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  • 1.2011 Basic & Advanced ApplicationsHands-On WorkshopPresented byELITE Aesthetic, Medical & Business Training Copyright 2008 ELITE

2. 2011 Founded in 2008 Independent Company - not supported by pharmaceutical companies, noproduct bias. Independent Instructors performing procedures outside classroom setting. ELITE Revolutionized the Industry: Overcoming major frustrations health care professional encounter. Most comprehensive, affordable, current, hands-on aesthetic training available. Dare 2 Compare. Various training options to accommodate needs of each health care professional. Offer a Business Implementation program. Offer not only non-invasive cosmetic procedures, but also Health & Wellnesstraining. Experience the Difference, Choose ELITE! 3. 2011 Aesthetic Medicine Botox Cosmetic & Dermal Filler (basic & advanced) Cosmetic Lasers & Light based systems Lipodissolve & Mesotherapy (basic & advanced) Chemical peels & Microdermabrasion Sclerotherapy Medical Training Sensible Weight Loss Wellness Integration program Fibromyalgia Dermatology for Non-Dermatologists Business Training Marketing Your Practice Effectively 3-day Business Training & Business Implementation program Experience the Difference, Choose ELITE! 4. 2011 Participants will leave class feeling confident to incorporate the newlyacquired knowledge/skills & procedures into their existing practice. Incorporate both basic and advanced applications. Extensive Hands-on workshop LIVE models. Comfort level with these procedures will increase with experience. Some providers may feel more comfortable beginning with friends and family. Experience the Difference, Choose ELITE! 5. 2011 9:00 amBotox Cosmetic Didactic Presentation 11:30 am Break 11:45amDermal Filler Didactic Presentation 1:00pm Lunch Break 2:00pm Demonstration Videos 3:00pm Hands-on Workshop on LIVE models 7:00pm Q&A, Evaluation & CertificationExperience the Difference, Choose ELITE! 6. 2011 In an ongoing effort of training improvement, we ask you to complete the EVALUATION form, and direct any questions or concerns directly to ELITE at:Phone: 1-877-847-9200E-mail: eliteambt@yahoo.comAll feedback will be used by ELITE to improve future training.ELITE will contact the instructor, if necessary and communicatewith the provider. ELITE provides RESOURCE CD If additional practical training is needed, instructors are available for private sessions.Experience the Difference, Choose ELITE! 7. 2011 2+ hours of LIVE DemonstrationsRegular Price $199Seminar Participants ONLY $99$100.00 Voucher for any other ELITE TRAINING within 30 daysExperience the Difference, Choose ELITE! 8. 2011FAST CASH PROGRAM$250.00 Instant CASH for EACH Paid Referral to one of our Seminars or Private Training$100.00 for each ONLINE Training Paid ReferralUnlimited Flyers availableExperience the Difference, Choose ELITE! 9. 2011FAST CASH PROGRAM$250.00 Instant CASH for EACH Paid Referral to one of our Seminars or Private Training$100.00 for each ONLINE Training Paid ReferralUnlimited Flyers availableExperience the Difference, Choose ELITE! 10. 2011 Become an ELITE Member Today And... SAVE Huge on Training SAVE Huge on Product Stay UP-TO-DATE on the latest JOIN our FREE WEBINARS! And More...Experience the Difference, Choose ELITE! 11. 2011 Dr. Mike Van Thielen Senior InstructorExperience the Difference, Choose ELITE! 12. Comprehensive Overview & Practical ApplicationsPresented by ELITE Aesthetic, Medical & Business TrainingCopyright 2011 ELITE 13. Reference: Botulinum Toxin Carruthers & Carruthers 2nd EditionProcedures in Cosmetic Dermatology Series, ISBN: 978-1-4160-4213-6 14. Introduction & History Statistics of Aesthetics Etiology of Aging Face Pharmacology & Physiology of Botulinum Toxin Functional & Practical Anatomy Storage, Handling & Dilution Indications, Contraindications & Complications Treatment of Upper Face Treatment of The Lower Face & Neck Adjunctive Treatments Client Education & Realistic Expectations Hands-on Workshop and/or (live) Demonstrations. 15. Love for BeautyLooking Young ForIdeal proportions &Biological AgeShapes NormalHarmony &Relationship BalanceBetween FacialUnits 16. MusclesInelastic,Attached To Aging Skin Skin WrinklesSkin Subject Flaccid,Repetitive perpendicular To Pull OfLoose Skin Movement To MuscleGravity Fibers Face LiftBOTOX Brow Lift Lasers & Light, RF, MesoRedundant SkinHyperdynamic Wrinkles 17. Strong contrast with current use of BTX. Botulism: Form of food poisoning (botulus = sausage). 1895: Belgian picnic (34 people ill, 3 died after eating raw, salted ham). Professor Emile Pierre Marie Van Ermengem identified the etiologic agent and named it bacillus botulinus. Renamed and reclassified as Clostridium botulinum. Anaerobic, spore forming bacterium that undercertain conditions can germinate and create a toxin. 18. Toxin: Resists alcohol, mild acid and enzymes. Not heat-resistant. Some animals (dogs, chickens) unaffected by toxin. Symptoms: blurred vision, nausea, dizziness, dry.mouth may progress to flaccid paralysis and death. Type A, B & E documented as causative strains forhuman cases of botulism. 19. 1920: isolation of toxins initiated by Dr. Herman Sommer. 1946: Type A Toxin isolated by Edward Shantz (for US Army). 1949: Burgen discovered mechanism of action. 1950s: Dr. Vernon Brooks: 1st. medical use of botulium toxin. 20. 1973: Dr. Alan B. Scott: 1st study demonstrating therapeuticvalue of BTX was published. Attempts to treat strabismus showed that BTX effectivelyweakens the eye muscles in primates. 1977: Treatment for strabismus attempted in humans. 1979: Dr. Schantz prepared 1st. Batch of 11-79, now calledBotox. The 150mg batch served as the source of all BTX-A usedin humans in USA until 1997. Limited FDA-approval to use of BTX-A for strabismus. 21. 1985: FDA-approval to include blepharospasm. 1987: Carruthers & Carruthers performed joint dermatological-ophthalmologica research with Dr. Alan B. Scott. Dr. Jean Carruthers observed significant improvement ofdynamic rhytides in glabellar region while treatingpatients for blepharospasm. 1989: Dr. Alan B. Scotts company Oculinum, Inc. acquired byAllergan, Inc. Name of product changed to Botox. FDA-approval to include hemifacial spasm. 22. 1991-1992: Drs. Jean & Alastair Carruthers reported and publishedinitial findings of BTX-A for cosmetic usage,demonstrating the safe & effective treatment of dynamicrhytides in the glabella. 1993: Blitzer and colleagues described use of BTX for rhytides ofthe forehead and elsewhere. 1997: BTX-A source by Allergan Inc. (Irvine, CA) FDA-approved. 23. 1999: New England Journal of Medicine Editorial One MansPoison Clinical Applications of Botulinum Toxinprovides examples of historic uses: Lower limb and upper limb spasticity in children. Anal fissures. 2003: FDA-approval for treatment of glabellar rhytides. Subsequent publications and usage expanded the useof BTX to new areas of treatment: Crows feet, neck (platysma), oricular muscles. Pain & spasms (migraine, torticollis). Hyperhydrosis. 24. Statistical data courtesy of:THE AMERICAN SOCIETY FOR AESTHETIC PLASTIC SURGERY (ASAPS) 25. 10 Million Cosmetic Procedures in 2009. Increase of 147 percent since1997. Repeat patients and those putting off surgery, are likely thereason for the growth in non-surgical cosmetic procedures. Growth in demand will likely return as the recession easesand baby boomers offspring begin to explore cosmeticprocedures. 26. Cronic UV-damage to the skin. Photo-aging due to cumulative sun exposure. Glogau Wrinkle Scale:Type 1: Early Wrinkles Type 2: Wrinkles in MotionPatient age: 20s to 30sPatient age: 30s to 40sEarly photo-agingEarly to moderate photo-agingMild pigment changes Appearance of smile linesMinimal wrinkles Early brown age spotsNo age spots Skin pores more prominent Early changes in skin texture 27. Type 3: Wrinkles at RestPatient age: 50s & olderAdvanced photoagingProminent brownpigmentationVisible brown age spotsProminent, small bloodvesselsWrinkles, even at rest Type 4: Only Wrinkles Patient age: 60s or 70s Severe photoaging Yellow-gray skin color Prior skin cancers Pre-cancerous skin changes (actinic keratosis) 28. Loss of subcutaneous fat. Loss of volume and fullness/roundness. Flattened, sunken appearance. Facial contours and mouth. Hyperdynamic wrinkles due to repetitivefacial expression. Smoking, frowning, squinting etc. Muscles that insert into skin. Frontal, glabellar, periocular, nasolabial, perioral Initially only wrinkles with movement, later at rest. 29. Loss of elasticity due to gravitationalchanges. Facial soft tissues lose resiliency and can no longerresist stretching forces and movement; no rebound. Facial soft tissues start to sag as a result of gravity. Remodeling of bony and cartilaginousstructures. Bone resorption results in decrease of facialvolume. Stretching of cartilage as a result of gravitationalforces results in drooping of facial structures (nasaltip) Facial assymmetry may result. 30. Pharmacology7 neurotoxins, serotypes A G Antigenically distinct Similar molecular weights (~150 kDa) Dichain molecule (heavy and light)- active molecule 3 functional domains: Binding domain (C terminus of H chain) Translocation domain (N terminus of H chain) Catalytic domain (C terminus of L chain) Zn metalloprotease 31. Pharmacology Three step process Irreversibly binds to presynaptic terminal of motor end plate Internalized into axon by endocytosis Cleavage of SNARE (receptor) proteins resulting in inhibition of neurotransmitter release SNARE proteins: N-ethylmaleimide sensitive factor attachment protein receptor Each serotype binds to a specific residue of one of the docking proteins (Botox=SNAP-25, Myobloc=VAMP) 32. Solstice Neurosciences (San Fransisco, CA) FDA-Approved Type-B 2500, 5000 & 10,000U Less potent (50-150