. • Clinical scientists. • Beauty Therapists. • Anyone proposing to sit our BTEC qualification. Course Content: The Core of Knowledge covers the following topics from the National Minimum Standards and MHRA 2008(03). • Characteristic Features of Light from Lasers/ILS Sources • Hazards from Device Malfunction • Equipment Management • Effects of Light on the Eye, Skin and Body Tissues • Safety Management, including Local Rules and Controlled Areas • Introduction to Risk Assessment and means to minimise risks, plus actions required in the event of an incident London Venue: 12 Bloomsbury Square, London, London Central, WC1A 2LP
Nottingham Venue: Mapperley Park Training Centre, 395 Mansfield Road, Nottingham NG5 2DL
Fee: Nottingham £195 +VAT OR London £210 +VAT (VAT included) | Lunch Provided
For more information or to book your place please contact: Latoyah Allen - Training Coordinator / Senior Administrator Mapperley Park Clinic 395 Mansfield Road Nottingham NG5 2DL Email: [email protected]
Download the application form and reserve your place today!
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Olympic Roundup - The British Sychronised Swimming Team Sponsored
by Motif™
London 2012 marked a historic event in the world of competitive swimming with this year being the first time ever that Great Britain has competed in both the Team and Duo events.
Britain's Olympic Synchronised Swimming Team came in sixth place in their first ever Olympics, although the Russian Team took home the Gold the team were happy to have earned sixth place meeting the target set by their coach prior to competing.
The squad performed their Peter Pan-themed free routine, achieving a combined score of 175.4 including their technical piece.
Team Member Jennifer Knobbs, 23, said she was pleased with how the ground-breaking team had done. 'It was an incredible performance, all our highlights functioned and we really felt as a team underwater. Hearing the crowd cheering, supporting us the whole way, really gives you the boost to perform that much more.'
We have enjoyed working with the girls on their run up to the event and their grace, poise and elegance in the water have made us immensely proud to have been their sponsor during the historic event. We cheered them on throughout the competition and will continue to do so in the future.
The team are now focused on next year's World Championships and beyond that, the team are pinning their medal hopes on the 2016 Olympic Games in Rio de Janeiro.
The Team Training at the Aquatics Centre in Olympic Park (Left) and Below Competing infront
of a World Audience.
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A Study Evaluating the Safety and Efficacy of the Velasmooth System in the Treatment of Cellulite
Sadick N, Magro C. Background: Most cellulite treatments are limited in their effectiveness. A combination of radiofrequency energy, infrared light and mechanical manipulation of the skin and fat merits further examination. Objective: Subjects were treated with a device combining these energies to evaluate its safety and efficacy. Methods: Sixteen subjects with cellulite were treated twice weekly for 6 weeks with the VelaSmooth system. One thigh was treated while the other served as a control. Treatment efficacy was measured through circumferential measurements of both thighs and by having the investigator and an independent evaluator grade visual improvement during follow-up visits. Five patients provided blood specimens for assessment of lipid and hormone levels and liver function. Two subjects provided three biopsies each in order to monitor the level of oestrogen and progesterone receptors.
Results: The overall thigh circumference decreased in 71.87% of the treated legs. The mean decrease was 0.44 cm of the lower thigh and 0.53 cm of the upper thigh. There was significant visual improvement in cellulite and skin texture. At the final follow-up visit, 50% of subjects had greater than 25% improvement (good be very good). Conclusion: This study showed positive results. Future studies
employing higher energy levels and additional treatments will likely augment the results of the present study.
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Skin Rejuvenation and Wrinkle Reduction Using a Fractional Radiofrequency System.
Hruza G MD, Taub A MD Introduction: Skin resurfacing has evolved rapidly over the past 15 years from ablative techniques to non-ablative methods and most recently fractional ablative resurfacing. The purposes of this study were to analyse the degree of tissue ablation, coagulation, and heating; and to evaluate the clinical efficacy and safety of a fractional radiofrequency (RF) device, for the treatment of wrinkles with fractional skin ablation and coagulation. Materials and Methods: Individuals scheduled for abdominoplasty received fractional RF treatment to the abdomen area, using different tips at varying energy densities and coverage rates. Biopsies were performed ex vivo following abdominoplasty and tissue samples were routinely processed and stained, using hematoxylin and eosin. Another group of subjects received 3 facial treatments, scheduled at 3 to 4 week intervals. Clinical improvement and response to therapy were evaluated with standardized photography and clinical assessment by the subjects and investigators. Results: Histological findings immediately post treatment revealed demarcated zones of ablation/coagulation/necrosis and subnecrosis up to a depth of 450 μm. Higher energy levels generated deeper effects. We noticed a tunable balance between ablation and coagulation/necrosis. These effects were coverage mode and energy density dependent. Subjects undergoing facial treatment had minimal pain, no permanent side effects, or significant downtime. Investigators’ assessment for improvement in skin texture correlated with subjects’ evaluation and was greater than 40% for approximately 50% of subjects. Eighty percent of the subjects were satisfied with the result. Higher energy levels and lower coverage rages produced better aesthetic results along with less pain. Conclusion: The clinical observation and histological findings suggest that fractionated ablative skin resurfacing using a fractional radiofrequency device resulted in a safe, tolerable and effective improvement in skin texture and reduction of wrinkles. The depth of tissue ablation, coagulation and necrosis and the relative proportions of these phenomena were found to be controllable and could be modulated to optimize treatment of variable dermatologic conditions.
Did you know....
We have over 700 published scientific papers?
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This article reviews a newly developed nonablative technology known as electro-optical synergy (ELOS). This new technology encompasses a unique blend of optical and electrical radiofrequency (RF) energies simultaneously applied to tissue. The rationale behind combining electrical and optical energies is 2-fold: (1) a synergistic effect occurs between the 2 forms of energy and (2) lower levels of both energies can be used, facilitating treatment for individuals of all skin types and hair colours and potentially reducing the risk of side effects associated with either optical or RF energy alone. ELOS technology has been evaluated for a number of clinical applications; including hair removal and leg vein removal, as well as treatment of all aspects of aging, from pigmented and vascular lesions to skin texture improvement and wrinkle reduction. Study results suggest that this technology is safe and effective. However, direct trials comparing the efficacy of the combined-energy technology with that of other laser- and light-based systems are still needed at this time. Laser therapy is one of the fastest growing technologies in cosmetic dermatology. According to recent estimates from the American Society for Aesthetic Plastic Surgery, the total number of cosmetic procedures performed in the United States has increased by 293% since 1997 to a total of 8.3 million surgical and nonsurgical procedures in 2003. Nonsurgical procedures, which include the subcategory of non invasive laser devices, have increased by an astounding 471%.Currently, the number of options in non invasive laser devices is overwhelming; cosmetic dermatologists can choose from more than 65 different laser systems for the treatment of a variety of cosmetic and medical skin conditions. This article reviews electro-optical synergy (ELOS), a novel technology that encompasses a unique blend of optical and electrical radiofrequency (RF) energies simultaneously applied to tissue. Most cosmetic dermatologists are familiar with nonablative laser devices that use a single optical energy source to achieve selective photothermolysis. However, directing optical energy to targets beneath the skin surface presents certain challenges. For example, light photons are scattered or absorbed by melanin on contact with the skin, and, as a result, only a variable proportion of photons actually reaches the target. Such variability necessitates providing higher energy for sufficient dermal heating thereby increasing the potential for epidermal complications (eg, crusting, dyschromia). The physician must consider a patient’s skin type, treatment site, and the optical wavelengths and pulse dosimetry of the laser system before performing any laser procedure. Electrical RF energy has become an increasingly popular method for nonablative cosmetic treatment. This type of energy interacts with tissue to produce heat. However, unlike optical energy, electrical RF energy produces heat from a current of ions rather than from absorption of photons. Thus, RF devices are dependent on the electrical conductivity of the target tissues to create selective thermal injury; RF energy is not scattered by tissue or absorbed by melanin, and RF devices have been reported to achieve dermal heating at a much greater depth of penetration
Electro-optical Synergy in Aesthetic Medicine: Novel Technology, Multiple Applications
By Neil S. Sadick, MD, FACP, FAACS
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than laser light devices.3 In addition, RF devices can heat or denature collagen and stimulate fibroblasts to form new collagen over time. Based on clinical experience, mild to severe pain (often requiring a topical anaesthetic) has been a limiting factor of RF devices. Incidences of blistering, burns, and inflammatory nodules also have been observed in some patients. The rationale behind combining electrical and optical energies is 2-fold: (1) a synergistic effect occurs between the 2 forms of energy and (2) lower levels of both energies can be used, facilitating treatment for all skin types and hair colours and potentially reducing the risk of side effects associated with either optical or RF energy alone. Synergistic Mechanism The optical and electrical RF energies of ELOS act synergistically in the following manner. The light-based component converts optical energy to heat according to the principle of selective photothermolysis, and the bipolar RF component generates heat through a current of ions based on the electrical conductivity of the target tissue. It is well-known that electrical current will always follow the path of least resistance, a phenomenon known in physics as impedance. Impedance is directly proportional to heat; the warmer a structure is, the more it will attract electrical current (i.e., higher heat=greater conductivity). This same principle of conductivity works in reverse. An area where cold is applied results in reduced conductivity in that area. In ELOS applications, the optical components are most often used to heat the target first to lower its resistance (impedance), constructing a preferred pathway for the electrical RF energy to concentrate at the target site. The RF energy then adds to the selective thermal heating of the target. The final component of ELOS-controlled heating is integrated contact cooling delivered by the handpiece. Precooling of the skin increases the impedance of the skin surface, providing protection and comfort. When combined with the correct selection of energies, precooling provides greater control and enhances the ability to direct therapeutic electrical current to a greater depth of penetration than light-based systems alone. Based on the mechanisms described, the optimal treatment method of ELOS is precooling of the epidermis followed by a near simultaneous application of the optical and bipolar RF energies. Treatment steps are as follows: (1) hydrate and cool the epidermis; (2) apply optical energy to selectively heat the target and bipolar RF energy to provide additional thermal energy to the heated target (the temperature of the epidermis should not exceed the target temperature); and (3) discontinue optical pulse and continue RF pulse for additional selective heating of the target.
Elos-Based Systems Two ELOS-based systems, the Aurora™ and Polaris™, are available to treat a number of clinical applications (Table). The Aurora system uses intense pulsed light (IPL) (400–980 nm, 580–980 nm, and 680–980 nm) for optical energy, whereas the Polaris system uses a high-power diode laser (900 nm) as its optical source. Both systems are comprised of a bipolar RF generator and optical light (broadband pulsed light or laser) delivered through a contact sapphire light guide, with bipolar RF energy delivered through electrodes embedded in the system applicator and brought into contact with the skin surface. The bipolar RF component of ELOS systems is designed so that the 2 electrodes are laterally affixed on opposite sides of the rectangular sapphire light guide. Electrical current is passed between 2 electrodes and is limited by the area between the electrodes. The penetration depth of electrical current can be calculated as half the distance between electrodes. Because the distance between the Aurora handpiece electrodes is 8 mm, the depth of penetration for this handpiece applicator would be 4 mm. Pulses of optical and RF energies are initiated at approximately the
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same time for both systems; however, in the Aurora system, the bipolar RF pulse is set at a longer duration than the optical pulse, enabling the optical component to preheat the target and increase RF selectivity. ELOS systems also include an active dermal monitoring system that measures changes in skin impedance. The user can adjust the system to provide an integrated safety mechanism (Impedance Safety Limit) that can prevent overheating of the dermis. The thermoelectric integrated contact cooling maintains a temperature of approximately 5°C before, during, and after energy delivery. Clinical Applications There are multiple potential uses of ELOS, including hair removal, reversal of photoaging, treatment of vascular and pigmented lesions, skin texture improvement, and wrinkle reduction. As with all cosmetic procedures, the cosmetic dermatologist must determine which type of treatment will best serve each patient depending on individual conditions, needs, and history. Patients should be counselled on pre- and post procedural care, as well as realistic expectations of the treatment potential. With ELOS systems, patients usually require 3 to 6 treatments for hair removal or skin rejuvenation. As with laser light therapy, a level of patient commitment is required before effects are observed, and patients must be informed of potential side effects. Skin Rejuvenation Skin rejuvenation involves reducing the signs of aging and photodamage and toning, smoothing, and evening out skin imperfections of all varieties. Nonablative photorejuvenation with laser light sources has become popular because it is minimally invasive, is associated with few complications, and requires little recovery time. The goal of nonablative photorejuvenation is to induce subsurface remodelling without ablating the overlying epidermis. Depending on the system specifications and selection of targets, some systems can be more effective than others. For example, the optical wavelengths that target melanin are most effective for treating pigmented lesions but at the same time may cause more complications in darker skin types. Although nonablative photorejuvenation is effective in reversing photodamage and treating fine lines and superficial defects, its efficacy in treating deeper wrinkles is limited. The Aurora SR system is specifically indicated for skin rejuvenation. A clinical trial by Bitter and Mulholland evaluated this system for skin rejuvenation in 100 subjects. Subjects with Fitzpatrick skin types II to IV received treatment on the face and upper neck. Each treatment consisted of 1 to 3 passes over the face using a pulsed light fluence of 28 to 34 J/cm2 and an RF current of 20 J/cm3. Improvements were observed in Erythema and telangiectasias (70%) and in lentigines and other pigmentary dyschromias (78%). In addition, both physicians and patients observed notable improvements in mild to moderate perioral, periocular, and forehead wrinkles. Mean improvement in skin texture and fine lines was 60%. Based on their clinical experience, Bitter and Mulholland noted that treatment for wrinkle reduction with the Aurora SR system appeared to provide greater efficacy than IPL alone. Moreover, subjects who had previously undergone treatment with IPL reported a preference for the combined optical and RF procedure because it resulted in a greater degree of skin improvement, more rapid onset of effect, and less discomfort. In most subjects, pigmented lesions crusted one day after treatment. Only a small percentage of subjects (2.8%) were dissatisfied with the level of skin texture improvement after treatment with the Aurora SR system. Hair Removal Laser light devices have been used effectively for hair removal. Based on the theory of selective photothermolysis, lasers and IPL sources with wavelengths in the visible to near-infrared region are
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the most effective for hair removal because they preferentially target melanin in the hair shaft. Within certain restrictions, most laser and IPL systems provide a degree of effective removal of dark hair on light skin. However, individuals with darker skin (Fitzpatrick skin types IV–VI) or tanned skin have a higher risk of blistering and undesirable pigmentation changes after laser light treatment because of the high concentration of melanin chromophores in the epidermis. Individuals with light-coloured hair (i.e., red, white, gray, or blond) are difficult to treat for hair removal because of low levels of melanin in the hair shaft, which fails to absorb enough optical energy to achieve selective thermal destruction of the follicle. ELOS systems may help to overcome these difficulties. The RF energy in ELOS systems is not dependent on melanin absorption and can be used with lower levels of optical energy, which enables their use in patients with dark skin or light-coloured hair. The theory is that the light is first absorbed and heats the hair shaft, while the additional conducted RF energy selectively heats the hair follicle. I have conducted 2 studies evaluating the efficacy of the Aurora DS system for hair removal. The first study was comprised of 40 adult subjects aged 18 to 46 years with Fitzpatrick skin types II to V and various hair colours. The second study was comprised of 36 adult women aged 38 to 83 years with overall lighter skin phenotypes (Fitzpatrick skin type’s I–V) and blond or white facial hair. In both studies, subjects received 3 to 4 treatments at 8- to 12-week intervals over a period of 9 to 12 months. Depending on skin and hair phenotypes, light energy ranged from 15 to 30 J/cm2; higher optical energy was used in subjects with lighter skin phenotypes and hair colour. The RF current ranged from 10 to 20 J/cm3 depending on the treatment site; higher RF energy was used on facial regions than lower body regions. Results for both studies were monitored 18 months after the first treatment or 6 months after the last treatment. In both studies, maximum hair reduction occurred 6 to 8 weeks after the first treatment, and hair density decreased progressively after each subsequent treatment. Hair removal was greater in subjects with dark hair (mean clearance, 80%–85%), which is similar to results achieved using laser light sources. In both studies, up to 60% hair clearance was reported in subjects with light hair phenotypes. Results from both studies showed no significant relationship between treatment response and skin colour. Side effects, including mild erythema and hyperpigmentation, were minimal. Because the Aurora DS system is not dependent on chromophore targeting, it is hypothesized that its mechanism of action for hair removal may be based more on the thermal damage induced by the RF than the optical component. Leg Vein Treatment Until recently, laser therapy for the treatment of leg veins was restricted to vessels smaller than 1.2 mm in diameter because of limited depth of penetration. Laser light sources in the visible-light wavelengths are appropriate for treating superficial small-diameter leg telangiectasias. Deeper penetrating infrared wavelengths have enabled effective clearance of veins up to 3 mm in diameter. For effective leg vein removal, laser light energy levels must be high enough to enable absorption by intravascular haemoglobin. The resulting heat coagulates or clots the blood, and vein destruction occurs. With ELOS technology, the 900-nm optical energy penetrates the dermis and is absorbed by intravascular haemoglobin. This energy is converted into heat, and blood vessel temperature subsequently rises, creating a preferential path of conductivity through the vessel. Blood has very high electrical conductivity, and increased conductivity correlates with higher temperatures. Thus, the RF energy in ELOS systems is preferentially absorbed by the target vessel because of the increased temperatures of the target tissue (produced by the laser), as well as the high electrical conductivity of the blood. Through the heat created by both the diode laser and RF current, the blood vessel is able to reach a sufficient temperature level to cause irreversible vessel shrinkage or destruction. Chess investigated the use of the Polaris LV for the treatment of leg veins with vessel diameters ranging from 0.3 to 5.0 mm. The study enrolled 25 female subjects (Fitzpatrick skin types I–IV) with
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a total of 35 sites.Energy settings were determined based on skin type and were increased until a vessel reaction was observed. The initial optical energy (900-nm diode laser) used in this study ranged from 80 to 120 J/cm2. Higher energy levels were used in subjects with lighter skin types. RF energy settings ranged from 80 to 100 J/cm3. Subjects received up to 3 treatments at 4- to 10-week intervals. At followup visits 1 month and 6 months after the final treatment, approximately 77% of treatment sites exhibited 75% to 100% vessel clearance; 13% of treatment sites exhibited 50% to 74% vessel clearance; and 10% of treatment sites exhibited 25% to 49% vessel clearance. In this study, up to 140 J/cm2 of laser energy and 100 J/cm3 of conducted RF energy, with pulses in the range of 100 to 300 milliseconds, resulted in substantial clearance of both small and large vessels (0.3–5.0 mm in diameter). Side effects included discomfort at the treatment site, dysesthesia (at 1 site), and eschars (at 3 sites). In a recently completed study of 50 patients who received leg vein treatment (vessel diameter between 1 and 4 mm) with the Polaris LV, preliminary assessment of results showed that most patients had good to excellent improvement in leg vein reduction. I have treated more than 1000 patients for a variety of clinical applications, including skin rejuvenation, hair removal, and leg veins, using ELOS technology systems. Based on my experience, the ELOS systems are effective, safe, and user-friendly. Integration of electrical RF and optical energies indicates that the ELOS systems do not rely on a single form of energy to achieve sufficient heating of the target site. The rationale behind a combination system such as ELOS is that there is a synergistic interaction between the 2 forms of energy. The optical component selectively preheats the target through selective photothermolysis, and the RF energy is driven to the target site by the electrical conductivity of the target tissue, as well as the increased conductivity generated from the optical preheating. Importantly, RF energy is not scattered by tissue or absorbed by melanin. ELOS technology overcomes the primary limitation of purely light-based treatments because it can be used on all skin types. In addition, with current lightbased systems, the cosmetic dermatologist must rely on clinical judgment to determine if the skin is overheating during the procedure, and, in many cases, the patient may show no discomfort or excessive erythema during treatment. The active dermal monitoring system on ELOS devices helps to safeguard against overheating of the skin. Also, the combination of energies allows lower levels of RF and optical energies to be used, potentially reducing the risk of side effects. Minimal pain is associated with ELOS treatment, and I have observed side effects such as blistering and erythema.
Neil Sadick, MD, FAAD, FAACS, FACP, FACPh, is one of our most renowned dermatologists and researchers, and his multiple discoveries have strongly influenced and transformed the future of dermatology.
Dr. Sadick's prestigious list of titles range from Clinical Professor of Dermatology at Weill Cornell Medical College, to President of the Cosmetic Surgery Foundation, Member of the Board of Examiners for the International Society of Hair Restoration Surgery, to Global Medical Advisor for Christian Dior Beauty, to name a few.
Dr. Sadick holds four board certifications: Dermatology, Cosmetic Surgery, Internal Medicine, and Hair Transplantation.
Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. In addition, he has written or edited more than 10 books on cosmetic surgery, hair, and vein treatment. Dr. Sadick has also been a guest lecturer at more than 500 medical seminar classes and workshops worldwide.
Neil Sadick, MD
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Syneron Transitions UltraShape® Business to Direct Sales in Canada
UltraShape® business to be supported by Syneron's direct sales, service and customer support services headquartered in Toronto, Canada. Syneron – Candela worldwide have annouced the complete transition of its UltraShape® business in Canada from its previous distribution network to the Company's Canadian headquarters in Toronto, Canada which includes, but is not limited to, sales, service and customer support. This news comes shortly following the Company's acquisition of UltraShape Ltd. on February 8, 2012. "The swift progress to Syneron's Canadian headquarters in Toronto represents our continued commitment to this region, its existing UltraShape customers, and is a positive step towards driving increased adoption of UltraShape in Canada," said Louis P. Scafuri, Chief Executive Officer of Syneron. "We are very excited to bring all entities of the UltraShape business in Canada closer to our strong existing infrastructure – providing new and existing UltraShape customers with direct access to the world-class business and service support that have earned Syneron its leading position in the worldwide medical aesthetic market." The UltraShape Contour |V3 system, the latest model by UltraShape, is cleared and commercially available in Canada as well as in Europe, Canada, Latin America and Asia. For more information about UltraShape® or any of Syneron's broad product offering, visit www.Syneron-Candela.co.uk
Syneron – Candela Support Flood Victims in Thailand
In conjunction with our distribution partner in Thailand, Astraco Medical Network LTD., we made a donation to the Princess Maha Chakri Sirindhorn Foundation to support victims of the severe monsoon-season flooding that occurred in Thailand in 2011 and continues to impact local communities. The donation to the foundation will help to support recovery in affected areas and provide relief for those impacted by the flooding. Miguel Pardos, Vice President Asia Pacific of Syneron commented, “We offer our condolences to those who have lost loved ones and our thoughts are with all the flood victims. Our sympathies remain with the Thai people at this difficult time.” Louis P. Scafuri, Chief Executive Officer at Syneron, said, “Syneron believes in helping others in need and giving back to the communities in which we live and operate. In particular, we believe in the importance of assisting the Thai people in their long-term flood recovery efforts. We are proud to make this donation in conjunction with our local distribution partner, Astraco Medical Network LTD.” For more information on the Princess Maha Chakri Sirindhorn Foundation and its support of flood victims in Thailand, please visit www.sirindhorn.net
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Contact us.... If you have any questions or require further information about any of our products or services please contact: Address: Syneron-Candela UK Ltd
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Who to contact at Syneron-Candela UK
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