Inside Aesthetics

Episode 177 hosts Dr Jake & David, your co-hosts of Inside Aesthetics. 

In this episode Dr Jake & David introduce their new series of episodes, 'The Business of Injecting'. We'll be stepping away from the nitty gritty of injecting technique to instead focus on the business side of things.

In future episodes of 'The Business of Injecting', we'll host injectors to discuss all sorts of aspects of their business model. We'll analyse their struggles and challenges, difficult decisions that need to be made, the friction points that aren't yet solved, financial concerns, staffing, hiring, firing and all the other issues that crop up when working in or owning an injectables clinic.

We'll also celebratrate some of the success stories of the barriers that injectors have overcome and showcase learning points that can be put into action by other injectors.

In this introductory episode we use Dr Jake's beginnings as an injectors to illustrate some of the issues that these episodes will discuss including:

- Why he became an injector and the motivations that drove him

- The clinics that he has worked in and thoughts on what makes an ideal clinic

- The dynamic of working for yourself vs working in an established practice

- The challenges that come with working in a busy clinic

- The concept of creating a culture in a clinic environment

- What happens when you lose respect from your staff as a clinic owner

- The basics of understanding your income vs expenditure

- What makes a successful injector and whether becoming a well known injector matters or not

PATREON:

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CONTACT INFORMATION:

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Episode 176 hosts Dr Stephania Roberts (Phlebologist & Cosmetic Physician from Melbourne, Australia) & Dr Niamh Corduff (Plastic Surgeon from Geelong, Australia)

In this mini series 'The Tox Talks', we feature expert injectors who have significant experience in using botulinum toxin. 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 our of toxins.

In chapter 8 we discuss the poorly understood topic of toxin resistance. In what was one of our most engaging podcasts to date, our expert guests debated the topic and we covered:

• What we mean by 'resistance'?
• Whether there's a difference between being resistant and being a 'non-responder'?
• What's a primary non-responder vs secondary non-responder?
• The incidence of toxin resistance - and the difficulty in quoting this rate
• The main steps in how Botox (Allergan brand) is manufactured and why this is relevant to the topic
• How this differs from the manufacture of Xeomin (Merz brand)
• Accessory proteins and their role in the body's immune response
• Neutralising antibodies vs non-neutralising antibodies
• Does a higher dose create a higher risk of resistance
• If so, what do we mean by 'high' dose?
• The role of dose frequency and risk of resistance
• What steps an injector should go through to review a patient complaining that their toxin 'didn't work'
• How to explain a less than satisfactory toxin outcome to to a patient
• Should you swap your patient to a different brand of toxin if you don't see results?
• The phenomenon of post-lockdown 'failed' toxin treatments globally - was this real or just perceived?
• What tests can you do for a true primary non-responder and whether these are practical in an every day injectors clinic

00:00 Introduction 01:03 Meet our Guests: Dr Stefania Roberts & Dr Niamh Corduff 04:55 What Toxin Resistance Actually Means 10:59 Primary Versus Secondary Non Responders 18:27 How Common Resistance Really Is 26:25 Role of Antibodies and Immune Response 33:29 Differences Between Toxin Formulations 41:37 Protein Load and Why It Matters 48:53 Dose, Frequency and Long Term Risk Factors 52:09 High Dose Treatments and Therapeutic Use 61:45 Real World Incidence in Clinical Practice 68:49 Managing Patients When Toxin Seems to Fail 76:38 Importance of Technique, Records and Follow Up 80:09 Patient Expectations and Communication 86:34 Preventing Resistance Through Smart Treatment Planning 90:43 Key Takeaways for Safe Long Term Toxin Use

ALL IA LINKS & CONTACT INFORMATION

Episode 176 hosts Dr Stephania Roberts (Phlebologist & Cosmetic Physician from Melbourne, Australia) & Dr Niamh Corduff (Plastic Surgeon from Geelong, Australia)

In this mini series 'The Tox Talks', we feature expert injectors who have significant experience in using botulinum toxin. 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 our of toxins.

In chapter 8 we discuss the poorly understood topic of toxin resistance. In what was one of our most engaging podcasts to date, our expert guests debated the topic and we covered:

• What we mean by 'resistance'?
• Whether there's a difference between being resistant and being a 'non-responder'? 
• What's a primary non-responder vs secondary non-responder? 
• The incidence of toxin resistance - and the difficulty in quoting this rate 
• The main steps in how Botox (Allergan brand) is manufactured and why this is relevant to the topic
• How this differs from the manufacture of Xeomin (Merz brand)
• Accessory proteins and their role in the body's immune response
• Neutralising antibodies vs non-neutralising antibodies
• Does a higher dose create a higher risk of resistance
• If so, what do we mean by 'high' dose?  
• The role of dose frequency and risk of resistance   
• What steps an injector should go through to review a patient complaining that their toxin 'didn't work'
• How to explain a less than satisfactory toxin outcome to to a patient
• Should you swap your patient to a different brand of toxin if you don't see results?
• The phenomenon of post-lockdown 'failed' toxin treatments globally - was this real or just perceived?
• What tests can you do for a true primary non-responder and whether these are practical in an every day injectors clinic

SUPPORT THE PODCAST:

If you enjoy listening to IA every week and would like to help support the podcast in a small way, we have a simple donation option: Buy us a coffee

PATREON:

Did you know that we have an online injectable education and business mentoring service called IA Patreon? Get access to the following benefits:

- Access to five main IA Whatsapp groups (General, Injectables, Skin & Devices, Business & Regenerative Aesthetics)  + three country specific groups (Australia, USA and UK)

- Weekly IA Injectable Hints & Tips (Patient assessments, injecting videos & other injectable education)

- NEW! Weekly Instagram Hints & Tips (Optimise your profile, content planning, how to use Instagram features, etc)

- IA Business Hints & Tips (Videos of business hints and experiences)

- IA Business Insights (Zoom recordings of David doing business coaching with our IA Patrons)

- IA Zoom sessions (Bimonthly Zoom sessions focussing on injectable & business topics)

- Access to our IA Library (Clinical papers, books & other resources)

- Re-watch 8 x IA Webinars (Recorded in the pandemic with global experts)

Our subscribers can also access:

Business mentoring opportunities with David (additional cost, limited slots)

Shadowing opportunities in clinic with Dr Jake (additional cost, limited slots)

CONTACT INFORMATION:

Subscribe to IA on Apple Podcasts

Subscribe to IA on Spotify

Other IA links:

Follow IA on Instagram

Sign up as an IA Patron

Visit the IA website 

Contact IA

Apply to be a guest on IA

Dr Jake Sloane:

Follow Dr Jake on Instagram 

Dr Jake's website

David Segal:

Follow David on Instagram

Episode 175 hosts Dr Leonie Schelke (Dermatologist, Amsterdam, Holland), Dr Stella Desyatnikova (Facial Plastic Surgeon, Seattle, USA) & Stuart Turner (Managing Director of Real Time Ultrasound Machines, Australia)

Leonie was one the earliest pioneers in using ultrasound for facial aesthetic treatments. She co-founded the globally-renowed complications centre at Erasmus University in Rotterdam where she and her colleagues manage national & international referrals. She also co-founded 'Cutaneous Facial Ultrasound' in 2019, a world-renowned course that teaches injectors the skill to use and interpret facial ultrasounds. .

Stella is a leading facial plastic surgeon and taught herself facial ultrasound independantly in the USA. She has incorporated this fully into her surgical and injectable consultations and is considered one of the leading experts of the technique in the world.

Stuart's background in physiotherapy taught him the foundations of musculoskeletal ultrasound long before it was being used in aesthetics. He's now the Managing Director of Real Time Ultrasound Machines who distribute and support injectors to use Vinno ultrasound devices across Australia.

00:00 Introduction 01:03 Meet our Guests: Dr Leonie Schelke, Dr Stella Desyatnikova & Stuart Turner 04:55 Early Experiences With Filler Complications 10:59 How Ultrasound Entered Aesthetic Practice 18:27 Understanding What Ultrasound Actually Shows 26:25 Learning to Read Images and Recognize Anatomy 33:29 Why Ultrasound Improves Injection Safety 41:37 Common Resistance to New Technology 48:53 Real World Uses Including Vascular Mapping 52:09 Using Ultrasound for Complication Management 61:45 Diagnosing Lumps, Inflammation and Filler Placement 68:49 Targeted Hyaluronidase and Lower Dosing 76:38 How Ultrasound Changes Treatment Planning 80:09 Patient Reassurance and Communication Benefits 86:34 Will Ultrasound Become Standard Practice 90:43 Final Thoughts on Safety and Future Adoption

This podcast was sponsored by Real Time Ultrasound Machines.

ALL IA LINKS & CONTACT INFORMATION

Episode 175 hosts Dr Leonie Schelke (Dermatologist, Amsterdam, Holland), Dr Stella Desyatnikova (Facial Plastic Surgeon, Seattle, USA) & Stuart Turner (Managing Director of Real Time Ultrasound Machines, Australia) 

Leonie was one the earliest pioneers in using ultrasound for facial aesthetic treatments. She co-founded the globally-renowed complications centre at Erasmus University in Rotterdam where she and her colleagues manage national & international referrals. She also co-founded 'Cutaneous Facial Ultrasound' in 2019, a world-renowned course that teaches injectors the skill to use and interpret facial ultrasounds. . 

Stella is a leading facial plastic surgeon and taught herself facial ultrasound independantly in the USA. She has incorporated this fully into her surgical and injectable consultations and is considered one of the leading experts of the technique in the world.

Stuart's background in physiotherapy taught him the foundations of musculoskeletal ultrasound long before it was being used in aesthetics. He's now the Managing Director of Real Time Ultrasound Machines who distribute and support injectors to use Vinno ultrasound devices across Australia. 

We discuss:

- The history of facial ultrasound & how our guests first started using it

- What ultrasound is exactly

- The basics of what an ultrasound image shows

- What 'resolution' means and why this is important when considering buying a device

- What a 'standard position' is

- The concept of 'vascular mapping' and using colour duplex

- How ultrasound can be used to inject more accurately

- The criticisms of ultrasound and why there are those who don't incorporate it into their practice 

 - Evidence of filler 'backflow'  

 - The role for injecting toxins under ultrasound 

- The significant advantages of using ultrasound when managing complications including dissolving filler lumps & treating vascular occlusions

- The confusing range of devices available and the difference between 'high end' devices and hand held ones.

- How Real Time Ultrasound Machines can support injectors 

Dr Jake will be hosting the first Cutaneous Facial Ultrasound course in Australia on August 10th!

• Dr Peter Velthuis will lead the training and will be assisted by his colleague Dr Tatjana Water (both from Holland)
• For more info and to book the course, click here 
• For IA listeners, you can save an extra $520 by using the discount code 'IAXCutaneous' on checking out

This podcast was sponsored by Real Time Ultrasound Machines. To save 10% of any Vinno device, get hands on & in clinic support, head to www.insideaesthetics.com/ultrasound and fill out your details 

IA PATREON:

Did you know that we have an online injectable education and business mentoring service called IA Patreon? Get access to the following benefits (depending on your tier):

- Access to four IA Whatsapp groups (General, Injectables, Business & Regenerative Aesthetics) 

- Access to our IA Injectable Live sessions (Injectable Zoom sessions led by Dr Jake)

- Access to weekly IA Hints & Tips (Videos, insights & other injectable education)

- Access to our IA Business Hints & Tips (Videos of business hints and experiences)

- Access to IA Business Insights (Zoom recordings of David doing business coaching with our IA Patrons)

- Access to our growing IA Library of clinical papers, books and resources

- Access to eight IA Webinars

- Business mentoring opportunities with David (30 minutes free for Platinum tier Patrons)

- Shadowing opportunities in clinic with Dr Jake (additional cost)

CONTACT INFORMATION:

Subscribe to IA on Apple Podcasts

Subscribe to IA on Spotify

Other IA links:

Follow IA on Instagram

Sign up as an IA Patron

Visit the IA website 

Contact IA

Apply to be a guest on IA

Dr Jake Sloane:

Follow Dr Jake on Instagram 

Dr Jake's website

David Segal:

Follow David on Instagram

Episode 174 showcases our hosts Dr Jake Sloane & David Segal

We start by discussing the economic strain we're experiencing globally and try to predict how hyper-inflation and rising interest rates might affect injectors and clinics.

We then explore Dr Jake's key takeaways from his European trip to his ultrasound and injecting course, IMCAS, Science of Aging & the Beauty Through Science conferences including:

- Ultrasound in facial aesthetics

- New toxins

- New fillers with new crosslinking technology

- Allergan's new hybrid injectable, 'HarmonyCa'

- Fat dissolving, the forgotten treatment!

In the second half of the podcast we explore the phenomenon of tribalism and polarisation within aesthetics. After an aesthetic injectors story on Instagram went viral amongst the aesthetic community last week, we explore why emotions run so high and try to make some sense of it all.

00:00 Introduction 01:03 Workforce Shortages and Rising Costs 04:55 Interest Rates and Economic Pressures on Clinics 10:59 How Consumer Spending May Change in Aesthetics 18:27 Chain Clinics Versus Boutique Practices 26:25 Key Learnings From the International Conference 33:29 Why Ultrasound Is Becoming More Important 41:37 Managing Complications With Better Imaging 48:53 New Anti Aging Research and Future Treatments 52:09 Emerging Hybrid Fillers and Skin Quality Solutions 61:45 New Toxins and Changing Product Landscape 68:49 Why Fat Dissolving Treatments Are Losing Attention 76:38 Social Media Influence and Industry Misinformation 80:09 Tribalism Between Brands and Training Groups 86:34 Importance of Open Discussion and Critical Thinking 90:43 Final Reflections on the Future of Aesthetic Medicine

ALL IA LINKS & CONTACT INFORMATION

Episode 174 hosts Dr Jake & David, your co-hosts of Inside Aesthetics. 

We start by discussing the economic strain we're experiencing globally and try to predict how hyper-inflation and rising interest rates might affect injectors and clinics.

We then explore Dr Jake's key takeaways from his European trip to his ultrasound and injecting course, IMCAS, Science of Aging & the Beauty Through Science conferences including:

- Ultrasound in facial aesthetics

- New toxins

- New fillers with new crosslinking technology

- Allergan's new hybrid injectable, 'HarmonyCa'

- Fat dissolving, the forgotten treatment!

In the second half of the podcast we explore the phenomenon of tribalism and polarisation within aesthetics. After an aesthetic injectors story on Instagram went viral amongst the aesthetic community last week, we explore why emotions run so high and try to make some sense of it all.

IA PATREON:

Did you know that we have an online injectable education and business mentoring service called IA Patreon? Get access to the following benefits (depending on your tier):

- Access to four IA Whatsapp groups (General, Injectables, Business & Regenerative Aesthetics) 

- Access to our IA Injectable Live sessions (Injectable Zoom sessions led by Dr Jake)

- Access to weekly IA Hints & Tips (Videos, insights & other injectable education)

- Access to our IA Business Hints & Tips (Videos of business hints and experiences)

- Access to IA Business Insights (Zoom recordings of David doing business coaching with our IA Patrons)

- Access to our growing IA Library of clinical papers, books and resources

- Access to eight IA Webinars

- Business mentoring opportunities with David (30 minutes free for Platinum tier Patrons)

- Shadowing opportunities in clinic with Dr Jake (additional cost)

CONTACT INFORMATION:

Subscribe to IA on Apple Podcasts

Subscribe to IA on Spotify

Other IA links:

Follow IA on Instagram

Sign up as an IA Patron

Visit the IA website 

Contact IA

Apply to be a guest on IA

Dr Jake Sloane:

Follow Dr Jake on Instagram 

Dr Jake's website

David Segal:

Follow David on Instagram

Episode 173 hosts Dr Ben Talei (Plastic Surgen based in Beverley Hills, USA)

Ben specialises in face lifts, rhinoplasties, peri-ocular surgery and in particular, has become world-famous for his own modified approach to the surgical lip lift.

The lip lift is a surgical treatment that has come back into vogue after first being invented in 1973 - but it never took off due to the unpredictable outcomes and unacceptable facial scarring. Dr Talei has revolutionised this type of surgery and trains surgeons in his technique. Being an injector as well as a surgeon, Dr Talei offers unique insight into the limitations of lip fillers and when surgery should be considered.

00:00 Introduction 01:03 Meet Dr Ben Talei 04:55 From Reconstruction to Cosmetic Surgery 10:59 Why Surgeons Should Learn Injectables 18:27 Understanding Lip Aging and Volume Loss 26:25 How Overfilling Changes Lip Anatomy 33:29 When Filler Is No Longer Enough 41:37 Assessing Tooth Show and Lip Length 48:53 Choosing Between Filler and Lip Lift 52:09 Common Mistakes With Lip Treatments 61:45 History and Evolution of the Lip Lift Procedure 68:49 What Happens During a Lip Lift Surgery 76:38 Recovery Timeline and Healing Expectations 80:09 Risks, Complications and Managing Scars 86:34 Treating Younger Patients and Overfilled Lips 90:43 Final Advice on Realistic Lip Rejuvenation

ALL IA LINKS & CONTACT INFORMATION

Episode 173 hosts Dr Ben Talei from Beverley Hills, USA.  

Dr Talei is a globally-renowned Facial Plastic Surgeon. He specialises in face lifts, rhinoplasties, peri-ocular surgery and in particular, has become world-famous for his own modified approach to the surgical lip lift. 

The lip lift is a surgical treatment that has come back into vogue after first being invented in 1973 - but it never took off due to the unpredictable outcomes and unacceptable facial scarring. Dr Talei has revolutionised this type of surgery and trains surgeons in his technique. Being an injector as well as a surgeon, Dr Talei offers unique insight into the limitations of lip fillers and when surgery should be considered.

 We discuss: 

- Dr Talei's practice

- How and why he learnt to inject as a facial plastic surgeon

- Basic lip anatomy

- The common peri-oral signs of aging

- Racial differences in the peri-oral layers

- What lip fillers Dr Talei prefers to use

- Dr Talei's thoughts on lip filler migration

- Hyaluronidase and the implications of using filler dissolving near the SMAS

- Dr Talei's own theory that the SMAS ages 

-  The history of the surgical lip lift and why it wasn't originally very popular

- How he modified the technique to improve the outcomes to become a world leader in the technique

- What happens on the day of a surgical lip lift

- What the recovery is like

- How to minimise facial scarring after a lip lift

IA PATREON:

Did you know that we have an online injectable education and business mentoring service called IA Patreon? Get access to the following benefits (depending on your tier):

- Access to four IA Whatsapp groups (General, Injectables, Business & Regenerative Aesthetics) 

- Access to our IA Injectable Live sessions (Injectable Zoom sessions led by Dr Jake)

- Access to weekly IA Hints & Tips (Videos, insights & other injectable education)

- Access to our IA Business Hints & Tips (Videos of business hints and experiences)

- Access to IA Business Insights (Zoom recordings of David doing business coaching with our IA Patrons)

- Access to our growing IA Library of clinical papers, books and resources

- Access to eight IA Webinars

- Business mentoring opportunities with David (30 minutes free for Platinum tier Patrons)

- Shadowing opportunities in clinic with Dr Jake (additional cost)

CONTACT INFORMATION:

Subscribe to IA on Apple Podcasts

Subscribe to IA on Spotify

Other IA links:

Follow IA on Instagram

Sign up as an IA Patron

Visit the IA website 

Contact IA

Apply to be a guest on IA

Dr Jake Sloane:

Follow Dr Jake on Instagram 

Dr Jake's website

David Segal:

Follow David on Instagram

Our guest:

Follow Dr Talei on Instagram

Episode 172 showcases our hosts Dr Jake Sloane & David Segal

With Dr Jake being away in Europe for a few weeks, we thought we'd do something a bit different.

In this episode we first discuss some big news regarding our studio and David's businesses. We then find out where Dr Jake is going and why.

We then take a break from our usual injecting topics to discuss a serious issue that seems be plaguing injectors, clinics and businesses all over the world - the weird world of Instagram hacking.

Imagine this scenario - you're an injector who's painstakingly built up your Instagram account to several thousand followers. You have real, engaged and loyal patients who stay in touch with your business via your Instagram profile.

You're posting regularly, the likes are growing, you're making connections and networking with other similar businesses, your profits have grown post-COVID and life is good.

Then one day, out of nowhere, you notice that you've been logged out of your Instagram account. When you try to re-log back in, you get an error message telling you that you've violated Instagrams terms and conditions. You have no idea what has happened, you're completely cut off from your business and there's absolutely nothing that you can do about it.

00:00 Introduction 01:03 Renovations and Life Outside the Clinic 04:55 Selling a Business and Major Career Changes 10:59 Why Owners Step Away From Established Clinics 18:27 Industry Changes and Economic Uncertainty 26:25 Preparing for International Conferences 33:29 Learning Ultrasound and New Clinical Skills 41:37 Why Ultrasound May Become Standard Practice 48:53 Choosing Equipment and Training Pathways 52:09 Balancing Innovation With Patient Safety 61:45 Social Media Risks for Clinics and Practitioners 68:49 Real Stories of Instagram Account Hacking 76:38 Business Impact of Losing Social Media Access 80:09 Essential Security Steps to Protect Your Account 86:34 Backup Strategies and Communication With Patients 90:43 Final Advice on Protecting Your Business Online

ALL IA LINKS & CONTACT INFORMATION