Pushing the Boundaries

By: Katharine Griffiths
Created on 11th October 2010

Mr Ayham Al-Ayoubi of London Medical & Aesthetic Clinic is at the forefront of advances in aesthetics. He brought SmartLipo to the UK and earlier this year he introduced Ellansé dermal filler. Here, he talks to Cosmetic Surgery & Aesthetics Guide about this new product

How long have you been using the Ellansé dermal filler?

I introduced it into this country in March 2010. It was developed in Holland by the company that was originally involved in developing the hyaluronic acid dermal filler Restylane and Sculptra, the facial volumiser. So I knew this was a well-established company in the field of aesthetic enhancement.

What makes Ellansé different?

Hyaluronic acid fillers give instant results, a great natural look and no real side effects but their major disadvantage is the short lifespan of those results. Sculptra, on the other hand, lasts for five years and is a very safe product, but the problem with Sculptra is that it doesn’t produce instant results for the patient.

I feel that Ellansé combines the advantages of both these products. It is free from any chemicals or artificial components and is fully reabsorbed by the body, so it is incredibly safe, but it also provides instant results that last much longer than other temporary dermal fillers.

What exactly is Ellansé composed of?

As with many other products on the market, Ellansé is based on a product that the body produces naturally: polycaprolactone.

This substance has been used for many years in medical applications for hip replacements or facial reconstruction because it is incredibly strong but doesn’t cause a reaction in the body.

Its composition means that you can manipulate it once it’s been injected and I feel that this makes it a much more forgiving product to work with. Hyaluronic acid fillers cannot be moulded once they are in situ so you have to very skilled at injecting, but with this product you have five to ten minutes post injection when you can sculpt it into the best position.

You’ve said that Ellansé is a totally natural product, but is there anyone who isn’t suitable?

It is extremely rare to be allergic to this product, however the doctor has to be careful with patients who are hypersensitive to different products and it is best to avoid injecting them.

There are also basic medical contraindications that hold true for all fillers, such as eczema or similar skin conditions. You also need to be careful if someone has just finished using steroids; it is best to wait for a month or so until the steroids have completely left the system.

Have you been pleased with the results you’ve seen so far?

I have been really pleased with the results and so have my patients. Not only do you have the immediate results that you get with HA fillers, but the effects continue to improve over the next couple of months as the injection also causes a slight inflammation that boosts collagen production.

So when HA dermal fillers are starting to dissipate, Ellansé is just reaching its peak. Patients that I injected in April/May looked even better at their June/July review and they were overjoyed.

It sounds like a great product. Are there any disadvantages to Ellansé in your eyes?

Every product has its advantages and disadvantages. As it is such a strong product you have to apply a stronger local anaesthetic to manage the discomfort. If the patient is very pain sensitive I might use a dental block, but for most the pain can be managed with good application of Emla cream.

I have used Ellansé on about 70 patients and in about 60 per cent of cases there was some redness that lasted for two to three days. However, this is easily camouflaged and is actually a good sign because it indicates that collagen production is being stimulated.

From a business point of view, doesn’t the longer-lasting nature of the results present a problem?

Some practitioners see this as a disadvantage, but it isn’t in my eyes. Obviously if I treat a patient’s nasolabial folds with Ellansé then I could potentially not see that patient again for another five years whereas with the HA fillers you will see the patient every six to nine months... and you can charge each time.

But, personally, I would rather give a long-lasting result which makes for a happy patient because then they are more likely to return for other treatments or recommend me to their friends and family. This is how it works with Sculptra, which can last for five years.

It is a short-sighted strategy for cosmetic doctors not to embrace this new treatment. Once patients realise that there are longer-lasting alternatives on the market they will search out the practitioners who offer them.

Do you still offer other products to your patients?

Definitely. Ellansé is a more expensive option so some patients prefer to stick to familiar products and I don’t think it is suitable for first-time patients as they need to see if they are happy with the enhancement before plumping for the longerterm option. Also Ellansé cannot be used in the lips and forehead, so other products are needed for those areas.

You are renowned for pushing the boundaries in how procedures can be applied. Where do you see yourself taking Ellansé?

I think with Ellansé we will be able to go beyond just targeting lines and wrinkles and be able to achieve a non-surgical facelift. The jaw line is a very challenging area to tackle without surgery, even with Sculptra, but I think we can achieve the desired lift with Ellansé. I am just looking for the perfect candidate at the moment.

CS&AG