Author: Michelle Dodd

IMPORTANT TGA UPDATE

Posted on by Michelle Dodd

On 7 March, 2024, that the Therapeutic Goods Administration (TGA) changed the advertising guidelines around cosmetic medicine in Australia.

Previously, the TGA gave cosmetic injectors indirect terms (“anti-wrinkle injections” and “dermal fillers”) we could use to refer to the prescription-only medications that are used in non-surgical cosmetic medicine, as direct references such as brand names and ingredient names of prescription-only medication are not permitted and are against the law. The TGA have made the decision to no longer permit these indirect terms – “anti-wrinkle injections” and “dermal fillers”. The TGA state that advertisement of the use and supply of a prescription-only medication have never been compliant with the therapeutic goods framework. This means we can no longer advertise price lists, before and after photos, testimonials about the products, claims about the medications, and give any public information about prescription-only medications.

As a result of these changes, patients can no longer self-select what prescription-only medications they wish to have in booking systems. The TGA state that the decision for a patient to be prescribed a medication is at the discretion of the practitioner. This means the names of the bookings on the booking system have had to change to a “general” consultation for wrinkle reduction, or volume loss.

The TGA also consider business names to be an advertisement and the use of “injections” in a business name is non-compliant. Therefore, I have had to change my business name to “MD Cosmetic Nurse”. The TGA stated the reason for these changes are the below: “The update aligns with the focus of other regulators on health professionals performing non-surgical cosmetic procedures and acknowledges the increasing vulnerability of Australians influenced by advertising in the cosmetic space. Prescription only medications carry higher risks than goods available for self-selection. Decisions about treatments that involve the use of prescription medicines should only be made by a health professional in consultation with each individual patient”.

Although I have had to make all of these changes – removal of all information about treatments, before and after photos, and price lists on my website and social media platforms, please be assured I am still performing consultations for the same treatments she has provided for over the past 10.5 years. Now, any information about treatments, pricing and showcasing of before and after photos can only, legally, be given to you during a consultation with myself. Please understand that reception staff cannot give out any information, so please do not get frustrated at them, as they are simply abiding by the law and doing their job. If you have any confusion with bookings, due to the new legal requirements, please contact me and I will help guide you, but please understand no information can be given outside of a consultation. I appreciate your understanding whilst we all adapt to the new changes.

What happens to the jaw bone when we age?

Posted on by Michelle Dodd

As we age, our bones naturally lose density and strength. This is a normal part of the aging process and is called bone resorption. Bone resorption is a process by which old bone is broken down and removed by cells called osteoclasts. This is followed by the formation of new bone by cells called osteoblasts. However, as we age, the rate of bone resorption increases and the rate of bone formation decreases. This imbalance leads to a loss of bone mass and strength. The jaw bone (mandible) is no exception to this process. As we age, the jaw bone can lose density and strength.

In a study comparing CT scans of a young and aged skull (pictured above), the aged skull showed the eye socket widens and lengthens, and the nose, brow and upper jaw all showed a decrease in angles. The lower jaw also decreased in length and height. You can see in the image that the jaw starts to turn into an italic “i”, when once was an “L” shape at the angle of the jaw.

In the study, they analysed CT scans of skulls in people between 20-40 years old, middle-aged people between 31 and 64, and mature people aged over 65. The same bone changes happened in both males and females, but young to middle aged females experienced bone changes earlier than men did at middle to older age.

Bone resorption means the skin, muscle and fat pads don’t have the support structure they once had and this is when the skin can show visible signs of hollowing and sagging.

Image credit: Howard Langstein/University of Rochester Medical Center.

4 Causes of under eye dark circles and treatment options

Posted on by Michelle Dodd

In order to get a result with your dark circle concern, the right diagnosis must be made of what is actually causing them. Not all dark circles can just be treated with one treatment modality

In a study on what causes, and treatment for infraorbital dark circles, the authors concluded 4 things, which may be one, more, or all of the below:

1. Hyperpigmentation. Excessive pigment under the eyes, especially pigment under bulging oribital fat pads, cause a shadowing effect, giving the appearance of dark circles. I get so many Fitzpatrick skin type IV, V and VI patients present to me concerned with darkness under their eyes, but 9/10 the cause is pigmentation and injectables cannot help with this. Depending on the skin type, the authors suggest depigmenting agents, peels and lasers.

2. Thin, translucent skin can cause the vascular structures to be visible under the eyes from the subcutaneous vascular plexus, or vascular structures within the obicularis oculi muscle. The authors stated that injection of fat under the skin and above the muscle could act as a shield to prevent visible vascular structures within the muscle.

3. Skin laxity causing shadowing. Over time, we lose collagen and elastin during the aging process and UV damage causes collagenases, further contributing to aging. The authors suggested ablative and non-ablative lasers (CO2) to help address skin laxity.

4. Orbital fat loss causing a tear trough. Due to the aging process, subcutaneous fat loss, thinning of the skin over the ligament creates hollowness under the eyes. Pseudohernination of the fat pad under the eye accentuate dark circles.

DOI: 10.1111/j.1524-4725.2009.01213.x