MAGAZINE – ISSUE 01 SINCLAIR.COM/UK SINCLAIR INSIDER
The secrets of my success, Ffyona McKeating, founder of Consultant Clinic P. 6
Dr Maryam McMillan uses MaiLi as her preferred HA P. 8
LanLuma is reshaping the landscape of Aesthetic Medicine, Dr Alex Parys P. 14
The Three Pillars of Website Success in Patient Acquisition P. 20
The Rundown
Welcome to Sinclair UK's inaugural edition of The Sinclair Insider, where we blend ancient Feng Shui wisdom with modern medical aesthetics with Pico Clinic's philosophy. Meet the pioneers shaping the industry, dive into success stories, and delve into insightful guides on PR. This first issue is packed with expert knowledge and is your premier guide to the evolving world of aesthetics.
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A beginners guide to PR for clinics Kendrick PR 10
Why I choose MaiLi Dr Maryam McMillan
The secrets of my success Ffyona McKeating
PICO Clinic treats with Feng Shui philosophy Dr Varna Kugan
Providing Aesthetic Excellence Globally.
Strength in adversity, route to success Dr. Victoria Manning 12
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Dermal Fillers: To inject or not to inject Dr Ahrooran Sivakumar
Patients, Practitioners and Pharmaceutical companies Dr Olha Vorodukhina
Lanluma is reshaping the landscape of Aesthetic Medicine Dr Alex Parys
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2023 highlights
The 3 pillars of website success Jack Gibson
The information on the articles contained in this magazine, have been prepared by healthcare professionals. Any opinions, views, advice provided are those of the healthcare professionals. Sinclair does not provide any warranty and does not accept any liability for the opinions, views or advice expressed
SINCLAIR INSIDER 3
PICO Clinic treats with Feng Shui philosophy Embracing Cultural Beliefs in Facial Enhancements with MaiLi Dr Varna Kugan
Soho in London. Dr Kugan * who is the PICO Medical Director and Master Trainer at the Pico Academy commented: I see many Chinese patients in my practice and can attest to these cultural beliefs that influence the aesthetic ideals and treatment requests of this demographic. What I love about MaiLi is the level of projection you can achieve with less product ** , not only is this cost effective for the patient but you significantly reduce the risk of ‘overfilling’. A lot of my work is structural and MaiLi Volume and Extreme give me the option to choose a high projecting gel that’s supple and mouldable depending on the patient’s skin envelope. MaiLi, used by the PICO doctors, is a pioneering type of hyaluronic acid filler which is very different in its makeup from the previous generation of HA fillers. It uses something called ‘Smart Spring’ Science which emulates the effects of the latest modern mattresses. It is a highly flexible gel which is malleable but retains its shape, so has a powerful lifting capacity. When you smile, your face doesn’t stay still, it moves in an animated way - however old-fashioned fillers are often rigid whereas when MaiLi is applied to highly mobile areas around the mouth or cheek area, it moves exactly like normal tissue. It is also highly elastic so it will always snap back into shape and will remain where it is placed and will not migrate. Another unique feature which differentiates MaiLi from other hyaluronic acid fillers is it is engineered without any oxygen, which means that there is less risk of the gel’s structural breakdown. This gives the product greater longevity and means that treatments last longer, typically a year *** , rather than the months afforded by most dermal fillers. For more information about MaiLi please visit www.maili.com
F eng Shui is the Chinese art of creating balance and harmony to encourage a healthy and prosperous life with bountiful opportunities. Commonly applied within the living environment these same principals have now been applied by the doctors at PICO Clinic who use a pioneering dermal filler called MaiLi to help amend the faces of patients to help encourage a more positive energy and an improvement in their prospects. In the Chinese culture, a full temple is an omen for a good marriage, whilst a wide, full forehead is a sign of wisdom, so the clinic has been approached by numerous patients of Chinese origin to fill the inward dips either side of the forehead of the brow to create a most auspicious, rounded upper face. Similarly, a curved chin with gentle rounding beneath is a sign of wealth and prosperity, and this area is also one where the doctors are asked to soften the jawline yet improve the connection between the jawline and the chin, contrary to the sharper and more defined jawlines preferred by Caucasian patients. However, one area where Asian patients are very cautious about requesting treatment is the lips, as custom has it that someone with thicker, full lips will talk too much or be ‘all talk and no action’! PICO Clinic was ‘Highly Commended’ for Best New Clinic in the UK and Ireland at the 2021 Aesthetics Awards and is based in
BEFORE / AFTER 3 ml of MaiLi treatment. Images show before and immediately after. *
BEFORE / AFTER 1.5 ml of MaiLi treatment. Images show before and immediately after. *
"What I love about MaiLi is the level of projection you can achieve with less product."
*Any opinions, views, advice provided are those of the physician. Sinclair does not provide any warranty and does not accept any liability for the opinions, views or advice expressed. Individual treatment results vary from patient to patient. **Clinical investigation 17E1176: in comparison to Juvéderm® Voluma, 24% less volume of product of MaiLi Extreme was injected for the same results in the treatment of the cheek area. ***Data on file
PHOTO: CHENG FENG, UNSPLASH
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SINCLAIR INSIDER 5
The secrets of my success
If you have meticulously planned your business model, and cut your cloth accordingly, you’ll understand the natural ebbs and flows of the industry. If there’s a dip, there’s usually an unavoidable seasonal explanation for it, and it’s merely a matter of riding it out until peak season ‘kicks in’. My lovely team do this every year, before about-turning and wishing they were less busy with just a little more down time! (Be careful what you wish for!). That’s business. But understand that, and avoid making impulsive decisions, based on a little frisson of panic. If your business needs triaging, take time to analyse your key staff and potential reasons for a dip, before acting disproportionately. Look at the yearly trends, and not the blips. Whilst it’s true, our businesses are often the babies we’ve hand-reared and developed with love, reacting emotionally never ends well. Ther may well be elements of your job you need to improve upon, but it’s highly unlikely they’ll suddenly present all at once in the space of a few weeks. SOCIAL MEDIA My favourite topic. Imagine you were offered a free mainstream TV channel, and allowed to advertise your business on it whenever you wanted? Imagine that your monthly viewing figures were more than the Queen’s Jubilee concert and the Eurovision Song Contest put together? Even better, your viewers were people that were specifically interested in the company, and that you had full control of what content was used? Now, imagine if you never bothered to take the time to use it. That sounds crazy, doesn’t it? Yet is the gift that too many of you ignore, despite complaining you could be busier. @Consultant_clinic regularly gets 27,000,000 hits a month, and therefore accordingly I spend at least 7 hours a day, trying to be creative and engage our viewers with interesting topics. I train my doctors to ask (beg!) for consent for before and after images, and I put them on photography courses to ensure they take clear images with decent equipment. I am constantly trying to consider, “what would I want to read?” We aim to both educate and entertain, and although it’s time consuming, there is much you can do to prepare posts in
zero filter actually began to work for me! It made it much easier to create posts, and work seamlessly harder, because the words flowed more easily when I wasn’t having to neutralise/curate my thoughts, or people please. I clicked onto (pun intended) the fact, that in general, viewers were really quite weary of same-y posts and topics, and wanted real, with heartfelt opinions and thoughts. The more I showed my true personality – the more people tuned in. Admittedly, it also brought those who disagreed to the fore, but it meant that if people booked into clinic based upon our genuine content and individuality, they were more likely in-synch with the ‘CC vibe’, and correspondingly satisfaction rates also supernova’d. Whilst I’m not suggesting for a moment, that you emulate my own personal, quirky way, I do strongly endorse articulating what you are impassioned about within our industry. Be your own true voice, as it’s always going to be better than a cover version. Social media followers are a discerning bunch, and they switch off faster than a New York minute if you’re not the real deal or speaking from the heart (even if it’s sometimes a little close to the bone). NO FAST TRACK Like social media, there is no fast track algorithm to the top. There is however, consistency, integrity, worth ethic, individuality and creativity. If being skilled and hard-working was all we needed, we’d all have retired by now. Working smarter and ingeniously, using social media tools, my personality and making my business scalable were key. It helped that I was nifty with figures and loved maths and projections – but if I hadn’t used them alongside of the afore-mentioned… I’d have been working harder and reaping far, far less. I’m not by any means perfect, and I learn exponentially every year, but I’m learning to spot and ride the tends, stream-line my efforts, celebrate my individuality and control the controllable. It’s taken me 13 long years, but my consistency is honed to almost military precision and my team are by far and away the best I could have ever wished for. I remunerate them accordingly and never miss an opportunity to thank them. They know how important they are to CC.
Ffyona McKeating Founder, The Consultant Clinic Group
advance and generate excellent content. If I had a penny for every time someone says “I can’t be bothered with social media”, I venture the CC turnover would double. Never, ever ignore free advertisement. Focus on learning how to create content quickly. Did you know, that of thousands of those interviewed on their death bed, one of the biggest regrets was a wish that they had been truer to whom they really were, rather than try to be liked? Personal regrets aside, a lot of the most memorable brands or people you know have a definite unique style all of their own. When I first opened our page on IG, I DON’T BE AFRAID TO BE TRUE TO YOURSELF was very ‘game show host’…. Bland, beige and with little real personality. I noticed, that when I was tired, less likely to employ the social filter we all use at times, and exhibit what I was truly passionate about, or interested in, the CC likes and engagement rocketed. My ADHD, and "Like social media, there is no fast track algorithm to the top. There is however, consistency, integrity, worth ethic, individuality and creativity."
Learn the secrets of Ffyona McKeating’s success as the owner and founder of The Consultant Clinic, the largest aesthetic clinic group in the world, boasting international locations including Harley Street, Dubai, and Beverly Hills.
PHOTO: KRISTINA FLOUR, UNSPLASH
I t’s a cliché, but if it was that easy to grow and maintain a clinic with an 8-figure turnover… the aesthetics market would be even more saturated than it is now. I see plenty of my colleagues ‘busy’, yet their profit margins are malnourished and their business model often unnecessarily complicated and less efficient. The goal is a streamlined, well-oiled machine. Easily said, far harder to execute. It’s difficult to condense into words (bear in mind, that work ethic is everything). However, without the following tips, I simply couldn’t have built (nor maintained!) my business/ brand without. GOLDEN STAFF Your team is most important element of your trade – your business can’t exist without them, and they should be treated/remunerated accordingly. There is never any place for greed in the workplace – my clinical staff are paid a 50% profit split – the highest in the industry, but then I have truly excellent doctors I never want to lose? It makes perfect sense. Conversely, we’ve all had staff akin to ‘metastatic cancers’ within the
company. They either under-perform, or just don’t fit the ethos of your much- loved business and consequently infect other staff members with negativity at alarming speed (which of course hurts productivity). As such, it’s equally important to cut that dead wood, as reward the loyal soldiers. I monitor complication rates and complaints and performance indicators, religiously and audit accordingly. Above a certain percentage just isn’t acceptable – because it significantly impacts the brand. Be brave, and understand your brand strength is vital – so if you need to remove a staff member, do exactly that. Rip the plaster off! You’ll heal far faster! DON’T CUT CORNERS WITH QUALITY I’ve seen so many companies compromise their brand, because there has been a seasonal sale, on a parallel import or different products. Your stock is the tool of your trade, and even the most dextrous of responsible surgeons cannot guarantee safety and results without using premium, guaranteed tools. If your favoured product is a little more expensive but yields better results that make your patients happier,
then raise the prices slightly to accommodate the same. Better to concentrate on nurturing your aesthetics brand as ‘premium’, than depleting the very life blood of what you do. NEVER dilute your quality for short term recompense. KEEP PERSPECTIVE AND ‘CONTROL THE CONTROLLABLES’ If you want to be a serious player in business, you’re going to have to ride out stormy seas you can’t control, at some stage. It happens and it’s inevitable. No one saw the pandemic coming, nor the subsequent ripple effects on our economy. But it’s so important to hang on to the larger landscape picture. One poorly performing month, is just that - one month that turns over a little less. I joke with my team, that at the end of the summer, I should send them each a pack of tissues, and a bumper pack of chill pills. Because invariably they catastrophise, each and every September, when the market is flatter, people are recovering from a summer holiday financial hit, and getting back into the Autumn ‘back-to-school’ routines.
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SINCLAIR INSIDER 7
My clinic, the Ambra Aesthetic Clinic, was created as a bespoke aesthetics practice with the help of an award-winning designer. Ambra is located in North Finchley, London, and combines a corporate brand image with contemporary, comfortable styling and state of the art equipment. Our passion for ethical and professional aesthetics practice is the driving force behind our holistic approach to care. We aim to provide a truly multidisciplinary service which couples high quality facial aesthetics and dentistry. Ambra combines excellent products with up-to-date, evidence based treatment methods and techniques, in order to tailor each treatment perfectly for each individual patient. Ambra provides a wide variety of treatment options from injectables to the latest technologies such as
Morpheus8, Neogen and Aerolase. The well-being and satisfaction of our patients is a fundamental aspect of the service that we provide, recognising that in order to exceed expectations, we require to invest extra time and effort with each of our patients. I exclusively use the entire MaiLi hyaluronic acid (HA) dermal filler portfolio at Ambra. When I first came across MaiLi, I was uncertain about the switch to yet another newcomer to the dermal filler market. However, over a period of time I grew to love the range. Within the MaiLi portfolio, there are 4 products; Extreme, Define, Volume and Precise, with each product being used for a different clinical indication. Specifically, I find MaiLi Volume to be particularly good for temples and midface volumisation; its cohesive properties are particularly
good in areas such the temples, and the product has excellent handling characteristics and outcome longevity. I found the MaiLi Dermal filler range to have excellent longevity. The feedback from my patients who have received MaiLi has been phenomenal. I feel the products create natural and subtle results and when compared to other brands I need less product to achieve the desired results. What I feel gives MaiLi the edge of the other products is MaiLi’s OxiFree™ technology, whereby the reactive oxygen species are removed, thus protecting the long chain HA network which therefore provides excellent product longevity. Over the years, I have had found the Sinclair team to be particularly helpful in both product training and customer support and are continuously invested in my education.
Why I choose MaiLi
Dr Maryam McMillan
Discover why Dr Maryam McMillan uses MaiLi as her preferred HA.
H aving already enjoyed a successful career in aesthetic dentistry, my progression into the practice of facial aesthetics was a very natural one. My professional career began in 2002 when I graduated from Sheffield Dental School having previously completed an honours degree in pharmacology. Consequently, I was awarded membership to the Faculty of General Dental Practice at the Royal College of Surgeons of England and following this I chose to embark on a pathway of postgraduate training in both aesthetic dentistry and facial aesthetics. The most rewarding part of my role as an aesthetics practitioner is my ability to combine a professional, evidence based and ethical approach to patient care, the results of which very often have a tremendously positive impact upon the wellbeing of my patients. "I found the MaiLi Dermal filler range to have excellent longevity. The feedback from my patients who have received MaiLi has been phenomenal."
AMBRA AESTHETIC CLINIC
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SINCLAIR INSIDER 9
A beginner's guide to PR for clinics
8 effective PR tactics used by successful clinics
existing customers, to suppliers, the media, influencers, and even employees. Below are our top 8 PR tactics to help you get your clinic noticed:
PR is about building trust and visibility, alongside authentic relationships with your target audience which includes everyone who touches your business, from prospective and
your brand is crucial to building an authentic and credible brand profile for your clinic. Finding and onboarding the right partner for your brand can feel overwhelming and you may wish to appoint a PR agency who specialises in influencer marketing and brand ambassador management, and have relationships with the top influencers in your industry. Let your patients help you promote your clinic and its services! Sharing success through well written case studies is a proven PR and marketing tactic to engage audiences and stimulate demand for products and services. A case study can help 5. CREATE AND SHARE PATIENT CASE STUDIES solidify your reputation for providing a great service – they are essentially a method of storytelling, it’s your
opportunity to remind customers of a problem and then explain how well you can solve this problem by sharing a visual example.
1. DEFINE YOUR USP A compelling USP (unique selling point) is vital in a crowded market like aesthetics and skin clinics as it will set you apart from the competition and help you clearly position yourself to journalists, influencers, and your target customers. Trying to define a compelling USP that accurately portrays what you do is a difficult task, but once your USPs are set they will shape all of your future messaging. 2. GIVE YOUR CLINIC A PERSONALITY I.E. YOU! Alongside your USP(s) you have the power to set your clinic apart from the competition. Your unique experience, expertise and style of service should all be harnessed into your brand to help build trust and a great reputation with target audiences. When you spot a story in the news that is relevant to your business or its services, then why not share your opinion and comment on it to raise your clinic’s profile? For example, if a celebrity raves about a treatment offered at your clinic why not remind your customers on social media that you offer it and boost enquiries. If you have existing media relationships, you can also reach out to your contacts as they may be intending to cover this story and looking for an expert opinion. Ambassadors for aesthetics and skin clinics are often celebrities, industry experts (i.e. MUAs) and influencers, and they often play an integral part in PR tactics. Partnering with the right ambassador who taps into your target audience and aligns with 4.COLLABORATE WITH BRAND AMBASSADORS AND INFLUENCERS 3. RESPOND TO THE NEWS AGENDA
6.WIN AWARDS AND GAIN ACCREDITATIONS
Associating your clinic with a reputable industry award and or accreditation is a great way to differentiate what you do, how you do it, and attract new audiences. Awards are an effective PR tool for building trust and assuring customers of high standards and they can help you outshine your competitors. With this in mind, why not enter your clinic and see what you can get shortlisted for or win! 7. HOST A PRESS EVENT A press event is the perfect tool to get press, influencers, and industry leaders talking about your clinic and it’s treatments. Well planned and memorable events drive brand engagement, create buzz with your target audiences, increase bookings, secure media coverage, and are your opportunity to bring your brand to life in an interactive and immersive way. 8. BE SOCIAL MEDIA SAVVY As an aesthetics or beauty consumer your target patients are going to be active on social media, particularly Instagram and TikTok, so it’s time to get involved and showcase your clinic’s expertise. Social media enables you to reach and engage with your target audiences with content that builds trust and aligns with your brand values, it’s not just about pushing your services in a bid to boost bookings or sales. Sinclair note: if you are already working with the Sinclair portfolio, reach out to your Sinclair representative to see how to collaborate with us on PR.
Kendrick PR
T he beauty, aesthetics, and wellness industries are some of the fast growing and competitive markets in the world - brands and clinics alike are vying for consumer attention as they bid to stand out from the crowd. Generating positive PR for a clinic is an effective way to raise its profile in a trustworthy manner, with the aim of engaging target patients and driving bookings. However, relatively few clinics invest in PR as this requires specialist knowledge and expertise. Kendrick, we’ve devised and delivered numerous winning PR strategies for leading clinics and in this article, we explain the importance of PR for clinics and share our top PR tactics to help get your clinic noticed by the media and your target customers. WHAT IS PR? Our favourite definition is: “PR represents what other people say about you when you’re not there.” The role of PR, or a good PR strategy, is to protect and enhance the reputation of your business. Yes, PR is all about reputation! And for your clinic, PR has the potential to influence: • How others, including your target patients, see your clinic • What people hear or say about your clinic • What people see in the media about your clinic • Partnerships with relevant brands, businesses and individuals in your field • And more! An effective PR strategy that is tailored
to your unique clinic will enable you to showcase your brand how you want it to be seen. Any clinic that is serious about getting the attention of the media, industry professionals, and their target patients should consider investing in PR as part of a holistic marketing strategy. Why is PR important for clinics? In crowded and competitive industries like beauty and aesthetics, there are many voices shouting to be heard, and clinics can get lost amongst their competition and fail to stand out. PR is a valuable long-term business strategy which can help clinics find and establish their position in the local market. The three key benefits of PR for clinics are: 1. To build and grow brand awareness and visibility, which can increase sales and grow your reputation. For example, when launching a new clinic or treatment PR is a very effective tool for generating that much needed ‘buzz’ and instant visibility. This initial buzz soon translates into demand and more bookings which in turn can boost 2. To add credibility and become the ‘convincer’ for your clinic, PR in the longer term can give potential patients reasons to choose YOU over a competitor. For example, when your clinic is regularly featured in local or industry press, or a prominent influencer talks about a great experience with your team, it will help revenue, profits, growth, and opportunity for your clinic.
build trust and persuade your target audience to move from ‘consideration’ of a treatment to ‘purchasing’ or engaging with your clinic. 3. To grow sales and profits, once the above points align in your long- term PR strategy you can expect to see a steady flow of new patient bookings and repeat bookings from your growing loyal customer base. In short, a great PR strategy for your clinic can build and grow brand visibility, trust and engagement – and of course, sales! To get started, consult with an experienced PR company with proven results in your field of aesthetics. When should a clinic utilise PR? PR is not a pick-up and drop activity – it is a long-term consistent tactic which can drive great results and media coverage but takes time, effort, and skill. Ideally, you will deploy creative and engaging PR tactics consistently at timely intervals throughout the year to keep your clinic on the radar of your target customers and in the media. However, there are a few key moments when utilising PR is essential: • Clinic opening (i.e. host a PR event for key media, influencers, and VIP customers) • New treatment launch • Seasonal events which resonate with your treatments and clientele (i.e. summer ready skin, Christmas or New Year party prep) • Clinic growth, awards and good news!
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SINCLAIR INSIDER 11
How finding strength in adversity is the route to success
Dr. Manning’s work at the prisons came to an end when they were merged into one site, almost exclusively housing sex offenders. “Until that point, I never knew what crimes people had committed because it wasn't relevant, but when you're working with sex offenders, who are a risk to women, you have to know…and when you know what some of these people have done to children and women, it screws with your head a little.” Medical Aesthetics was a natural change in direction. She had already treated clients from her home in Shropshire in addition to her work as a GP, so when she left her prisons role, it made sense to turn that into a full-time business. “I met Charlotte 11 years ago and of course, it's nicer to do these things in conjunction with somebody because you can share the highs and lows, so we set up River Aesthetics, and in the first two years neither of us took any money out of the business; we reinvested everything we earned and just gradually grew together, which is great because we both had very different personality types.” She explains that “Charlotte and I were like chalk and cheese - she concentrated on the core business and I networked and sought out opportunities. You have your ups and downs, but at the end of it, we're still great friends and we're still working together 11 years later.” The Private Clinic’s acquisition of River Aesthetics completed in August 2023, something that Dr. Manning says was exciting and a “real career achievement” for her. And she stresses it certainly didn’t signal the end of her and Dr. Woodward’s journey with the business they built together. “We want to keep building and improving the revenue for River to take it to the next level: I think being integrated into something bigger will help us to improve the service because we now have access to a private hospital with consultants and other services, so we know, our patients are going to benefit.” What the sale has done, is allow Dr. Manning to reduce her days in the clinic while increasing the time she spends teaching and speaking at training events.
So what does the future hold? “When Edward died, I didn’t know which way to turn. And then we started River, and I funded it all on credit cards: I couldn't let it fail because I had two young children, of seven and eight…they were fully reliant on me…in the face of adversity, you can make these things work. “I remember working with business coach Pam Underdown in the early stages, saying to her ‘I can't do this, I need to get a proper job, I need to earn money’. She said to be ‘no, you can do it, you’ve just got to keep going - sweat, blood and tears’. And we did.” Dr. Manning is certainly glad she took that advice and dug deep to make the business a success. “The financial freedom I got from doing it and actually paying off everything, all the debt… that was a phenomenal achievement.” And she’s now ready for the next stage of her career: “I love treating patients, so I don't want to give that side up and I want to be able continue learning and to do more teaching, because that's what I really enjoy doing. I also want to do a lot more mentoring, of people who are trained but need a little bit of a helping hand along the way.” She also stresses that both she and Dr. Woodward are still focused on growing River through The Private Clinic Group. “We want to see it grow…because then we can say that was ours and that's what we did and that's where it is now. And that's a really good thing to be proud of, isn't it?”
"When we started getting involved
She notes how her relationship with Sinclair has blossomed over the years. From the early days of offering fillers to being one of the first clinics to offer Silhouette Soft thread lifts. “When we started getting involved in Silhouette Soft, that's what really put River Aesthetics on the map and we found a niche, which was collagen stimulation,” she says. They famously treated Meg Mathews, former wife of rock star Noel Gallagher, with Silhouette Soft, with a story and photographs making it into the Sunday Times colour supplement. - which Sinclair’s PR set up. “I'll never forget that day; sitting on the beach on the Sunday when the article came out. The phone just did not stop ringing. “That's what River Aesthetics became known for, and we just piggybacked on that and it took us to the next level. We became closer to Sinclair as a result and became involved in teaching and speaking, and that’s what helped credential us. In fact, Dr. Manning says working with Sinclair has helped introduce her and Dr. Woodward to “amazing” people, plus taught her a lot. “Being one of the global trainers, you get to meet the best-of-the-best across the world.” She adds: “I've stayed loyal to Sinclair, and they've had my back and looked after me. But also River as well -we've had a lot of opportunities through Sinclair and because of Sinclair, River has continued to grow.” Looking back there are certainly things Dr. Manning would have done differently: “But it's been an incredible journey…and we have learned from it, we really have,” she says. in Silhouette Soft, that's what really put River Aesthetics on the map and we found a niche, which was collagen stimulation."
Dr. Victoria Manning, Clinical Director of River Aesthetics
If anyone is an example of success triumphing over adversity, Sinclair’s global aesthetics trainer Dr. Victoria Manning is it. From an uncertain start into medicine, to raising two young children after the premature death of her husband, all while launching a new business; she’s proof that determination, sheer grit and hard work can overcome even the most difficult circumstances.
PHOTO: SEYEDEH HAMIDEH KAZEMI, UNSPLASH
T oday, Dr. Victoria Manning is clinical director of River Aesthetics (now part the Private Clinic Group), an award-winning cluster of clinics she co-founded with her business partner Dr. Charlotte Woodward. Together they specialise in advanced non-surgical aesthetics for natural-looking results, using the very latest in technologies. Both are also global trainers and international speakers. Dr. Manning’s journey to becoming a leader in global facial aesthetics was not a typical one. At the tender age of 11-years she decided she wanted to be a doctor, despite her grandfather – a former Secretary of the British Medical Association (BMA) - telling her she wasn’t clever enough. “I thought, bugger you, I'll prove you wrong. I think that's probably why he did it; because he knew I was a little bit bloody-minded,” she says, admitting though, that she didn’t quite make the grades to study medicine at first. “Unfortunately, I had a bit of an issue with physics. I got an A and an A* in Biology and Chemistry, but I didn’t
quite make the grade as physics was a complete anomaly to me, so I didn't get into medical school first time round: I was absolutely gutted.” Despite the early set-back, Dr. Manning got into Southampton University via Clearing, to study Physiology and Biochemistry, and then applied to transfer into medicine. “I literally badgered the medical Dean and I think he got so fed up with me if I got a First or a 2-1 in my first year I could transfer. So I literally worked my backside off and got a First in my first year and managed to transfer over to medicine.” By the third year of medical school, Dr. Manning had secured a Royal Navy cadetship that paid for the rest of her time at university. She completed her House jobs at the Navy’s then Royal Hospital Haslar in Gosport near Portsmouth, and Frimley Park in Camberly, Surrey, before a heart problem ruled her out of serving at sea. Following her medical discharge from the Navy she embarked on GP training at St Mary's Hospital in London’s Paddington and completed
her time as a registrar in Shropshire, after moving there with her husband, Edward. She became a partner at a rural GP practice for 10 years, however, when Edward died, leaving her with two small children to raise alone, she didn’t want to stay in the area, and instead moved back to the Isle of Wight. “In Shropshire, my speciality had been treating patients for substance abuse and I became a GPwSI in drugs and alcohol and CCG lead for addiction, which prompted me to work in prisons.” At that time the Isle of Wight was home to three prisons: Camp Hill, a Category C; Parkhurst and Albany. Dr. Manning mainly worked at Camp Hill with petty offenders who’d found themselves in trouble as a result of their addictions. She explains: “I treated patients as I would like to be treated myself, which meant in the seven years I was there, I never had one issue. I had a really good rapport with these guys and they respected me for it, I guess, and seeing some people actually turn their lives around was really, really rewarding.”
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LanLuma is poised to continue reshaping the landscape of aesthetic medicine (as well as patient’s buttocks!)
septae, resulting in an uneven appearance of the skin in 85-98% of women [Janda, K; Tomikowska, A (2014). "Cellulite - causes, prevention, treatment". Annales Academiae Medicae Stetinensis. 60 (1): 29–38. PMID 25518090]. By breaking these septae via cannula subcision, and then placing a thin layer of LanLuma, skin quality is improved by a relaxing of tension, and collagen stimulation improving skin quality and thickness. This leads to a reduction in the visibility of cellulite dimples and smoother skin. SKIN LAXITY: For crêpey/lax skin (for example, on the neck, upper arms, abdomen), by injecting LanLuma in a more dilute form, the product acts more as a collagen stimulator rather than volumiser, allowing for both results and longevity that far exceed alternatives such as skin boosters. This is particularly advantageous in areas such as necks and hands, where skin boosters alone are often insufficient on anything other than mildly dehydrated skin. Ageing hands often show prominent veins, wrinkles, and volume loss. LanLuma injections in the back of the hands can restore lost volume, improve skin texture, and reduce the visibility of veins and tendons*. The results are natural-looking, with rejuvenated, youthful hands. As the collagen stimulation lasts over 2 years, treatment is often a lot more sustainable/cost effective vs shorter lasting skin boosters. CONCLUSION: LanLuma is a dynamic tool in the realm of non-surgical aesthetics. Its collagen- stimulating properties enable it to address a wide range of aesthetic concerns, including hip dip correction, buttock enhancement, appearance of cellulite, skin rejuvenation for the hands and neck. With its impressive versatility and safety profile, LanLuma is poised to continue reshaping the landscape of aesthetic medicine (as well as patient’s buttocks!), offering natural-looking and lasting enhancements with minimal downtime or invasiveness. In the words of Lisle Von Rhuman: it’s “a touch of magic in a world obsessed with science”!
BUMS: One of the main areas in which LanLuma shines is in its application for buttock augmentation. We’re not talking about excessive BBLs from the 2010s era here, but more natural contouring and volume improvement – think J Lo curves rather than Kim K on the cover of Paper Magazine balancing a bottle of bubbly on her rather voluminous derrière. For hip dips, strategic injections with LanLuma can provide a smoother transition between the hip bone and thigh, resulting in more aesthetically pleasing contours. When we consider the options for buttock contouring, we have previously been broadly limited to surgical intervention or HA based filler. Surgery can be costly, with recovery taking weeks, and at one point it was found to have the highest death rate of all cosmetic surgery procedures (1 in 3000), due to pulmonary fat emboli. These worryingly high risks resulted in the British Association of Aesthetic Plastic Surgeons (BAAPS) advising their members to cease surgical BBL procedures in 2018 until their Gluteal Fat Grafting guidelines were produced 4 years later in 2022. LanLuma is injected into the subcutaneous fat layer, which has far less risk of penetrating major vessels, and particle size is smaller than that of HA (40-63 μm vs 300-500 μm). Recovery is far swifter too, with significantly more manageable aftercare (and therefore greater compliance), where the patient only needs to massage the area, and avoid vigorous exercise for a week. The procedure is also very well additional analgesia (eg tumescent infiltration) for buttock treatments as it generally is not required in my experience. tolerated in terms of pain – I personally don’t perform any CELLULITE: With cellulite, this is usually caused in females by a combination of the fibrous septae placing tension on the skin surface, and fat protruding through these
Dr Alex Parys
BEFORE / AFTER 6 MONTHS Lanluma X (2 vials per side over 2 treatments). Actual patient, individual results may vary
PHOTO: ALEXANDER-KRIVITSKIY, UNSPLASH
INTRODUCTION: B
Step in LanLuma – offering transformative results in an array of aesthetic applications for both face and body! Beyond combating the signs of ageing such as skin laxity, LanLuma has also shown great outcomes in reducing the appearance of cellulite, skin laxity and enhancing the contours of the gluteal region, offering a holistic approach to dermatological care. WHAT IS IT? LanLuma is a poly-L-lactic acid (PLLA), a biocompatible and biodegradable implant. When injected into the skin, it increases the volume of depressed areas, particularly corrects skin depressions. Over time, LanLuma gradually replaces lost volume and improves skin texture, making it an ideal choice for various
aesthetic concerns. Due to the product’s principle ingredient (PLLA), Lanluma provides natural-looking results that appear gradually and last more than two years 1 . Results will start to appear after 6 weeks and progressively improve over 9 months. It comes in two vial sizes, 40ml and 15ml. The versatility of LanLuma is one of its key benefits – it can be used on the face, décolletage, neck, upper arms, hands, thighs, abdomen, buttocks, and areas of cellulite * . Results are not instant, but instead appear gradually after around week 6 once the collagen stimulation has kicked in. The stimulation of collagen production improves the skin and soft tissue quality, this results in much more natural-looking, lighter and springier result. In terms of safety, the main component of LanLuma, PLLA, has a well-established safety profile, having been used in the medical field for over 30 years. Adverse events are generally mild and transient. Common side effects include swelling, redness, and bruising at the injection site, which typically resolve within a few days. Proper injection technique and patient selection are crucial to minimising risks. Adverse events have an overall incidence of 0.19% (1 event every 526 vials) 2 .
ums, tums and sagging skins – the eternal struggle of the modern world!
An often unwanted, yet universal, phenomenon that accompanies the passage of time is skin ageing. As individuals grow older, the skin undergoes a series of structural and functional changes, resulting in the development of wrinkles, fine lines, and a loss of skin elasticity. These signs of ageing are often a source of concern for many, prompting a search for effective treatments to restore a more youthful appearance. Whilst we are still waiting for an elixir of youth, like that created by Lisle Von Rhuman from the 1992 Hollywood Movie classic, Death Becomes Her, capable of turning back the hands of time on both our skin and body with a simple sip of a glowing levitating potion, there has been significant evolution of aesthetic medicine in recent years. This has led to a growing interest in non-surgical approaches to address various cosmetic concerns that were previously often only achievable by going under the knife, such as buttock augmentation, hip dip correction, and difficult to treat conditions such as cellulite. Energy-based devices have shown promise in helping treat skin laxity and cellulite, although these do often come with a significant financial outlay for the clinic.
BEFORE / AFTER 3 MONTHS LanLuma X 1 vial per side. Actual patient, individual results may vary
*The information of this article has been prepared by healthcare professionals. Any opinions, views, advice provided are those of the healthcare professionals. Sinclair does not provide any warranty and does not accept any liability for the opinions, views or advice expressed. 1) Data on file 2) M Mark Mofid, et al, Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force, Aesthetic Surgery Journal, Volume 37, Issue 7, July-August 2017, Pages 796–806, https://doi.org/10.1093/asj/sjx004https://pubmed.ncbi.nlm.nih.gov/28369293/ 3) https://baaps.org.uk/_userfiles/pages/files/baaps_document_on_gluteal_lipofilling_safety_and_recommendations_final_1.pdf 4) Narins RS, et al. J Am Acad Dermatol. 2010;62:448–62.
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Patients, practitioners and pharmaceutical companies shaping the future of medical aesthetics
For this type of patient treatment options can include fat dissolving treatment /fat freezing. Carboxy therapy can provide both small reduction in volume as well as skin tightening, energy-based devices such as HUFU and radiofrequency can help with reduction in fat and tightening the skin. A very effective treatment to reduce double chin appearance can be dermal fillers*. In the hands of experienced and artistic medical aesthetics practitioners they really can achieve a significant reduction. With developments in technologies, we now have products with an excellent safety profile, such as MaiLi, which allows practitioners to deliver beautiful, long-lasting results with no or just minimal downtime*. Before treatment, it is paramount to perform a full facial assessment to understand the prospective patient’s injection anatomy, age related changes in anatomy, facial proportions, beautification of the face and product characteristics. Our approach will be completely different if we are to treat a genetic problem or treat age related changes. If the double chin is caused mainly by genetic problems, we can treat just the lower third of the face (mainly focussing on the chin area) by creating length and projection. Whereas if the cause is induced by ageing than we must take a full-face approach and treat the upper and mid third of the face, before treating the lower third, including chin. The age of the patient and clinical presentation usually determines the required volume of product. These three cases are illustrative examples of: • Early age-related changes (pic1 ). Total volume 4ml: 3 MaiLi Extreme and 1 MaiLi Volume. Chin was treated with 2 ml Extreme. • Genetically induced and early age- related problems (pic2). Total volume 7ml: 4 Ml of MaiLi Extreme used to treat the jaw and chin areas. • Complex and quite challenging case where we see a combination of a genetically small chin, combined with establish signs of ageing (pic 3). Total volume 14 ml treatment was performed in two stages. Total
volume used in chin session 1 was 4ml Maili Extreme. Session 2 Maili Extreme 3 ml was used in chin area. The chin has a number of different anatomical subunits: • Labio-mental angle (treatment of this area reduces appearance of mental chris and opens labio mental angle, elongates the chin) • Apex of the chin (elongates the chin and can play a role in slimming the face, giving the face a more v shape) • Anterior pogonion (gives anterior projection to the chin and reduces hyperactivity of mentalis muscle) • Menton (gives anterior rotation as well as tightening submental area, reducing the double chin appearance) • Lateral chin/prejowls sulcus (reduce appearance of double chin and improves definition of jaw line) Usually, all anatomical subunit areas require treatment to achieve balanced and long-lasting results. The typical volume of product to achieve improvements or structure to the chin varies from patient to patient and can range from 2 to 4 mls. In more difficult cases the volume can be doubled, but this needs to be done over multiple sessions. Often the chin and lower third of the face are more sensitive and the patient can be quite aware and sensitive to the filler in the chin area. Therefore, using product which has low G and high E prime is optimal to ensure good tissue integration and patient comfort. That is why my preferred product of choice is MaiLi Extreme for chin treatments. There is so much educational information available to the patients and they often come to the clinic well informed about different treatment options. As a result, it is important to conduct a thorough consultation; providing patients with an understanding of the problem as well as detailed advice about the best treatment solutions. It is also very important to take into consideration patients’ expectations and lifestyles when creating a treatment plan. The patient is often quite surprised by what can be achieved these days without surgery and with minimal downtime.
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BEFORE/AFTER 1 MONTH 4ml total (3ml Extreme, 1ml Volume)
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Dr Olha Vorodukhina
Explore the evolution of medical aesthetics and the role of dermal fillers like MaiLi in treating double chins, as we delve into the latest nonsurgical advancements.
BEFORE/AFTER 1 MONTH 6.7ml total (3.7ml Extreme, 2ml Volume, 1ml Precise)
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PHOTO: ELISA PHOTOGRAPHY, UNSPLASH
W orking in medical aesthetic industry for the last 10 years, I can see how fast and dramatically this industry has changed and grown. Medical aesthetics practice has undergone a dramatic change in the last 3-4 years, as technology has improved which makes our treatments very safe and we see the introduction of new high- quality products like MaiLi that provide patient with natural long- lasting results 1 . Customer behaviour has changed too. I meet more patients who are looking at preventative treatments. Generation millennials want to address problems before they become more noticeable or severe. This generation also often influences their parents to have treatments and take better care of themselves. As a result, we see how more and more patients choosing a non-surgical route over surgical procedures and results of nonsurgical treatments, when they planned and performed correctly, can be sometimes comparable with surgical results * . In this article I will explore and showcase role of dermal fillers in treatments of double chins.
A double chin is a loss of definition of the jawbone and accumulation of fatty tissues in submetal area. It affects both male and female. According to Google 70% of Americans have double chin 2 . While a survey conducted by PR newswire survey reported respondents alter their behaviour to address their double chin 3 . The report cited: • 35% shy away from photos • 35% avoid video chats and conference calls • 29% of men have grown a beard to hide the area under their chin (younger men were more likely to do this than their older peers) Upon evaluation of photographs of individuals with varying levels of submental fullness 78% of respondents admitted they are more likely to notice a double chin on a woman than a man. THERE ARE THREE MAIN CAUSES OF DOUBLE CHIN: • Obesity and excess weight • Genetics associated with bone deficiency in mandible and over projection in maxilla. Typically, these patients will be presented
with dental class II occlusion (overjet or overbite) • Age related changes such as
BEFORE/AFTER 1 MONTH 15.4ml over 2 sessions (4ml Volume, 11ml Extreme, 1ml Define)
weakening of retaining ligaments and displacement of superficial fat compartments If the patient has excessive weight, it will be wise to give them advice on healthy lifestyle and weight management or refer them to appropriate colleagues such as their GP, nutritionist, or fitness coach. Cosmetic interventions will most likely not be effective or ethical in those patients. Genetic problems such as lack of bony projection and class II malocclusion can be successfully treated by a multidisciplinary team: Dentist/Orthodontist to correct the dental occlusion, Max Fax surgeon to perform surgical repositioning of the jaw relationship, Plastic Surgeon to perform a chin implant treatment and Medical Aesthetics Professional to achieve aesthetic improvements with minimal intervention. Age related adiposity of fat in submental area is often result of both the accumulation of undesirable fat and fat displacement. Often it can be exacerbated by loose skin (skin laxity).
The double chin is one of those areas that patients do not expect to go away or reduce after filler placement. I often compare it with a non-surgical rhinoplasty; people don’t know that significant improvements to the appearance in these areas can be achieved without surgery. In fact, we often combine treatment of the chin, lips and nose to improve the patient’s profile (profiloplasty). I am a big advocate of preventative medicine, and in this case, I would say pre-ageing medical aesthetics. I advise addressing the problem before it becomes moderate or severe. The greatest advantage of doing so is that at this stage there are minimal treatment needs and a minimal amount of product is needed to achieve great long-lasting results and happy patients who trust you to guide them on their beautiful, positive and healthy ageing journey.
Actual patient, individual results may vary. 1) Data on file 2) Google 3) https://www.prnewswire.com/news-releases/new-survey-reveals-impact-of-double-chin-on-self-perception-and- behavior-300422717.html *The information of this article has been prepared by healthcare professionals. Any opinions, views, advice provided are those of the healthcare professionals. Sinclair does not provide any warranty and does not accept any liability for the opinions, views or advice expressed.
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