Inside Aesthetics

Episode 163 showcases our hosts Dr Jake Sloane & David Segal On the back of our discussion with Jahan Kalantar (episode 160), we look at the numerous compliance issues within injectable clinics from an injector and business owners perspective. We discuss: - The background to why compliance and regulations in Australia are so topical - Who makes the rules - Clinical notes for injectors - Stock checks and receiving stock in clinic - What to do when stock goes missing or is damaged - Drug storage and fridge requirements - The role of clinical audits in injectable clinic - Room cleanliness - The dynamic of sharing rooms between multiple injectors - The problem with compounded drugs - The issue with friends and family in the injecting room - The role of 'Secret Shoppers' 00:00 Introduction 04:55 Why Regulation in Aesthetics Is Increasing 10:59 Understanding Your Legal and Professional Responsibilities 18:27 Common Compliance Risks in Everyday Practice 26:25 Importance of Accurate Clinical Notes and Documentation 33:29 When Audits Happen and What Inspectors Look For 41:37 Managing Stock, Drug Books and Inventory Control 48:53 Safe Storage, Fridge Monitoring and Expiry Checks 52:09 Handling Adverse Events and Patient Complaints 61:45 Why Clear Protocols Protect Clinics and Staff 68:49 Training Teams and Setting Operational Standards 76:38 Preventing Errors With Communication and Systems 80:09 Lessons From Real Clinic Incidents and Mistakes 86:34 Building a Culture of Safety and Accountability 90:43 Key Takeaways for Running a Compliant Clinic ALL IA LINKS & CONTACT INFORMATION

Episode 162 hosts Gillian Murray (Prescribing pharmacist, clinical researcher and pharmacist injector based in London, UK) Gillian has over 16 years experience working within the National Health Service and is the directorate pharmacist. In this role she consults on pharmacy education strategies at a local as well as national level. She is a senior lecturer in clinical pharmacokinetics at Kings College University. Passionate about using medicines safely, Gillian set up 'Medicine in Aesthetics' to support aesthetic practitioners. She is also the Secretary for Complication in Medical Aesthetics Collaborative (CMAC). Gillian has a particular interest in hypersensitivity reactions, filler gel chemistry, rheology and is currently undertaking post-graduate research in this field. We explore: How we came across Gillian's work Her background as a pharmacist and what a prescribing pharmacist is The dynamic of being a pharmacist injector in the UK What hyaluronic acid is and what it looks like structurally What the difference between natural and filler hyaluronic acid is What crosslinking is and what BDDE is The circumstances where we need to dissolve HA What hyaluronidase is How hyalase differs from hylanex On label uses of hyaluronidase vs off label uses The history of using hyalonidase to dissolve fillers What the incidence of allergic reactions is when using hyaluronidase Whether we should do patch testing with hyaluronidase or not Protocols for using hyalase - both emergency and elective The concept of 'dissolving clinics' and patients requesting their fillers to be removed The use of ultrasound guided hyaluronidase injections - is it the gold standard? 00:00 Introduction 01:03 Meet Gillian Murray 04:55 Role of CMAC and Managing Complications 10:59 What Hyaluronidase Is and How It Works 18:27 When and Why We Use Filler Dissolving 26:25 History of Hyaluronidase in Medicine 33:29 Different Brands and Purity of Hyaluronidase 41:37 Emergency Protocols for Vascular Occlusion 48:53 Pain, Swelling and Patient Reactions Explained 52:09 Allergy Risk, Bee Stings and Skin Testing Debate 61:45 Does Hyaluronidase Affect Natural Tissue 68:49 Risks of Overusing Dissolving Treatments 76:38 Elective Dissolving and Patient Expectations 80:09 Why Good Injecting Reduces the Need to Dissolve 86:34 Common Complications Seen in Practice 90:43 Final Safety Lessons for Responsible Use ALL IA LINKS & CONTACT INFORMATION

Episode 161 hosts Lori Robertson (Family nurse practitioner based in California, USA) Lori joins us in the 5th Chapter of our mini-series called 'The Injector Diaries'. These episodes feature in depth conversations, stories and experiences from injectors around the globe. Each injector brings their own unique take on things and we'll showcase every level of injector, from newbies to masters. We'll explore how and why they chose to inject, why they favour using certain products, look under the hoods of their clinics and businesses and aim to learn from and inspire our injector listeners. 00:00 Introduction 01:03 Meet Lori Robertson 04:55 From ICU Nursing to Aesthetic Medicine 10:59 Discovering Aesthetics and Early Training Challenges 18:27 Why Continuous Education Matters in Injecting 26:25 Becoming a Trainer and Teaching Safe Techniques 33:29 The Problem With Short Courses and Limited Experience 41:37 Building a Comprehensive Training Program 48:53 Hands On Mentorship and Time on Tissue 52:09 When New Injectors Are Ready to Practice 61:45 The Importance of Patient Selection and Ethics 68:49 Managing Expectations and Avoiding Overtreatment 76:38 Why Saying No Builds Trust and Reputation 80:09 Balancing Business Growth With Patient Safety 86:34 Mentorship, Community and Ongoing Learning 90:43 Final Advice for Safe and Sustainable Practice ALL IA LINKS & CONTACT INFORMATION

Episode 160 hosts Jahan Kalantar (Criminal Lawyer based in Sydney, Australia) Jahan also has an incredibly popular TikTok account where he provides entertaining and concise explanations about legal concepts. Having discussed some of the legal principles that injectors need to be aware of in previous episodes (episodes 51, 66 & 114), we now explore things from a prosecuting solicitor's perspective. Disclaimer: The information in this podcast is general in nature should not be taken as legal advice. Governing laws between countries, states and cities can vary greatly. You should seek your own independent advice before making decisions of a legal nature. We explore: - Jahan's career to date and how he became interested in the law of cosmetic medicine - Why he changed from working as a barrister to working as a solicitor - The reasons why patients usually sue cosmetic practitioners - What constitutes a 'bad' outcome? - Why poor communication is usually at the root of medicolegal complaints - What exactly happen and what the main steps when a patient sues - What exactly is 'informed consent' from a legal perspective? - Consent forms and how to use them properly - How and why can patients can still successfully take legal action, despite signing these forms which communicate the possible risks/complications associated with both surgical and non-surgical treatments? - The crucial importance of excellent note taking and the perils of not doing them at the time of the treatments - Why you should take clinical photography seriously - The legal implications of registered nurses using remote prescribing doctors - Terminating difficult consultations before they become a bigger problem - Responsible and professional behavior - how solicitors can use your social media to build a case against you 00:00 Introduction 01:03 Meet Jahan Kalantar 04:55 Understanding Medical Negligence and Litigation 10:59 Why Patients Decide to Sue Practitioners 18:27 Communication Breakdowns and Expectation Management 26:25 Real Case Example Poor Outcome and Escalation 33:29 The Importance of Professional Boundaries With Patients 41:37 Responding to Complaints and Handling Conflict Early 48:53 Saying Sorry Without Admitting Legal Liability 52:09 The Legal Process From Complaint to Settlement 61:45 Why Detailed Clinical Notes Are Critical Protection 68:49 Documentation Mistakes That Create Legal Risk 76:38 Photography, Consent and Medical Records Standards 80:09 Identifying High Risk Patients and Red Flags 86:34 Protecting Your Practice With Systems and Protocols 90:43 Final Advice for Reducing Legal Risk in Aesthetics ALL IA LINKS & CONTACT INFORMATION

Episode 159 hosts Sia Hendry (Skin & laser therapist) & Tiarnna Smith (Clinical Application Specialist for Alma Lasers) from Sydney, Australia Sia has been at the forefront of skin and laser treatments in Australia for over 15 years and is the owner of 'You by Sia' in Bondi Junction. Sia was one of the first clinics in Australia to offer laser hair removal and has seen first hand how the technology has changed over time. Tiarnna's background is in medical engineering and she is one of Alma's clinical specialists. In this role she supports Alma's customers in all aspects of training and education when using their devices. In this episode we focus on laser hair removal - the most popular cosmetic treatment performed in Australia today. We first reflect on how this came to be and contrast it to other countries where laser hair removal is often less available and far less affordable. We then compare and contrast older laser hair removal technology with Alma's newest device the 'Soprano Titanium'. We cover: How laser hair removal actually works? We re-cap on the basic physics of lasers & wavelengths including 755nm, 810nm & 1064nm Sia's early experience with older laser hair removal technology and the disadvantages it had Why older technology created significant pain and how the Soprano Titanium has improved on this How painful treatments can lead to poorer compliance (particularly in the male demographic) and a less efficient business model The use of separate skin cooling devices in traditional laser hair removal vs how the Soprano Titanium cools the skin from within the handpiece Why regardless of the laser used, you will always need multiple treatments to achieve permanent hair reduction Reducing the risk of serious adverse events when using laser hair removal devices - how automated settings have reduced human error Treating skin of colour – how the Soprano Titanium device has solved one of the most significant limitations of older laser hair removal technology Whether we can also treat patients with fake tan or sun tanned skin with the Soprano Titanium? Hair colour limitations - can we now treat blond and red hair? Medications - what patients need to tell their therapist before having laser hair removal How upgrading technology has improved Sia's business, revenue and staff satisfaction Alma's services including supporting clinics to trade in their older laser hair removal device 00:00 Introduction 01:04 Meet our Guests: Sia Hendry & Tiarnna Smith 04:55 Early Challenges in Laser Hair Removal 10:59 How Laser Hair Removal Technology Has Evolved 18:27 Safety Risks and Common Treatment Complications 26:25 How New Technology Improves Comfort and Efficiency 33:29 Understanding Pain Reduction and Cooling Systems 41:37 Treating Tanned and Darker Skin Types Safely 48:53 Blonde, Red and Difficult Hair Types Explained 52:09 Managing Contraindications and Patient Selection 61:45 Permanent Hair Reduction and Maintenance Treatments 68:49 Training Staff and Adopting New Technology 76:38 Business Benefits Faster Treatments and Higher Capacity 80:09 Cost Savings Without Consumables and Maintenance 86:34 Adverse Events, Safety Protocols and Risk Reduction 90:43 Final Advice for Clinics Considering New Devices This episode was brought to you in partnership with Alma Lasers ALL IA LINKS & CONTACT INFORMATION

Episode 158 hosts Dr Niamh Corduff (Plastic Surgeon & Merz KOL based in Geelong, Australia) In this new mini series, 'The Tox Talks', we feature expert injectors who have significant experience in using botulinum toxins. These episodes explore our guests experiences using particular brands, the evolution of their injecting techniques and we get special insights into the subtle nuances of getting the best out of toxins. In Chapter 1 we focus on the brand known as Xeomin or Boucouture (Incobotulinum toxin A) distributed by Merz Aesthetics. 00:00 Introduction 01:03 Meet Dr Niamh Corduff 04:55 Early Adoption of Toxin in Clinical Practice 10:59 Why Non Surgical Treatments Expanded So Quickly 18:27 Learning Injection Technique Beyond Textbook Anatomy 26:25 The Art Versus Science of Aesthetic Injecting 33:29 Training Challenges and the Need for Better Standards 41:37 Understanding Different Toxin Brands and Manufacturing 48:53 Technique Adjustments Between Products 52:09 Precision, Spread and Injection Strategy 61:45 Longevity, Dosing and Patient Expectations 68:49 Risk of Resistance With Long Term High Dose Use 76:38 Storage, Stability and Practical Clinic Considerations 80:09 Choosing the Right Product for the Right Patient 86:34 Key Lessons for Safe and Effective Toxin Practice This is a non-sponsored episode and does not replace training in any way. Our guest speaks from her own experiences and we do not promote or endorse any brand of product. ALL IA LINKS & CONTACT INFORMATION

Episode 157 hosts Dr Martina Lavery (Dental surgeon & facial aesthetic injector based in Sydney, Australia) Martina joins us in the 4th Chapter of our mini-series called 'The Injector Diaries'. These episodes feature in depth conversations, stories and experiences from injectors around the globe. Each injector brings their own unique take on things and we'll showcase every level of injector, from newbies to masters. We'll explore how and why they chose to inject, why they favour using certain products, look under the hoods of their clinics and businesses and aim to learn from and inspire our injector listeners. 00:00 Introduction 00:45 Meet Dr Martina Lavery 02:55 Martina Background Dentistry 07:10 Dentistry Competition Ethics 16:10 Trust Education Consent 26:10 Choosing Ethical Dentist 31:25 Why She Started Injecting 36:00 Training Evidence Wild West 39:25 Aesthetics Meets Function 39:45 Credentials Versus Skill 40:55 Masters And Board Battle 42:25 Dentists Scope In Injectables 44:40 Art Training And Mentors 49:25 Protocols Versus Intuition 55:40 Stigma And Anonymous Complaints 01:00:00 Fixing The Complaint System 01:03:00 Dental To Aesthetic Consult Flow 01:07:20 Oral Bacteria And Filler Risk 01:11:25 Photography Vectra And Ultrasound 01:15:55 Managing Difficult Patients 01:17:35 Dysmorphia and Red Flags 01:19:30 Social Media Reality Shift 01:22:30 COVID Stress and Bruxism 01:23:40 Instagram Reels Strategy 01:28:10 Marketing Attribution Puzzle 01:29:20 New Clinic Expansion Plans 01:32:35 Designing a Calmer Clinic 01:36:05 Quickfire Injector Toolkit 01:41:40 Lessons Community Competition 01:44:05 Wrap Up and Where to Find ALL IA LINKS & CONTACT INFORMATION

Episode 156 hosts Professor Bob Khanna (Dental surgeon and expert facial aesthetic educator from Reading based in the UK) Professor Khanna was the world's first recognised dentist to offer injectables and since 1996, he's been a leading thought leader in the field. He's continually evolved his own novel techniques and modalities to treat the face holistically. He is also a global-thought leader in the diagnosis and management of teeth grinding and clenching problems, also known as 'bruxism'. Injectors very commonly treat the masseters for both aesthetic and teeth grinding and so we ask the question - should they be doing this and what problems might they inadvertently create without a thorough examination? We discuss: - What bruxism is and how grinding differs from clenching? - Why these issues occur? - The role of posture in preventing parafunctional habits - The problem with soft dental plates that are commonly made by dentists to protect the teeth - How bruxism contributes to 'TMJ' (jaw joint) disorders - The forces that are generated between the teeth when grinding - What happens in bruxism exactly and what are the consequences of it? - How dentists identify bruxers: key bullet points when examining the face and mouth - Why most dentists aren't experts in treating and assessing bruxism symptoms - What injectors should ask and do when assessing their patients - The anatomy of the muscles of mastication, as well as some of the accessory muscles involved in bruxism - The role of botulinum toxin to treat the muscles of mastication - the risks of overtreating the masseters: physiological and aesthetic - how to approach the masseter - How to approach the temporalis - how to approach the lateral and medial ptyergoids - how to decide if these muscles are impacted or need treating in bruxism? - how injectors can work alongside dentists in managing bruxism symptoms 00:00 Introduction 01:03 Meet Professor Bob Khanna 04:55 Early Adoption of Botox in Dentistry 10:59 Why Anatomy Knowledge Matters in Aesthetic Practice 18:27 Understanding Bruxism and Teeth Clenching 26:25 Functional Versus Cosmetic Masseter Treatment 33:29 Risks of Treating Muscles Without Addressing Occlusion 41:37 Signs and Symptoms of Grinding and Jaw Dysfunction 48:53 Comprehensive Assessment and Diagnosis Approach 52:09 Role of Dentists and Multidisciplinary Collaboration 61:45 Why Soft Splints Often Fail Long Term 68:49 Using Toxin to Reduce Muscle Spasm Safely 76:38 Treatment Planning Beyond Aesthetic Slimming 80:09 Managing Patient Expectations and Long Term Care 86:34 Key Lessons for Safe Masseter and Bruxism Treatment ALL IA LINKS & CONTACT INFORMATION

Episode 155 showcases our hosts Dr Jake Sloane & David Segal They first summarise their Christmas break (or lack of it!) and the new challenges that they faced when reopening their clinics in 2022. They share their plans for IA this year including: - Continuing IA's new and extremely popular mini series, 'The Injector Diaries' & 'Treatments and Regions Uncovered' - Two new mini series starting soon called 'Disasters & Solutions' & 'The Tox Talks' Dr Jake and David then get into the main topic of this episode - an in depth discussion about what aesthetic treatments they've both had including: - what skin care and products they use - Botulinum Toxin treatments: when they both started having Botox, what areas were treated and why - fillers (including both hyaluronic acid fillers and biostimulators): what areas of the face they have had treated and why - fat dissolving injections: Dr Jake's experience with Belkyra - cosmetic surgery: David talks about a procedure he had a few years ago 00:00 Introduction 01:04 COVID Disruptions and Clinic Challenges 10:59 Podcast Plans and New Series for 2022 18:27 Future Topics and Industry Trends 26:25 Why Learning From Mistakes Matters 33:29 Treatments and Regions Series Explained 41:37 Body and Skin Treatments Beyond the Face 48:53 Industry Growth and New Technologies 52:09 Transition to Personal Treatment Stories 61:45 Skin Care Routines and Sun Protection Basics 68:49 First Experiences With Botox and Early Treatments 76:38 Male Aesthetic Preferences and Natural Movement 80:09 Volume Loss, Aging and Role of Fillers 86:34 Honest Reflections on Treatments and Expectations 90:43 Final Thoughts on Aging Well and Looking Natural ALL IA LINKS & CONTACT INFORMATION

Episode 154 hosts Dr Steven Weiner (Facial plastic surgeon based in Florida, USA) In 2005 Dr Weiner 'laid down his scalpel' and has since become one of the world's leading injectors and an expert in non-surgical treatments. He's one of Galderma's global KOL's and is also a leading thought leader in the emerging sub-speciality of using ultrasound in injectables. In these episodes called 'Treatments & Regions Uncovered', we drill down into how to approach specific areas of the face, what techniques can be used and what our guests have changed over time as they mastered their techniques. We'll also explore the patient perspective and get an understanding of their needs and complaints, as well as discussing any alternative treatment options that might be considered. We also discuss the anatomy and facial ageing signs of the area to better understand what's happening before going on a deep dive to find out: - how our guests do it - what products and tools they prefer and why - what approaches they use and why - what we can learn from their experiences and the complications that they've encountered As an extra twist to these episodes, our co-hosts Dr Jake and David take on slightly different roles! David will act as our main host and give his own 'patient' perspectives whilst Dr Jake will join the week's guest as a second expert injector to share his own insights, tips and tricks. In the 2nd chapter of 'Treatments and regions uncovered' we'll be exploring the chin and jawline areas, the boundaries of the lower face and key facial signs of sexual dimorphism. We cover: - Some of the anatomical terms used to describe the area - What patients typically complain of when considering chin and jawline treatments - What factors have an influence in chin and jawline definition - Sexual dimorphism in chin and jawlines and whether we should follow the 'aesthetic rules' concerning these - What treatment modalities can be used to improve the chin, jawline and also the neck - What do 'bad' lower face filler treatments look like? - The role of toxins in the chin and the masseters - The interesting concept of 'mewing' and how this may impact on our facial aesthetics - Needle vs cannula techniques when approaching the chin and jawline fillers 00:00 Introduction 03:10 Jawline Trend Setup 04:00 Meet our Special Guest: Dr Steven Weiner 07:00 Why He Quit Surgery 11:00 Jawline Assessment Basics 16:00 Ratios Rules And Diversity 22:20 Neck And Fat Reduction Tools 26:10 Patient Complaints And Goals 29:15 Neck Treatments Strategy 33:15 Chin Jaw Anatomy Terms 36:25 Bad Jawline Filler Pitfalls 38:05 Why Humans Have Chins 38:45 Why We Have Chins 39:55 Hormones And Jawlines 42:45 Teeth Extraction Effects 49:35 Mewing Explained 53:50 Assessment And Injection Plan 54:15 Cannula Planes And Ports 57:30 Product Selection Choices 01:05:55 Chin Toxin Technique 01:09:30 Volumes And Staging 01:13:50 Complications And Ultrasound 01:18:00 Managing Occlusion Anxiety 01:19:35 Ultrasound Guided Hyalase 01:20:50 Oxygen Patch Adjunct 01:22:50 Trust After Complications 01:26:10 Spotting Early Occlusion 01:29:50 Anatomy Variations on Ultrasound 01:33:55 Jawline Q&A Techniques 01:39:55 Aging Jawline Advice 01:42:40 Future Treatments Microcoring 01:46:30 Masseter Botox Slimming 01:50:20 Wrap Up and Next Panel ALL IA LINKS & CONTACT INFORMATION