The Victorian Cosmetic Institute

Osmosis skin care is now available at The Victorian Cosmetic Institute. Osmosis skin care was founded by Dr. Ben Johnson who states that 'Our philosophy begins with the understanding that aging and most skin condition issues occur primarily in the dermis. Unfortunately, the overwhelming majority of skin care companies target the epidermis instead. Research shows that the average absorption of skin care is 2% no matter what pH is used. This means that 98% of most skin care products remain in the epidermis exfoliating and irritating (which actually ages the skin) and creating a temporary plumping that has fooled us into thinking our skin is healthier when it is not. ' Osmosis uses a liposomal delivery system that allows higher concentrations of its active ingredients to be delivered into the dermis with less irritation.

One of the key ingredients in Osmosis is retinaldehyde. Retinaldehyde has a number of properties that help to promote skin health and reduce aging. Furthermore, it is also effective in the treatment of acne and rosacea.

Retinaldehyde is a topical retinoid that has much less irritancy than other retinoids.
The following are studies of the effect of retinaldehyde on the skin:

STUDY 1
Retinal is very well tolerated.
“Tolerance of Topical Retinaldehyde in Humans”
Sachsenberg, E.M, , Dermatology, 1999;(suppl 1)199:61-63
Key Points of Study
This study showed that Retinal was much better tolerated (than RA) by a majority
of the 357 patients tested.
Unlike retinoic acid’s phototoxicity and inflammation potential, none of the 45
patients tested separately showed any phototoxic effects.
Overall, Retinal had a side effect profile almost as low as the placebo as opposed
to the much higher levels of irritation associated with Retinoic Acid.

STUDY 2
Retinal is the best choice when treating photodamage!
“Efficacy of Topical 0.05% Retinaldehyde in Skin Aging
by Ultrasound and Rheological Techniques”
Diridollou, S., Vienne, M.P., Dermatology, 1999;199(suppl 1):37-41.
Key Point of Study
40 patients were involved in this one year study that demonstrated that
Retinaldehyde significantly increased both the thickness and elasticity of the skin.

Dermatology 1999;199:29-31 (journal) found that Retinaldehyde has been shown to exert antibacterial activity. Propionibacterium acnes, the bacteria that is one of the causes of acne, is reduced with Retinaldehyde.

STUDY 3
Retinal as effective as Retinoic Acid without the irritation!


“Profilometric Evaluation of Photodamage after Retinaldehyde
and Retinoic Acid Treatments”
Creidi, P., Vienne, M.P., J. Am Acad Dermatol, 1998; 39: 960-965.
Key Points of Study
Summary: This study showed that Retinaldehyde was very effective at reducing
facial wrinkles.
Retinaldehyde was as effective as retinoic acid with much fewer side effects in
this double-blind study.

STUDY 4
Retinal shows low irritancy so patient compliance was better.
“Tolerance Profile of Retinol, Retinaldehyde and Retinoic Acid
under Maximized and Long-Term Clinical Conditions”
Fluhr, J.W., Vienne, M.P., Dermatology 1999; 199(suppl 1):57-60
Key Points of Study
Retinaldehyde had a much lower irritancy rate than retinoic acid on the 355
patients involved in this study.
The patients on Retinal were much more compliant and had far fewer side
effects than those on retinoic acid.

STUDY 5
Retinal is a powerful skin remodeler!
“Repair of UVA-Induced Elastic Fiber and Collagen Damage by
0.05% Retinaldehyde Cream in an Ex-Vivo Human Skin Model”
Boisnic, S., Branchet-Gumila, M.C., , Dermatology, 1999; 199(suppl 1):43-48.
Key Point of Study
This study on human skin explants showed that all UVA treated skin had
significant damage of collagen and elastin and ALL of that damage was repaired with
the application of Retinaldehyde 0.05%.


STUDY 6
Retinal is great for wrinkles
“Clinical Use of Topical Retinaldehyde on Photaged Skin”
Creidi, P., Humbert, Ph., Dermatology 1999; 199(suppl 1): 49-52.
Key Points of Study
85 patients with photodamage were treated with 0.05% Retinaldehyde and had an
improvement in coarse and fine wrinkling rated as improving from “moderate” to “slight”.
The 85 patients in the study showed substantial improvement in facial redness and
telagestasias while a majority reported brighter, more radiant skin. This study also showed
improved hydration, reduced oil and roughness in a vast majority of the patients.

STUDY 7
Retinal is great for Rosacea
“Retinaldehyde Alleviates Rosacea”
Vienne, M.P., Ochando, N., Dermatology 1999; 199(suppl 1):53-56.
Key Point of Study
In this 23 person study, 75% of rosacea sufferers had reduced redness and only
one of these sensitive skin types had any side effects (and they were mild).

STUDY 8
Retinal is antibacterial, Retinoic acid is not
“Antibacterial Activity of Retinaldehyde against P. Acnes”
Pechere, M., Pechere, J.C., , Dermatology 1999; 199(suppl 1):29-31.
Key Point of Study
This study showed Retinaldehyde was highly effective at reducing P Acnes
bacteria populations. All-trans retinoic acid does not have a direct antibacterial effect.

STUDY 9
Retinal is great for acne
“Comedolytic Effect of Topical Retinaldehyde in the Rhino Mouse Model”
Fort-Lacoste, L., Verscheure, Y., Dermatology 1999; 199 (suppl 1):33-35.
Key Point of Study
Retinaldehyde had statistically similar comedolytic effect to retinoic acid while
showing less irritation.


STUDY 10
Retinal normalizes VEGF helping hide capillaries
“Effects of Retinoids on Vascular Endothelial Growth Factor Production
by Cultured Human Skin Keratinocytes”
Lachgar, S., Chalveron, M., Dermatology 1999; 199(suppl 1):24-27
Key Points of Study
Retinal regulates VEGF which is increased in a variety of skin conditions.
The normalizing ability of Retinal makes it an excellent choice for actinic
keratosis, telangectasias and rosacea.

STUDY 11
“Metabolism of Retinaldehyde”
Sorg, O., Didierjean, L., Dermatology 1999; 199(Suppl 1): 13-17
Key Points of Study
Retinal is the closest chemical form (of the retinoids) to retinoic acid and is
quickly converted to retinoic acid.
Retinal is stored by the skin for easy access unlike retinoic acid which cannot be
stored and thus becomes a source of irritation.
All-trans retinal is the most potent form.

STUDY 12
Retinal is the best retinoid available
“Topical Natural Retinoids”
Saurat, J.H., Sorg, O., Dermatology 1999; 199(suppl 1):1-2
Key Points of Study
Retinoids have an average of 2% penetration which means that 98% sit on the
surface of the skin causing irritation.
Retinoic Acid cannot be stored by the skin so any excess is a source of irritation.
Retinal is the precursor to retinoic acid and is quickly converted to retinoic acid
in the skin to maximize the stimulation of RA receptors.
Retinal that is not used is stored by the skin for future use.
The preferred form of retinal is all-trans retinal.

In 1983 Tim Finn sang 'There's a fraction too much friction' which listed as New Zealand's 41st most popular song of all time according to APRA (the Australasian Performing Rights Association).

In 2008, 'fractionated' lasers are have become the new craze in laser technology with multiple laser companies releasing various versions of fractionated lasers. Instead of treating the whole skin surface, fractionated lasers, as the name suggests, treat only a fraction of the skin surface. Usually, multiple individual microscopic columns of laser energy are fired into the skin.

The creation of fractionated lasers were a response of the laser companies to the needs of people in today's society who cannot afford prolonged recovery times, yet still want to look their best. Most commonly, fractionated lasers are used for reducing acne scarring, and reversing the hallmarks of sun-damage (wrinkles and pigmentation).

Fraxel was one of the first fractionated laser systems on the market. Mosaic is the latest fractionated laser to hit Australian shores. Their patented Controlled Chaos Technology randomises the beams and helps to even delivery of the laser. Other examples of fractionated lasers include Cynosure's Affirm, that combines two laser wavelengths in the same pulse to help to target various skin layers.

The concept of fractionated treatment of the skin is something that is not limited to lasers however. Skin needling is a non-laser treatment that involves involves puncturing the skin multiple times with small needles attached to a cylindrical roller to induce collagen growth and improve similar skin concerns.

The Victorian Cosmetic Institute will soon be trialling various of the new fractionated lasers including Cynosure's Affirm and comparing them to skin needling to test which provides the best results in terms of skin rejuvenation, reduction in acne scarring and skin pigmentation.

Dr. Gavin Chan performs lip enhancement on Anissa from Kiss FM. See video;

Overactivity of the masseter muscle, the muscle responsible for chewing that is located at the angle of the jaw, is often responsible for teeth grinding and headaches. This can often be a debilitating condition, and as the grinding usually occurs at night, this is a common cause for early morning headaches. The temporalis muscle, located over the temples, is also associated with this problem.

Due to TGA restrictions, the actual name of the muscle relaxant used cannot be named, but is a commonly used injection for treating facial wrinkles that can also be used as a simple and effective means of helping reduce masseter muscle overactivity. This muscle relaxant helps to reduce the overactivity of the muscle, without disturbing the normal functioning of the muscle. In a study of 90 patients who had facial headaches, 60 were given the muscle relaxant to the masseter muscles, and 30 were given a placebo. The results showed a significant improvement in those receiving muscle relaxant treatments (The Journal of Oral and Maxillofacial Surgery Volume 61, issue 7, Lindern et al).

Furthermore, there is a cosmetic enhancement that can occur with this treatment, as the jawline tends to slim and look less 'square'.

Hyperhidrosis, or excessive sweating beyond the natural requirements of the body, is a common problem that affects approximately 3% of the world's population. It can affect one's social life,work and psychological well-being. It can prevent those affected from certain social activities, restrict the type and colour of clothing worn, and affect self-confidence.

A recently published article in the Dermatologic Surgery journal studied the use of a particular injectable medication, more commonly used for facial wrinkles. The name of this substance cannot be named due to TGA restrictions, but it can also be used for underarm sweating. Although, this treatment is commonly performed currently, the article formalised the treatment by studying 52 patients over the period of 4 years (from May 2001 to December 2005).

After treatment with the injections into the underarms, the patients remained asymptomatic for an interval of 3 to 14 months, with a median of 5.97 months. No significant complications were noted from this treatment modality and a total of 97% of patients were highly satisfied with the treatment.

Treatments such as these can help reduce the need for operations such as an ETS or endoscopic thoracic sympathectomy to help stop sweating. Botulinum toxin type A for localised areas such as the underarms is a safe and effective means of treating excessive sweating.

Dr. Tzikas reports in the recent Dermatologic Surgery Journal his findings about the use of Radiesse, or calcium hydroxylapatite, for facial soft tissue augmentation. His study spanned over 52 months and involved in the treatment of 1000 patients.

More than 80% of patients in this study reported persistance of the product for greater than 12 months, with the most common side effects as redness or bruising.

Radiesse in this study was used in the lips leading to the formation of nodules in some cases which needed to be physically removed (for this reason Radiesse is not recommended at The Victorian Cosmetic Institute for the augmentation of lips). Outside of the lips, only 2 patients experienced nodule formation.

The picture shown illustrates a patient before and after cheek augmentation with Radiesse performed by Dr. Tzikas.

Injectable rhinoplasty is the latest technique to non-surgically reshape a nose. Stars such as Ashlee Simpson have been purported to have undergone this procedure (see photo). The actual shape and size of the nose is perceived by its contours, rather than its absolute size. By injecting dermal filers such as Radiesse into areas such as above a bump, or into a hollow in the nose, the nose can be made to appear smaller and straighter. Also, the entire height of the nose can also be lifted in some cases.

The price for injectable rhinoplasty with Radiesse is $660 and can last for around 18 months.

As of Monday July 14th 2008, our Berwick branch is moving to Suite 2, 72 Gloucester St, Berwick.

The new premises are walking distance (one block) from the previous.

There should be no disruption to our usual services. The phone number remains unchanged: 9707 0888

Click here for a map of the location of the new premises.

The balance between the facial features often determines the perception of the actual size of certain parts of the face. For example, enhancing the chin can make a perceivable decrease in the apparent size of the nose. Chin enhancement can be performed with dermal fillers that last from 6 to 18 months. There is also improvement in the 'double chin' when the chin is enhanced to project further forward.
For more information on non-surgical facial shaping, click here.

Plasma skin regeneration, used to resurface skin, has been FDA approved for the treatment of acne scarring.

A study conducted by Potter et al in the UK showed a 23% improvement in acne scarring after 6 months and this was sustained for 2 years. The study used silicone elastomer moulds to measure the improvement of the scarring pre and post treatment.

Clinically, at The Victorian Cosmetic Institute, we have noticed an improvement in acne scars for those who undergo the high energy (PSR3) plasma treatments, with a noticeable improvement in skin texture, wrinkles and pigmentation also.

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