SYNERGIE®: STATE-OF-THE ART LECTURES IN AESTHETICS AT MANOIR DE FONTAINE, DURBANVILLE
Prof Don du Toit, of Cape Town, and two other prominent aesthetic physicians, provided three state-of-the-art guest lectures at a woman’s beauty open-day on 8 October 2008, at the luxurious Manoir de Fontaine in Durbanville. These included:
- Treatment of cellulite for beauty and wellness.
- Autologous cellular regeneration (ACR) and facial regeneration with platelet-rich plasma. Also referred to as PRP (Google: PRP for more information) or PLASMA RESURFACING OF THE FACE (PRP is distributed by Omnimed (Pty)., (Ltd), Randburg, Gauteng. Contact person is Sammi van Rooyen 011-792712). Hands on-training is provided for doctors and aesthetic practitioners throughout South Africa. Also used to enhance chronic wound healing, ulceration etc (Contact Sammi van Rooyen at Omnimed, Randburg, Johannesburg). PRP is now also available as needless PRP-MESOTHERAPY and therefor no pain. The face, neck and décolleté can be rejuvenated with peptides and plasma resurfacing and gives good results and the process is totally pain free. The PRP is given via the EPOREX® device, which performs excellent pretreatment microdermabrasion by ultrasound, and facilitates plasma resurfacing with PRP and is completely safe. This has become a very sort after beauty treatment and facilitates skin rejuvenation with the clients own plasma and peptides and the treatment is available in Cape Town. The mechanism is via galvanic stimulation, enhanced transdermal delivery of product via isophoresis and electroporation. The process of plasma resurfacing is referred to PRP-mesotherapy and is pain free. The EPOREX® device is distributed in South Africa by Bester Medical Aesthetics, Panorama, Cape Town.
- PDT LED PHOTOFACIAL: Photofacial rejuvenation to improve tone, texture and radiance of the skin. Rejuvelight® is cost effective and a safe red-light based rejuvenation option with no down-time and pleasing immediate result. Dr Nardus le Grange, also a guest speaker at the open-day confirmed the nature and efficacy of LED therapy in facial rejuvenation, apart from the application of light TCA-chemical peels and inducing gentle skin exfoliation. To this can be added fillers such as Juvederm® Ultra (Allergan®) and Botox® etc. Juvederm® and Botox® are distributed by Genop® in South Africa.
CELLULITE: TREATMENT AND OPTIONS AVAILABLE
Prof Don du Toit, a guest speaker at the woman’s beauty open day held at Manoir de Fontaine during October 2008, gave an overview on cellulite and viable treatment options available ( surgical and non-surgical).
Currently, depending on the clients budget and understanding of down-time there are two thoughts on the treatment of cellulite:
- Surgical: liposuction and abdominoplasty. Down-time is needed and it means an operation for the client in a hospital. Performed by a skilled plastic surgeon renders results far superior and longer lasting than any non-invasive therapy such as with anti-cellulite devices that mean many exhausting and costly treatments, often being exposed to long periods of ultrasound waves and the results are mostly moderate, at best variable.
- Non-invasive such as with: Massage, wraps, anti-cellulite creams, ultrasound, Ultrashape®, Velasmooth®, Velashape®, Thermage®, RF, Elos® technology, Synergie®, Endermologie®, mesotherapy, Power plate®, diets, etc
- Skin Classification: Stage 0..skin normal. Stage 1...smooth but undulates on pinching. Stage 2..” Orange peel” or “mattress” appearance, unstimulated. Stage 3...”Orange peel” plus, raised and depressed areas and nodules.
- Cellulite types. Oedematous, adipose, interstitial, fibrous. Normo, gynoid, android, mixed and Dercum’s disease. Most clinics, and salons fail to follow or appreciate the route of robust science, forget to classify the skin and cellulite type. This is why the results of non-invasive treatment is so variable and why so many treatments are needed or are resistant to treatment.
- Cellulite stages: Stage 1, stage 2, stage, 3 and stage 4. Again, a failure to understand or to ignore the interstitial nature of the process, stratum corneum and texture changes, blood vessel or microvascular break down, connective tissue tears and fibrous septa explains the reason for treatment failure.
- SYNERGIE® AESTHETIC MASSAGE SYSTEM: This is ideal for salons and beauty clinics and results are slightly superior to other forms of non-invasive treatments of cellulite ( this includes ultrasound and RF). Synergie® superior results are because the treatment is supplemented by special skin-hugging garments that compresses the adipose tissue in-between treatments. The technology includes vacuum suction and allows for subdermal tissue massage, and a device is in use at Aesthetics, Tyger Waterfront, Bellville, Cape Town. This is one of the draw-backs of ultrasound that does not offer the client any form of massage to rid the system of lipid-edema. Twice-weekly treatment is initiated, followed by 1 -monthly treatment as maintenance. The effects, according to the manufacturer, are cumulative and thus effective if the client aborts or interrupts treatment. The technology allows for body sculpting and contouring and visible results are apparent within 4-5 treatments. Each session is about 30 minutes and has huge advantages over time-consuming ultrasound that varies between 72 and 90 minutes. Of importance is that the device is FDA approved, when many other including some ultrasound devices are not, and have not been subjected to FDA clinical trials.
- Diagnosis: Detect the presence of soft, hard, mixed, and not-true cellulite. Exclude advanced lipodystrophy and lipidema, which may not be candidates for non-invasive cellulite treatment. Blood screening tests include: glucose, lipids, liver-functions, renal function, electrolytes, haematology and full blood count, protein analysis.
- Special imaging: Adipose tissue echography,3D Skin and fat MR imaging,3D ultrasound imaging to demonstrate fibrous septa, video capillaroscopy (VCOP images) as recommended by Dr Leibashoff.
CELLULITE TREATMENTS: YOUR CHOICES
- Complete cure and reversal not possible and recurrence are a problem. Diet, and exercise program is imperative. Exercise again, increases appetite that leads to nibbling and night-foraging in the fridge and inevitable weight gain.
- Anti-cellulite topical creams and snug-fitting shorts ( neoprene)
- Endermologie® (LPG)
- Synergie® cellulite program ( vacuum massage)
- Velasmooth® and Velashape®
- Ultrashape® 1 and 2
- Thermage®, Alma®
- Wrapping (offered by salons and is effective if combined with diet and exercise) .
- Liposuction( more effective than other forms of non-invasive treatments). Performed by a plastic surgeon, usually under general anaesthesia. Morbidity in the hands of an experienced surgeon is negligible.
- Smartlipo® and Liposhape garments. A new generation of liposuction devices. Very effective if compared to massage devices. Tip of cannulae contains a laser that is used to rejuvenate and smoothen the skin and avoid furrows after liposuction. Very popular in Johannesburg, minimal down time and the procedure is performed under local anaesthesia. One advantage is that a double chin can also be very effectively treated. Suitable for lower abdomen, love-handles and saddle -bags.
- Abdominoplasty ( renders the flattest stomach and far superior end-point result than non-invasive treatments. Costly and only available at plastic surgeons practices). Formal operation, needs general anaesthesia, and has down-time.
- Carboxitherapy ( Carbomed®....Carbossi Terapia), www.carbossiterapia.it . Distributed by Mr H. Bester of Bester Medical Aesthetics, Panorama, Cape Town ,South Africa.
- Mesotherapy ( silicum salts and asian centella)
- Lipodissolve injections ( phosphatidyl choline)
- Power plate® together with a dietary program to facilitate a wellness outcome.
AESTHETICS: PHOTOFACIAL REJUVENATION WITH RED LIGHT ( REJUVELIGHT®) TO ENHANCE TONE AND TEXTURE OF THE FACE.
Red-light rejuvenation of the face in the range 633nm is effective, especially if combined with superficial peels with glycolic acid or TCA. Dr Nardus le Grange, an aesthetic practitioner at Aesthetics, Tyger Water Front, confirmed at the open day for woman, that this combination was cost effective and clinically effective.
PLATELET-RICH PLASMA (A-PRP) FOR FACIAL REJUVENATION BY PLASMA RESURFACING OR PRP-MESOTHERAPY
Prof du Toit showed proof-of-science , by advanced skin analyses, and cell biology, that autologous PRP ( A-PRP) can induce skin regeneration in selected patients with chronological and photoaging ( for more information, detail is provided on this website to make an informed decision). Patient selection is important and skin analysis done before treatment is advisable. He demonstrated that there are numerous ways to generate PRP, but that PRP and distributed by Omnimed™ in Randburg, renders the best quantification criteria and best clinical results. PRP-mesotherapy injections provide excellent rejuvenation of the neck and décolleté through plasma resurfacing. The PRP can be administered via a conventional syringe as mesotherapy or given via a mesogun, alternatively by the EPOREX® needleless system. The most important advantage of PRP is the safety profile and that the patient’s own plasma is used for the dermal and subdermal rejuvenation. Plasma resurfacing with PRP-mesotherapy has been shown to be safe and effective in Japan, England and France to mention a few. Addition of REJUVELIGHT® enhances the results and outcomes of PRP further. Results are visible within 2-3 weeks and the effect is sustained for about 1 year at which stage resurfacing is needed or addition of adjunctive treatment such as chemical peeling, Botox or fillers. PRP is effective if utilized with a mesogun EPOREX ®, because precise transcutaneous administration is possible.
LED PHOTOFACIAL REJUVENATION WITH THE REJUVE-LIGHT®.
LED light-therapy has been shown to have modest and pleasing facial rejuvenation properties. The treatment takes 20 minutes a session, is painless and the procedure can be safely directed by a therapist. The beauty is that the whole face and décolleté can be treated at one session and does not carry the risk of laser therapy, flash trauma and dermal-induced scarring. Combination with chemical peels and careful epidermal exfoliation renders good results. Addition of the attraumatic use of the DermaRoller® of Lamelle Laboratories will enhance the results even further. This approach is of course far more cost-effective than fractitional or mosaic laser treatment. All these modalities are available at AESTHETICS, at Tyger Waterfront ( contact number: 021- 9148415).
STATE-OF-THE ART LECTURE ON AESTHETIC OPTIONS FOR FACIAL REJUVENATION BY DR NARDUS LE GRANGE.
At the women’s open, beauty-day held at Manoir de Fontaine in Durbanville, Dr le Grange, being one of the guest speakers, emphasized the importance and application of fillers, Botox, MDA, LED and platelet-rich plasma ( plasma rejuvenation), also referred to as PRP in aesthetic practice ( available from Omnimed, Randburg, Gauteng). Dr Le Grange also gave an overview of sclerotherapy of skin spider-veins and telangiectasis (lower legs) that is far superior and quicker than laser or IPL treatment. This is also the experience of vascular surgeons. More details, application, are available on this website regarding plasma rejuvenation with PRP.
OVERVIEW LECTURE OF COSMETOLOGY, COSMECEUTICALS AND PEPTIDES BY DR BRADLEY WAGEMAKER OF LAMELLE LABORATORIES.
Dr Wagemaker, the medical director of Lamelle Laboratories in Gauteng, also a guest speaker, explained that topically applied retinoic based cosmetic creams provide 10% absorption of the active components and explains why it takes 9 months to show any positive clinical results, regarding rejuvenation of the skin. This is a very small percentage and he explained that the skin absorption is poor. Others have confirmed that Vitamin-A based cosmeceuticals take many months before results can be observed. He also quoted from the German medical literature that showed that absorption can be dramatically increased by gentle rolling of the skin with tiny needles on a roller ( Dermaroller®). This roller does not penetrate the skin, but punctures the outer layer and that enhances absorption of the active components in the product in the skin. Electroporation works on a similar basis. The patient uses her own roller and there are guidelines for hygienic cleansing. The roller of the recipient should not be used on other people. He went on to explain further the application of peptide-based creams referring specifically to the use of IGF. Dermaheal® is a new range of skin products that are very innovative. See figure 7 for product range of Dermaheal® that is available in South Africa.
BOLANDCELL ACADEMIC REFERENCE
Goldman MP, Bacci PA, Leibaschoff G, Hexel D, Angelini F. Cellulite. Pathophysiology and treatment. Taylor and Francis. New York, London, 2006: 1-327.
Website up-dated and posted 18 October 2008
Fig 1: Aesthetics Clinic at Tyger-Waterfront, Bellville and near Tygervalley Shopping Mall.
Fig 2: Aesthetics: Open woman’s day ( theme aesthetics update and cosmetics, cellulite, beauty and wellness) attended by 80 delegates held at Manoir de Fontaine at Eversdal Heights, Durbanville ( see www.manoir.co.za) on 8 October 2008.
Fig 3. Dr Bradley Wagemaker, and Medical director of Lamelle Laboratories lecturing in aesthetic advances and cosmetic approaches during woman’s day at Manoir de Fontaine in Durbanville.
Fig 4: Dr Nardus le Grange ( Aesthetic Practitioner at Aesthetics, guests, Prof Don du Toit, and Dr Bradley Wagemaker ( Medical director of Lamelle Laboratories) at the open day at Manoir de Fontaine.
Fig 5: Aesthetic lecturers at the Aesthetics Woman’s open day on 8 October 2008, at Manoir de Fontaine, Durbanville.
Fig 6: Aesthetics Tyger Waterfront Woman’s open day at Manoir de Fontaine. Dr Nardus le Grange ( aesthetic practitioner) and Debbie le Grange ( CEO). Aesthetic workshop was held at Manoir de Fontaine, where state-of-the art aesthetic treatment were presented by Drs Nardus le Grange, Bradley Wagemaker and Prof Don du Toit on 8 October 2008.
Fig 7: Dermaheal® new cosmetic range from Lamelle Laboratories was on display at the open day held at Manoir de Fontaine.
Fig 8: Carbomed® device (Carbossi Therapia) used for clinical application of carboxitherapy, cellulite, rejuvenation, skin tightening, wrinkle therapy and psoriasis. Available from Bester Medical Aesthetics, Panorama, Cape Town.