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THE AESTHETICS AWARDS 2026 WINNERS REVEALED April 2026 | VOLUME 14 - ISSUE 5

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CPD: BoNT Complication Management Dr Carol Mastropierro discusses botulinum toxin complications and management

Special Feature: Approaches to Non-surgical Facelifts Integrative Strategies for Facial Sculpting

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Kate Monteith-Ross discusses regenerative approaches in skin treatments Amanda Elbourn explores medical aestheticians role in aesthetic services

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Contents • April 2026 08 News The latest product and specialty news

17 News Special: Calls For a Ban on Dermal Fillers for Breast Enhancement Aesthetics explores calls for an immediate ban on dermal fillers being used for breast augmentations

CLINICAL PRACTICE 18 Event Preview: Inspiring the Aesthetics Community Explore the standout moments from ACE 2026

24 Special Feature: Non-surgical Facelifts Practitioners discuss their clinical approaches to non-surgical facial lifting

29 CPD: Botulinum Toxin Complication Management Dr Carol Mastropierro discusses botulinum toxin complications

34 A Split-Scar Evaluation of PNs and CO2 Laser

News Special: Calls For a Ban on Dermal Fillers for Breast Enhancement Page 17

Dr Jordan Faulkner examines treatments for scar remodelling

36 Mechanistic Synergy of Multi Acid Peels Kate Monteith-Ross explores regenerative approaches in skin treatments

38 Aesthetics Awards Winners Revealed Discover your 2026 Aesthetics Awards Winners

53 You Cannot Rebuild the Skin Without the Materials to Build It Introducing Celora™ Vita: a biorestorative injectable that addresses skin ageing at its source

54 Considering Integrative Strategies for Facial Sculpting Dr Hasaneen Al Janabi explores non-surgical refinement

59 Elevate to Elite SkinPen Precision Elite is setting the new standard in microneedling in the UK & Ireland

60 Strategies for Abdominal Skin Tightening Dawn Attewell examines physiological changes in skin laxity

62 Skin Tightening in the Longevity Era Why needles fractional RF technologies are reshaping preventative aesthetics

Special Feature: Exploring Non-surgical Facelifts Page 24

Clinical Contributors

63 Abstracts

Dr Carol Mastropierro is an aesthetic doctor, and clinical

A round-up and summary of the latest clinical studies

trainer at Harley Academy in London. She runs Wrinkless Clinic in Hertfordshire and has a special interest in anatomy-led aesthetic

IN PRACTICE

treatments, regenerative medicine and advancing safety.

64 Converting Leads for Clinic Growth

founder of Allo Aesthetics. He is also the founder and lead mentor

Dr Jordan Faulkner is a full-time cosmetic physician and

Adam Smith shares how clinics can improve lead management

67 Evolving Role of Medical Aestheticians Amanda Elbourn explores governance-led aesthetic services

70 Exploring Key Trends with Specialty Figures

of Unite Aesthetics Initiative and is a clinical educator at Interface Aesthetics. Kate Monteith-Ross is an independent nurse prescriber and founder and clinical director of The Clinic by La Ross, urban training and is the cofounder of The Nurses Network. Monteith-Ross

ACE 2026 hosted The Candid Trends Panel

specialises in evidence-informed, minimally invasive treatments. Dr Hasaneen Al Janabi is the founder of the Dr Hass

73 In The Life Of: Amy Bird Winner of this years Evolus Award for Aesthetic Nurse Practitioner of the Year Amy Bird shares a day in her life

74 The Last Word: Hair Transplant Surgery Mr Greg Williams argues the importance of training in hair transplantation

Clinic in Mayfair, renowned for his expertise in non-surgical facelifts, advanced filler techniques and Endolift laser treatments. He is the lead trainer at the British Aesthetic Academy. Dawn Attewell is a nurse practitioner specialising in regenerative and device-based treatments for skin quality and

NEXT MONTH: SKIN, HAIR AND DERMATOLOGY

body rejuvenation. She focuses on structured patient assessment,

• Mitochondria Disease • HA-based Skin Boosters • Vaping and Skin

evidence-based treatment planning and combination treatments.

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Editor’s letter April is here, and after an incredible few days celebrating the very best in medical aesthetics at the Aesthetics Conference & Exhibition (ACE) and The Aesthetics Awards, I have been reflecting on just how far our specialty has come – and how quickly it continues to evolve. This year’s ACE was our Holly Carver most successful yet, with a record-breaking Editor & Content Manager number of attendees joining us to learn, share and connect. Thank you to everyone who took part – your energy and commitment are what make this event such a powerful hub for education and collaboration. In this issue of Aesthetics, we recognise the 2026 Aesthetics Awards Winners. The standard of entries rises every year, and the innovation, integrity and patient focus shown by our Finalists and Winners are truly inspiring. Turn to our Winners’ spread to see who took home the top accolades and to discover the individuals, clinics and companies setting the benchmark for excellence in our field. Our clinical spotlight this month is on skin tightening – an area

developing at pace as patients seek effective, natural-looking rejuvenation with minimal downtime. In our Special Feature, we explore non-surgical facelift strategies, examining how practitioners are combining energy-based devices, injectables and skin quality treatments to lift and contour the face without surgery. We also look at advanced approaches to abdominal tightening, addressing one of the most in-demand body concerns in clinic, and we share the latest thinking on scar healing to optimise aesthetic outcomes and support patient confidence. With the insights and conversations from ACE still front of mind, you will find our full post-event write-up on p.18, capturing the key themes, standout sessions and practical takeaways for your practice. What is clear is that our community remains committed not only to delivering excellent results, but also to prioritising safety, ethics and long-term patient wellbeing. As always, I would love to hear your thoughts on this issue – whether it is your feedback on ACE, your experience at The Aesthetics Awards, or the topics you believe our specialty needs to explore next. Please do get in touch and be part of the conversation.

Clinical Advisory Board

Leading figures from the medical aesthetic community have joined the Aesthetics Advisory Board to help steer the direction of our educational, clinical and business content

Sharon Bennett is the former chair of the British Association of Medical Aesthetic Nurses (BAMAN), UK lead of the BSI committee for aesthetic non-surgical standards and member of the Clinical Advisory Group for the JCCP. She is a trainer and a registered university mentor in cosmetic medical practice, and is finishing her MSc at Northumbria University. Bennett has won the Aesthetics Award for Nurse Practitioner of the Year and the Award for Outstanding Achievement.

If you are interested in contributing to the journal, get in touch... Email: editorial@aestheticsjournal.com

Sharon Bennett, Clinical Lead Mr Naveen Cavale has been a consultant plastic, reconstructive and aesthetic surgeon since 2009. He has his own private clinic and hospital, REAL, in London’s Battersea. Mr Cavale is the national secretary for the ISAPS, president of the Royal Society of Medicine, and vice-chair for the British Foundation for International Reconstructive Surgery.

Dr Mayoni Gooneratne (MBBS, BSc, MRCS, MBCAM, AFMCP) was an NHS surgeon before establishing The Clinic by Dr Mayoni and founding Human Health – an initiative combining lifestyle with traditional and functional medicine to provide a ‘cell-up’ regenerative approach to aesthetics. She is also the co-founder of The British College of Functional Medicine.

Dr Sophie Shotter is the founder & medical director of Illuminate Skin Clinic in Kent and Harley Street, London. Her passion is for natural treatments delivered with utmost attention to safety. She works closely with Allergan as part of their UK and International Faculty.

Miss Elizabeth Hawkes is a consultant ophthalmologist and oculoplastic surgeon. She is the lead oculoplastic surgeon at the Cadogan Clinic, specialising in blepharoplasty and advanced facial aesthetics. Miss Hawkes is a full member of the BOPSS and the ESOPRS, and is an examiner and fellow of the Royal College of Ophthalmologists.

Jackie Partridge is an independent nurse prescriber. She is the clinical director and owner of Dermal Clinic in Edinburgh and a KOL for Galderma. She holds an MSc in Non-surgical Aesthetic Practice and a BSc in Dermatology. Partridge is a stakeholder group member with Scottish Government/HIS, Honorary BACN member and JCCP Fitness to Practice Nurse.

Dr Anjali Mahto is one of the UK’s leading consultant dermatologists. She is a Fellow of the Royal College of Physicians, member of the Royal Society of Medicine and a spokesperson for The British Skin Foundation. In 2023 Dr Mahto opened Self London, a dermatology and lifestyle clinic aimed at managing skin conditions holistically.

Mr Adrian Richards is a plastic and cosmetic surgeon with over 30 years’ experience. He is the clinical director of the aesthetic training provider Cosmetic Courses and surgeon at The Private Clinic. He is also a member of the British Association of Plastic and Reconstructive and Aesthetic Surgeons and the British Association of Aesthetic Plastic Surgeons.

Dr Souphi Samizadeh is a dental surgeon with a Master’s degree in Aesthetic Medicine and a PGCert in Clinical Education. She is the founder of the Great British Academy of Medicine and Revivify London Clinic. Dr Samizadeh is a Visiting Teaching Fellow at University College London and King’s College London.

Dr Stefanie Williams is a dermatologist with a special interest in adult acne, rosacea and aesthetic medicine. She is the founder and medical director of multi-award winning EUDELO Dermatology & Skin Wellbeing in London, and creator of Delo Rx skincare. She is the author of three books and has published more than 100 scientific articles, book chapters and abstracts.

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Regulation

Talk #Aesthetics Follow us on Instagram @aestheticsjournaluk

Members of the Scottish Parliament have voted to pass the Non-surgical Procedures and Functions of Medical Reviewers (Scotland) Bill on March 17, receiving 124 votes in favour.

#ACE2026 Taimur Shoaib @shoaib_ plasticsurgeon Thank you to everyone who attended my ACE session. The arena was packed, and it was great to catch up with friends and colleagues!

From September 2027, all aesthetic procedures must be delivered within a Healthcare Improvement Scotland (HIS)-registered clinic, with a qualified prescriber onsite at all times. The legislation will now prohibit non-surgical cosmetic procedures for under-18s and introduce tighter controls on interventions such as botulinum toxin injections, dermal fillers, liquid Brazilian butt lifts (BBLs), laser treatments, chemical peels, microneedling and cellulite treatments. #AestheticsAwards2026 Dr. Bethany Rossington @dr.bethany.rossington I am so proud, overwhelmed and excited to share that last night I was awarded the Rising Star of the Year award at The Aesthetics Awards!

#Recoginiton Dr Yannis Alexandrides MD @dryannisofficial Celebrating my inclusion in the Tatler Beauty & Cosmetic Surgery Guide 2026 this morning. Moments like these continue to elevate the standard within our field.

Under the new law, it will be a criminal offence to provide these procedures to anyone under 18, or to carry them out outside permitted premises, with a maximum fine of £20,000. Individuals within organisations could be held personally liable for offences. Treatments will be limited to approved clinical environments – NHS GP practices, dental practices and pharmacies, as well as private hospitals and clinics registered with HIS – and must be overseen by healthcare professionals registered with the General Medical Council (GMC), Nursing and Midwifery Council (NMC), General Dental Council (GDC) and General Pharmaceutical Council (GPhC). Speaking on behalf of the Government on March 17, Public Health Minister Jenni Minto, added, “Many people have had positive experiences with responsible and caring practitioners. But, as the sector has grown, so have stories of people who have been harmed or injured.” The legislation will also grant powers to the Scottish Government and local authorities to introduce further measures, including stipulating who may provide procedures and what training or qualifications they must hold.

#Networking Dermapenworld UK @dermapenworld_uk So grateful to share this special moment at The Savoy with specialty leaders and inspiring professionals, including Dr Andrew R Christie, director of DermapenWorld Corri Marshall and Dr Olha Vorodyukhina.

#PrimeX Alma UK & Ireland @almaukandireland Yesterday, we welcomed clinics from across the UK to explore post-weightloss care, a rapidly growing focus within aesthetics. Thank you to everyone who joined us!

Scottish Parliament passes Non-surgical Procedures Bill

Speaking to Aesthetics, nurse prescriber Frances Turner Traill shared, “This is a historic milestone for patient safety in Scotland and a long-awaited validation of medical-led model of aesthetics. By moving primary legislation, Scotland is establishing a statutory backbone for our specialty – shifting to mandatory legal requirement that cannot be bypassed. This legislation ensures that patients are guaranteed clinical oversight in a sterile, inspected setting. This collaborative approach serves as the new gold standard for regulation.” Nurse prescriber and clinical advisory board member Jackie Partridge said, “In order for non-healthcare practitioners to become registered with HIS they must operate within a regulated setting that includes a qualified medic onsite at all times while treatments are carried out. This medic must be formally associated with the clinic, and the premises must meet the same HIS standards as those already applied to regulated healthcare providers. Before the legislation comes fully into force, further regulatory frameworks must be established by the Scottish Government, and the Bill must receive Royal Assent.”

Aesthetics | April 2026

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Event Launch

Vital Statistics

The Aesthetics Business Show to launch in 2027

A survey of 2,500 consumers indicated they prefer products centred on wholebody balance and resilience, rather than appearance or damage correction

Aesthetics is thrilled to unveil The Aesthetics Business Show, launching at the Aesthetics Conference & Exhibition (ACE) 2027. Co-located with ACE on March 12-13, The Aesthetics Business Show is a dedicated forum designed to support the commercial success and long-term growth of aesthetic practices. Hosted within the Gallery Hall at the Business Design Centre, the event will feature two specialist business theatres delivering high-value content across strategy, finance, operations, marketing, compliance, leadership, services and solutions. The programme is tailored for all key clinic roles, including owners, partners, managers, team leaders, front-of-house professionals, as well as marketing and business support teams. Each year will focus on a clear annual theme – such as growth, resilience or innovation – providing attendees with a structured learning journey. The agenda will also include an Association Zone, Mentoring Speed Dating, insights from Finalists and Winners of The Aesthetics Awards and perspectives from cross-sector business leaders.

(MMR Research, 2026)

A study of 3,000 GLP-1 patients, alongside 2,000 UK adults, revealed that two in three patients hide their GLP-1 treatment from some or all friends and family (Simple Online Pharmacy, 2026)

Research from 113,630 patients revealed 80% of weight-loss prescriptions are issued to women, with the highest uptake among adults aged 30-49

Attendees will leave with practical, actionable strategies to enhance performance, patient experience and compliance, while exhibitors gain direct access to high-level decision-makers, positioning themselves as strategic partners within a focused business hub. Shannon Kilgariff, event director and publisher at Aesthetics, commented, “The Aesthetics Business Show represents a new shift in our field, as we aim to deliver meaningful insight and practical solutions for our attendees. Feedback from our ever-evolving specialty shows that professionals are increasingly seeking stronger business support, and Aesthetics are committed to providing exactly that. We’re excited to launch the show at ACE 2027 – see you there!” Advertising

CAP reviews BBL breaches The Committee of Advertising Practice (CAP) has reported widespread breaches of advertising rules in online promotions for non-surgical Brazilian butt lift (BBL) procedures.

(The Health Foundation, 2026)

Out of 300 individuals, 59% said they would follow medical professionals on social media for new wellness product compared to 33% who look to influencers (Karla Otto and Phronesis Partners, 2026)

CAP shares that its AI monitoring system identified over 900 adverts between April and December 2025, with only 11.5% complying with the rules. Common issues included misleading safety claims, such as “0% infection rate,” and ads presenting procedures as risk-free. Some promotions also used time-limited offers or exploited body insecurities, pressuring patients into quick decisions, according to the watchdog. CAP required clinics to amend or remove non-compliant ads and worked with Meta to take down problematic content. The organisation described the high breach rate as unusual, suggesting wider issues in the unregulated sector. Meanwhile, compliance among overseas cosmetic surgery adverts has improved, though concerns remain about pressure tactics and unrealistic body image messaging. Isabel Lucas, compliance executive at CAP, commented, “While it’s positive that our monitoring and enforcement action has led to real improvements in advertising for cosmetic surgery abroad, it’s deeply concerning to see so many ads for liquid BBLs continuing to break the rules. We know these procedures carry significant risks, which is why it’s so important ads are responsible.”

Only 25.9% of undergraduate medical students reported being familiar with the plastic surgery training pathways (Plastic and Reconstructive Surgery, 2026)

One in four working women out of 898 feel menopause is misunderstood and insufficiently addressed in the workplace (Live Career, 2026)

Aesthetics | April 2026

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Events diary 17 -19 April 2026 Wigmore Presents th

2nd May 2026 BCAM conference 24th-25th September 2026 BAMAN Autumn Aesthetic Conference 1st-2nd October 2026 Clinical Cosmetic Regenerative Congress (CCR) & Medical Longevity Summit (MLS) 7th November 2026 RAMCE November 2026 Interface Expo

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Patient Safety

NHS data highlights plastic surgery negligence Medical negligence solicitors Blackwater Law has outlined that clinical negligence claims linked to plastic surgery within the NHS have risen significantly. According to the company, figures from the NHS show 75 claims were recorded in 2024/25, up from 53 the previous year, marking one of the highest totals in recent years. The data highlights a range of alleged patient harms, including unnecessary procedures, nerve damage and scarring. Unnecessary operations were the most frequently cited issue, while other claims involved serious complications such as infection and, in rare cases, fatalities. Jason Brady, partner and head of medical negligence at Blackwater Law, commented, “The data reveals that there has been a rise in avoidable injuries from plastic surgery treatment. Such injuries can be distressing because there can be visible in appearance, with scarring together with physical and psychological symptoms. There can be other more severe injuries such as nerve injuries, chronic pain and amputations. If the treatment provided fell below the accepted standard this could lead to a medical negligence claim for compensation.” Anniversary

IN T HE ME D I A What’s trending in the consumer press

Hello! discusses the rise of regenerative treatments Hello! magazine reported a growing shift within patient preferences towards regenerative aesthetics. “The concept of the ‘negative aesthetic footprint’ has led practitioners to favour regenerative treatments over traditional fillers,” explained aesthetic practitioner Dr Carmen Ayestarán. The feature traces a shift over the past two decades, from wrinkle-filling and volume restoration to today’s “no-trace” treatments, where subtle, natural-looking results are the primary goal. BBC News scrutinises sunbed usage BBC News has identified hundreds of adverts on TikTok, Instagram and Facebook claiming sunbeds can boost energy or treat skin and mental health conditions. Following the investigation, BBC News spoke to two people diagnosed with skin cancer in their twenties. Sam, 27, developed basal cell carcinoma after using sunbeds at 25. Cass, also 27, was diagnosed with melanoma after regular sunbathing and occasional sunbed use. “Everyone used to say sunbeds were really bad for you, but I never thought anything bad would happen to me. At just 22, I was diagnosed with melanoma,” said Cass. In response, the Sunbed Association says it regulates UV strength, bans under-18s and limits sessions to 60 per year.

BCAM announces annual conference The British College of Aesthetic Medicine (BCAM) has unveiled its 25th Anniversary Conference, taking place on May 2 at the Pullman London St Pancras. Presented in a TED-x style format, BCAM confirms that the 2026 conference will bring together leading speakers such as Dr Steven Harris, Mr Dalvi Humzah, Mr George Christopoulos, Dr Christine Hall, Dr Mayoni Gooneratne, nurse prescriber Julie Scott and BCAM’s founding members. According to BCAM, delegates can expect a full educational journey, covering the most in-demand topics at the moment as well as innovations shaping the next decade of aesthetic practice. The event also promises networking and collaboration within a collegiate environment. The organisation shares that the celebrations will continue with a gala dinner featuring fine dining, live entertainment from Soulstress Groove, a five-piece band and an evening dedicated to honouring BCAM’s achievements, impact and community spirit. Sadie Van Sanden Cooke, chief operating officer at BCAM, shared, “Our 25th Anniversary Conference is a celebration of history and progress in medical aesthetics – uniting leading clinicians to share ideas, spark debate and shape the future of safe, science-led patient care. We look forward to welcoming both members and non-members to be part of this special milestone.” Women’s Health

NICE backs non-hormonal menopausal pill The National Institute for Health and Care Excellence (NICE) has recommended a new non-hormonal pill for women experiencing menopause symptoms. NICE stated that fezolinetant can now be prescribed on the NHS for women who are unable to take hormone replacement therapy (HRT) or for whom it is not suitable. The organisation explains fezolinetant works by blocking nerve pathways in the brain that trigger hot flushes and night sweats. According to NICE, around 500,000 women in England and Wales could benefit from the drug, which is taken as a 45mg tablet once a day. This announcement comes after the Medicines and Healthcare products Regulatory Agency (MHRA) approved the treatment in December 2023. Helen Knight, director of medicines evaluation at NICE, said, “We know that menopausal hot flushes and night sweats can have a profound impact on quality of life and significantly affect overall wellbeing. The evidence shows fezolinetant can meaningfully reduce symptoms and was found to be cost-effective. This decision will give much-needed relief to those for whom HRT is unsuitable.” Aesthetics | April 2026

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Unlicensed Medicine

MHRA crack down on weight loss drug facility Officers from the Criminal Enforcement Unit (CEU) of The Medicines and Healthcare products Regulatory Agency (MHRA) have raided premises involved in the manufacture and sale of unlicensed weight-loss medicines. The MHRA reports that the officers seized almost 2,000 doses of unauthorised weight-loss medicines awaiting dispatch to customers, alongside manufacturing equipment, suspected pharmaceutical ingredients, packaging and commercial vehicles. The two premises were located in Lincolnshire and Nottinghamshire. The MHRA states that the sites are believed to have been used for the manufacture and distribution of unlicensed weight-loss medicines, including retatrutide and tirzepatide, as well as peptide products. Andy Morling, head of the MHRA’s criminal enforcement unit, commented, “The message to those illegally trading in medicines could not be clearer – we are coming for you. Every illegal product and every piece of manufacturing equipment we seize disrupts these criminal networks and brings us closer to dismantling them entirely.” Reward Programme

The Aesthetics Journal Alliance launches The Aesthetics portfolio has introduced The Aesthetics Journal Alliance, a programme to champion brands dedicated to supporting the aesthetics community. Designed to foster a recognised network of trusted, leading aesthetics brands, membership is open to the companies that are most dedicated to shaping and growing the aesthetics community through the Aesthetics Journal and its flagship events, the Aesthetics Conference & Exhibition (ACE) and the Clinical Cosmetic Regenerative Congress (CCR). Members have been announced for 2026, and include Alma, Beautology, Cosmeditech, Cutera, DermaFocus, Dermapenworld, Fotona, Galderma, Healthxchange, Hydrafacial UK, IVANMED, Pure Tone Aesthetics, Revance and SkinCeuticals. Shannon Kilgariff, event director and publisher at Aesthetics, commented, “The Aesthetics Journal Alliance marks an exciting new chapter for our partners who are leading the way to support the progression of the aesthetics community. We’re proud to introduce this initiative and celebrate those who help drive our community forward.” Consolidation

DD Group acquires Fox Group Global Ltd Dental equipment and supplies company DD Group have acquired UK-based aesthetic product distributor Fox Group Global Ltd. Subject to customary regulatory approvals, the transaction is expected to close in the second quarter of 2026. DD Group distributes dental and medical products across the UK and Europe and, through its MedFx division, supplies the aesthetics sector. Following completion, Fox will continue to operate under its existing management team. Howard Taylor, CEO of DD Group, commented, “We look forward to working with the Fox team following completion of the transaction.” John Thompson, managing director of Fox Group, said, “The transaction provides continuity for our customers and employees, and we will continue to focus on product quality, compliance, and customer service.” Aesthetics | April 2026

BAMAN UPDATES A round-up of the latest news and events from the British Association of Medical Aesthetic Nurses

BAMAN LOBBYING AT THE SCOTTISH PARLIAMENT BAMAN were at the Scottish Parliament for the Stage 2 hearing of the Non-surgical Procedures Bill on February 24, as the professional body representing medical aesthetic nurses. As an association, we advocate for a Scotland where patient safety comes first. Experience alone is not a substitute for medical registration, and high-risk injectables belong in permitted, clinical premises – not in unregulated residential settings. The amendments that BAMAN opposed did not pass, which is good news for patient safety. Health Improvement Scotland will be attending our Edinburgh Regional Meeting on March 23 to provide Scottish members with a comprehensive update on national regulation.

REGIONAL MEETINGS As the rest of BAMAN’s regional meetings unfold across the country, we continue to create welcoming spaces for nurses, providing a broad educational agenda alongside essential training and updates. Recent events throughout February and March have demonstrated why these gatherings matter. So far, our meetings have been attended by more than 150 BAMAN members across the country, including regional leaders, committee members and BAMAN’s board of directors. BAMAN board of directors’ member and education and training committee chair Anna Baker has attended the first three meetings of the year in Kent, Windsor and Chester. She reflects on the programme so far, saying, “It has been a pleasure to listen to so many stellar medical practitioners sharing a wealth of clinical experience and a variety of case studies! These meetings are an invaluable means of connecting to fellow nurses and a testament to the hard work and commitment of all our valued regional leaders across the UK. There is plenty more to come!” All upcoming BAMAN regional events and meeting dates are available to book via the BAMAN website. Secure your place now – it’s free for BAMAN members!

This column is written and supported by BAMAN

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Launch

DermaFocus unveils amino acid injectable

01 & 02 October 2026

Aesthetic distributor DermaFocus hosted an event to celebrate the launch of Celora Vita on March 13.

Excel, London Save the Date: CCR 2026

Shaping the future of medical aesthetics, CCR returns to London on October 1-2

The evening was dedicated to exploring the evolving role of regenerative science in medical aesthetics, bringing together more than 250 practitioners, faculty members and press.

Taking place at Excel, London, the Clinical Cosmetic Regenerative Congress (CCR) will once again bring together doctors, nurses, dentists, surgeons, dermatologists, clinic owners, emerging practitioners and specialty partners for two days of evidence-based learning, live demonstrations and networking.

The educational programme began with a presentation from cosmetic dental surgeon and aesthetic practitioner Dr Lee Walker, who discussed the critical role of amino acids as the building blocks of skin regeneration, emphasising that stimulation alone is insufficient without the substrates required for extracellular matrix rebuilding. Following this, aesthetic practitioners Dr Catherine Fairris and Dr Olivia McCabe-Robinson introduced Celora Vita, outlining its indications, clinical positioning and protocols for integration into practice. Plastic surgeon Mr George Christopoulos concluded, explaining how the product complements the wider DermaFocus regenerative portfolio.

What’s new this year? For 2026, CCR is evolving to reflect the way you practise – with a stronger focus on longevity, collaboration and whole-patient care. The Medical Longevity Summit (MLS) moves to a new, dedicated location on the show floor, supported by an all-new MLS theatre set-up, now expanded into two theatres to meet growing demand for content on hormones, metabolism, women’s health, nutrition and lifestyle medicine. Dentistry takes centre stage too, with a new one day dentistry focus created specifically for dental practitioners working in, or moving into, medical aesthetics. Expect tailored content on anatomy, complications, treatment planning and practice growth. Responding to the surge of interest in trichology and integrative skin health, CCR 2026 will also host a brand-new Hair, Scalp & Skin Stage on day 2, spotlighting practical, protocol-driven sessions you can implement straightaway in clinic. This year will also see an enhanced presence from The Aesthetics Awards. A new feature on the show floor will coincide with the Rising Stars programme, offering an inspiring space to celebrate excellence, discover previous Winners and meet the future leaders of the medical aesthetics specialty. Register your interest now! Mark your diary now and register your interest online to be the first to hear when registration opens and content is revealed. CCR 2026 is where the next chapter of medical aesthetics begins – make sure you are there!

Scan the QR code to register your interest

Milad Bemana, co-founder and executive director, shared, “We were delighted to welcome some of medical aesthetics’ most respected practitioners, our exceptional faculty and members of the press, for an evening of science, inspiration and connection. The energy in the room was a testament to what this launch represents; a community excited by what comes next for regenerative aesthetics and the role true biorestoration will play in shaping it.” Distribution

Healthxchange appointed as exclusive distributor for Potenza Aesthetic distributor Healthxchange has announced its exclusive distribution of the Potenza radiofrequency (RF) microneedling system in the UK and Ireland. According to the company, the Potenza system combines monopolar and bipolar RF with both invasive and non-invasive modalities. The device incorporates a patented pumping-tip mechanism that, the company says, enables topical agents to be delivered into the dermis while producing a thermal coagulative effect. Healthxchange says the partnership broadens its portfolio of energy-based devices and is intended to support its position in advanced aesthetic technologies. Jack Curran, CEO of Healthxchange, commented, “As demand grows for advanced, versatile energy-based technologies, our focus remains on providing clinicians with proven solutions that support personalised treatment and strong patient outcomes. Potenza is an important addition to our portfolio and reinforces our commitment to innovation and professional education within the aesthetics sector.”

Aesthetics | April 2026

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On The Scene

Revance unveils new microneedling technology Aesthetic manufacturer Revance, formerly Crown Aesthetics, hosted a launch event for the SkinPen Precision Elite microneedling device at 180 Health Club London on March 2. The event marked the first of four UK and Ireland launches organised by Revance to introduce the company’s latest microneedling technology to healthcare professionals and advanced skin therapists. Presentations were delivered by aesthetic practitioners Dr Ahmed El Houssieny and Dr Bryony Elder, nurse prescriber Mary Irving and education manager at Revance Kat Coleman. Speakers outlined the features of the SkinPen Precision Elite and discussed integrating microneedling treatments into clinical practice. Joanna Neal, marketing manager at Revance UK&I, commented, “We were delighted to welcome new and existing SkinPen users to our event in London to showcase our latest device the SkinPen Precision Elite. It marked the first event taking place across the UK&I over the next month, showcasing our commitment to education and commercial support to ensure SkinPen Precision Elite is successful investment for clinics.” Operational Support

CPPE officially debuts in the UK Aesthetics attended the official European launch of Cosmetic Physician Partners Europe (CPPE) at the Royal Society of Medicine on March 5. Etienne Billette, CEO of CPPE, and Nils Wickman, head of operations, outlined the company’s approach and objectives. According to the company, CPPE works in partnership with practitioners seeking greater operational structure within their clinics, aiming to provide support across areas including marketing, operations and compliance. During the presentation, the company also explained its core pillars, which include building a community of aesthetic practitioners, providing centralised services, establishing a growth framework, and investing in people, technology and facilities. Miss Jennifer Doyle, consultant oculoplastic surgeon and a partner of CPPE, commented, “Within the aesthetics specialty, it is rare to find real collaboration between practices. I love the concept of partnering with like-minded practitioners within the field, and improving practices as a group for the benefit of patients and clinicians alike.” Body Contouring

Lynton Lasers launches ONDA Pro at ACE Aesthetic device company Lynton Lasers introduced body contouring device ONDA Pro in the UK at the Aesthetics Conference and Exhibition (ACE) 2026. Developed by laser manufacturer DEKA and distributed exclusively in the UK by Lynton Lasers, ONDA Pro builds on an established contouring platform to deliver enhanced results across the face and body. According to Lynton Lasers, the device works more deeply within the tissue to target adipose structures while stimulating collagen associated with firmness. The result is visible contour refinement and skin tightening, without unnecessary surface heating, according to the company. Hayley Jones, commercial director at Lynton Lasers, commented, “Face-first solutions are increasingly in demand as contouring continues to evolve. It’s no longer just about body shaping – practitioners are seeking technologies that support facial definition and structure without compromise.” Aesthetics | April 2026

Insider News

Joshua Catlett, founder of Verilo You specialise exclusively in healthcare business sales – why does aesthetics need its own approach? Because aesthetics isn’t like selling a generic business, and it isn’t quite like selling a GP practice either. The revenue model is elective and consumer-driven, the workforce picture can be complex and regulatory change is actively reshaping what buyers are willing to pay. A generalist broker will price the business. A specialist will position it. The difference, in our experience, can be significant. What’s the single biggest thing that suppresses the value of an aesthetics practice? Owner dependency. In aesthetics more than almost any other sector, the business can be built around one person – their name, their following, their hands. Buyers will pay a premium for a practice with a clinical team, a strong patient database and revenue that doesn’t walk out the door when the owner does. If you are the business, that’s not insurmountable but it needs to be addressed before you go to market. Regulation in aesthetics is tightening. Is that good or bad news for owners considering an exit? For well-run practices, it’s good news. Licensing requirements and the push toward clinical oversight are filtering out the lower end of the market. Buyers, particularly those backed by private equity, are actively seeking practices that will be compliant and credible under the new framework. If your business is already operating to that standard, your timing may be better than you think. Verilo advises on the sale of health, medical, and wellness businesses across the UK. To understand what your aesthetics practice is worth, visit verilo.co.uk

This advertorial was written and supplied by Verilo

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Patient Education

Aesthetics

mesoestetic unveils new solution

Verification and consumer education platform Twiqk was released on March 15, aiming to support safer and more accountable growth in the non-surgical aesthetics sector.

Aesthetic manufacturer mesoestetic has announced the launch of c.prof mesoxome. According to the company, the new line is powered by proprietary mesoxome technology, combining specialised exosomes with targeted actions and polydeoxyribonucleotide (PDRN) polynucleotides to support regenerative and reparative processes.

Founded by social entrepreneur and doctoral researcher Josh Sim, the initiative aims to bring together consumer education with professional credibility. Its advisory board is chaired by aesthetic practitioner Dr Patrick Treacy, with leadership from editor Anna Dobbie. According to the company, Twiqk will feature medically reviewed educational content alongside a vetted directory of practitioners registered with bodies including the General Medical Council, Nursing and Midwifery Council and General Pharmaceutical Council, as well as a clinic finder searchable by treatment and location to help patients make informed choices. Dr Treacy commented, “The platform’s focus on transparency, practitioner verification, governance and quality assurance addresses some of the most pressing challenges currently facing our specialty. By strengthening standards and promoting independent oversight, Twiqk has the potential to enhance public trust and support responsible practitioners.”

mesoestetic explains that the indication-specific solutions are designed for professional use with devices and transepidermal administration systems. Stephen Schofield, commercial director at mesoestetic UK, shared,” The introduction of c.prof mesoxome range represents a significant advancement in professional microneedling solutions, combining next-generation mesoxome exosome technology with regenerative PDRN and active ingredients to deliver targeted, high-performance results.” Appointment

Laboratories VIVACY UK introduces new sales director

Sun Protection

Environ releases RAD ACTIVÉ Skincare company Environ, available through by aesthetic distributer iiaa, launched a new SPF at the Aesthetics Conference & Exhibition (ACE) 2026. According to Environ, the launch represents a modern evolution of its original RAD formulation, first introduced in 1992. The company says the new product builds on its long-standing approach of combining antioxidants with UV protection. Environ adds that the formula offers SPF20 and features vitamins C and E, along with beta carotene, supported by a blend of physical and low-level chemical sun filters, designed to deliver essential, effective daily UV protection. Dr Des Fernandes, Environ’s founder and scientific director, said, “It isn’t sensible to rely on the SPF alone. For safe and effective protection against photo-damage and the prevention of skin cancer, one must adopt a holistic approach, starting with the daily topical replenishment of vitamin A and antioxidants and supplements.”

A round up of the latest aesthetic clinics opening across the UK Dr Mihaela Gulyas, founder and medical director, marked the launch of SKNCode London with an exclusive opening lunch at Annabel’s, London. Dr Gulyas delivered opening remarks outlining the clinic’s philosophy of regenerative aesthetics, intelligent treatment planning

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Solution Range

New educational platform launches

This month’s newest clinic openings

Aesthetics

Aesthetic manufacturer Laboratories VIVACY UK has announced the appointment of Katie Hughes-Dawkins as sales director for the UK and Ireland. According to the company, Hughes-Dawkins brings extensive experience to the role, previously working as global head of engagement and relations at aesthetic distributor Harpar Grace International. Brianna Broadbridge, general manager for Laboratories VIVACY UK, commented, “We are delighted to welcome Hughes-Dawkins as our national sales director for the UK and Ireland at such a pivotal moment for the company. Her deep experience and knowledge of the aesthetics market, combined with her impeccable reputation and strong focus on patient needs, will be a tremendous asset as we continue to strengthen VIVACY’s presence in the region.”

and long-term skin longevity. She commented, “I feel incredibly proud to introduce the clinic in a room surrounded by such influential editors and specialty voices who shape the future of beauty and wellness.” Aesthetic practitioner Dr Morteza Jalali has announced the launch of his new clinic, Morteza Jalali Medical Aesthetics, in Chiswick, West London. Clinic services include botulinum toxin

and regenerative treatments, such as polynucleotides. With a background in regenerative medicine, his aim is to offer a portfolio of science-driven, evidence-based treatments to his local community, through a patient-centred, ethical practice. Dr Jalali commented, “Precision, discretion and respect for individuality form the cornerstone of everything we do.”

If you’re opening a new UK clinic soon, let us know at editorial@aestheticsjournal.com

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Regenerative Medicine

SuneKOS presents roundtable discussion Hosted in partnership with its UK distributor, AestheticSource, SuneKOS welcomed members of the press to Pimlico Pantry on February 26. The morning opened with an introductory presentation from Tiziano Cameroni, chief executive officer and co-owner of Professional Dietetics, the pharmaceutical company behind SuneKOS. Cameroni provided an overview of the product, outlining its key clinical applications across medical aesthetics, gynaecology and wound care. Contributing to the discussion, aesthetic practitioner Dr Sophie Shotter shared her clinical protocols and presented case studies. She explained that the typical protocol involves three injection sessions spaced two weeks apart, with maintenance tailored to each patient. Speaking with Aesthetics, Dr Shotter said, “I’ve been using SuneKOS for around 18 months, and it has become one of my most used in-clinic treatments. I shared patient experiences of results and satisfaction in comparison with other skin injectable treatments they may have had before, and especially in the delicate periorbital area.” GLP-1 Education

Alma hosts weight-loss event Aesthetic device company Alma invited press and aesthetic practitioners to explore the opportunities created by post-weight-loss patients. The event aimed to define who this evolving patient demographic is, examine their clinical and emotional needs and provide actionable guidance on how aesthetic practitioners can adapt their service offerings accordingly. The programme also spotlighted Alma’s PrimeX device, which aims to address fat reduction, skin laxity and textural concerns commonly seen in post-weight-loss patients, according to the company. Abby Cotter, senior brand manager at Alma, shared, “Today’s patients are seeking comprehensive solutions, addressing not only facial ageing and fat loss, but full-body transformation and skin quality. This event was about helping clinics recognise that opportunity and equipping them with the tools to confidently deliver it.” New Technology

Dermapenworld unveils two devices Aesthetic device company Dermapenworld showcased two new device platforms at the Aesthetics Conference & Exhibition (ACE) 2026. The company introduced the EXO-GROW L.E.D Laser Cap, a combination device designed for patients experiencing hair loss, shedding or thinning. According to Dermapenworld, the cap combines 202 LEDs at 620 nm, 650 nm and 660 nm with 72 lasers at 650 nm, and is intended for use alongside its EXO-GROW Hair Tonic to enhance the delivery of topical products. Dermapenworld also presented Dp SYNERGIST, a multi-technology treatment platform designed to support customisable professional skin treatments and optimise the delivery of active ingredients. Andrew Hansford, education ambassador at Dermapenworld, commented, “Dermapenworld has consistently been at the forefront of technological advancements, striving to integrate our specialty-leading Dermapen 4 with innovative enhancements to the brand.” Aesthetics | April 2026

News in Brief IBSA UK&I unveils training programme Pharmaceutical company IBSA UK&I has launched the Official IBSA Training Programme for the UK and Ireland. Delivered by a national faculty of seven specialist trainers, including two full-time IBSA trainers, the programme offers bespoke one-to-one training supported by online pre-learning to maximise hands-on experience. Available across major UK locations, including Scotland, London, Manchester and Dorset, the curriculum covers four IBSA product ranges – Profhilo, Profhilo Structura, Viscoderm Hydrobooster and Aliaxin fillers. Medical Fabrica introduces permanent hair removal device Healthcare technology company Medical Fabrica has launched a permanent hair removal device called White Hair Pro. The company explains the device is designed to complement existing laser systems and can treat white, grey and light hair across all skin types – cases that Medical Fabrica claims have traditionally been difficult to treat. The company adds that White Hair Pro can also be used safely on tattooed skin, delivering effective hair removal without affecting pigment or causing discolouration. Harpar Grace International announces leadership restructuring Aesthetic distributor Harpar Grace International has introduced several appointments, including Erica Casey as chief executive officer. The company explains that Casey will oversee the organisation’s strategic, operational and commercial direction. Founder Alana Chalmers will assume the newly created role of executive chair, innovation and impact. The company also confirmed the promotion of Michal Bartunek to chief operating officer and the appointment of Tanith Facey as head of sales operations. Marllor Biomedical partners with Wigmore Medical Aesthetic manufacturer Marllor Biomedical has entered an exclusive distribution agreement with aesthetic distributor Wigmore Medical. Martina Motolese, chief operating officer at Marllor Biomedical, shared, “This partnership reflects a shared commitment to clinical excellence, responsible innovation and long-term brand building. Together, we aim to further elevate treatment standards, support practitioners through high-level education and expand patient awareness of evidence-based body treatments.”

Acre Pharmacy FP Ad April_SCOTT_REDONE.indd 1

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Aesthetics

Calls For a Ban on Dermal Fillers for Breast Enhancement Aesthetics explores calls for an immediate ban on dermal fillers being used for breast augmentations Medical aesthetic and surgical groups across the UK are advocating for an immediate prohibition on the injection of synthetic dermal fillers into breast tissue, according to the British Association of Aesthetic Plastic Surgeons (BAAPS).1 BAAPS maintains that there is “no justification whatsoever” for the administration of dermal fillers in the breast region, characterising the practice as ‘high-risk’ and of limited therapeutic or aesthetic benefit. The call follows renewed debate around the regulation of high-risk aesthetic procedures in the UK, as the Government prepares to introduce a licensing scheme for non-surgical cosmetic treatments.2 The British Association of Medical Aesthetic Nurses (BAMAN) and The British College of Aesthetic Medicine (BCAM) told Aesthetics that they support BAAPS’ call for an outright ban. Gareth Lewis, chief operating officer at BAMAN, commented, “As a professional association representing nurses working in medical aesthetics, BAMAN believes that procedures with a high-risk profile and limited evidence base should not be performed. We support stronger regulatory oversight within the aesthetics sector and welcome calls for clearer guidance and restrictions to better protect patients.”

Current regulatory framework Under current guidelines, there are no mandatory licensing requirements for individuals offering dermal fillers, unless the treatment involves a surgical procedure or is carried out by a healthcare professional (HCP) in a regulated setting.2 This has led to variation in practitioner qualifications and oversight, particularly for higher-risk procedures.2 BAAPS shared with Aesthetics that the organisation is now raising awareness of the issue, as regulation of non-surgical procedures has recently come into force in Scotland, with England potentially following soon. BAAPS believes this is

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BAAPS president and consultant plastic surgeon Ms Nora Nugent explains that under the licensing scheme, breast fillers would fall into the Red Category and therefore be categorised as high risk for only doctors to perform.2 However, Ms Nugent believes that licensing does not go far enough, and for this specific procedure, there are no benefits to outweigh the risks involved.

that, in regard to protecting the public against dermal fillers being used in the breast region, education alone is not enough to mitigate the risks. Dr McKeown says, “Those in vulnerable positions will still make unwise choices, particularly if they are being influenced by reckless marketing on social media. That’s why we need robust regulation to prevent people from making decisions that are a significant danger to their own health.”

Safety concerns

Practitioner responsibility

BAAPS has referenced several complications following the use of synthetic dermal fillers in breast tissue, including severe mastitis, abscesses requiring surgery, hard and misshapen lumps, migration of filler to other areas of the body, long-term pain and interference with breastfeeding.1

Ms Nugent adds that from an aesthetic practitioner’s perspective, being aware of the risks and problems associated with dermal fillers in the breast region is key. “Practising within your scope of training and experience is important,” she says, highlighting, “If you do not normally treat breast conditions and/or do not have a good understanding of breast physiology and pathology, do not place dermal fillers within breasts.”

the right moment to ensure the regulatory framework is implemented properly.

Aesthetic practitioner and BCAM member who advocates for patient safety across the sector, Dr Darren McKeown, suggests that breast fillers may pose a greater risk by potentially interfering with cancer detection. Dr McKeown explains that all fillers carry a risk of nodules and inflammatory reactions. In most areas of the body, if a new lump appears at the site of a previous filler injection, clinicians can reasonably assume it is likely related to the filler itself. However, he warns that the situation is very different in breast tissue, saying, “Assuming that a new lump in a patient with prior breast filler is simply a filler-related issue would be a high-risk strategy.” In reality, Dr McKeown says, the lump could just as easily represent a new cancer, and distinguishing between the two can be extremely difficult. “We know that breast fillers make the interpretation of mammograms much more challenging and can delay the diagnosis and treatment of cancer. For me, this makes the procedure unacceptably high risk,” he explains.

The impact of social media The promotion of breast filler treatments on social media, combined with the appeal of non-surgical breast enhancement, continues to drive patient interest. To illustrate, in 2024 the Advertising Standards Authority (ASA) and the Committee of Advertising Practice (CAP), took action against treatment provider CCskinlondondubai. The company was found to be pressuring patients into booking dermal filler breast procedures through flash sales, exploiting women’s body image insecurities, and trivialising the risks associated with cosmetic interventions.4 Both Ms Nugent and Dr McKeown believe Aesthetics | April 2026

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News Special Breast Fillers

Ms Nugent adds that should a patient request a breast enhancement, practitioners must refer them to a qualified plastic surgeon, rather than undertaking the procedure themselves or directing the patient to someone without appropriate training in aesthetic breast surgery or breast disease.

Prioritising patient safety In response to concerns that an outright ban could drive patients to seek the procedure through unsafe channels, Ms Nugent adds, “We cannot shy away from denouncing a harmful procedure simply because an unscrupulous practitioners will continue to carry it out underground. What is needed are robust legal consequences for those who put patients at risk by performing high-risk procedures in non-clinical settings, without the qualifications.” Dr McKeown agrees that a complete ban on breast fillers is the only sensible move forward, concluding, “If this drives the practice underground, then in the same way we have enforcement in place with other people who break the law, we need to see robust enforcement to prevent and deter it. This is a serious public health issue affecting women, and it must be recognised and treated as such.” VIEW THE REFERENCES AT AESTHETICSJOURNAL.COM 17

Event Report ACE 2026

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Inspiring the Medical Aesthetics Community Explore the standout moments from ACE 2026

Last month, the Aesthetics Conference and Exhibition (ACE) 2026 hosted 3,458 aesthetics professionals for an event focused on learning, connection and the future of medical aesthetics. Across two busy days, delegates immersed themselves in six high-level educational streams with more than 100+ expert speakers, discovered an exhibition floor packed with 100+ leading brands and benefited from numerous opportunities to network and share best practice. ACE once again achieved record-breaking attendance, underlining the growing appetite for fresh innovation, refined techniques and evidence-based clinical guidance in the specialty. 18

Following the close of the second day, 860 guests gathered for The Aesthetics Awards, recognising the individuals, teams and clinics who have excelled over the past year. To explore this year’s Winners, turn to p.38. Shannon Kilgariff, event director and publisher of the Aesthetics portfolio, said, “ACE 2026 united top specialty brands with an exceptional faculty of speakers. Delegates were able to gain up to 15 CPD points across six educational theatres, each delivering varied, engaging and practical content. We are incredibly grateful to our exhibitors, sponsors, attendees, speakers, associations and partners for their vital role in making ACE 2026 such a success. We are already excited to come together again in October for CCR 2026!”

Aesthetics | April 2026

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Injectable insights with Allergan Aesthetics Allergan Aesthetics, an AbbVie company, returned as Headline Sponsor for 2026. Across the two days, the company presented dynamic sessions packed with valuable insights for medical aesthetic practitioners, delivered injectable demonstrations and covered a range of techniques and approaches.

Event Report ACE 2026

Hall. Designed as a practical, on-the-ground forum, it will feature expert-led talks, panel discussions and interactive sessions to help delegates build stronger, more sustainable and more profitable aesthetic businesses. More details will be announced soon.

Speakers across the two days included: · Dr Nestor Demosthenous · Nurse Julie Scott · Nurse Alice Henshaw · Mr Taimur Shoaib · Mr James Olding · Dr Sophie Shotter · Dr Apul Parikh

The latest specialty developments at the Innovation Forum Attendees stepped into the future of medical aesthetics at The Innovation Forum, supported by Theatre Sponsor Dermapenworld. The theatre featured a series of engaging sessions with the latest product launches, game-changing breakthroughs and revolutionary techniques from specialty thought leaders. Companies included:

Cutting-edge business insights at the In Practice Theatre The In Practice Zone, supported by Associate Sponsors Phorest and Zenoti, served as the go-to destination for visitors seeking practical business guidance and specialist education. Curated by the Aesthetics Journal team, the In Practice Theatre delivered focused content on core topics such as regulation, finance, marketing and mental wellbeing – all designed to help delegates build thriving clinics and sustainable careers. Cosmetic Courses led a focused Starting Strong in Aesthetics agenda for newer practitioners, looking at regenerative treatments, Level 7 qualifications, how to build a sustainable career, as well as a panel discussion on building a safe, resilient practice from day one. The stage was also host to the Aesthetics Business Blueprint, chaired by digital marketing specialist Rick O’Neill. It offered a fast-paced deep dive into growth and profitability. Contributors including Natalie Dryden, Kenny Thomson, Vanessa Bird, Adam Smith and Nick Cooling-McClagish covered everything from operational systems and staff behaviours to cyber security, ethical sales, lead conversion and performance metrics. The In Practice programme concluded with a high level discussion on patient safety and cosmetic regulation, chaired by the Joint Council for Cosmetic Practitioners acting co-chair Andrew Rankin, and with contributions from British College of Aesthetic Medicine chief operating officer Sadie Van Sanden Cooke, British Association of Medical Aesthetic Nurses COO Gareth Lewis and British Association of Aesthetic Plastic Surgeons representative and plastic surgeon Mr Reza Nassab. Together, they addressed the regulatory direction of travel, high risk procedures and the shared responsibility of practitioners, associations and policymakers in raising standards. Next year, ACE will debut a brand new educational stream – The Aesthetics Business Show, located in the previous Platinum

· · · · · · · ·

Ace Medicine ALLlSKIN MED Alma Arthrex BTL Aesthetics Chaeum Pharma Dermapenworld Fotona UK

· · · · · · · ·

GE Healthcare Hydrafacial iiaa IDENEL Klira Sciton SkinCeuticals Sofwave

Art and science at the Aesthetics Mastery Theatre At the Aesthetics Mastery Theatre, delegates experienced expert-led live demonstrations and in-depth discussions that showcased the latest techniques and innovative products transforming the field. DermaFocus, the Theatre Sponsor, hosted lunchtime takeover sessions on both days, discussing a new era of regeneration and unveiling its latest product launch, injectable proprietary product Celora Vita. Live demonstrations on the stage included insights into injectable treatment using Profhilo Structura with IBSA and SuneKOS with AestheticSource. Other companies on the stage included:

· S.Thepharm · Healthxchange · Merz Aesthetics

· BeautyEurope · Evolus

Upholding standards in the field at the Association Theatre The Association Theatre united leading medical aesthetics associations to support professionals, promote ethical standards and drive specialty development. They explored key topics, including safety, ethics and the latest advancements in the field.

Aesthetics | April 2026

Event Report ACE 2026

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Associations included:

· · · · · · ·

ACE Group World ASA ADAP BAHRS BAMAN BCAM BMLA

· · · · · ·

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Across the two days, ACE offered delegates a variety of opportunities to connect with colleagues, create new connections and expand their support networks.

BSF ICAM JCCP MHRA TNN WIHC

Mentoring and round tables

Brand new for 2026, the Cutting Edge Theatre highlighted pioneering theories and emerging concepts in medical aesthetics, giving practitioners a platform to explore the future of the specialty. Designed as a hub for education and thought leadership, it challenged perspectives and inspired innovation across the aesthetics community. Brands included:

· Galderma · Laboratories VIVACY

Leading aesthetics brands

Aesthetics Mentoring at ACE 2026 created a structured yet informal space for delegates to learn directly from established leaders in the specialty. Sponsored by Allergan Aesthetics, an AbbVie company, the programme paired aspiring and advancing practitioners with experienced mentors to discuss real-world challenges in clinical practice, business development and career planning. Held in small, one-to-one groups, the sessions were designed to foster meaningful conversations, rather than lectures, and to help attendees build a support network they could draw on long after the event. ACE also introduced Aesthetics Journal Round Tables for the first time, designed specifically for senior voices, emerging leaders and respected specialists within the field. These small-group sessions provided a confidential and collaborative environment where real challenges, opportunities and perspectives were explored openly and constructively.

Alongside the five content streams, all 100+ exhibitors expertly showcased the latest injectables, skincare, devices, business solutions and more. The ACE Awards returned to honour the individuals and teams whose outstanding contributions are driving the conference’s success. A huge well done to the winners:

· Best Stand – Allergan Aesthetics · Best Visitor Experience - Dermapenworld · Best Marketing Campaign - SculptPro Aesthetics · Most Influential Speaker – Dr Jordan Faulkner 20

Aesthetics

Uniting the community

The Cutting Edge Theatre

· Croma Pharma · Cutera

Aesthetics

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Event Report ACE 2026

The Networking Trail The ACE Networking Trail provided a clear, structured way for delegates to connect across the show floor, transforming informal encounters into purposeful opportunities to build relationships. Sponsored by Dermapenworld, it linked together all the key social touchpoints at ACE – from professional meet-ups and lounge sessions to drinks receptions – so that visitors could easily weave networking into their event experience alongside education and time in the exhibition. Dedicated networking for doctors, nurses and dentists at the BAMAN and BCAM stands encouraged open conversation and peer support, while Aesthetics Journal Member Drinks helped connect members, the Clinical Advisory Board and Aesthetics Reviewing Panel in person, and VIP receptions offered a focused environment for higher-level business discussions and collaboration. Specialty and brand partners also played a central role. The Aesthetics Industry Networking Drinks fostered new links between suppliers, exhibitors and the Aesthetics team, while the In Practice Zone networking brought together professionals interested in business growth and operations. Dermapenworld hosted stand drinks and the official networking event at the end of day 1 – uniting practitioners, speakers, exhibitors, finalists and press in one place to celebrate the specialty, strengthen existing relationships and spark new ones. Across both days delegates could gather in the Lumenis Chill Out Lounge to connect with friends and peers and have a moment to reflect on the learnings of the day.

What the community had to say... “ACE is the pinnacle conference of the year! One of the best things is networking with your colleagues, finding out what you can learn from them, and then being able to incorporate it into your daily practice.” Dr Ahrooran Sivakumar, aesthetic practitioner “ACE for me never disappoints year on year! I have been coming for 14 years, and every year it feels more special. There are great opportunities for learning, and it is also so much fun!” Anna Baker, nurse prescriber “ACE is a non-negotiable event for me. You can meet up with peers, discuss the latest innovations, gain some education, and then it culminates with everyone celebrating the last 12 months at The Aesthetics Awards!” Dr Jordan Faulkner, aesthetic practitioner

The two days of networking concluded with the dazzling Aesthetics Awards, taking place at the Hilton, Park Lane. Find out the Winners on p.38.

See you next time! That’s a wrap – another incredible ACE has come to an end! Save the date for March 12-13 2027, when ACE and The Aesthetics Awards make their return. Up next, CCR will take place at Excel London on October 1-2, so make sure to register your interest today. Stay tuned for more details – we can’t wait to connect with the specialty once again!

*This event is partly sponsored by pharmaceutical companies. This includes but is not limited to exhibition spaces and speaker programme. Full details of each company’s sponsorship are available at https://www.aestheticsconference .co/about-ace/sponsors-and-partners-2/

Aesthetics | April 2026

REASONS TO CHOOSE BOCOUTURE • Results seen as early as 7 days, lasting

up to 4 months in upper facial lines1 • A well characterised safety profile1 • Convenient – no refrigeration needed

prior to reconstitution1

Scan the QR code to access BOCOUTURE UK and Ireland Prescribing Information

1.BOCOUTURE Summary of Product Characteristics. Merz Pharmaceuticals GmbH: https://www.medicines.org.uk/emc/product/600/smpc (Last accessed January 2026). M-BOC-UK-0591 Date of Preparation: January 2026

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Access complimentary training resources

Merz Aesthetics Exchange (MAX) is a promotional website developed and funded by Merz Aesthetics UK & Ireland.

Adverse events should be reported. Reporting forms and information for United Kingdom can be found at https://yellowcard.mhra.gov.uk/. Reporting forms and information for Republic of Ireland can be found at https://www.hpra.ie/homepage/about-us/reportan-issue. Adverse events should also be reported to Merz Aesthetics UK Ltd by emailing UKdrugsafety@merz.com or calling +44 (0) 333 200 4143.

17/02/2026 11:15 10:36 05/02/2026

Special Feature Non-surgical Facelifts

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Exploring Non-surgical Facelifts Practitioners discuss their clinical approaches to non-surgical facial lifting A non-surgical facelift is a minimally invasive procedure aimed at lifting, repositioning and rejuvenating facial tissues.1 Unlike a traditional surgical facelift, which involves incisions, general anaesthesia and a prolonged recovery period, non-surgical techniques typically require little to no downtime, can often be performed under topical or local anaesthetic, and carry a lower risk of complications such as scarring, haematoma, infection or nerve injury.1 In practice, non-surgical facelift protocols typically target mid-face volume and contour (cheeks and temples), lower-face definition (jawline and chin) and perioral and periocular lines and folds, as well as overall skin texture and tone. Contemporary strategies have evolved from isolated treatments to comprehensive, layered approaches.2,3

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age-related volume loss typically occurs. This includes assessing temple hollowing to determine whether volume loss is deep – such as loss from bone and the deep temporal fat pad – or more superficial, which would require treatment in different tissue layers.10 Ms Cain also evaluates the mid-face, particularly the malar fat pad and its descent, as well as the depth of marionette lines, the presence of jowling and the angle of the mandible to assess structural volume loss. In addition, she checks for a prominent submandibular gland, noting that this can contribute to jowling and may not be fully correctable with non-surgical treatments, as it is often a surgical issue.11 For objective and patient-educational assessment of skin, Ms Rollett combines simple tools with imaging. “We still do pinch tests,” she says, adding, “We also use an imaging system as it can highlight irregularities on the skin and indicates where volumes depleted.” Her choice of imaging is Alma IQ. Ms Rollett manually manipulates the skin to understand laxity and intrinsic quality. “When we’re going to move the skin out, when you pull the skin tight, does the skin look good, or is it still crepey and dehydrated?” she states. Before

Aesthetics spoke to aesthetic practitioner Dr Vikram Swaminathan and plastic surgeons Ms Nathalie Cain and Ms Rebecca Rollett, to explore how they design, sequence and deliver non-surgical facelift treatments in modern clinical practice.

Emerging evidence A retrospective observational study published in Plastic and Reconstructive Surgery – Global Open reported improvements in physician-assessed aesthetic scores and soft tissue repositioning when thread lifting was combined with high-intensity focused ultrasound (HIFU), with a favourable safety profile.4 Similarly, a case report and small clinical series published in Journal of Cosmetic Surgery suggest that combining PDO threads with hyaluronic acid (HA) fillers may enhance lifting effects and patient satisfaction.5 Beyond mechanical lifting, emerging systematic reviews published in Aesthetic Plastic Surgery highlight the potential value of integrating biostimulatory injectables – such as poly-L-lactic acid (PLLA), calcium hydroxylapatite (CaHA) and polycaprolactone – with neuromodulators, dermal fillers and energy-based devices to improve skin quality, elasticity and contour.6 However, while early outcomes are encouraging, the practitioners interviewed acknowledge that much of the current evidence remains observational, retrospective or limited by small sample sizes.

Patient indications and assessment Dr Swaminathan explains that facial ageing rarely presents as a single issue. Instead, he notes that it typically results from multiple structural and textural changes occurring gradually across the face. “We know that with ageing, you develop skin changes due to the loss of collagen and broader alterations in skin structure,” he says.7 Dr Swaminathan assesses that these changes often present as fine lines, wrinkles, pigmentary irregularities and reduced skin elasticity.8 “If there are obvious areas of volume loss, it might present as flattening of the mid-cheek compartments or increased prominence of the nasolabial fold,” he explains. “We’re also looking for signs of sagging or ptosis of tissues,” Dr Swaminathan notes, citing jowling, loss of jawline definition and deepening marionette folds as indicators.9 Ms Cain explains she evaluates key anatomical areas where 24

After

Figure 1: A 67-year-old female patient at baseline and 10 weeks after two Alma Hybrid treatments to the periorbital area, performed eight weeks apart. Images courtesy of Ms Rebecca Rollett.

Treatment modalities in combination protocols As techniques and technologies continue to advance, clinicians are tailoring combination treatments to achieve synergistic, longer-lasting results. Dermal fillers For Dr Swaminathan, fillers are the backbone of modern non-surgical facial rejuvenation. “Dermal fillers are incredibly versatile across the whole face,” he says, elaborating, “They can be used for upper facial structures, brow lifting, adjusting facial proportions in the lower face and even reducing the downward pull of depressor muscles in the jaw and neck to create a lifting effect.”12 He compares fillers to a balloon, stating, “You can inflate it and it’ll lift beautifully, but if you overfill, you distort the features” Fillers restore lost volume and soften age-related changes immediately, providing lift, contour and volume replacement in one.13 When it comes to product choice, Dr Swaminathan likes to use Saypha dermal fillers. “Once we have achieved the desired result, I typically maintain these no more than once a year,” adds Dr Swaminathan. Ms Cain explains that she volumises key structural areas using HA fillers in a specific order, temples, medial cheek, gonial angle and

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marionette lines, as she believes this has the biggest impact on lifting the face. “I like to use Belotero Volume, as it has a good lift capacity, lasting around 12 months without significant biostimulatory effect,” she says.14 Technique Dr Swaminathan primarily uses cannula-based procedures, placing product in the subcutaneous layer of the temples, along the zygomatic arch and into the mid-face’s superficial and deep medial compartments. “Placement in the subcutaneous areas, nasolabial and marionette folds, and along the jawline helps to contour the face while softening visible signs of ageing and facial sagging,” he notes.13,15 Dr Swaminathan adds that his preference for cannula technique also informs his choice of instrument, explaining, “I have recently been favouring the Croma TSK 25G 38mm cannula for my procedures.” Ms Cain highlights that the temples are “One of the highest risk areas to inject,” adding that preventing vascular occlusion is “a marginal gains thing.”16 She emphasises careful technique, “You’re always watching and looking, you’re injecting slowly, and you’re using a cannula wherever you can,” she says. For temple hollowing, Ms Cain uses a deep bolus onto bone before layering a diluted HA subcutaneously, noting, “I dilute the HA one-to-one with saline, and in the subcutaneous layer with a cannula, I rejuvenate on top of that.” Regarding the medial cheek, Ms Cain prefers a lateral-to-medial approach, placing the cannula onto the periosteum. She cautions, “Lateral to medial reduces the risk to the infraorbital foramen, not advancing too medially avoids accidental injection into the nasolabial fat pad which is not an area that needs volumising.” At the gonial angle, Ms Cain injects deeply onto bone with a needle, explaining, “Anything you’ve injected that’s acting as an implant has to sit against a hard surface. A needle is required because I find that you can’t scratch through the periosteum with a cannula.” For marionette lines, Ms Cain uses a 25G-27G cannula subcutaneously, sometimes adding a periosteal bolus in patients with a deep pre-jowl sulcus, performing multiple passes to build volume gradually. Before

After

Special Feature Non-surgical Facelifts

“If a patient has anterior laxity, folds, a cobra‑neck deformity, lots of horizontal lines in the neck or a very prominent submandibular gland, they’re more of a surgical candidate” Ms Nathalie Cain biostimulation. “I use a lot of hyper-dilute calcium,” she explains, noting her preferred product as Radiesse. She combines CaHA with a skin-quality injectable containing HA, peptides and minerals, for example New Cellular Treatment Factor (NCTF). “When you mix the calcium with the NCTF, the calcium spheres dissociate within that fluid,” she says, adding, “Because there’s more surface area of the calcium to actually contact the fibroblasts, you get more of a biostimulatory effect than a volumising effect.”19 Ms Rollett prefers a PLLA-based biostimulator as it is a much softer molecule, meaning the wound-healing response it triggers is gentle and controlled. “It’s a spherical molecule that subtly stimulates collagen production, so under the skin the new tissue forms as organised collagen rather than dense scar-like collagen,” she explains.20 She adds the gradual neocollagenesis it induces produces a refined texture and improved firmness without the abrupt effects sometimes seen with other biostimulators. “For this I like to use Juläine,” notes Ms Rollett. Technique Dr Swaminathan uses a 10-point PN protocol, providing predictable results over several years of practice. “Typically, PN treatments are scheduled every four months, with device-based procedures often performed in the intervening period, roughly every three to six months,” he says.21

Figure 2: 67-year-old female patient at baseline and six months after hyperdilute Radiesse mixed with NCTF (2:1), 4ml of Belotero Volume hyaluronic acid filler and botulinum toxin to the glabella. Images courtesy of Ms Nathalie Cain.

Biostimulatory agents Dr Swaminathan highlights polynucleotides (PNs) as a key tool in his non-surgical facelift protocol. “PNs are fantastic for progressively enhancing collagen within the dermis,” he says, adding, “Over time, they support other treatments and contribute to a comprehensive non-surgical facelift.”18 His product of choice tends to be PolyPhil. Ms Cain focuses on CaHA for its dual effects of volumisation and

Ms Cain explains her planning process, noting, “I plan out the base. When you dilute calcium hydroxyapatite 2:1, you end up with 4.5ml. I look at where the laxity is or where they’ve got the most lines, and I plan the fans that would have a 0.5ml volume.” She injects retrograde using a fan pattern to achieve immediate lift.” she notes. For areas of poor skin quality, she uses CaHA anteriorly with caution. Her technique is always subcutaneous with a cannula, using the needle just through the dermis to fan out the product. “I just make the needle entry through the dermis, and then fan it out like that,” she adds. Ms Cain also emphasises safety. “The biggest issue, though very rare, is a tiny calcium nodule forming in the skin. It feels like a small lump, especially in mobile areas like the neck,” she notes. In such cases, she uses saline injection to resolve the nodule.

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Special Feature Non-surgical Facelifts

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“Neuromodulators allow us to do much more than just soften lines. By reducing the downward pull of depressor muscles in the lower face and across the neck, we can create a gentle lifting effect” Dr Vikram Swaminathan Neuromodulators “Neuromodulators allow us to do much more than just soften lines,” explains Dr Swaminathan. “In the upper face we can smooth wrinkles, subtly lift the brow and even influence proportions in the lower face. By reducing the downward pull of depressor muscles in the lower face and across the neck, we can create a gentle lifting effect,” he notes. He increasingly uses toxin in the neck and jawline, where relaxing key muscles can refine contour and reduce the appearance of sagging.22,23 “I usually repeat toxin treatments roughly every four months,” he says, “My product of choice is Letybo.” Technique Dr Swaminathan takes an individualised approach to neuromodulator treatments, tailoring injections to each patient’s anatomy and facial movement. He notes, “Technique depends on factors like eyebrow position, upper lid ptosis and even smile dynamics.” Dr Swaminathan explains that the procedure focuses on targeting specific muscles. “It’s about injecting in or on the areas of the muscles being targeted. For example, when performing jawline and neck-lifting procedures with botulinum toxin, I inject superficially just under the skin, carefully avoiding the midline of the neck and going too deep,” he adds. Devices At the dermal level, Ms Cain combines microneedling with radiofrequency (RF). “We know that needling the skin – traumatising the skin at a dermal level – stimulates collagen production within the dermis,” she explains. “Everything about tightening is about stimulating fibroblastic activity,” Ms Cain adds.24 She notes that while microneedling alone can trigger this response, combining it with RF enhances collagen stimulation due to the specific wavelength effects on fibroblasts.25 “Depth is crucial,” she explains, adding, “Superficial needling at around 0.7mm may just look like a peel, but when I treat at 2-3mm, I reach the dermal layers rich in fibroblasts, optimising tightening and texture improvement.” For deeper tissues, Ms Cain uses a device that combines RF with neuromodulation to target the superficial musculoaponeurotic system (SMAS). “With EMFACE, the pads go on the face and RF specifically targets the deeper level,” she explains. “If you tighten up 26

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the muscular component and increase the bulk of the muscle, you get a rejuvenating effect,” Ms Cain notes.26 Ms Rollett’s primary energy-based platform is the Alma Hybrid, which combines CO2 with a 1570 nm erbium glass wavelength in a single device. She uses this for a range of indications including “periorbital tightening, full-face rejuvenation and scarring. She explains, “Because it’s CO2 and erbium glass, you can penetrate the skin like with two beams of laser at the same time, so you get a deeper dermal and a resurfacing effect in one.”

Technique Ms Cain stresses the importance of precision. “With microneedling and RF, the main risks are superficial or partial-thickness burns,” she warns. “This happens if you overlap areas too much, don’t sequence treatments properly or use inappropriate technology,” Ms Cain explains.25 Ms Rollett’s protocols typically include topical anaesthetic, dental blocks where appropriate, cooling fans and integrated contact cooling from the handpiece. Ms Rollett’s labels ocular safety as a non-negotiable. “The really important thing about energy-based devices is eye shields. It needs to be titanium eye shield. You need to have proper eye contact and protect the globe,” she adds.27 Ms Rollett cautions potential complications from CO2 and other resurfacing lasers include severe burns leading to scarring, tethering and long-term textural change, especially when used inappropriately in higher Fitzpatrick skin types.28 “The 1570 nm the erbium glass you can use on Fitzpatrick type VI,” she notes.

Insights on sequencing Ms Cain outlines her typical six-month protocol. At baseline, patients receive a CaHa wash under the skin, which is repeated at three months and sometimes at six months. “In terms of the fillers, I like to try and do some of those in the first three months, because you will see the results immediately, and it’ll help patients trust the process,” she says. She adds that top-ups are generally scheduled between three and six months.

“Careful counselling and transparent communication are just as important as the treatments themselves” Ms Rebecca Rollett

Ms Cain notes that she uses device-based treatments, such as RF and microneedling, following after the first round of fillers, typically around one month in. “For me, a non-surgical facelift is achieved over a six-month period,” she concludes. For patients seeking rapid improvement, Dr Swaminathan often leads with injectables. “If in the first few sessions they really want to see immediate improvements with facial features or lifting, then I start with botulinum toxin and dermal filler,” he notes. However, some patients require a gentler introduction. “I see this a

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lot in patients who are new to aesthetics. They might be comfortable with toxin, but dermal fillers feel more intimidating because of reports they’ve seen or heard in the media,” Dr Swaminathan explains. For these individuals, he starts with skin-based treatments. Once improvements from PNs are visible, Dr Swaminathan gradually introduces neuromodulators and, when the patient is ready, Before

Special Feature Non-surgical Facelifts

completes the non-surgical lifting with dermal fillers. Ms Rollett bases her sequencing on the patient’s timeline, experience level and tolerance for downtime. “The question for the patient is, what is your timeline? Are you wanting something for three months’ time, or are you wanting something for your daughter’s wedding next year?” she says. “We bring patients in a week before for PN treatment to the face, and then they have CO2 a week later,” she adds. Ms Rollett explains that post-laser maintenance usually begins around six months. “In my experience, when CO2 is used on the right settings, results can last for at least 18 months,” she says.

When to refer for surgery Ms Cain adds that she considers a surgical approach in cases of neck ageing, as attempting to manage significant laxity non-surgically “asks too much” of biostimulatory injectables or devices. “If a patient has anterior laxity, folds, a cobra neck deformity, lots of horizontal lines in the neck or a very prominent submandibular gland, they’re more of a surgical candidate,” she notes.

After

Clinical practice All practitioners interviewed agree it is down to the practitioner to tailor treatment plans to each patient’s unique anatomy, concerns and goals. Ms Rollett concludes, “Careful counselling and transparent communication are just as important as the treatments themselves. Practitioners have a professional responsibility to be clear and set realistic expectations for this, ensuring patients understand both the benefits and limitations of the procedure.” Figure 3: 58-year-old at baseline and four weeks after one session of Saypha dermal fillers and one cycle of Letybo. Images courtesy of Dr Vikram Swaminathan.

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CPD BoNT-A

Botulinum Toxin Complication Management Dr Carol Mastropierro discusses botulinum toxin complications and strategies for managing common side effects Botulinum toxin (BoNT-A) injections are the most widely performed non-surgical aesthetic procedure in the UK, with an estimated 900,000 treatments carried out annually.1 Their popularity is founded on high patient satisfaction, minimal downtime and a well-established safety profile.2 Nonetheless, despite being generally safe when performed by trained practitioners, complications can occur. A meta-analysis of facial BoNT-A injections found a total complication rate of around 16%.3 Although the majority of these events are mild and self-limiting, they may have significant implications for aesthetic outcome, patient confidence and clinician reputation. This article provides a practical overview of the most common complications associated with BoNT-A injections.

Upper face complications There are several complications that can occur in the upper face, including asymmetry, ptosis and dry eyes. Brow asymmetry Brow asymmetry, also known as Spock brow or Mephisto sign, presents as an exaggerated elevation of the lateral eyebrow. It occurs when the middle or central frontalis fibres are over-relaxed while the lateral fibres remain active, creating a peaked or surprised expression.4 The term Mephisto sign was first described to characterise the unnatural arch of the distal brow following botulinum toxin injection.4,5 This complication can be unilateral or bilateral and is more likely to appear in patients with strong lateral frontalis recruitment or pre-existing asymmetry.6 It may also result from under-treating the lateral portion of the frontalis or not injecting sufficiently close to the frontotemporal ridge, where the lateral fibres of the frontalis insert. The issue is purely aesthetic and can be easily corrected at the two-to-four-week review period by adding a small top-up dose, typically between one and four units, to the area of residual movement within the frontalis muscle.6 This restores balance without significantly affecting brow height.

Brow ptosis Brow ptosis represents an objective lowering of one or both eyebrows due to excessive weakening of the frontalis.7,9 It can be unilateral or bilateral and is more commonly seen in females.9 Patients often describe a sensation of heaviness or the need to physically lift their eyebrows with their fingers when applying makeup.7 The complication typically arises from excessive dosing or from injecting too close to the eyebrow – less than 1.5-2cm from the superior orbital rim.9 Management primarily involves reassurance, as the effect is self-limiting and will resolve spontaneously as muscle activity returns after eight to 12 weeks after treatment. However, improvement can sometimes be achieved by targeting the opposing depressor muscles during review. A small top up may be injected into the glabella complex if residual movement remains or directly beneath the brow into the superior fibres of orbicularis oculi, which can help reduce the downward pull and aid brow repositioning.7

True allergic/ hypersensitivity reactions to BoNT-A are very rare in practice, with a pool of very few published hypersensitivity events of mild, non-pruritic erythema

Forehead heaviness Patients may experience a perceived heaviness or a flattened forehead contour following treatment, generally when the frontalis is over-treated, particularly in those with recognised risk factors such as a hyperactive frontalis, skin laxity over the eyelids, hooded eyes, smaller foreheads, female sex and age above 65.7 It is important to explain to patients that forehead heaviness is a sensation rather than a visible change – there is no actual brow descent or alteration in position.8 Management revolves around reassurance, as this sensation will subside in the following three to four weeks. For subsequent treatments, adjustments can be made for higher-risk patients, either by reducing the total dose or placing injection points further away from the eyebrow.7

Eyelid ptosis Eyelid ptosis occurs when BoNT-A diffuses into the levator palpebrae superioris muscle, leading to partial drooping of the upper eyelid.10 This is most often associated with a deep injection at the tail of the corrugator, where toxin may track inferiorly through the orbital septum, or from overly medial and deep placement during a direct brow lift of the orbicularis oculi.10 Clinically, less of the iris is visible on the affected side, creating mild asymmetry that can be accompanied by a sense of visual disturbance.10 Certain anatomical variants – such as the presence of a supraorbital foramen rather than a notch, more frequently seen in South and East Asian patients – may increase

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the risk of diffusion and subsequent ptosis.11 Management primarily involves advice to temporarily abstain from driving or operating machinery if visual disturbances are present and reassuring symptoms typically resolve within six weeks.10 Apraclonidine 0.5% eye drops can be used to stimulate Müller’s muscle, providing a temporary 1-2mm lift to the lid.12 Patients can apply one drop in the affected eye up to three times daily until the symptoms resolve for up to six weeks. In advanced practice, tarsal or pre-tarsal injections have been described as a method to reopen the eyelid aperture in more severe cases, though this technique should be reserved for experienced injectors only.13,14 Dry eyes and periorbital puffiness Injection of BoNT-A around the periorbital region can lead to dry-eye symptoms when the upper orbicularis oculi or nearby lacrimal gland structures are inadvertently affected. Studies show that injecting into the lateral canthus and paracanthal area may impair the function of the lacrimal pump, reduce blink efficiency and disrupt meibomian gland secretion, thereby altering tear film stability and precipitating dryness.15,16 Additionally, in patients with pre-existing deep-set eyes or lower orbital support weakness, the loss of orbicularis tone may permit fluid accumulation as the muscle’s pumping action is relaxed, exacerbating under-eye puffiness.17 Management includes pre-treatment screening for ocular surface disease, using the snap-back test and distraction test in the lower lid, conservative dosing in the periorbital region, and provision of lubricants if symptoms occur.15 Avoidance of deep injections near the lacrimal gland (located superior-lateral to the orbit) and maintaining a safe distance from the orbital rim are key preventive measures.18 Malar shelf

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Side effect/ complication

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Cause

Management

Brow asymmetry (Spock brow/ Mephisto sign)

Under-treatment of the lateral frontalis fibres or injection too far from the frontotemporal ridge

Top-up of 1-4 units in areas of residual movement at two to four week review

Brow heaviness/ brow ptosis

Over-treatment of the frontalis or injection points placed too close (<2 cm) to the superior orbital rim

Reassurance; may rebalance by injecting depressor muscles (glabella or upper orbicularis oculi); adjust technique and dose at next session

Eyelid ptosis

Toxin diffusion into the levator palpebrae superioris, often from deep corrugator or medial brow injections

Reassurance; Apraclonidine 0.5% eye drops; consider pre-tarsal injection in experienced hands

Dry eyes/ periorbital puffiness

Over-inhibition of orbicularis oculi near the lacrimal gland, impairing blink and lymphatic drainage

Reassurance; ocular lubricants; lymphatic drainage; avoid deep injections near the lacrimal gland in future treatments

Malar shelf (cheek shelf appearance)

Imbalance between orbicularis oculi and zygomaticus activity due to over-relaxation or toxin spread

Conservative management; reassurance; gentle lymphatic massage; adjust lateral canthus dose or injection depth at next session

Table 1: Side effects of BoNT-A, causes and suggested management.4-49

Lower-lip asymmetry Asymmetry of the lower lip occurs when botulinum toxin spreads to the depressor labii inferioris (DLI) following injections into nearby muscles, most commonly the depressor anguli oris (DAO). This diffusion can cause an elevation of the treated side of the lower lip, while the opposite side continues to depress normally, producing a tilted or uneven smile.27-29 The same mechanism may also occur if toxin is injected too superficially or too laterally in the mentalis region, weakening the central fibres and revealing asymmetrical DLI function.28,29

A less commonly discussed but increasingly recognised aesthetic complication is the appearance of a malar shelf or cheek shelf – a visible ridge or bulge across the mid-face when the patient smiles. This occurs when the balance between the orbicularis oculi and the zygomaticus complex is disrupted following upper-face toxin injection. Over-relaxation of the orbicularis oculi reduces muscle tone and lymphatic drainage, while the unopposed activity of the zygomaticus major and minor during smiling causes bunching of the malar fat pad and formation of a shelf-like contour.19,20 Diffusion of toxin into adjacent elevator muscles, such as the zygomaticus minor or levator labii superioris alaeque nasi, can also contribute to this effect by altering the smile vector and reducing mid-face elevation.21 The problem is usually transient but can be exacerbated in patients with pre-existing malar oedema, mid-face volume loss or deep-set eyes.22 Prevention relies on avoiding deep or high-dose injections near the lateral orbital rim and zygomatic arch, particularly in those predisposed to under-eye swelling. Management involves reassurance, conservative massage or lymphatic drainage, and minor rebalancing at follow-up if asymmetry persists.23

Complications involving the upper lip are primarily functional. Difficulty pursing the lips during smoking or using a straw are common following lip-flip procedures or when treating the levator labii superioris alaeque nasi (LLSAN) for a gummy smile.30,31 These effects usually result from uneven relaxation or over treatment of the orbicularis oris altering smile balance or upper-lip movement.32 Occasionally, patients may report difficulty sealing the lips or talking, but these events are transient and resolve as muscle activity returns over the following six to eight weeks.32,33

Lower face complications

Platysmal complications

Complications in the lower face include lip asymmetry, functional issues and platysmal concerns. Smile asymmetry Smile asymmetry at the corner of the mouth may occur when BoNT-A spreads unintentionally into muscles responsible for smile elevation. One mechanism is diffusion from orbicularis oculi injections into the zygomaticus complex, particularly the zygomaticus major, resulting in reduced elevation of the ipsilateral mouth corner when smiling.24,25 Another frequent cause is linked to masseter injections that are placed too high or too medially, where toxin can spread to the risorius muscle and weaken its lateral pull, leading to a visible ‘drop’ of the oral commissure on that side.26 30

Upper-lip complications

Platysmal complications are uncommon but can occur if toxin diffuses too deeply or too medially. The main functional risk is transient dysphagia, due to spreading into the strap muscles (sternohyoid or sternothyroid) involved in swallowing.34,35 Aesthetic issues such as uneven neckband relaxation or skin laxity can also occur if dosing or depth is inconsistent.36 These effects are dose-dependent and short-lived and fully resolve as the toxin is metabolised at 12 weeks. Lower face complication management All of the above lower face complications are self-limiting and resolve as neuromuscular transmission recovers.34,36,37 Conservative management is advised, such as reassurance, photographic

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monitoring and review. While contralateral microdosing could theoretically visually balance asymmetry, it is best avoided in most cases due to the risk of compromising expression or function. Prevention relies on precise injection placement – maintaining correct depth and lateral margins for masseter, DAO, mentalis and platysma injections – and respecting individual anatomy to minimise diffusion risks.28,29,35-37

Systemic complications Botulinum toxin can also cause systemic complications. Flu-like symptoms Transient flu-like symptoms such as fatigue, malaise, myalgia and low-grade fever have been reported following botulinum toxin injections. A review estimated an incidence ranging from 1.7% to 20% across 20 clinical studies and post-marketing reports, with all cases described as mild and self-limiting.36 Symptoms typically resolve within one to two weeks and are managed conservatively with rest, hydration and simple analgesia or antipyretics.32 Iatrogenic botulism

as well as addressing non-antibody related causes for reduced efficacy, such as dilution/handling errors, dosage and injection technique.47

A detailed understanding Although complications from botulinum toxin are uncommon, their impact on both aesthetic outcomes and patient confidence can be significant. Avoiding these complications relies on a detailed understanding of facial anatomy, muscle function and the interaction between different muscle groups.48 Despite best practice, complications can still occur. As medical professionals, our responsibility is to use licensed products only and to offer patients the best possible care – to review them face to face, listen with compassion, and apply our anatomical knowledge to alleviate the issue wherever possible. When complications cannot be corrected immediately, reassurance, honesty and empathy remain the cornerstone of safe, ethical aesthetic practice.49

Test your knowledge! Complete the multiple-choice questions and email memberships@aestheticsjournal.com to receive your CPD certificate!

Questions

While true systemic botulism from licensed cosmetic products is exceptionally rare, the UK recently reported a cluster of iatrogenic botulism cases linked to unlicensed toxin use. Between June 4 and July 14, 2025, the UK Health Security Agency (UKHSA) confirmed 38 cases associated with counterfeit or unlicensed products.33 By August 6 that year, the total had risen to 41 clinically confirmed cases, most requiring hospital treatment and several intensive care admissions.38 Investigations identified that the majority had received products not authorised in the UK.38,39 Management of suspected botulism involves hospitalisation, supportive care and administration of botulinum antitoxin as indicated.38 Immune-mediated reactions Pharmacovigilance/clinical reviews list hypersensitivity among recognised but uncommon ADRs with licensed BoNT-A, usually related to excipients rather than the neurotoxin itself.40-42 Overall, the published evidence base consists of isolated case reports and very small series, underscoring that true allergic/hypersensitivity reactions to BoNT-A are very rare in practice, with a pool of very few published hypersensitivity events of mild, non-pruritic erythema after upper-face BoNT-A aside from a single widely cited single anaphylaxis case followed masseter BoNT-A in a 35-year-old woman.39,40 Management depends on severity. Mild local reactions only require observation and oral antihistamines. In the rare event of systemic hypersensitivity or anaphylaxis, immediate intramuscular adrenaline and urgent medical care should be sought, in line with established anaphylaxis guideline.43,44

a. Over-treatment of the glabella 1. What is the most common cause of the ‘Spock brow’ (Mephisto sign) following botulinum toxin treatment?

2. Which muscle is primarily affected in eyelid ptosis following botulinum toxin injection? 3. Which of the following is an appropriate first-line management for mild brow ptosis following botulinum toxin injection? 4. Difficulty pursing the lips, smoking or drinking through a straw after a lip-flip procedure is most commonly caused by weakening of which muscle? 5. Which strategy may reduce the risk of antibody formation and secondary non-response to botulinum toxin?

Antibody formation/secondary non-response

b. Diffusion into the levator palpebrae superioris c. Over-relaxation of the central frontalis fibres with preserved lateral activity d. Excessive treatment of the orbicularis oculi a. Orbicularis oculi b. Levator palpebrae superioris c. Frontalis d. Corrugator supercilii a. Immediate hyaluronidase injection b. Surgical brow lift c. Reassurance and review as the effect is self-limiting d. Oral corticosteroids a. Zygomaticus major b. Levator labii superioris alaeque nasi c. Orbicularis oris d. Depressor anguli oris a. Treating every 4 to 6 weeks b. Increasing dilution of toxin c. Injecting higher doses than manufacturer recommends d. Maintaining treatment intervals of at least 12 weeks Answers: C,B,C,C,D

A small proportion of patients experience reduced responsiveness to BoNT-A over time. The mechanism remains unclear, but the literature suggests resistance may involve formation of neutralising antibodies (NAbs) in addition to individual immunogenicity, total dose or retreatment frequency.42,43 Prudent practice avoids unnecessary ‘booster’ doses and keeps intervals ≥12 weeks between treatments, as it appears that the risk rises with higher cumulative dosages and short treatment intervals,45,46

Possible answers

Dr Carol Mastropierro is an aesthetic doctor and clinical trainer at Harley Academy in London. She runs Wrinkless Clinic in Hertfordshire and has a special interest in anatomy-led aesthetic treatments, regenerative medicine and advancing safety in aesthetic practice. Qual: MD, PigCert, MBBS

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Aesthetics | April 2026

Azzalure® is indicated for the temporary improvement in the appearance of moderate-to-severe glabellar lines seen at maximum frown and/or lateral canthal lines seen at maximum smile in adult patients under 65 years, when the severity of these lines has an important psychological impact on the patient1

FOR HEALTHCARE PROFESSIONALS ONLY

Primary end point in an open-label, multicentre, interventional study which evaluated subject satisfaction following injections of ABO 50 U in the glabellar lines at baseline and 6 months. The primary end point was subject satisfaction at 12 months. Treatment efficacy was assessed using the subject satisfaction questionnaire, FACE-Q Scales (psychological function and appraisal of lines), and the GLSS (scale ranging from 0 [none] to 3 [severe], assessed by both subject [Static 4-point categorical scale] and investigator [4-point photographic scale] at maximum frown) at baseline, 1, 3, 6, 7, 9, and 12 months.3

Secondary end point in a 150-day prospective, single-dose, multicentre, randomised, parallel-group, placebo-controlled, double-blind study of 300 patients with moderate to several glabellar lines treated with ABO (50 Units [U]). Primary end point was response at 30 days. Median time to onset of effect was 2 days.1,2

†

‡

Galderma Azzalure DPS Ad April_SCOTT_REDONE_v2.indd All Pages

§ AboBoNT-A was first approved for therapeutic use in December 1990 and aesthetic use in April 2009.4-7

REFERENCES: 1. Galderma (UK) Ltd. Azzalure® Summary of Product Characteristics. February 2024. 2. Monheit G, et al. Dermatol Surg. 2020;46:61–69. 3. Schlessinger J, et al. Dermatol Surg. 2021;47:504–9. 4. Brandt F et al. Dermatol Surg. 2009;35:1893– 1901. 5. Monheit GD, Pickett A. Aesthet Surg J. 2017;37:S4–11. 6. Kassir R, et al. Dermatol Ther (Heidelb). 2013;3:179–89. 7. Ipsen Biopharmaceuticals, Inc. and Galderma Laboratories, L.P. Dysport® Prescribing Information. September 2023. Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search for Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to Galderma (UK) Ltd, E-mail: medinfo.uk@galderma.com Tel: +44 (0) 300 3035674

Botulinum toxin type A

Uniquely You. Naturally Azzalure. The powder injectable wrinkle treatment that offers a lasting natural look in as little as two days and 95% of patients were satisfied with only 2 treatments a year.*1-3

2 2 days for results†1,2

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treatments a year‡1,2

decades of proven results§4-7

Galderma portfolio available at our distribution partners

11/03/2026 16:36

Case Study Scar Remodelling

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A Split-Scar Evaluation of PNs and CO2 laser Dr Jordan Faulkner examines how multimodality treatments may influence scar remodelling Surgical scars undergo prolonged and dynamic remodelling over 12-18 months, with collagen organisation, vascular maturation and extracellular matrix restructuring continuing well beyond the early healing phase.1-3 This prolonged timeline makes it challenging to determine how much clinical improvement reflects natural maturation versus treatment effect. Regenerative treatments, such as polynucleotides and hyaluronic acid (PN-HPT and HA) and fractional CO2 laser resurfacing, are supported by an expanding body of evidence demonstrating benefit in surgical, traumatic and acne scar remodelling.4-7 PNs have been shown to enhance fibroblast proliferation, support extracellular matrix recovery and modulate inflammation, while fractional CO2 laser therapy remains one of the most consistently validated modalities for collagen remodelling and scar texture improvement.4-7 Hypopigmentation in scars can be particularly challenging to treat, as restoring lost pigment is often more difficult than reducing excess pigmentation. Emerging approaches such as fractional laser–assisted drug delivery with agents like bimatoprost have been explored as potential treatment options.6,7

Treating a split-scar Generating high-level comparative evidence in scar management is difficult. Ethical constraints prevent the deliberate induction of scars for research, and many patients are reluctant to participate in split-scar designs. As a result, the evidence base rarely allows direct comparison between treated and untreated tissue within the same scar. No single modality can address all stages of scar maturation, which include inflammation, fibroblast activity, collagen deposition and matrix remodelling.1,2 Treatments targeting only one phase may not reflect this complexity. The combination of PN-HPT and HA, which enhance dermal quality, with fractional CO2 laser, which remodels collagen via controlled microthermal injury, provides a biologically rational approach.4-10 Although not yet evaluated in controlled trials, the mechanisms are distinct and complementary. 34

Product choice rationale Before detailing the intervention protocol, it is useful to outline the principle behind the product choice in this case. PN-HPT and HA PNs are increasingly used in regenerative aesthetic practice for their ability to support dermal repair and improve overall skin quality.4-10 Highly purified PNs have been shown to promote fibroblast activity, enhance tissue hydration and contribute to more organised collagen remodelling.4-10 In the context of a maturing surgical scar – referring to the first 12 months of healing, when scar progression can still be meaningfully influenced – the inclusion of HA offers several practical advantages.10-12 During this phase of collagen remodelling, HA supports immediate and short-term hydration, helping maintain comfort and suppleness in tissue that may otherwise feel dry or tight.10-12 It also creates a favourable biophysical environment that complements the regenerative activity of PNs, supporting tissue softness as collagen fibres reorganise.10-18 From a practical perspective, HA may additionally improve injectability and promote more even intradermal distribution.18 Although generally well tolerated in aesthetic practice, patient selection remains important when using PN-HPT and HA formulations. Published clinical experience suggests favourable safety profiles in healthy individuals seeking skin quality improvement or scar support.9,10 However, as with other intradermal injectables, treatment should be approached with caution in patients presenting with active infection at the treatment site, autoimmune connective tissue disorders, known hypersensitivity to product components or impaired wound healing.2,10 Before PN-HPT treatment, clinicians should assess scar maturity and local tissue stability, particularly in the early postoperative period. The incision must be fully epithelialised and free from infection, dehiscence or instability before intradermal injection to avoid disrupting healing or introducing infection.2 Residual erythema, oedema and overall scar pliability should also be evaluated, as these may indicate whether the tissue has progressed beyond the acute inflammatory phase and can tolerate intervention.2 A brief Aesthetics | April 2026

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review of systemic factors affecting wound healing – such as smoking status, metabolic disease, medication use and any history of hypertrophic or keloid scarring – can also help determine appropriate treatment timing and patient suitability.2 Fractional CO2 and non-ablative laser Fractional CO2 laser resurfacing is supported in the literature for improving surgical and traumatic scars.2,6,7 Systematic reviews show it creates controlled microablative zones in the dermis, disrupting dense collagen and stimulating organised neocollagenesis, which can improve scar texture, pliability and thickness.6,7 Platforms combining ablative CO2 with a non-ablative 1570 nm wavelength enable treatment at multiple depths, targeting superficial irregularities while thermally stimulating deeper dermal collagen remodelling.19 Fractional CO2 can soften rigid, disorganised collagen within surgical scars, stimulate controlled dermal wound healing and neocollagenesis and improve scar texture, thickness and functional pliability.2,6,7 It is considered particularly useful in surgical scars, which commonly develop dense collagen bundles or altered fibre orientation during natural maturation. The 1570 nm wavelength supports deeper collagen remodelling and gradual fibre reorganisation, with reduced downtime compared with fully ablative approaches.19-21 Fractional CO2 laser is generally suitable for surgical scars in individuals without active infection, uncontrolled inflammatory dermatoses or impaired wound healing.2,6 Relative contraindications include recent isotretinoin use, active keloid instability and patients with a history of abnormal scarring who may require cautious parameter selection.1,2,6 Careful pre-treatment assessment is essential before fractional laser intervention. Clinicians should evaluate skin type, scar maturity and overall patient health, as these factors influence treatment response and the risk of adverse events.6,7 Assessment typically includes determining Fitzpatrick skin type, reviewing any history of abnormal scarring or pigmentary change, assessing the scar’s age, thickness and vascularity, and confirming there is no active infection, inflammation or delayed healing in the area.6,7 These factors help guide appropriate parameter selection and minimise complications such as prolonged erythema, post-inflammatory hyperpigmentation or delayed recovery following fractional CO2 resurfacing.6,7

Limitations Limitations should be acknowledged – as a single-patient case report, it cannot determine treatment efficacy. Confounding

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factors, including increased mechanical tension across the superior and posterior shoulder and the presence of underlying surgical hardware, may also have contributed to keloidal scar formation.1 Additionally, the lack of randomisation and blinding limits the interpretability of the findings. It is also important to note that high-level evidence comparing multimodality pathways with single modalities is unlikely ever to be produced, as deliberately inducing or splitting scars for research is not ethically feasible. Procedures that intentionally cause tissue injury are not permissible under established human research ethics frameworks.22

Case study A split-scar evaluation was performed on a 12cm surgical scar following fixation of an acromioclavicular joint injury in a 30-year-old Caucasian male (the author). For the first two weeks after surgery, standard post-operative wound-care protocols were applied. This included keeping the incision clean and dry, avoiding unnecessary tension on the wound and performing gentle cleansing with sterile saline once dressings were removed. Topical products, UV exposure and excessive shoulder movement during this period were also avoided, in line with common guidance for optimising early scar formation.2 At week four, treatment of the inferior/anterior half of the scar only began, leaving the superior/posterior segment untouched to act as an internal control. Treatments were performed every two weeks from week four through week 16, beginning with Newest and then alternating between PN-HPT and HA (Newest) and fractional CO2 and non-ablative laser (Alma Hybrid). Other alternative products include Ameela Polynucleotides and Croma PolyPhil. The PN-HPT and HA sessions consisted of 2ml intradermal micro-bolus injections placed along the length of the treated half of the scar using a 30G needle. The fractional laser treatments utilised combined ablative CO2 and non-ablative 1570 nm wavelengths. CO2 settings were 25W power, 0.8ms pulse duration, 20mJ energy, 11x11 pixels/cm² density, HyGrid ratio 2:1, with high cooling and singular mode. The 1570 nm wavelength was delivered at 8W power, 1.0ms pulse duration and 8mJ energy. This dual-wavelength configuration was selected to achieve superficial ablation with concurrent deeper dermal thermal stimulation. In this case, laser sessions were timed between PN-HPT treatments to leverage a potentially better-prepared tissue environment – one in which

Aesthetics

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fibroblasts are active and the ECM is more hydrated. Although this remains theoretical and cannot be confirmed without mechanistic studies. Results Following completion of the 12-week protocol, a two-month period was allowed for collagen remodelling processes to stabilise. At month nine, punch biopsies were taken from both the treated and untreated halves of the scar and submitted for histological analysis to directly compare collagen architecture, density and keloid formation tendencies (Figure 1&2). One of the most consistent subjective observations during treatment was a noticeable reduction in erythema approximately one week after each PN-HPT and HA session.

Case Study Scar Remodelling While such observations will remain anecdotal, they may offer additional practical insight into how sequencing and timing of regenerative treatments influence scar maturation over extended periods. Any relevant developments or changes will be documented to contribute to the growing practice-based understanding of regenerative scar care.

Histology findings Over the course of the treatment phase, the inferior/anterior (treated) portion of the scar showed progressive softening and a noticeable reduction in erythema. Dermatopathology confirmed structural differences between the two halves of the scar. Untreated (superior/posterior) half: Unremarkable epidermis with a scar in the dermis of moderate density and low vascularity which includes thick keloidal collagen bundles. Treated (inferior/anterior) half: Unremarkable epidermis with a scar in the dermis of low density and low vascularity with no feature of keloid.

Figure 1: Nine-month clinical image showing the inferior/anterior half treated with Newest and Alma Hybrid, which appears flatter and less erythematous.

Figure 2: Image demonstrates where biopsies were taken from for histological analysis.

Maintaining results Future management will involve treating the remaining half of the scar using the same PN-HPT and HA and hybrid laser protocol. Although this will not allow further controlled comparison, it will allow observation of whether the untreated segment can be brought closer in appearance and texture to the side that underwent multimodal treatment. Continued follow-up will be important to assess the longer-term behaviour of both halves of the scar, particularly with respect to pliability, erythema and the potential development of hypertrophic or keloid features. Monitoring over time allows for clearer evaluation of how each side evolves as remodelling progresses. Importantly, unlike ageing skin, which continues to undergo gradual decline, a scar that has fully matured typically remains more stable in quality. Once this maturation phase is complete, ongoing maintenance treatment is generally not required. Aesthetics | April 2026

The presence of keloidal collagen bundles in the untreated half corresponded clinically with its raised, firmer appearance. The absence of these features in the treated half aligned with the softer, flatter visual outcome. Although mechanical tension (the superior shoulder location) and the presence of underlying metalwork may have contributed to keloidal change in the untreated portion, the contrasting histological profiles provide meaningful insight into the differing healing pathways.1

Reflections on multi-modality scar care This case highlights the value of observing scar response when different approaches are applied in a controlled manner. As regenerative aesthetics evolves, reflective practice, transparent reporting and respect for biological variability remain important in guiding individualised scar management strategies. Dr Jordan Faulkner is a cosmetic physician and founder of Allo Aesthetics. He is also the founder and lead mentor of Unite Aesthetics Initiative and is a clinical educator at Interface Aesthetics. Dr Faulkner is a brand ambassador at Revanesse, faculty member at DermaFocus and co-owner of Myokine Ltd. Qual: BMedSci, BMBS, PGDip(Aes)

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Treatment Approach Skin Quality

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Mechanistic Synergy of Multi‑Acid Peels and Biorevitalisation Independent nurse prescriber Kate Monteith-Ross explores regenerative approaches in skin treatments The landscape of medical aesthetics is shifting from volumetric interventions to prioritising skin health, function and quality.¹ Controlled, minimally invasive interventions that stimulate regeneration are now central to modern medical aesthetics. This includes polynucleotides and amino acid replacement therapy.² Controlled injury followed by targeted biological support can improve healing outcomes, in line with established wound care principles.³ Chemical peels and injectable biorevitalisation are established modalities which, in combination, may harness cutaneous repair mechanisms more effectively than either alone. Biorevitalisation is a minimally invasive intradermal treatment using hyaluronic acid with bioactive compounds such as vitamins and antioxidants. Evidence highlights the role of ascorbic acid in modulating collagen synthesis, cellular proliferation and hypoxia-inducible pathways during wound healing.4

Biological basis of regeneration Skin regeneration is a highly coordinated biological process involving dynamic interactions between keratinocytes, dermal fibroblasts, endothelial cells and various immune cell populations.5 Controlled epidermal injury activates the classical wound-healing cascade as follows, haemostasis, inflammation, proliferation and remodelling.6 Acute inflammation is necessary to recruit growth factors, activate fibroblasts and stimulate collagen synthesis. However, dysregulated or chronic inflammation can lead to adverse outcomes such as post-inflammatory hyperpigmentation (PIH), delayed healing and collagen degradation.7 High-molecular weight-hyaluronic acid (HMW-HA) and targeted amino acids provide structural and metabolic support during regeneration. HMW-HA supports extracellular matrix scaffolding, facilitates fibroblast migration and modulates inflammatory signalling through CD44 receptor interaction. It also reduces excessive pro-inflammatory cytokine activity and protects the matrix from enzymatic degradation.9 Amino acids, such as glycine, proline, hydroxyproline, lysine and arginine, serve as substrates for collagen formation, 36

angiogenesis, tissue repair and modulation of inflammatory responses.10-14 HA and amino acids as biological regulators HMW-HA functions as more than a hydrating agent. It provides structural support to the extracellular matrix, guides fibroblast migration and suppresses excessive inflammation.9 Targeted amino acids complement these effects:

· Glycine: ~33% of collagen composition; anti-inflammatory via glycine-gated chloride channels.11,12 · Proline/Hydroxyproline: Stabilise collagen triple helix, organise fibrils.13,14 · Lysine: Collagen cross-linking, tensile strength, angiogenesis, reduced scarring.15,16 · Arginine: Nitric oxide precursor, enhances microcirculation, promotes collagen deposition, supports macrophage M1-M2 transition.17,18 · Alanine/Valine: Support energy metabolism and protein synthesis, accelerate barrier restoration.19,20 This combination ensures that fibroblasts, keratinocytes and endothelial cells have the substrates required for efficient repair immediately after controlled injury.

Mechanism of action At a cellular level, the peel-induced controlled injury stimulates keratinocyte turnover and dermal fibroblast activation, while HMW-HA supports extracellular matrix hydration and CD44-mediated cell signalling. Concurrently, amino acids provide substrates for collagen synthesis and tissue repair. Together, these processes enhance dermal remodelling, improve skin density and optimise clinical outcomes in texture, hydration and pigmentation.8 Multi-acid peels as a regenerative trigger Superficial multi-acid peels combine trichloroacetic, tartaric, lactobionic, ferulic, kojic and citric acids.14 Their regenerative effects include:16-19

· Disruption of corneocyte cohesion,

promoting uniform epidermal renewal

· Initiation of a controlled inflammatory cascade necessary for remodelling Aesthetics | April 2026

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· Tyrosinase inhibition and metal

chelation to modulate pigmentation

· Antioxidant activity to reduce oxidative stress and support repair

· Fibroblast activation via cytokine signalling

· Upregulation of extracellular matrix (ECM) synthesis

· Inhibition of matrix

metalloproteinases (MMPs)

· Improved dermal hydration supporting collagen organisation

· Stimulation of basement

membrane renewal The peel induces a controlled epidermal injury that transitions the skin through wound-healing phases. This creates a window in which the application of HMW-HA and amino acids can modulate inflammation and accelerate tissue repair.20

Indications The combined multi-acid peel and biorevitalisation approach is indicated for:22

· Pigmentation disorders · · · ·

and photoageing Inflammatory skin conditions Acne and post-acne scarring Poor skin tone, laxity and hydration deficits Higher Fitzpatrick phototypes prone to hyperpigmentation

Patient selection and considerations Careful patient assessment is essential in chemical peeling. Active bacterial, viral or fungal infections and open wounds are listed as absolute contraindications and should be resolved prior to treatment, as they increase the risk of complications. Pre-existing inflammatory dermatoses also complicate healing, and recent systemic isotretinoin use (within the past six to 12 months) is a recognised risk factor for delayed wound healing and scarring.23 Fitzpatrick skin types V-VI have increased risk of pigmentary dyschromia with medium or deep peels, and are typically managed with conservative superficial approaches and thorough counselling. Unrealistic expectations or poor compliance further complicate outcomes.24 In addition to peel-specific contraindications, patient suitability for injectable treatments must be carefully evaluated. Pregnancy or breastfeeding, active infection at the injection site, known hypersensitivity to product constituents, uncontrolled autoimmune disease, active malignancy or poorly controlled systemic conditions, such as diabetes, may increase the risk of adverse events or impaired

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healing.25 A comprehensive medical history and assessment of previous dermal filler placement, particularly superficially placed or long-lasting products, is also essential when planning combination protocols. Adverse effects associated with injectable hyaluronic acid (HA) are typically mild and self-limiting, most commonly including transient erythema, oedema and bruising lasting several days.25 However, clinicians must counsel patients regarding recognised delayed complications, including inflammatory nodules and foreign-body granuloma formation, which may occur weeks to months following treatment and require medical management.26 Clear discussion of these risks forms part of appropriate consent and expectation management when integrating injectable therapies into regenerative treatment plans. Before

After

Treatment Approach Skin Quality

Treatments were spaced at four-week intervals to allow sufficient time for tissue recovery (Figure 1). This timing aligns with established protocols for superficial and medium-depth resurfacing procedures, allowing the epidermis and dermal structures to complete early wound healing, barrier restoration and matrix remodelling. The interval also maximises cumulative regenerative effects while minimising the risk of over-treatment.29 Adjunctive topical support, including moisturisers or barrier repair agents, was recommended to enhance post-peel recovery. Whilst the patient used their own SPF, the moisturiser recommended was Noon Optimal Moisturising Guardian. It restores and strengthens the skin barrier with a physiological blend of lipids, including ceramides 2, 3 and 6, cholesterol and essential free fatty acids. These agents support the epidermal barrier, reduce transepidermal water loss and help maintain tissue integrity following superficial chemical resurfacing. In clinical practice, such peel-based combination protocols are generally well-tolerated, with minimal downtime and a low risk of bruising or significant adverse effects.30 Post-treatment assessment demonstrated a marked reduction in pigmentation, improvement in overall skin brightness and a visible reduction in pore size. Skin firmness increased, suggesting collagen restoration, alongside a measurable reduction in wrinkle depth observed both clinically and through skin analysis. Improvements in hydration and barrier function were evident, contributing to a more even, radiant complexion and enhanced overall skin quality.

Figure 1: 61-year-old female patient at baseline and four months after three treatment sessions of Jalupro Glow Peel and three sessions of HMW product

The low-level inflammation present mainly in her medial cheek region also significantly improved. The patient had no side effects, with downtime between 24-48 hours. For maintenance, the patient was recommended a repeat treatment at four to six months for chemical peel and HMW treatment.

Case study

Practical considerations

A 61-year-old female patient presented with concerns of poor overall skin tone and quality, characterised by enlarged pores, diffuse hyperpigmentation, a dull complexion, reduced dermal hydration and clinical features suggestive of diminished collagen and elastin density. Her prior aesthetic treatment history included multiple sessions of microneedling, chemical peels of comparable depth and traditional HA-based skin boosters. These interventions yielded limited and short-lived improvements.

Combination therapies with other regenerative modalities, such as microneedling followed by chemical peeling, have been shown to produce additive improvements in skin quality and scar appearance compared with monotherapy.32

The patient also reported poor longevity of injectable skin booster outcomes, which was considered potentially indicative of compromised skin barrier function.27 Notably, the patient had experienced PIH following previous chemical peel treatments, despite comparable peel depth, although those peels differed in formulation and did not include the same amino acid clusters or regenerative ingredients used in the present protocol. Treatment plan The patient subsequently underwent a structured treatment regimen consisting of three treatment sessions. Each session comprised 1.5ml of the Jalupro Glow Peel, followed immediately by the administration of one full syringe of the Jalupro HMW-HA as well as amino acid injections. This was delivered using a micro-droplet injection technique to achieve global facial coverage, including the forehead, temporal regions, lateral cheeks, perioral area, chin, nasolabial folds and jawline. All injections were performed external to the orbital rim, with no periorbital injections. The peel promotes cellular turnover, improves overall skin texture and delivers an immediate enhancement in radiance and skin quality.27 The HMW-HA solution incorporates amino acids and is classified as a dermal biorevitaliser. It targets depressions and irregularities caused by ageing, wrinkles or scarring, providing structural support and enhancing dermal matrix regeneration.28

This approach allows treatments to be aligned with the natural phases of wound healing, optimising regenerative outcomes by supporting controlled tissue remodelling and collagen synthesis.28,29

Structured treatment protocols provide predictable timelines for patient outcomes. Visible improvements in skin texture, radiance and contour are typically observed within four to six weeks following the first session, allowing both clinicians and patients to plan subsequent treatments with greater precision.33

Regenerative insights Controlled epidermal injury paired with metabolic and structural support accelerates repair, optimises collagen deposition, reduces inflammatory complications and improves skin tone, texture and hydration. This approach prioritises regenerative outcomes, supports ethical practice and allows clinicians to deliver visible, long-lasting improvements while maintaining skin health. Kate Monteith-Ross is an independent nurse prescriber and founder and clinical director of The Clinic by La Ross, urban training and is the co-founder of The Nurses Network. Monteith-Ross has a Bachelor’s degree, a Masters in Nursing, a Post Graduate Degree in Education and consequently her independent and supplementary prescribing qualification. Qual: MSc, INP

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Aesthetics | April 2026

The

Winners On March 14, the ‘Oscars of Aesthetics’ made a spectacular return! With 860 guests, The Aesthetics Awards 2026 was our most dazzling ceremony yet. The highly anticipated ceremony honoured some incredible achievements within the specialty over the past year, with 26 outstanding Winners receiving well-deserved recognition. The prestigious Hilton Park Lane in Mayfair provided a spectacular backdrop for an unforgettable evening. Guests dazzled in stunning gowns, enjoyed endless photo opportunities, and were entertained by iconic celebrity host Rylan Clark. The celebrations continued well into the night, with guests dancing at the glamorous Healthxchange Professional after-party. A heartfelt thank you to our judges, who meticulously evaluated each entry with fairness and expertise in line with our Independent Awards Standards Council accreditation, as well as to over 2,700 community voters for their invaluable input. We also extend our deepest gratitude to our sponsors – your support makes this extraordinary event possible year after year! Particular thanks go to our partners BAMAN, CMAs, The Tweakments Guide and Waken Mouthcare, as well as our charity partner British Skin Foundation. Congratulations to all our Winners, as well as those who received Commendations and High Commendations. With nearly over 400 entries this year, becoming a Finalist is an incredible accomplishment. Thank you for joining us at The Aesthetics Awards 2026 to celebrate the very best in medical aesthetic excellence!

THE AESTHETICS JOURNAL AWARD FOR OUTSTANDING ACHIEVEMENT IN MEDICAL AESTHETICS, SUPPORTED BY HEALTHXCHANGE

WINNER: PROFESSOR DAVID SINES “I feel truly overwhelmed and so grateful to the medical aesthetics community for this incredible honour. It’s not just about me, it belongs to the many people I’ve had the privilege of working with over the past 40 years, all committed to improving patient safety. This is a shared achievement, and I can’t begin to express how thankful I am. This Award really captures the very best of what we’ve accomplished together.” Professor David Sines

Aesthetics | April 2026

THE ALLERGAN AESTHETICS AWARD FOR BEST CLINIC TEAM

WINNER: ESTEEM LIFE MEDICAL GROUP “Winning this Award is a testament to all the hard work that goes on within the team. As the clinic lead, I can say I am beyond proud of them, and this is the most meaningful award we have ever received.” Dr Cemal Kavasogullari, founder

Highly Commended:

• Derma Consult Skin Specialist Ltd

• KAST Aesthetics Ltd

• Dr Leah Clinics

Commended:

• Dr Sobia Medispa

• Paragon Aesthetics and Thames Skin Clinic

• Dr Yusra Clinic

Finalists: • Adonia Medical Clinic • Aurielle Aesthetics • Cliniva Medispa

• Harley Street Injectables • The Ezra Clinic • The Cosmetic Centre • Novello Skin

• Define Clinic

Highly Commended: • Amer Clinic and The Stockbridge Clinic

Commended: • Berkeley Hair Clinic

Finalists:

• Naturally Flawless Aesthetics Ltd

• Dr Harry Clinic • ERA Aesthetics & Wellness • JOURNEY Clinic • KinDRed Clinic

• OSO Medical Ltd • Skin Therapy Medical Aesthetics • The Aesthetics Doctor

• Leicester MediSpa Ltd

• The Medispa

• My Aesthetics Clinic

THE IBSA AWARD FOR BEST NEW CLINIC, UK & IRELAND

WINNER: HART MEDICAL “It’s truly phenomenal to have even been nominated alongside such incredible practitioners and amazing clinics. I feel genuinely honoured to be recognised for my hard work, for the growth, and for the commitment we’ve made to the specialty.” Eleanor Harley, founder Aesthetics | April 2026

Highly Commended:

THE ACRE AWARD FOR MANUFACTURER OF THE YEAR

• Bottled Science Ltd

Commended: • Galderma UK and Energist

Finalists:

WINNER: EVOLUS

• Boley Nutraceuticals Ltd

“I am absolutely ecstatic, and just can’t quite believe it. We’ve got the most amazing team who graft hard everyday, and the most incredible customers who believe in us. We’re still a small company with only one product, so the scale of recognition is what makes winning so special.”

• Candela • InMode UK

Suse Alexander, general manager

THE DERMAPENWORLD AWARD FOR BEST CLINIC NORTH ENGLAND Highly Commended:

WINNER: DR YUSRA CLINIC

• Bank MediSpa

“We’re absolutely thrilled. I’m incredibly proud of my team, and I’m looking forward to heading back to the clinic to celebrate this achievement together. Sharing this moment not only with our team but with the entire aesthetics community is both rare and incredibly special, and it’s something we genuinely look forward to each year.” Dr Yusra Al-Mukhtar Dr Yursa Clinic, founder

Commended: • Paragon Aesthetics

Finalists: • Cliniva Medispa • Dr Wass Skin Clinic • Sculpted by Doctors

Aesthetics | April 2026

Highly Commended: • FaceTherapyNI Academy

THE ACE AWARD FOR INDEPENDENT TRAINING PROVIDER OF THE YEAR

Commended: • Cosmetic Courses

Finalists: • Cliniva Cosmetic Training

WINNER: DERMA INSTITUTE

• Inspired Cosmetic Training • NEXTGENERATION Mentorship • The London Academy of Aesthetic Medicine

“We’re honestly so surprised and honoured to win this Award. Our team has put in an immense amount of effort this year, and we’re incredibly grateful to see that recognised. It’s a huge milestone for us, and with the changes ahead in regulation, we’re excited to support and lead the community.” Dr Firhaas Tukmachi, co-founder

Highly Commended: • London Professional Aesthetics

Commended: • Thames Skin Clinic and The Cadogan Clinic

Finalists: • Berkeley Hair Clinic • Centre for Surgery

THE LUMENIS AWARD FOR BEST CLINIC LONDON

• Clinicbe • Dr Nyla Medispa • Facial Sculpting by Dr Nina Bal

WINNER: ADONIA MEDICAL CLINIC “As we approach our 10th year at Adonia Medical Clinic, we know that running a business is never easy – but it’s been an outstanding year, and this truly feels like the crown to take home.” Dr Ifeoma Ejikeme , founder

• Harley Street Injectables • Harrods Wellness Clinic • PICO London • Simply Clinics – Uxbridge • Takroni Clinic • The Clinic Holland Park • The Ghanem Clinic • Yuki Clinic

Aesthetics | April 2026

THE TSK LAB AWARD FOR INJECTABLE PRODUCT OF THE YEAR

WINNER: PROFHILO STRUCTURA (IBSA DERMA UK) “This feels quite surreal. The foundation that HA-Derma has built over the last 10 years, alongside our hard work over the last nine months, has really led to this point. I’m so happy for my team, who are all new to the business, and have kicked off so strong with such a wonderful Award.”

Highly Commended:

Alex Stuart, country director

• SCULPTRA (Galderma) and SKINVIVE by JUVÉDERM (Allergan Aesthetics UK)

• SuneKOS (AestheticSource)

Commended:

Finalists: • FILLMED Juvelook (Laboratoires FILLMED UK) • Plinest® Polynucleotides HPT® by Mastelli • Pluryal Densify (MD Skin Solutions)

BEST CLINIC MIDLANDS & WALES Highly Commended: • MediZen Clinic and Three Medical Aesthetics

Commended:

WINNER: HAMPTON CLINIC

Finalists:

“I am feeling so excited, just absolutely thrilled to bits! We won this back in 2022, so to be four years on and do it again, it means the absolute world to us. I can’t recommend nominating yourself for an Award enough, it feels incredible to be recognised.”

• Air Aesthetics & Wellness Clinic

Dr Lorraine Hill, founder

• Your Beauty Doctor

• Astounding Skin Aesthetics • Dr Ana The Skin Clinic • Novello Skin • Zenith Cosmetic Clinics

Aesthetics | April 2026

Highly Commended: • Simone Shoffman (Healthxchange)

Commended:

COMPANY CHAMPION OF THE YEAR

WINNER: KAREN HOULIHAN (DERMAFOCUS) I love what I do. From the incredible people I work with, to the amazing patients who’ve become friends along the way. We’re part of a such a fantastic and exciting community. A huge thank you to everyone involved, it’s greatly appreciated.”

• Rebecca Henry (DermaFocus) and Georgina Mackley (Harpar Grace International)

Finalists: • Victoria Millerchip (AestheticSource) • Gemma Hunter (AlumierMD) • Elaine Krebs (Galderma)

Karen Houlihan

• Mike Sherwood (Derma Institute)

Highly Commended:

BEST CLINIC SCOTLAND

• The Mayfield Clinic

Commended:

WINNER: CLINETIX

• Esteem Life Medical Group

“It feels so great to be recognised for our effort, dedication and everything we engage into our patients. For the last 20 years we’ve been working tirelessly to improve the standards within medical aesthetics, and in an ever-evolving field, and we’re so proud to be part of its history and future.” Dr Emma and Simon Ravichandran, founders

Finalists: • Highland Medical Aesthetics Ltd • Infinity Skin Clinic Edinburgh by Dr Claire • Precise Medical Aesthetics

Aesthetics | April 2026

THE REVANCE AWARD FOR BEST NON-SURGICAL RESULT

WINNER: DR ZOYA AWAN “It’s an absolute honour to win this, especially among peers I truly admire and respect, it’s incredibly humbling. This case is a meaningful milestone for me because of what it represents. My patient was a domestic abuse survivor, and her journey is a powerful reminder that beauty isn’t just skin deep, we can help transform lives from within.” Dr Zoya Awan, aesthetic practitioner

Highly Commended:

• Dr Cormac Convery

• Dr Judith Storm

• Dr Harry James

Commended:

• Dr Johanna Ward

• Dr Cemal Kavasogullari

• Dr Lorraine Hill

Finalists:

• Dr Tanja Phillips

• Dr Ana Mansouri

• Dr Yusra Al-Mukhtar

• Dr Anna Hemming

• Monika Jakstiene

• Dr Bisma Hussain

Before

After

Highly Commended: • Night Repair Therapy (The Skin Diary) and PCA Skin, Church Pharmacy

Commended: • Skinade®

Finalists: • ALASTIN Skincare (Galderma) • ALLSKIN | MED

THE CANDELA AWARD FOR SKIN PRODUCT/RANGE OF THE YEAR

WINNER: OBAGI MEDICAL SKIN RANGE (HEALTHXCHANGE) “It’s a true team effort from everyone at Obagi Medical and Healthxchange, and we’re incredibly proud of what we’ve achieved together. To receive such a prestigious Award not once, but twice in a row, is a fantastic honour.” Laura Higgins, head of sales

• AlumierMD • GF5 Next Generation (CellDerma) • HydroPeptide Skin Range (Wigmore Medical) • Klira Routine (Klira) • NOON Aesthetics (ACRE) • P-TIOX (SkinCeuticals) • Purasomes® Skin Range (DermaFocus) • Revision Skincare® Skin Range (AestheticSource) • ZO Skin Health

Aesthetics | April 2026

Highly Commended: • South William Clinic Group

THE INMODE AWARD FOR BEST CLINIC IRELAND & NORTHERN IRELAND

Commended: • Dr Bonny Clinic

Finalists: • A Aesthetics North Coast • FaceTherapyNI

WINNER: ARRAY AESTHETICS

• The Laser + Skin Clinics

“This Award is a reflection of the unwavering dedication, passion and expertise of our incredible team, who consistently go above and beyond to deliver the highest standards of care. We are deeply grateful for their hard work and commitment, which continue to shape the success of our clinic.”

• The Skin Nurse Clinic

Dr Judith Storm, co-founder

• ORA Clinic • The Glow Clinic

THE AESTHETICS BUSINESS SHOW AWARD FOR BEST SERVICE/SOLUTION PROVIDER

Highly Commended: • Aesthetic Nurse Software

Commended: • PatientPerfect

WINNER: AESTHETIC RESPONSE “Winning this Award is so amazing and so unexpected. Being Finalists, especially when you’re up against such strong competition and people you truly admire, makes it all the more special.” Gilly Dickons, director

Finalists: • AesthetiDocs • Clinic Grower • Digital Aesthetics • HARLEYDOC • Kendrick PR • My Compliance Clinic • Organised Success Company • YDY Business Coaching Ltd • Zenoti

Aesthetics | April 2026

Highly Commended: • Church Pharmacy

THE CCR AWARD FOR DISTRIBUTOR OF THE YEAR

Commended: • DermaFocus and AestheticSource

Finalists: • ACRE • Harpar Grace International • Pure Swiss Aesthetics

WINNER: HEALTHXCHANGE

• Unique Skin

“We couldn’t be more grateful for everyone who voted for us. Within medical aesthetics, we’re increasingly witnessing counterfeit products, falsified medicines and patients at risk. So, today isn’t about Healthxchange winning, it’s about doing the right thing in the right way.”

• Wigmore Medical

Jack Curran, CEO

• Sculpt Pro Aesthetics

Highly Commended: • Anna Medical Aesthetics

Commended: • Dr MediSpa and Perfect Skin Solutions

Finalists: • Aurielle Aesthetics • Balance Wellness • Define Clinic • Dr Tanja Phillips Medical Aesthetic Clinic • Harrow On The Hill Dental & Facial Aesthetics

THE GALDERMA AWARD FOR BEST CLINIC SOUTH ENGLAND

• Medikas • The Courtyard Aesthetic Clinic • The Doctor Clinic

WINNER: BERKSHIRE AESTHETICS “This win has been completely out of the blue, so we’re feeling very overwhelmed, but happy. This is our first time here at The Aesthetics Awards. All the hard work we put in throughout the year has been spotlighted tonight, and it’s been an incredible ceremony.” Dr Selena Langdon, founder

Aesthetics | April 2026

Highly Commended: • British Association of Medical Aesthetic Nurses, Education and Training Committee

Commended: • Aesthetic Nurse Mentors Ltd

Finalists: • Dr Olha Vorodyukhina & Angels Twelve, Beyond the Mirror • Dermalux LED Acne Campaign

THE ZENOTI AWARD FOR BEST INITIATIVE/STRATEGIC PROJECT IN AESTHETICS

• FaceTherapyNI, The A-List Conference & A-List Edit • LTF Digital, The LTF Leg Up Foundation

WINNER: BRITISH COLLEGE OF AESTHETIC MEDICINE, VET IT BEFORE YOU GET IT

• VL Consultancy, The Late Late Aesthetics Show

“Here at BCAM it is our 25th anniversary, and our Board of Trustees work incredibly hard on regulation and governance, while also striving to stay relevant through all of our educational initiatives. I think this is a real recognition of everything the team does, as well as the dedication of our trustees.” Sadie Van Sanden Cooke, chief operating officer

Highly Commended:

DEVICE OF THE YEAR

• NeoGen (Energist)

WINNER: LUMENIS ULTRAPULSE ALPHA CO2 LASER (LUMENIS)

Commended: • LaseMD ULTRA (Seriderm UK) and Dermalux Tri-Wave MD (Aesthetic Technology Ltd.)

Finalists: “It’s incredibly rewarding to see this device receive such recognition. It’s widely used across NHS burns departments as well as in private clinics by dermatologists and plastic surgeons. This Award reflects how our continued innovation has helped shape and advance the field.”

• Dermapen 4 (Dermapenworld UK)

Eddie Campbell Adams, head of sales

• Optimas Max (InMode)

• Emerald Laser (Erchonia) • Gentlo (Beamwave Technologies) • Sculpta by Déesse PRO (Harpar Grace International) • SkinPen® Precision (Revance) • Sofwave • XCellarisPro Twist (Wigmore Medical)

Aesthetics | April 2026

Highly Commended:

THE DERMA INSTITUTE AWARD FOR BEST AESTHETICS, WELLNESS AND LONGEVITY CLINIC

• mSkin

Commended: • TRACE Medispa and Human Health

Finalists: • Air Aesthetics & Wellness Clinic

WINNER: ESTEEM LIFE MEDICAL GROUP

• Clinicbe

“This is our ethos – wellness and longevity, combined with aesthetics. We are so happy. It’s affirmation of the blood, sweat and tears that the entire team put in every day so it’s a satisfactory feeling that we have done a good job. We are over the moon!” Dr Cemal Kavasogullari, founder

• OSO Medical Ltd • The Doctor Clinic • The Wellness Atelier

Highly Commended:

Finalists:

• Dr Anna Hemming and Dr Ana Mansouri

• Emma Anderson

Commended:

• Dr Ben Taylor-Davies

• Dr Amy Law

• Linia Medical Group

• Dr Ahrooran Sivakumar • Dr Bonny Armstrong • Dr Christopher Hutton • Dr Dorota Chudek • Dr Sonia Soopen • Natalie Fletcher

THE DERMAFOCUS AWARD FOR BEST INJECTABLE RESULT

WINNER: DR ALISON COLVILLE “I decided to go for this award because being recognised for your work means so much, and I wanted to take that chance. I submitted a case that was incredibly meaningful to me, which makes this moment even more special. The energy tonight has been amazing, as it always is.” Dr Alison Colville, aesthetic practitioner Before

Aesthetics | April 2026

After

Lorem ipsum

THE SKINADE AWARD FOR BEST CLINIC TEAM MEMBER

Surgical Programme

WINNER: BRENDAN MOLLOY (SOUTH WILLIAM CLINIC GROUP) “It’s incredibly rewarding to have our hard work recognised, especially the effort that goes in day in, day out. Having just celebrated our 10-year anniversary, this Award has come at the perfect time. The energy tonight has been fantastic, with a real sense of fun and nostalgia. I would absolutely encourage others to put themselves forward, the recognition is such a rewarding experience.” Brendan Molloy, CEO Highly Commended:

Commended:

• Caj Shusee (Berkeley Hair Clinic)

• Kani Haki (The KP Clinic)

Finalists:

(Dr Ducu London)

• Alexandra Olaru (South William Clinic Group)

• Nicky Barraclough (Cliniva Medispa)

• Kelly Mullins (Aurielle Aesthetics)

• Ras Ivanauskaite (Linia Skin Clinic)

• Lorraine Cahill (Laser + Skin Clinics)

• Yuting (Trina) Huang (OSO Medical Ltd)

• Nefise Tasdelen

• Zoe Rendell (Wellface Ltd)

Highly Commended: • Obagi Rebalance Skin Barrier Recovery Cream (Healthxchange) and Relfydess (Galderma)

Commended: • Alma Harmony (Alma UK and Ireland) and VOL.U.LIFT by IMAGE Skincare (Wigmore Medical)

Finalists: • Advanced RGN-6 (SkinCeuticals) • iS Clinical Extra Strength Active Peel Brightening System (Harpar Grace International) • Longevha (Caromed Italia)

DIGITRX BY CHURCH PHARMACY AWARD FOR BEST NEW INNOVATIVE PRODUCT

• Stratacel (Stratpharma) • The Dayscript (Klira) • ToskaniMed Lumicen Boost Serum (The Glow Group) • ZO Skin Health Peptide Facial Refining Concentrate (ZO Skin Health)

WINNER: EXOMIND (BTL AESTHETICS) “It’s been a breakthrough moment for us and we can’t thank The Aesthetics Awards enough. Tonight has been amazing! For anyone thinking to apply to The Aesthetics Awards we’d say go for it! It is a credibility within the specialty.” Lauren Clements, UK marketing manager and James Carr sales and marketing director

Aesthetics | April 2026

Highly Commended: • Dr Ben Taylor-Davies

Commended: • Eleanor Hartley

Finalists: • Amanda Hong • Mei Abadiano

THE ALUMIERMD AWARD FOR RISING STAR OF THE YEAR

• Dr Ahrooran Sivakumar • Dr Bisma Hussain • Dr Cemal Kavasogullari

WINNER: DR BETHANY ROSSINGTON

• Emma Anderson • Dr Dorota Chudek

“I am speechless and blown away that I have won an Aesthetics Award for Rising Star of the Year. So much as has gone into being where I am today, so much behind the scenes, sacrifice, sleepless nights, so to be recognised was truly unexpected. It just means so much to me.”

• Lucy Foster

Dr Bethany Rossington, aesthetic practitioner

• Dr Jessica Halliley

• Dr Hazel Parkinson • Dr Harry James • Shannon Simpson

Highly Commended:

THE EVOLUS AWARD FOR AESTHETIC NURSE PRACTITIONER OF THE YEAR

• Alexandra Mills

Commended: • Yuliya Culley

Finalists: • Alice Henshaw

WINNER: AMY BIRD

• Amanda Demosthenous

“There were some incredible nurses in this award category this year, colleagues I truly admire and look up to, so I’m honestly speechless to have won and feel so honoured. To anyone thinking of entering, believe in yourself and do it.” Amy Bird, aesthetic nurse prescriber

• Anna Lee • Jacqueline Naeini • Kelly Richards • Lisa Waring • Nicola O’Byrne

Aesthetics | April 2026

Highly Commended:

THE GETHARLEY AWARD FOR MEDICAL AESTHETIC PRACTITIONER OF THE YEAR

• Dr Nestor Demosthenous and Dr Zainab Al Mukhtar

Commended: • Dr Bonny Armstrong and Mr Ali Ghanem

WINNER: DR ANNA HEMMING

Finalists: • Dr Ahmed El Houssieny • Dr Ahmed El Muntasar • Dr Ana Mansouri • Dr Beatriz Molina

“Winning this award means a huge amount to me, as I have been in the medical aesthetics field for about 17 years and have built everything that we have including my brand, treatments and portfolio from scratch. However, without my team and patients, this Award wouldn’t be possible.” Dr Anna Hemming, aesthetic practitioner

• Dr Barbara Kubicka • Dr Dev Patel • Dr Ifeoma Ejikeme • Dr Leah Totton • Dr Rehanna Beckhurst • Dr Selena Langdon • Dr Yousrah Ahmed • Miss Jenny Doyle

See you next year! Massive congratulations once again to all our Winners, High Commendations, Commendations and Finalists! Don’t forget to tag us on Instagram @aestheticsjournaluk when sharing photos and videos of you and your team using the hashtag #AestheticsAwards2026. If you would like to receive feedback on your entry, contact the team via contact@aestheticsjournal.com before April 10. Entry will open for The Aesthetics Awards 2027 in the summer, so keep an eye out for details soon. Also stay tuned for more information on the Aesthetics Results Awards, debuting at CCR on October 1-2.

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Aesthetics | April 2026

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You Cannot Rebuild the Skin Without the Materials to Build It

Introducing Celora™ Vita: a biorestorative injectable that addresses skin ageing at its source Much of what we understand as skin ageing is not simply the passage of time. It is the progressive depletion of the raw materials the dermis needs to maintain itself, the amino acid substrates that fibroblasts rely on to synthesise collagen, elastin and the extracellular matrix. When those substrates run low, the skin’s ability to repair and renew becomes limited, and no amount of volumisation addresses that underlying deficit. Celora™ Vita has been developed to replenish what is missing at a biological level. With this launch, DermaFocus marks its next strategic step, evolving from a trusted distributor into a brand owner and leader in regenerative aesthetics.

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fundamental structural building blocks of collagen and elastin. The full set of branched-chain amino acids, valine, leucine and isoleucine, support protein synthesis and tissue repair. Serine and alanine contribute to the natural moisturising factor (NMF), enhancing dermal hydration, while cysteine and glycine support antioxidant defence through the glutathione pathway, helping protect the skin against oxidative stress.5 Celora™ Vita is one of the most complete amino acid blends in its class and is designed for physiological regeneration, supporting long-term skin quality and durability.

Clinical integration and patient selection Clinical evidence supports measurable improvements across key skin quality parameters, including hydration,5,6 natural brightness,1,6 firmness and elasticity,1 skin texture,6 and wrinkles and fine lines1,6 for comprehensive skin quality improvement. In a 2024 study by Scarano et al., significant improvements vascularity and collagen type 3 synthesis were observed following a structured amino acid treatment protocol, with results maintained at follow-up. Celora™ Vita has been developed to integrate seamlessly into modern aesthetic practice. Its versatility allows it to be incorporated across a wide range of indications and treatment plans, including:

· Early intervention and prejuvenation protocols · Skin quality optimisation in patients with early to moderate signs of ageing1

Positioning within the DermaFocus regenerative portfolio Celora™ Vita sits alongside Plinest® and Purasomes within the DermaFocus regenerative portfolio. For practitioners building regenerative protocols, this offers the ability to address multiple sources of skin ageing within a single structured programme. For DermaFocus, it marks a shift from distribution partner to active participant in the innovation, education and clinical development of regenerative aesthetics.

Celora™ Vita: a biorestorative injectable approach Celora™ Vita is an injectable formulation medical device intended for intradermal administration to support full facial skin biorestoration and overall skin quality improvement. The formulation combines:

· A targeted combination of amino acids, chosen for their

involvement in collagen synthesis, elastin production and complete extracellular matrix renewal · Low molecular weight hyaluronic acid, selected for its role in dermal hydration and microenvironment support.¹ This composition reflects a deliberate move away from volumisation and towards substrate-based skin biorestoration, supplying the dermis with the essential building blocks behind skin quality.

Milad Bemana, executive director for DermaFocus, shares, “Regenerative aesthetics is moving in a clear direction practitioners want treatments that restore skin quality, not just alter appearance. Celora™ Vita reflects that direction. It gives clinicians a scientifically grounded tool to address substrate deficiency something that has been overlooked for too long and it does so within a framework that integrates naturally with the protocols they are already building.”

This article is written and supplied by DermaFocus

The scientific rationale Skin quality depends on active fibroblasts maintaining collagen, elastin and hyaluronic acid within the extracellular matrix. With age and biological stress, this process slows as fibroblast efficiency declines.2 Amino acids are essential substrates for structural skin proteins. As collagen and elastin production decreases from early adulthood, reduced amino-acid availability limits protein synthesis. This contributes to loss of elasticity, hydration and dermal support.3,4 The amino acids in Celora™ Vita have each been selected because they play a precise and complementary role in complete extracellular matrix renewal. Glycine, proline, lysine and alanine serve as

Acknowledgements: DermaFocus thanks Dr Raquel Amado, Mr George Christopoulos, Dr Jordan Faulkner, Dr Xavier Goodarzian, Dr Steven Land, Dr Kam Lally, Dr Yusra Al-Mukhtar, Dr Olivia McCabe-Robinson and Dr Sach Mohan for their clinical expertise and input during the development of Celora™ Vita. Product and Training Information

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Aesthetics | April 2026

11:20

Rejuvenation Multimodal Approach

@aestheticsjournaluk

Aesthetics

Considering Integrative Strategies for Non-Surgical Facial Sculpting Dr Hasaneen Al Janabi explores the procedural framework and clinical applications of non-surgical refinement in contemporary practice The field of facial aesthetics has undergone a profound transformation in recent years, driven by the growing demand for results-oriented yet minimally invasive procedures. More patients than ever are seeking alternatives to traditional surgical facelifts – solutions that deliver appreciable lift, contouring and revitalisation while minimising downtime. According to the International Society of Aesthetic Plastic Surgery (ISAPS) 2024 Global Survey, approximately 37.9 million aesthetic procedures were performed worldwide, including over 20.5 million non-surgical treatments, representing an increase of roughly 7-8% compared with 2023 and more than 40% growth since 2020.1

Given this layered aetiology, single-modality treatments often fall short of providing comprehensive and enduring results. Relaxing dynamic lines with neurotoxins or restoring volume with dermal fillers may be beneficial, but laxity, poor skin quality and surface irregularities often persist if collagen stimulation and skin-directed therapies are not incorporated.2,3

Practitioners increasingly recognise the value of combining cornerstone procedures such as dermal fillers and threads with adjunctive skin treatments and lasers such as fractional resurfacing and collagen-stimulating injectables (e.g. skin boosters and polynucleotides).2,3

Clinical candidacy

This multimodal approach addresses laxity, texture, hydration and pigmentation in a holistic manner, enabling personalised, natural-looking results with sustained benefits.

In practice, assessment should include a structured facial analysis of volume loss, ligamentous laxity and skin quality, alongside dynamic assessment (animation) and symmetry at rest. Facial ageing severity may be broadly categorised using recognised grading systems, such as the Baker classification of facial ageing, which describes progressive stages of laxity and soft-tissue descent.4 Reviewing prior treatments, anticoagulant use, scarring tendency and patient expectations helps determine whether lifting, volumisation, resurfacing or skin quality optimisation should be prioritised.

The nature of facial ageing Facial ageing is a multi-layered process affecting every component of facial structure.

· Skin: Over time, the skin loses elasticity

due to decreased collagen and elastin synthesis, manifesting as sagging, fine lines and wrinkles. Texture becomes rougher, and dyschromia or pigmentation concerns may develop.2 · Subcutaneous fat: Redistribution and loss of facial fat create hollows in the mid-face, temples and periocular region, while deeper fat pads may descend, contributing to jowls.2 · Muscles and ligaments: Soft tissue support weakens with age, deepening grooves and folds such as the nasolabial and marionette lines.2 · Bone: Age-related bone resorption alters the underlying scaffold, particularly in the orbital and maxillary regions, exacerbating soft tissue descent.2 54

Evidence increasingly supports a multimodal approach as the gold standard for facial rejuvenation.3 Combining lifting techniques, lasers and hydrating injectables optimises outcomes by targeting multiple aspects of ageing simultaneously, prolonging results and reducing the long-term need for more invasive intervention.3 Ideal candidates for a combination of minimally invasive facial rejuvenation techniques are typically patients with early-to-moderate laxity who have realistic expectations and seek natural improvement with minimal downtime.3

Importantly, non-surgical approaches are not direct substitutes for surgical facelifts in cases of severe laxity or significant tissue redundancy. Rather, they provide an effective alternative for patients who are not surgical candidates, are averse to surgery or wish to maintain results between surgical interventions.4

Core modalities for non-surgical sculpting A multi-modal treatment plan typically encompasses a bespoke combination of procedures tailored to the individual patient’s anatomy and stage of ageing. Aesthetics | April 2026

Aesthetics

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Thread lifting Thread lifts (e.g. polydioxanone or poly-L-lactic acid threads) are placed beneath the skin, commonly via a 19-21G cannula, to reposition sagging tissues while also stimulating collagen production. Results are often visible immediately, with further improvement developing over three to six months. Contraindications include active infection and significant bleeding risk/anticoagulation; adverse events may include bruising, asymmetry, thread visibility/palpability and, rarely, infection.5 According to the Care Quality Commission (CQC), procedures involving the insertion of instruments or equipment into the body, including all forms of thread lifting, are classified as regulated activities. Therefore, where such procedures are performed by a healthcare professional, the provider must be registered with the CQC in order to operate legally.6 Dermal fillers Injectable hyaluronic acid (HA) restores volume in key areas such as the cheeks, jawline and temples. By re-establishing structural support, fillers contribute significantly to overall facial contour and rejuvenation.7,8 As a general principle, higher-G’ products may be preferred for structural support (e.g. mid-face and jawline), while softer gels can be used for more superficial contour refinement depending on tissue quality and movement. Key risks include vascular occlusion and delayed inflammatory reactions, and safe practice requires detailed knowledge of facial vascular anatomy and appropriate emergency preparedness.9,10 Energy-based tightening devices Energy-based devices (EBDs) deliver focused stimulation to promote collagen and elastin production, resulting in gradual tightening and lifting. High-intensity focused ultrasound (HIFU): Delivers focused ultrasound energy to deeper fascial layers, including the superficial musculoaponeurotic system (SMAS), creating thermal coagulation points that stimulate collagen remodelling and lifting. It is typically used when deeper structural tightening of the lower face or neck is required.11,12 Radiofrequency (RF) devices: RF energy produces controlled dermal heating, promoting collagen contraction and neocollagenesis. RF devices are commonly used for mild laxity and improvement of overall skin quality and texture.13 Subdermal laser tightening: Endolift utilises a micro-optical fibre to deliver targeted heat

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Aesthetics

energy beneath the skin, supporting both skin tightening and lipolysis. It is typically used in cases of mild-to-moderate skin laxity or where localised fat ablation is needed, such as in the submentum or upper neck.14-16 Contraindications vary by device but commonly include pregnancy, active infection and impaired wound healing. Adverse events may include transient swelling, burns due to inappropriate settings or temporary sensory disturbance.11,13,15 Treatment selection depends on the dominant ageing pattern; volume loss may respond best to fillers, early laxity to threads or EBDs such as RF or HIFU and more localised tissue descent to subdermal laser tightening.3

Adjunctive treatments For optimal rejuvenation, superficial concerns such as pigmentation, redness and texture must be addressed alongside deeper structural correction. Lasers Lasers play an invaluable role in improving skin surface and dermal remodelling.17

· Fractional CO2 and Er:YAG lasers

create controlled microthermal injury, promoting collagen remodelling and resurfacing, improving fine lines, pores and dyschromia.18 · Nd:YAG lasers target vascular lesions and enhance dermal remodelling with minimal epidermal disruption.17 Contraindications may include active infection, recent isotretinoin (depending on protocol), photosensitising medications and inflammatory dermatoses; parameters should be tailored to skin type and downtime tolerance.18,19 Optimal timing depends on device choice, patient tolerance and clinical objectives, reinforcing the need for stepwise treatment planning.20 Skin boosters Skin boosters are micro-injections designed to enhance hydration, elasticity and dermal quality.20-22 Common options include:

· Low-viscosity HA skin boosters:

Low-viscosity injectable HA spreads evenly in the dermis, drawing in water and enhancing glow and suppleness.23 · Polynucleotides and peptide-based regenerative injectables: These stimulate wound healing pathways, enhance fibroblast activity, improve skin density and may support synergistic effects alongside other treatments.21 Skin boosters are especially beneficial following lifting and resurfacing procedures, as they enhance tissue hydration, integrate

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micro-injuries from EBDs and improve radiance. They are suitable for all skin types and are an excellent adjunct to volumising or lifting treatments.20-22 A recommended protocol typically consists of one monthly injection for three months, followed by one maintenance injection every eight to 12 months.20-22 They are generally well tolerated, though contraindications include active infection at the injection site and caution in pregnancy/breastfeeding. Adverse events may include transient swelling, bruising or small nodules.20-22

Sequencing strategies Treatment success hinges on comprehensive assessment and structured planning.

· Assessment: Conduct a full facial

analysis, considering anatomical changes in volume, laxity and skin quality. Identify the patient’s goals and assess suitability for various modalities. · Sequencing: Typically, lifting treatments (such as fillers) are performed first to reposition and support tissues. After adequate healing – typically two to four weeks – resurfacing or subdermal laser procedures can be performed, followed by skin boosters to address skin texture and laxity.23 Staged intervals A practical framework may include:

· Week zero: Fillers/threads · Week two to four: Resurfacing with EBD or subdermal laser

· Week four to six: Skin boosters

Although individual procedures may involve minimal recovery time, combining or sequencing multiple treatments requires careful planning and structured scheduling to maintain patient safety.

When planning treatment sequencing, careful consideration must be given to the interaction between modalities. Performing laser therapy prior to lifting procedures may reduce the risk of disrupting newly placed threads or recently injected filler material.24 Conversely, laser treatment following lifting can be appropriate when non-ablative protocols are selected, provided sufficient healing time has elapsed and adequate tissue integration of threads or fillers has occurred.24 Overlapping treatment of anatomical areas within a single session should be avoided.24 Studies indicate that combining lifting procedures with lasers and skin boosters yields superior, longer-lasting outcomes compared with monotherapies.3,24 Improvements include better resilience, firmer contours, smoother skin and enhanced luminosity.3,24 Maintenance is usually required every 12-24 months for Aesthetics | April 2026

Rejuvenation Multimodal Approach threads, while HIFU/RF may be repeated annually and laser/booster sessions may be repeated as needed.5,11,20 Example case study A 66-year-old female presented with visible facial ageing consistent with Baker classification II, characterised by mild-to-moderate jowling, fine lines and wrinkles and generalised volume loss.4 Volume depletion was most evident in the temporal, forehead, medial cheek, buccal and pre-auricular regions. Initial treatment consisted of full-face Endolift performed on November 26 to address skin laxity and support collagen remodelling. This was followed by face and neck botulinum toxin, combined with 9ml of HA dermal filler, on January 14 to restore structural support and improve facial contour. A further session on February 11 included 4ml of HA dermal filler and a face and neck skin booster, aimed at optimising dermal hydration and improving overall skin quality.

Recovery and patient expectations Recovery following lifting treatment is usually swift. Most patients resume normal activities within 24-48 hours, although minor swelling or bruising may occur. With laser devices, swelling may be more significant and may last up to two weeks.5,18 Results unfold progressively, reaching optimal effect over several weeks to months depending on the modalities employed. Clinically, improvement is typically seen as better jawline definition, softening of marionette/nasolabial folds, reduced lower-face laxity, improved skin firmness and enhanced surface luminosity.7,8,20,24 Adherence to evidence-based protocols, clear consent processes and shared decision-making remain central to safe and effective practice.

Non-surgical rejuvenation By recognising the limitations of single modalities and leveraging combination approaches – threads, fillers, lasers and skin boosters – aesthetic practitioners can deliver bespoke, holistic care with natural and sustained outcomes.3,23 Dr Hasaneen Al Janabi is the founder of the Dr Hass Clinic in Mayfair, renowned for his expertise in nonsurgical facelifts, advanced filler techniques and Endolift laser treatments. He is the lead trainer at the British Aesthetic Academy, regularly teaching practitioners the latest in facial rejuvenation. Qual: MBBS, BSc (Hons), MRCS (ENT)

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procedure for every provider. This allows your practice to standardise SkinPen procedures.

SkinPen Precision Elite, the leading microneedling device in the US, is now setting the new standard in microneedling in the UK & Ireland. As of 2026, Revance has a 13-year legacy of advancing microneedling worldwide. According to market research, SkinPen is the leading microneedling brand in the U.S. with distribution in over 60 countries worldwide with over 18,000 practitioners choosing SkinPen.1 When it comes to microneedling technology, not all devices are created equal. SkinPen sets itself apart as the highest standard in microneedling, offering unmatched precision, safety and performance.

Carefully engineered for all day provider comfort, the perfectly balanced, ergonomic design of SkinPen Precision Elite is designed to reduce the risk of provider fatigue, ensuring comfort and control throughout the day. And with a perfectly weighted handpiece, SkinPen Precision Elite maintains ideal skin contact. With a focused field of view, SkinPen Precision Elite offers enhanced visibility of the treatment area, offering precise treatment.

SkinPen Precision Elite Meets The Needs Of Today’s Patients · Little to No Downtime: Most patients leave with mild erythema,

and for most by the next day the redness has reduced. Skinfuse Rescue Calming Complex is suggested for use 24hrs post treatment, which is included in the SkinPen Treatment Kit for patients to take home.

· A Natural Alternative, 12 Months of the Year: SkinPen Precision Elite triggers the body’s natural wound healing cascade to achieve dynamic results any month of the year*.

With its validated engineering, industry-leading clinical research, and innovative features, SkinPen can provide consistent, reliable results for providers and patients alike. This is not just a microneedling device – it’s a technology designed to elevate patient outcomes while enhancing treatment confidence.

· A Procedure with Minimal Discomfort: Topical numbing can be

SkinPen® Precision Elite

· Safe for Fitzpatrick Types I-VI: Clinically proven safe and effective

The FDA-cleared microneedling device now available for practitioners across the UK and Ireland, offers unparalleled precision – this next-generation technology is transforming how clinicians approach skin remodelling.2

Clinically Proven Results

Intelligent Design. Elite Performance. The newest microneedling innovation, SkinPen Precision Elite builds on the trusted features of SkinPen Precision, SkinPen Precision Elite adds additional features designed for providers and patients who demand an elevated experience. The new Interactive Digital Display provides intuitive guidance throughout the entire treatment, including an Elite Cartridge Unit installation prompt, battery charge indicator, and straightforward troubleshooting on screen. The SkinPen Elite Cartridge Unit also takes everything we love about SkinPen Precision and elevates it with new features designed to enhance the provider experience. The Elite Cartridge Unit is powered by ActiSine™ Technology. The advanced active retraction of SkinPen Precision Elite ensures full retraction of the needles with every stamp, unlike devices that rely on a spring mechanism to remove the needles, reducing dragging of the skin. By treating and not traumatizing the skin, SkinPen Precision Elite offers consistent results while reducing the risk of prolonged downtime.

used to ensure patient comfort, making this a well-tolerated and easy procedure for providers to perform. to treat facial acne scares for all skin types.3

SkinPen currently boasts 5 peer-reviewed, published clinical studies and over 90 validation studies to prove the technology meets its published specifications. In clinical studies, SkinPen achieves a 96% satisfaction rate among providers, showcasing its exceptional quality and reliability. This high level of satisfaction empowers our practice partners to grow their business through patient satisfaction, retention, and referrals. With over 18,000 aesthetic practices and over 5 million patients worldwide, you can rely on SkinPen as a brand to deliver a high standard in microneedling.4,5

Discover the SkinPen Difference SkinPen Precision Elite isn’t just an upgrade; it empowers providers with the tools they need to deliver exceptional results safely and efficiently. Experience the future of microneedling and elevate to SkinPen Precision Elite.

This article is written and supplied by Revance

The new cartridge design allows for simple installation for seamless setup. Simply set the cartridge on the handpiece and twist to lock, eliminating the risk of accidental lockout and creating a seamless, stress-free setup. With the Elite Cartridge Unit, patient safety is enhanced with SkinPen Connect, digitally recognising and verifying every cartridge to ensure authenticity and single use. This provides peace of mind for both providers and patients.

Efficiency Meets Elite Performance The unique Elite Efficiency Timer (EET) further enhances treatment accuracy and efficiency by expertly guiding the timing of every

To learn more about integrating this advanced system into your clinic contact enquiries@revance.com

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Aesthetics | April 2026

Case Study Skin Tightening

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Strategies for Abdominal Skin Tightening

Treatment options

Nurse practitioner Dawn Attewell explores the treatment strategies for skin laxity in medical aesthetics

When it comes to treatments, surgical correction remains the most definitive approach for significant abdominal skin laxity, as it allows direct removal of excess tissue and correction of deeper structural concerns such as rectus diastasis. Patients who exhibit marked overhang, deep folds or true skin redundancy are therefore more appropriately managed surgically, as non-surgical tightening cannot remove excess skin regardless of treatment frequency.7,9 Non-surgical treatments are best suited to patients with mild-to-moderate laxity, where the primary issue is reduced dermal firmness rather than true excess skin.12,13

Abdominal skin laxity is a common presentation in medical aesthetics, particularly among patients with a history of pregnancy, weight change or natural ageing. While patients often view it as a cosmetic issue, it reflects underlying anatomical and physiological changes.1 This article explores abdominal skin laxity through a structured clinical approach, covering its development, clinical assessment and treatment options based on severity and patient goals.

Pathophysiology Abdominal skin laxity develops through progressive biological and structural changes that reduce the skin’s firmness and support. As part of natural ageing, the skin undergoes a steady decline in its structural proteins. Collagen fibres become fragmented and disorganised, reducing dermal strength and resistance to stretching.2 Elastin fibres also lose density and function, limiting elastic recoil and the skin’s ability to return to its original position.3 In parallel, gradual thinning of the epidermis weakens the dermal –epidermal junction, contributing to early textural laxity.1 These intrinsic changes are compounded by external pressures such as cumulative ultraviolet exposure, smoking, weight fluctuations, environmental pollutants and suboptimal nutrition, all of which accelerate oxidative stress and impair connective tissue repair.4,5 Over time, these processes lead to skin that appears thinner, less elastic and more prone to laxity. With weight loss specifically, shifting patterns of subcutaneous fat remove internal volume that once provided contour and support, making the skin drape more noticeably.6

Evaluating abdominal skin laxity Assessment of abdominal skin laxity is most effective when using a structured approach connecting clinical findings to underlying causes. Looking at a detailed patient history is a critical first step, as past pregnancies, major weight changes and prior abdominal surgeries often explain the development and distribution of laxity.7 Anatomy-first planning is fundamental. Clinicians should assess for hernias, diastasis recti and other abdominal 60

wall abnormalities before treatment, adapting technique and modality choice accordingly.7 Visual inspection provides further information on how the abdominal skin responds to gravity. Examining the patient in different standing positions reveals sagging patterns, folds above or below the umbilicus and changes in umbilical orientation.8 Surface features like symmetry, scars and striae provide further insight into tissue quality and prior stretching.9 Manual examination then helps confirm visual findings. The pinch test assesses skin thickness, elasticity and recoil, with delayed return indicating reduced elasticity.10 Tissue volume helps distinguish skin redundancy from subcutaneous fat and palpation identifies focal fat deposits, rectus diastasis or hernias, all of which affect treatment planning and safety.11 From there, photographic documentation from multiple angles then supports consistent monitoring and objective comparison over time. Complementing this with validated grading scales helps classify laxity severity in a reproducible way. While specific abdominal scales are limited, similar qualitative approaches using visual assessment and palpation are common, and photonumeric scales validated for areas like thighs and buttocks can often be applied to the abdomen.12 In practice, the extent of evaluation depends on the planned treatment. Patients being considered for surgery require a more detailed assessment, including measurement of abdominal circumference, dermal thickness via ultrasound and three-dimensional imaging. This evaluation is essential for surgical planning, as it allows precise characterisation of skin redundancy, fat distribution and abdominal wall integrity.7,9 Candidates for non-surgical tightening still need structured evaluation, but with a targeted focus. Assessment considers whether the laxity pattern and severity are suitable, whether tissue is likely to respond and whether patient expectations match achievable results. Aesthetics | April 2026

Options can be divided into surgical and non-surgical approaches. Surgical options

Non-surgical options Technologies used in non-surgical abdominal skin tightening encompass both energy-based devices (EBDs) and injectable biostimulatory treatments, which may be employed alone or in combination depending on laxity severity, tissue characteristics and patient goals. While these injectables and EBDs cannot remove redundant skin, their combined use can produce clinically meaningful, incremental improvements in skin quality and laxity in appropriately selected patients whose tissue retains sufficient biological capacity for remodelling.14

Abdominal skin laxity develops through progressive biological and structural changes that reduce the skin’s firmness and support

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EBDs EBDs such as plasma, radiofrequency (RF) and RF-assisted microneedling create controlled thermal or plasma-mediated injury within the dermis, leading to fibroblast activation, neocollagenesis and modest tissue contraction. Devices currently used in aesthetic practice include plasma-based systems, RF-assisted microneedling platforms and electromagnetic muscle stimulation technologies used for body contouring.15 EBDs typically produce modest improvements through dermal collagen contraction and remodelling rather than true skin removal, resulting in less dramatic outcomes than surgical excision and potentially requiring multiple treatment sessions.16 Patient suitability depends on baseline skin quality, degree of laxity and realistic treatment expectations. Individuals with mild-to-moderate laxity and preserved dermal integrity tend to respond most favourably, whereas patients with significant redundant skin may achieve limited improvement with non-surgical technologies. Additionally, the clinical evidence supporting many non-surgical tightening technologies remains limited, with variability in study design and objective measurement of outcomes reported across the literature.14 Injectables Injectable treatments further complement device-based approaches by targeting dermal quality and extracellular matrix support. Biostimulatory agents such as poly-L-lactic acid and calcium hydroxylapatite promote neocollagenesis through controlled inflammatory and scaffold-based mechanisms, leading to gradual improvements in skin thickness, firmness and tensile strength.10 Skin remodelling injectables, including hyaluronic acid combined with amino acids and other supportive components, act by enhancing fibroblast activity, supporting collagen and elastin synthesis and improving hydration and tissue elasticity over time.17 These treatments are most appropriate for patients with mild-to-moderate laxity and adequate dermal thickness, with clinical improvements typically developing gradually over several weeks as collagen remodelling occurs. Injectable biostimulatory treatments may improve dermal quality by stimulating collagen production, but results develop gradually and depend on patient response, often requiring repeat treatments to maintain the effect.13

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From an anatomical perspective, safe and effective treatment planning requires awareness of key abdominal landmarks and underlying structures. The abdominal wall consists of layered skin, subcutaneous tissue and the superficial fascial system overlying the rectus abdominis muscles and linea alba, with the umbilicus serving as a central surface landmark during aesthetic assessment and injection planning.18 Injections are typically performed within the superficial subcutaneous or deep dermal plane to avoid deeper structures, with clinicians maintaining awareness of the course of the superior and inferior epigastric vessels within the rectus sheath and the segmental intercostal neurovascular bundles that supply the abdominal wall.19 Careful mapping of the treatment area relative to these landmarks helps minimise the risk of vascular injury and supports even distribution of product across the lax tissue envelope.

Combining modalities When combination treatments are used, EBDs are typically performed first to initiate dermal remodelling and collagen stimulation. Treatment protocols commonly involve a course of three to six sessions, depending on the device technology and severity of laxity, with sessions usually spaced four to six weeks apart to allow adequate tissue recovery and collagen remodelling between treatments.14 Biostimulatory injectable treatments may then be introduced approximately two to four weeks after the final device session to support ongoing collagen stimulation and extracellular matrix remodelling. Treatment protocols typically involve two to three sessions spaced four to six weeks apart, allowing progressive neocollagenesis and gradual improvement in dermal firmness. Skin-remodelling injectables may subsequently be introduced two to four weeks following the final biostimulatory session, if required, to further enhance hydration, fibroblast activity and dermal quality. Clinical improvements from biostimulatory treatments generally develop progressively over several months and may last 12 to 24 months depending on the product used and individual patient factors. Whereas skin-remodelling injectables typically require periodic maintenance treatments every six to 12 months to sustain results.10 Aesthetics | April 2026

Case Study Skin Tightening Aftercare following these treatments generally includes avoiding excessive heat exposure, strenuous exercise and pressure on the treated area for 24 to 48 hours, with patients advised that mild erythema or swelling may occur temporarily.13

Considerations, contraindications and safety Safe treatment of abdominal skin laxity requires careful attention to contraindications and patient-specific risk factors. Energy-based procedures are generally avoided during pregnancy and breastfeeding, in the presence of active infection or impaired skin barrier, and in patients with conditions associated with poor wound healing.13 Injectables are similarly contraindicated in active infection, known hypersensitivity to ingredients and certain autoimmune or immunosuppressed states, where risk–benefit assessment and conservative dosing are essential.20 Conservative treatment parameters, meticulous asepsis and avoidance of overtreatment reduce the risk of complications such as burns, prolonged oedema, pigmentary change and nodularity.21 Post-treatment counselling is equally important. Patients should be advised that tightening and biostimulatory effects develop gradually over weeks to months, and that adherence to aftercare instructions, weight stability and healthy lifestyle practices supports optimal outcomes.14

Optimising outcomes Non-invasive and minimally invasive modalities can deliver clinically meaningful, incremental improvements in skin quality and laxity when the primary issue is dermal integrity rather than true tissue redundancy. Outcomes are enhanced when treatments are personalised, sequenced thoughtfully and supported by lifestyle optimisation. Dawn Attewell is a nurse practitioner specialising in regenerative and device-based treatments for skin quality and body rejuvenation. Her clinical work focuses on structured patient assessment, evidence-based treatment planning and combination treatment approaches designed to optimise outcomes in patients presenting with skin laxity. Qual: RGN Diploma HE, Bsc Hons, Msc

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Advertorial Zemits

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Skin Tightening in the Longevity Era Why needles fractional RF technologies are reshaping preventative aesthetics

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eliminating the need for anaesthesia. Treatments typically take around 30 minutes, allowing clinics to incorporate them easily into preventative skin programmes.6 For clients, this makes fractional RF tightening particularly attractive as part of ongoing skin maintenance protocols, where treatments are performed periodically to support collagen renewal and maintain skin firmness.

The aesthetic conversation around ageing is evolving. Increasingly, practitioners are moving away from aggressive corrective procedures toward longevity-driven protocols designed to maintain skin strength, elasticity and resilience over time. In this context, skin tightening technologies have become central to preventative aesthetic strategies. Rather than waiting for visible laxity to develop, many clinics are introducing treatments earlier, supporting the skin’s structural framework before significant collagen decline occurs. Among the technologies gaining attention in this space is Zemits CrystalFrax Pro, a needle-free fractional radiofrequency system designed to stimulate collagen remodelling while maintaining the integrity of the epidermal barrier. By combining controlled fractional RF energy with temperature-regulated dermal heating, the technology offers practitioners a method of stimulating skin regeneration while maintaining comfort and minimal downtime.

Fractional RF and the science of skin tightening Collagen and elastin fibres are responsible for maintaining skin firmness and elasticity. However, from the mid-twenties onwards, collagen production gradually declines, contributing to loss of skin density and the appearance of laxity.1 Fractional radiofrequency technologies address this process by delivering controlled heat energy into the dermal layers, where fibroblasts – the cells responsible for producing collagen – are activated. Systems such as CrystalFrax Pro utilise NanoFractional RF energy to create a matrix of microthermal zones within the skin. These microthermal coagulation points trigger the skin’s natural regenerative response, stimulating fibroblast activity and encouraging collagen remodelling.2 The treatment operates in two complementary stages. The first stage uses a MatrixFrax™ fractional RF applicator, which generates a precise energy grid across the skin surface. This pattern allows for controlled thermal stimulation without excessive tissue stress, helping improve skin texture while supporting cellular renewal within the epidermal and upper dermal layers.3 The second stage introduces temperature-controlled multipolar RF heating, which gradually raises dermal temperature to approximately 41-45°C, a range commonly used in professional RF treatments to stimulate fibroblast activity and encourage collagen contraction. By maintaining this controlled thermal environment, practitioners can support gradual skin tightening while preserving patient comfort.4 The result is a treatment that addresses common aesthetic concerns, such as skin laxity, wrinkles and fine lines, uneven texture, acne scarring and stretch marks, whilst supporting the long-term goal of maintaining dermal strength.5

The role of conductive gels in RF performance While the device itself delivers the therapeutic energy, the conductive medium used during treatment plays an important role in both safety and performance.7 Formulations such as Zemits HyaTight RF Skin Tightening Gel are specifically designed for electrical therapies, combining glide, thermal protection and skin-supporting ingredients. One of the key components is hyaluronic acid, a well-known humectant capable of retaining significant amounts of moisture. Within RF treatments, hyaluronic acid helps maintain hydration in the superficial layers of the skin while supporting the skin’s protective barrier during thermal stimulation.8 The formulation also incorporates niacinamide (vitamin B3), an ingredient widely recognised for its ability to strengthen the skin barrier, support hydration and improve overall skin tone. Panthenol, another commonly used dermatological ingredient, contributes soothing and moisturising properties, helping maintain skin comfort during energy-based treatments.9 Botanical extracts further complement the formulation. Liquorice root extract is known for its antioxidant and calming properties, while Fucus bladderwrack extract, derived from marine algae, is valued in skincare for its antioxidant activity and ability to support microcirculation.10 CrystalFrax is a next-generation needle fractional RF rejuvenation system that delivers fast results without damaging the epidermis. It promotes deep collagen restoration while remaining cost-effective, as it removes the need for expensive cartridges.10

This advertorial was written and supplied by

For more information or to book a virtual demo, please visit zemits.co.uk or call +44 (20) 45325922. Product and Training Information

Needle-free regeneration for modern clinics While RF microneedling devices remain widely used, needle-free fractional RF systems are increasingly appealing for clinics seeking lower downtime and improved treatment accessibility. Unlike microneedling RF, which creates mechanical channels in the skin, CrystalFrax Pro delivers energy without breaching the epidermal barrier, significantly reducing recovery time and 62

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Aesthetics | April 2026

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Clinical Papers Abstracts

A summary of the latest clinical studies Title: The LaserLift, a Minimally Invasive Laser-Assisted Facelift: 10

Title: Rheological and Structural Analysis of Hyaluronic Acid

Author: Nedra Gharbi

Authors: Ana Claudia Carbone, et al. Published: Dermatology and Therapy, March 2026 Keywords: Dermal filler, Hyaluronic acid, Rheology

Years of Regenerative Surgery in Aesthetic Facial Rejuvenation

Published: Aesthetic Plastic Surgery, March 2026 Keywords: Face and neck rejuvenation, Facial contouring, Skin tightening

Treatment efficacy was assessed for each patient using the Global Aesthetic Improvement Scale (GAIS) and a modified seven-category photographic classification evaluated by the treating surgeon. Among the 256 patients, 142 completed follow-up evaluations ranging from six months to ten years (mean ~63 months). A 22.67% improvement in face and neck classification scores was observed. Significant enhancement in skin firmness and collagen production was noted across all age groups. Younger patients responded particularly well, but positive outcomes were seen in older individuals as well. Patient satisfaction was very high, with a mean GAIS score of 1.32, and 95.45% of patients reported high satisfaction. The Precision Tx™ laser treatment significantly improves skin tightening, collagen production, and facial contouring. Precision Tx™ laser treatment is less invasive than traditional facelifts, with high patient satisfaction and a shorter recovery time. The results of this study support the use of Precision Tx™ as a new regenerative surgery for face and neck rejuvenation.

Title: Comparative Evaluation of High-Frequency Microneedling Using a Layering Technique Versus Conventional Technique for Facial Rejuvenation Authors: Ye Tang, et al. Published: Journal of Cosmetic Dermatology, March 2026 Keywords: Facial rejuvenation, Microneedling, Skin quality To evaluate the effectiveness of high-frequency microneedling (HFM) using a layering technique versus conventional HFM for facial rejuvenation, with the Fitzpatrick Wrinkle and Laxity Classification Scale (FWCS) score at 3 months post-treatment as the primary endpoint. The conventional group received standard HFM, while the layered group received HFM with needle length, power, and pulse width adjusted for superficial, middle, and deep skin layers. The primary endpoint was the Fitzpatrick Wrinkle and Laxity Classification Scale (FWCS) score at 3 months post-treatment. Secondary endpoints included FWCS scores at 1 and 2 months, VISIA-derived skin texture/pore scores, Global Aesthetic Improvement Scale (GAIS) scores, Cutometer skin rebound rate, and patient satisfaction. Assessments were performed pre-treatment and at 1, 2, and 3 months post-treatment. Statistical analyses were conducted using SPSS 22.0, with linear mixed-effects models for repeated measures, ordinal methods for GAIS, and Fisher’s exact test for satisfaction. The HFM layering technique demonstrates superior efficacy over conventional HFM for facial rejuvenation, with more significant and sustained improvements in wrinkles, skin texture, pores, and elasticity, as well as higher patient satisfaction. Both techniques are safe, though the layered approach is associated with slightly longer downtime.

Fillers Used for Chin Augmentation

This study aimed to compare four commercially available HA gels specifically indicated for chin projection: JUVÉDERM® VOLUX, RESTYLANE® LYFT, PERFECTHA® SUBSKIN, and RESTYLANE® SHAYPE. The samples were characterized using scanning electron microscopy, dynamic light scattering, zeta potential, and swelling factor (SF). Rheological assessments included frequency sweep, amplitude sweep, and cohesivity modulus (MOC). All tests were performed in triplicate. JUVÉDERM® VOLUX exhibited the highest SF values (3.28-3.37), indicating greater swelling capacity, whereas RESTYLANE® LYFT showed the lowest (1.53-1.66), reflecting a denser and less expansive profile. Rheological analysis revealed that RESTYLANE® LYFT and RESTYLANE® SHAYPE had higher storage modulus (G’) values at elevated frequencies. MOC was significantly higher for RESTYLANE® SHAYPE and PERFECTHA® SUBSKIN compared with JUVÉDERM® VOLUX, suggesting greater resistance to deformation. Overall, RESTYLANE® SHAYPE demonstrated the most favorable balance, combining moderate SF, high G’ values, and elevated MOC. However, patient-specific anatomy, aesthetic goals, and injector expertise remain critical in determining the most appropriate product for chin contouring.

Title: Endoscopic Intramuscular Fat Grafting for Precise and Safe Abdominal Contouring: Introducing the Supercharged Body Technique-Preliminary Report of a Novel Approach Author: Hüseyin Kandulu Published: American Society for Aesthetic Plastic Surgery, March 2026

Keywords: Body contouring, High-definition liposuction,

Muscle volume

To evaluate the benefits and efficacy of the Supercharged Body Contouring (S-Bc) technique, which employs endoscopic intramuscular fat grafting to augment the rectus abdominis and external oblique muscles under direct endoscopic visualization. From October 2019 and November 2024, 32 patients (30 male, 2 female) underwent abdominal deep plane liposuction with preservation of superficial fat, combined with the S-Bc technique, a novel endoscopic intramuscular fat grafting method designed to enhance abdominal muscle definition. No significant complications, such as infections, pulmonary embolism, venous embolism, or fat embolism, were reported. A minor complication, mild seroma, occurred in 8 patients. Other minor issues included temporary bruising in 2 patients and slight asymmetry in one, which was addressed with a secondary fat injection at 3 months. At the 1-year follow-up, the median patient satisfaction score was 9.5 out of 10 (range: 7-10, 95% CI: 9-10). The fat injection technique for enhancing muscle appearance produced sustained results in all patients. Skin tightening evaluations showed 56.25% (n = 18) of patients rated as good, 40.6% (n = 13) as very good, and 3.12% (n = 1) as moderate.

Aesthetics | April 2026

Sales Strategy Lead Management

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Converting Leads for Clinic Growth

However, clinics should avoid sending a generic message such as, “Thanks for your enquiry, how can we help?” While polite, it does little to move the patient forward. A stronger first response should build trust, create clarity and make the next step in the patient’s journey feel simple and comfortable.

Sales director Adam Smith shares how aesthetic clinics can improve lead management and convert enquiries

One useful way to approach this is through the ACE framework which stands for authority, comfort and educate. Your first response should establish authority, create comfort and educate by sharing one helpful, treatment-relevant piece of information that supports the patient in making their decision.

Aesthetic clinics do not have a lead problem; they have a lead handling problem. Research from the Massachusetts Institute of Technology (MIT) and sales engagement platform InsideSales demonstrates that companies that contact leads within five minutes are 21 times more likely to qualify that lead compared to those who wait 30 minutes.1 Investment in advertising, website optimisation and generating enquiries is important, but if follow-up is slow, inconsistent, scattered across multiple channels or worse, never happens, a significant number of potential patients will never convert. In my work with both independent practices and large clinic groups, the concept of the ‘leaky bucket’ comes up frequently. It refers to the gradual loss of potential patients or revenue at different points in the patient journey. Often this doesn’t present as an obvious crisis, but instead shows up as a slightly quieter diary, lower utilisation, pockets of white space, and the frustrating feeling that you’re doing the right things without seeing the results. Small operational tweaks within lead management can create an immediate financial impact, without touching your marketing budget. Across hundreds of our clinics, the businesses that improve conversion the fastest are rarely the ones with the most leads. They are the ones that respond better, follow up consistently and track what works. This article explores the principles of effective lead management, demonstrating how speed, consistency and structured follow-up can transform enquiries into booked consultations.

The initial enquiry When a prospective patient enquires, they are often already well along in their decision-making process. They are evaluating their options, seeking reassurance and trying to determine which clinic feels trustworthy and easy to engage with. However, if the response is delayed, that initial momentum can quickly fade. Patients may become distracted, question the timing or simply choose the clinic that responded first. This is not about aggressive selling, but rather about being present at the precise moment the patient is ready to move forward. An aggressive response might immediately push the patient to book, offering discounts or applying pressure before they have had the opportunity to fully understand the treatment. A present and supportive response does the opposite. It reassures the patient that they are in the right place, provides clear information and gently guides them towards the next step, such as booking a consultation or asking further questions. The difference lies in the intention – one approach pushes for a sale, while the other removes uncertainty and helps the patient feel confident about progressing. While this may sound straightforward in theory, the reality of a busy clinic can make consistent responses difficult. Enquiries often arrive while reception teams are managing missed calls, a full diary and multiple administrative tasks. With messages coming through website forms, WhatsApp, email, social media and phone calls, it becomes easy for one enquiry to slip through the cracks. To prevent this, the first operational improvement is simple. Every enquiry should receive a fast, professional and consistent automated response, regardless of the channel through which it arrives. 64

Addressing typical patient concerns through FAQs Most patients tend to have the same core questions about costs, financing options, timelines, recovery and what to expect during the consultation itself. However, they don’t always ask them directly, often because they don’t want to dig through a website, can’t call during working hours or just want a straight answer. Answering those questions upfront through an intelligent chatbot, or content-specific automation (via preferred channel of response), removes friction and also protects the human touch. We’re not talking generic templates, but instead friendly, engaging messages on WhatsApp, with videos from you or more formal emails, depending on your tone and treatment of interest. When your team isn’t stuck repeating FAQ answers, the conversations that do happen are warmer, personalised and far more effective, going deeper into the patient’s needs and wants. This then makes it quicker and easier to convert them. These are the questions patients most frequently want answered:

· · · ·

How much does it cost? (Even a “prices from” range helps). Do you offer payment plans or financing options? How long does the procedure take? What’s the recovery time like? (This ranges from side effects to downtime).

· What happens during the consultation? By handling the simple FAQs immediately, automatically or convincing the patient through testimonials, case studies or welcome/treatment videos, the prospective patients who do want to liaise with the reception team or new patient coordinator, receive a better experience. This is because your team now has the time and headspace to deliver a true five-star conversation, not a rushed response between ten other tasks because they are rushed off their feet handling an influx of calls and emails.

The first stage of contact A strong lead handling system doesn’t rely on staff memory to follow up or reply; it relies on the structure. A practical approach many clinics adopt is to combine an instant acknowledgement with a short sequence of content touchpoints that build trust, answer the obvious questions and makes the next step feel easy. The purpose of these messages is to convince the patient to book without a human needing to call or message, or give the patient enough confidence that your clinic is the right one to choose so they are easily converted once called by your staff. Reducing friction increases conversion. A typical structured first stage might look like: Immediate treatment-specific email acknowledgement Confirms receipt of the enquiry; provides information on the treatment and outlines the treatment next steps to start treatment in a clear, visual and easily scannable format.

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Sales Strategy Lead Management

It is important that the email is short enough to read in less than 30 seconds, and you use bullet points instead of long text paragraphs. It’s also useful to suggest a timeline in which the team will be in touch with them.

Day 30: Light check-in reminding the patient the clinic is available if needed.

First WhatsApp touchpoint

Day 60+: Following this, I would suggest marking these leads as “gone cold/long term nurture and adding to your marketing database lists, provided you have got the patient’s consent.

Provides a personal introduction, such as a brief welcome message from the practitioner, overview of the clinic and one unique selling point about the clinic to provide authority – this is designed to build trust and establish rapport from the outset. It is important to note that if you are using WhatsApp on a mobile or desktop, you must ensure that you are compliant with data protection and consent requirements, that patients can opt out of marketing messages easily. If you are using General Data Protection Regulation (GDPR) compliant software, this should be done automatically. Second WhatsApp touchpoint (approximately two minutes later) Shares a concise educational video that explains the treatment clearly, helping the patient understand what to expect. A clearer explanation might be: “Dermal fillers are used to restore volume and shape in areas such as the lips or cheeks. The treatment usually takes around 20-30 minutes and results are visible immediately, with most patients experiencing minimal downtime.” Using simple, patient-friendly language reduces confusion and helps prospective patients feel more comfortable moving forward. Third WhatsApp touchpoint (approximately two minutes later) Presents a treatment-specific patient case study or a set of before-and-after images, accompanied by a brief story outlining the patient’s initial concern, their desired outcome, the treatment timeline and the final result. These automations should all include a clear call-to-action, whether that is to book, schedule a call, or speak with a team member now. They should also be contextual to the treatment the patient has enquired about, not generic. The goal here isn’t to overwhelm the patient; it’s to do the simple heavy lifting early so the patient can build confidence without needing to speak to a member of the team straight away.

Following up Even with a fast first reply, many patients won’t book on the spot. Especially for higher value treatments, however, the “no” is often just “not right now”. Patients often delay for a variety of reasons. They may wish to discuss the decision with a partner, wait until payday or plan around a wedding, holiday or birthday. Some feel nervous, while others simply need more time to consider their options. The enquiry has not disappeared; it is merely on pause. To manage this effectively, clinics benefit from having a clear and consistent follow-up strategy in place. A simple 60-day follow-up structure A structured follow-up process helps clinics stay visible and supportive without overwhelming the patient. Communication should be more frequent in the first week, then gradually reduce over time. Day one: Immediate acknowledgement and educational information about the treatment. Day two: Friendly follow-up offering to answer any questions. Day four to five: Patient success story or before-and-after results to build confidence. Day eight: Gentle reminder about booking a consultation. After the first week, follow-up becomes less frequent but still helpful: Day 15-22: Helpful information answering common patient questions.

Day 45-60: Final follow-up linked to natural decision triggers such as events, holidays or personal timing.

Patient correspondence Automation is powerful for speed and consistency, but the moment a patient replies or picks up the phone, the goal changes. Now it becomes a human conversation, not a system conversation, and the clinic’s job is to build trust and guide the inquiry into a booked consultation. It’s worth remembering that a reply isn’t a sale, and a phone call isn’t a sale either. It’s simply a sign of intent, and your job is to handle that intent properly. Instead, train your team to capture a few key points every time and plug this into your CRM, lead system or Excel such as what treatment are they interested in and what their timeline is. Based on what they tell you, create follow-up tasks that feel personal and relevant. If they mention a birthday, a wedding or a holiday, your follow-up should be timed around their real decision window, otherwise, touch base with them at least once a month.

The role of reporting After optimising first responses and follow-up, the final step is to measure outcomes, as without tracking conversion, even the best processes can leak revenue unnoticed. Most clinics track revenue and costs based on their Profit & Loss Accounts (their bottom line revenue) but the real lever is conversion rate, because it tells you whether your lead handling is working or leaking. There are many conversion rates to track, but the main conversion is lead to consult/booking. You may then want to track lead to treatment started, or consult to treatment started. But the main focus of your lead handling is the efficiency with which you convert leads into patients visiting the clinic. Once clinics can clearly see what is happening across their inquiry journey, they can make far more informed business decisions. These decisions could include whether enquiries are being responded to quickly enough, whether certain treatments are converting better than others, and which marketing channels are generating the highest quality enquiries. With this level of visibility, clinics can refine both their marketing investment and their internal processes, ensuring that fewer opportunities are lost.

The real question You don’t need more leads to grow; you need fewer leaks in your sales ‘bucket’. When clinics improve speed, improve the content they send and structure follow-up across the inquiry journey, conversion rises naturally, because the patient experience becomes clearer, faster and more reassuring. If you want more bookings without spending more on ads, ask yourself one question: How many leads are you already paying for that you never convert? Adam Smith is co-founder and sales director at Boxly and Beami, a CRM platform designed for dental and aesthetic clinics. He works closely with practices across the UK and internationally, helping them improve patient acquisition, streamline inquiry management and increase conversion from lead to consultation through structured communication and automation strategies.

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Aesthetics | April 2026

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Involving Medical Aestheticians Within Multi-Disciplinary Practice Specialist aesthetic business consultant Amanda Elbourn explores how clinics can utilise medical aestheticians to support aesthetic services As consumer demand for device-led and skin-focused interventions continues to grow, aesthetic clinics are reassessing workforce models, governance and service delivery. As such, medical aesthetic practitioners and clinic owners need to create a multidisciplinary teams to support patient outcomes and the sustainable development of UK aesthetic practice. Medical aestheticians are becoming increasingly central to the provision of safe, effective and scalable aesthetic services. In 2025, the UK aesthetic devices market was valued at over £750 million, reflecting sustained investment in energy-based and technology-driven treatments that require skilled, trained practitioners.1 Aestheticians often provide ‘gateway’ services such as medi-facials, which bring patients into clinics, and they frequently play a foundational role in the patient journey while also contributing significantly to revenue through retail skincare sales.2 Many medical aestheticians undertake advanced Office of Qualifications and Examinations Regulation (OFQUAL)regulated qualifications encompassing device modalities and skincare, alongside manufacturer-approved training. These additional qualifications make them highly employable within aesthetic practices seeking to expand treatment portfolios through regular, repeat-business models delivered by skilled skincare and laser therapists.

Education, training and regulation Over recent years, the role of the medical aesthetician has continued to evolve alongside regulatory developments within the UK aesthetics sector. This is typically evidenced through recognised qualifications (OFQUAL-regulated Level 4 and above) aligned with the Joint Council for Cosmetic Practitioners (JCCP) and Cosmetic Practice Standards Authority (CPSA) competency frameworks.3 The JCCP recognises non-healthcare practitioners, including medical aestheticians and skin specialists, within its voluntary register. Provided they can demonstrate appropriate training (Level 4 or above for registerable treatments), competence and adherence to professional standards within their scope.4

Training pathways for medical aestheticians typically progress from Level 2 and 3 qualifications into Level 4 and Level 5 advanced skin rejuvenation and device-led treatment frameworks. Level 4 and Level 5 are readily available through additional OFQUAL-regulated educators, including the Confederation of International Beauty Therapy & Cosmetology (CIBTAC) and Vocational Training Charitable Trust (VCTC), and are often completed alongside employment.5 Medical aestheticians are not permitted to prescribe but play a central role in supporting treatment planning, delivery and long-term skin health. Depending on underlying qualifications, in-house, manufacturer-specific and CPD training, medical aestheticians often have a role to play in the delivery of a non-exhaustive list of facial and body treatments, including medi-facials, chemical peels, skin exfoliation with microdermabrasion and laser and light-based treatments. With potential statutory changes on the horizon for the aesthetic sector, the specialty will see increased scrutiny of non-healthcare roles like medical aestheticians.6 Clinics may therefore benefit from proactively reviewing training standards, competency frameworks and scope of practice across their teams. Practical steps for clinic owners may include: • Auditing current team qualifications, mapping each practitioner against OFQUAL Levels 2–5, relevant competencies and documented device training. • Defining a minimum entry level for the role of medical aesthetician within the clinic, for example, Level 3 as a baseline qualification with a requirement to progress to Level 4 within a defined timeframe. • Reviewing treatment allocation, identifying which procedures should be delivered only by practitioners holding Level 4 or higher qualifications, such as laser/IPL treatments, medium-depth chemical peels or radiofrequency microneedling. • Confirming insurer expectations, ensuring that practitioner qualifications and device competencies align with insurance requirements and updating job descriptions or competency frameworks accordingly. Alongside technical training, increasing Aesthetics | April 2026

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Multidisciplinary Teams Workforce Models emphasis is placed on consultation skills, which can be assessed using checklists and roleplay, risk assessment, documentation, treatment justification and adherence to governance standards, reflecting the growing complexity of device-led aesthetic care. Recognition of potential complications associated with different treatments, along with appropriate mitigation strategies and escalation pathways within the multidisciplinary team, should be clearly defined within standard operating procedures. These can be reinforced through in-clinic training, including case reviews, shadowing and mentorship. While not all medical aestheticians work directly alongside regulated medical professionals, alignment with appropriate medical oversight and multidisciplinary collaboration is increasingly recognised as best practice.7 From my own experience running operations for a national chain of aesthetic clinics, therapist-led services provide a scalable and cost-efficient route to growth, increasing treatment capacity without disproportionate increases in medical staffing costs.

Clinical integration Introducing therapist-led aesthetic services into your clinic requires careful planning to ensure alignment with clinical governance, scope of practice and patient safety standards. Clinics must operate within clear governance frameworks, with defined scopes of practice aligned to formal qualifications. Without clear structures in place, the delegation of advanced treatments can create uncertainty around responsibility, oversight and escalation. Defining code of practice and roles Clinics must establish clear role definitions, delegation and triage protocols, using appropriate screening checklists, and escalation pathways – particularly where treatments involve advanced energy-based devices or form part of combination treatment plans and subsequently require the involvement of a prescribing clinician. A typical operational pathway may begin with a medical aesthetician conducting the initial skin consultation. This includes assessing the patient’s concerns, reviewing their medical history and identifying suitable treatments within their scope of practice. The aesthetician may recommend treatments such as medical-grade facials, superficial chemical peels, LED therapy or device-based skin rejuvenation, where they hold the appropriate training and competency. If the patient is interested in treatments that require prescribing authority or higher clinical oversight, the case should be escalated. This may include injectable treatments, prescription skincare or certain 67

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advanced energy-based device treatments. In these situations, the aesthetician refers the patient to a prescribing clinician for further clinical assessment. The prescribing clinician will review the patient, confirm suitability for treatment and prescribe where required. They may also perform or supervise the higher-risk element of the treatment plan. Following this, the aesthetician may continue to deliver maintenance or adjunctive treatments within their own scope of practice as part of the overall treatment programme. Scopes of practice should be clearly aligned with formal qualifications, device training and demonstrated competence. Structured onboarding, supervision and mentorship are therefore critical to supporting safe delegation and consistent service delivery during periods of service expansion. Establishing supervision and governance Supervision arrangements should be clearly established. This would include joint case triage, supervised delivery, as assessed by a senior practitioner during several cases, and ongoing case debriefing. Ongoing case debriefing would discuss what went well and where improvements could be made, as a reflective exercise with more senior or advanced medical aestheticians within the team or directly with clinical staff. Each medical aesthetician should have a named supervising clinician with explicit oversight responsibility, including defined escalation pathways and clear expectations, using documented protocols, regarding when cases require clinical review or sign-off, employing aids like tick box systems for decision-making. Complex presentations, combination treatment plans and higher-risk patients should require documented clinical approval prior to treatment. Complex presentations may include patients with active inflammatory skin conditions such as acne or rosacea, pigmentary disorders including melasma or post-inflammatory hyperpigmentation or compromised skin barrier function. Combination treatment plans involving multiple modalities, for example, the integration of injectable treatments with energy-based devices, chemical peels alongside laser or radiofrequency treatments, or staged regenerative therapies, may also require the prescribing clinician to review to ensure appropriate treatment sequencing and patient safety. Higher-risk patients may include individuals with relevant medical conditions, those taking medications that may affect skin healing, patients with a history of keloid scarring, or individuals with darker skin types where the risk of pigmentary complications may be increased with certain technologies.

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Clear escalation pathways are also vital, particularly where advanced energy-based technologies are involved or where medical oversight may be required. Mentorship and multidisciplinary support Structured mentorship provides medical aestheticians with ongoing clinical guidance, reflective practice and real-time feedback, particularly when working with advanced devices, combination treatment plans or patients with complex skin presentations. Mentorship may be delivered through a combination of internal multidisciplinary team support and external expertise, depending on the structure, size and maturity of the clinic. Within established teams, mentorship often involves collaboration between medical aestheticians, prescribing clinicians, senior therapists and operational leads, supporting integrated treatment planning and shared clinical decision-making.

Integrating new devices within clinic teams During periods of service expansion or introducing new technologies, external mentorship such as programmes designed specifically for medical aestheticians can provide additional objectivity, specialist insight and structured oversight, complementing internal governance frameworks. In practical terms, oversight can be formalised through monthly case review meetings, quarterly competency reviews, device-specific sign-off before independent delivery, and supervision of the first five to 10 complex cases to ensure safe consolidation of skills. When introducing new technologies, a structured implementation pathway should be mandatory, which may include a supervised launch period, defined training progression, risk assessment and management, escalation pathways, a gradual autonomy model, and formal audit following the first 10-20 cases. This approach protects patient safety, supports practitioner development and provides doctors with clear medico-legal visibility and accountability within the multidisciplinary team.

Business impact From a commercial and operational perspective, medical aestheticians play a critical role in improving both efficiency and clinical performance within aesthetic practices. By delivering a wide range of advanced skin and device-led treatments, they enable prescribing clinicians to focus on more complex, higher-value procedures that are better aligned with their skill set and have greater revenue-generating potential. Aesthetics | April 2026

Multidisciplinary Teams Workforce Models Importantly, medical aestheticians also support clinics in maximising the return on investment from high-cost aesthetic devices. Regular therapist-led treatments help ensure that technologies such as laser, radiofrequency and other energy-based systems are consistently utilised, rather than remaining underused between medical clinician-led procedures. They also play a key role in driving maintenance treatment programmes and medical-grade skincare adoption, supporting ongoing patient engagement between injectable or medical appointments. This contributes not only to improved skin outcomes but also to stronger long-term patient retention and lifetime patient value. Clinics should support this model by monitoring key operational and commercial metrics that demonstrate the value of therapist-led services. Relevant KPIs may include device utilisation rates, consultation-to-treatment conversion rates, average treatment revenue per patient, retail skincare sales per patient, and uptake of maintenance treatment programmes. Tracking these indicators allows clinics to assess the operational and commercial contribution of medical aestheticians, optimise the use of high-cost devices, and ensure prescribing clinicians can focus their time on more complex procedures. Regular KPI review can also inform service mix decisions, workforce planning and pricing strategy, supporting both improved clinical outcomes and sustainable business performance. From a governance perspective, integrating these metrics into routine operational performance reviews and team objectives enables clinics to align clinical delivery with measurable business outcomes while maintaining a patient-centred treatment approach.

A forward-looking model Medical aestheticians contribute to the UK aesthetics sector not only through treatment delivery, but also through treatment planning and ongoing care. With appropriate training, governance and supervision, they help clinics improve efficiency, make better use of technology and expand services safely. Amanda Elbourn is a specialist aesthetic business consultant with extensive experience supporting UK aesthetic clinics in clinical governance, operations, and workforce development. With a background in senior operational leadership within multi-site aesthetic practices, she leads AB Aesthetic Consultant Services.

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of a wider wellness journey, bringing in a consultant endocrinologist and nutritional support to create a more comprehensive patient experience.

Exploring Key Trends with Specialty Figures The Aesthetics Conference & Exhibition (ACE) 2026 hosted The Candid Trends Panel, offering key insights and practical advice Held on Saturday, March 14 at the Business Design Centre in London, The Candid Trends Panel was chaired by Alice Hart-Davis, aesthetic and beauty journalist and founder of The Tweakments Guide. Drawing on recent data and metrics provided by Rare, a data-driven company specialising in business intelligence for the aesthetics market, the panel explored key developments expected to influence medical aesthetics in 2026, including the impact of GLP-1 medications and the growing interest in regenerative treatments. In an ever-evolving specialty, the discussion combined market data with practitioner perspectives, offering insight into emerging trends and what clinicians are observing in practice. Joining Hart-Davis on the panel was independent nurse prescriber Julie Scott, who has more than 30 years of experience in medical aesthetics. She is a lead clinical trainer for Interface Aesthetics, an aesthetic mentor and international speaker, and was named Aesthetic Nurse Practitioner of the Year at The Aesthetics Awards in 2022 and 2024. Also on the panel was Miss Jennifer Doyle, consultant oculoplastic surgeon and co-founder of The Clinic Holland Park. Alongside her private practice, she works part-time as an NHS consultant at Milton Keynes University Hospital. Completing the panel was founder of Rare, Ben Pask, who specialises in data, insight and technology within the private healthcare market.

Considering medicated weight management in clinic Pask opened the panel discussing the rise of GLP-1 treatments, sharing that after watching the sector grow over the last five years, 70

14% of medical aesthetic clinics now offer weight management treatments, adding that the figure has risen by 2% in the last three months. Addressing the oral formulations of GLP-1 medication, Pask suggested that this development is expected to further accelerate growth in the area. Hart-Davis opened the discussion by questioning whether the current level of uptake represents “a missed opportunity,” or if genuine hurdles – clinical, regulatory or patient-driven – are slowing adoption. Miss Doyle mentioned the challenges clinics face when introducing weight management services, particularly around regulation. She explained that although her clinic has incorporated the treatment, doing so required extensive approval from the Care Quality Commission (CQC). Miss Doyle noted, “For clinics already registered with the CQC, adding a weight management service is not automatic, explaining that clinics must undergo further interviews and submit additional regulatory documentation before approval is granted.” The process, she added, involves a significant time delay and financial commitment. She also highlighted, “These requirements can create barriers for many practitioners in a sector that is largely made up of single-owner clinics that may not be CQC registered.” Alongside regulatory hurdles, Miss Doyle pointed to growing competition from online pharmacies offering weight-loss medications directly to patients. As a result, she believes clinics must focus on how they differentiate themselves from purely transactional services. “What we can offer our patients in clinic is more of a holistic view on this,” she said. Miss Doyle explained that she approaches treatment as part Aesthetics | April 2026

Scott stressed that obesity is a chronic medical condition, and shouldn’t be treated as a trend linked to GLP-1 medications. She noted, “Practitioners must ask themselves whether they have the expertise, knowledge and infrastructure to properly support patients throughout treatment.” For Scott, that assessment led to the decision to refer patients elsewhere. “You can’t be a master at everything,” she explained, adding that she is comfortable directing patients to clinicians who have the appropriate systems and multidisciplinary support in place. Scott also expressed concern that some practitioners may be offering the treatments without sufficient preparation, saying, “The prescribing is the easiest part.” Pask reflected on research into practitioners’ views on weight-loss medications, identifying three groups. One already had experience and used them confidently within broader care. About a third were cautious but open to learning more. The final group were hesitant, often lacking confidence to support patients beyond prescribing, with a small subset opposed to the treatments altogether. Discussing oral weight management medication Scott expressed concern about the wider accessibility of oral weight-loss medications. While increased access could be positive, she warned it also raises risks. “I think the problem could spiral without any regulatory monitoring or requirements,” she said. Scott stated that efficacy and patient safety remain critical. “In a highly unregulated specialty, prescribing treatments without adequate support or guidance can have serious consequences,” she explained. Greater accessibility, she argued, strengthens the case for robust monitoring and professional supervision to ensure safe and effective use. Miss Doyle noted that current oral options are limited by efficacy and side effects. “The phase three results from Eli Lilly’s oral attempt showed a high side-effect profile, and people weren’t losing as much weight,” she said, adding that viable alternatives may take time to arrive.1 She emphasised that it’s not about trivialising these medications, but ensuring they are used responsibly as part of a structured plan to treat obesity, a chronic health condition.

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Highlighting the growth in regenerative medicine Next, Pask highlighted the growing popularity of regenerative medicine within clinics, noting that regenerative treatments are now offered by one in three clinics in the UK. He said, “Some of the biggest changes we have seen are in treatments such as polynucleotides, which grew by 202% last year.” Despite this surge, Pask noted that clinics are still more likely to invest in energy-based devices, with more than 40% doing so, compared with 32% focusing on regenerative medicine alone. When asked how she defines regenerative medicine, Miss Doyle explained, “I think it’s anything where you’re harnessing a response from your body – whether to generate collagen, lift or tighten the skin.” She continued explaining that it could range from a controlled thermal injury, an energy-based device or an injected material that stimulates the body. Scott agreed, simplifying the concept with what she calls the three B’s. “Biostimulation, bioremodelling and biorevitalisation. Anything that asks the cells to upregulate, perform or stimulate falls under this. That said, it’s become a buzzword, and many treatments are now grouped under it,” she noted. Scott added that scientific advancements are exciting but stressed the importance of evaluating the evidence before adopting new techniques. She said she often observes new approaches for a year or more before integrating them into practice, monitoring what works and what doesn’t. Scott also highlighted the value of combination strategies, recognising that ageing affects multiple structures and requires layered treatments. “We know that ageing is on many different modalities, and structurally we need to use different treatment modalities,” she said. Pask noted that defining regenerative medicine can be complex, as different practitioners often have their own interpretation of the term. He added, “It’s an interesting question because everyone seems to define it slightly differently. In the injectables space, treatments like polynucleotides would generally be considered part of that category. As an indicator of growth, that area has increased by about 202% over the past 18 months. It sounds huge, but in reality it still only accounts for around 10% of the market.” Scott cautioned that patient demand is often trend-driven, noting that many patients request specific treatments without considering whether foundational structural support is needed first. She advised younger practitioners to remain curious but always prioritise evidence-based practice.

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“Look into them. Be curious, utilise them – but look for the evidence. And if you’re not seeing it in your practice, question it,” she said. Questioning the shift from traditional treatments Hart-Davis suggested that, based on feedback from her social media audience, some patients appear to be moving away from toxin and showing greater interest in regenerative medicine. However, this contrasts with the clinic data and practitioner insights discussed by the panel. Pask noted that toxin is still offered in nine out of 10 clinics, highlighting how online sentiment can differ from the reality seen in clinical practice and illustrating the uncertainty around wider patient perceptions and trends. Miss Doyle stressed that regenerative treatments do not replace traditional approaches such as filler or toxin. “They’re not designed to create volume, they’re not going to paralyse muscle movements and they’re not going to substitute from the traditional treatments,” she explained. Miss Doyle emphasised using these treatments responsibly and avoiding overpromising results from a single procedure. Discussing trends, Miss Doyle noted that while toxin remains the most popular treatment in the US, laser resurfacing has risen to second place.2 Patient interest, she observed, is increasingly focused on improving tissue health and quality rather than solely achieving cosmetic effects. Miss Doyle concluded that regenerative treatments are most effective when used sensibly, in combination with other modalities, and guided by evidence. Scott added, “At the end of the day, trends will come and go, but anatomy and the ageing process remain the same. No regenerative treatment will replace hyaluronic acid dermal filler. Consulting, listening and educating patients is essential – without that, you’re doing your patients a disservice.”

Knowing when to incorporate trends into practice The panel was questioned, “When should practitioners adopt new trends in their clinic, and how can they distinguish between short-lived fads and lasting innovations?” “I’ve got two words of advice on this,” said Hart-Davis, “and they are ‘Watch’ and ‘Wait.’ Whenever a new trend appears, you need to remember that much of the excitement behind it is driven by marketing. Just because something is being hyped on social media, perhaps linked to a celebrity, and patients are asking what it is, how it works and when you’ll offer it, doesn’t mean you have to jump on the bandwagon straight away.” Aesthetics | April 2026

Specialty Insights Business Growth Hart-Davis emphasised the importance of taking a step back and evaluating whether the treatment represents genuine clinical progress, questioning, “Does it solve a real-world problem for your patient group? Is there proper data and published research behind it? Who is already adopting it – and are respected peers among them?” Scott explained, “Social media and marketing can sometimes make things move very quickly, but not every trend translates into good clinical practice.” She suggested that speaking with trusted colleagues and learning from real-world experience is invaluable, highlighting, “The treatments that tend to stand the test of time are those backed by good data, deliver consistent results and genuinely benefit patients rather than simply responding to hype.” Pask explained, “An analogy is walking through a large town or small city. Not everyone is doing the same thing; you see distinct groups of people, different communities, different rhythms of life all happening alongside each other. The aesthetics market is exactly like that. So when it comes to distinguishing a lasting trend from a passing fad, rather than watching the whole market, watch your tribe.” Pask elaborated that practitioners should focus on a small group of comparable businesses and track how their offerings and messaging evolve, saying, “Consistent shifts within that peer group are more meaningful than isolated trends elsewhere.” Pask concluded that the diversity of the aesthetics field is its greatest strength. He said, “It means trends get road-tested across many different contexts before they reach mainstream adoption. Practitioners who understand which part of the market they sit in are far better placed to make smart, timely decisions, rather than chasing every headline.”

Considering the evolving landscape The panel finished with all practitioners emphasising the importance of managing patient expectations in both weight management treatments and regenerative medicine, ensuring that demand aligns with safe, evidence-based practice. Scott drew the panel to a close, stating, “I think it’s really important that we don’t rush to adopt every new trend that appears in aesthetics. It should be about taking the time to look at the evidence, understanding the science and making sure there is proper education and training available before introducing it into a clinic.” VIEW THE REFERENCES AT AESTHETICSJOURNAL.COM 71

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In The Life Of: Amy Bird Nurse prescriber Amy Bird, Winner of the Evolus Award for Aesthetic Nurse Practitioner of the Year at this year’s Aesthetics Awards, shares an insight into her daily practice

In The Life Of Amy Bird

Lunch usually involves a “soup run” to a local café with the team. My favourite is broccoli and stilton, which I often eat at my desk while catching up on emails or ticking off jobs. In terms of the treatments we offer in clinic, botulinum toxin and skin-rejuvenating procedures are the most popular treatments in my clinic. Our skin programmes combine multiple modalities, including energy-based laser and light devices alongside medical-grade skincare. We are a major client of Obagi Medical, and also use devices from Alma Lasers, as well as Hydrafacial, which patients love for maintaining long-term skin health. After clinic, my evenings are child-focused. On longer days, my children may have dinner at their grandparents’ before I collect them. Otherwise, we follow the usual rhythm of dinner, bath and bedtime. I usually sit down around 9pm, unwinding with Netflix. I’m a big fan of drama series, having watched all of Bridgerton and loved Mr Mercedes.

Other work commitments... My role as BAMAN chair is full-time, involving close work with the Joint Council for Cosmetic Practitioners (JCCP), sector change, regulation and nurse advocacy. I have also judged a national specialty award for four consecutive years. Additionally, I am a key opinion leader (KOL) for pharmaceutical company Evolus, and have recently accepted a position on the Evolus International Global Nurse Faculty, which I am incredibly proud of.

A typical working day… I wear many hats – mother, chair of the British Association of Medical Aesthetic Nurses (BAMAN), nurse prescriber and clinical director of Kast Medical Aesthetics – so my mornings are a masterclass in multitasking. With two children to get ready for school, my day typically begins between 5-6am. I start with a couple of Earl Grey teas while organising uniforms, breakfasts and school bags, before jumping onto a Zoom call with BAMAN to discuss evolving regulatory developments or our ongoing prescribing and lobbying work. Some mornings are so busy that my calls follow me all the way to the school run. After dropping my children off, I arrive at the clinic at around 9am. My clinic days fall into two categories – admin days and injecting days. On admin days, we begin with a team huddle, followed by a meeting with my clinic manager and compliance manager. We review governance, regulatory responsibilities, business structure and the week’s operational priorities. The rest of the day is dedicated to the business side of clinic, from speaking with my accountant, reviewing marketing strategy, overseeing operations and managing the many moving parts that come with leading of running a clinic. My work as BAMAN chair often weaves into these days. I also provide clinical oversight for our aestheticians. If they need assessment or prescriptions, I step in to support them. Likewise, when another injector is in clinic, I remain available for guidance or a second opinion. On injection days, I typically work a 12-hour shift, seeing anywhere from five to 29 patients depending on the appointment type and duration. My team are incredibly conscientious, often playing calming music as I walk into my clinic room to create the right atmosphere for a focused, positive day. My injecting days involve treatment notes, reviewing clinical photography and conducting follow-ups. Documentation is a critical part of safe practice, but with a strong management team handling patient follow-ups, bookings and operational flow, I can concentrate fully on treatments.

I’ve been closely involved in both the training and development for Evolus’ Nuceiva toxin over the past two and a half years. I will now be leading the international and UK rollout, representing the brand and supporting the launch of both the Nuceiva toxin and hyaluronic acid dermal filler range. I also enjoyed speaking at the Clinical Cosmetic Regenerative Congress (CCR) 2025, where I presented as both BAMAN chair on regulatory advancements, and as a nurse prescriber on rejuvenation.

Most memorable day in your career… The most memorable day in my career was when I was lucky enough to win The Evolus Award for Aesthetic Nurse Practitioner of the Year at The Aesthetics Awards 2026 – largely because it came as such a surprise. Having been a Finalist in previous years, I had always felt honoured just to be recognised, and this time I really took the opportunity to reflect on past feedback and put everything into my application. When my name was announced, I was in complete shock. It was was one of those rare moments where you think, “Is this actually happening,” and I realised I hadn’t prepared myself for it at all. For me, it has never really been about personal recognition – I do what I do for my patients, my team and the wider community. That’s why the win felt so emotional, and even now, it still doesn’t quite feel real. If you were to choose a career outside of the medical field, what do you think you would have been? A sociology teacher. Best piece of advice you have ever received? Stick in your lane and don’t get drawn into the glitz and glam – having professional credentials always pays off in the long run. Favourite movie growing up? Saving Private Ryan.

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The Last Word Hair Transplants

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Aesthetics

Who Should Make the Cut in Hair Transplant Surgery? Plastic surgeon Mr Greg Williams argues for the importance of professional standards and training in hair transplantation Hair transplant surgery is becoming increasingly popular in the UK. Yet despite its growth, there is no official register of clinics in the UK offering this procedure, making it impossible to determine precisely how many exist nationwide. Although hair transplant surgery in England falls within the scope of the Care Quality Commission (CQC), there are ongoing concerns that a number of clinics offering the procedure may not be appropriately registered. Of those that are, many have never been inspected, and some remain rated ‘needs improvement’ for prolonged periods. The issue currently facing the field is the lack of transparency regarding which parts of a hair transplant surgery procedure are ‘surgical’, and therefore should be performed by a doctor, and which steps are non-surgical and may be therefore delegated to non-doctor technician assistants.

Regulatory ambiguity Despite being described as ‘surgery’ and involving skin incisions, it remains unclear whether the Royal College of Surgeons of England (RCS England) formally recognises hair transplantation as a surgical procedure. Hair Restoration Surgery, as a modality, is currently overseen by the Joint Council for Cosmetic Practitioners (JCCP), which has proposed that be placed in the red Category (high risk) under Government’s licensing scheme for non-surgical cosmetic procedures in England.1 At present, there is no accredited UK training pathway in hair transplant surgery and no specific qualifications required to perform it. The RCS England does not have provide an official definition of surgery and, without this, it is difficult to understand the legal position on who can perform surgery in humans. However, the JCCP’s guidance is that only General Medical Council (GMC)-registered doctors should perform hair transplant surgery and the GMC has a Memorandum of Understanding with the JCCP.2 The position of the International Society of Hair Restoration Surgery (ISHRS) is that, in the UK, only doctors should perform the skin incision steps, while non-doctor technician assistants may perform the non-surgical steps which include removing follicular unit grafts that have been incised by a doctor as 74

part of the follicular unit excision (FUE) donor hair harvesting method.3 The professional expectation, therefore, is that surgery should be performed by doctors – even if regulatory language remains imprecise.

The risks of delegation Hair transplant surgery generally has three stages – harvesting follicular units from a donor area (naturally occurring groups of one to four or five hairs) from a donor area, making recipient site skin incisions and implanting the follicular unit grafts in the recipient area. FUE, the most widely used donor hair harvesting technique, has two distinct steps: a skin incision step and a graft extraction step.4 Harvesting thousands of follicular unit grafts is physically demanding, and it might be tempting for doctors to delegate this to non-doctor technician assistants. Supporters of delegation argue that experienced technicians can safely perform parts of the procedure under medical supervision. In high-volume clinics, this model is presented as efficient, cost-effective and entirely routine. However, efficiency and affordability cannot override professional accountability. If the skin incision step constitutes surgery, then delegating it to non-doctor technician assistants is not simply a business decision – it’s a regulatory one. In health tourism destinations, one doctor may supervise multiple procedures simultaneously while technicians perform skin incision steps. This commercial model has now spread globally, including to the UK.

The ethical problem If the FUE hair harvesting stage involves making surgical skin incisions, then delegating that step to a non-doctor is not merely an operational choice – it is an ethical one. The distinction between ‘extraction’ and ‘incision’ is not semantic – it determines who is lawfully and professionally responsible. Many clinics are commercially owned and operate high-volume business models. Some require patients to sign consent forms acknowledging that non-doctor technician assistants will perform incisions, while being reassured that the process does not constitute ‘surgery’. Patients are often

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told this arrangement is ‘normal practice’. However, common practice does not automatically equate to acceptable practice. The position of BAHRS is that doctors who delegate surgical incision steps to non-doctor technicians are acting unethically and should be reported to the GMC.5 There has yet to be a well-publicised case in which significant sanction has clarified this boundary – leaving a regulatory grey area.

Accountability The ambiguity deepens when outcomes are poor. If a single doctor owns a clinic and performs all surgical steps, responsibility is relatively clear. However, many clinics employ freelance doctors while retaining the patient contractual agreement at corporate level. In cases of complication or unsatisfactory result, does responsibility lie with the clinic or the individual doctor? Legally, it may rest with the clinic. Professionally, the GMC is likely to hold the doctor accountable. If surgical steps were delegated – and if non-doctor technician assistants are employed by the clinic rather than the doctor – the chain of accountability becomes even more blurred.

Patient guidance This debate is not about professional protectionism. It is about patient safety, transparency and responsibility. If hair transplantation involves surgery – and it does – then the surgical steps should only be performed by doctors in the UK. CQC and the equivalent regulatory bodies in the devolved nations Healthcare Improvement Scotland (HIS), Healthcare Inspectorate Wales (HIW) and Regulation and Quality Improvement Authority (RQIA) must provide clearer definitions, and enforcement must follow where standards are breached. Until regulation is clearer and enforcement more robust, the responsibility lies with doctors to self-regulate and with both patients and clinicians to report doctors who practice in an unethical manner to the GMC. Mr Greg Williams is a plastic surgeon with a full-time practice in hair restoration and hair transplant surgery. He is the past president and current vice president of the British Association of Hair Restoration Surgery. He has chaired the International Society of Hair Restoration Surgery (ISHRS) Ethics Committee, is the current chair of the ISHRS Guidelines Oversight Committee and is now the ISHRS Secretary. Qual: FRCS (Plast)

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Aesthetics | April 2026

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IMPORTANT SAFETY INFORMATION. Patients may experience potential side effects with SKINVIVE™ by JUVÉDERM® facial filler, which include inflammatory reactions (redness, oedema, erythema, etc.), haematomas, induration or nodules, staining or discolourations at injection site, etc. SKINVIVE™ must not be used in: patients suffering from untreated epilepsy; patients who tend to develop hypertrophic scarring; patients with known hypersensitivity to hyaluronic acid and/or to gram positive bacterial proteins as hyaluronic acid is produced by Streptococcus type bacteria; patients with known hypersensitivity to lidocaine or to amide-type local anaesthetics; patients suffering from porphyria; women who are pregnant or breastfeeding; children. SKINVIVE™ must not be used in areas presenting cutaneous inflammatory and/or infectious processes (acne, herpes etc.).4 Please refer to SKINVIVE™ by JUVÉDERM® Directions for Use (DFU) for a full list of adverse events, indications and contraindications.4 HA, Hyaluronic acid. Footnotes: * Lasting up to 9 months as reported by 76.2% of patients. As reported by patients (127/131; 1 subject did not respond) in a composite satisfaction score, which includes how healthy their facial skin looked.1 † Skin hydration was measured using the MoistureMeterD instrument with the XS 5 and S 15 probes (depth of effective measurement: 0.5 and 1.5 mm, respectively).2 ‡ Instrument measures of skin hydration, smoothness, and skin deformation parameters were performed on the cheek, forehead, and neck of one side of the face on Day 0 and at 30 days after initial treatment (before touch up), Months 1, 4, 6, and 9 after the last treatment, and Month 1R. Skin hydration was measured using the MoistureMeterD instrument(n=131) and top-up treatment administered at Day 30 (n=31) to correct asymmetry.2 § Based on a search of published clinical studies of injectable HA treatments in March 2023. A duration of 9 months of skin hydration was established with SKINVIVE™.3 || The Fitzpatrick classification denotes six different skin types, skin colour and reaction to sun exposure (type I: burns easily, never tans; type II: burns easily, tans minimally with difficulty; type III: burns moderately, tans moderately and uniformly; type IV: burns minimally, tans moderately and easily; type V: rarely burns, tans profusely; type VI: never burns, tans profusely).7 ¶ Data from a randomised, evaluator-blind, delayed control study in which 209 patients with moderate/ severe Allergan Cheek Smoothness Scale scores were randomised to receive VYC-12L via intradermal microdepot injections to both cheeks (n=136) or control (no treatment with optional treatment) (n=73). The majority of patients had Fitzpatrick skin types III/IV (58.8%), followed by I/II (32.0%) and V/VI (9.2%). Effectiveness measures included changes in cheek skin smoothness, changes in cheek fine lines and skin hydration at months 1, 2, 4 and 6 after the final injection (initial or touch-up).6 ** Data from a prospective, single-arm study in which 131 patients with moderate/severe cheek skin roughness as per Allergan Skin Roughness Scale received VYC-12 intradermally in the cheeks and forehead, with an option to treat the neck. Select patients (n=31) received touch-up treatment 30 days after initial treatment to correct asymmetry. The majority of patients had Fitzpatrick skin type III (53.4%), followed by II (35.1%), IV (10.7%) and V (0.8%). Assessments of cheek skin roughness, cheek fine lines and skin hydration were performed at 30 days after initial treatment (before touch-up), months 1, 4, 6 and 9 after last treatment (initial or touch-up) and 1 month after repeat treatment.2

†† Data from a retrospective case review undertaken at a single cosmetic dermatology clinic in Vancouver, Canada. A total of 736 patients treated with a total of 1577 VYC-12 treatments were identified; for each VYC-12 treatment, other modalities used on the same day or in the subsequent 9 months were recorded. 718 patients received same-day or asynchronous combination treatments, and 1444 VYC-12 treatments were performed with same-day combination treatments. Data captured included VYC-12 volumes, time interval between treatments, patient age, gender, and adverse events. 5 §§ Data from a prospective, single-arm study in which 131 patients with moderate/severe cheek skin roughness as per Allergan Skin Roughness Scale received VYC-12 intradermally in the cheeks and forehead, with an option to treat the neck. Select patients (n=31) received touch-up treatment 30 days after initial treatment to correct asymmetry. Subjects assessed their return to normal daily social activities (yes/no) in diaries on days 1, 2 and 3 after each treatment.1 References: 1. Ogilvie P et al. J Cosmet Dermatol. 2020;19(5):1065–1070. 2. Niforos F et al. Clin Cosmet Investig Dermatol. 2019;12:791–798. 3. Allergan Aesthetics. Unpublished data. SKINVIVE™ by JUVÉDERM® – 9-month duration of skin hydration in clinical trials. REF-108945. March 2023. 4. SKINVIVE™ by JUVÉDERM® DFU. 20081699. Revision 2023-10-04. 5. Zarbafian M et al. Dermatol Surg. 2022;48(3):369–372. 6. Alexiades M et al. Dermatol Surg. 2023;49(7):682–688. 7. Sachdeva S. Indian J Dermatol Venereol Leprol. 2009;75(1):93–96. Adverse events should be reported. UK reporting forms and information can be found at https://yellowcard.mhra.gov.uk or via the MHRA Yellow Card app, available at Google Play or Apple App stores. Adverse events should also be reported to AbbVie on ProductSurveillance_EAME@allergan.com. UK-SKV-250225 | November 2025

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