Cosmetic Clinics

Dr Joshua Berkowitz opened the Wimpole Aesthetics Centre way back on 2005, on Wimpole Street in Central London. During the time the clinic and he were taking those first steps, he had only one member of staff supporting him.

In only two years these numbers had swelled to four skilled aestheticians to support him, who brought a wide range of skills and knowledge with them. Along with this was the fact that Dr Berkowitz ensured the clinic utilised the most up to date technology and equipment to provide the best possible results for his patients, and to keep them at the cutting edge of their range of cosmetic procedures and anti-ageing treatments.

Today, Dr Berkowitz attributes the success of the Wimpole Aesthetics Centre to this collection of skills, knowledge and technology along with the passion his dedicate team have for their work and the extra special care that each individual patient receives. Patient privacy, dignity and confidentiality are always respected. Each individual will always be welcome and valued as our patient and treated accordingly with courtesy and consideration.

The philosophy followed at the Wimpole Aesthetics Centre is that each patient receives safe, proven and high quality therapies that are tailored to meet the individual’s requirements and aspirations. We aim to be innovative and to only use fully-tested, non-surgical rejuvenation and anti-aging treatments to achieve excellent results for each patient.

Wimpole Aesthetics Centre also believes in ensuring the patients are aware of the limitations of any procedures, along with the benefits, we use and that not every procedure may be utilised by everyone. In this regard we make sure patients are fully aware of what procedures and treatments are right for them, will provide the best benefits and what results can be expected during consultations before any course of treatment is decide upon. This realistic, frank and honest assessments of patients conditions and what can be expected from any procedure, and if these fit with the client’s expectations so any unnecessary disappointment is avoided.

At the Wimpole Aesthetic Centre we are realise and are aware that patients vary greatly and may require several different rejuvenation therapies and aesthetic treatments to achieve the goals they desire, to this end we are able to offer a wide range of treatments; performed by various members of our aesthetic team. Generally, the same therapist will perform a course of treatments in order to have continuity and help build up trust and respect between the therapist and patient.

All our therapists are fully trained to use our equipment and products and we ensure our range of technical skills is kept up to date. In support of our own personal knowledge and skill base, our therapists and aestheticians regularly attends lectures and conferences to further increase our knowledge. It is through this continually updating of our skills that we can confidently offer out treatments and the superior results that come with them.

Some of the treatments available from the Wimpole Aesthetics Centre include:

- Vaser Lipo (State of art non-surgical Liposuction)
- Smart Lipo (For the removal of smaller deposits of fat)
- Thermage (Skin Tightening)
- Laser Hair Removal
- Microdermabrasion
- Chemical Peels
- Botox Treatments
- Sculptra
- Dermal Fillers
- Leg Vein Treatments
- Vela Smooth (Cellulite Treatment)

This are just a few of the anti-ageing and cosmetic procedures we can provide.

Our fees are competitive and we will always give a clear indication of the cost of any treatment,or course of treatments and in some cases we are able to offer payment plans.
We hope this gives you some insight into the Wimpole Aesthetics Centre and will be providing more information on our treatments and staff members soon.

The Wimpole Aesthetics Centre, part of the Cosmetic Clinics Groups, is based in Central London at the following address:

48 Wimpole Street
London
W1G 8SF

Telephone: 0207 224 2247
Fax: 0207 935 2845
Email: drberkowitz@cosmeticclinics.co.uk
Website: www.wimpoleaesthetics.co.uk or www.cosmeticclinics.co.uk

Continuing from our previous article we will discuss the texture changes that can be responsible for dark circles and ways to combat them.

Hollow Eyes
Hollowing under the eyes creates the so called exposed ‘tear trophs’ or ‘tear ducts’ which is a groove running from the inside corner of the eye to the lower part of the eyelid and quite often into the cheek.

This is usually related to the normal ageing process. We loose approximately 5 ml of fat from our face every year and this fat loss is what is to blame for the appearance of deep folds and sagging in the skin as well as hollowing of the cheeks and eyes.

The human face can be likened to a balloon which is well inflated when we are young and our faces are full of “puppy fat” and gradually deflates with age as we loose fat. This process can be greatly accelerated by a rapid weight loss following yo-yo dieting. The skin is often unable to adapt to the rapid change of volume and sags as opposed to recoiling back into the new shape and can lead to premature ageing and increased wrinkles. In younger individuals and also in males, where the skin is thicker and more elastic yo-yo dieting is less risky. However women over 30 yrs should be careful and plan any weight loss over a longer period of time in order to avoid this problem.

Hollow eyes can also be hereditary in which case they are apparent from a very early age (usually 20 -25 yrs). We ask patients to bring photographs of themselves when they were younger and also pictures of their parents. This is useful to determine hereditary factors.

One important cause of premature eye hollowing is following surgery to the lower eye lid (lower blepharoplasty). When the problem is lower eyelid bags many patients resort to surgery which can be effective way of removing the bags. ‘Eye-bags’ are due to protruding fat and therefore removing some fat usually brings an immediate good result. However in the long term this lack of fat together with the natural ageing process can speed up the appearance of hollowing around the eye. There are many techniques for operating on the lower eyelid and some of the older methods involved removing too much fat. Modern techniques used in today’s surgery are more sparing towards the eyelid fat and involve repositioning of the fat rather than removal.

Treatment
The best treatment for correcting hollow eyes is by using a non-permanent dermal filler. My choice when it comes to dermal fillers is stabilised hyaluronic acid. The advantage of using this type product is that the effects can be fully reversed even earlier than the natural absorption of the product, which can be reassuring to the patient.

The dermal filler is placed deep over the bone in order to fill in the groove. The procedure is almost painless and rarely requires an anaesthetic. The success rate is very high ( 80 -90%) and the results can last for over a year. It can however be a dangerous procedure in un-experienced practitioner as it can quickly turn the hollow eyes into baggy eyes if the product is placed incorrectly i.e. too superficial. For this reason always seek out an experianced cosmetician and go ensure you are completely happy with everything discussed with you. If you have any questions, you should always ask them.

Over the next few weeks we will outline the differing reasons or causes for dark cirles under the eyes and what treatments are avialble to combat them, so keep an eye out for Part 3!

by Lucy Glancey

For more information on dark circles, treatments and dermal fillers, visit www.cosmeticclinics.co.uk

Dark circles under the eyes together with cellulite are probably the most commonly talked about aesthetic imperfection. This is partly due to the fact that there is very little one can do to completely eliminate either of them. For both conditions a variety of over the counter creams are sold that promise the world but deliver less than modest results, as many of us who have tried them can confirm. However in the treatment of dark circles new advances in cosmetic medicine, such as laser surgery and dermal fillers, the condition can be improved up to 80 – 90 % (depending on the reason for the dark circles) which is good news for those who have been long suffering.

What are dark circles?
This is the appearance of different colour, texture or a mixture of both on the lower eyelid area. It is far more difficult to treat the so called complex circles where there is a combination of colour difference and textural changes. In our clinic we use grading system for patients with dark circles. There are 4 grades;

Grade 1 – these are very mild and only visible without any make up. They disappear totally when make up or concealer is applied.

Grade 2 – these are visible even with make-up but of moderate severity. A good way to demonstrate grades 1 and 2 better and especially for the purposes of medical photographs is to ask the patient to put their chin down and look up to the ceiling without moving their head. This is important when we take before and after pictures in order to clearly demonstrate the results of the treatment

Grade 3 – these are severe and give the impression of baggy eyes (the so called false or pseudo – eye bags)

Grade 4 – these are the complex dark circles where there is a combination of not only texture but a colour change as well. They require more treatment sessions compared to the other grades.

Over the next few weeks we will outline the differing reasons or causes for dark cirles under the eyes and wat treatments are avialble to combat them, so keep an eye out for Part 2!

by Lucy Glancey

For more information on dark circles, treatments and dermal fillers, visit www.cosmeticclinics.co.uk

The basic methodology behind laser hair removal is that the lights seek out the melanin in the follicle of the hair itself, and then permanently removes the hair. The ideal candidates for laser hair removal will have light skin and dark hair. Common sites to have laser hair removal include, but are not limited to, the following areas: upper lip, chin, shoulders, back, abdomen, pubic area, chest, arms, legs and thighs.

The benefits of laser hair removal are numerous. Instead of the inconvenience of resorting to the temporary means of shaving, or resorting to more painful electrolysis, you can go a mere 5-7 times for Laser treatment and find yourself hair free in a relatively short time. Most dermatologists that offer laser hair removal space out the treatments between 3-12 weeks. This largely depends on your own reactions to the treatment, your skin type, how much hair you are removing, and the removal site.

There are a few other factors to hair removal to consider as well. For example, a person getting their back or legs done would have to go through less sessions than one getting any area on the face treated. Proper research of your dermatologist of choice, as well as the treatment in general is important. Like any other sort of treatments, there are risks. These can range from mild reactions like acne or small white spots on the skin to minimal or heavy swelling.

Most do not experience such adverse reactions, but you should always report any issues you might end up having. All in all, laser hair removal is a fairly painless procedure that leaves you with smooth hairless, bump free skin. All this at a good price, with the advantage of not having to keep a supply of razors and other costly supplies leaves little to no doubt as to the proper choice.

With traditional Follicular Unit Extraction (FUE) grafting, the hairs are pulled out (like a banana being pulled out of its skin from one end) and the grafts may be stripped of their outer root sheath (ORS). If that happens, the hairs may lose the dermal papillae and possibly the bulb as well. The good news is that the growth elements of the mature terminal hair shaft are multifocal (have more than one site controlling the growth) so hair bulbs and dermal papillae cells that may be damaged may still produce full terminal hair, albeit less thick.

The two strongest growth areas of the mature terminal hair include (a) the dermal papillae and (b) the area near the insertion of the tiny muscle attached to the hair in the vicinity of the sebaceous gland. Any damage to the growing hair will produce a weaker and thinner hair. The research to show the damage to a follicular unit stripped of its dermal papillae and its ORS has not been well documented, but the conclusions drawn here are logically based upon the science of hair growth as we know it.

In a landmark study on hair transplant surgery, Dr. Kim, a noted Korean researcher, demonstrated that attempts to cut one hair into two parts to grow more than one hair from parts of a single hair, failed to grow more than one hair. When the (a) transected lower half of the hair was placed in a patient, it often grew a finer, weaker hair and (b) transected upper half of hair was placed in a patient, no hair grew.

Potential issues of using FUE for hair restoration.

• Loss of hairs inside the grafts from amputation/transection of the hairs; i.e. some of the amputated hairs die.

• Stripping of the critical growth centres of the hairs within the graft during the extraction process.

• Loss of the hair bulb or dermal papillae (the dermal papillae, which is located at the very bottom of the hair bulb, is responsible for hair re-growth after hair cycling from the telogen phase into the anagen phase).

• Buried grafts (grafts that are pushed below the skin becoming foreign bodies with potential cyst formation or even abscesses producing possible infections) thus wasting valuable hair resources.

• Necrosis (gangrene) of the donor area in large FUE sessions has been recently reported at the September 2008 ISHRS meeting in Montreal. It is not clear why this has occurred, since so little information on this potential complication has been presented.

For more information on FUE and hair transplant surgery visit www.cosmeticclinics.co.uk to find your nearest hair restoration specialist.

by Dr S R Bassi

The best follicular unit extractions (FUE) come when the entire follicular unit, the bulb with the dermal papillae and the capsule are removed intact and there is no amputation/transection of hairs within the graft.

In theory, the more the follicular unit is stripped of its surrounding tissue, the lower the growth potential. If the outer root sheath (ORS) is not violated and some fat remains below the bulb, one can assume that the follicular unit was removed without damage. If the lower ends of the hairs of the excised follicular unit contain a glistening covering and the bulb is intact, then it can be assumed that the follicular unit came out wholly intact. If the outer root sheath is violated and stripped from its covering, one should expect some negative impact on the growth. This could result in a thinner, less robust hair from one or more of the hair follicles within the extracted follicular unit. In summary, the best preserved follicular unit is one where the ORS is intact, the hairs are covered with a glistening covering, there is fat at the bottom of the bulb where the dermal papilla is located, and there is no amputation/transection of the hairs within the graft.

The follicular unit is surrounded by a capsule that isolates the hairs from the surrounding dermis and fat. This capsule is called the outer root sheath (ORS) and extends to the surface of the skin to produce the pore the hair exists from. When we extract a follicular unit from the scalp using the strip harvesting method, for example, this outer root sheath is included in the graft. All of the vital structures of the follicular unit lie encased in this ORS.

At the bottom of the bulb of the hair, lies a structure called the dermal papillae (DP). The hair bulb looks like a catcher's mitt from the bottom, and the DP is the ball inside the mitt. The DP contains the master switch that controls the hair growth genetically. Cells inside the DP express the genetics that initiates the hair growth process and is integrally involved in the various stages of the hair cycle. In the photo below (at right), we see two hairs, one fully developed (terminal) hair and one small hair that is growing out of its telogen (resting) phase into its anagen (growth) phase, evolving into a mature terminal hair.

Note that the telogen hair produces a finer hair while the hair is growing. This hair will get thicker as the hair matures into its 'terminal' status. The bulb at the bottom of the telogen hair stands out prominently as it does in the mature terminal hair but the DP cannot be seen without special stains or equipment.

More information on FUE will follow in further articles, alternately visit www.cosmeticclinics.co.uk to find your nearest hair restoration specialist.

by Dr S R Bassi

There are several advantages of FUE (Follicular Unit Extraction). With moderately sized procedures, it leaves virtually imperceptible punctuate scars in the donor area once healed. During the post operative period, there are only a few limitations placed upon the patient for the first week or so. Patients rarely report any donor area pain from the excision area. The donor area can be washed as vigorously as necessary to obtain a clean wound. Hair grows out from the donor area fairly quickly so by one week after an FUE procedure most donor wounds will be covered by a short beard-like growth of the hair making the donor excisions nearly undetectable.

The FUE hair transplant surgery technique is difficult and tedious to perform on the part of the physician and staff. FUE is not for everyone and it takes a skilled, trained doctor to differentiate who is a candidate for this hair transplant procedure and who is not. Over the years, more and more doctors began offering the procedure, but few have shown real expertise in this field. At the onset, patient successes were few and many were highly suspect. Widespread failures of FUE were not uncommon. As difficult as it was for the doctor to master the FUE surgery, it was equally difficult for the patient to comprehend what FUE procedures could and could not accomplish.

FUE is a minimally invasive, precise, technically demanding hair transplant surgery procedure that is influenced by the technical skills of the doctors, and is hindered by the absence of uniform surgical tools. Transection rates should be tracked and you should ask to see that documentation at the end of your procedure. Finally, to be sure you procedure will go as planned; the doctor's technique must be replicable from one patient to another.

More information on FUE will follow in further articles, alternately visit www.cosmeticclinics.co.uk to find your nearest hair restoration specialist.

by Dr S R Bassi

In late July, there was something of a Vaser Lipo master class held at Selston Cosmetic Clinic in Nottinghamshire.

Hosted by Selston's resident cosmetic doctor, Dr Sashi Bassi, the master class was attended by several other members of the Cosmetic Clinics Group, all experts in Vaser Lipo techniques and national trainers for Vaser Lipo in the UK.

Along with Dr Bassi the attendees included Dr Kam Singh of Beau Aesthetica Spa & Clinic (Leicester), Dr Joshua Berkowitz of The Wimpole Aesthetics Centre (London) and Dr Bhavesh Bodalia of The Gables Medicentre (Coventry). Each doctor has many years of experience in cosmetic and aesthetic procedures and treatments and were the first to use Vaser as a new method of liposuction.

Having such a gathering of expertise was quite a boon and this combined knowledge was to be utilised on 3 different patients’ inner thigh and knee areas. Obviously each patient was unique and the doctors debated their preferred approaches and techniques to the areas undergoing the Vaser Lipo procedure. It is interesting to see the little differences each doctor has to the same fundamental procedure, and the combination of these led to achieve very satisfying and impressive results for each of the patients involved.

Of course the patients were not the only beneficiaries to the mater class, as each doctor gleaned a few differing styles, techniques and insights into each others years of training and expertise, which in turn added to their own repertoire and skill set.

Vaser Lipo, one of the most advanced and beneficial forms of liposuction, is available from several of the clinics in the Cosmetic Clinics Group. For a full list, visit www.cosmeticclinics.co.uk and use the handed treatment & clinic locator to find your nearest clinic offering Vaser Lipo.