Skin Integrity Blog

Independent Botox Information

Sat, 05 May 2012 02:51:00 GMT

As a doctor, I always try to base my research on independent, peer reviewed evidence. It is amazing how often conflicts of interest appear in research with the vast majority of drug trials being sponsored by the companies that manufacture these drugs. Even doctors giving presentations at conferences are often sponsored by drug companies.

As consumers, I would advise seeking advice from independent sources. Any doctor or clinic that is offering a cosmetic treatment and advertises that treatment has a potential conflict of interest and may present incomplete or biased information. There is always a balancing act between ethical responsibilities and professional standards and business interests.

Independent information is often difficult to find. I have located some independent information about botox injections on the following site:

http://www.mydr.com.au/skin-hair/botox-injections

Penthrox Pain Relief Now Available

Sat, 07 Apr 2012 07:40:00 GMT

Skin Integrity is pleased to announce that Penthrox is now available to assist with pain relief during cosmetic procedures. Penthrox is an inhaled analgesic (similar to happy gas) that can make procedures such as dermal fillers, anti-wrinkle injections, chemical peels and photodynamic therapy considerably more comfortable.

Penthrox is a hand held device that has been used in Australia for more than thirty years and is often used by ambulances. It provides strong pain relief. The client is in control of the device, therefore feeling more comfortable. Penthrox is safe and can be used in most situations.

Penthrox has a rapid onset of action and is short lasting. After a short period of observation (generally around 30 minutes) most clients are able to drive home. Understandably, many clients are anxious about needles or pain during procedures. Penthrox is an excellent option to help these clients tolerate their procedure. Other modalities used at Skin Integrity for pain relief include ice, local anaesthetic cream and nerve blocks.

The cost of Penthrox is $50 in addition to the procedure cost. It can only be administered under medical supervision.

Is There a Doctor in the House?

Wed, 28 Mar 2012 06:51:00 GMT

Despite its increasing popularity, it is important to realise that Cosmetic Injections such as botox and dermal fillers are medical procedures. In addition, the products used are prescription only and can only be prescribed by a Registered Medical Practioner. Therefore, it is illegal for these products to be administered by a Nurse or any other person unless the injector is being supervised by a doctor.

Availability for follow up following any Medical procedure including Cosmetic injections is also important. As with any Medical procedure, Cosmetic Injections can have adverse reactions and side-effects. It is essential that the treating doctor be available to address any concerns following your treatment, preferably by face to face consultation. By operating at one location on the Central Coast, Dr Stephen Wassall from Skin Integrity is able to offer the highest level of Medical care and follow up.

Skin Integrity is a properly equipped Medical Clinic. It has been purpose designed to ensure that all treatments are given in an appropriate Medical environment. Medical standards and procedures such as patient confidentiality are strictly adhered to.

Be aware that some practitioners working out of Beauty or Hairdressing Salons are describing these as "Clinics". In Dr Wassall's opinion, this is potentially misleading.

For more information on delegation of Cosmetic injections please click here.

The Ultimate Celebrity Beauty Secret!

Thu, 12 Jan 2012 07:42:00 GMT

Skin Integrity has just become aware of the best kept beauty secret ever! We now know what keeps those Hollywood stars looking amazing. Watch the video below to reveal the secret. This video is only recommended for those people with a sense of humour ............

Fotoshop by Adobé from Jesse Rosten on Vimeo.

Skin Integrity awarded Platinum Plus Status

Sun, 08 Apr 2012 02:50:00 GMT

Skin Integrity is pleased to be classified as a Platinum Plus Injecting Clinic. This status is awarded by Allergan, the manufacturer of botox. The Platinum Plus status is awarded based on the amount of botox used over the preceeding three months. It is an achievement that Skin Integrity is very proud of, particularly as Dr Wassall is the only doctor injecting at the clinic.

Platinum Plus status is a further reassurance that your cosmetic injections are being performed by a very eperienced practitioner. Dr Wassall started performing cosmetic procedures in 2002 and has performed thousands of procedures. Despite his experience, he maintains a very competitive pricing structure. Furthermore, Platinum Plus status guarantees that the botox used is fresh, giving the best opportunity for optimal outcomes. By being based at one location on the Central Coast and not travelling to multiple sites the potential problem of product dergredation is also avoided.

What's New on You?

Mon, 28 Nov 2011 02:58:00 GMT

Total Body Photography has emerged as the single most useful tool for early detection of melanoma in high risk individuals. If detected early enough, melanoma is 100% curable. Once a melanoma has spread to other parts of the body the cure rate falls to below 50%.

For more information click here.

Medical Microdermabrasion Now Available

Thu, 10 Nov 2011 00:34:00 GMT

The combination of Microdermabrasion followed by Sonophoresis delivers healthy, radiant looking skin and is called Microplus. It is an effective treatment for:

Fine lines and wrinkles
Acne, blackheads and congestion
Pigmentation
Rejuvenation of dull, tired skin
Open pores

Skin Integrity is currently offering an introductory 30 minute treatment for $75.

For more information click here:

Why Choose Dr Wassall?

Sun, 08 Apr 2012 02:56:00 GMT

Dr Stephen Wassall was born on the New South Wales Central Coast. He continues to work and live on the Central Coast and is actively involved with the local community. As he lives locally, he is available to attend to your needs in the unlikely event of a complication or side-effect. He is always contactable by telephone.

Some practitioners travel from other destinations to perform treatments on the Central Coast. They will usually offer services at Beauty Salons or even hairdressers. Some medical cosmetic treatments consist of the administration of a relatively fragile purified protein. The integrity of this protein can suffer if it is not stored at a certain temperature or it is subject to movement. Always ensure that your practitioner is using fresh, non-reconstituted product for each site they are performing procedures, particularly if they have travelled long distances.

Dr Wassall has been performing Medical Cosmetic Procedures on the Central Coast for 10 years. He is highly experienced and has performed thousands of procedures. Despite this, he offers a very competitive pricing structure. Clients that purchase larger volumes of product can save more. There are practitioners that are considerably less experienced charging considerably more for the same products. Dr Wassall offers complimentary, no obligation consultations and price quotations.

Dr Wassall is committed to ethics, integrity and professionalism. He will not compromise his medical standards for profit. He often declines to perform procedures he does not believe are in the best interests of his clients. For further information on Dr Wassall's education and training click here.

MoleMax vs Digital Camera

Thu, 10 Nov 2011 02:31:00 GMT

Dr Wassall was the first doctor on the New South Wales Central Coast to use a MoleMax machine. This device is designed to take a digital image of a suspicious mole to allow monitoring for future changes which may indicate that it is a melanoma. Dr Wassall used this machine as the workhorse of his Skin Cancer Practice from 1998 until 2006. Due to advances in technology, Dr Wassall no longer uses the MoleMax camera but rather uses a digital camera attached to a dermatoscope to take photographs of suspicious moles.

A lot of patients ask him why he has changed his method. Look at the photographs below and the answer should be apparent.

Dr Wassall has taken a photograph of a melanoma using the two systems. The first photograph is taken with the MoleMax camera and the second one with a digital camera attached to a dermatoscope. It is obvious that the digital camera image is much clearer with more colours and features visible. These photographs had to be reduced in size for publication on the internet. When these photographs are looked at next to each other at full size the difference in quality is even more apparent. Some of the features that identify this lesion as a melanoma are not visible on the MoleMax photograph.

It is more time consuming to photograph and store images using a digital camera as opposed to a MoleMax machine. However, Dr Wassall believes the extra time and effort is justified when the differences in image quality are so significant. It is also for this reason that Dr Wassall uses hand held dermatoscopes for his examination rather than the MoleMax machine. He believes that the features visible with the MoleMax machine are often not sufficient to allow a precise diagnosis in many circumstances. His opinion is that the MoleMax machine is still a useful tool for monitoring moles for change but is not the best tool available for initial diagnosis.

For more photographs taken with a digital camera attached to a dermatoscope, please go to the Image Gallery.

Mediskin Clinic to become Skin Integrity!

Thu, 03 Nov 2011 12:53:00 GMT

As many of you may be aware I recently resigned as a partner of Terrigal Medical Centre. From July Mediskin Clinic will be renamed Skin Integrity and I will be responsible for running the business. It will operate exclusively as a Skin Cancer and Cosmetic Medicine Clinic.

I wish to offer a premium Skin Cancer service and will be expanding the range of services available. Total Body Photography has been proven to be an invaluable tool in the early detection of melanoma in high risk individuals. I will installing a high quality photography studio to offer this service to new and existing patients. I have also recently invested in equipment to perform a procedure known as Photdynamic Therapy. Photodynamic Therapy is a light based treatment used to eliminate certain precancerous spots and superficial skin cancers. It gives excellent cosmetic results and is considered the gold standard treatment for skin cancers in certain circumstances. This system complements the array of treatment options I already offer to ensure each patient is given the optimum treatment for their particular condition. I will also be setting up a dedicated Operating Theatre with modern sterilising and surgical equipment. We are also hoping to offer twilight sedation and will be able to perform more complex surgical procedures onsite than is currently possible. We will continue to use digital monitoring of suspicious moles but with higher resolution cameras and monitors.

I will be employing Registered Nurses and investing in their ongoing education in Skin Cancer Medicine. They will be able to assist me in offering the highest standard of care. I have completed a Masters Degree in Primary Care Skin Cancer Medicine and I am hoping to continue my education by undertaking Diplomas and Degrees with the University of Graz in Austria. The Skin Cancer training available at this facility is highly regarded internationally.

New computers and software will be installed to streamline the appointment process. SMS and email reminders will be available for appointments and follow up. We are hopeful of reducing waiting times for appointments and improving access to care. We will also be liasing more closely with your usual GP to ensure they are informed of significant findings.

The aim of Skin Integrity is to offer the highest quality Primary Care Skin Cancer service possible. Service and treatments will be personalised and optimised for each individual. As you can imagine, the costs involved in setting up and running a premium service of this nature are considerable. Unfortunately the Medicare rebate from the Government is insufficient to subsidise this level of service and facilities. As a result, there will be a modest increase in fees for skin checks and procedures performed in the Operating Theatre. Discounts are available for Pensioners and Children under 16 but bulk billing will generally be unavailable. I understand that some individuals suffer genuine financial hardship and I am always happy to discuss individual circumstances to ensure patients are not denied access to care.

Skin Integrity will offer a more comprehensive range of diagnostic and treatment services than any other Primary Care Skin Cancer facility on the Central Coast.

Nurses Illegally Injecting Botox

Thu, 03 Nov 2011 12:54:00 GMT

Below is a reprint of an article that appeared in the Daily Telegraph on 10th July, 2009. I believe that there are some excellent nurse injectors but I believe it is important to be transparent and honest about who will be performing the procedure from the outset. Dr Wassall performs all injectable treatments personally and never delegates this task. As with everything, the buyer must beware!

Nurses illegally inject botox with doctors supervising claim
by Kim Christian

NURSES are illegally injecting botox after recruiting doctors to supervise the procedures, cosmetic physicians say.

The Cosmetic Physicians Association of Australia (CPSA) says it's aware of doctors prescribing S4 medicines such as botulinum toxin, or botox, enabling nurses to administer unsupervised treatments.

In a bid to stamp out the practice, the CPSA has taken the unusual step of criticising fellow doctors and nurses.

CPSA president Gabrielle Caswell said the organisation was aware of "a couple of dozen" doctors who were illegally prescribing medicines to nurses to carry out "volumizer" treatment.

"We find it very inappropriate that there are doctors that are doing this inappropriate act and that's why we've basically decided that we want to stop the practice," Dr Caswell said.

There were more than two cases of nurses being investigated by medical authorities, she said.

A doctor has to complete a full medical history and examination before administering filler treatment such as botox, she said.

Dr Caswell said it was illegal and against medical board guidelines for nurses to administer botox treatments without a doctor's supervision.

However, she said there were cases of nurses holding botox parties and travelling interstate to carry out the treatments.

"We are aware of nurses attempting to encourage doctors, who may or may not be experienced in cosmetic medicine, to provide the order for unsupervised administration of injectable medications without the doctors having any access to the patients," she said.

"The nurses are seeking doctors to perform this task as they are unable to access the medicines themselves."

The CPSA has written to nurses boards, medical boards and state health departments to draw public attention to the issue.

"Maybe things that have become habitual have to be sometimes pulled into line," she said.

Excess Underarm Sweat

Sat, 05 Nov 2011 05:25:00 GMT

Excessive underarm sweating is a problem that affects many adults. It can lead to stained and ruined clothes, embarrassment and social withdrawal. Sufferers may not be able to follow their chosen career due to an inability to comfortably wear a particular colour or type of uniform. If sweating is significantly interfering with your daily activities and over the counter agents have been ineffective, you may be a candidate for treatment with an injectable medicine. Management of excess hand and foot perspiration is less successful and painful. It is important to see an experienced doctor to discuss products and all treatment options. Management of excess hand and foot perspiration is less successful, painful and more expensive.

The injectable medication used is also product for facial cosmetic procedures. In the treatment of excess perspiration it works by blocking the release of a substance, which activates the sweat glands. The effects of the treatment are usually apparent within a week of treatment and generally control excess perspiration for nine to twelve months.

Excess perspiration treatment usually takes 30 minutes and there is no specific aftercare required. Unfortunately, the cost of treatment for is not covered by Medicare but may be partially claimable from your Health Fund. Dr Wassall offers this treatment for $950 which is significantly less than most other practitioners.

For more information please contact us.

What is a Cosmetic Physician?

Sat, 05 Nov 2011 05:25:00 GMT

Cosmetic Physician is a title commonly used to describe a Medical Practitioner that provides one or more non-surgical medical procedures designed to augment or enhance their patient's appearance. Procedures performed include anti-wrinkle injections, dermal fillers, chemical peels, laser and IPL therapy, cosmetic mole removal, acne treatments, leg and facial vein treatments, microdermabrasion and photodynamic therapy.

It is important to realise that the the title Cosmetic Physician is not a recognised specialist qualification. No exam or post-graduate study is required to use this tiltle.  In fact, any registered Medical Practitioner could refer to himself as a Cosmetic Physician. This is potentially somewhat confusing as the tiltle Physician generally refers to a recognised specialist with post-graduate training and qualifications. It is for this reason that I personally use the term Cosmetic Medicine Doctor.

In Australia there is no government recognised post-graduate Cosmetic Medicine or Cosmetic Surgery qualification. There is no officially recognised training or accreditation in any of the procedures.  Training generally is provided by drug companies that produce the products that Cosmetic Doctors use. This is not to say that training is inadequate. In fact, my experience has been that the training and ongoing education provided by these companies is excellent.

There are two groups in Australia that represent doctors paractising non-surgical cosmetic procedures. These are the Australasian Society of Cosmetic Medicine and the Cosmetic Physicians Society of Australasia. No exam needs to be passed to become a Member of either of these Societies (check the websites for further details on Membership). Both these Societies provide educational events and seminars as well as offering more advanced education such as Diplomas and Fellowships.  Whilst I am a supporter of ongoing education it is important to realise that none of these qualifications are recognised by the government as conferring specialist status.

What is the Best Dermal Filler?

Thu, 03 Nov 2011 15:39:00 GMT

I am often asked which dermal filler is the best. The short answer to this is that there isn't one - it is like asking if Coca Cola is better than Pepsi.

In my practice I only use temporary hyaluronic acid fillers. These are by far the most popular type of filler with a proven record of safety and efficacy. There are three brands of hyaluronic acid fillers that I use and each of these brands has several products within the range.

Why do I use so many different products - simply because one product does not fulfil all my requirements. Products come in different sized syringes, some are thicker than others, some are mixed with local anaesthetic etc. Some of the products will stay pretty much where they are injected, whilst others tend to merge into the surrounding tissues. As a result, I prefer certain products in some areas of the face and others in different areas. Some products can be injected close to the surface for superficial wrinkles whilst others are better for deeper folds.

Therefore, I may utilise different products on the same patient. As a patient ages the most suitable filler for them may change (afterall, nobody says you need to drink Coca-Cola all your life!). It is important to match the needs of the patient with the characteristics of the product being used to maximise the patient outcomes and minimise potential problems.

Therefore, my advice is to find a doctor that you feel comfortable communicating with and discuss your requirements with him or her. They should be able to explain which dermal filler they feel is best for you and why.

Skin Cancer Clinics

Sat, 05 Nov 2011 05:24:00 GMT

There has been considerable media attention lately with regard to Skin Cancer Clinics. Various medical specialists are making statements about whether or not Skin Cancer Clinic doctors are adequately trained to perform skin cancer checks and offer treatments.

Dermatologists have generally been critical of Skin Cancer Clinics and suggested that only dermatologists or GPs should perform these checks. However, the majority of doctors in Skin Cancer Clinics are GPs! There is also no possibility that dermatologists could cope with the influx of extra patients if they performed these checks. It often already takes several months to see one.

There does seem to be an element of "turf protection" from the dermatologists but they do raise valid points regarding safety and appropriate training. The Cancer Council of NSW has produced a guide to Skin Cancer Clinics. This is presented in an unbiased manner and makes some good suggestions. Please visit www.cancercouncil.com.au/editorial.asp?pageid=1339.