Another exciting day. Good start by arriving on time.
Rhinoplasty is probably one of the most challenging procedures that we do in terms of meeting patient expectations. It is just as important to preserve function as well as form. Mr Charles East shared with us 10 tips on how to avoid problems.
Sir Bruce Keogh, National Medical Director of NHS England, made a surprising guest appearance to give us an update on the recommendations that his committee made to the Government with regards to cleaning up the aesthetic industry, post PIP scandal. The bad new is that nothing is going to happen now till at least the second half of next year as the parliament now head towards the election year. Good news is that we have his assurance that he will continue to sit on top of this very important issue and push actions through. I heard distinct murmurs of scepticism.
As a direct result of Sir Keogh’s criticism of the lack of data and evidence base in our industry, the Healing Foundation and BAAPs, led by Rajiv Grover has been successful in setting up the National Institute of Aesthetic Reseach (NIAR), now in it’s second year. We heard from the CEO, Brendan Eley on the ongoing research projects.
The next lecture was my favourite for the day. Delivered crisply by Rajiv Grover in his usual methodical, logical and yet entertaining fashion. i now understand why my SMAS layer (Oriental genes) is slower to droop than my Caucasian cousins. It is thicker and I will do well with a SMAS plication when I have my facelift whereas my Caucasian cousins will need a SMASectomy. The good news for our Caucasian patients who have regular filler injections is that the collagen stimulating effect of the filler makes their SMAS more like the Oriental thick SMAS, hence delaying aging.
The keynote lecture by Dr J Stuzin on his 30 year experience of face lifting highlighed 2 things – less is better and it is about restoring a youthful facial shape and minimizing the stigmata of surgery.
The keynote lecture by Dr A Verpaele taught us that 1 + 1 can be more than 2. Addressing the many elements of aging in the face – skin texture, skin laxity, volume loss, volume displacement with appropriate and not necessarily aggressive procedures can produce a more youthful, pleasing and he likes to use the word ‘reposed’ appearance without excessive downtime and more importantly with minimal risks. Exactly my own philosophy and that is why most patients having a facelift almost invariably need some degree of fat grafting and skin resurfacing either with lasers or chemical peels.
Dr Verpaele also shared with us the new concept of nano fat graft. This is fat graft passed from 1 syringe to another so that the cells are ruptured and then filtered to separate fibrous remnants from the residual aspirate which now consists of adiposite derived stem cells and other stromal components. This thin aspirate is now injected intradermally to improve skin quality – mesotherapy style.
Finally, Coolsculpting, the device that kills fat cells by freezing them. This is a completely non surgical technique and Dr Jennifer Harrington from Minesota shares with us her transition from being a traditional plastic surgeon that cuts, to one that has crossed the bridge to include the non surgical in her practice. 2 years on and she will be adding another machine to her existing 2 – compelling evidence for the demand and it’s success.
This has been a recurring message throughout the 2 day meeting. Non-surgical techniques do have a role in the management of our patients in a modern day aesthetic practice. We are the best people to look at the evidence base behind the array of products and devices, select treatments that work and provide this service as part of a continuum of our surgical work. This is the only way we can ‘stay on top of the game’, to borrow a phrase from Dr Harrington.
After an enligtening 2 days of lectures and catching up with colleagues from across the UK, it is time to get back to Birmingham and a full day of operating tomorrow.
Mrs CC Kat is a leading Midlands Consultant Plastic Surgeon specializing in cosmetic and reconstructive surgery. She is a full member of both British Association of Aesthetic Plastic Surgeons (BAAPS) and British Association of Aesthetic , Plastic and Reconstructive Surgeons (BAPRAS) as well as several international aesthetic surgery associations. She worked as a Consultant Plastic Surgeon at the Heart of England NHS Foundation Trust but now runs her private practice, CC Kat Aesthetics – Birmingham Laser, Skin and Cosmetic Surgery Clinic, full time. For more information, visit www.cckat.com or call 08453731818.