The big question - Who owns the aesthetic space?
This is such an interesting question and one which will get everyone thinking. The Cosmetic market is comprised of Non-surgical and Surgical professionals which have various organisations representing each specialty. We have the Australasian Society of Aesthetic Plastic Surgeons (ASAPS) who practice surgical and non-surgical aesthetic treatments. ASAPS run the Non-Surgical symposium (NSS) and it has grown to be the most recognised and largest non-surgical conference in Australia. We have several boutique conferences which are hosted by the industry suppliers and independent cosmetic symposiums and conferences throughout the year. Then we have the dermal clinicians and of course the Australian Society of Cosmetic Dermatologists.
The ASCD conference was unique in that everyone appeared normal with normal facial features. Quiet bazar for an aesthetic conference as I normally feel inadequate at these events, surrounded by huge cheeks and lips. Another interesting point was that the boundaries were very clear, everything was kept within the dermatology realm. In talking about case studies in ‘The Complications Cup’, the dermatologists would state “I would refer this to our other speaker Dr Callan, as he is a burns surgeon” or “this patient requires a blepharoplasty, I would refer to Dr Liew” and vice versa. At one point, Dr Goodman asked Dr Niamh Corduff (Plastic Surgeon) is your title referralologist? As every second answer was “I would refer this to Dr Goodman, as he is the expert in this”.
This was an interesting collaboration between surgeons and dermatologists, which left me at the end of day 2 wondering, who is the best when it comes to the non-surgical cosmetic space? The Plastic Surgeons? The Dermatologists? The Nurses? (we also know that GPs, dentists and even vets have broached this field). As a patient, who is your safest and best bet? This is a difficult question I was left to ponder over. With regards to cosmetic surgery, the answer is clear, its black and white. Either you are a surgeon, or you are not. It’s really that simple. In the non-surgical space, it is not that simple, there is no benchmark, there is not even a minimal training requirement for injecting and there is no clear “peak body”. If that wasn’t bad enough or confusing enough, the laser safety regulations are different from state to state and across Australia (and then different again in other countries). We learnt from Dr Matteo Tretti Clementoni that in Italy you must be a doctor to operate a laser.
There is a myriad of complications that can occur from the various treatments and they can include, laser burns, infections, necrosis (dead patches of skin), scarring or even blindness from filler. When you see all the things that can go wrong it makes you wonder if it is worth it, this constant chase for eternal youth. What is often advertised as a “lunch time treatment” or “little to no downtime” can often turn into a horror story. What appears to be a cold sore post lip filler can progress to a black dead section of your lip – eek. I was certainly freaked out. So, I began to think, is it safe to have a dentist, vet or new grad nurse doing your Groupon filler treatment? Absolutely not. Is it safe to have a plastic surgeon, dermatologist or cosmetic nurse doing your treatment? In reality, the answer is still no. We learnt no one is safe, no one is free from the risk of complications. The great Dr Peter Peng shared a complication from within his clinic, followed by others. It turned out everyone will at some stage have a complication, this is not an exact science. The vessels in the face are many and are not always in the same areas for every patient. Many slides presented at the ASCD showed how they are different from race to race let alone the minor differentiations for individuals. Ultimately it comes back to safe practice and doing your best to minimise complications.
So, what must you look for in an injector or anyone treating with a laser?
1.Ensure they are a registered health professional (If they are not, they are not governed by a code of conduct, ethics or standards of a profession)
2.Ensure they have a reputable clinic, long standing clinic
3.Don’t be afraid to ask, ask how long have they been practicing? What training have they had? Have they had any complications? What happens if something goes wrong? And Can I come back for a check up if I have a concern?
4.A clinician with skill and insight will want to take into consideration your whole face and will turn you away if your expectations are not realistic or achievable. Someone just in it to earn a dollar will just do what you ask for with out thinking about the poor outcome or how it effects the rest of your face.
It was interesting how many dermatologists encourage clients to come back or send images repeatedly just for observation. No ethical practitioner wants a patient left untreated with an infection or adverse event. And when this happens (not if but when it happens) it is documented and utilised as a learning experience. Having the knowledge of what to look for, when and how, is what makes a great injector and/or laser technician. Dermatologists certainly play a huge role in the aesthetic space, their knowledge of the skin, anatomy and physiology is second to none. Their ethical standard, empathy and love of science is unarguable.
When it comes to the non-surgical aesthetic industry, it would seem no-body “owns” this space and there is no room or time for competition. Collaboration, evidence and sharing knowledge is by far the best approach to achieving consistently high standards of patient care. Patient safety first should be at the forefront of every organisation. Greg Goodman certainly succeeded in providing a high level of education at ASCD’s second standalone annual meeting. This maybe a dermatology meeting but it was also a meeting free from politics, with medical and non-medical speakers. The non-surgical symposium maintained its position as the pinnacle event with the highest number of delegates and international speakers. The anatomy workshop is one of the most sought-after workshops in which specialist surgeons work alongside nurses and general practitioners. Dr Tim Papadopoulos is one of our country’s most experienced speakers and well-connected medical professionals. It appears he is friends with every international speaker at every conference and as such can pull together incredible educational programs, second to none. These meetings undoubtably were successful for the busy exhibitors in 2018, and I expect there is a significant waitlist of sponsors for this year’s meeting.
This year we have started with Cosmedicon 2019 and the bar has been set high, combining practical, interactive sessions and buckets of fun. With NSS, ASCD and the emerging professions delving into aesthetic medicine, who should or should not be allowed to attend an educational conference? If every conference is about education and networking, why are the doors open to some and closed to others? Networking is extremely important in this space, and every practicing injector ideally would have a plan in the event of a complication, especially if they are travelling abroad. This year will see the inaugural Aesthetics 2019, which has been founded by the highly renowned Specialist Plastic Surgeon Dr Steven Liew, As per ASPS “featuring a truly multidisciplinary team approach (cosmetic physicians, cosmetic nurses, plastic surgeons, dermatologists) to the education of non-surgical aesthetic practice in Australasia for ALL non-surgical practitioners in an interactive and dynamic platform.” It would appear no one owns this space and conferences are adapting to the concept of opening their doors to all practitioners from surgeons to nurses and ALL in-between with patient safety at the forefront of every program. Watch this space as we will be attending: The Plastic Surgery Congress, The Non-Surgical Symposium, SkinCon 2019, ASCD and Aesthetics 2019.