St John Clinic Newsletter September, October, November 2015

Lady St John of Bletso MBChB MRCOG

Welcome back!

I hope you’ve had a wonderful break this summer. For those of you who are new to the clinic, newsletters are sent electronically to subscribers every 3 months. They always contain an offer and I write about what I think is important regarding the cosmetic medical industry as a whole.This industry continues to grow at a rate of over 10% globally year on year, with non surgical treatments accounting for more than 80% of all procedures. Botox® and fillers continue to lead the way. Rightly so, as with these two treatment modalities almost all of the features of the ageing face can be corrected. It is for this reason that I decided to concentrate my practice on Botox® and filler treatments, offering a bespoke specialist service to my clients. As many of you will know, I have no hesitation in referring clents to leading practitioners for treatments that I don’t offer- surgical procedures, fat removal, etc.

The major drug companies are realising more and more that “natural is key” and research shows that most of us want to look fresher following treatment, not necessarily substantially younger. What we do not want is to look artificial or “done”.

Galderma, one of the leading companies, have recently chosen Sharon Stone as their ambassador. She’s happy to admit to using dermal fillers and as you know she looks incredible for her age (apparently late fifties), in a very natural way.

I know I’m repeating myself when I say that what I mean by a “filler” is “a reversible, biocompatible clear gel intended to correct the signs of ageing”. Fillers have unfortunately become associated with gross facial disfigurement in a minority of cases. If a treatment is done properly the client simply looks like a fresher version of themselves.

I’ve long been highlighting the skin rejuvenating effects of regular vitamin A cream and more recently of vitamin C serum. Until Christmas I’ll be offering one of the following per client when you attend for Botox® or filler treatment:

a tube of tretinoin half price* (either tretinoin 0.05% 20g for £23 or tretinoin 0.1% 45g for £50)
a vitamin C serum half price (Skinceuticals CE Ferulic 30ml for £55 or Phloretin CF 30ml for £68)

Due to the success of the offer in my last newsletter, namely those of you having tear trough treatment receive a second syringe at heavily discounted price, I’ve decided to continue this offer until Christmas.

For the first time in more than 5 years I’m increasing my Botox® pricing by on average 4.25% for 1, 2 or 3 zones (or less than 1% per year). From 7.9.15 the new pricing will be £200, £285 and £340 for 1, 2 and 3 zones with extra zones remaining the same (£25 for bunny lines, upper lip lines, mouth corners, chin and £100 for masseter, neck).

The Fulham Broadway clinic has been closed temporarily but we are hoping to reopen it and to restart regular clinics shortly. We’ll keep you informed as to progress and apologise for any inconvenience caused in the meantime.

Vitamin A cream and your skin

Special offer – half price tretinoin or vitamin c serum (please see above)

It is quoted that after our twenties we lose 1% of collagen in our skin every year. Collagen production is responsible for dermal thickness and without it our skin thins and becomes inelastic. Add to this the accompanying loss of soft tissue beneath the skin and of bone itself and you can appreciate how this overall loss of plumpness contributes to sagging of the facial skin with age. Women are particularly vulnerable approaching the menopause when declining oestrogen levels exacerbate the decline in collagen production and the increase in collagen degradation.

50 years ago, Vitamin A in the form of tretinoin cream was found to have a beneficial effect on a variety of skin disorders such as acne. More recently it has been scientifically proven to reduce lines and wrinkles by its effects on cell turnover and collagen stimulation. Skin treated with regulator treinoin glows, has an even tone (reduced pigment patches) is refined (smaller pores) and is less wrinkled.

The benefits are related to the length of regular use. At 4 to 6 weeks the skin surface is noticeably improved but it is only with long term use (i.e. 12 months or more) that statistically significant improvement in skin thickness and wrinkling occurs.

The combination of tretinoin with hydroquinone 4% (Obagi blender) is quoted as helping to drive tretinoin into the dermis where it exerts its collagen stimulating effects, thereby minimising the surface irritation which so often discourages users of tretinoin initially. Like many other aesthetic doctors, I encourage use of 4% hydroquinone limited to a few months at a time despite the fact that this product is FDA approved.

I advise small amounts of these two products at night two or three times per week initially until tolerance is achieved when the dose can be increased.

* Please note the importance of regular use of a good sunscreen as your skin will be more photosensitive while using tretinoin. Not to be used during pregnancy or while breastfeeding.

Special offer for fillers to the tear trough and upper cheek.

Tear trough treatment £500 Second syringe to cheek/nasolabial lines £200 (instead of £350) Offer ends at Christmas. I’ve decided to continue to offer a discounted second syringe to this area of the face as highlighted in my previous newsletter. In essence, I’m finding that those with under eye shadows/hollowing benefit from not just treating this area directly but from a further syringe in the upper cheek, effectively providing layered support to the mid face. Everyone’s needs are different and sometimes I use a little of this second syringe to correct a frown furrow or nasolabial lines at the same time. My overall aim is to make you look fresh and natural and the results often last for a year.

Botox® – new pricing from 7.9.15

I’m generally averse to price increases and keep my pricing as competitive as possible. My last price increase for Botox® was more than 5 years ago but at the same time I set up the loyalty scheme (regular clients were rewarded by an average price reduction of 20%) There is no actual joining process for the loyalty discount. You will simply receive a free treatment according to the dates of your previous four treatments.

The loyalty scheme will continue in that clients repeating treatments at 4 monthly intervals will receive a fifth treatment free.
The new price you will pay is as follows:
one zone £200 ( average for loyalty clients £160)
two zones £285 ( average for loyalty clients £228)
three zones £340 ( average for loyalty clients £272)

Extra zones will not increase – nasal bunny lines, vertical lip lines, mouth corners, chin £25
– masseter (slims lower face) neck “nefertiti lift” £100

Forthcoming clinics

Bath
Bath : Sept 5/6, Sept 27th, Oct 24/25, Nov 21/22, Dec 12/13, Jan 9/10, Feb 13/14

Scotland
Glasgow/Edinburgh EH5 : Jan 16th, Feb 6th, Mar 19th, Apr 23rd, May 21st, Jun 11th
Edinburgh EH13/Aberdeen : Jan 17th, Feb 7th, Mar 20th, Apr 24th, May 22nd, Jun 12th

That’s all for now and I look forward to seeing you at one of the St John Clinics soon.

With all best wishes,

Lady St John of Bletso MBChB MRCOG