AUSTRALIAN
ISSUE 4/ 2013
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breast
CANCER
INSIDE
WITH DR CHANTEL THORNTON
DIRECTORY SURGEONS DENTISTS PRACTITIONERS SUPPLIERS
INSPIRE RECONSTRUCTIVE & COSMETIC STORIES TO
ISSN 2201-4381 04
9 772201 438005
THE
Importance of
LOOKING & FEELING Y O U R
V E RY
B E S T
Dr Anh Nguyen
It took me a year after the birth of my son to fit into my pre-pregnancy clothes again and slowly regain my body confidence. So when women come to me wondering if I understand how they feel about their concerns, I can honestly say that I know what it feels like to feel self-conscious and/or unattractive.
I certainly did not like how my body had changed after having my son and I resented the fact that the weight did not fall off like it did when I had my daughter many years before that. I felt frumpy and self-conscious and did not like going out socially as I was too afraid to be seen by people who knew me, only to comment on how much weight I had put on. I understand that we are often our worst critics. I know that despite the fact that those around us accept, adore and love us as we are, it is still so important for US to look our best for OURSELVES. At the end of the day, what counts is how we feel. I personally feel I look better now than I did 10 years ago, and I certainly feel more confident. It feels great when friends and family comment and is especially pleasing when no one close to me can tell what I have had unless they compare the subtle changes of the ‘before’ and ‘after’ photos. To me, this means that I still look like myself. I chose a career in medicine largely to help people and make a tangible difference to their lives. In some aspects of my work as a plastic surgeon, I treat skin cancers, reconstruct defects and perform
trauma surgery, which in most cases, is largely about physical and functional outcomes. But the aspect of my work that I am passionate about is helping patients look better and feel more confident – and I see this in my cosmetic surgery practice. Patients who return for review after having had a breast reduction for example, walk in with a newfound confident posture and positive grin because they feel they can wear the clothes they want, dance and play the sports they haven’t been able to before and be less self-conscious that people are looking at their faces rather than at their breasts, for example.
and we should never underplay the significance of aesthetics in all aspects of our life. Helping improve how one looks for the benefit of a confidence boost is not about vanity. As plastic surgeons, an aesthetically nice result that we strive to achieve is one that is natural and subtle.
Others who have felt they look tired and are concerned about their heavy eyelids report they look and feel ‘fresh’ and more youthful after eyelid rejuvenation. I had a patient who was bothered by a scar on her back to the point that she did not cut her hair and never wore the outfits she wanted to because she was self-conscious about her back. After I revised the scar, she got a bob haircut, wore a dress with spaghetti straps and told me “you have no idea how you have transformed my life”. All viewpoints should be taken into consideration when contemplating having any cosmetic intervention. But I think that appearances matter
I am not advocating that we should all have cosmetic treatments. Having said that though, I still want to look good, if not my best when it matters most to me, because when I look great, I feel like I am at my best and can accomplish anything. I wish the same for my patients – to look their best and feel fabulous too.
Cosmetic enhancements – whether non-invasive (makeup, eyelash extensions, skin treatments etc) or invasive (surgical for eg.) – can help those looking for an improvement in their appearance, and this in turn, may have a positive impact on one’s selfesteem and well-being.
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Anh
true
Love starts with your own body, so start to love the skin you are in...
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The
Brighton Day Surgery
D R
J U L I E
LAWRE NC E Breast Augmentation Breast Reduction Breast Lift Gynaecomastia Abdominoplasty Facelift Otoplasty Rhinoplasty Anti-wrinkle Injections Dermal Fillers Skin Cancer Surgery Since establishing Brighton Day Surgery in 1993, Dr Julie Lawrence has built up the practice through a combination of hard work and a commitment to excellence, achieving this with the support of a dedicated team of highly skilled professionals. Dr Julie Lawrence is a Plastic and Reconstructive Surgeon. Graduating in Medicine and Surgery from the Adelaide University, she trained at the Royal Adelaide Hospital and Flinders Medical Centre. Training in plastic surgery in Christchurch, New Zealand followed this and she gained her Fellowship in Plastic and Reconstructive Surgery in 1991 under the auspices of the Royal Australasian College of Surgeons. Dr Lawrence then left to go overseas for further training, spending 18 months in Oxford in England as a Post- Graduate Fellow and also a Locum Consultant, and then as a Post-Graduate Fellow in hand surgery in Indianapolis in Indiana, USA.
On returning to Brighton, South Australia, in 1993, she established the Brighton Day Surgery. The practice has grown over the past two decades and now has nurse injectors on staff, as well as offering surgical procedures under local anaesthetic and sedation involving an anaesthetist. All surgical procedures requiring overnight stays are performed at Flinders Private Hospital, Ashford Hospital or Noarlunga Hospital. Dr Lawrence is also able to operate on patients who have no private health insurance at Noarlunga Public Hospital and at the Repatriation General Hospital. Dr Julie Lawrence is currently a Specialist Clinical Educator at Flinders University and is president of the South Australian Hand Surgery Society. Dr Lawrence is a member of the Australian Society of Plastic Surgeons and the Australian Hand Surgery Society. She is also an associate member of the American Society of Plastic Surgeons and the American Society of Hand Surgery.
BRIGHTON
DAY SURGERY
Brighton Day Surgery is committed to providing cosmetic surgery and non surgical procedures for women by women. Providing a comfortable and relaxing environment is the first step and this approach is followed during all stages of treatment to ensure patients feel content and confident at all times. Established almost two decades ago, Brighton Day Surgery was declared a day hospital by the Minister for Health and Family Services shortly after opening. It has been fully accredited by the Australian Council on Healthcare Standards since 2001 and has hospital agreements with all major health funds. In addition to plastic and reconstructive surgery, the Brighton Day Surgery offers a range of cosmetic surgery and non surgical skin rejuvenation procedures to enhance your natural look. Dr Julie Lawrence and Dr Lisa Marks, alongside Nurse Injectors Leisa Chappell and Stephanie Mebberson are highly trained and experienced to offer just the right treatment for your individual needs. Brighton Day Surgery has created a personal and caring atmosphere and provides a first class operating facility in a convenient location. Situated within walking distance of the Brighton cafÊ precinct and beach allows carers to fill in their time in a great environment while waiting for patients to be discharged. The Brighton Day Surgery is also situated close to bus and train routes and within 5 minute’s drive from Marion Shopping Centre.
www.brightonplasticsurgery.com.au 1 Jetty Rd,Brighton, South Australia, 5048 Ph(08) 8377 1775 E info@brightonplasticsurgery.com.au
After completing his medical degree at the University of Sydney, Dr Richard Sackelariou then trained in general surgery, followed by advanced training in Plastic & Reconstructive Surgery. He also undertook training in Cosmetic Surgery in Paris at the Clinique Turin. He is a fellow of the Royal Australasian College of Surgeons (FRACS) and a fellow of the Royal College of Surgeons (FRCS England). He also is a member of the Australian Society of Plastic Surgeons (ASPS) and the Australian Society of Aesthetic Plastic Surgeons (ASAPS).
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INDUSTRY NEWS:NEW TECHNIQUE Ten Years of Treatments
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A NEW TECHNIQUE in non-surgical cosmetic treatments is the X Lift: The Non-Thread Thread Lift. This technique was pioneered in Australia by our own Dr Argie Xaftellis. It involves using the collagen inducing product Radiesse® to create threadlike bands that provide a soft lift that continues to improve as the collagen induction kicks in. The results are similar to traditional thread-lift and not a replacement for a face-lift if the sagging skin is too loose. All patients can be treated but the best candidates are those who are just starting to show signs of sagging in the brows, cheeks, jowls and neck. The results last 12 to 18months whilst traditional thread lifts last only 2 or 3 years. The advantages of the X-lift over traditional thread lift include its speed taking only 30minutes, no risk of foreign body reaction since Radiesse® consists of calcium and phosphate molecules which are natural to the body, no “popping” through the skin of the thread, no damage to the dermis, minimal swelling and bruising with virtually no downtime. The best thing of all is that for less than the cost of one area of traditional thread lifting, the X-lift can do the entire face. Dr Argie describes the new technique as, “Just another weapon in the war against aging”. We say fight in! This procedure will be available within the next few months Australia wide to any doctors using the Radiesse® product.
client. These women are passionate about
helping their clients to achieve results that will make them look and feel better.
BEFORE
AFTER 6 WEEKS
Dr Argie XAFTELLIS KRISTINA KYRIACOU
Full Range of Treatments:
is our newest addition to the NipTuck family and will be providing her insights on the cosmetic industry as our Resident Beauty Columnist. If you have any questions or topics you would like her to discuss in upcoming issues then please email your queries here: kyriacou.kristina@gmail.com You can also find Kristina on YouTube where she discusses the latest in products, trends and beauty treatments.”
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COVER PHOTO: ALEX FEVOLA
Welcome to our 4th edition of NipTuck Magazine. A year on and having travelled around Australia many times, meeting numerous specialists and suppliers, we have developed new knowledge and tremendous respect for the cosmetic and reconstructive industry. We are new to the industry, but we are not new to publishing, having other titles in print now for more than 20 years; however we are thrilled to say, ‘Happy First Birthday’ to us! It is with great pleasure that we thank you, our readers and advertisers, for your continued support.
A major highlight for the NipTuck Team this quarter was attending the Australasian Society of Aesthetic Plastic Surgery (ASAPS) and Cosmetic Physicians Society of Australasia (CPSA) cohosted Non-Surgical Symposium, held in Sydney in August. The range of non-surgical rejuvenation options presented was staggering and apart from getting to see the very latest ‘cool stuff ’, we also met some fantastic practitioners – surgeons, dermatologists, cosmetic doctors, nurse aestheticians and dermal therapists. All very passionate about their craft, full of enthusiasm at the opportunity to access the very latest information from local and international presenters and surprisingly more than willing to hit the dance floor multiple times. My feet are still recovering! Following the fun of networking and some serious research, we have been very busy over the past few weeks pulling together what has been our most heartfelt issue yet. ‘NipTuck presents: Inspire’ comes from an overwhelming desire of the NipTuck team to show you, in greater depth, the fabulous people we get to meet every month; people who are making an enormous impact on the lives of many, every day and in so very many ways. This is more than evident in our feature ‘Transforming Lives’ as we discover the secret ‘other lives’ of some people whose faces are very familiar to NipTuck readers and learn just what it is they do in their ‘spare time’. We are grateful to them for sharing stories of their work with
DISCLAIMER NipTuck Magazine is produced and published by Nip & Tuck Magazine Pty Ltd. With exception of provided material, reproduction in whole or part is not permitted without the written consent of the publishers. All reasonable efforts have been made to trace copywriting holders. NipTuck magazine (Nip & Tuck magazine Pty Ltd) may be a distributor of the content supplied by third parties. Any opinions, advice, statements, services, offers or other information or content made available by third parties are those of the respective author(s), and Nip & Tuck magazine Pty Ltd is not responsible for any material published by third parties. Nip & Tuck magazine Pty Ltd cannot and does not endorse in any way, nor does it vouch for, the accuracy or usefulness of such material. Furthermore, Nip & Tuck magazine Pty Ltd expressly disclaims any liability associated with material contributed by third parties. All readers are advised to seek medical advice from a doctor if considering any cosmetic procedure. NipTuck magazine does not purport to be a substitute for medical advice. Publishers, contributors and authors do not accept any liability whatsoever in respect
Interplast and OSSA and hope you enjoy reading about it as much as we enjoyed working with them on it. October is Breast Cancer Awareness Month and we were thrilled when Specialist Breast Surgeon Dr Chantel Thornton agreed to be on our cover and provide us with some very interesting information about a disease that has touched us all in one way or another. Along with the team at Peter MacCallum Cancer Centre and the Breast Cancer Network of Australia, we have been able to create a comprehensive guide that we hope clears up your unanswered questions and informs you in ways you had not expected. So for this issue we have dug deep. We have spoken to dozens of inspirational people – surgeons, physicians, patients and organisations who all have inspiring stories to tell. There is no way any of us could know the extent of the work these special practitioners do, so this month we are attempting to unfold more of the mystery! To the NipTuck team of writers, lead by Melinda Barlow (www.dragonflytrading.wordpress.com), Krys and her team of graphic designers, and our many photographers across Australia, thank you for your excellent work. Happy Birthday!
Elli Vukasovic
PUBLISHING DIRECTOR
to an action taken by a reader in reliance on the recommendations set out in this magazine. Models depicted may not necessarily have received treatment described in this magazine. All advertisers and Nip & Tuck Magazine Pty Ltd follow and uphold the advertising policies set out by the Australian Competition and Consumer Commission (www.accc.gov.au), the Therapeutic Goods Administration (www.tga. gov.au) and individual state medical boards. All reasonable effort is made by Nip & Tuck Magazine Pty Ltd to ensure that all advertisements accepted for publication follow these guidelines. Copies of these guidelines are available from these agencies on their websites. All NipTuck Magazine advertisers assume sole responsibility and liability for statements contained in their editorial copy and advertising copy and hold harmless and indemnify Nip & Tuck Magazine Pty Ltd and its offices, Directors and employees from and against all liability, loss, claim, damages, cost or expenses arising out of matter contained in their editorial or advertising. Advertisers accept these terms and responsibilities when signing an advertising contract with Nip & Tuck Magazine Pty Ltd.
S E C T I O N S
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QLD
82
ACT/NSW
106
WA
124
VIC
144
SA
Cover Story
Dr Chantel Thornton Page 22
Photo: Alex Fevola
Actual breast augmentation patient of Dr Miroshnik
DR MICHAEL MIROSHNIK
Breast Augmentation Specialist MBBS, FRACS (Plast.) Plastic & Cosmetic Surgeon
www.drmiroshnik.com.au
T: (02) 9389 8108 or 1300 88 90 50 More information on page 152 (NSW Section)
th e
spe c ialis ts DR YUGESH CAPLASH
DR ANH NGUYEN
DR JULIE LAWRENCE
RS
DR RICHARD BLOOM
DR PETER CALLAN
U
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DR PHIL RICHARDSON
O
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TR
IB
DR KIM TAYLOR
C
DR RICHARD SACKELARIOU
the
DR HOWARD WEBSTER
exper ts
DR DEAN TROTTER
MR DAVID MORGAN
DR ASH SANKARAYYA
SHARYN YELLAND
DR JOHN NEWTON DR ROBERT PAUL
DR RAKESH GULIA DR MARIUSZ GAJEWSKI
DR CHANTEL THORNTON
the
DR GILLIAN MITCHELL
be s ts in the ir fie lds DR ALASTAIR TAYLOR
DR SATERA PAPAGEORGIOU DR HAMISH FARROW
DR LINDA WILLIAMS
DR RICHARD RHADON
DR MICHAEL MIROSHNIK
DR TONY TAN
DR ARGIE XAFTELLIS
DR OSEKA ONUMA
DR TIMOTHY GOH
DR PETER WIDDOWSON DR IAN TIMMS DR VAN PARK
SELINA LAM
DR MISAGH HABIBI
DR MARK EDINBURG
DR MICHELLE HUNT
DR PETER OLIVER
RUTH LAVELL RN
DR MICHAEL WEYMOUTH
DR MANSOOR MIRKAZEMI
DR ANNEMAREE COLE
DR YOHEI TANAKA
SARAH CHATBURN RN
LEISA CHAPPELL RN
DAVID GINGES
STEPHANIE MEBBERSON RN
DR LISA MARKS
SHERYNA WILSON
MELINDA BARLOW
KRISTINA KYRIACOU
INGE DRUCKER
DR EWAN MACAULAY
RACHAEL JOINER
IRENE HENDEL
KRYSTAL BARTER
the
contr ibutor s
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DR
THORNTON Chantel is a breast surgeon specialising in the treatment of all benign and malignant breast conditions, including sentinel node biopsy, risk reduction surgery (skin sparing and nipple sparing mastectomy) and delivery of multidisciplinary breast cancer care. She has a special interest in oncoplastic breast cancer surgery, a relatively new sub-specialty aimed at maximising cosmetic results with breast conservation surgery. Chantel is a member of the American Society of Breast Surgeons, Victorian Medical Women’s Society, the Australian Federation of Medical Women and the Medical Women’s International Association. She is also a member of Women on Boards, and a member of the Cancer Council of Victoria, Victorian Cooperative Oncology Group, Breast Cancer Committee and a long-time supporter of Breast Cancer Network Australia. Philanthropy is an important part of Chantel’s life, and she is currently on the Committee of Women at The Alfred, and is a Board Member of the Foundation for Surgery, Royal Australasian College of Surgeons. Her former roles include Patron of the Royal Flying Doctors Service Flying 1000, Chair of Life Support which supports trauma care at The Alfred Hospital and Board Member of The Alfred Foundation. She has also been an Honorary Lecturer at Monash University. Chantel is currently working in private practice at Epworth Breast Service, Epworth Hospital, Richmond and Hobson’s Bay Specialist Centre, Williamstown, Victoria and has appointments at the Peter MacCallum Cancer Centre, and St Vincent’s Breast Screen.
22 NIPTUCK Magazine
breast
CANCER Cover Photography: Alex Fevola
In recognition of October as Breast Cancer Awareness Month, we invited Melbourne Specialist Breast Surgeon Dr Chantel Thornton to feature on our cover this issue and give us some background information on this high profile disease that these days seems to leave few families untouched but many of us still know very little about.
Compiled by Melinda Barlow with specialist contribution from Dr Chantel Thornton, Dr Gillian Mitchell, Dr Hamish Farrow, Peter MacCallum Cancer Centre, BCNA Breast Cancer Network Australia, Think Pink Foundation and Pink Hope.
Origins and Incidence
Breast cancer affects men and women, though men only make up about 1% of cases, with roughly 100 men diagnosed in Australia each year.
breast
CANCER Continued from previous page
BREAST CANCER:
It is a disease of ageing and most women are diagnosed post-menopausally. Surprisingly, though more attention seems to be focused on younger women, just one quarter of women who are diagnosed are younger than 50 years of age. The incidence of breast cancer has increased considerably since the early 1980s. There were 5,317 cases diagnosed in 1982, and that number almost tripled to 13,688 over the subsequent decades to 2009. In 2020 it is estimated that there will be 17,210 new cases of breast cancer diagnosed in women. Breast cancer is the most common cancer in Australian women (excluding nonmelanoma skin cancer), accounting for 27.4 percent % of all new cancers in women. About 15,000 women are diagnosed each year. One in eight women will be diagnosed with breast cancer before the age of 85.
Risk Factors and Familial Origins
Breasts are made up of lobules, ducts and stroma. The lobules produce milk, the passages that connect the lobules to the nipple (and transport the milk) are the ducts and everything else is given the generic name of stroma. This refers to fatty tissue and ligaments surrounding ducts and lobules, blood vessels and lymphatic vessels. Breast cancer is an abnormal growth of cells that normally line the ducts and the lobules. Breast cancer has different points of origin. Ductal carcinoma begins in the ducts and this makes up 80% of cases. Around 15% of diagnoses come from lobular cancer (in the lobes) and the rest have the origin in breast tissue. It is important from a treatment perspective to classify the cancer based on its location and how it has, or will spread. Breast cancer is broadly divided into two groups – • Non-invasive cancer or ‘carcinoma insitu’. This refers to cancer that exists inside the ducts or lobules and has not spread beyond them. • Invasive cancer. These are cells that have spread beyond the walls of the ducts or lobules. A single breast tumour can have a combination of invasive and non-invasive cancer. Breast cancer spreads (a secondary cancer or metastasis) by entering the lymph vessels and spreading to reach the lymph nodes (glands) and/or entering the blood stream and spreading to other organs.
24 NIPTUCK Magazine
There are a number of risk factors contributing to development of breast cancer. Being female is a primary factor, as are advancing age, dense breasts and a past history of premalignant breast pathology. Hormonal factors are commonly causes too, with prolonged exposure to oestrogen and progesterone through things such as early onset of the first period, late menopause or extended use of combined Hormone Replacement Therapy increasing risk. Lifestyle factors such as obesity, a high fat diet, excess alcohol consumption and a sedentary life style are associated with increased risk too. The factors that have been of greatest discussion of late are related to familial origins. Angelina Jolie’s recent announcement has certainly increased awareness of the issues even though family history has long been known to be a risk factor for developing breast cancer. Associate Professor Gillian Mitchell - Medical Oncologist and Head of the Familial Cancer Centre at the Peter MacCallum Cancer Centre - explains that an important cause of the familial risk comes from mutations in genes responsible for suppressing tumour growth, such as the BRCA1 or BRCA2 genes. “These mutations can be inherited from your mother or father with BRCA mutations being the most common. BRCA mutations occur in about 0.2% of the general population but in certain populations they can occur more frequently, such as people of Ashkenazi Jewish ancestry where the background frequency is as high as 2%. For women with a BRCA mutation this translates into a lifetime risk of breast cancer of up to 85% (compared to a lifetime population risk of 11% in the general population), with almost half of this risk occurring before age 50. These mutations also increase the risk of ovarian cancer.” Familial breast cancer makes up approximately 20% of cases, but only 5 10% of all breast cancers will be due to a high-risk gene mutation. Mutations in the
BRCA 1 and 2 genes are found in less than 20% of high-risk families with the remaining families due to mutations in other high-risk genes, many of which are still undiscovered, or an accumulation of a number of lowerrisk gene variations. Most breast cancers occur without a family history. Genetic testing should be discussed with all women who have a strong family history of breast or ovarian cancer, especially young women under 40 who have previously been diagnosed with breast cancer. There is still a way to go in Australia to improve access to effective screening opportunities for all women. Those with the family history are entitled to Medicare funded MRI screening, but those who do not, are not entitled. As well as screening, some patients who are shown to have a BRCA or other gene mutation will choose to have surgery to remove their breast and/or ovarian tissue, whereas medication (such as the oestrogen receptor modulator, tamoxifen) to almost halve their breast cancer risk is an option for others. Risk-reducing medication is available to all women at risk, not just for those with a known gene mutation.
Treatment
Treatment is dependant on the classification and extent of the spread. The aim of surgery and radiation therapy is to control the cancer locally. Chemotherapy and endocrine therapy help to treat any tumour that might have escaped to distant organs (systemic treatment). Breast cancer surgery involves removing the tumour from the breast and may require sampling the axillary lymph nodes. Today 75% of all women diagnosed with breast cancer have breast conservation surgery. Commonly known as a lumpectomy, it removes the tumour and surrounding tissue but aims to conserve the breast itself. ‘Oncoplastic surgery’ is the integration of plastic surgery into breast cancer surgery for reconstructive purposes and this ensures the breast is maintained and cosmetically refined to improve its appearance after surgery. For more severe cases, and occasionally those with family history, a mastectomy can be the preferred, and sometimes the only, option. A simple mastectomy removes the entire breast but maintains the pectoralis muscle. Reconstructive surgery may or may not happen after this. There is also a technique called a skin-sparing mastectomy, which preserves the nipple and areolar and involves an immediate reconstruction as part of the procedure. If cancer cells are detected in the lymph nodes (the axillary nodes are situated in the armpit), before surgery, an axillary lymph node dissection will be required. If there is no known spread to the lymph nodes pre operatively a sentinel lymph node biopsy will be undertaken.
Breast Reconstruction
There are a few options that take into consideration the patient’s breast and body shape and also the outcome they would prefer. Some opt for implants (prostheses),
others choose to have their existing tissue arranged to reshape and restore form and there is also the option of a combination of both. The decision about when to reconstruct is always down to the surgeon and when they feel it is safe to proceed, with management of cancer and preserving life as their primary concern. Plastic and Reconstructive Surgeon Dr Hamish Farrow says that Angelina Jolie’s experience has heightened public awareness of the options. “Breast reconstruction continues to evolve at a rapid pace. Technology and techniques are changing every year and developments such as the inclusion of a delay procedure to make the nipple survival safer, and addition of tissue grafts – ‘ADM’ - to get a better shape in the lower breast are giving greater promise for better results. More plastic surgeons are choosing to specialise in this area of care as reconstruction is now often done at the time of mastectomy. It can however be as effective anytime later too. For many women this can allow them to continue with a shape that allows for normal clothing choices, and the important feeling of being complete, feminine and sexy despite having lost a breast.” Dr Thornton comments further on the subject of reconstruction. “Unfortunately despite the incidence of breast cancer in Australia being among the highest in the world our rates of reconstruction post mastectomy are still very low. It has been estimated that less then 14 % of all Australian women under going mastectomy will have a reconstruction. This figure is significantly lower then other countries in the western world where the reconstruction rates are up to 50%. The factors in Australia associated with lower rates of reconstruction include women from rural communities, women who are over 65, those who are less well educated or from a poorer socio-economic group, and those with no private health insurance. This is an area that I am particularly passionate about, as I would like to see all Australians with the ability to access breast reconstruction. Australia is a prosperous country, as doctors treating patients with breast cancer we should have an expectation that our patients will treated on level with the world’s best practice regardless of social, demographic, and financial situation. Access to the best possible health care should be a right for all Australians!” The key approach to improving Australian’s breast cancer outcomes must be a multi-disciplinary one. There are many specialist breast units in Australia that have multi-disciplinary care and this has been shown to improve patient outcomes as well as enhance the quality of care and overall patient experience. The patient - focused team consists of breast and plastic surgeons, radiologist, pathologist, radiation and medical oncologist, genetics physician, breast care nurses, administration and support staff.
Support Networks
Organisations such as Breast Cancer Network Australia are really the backbone to the whole process as they highlight how much lay women in the community have achieved - thus improving outcomes for women with breast cancer. BCNA has lobbied government to get Herceptin on the PBS and to help fund breast care nurses. They have encouraged women to seek out breast reconstruction, and provided special bras and breast prostheses post operatively. They are vital in helping to understand the psychological, and social impact a diagnosis of breast cancer can have on a woman’s life as well as the impact of that diagnosis on her family, her community and for Australian’s collectively. Think Pink Foundation focuses on helping people who have the disease at every stage of the journey from initial diagnosis, through treatment and onto survivorship. The foundation provides direct emotional, practical and physical support through a comprehensive range of programs. Looking after the psychological and emotional aspects of the disease is very important to patient outcomes, their wellbeing and quality of life. Pink Hope is a registered charity, established and founded by Krystal Barter in 2009 whilst recovering from her preventative double mastectomy. Having experienced the isolation and lack of information for high-risk families, Krystal created Pink Hope for women like her, with the goal of providing unique and tangible resources. Pink Hope is Australia’s only charity designed to inspire women to be proactive and vigilant with their breast and ovarian health, and to ensure this generations high-risk families don’t become the next generation’s cancer victims.
Dr Chantel Thornton
is a Specialist Breast Surgeon currently working at the Epworth Breast Service, Epworth Hospital, Peter MacCallum Cancer Centre, St Vincent’s Breast Screen and Hobson’s Bay Specialist Centre in Victoria. Associate Professor
Gillian Mitchell
is a Medical Oncologist and Head of the Familial Cancer Centre at the Peter MacCallum Cancer Centre in Melbourne.
Dr Hamish Farrow is a fully
qualified Plastic and Reconstructive Surgeon. He is in private practice at Hawthorn Plastic Surgery in Victoria.
THINK PINK FOUNDATION: is an independent, volunteer based charity that dedicates its efforts and the funds it raises to provide practical support for people diagnosed with breast cancer. There are many different ways to get in touch with Think Pink. All enquiries are welcome and are treated with respect and confidentiality. You are most welcome to visit the Living Centre once or many times and we look forward to receiving you. For more information visit www.thinkpink.org.au
Follow Us 2think_pink_aus www.facebook.com/pages/TheThink-Pink-Fpundation-Australia
Statistically, one in nine women will be diagnosed with breast cancer during their life time. This means that this year, approximately 14,500 women will be diagnosed with breast cancer nationally and a little over 3,500 of those will come from Victoria. One per cent of all cases diagnosed will be men. There are many different breast cancer charities and not-for-profit organisations associated with the breast cancer cause, each addressing worthwhile, but very different aspects of the issue. Some are concerned with funding research to find a cure, some provide vital information to patients and advocacy to government, while others provide funding to employ vitally needed breast care nurses in treatment centres – especially in rural areas. While all of these activities are important and certainly part of the long term plan to overcome and hopefully eliminate the disease, at
Think Pink the focus is on the very real needs and struggles of those who have been diagnosed and are currently living through what is probably the most challenging time of their life. Guided by Chair Irene Hendel, herself a two-time breast cancer survivor, Think Pink became focussed on directly helping people who have the disease – at every stage of the journey from initial diagnosis, through treatment and onto survivorship. In 2010 the Foundation established its unique, nonclinical based facility called The Living Centre, which provides direct emotional, practical and physical support to breast cancer patients through a comprehensive range of support services. Simply put, Think Pink’s Mission is to enable a better journey through breast cancer for patients and their families – all of whom are affected by a diagnosis.
The Living Centre Ground Floor, 390 St Kilda Road Melbourne VIC 3004 T: (03) 9820 2888 | F: (03) 9820 0388 | E: dspence@thinkpink.org.au W: www.thinkpink.org.au | Facebook: - The Think Pink Foundation Australia
How You Can Help The breast cancer journey is a difficult one for anyone to experience. At Think Pink we help breast cancer patients and their families in practical ways, but we couldn’t do that sustainably without the support of many selfless individuals and organisations. As a not-for-profit, volunteer-based charity, we receive no ongoing government funding. Your kindness and generosity will profoundly and directly benefit women and men with breast cancer.
Irene Hendel
Chair of the Think Pink Foundation, Founder of the Living Centre and Breast Cancer Survivor
Some simple ways in which you can help: Fundraise, Volunteer, Donation (financial or Goods or Services), In memoriam, Leave a legacy, Raffle tickets and more. For further information please visit, www.thinkpink.org.au
Rachael J O IN E R Think Pink Living Centre Advocate Rachael Joiner has been a senior political advisor to four Ministers of the Victorian State Parliament and is an erudite and committed advocate for The Think Pink Living Centre. Her story is one of highs and lows, inspiration and optimism. Unfortunately, Breast Cancer runs genetically in Rachael’s family and has affected several generations. Rachael is pleased to share a little of her story with us:
Breast Cancer Survivor and Living Centre Advocate
Rachael Joiner speaks at the 2013 Think Pink Masquerade Ball
I was introduced to The Living Centre when I did their first young women’s “Day of Indulgence”. This was prior to my chemo commencing. I remember checking out the wig library, just in case I needed it. But then going back to the Living Centre when I was bald was really hard. I mean, to go from having thick, beautiful straight hair to none was so humiliating! But I received such gentle and respectful support from everyone there in choosing my first wig, which I called the “Russian Spy”. It was a stylish black bob, and became my favourite and most comfortable wig.
Enabling a better journey through breast cancer
The Living Centre supported me emotionally by connecting me to other women, especially women of my own age, who were in the same situation. They also offered me counselling and meditation, as well as explaining to me the potential impact that the treatment may have. There were other women who had already started their treatment who helped prepare me for what I was in for. It was this that provided me with the first feeling of calmness since my diagnosis. My family, friends and later my new partner have been brilliant throughout all of this, but the fact is you feel isolated. The people I met at The Living Centre gave me a different kind of sanctuary where I knew they completely understood what I was feeling. As a young woman with breast cancer, I could talk with other young women who also had breast cancer. We found relief in sharing with each other, and I found myself relieved and pleasantly surprised that I wasn’t alone in my struggles. A lot of women haven’t had kids so fertility is a massive issue. The treatment is very hard for us, as our fit bodies fought back! It is fantastic to have other women to talk to and not feel so isolated and alone. Also the nurses at The Living Centre were there 24/7 to answer any weird or wonderful questions that I may have had. Your world really does turn upside down and those that are there with you really are a part of that journey, so it’s a test of character strength and loyalty. I’m still in the process of recovery and am looking forward to a happy and healthy life.
NIPTUCK Magazine
27
Fallopian Tubes The
Not So Innocent?
Counselling women about Fallopian tube occlusion, which is the most common method of sterilization through the surgical blocking of the fallopian tubes, is an exercise that has, in the recent past, received great scrutiny by various courts of law around the world. The reason for this lies primarily in the consequences of failure of tubal occlusion, which of course is pregnancy.
Dr Oseka Onuma
BSc., MJur., MBBS, FRCOG, FRANZCOG Gynaecology. Uro-Gynaecology. Pelvic Reconstructive Surgery.
My memory of specialist training in the UK is clear regarding the importance of ‘informed consent’, which has a legal rather than a medical definition and involves a number of assertions, not least being the patient’s ‘capacity’ to consent. Capacity is another legal term beyond the scope of this article.
Legal guidance dictates that when counselling women about tubal occlusion for sterilization, they are informed; 1. that the procedure should be regarded as irreversible; 2. of alternatives to tubal occlusion such as using an IUCD, the oral contraceptive pill, Depoprovera, Implanon, Essure procedure or the partner having a vasectomy; 3. that the procedure has a failure rate estimated as 3-4/1000; that if reversal is requested, it is not covered by the public health system and may not be effective; and 4. of other risks associated with any surgical procedure and risks associated with tubal occlusion specifically. Most tubal occlusion procedures are carried out using laparoscopic (‘key-hole’) surgery and the majority of patients will go home the day of surgery with little down time. In principle tubal occlusion requires that the tubes are blocked so that it is not possible for sperm to pass through and come into contact with an egg released at the time of ovulation. The two most common occlusive techniques use either the Filshie clip or Fallope ring. The tubes are compressed, the blood supply interrupted and that part of the tube dies. It is not uncommon for me to see a highly anxious woman who underwent tubal occlusion in the past to present worried that she was at risk of becoming pregnant because a scan (performed for an unrelated cause) found that the Filshie clip was lying in the pelvis. They are reassured when I explain that when the tube loses its blood supply, it shrinks and some clips will eventually fall off. The tubes, however, are irreversibly damaged by this time so there is no risk of pregnancy.
Fallopian tubes
Uterus, with intact fallopian tubes and ovaries.
Tubal Occlusion
Application of a Filshie clip to block the right fallopian tube.
Filshie clip
Lifting the fallopian tube as application of the Filshie clip to ensure that the clip has completely blocked the tube.
Endoloop
Application of the Endoloop device over and around the right fallopian tube.
Endoloop Completed
Removal of the outer part of the right fallopian tube after application of the Endoloop device.
Over the last decade, I have been offering women intent on undergoing a tubal occlusion procedure the option of tubal removal or ‘salpingectomy.’ The simple reason for this is that tubal occlusion has a failure rate of 3-4/1000 and the removal of the fallopian tubes has a failure rate 1000 times less. Furthermore, removal of the fallopian tubes can also be achieved through key-hole surgery allowing the patient to be discharged on the same day with a similar down time to tubal occlusion. The patient then balances this against an increase in surgical time of approximately 10 minutes and a very slightly increased risk of blood loss. Removal of the ovaries at the time of hysterectomy (for non-cancerous conditions such as heavy periods) is often performed as a means of trying to reduce the ovarian cancer risk. Offering a woman bilateral oophorectomy (removal of both ovaries) when they are undergoing hysterectomy after their menopause has, until the recent past, been uncontroversial and a normal part of the consent process prior to surgery. Removal of the ovaries in women undergoing hysterectomy prior to their menopause has attracted more debate and discussion about the relative merits because removal of the ovaries results in a medically induced menopause.
What general facts do we know about ovarian cancer? 1. 1 in 77 women will develop ovarian cancer before the age of 85. 2. More than 1200 women are diagnosed with ovarian cancer every year and around 800 will die from the disease. 3. Ovarian cancer is the 6th cause of cancer death in Australian women. 4. Approximately 75% of women are diagnosed with ovarian cancer at an advanced stage when the cancer is difficult to treat successfully. 5. If the disease is detected and treated at an early stage it is expected that an 80% rate of recovery can be achieved. 6. The median age for first diagnosis is 64. Recent evidence that the ovaries continue to produce low levels of oestrogen and testosterone contributes to the conflicting evidence as to the merits of ovarian removal. Counselling women about ovarian removal remains a complex exercise and must take into account each woman’s particular circumstances and outlook. At the same time there is growing evidence that some of the more common types of high grade ovarian cancer actually arise from the outer aspects of the fallopian tubes rather than being ovarian in origin. In other words, many ovarian cancers may not actually have arisen from the ovary. This finding is likely to have a significant impact on the direction of research on ovarian cancer. More immediately though, it throws a whole new light on how we counsel women about tubal removal. The Fallopian tubes do not produce any hormones and have no known function once the woman has completed her family or decides she does not want to have a pregnancy. Removal of the tubes does not appear to complicate the surgery of hysterectomy nor does it have any effect on ovarian function. In fact, the question that I have now begun to pose to any patient of mine who has completed her family or who does not want any future pregnancy and is intending to undergo an abdominal gynaecological procedure is ‘would you like me to remove your fallopian tubes at the same time.’ Perhaps the time has come for women to be more proactive and ask their gynaecologist about the risks and benefits of having their fallopian tubes removed.
Support plastic and reconstructive surgeons to help others. Donate today and repair bodies and rebuild lives.
interplast.org.au
AUSTRALIAN SURGEONS
TRANSFORMING
Written by Melinda Barlow
EVERY DAY IN AUSTRALIA AND ACROSS THE GLOBE, LIVES ARE BEING TRANSFORMED. PLASTIC SURGERY IS MORE THAN JUST BEAUTIFUL BREASTS AND FACELIFTS - IT IS A HIGHLY SPECIALISED PROFESSION DEALING WITH ALL MANNER OF FUNCTIONAL AND AESTHETIC CHALLENGES. REQUIRING SKILL AND PRECISION, SURGERY MUST BE PERFORMED WITH AN ARTISTIC AND DELICATE HAND, AND A COMPREHENSIVE UNDERSTANDING OF HOW APPEARANCE IMPACTS ON HUMAN EXISTENCE.
Photos: interplast.org.au
Australia has an abundance of highly skilled plastic, aesthetic and reconstructive surgeons, who have, for the most part, completed their training right here on home soil. Many have ventured off to learn further afield once their initial training was completed, but all have returned, bringing with them the very latest techniques and procedures from across the globe. Our local surgeons rank amongst the best in the world and are internationally renowned within their field of expertise.
a career where they could make a difference. For many that was reconstructive surgery. Non profit organisations such as Interplast Australia & New Zealand (Interplast) and OSSA, provide free reconstructive surgeries to patients that may not otherwise be able to receive treatment. They support surgical training and implement health programs in over 25 countries to ensure better aesthetic outcomes for people in need. Australian surgeons featured in this very issue are volunteering their time for organisations just like this one.
There is a certain glamour attached to the profession of plastic surgery – this is undeniable. However the celebrity and the glitz and hype often overshadow the real stories, the human stories. Those of everyday people going through enormous difficulties, and the surgeons that are there for them, every step of the way, helping to piece their lives back together.
The impact of reconstructive facial surgery is immeasurable in countless cases. Children living in remote villages that have been ostracized because of their facial deformities have had their whole life turned around by their equivalent of a knight in shining armour – or in this case - scrubs. A series of surgeries, correcting displacement of features or reconstructing where abnormalities exists, has provided them with a ‘normal appearance’ and a second chance. Having the opportunity to reintegrate into the community, go to school, make friends and achieve a healthy abundant social existence is a small thing, but provides the one thing every child is entitled to – a normal childhood.
There are numerous stories about the moment someone’s life was turned upside down, but little is publicised about the unsung heroes of the event – the surgeons. Maybe it was a workplace injury – a crushed hand, a deeply lacerated leg. Or a badly damaged nose as the legacy of a sporting career – rhinoplasty after years of suffering allows not only an improved appearance but the capacity for the simplest of functions – free and easy breathing. Surgeons are performing the most delicate of procedures, and restoring form and function, in the midst of fear and trauma as patients recover from shocking accidents, they never expected to have. A lot of our surgeons share a common vision in the surgical possibilities that can transform the lives of children. Having travelled in developing countries, or seen documentaries about birth defects or facial disfigurements, the seed was planted to choose
Then there are the things we are totally unprepared for – devastating life events that change everything in an instant. Horrific car accidents, gunshot wounds, the remnants of years of physical abuse. It is a sad irony that such trauma had to happen to get us there, but Australia has led the world in its innovative approach to treatments for burn victims, as a result of tragedies such as the Bali bombings and the fires of Black Saturday. Finally, there are the countless women that have been affected by breast cancer. But it’s not just the women is it. Whole families, whole communities
are affected when someone is diagnosed. Many of our surgeons have lost mothers, sisters and wives, to breast cancer and this became the motivation behind their practice. Their approach to patient care can’t help but be informed by this, and families are the fortunate beneficiaries. Seeing husbands and children watch the most important woman in their life become a shell of herself is one of life’s great heartbreaks. We have learnt in this issue, why many of our surgeons got into breast reconstruction surgery. Their stories are deeply moving and highly emotional, and the result is a surgeon who sits with families, holds their hand, calmly and patiently answering question after question. Then when he nods, and says I understand, well, families can be comforted somewhat by this, because he really does. There is a fine line between vanity and dignity. Our perception of our personal appearance affects how we move around in the world, whether we like it or not. Suffering though disfigurements can be psychologically scarring and emotionally debilitating and the impact of reconstruction can be life changing. In a lot of cases, reconstruction is necessary to restore basic function, but in others it is for emotional well being as much as anything else. For a woman to feel whole again, and have her feminine self restored, or for a child to lift his face to the world with pride rather than shame. These are the human faces of reconstruction. In this issue we feature state by state some of the very best reconstructive surgeons in the world. They are extraordinary professionals and they are all right here in Australia, ready and waiting for you. Read their stories, learn why they do what they do and get inspired.
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33
THE
SURGEONS’ STORIES
TRANSFORMING
MR DAVID MORGAN INTERPLAST
MR PETER CALLAN INTERPLAST
I had known about Interplast since I started training in plastic surgery. It was always something that I had wanted to do. I made enquiries when I was a trainee but they only send fully qualified surgeons as volunteers. I was fortunate enough to be asked along to a trip to Tonga last year with a friend from Sydney. We really had a great trip. I loved the team aspect of it - the collaboration with the other doctors and nurses, and meeting the locals.
Many plastic surgeons in Australia have volunteered to do two weeks with Interplast at some time or another. For some it’s regular, for others it’s occasional. My first trip was in 1997 to the Solomon Islands, and my other trips have been to Sri Lanka. Much of the work I have done has been related to microsurgical reconstruction such as breast reconstruction, or facial surgery for congenital problems such as cleft lip and palate, or trauma from burns.
Tonga has very good facilities but our work there is to help out with the sheer volume of work that needs to be done. We do surgeries that the local surgeons either don’t have time to get to, or don’t quite have the skills yet to do. By bringing in expertise they don’t have access to, we boost the available manpower and this helps them to get through the things that need to be done all the time. I’ve recently taken on the country coordinator’s role for Tonga and we are going back there again in early November. It will be largely the same team, and my job will be to make sure the services provided are well controlled and properly manned.
The team consists of at least one nurse, an anaesthetist and two surgeons. We take boxes and boxes of equipment with us such as essential instruments, sutures, and dressings so as we don’t impact on the availability of local supplies. The best part of the trips for me is working so closely with the highly skilled local surgeons in the countries we visit. We also liaise very carefully with them beforehand and while we are there, as well as the governments of the countries we visit, as it is extremely important to be sensitive to the effect your visit may have.
A lot of developing countries spend a lot of money to put the infrastructure in place but don’t necessarily have the skillsets to implement or maintain it. This is where Interplast’s work is invaluable.
For more information on Mr David Morgan see ‘Renew Plastic Surgery’ (VIC section)
In the Solomons a ‘forward team’ went over before we arrived to spread the word that we were coming. One man travelled with his child for two days to get to us, partly by land, partly by boat. I have found my trips extremely rewarding personally. A strong bond develops between team members and the medical personnel in the countries we visit, and the patient stories are extraordinary.
For more information on Mr Peter Callan see ‘Peter Callan Plastic Surgeon’ (VIC section)
INTERPLAST AUSTRALIA & NEW ZEALAND (INTERPLAST) Interplast are a not-for-profit organisation working to improve the quality of life for people with disability who are disabled as a result of congenital or acquired medical conditions such as cleft lip and palate or burn scar contractures. Interplast sends fully qualified Australian and New Zealand volunteer plastic and reconstructive surgeons, anaesthetists, nurses and allied health professionals to the Asia Pacific region to provide free surgical treatment for patients who would otherwise not be able to afford access to such services. They also focus heavily on training local medical personnel to act independently. Their purpose is to provide life-changing surgery today and sustainable health systems tomorrow. Find out more at www.interplast.org.au
THE
TRANSFORMING
DR MANSOOR MIRKAZEMI
SURGEONS’ STORIES MR YUGESH CAPLASH OSSA
INTERPLAST
When I finished medical school in Tasmania, I asked one of the plastic surgeons (Simon Thompson) who had just returned from an Interplast trip if I could go with him on his next trip. He said that only qualified plastic surgeons could participate. I couldn’t wait to be involved.
Initially my volunteer work started in India for Rotary International, repairing children’s cleft lips and palates. I got introduced to OSSA by fellow surgeon Mark Moore who was doing trips to East and West Timor. I’ve been going to East Timor for three years now and there is still a considerable part of the population who have cleft lips and palates, many of them adults who have lived with it all of their lives.
I have been going to Sumbawa Besar in Indonesia for two weeks every year since 2009 with my colleague and mentor Dr Ian Carlisle, two anaesthetists and two nurses. There is only one general surgeon in Sumbawa who is unable to treat the large number of patients who require surgery. We have two Indonesian surgeons who join us for a week or two. This is a fantastic opportunity for us to exchange our experiences and learn new techniques as well as make new friends.
Our trips usually are comprised of one nurse, one anaesthetist and one surgeon. We bring our own instruments and have managed to secure donations from suture companies. We examine new patients and follow up on patients that have had surgery on previous trips we made. We usually see an average of 40 patients a week, and probably operate on 30 in that time. It’s a very busy time but we are now getting the chance to teach the local surgeons how to perform these surgeries, so the trips have become teaching visits now too.
In two weeks we see about 250 patients and perform between 80 to 100 operations, involving cleft lips and palates, release of burn contractures, hand surgery, facial reconstruction after flesh-eating infections usually involving microsurgery, cancer removal and reconstruction, and some minor procedures. In terms of facilities and equipment, we are given two operating tables. Everything else we provide. The facilities are very basic, but we make things work and provide the same care we extend to our patients here in Australia. Local nurses get heavily involved in the work and help us in all aspects of patient care. They are supervised by our two Aussie nurses.
It really does change people’s lives when they have the surgery. Especially the children – you can see it in some of the parent’s eyes, they feel so happy to see how completely their child’s profile has changed.
For more information on Dr Yugesh Caplash see ‘Advanced Plastic & Cosmetic Surgery’ (SA section)
I escaped from my country due to persecution and came to Australia with my sister in the mid 1980s. I was helped by the Australian people to study and make a life for myself. I know what it means to be desperate and destitute and I highly value and appreciate what this country has provided for me. I see it as my duty and privilege to help others and make a difference in their lives, however small that might be. Interplast gives me an opportunity to use my skills, and bring happiness to so many people. It reminds me to focus my thoughts and efforts to what medicine is all about and the reason we are here on this earth: to make a positive impact on other people’s lives and bring a smile to their faces.
For more information on Dr Mansoor Mirkazemi see ‘Collins St Plastic Surgery’ (VIC section)
Overseas Surgical Specialists Association (OSSA) The Overseas Specialist Surgeons of Australia (OSSA) came to being in the early 1990s through Dr John Hargrave, a respected leprosy specialist, hand and burns surgeon based in the Northern Territory who identified the need for reconstructive surgical services in neighbouring Eastern Indonesia. Since its formation, OSSAA has, through the magnificent volunteering spirit of the doctors and nurses and the generosity of its members, supporters and medical suppliers (plus some government funding) continued to grow - the number of consultations and operations are now approaching 800 and 400 respectively per year. For reasons of continuity, trust, and local capacity building, OSSAA has maintained its focus in Flores, East and West Timor. Find out more at www.ossaainc.org.au
Does the thought of false
“
Dentures used to be a fact of life but times have changed. They are often the dreaded nightmare of people suffering from dental problems. If you have dentures or advanced dental or gum disease requiring extractions, there is now a much better solution available
“
says Perth implant dental surgeon Dr Misagh Habibi.
The nightmare of dentures Closing the last page of your novel, you turn to your partner and give them a tentative good night kiss. Before you can nestle in for the night, like a robot you find yourself entering that dreaded routine. You take off your earrings, then your glasses, placing them gently next to the glass of water on your bedside table. As elegantly as one could do such a thing, you reach your fingers into your mouth and ever so discretely, you pull out your plastic teeth and drop them into the glass where they sink like a stone. At that instant the sinking of your face is accompanied by a
sinking feeling in your gut. You won’t turn back to face your partner again until morning. You struggle to sleep, remembering that moment from today’s work function when, careful though you were in not eating anything, your boss saw your false teeth drop down as you tried so very hard to adequately laugh at his tired and wrung out joke from last year’s work party. That exact moment when his self-satisfied smirk snapped into a confused grimace of dis-taste replays slow-mo in your mind.
Dr Misagh Habibi
teeth give you nightmares?
Suddenly you wake in an anxious sweat thinking about tomorrow’s dental appointment and realise you had been dreaming. Your teeth are in bad shape. Your gums are no better. Will the dentist say your denture nightmare has to come true?
We know that the loss of teeth causes shrinkage of the upper and lower jaw bones, creating accelerated aging of the face and chewing difficulties and we know that dentures can actually accelerate this aging process.
Luckily, with advances today in the field of oralimplantology, the answer is no. If you suffer from dentures or advanced dental disease requiring extractions, dental implants and the All-on-Four solution could be your saving grace.
Even the best fitting removable dentures could cause additional problems such as difficulty speaking, reluctance to laugh, and the widely heard complaint: sore spots and painful blisters.
Denture wear has long been a fact of life. Our older citizens will tell us that it was common place in their day to have all of your teeth removed in favour of dentures. Thankfully, the problems associated with denture wear and the effect on quality of life are now better understood. According to a scientific finding published by J. Fisk et al, in 1998, the most common complaints from people wearing dentures include a sense of premature aging, less selfconfidence and frequent embar-rassment.
An implant-supported bridge or prosthesis is skillfully made by a technician in collaboration with the dental implantologist/specialist, to create the functional and aesthetic results that are suitable for each case. If planned well from the beginning, there is often a great deal of flexibility in terms of the exact aesthetic outcome achieved, to make sure it suits the appearance and preferences of each patient.
The implant solution: No comparison with dentures
Implant bridges or prostheses can be made from acrylic, acrylic on metal, porcelain on metal orzirconia. They are designed to create a very precisely designed bite, function, and smile, and are secured onto the dental implants which have been surgically inserted into the jaw bone. Once fit, they are fixed and cannot be removed (except by the dentist if they require any modification or repair).
A well designed dental prosthesis anchored by dental implants can create greater, more natural-looking support for the face and prevent or treat premature aging.
Conventional dentures (even with an adhesive) generally restore only 10% of chewing function, while a dental implant prosthesis restores 60–100% in similar evaluations.
People who wear removable dentures report that they enjoy food and drinks less, no longer laugh freely and find social networking more difficult.
NIPTUCK Magazine
37
At the same time, a well designed implant bridge can achieve outstanding cosmetic results. Removable denture wearers often complain of chronic problems due to bad fit, and over time the dentures have to be re-fit and remodelled as the jaws continue to shrink. Implant-supported prosthetic solutions such as the “All-on-Four bridge” never need adhesives or a denture relining, and provide a secure and solid solution that can feel and act as a new, healthy set of teeth.
The All-on-Four Dental Implant Solution for Patients with Dentures (Pictured above)
Decades ago Professor B.I. Branemark of Sweden discovered “osseo-integration”, which is the phenomenon that bone fuses to titanium. Now titanium implants placed in bone have created a diverse array of solutions in surgery. In the earlier days, the Professor’s main use of implants was usually 5 implants placed in the lower jaw (mandible), which after the anosseo-integration period of 6 months, were used to support a new set of lower teeth. The main candidates were people with lower dentures. This is because lower dentures are the loosest, and can often be problematic and difficult to live with, getting worse with time as the jaw bone shrinks without teeth. The long term results of implants for full jaw teeth replacements are conclusive, in that they provide a high rate of predictable long term success.
38 NIPTUCK Magazine
We now know that in many cases, with precise techniques, design, planning and execution, we can actually use as little as four dental implants to predictably support an attractive set of new teeth, not after 6 months, but immediately. This was coined the “All-onFour” treatment concept by its inventor, Dr Malo of Portugal. Many people with missing or diseased teeth have areas of missing/resorbed jaw bone and other anatomic restrictions, which causes a challenge or limitation in conventional dental implant treatments. The All-on-Four concept uses angled implants positioned in precise locations and angles to bypass those problems. For this reason, many patients who would otherwise need multiple surgeries including bone and soft tissue grafts to create a foundation for dental implants, can be treated successfully in just one surgery with this simplified concept. Following the surgery, custom designed teeth can be fit either immediately, or within a few days of surgery – depending on the precise nature and materials design of the prosthesis.
An Instant Transformation for Patients With Diseased Teeth. This transformative treatment concept is not just for the toothless. It can also be suitable for those with widespread, complex dental problems – possibly advanced gum disease, dental decay, root or gum infections, or a combination of these – often coupled with cosmetic concerns.
The benefit of the All-on-Four solution is that it can potentially provide a solution that avoids multiple procedures and months-years of treatment, even in limited bone availability, at the same time being able to create major cosmetic changes to the smile and face. In this technique, following detailed 3-D imaging and planning, the teeth are removed, any disease or infection is debrided from the jaw bone which is shaped and adjusted for the dental implant reconstruction, and the 4 specially positioned and angled implants are placed all in one procedure. Usually the level of the original bone and gum height is reduced surgically, allowing it to be reconstructed in the implant bridge (or prosthetic teeth) to ensure great cosmetic results, gum form and ease of cleaning. In my practice we often complete this procedure in the relaxing, stress-free, memory-free and pain-free comfort of IV Sedation. The procedure can also be carried out under General Anaesthetic, or sometimes Local Anaesthetic. The new teeth (implant prosthesis) can be fit within 3-4 days of surgery. Sometimes minor grafting procedures may simultaneously be carried out near the dental
implants or in the sinuses of the upper jaw. In other cases the cheek bones (zygoma) can be used as anchoring points for the dental implants.
Is it right for me? Considering your options The All-on-Four treatment concept is not suited for everybody, and it is also not always possible to make the new teeth straight away without healing time. However in a great deal of complex dental cases, it provides a viable option. As with any surgical and reconstructive procedure, there are many factors to consider before treatment is undertaken. First you should seek the assessment and advice of an implant dentist or specialist who is experienced in this type of procedure. You should feel comfortable with your surgeon, and consider second opinions for your case. You should make sure that all pros and cons of the treatment are provided to you, including any alternative treatments that may be suitable. You should understand long-term implications and requirements of your different treatment options. Finally, no two cases are the same and as with any surgical procedure it is not without risk – and your surgeon should be able to discuss the nuances and any potential risks of your unique case with you. If you are suitable for this treatment solution, then it can undoubtedly help bring about a positive change in your life – healthy eating, comfortable chewing and just as importantly, a beautiful, secure smile that allows you to socialize and get through your life with confidence.
SKIN REJUVENATION
Why am I ageing? RESIDENT BEAUTY COLUMNIST KRISTINA KYRIACOU
EXCESS ALCOHOL
1
SUN EXPOSURE
SMOKING
Written by
4
3
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STRESS
INADEQUATE SLEEP
2
5
REJUVENATION
Considering the skin’s quality and volume has become more relevant with the advent of a number of newer treatments. The aim of treatment is to produce more volume in the skin itself by increasing the thickness of collagen and elastin in the layer of the skin called the dermis. Many treatments are available from energy based ones using light e.g. laser and IPL or radiofrequency to dermabrasion, chemical peels, dry needling, and injectables. All of these will stimulate an increase in the amount of collagen and elastin and they also have other individual benefits and so the choice of procedure will be influenced by the client’s needs. Chemical peels can be made from very many different ingredients and be of varying intensity. For the most part a deep peel is not necessary and a series of lighter peels will remove superficial imperfections
and stimulate collagen production Injection of a thin form of Hyaluronic acid which in other forms is used to fill lines and to contour the face is a good safe way to hydrate and moisturize the skin from the inside whilst provoking collage production. A series of treatments a month apart gives the best results. Injection of your plasma into your skin is a procedure that has gained popularity in the last few years. Plasma is a constituent of the blood and contains cells called platelets, which store a variety of compounds that promote healing and are released into the skin. This is a safe well tolerated clinic procedure that has the appeal of using your own self made product! Dry needling of the skin, sometimes referred to as collagen induction therapy, is also commonly performed and uses
cylinders with tiny needles rolled against the skin. These are just a few ways to help volumise and rejuvenate the skin and form part of the overall plan that your Cosmetic doctor will tailor to your needs……so stop beating up your skin and make an appointment to see what’s out there! Written by
Dr
ASH
S A NK A R AY YA from THE COSMETIC STUDIO in Brisbane and the DARWIN COSMETIC CLINIC
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SKIN TREATMENT
The light on
Beautiful skin Forever Young BBL has been shown to literally turn back the clock on ageing and sun-damaged skin. How well our skin reflects our age depends on a combination of genetics and lifestyle. There’s a lot we can do to make our lifestyle as youth-friendly as possible: sun protection, a healthy diet, no smoking, less alcohol, regular exercise. And there are plenty of treatments to help undo ‘external’ ageing. But how we will age ‘intrinsically’ is pre programmed in our genes. There’s nothing we can do to reverse that process – or is there? can be applied immediately post treatment making this an ideal procedure for busy people. Results are evident within 2 weeks of the first treatment.
A recent study by dermatologists at Stanford University in the USA has found that older skin treated by Sciton Forever Young BBL (Broadband Light) technology more closely resembled the gene expression profile of younger, untreated skin, as opposed to older people who’d had no treatment. This resulted in the trial participants’ skin having increased elasticity, more ordered and uniform collagen production and significant improvement in fine wrinkles, pigmentation and vascular lesions. Another, retrospective study was conducted on 11 patients treated with Forever Young BBL over the past nine years. It revealed that those patients appeared not to have aged over the study period and, indeed, looked 10 years younger than their actual age Sarah Chatburn is a Registered Nurse specialising in cosmetic dermatology and the Director of Coco Skin and Laser Clinic in Merewether. She also works part time at Lake Macquarie Dermatology as the Laser nurse specialist, and has used BBL Forever Young as a key part of her practice for many years. She spoke to Nip Tuck about her use of the product. Broadband light offers a longterm skin rejuvenation solution for clients with results that last! I have worked in the cosmetic/ dermatology field for the past six years. During that
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We perform treatment on a wide range of clientele including teenagers with acne and men and women that would simply like ‘a freshen up’. BBL can be used on multiple areas of the body including the face, neck, chest, back, arms, legs and hands. I believe that through the use of BBL we are able to give clients their ‘glow’ back. When the skin in clear and free of imperfections, light is able to reflect from underneath, this is a sign of youth and vitality. Clients describe themselves as feeling ‘fresher, smoother and younger! time I have found BBL to be effective for a wide range of skin concerns including long term skin rejuvenation. I have predominately used BBL for excessive sun damage, freckles and lentigines, acne, rosacea, anti ageing maintenance, port wine birthmarks and hair reduction. I have found it to be my first choice for reliable, effective and lasting results. As a practitioner I find the device extremely versatile as it offers a wide range of wavelengths suitable for multiple skin types and applications. By selecting the appropriate wavelength I
am able to provide a specialised treatment that is both safe and effective with high practitioner and client satisfaction. Fantastic results can be achieved in just one fifteen minute procedure, which is simple to perform and comfortable to experience. Ultrasound gel is applied to cleansed skin and the light is then passed over the treatment area. The sensation can be compared to that of a flick with a hot rubber band. Clients experience a mild sunburn sensation, which subsides within a few hours, Makeup,
I can positively state that this product offers long term skin rejuvenation with results that last many years! Definitely a favourite in our clinic!
Sarah Chatburn RN
Beauty Fillers
FILLING YOU IN Injectable dermal fillers have come a long way since we used collagen (derived from cow hide) to combat lines and wrinkles. We look at the latest products, trends, techniques and the dos and don’ts. Dermal fillers are typically used to rejuvenate ageing faces but, increasingly, younger people without any obvious signs of ageing are seeking injectables to stop their features sagging in the first place. Volume in the cheeks is one of the hallmarks of youthfulness. As we get older, this midface fullness gradually declines and can lead to a hollowed, sagging, aged appearance. “We are seeing a trend towards people even in their early 30s having dermal fillers to maintain their cheek fullness,” says Sydney cosmetic physician Dr Peter Bakaric. “There’s a feeling of `why wait till I’ve lost it’. “Obviously much smaller amounts of filler are required than for a person whose face has already started to lose volume. But that extra bit of support keeps the contours intact and also provides a buffer from the natural deflation process. A treatment roughly every year or two, depending on the individual, would be enough to maintain these effects. “Of course with fillers you can also create the effect of high cheekbones, which are typically seen as being youthful and attractive, where there were none before!” Dr Bakaric says one of the biggest advances in the anti-ageing industry over the past decade has been the introduction of different consistencies of hyaluronic acid (HA) dermal fillers that allow this youth-enhancing “revolumisation”. First-generation fillers were very light in texture and used literally to fill lines, wrinkles and grooves, or add definition to the lip line.
are becoming a lot more savvy about how fillers should be used. “My patients want subtle, natural-looking results. And nowadays in Australia, cosmetic injectors tend to be a lot more conservative in the amount of product they use than, say, is the case in the US,” he says. “The trend here is increasingly to have smaller amounts of filler more often, to maintain a fresher, younger-looking appearance. “Done well, the effect of fillers can be subtle, attractive and rejuvenating but the downside is that it takes surprisingly little extra volume to create a strange-looking face that is very obviously `filled’.” “Pillow cheeks” and “trout pout” lips as seen at various times on celebrities such as Madonna, Lindsay Lohan, Lisa Rinna and Melanie Griffith are examples of going too far. As with cheeks, fullness in lips is regarded as a sign of youth and sexuality. The volume of lips in both men and women reach full thickness in the 20s and start shrinking between 30 and 40 years of age. The upper lip thins and the upper lip line (vermillion border) can become less defined. The Cupid’s bow that forms the centre of the top lip will also lose its projection and flatten out.
But newer products such as Modelis and Fortelis are more “viscous” and so can be “moulded” to strategically build up depleted areas of the face. HA is a sugar that naturally occurs in the body and is capable of holding 1000 times its own weight in water. This capability in dermal fillers further enhances their contouring effects and can help improve skin hydration.
Lips can be beautifully restored to their previous shape and plumpness, or made look better than Nature intended, with HA fillers such as Esthélis. However, overfilling lips, just as overfilling cheeks can make them look like pillows, defeats the purpose. In most cases, the upper lip is smaller than the lower lip and these proportions should ideally be maintained during a lip augmentation. Making the upper lip look larger than the lower can lead to the notorious “trout pout” or “duck bill” appearance.
Dr Bakaric says that injecting techniques have also evolved considerably as dermal fillers have become more varied and sophisticated. Equally, he adds, consumers
Another area at risk of overfill/overkill is around the eyes. Products such as Esthelis to fill the tear troughs is a remarkable rejuvenator. Hollowing under the eyes can
44 NIPTUCK Magazine
Photos Courtesy: anteis sa
make people look older than they are, tired or even angry and enhance the appearance of dark circles. Subtle filling in this area to plump out the hollows gives an instant freshening effect to the whole face and reduces the appearance of dark circles. But again, the skill of the injector is allimportant. Too much filler under and around the eyes, especially in people with fat pads in that area, can lead to puffiness or the appearance of bags.
WHAT DERMAL FILLERS CAN NOW DO FOR YOU Leading dermal fillers such as Modelis, Fortelis, Esthelis and Mesolis are variously be used to: • Fill lines and wrinkles • Smooth nasolabial (nose to mouth) folds and marionette (mouth corner to chin) lines • Restore volume to “flattened” cheeks and the temple area • Fill tear troughs to offset a hollowed appearance under the eyes and reduce the appearance of dark circles • Restore or improve lip contours and volume • Hydrate the skin at a superficial level to restore the skin's elasticity and glow and help prevent the appearance of lines and wrinkles. Mesolis is the product of choice for this. These products can last for up to a year, and are gradually resorbed into the body. Modelis can last for up to two years.
s a volumi s er: A A LITTLE GOES A LONG WAY
Initially I had some samples to try, and after just one use I was convinced. I trialed the product and loved it immediately. I find it gives a lot more structure for women who want to look sharp and structured. It helps to redefine shape after bone loss as it replaces the contours that bone used to shape. Also, deep use gives a sharper contour. I use Radiesse® as a total approach to the face. I can use just one vial and cover the mid, upper and lower face as well. I also use it for highlighting the face because it doesn’t make things too puffy. One of the great advantages of the product is that you can use it as a volumiser, as a lifter and to stimulate collagen growth, depending on how you inject it. The means of administration 48 NIPTUCK Magazine
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will determine which of the three different results will be achieved. As a volumiser it’s a great product - a little goes a long way. It’s one of the few products that actually stimulate collagen growth. There are some other filler products that give volume by absorbing fluid. What I like about Radiesse® is that it’s less likely to ‘overpuff ’. This means it is great to use in cheeks and chins where fluid can be commonly retained with normal bodily fluctuations. Often women specify that they don’t want to look ‘too puffy’ so this is when I would use Radiesse®. It helps to achieve the look they want in a natural and contoured way. There is a great technique I use often that can be achieved with Radiesse® that makes it function like an extension of your own makeup brush. In
Images Courtesy of Merz Aesthetics Australia
Dr Van Park has been using Radiesse® Volumising Filler for the past 5 years and has become a loyal fan. Nip Tuck spoke to her about her experiences using the product.
instances where someone would use light reflecting make up to highlight certain angles of the face and give definition, Radiesse® can do the same job. I put it in the countours where the light will reflect from the face and it is a really subtle way of achieving great natural results with this kind of a filler.
Dr VAN PARK
Want A Dream Smile...
For Any Occasion!
Ask Your Dentist About • Easy • Painless • Affordable • Beautiful • www.godental.com.au
SKIN CARE
COSMECEUTICALS: W h a t a re the y ? H ow ca n t h e y h e l p m y s kin? written by: resident beauty columnist Kristina Kyriacou
Essentially the term cosmeceutical refers to the combination of cosmetic products and pharmaceuticals. Cosmeceuticals differ from standard beauty products as they contain active ingredients with medical or dermatological benefits. Whilst some beauty products may claim to have cosmeceutical properties or ingredients the majority of them don’t contain high enough concentrations to penetrate the skin deeply enough. Cosmeceuticals on the other hand reach a deeper level of the skin without the need for a medical prescription. However, with every product promising younger looking skin and antiaging benefits, it can be difficult to distinguish the real products from the gimmicks so make sure you look out for some of these key ingredients to ensure you are getting the most out of your skincare: Antioxidants: Whilst you can’t reverse the effects of free-radical damage and aging, you can certainly prevent or slow these destructive forces. Antioxidants can also
reduce inflammation of the skin, counteract collagen destruction and encourage cell growth to reduce the appearance of fine lines and wrinkles. The best known and most commonly used antioxidant is Vitamin C, which should arguably be part of every skin care regime. Retinoids: When we talk about retinoids we mean Vitamin A. Vitamin A has been used medically most commonly to treat acne but is now very much part of the beauty and anti-aging armamentarium. It has been shown in studies to have positive effects on collagen, increase skin cell turnover and inhibit certain steps involved with pigmentation. Vitamin A should not be used in pregnancy and is generally used under medical supervision. Exfoliants: The role of exfoliants is to encourage the surface skin cells to shed and thus help produce a smoother brighter skin. This is because a thick layer of surface cells can build up which makes the skin look dull and can also
impede the absorption of your skin care products. A variety of acids are used in differing strengths as chemical exfoliants e.g. Alpha hydroxyl acids (AHAs) as well as physical exfoliants such as scrubs. Skin lightening ingredients These generally inhibit melanin formation at a cellular level (Kojic acid) or bleach already established pigment (hydroquinone) reducing the appearance of brown discolouration often caused by hyper-pigmentation and sun damage. Peptides: Peptides are a group of substances some of which are commonly found in creams these days. These creams tend to be expensive but can help with anti-aging by promoting collagen synthesis. Remember that this list is not exhaustive and there are many other ingredients to look out for when it comes to cosmeceuticals. Your skin is invaluable so ensure you invest in some quality skincare to protect yourself against the effects of photo-ageing.
At arc medispa, our dermal consultants use up-todate dermal treatments and skincare products for everyday skin maintenance and skin correction.
Sun damage, uneven skin tone or pigmentation an issue? Interested in anti-ageing treatments for good skin health?
• Skin Assessments • Skin Needling • Chemical Peels • Light & Laser Therapies • Microdermabrasion • Medi-Facials
For an appointment, call Melbourne 03 9828 1300 or Shepparton 03 5820 0500 Member of the ARC Plastic Surgery Group
www.arcmedispa.com.au
Facial Rejuvenation for:
Feel
refreshed & youthful with
FACIAL rejuvenation Freshen up your look with anti-wrinkle treatments and dermal fillers.
• Soften & Smooth
Dynamic Wrinkles • Full & Defined Lips • Cheeks with Volume • Softened Jowls
By Cosmetic Physicians Dr Vilma Di Maria MBBS FRACGP
Dr Lisa Freeman
MBBS FRACGP DRACOG
Dr Fiona Jane MBBS
For an appointment, call Melbourne 03 9828 1300 or Shepparton 03 5820 0500 Member of the ARC Plastic Surgery Group
www.hyperdermics.com.au
NIPTUCK Magazine
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ASK THE
EXPERT What are the most common types of scars that you are presented with in your work as a dermatologist? As a Dermatologist who performs Mohs’ surgery and Laser therapy I see a number of different types of scars, ranging from normal post-operative scars to red, raised, stretched, atrophic (thinned) or keloidal (thickened) scars. I also see a number of patients with acne scars. What issues do these present for the patient? Apart from the unsightly appearance, some scars (such as keloids) can cause symptoms of itch and discomfort, or restriction of movement (particularly if located over a joint). How important is scar minimisation as part of your treatment protocol? (Ie. do you perform treatments where associated scarring is a potential consequence? Is scarring a concern expressed by clients? Scar minimisation is extremely important, as all patients want the best cosmetic result possible. All surgery has the risk of scarring, but everyone heals differently, so some patients heal with invisible scars while others develop obvious ones. Patients need to be informed of the likely risk of an obvious scar, for example, some areas of the body such as the chest and back, and some ethnic groups have a higher risk of keloid scars. We always instruct patients to minimize excessive movement of the treated area, as this increases tension on the wound, and the likelihood of developing an obvious scar. Various suture techniques can also be used to minimize scarring. Good wound care following surgery is very important. There is also good evidence that some topical therapies, such as silicon gel, can help minimize and
52 NIPTUCK Magazine
improve the appearance of scars. Fortunately, most of the modern lasers that I use have very low risks of scarring, and can in fact be used to treat scars. How do you currently address scarring issues in-clinic? Our first aim is to try and minimize scarring by preventative measures and good surgical and laser technique. If patients do develop an obvious surgical scar, the treatment required will depend on the type of scar and the patient’s wishes. Common treatment options include silicon gel, cortisone injections, laser therapy and sometimes further surgery. How does the use of Strataderm and Stratamed fit into your practice? There is good evidence that silicon gel can help prevent as well as treat abnormal scars. I commonly use Stratamed on wounds immediately after surgery, or procedures such as skin curettage, and laser therapy, as it is safe to apply on broken skin. For wounds that have healed, or old scars, Strataderm can be used. I have also used it for wounds that have broken down, superficial burns and other skin injuries. It also seems to minimize the risk of pigmentation following skin injury in darker skin types.
Dr Michelle
Hunt
Dermatologist Nip Tuck Magazine asked Dermatologist, Dr Michelle Hunt about the importance of scar minimisation and wound healing as part of her busy practice, Inner Sydney Dermatology.
www.innersydneydermatology.com.au
BEFORE
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treatment with
STRATADERM
BEFORE
How long have you been recommending these products? I have been using Strataderm and Stratamed for at least 9 months What feedback have you received from patients about their experience using Stratamed and/or Strataderm? Overall I have had very positive feedback from patients. They find it easy to use, and have been happy with the results.
AFTER
treatment with
STRATAMED
Strataderm - effective and affordable silicone scar therapy for old and new scars ƕ 6RIWHQV DQG ˘ DWWHQV UDLVHG VFDUV ƕ 5HOLHYHV WKH LWFKLQJ DQG GLVFRPIRUW DVVRFLDWHG ZLWK VFDUV ƕ 5HGXFHV UHGQHVV DQG GLVFRORUDWLRQ ƕ 3UHYHQWV DEQRUPDO DQG H[FHVVLYH VFDU IRUPDWLRQ
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www.strataderm.com
Distributed by SciGen (Australia) Pty Ltd Suite 1, 13b Narabang Way, Belrose NSW 2085, Australia Ph: 1800 676 833
Switzerland
Somet imes it’s the
simple things...
Something as simple as removing unwanted hair can dramatically change the way we feel about ourselves.Hiding hairy legs under pants when we’d rather be in a skirt; keeping our arms close to our sides like stiff soldiers or wearing shorts over our bikini bottoms. There are even men who haven’t been seen without a t-shirt for decades.
U
nwanted hair can place all sorts of restrictions on how we enjoy life. We’ve been removing hair for as long as there have been sharp tools to scrape whiskers of faces. Nothing much changed for centuries, until we discovered that we could pour a layer of hot wax over the hair and rip it out by the roots. If that sounds painful, it feels a lot worse. Then came the messy creams that might or might not work – depending on whether you could understand the directions for use.
after a treatment to get the optimum results. Every consultation is discuss their concerns and ask as many questions as they would like.
Before, During and After Care
Ten Years of Treatments
Not everyone understands how important it is to take proper care of your skin between treatments but Hairfree clients have the advantage of the E+ skincare range, which is exclusive to Hairfree, and has been specially formulated to use with Hairfree treatments. The range includes an exfoliator and sun protector and is designed to ensure smooth, sexy skin all year round.
With more centres in more places, and doing more than 100,000 treatments every year, it’s no wonder Hairfree has become the trusted name in gentle, pain-free, risk-free hair removal.
Hairfree understands that more and more people are time-poor and can’t afford to wait around for things to happen. Hairfree’s IPL treatment machines are designed to provide optimum results with little or no discomfort in the shortest time possible. Treatment times can range from as little as 5 minutes for an underarm or lip to 30 minutes for a full back. There’s no down time for clients so treatments can be scheduled before or after work or during lunch hours. No one needs to know where you’ve been.
Almost 10 years ago, Hairfree offered a new solution to the problem of unwanted hair: simple, affordable treatments using IPL to remove hair once and for all. Before Hairfree, only the lucky few with generous bank balances could afford permanent hair removal using lasers – and even that was hardly pain free.
Professional Therapists
Every one of Hairfree’s professional therapists has undergone a lasersafety training course and has a caring, sensitive and professional approach to designing treatment programs for every individual client. These women are passionate about helping their clients to achieve results that will make them look and feel better. therapist will spend at least 30 minutes discussing the client’s needs and matching treatment programs to expectations and budgets. Hairfree believes clients need as much infor mation as possible before they begin. At Hairfree, your therapist will explain why a single treatment won’t be enough because of the different ways hair can grow in different places at different times. Factors such as any underlying medical conditions or medications being taken by clients will be taken into consideration. The therapist also advises the client on what to do before, during and
Experience Counts
Too often, people choose hair removal from a salon or centre on price alone. But what might seem like an internet bargain can often be disappointing. Clients can feel rushed and literally zapped because with the wrong treatment machine, there can be real discomfort and pain. You want to be sure that the person treating you has the experience and knowledge to treat you properly and not like a voucher to get in and out as quickly as possible.
Range Of Treatments
Hairfree can also offer you a range of the treatments to complement your hair removal – from skin rejuvenation and tattoo removal to acne treatments and anti-wrinkle injections. Hairfree – you’ll love the freedom.
www.hairfreeonline.com.au Book online or Call 1300 HAIRFREE (424737)
BREA KTHR FAT
UGH
BL AS T ER !
Nip Tuck Magazine Spotlights on truSculpt
TRUSCULPT’S RADIO-FREQUENCY (RF) TECHNOLOGY WORKS BY HEATING FAT CELLS TO A SUSTAINED, YET TOLERABLE, TEMPERATURE THAT ULTIMATELY DESTROYS THEM.
TruSculpt’s Radio-Frequency (RF) technology works by heating fat cells to a sustained, yet tolerable, temperature that ultimately destroys them. This breakthrough treatment can be applied to areas of the body where fat has accumulated and is otherwise difficult to target with diet and exercise alone – most often the thighs, abdomen, buttocks and arms. A typical treatment takes around one hour and you can go back to normal activities straight afterwards. It’s recommended that you have at least one to three treatments per area depending on the amount of fatty deposit present, spaced two months apart. Results are typically seen between 8-12 weeks after the treatment. Dr Lindsey Hooke researched various body contouring systems and was so impressed by the results from a truSculpt treatment targeting the fatty areas on her back and hips that she was the first in Australia to introduce it to her clinic Rejuven8Cosmetix in July 2013. She says that her clothes fit so much better within just four weeks of the first treatment and her clients are experiencing even better results on their outer thighs, abdomen and arms. Several clients have been so impressed by their first treatment that they’ve gone on to treat other areas of their body.
Giselle TeAmo underwent liposuction on her legs 13 years ago, and explains that while the results were pleasing, she still had a pocket of fat and quite a lot of dimpling at the top of her legs. Within 5 weeks after her first treatment with truSculpt at Rejuven8Cosmetix the results were visible:
“
I’ve already noticed a difference. Before the first treatment I was wearing size 8, and I’m now comfortable in size 6. I dropped a jeans size, SHE SAYS. “truSculpt has also improved the texture of my skin and tightness. As you get older, your skin loosens and it feels so much tighter after treatment with truSculpt. It feels like I’ve done squats for three months from a firmness point of view. The inside of the top of my legs is nowhere near as saggy and the inside of my knees was bulky and has now trimmed down. The definition in my legs is so much better. My partner is always saying “How good are your legs looking!” “Liposuction worked for me but after lipo I had to wear compression tights for 6 weeks, rest for two days, and there was bruising and an incision mark left from the procedure.”
WANT TO LOOK YOUR BEST THIS SUMMER? Cutera’s breakthrough technologies have it covered – from top to toe. •BODY CONT OU RING? –
truSculpt targets stubborn areas of fat that are hard to reach with diet and exercise alone
•LEG VEINS? - Excel V can treat leg veins up to 4cm in diameter “With truSculpt there are no compression garments, no bruising and no downtime.” “Now I exercise just to feel healthy and can enjoy my body. I don’t need to be focusing my exercise so intensely on any problem area. If I exercise it is because I want to.”
•PIGM ENTAT ION? – AcuTip can treat precisely, without causing side effects on surrounding, normal tissue •SC AR RED UCT ION? GenesisPlus is used for scar reduction (including hypertrophic scars and Keloids) to accelerate scar remodeling, improve erythema and enhance cosmesis. •SKIN L AXIT Y AND WRINKL ES?
– Titan can be used on both face and body – most typically for skin tightening of jowls and abdomen.
•SKIN REJU VEN AT ION? – Laser BEF O R E
A F T ER
Genesis can be used on a wide variety of skin conditions – improving skin texture and tone, and reducing pore size.
•T OEN AIL FUNGUS? – Genesis Plus has been TGA approved to treat onychomychosis (toenail fungus) •VASCU L AR ISSU ES? – Limelight can be used effectively on telangiectasia and to diffuse redness •WAR T S? – Genesis Plus provides the power needed for effective treatment of warts
DR SAURAV GUPTA
SU R FER S D EN TA L S PA
You can contact Dr Saurav Gupta at: Surfers Dental Spa, Level 1 Suite 4, The Hilton, Surfers Paradise Boulevard, Surfers Paradise QLD 4217 – Tel 07 5538 0101
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Lisa has referred many of her friends and family to us, and she brings a big smile to our faces too whenever she visits us with her new, happy, big smile!
DR JASON PANG
COSMIC SMILE DENTAL You can contact Dr Jason Pang at: Cosmic Smile Dental, Suite 212, 40 Yeo Street Neutral Bay NSW 2089 - Tel 02 9904 2880
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58 NIPTUCK Magazine
I was one of the first dentists in Australia to provide Snap-On Smile, and I have found many successful applications for patients. There are a number of ways to change a patients’ smile, but few options to do so quickly, affordably, and without having to use needles or drills. We have helped hundreds of patients smile with new confidence, and have patients fly in from around Australia to see us. Lisa, one of our favourite cases, had many fillings and extractions. She was desperately worried about how her smile would look. Lisa had heard of many options, but chose SOS as it could give her “beautiful teeth like other people” and was within her budget. She cautiously had a top one crafted, but once we inserted it for her she was so happy and insisted that we make a bottom one straight away. She hasn’t stopped smiling since. Lisa tells us how much her life has changed, and how much more confident she is at work and in her private life.
One patient had a denture but you could not see any of his top teeth. He used to spend most of his time in his room and now feels much more confident about his smile. He was quite hesitant about getting a Snap-On Smile as he wasn’t sure it would make much difference. However once a diagnostic wax up was made and tried on, he was sold. He loves it and has become a regular patient of the practice. Another happy patient is a singer and an actress who has been in many Australian films. She is a confident woman but never smiled with her mouth open. She was worried that the Snap-On Smile would be a problem for singing but it has not been an issue. She is now very much more confident with her smile and very happy with the result. She now also brings her husband to the practice. I hope she’ll have a role where we can see her smiling more!
I
t is an amazing time in dental care, with impressive options that, unlike traditional techniques no longer require painful needles and drilling away of your sensitive tooth structure to help you improve your smile. You can ask your own or find a specially trained dentist about LUMINEERS, the world’s leading no needle, no drill porcelain veneers or ‘Snap-On Smile’. Snap-On Smile is an affordable, removable option that is perfect for those needing a safe and quick result, and available at specially trained dentists around Australia.
To find out whether you are suitable for Snap-On Smile – ask your dentist, or to find a specially trained dentist nearby, or for more information, please feel free to email assist@godental.com.au
Snap-On Smile has changed tens of thousands of lives, around the world. Many people have been impressed by the simple and affordable choice that can be used for young and old alike, to replace missing teeth, improve the shape, colour and appearance of smiles, hide chipped or worn or mildly crowded teeth and restore confidence so easily. These are just a few of the wonderful cases from very happy patients around Australia!
Our patient was very unhappy with the colour, shape and symmetry of his teeth. He was too self-conscious to smile and lacked confidence in his appearance. He had seen other dentists and was discouraged by so many conflicting, scary and expensive treatment options. Some suggested that he would need ‘tens of thousands of dollars’ worth of treatment, his teeth drilled back, and crowns or traditional veneers placed. He was uncomfortable with very complex treatment plans that had been presented to him elsewhere. Within two short appointments, without any needles, drilling away of his teeth and much less cost, we were able to help him achieve his aims. We were able to keep things simple and end up with a great result. Now our patient is happy to smile, feels much more confident and has been referring many others to our practice!
Heather’s mother brought her in to find out whether we could help her. She had seen many dentists before us, and was quoted between $30,000-$40,000 for orthodontics, implants and veneers. Emma barely spoke at her appointment, and certainly did not smile. Her mother needed something affordable and effective, to improve a smile that was missing teeth, gappy, discoloured, with oddly shaped teeth. In just two short appointments, without the use of needles or drills, and less than a 10th of the quotes she had been given, we gave her the smile she had dreamed of. After a few months, Heather came back, happy, smiling, and tells us that we have “completely changed her life”. Heather’s Snap-On Smile story illustrates how important your smile is to how you are perceived and how you perceive yourself. We were so honoured to be part of her amazing journey.
DR RON FULOP
M I TC H A M D EN TA L C LI N I C
You can contact Dr Ron Fulop at: Mitcham Dental Clinic, 24 McDowall Street Mitcham VIC 3132 – Tel 03 9874 2300
BEFORE
AFTER
DR TIMOTHY GOH
OX FO R D D EN TA L P R A C TI C E
You can contact Dr Timothy Goh at: Oxford Dental Practice, Shop10/169 Unley Road Unley SA 5061 – Tel 08 8357 8900
BEFORE
AFTER
AFTER NIPTUCK Magazine
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YOUR EYES
e windows to your soul Lasik Laser Eye Surgery
Laser assisted in situ keratomileusis ( LASIK ) laser eye surgery can change your life completely
written by Dr Robert Paul
WA Laser Eye Centre Ophthalmologist and Director of Surgery, Dr Robert Paul, has seen the modern surgery change people’s lives for more than a decade. Lasik Laser Eye Surgery itself, involves using a laser (intralase) to create a very thin flap within 10 seconds on the cornea – which is the clear dome at the front of the eye – then that flap is lifted up, and a nanosecond laser (Excimer) permanently reshapes the eye, resulting in corrected vision.
Ophthalmologist and Director of Surgery at WA Laser Eye Centre
What to expect from LASIK:
There are many benefits to LASIK, including short procedure time, quick recovery time, a cost effective alternative to spectacles, very little pain, and the procedure’s permanency.
99 per cent. If you’re long-sighted, or have astigmatism – which is where the eyes are irregularly shaped – you have a 95 per cent chance of getting 20/20 vision the day after the operation. Even reading problems can be effectively treated with Lasik
If you’re short sighted, generally 98 per cent of people will achieve 20/20 vision the day after the operation, and by about a week, that improves to
The whole Lasik procedure is now bladeless. Generally, WA Laser Eye Centre has two provisos for
laser surgery candidates: The surgeons like your eyesight to have been stable for at least one to two years, and for the person to be over 18 years of age. It is vital that your Surgeon has been formally trained in Laser Eye Surgery and preferably is a corneal specialist. The use of the most advanced bladeless technology is essential.
• Local anaesthetic drops and an oral sedative are used to relax you before surgery • Slight pressure will be felt while the flap is created, and after that the procedure will be completely painless • You focus on a fixation light during the surgery, but the laser follows the eye if movement is detected. (The laser at WA Laser Eye Centre has the fastest eye tracker of it’s kind) • The whole procedure takes about ten minutes • The laser takes 1.3 seconds to correct every point of error – Most treatments are under 5 to 10 seconds • You will need to wear goggles after the surgery until your checkup the next day • You can drive after the check up, and two days off work is all that is generally needed
A 131 Summers Street, Perth WA 6000 | P (08) 9328 8349 | F (08) 9228 9377
www.medifit.com.au
IM AN I
FACIAL PLASTIC SURGERY & COSMETIC SURGERY SPECIALISTS Dr. Pedram Imani is a certified specialist facial plastic and reconstructive surgeon in Perth, Western Australia. Dr. Imani exclusively performs procedures on the face and the neck. The intricacies of facial plastic surgery from both a functional and aesthetic perspective require considerable skill and finesse. Dr. Imani’s significant talent, complemented by a commitment to training both domestically and internationally gives him the ability to address each individual patients problems for the best outcomes in both form and function. Dr Imani performs both cosmetic and functional procedure on the face and neck. These include both surgical and non surgical minimally invasive procedures. With a prime subspecialty of Rhinoplasty (nose reshaping), he also performs Otoplasty (ear reshaping), Blepharoplasty (eyelid reshaping), Brow lift, Neck rejuvenation and Face Lift.
patients to wait for their treatments away from public view. An operating room and Laser specific room give Dr Imani the facilities he needs to carry out the wide range of procedures on offer. Two consulting/treatment rooms and a dedicated dermal therapy room complete the practice.
Dr Imani also offers a host of non surgical procedures including Laser rejuvenation, Scar removal, facial volumisation, skin tightening and wrinkle relaxers.
Medifit, one of Australia’s leading medical design and construction companies was contracted to fit out the premises, and they carried out the project on time and seamlessly. Once begun, the fit out progressed rapidly and professionally and all timelines were met.
An increased demand for Dr Imani’s services lead to the decision to expand the practice and establish a state of the art consulting suite. After years of operating from a suite in a local hospital, the lack of potential for expansion was limiting the growth of the practice and a new site was identified in the up market suburb of Claremont, Western Australia. The new practice consists of several procedure rooms and consulting suites designed for maximum privacy and operational efficiency. Facial plastic and cosmetic surgery is often a very personal decision and private waiting areas provide a stylish and comfortable environment for
Medifit’s Managing Director, Mr Sam Koranis says “ The new practice gives Dr. Imani the opportunity to offer a complete patient experience at a level commensurate with his skill and ability. The built environment at Imani Facial Plastic Surgery & Cosmetic Surgery represents the practice outcomes that can be achieved when professionals at the top of their fields combine. “ Dr Imani adds “Everyone has had positive comments about our practice. We believe that it is a state of the art consulting suite.”
Imani Facial Plastic Surgery & Cosmetic Specialists Suites 3 and 4 40 St Quentin Avenue Claremont WA 6010 www.facial-plasticsurgery.com.au / Ph (08) 9230 7300
62 NIPTUCK Magazine
INDUSTRY
ydney S
Non-Surgical Symposium comes to
More than 400 medical practitioners attended the 2013 Non-Surgical Symposium (NSS) in Sydney to participate in a range of seminars from rejuvenation with laser to skin care and injectables.
64 NIPTUCK Magazine
NIPTUCK Magazine
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INDUSTRY
NON-SURGICAL SYMPOSIUM with
Dr Tony
Tan
ASAPS & CPSA: 2013 Non-Surgical Symposium
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NIPTUCK Magazine
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QU E E N 68
SLAND 69
Dr Phil Richardson MBBS (Hons), FRACS (Plast.)
Dr. Philip Richardson is a skilled and accomplished plastic and cosmetic surgeon and a certified member of ASPS (Australian Society of Plastic Surgeons), ASAPS (Australian Society of Aesthetic Plastic Surgeons), and RACS ( Royal Australian College of Surgeons). After graduating with First Class Honours in Bachelor of Medicine and Bachelor of Surgery from the University of Queensland, Dr. Philip Richardson completed a three-year residency at the Princess Alexandra Hospital, Brisbane. He was then immediately accepted into the Plastic and Reconstructive training program where he undertook four years of specialised training at the Princess Alexandra Hospital, Mater Children’s Hospital, the Royal Children’s Hospital in Brisbane, and the Royal Children’s Hospital in Melbourne. Dr. Philip Richardson’s areas of interest include breast augmentation and breast reduction. He also works as a visiting reconstructive surgeon at the Royal Children’s public hospital in Brisbane.
From initial consultation to post-operative care, Dr. Richardson and his professional staff are committed to ensuring the absolute comfort and safety of each patient, whilst utilising the most advanced techniques to achieve desired results. With Dr. Philip Richardson’s extensive education and experience, you can be confident that your well-being and appearance are in the hands of a knowledgeable and skilled plastic and cosmetic surgeon.
BR I S BA N E
Plastic Surgery Team
IT’S THE LITTLE THINGS THAT OPTIMISE THE
Patient Experience
Before
After
Before
After
One of the most important aspects of breast augmentation surgery is making the patient experience as comfortable, straight forward and as worry-free as possible. To achieve this, what I like to do is make things as easy as possible by addressing the small things throughout each of the pre-operative, intra-operative and post-operative processes. For pre-operative consultations, I have very convenient office locations, that all have sufficient and convenient parking as well as being close to public transport. Consultation times can be made during the day but also after hours and on a Saturday morning thereby offering times that suit most people. After a thorough consultation patients are encouraged to come back and see me as many times as required or contact my rooms so that they are adequately informed of the outcome they should expect along with the postoperative recovery and the potential risks. Most of my breast surgery is done as day surgery so my patients can recover in their own home with their family. I rarely use drainage tubes, which is convenient for the
patient, but this also means no discomfort for the patient when the tubes are removed. Patients are relatively pain free following surgery, due to optimal pocket dissection, optimising medications to ensure minimal vomiting and the application of sufficient local anaesthetic around the implants. On waking, patients find they have already been fitted with a very comfortable bra which is what they wear post operatively as a support for six weeks. All sutures are dissolving removing the need for removal of sutures. After two or three hours in recovery, patients are taken home by family or friends and to alleviate the need to visit a chemist, they are given a pack with antibiotics, pain relief and bowel medication and extra support bras. Patients are allowed to shower after forty-eight hours and they are encouraged to get up and move around as tolerated, which tends to speed recovery. In fact the recovery is all designed to be quick and easy.
Following surgery I am available twenty-four hours a day for any concerns and during work hours my friendly office staff and nurses are all available. I personally follow up with patients post-operatively and see patients at one week, six weeks, three months, six months, one year and then every two years with an ultrasound. I see patients outside of this schedule at their request or if there are any concerns. The sum of all the little things from an easily accessible initial consultation, to processes that ensure less discomfort and pain, to the final touches making the post-operative time as easy as possible leads to a much quicker and pleasant recovery. In addition because the outcome of breast surgery is optimal this leads to minimal numbers of revisions and secondary breast surgery. I like to make the whole process of breast surgery as comfortable as possible and hopefully this optimises the patient experience.
w w w. b r i s b a n e p l a s t i c s u rg e r y . c o m
Actual patient of Dr Phil Richardson
Dr Phil Richardson MBBS (Hons), FRACS (Plast.)
Brisbane Plastic and Cosmetic Surgery
Level 1, 38 Misterton Street Fortitude Valley QLD 4006 | 1300 789 240 Dr Richardson also consults at Kippa-Ring on the Redcliffe Peninsula:
Suite 22 Peninsula Specialist Centre Cnr George and Florence Streets Kippa Ring QLD 4021 BrisbanePlasticAndCosmeticSurgery
DR LINDA
Williams Dr Linda Williams graduated in Medicine from the University of Queensland in 1985. Following 5 years experience at the Mater Hospital in Brisbane and St Mary’s Hospital in London, she returned to General Practice in Brisbane and gained her Fellowship in The Royal Australian College of General Practitioners in 1993. She subsequently worked for 8 years as a Surgical Assistant for Plastic and Orthopaedic Surgeons before establishing her own clinic, Artisan Cosmetic Clinic in Brisbane in 2002. Dr Williams now specialises in non-surgical cosmetic procedures using nonpermanent fillers, wrinkle correction, skin rejuvenation with peels and pulsed light, HydraFacialTM, CoolSculpting® non-surgical fat reduction and TITAN® thermal skin tightening. Her expertise lies in Natural LookTM total facial rejuvenation that will leave clients feeling confident and comfortable in their own skin. Dr Linda’s keen interest in maintaining ‘best practice’ skills and experience in cosmetic enhancement techniques and anti-ageing medicine has resulted in her regular attendance and involvement at national and international conferences and events. She has been a national and international trainer for Allergan since 2007. From anti-wrinkle injections, lip enhancement and photo rejuvenation – through to acne solutions and preventative treatments that contain ideal anti-ageing ingredients — Dr Williams and her highly experienced team at Artisan offer a customised approach to support both men and women of all ages in looking and feeling their best.
SERVICES
SEE THE RESULTS FEEL THE CONFIDENCE
• Muscle relaxant wrinkle injections • Lip enhancement & rejuvenation • CoolSculpting® Fat Reduction • TITAN® skin firming & tightening • Photorejuvenation • Skin revision
• HyrdaFacial™ • 8 Point Approach • Volume & filler injections • Pigmentation & capillaries • Pulsed light hair removal • Healthy ageing nutritional supplements • Relaxation & beauty
NATURAL-LOOKING REJUVENATION BEGINS HERE The Miro, 3/41 Robertson St, Fortitude Valley Ph 07 3852 3211 | www.artisanclinic.com.au
THE LATEST
TECHNOLOGY
Dr Linda Williams gives Nip Tuck readers a peek at the exciting new ‘Treatment To Transformation’ body sculpting program by CoolSculpting, available at Artisan, for those wishing to re-shape and transform their body without downtime or expensive surgery. CoolSculpting’s new ‘Treatment To Transformation’ program provides dramatic, liposuctionlike results, without the risks of surgery, general anaesthetic, needles, scars or downtime. Using the power of cooling to reduce stubborn bulges in a safe non-surgical way, the contouring treatment is TGA approved for fat reduction with proven results seen in clinical studies. “The process begins with a consultation with your Artisan clinician, who will assess your areas of most concern, and create a treatment plan based on your goals and realistic expectations,” explains Dr Linda. Then it is just a matter of sitting back and relaxing while the CoolSculpting treatment applicator heads are placed on hard-to-budge fat, reducing the temperature of the fat cells. The body then metabolises and eliminates the treated cells in the proceeding three months. But now thanks to the knowledge accumulated from over 700,000 CoolSculpting treatments performed worldwide, this non invasive option has “evolved from simply targeting a distinct bulge of fat, to a procedure that can reshape most parts of the body without going under the knife”. Dr Linda explains to Nip Tuck: “The ‘Treatment to Transformation’ program occurs in conjunction with healthy
nutrition and activity, with the overall goal of body shaping, rather than treating individual fat deposits.” The technique has achieved headline-grabbing body contouring results for celebrities such as Christina Aguilera. But unlike the costly surgical interventions of the past, CoolSculpting is not exclusively for those with deep pockets or a celebrity name. The treatment starts at $799 and is most popular amongst men and women 5-15kg over their ideal weight with stubborn bulges that a healthy diet and exercise can’t budge.
Prior first Coolsculpting
After: right and left back love handles
After: 2nd Treatment
Artisan client
“It is particularly effective for women with a post-pregnancy ‘belly’ and men with spare tyres or love handles,” Dr Linda said. “When it comes to CoolSculpting, it’s the operator that makes the difference to your overall result through experience and extensive training.” Artisan was the first to offer CoolSculpting in Brisbane, and its clinicians have the expertise required to plan the strategic positioning of the heads to achieve ideal body sculpting results, tailored to the individual. Results can be achieved with a single treatment, and multiple sessions are required for the body contouring ‘Treatment To Transformation’, with programs priced on consultation.
Before
After
images supplied by Zeltiq
After 1 treatment of upper & lower abdomen
Artisan client
Before
After
TEETH By Dr Anne-Maree Cole
Dr. Anne-Maree
COLE B.D.Sc MICCMO Aesthetic Excellence 151 Robertson St. Fortitude Valley, Brisbane Ph: 07 3257 1577
25 years on‌
Teeth envy. Do you suffer from it? Do you look at your friends’ great teeth, even strangers and wish that you could have a beautiful smile too? Do you try to hide your smile in their presence? In photos? If you do, you are not alone. I, too have lived this and came through the other side. Let me share with you my story…
I was a sickly child. The antibiotics that saved my life made my teeth dark and ugly. I hated them. Even my teachers made comments when I was least expecting it that took the wind right out of my sails. I was young and pretty with beautiful skin. I looked good … until I smiled. The photos ruined The joy stolen The confidence taken away I was 27 when I discovered the possibilities of porcelain veneers and I jumped at the chance to finally look normal. That was 25 years ago. I won’t say it was the best thing I ever did because my husband and family and career hold that position but it was the best thing I ever did just for me. Has it made a difference? Oh my goodness, it is nearly impossible to put it into words. I no longer fear a photograph. I laugh and smile and greet new people and old friends with confidence and joy. I can be me. My career has taken me to great heights. I lecture nationally and internationally. I share my passion and teach others how to help people just like I was helped. I could never have had the confidence to do that if my teeth had remained as they were. No amount of makeup or hand covering or awkward smiling could have made a difference but dentistry did. Dentistry freed me to be me. This is my story. I look forward to being a part of yours.
Before porcelain veneers NIPTUCK Magazine
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Everybody’s story
is unique.
Dr. Anne-Maree
COLE The smile is God’s gift to humanity. It reaches out and touches one’s soul. A smile has the power to heal, give warmth and share joy. In our disconnected world, it connects people. How important is a smile? It may be the most important thing of all. © Dr Anne-Maree Cole
Your reasons for doing things, what you want to achieve, how you have been affected up until now, what your concerns are, what is important to you … is important to me. By sharing your story with me, I can then create a plan with you that will address your needs and wants and budget. If I understand you, I can help you. Please take a moment to consider these questions and share with me what you need and want me to know.
In your own words, tell me how your less than perfect smile has affected you: What would it mean to you to have a beautiful smile … to look and feel normal? Why have you decided that now is the time to do something about it? What are your biggest fears? What are your biggest hopes?
I look forward to meeting you and helping you. 76 NIPTUCK Magazine
TIRED OF YOUR TEETH MAKING YOU LOOK OLDER THAN YOU FEEL? SPEAK TO SOMEONE WHO LISTENS, UNDERSTANDS AND CAN HELP.
BEFORE
AFTER
DR. ANNE-MAREE COLE B.D.Sc MICCMO 151 ROBERTSON STREET FORTITUDE VALLEY QLD 4006 PHONE: 07 3257 1577 WWW.AESTHETICEXCELLENCE.COM.AU CONNECT@AESTHETICEXCELLENCE.COM.AU
BREAST RECONSTRUCTION
Dr Widdowson has been specializing in all forms of aesthetic breast surgery for 28 years and over this time he has specialized in one of the more difficult aspects of breast surgery - reconstructive breast surgery after mastectomy (for breast cancer).
after
MASTECTOMY Pre Operative Tissue Expander Breast Reconstruction
Pre Operative Latissimus Dorsi Flap Right Breast
Post Operative Tissue Expander & Implant Left Breast. Right Breast Mastopexy with Implant
Post Operative Latissimus Dorsi Back Scar
Post Operative Latissimus Dorsi Reconstruction with Nipple Reconstruction
Pre Operative Abdominal Tram Flap
Post Operative Left Breast Abdominal Tram Flap & Nipple Reconstruction Right Breast Mastopexy
Breast reconstruction is an increasingly common surgical procedure for women who have had a mastectomy. Reconstruction of the breast after removal of cancer may be extremely important to the individual female. The procedure can create a breast that resembles a natural breast in appearance and form and after undergoing this procedure women often report feeling happier with their appearance and have renewed selfconfidence. “Breast reconstruction has improved significantly in the past 20 years” says Dr Widdowson “ and the techniques available today make reconstructing the breast a real art”. There are two main types of reconstruction and these are prosthetic reconstruction where artificial implants are used and autogenous reconstruction where tissue from elsewhere in the woman’s body is used to create the breast mound.
IMPLANT RECONSTRUCTION The surgery for prosthetic reconstruction is less complicated than for autogenous reconstruction. A tissue expander is inserted below the muscle of the chest wall, and is slowly enlarged over a number of months until they are the desired size. This is so the skin can slowly stretch. The second stage of this reconstruction is when the tissue expander is removed and replaced with an implant. Studies have shown
that implants are not a good option for women who have undergone radiotherapy, as complications such as hardening (capsular contracture) of the breast may occur.
AUTOGENOUS RECONSTRUCTION In autogenous tissue reconstruction, a piece of tissue containing skin, fat, blood vessels and sometimes muscle is taken from elsewhere in a woman’s body and used to rebuild the breast. This piece of tissue is call a flap. Different sites in the body can provide flaps for breast reconstruction:
TRAM FLAP: Tissue including muscle, that comes from the lower abdomen. This is the most common type of tissue used in breast reconstruction.
DIEP FLAP: Tissue that comes from the abdomen as in a TRAM flap, but only contains skin and fat and involves microvascular transfer.
LATISSIMUS DORSI FLAP: Tissue that comes from the middle and side of the back. Quite often after reconstructing one breast, surgery needs to be performed on the other breast (either a breast reduction or breast lift) to give a more symmetrical appearance. Nipple reconstruction can also be performed on the reconstructive breast and this usually takes place after the reconstructive breast has fully healed.
Dr Widdowson is a leading specialist in Australasia for his aesthetic breast surgery, (including breast augmentation, uplift, reduction and reconstruction following mastectomy). He is also an expert in secondary breast surgery following complications of breast surgery such as implant rupture, capsular contracture, scar revision and reconstruction.
DR PETER
WIDDOWSON M.B, CHb, F.R.A.C.S (Plastic and Reconstructive)
Following his graduation through the Royal Australasian College of Surgeons with a Gold Medal in Surgery in 1982 and post graduate study in Glasgow, Scotland, England and Australia, Dr Widdowson accepted a Consultant position at Waikato Hospital, Hamilton, New Zealand in 1987. As Director of Plastic Surgery at Waikato Hospital for 12 years Dr Widdowson’s work included burns victims, art of microsurgery, paediatric surgery (cleft lip and palate), skin cancer patients and hand surgery. In 1999 Dr Widdowson joined the Lotus Institute on the Gold Coast and for the last 13 years has established his reputation in the cosmetic industry through commitment, integrity and excellence. Dr Widdowson specializes in all types of cosmetic surgery including breast enlargement, reduction, uplift and reconstruction, body contouring, facial surgery, ear pinning, nose reshaping, abdominal surgery, male breast surgery and some reconstructive and skin cancer surgery. Dr Widdowson believes that a holistic approach to health and beauty is important – nutrition, exercise, spiritual well being and the use of tried-and-true skin products and surgical and non-surgical procedures, all combine to create an individual that is healthy, younger looking and better equipped to face the years ahead.
• Abdominoplasty • Brachioplasty (arm reduction) • Breast Augmentation • Redo Breast Augmentation • Breast Reduction
HEAD OFFICE: Level Two, 2 Short St Southport 4215 Tel: (07) 5509 4488 Fax: (07) 5528 4166
• Breast Mastopexy (uplift) • Breast Reconstruction • Facelifts • Upper and Lower Blepharoplasty (eyelid reduction)
MAILING ADDRESS: PO Box 796 Dr Peter Widdowson M.B, CHb, F.R.A.C.S (Plastic and Reconstructive)
• Browlift • Rhinoplasty • Facial laser • Liposuction • Gynaecomastia • Otoplasty
www.lotus-institute.com.au
Member of the CPSA
Dr Ash Sankarayya is a Cosmetic Physician and General Practitioner. Known as Dr Ash to his patients, his popularity continues to grow, largely due to his empathy and charm. Dr Ash was born and educated in England and qualified in medicine at Birmingham University in 1986. He has had 26 years in the medical field and more than 10 years experience in aesthetic medicine. He subsequently studied Law which he completed prior to moving to Australia in1993. Initially trained in General Practice, Dr Ash has specialised in nonsurgical Cosmetic Medicine and Skin Cancer diagnosis and management. He now lives in Brisbane’s CBD with his family. Dr Ash is married to beautiful Steny, a Beauty Therapist with 30 years industry experience and his clinic manager. Together they established Darwin Cosmetic Clinic in 2000 which Dr Ash still owns and visits on a monthly basis, much to the delight of his extremely loyal Darwin patients. Currently residing in Brisbane, Dr Ash and Steny are owner operators of the
newly opened The Cosmetic Studio Brisbane, conveniently located in Adelaide Street in Brisbane. Together, Dr Ash and Steny are focused on subtle and natural results through experience and ongoing education. Dr Ash Sankarayya is a full member of the Cosmetic Physicians Society of Australasia (CPSA). Dr Ash is passionate about providing the finest care and comfort to ensure the patient experience is as relaxing as possible. For this reason his patients enjoy a warm, friendly and modern atmosphere in his clinics and feel relaxed and comfortable while receiving their beauty enhancing treatment. The popularity of Dr Ash is without a doubt due to his ability to build long term relationships and his patients talk about him with affection and loyalty. His non-surgical Cosmetic procedures produce a subtle and natural result.
www.thecosmeticstudio.com.au
We pride ourselves on providing the finest care and patient comfort so your experience is as relaxing as possible.
ANTI-WRINKLE INJECTIONS DERMAL FILLERS FRACTIONAL RF
(NEW FOR SKIN REJUVENATION)
PLATELET RICH PLASMA (PRP)
ACNE TREATMENT
SKIN REJUVENATION
MICRODERMABRASION
SKIN PIGMENTATION COSMETIC MOLE REMOVAL SKIN CANCER CHECKS
With an emphasis on “NATURAL” results & expert treatment, Dr Ash and his team look forward to meeting you today!
Cosmetic in the City Our new clinic is headed by Dr. Ash Sankarayya, the qualified professional at The Cosmetic Studio. It is on the corner of Adelaide Street and Boundary Street. Contact us today to book your private appointment
www.thecosmeticstudio.com.au
The Cosmetic Studio Brisbane 485 Adelaide Street (This is the building on the corner of Boundary St and is the new Meriton Soleil apartment block.)
Brisbane 4000 Ph: (07) 3012 8023 E: ash.steny@bigpond.com
Darwin Clinic 1/53 Ross Smith Avenue, Parap, Darwin NT 0820 Ph: (08) 8981 5227
Australian Capital Territory
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NEW SOUTH WALES
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The The Body Body Beautiful Beautiful DRDR ALASTAIR ALASTAIR TAYLOR, TAYLOR, A HIGHLY A HIGHLY QUALIFIED, QUALIFIED, ACCREDITED ACCREDITED PLASTIC PLASTIC SURGEON SURGEON WITH WITH MANY MANY YEARS’ YEARS’ EXPERIENCE EXPERIENCE IN IN ALL ALL AREAS AREAS OFOF RECONSTRUCTIVE, RECONSTRUCTIVE, COSMETIC COSMETIC AND AND MICROSURGERY, MICROSURGERY, REVEALS REVEALS HOW HOW HIS HIS UNIQUE UNIQUE APPROACH APPROACH TOTO ABDOMINOPLASTY ABDOMINOPLASTY CREATES CREATES AA BETTER BETTER BODY BODY LIFT LIFT RESULT. RESULT.
I was I was intrigued intrigued to see to see an article an article recently recently trumpeting trumpeting ‘Half‘Half theirtheir Size’. Size’. TheThe article article showcased showcased people people celebrating celebrating the the lossloss of between of between 80 -80 90kg. - 90kg. ThisThis is anis an amazing amazing result result achieved, achieved, either either through through sheer sheer will will power power or restrictive or restrictive stomach stomach surgery. surgery. Significantly Significantly though, though, all the all the postpost weight weight lossloss pictures pictures were were clothed. clothed. It‘s It‘s great great people people cancan go from go from wearing wearing large large tent-like tent-like clothes clothes to more to more fitted fitted andand shaped shaped clothing, clothing, but but the the truthtruth is the is the picture picture is not is not so pretty so pretty once once clothing clothing comes comes off. off. Massive Massive weight weight loss loss leadsleads to significant to significant skin skin redundancy. redundancy. BodyBody typestypes may may differ,differ, but generally but generally people people weighing weighing over over 130 130 kg will kg will carrycarry a ‘spare a ‘spare tyre’,tyre’, which which is largest is largest rightright in front. in front. Depending Depending on the on the amount amount of weight of weight lost, lost, this fatty this fatty apron apron can hang can hang down down almost almost to to their their knees. knees. OnceOnce the weight the weight is lost is the lostskin the skin rarelyrarely retracts retracts and and the the flap is flap leftisbehind. left behind. Breasts Breasts also also deflate deflate with with weight weight loss,loss, looking looking flat flat and and unattractive unattractive (even(even in men) in men) and and legs,legs, previously previously quitequite round, round, sag. sag. This This skin skin needs needs to betoexcised be excised and and the tradeoff the tradeoff is theisscars the scars are long. are long. The surgical The surgical processes processes required required to excise to excise this excess this excess skin skin are are lengthy lengthy ones.ones. OverOver the years the years I have I have moved moved awayaway fromfrom the one the large one large procedure procedure preferring preferring to stage to stage the surgeries the surgeries making making the process the process easier easier and and reducing reducing the risks the risks for the forpatients. the patients. I prefer I prefer to remove to remove the stomach the stomach apron apron as the asfirst the operation. first operation. This This apron apron is hotis and hot and sweaty sweaty and and can be candifficult be difficult to keep to keep clean; clean; as a as a resultresult manymany patients patients suffersuffer yeastyeast infections infections underneath underneath it. Tucking it. Tucking a a largelarge volume volume of skin of skin inside inside clothing clothing can also can also be frustrating be frustrating and and depressing. depressing. The rectus The rectus muscle muscle can also can also split split as a as result a result of the offat the fat inside inside in theinabdomen the abdomen and and this will thisrequire will require surgical surgical repair. repair. Removing Removing this apron this apron of skin of skin leadsleads to a to much a much moremore comfortable comfortable existence existence where where patients patients can celebrate can celebrate their their achievement. achievement.
About AboutDrDrTaylor Taylor Dr Taylor Dr Taylor is a highly is a highly qualified, qualified, accredited accredited plastic plastic surgeon surgeon with with manymany years’ years’ experience experience in allinareas all areas of reconstructive, of reconstructive, cosmetic cosmetic and and microsurgery. microsurgery. In hisIncontinued his continued pursuit pursuit to provide to provide outstanding outstanding commitment commitment to histopatients, his patients, and and afterafter yearsyears of research, of research, Dr Taylor Dr Taylor is is also also proud proud to have to have pioneered pioneered and and to deliver to deliver a program a program designed designed to to layerlayer and and sequence sequence non-surgical non-surgical rejuvenation rejuvenation treatments. treatments. He has He ahas well a well established established practice practice in Canberra in Canberra at the atpurpose the purpose built built Canberra Canberra Aesthetic Aesthetic and and Plastic Plastic Surgery Surgery (CAPS) (CAPS) Clinic. Clinic. Dr Taylor Dr Taylor works works only only in Canberra in Canberra which which ensures ensures his availability his availability to histopatients his patients pre and pre and postpost operatively, operatively, and and to those to those patients patients beingbeing treated treated with with non-surgical non-surgical modalities. modalities. Dr Taylor Dr Taylor is a Fellow is a Fellow of the ofRoyal the Royal Australasian Australasian College College of Surgeons of Surgeons (FRACS) (FRACS) and and a Member a Member of the ofAustralian the Australian Society Society of Plastic of Plastic Surgeons Surgeons (ASPS). (ASPS). Trained Trained in theinmajor the major teaching teaching hospitals hospitals of Sydney, of Sydney, Dr Taylor Dr Taylor maintains maintains industry-leading industry-leading surgical surgical techniques techniques through through regular regular involvement involvement at international at international surgical surgical meetings. meetings.
CONTACT CONTACT DR DR TAYLOR TAYLOR AT THE AT THE CAPS CAPS CLINIC CLINIC 7 PHIPPS 7 PHIPPS CLOSE, CLOSE, DEAKIN DEAKIN ACTACT 2600 2600 Phone Phone (+612) (+612) 6282 6282 1177 1177 www.capsclinic.com.au www.capsclinic.com.au
An abdominoplasty An abdominoplasty allows allows me me to repair to repair the separation the separation of the of the abdominal abdominal muscles, muscles, liposuck liposuck the uneven the uneven flanks flanks and and remove remove at least at least 50cm 50cm or more or more of of excess excess skin.skin. If required If required we we come come backback in sixinmonths six months time time and and address address the back the back of the of the bodybody with with a posterior a posterior bodybody lift. lift.
“The “The picture picture is not is not soso pretty pretty once once clothing clothing comes comes off.” off.”
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Skin Skin excision excision surgery surgery following following weight weight loss loss needs needs to beto be individualised individualised to give to give the best the best outcome outcome for the forleast the least expense expense in both in both monetary monetary terms terms as well as well as the astime the time off work. off work. Dr Alastair Dr Alastair Taylor Taylor MBBS MBBS | FRACS | FRACS Patient Patient photos photos used used with permission. with permission.
Repair Reshape Revise
Discover how an abdominoplasty can change your life. Contact The CAPS Clinic Ph (02) 6282 1177
PUT DOWN YOUR COOKIE CUTTER. ABDOMINOPLASTY IS NOT ONE SIZE FITS ALL. Abdominoplasty is definitely not a one size fits all operation. Aside from the functional aspects of the surgery one must also consider the aesthetic results and this can be difficult to predict. When I am assessing a patient for this surgery the very first thing I consider is their overall body shape. We often talk about the ‘apple vs pear’ and this alone is a very effective method of predicting an outcome, especially when we are talking about a reconstructive procedure following weight loss.
capsclinic.com.au
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The majority of patients I see following weight loss will require an abdominoplasty to tighten the abdominal apron. If the patient requires the buttocks to be addressed a posterior body lift can be performed six months later - this pulls the legs up like a pair of trousers, elevating the buttocks and tightening the lateral thighs. Some patients will not require a posterior body lift operation, only those who have a lot of buttock and lateral thigh laxity will need this. Apple shaped people who put on their fat in their flanks as well as the inner thighs will not need the procedure as the outer thighs and buttocks have never been large, so therefore don’t get wrinkled and collapsed with weight loss. Most men fit into this group. An abdominoplasty allows me to repair the separation of the abdominal muscles, liposuck the uneven flanks and remove at least 50cm or more of excess skin. If required we come back in six months time and address the back of the body with a posterior body lift. Skin excision surgery following weight loss needs to be individualised to give the best outcome for the least expense in both monetary terms as well as the time off work.
“I am finally confident again and not ashamed to walk around.” - CAPS Patient
Sole’vita. Canberra’s premier medical & surgical facility. p (02) 6282 1153 | solevita.com.au
The internet just had a facelift. We are live. capsclinic.com.au
DR MARK
EDINBURG
Aesthetic Expert Plastic, Reconstructive & Cosmetic Surgeon
Plastic, Reconstructive & Cosmetic Surgeon Dr Mark Edinburg MBBCH FRACS is Medical Director of The Eden Institute of Plastic & Cosmetic Surgery and MediSpa, with more than 20 years of outstanding medical service and achievements. Dr Edinburg’s decades of Breast Augmentation knowledge and experience combined with his understanding of the individual needs of each of his patients combine to deliver excellent natural-looking aesthetic results. Renowned as an expert in natural-looking surgical outcomes, Dr Edinburg is dedicated to enhancing each person’s individual form and being. He believes that a good Surgeon has to have a combination of expert surgical and technical skills and an appreciation for well defined beauty combined with a real understanding that each patient is an individual and each procedure needs to be assessed in terms of that specific patient’s individual needs. As well as being a leading Plastic and Cosmetic Surgeon, Dr Edinburg is also a specialist Skin Cancer and Hand Surgeon, based on decades of training, locally and internationally, including a Fellowship at Canniesburn Hospital in Glasgow, Scotland. Even though Dr Edinburg has two decades of successful surgical experience, he is vigilant about being committed to advances in Plastic Surgery as a regular participant at Advanced Training updates at the Royal Australian College of Surgeons and the Australian Society of Plastic Surgery, and also regularly spends time operating with other surgeons all over the world, exchanging ideas and techniques. In a field where education and technical skill is of paramount importance to ensure safe and effective surgical and non-surgical treatments, Dr Edinburg’s credentials position him as a pre-eminent Plastic Surgeon in Australia, delivering outstanding results for surgical and non-surgical rejuvenation for face, breast, body, hand, skin cancers and skin health treatments.
B O D Y • B R E A S T • FA C E • M E D I S PA
CONTACT US: BAULKHAM HILLS CLINIC Clinic C1 Solent Centre 3 Burbank Place Norwest Business Park Baulkham Hills T (02) 8814 5800 E doctor@edeninstitute.com.au
CHATSWOOD CLINIC 201/443 Victoria Ave Chatswood Sydney T (02) 8814 5800 E doctor@edeninstitute.com.au
RICHMOND CLINIC
47 East Market St Richmond Sydney T (02) 4588 5636 E doctor@edeninstitute.com.au
www.edeninstitute.com.au FIND US ON
DR EDINBURG’S PROFESSIONAL A F F I L I AT I O N S • Australian Society of Plastic Surgeons ASPS • Australasian Society of Aesthetic Plastic Surgeons ASAPS • Australian Hand Surgery Society AHS • American Society of Plastic Surgeons ASPS USA • Royal Australasian College of Surgeons FRACS • Australian Medical Association AMA • International Society of Aesthetic Plastic Surgeons BEFORE
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SPECIALIST SURGICAL SKILLS
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• Facial Cosmetic Surgery • Blepharoplasty • Rhinoplasty • Face Lifts • Breast Reduction • Breast Lift (Mastopexy) • Breast Augmentation • Gynaecomastia (Male Breasts)
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• Abdominoplasty • Liposuction • Otoplasty • Hand Surgery • Lesions, benign or malignant, face & body • Skin Flaps & Skin Grafts • Advanced Medispa • Anti-wrinkle treatments
BODY B E A U T I F U L
PLASTIC SURGEON DR MARK EDINBURG DISCUSSES THE TUMMY TUCK PROCEDURE AND WHAT MAKES A DIFFERENCE IN GETTING THE BEST END RESULT.
Toned, flab-free, flat are descriptions our team at the Eden Institute of Plastic & Cosmetic Surgery hear when patients discuss their desire for a slimmer, flatter tummy. You are 35+ and your children are growing up. The children were born by normal vaginal delivery or caesarian section. Some of you may have a gastric band and others may have had a gastric sleeve procedure. Some may have had other surgical procedures such as hernia repairs, appendix removal or laparoscopic procedures. You complain of extra tissue almost like a “tyre” around your mid drift – a tummy which sticks out. You often wear a corset to pull it in. Bikinis are out of the question. It is worse when sitting, hanging over your undies, sweat rashes, discomfort with clothing. Despite eating a good diet and exercising 3-4 times a week you are unable to shift the weight from the abdomen or the hips. In fact the more weight you lose the thinner your face appears and your breasts become smaller.
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The good news is that at the Eden Institute of Plastic & Cosmetic Surgery, we have a solution to help you. At the outset though, if you are very overweight, I will send you away to lose some of it. This will help you recover quicker from surgery as well as obviating some potential post –operative complications such as wound breakdown and infection. However, for those patients who have tried diet, exercise and cannot shift the weight, we work around those barriers and find a solution. Prior to any procedure we take a full medical history including medication, herbal supplements, allergies, inflammatory conditions and importantly, whether you smoke. If you smoke, then Tummy Tuck surgery is not for you because you definitely will have wound healing problems.
From here, we will progress to an examination of your abdomen and back including your thighs and buttocks as each is a component part and integral to a good surgical outcome. Yes, we might consider combination surgery such as Tummy Tuck and Thigh Lift or Liposuction or Buttock elevation or Belt Lipectomy or even Breast Lifts and/ or Reduction.
Central to your Tummy Tuck is the appearance of the Mons Pubis area which may have dropped or become bulgy. The hip area is also important as there is no point having a flat tummy and when you put on your jeans you notice your muffin tops bulging over the sides.
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I hate my belly rolls
The examination is done in front of a long mirror so that I can show you what and where the problems are. This will give me a chance to show you where the incisions are made and where the scars will land up and in particular, with reference to your panty lines so that I can keep the scar within these boundaries. I will show you what the mons area may need to be reduced and lifted so you can get an idea of what the end result may look like. I will indicate to you how far towards your hips the scar will extend and how this will affect your upper thighs. I will assess and show you the hip area and whether you may require additional Liposuction in this area. Tightening of the tissue around the muscle (rectus fascia) will flatten your tummy and provide an improved waist line. I will also re-locate and re-fashion your own belly button usually making it smaller and provide an “inny� one if possible.
Next, I will get you to lie down on the bed and I will examine the tummy for any lumps or organ enlargement and exclude any hernias in the abdomen, belly button and upper thighs. Once this is complete we will sit down together and discuss the following: 1. 2.
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Once your Tummy Tuck is completed you will feel slim and trim in your middle with great confidence!
The planned operative procedure with the help of diagrams. Your stay in hospital which is usually three to four days depending on when the drains can be removed. We encourage you to mobilise as early as possible. We will talk about your recovery period and I will indicate what the expectations are over the next two weeks. I will review you in the rooms at a week and again at six weeks post-operatively. At all times, you will have access to me or my very capable nurse. We will discuss potential complications of surgery. I feel that you need to be aware of these so that appropriate informed consent can be made regarding these procedures. I will show you photographs across a range of tummy problems and you will be able to see the pre-operative presentation and post-operative results. Our team Debbie, Michelle, Michelle, Helen and I are here to answer any and as many questions you have, so arrive at the consultation prepared.
Dr Mark Edinburg MBBCH FRACS
THE SKINNY
ON LASERS with Dr Jack Ting
NEW ERA OF BODY SCULPTING DR TING BEGAN USING LIPOSONIX –NEW ULTRASONIC DEVICE FOR FAT REDUCTION/BODY CONTOURING– LAST NOVEMBER WHEN IT WAS INTRODUCED TO AUSTRALIA. HE HAS SINCE BEEN REFINING HIS TECHNIQUE SO THAT HE IS NOW ABLE TO ACHIEVE INCREDIBLE RESULTS IN PATIENTS’ SIZE AND SHAPE AFTER JUST ONE TREATMENT.
“After using Liposonix over successive treatments for the first few months I decided to raise the energy levels to achieve more significant results in just one session. It is very motivating for them to see results in as little as two weeks, with full results in around 12 weeks.” Because he uses a higher level of energy it can be painful and so Dr Ting offers appropriate pain relieving medication during treatment. Patients can also expect to have bruising for a week or more afterwards. “I believe in the `no pain, no gain’ approach,” he explains. “And certainly my patients have been happy with their results. Some have experienced a reduction in treatment areas of as much as 6.5cm. Many patients report dropping a clothes size. Liposonix uses specific High Intensity Focused Ultrasound (HIFU) targeting fat cells under the skin. It works through vibrations of fat molecules, causing
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friction and generating heat to kill fat cells. Liposonix also denatures collagen through heat; this process stimulates the regeneration and remodeling of collagen; thus, the tightening of skin. The body naturally processes and removes the destroyed fat tissue over the next 8-12 weeks. The treated fat cells are permanently destroyed but if you gain weight, remaining fat cells will enlarge. A recent patient, Victoria, 42, reports that only seven weeks after treatment on her upper and lower abdomen and hips, her jeans feel much looser and her
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stomach and midriff significantly flatter, meaning she can also wear tighterfitting tops. “I can really feel a difference,” she says. “I look better in my clothes and definitely feel slimmer and more comfortable, especially around my stomach and hips. This has made me feel a lot more confident, especially as I’m about to go on holidays to Hawaii. My husband is so impressed with the change he’s seen in my body that he’s now doing it too. “I still have five weeks before I will see the full improvement, so I am really excited. I am so glad I did this.”
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RAYS OF HOPE FOR SKIN SCARS FROM INJURIES, OPERATIONS, BURNS AND ACNE, STRETCH MARKS, SEVERE HYPERPIGMENTATION (DARK DISCOLOURATIONS), AND HYPOPIGMENTATION (LOSS OF PIGMENT), ONCE YOU HAD THEM, YOU WERE STUCK WITH THEM FOR LIFE. THEY MIGHT SOMETIMES FADE, BUT THEY WERE ALWAYS THERE.
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Fraxel lasers have changed all that in the past decade, according to Dr Ting, one of Australia’s foremost practitioners in the technology. “Whatever skin problem a patient comes to me with I can mostly fix it with one of the Fraxel lasers. If the condition is severe – such as one patient who travelled from Adelaide several times over a couple of years to have her motor vehicle accident scars treated – it may take a while to achieve optimal results, but I get there”. “I have spent a great deal of time developing new methods of treatment and then refining them so I can achieve outstanding results on notoriously difficult skin problems.” All Fraxel lasers rejuvenate skin. Fraxel lasers are fractional lasers, meaning they do not remove the entire surface layer of skin, instead, they make thousands of microscopic “pinpricks” of variable depths, causing injury to collagen to stimulate
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collagen regeneration and remodeling and rejuvenate the skin; in the process, Fraxel lasers can remove skin blemishes, pigmentation, repair scars, reduce stretch marks and tightening of skin. Fraxel re:store Dual is one of the most recent advances in the technology, consisting of 1 device with two lasers: 1) Fraxel re:store 1550nm wavelength, the original Fraxel laser used to remove scars on the face and entire body; 2) Fraxel re:store 1927nm wavelength is very effective in removing pigmentation in 95% of cases. There is 5% recurrence of pigmentation due to intrinsic medical causes or unknown cases. Fraxel re:pair 10,600nm wave length is mainly used for skin tightening. It is more useful for reduction of wrinkles, treating acne scars where other treatments failed. The initial recovery time for facial skin is 7-8 days, but patients may only need one treatment for outstanding rejuvenation results that last for many years.
Dr Jack
TING Dr Jack Ting is Australia’s most experienced laser cosmetic surgeon, with a reputation for outstanding results in Fraxel laser skin rejuvenation and correction at his clinic in Coogee, Sydney. A pioneer in the field, he performed among the first eye lifts (blepharoplasties) in Australia using laser rather than a scalpel 21 years ago. Dr Ting continues to lead the way in innovative, safe and highly effective laser procedures. He is also one of the first doctors in Australia to use the new Liposonix non-invasive fat reduction technology. He talks to NipTuck about the impressive results he has achieved so far with Liposonix and the many ways in which he uses Fraxel to change patients’ lives.
LASER COSMETIC DAY PROCEDURE CENTRE 218 Coogee Bay Road, Coogee NSW 2034 Tel 02 9665 3247
www.drting.com.au A Division of Cakuva Pty. Limited A.C.M. 001 230 440 A.B.N. 63 228 152824
Dr. John Newton, M.B.B.S., F.R.A.C.S. COSMETIC PLASTIC SURGEON Phone 02 4948 4200
The Knowledge, The Experience, The Wisdom as used in my website
Meet Dr John Newton Dr. John Newton is an experienced, fully qualified surgeon practicing in Warners Bay, a suburb of Newcastle in the Lake Macquarie region. He has higher qualifications in both cosmetic and reconstructive plastic surgery. A native of Newcastle, NSW, he has studied plastic surgery in Melbourne, Australia and London, England. Among other professional affiliations, Dr. Newton is a fellow of the Royal Australasian College of Surgeons. Dr. Newton always strives to produce high-quality surgical results at his Warners Bay practice and always treats his plastic surgery patients with absolute integrity. If surgery is not the right option for you, he will tell you so. Dr. Newton uses only proven, established plastic surgery procedures that produce reliable and aesthetically pleasing results.
14 Howard Street, Warners Bay | 02 4948 4200 www.cosmeticplasticsurgery.com.au
Dr. John Newton, M.B.B.S., F.R.A.C.S. COSMETIC PLASTIC SURGEON Phone 02 4948 4200
SEEING ME IN
3-D
The use of 3-D imagery in Plastic Surgery has moved from fantasy to reality. Patients present to me hoping to that I can help bring about a change in their appearance. This is usually because the patient feels that they have a feature of their anatomy which does not fit in with the normal spectrum of appearance. Expectations people have about their appearance vary from realistic to what I guess could be described as over ambitious. It is my responsibility to advise them as to what is appropriate to consider having done, given their individual circumstance. It takes quite a while to become comfortable with this, comfortable enough to sometimes advise a patient that their expectations are unrealistic and confident enough to advise a patient correctly about what changes can be realistically produced. The classical example of this is breast enlargement. Standardly the Surgeon will assess the patient in regard to their individual breast characteristics such as the amount of soft tissue present to cover an implant and importantly some specific measurements of breast width and nipple height need to
be taken in to account. This allows us, as surgeons, to advise a patient as to the size and style of an implant and the plane into which the implant might be able to be placed. Part of this process is to show patients photographs and to use sizer kits, which are made up of prostheses which are placed into braziers, to allow the patient to perceive her figure when she looks into the mirror. 3-D imaging is now available to allow us to help with this decision making and this advice. The Vector three dimensional imaging system uses 6 cameras to take photographs and then using, computer programming, I am able to alter the characteristics of the patient’s anatomy to demonstrate a “before and after” appearance in a variety of surgeries. It can be used on faces in relationship to the facial tissues, the skin surface and the nose, but perhaps its most exciting application relates to breasts. It gives imagery that allows a better insight into cosmetic breast enlargement, breast reconstruction and management of breast asymmetry for both myself and my patients.
The machine is programmed to morph the appearance of the patient from their current status to their post-surgical status and its software includes an enormous variety of implant sizes and shapes. The machine takes specific measurements, from which it can calculate volumes and volume differentials and, using those measurements, can build an image of the appearance the patient and I might hope to achieve with Plastic surgery. This 3-Dimensional image can be viewed from a variety of perspectives. It may well help with balancing differentials from left to right and I find it very useful in estimating an appropriate sized reconstruction implant for a girl having a mastectomy. I don’t see this technology as revolutionary from my position as a Plastic Surgeon regarding decision making, but importantly I do see it as revolutionary in allowing the patient a more accurate perception of the results of the surgery being considered. This is very important in aligning reality and expectation.
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Dr. John Newton, M.B.B.S., F.R.A.C.S. COSMETIC PLASTIC SURGEON Phone 02 4948 4200
FACE LIFT FAQ’s Face lift surgery aims to improve the contours of the face and neck and thereby reduce evidence of a geing. Sa gging skin is removed and tightened. Deep tissues are lifted and supported. It is a significant operation and raises lots of questions in patient’s minds.
The most common initial question is whether they are suited and should they have it now. Suitability to facelifting depends on two things. It depends on how concerned the patient is about their appearance and whether facelifting will bring about the changes they are looking for. Whether they should have the operation now depends on a combination of those two factors.
ear, drop into the ear and then around underneath the ear lobe, back up the posterior aspect of the ear and a variable length backwards into the hair on the back of the neck. This scar is designed to sit in skin folds or to be hidden by hair itself. Fortunately the instance thickening of this scar is very low and the scar becomes very acceptable after only a short period of time.
Patients also commonly ask about whether the facelift can be carried out under local anaesthetic or whether it requires a general anaesthetic. There is no doubt that mini facelifts can be carried out under local anaesthetic. This is often a cost effective and suitable way to do things. Once facelifts become more extensive however, it is appropriate to consider general anaesthesia. There is quite a bit of operating to do. Skin has to be lifted extensively and muscles and fat also rearranged. General anaesthesia can make this a far more tolerable procedure for patients.
Hairline doesn’t tend to change much with this scar. The scar runs around and just inside the hairline causing very little disturbance to the hairline itself. Hair growth is interesting however; it is not at all uncommon for hair to thin out a little after a patient has had a facelift. This is a temporary thing and the hair comes back to its normal status before too long.
Common questions about the operation itself include things like: “how long it will take?” The operation can range between 2 hours and as much as 6 hours. “Will I have drains?” the answer to which is that for a large facelift I do use drain. “Will I have a lot of bandaging on my face when I wake up?” I generally use foam as soft tissue support with an elasticised balaclava like garment over the top. Post operatively, patients are interested in knowing, in particular, how long they will have to wear the support garment. In short it stays on without interruption for roughly one week, after that I will see the patient in the rooms and then we review how long it stays on, but in general, it is appropriate to wear a support garment when it is socially acceptable (that is to say about the house) for about 4 weeks. Another common question relates to scarring and hairlines. The scarring for facelifting is designed to be hidden. Scars are also getting shorter. I guess if we take the scenario of a major facelift, the scarring might extend from the temple down and under the sideburn area, back towards the
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Traditional questions like how painful will it be and how long will the swelling last are also very common. The pain associated with a facelift is generally not severe. Most patients go home using only Panadol or Panadeine. If there is severe pain, it may reflect something concerning happening and it is probably appropriate that the patient get back and sees their doctor. The amount of swelling that is present also varies from patient to patient. Some patients do swell more than others and take longer for the swelling to resolve. Swelling and bruising are generally quite acceptable within a one to two week period post operatively but all the swelling will take several weeks to go. The patients themselves usually find they are socially quite acceptable by the end of 2 weeks. Another quite common question is how long will it last. The answer to this is that a facelift lasts forever. To allow patients to understand this I explain that if they have a facelift at 50 and there appearance after the facelift is the appearance they had when they were 40, then that 10 year gap between their true and apparent age has been created and will last. When they get to 60 they will of course look closer to 50. Skin care, protecting skin from the sun and not smoking reinforce that age/appearance gap.
Another common concern expressed by patients is will they have a “wind tunnel look”. Very aggressive older style face lifts did produce a wind tunnel look initially and we are all aware of the photographs displayed in Women’s magazines of what appear to be severely over done facelifts. Responsible modern surgery does not produce this effect. The aim is to rejuvenate the face, not to change it dramatically. Last but not least, patients ask about serious complications of a facelift. I think there are 2 serious complications. They are nerve damage, to one of the motor nerves of the face, and skin dying off. In the case of nerve damage with modern facelifting techniques the probability of significant nerve damage is low, but it is never zero. There is always a small potential for branches of the facial nerve to be damaged. This can lead to weakness of one side of the face. If the nerve is cut, it does not regenerate and reparative surgery may be required. If the nerve is stretched or bruised it generally recovers relatively quickly. Skin dying off is also very rare. The skin of the face is lifted, excess skin is cut off and then the wounds are closed under some degree of tension. This process could embarrass the blood supply to the skin sufficiently for skin to dye off. This is rare unless the patient has had prior surgery or is a smoker. (The instance in smokers is much higher than in the non-smoking population). If skin dies off it is obviously a very difficult problem and may well require further surgery at a later date to repair an unfortunate appearance. It is very common to have concerns and doubts about facelifting surgery. Plastic Surgeon’s understand this and you should not hesitate to ask any questions that you would like to ask.
DR JOHN V NEWTON
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After graduating from the University of NSW, Dr Tony Tan trained in emergency medicine but over the last four years has dedicated his focus to cosmetic medicine, working full time in same. He is passionate about his work and believes that everyone has natural beauty potential, and that it is the duty of the treating physician to release this potential within the process of facial rejuvenation, or rather beauty maximisation. This can be achieved non-surgically using a combination of therapies in a comprehensive “pan-facial� approach. He is the founder and director of Oz Locums Medical Staffing’ agency and Beauty Logic cosmetic clinic in Fairfield, Sydney.
FACE OF THE
FUTURE COSMETIC PHYSICIAN DR TONY TAN, OF SYDNEY’S BEAUTY LOGIC CLINIC, UNVEILS HIS TAN-FACIAL (PAN-FACIAL) APPROACH TO BEAUTY MAXIMISATION, TWO YEARS IN THE MAKING. The TAN-facial is not just rejuvenation but Beauty Maximisation, addressing every aspect of the facial ageing process for more beautiful, longer-lasting results, according to Dr Tony Tan. “I use this technique is to create a more attractive version of a patient, not a different look, “ he says. “It is based on an age-old mathematical ratio Phi:1.618 that the ancient Greeks called the Golden Ratio and Renaissance artists the Divine Proportion. It has been used for thousands of years in art, music and architecture. Now it is being embraced in cosmetic rejuvenation to achieve the most beautiful proportions and contours possible for a patient’s individual face.” Whether we realise it or not, irrespective of our age, nationality or racial background, we are subconsciously programmed to recognise what constitutes a beautiful base. This is based on proportions that approximate the Phi mathematical ratio. This is the basis of the TAN-facial. Dr Tan uses these mathematical principles when determining the best holistic or “pan-facial” approach to treating a patient’s face. He doesn’t just deal with the surface lines, wrinkles and folds or skin laxity but goes deep beneath the surface to restore the foundations and, thus, more youthful contours. “Most of my clients tend to be focused on the lines and creases on their face, such as the jowls, the
deep nasolabial folds that run from their nose to their mouth and the marionette lines that run from the corners of the mouth to the chin,” he says. “But it important they understand what has caused these age-related concerns, that they are largely a byproduct of volume loss underneath the skin. So I spend a great deal of time with each patient discussing the ageing process.” Of course everyone ages differently and at a different rate but the basic process applies: the skin thins, muscles lose bulk, fat disappears and bones resorb. This leads to what Dr Tan describes as Deflation, Deterioration and Descent. Dr Tan uses a combination of dermal fillers, anti-wrinkle injections and other non-surgical procedures such as laser and Intense Pulsed Light (IPL). “My technique has been two years in development and streamlining and I am now ready to call it the TANfacial approach,” he explains. ”I first assesse volume loss in each tissue layer to identify negative vectors (directions). Then I use a Phi caliper to measure a patient’s face and so help determine how I will treat them to achieve the most beautiful proportions – and that I don’t over-correct certain areas. “In effect, I rebuild the facial structures. I start by replenishing volume loss in the bony regions first to create better structural support
for the face and improve contours so they look more youthful. Then I work my way up through the layers of the skin.” If there is significant sagging of the face, my also recommend thread lifts to gently raise the brow and contour the lower face, reducing jowls.
BEFORE
“As ageing is global and three dimensional,the rejuvenation process, or Beauty maximisation process, should be three dimensionalmoving superiorly (Upward), laterally (sideways) and outwards,” he says. “Lines and folds are secondary manifestations of ageing, not the primary problem. Filling these lines and wrinkles without addressing volume loss would achieve a two dimensional improvement but would not address the real issues.” The TAN-facial can be carried out over several stages. When the treatment has been completed, Dr Tan recommends freshen-ups every 8-12 months to maintain results. “One of the greatest benefits of the TAN-facial is the natural-looking results that attract my patients comments like `you look great’, `you look so well’,” he adds. “It pleases them that, unless they decide to tell people what they’ve had done, no one would know. The TAN-facial is designed to release a patient’s natural beauty potential, create a more attractive version of themselves, not a different look.”
AFTER
Ageing is a choice
Let us help you make the right beauty decisions READ ABOUT OUR BEAUTY PHILOSOPHY
Phone 1300 196 196 or 02 8212 5557 196 The Boulevarde Fairfield Heights Sydney NSW 2165
w w w. b e a uty logic . c om. a u
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HOW TO LOOK AFTER YOUR FACE IN
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RICHARD by DR SACKELARIOU
There is not one of us immune to the effects on our skin of ageing. Some people age very well, and some faster than others. NSW plastic surgeon Dr Richard Sackelariou presents a series of articles starting in this issue of Nip Tuck, outlining your skin care needs and the surgical options for every age range. This month he focuses on those halcyon days of our youth. The fresh, plump, wrinkle free skin of our twenties.
Before Lip Lift
In your twenties, gravity has yet to make its presence felt. However there are still many things you can do to ensure you will enter your next decade – the thirties - with your most precious possession, your face, in the best possible condition and shape. Probably the most important skin care tips for this age are not related to surgery at all. They are, without doubt: good hydration, moisturiser, sunblock and avoiding nicotine. Sun damage and toxin exposure are the greatest hindrances to healthy skin. The sun damages the surface layer 100 NIPTUCK Magazine
After Lip Lift
and affects your skin’s moisture balance, while nicotine causes blood vessels to spam, resulting in skin that looks older and takes on a more weathered appearance, much faster. Many treatments help address these areas of damage, if prevention has not been enough. Antiwrinkle treatments, like botulinum toxin, are very useful in softening crows feet and minimising frown line formation, while dermal fillers will give you fuller lips and soften nasolabial folds as well as plumping up cheeks.
Surgery at this time of life can involve reshaping the nose with rhinoplasty, augmenting the jawline with a chin implant and filling out the cheeks with cheek implants. Good facial bone structure will help keep you looking young longer, protecting you against the effects of gravity on the soft tissues of the face. Looking after your teeth is part of this as they provide structure to the face preventing bone resorption that, over time, can have an ageing effect. One of the most dramatic changes you can make in your twenties is from a lip lift. Lifting the upper lip changes the proportions of the lower half of your face so the balance changes with more red lip and eyeteeth showing. Your eyes and teeth become more noticeable creating a more glamorous look to the lips and face.
20
Over
Years Experience
Finally learn to smile easily. This sounds simple enough but doing this will give you an instant facelift and bed down facial muscle memory to take you through the many decades to come.
Before Lip Lift
After Lip Lift
• Use sun protection • Avoid Nicotine • Consider anti - wrinkle and filler treatments • Liplift if needed
TREATMENTS Breast Emlargemnt Breast Lift Nose Reshaping Face lift Eye Lift Brow Lift Lip Lift Chin/Cheek Implants Ear Shaping Liposculpture Abdominal Reduction Male Breast Reduction
2/15 Cross Street Double Bay NSW 2028 Ph (02) 9362 0676 www.cosmetic-surgery.net.au
Breast
Actual breast patients of Dr Miroshnik
Creating body balance and Breast augmentation has come a long way in recent years. Today in 2013, every aspect of the procedure is customisable so whatever style or shape you desire, there is usually a solution available to give you results that will match your expectations. Dr Michael Miroshnik is a fine example of the excellent surgical care available to women today for breast augmentation procedures. “Women undergo breast augmentation for a variety of reasons, and all have different personal outcomes in mind. In 2013, breast augmentation is not simply about size but also about shape. Some women lack inner cleavage, whereas others lack upper fullness or outer curvature, whereas others again
are more concerned about an element of droop to their breasts that they would like corrected.” says Dr Miroshnik. Achieving the best possible result requires a great deal of surgical planning in every operation. “It’s vitally important to gather the right information during the consultation process, both in terms of the patient’s physical needs as well as her own perceived requirements from the operation. Many of my patients start with small, A-cup sized breasts and desire a result that looks as natural as possible. Others, on the other hand, are looking for a fuller, more enhanced look with accentuated curves and cleavage.”
Breast Augmentation
Actual breast patients of Dr Miroshnik
BEFORE
AFTER
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T: (02) 9389 8108 (Sydney) | 1300 88 90 50 (Intertstate)
Perfection
with Dr Michael Miroshnik
harmony with each surgery.
Actual breast patients of Dr Miroshnik
Dr Miroshnik practices the ultrafast recovery technique. Almost all procedures today can be conducted in a day hospital setting, with the patient returning home within a few hours of the procedure being completed. Due to modern anaesthesia and pain control, time back to work is faster than ever at approx. 7 days for office based jobs. Due to his detailed, systematic and comprehensive approach, Dr Miroshnik has achieved widespread acclaim for his skills and expertise in all forms of cosmetic breast surgery. As a result, he has patients that travel to see him in his Sydney clinic from all over Australia and even abroad!
DR MICHAEL MIROSHNIK
Plastic & Cosmetic Surgeon MBBS, FRACS (Plast.)
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www.drmiroshnik.com.au
DR MARIUSZ GAJEWSKI
Helping people to look beautiful and feel their best. Cosmetic physician Dr Mariusz Gajewski – or Dr Maz – as he’s better known, believes in the right of the individual to pursue beauty, whether through preventive measures over a lifetime or with the help of minimally invasive medicine.
1 Union Street, Pyrmont, Sydney NSW 2009 Ph: 02 9518 4984 E: info@starcosmeticmedicine.com.au
Dermal Fillers • Liquid Facelift • Wrinkle Injection Laser & Beauty • Cellulite & Body Contouring
Everybody’s beautiful in his or her own way, but it’s nice to have an unfair advantage right? before
Dr Maz has a sparkling list of celebrity media clients who have valued his professional and skilled approach. Over the years they have continued to adapt their appearance with the help of Dr Maz, to meet the demands of what for many is a high profile life that does not come without expectation where appearance is concerned. Dr Maz is particularly sensitive to this and has earned a reputation of providing great results with a flawless finish. “Everybody notices but nobody knows” he says. “The best result is when the results are invisible. We really don’t make change for change’s sake, but make minor adjustments that will suit the face – restoring the lip border, making the nose a little straighter, or restoring the angle of the cheek – all contribute to balance out the facial symmetry.” Star Cosmetic Medicine is a one-stop destination for all manner of aesthetic procedures including wrinkle injections, dermal fillers, laser treatment, cosmetic dentistry and cellulite treatments to name a few.
after
The experience begins as soon as you enter the doors of the 140 year old Victorian mansion in the glamorous heart of Darling Harbour. It ends with you receiving comprehensive and professional treatment from the team at Star Cosmetic Medicine. Many of whom are also sought after in advisory and training roles. Dr Maz is also the only Australian doctor elected to the Global Medical Advisory Board and has made a number of appearances in the national media for his broad knowledge and engaging approach.
Dr Maz believes there are 7 factors that affect your ability to have beautiful long lasting natural skin.
before
after
before
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Sun exposure - it’s incredibly important to prevent skin damage from the sun and other environmental factors. This is a big issue for Australians as the sun is one of the single most caustic damaging things for skin, and we must reduce our exposure to it wherever possible.
2
Genetics – ah if only we had control over this. This is an area we can do nothing about, but an awareness of genetic tendencies can help you to implement preventative measures over the long term.
3
Smoking – of course damages every other organ, but will also damage skin as one of the largest organs of the body. From an aesthetic perspective it commonly causes fine lines around the mouth and eyes so cosmetic reasons alone are enough to make you quit!
4
Stress – the effects of stress on skin can accelerate the ageing process. Frown lines, and crows feet are exacerbated by anxiety, and fluctuating hormones and chemicals in the body can produce a general lack of radiance and imbalance to skin’s function.
5
Pregnancy – granted this does not affect everyone but it certainly can have a dramatic effect on skin. Changing blood volume in the body plus fluctuations in weight and hormones can result in pigmentation changes, stretch marks and excess skin. These can be treated with dermal fillers and sometimes surgery as well.
6
Skin care – everybody needs to moisturise to hydrate the superficial layer of the skin – the stratum corneum. This layer acts as a barrier to shield against the outside world, so if you keep that outlet layer hydrated it looks better for longer and the more delicate layers underneath are protected.
7
Cosmetic Medicine. Wrinkle injections are essentially muscle relaxants. They are used in some medical areas such as for children with cerebral palsy. But when used judiciously, they are excellent in frown lines, ‘crows feet’ and several other areas. Dermal fillers have a role in creating volume and structure. Used in areas such as cheeks, the hollows beneath the eyes and lips. A proper medical assessment is critical in these treatments.
Dr Mariusz Gajewski is a dedicated and professional surgeon, passionate about the work done by the team at Star Cosmetic Medicine and a great advocate for the artistry in cosmetic medicine and the individual’s right to choose.
www.starcosmeticmedicine.com.au after
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AUSTRALIA Photo courtesy of www.davidbroadway.com.au
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What do you look for in a
COSMETIC DOCTOR? Female | Experienced | Fully Qualified | Practices at the highest standards | Of Good Standing within the industry | Personalized service | Caring, gentle Knowledge of Artistry and balance | Prefers a natural approach | Latest in technologies and techniques Provides detailed consultations | Listens
Any of the above?
Then consider ARGERA Antiaging Centre for your next medical cosmetic treatment.
‘IT’S WORTH TRAVELLING FOR GOOD CARE’
TREATMENTS
Safe wrinkle relaxers and fillers including facial volumizing and lip restoration/augmentation • Latest skin treatments for pigment, texture, poor elasticity, acne and acne scarring • Thermage® • Spider Veins • Fat dissolving • Liposuction • Thread lifting • Medical Strength IPL • Excess Underarm Sweating • Medical Strength Skincare
Joondalup, West Australia PH (08)93014244 | E: info@argera.com.au W: www.argera.com.au
NIPTUCK Magazine 109
Before
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110 NIPTUCK Magazine
What do you look for in a
COSMETIC DOCTOR?
• Female • Experienced • Fully Qualified • Practices at the highest standards • Of Good Standing within the industry • Personalized service • Caring, gentle • Knowledge of Artistry and balance • Prefers a natural approach • Latest in technologies and techniques • Provides detailed consultations • Listens
ANY OF THE ABOVE?
‘EAST PERTH CLINIC
NOW OPENED’ Unit 3, 135 Royal St East Perth 6004 WA info@argera.com.au P : 08 9301 4244 F : 08 9301 4355
Then consider ARGERA Anti-aging Centre for your next medical cosmetic treatment.
TREATMENTS
Safe wrinkle relaxers and fillers including facial volumizing and lip restoration/augmentation • Latest skin treatments for pigment, texture, poor elasticity, acne and acne scarring • Thermage® • Spider Veins • Fat dissolving • Liposuction • Thread lifting • Medical Strength IPL • Excess Underarm Sweating • Medical Strength Skincare
J o o n d a l u p , We s t A u s t r a l i a P H ( 0 8 ) 9 3 0 1 4 2 4 4 | E : i n f o @ a rg e r a . c o m . a u | W : w w w. a rg e r a . c o m . a u
Asanka smiles
again
Asanka De Alwis had little knowledge of what was ahead of him when earlier this year he started to experience a range of symptoms indicating something was not right.
H
e had no idea that a few months into the year he would have no upper teeth, which would prove a traumatic experience for someone as active and young as Asanka, especially working in sales. He had been having regular fevers accompanied by unexplained pain in his mouth. Over time the pain also radiated into his face and he sought the opinions of several doctors, dentists and oral surgeons. Unfortunately what happened next was many months of pain, examinations, and misdiagnosis. Asanka had a few teeth removed, some root canals, but kept getting sinus type illnesses and facial pain that would not subside. He continued on with work, and over time started to get much worse and feel quite weak. The recurrent infections and illnesses were starting to take their toll and he was becoming understandably frustrated. He also started to have the sensation as if something was ‘in his nose’. In yet another dental visit he explained what he had been experiencing and was sent for standard teeth x rays, which showed no abnormalities. Asanka was referred to a pain specialist. This happened over the course of many months and each practitioner had a different approach, but none so far had been able to identify what was going on. Asanka had various pain medications, plus antibiotics and still the pain would return. He also lost his sense of smell and taste. Eventually an oral surgeon was able to locate the problem of teeth dislodged into his sinuses. “Basically I had teeth growing in my nose.”
I can’t believe I went through all that pain and horror for so long, to then wakeup the day after treatment feeling better than I had in years. I got my sense of taste and smell back, I could breathe clearly again and no longer had to suffer recurrent infections and pain. Best of all I have REALLY beautiful teeth. I love them!
Though Asanka started to feel better, he was shocked to discover pieces of bone coming out through his gums. “I could feel these pieces of hard material coming through and even pulled some out myself at one stage.” This is when Asanka’s past came back to haunt him. “When I was younger I had been attacked as a result of prejudice and suffered multiple facial fractures in my face. Those fractures had healed but the removal of the teeth exacerbated an already weakened bone foundation and when the teeth were removed things started to fall apart.” Asanka went to a periodontist and was told that nothing could be done and then suffered some months with no teeth and uncertainty about what to do next. However he persisted with trying to find answers and to his credit never gave up. A visit to a facial plastic surgeon is where Asanka’s life began to change. The plastic surgeon listened to Asanka’s story and advised him to go to Dr Misagh Habibi at Perth Implant, Surgical & Sedation Dentistry for an assessment.
Photography by archerimagery.com.au
“My whole life had been affected by my health for months. I had been through constant pain, recurrent infections and fevers as well as losing my teeth at the same time as starting a new job in sales which was very challenging. I went to Dr Habibi with no teeth and parts of my upper jaw missing. He heard my story, made no assumptions, and really cared about my complete welfare. He proposed solutions to reconstruct my smile. I felt confident for the first time and couldn’t believe there might finally be an end in sight.” Dr Habibi dealt with Asanka’s issues immediately. He began with investigative work including x-rays and a CT scan. He then spent some time working out the best approach by 3-D computerized planning, and organised for Asanka to be measured for prosthetics. Following this, Dr Habibi performed one operation for Asanka under sedation, correcting the sharp and painful areas of Asanka’s upper jaw bone and placing four dental implants in accordance with the “All-on-Four” technique. The following day, Asanka’s teeth were tried in for a final cosmetic and functional assessment. Only two days after surgery, his new teeth were attached to the dental implants and he was able to smile and chew for the first time in years. “I can’t believe I went through all that pain and horror for so long, to then wakeup the day after treatment feeling better than I had in years. I got my sense of taste and smell back, I could breathe clearly again and no longer had to suffer recurrent infections and pain. Best of all I have REALLY beautiful teeth. I love them!”
114 NIPTUCK Magazine
DR I A N TIM M S
MB BS, BSc,
FRCS, FRACS (Plastic and
Reconstructive Surgeon)
Having grown up in the south of England Dr Timms studied medicine at University College and the Middlesex School of Medicine. After graduating Dr Timms completed his Fellowship with the Royal College of Surgeons of England prior to emigrating to Australia in 2000.
Dr Ian Timms
MB BS, BSc, FRCS, FRACS
Plastic and Reconstructive Surgeon
Cosmetic Surgery Breast Reconstruction Facial Aesthetic Surgery
Dr Timms was appointed to the advanced Plastic & Reconstructive Surgery training programme in Western Australia where he worked in both Perth and for some time in Sydney. Upon successful completing the exams Dr Timms was awarded Fellowship in Plastic and Reconstructive Surgery from the Royal Australasian College of Surgeons. In 2007 Dr Timms returned to the U.K. for one year undertaking a Cosmetic and Microvascular surgery Fellowship at The London Clinic. In March 2008 Dr Timms commenced a private practice and now operates at Mount Hospital, Hollywood Private Hospital and Cambridge Day Surgery and is accredited at SJOG Subiaco and Murdoch, and Bethesda Hospital. Dr Timms is passionate about providing individualised care with empathy to each patient’s needs and along with his personally selected and well trained staff is determined to provide this care to the highest possible standard. All patients are warmly welcomed, cared for and treated with dignity and compassion. Dr Timms’ practice has the latest in 3D camera systems, the Vectra XT imaging system that greatly assists in educating patients and demonstrating the likely outcome of surgery particularly in Breast Augmentation.
Hand Surgery
Dr Timms’ specialty clinical interest is in Breast Reconstruction and all other aspects of breast surgery including Augmentation, Mastopexy, Reduction and correction of asymmetry.
Suite 3, 200 Rokeby Road Subiaco 6008
Additionally Dr Timms undertakes a wider range of cosmetic procedures including Blepharoplasty, Rhinoplasty, Abdominoplasty, Labioplasty and Body Contouring (body lifts, arm reduction and thigh lifts).
Phone: 08 9381 3288 Fax: 08 9381 5333 Email: info@sculptingsurgery.com.au
P E R S O N A L PROFESSIONAL PROGRESSIVE
Mmakeover UMMY Previously combining two procedures such as an abdominoplasty with breast augmentation or mastopexy (Breast Lift) was a rare undertaking. But increasingly this combination of surgeries is more and more common.
Early post opearation
result showing the pattern of scarring on the lower abdomen and around the umbilicus
As we appear to have less time on our hands, and this can certainly be true of many (young) mothers, combining two procedures means only one recovery time and results that are not compromised by combining these surgeries. The hospital stay is related to the abdominoplasty and is generally 1 – 3 nights, depending on whether a mini or radical abdominoplasty is required. Before | 37 year old with 4 children
After | Anatomical implants 370
Abdominoplasty procedures involve not only removing the excess skin (with those stretch marks) but also suturing the six pack muscles back together (as they have been separated in pregnancies), with liposuction as required. The ideal time to undertake this surgery is when closest to your ideal weight, since it is not a substitute for weight loss. The results are to restore the waistline and flatten the tummy but there is a long scar as the pay off, thankfully this is low and hidden in the bikini area. Before | 53 year old
After | Mastopexy only
Augmentation or other breast procedures at the same operation have little addition effect on total recovery, since the discomfort of these operations settles very quickly. The VECTRA XT Imaging System and Canfield’s Sculptor™ software allows the patient to see how implants will change their breasts and adds a significant value to their consultation and understanding of what can be achieved. The whole process takes only a few minutes to take the images from the cameras and render them into a 3D picture that can then be rotated on the screen. The computer software measures distances and calculates approximate volumes, and then implants that are suitable for that particular person can be superimposed and can model the expected surgical outcome. The VECTRA XT Imaging System allows for good communication between surgeon and patient as well as better education for the patient. It gives the surgeon a better understanding of what the patient is desiring or expecting. In my practice this is not the only assessment method used as patients can also trial sizes in a bra; thus bringing together a technical and manual process to ensure the right implant choice can be made. NIPTUCK Magazine 117
DR PAUL PROFILE Dr Robert Paul is renowned as one of Perth’s finest refractive eye surgeons. After completing Ophthalmology specialist training in WA, he undertook Fellowship training in Laser Eye and Refractive Surgery and Corneal Transplantation, in Canada. He returned to Australia to establish the WA Laser Eye Centre, and was the first surgeon in WA to perform laser cataract surgery and insertion of cachet phakic intraocular lenses. Dr Paul was awarded the Helen Jane Lamard Prize by the University of WA for ‘Best student in Surgery’ in 1999, and was runner up for best paper at the Toronto Research Day presentation in 2002. He has maintained involvement in development of the profession, as an examiner of Canadian Ophthalmologists and Western Australian medical students and through training of Eye Surgeons as an Ophthalmology Consultant at Fremantle Hospital 2002 - 2007. He is a mentor for Fellowship training in laser refractive surgery and the Treasurer of the WA Branch of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO).
www.walasereye.com.au
WA LASER EYE CENTRE WA Laser Eye Centre is one of Perth’s premier refractive surgery centres operating under the experienced guidance of our principal surgeon, Dr Robert Paul. He was the first surgeon in WA to have formal higher training in Laser Eye Surgery and is one of Perth’s most experienced and qualified refractive surgeons. WA Laser Eye Centre offers the most advanced techniques available in laser and refractive eye surgery, specialising in LASIK, PRK, and the KAMRA Inlay™
procedure along with Multifocal and Refractive Intraocular Lenses to correct short-sightedness (Myopia), long-sightedness (Hyperopia) and astigmatism. Our treatment centre is located in our rooms at Melville, and appointments are available at our branches in Melville and Hollywood Medical Centre in Nedlands for pre and post-operative assessment. Our friendly team are here to help you with any questions you may have. We offer the highest level of expertise
and experience as well as the latest technology for vision correction. WA Laser Eye Centre uses the world’s most advanced technology and our staff are trained specifically for this high precision surgery. This is apparent from the first consultation through to treatment and post-operative care. We would like you to feel confident that you are making a well informed decision about your treatment options and encourage you to contact us with any questions you may have.
Hollywood Medical Centre, Suite 30 Level 1, 85 Monash Avenue NEDLANDS WA 6009 Melville Suite 1, 533 Canning Highway MELVILLE WA 6154 Phone: (08) 9330 8463 | Fax: (08) 9330 6994
be Your ultimate, most beautiful you with high quality treatments…
POST-WEIGHT LOSS
BODY C ONT OUR I N G
N ow th at you h ave l o s t th e wei g h t… wh at h a ppens next? Dr Anh Nguyen
Dr Anh Nguyen
MBBS (HONS) FRACS (PLASTIC SURGERY) FEMALE PLASTIC & COSMETIC SURGEON
CONSULTING ROOMS IN NEDLANDS, JOONDALUP, DUNCRAIG AND PERTH CBD.
you
• Breast Augmentation • Breast Lift • Breast Reduction
Body lift (Torsoplasty Circumferential lipectomy)
A body lift is the circumferential removal of excess skin and fat from the abdominal wall, flanks and the back (aka torsoplasty or circumferential lipectomy). A body lift can also tighten the abdominal muscle wall, lift a sagging mons pubis, lift the thighs and lift the buttock.
Breast augmentation/Breast lift & augmentation
Weight loss can also result in breast sagging (ptosis) and deflation. This can be addressed with a breast lift alone or in combination with a breast enlargement procedure.
Arm lift (Brachioplasty)
An arm reduction or arm lift, also known as brachioplasty, can reduce the circumference of the arms or improve the appearance of ‘bat wings’ or ‘tuckshop lady arms”. The
• Abdominoplasty • Liposuction • Labiaplasty • Mummy makeovers • Body lift • Thigh lift • Arm lift • Liposonix
• Face and neck lift • Eyelid rejuvenation • Rhinoplasty • Brow Lift • Non-surgical rejuvenation • Fraxel Laser
SE RVICE S
Are worth it – compassionate care means confidence at our Perth clinic…
procedure involves removing an ellipse of hanging skin on the undersurface of the arms, leaving a long scar on the undersurface of the arm.
Thigh lift
The thighs can be reduced via a medial thigh lift/reduction, which can involve removal of a wedge of loose skin from the inner thighs leaving a scar in the groin crease. Alternatively, it can involve a longitudinal scar along the length of the inner thigh where a vertical ellipse of excess skin is removed.
Facelift
Weight loss can affect the face too! Volume depletion in the face can leave us with more prominent jowls, hollow cheeks, scalloped temples and make lines and wrinkles more pronounced. A facelift and re-volumising with fat or fillers can improve the appearance of a face that has shown signs of significant weight loss.
To find out more, book a consultation with Dr Anh Nguyen, a caring specialist female plastic surgeon who is dedicated to helping women and men achieve their body goals and regain their confidence.
Cosmetic Nurse Ruth Lavell of Looks Divine shares her 18 years of beauty secrets. Today’s woman is savvy and educated about what she wants. She doesn’t want the buff and fluff of our mothers and grandmothers - she wants something that is going to ‘work’ and give her long lasting results. She educates herself with the Internet and social media and looks hard to find the right answers. In my 18 years as a cosmetic nurse a lot has changed. We want things to work NOW, we want results NOW, we want to see a difference NOW! I am no different. Products that perform and do what they promise are top of my list. Skin care that delivers the clean, glowing, youthful and plumped up look - that’s what I want because if my skin looks good, the lines and imperfections don’t show as much. I use Skin Synergy. Skin Synergy is an Australian made ACTIVE skincare product that is full of Glycolic acid to clean away dead skin cells and Vitamin C to feed my skin and promote collagen growth. It also contains Vitamin A for skin turn over and stimulation and hyaluronic acid, a powerful ingredient to provide moisture and plumping of the skin. The best thing about Skin Synergy, is that it works! To see more, go to www.skin-synergy.com.au I also must confess that I use: • A wrinkle relaxer; • A dermal filler in my lips; and • A dermal stimulator in my cheeks to add volume to to my skin. Let’s face it, at 50 everything needs a little help! Make sure you don’t overdo it – you need to keep it natural looking. The other special ingredients are a lot of laughter and wine - life is too short to be miserable!!!! For more helpful tips on cosmetics email me at info@looksdivine.com.au
Ruth
www.skin-synergy.com.au
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Since opening in 2007, Looks Divine has become one of Perth’s most well known and respected clinics with locations in Nedlands and the CBD of Perth. Both Looks Divine centres are accredited with the ISO 9001 International Standard of Excellence in Aesthetics and Cosmetics – recognised for respecting international standards. Looks Divine offer a wide range of Beauty, Skin treatments, the latest cosmetic treatments and plastic surgery. This includes anti-wrinkle treatments and dermal fillers, peels and facial plastic surgery. Their team of professionals aim to ensure everyone’s experience is second to none by providing: • honest advice about the most effective treatments; • realistic expectations on what can be achieved; and • minimizing any discomfort associated with these treatments. Looks Divine carefully explain the risks associated with each procedure and offer up-to-date information on skin, cosmetic procedures and hormonal replacement as well as the best products and equipment for each treatments. The specialist team of Doctors, Nurses and Dermal Therapists on site are carefully chosen and undergo continuous training to provide you with the best service in a friendly and relaxed environment.
S E R V I C E S • Anti Wrinkle Treatment • Body & Spa Packages • Chemical Peels • Dermal Fillers • Facials
• IPL Treatments • Massage • Microdermabrasion • Products • Tattoo Removal • Wrinkle Relaxers
1 2 2 b D a l k e i t h R d Nedlan ds | Ph 9386 9699 • level 1/ 663 H ay St Per th CBD | P h 9321 3551 E ma i l in fo@ loo ks divine.com .au | We b www.looksd ivine.com.a u
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When is a nose
NOT A NOSE? “Why hasn’t anybody noticed that I’ve had a rhinoplasty?” Dr Peter Callan Is there a special body feature you are known for? Do you have the nose of Adrien Brody or Owen Wilson? Angelina Jolie’s lips? Maybe Freddie Mercury’s teeth? Marty Feldman’s eyes or Dolly Parton’s … um ... hair? Of course most of us are not known for any particular feature. We are recognised by our ‘gestalt’ or ‘whole’. So if you are known by your overall appearance, is it any wonder that when you have a well performed procedure that increases your overall facial harmony, no one else seems to even notice? No one perhaps
BE FO RE
except the very few people that notice these things, or those closest to you who know you very well. Have you ever seen someone after they have shaved off their beard and are unsure what the difference is? It’s because you know them as a whole, with or without a beard. Without their beard they can look as normal as they do with a beard. There is a fear among many people that plastic surgery would be noticeable. Of course it is noticeable if you have before and after photographs,
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Facebook - Peter Callan Plastic Surgeon
B E F OR E
but could you honestly look at the face in these pictures and detect that she’d had a rhinoplasty if you didn’t have the before photographs with which to compare? Even if you had known her before you may not have noticed. It may well be that despite what you think, your nose is a not a feature that needs any treatment at all because it fits within your face perfectly well. Be prepared to be told you need nothing at all!
A FTE R
So when is a nose not a nose? When it blends into the face. Because then no one notices it as a nose, just as one of the parts comprising the whole. So that is the thing – everything should fit. When you see your plastic surgeon, no matter whether you are having facelift surgery, eyelid surgery, fillers, antiwrinkle injections or whatever, and you say - I don’t want to look fake (or done or different) or I don’t want to lose my ethnicity – you needn’t worry. It’s our aim to make you look the best version of normal you can be.
DR PETER CALLAN MBBS, FRACS, MBA
“The decision to have plastic surgery may be one of the most important decisions you will make.” PROCEDURES
B E F OR E
BREAST
BODY
COSMETIC
FACE
HAND
SKIN
A FTE R
Suite 3, Level 1, 83 Myers Street, Geelong, Victoria 3220 P: +61 3 5222 2440 | E: simone@petercallan.com.au W: www.petercallan.com.au | www.rhinoplastygeelong.com.au
MR HOWARD
Webster MBBS Hons FRACS (Plast) MBA
THE MOMMY M A K E O V E R
Mr Howard Webster is a Specialist Plastic Surgeon at ARC Plastic Surgery. He consults in Melbourne and regularly in Shepparton. With more than 18 years experience in private practice, he focuses primarily on body, breast, face and nose cosmetic and reconstructive surgery. Howard trained in Melbourne and Brisbane. And subsequently spent three post-graduate training years in the UK and US. BEFORE
AFTER
Before and after a ‘Mommy Makeover’. Any surgical or invasive procedure carries risk. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
128 NIPTUCK Magazine
Our friends from America are great at coming up with names and brands and the ‘mommy makeover’ is currently being performed more than ever before in Australia.
are needed to return the body to its best shape. Breast surgery can involve enlargement, lifting, lift plus implants or a reduction, depending upon what the pregnancies have caused.
Human babies grow really large inside the body before they’re born, so there is a lot of stretching of the body from the muscle layer to the skin. Along with the baby itself, there is fluid retention and weight gain necessary to support the demands of the growing baby, plus the breasts then grow to feed the baby after it’s born.
It can be a lot of surgery to do in one session. A few weeks ago, I removed a total of eight kilos of tissue from a patient in a mommy makeover – two kilos from each breast, and four kilos from the tummy. This is pretty major surgery which required a four night hospital stay. In most cases, the surgery takes about 4 hours for everything, and is usually a two night stay.
After pregnancy, some women’s bodies are permanently changed, even damaged, by the whole process. Despite restoring fitness and health, exercising and losing the baby weight, many women find the changes distressing, and would like their body to be more like it was before the kids, bless their hearts, wrecked it. Changes in breast shape, size and perkiness occur. In the tummy, there can be more bulk often called the muffin top, loose and damaged lower tummy skin, and loss of the narrowness of the waist due to a permanent separation of the rectus (or six pack) muscles. Some people get loose or lumpy upper abdominal skin too. A mommy makeover is not one operation. It’s a planned series of steps individualised to the person to correct the pregnancy body issues. For the tummy it involves a tummy tuck, a body lift, a rectus muscle repair, liposuction of the waist and lower back in whatever combination
A lot of attention is paid to fixing all the problems – front, back and breasts – but we also pay a lot of attention to the scar position, so with bra and panties on, the scars are not visible. For breast lifting and reduction, the lollipop incision is mostly used. In the case illustrated, the scars are still very red, so you can clearly see them. The patient is several months after surgery. The scars will fade to white in the next year. The tummy scar is carefully positioned to be low and under her underwear line and the lipo around the waist aims to give her the best pre pregnancy appearance possible. The mommy makeover has been an advance for plastic surgery in Australia and for our patients. When the person is well, and it’s safe to undertake multiple procedures at one time, then it can realistically reverse many of the negative changes your beautiful children have caused to your body.
arcplasticsurgery.com.au
DR KIM
Taylor MBChB FRACS (Plast)
BREAST IMPLANT S E L E C T I O N
Q&A After graduating from medical school in New Zealand in 1996, and undergoing specialty training in Sydney, and fellowships in Melbourne, Dr Kim Taylor now receives wide recognition for her work as a plastic surgeon and is the recipient of a number of awards.
A key decision of any patient undergoing breast augmentation surgery is implant selection. Dr Kim Taylor talks with NipTuck about implant options, and discusses what exactly are ‘jelly bean’ implants.
implants include capsular contracture, rupture of the implant and secondary infection. It is important to discuss the risks with your surgeon and make sure the choices you are making are fully informed and supported.
Q: What are the most common implants? A: The two most commonly used implants available are silicone gel filled or saline filled. Both of these implants have an external silicone casing. In Australia, most plastic surgeons use silicone gel filled implants.
Q: Which is better – silicone or saline? A: Both have their benefits and neither are without issues. A lot of patients prefer the results that a silicone implant provides in that they give a good size and shape, and the contour and touch feels very natural. Some people feel more comfortable with saline implants because if they do rupture the saline is not harmful – it is simply reabsorbed into the body. Although, with the saline gone, the breast size immediately reduces, and the implants will need to be replaced.
Q: I’ve read about ‘jelly bean’ implants. What are these? A: These are silicone implants that are filled with a medical grade viscous silicone gel (an inert, synthetic compound). This is why the confectionery names ‘Jelly Bean’, ‘Gummy Bear’, and ‘Raspberry Jelly’ are often used to describe the implants. They have a semi-rigid coating with a soft centre. I prefer to liken the texture of the gel to ‘Turkish Delight’. Vectra 3D Imaging Simulations.
Q: What is the risk of leakage with these implants? A: The risk is much lower these days than it was when breast implants were first invented more than 50 years ago. The gel is semi solid and the outer casings are now much stronger, so leakage is less likely. If silicone leaks, as it is more viscous, it doesn’t migrate to other parts of the body. Q: Are there other risks associated with implant surgery? A: There is always a degree of risk when a patient undergoes a surgical procedure. Some of the risks associated with
Q: How do I know which one to choose? A: You should talk about this in detail with your surgeon. A good surgeon will outline the pros and cons, and after doing a full assessment will be able to advise you on the best type of implant, and the size and shape that will suit your body shape, skin tissue and lifestyle. No two surgeries are the same so it’s really important that your treatment is tailored just for you to get beautiful lasting results. At ARC Plastic Surgery, we offer Vectra 3D Imaging to help aid implant selection. Images of the patient are taken to create a 3D pre-operative computer image of the patient and different implant sizes and shapes can be trialed to simulate the appearance post ‘breast augmentation’ procedure.
Vectra 3D Imaging Simulations.
For An Appointment Call : Melbourne 03 9828 1300 / Shepparton 03 5820 0500 Call Melbourne for consultations at Blackburn, Bundoora & Sydenham
NIPTUCK Magazine 129
MR RICHARD
Bloom MBBS Hons FRACS (Plast)
ABDOMINOPLASTY Q&A Specialist Plastic Surgeon Mr Richard Bloom trained in Melbourne and attained a full fellowship in 2002. He undertook further training in the UK and US prior to commencing practice as a plastic surgeon in Melbourne in 2003. He is Currently the National Board Chairman for Plastic Surgery Training through the Royal Australasian College of Surgeons and is a member of the Australian Society of Plastic Surgeons council. With a wide field of expertise across all areas of reconstructive and plastic surgery, his main focus and interest is with breast surgery patients, facial rejuvenation procedures and body contouring surgery, particularly for patients who have undergone dramatic weight loss.
Vectra 3D Imaging Simulations.
130 NIPTUCK Magazine
Most of us have thought about a ‘tummy tuck’ or abdominoplasty at one time or another but don’t really know what’s involved. Dr Richard Bloom gives us some information on new developments in treatments.
This innovative technique has revolutionized the way tummy tucks are performed. Since we have started using it we have found that our patients are more comfortable, heal faster and have less swelling than ever before.
Q. Who is the best candidate for abdominoplasty? A: The best candidates for a tummy tuck are men or women in relatively good shape who have developed loose abdominal skin that won’t respond to diet or exercise. This commonly occurs after weight loss or pregnancies, where the skin has been stretched beyond its normal elasticity and won’t return to normal.
Q: Is it Painful? A: Pain after surgery is not only uncomfortable; it can also slow down the healing process. To avoid this situation we have started using Pain Buster™ to ease the pain in the first 48 hours after surgery. The pain buster consists of a small bulb which automatically delivers long acting local anaesthetic to the wound via hair-thin tubing. The bulb containing the local anaesthetic is carried in a small pouch which patients carry with them. The result is that patients feel virtually no pain. That means that our patients usually need less prescription pain medicines that can be associated with significant side effects such as nausea, vomiting and allergic reactions.
Q. What is involved in the consultation process? A: I take a full history and perform an examination to assess your particular concerns, discuss your goals and also ensure that you are a good candidate for the surgery. Using a revolutionary software program called TouchMD, I am able to demonstrate how the operation is done and where the scars will be placed on your actual photos. Q: What is the ‘No Drain Tummy Tuck’? A: Older tummy tuck surgery techniques, relied on a drain to suck down between the skin and muscle to avoid leaving a space where fluid could collect and often the drain would stay in for several days after surgery. We have started performing a ‘no drain tummy tuck’ surgery. It’s a new drainless technique, using Progressive Tension Sutures (PTS) that seals the space between the skin and muscle where fluid tends to accumulate, with a special internal stitch, which locks the skin, and muscle in place with the barbs of the suture.
Q: Are there risks involved in abdominoplasty? A: There are always risks associated with any surgery and specific complications associated with this procedure. Postoperative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but may require a hospital stay. Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers are advised to stop, as smoking may increase the risk of complications and delay healing. You can reduce your risk of complications by closely following your surgeon’s instructions before and after the surgery, especially with regard to when and how you should resume physical activity.
arcplasticsurgery.com.au
MR DEAN
Trotter MBBS FRACS (Plast)
BREAST LIFTS Q&A
Specialist Plastic and Reconstructive surgeon Mr Dean Trotter studied medicine at the University of Melbourne and trained at Melbourne’s major plastic surgery centres including The Alfred, The Royal Children’s and St Vincent’s hospitals. He completed a fellowship with the Royal Australasian College of Surgeons (FRACS) in 2009 and went on to complete a microsurgical fellowship in the UK, with a focus on breast procedures. Dean completed an additional fellowship in Buenos Aires, focusing on aesthetic plastic surgery and the use of cosmetic fat grafting.
Dr Dean Trotter has been performing breast lifts and augmentations for a number of years. Nip Tuck sat down with him to ask some of the basic but essential questions for women thinking about having one of these procedures. Q. What is the average age range of women who decide to have a breast lift procedure? A: There is quite a broad range in age of women who are seeking a breast lift (mastopexy). Some are young women who feel that their breasts are ‘saggy’ or look older than their age would suggest, others are women who have ‘deflated’ breasts such as occurs after pregnancy and breast-feeding. Then there are older women who have lost breast volume due to the effects of aging who would like their breasts rejuvenated. Q: What’s the difference between a breast lift and breast augmentation? A: A breast lift typically involves lifting the nipple and areola up on the breast to a more ideal position. This may occur with an implant alone, however unless only a very small lift is required then scars will be necessary in order to lift nipple areola complex into a better position. Q: Do you use any form of implant in a breast lift procedure? A: Yes, I do this procedure quite commonly. A breast lift can be combined with a breast implant – this is called an augmentation mastopexy. This is a good
choice for women who would like to renew their small volume breasts that are drooping. Q: Why would I choose to have a breast lift over a breast augmentation? A: If you have a breast volume you are happy with and do not want an implant, plus you don’t mind a scar on the breast, a breast lift is the right procedure for you. Q: What’s the recovery time after a breast lift procedure? A: I generally suggest about 2 weeks off work and 6 weeks off the gym or other intensive physical activities. Q: Can I still breastfeed? A: It is hard to say. Depending on the technique used and the amount of lift required your ability to breast feed may be affected. Studies suggest that up to around 50% of women will have difficulty breastfeeding following breast lift surgery. Q: How long do the results of the procedure last? Will I need another lift in the future? A: The results of the lift definitely change over time, due to gravity and the loss of elasticity in the breast tissues and skin. The initial fullness in the upper half of the breast tends to disappear over several months, unless an implant is used to fill this area. However, the nipple position tends to maintain its improved position and the breast usually not need another lift in the future.
Vectra 3D Imaging Simulations.
For An Appointment Call : Melbourne 03 9828 1300 / Shepparton 03 5820 0500 Call Melbourne for consultations at Blackburn, Bundoora & Sydenham
NIPTUCK Magazine 131
david MORGAN Morgan MR DAVID
Plastic and Reconstructive Surgeon
rhinoplasty facial cosmetic surgery breast augmentation breast reduction abdominoplasty Cabrini Brighton, Suite 4, 243 New St. Brighton, 3186 Tel 9591 0422 | Fax 9591 0290 A/H 8508 9000
Mr Morgan graduated from the University of Melbourne in Medicine in 1993 and after completing four years of post-graduate surgical training at St Vincent’s Hospital in Melbourne, was accepted into the Plastic and Reconstructive Surgery training program, successfully completing this rigorous process in 2003 and becoming a Fellow of the Royal Australasian College of Surgeons. Mr Morgan is a member of the Australian Society of Plastic Surgeons (ASPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Australian & New Zealand Society of Craniomaxillofacial Surgeons, and is an International Member of the American Society of Plastic Surgeons. He is currently the Victorian Chairman of the Board of Plastic & Reconstructive Surgery, making him responsible for the training of the next generation of plastic surgeons.
BEFORE
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P re -O p e ra t i o n P h o to s : Forehead/Orbit Reconstruction
Patient had a custom-made implant inserted into her right forehead to correct her eye socket and brow after a major car accident.
For many people, plastic surgery is not a choice, it is a necessity. Accidents happen, but only to other people right? Of course accidents can happen to any one of us at anytime, and our lives may never be the same. However thanks to highly experienced and empathetic surgeons like Dr David Morgan, things can be restored to some kind of normality from what for many can seem like the point of no return. Dr Morgan recently discussed this part of his practice with us. “We see a lot of people who have experienced a variety of trauma and come to us for corrective surgery. The most common presentations I see are significant facial fractures that result from coming off a bike or being in a car accident.” Facial fractures are repaired initially with small plates and screws in the very early stages after the injury. In some cases where there has been significant injury, there may be secondary deformities that can greatly affect the patient’s self esteem and their ultimate recovery. “A lot of our work is done using custom made implants,” says Dr Morgan. “We use these to re-establish the correct contours of their face and improve their facial symmetry.”
P o s t - O p e ra ti o n P h o to s : Forehead/Orbit Reconstruction
Patient had a custom-made implant inserted into her right forehead to correct her eye socket and brow after a major car accident.
w w w. re new pl as ti cs u rg ery . c om . a u
Computer CT scanning captures the images and data is sent off to the implant manufacturer. They make a customized sample that is then sent back to be adjusted where required. This is then used to make the final implant and the implants, once completed, are then surgically put into position. “Often after traumatic injuries, people may never look the same again. Our aim is to correct some of the residual facial deformities that they have from their accident as best we can. They often have quite significant scarring but at least we can re-establish the correct shape, make their eyes more symmetrical, and help blend things together so they look as natural as possible. In this way, we can help them move on with their life again”. Dr Morgan believes this is the most rewarding part of his practice. “We are taking something that was destroyed and fixing it for them. This can be such a positive change for people and is often transforming in terms of their selfconfidence.” NIPTUCK Magazine 133
Art De Dente proudly welcomes you to what can aptly be described as an urban dental oasis. Located at 190 Queen Street in the heart of Melbourne, Art De Dente is a place where elegance and compassion converge with health and wellbeing in a setting of luxury and comfort. First established in 2007, Art De Dente lives up to the vision of Dr Rakesh Gulia and Dr Saloni Balhara, who wanted to create a warm, friendly, comfortable, state of the art dental day spa centre. They had conceptualised a space within an urban environment, where you could experience the ultimate in patient service and care, providing the most advanced techniques and technology to help achieve beautiful and natural smiles. This was recently achieved in August 2012 when moving to their current location on Queen Street. Art De Dente is a place where complimentary services such as radiology and dental laboratory services are provided to allow for all dental procedures to be carried out in maximum comfort and safety. The highly trained dental team has a passion to excel and demonstrate this
by attending continuing education and training seminars and courses to remain abreast of the ever-changing world of dentistry. The team takes pride in exceeding your expectations by taking the time to listen and understand your needs and desires. The care facilities include conscious sedation, twilight sedation and sleep dentistry under the supervision of a specialist anaesthetist. At Art De Dente you are in charge of the decisions for your care after a complete understanding of all your options presented to you by the dental team. You will be guided and supported every step of the way from your initial contact to the completion of your treatment. Dr Gulia and Dr Balhara believe in nurturing trust and building relationships with their patients that last a lifetime.
www.cosmeticdentistsmelbournecbd.com.au
P ATI EN T R O O MS Dentistry has come a long way since the first English dental publication in 1685. At Art De Dente, we have evolved past just “Dentistry”. All of our surgeries are equipped with state of the art technology and a full entertainment suite with an overhead LCD screen to help make your appointment more comfortable. While in the chair, you can choose to surf the net, listen to your favorite music or simply watch a movie of your choice. We are proudly supported by the leading world-class dental laboratory “Omega Ceramics” with an on site facility.
CA FÉ PET IT Enjoy a muffin freshly baked with a cup of coffee or rather an apple, read the paper, browse the net or simply enjoy the ambience. Enjoy our beautiful tropical fish in the aquarium, immerse your senses to the gentle flow of water with light music to help you relax, take a break in the CafÊ Petit with a view of the Melbourne skyline and catch up with the daily news and stories.
C LI N I C AL C A R E We pride ourselves on maintaining the highest standards of infection control and safety procedures. All of our services are performed onsite. In most cases, Dental Implants, Crowns and Veneers can be completed on the same day.
Address Level 17, 190 Queen Street, Melbourne, Victoria 3000 | Telephone (03) 9642 8955 / 9642 8893
MI K E G R EER “I was always terrified of the dentist. As a child, I have vivid and horrid memories of my dentist actually tying me into the dental chair to do treatment. This caused me great distress and scarred me psychologically. It then got worse as an adult when my next experience involved the army dentist – after my experiences with that dentist, I was now scarred for life! So, as an adult, I just stopped seeing any dentist, as my belief was that ‘all dentists hurt’. Then, due to an accident, I was forced to face my fears. I had no idea where to go or who to see, as I knew it was going to be a very bad day no matter what.
My wife worked at HBA and a friend of hers recommended Art De Dente. My first visit revealed an abscess with my front teeth and extensive loss of supporting bone. I was then referred to a specialist for treatment. After that consultation I was not happy and because of the attention and care received from everyone at Art De Dente, I returned and asked them to do the job instead. The process took about 6 months and I am extremely happy with the results, plus, I have regained my confidence with the dental profession. I can see now the value in finding a good dentist who understands the fear involved.”
The ‘bone ring technique’ procedure utilized for Mr Mike Greer is a single stage procedure involving bone transplantation and implant placement at the same time. This procedure is utilized to minimize the total treatment time to 6 months. Bone Ring Graft + Implant Placement
Prosthetic Restoration
TOTAL TREATMENT TIME 6 months
6 months Conventionally, a two-stage technique is employed with required healing times in between the procedures taking the total treatment time to almost a year. Bone Block Graft
Implant Placement
5 months
Prosthetic Restoration AT consultation appointment
On the day Bone Ring Tech
Healing 5 months
Final Prosthesis
6 months
‘Bone ring technique’ is routinely performed at Art De Dente reducing the total treatment time to 6 months. Dr Rakesh Gulia at Art De Dente trained under the expert guidance of Dr. Bernhard Giesenhagen in Vienna who has pioneered the ‘bone ring technique’, which allows bone transplantation and implantation to be performed on large three-dimensional bone defects in a single operation. This technique can be used for almost all indications, including sinus lift procedures.
www.cosmeticdentistsmelbournecbd.com.au
GET TEETH
MAR A VLAHUSI C
DAY
Before
in a
ASK US HOW?
Before
After
After
Using dental implants and a new technique called “All-On-4”, we can now replace missing teeth and full dentures in one day. Am I an Ideal Candidate? Patients with missing and failing teeth as well as patients with full or partial dentures can benefit with this technology. What is “All-On-4”? An All-On-4 is a procedure to replace full conventional removable dentures with permanent fitting teeth. Using 4 implants, we permanently anchor the teeth in place so they look and feel like your original teeth. How long does the actual procedure take? It usually takes 2 to 4 hours under sedation to complete the surgery. What’s different about this procedure? This procedure is less invasive than other implant techniques. Using advanced x-ray and 3D imaging we can accurately predetermine the most suitable site. The implants are paced in the front part of the upper and lower jaws and the back implants are placed at an angle, so as to avoid where possible, anatomical structures and to maximize the stability of the bridge. Unlike conventional procedures, patients can avoid healing times of (up to) a year.
AN N E MU LC AI RE Before
When will I get my teeth? In most cases you will get your teeth on the same day. However, depending on the treatment, for your comfort, it may take 1-2 days from surgery to placement of the new teeth.
Before
It must be painful? This procedure is done using anti-inflammatory medication prior to surgery. On the day we use effective pain management and long acting local-anesthetics. Most patients experience little or no discomfort and/or swelling.
After
After
The procedure illustrated above may not be suitable for all patients. The before and after pictures are indicative only and individual results may vary. Any surgical procedure carries its own risks and we advise you to seek an independent opinion. Scan the QR code & Like us on Facebook to get dental tips & exclusive offers!
How long does it take to heal? The integration of the bone and the implant can take up to 6 months. Some modifications to your diet will be recommended to insure the best possible outcome. I have several missing teeth, how can we replace those? If you only need to replace individual teeth, then we can use immediate replacement implants to fill in those gaps. Generally, each missing tooth will have its own prosthetic implant to replace the original tooth. Can this technology be used to replace a bridge? Yes. In most cases a crowned bridge can be replaced with implants
Address Level 17, 190 Queen Street, Melbourne, Victoria 3000 | Telephone (03) 9642 8955 / 9642 8893
PIP IMPLANT
SURGICAL PROCEDURES • Facial aesthetic procedures • Nasal Refinement • Breast surgery – cosmetic and reconstructive • Abdominoplasty (tummy tuck) • Body contouring • Skin cancer and hand surgery
NON-SURGICAL PROCEDURES
• Anti-wrinkle treatment • Fillers • Skin needling • Skin care • Facial peels
PERI-AREOLAR INCISION
BEFORE
AFTER
PERI-AREOLAR INCISION
BEFORE
AFTER
Silicone smooth round extra high profile implants 295 ml.
Saline round high profile implants filled to 400 ml on the right 370 ml on the left
DR MANSOOR HAS EXTENSIVE EXPERIENCE IN ALL TYPES OF IMPLANTS AND WILL COMPLETELY INVOLVE YOU TO MAKE AN INFORMED AND APPROPRIATE SELECTION. PERI-AREOLAR INCISION
BEFORE
AFTER
Reconstruction after mastectomy with teardrop high profile implants 440 ml
INFRA-MAMMARY INCISION
BEFORE
AFTER
Abnormal rib curvature (pectus carinatum). Polyurethane teardrop extra high profile implants 290 ml
DR RICHARD
RAHDON Body Recon is a specialist plastic and reconstructive service with a full range of cosmetic and reconstructive procedures as well as a range of non-surgical treatments.
96 Gheringhap St, Geelong Victoria
(03) 5221 1747
Some things are important enough to travel for and Body Recon in Geelong is one of them. This award winning cosmetic clinic has established a reputation for having available the very latest in products, procedures and techniques, as well as state of the art equipment and technology to provide you with the very best of care, to get the very best results.
Level 5, 80 Myers St, Geelong Victoria
(03) 5221 3739
appointments@bodyrecon.com
www.bodyrecon.com
PLASTIC SURGERY BREAST SURGERY • FACE SURGERY • BODY SURGERY • RECONSTRUCTIVE SURGERY COSMETIC CLINIC •INJECTABLES • LASER THERAPIES • SKIN TREATMENTS • BEAUTY SERVICES
Cosmetic and reconstructive procedures are administered by Dr Rahdon and his team of cosmetic nurse specialists, dermal clinicians, laser therapists and advanced aestheticians. The surgery offers a 24 hour on-call service as well as priding themselves on an outstanding level of friendliness, professionalism and commitment to compassionate client care and support. Body Recon has a very comprehensive website for detailed information about the clinic and it’s philosophy as well as before and after videos, Q&As and interesting articles regularly on their blog. Find them online at www.bodyrecon.com
Facial Rejuvenation
The team at Body Recon offers friendly and professional services to both surgical and cosmetic patients. Operating from two sites, Body Recon has rooms located in St John of God Hospital and Body Recon Cosmetic Clinic is located at 96 Gheringhap Street in the heart of Geelong. Patients are welcomed into calm and stylish surrounds, and have the chance to forget about the world outside as they enjoy the tranquil internal courtyard and vertical garden. Treatment rooms offer complete discretion and privacy and patients may enjoy relaxing music and high quality products in a professional environment with the reassurance that comes with a medically supervised facility.
Actual Patients of Dr Rahdon
Rhinoplasty
Dr. Rahdon is a consultant plastic and reconstructive surgeon who is also an expert cosmetic surgeon. This professional skillset is rare in Australia and patients should always consult a professional plastic surgeon with cosmetic skills, as safe and effective treatment can only be obtained with confidence from an appropriately qualified surgeon.
Body Recon Plastic Surgery offers a complete range of cosmetic procedures, specializing in breast enlargement and reduction, breast reconstruction, facial surgery including facelift and rhinoplasty, as well as tummy tucks and “mummy makeovers”. Most of these procedures are performed at St John of God Day Surgery (voted best Day Surgery in Australia for 3 years in a row). Body Recon Cosmetic Clinic focuses on paramedical services including injectables, laser therapies, advanced skin treatments and beauty therapy services.
Breast Augmentation
Dr Richard Rahdon is the principal surgeon and he is passionate about offering high quality care, comprehensive treatments and adopting a more holistic approach to patient care.
A B EAU TY EXPERIEN CE LIKE N O OT HE R
FAC E AND B O D Y T R E AT M EN TS • S K I N C A R E • A N T I - A G E I N G I NJE C TAB L E S
Palom a M edi S pa is a n e w a n d u n ique c o n c e p t i n sk i n c a r e t r e a t m e n t , o f f e r i n g c u t t i ng edge treatm ents fr om acros s t h e globe in a s tu n n in g i n d u st r i a l st yl e sp a c e i n i n n e r su b u r b a n M e l b our ne. Creator I nge Drucker ha s e n s u re d e v e r y de ta il h a s b e e n c o n si d e r e d i n t h e d e si g n o f h e r g l a m orous and total l y re la x in g s p a c e a t S t o c k l a n d To o r o n g a i n G l e n I r i s. Paloma MediSpa offers solutions for all skin conditions and treatments designed to enhance your appearance. Inge’s philosophy is ‘change the outside and the inside just follows.’ For people looking to address the status of their skin and skin conditions Paloma MediSpa offers an approach that focuses on the uniqueness of each individual’s skin. “We have an integrated range of services designed to make the Paloma experience rewarding with the desired results being delivered,” says founder, Inge Drucker.
create an inviting and chic ambience. The waiting area blends replica furniture with concrete and chrome, yet delivers a soft, soothing, relaxing and peaceful environment.”
The Paloma experience starts as soon as you arrive. “My aim was to create an experience from go to woe. It starts with a clinic layout that conveys a mix of an industrial design, by Melbourne architect Warwick Sassman, and is complemented by fittings and furniture to
DMK believes that the origin of most skin conditions is a result of disharmony within the skin. Using the principles of biochemistry, DMK has formulated a range of treatments and products designed to educate skin to perform like youthful healthy skin.
Treatments range from customised skincare treatments using world-renowned DMK products, to anti-ageing and profile enhancing injectables under the Dermox Group brand. DMK products are the brainchild of biochemist Danné MontagueKing from California.
DMK’s revolutionary concept of REMOVE, REBUILD, PROTECT, MAINTAIN aims to match an individual’s biochemistry with the appropriate skin therapy. Botanical-based paramedical products make up the DMK skin care program. Paloma MediSpa offers skin revision procedures for those who want results. Specific treatments are designed for addressing pigmentation issues, rosacea, acne, open pores, scarring, milia, wrinkles, sun damage, fragile capillaries and premature ageing. There is a solution available for all skin types and conditions, so why not meet with Inge and the team and enjoy the full Paloma MediSpa experience today.
D M K RE S URFACI N G T RE AT M E N T
BEFORE
DU R ING
AFTE R
www. p al o m am ed i s p a. co m . au NOW OPEN POD IU M L E V E L ST OC KL AN D T OO R O N G A C N R TO O R A K A N D TO O R O NGA R DS GL E N I R I S | P H ( 03 ) 98 2 2 7 7 1 8
Creative DENTISTRY
DR PETER OLIVER of Creative Dentistry
Dr Peter Oliver of Creative Dentistry specialises in cosmetic dentistry, and the treatment of jaw, neck and shoulder problems caused by dental issues. He has a special focus on catering to nervous patients with a range of treatment options (including sedation and general anaesthesia) that help to alleviate the anxiety experienced by many in anticipation of, and during dental procedures. Dr Oliver graduated from the University of Adelaide in 1972. “I have been practicing for more than 40 years and I am still passionate about dentistry,” he says. “I am an empathetic dentist and I understand my patients’ concerns. I know what they want and I care.” Dr Oliver explains his top options for improving patients’ smiles and therefore, their lives.
Creative dentistry is all about creating an image for the patient that will give them confidence about their appearance – and, thus, in themselves. With more than 41 years’ clinical experience Dr Oliver believes his understanding of what a patients needs and wants is of utmost importance. “We are about solving problems involving teeth and facial muscles. Many of the techniques used involve no, or little drilling, which can be a source of distress for patients.”
These techniques include:
impression is needed. No more partial dentures! QuickSmile is another, similar option.
LUMINEERS For the smile you always wanted, a contact lens-thin porcelain veneer is placed over existing teeth like a fingernail. They are clinically proven to last up to 20 years, and simply require a very accurate dental impression of a patient’s mouth.
NO MORE GRINDING AND CLENCHING (BRUXISM) The same botulinum toxin injections that are used to “iron out” wrinkles on the face can be used to relax the muscles of the jaw that are engaged when people grind or clench their teeth. This allows symptoms like headaches and temporal-mandibular joint (TMJ) problems to be controlled, and minimise damage to the teeth themselves.
SNAP-ON SMILES These are teeth made from a proprietary formula of hitech dental resin, very thin yet extremely strong, that fit over your own teeth to give you a beautiful, natural looking smile – and can be inserted and removed whenever you want. Ideal for replacing missing teeth and hiding discoloured, worn or cracked teeth. Again, no needles or drills – simply an accurate
DENTISTRY HAS CHANGED:
We listen, we solve, we act. www.creativedentistry.net
ORTHODONTICS Invisalign, so-called “invisible braces”, are clear retainers worn for 12-18 months to correct crooked teeth. Ideal for adults who would feel self-conscious wearing traditional metal braces.
INMAN ALIGNER This is the fastest technique to straighten anterior teeth (the front six teeth, which are also referred to as incisors and cuspids), in most cases within 4-16 weeks. It is a removable orthodontic plate, not fixed. TOOTH WHITENING We offer immediate in-clinic bleaching and also offer patients take-home bleaching kits. MINI-IMPLANTS These are used for the anterior and premolar (located between the canine teeth and molars) areas. They are small diameter titanium alloy implants (less then 3mm wide). After injecting local anaesthetic into the gum, the implants are inserted into the bone. They can be used for crowns, short bridges, partial dentures or full dentures.
83 Raglan St, Port Melbourne VIC, 3207 creativedentistry@hotmail.com Ph 03 9939 9658 | Mo 0411 148 645
SOUTH A
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USTRALIA
Photo courtesy of www.bradgriffin.com
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THE AESTHETICS OF RECONSTRUCTION
• Cancer of the nose
The capacity for Australian surgeons to restore and repair in response to our urgent need, or as an improvement on what we already have is constantly evolving. Dr Yugesh Caplash talks about the options for reconstructive and aesthetic surgeries. RECONSTRUCTION
AESTHETIC SURGERY
Dr Caplash sees a lot of patients who have
There are various forces at work
experienced loss of facial tissue due to cancer.
as we age and plastic surgeons like
After sections of the face have been removed, then
Dr Caplash have a number of
the facial jigsaw puzzle begins. “I rebuild those lost
treatment methods that improve
anatomical components with tissue from other parts
what is normal ageing and also
of the body and reconstruct the affected area so
pull the years back a little to make
they can go back to looking and feeling like
things better.
volume with fat injections or
Facial ageing is a complex process.
be used to reduce the fine skin
themselves again.” People can lose large portions of their facial features – cheeks, lips, noses and so on – after cancer removal. The key to rebuilding is to match the right tissue with the missing section of face so there is a blended effect in the repaired area. Creating the tissue building blocks involves sourcing skin, soft tissue and bone from another part of the body with a blood supply – such as the tummy or the leg. “I then reconnect the blood supply and shape the tissue taken from another area to look more like it’s an inherent part of the face” explains Dr Caplash. “For example tissue from the forehead might be used to repair the nose or tissue from the tummy or leg can rebuild sections of cheek and jaw that may have been lost or removed. I build up the section of cheek then thin and define it to improve it and make sure it matches the other side. However, there are limitations to our reconstructive abilities due to the complex nature of reconstruction. IN some cases a face transplant may be the only solution.
As laxity develops between the mobile and the fixed in the different layers and the effect of gravity means there is a downward descent. The fatty tissue in our face that gives us a youthful appearance starts to shrink down and descend and the bones that form the underlying structure of our face start to
Features common to the ageing face – cheek jowls, turkey gobbler neck and thick skin folds are all improved by re-suspension of the deeper layers and removal of abnormal fatty accumulations. Deep creases in the face can also be improved by adding extra fillers. Anti wrinkle injections can creases and improve skin’s smoothness. The final step to the aesthetic approach is good skin care. Implementing a focused skin care regime that will improve the quality of the skin and the give it a healthier look puts the finishing touches on. This can also be
experience loss of mass.
supported by laser treatment for
“In order to put things back in
The laser has minimum downtime
place, or revise those areas, I work on the deeper tissues in the face and neck and lift them to a more normal position. I then take out the excess skin that has become lax and improve the appearance overall. ”
rejuvenating tired looking skin. and works on the deeper supportive collagen layer that firms the skin. It also reduces the appearance of sunspots.
Advvanced Plastic Advanced Plastic & Cosmetic C osmetic Surgery Surgery
DR YUGESH
BEFORE_Lower face neck and bleph
CAP CAPLASH LASH His surgical skill & respect as a leader for caring & concern for his patients.
AFTER Lower face neck and bleph
Cosmetic Surgery procedures: BEFORE Neck and lower face
Reconstructive procedures:
AFTER Neck and lower face
10 Waterloo Waterloo SStreet, treet, Glenelg Glenelg SA 5045
08 8297 1476
yyugesh@apcsurgery.com.au ugesh@aapcsurger y..com.au
PRACTICE PHILOSOPHY
Dr. Satera Papageorgiou
Our dentists are highly experienced with many years of practical dental exposure and have at their disposal the latest in dental technology.
BDS(Adel)
Teeth-whitening procedure using the latest technology; treatment is performed in a single1 hour appointment with immediate results.
Patient’s teeth before Invisalign tooth alignment.
Patient has had resin veneers replaced to her two front teeth, and reshaping edges of existing teeth.
Same patient after 17 months of Invisalign tooth alignment. Incisors have been re-contoured to give a softer edge to these teeth.
Dr Satera Papageorgiou is the owner and practice principal of Mawson Lakes Dental in Adelaide and Copper Coast Dental, Kadina. She practices all modalities of dentistry and has a keen interest and extensive experience in rehabilitative, cosmetic and implant dentistry. She is Invisalign accredited, and has also more recently become qualified to place implants to replace missing teeth, as well as mini dental implants to support an over-denture. Dr Papageorgiou has in the past been a councilor on the Australian Dental Association SA and a member of the Peer Review Committee. She has also been the Dental Representative on the Medical Advisory Committee for the Calvary Central Districts Hospital for the past 22 years. Dr Papageorgiou practices a holistic approach to dentistry and believes in treating all members of the community as equals when it comes to their dental needs. She is a keen advocate of improving the health and
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dental health status of rural Australians and has involved herself with offering her services to remote communities in the Northern Territory. Equally she enjoys looking after families and seeing her patients and their families return year after year. Dr Wayne Lowe is the full-time dentist at Copper Coast Dental and he enjoys all facets of general practice dentistry. He has 35 years’ experience with particular interests in dentures, cosmetic dentistry, crown and bridge-work, and porcelain veneers. He is a member of the Australasian Sleep Association in which he has a special interest in sleep apnoea and oral anti-snoring devices. Dr Lowe’s dental philosophy is to treat patients with high quality and pragmatic dental care. He can often be heard advising that “this is what I’d do if I or one of my family had a dental problem”. Not only do we aim to restore function we also strive to improve the appearance
of our patient’s smile. One’s smile can be improved in a variety of ways; however we are always aware that no one person’s needs and desires is the same. Improving one’s smile can be achieved in a variety of ways. These may involve teeth whitening using the Smartbleach® Teeth Whitening which is the latest inhouse LED whitening system, resin and porcelain veneers, natural looking porcelain fillings or Invisalign teeth alignment with clear braces. Dental implants are becoming increasingly popular as patients realise this option can be relatively simple and comparable in cost to a bridge or root canal therapy and a crown. In both the Mawson Lakes Dental and Copper Coast Dental practices our aim is to inform patients of their dental needs. This is accomplished by making patients aware of their oral health and offering the most effective preventive and restorative options in order to achieve and maintain optimal oral health.
a beautiful smile Would you like to improve your smile? Mawson Lakes Dental and Copper Coast Dental offer a wide range of treatments that can help to create a beautiful healthy smile.
• • • • • • • • • • • • •
General Dentistry In-house IV sedation GA in hospital Teeth whitening Cosmetic dentistry – resin and porcelain veneers Crowns – bridges Implants CEREC – porcelain restorations Sleep Apnoea Devices Hygienist Dental Therapist – children’s dentistry Invisalign accredited – clear braces - tooth alignment Dento-facial aesthetics
Dr Satera Papageorgiou Dr Cathy Wiering | Dr Stephanie Walls Shop 10, The Promenade Shopping Centre, Mawson Lakes SA | Ph 08 8260 2499
Dr Satera Papageorgiou & Dr Wayne Lowe Shop 2/77 Port Road, Kadina SA 5554 Ph 08 8821 3096
www.mawsonlakesdental.com.au
www.coppercoastdental.com.au
COSME T IC Rejuvenation B R I G H T O N D AY S U R G E RY OFFE RS A C O S M E T I C E X P E R I E NC E F OR WOME N WHO WA NT T O R E J U V E NAT E T H E IR A PPE A RA N CE A ND R E NE W T H E I R C O N FIDE N CE .
LEISA
Chappell STEPHANIE
Mebberson
Nurse Injectors Leisa Chappell and Stephanie Mebberson are highly trained and experienced in the use of dermal fillers and anti-wrinkle treatments and in conjunction with other cosmetic rejuvenation procedures can advise on how to improve skin texture, clarity and appearance and address issues related to pigmented and aged skin. Other treatments available include facial peels, brightening serums, microdermabrasion and sonophoresis. These can all improve texture dramatically and rejuvenate the skin leaving it with a healthy glow. Staff can provide comprehensive advice on caring for your skin, how to maintain a natural youthful appearance and the benefits of preventing skin damage with Ultraceuticals skin care products and the Jan Marini Skin Care Management System. Ultraceuticals is a skin care range delivering real skin care with visible results. This cosmeceutical skin care range offers a scientific approach to combat ageing skin and promote youthful, healthy complexions. The Jan Marini Skin Care Management System is a medically validated range of products identifying the benefits of Vitamin A & C and glycolic acid on the skin to assist in treating ageing, pigmented and acne prone skins. To soften facial lines and wrinkles and improve the appearance of the skin, wrinkle treatments such as Botulinum toxin are extremely effective. Botulinum is a purified protein that works by
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blocking nerve impulses that trigger muscle contractions, which can produce facial lines and wrinkles. The effect is temporary and can last around three to four months depending on the client. This treatment can also be used for excessive underarm sweating (axillary hyperhidrosis). Suitability for this treatment is assessed at the time of consultation and a consent process obtained. Dermal Fillers are non surgical facial treatments, which return volume to areas of the face where the depletion of collagen is evident. They re-volumise and reshape the face, assisting in softening facial lines while improving skin texture and hydration. Hyaluronic acid is the primary ingredient of the dermal fillers used at Brighton Day Surgery. It is a naturally occurring substance in the body, therefore lowering allergic reactions post treatment and can be used to augment the cheek area, plump the lips and improve lines around the nose, mouth and chin and across the forehead and browline. The friendly staff at Brighton Day Surgery are well informed and highly experienced. They would be very happy to discuss your individual treatment options in a comprehensive free consultation. Here you have the opportunity to ask questions and view photographs, be informed of the results you can expect and the time frames involved to achieve these results. Please call (08) 83771775 to arrange an appointment.
SCLEROTHERAPY DR
LISA
Plastic Surgery for women by women
MARKS
Veno us d is ea s e i s a pro bl em f o r a la r g e n u m b e r o f men an d w o m en a nd t rea tm e n t o p tio n s h a v e chang ed s i g ni fi ca nt l y o v er t he la s t tw o d e c a d e s .
From small spider veins to large varicose veins that have a potential for serious consequences such as venous leg ulceration, pigmentation and venous eczema, there are now nonsurgical options widely available. These offer a more complete treatment and result in less side effects than surgical management. Treatments are based on an adequate assessment of the venous system in the legs by use of Duplex Ultrasound mapping. This examination is fundamental to designing an appropriate treatment for each individual patient. The mapping scan provides the treating doctor with a detailed picture of venous anatomy and shows the pattern of venous disease. It also measures diameters of abnormal and normal segments of the venous system and assesses both superficial and deep venous anatomy and function. Based on the ultrasound mapping, the most appropriate treatment can be performed.
For the largest of varicose veins, where the main truncal veins are incompetent, then endovenous laser ablation or similar endothermal treatment may be offered. For patients with moderate varicose veins or less extensive venous incompetence, ultrasound guided foam sclerotherapy can be used. As there is maximum safe dosage of the foam sclerosant, multiple treatments may be required. With these treatments, there is no scarring but there is some recovery time with some bruises, lumps and pigmentation that fade over a number of weeks after the treatment. Compression stockings must be worn for approximately 2 weeks after treatment. For more detailed information about any of these treatments, please call the Brighton Day Surgery on (08) 8377-1775 to arrange an appointment to discuss your individual needs with Dr Marks.
DR LISA MARKS SCLEROTHERAPY Dr Lisa Marks graduated with a Bachelor of Medicine and a Bachelor of Surgery from Flinders University in 1994. She has gone on to train in surgery and cosmetic and laser medicine and in 2008 began extensive further training in the non-surgical management of venous disease with the Australasian College of Phlebology. Dr Marks has worked in cosmetic and laser medicine since 1999 in private practice and has a certificate in Dermatology from Monash University. The scope of her practice extends from vascular birthmarks to skin cancer management, treating veins of all sizes from cosmetic spider veins to very large varicose veins with skin changes and ulceration. These treatments include Endovenous Laser ablation for the largest varicose veins, ultrasound guided sclerotherapy and microsclerotherapy. Patients with all forms of venous disease can be assessed and managed at The Brighton Day Surgery by Dr. Lisa Marks.
D R . J U L I E L AW R E N C E Plastic & Reconstructive Surgeon Medical Director of the Brighton Day Surgery
At The Brighton Day Surgery, we offer a cosmetic experience for women who want to rejuvenate their appearance and renew their confidence.
Services
Breast • Breast Augmentation • Breast Reduction • Breast Lift Body • Liposuction • Abdominoplasty • Labioplasty Face • Eyelid Reduction • Facelift • Nose Surgery • Ear Surgery
Skin Rejuvenation • Volume Restoration using Dermal Fillers • Wrinkles / Expression Lines • Skin Texture and Pigmentation
1 Jetty Rd,Brighton, South Australia, 5048 Ph: (08) 8377 1775 E :info@brightonplasticsurgery.com.au
www.brightonplasticsurgery.com.au
www.syluxuryspa.com
Located on the banks of the beautiful River Torrens opposite the Festival Theatre, SY Luxury Spa is the only luxury spa destination on the parklands in the heart of Cultural North Adelaide.
An atmosphere of tranquil escapism offering the finest treatments to rejuvenate both your body and soul, where you will find the serenity, beauty and equilibrium to achieve complete rejuvenation. Pampering, Stress Reduction, Therapeutic or Relaxation options. Enjoy an experience that is quite simply unparalleled!
• SIGNATURE LUXURY HAMMAM RITUAL • EXCLUSIVE SPA FACIAL RITUALS • HAMMAM STEAM ROOM RITUAL • WELLNESS MASSAGE • WELLNESS PREGNANCY MASSAGE
• HANDS & FEET INDULGENCE • STEAM ROOM & SPA • SHARED ENJOYMENT & SPA EVENTS • WAXING • LASH & BROW TINTING • SPRAY TANNING
Signature Luxury Hamman Ritual Melt into your own private steam room, beautifully appointed with star lit sky line, hot stone bed, rain shower and plunge pool. You will be provided with our own Hamman inspired exfoliation smoother infused with crushed coffee, organic cane sugar, almond, cocoa butter, vanilla bean & Moroccan rose. The ideal pre treatment addition to boost circullation, promote detoxification, clear the mind and deepen the benefits of your spa treatment.
Next Generation Club War Memorial Drive, North Adelaide 5006 E: info@syluxuryspa.com | Ph: 08 84107877 | Fax: 08 84108187
´7UXVW 2QO\ LQ ([SHULHQFHµ
Beauty&Breast The
Photos and Words by: Selina Lam of Beauty Access
Selina Lam is an experienced Para/Medical Cosmetic Tattoo Practitioner and Trainer. Patients are usually referred by a surgeon or professional consultant. Selina creates a natural looking 3-D nipple and areola, using blends of soft natural coloured pigment.
Areola & Nipple Tattoo YOUR QUESTIONS ANSWERED The natural result of micro-pigmentation of the areola and nipple restores confidence and helps you feel desirable again after losing one or two breasts to cancer after surgery. We understand that after diagnosis and invasive surgery, often the last thing you want to think about is more reconstructive work. Many patients and surgeons will opt for 3D tattoo rather than darker skin grafts taken from other areas of the body. Over the years, para- medical tattooing has proven to give a more realistic and satisfying result. Many clients claim it has changed their lives and increased their confidence and femininity. Services that a Para/Medical Cosmetic Tattooist performs include reducing visibility of scars, improving loss of natural skin pigmentation, areola and nipple creation and re-pigmentation.
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Is para/medical tattoo different to other semi-permanent tattoo procedures? The para/medical or the semi-permanent cosmetic tattoo of the areola and nipple restorative technique is much like a cosmetic tattoo. However, different procedures, tools and needle combinations are used. This specialised work will create a natural looking nipple and areola.
Before - cosmetic tattoo
After - Immediately after micro-pigmentation on both breasts
How long does the procedure take? Micro-pigmentation is usually completed within two hours. This includes the measure and design of the nipples and areolas, colour selection and matching to skin tone and finally tattooing the work of art.
You have a choice? At Beauty Access Cosmetic Tattoo Centre, we appreciate that everyone is different and encourage clients’ involvement throughout the entire process. Once the client is completely satisfied with all aspects of the process, which have been specifically tailored to their individual needs, will the procedure take place.
Any discomfort? Anaesthetics are used throughout the procedure for the comfort of the client completely minimising pain.
Australia
After-care? Instructions will be provided to ensure best results for aftercare. The areola area will be prepared and covered with a gauze swab, and you will be asked to keep the area moist with an ointment to help the healing process. Following the tattoo procedure, you will notice subtle changes and improvements occurring over the next few days. Immediately after tattooing, the tattooed area will look darker than the final result. However over the ensuing couple of weeks, the area will look more natural and softer in colour. When the area is totally healed, usually within 6-8 weeks from the initial procedure, a second session is required called the perfection session. The perfection session completes the process by touching up any colour imperfections and shaping.
BILATERAL
Permanent Cosmetic Training
Beginners • Advanced • Refresher Classes
Training partner RTO:21791
Design and perform cosmetic tattooing/micropigmentation prodcedures (WRBSS505B)
BEFORE
AFTER
Stage 1 –before cosmetic tattoo
stage 2 – designing nipple & areola
Stage 3 – After 3 D Nipple & Areola Re-pigmentation
EMAIL: sales@beautyaccess.com.au
UNILATERAL The Secret is SofTap® Before - Nipple and Areola tattoo
After –Immediately after micro-pigmentation
A nipple has been surgically set in place ready for micro-pigmentation
Designing of Areola and Nipple
Stage 1 – before cosmetic tattoo
After surgery, not all women will have a nipple or alternatively the nipple has collapsed. Artistry in recreating a 3D nipple is important to build an illusion of an erect nipple with colour. Para/Medical Cosmetic Tattoo Specialists, such as myself, need to design areola and nipple according to individual skin tones, surgery results, and patient preferences, creating a beautiful symmetrical work of art.
Permanent Makeup Services at Beauty Access: Eyebrows – Hairstrokes or block Eyeliners • Lips • Scar camouflage Nipple & areola re-pigment Corrections • Removal
Ph 08 8364 2126 M 0419 828 691 E sales@beautyaccess.com.au stage 2 – designing of the nipple & areola
Stage 3 – after 3D Nipple & Areola re-pigmentation
SofTap® Permanent Cosmetic Trainer & Supplier
Before
Dr. Onuma An internationally recognised
Gynaecologist & Pelvic Reconstructive Surgeon Highly educated, Dr Onuma has a degree in Pharmacology from the University of Leeds, completed his MBBS (Medicine) at the University of London and gained a Master of Jurisprudence at the Faculty of Law, University of Birmingham.
The Australian Centre for Female Pelvic and Vaginal Rejuvenation ! # " " "
4 Robe Terrace, Medindie, South Australia, Australia, 5081
The Australian Centre for Female Pelvic and Vaginal Rejuvenation
A
fter completing his specialist training in the UK in the 1990’s, Dr Onuma came to Australia, undertook a Fellowship in Minimal Access Urogynaecology and Pelvic Reconstructive Surgery and became a Fellow of the Royal Australian and New Zealand College of Obstetrics and Gynaecology. He was awarded in the UK by elevation to Fellow of the Royal College of Obstetrics and Gynaecology. % of Specialist Training (UK and European accreditation as a specialist Obstetrician and Gynaecologist), and is a Member of the International Urogynaecological Association and the British Society of Urogynaecology. He is an invited reviewer for the European Journal of Obstetrics & Gynaecology and Reproductive Biology in the area of female pelvic medicine and reconstructive surgery.
of Adelaide. The Institute specializes in female sexual function surgery, offering a range of procedures that improve the appearance and functional of the external genitalia, vagina and pelvic structures. Across the spectrum of pelvic reconstructive surgery, Dr Onuma’s patients present with a range of issues. Whether it is to enhance " % urinary dysfunction, to restore pelvic support or for aesthetic or functional labial surgery, the Laser Vaginal Rejuvenation Institute is dedicated to Dr Onuma’s ethos of ‘looking good, feeling better’ using advanced minimal access surgical techniques that promote rapid recovery.
! % Australia accepted to train in Laser Vaginal Rejuvenation™ in Los Angeles, USA, and now directs The Laser Vaginal Rejuvenation Institute
Dr Oseka Onuma
Q&A
BSc., MJur., MBBS, FRCOG, FRANZCOG Gynaecology. Uro-Gynaecology. Pelvic Reconstructive Surgery. # # % % you decide to pursue a career in this area? I am lucky to have been able to meet and train with and collaborate with experts all over the world in different aspects of female pelvic reconstructive surgery. There are a range of pelvic disorders affecting millions of women, and I am motivated in my work to strive to improve the quality of life of women. Many women are self conscious about their gynaecological issues. How would you encourage them to seek treatment? Every individual gets to a point where things are getting worse rather than better. It’s normal to feel embarrassed and afraid, but % % $ you are already on the way to a solution. Patients often comment after surgery that they wish they had done it years ago. How do you make women feel at ease in consultation with you, when discussing issues of an intimate nature? It’s important to listen to patients without judgement and communicate with them in a way that lets them know you are on their side. I have to ask very intimate questions to get to the source
of the problem. I always explain this and let them know that only ! ! % that women, though often initially hesitant to volunteer intimate information, will respond very positively to direct, well targeted questions. With Pelvic Floor Disorders (PFD) affecting so many women, how do women know what they should seek treatment for and what is ‘normal’ or ‘just part of being a woman’? The term PFD covers a range of disorders all relating to the muscles and connective tissue of the pelvis, and resulting from the impact of physiological and traumatic change to pelvic organs. It’s important to be familiar with what your symptoms are and how they bother you. Do not let others patronise you and tell you ‘it’s part of being a woman’. You need to recognise what is normal for you and ask yourself if it is affecting your quality of life. For example, leakage of urine during exercise is not normal but many women put up with it for years before seeking help. During this time they may rationalize the abnormality as their new ‘norm’ until they have an accident in an embarrassing situation.
www.dronuma.com (08) 8344 6085
C OS M E T E K Cosmetic & Vein Clinic
“
In a lot of cases people leave veins for so long, thinking they are harmless, but a seriously bulging vein can become ulcerated from a simple knock,” says Sheryna. “So it’s really important to have them checked regularly and treated wherever necessary.
“
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“
UGS HAS SEVERAL ADVANTAGES OVER SURGERY says Sheryna
varicose veins spider veins
&
C OS M E T E K Cosmetic & Vein Clinic
BEFORE
WRINKLE TREATMENT
LASER HAIR REMOVAL
AFTER
BEFORE
AFTER
ARBONNE SKIN CARE
DERMABRASION
Contact Cosmetek Cosmetic Clinic 2-294 Payneham Road, Payneham SA 5070 Phone: 08 8363 6606 or 0414 889 968 Email:info@cosmeticclinic.com.au Fax: 08 8363 0681
www.cosmeticclinic.com.au
BY DR MICHAEL MIROSHNIK
Nonsurgical rejuvenation of crows feet and frown lines
Nonsurgical chin enhancement
Wrinkle reduction with fractional laser technology
Nonsurgical nose correction and cheek enhancement
Nonsurgical lip enhancement
Nonsurgical brow lift and reduction of under eye bags
The medispa was developed with the philosophy of providing the very latest and best in injectables and non-surgical enhancement therapies. All treatments are delivered by industry leading nurses and dermal therapists, each of whom was hand picked by Dr Michael Miroshnik:
Non-surgical lip enhancement
Non-surgical rejuvenation of the eye region
Non-surgical reduction of smile lines and crows feet
Non-surgical nose and cheek enhancement
To complement our treatments, we are proud to offer an elite range of take home skin care featuring some of the most proven anti-aging ingredients in the market today. Available for online purchase: www.elixxir.com.au
Non-surgical brow lift
Non-surgical wrinkle reduction
Suite 701, Level 7, 28 Spring Street, Bondi Junction, NSW 2022 T: 1300 854 610 Elixxir Medispa: www.elixxirmedispa.com.au • Elixxir Skincare: www.elixxir.com.au
DR MICHAEL MIROSHNIK Plastic & Cosmetic Surgeon MBBS, FRACS (Plast.)
www.drmiroshnik.com.au T: (02) 9389 8108 or 1300 88 90 50
Dr Phil Richardson MBBS (Hons), FRACS (Plast.)
Brisbane Plastic and Cosmetic Surgery
Level 1, 38 Misterton Street Fortitude Valley QLD 4006 | 1300 789 240 Dr Richardson also consults at Kippa-Ring on the Redcliffe Peninsula:
Suite 22 Peninsula Specialist Centre Cnr George and Florence Streets Kippa Ring QLD 4021 BrisbanePlasticAndCosmeticSurgery
Actual patient of Dr Phil Richardson