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Our reception/shop is ready to open!

Open afternoon to be held on Friday 1st April between 3pm and 6pm.

As some of you will know, we have been working really hard over the past couple of months to set up a welcoming reception area for our patients. As our ideas have evolved we have also decided to get some local small business people to stock the area with their hand crafted goods.

So from Friday you will be able to buy from a small range of crafts, skincare, crystals and candles. These products are already much loved by myself and I am honoured that the business owners have decided to sell their products through us. Available will be:

* T.H.E Skincare from The Happiness Emporium
* Sea glass art by Seaglass Cottage
* Crystals and metaphysical items from The Spiritual Worker
* Scented candles, wax melts and diffusers from Divine Candle Company

On Friday 1st April we will be holding an open afternoon with wine, nibbles and freebies for visitors and an opportunity to meet the people who have created these wonderful products. 

We hope you can join us on Friday, but if not we look forward to seeing you soon.

Best wishes,
Helen x

What’s new in 2022!

Happy belated New Year!


As you may remember, we became CQC registered at the end of last year. This means that I can take the clinic from offering exclusively cosmetic treatments, to offering medical treatments as well.

So what’s new?

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First off, we have the wonderful Sarah Appleton joining us to offer ear irrigation services. 

Sarah is an NMC registered Nurse with over 30 years experience. More recently she has been working in General Practice and at the vaccination centres. She is fully qualified in ear irrigation and has a wealth of experience and knowledge on the subject.

Ear irrigation (or syringing) used to be offered in General Practice, but this NHS service stopped when the funding was withdrawn. It is often recommended prior to having hearing tests and hearing aid fittings, and it is also used when there is a large stubborn build up of wax in the ear.

This service with take place on Wednesdays in our CQC registered clinic in Frinton on Sea and costs £80.

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I will be starting Rosacea clinics, where you can get individual support and treatment for any problems you may be having with Rosacea.

Rosacea is one of those conditions that is often ignored, suffered or mistaken for acne. Whilst there is no cure, a thorough assessment and excellent management plan can keep any signs and symptoms under control.

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Following on from this, I am offering an Acne management clinic for all ages. 

90% of teens suffer from acne and I believe that it is generally poorly managed. From my experience in General Practice I have found that there is little understanding from patients and clinicians alike on the best methods of treatment and maintenance. 

For this reason I’m really excited to be offering this service so that I can help people who have slipped through the net.

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Finally, I’ll be training in thread vein treatment and I’m requesting some models to have sclerotherpay at half the price of usual treatment.

This will be really useful for me to be able to market the treatment and show how it works. If you know anyone, or you yourself may be interested drop me a message.And I have one request. You have all been amazing at filling in your Pabau review forms, but I would be very very appreciative if you could each leave me one Google review.

Keeping the business at the top of the search engine and providing Google reviews will be essential for our growth and continuation over the coming year. It would mean so much to me.

Thank you again for all of your continued support. I am so grateful.

Best wishes,

Helen

We are CQC registered!

Hello to my lovely patients, and thank you for your continued support. As we are coming up to Happy Face Aesthetics 3rd birthday I am delighted to announce that I am now registered as a provider with the Care Quality Comission.

I have been working very hard on countless policies, risk assessments and service improvement measures to ensure that the clinic is as safe, effective, caring, responsive and well led. After a long interview and an inspection I am so proud that I am registered.

For you this means that you can rest assured that you are being cared for to a high standard and that I will be inspected and graded accordingly. For the clinic it means that I can diagnose and treat people for certain medical conditions within the scope of the clinic services. In the future I am hoping to extend my registration to incorporate minor surgery activities and diversify the clinic practice.

I would like to end by thanking you again for being marvellous. I am so fortunate to serve such a wonderful population of people, and I hope you will continue to join me as we look forward to an even brighter future.

Best wishes,
Helen x

When lip fillers go wrong!

You may have seen a few a weeks ago that I posted some content about an 18-year-old woman who I saw as an emergency after she had lip fillers. This patient has been very brave and has allowed me to share her story as a lesson to others and as a learning point for myself and other practitioners. The following account is based on the patients’ and my experience of treating her.

I had scheduled a weekend off to prepare Ena for school, and we were both mooching around the house in our pjs. I received a phone call from an anxious mum who told me her daughter (who we will call K) had spent the night in A&E after having lip fillers with another practitioner. A&E could only give her antihistamines. She told me that they had contacted the original practitioner who, K tells me, told her that her swelling, and pain was normal. They also told me they had contacted various other practitioners who advised that she be seen by the original practitioner or someone who is a registered healthcare professional.

I asked mum to get K to send me some pictures. What I saw was some very swollen lips with a dusky looking area at the right Glogau-Klein point (GKP). I could see that K needed to be reviewed quickly and dragged my behind out of the house.

I met K, who is a lovely, articulate, and beautiful 18-year-old. Her mum joined us soon after to support her. I took a detailed history, here is some of what she told me:

  • She had found the practitioner through social media and liked her work and appearance.
  • The practitioner was a non-healthcare professional and worked in a local salon as well as offering injections in her own home.
  • The patient went to the practitioners’ home and paid £100 for 1ml of injectable dermal filler.
  • K said that the treatment was very painful and continued to be painful for the whole day and night.
  • Her lips swelled to the point that she couldn’t close her mouth, eat, or drink.
  • K says that she contacted the practitioner who told her there was nothing to worry about.
  • She eventually went to A&E and was discharged in the morning with some antihistamines.
  • Her mum spent the morning calling other practitioners who were not available to see the patient or were too far away. One Harley Street doctor advised that K be seen immediately.

I then performed a physical examination that included feeling for lumps and checking blood flow. I could feel two large masses of filler in the top lip and one large mass in the bottom lip. Blood flow was appropriate in most of the lip, but blood return to the GKP and surrounding area slow and sluggish. On the inside of this part of the lip there was a large haematoma with an area that looked macerated, and I could not discern if this was caused by trauma created by the lip rubbing on the teeth or by small blisters (often present with vascular occlusion).

After a discussion with K and her mum, I felt it was appropriate to dissolve the filler as an emergency. I believed that that K had a compression occlusion, whereby the filler was squeezing the artery so that blood and oxygen could not perfuse an area of tissue. Without an ultrasound it was difficult to determine what kind of occlusion it was, but I felt the risk of not dissolving immediately outweighed the risk of dissolving. Also, K was still in pain, and that itself was a good reason to dissolve.

We discussed the procedure, the contraindications to using hyalase, went through the consent forms together, took pictures and made a video consent also. It was important for K to understand how Hyalase works by turning the dermal filler from a polymer into a monomer, allowing us to massage out and away. There are also undesirable effects and risks to using hyalase. Hyalase  dissolves your own hyaluronic acid meaning you can have a period of loss of natural volume; it can be sore to have the treatment; there is often bruising associated. However, the most concerning thing is that there is a 1 in 2000 chance of allergic reaction to hyalase. Like anything in medicine, treatments are rarely simple, so in case of anaphylaxis I had my emergency adrenaline ready, and my emergency protocol open on my desk.

K had no prior history of any allergy and as this was an emergency treatment, we did not perform a skin test. I reconstituted with lidocaine and injected directly into the mounds of filler starting with the area of concern. Almost immediately to flooding the area massaging, it became pink and well perfused. The hyalase itself caused swelling and bruising, but capillary refill time was less than two seconds, and I was satisfied that we had succeeded. After 30-minute rest and some more pictures, I discharged K with some prophylactic antibiotics and a follow up appointment. We kept in touch for the next few days and K’s lips returned to normal over the next 2 weeks.

What had originally cost K £100 ended up costing her a further £200 for me to dissolve, plus the cost of a private prescription for antibiotics. However, the pain and the time it took K to put her condition right cannot be equated to money.

How can we stop situations like this happening again? It’s true that even the most experienced medical aesthetic practitioner will have complications in their patients resulting from their treatments, but a good practitioner will recognise this and treat it as soon as possible. The government need to define minimum training and practice requirements for all of us and regulate the industry rigorously so that we are 1. Trained to the highest standards; 2. That non healthcare professionals work closely with a prescribing clinician; 3. That those who meet the standards are registered under a governing body. Until then it is up to the patients to be informed enough to decide who they go to for treatment, so here are some red flags for you to look out for.

Red flags:

  • Cheap prices – they are using the cheapest products.
  • Time limited offers on injectables – this is coercive and makes a quick buck
  • Bundle deals on injectables e.g., ‘6ml of filler for a low price’– coercive, enticing you to have treatments you don’t need or want.
  • They treat you in their kitchen or lounge – if they treat you from home, they should have a specific clinic room.
  • Use hashtags on their social media like #medicalaesthetics #nurseinjector #doctor, but you can find no evidence of them ever being registered with the GMC or NMC or any other professional regulator, or they are no longer registered.
  • When you ask to see their medical director or supervisor, they are not available, or things start getting a bit shady.
  • They don’t offer consultations.
  • If they do offer consultations, they do not complete and full medical and facial assessment.
  • If they do not allow you time ask question, they do not tell you risks and do not allow you to read and sign a consent form.
  • If they are not going to be available for the two weeks after your treatment, or they cannot provide contact details for another practitioner e.g., Going on holiday.
  • They can provide no evidence of complications training and do not have a healthcare professional on call to help them deal with complications.
  • They do not have quick access to emergency drugs and do not have protocols to deal with emergencies.
  • They have had 1-2 days training in injectables with no previous medical/nursing experience – a good practitioner will pay to shadow another experienced practitioner and have some mentoring sessions.

It is not the responsibility of other practitioners to fix the problems of our patients. This only happens if you are not qualified to deal with the results of your work, or the patients has lost trust in you for various reasons (for example, you haven’t listened, or you have dismissed their concerns).

It is not the responsibility of the NHS to fix the problems aesthetic practitioners create. The NHS and its’ staff are on their knees. Resources should be saved for patients with actual life limiting health problems. Unless our patients suffer from life threatening complications like anaphylaxis, we should not be burdening the NHS. It is ours and our patients’ responsibility to manage and pay for any undesirable effects.

Furthermore, healthcare professionals who are not trained in medical aesthetics will not have the knowledge or resources to deal with complications from aesthetic injectables. For example, in the case of a vascular occlusion that is affecting a patient’s vision, the practitioner should accompany the patient with their own emergency drugs to the ophthalmologist if they are not trained to deliver retrobulbar injections.

I want to end this by stating that I do not think that all beauty therapist aesthetic practitioners are bad at their job. Equally I do not believe that some medical/nursing aesthetic practitioners practice ethically and safely. I do not think the beauty therapist in this case is to blame for the following events. I do however blame training academies who do not prepare their trainees to deal with adverse events, and I do blame the government for not having regulations and standards in place that protect our patients from all of us (no matter our profession).

Helen Western

Advanced Nurse Practitioner– Independent prescriber – NMC registered – registered nurse – aesthetics – Harley trained – insured – wrinkles – dermal fillers – microneedling – skincare – Frinton – lips – cheeks – marionette lines – nasolabial folds – beauty – Walton on the Naze – Holland on Sea – Clacton – Clacton on Sea – Frinton-On-Sea – Colchester – Harwich – aesthetics – Frinton – fillers – Obagi – skin care – Mole checks – Cryotherapy – moles – skin tags – skin boosters

Lets talk about ‘Pillow Face’!

I love hyaluronic acid dermal fillers, and a modest amount expert placed in one’s face can have a beautiful and rejuvenating effect. What I don’t like is our obsession with trying to look like we did in our 20’s.

This distraction with youth often leads patients and practitioners to keep filling and filling, trying to chase the unobtainable. We have all seen those faces. The ones that are filled to max capacity. They look unnatural and almost disfigured. Now I’m not saying that adding a bit of oomph to your natural features is a bad thing. We just need to know when to stop.

Dermal fillers essentially fill a pocket of tissue to create lift and volume. It seems obvious then that if you keep filling the pocket it will become overstretched and you’re going to lose some. Yes, I said it! The filler will start to spread to places you hadn’t intended it to be. So, lets break down what contributes to pillow face. Starting at the top.

Forehead

Your forehead is covered in very thin layers of tissue, with slight concavity at the temples and gentle angles from the hair line to brow. In this area dermal filler can be used to smooth wrinkles and revolumise the temples. Because we are working with such a small space even a small amount of overfill can result in the loss of natural angles and rounded temples. Whilst the difference may be subtle, that fact that is very slightly odd-looking changes your overall appearance.

Nose

The angle from the forehead to the nose (nasofrontal angle) is an area the is most often filled when patients are hoping to achieve a straight, Eurocentric appearance with dermal fillers. It is very commonly overfilled, taking away that natural angle, creating instead and high and broad angle that quite frankly looks strange.

Cheeks

Cheeks can contribute to pillow face in 2 ways. 1. Overfilling the lateral aspect of the cheeks can create a ledge that throws out the balance of the face. We all want cheek bones and contour, but don’t need to look like Maleficent to get there. 2. As we age the apples of our cheeks flatten out and adding a bit of filler creates a feminine youthful look. It goes wrong when we keep filling. Again, the pockets have limited space so instead of creating definition we end up creating chub.

 Jaw and chin

So, we’re trying to create soft angles, but when we get to the jaw we want a razor sharp line? Don’t get me wrong, I think jaw revolumisation for older patients is transformative. But adding bulk to this area gives me Desperate Dan vibes and means the chin disappears somewhat.  In this case, instead of adding modest volume to the chin to create balance, we need to add much more, creating the typical witches chin that seems popular at the moment.

Honorable mention … Lips

The space in which your lips are housed is very small so when we overfill them the product needs to go somewhere (Russian lips, I’m looking at you!). Over time little bits of filler leak into the surrounding tissue. You may not notice it for a couple of years, but it’s happening. Then all of the sudden you notice that you no longer have lips, but a mound of tissue and dermal filler that starts under your nose.

What can we do to keep looking good without pillow face?

There are options.

1. Don’t do anything. You’re ageing and embracing this is healthy and empowering.

2. Use effective skincare recommended by your practitioner consistently. Healthy glowing skin is the cornerstone of aesthetics and is beautiful whether you have wrinkles or not.

3. Go to practitioner who believes in moderation and can skilfully place small amounts of dermal filler for maximum effect.

4. Consider consulting a plastic surgeon with a good reputation who specialises in natural looking facial surgery.

Whatever you decide to do with your face remember that any plan you embark on should be about self-love and not loathing. If you hate your appearance or are preoccupied by your features it is worth exploring this with a counsellor or therapist, as these are issues that cannot be resolved under the needle.

AND wear your bloody sun protection!

Disclaimer: No hate to those whose desired aesthetic is ‘pillow face’.

Helen Western

Advanced Nurse Practitioner– Independent prescriber – NMC registered – registered nurse – aesthetics – Harley trained – insured – wrinkles – dermal fillers – microneedling – skincare – Frinton – lips – cheeks – marionette lines – nasolabial folds – beauty – Walton on the Naze – Holland on Sea – Clacton – Clacton on Sea – Frinton-On-Sea – Colchester – Harwich – aesthetics – Frinton – fillers – Obagi – skin care – Mole checks – Cryotherapy – moles – skin tags – skin boosters