Cosmetic Surgery and Beauty Magazine #62

RRP $14.95 (incl. GST) (NZ $15.95 incl. GST)
ISSUE 62 • NOV-JAN 2014
LATEST
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ISSN 1834-383X
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ENT & Facial cosmETic surgEoN
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FACIAL REJUVENATION &
RHINOPLASTY SPECIALIST
HARMONY,
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Reduce the signs of ageing with
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ARTISTRY

Prosthodontics
& Implant Surgery
DESIGNER SMILES TM
Centre for cosmetic, reconstructive
and implant dentistry
Dr Sarkis Nalbandian completed his Bachelor of Dental Surgery with
Honours in 1983 and Diploma in Clinical Dentistry (Oral Implants) in
2000 at The University of Sydney. He also completed his Masters in
Prosthodontics in 2004 at the prestigious King’s College, University
of London with distinction. He is a fellow of the Royal Australasian
College of Dental Surgeons.
B.D.S. (Hons.) Uni.Syd.
FRACDS
Grad. Dip. Clin. Dent. (Oral Implants) Uni.Syd.
M.Clin.Dent (Prosthodontics) King’s College Uni. London
Dr Nalbandian specialises in Dental Implants and Prosthodontics
for treating simple to complex dental, functional and aesthetic
problems.
He lectures on topics including Dental Implantology, Prosthodontics
and Implant Surgery.
He maintains a specialised practice in Sydney limited to Aesthetics,
Prosthodontics & Implant Surgery.
Dr Sarkis Nalbandian
B.D.S. (Hons.) Dip. Clin. Dent. (Oral Implants) Uni.Syd. FRACDS
M.Clin.Dent (Prosthodontics) King’s College Uni.London
Designer Smiles
17 Gerard Street Cremorne NSW 2090
For more information call
02 9953 4189
Fax 02 9953 4358
www.designersmiles.com.au

Dr Alex Phoon
MBBS BSc (Med)
MS (Plast)
FRACS
Plastic Surgeon
HARMONY,
BALANCE,
ARTISTRY
Silkwood Medical
Level 4, 75 Grafton Street Bondi Junction NSW 2022
Telephone 1300 SILKWOOD or 1300 745 596
www.silkwoodmedical.com.au

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MBBS BSc (Med)
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ARTISTRY
Silkwood Medical
Level 4, 75 Grafton Street Bondi Junction NSW 2022
Telephone 1300 SILKWOOD or 1300 745 596
www.silkwoodmedical.com.au

You deserve
to have a Clear
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I know what it is like to have your confidence
affected by how you feel about your skin.
Having problem skin since my teens, I discovered
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As a registered nurse, I head up a team of
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So if there’s something bothering you about
your skin, come and find out how we can help.
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Dr John Flynn
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Dr John Flynn
skin clinic
Reshaping can create
cosmedic&
the look you want
skin clinic
Breast augmentation can
enhance the natural size
and shape of your breasts
Refi nement in Cosmetic Surgery
With breast augmentation, your natural form can be
enhanced and complemented. This results in a balanced
and symmetrical effect that suits your individual body type
and achieves a feminine silhouette.
Liposuction to Shape and Contour
With liposuction, Dr John Flynn can reshape and contour
your form to achieve balance between your body’s
proportions. Areas such as the abdomen and inner and
outer thighs respond particularly well to this procedure.
CERTIFIED
IN COSMETIC
SURGERY
Dr John Flynn
M.B., B.S., Dip. R.A.C.O.G., F.R.A.C.G.P.
Dip. P. Dermatology., F.A.C.C.S.
Fellow of the Australasian College of Cosmetic Surgery
Certifi ed by the American Board of Laser Surgery
Dr John Flynn has over 20 years of experience as
a medical practitioner on the Gold Coast
AD Flynn.indd 1
CERTIFIED
IN COSMETIC
SURGERY
20/4/09 9:01:39 AM
AD Flynn.indd 1
For more information or to make an
appointment call Cosmedic and Skin Clinic
1300 88 13 88
Southport | Gold Coast
Suite 2, 98 Marine Pde, Southport 4215
www.cosmedic.com.au | info@cosmedic.com.au
Dr John Flynn
20/4/09 9:01:39 AM
cosmedic& skin clinic
Dr John Flynn

www.biodermis.com.au

The Australasian College of Cosmetic Surgery
Raising Standards,
Protecting Patients
Dedicated to quality, ethical
and responsible practice.
Accreditation is Important
All Fellows of the Australasian College of Cosmetic
Surgery (FACCS) are specifically trained in cosmetic
surgery and are required by the College to maintain
their skills through a Continuing Professional
Development programme.
All Fellows of the Faculty of Medicine (FFMACCS)
are specifically trained in cosmetic medicine and
are required by the College to maintain their skills
through a Continuing Professional Development
programme.
CERTIFIED
IN COSMETIC
SURGERY
If doctors display this Seal,
you can be assured they
comply with the College’s
exemplary standards of its
Code of Practice, available
at www.accs.org.au
How qualified is your doctor?
Do they have the right to display these symbols?
For further information about the College
and its members and Fellows in your state call:
1800 804 781
admin@accs.org.au
www.cosmeticsurgery.org.au

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DR JOSEPH GEORGHY
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of the European Society of Aesthetic Surgery,
Cosmetic Physician; FFMACCS, Degree in Anti-
Aging & Regenerative Medicine (Germany) Member
of the American Academy of Cosmetic Surgery
DR VERA GEORGHY
Dental Surgeon, University of Adelaide,
Fellow, Diplomate & Lifetime Member in
the World Congress of Minimally Invasive
Dentistry (WCMID).
Voted Clinician of the Year 2009 San
Francisco, USA
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313 Pacifi c Highway
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02 9956 7200
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contents
regulars
26 Editor’s letter
28 Contributors
32 Newsfront
42 Where does that come from?
Queen Elizabeth I: a toxic beauty
167 How to subscribe
186 Directory
features
52 Beauty and the breast
The allure and enigma of breasts
56 Breast options and choices
The many components of
breast augmentation
60 PIP implants
What have we learned?
88 Diets decoded
We investigate the top
trending diets
90 The smarter way to work out
The benefits of high intensity
interval training
142 Skincare for all ages
What to use and when
160 Safeguard your skin
How to choose a quality sunscreen
172 7 deadly makeup skins
Our guide to avoiding
makeup mishaps
industry
36 Regenerative medicine
Behind the scenes at the
BioBridge Conference
40 Non-surgical meeting
Highlights from the ASAPS
non-surgical symposium
44 Reap the rewards
The many benefits of customer
loyalty programs
46 Cosmetex 2014
What’s on the agenda
breasts
50 Perfect fit
New lingerie range specifically
for augmented breasts
62 Your guide to breast
augmentation 2014
70 Breast curves
Creating the perfect
shape for you
74 Breast augmentation
case study
76 The case for polyurethane
breast implants
78 Balanced proportions
Rejuvenating the ageing breast
84 Restoring shapely breasts
Breast reduction surgery
body
93 The numerous benefits of
resistance training
96 Defining touch
All about body implants
98 The modern tummy tuck
Abdominoplasty explained
100 Refine your shape
Microcannula liposuction
102 Body contouring
Non-surgical body shaping
104 Trim and tone
Reduce fat and tighten skin
intimate surgery
106 Speaking out
Empowering women
with options
108 What lies beneath
Cosmetic and functional benefits
of female genital surgery
teeth
112 Rejuvenate your smile
Ultra-thin porcelain veneers
114 Teeth whitening
Next-generation technology

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By harnessing the growth factors contained in our blood, it’s possible to accelerate and
increase tissue regeneration by stimulating collagen production, stem cell migration,
differentiation, and proliferation, and stimulation of new blood vessels, nutrients, antioxidants
and the other components of the extracellular matrix.
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SUBSCRIBE NOW!
contents
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see page 167
face
116 Refresh your look
Facelift case study
118 Bespoke beauty
An individual approach to face,
neck and nose surgery
122 In profile
Male nose and chin surgery
124 Let’s hear it for the boys
Facial rejuvenation just for men
126 Great skin at every age
The ‘layer cake’ approach to
skin health and beauty
128 Building beauty from within
An injectable that targets skin
ageing from within
130 The skin revolution
World-first dual-mode
radiofrequency device
134 Energise your skin
Light-based energy to boost
skin health and cellular activity
136 Platelet-rich plasma
therapy (PRP)
Use your own cells to restore
lost volume
cosmetic tattoo
140 Restoring confidence
Cosmetic and medical tattooing
skin
146 The royal suite
New skincare range to target
signs of ageing
148 Spot-on skin
Treating pigmentation
150 Vitamin D link to vitiligo
154 Your best skin ever
A personalised approach
156 Tattoo removal revolution
Breakthrough laser treatment
158 Cosmeceutical skincare
beauty & spa
170 Hair extensions
174 Beauty buzz
Latest beauty products
180 Get glowing
Shedding light on illuminators
185 Editor’s favourites
cover stories
50 Breast special
60 PIP implant update
88 Diets decoded
90 Fast track fitness
98 Body contouring
142 Skincare by numbers
172 7 deadly makeup sins
174 100+ beauty products
Now you can subscribe online at
www.cosbeauty.com.au

LETTER
FROM THE EDITOR
Another year gone and what a full and fulfi lling one it’s been for
me – both professionally and personally. On a professional level,
the calendar year was jam-packed with innovative conferences
Ahighlighting the continuing advances in aesthetics and anti-ageing.
My most recent travel was to the US, where I also had the opportunity
to discuss the current proliferation of traditional, new and emerging media
channels. The big talk these days is how to get the most from marketing
efforts – the overwhelming view is that the most successful strategies take
a multi-media approach, integrating both print and online marketing.
There are very good reasons for this as, according to recent research,
print advertising is the number-one driver in directing consumers to
websites. Here at Bella Media, we’ve embraced this cross-platform
approach by integrating websites and electronic initiatives with print offerings to enhance
the client and consumer experience. It’s an exciting time to be part of publishing and content
provision, with the ability to interact with and engage an ever-expanding audience.
On a personal level, I’ve also adopted this integrated approach to my lifestyle. I believe
a holistic outlook is integral to optimising health, wellbeing and beauty. The importance of
an active lifestyle and maintaining a healthy weight are both key to enjoying good health
for longer, and I have had a rigorous eight months of training for the New York Marathon.
Unfortunately, a leg injury has hindered this goal, so I am now looking to the Gold Coast
Marathon in July 2014.
In this issue, we look at the benefi ts of high intensity interval training on page 90 and
investigate whether today’s top trending diets really do work on page 88. There’s also great
advice on page 142 on the right skincare for your age, as well as the seven makeup sins to
avoid at all cost on page 172.
A holistic approach is especially important in the cosmetic surgery arena – the best
results are often seen when aesthetic treatments are combined with a healthy lifestyle and,
importantly, realistic expectations of what cosmetic surgery can achieve. While a procedure
can go a long way in improving self-confi dence, it should not be viewed as a panacea.
One of the cosmetic surgeries with the highest patient satisfaction levels, when done
for the right reasons, is breast augmentation. This issue contains our annual Breast Special
from page 50, and we’ve compiled an array of information to help you make an informed
choice on all aspects of the procedure – and to help you achieve the best possible results.
The Bella Media team and I wish all of our readers a happy and healthy 2014 – and
we look forward to continuing to bring you comprehensive, authoritative and relevant
information about cosmetic surgery and beauty.
Michelle Kearney
Editor-in-Chief
michelle@bellamedia.com.au
Michelle Kearney is sole director of The Bella Media Group and no other parties or individuals have any fi nancial interest in the
company or in Australian Cosmetic Surgery & Beauty Magazine (ACSBM). Reproduction in whole or in part is not permitted without
the written authorisation of the publisher. All reasonable efforts have been made to trace copyright holders. All manuscripts and
articles submitted for publication remain the property of The Bella Media Group. This magazine contains general information only and
does not purport to be a substitute for medical advice. All readers are advised to seek medical advice from a doctor if considering
cosmetic surgery. The publisher and the authors do not accept any liability whatsoever in respect of an action taken by readers in
reliance on the recommendations set out in this magazine. Except where specifi ed in captions, photographs depict models who have
not necessarily received treatments described in this magazine.
Advertising Policy ACSBM follows and upholds the Australian Competition and Consumer Commission (ACCC) Guidelines to
Advertising Medical Services, the Therapeutic Goods Administration (TGA) advertising regulations for therapeutic goods and services,
and individual state Medical Board guidelines. All reasonable effort is made by ACSBM to ensure that all advertisements accepted
for publication follow these guidelines. Copies of these guidelines are available from the individual agencies and boards. ACSBM
reserves the right to reject advertising that is in breach of these guidelines. All ACSBM advertisers assume sole responsibility and
liability for statements contained in their advertising copy, and hold harmless and indemnify ACSBM, Bella Media, and offi cers,
directors and employees from and against all liability, loss, claim, damages, costs or expenses arising out of matter contained in the
advertising. Advertisers accept these terms and responsibilities when signing an advertising contract with ACSBM.
www.cosbeauty.com.au
Read the digital edition at www.zinio.com
Issue 62
NOV - JAN 2014
Editor-in-Chief
Michelle Kearney
Editorial Director
Aimée Surtenich
Production Coordinator
Camila Kawashita
Art Directors
Debbie Pilarinos,
Stéphanie Blandin de Chalain
Writers
Caitlin Bishop, Tara Casey,
Nicola Donovan, Lizzy Fowler,
Aimée Surtenich
Photographers
Debbie Pilarinos, ShutterStock, Picdesk
Distribution & Subscription
Enquiries
Bill Dunk
Phone 02 9398 2755 Fax 02 9398 2855
Email acsmag@bellamedia.com.au
Advertising Enquiries
Michelle Kearney
Phone 02 9398 2755 Mob 0419 624 246
Email michelle@bellamedia.com.au
Lauren Vescio
Phone 02 9398 2755 Mob 0431 400 381
Email lauren@bellamedia.com.au
Editorial Enquiries
Michelle Kearney, Aimée Surtenich
Phone 02 9398 2755 Fax 02 9398 2855
Email acsmag@bellamedia.com.au
Produced & Published by Bella Media
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Managing Director
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General Manager
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All ‘before and after’ photographs in
Australian Cosmetic Surgery Magazine
articles are of genuine patients. It is
important to understand that they represent
one person’s experience and there is
no guarantee that any other patient will
experience similar results.
26

Expertise is Everything
More than 30 Years Experience in Cosmetic Plastic Surgery
Specialising in all Facial, Breast and Body Surgery
The Cosmetic and
Restorative Surgery Clinic
20 Manning Road,
Double Bay
02 9362 7400
Fax: 02 9328 6036
Email: info@cosmeticsurgeryoz.com
Dr Darryl J Hodgkinson
MB, BS (Hons), FRCS (C), FACS, FACCS
American Board of Plastic Surgery
Cosmetic Plastic Surgeon
www.cosmeticsurgeryoz.com
The definitive website for all your cosmetic surgical queries. More than 50
megabytes of information and hundreds of Dr Hodgkinson’s outstanding results.

CONTRIBUTORS
Ricky Allen Dr John Flynn Dr Joseph Georghy Dr Paul Gerarchi Val Glover-Hovan
Dr Doug Grose Suzie Hoitink Dr Darryl Hodgkinson Eva Karpati Dr Jim Leavesley
Dr Steven Liew Dr Vlad Milovic Dr William Mooney Dr Colin Moore Dr Pouria Moradi
Dr Sarkis Nalbandian Dr Warwick Nettle Dr Oseka Onuma Dr Alex Phoon Rita Porreca
Dr Michael Rich Dr Kourosh Tavakoli Terri Vinson
28 www.cosbeauty.com.au

RHINOPLASTY SPECIALIST
MBBS, BSc (MED), MS (UNSW),
FRACS (PLAST)
Dr Tavakoli is a renowned
cosmetic plastic surgeon
who is a Fellow of the Royal
Australasian College of Surgeons
and a Member of the Australian
Society of Plastic Surgeons.
He specialises in all aspects of
facial cosmetic surgery, with a
particular interest in cosmetic
rhinoplasty and facelift.
Follow Dr Tavakoli on
New premises: Suite 1, 376 New South Head Road, Double Bay
1300 368 107 | drtavakoli.com.au

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Microcannula Liposuction
By Dr Michael Rich
Dr Rich has been performing liposuction in Australia since
1992 after training in the United States with Dr Jeffrey Klein
(acknowledged to be the ‘father of modern liposuction’). With
20 years of experience and thousands of procedures, Dr Rich is
considered a leader in Australia for liposuction. He has chaired
liposuction symposiums at the World Congress of Dermatology
and has chaired the liposuction symposium for the
Australian College of Cosmetic Surgery.
Microcannula Liposuction offers:
• The benefit of being performed under local anaesthetic
• Minimised risk of bleeding, bruising and discomfort
• Smoother liposuction results
• Virtually undetectable scars
• Skin tightening and retraction over the ensuing months
• Minimal downtime
Microcannula Liposuction can be used for:
• Abdomen
• Love handles
• Legs
• Buttocks
Member of:
• Arms
• Back
• Breasts – male and female
• Double chin and jowls
MELBOURNE CLINIC
SYDNEY CLINIC
enRich Dermatology & Cosmetic Surgery Centre
872 High St, Armadale
www.mrich.com.au
03 9500 9500
The Facial Rejuvenation Clinic
263 George St, Sydney
www.facialrejuvenation.com.au
1300 88 99 35

newsfront
NEWSFRONT
CATCH UP WITH THE LATEST IN THE INDUSTRY...
East meets West
Dr Darryl Hodgkinson reports on the 4th Aesthetic Meeting between
the International Society of Aesthetic Plastic Surgeons and the China
Society of Plastic Surgeons in Shanghai.
Held on 24 October, 2013, 250 attendees and 15 international faculty
met in Shanghai. The main emphasis was on eyelid surgery, particularly the
experiences of the Korean and Taiwan surgeons treating ptosis.
Most interesting to me were the breast sessions, with a review of
anaplastic large cell lymphoma associated with textured implants, and the
somewhat controversial use of texturing in contemporary implants.
Presentations on face lifting showed a variety of techniques – some of
them quite invasive, some of them less invasive – to try to elevate the midface,
cheeks and jowl areas.
There was also extensive discussion about non-surgical procedures,
including fat injections. There is a lot of enthusiasm about this technique, but
in my opinion I believe there is not enough science to support the enthusiasm
at this point; I believe the same can be said for ‘stem cell’ face lifting.
4 Apps to help you butt it out this New Year
Kick the habit and reap the numerous health and cosmetic benefi ts! Here are four
tried-and-tested apps worth downloading to help you give up smoking – and stay smoke-free.
Livestrong My Quit Coach
Available for the iPhone | Free
Track your progress with this welldesigned
app that will help you see
how well you’re doing on a monthly,
daily – even hourly – basis, awarding
achievement badges depending on
your progress.
My QuitBuddy
Available for iPhone
and Android | Free
This app, developed by the Australian
National Preventative Health Agency,
includes quit tips, countdowns,
motivational messages and nifty
features such as a ‘panic button’
designed to provide a range of
distractions when cravings hit a
high note.
QuitNow!
Available for iPhone,
Android and Blackberry | Free
As well as outlining how much money
you’ve saved from avoiding your
regular cigarette purchases, the app
delivers messages indicating how
much your health has improved
since starting your journey, based on
information from the
World Health Organisation.
Quit Smoking Now with Max Kirsten
Available for iPhone, iPad
and Android | $7.49/$4.99
Having helped thousands of
people give up smoking through
hypnotherapy, Max Kirsten has taken
his Quit Smoking programme to the
smartphone. With features, fact cards
and a smoking calculator, alongside
all the audio sessions, this app has
been rated amongst the world’s
best apps.
32 www.cosbeauty.com.au

Natural diversity
Women’s Health Victoria has recently launched
Australia’s fi rst online ‘labia library’, displaying real,
not pornographic, images of the female anatomy to
show the natural variations that can occur between
women’s bodies and to education women that there
is more than one defi nition of ‘normal’ when it comes
to the vagina.
The aim of Labialibrary.com.au is to alleviate
common concerns about labia size and shape, and
to help reduce body image anxiety. The site features
a photo gallery of 20 unaltered vulvas to increase
awareness about what ‘normal’ looks like.
Palomar Acquired
by Cynosure
Cynosure, a leading company in laser and light based
treatments for minimally invasive and non-invasive aesthetic
applications, recently acquired medical device company
Palomar.
The acquisition of Palomar is set to complement
Cynosure’s product range and customer base, with
added product and service revenues and stronger global
distribution network.
Joseph Caruso, Chairman, President and Chief
Executive Offi cer of Palomar says: “Both companies share
the same passion for innovation, and this combination
creates a single, unifi ed organization that is positioned for
continued success.”
Cynosure is a leading developer and manufacturer of a
broad array of light-based aesthetic and medical treatment
systems. Cynosure’s products are used to provide a diverse
range of treatment applications such as hair removal, skin
rejuvenation and scar reduction, as well as the treatment of
vascular lesions.
Exercise: a weapon
against dementia?
New research has found physical activity is key to leading
a ‘brain-healthy’ lifestyle and can help fi ght the progression
of dementia.
The study, released by Alzheimer’s Australia and Fitness
Australia, combined and reviewed the latest research from
Australia and around the world. It found those hours on
the treadmill can go a long way in improving brain health,
increasing memory and refi ning cognitive skills.
Importantly, these improvements occur alongside a
decreased chance of developing dementia and, in cases
of existent dementia, a reduction in the disease’s progress.
Co-author of the study Dr Maree Farrow from The University
of Melbourne explains the importance of these fi ndings:
‘Research has found that about half of Alzheimer’s
disease cases are potentially attributable to risk factors you
can change,’ Farrow says. ‘Physical activity has a signifi cant
positive impact on brain health and can reduce the risk of
developing dementia.’

newsfront
HARNESS
YOUR HEALING
POWER
DR GLEN CALDERHEAD REVEALED HOW HEALITE II CAN
BE USED TO REJUVENATE THE SKIN AND ACCELERATE
HEALING AT A WORKSHOP HOSTED BY ADVANCED
COSMECEUTICALS. CAITLIN BISHOP REPORTS.
On the cutting-edge of anti-ageing and regenerative
medicine, Advance Cosmeceuticals hosted a workshop
investigating the latest developments in skincare and
regenerative light therapy at Sydney’s Hilton Hotel in
August 2013.
The workshop featured American cosmetic surgeon and
dermatologist Dr Ronald Moy, who spoke about the benefi ts
and science behind skincare line DNAEGF Renewal, and
internationally recognised Scottish scientist Dr Glen Calderhead,
who spoke on the regenerative benefi ts of Healite II.
Healite II is a therapeutic and healing light therapy that can
be used as a standalone aesthetic treatment, or to accelerate
healing following more invasive procedures. It calls upon different
light wavelengths, including infrared, to stimulate cellular activity
in the dermis and underlying tissue. This is effective in helping
to accelerate wound healing, increase microcirculation, treat
active acne and rejuvenate the complexion.
Treatment with Healite involves the delivery of yellow light, at
590nm, and infrared light, at 830nm. Dr Calderhead explains
the two wavelengths target different areas.
‘Treatment with Healite II starts with one minute of yellow
light, which stimulates cells in the epidermis,’ he says. ‘The
yellow light targets keratinocytes and merkel cells, which are
highly endowed with mitochondria, or energy stores. This fl oods
the epidermis with energy and prepares the skin for the delivery
of infrared light, which targets the dermis and underlying tissue.’
Dr Calderhead explains infrared light activates cellular
membranes and enhances microcirculation in the dermis,
increasing cellular turnover and fl ooding the site with oxygen
and nutrients. He showed several case studies where treatment
with Healite II not only achieved rejuvenation at the treatment
site but also caused a larger systemic effect – where heat,
increased blood fl ow and heightened cellular activity occurred
throughout the body after treatment.
Treatment with Healite II can be used for facial
rejuvenation, and also to accelerate healing following more
invasive procedures such as laser treatment or cosmetic
surgery. Because of its regenerative and healing properties,
Healite II is effective in helping to reduce the amount of
bruising, swelling and scarring post-operatively.
‘By harnessing the body’s natural processes and
accelerating and boosting their activity, Healite II can be
used for a variety of rejuvenating and healing applications,’
says Dr Calderhead. ‘It heightens blood fl ow, which delivers
increased oxygen and nutrients to the treatment site, and
incurs a rejuvenating, brightening and energising effect.’
34 www.cosbeauty.com.au

New from Allergan
Allergan has introduced dermal fi llers Juvederm
Volbella and Juvederm Volift to Australia. Used
to enhance the lips, reduce the appearance of
wrinkles and fi ne lines and restore volume, the fi llers
are formulated with a local anaesthetic to reduce
discomfort during treatment.
At the launch, French plastic surgeon Dr Herve
Raspaldo shared his experience in using dermal
fi llers for facial rejuvenation: ‘The loss of volume in
the face is now also recognised as a fundamental
part of ageing and can be treated using minimally
invasive procedures and products to provide a more
natural, relaxed look.’
Sydney plastic surgeon Dr Steven Liew agrees:
‘Juvederm Volbella and Juvederm Volift are a
welcome addition to current treatments that
rejuvenate the face and restore volume.’
Minimally-invasive solutions
Japanese plastic surgeon and internationally renowned researcher
Dr Yohei Tanaka spoke on the benefi ts of non-invasive methods
for body contouring and facial rejuvenation at a recent breakfast
hosted by Cutera. He spoke on the benefi ts of the Cutera systems
TruSculpt and Titan, which use radiofrequency and infrared
technology to achieve aesthetic results.
Dr Tanaka presented several case studies on TruSculpt, showing
its effect on wrinkle reduction and general facial rejuvenation, as
well as his non-invasive body contouring results using Titan.
Cynosure Acquires Palomar
Cynosure, a leading company in light-based treatments for
minimally invasive and non-invasive aesthetic applications, recently
acquired medical device company Palomar.
The acquisition of Palomar is set to complement Cynosure’s
product range and customer base, with added product and
service, and stronger global distribution network.
Joseph Caruso, Chairman, President and Chief Executive
Offi cer of Palomar says: “Both companies share the same passion
for innovation, and this combination creates a single, unifi ed
organisation that is positioned for continued success.
Cynosure is a leading developer and manufacturer of a broad
array of light-based aesthetic and medical treatment systems.
Its products are used to provide a diverse range of treatment
applications such as hair removal, tattoo removal, skin rejuvenation
and scar reduction.

industry
A Regenerative Revolution
An amalgamation of world leaders in regenerative medicine met in
Venice for the 5th International BioBridge Foundation Conference.
Caitlin Bishop reports.
The canals of Venice framed the innovative, inspiring
and cutting-edge hub of the 5th International
BioBridge Foundation Conference, held in September
2013. Some of the world’s greatest minds in regenerative
medicine, alongside cosmetic and medical practitioners,
scientists, commercial professionals and biotechnology
experts, descended on the beautiful Italian city to discuss,
dissect and advance the field of regenerative medicine.
Australian guest speakers included Dr Herbert Hooi, Nicole
Belle RN and Dr Philip Lim.
BioBridge is a foundation dedicated to funding research
and ongoing education in regenerative medicine. In support
of this, RegenLab hosted the Venice conference and
put together two days of keynote talks, workshops and
discussions. Regen Lab has been at the forefront of technical
and science-based solutions in Australia since 2007, when
it received TGA registration for Regen Platelet Rich Plasma
(PRP). Indeed, according to Dr Abbas Al-Taif in Sydney, it was
PRP that was the main focus of this year’s BioBridge event.
‘Most of the topics covered at the BioBridge conference
in Venice were based on detailed medical applications
for the use of autologous PRP in the field of regenerative
medicine,’ says Dr Al-Taif.
The potential for using PRP in conjunction with fat
transfer in both medical and aesthetic settings was a hot
topic at the 2013 event. Indeed, PRP has been touted to
improve graft adherence, endurance and survival following
surgical procedures
‘PRP can be used with fat transfer in both breast
augmentation and facial rejuvenation procedures,’ Dr
Al-Taif says. ‘Stem cells and fat transfer applications were
also part of the conference agenda.’
36 www.cosbeauty.com.au

industry
Autologous PRP
Signifying an innovative and endlessly applicable
rejuvenating therapy, autologous PRP utilises a
concentration of human platelets to promote healing in
both hard and soft tissues. It is used in orthopaedics, sports
medicine, wound healing, neurosurgery, dentistry and
ophthalmology, as well as in cosmetic, plastic, maxillofacial
and cardiothoracic surgery.
‘Platelets are not only important for clotting of the blood
but actually play a much greater role in the repair and
modelling of tissue,’ explains cosmetic physician Dr May
Marr from Lennox Head in NSW. ‘They orchestrate the
repair and rejuvenation process via growth factor proteins,
which is how cells communicate with each other.’
The treatment involves sampling the patient’s own
blood, centrifuging the sample to effectively concentrate
the platelets in a small volume of plasma, and reinjecting the
Regenerative medicine is a
“Golden Field” of creative
thoughts, scientific knowledge
and practical applications
One of the speakers at this year’s conference, Dr Ali
Modaressi, a plastic surgeon from Geneva, uses PRP
with many different surgical and non-surgical aesthetic
procedures. ‘We use Regen PRP in a wide variety of facial
plastic and reconstructive procedures,’ he says. ‘I have
found Regen PRP aids in healing, reduces bruising and
swelling, and expedites the healing process after surgical
procedures such as facelift and rhinoplasty. Regen PRP
can also enhance the effects of laser treatment, resulting
in even better outcomes, particularly in the reduction of
lines and wrinkles and the improvement of skin tone, colour
and texture.’
Regenerative medicine
In Australia, regenerative medicine, and the use of PRP, is an
emerging field gaining significant attention. The possibilities
that lay in utilising the body’s own processes to repair and
replace damaged tissue has profound implications in both
medical and aesthetic rejuvenation.
‘Regenerative medicine is a “Golden Field” of creative
thoughts, scientific knowledge and practical applications.
Moving forward, we need to find safe and creative ways for
its management, and continue to explore the different ways
we can use a person’s own tissue to achieve results,’ Dr
Al-Taif concludes. csbm
concentrated product into the treatment area. Platelets act
as vehicles for the delivery of growth factors, which induce
the proliferation of fibroblasts, osteoblasts and endothelial
cells. Simply put, treatment with PRP kickstarts cellular
processes for a regenerative effect.
‘I find PRP is one of the most safe and successful
modalities in regenerative medicine,’ Dr Al-Taif explains.
‘I use it for face and neck skin rejuvenation; scalp hair
regrowth; scar treatment; and hand rejuvenation. I am also
preparing future scientific studies into the use of PRP for
both erectile dysfunction and vulvo-vaginal rejuvenation.’
PRP and cosmetic medicine
It’s thanks to companies such as RegenLab that treatment
with PRP has gained such traction in a cosmetic setting.
PRP is now a popular addition to aesthetic surgery clinics
throughout Australia, and can be used as both a standalone
treatment or in conjunction with other modalities.
The treatment is effective in improving skin texture and
radiance, reducing the appearance of wrinkles and fine
lines, and fading dark circles under the eyes. Fuelling the
dermis with growth factors and stimulating the cell renewal
process, PRP can be injected around the eyes, across
the cheeks, midface and forehead, along the jaw line and
décolletage, and on the backs of the hands.
www.cosbeauty.com.au 37

industry
What is Regenerative Medicine?
Regenerative medicine research:
• Investigates ways to help the human body repair,
replace, restore and regenerate damaged tissues
and organs
• Uses cells, genes or other biological building
blocks, along with bioengineered materials
and technologies
• Focuses on restoring the remarkable tissue
regenerative capacity that all humans have
before birth
Regenerative medicine scientists are asking:
• How do some human tissues (our skin,
blood cells and lining of the digestive tract)
naturally regenerate?
• What determines this ability of cells? What
switches it on and off?
• How do newts re-grow their tail or limb, or fish
regenerate their fins or heart? What biological
and molecular processes make this happen?
• Do the parts of our bodies that do not regenerate
(such as the brain and heart) retain a latent ability
to regenerate?
Regenerative medicine could:
• Halt, reverse and prevent damage to vital organs
such as kidneys, livers and even hearts
• Grow new vital organs for people with organ
failure due to disease, injury or genetic conditions
• Treat and cure diabetes through stem cell therapies
• Reverse the effects of neuro-degenerative
diseases such as dementia, Alzheimer’s disease
and Parkinson’s disease
• Stop the body attacking itself in auto-immune
diseases including multiple sclerosis, type 1
diabetes, Crohn’s disease and rheumatoid arthritis
• Treat cancer by building on current stem cell
therapies such as bone marrow transplants
for leukaemia
• Prevent ageing
Regenerative medicine can involve:
• Regeneration of tissues by injecting or implanting
regeneration-competent cells (usually derived
from adult or embryonic stem cells)
• Protecting cells and tissue from damage due to
disease or injury (e.g. by preventing cell death)
• Inducing regeneration in tissue by recruitment
of a patient’s own cells to the tissue or using
proteins or gene delivery to stimulate cell division
in the tissue
• Prevention of inflammation and scarring in tissues
to better enable the use of these methods
Before and After photos courtesy of Nita
McHugh from Rejuven8 in Penrith, Sydney
38 www.cosbeauty.com.au

industry
A5M: The latest in anti-ageing
caitlin bishop reports on The AustralAsian Academy of Anti-Ageing
Medicine conference (a5m), which highlighted advancements in both
aesthetic and anti-ageing medicine.
Scientists, plastic and cosmetic surgeons and
researchers descended upon Melbourne last
August for the AustralAsian Academy of Anti-Ageing
Medicine (A5M) conference. From the theory of beauty and
aesthetics to the importance of gut bacteria, the two-day
event presented a range of topics, integral to combating
the signs, diseases and conditions associated with ageing.
With a theme entitled ‘Obesity and the Metabolic
Syndrome: An integrative practice’, the talks, workshops
and demonstrations took a holistic approach to anti-ageing
practice. International keynote speakers included Dr Mark
Donohoe, Professor Garry Egger, Dr Thierry Hertoghe and
Dr Steven Dayan, and the topics ranged from skin health to
the connection between obesity and the brain.
In a talk on ‘The Unifying Theory of Beauty’, American
plastic surgeon and author Dr Steven Dayan spoke about
his goals in aesthetic medicine. He explained his expertise
lies in the space between beauty and attractiveness.
‘Beauty is primal and raw; it’s an energy that fuels
evolution,’ Dr Dayan says. ‘According to evolutionary
biologists, our only purpose on Earth is to procreate
and the brain is pre-wired to look for signs of fertility. These
signs of fertility are manifested as beauty to our eyes.
However, beauty and attractiveness are two different
things: beauty is fundamental but attractiveness combines
many difference elements, most importantly confidence.
This is where I work.’
In a somewhat controversial approach to aesthetic
medicine, Dr Dayan explains his job is not to make people
beautiful; it’s to make people feel more confident.
‘The number-one element to attractiveness is confidence;
if we can help to make someone more confident, we can
help them be more attractive,’ Dr Dayan says. ‘As a plastic
surgeon, it’s not necessarily my primary aim to make
people look beautiful, it’s about making them feel beautiful
– sometimes it requires surgery, while other times nonsurgical
rejuvenation is all that is required.’
In taking this subtle approach to aesthetic rejuvenation,
Dr Dayan stresses the importance of striving for naturallooking
results in facial rejuvenation. He showcased several
case studies, where minimal changes – for example using
filler to slightly upturn the corners of the mouth, achieved
significant and aesthetically pleasing results.
Minimal changes can create
significant and aesthetically
pleasing results
Dr Dayan’s talks were heard alongside lectures on the
links between intestinal bacteria and overall health, how
the processed foods we eat can cause chronic, systemic
inflammation and how obesity may well be related to a
whole range of previously unconsidered factors – from gut
flora and genetics to inflammation and climate change.
The variety of knowledge and high level of expertise at
A5M left those in attendance enthused and motivated to
continue their work into anti-ageing medicine.
Indeed, the mixture of topics covered, and the originality
of ideas broached and expanded upon, certainly fuelled
stimulating discussion at the exciting and thoughtprovoking
future possibilities in both aesthetic and medical
anti-ageing science. csbm
www.cosbeauty.com.au 39

industry
ASAPS 2013
Non-Surgical Symposium
The 2nd Annual Non-Surgical Symposium,
hosted by ASAPS and the CPSA, explored the
extensive possibilities in the world of nonsurgical
rejuvenation. Caitlin Bishop reports.
Signifying a joint pathway towards future non-surgical
advancements, the Australasian Society of Aesthetic
Plastic Surgery (ASAPS) and the Cosmetic Physicians
Society of Australasia (CPSA) hosted the second annual
Non-Surgical Symposium at Sydney’s Hilton Hotel in August
2013. An amalgamation of plastic surgeons, dermatologists,
cosmetic doctors and physicians descended upon the city
for the four-day conference and were presented with talks,
discussions and workshops from the world’s best in nonsurgical
rejuvenation.
The partnership of ASAPS and the CPSA is an indication
of the future potential of aesthetic medicine – combining
both surgical and non-surgical techniques to optimise results
in cosmetic rejuvenation. The conference hosted several
international keynote speakers, including French facial plastic
surgeon Dr Herve Raspaldo, Singapore plastic surgeon Dr
Woffles Wu, American plastic surgeon Dr Michael Kane,
dermatologist Dr Henry Chan and plastic surgeon Dr Wilson
Ho, both from Hong Kong, American dermatologist Dr Zoe
Draelos and German dermatologist Dr Sabine Zenker.
With presentations on acne treatments, facial rejuvenation,
fat reduction, body contouring, skin tightening, fat grafting and
different methods for laser, microneedling and injectables, the
conference was a comprehensive dissection of the possibilities
in non-surgical rejuvenation – or ‘beautification’ as Dr Woffles
Wu put it. How these methods could be used as an alternative
or adjunct to aesthetic surgery was extensively discussed.
‘Non-surgical procedures can bridge the gap to surgery, and
the two approaches complement each other extensively,’ Dr
Raspaldo explains. ‘By combining the two, or having multiple
modalities with which to treat each patient, the results are
improved and patient satisfaction is increased.’
Many of the workshops explored different ways to
rejuvenate the face, and various ideas on ‘defining beauty’
were shared. Sydney plastic surgeon Dr Steven Liew explained
ageing is multifaceted, and achieving an aesthetically pleasing
result in facial rejuvenation involves a multi-modal approach.
He believes combining surgical and non-surgical procedures
Photos courtesy of Woodrow Wilson
40 www.cosbeauty.com.au

industry
can, in some cases, more effectively address the different
elements of ageing.
‘Facial ageing is complex – there’s volume loss,
loosening of the skin and changes to the skin itself, as well
as the bone and soft tissue,’ Dr Liew says. ‘While surgery
can tighten skin, it does not necessarily address skin quality
or volume loss. Now, with the combination of surgical
and non-surgical methods, we can create natural-looking
results that are more aesthetically pleasing, because several
factors of ageing are addressed, not just skin tightening.’
Dr Raspaldo believes establishing a heart-shaped facial
structure is key to an aesthetically pleasing result. He
commonly uses dermal fillers and injectables to smooth
facial junctions and contours in facial rejuvenation.
‘In my opinion, when the lower face is slimmer than
the mid and upper face, the face looks more attractive
– it’s important to emphasise the mid-face and restore a
heart-shaped volume,’ Dr Raspaldo explains. ‘Anti-wrinkle
injections and dermal fillers can be effective in restoring
symmetry and volume, diminishing lines and smoothing
facial junctions. For example, removing the shadow in
the cheek-jowl hollow can make the face appear more
naturally youthful.’
Notably, skin health, and the importance of combining
skincare and cosmetic treatments for optimal results, was
not forgotten. Dr Zoe Draelos spoke on different topical
ingredients, including stem cell creams and potential
cellulite solutions. Dr Sabine Zenker shared her expertise
and experience in using active, chemical peels, particularly
in treating hormonal melasma, and also ran workshops
on emerging technologies such as Platelet Rich Plasma.
Dr Greg Goodman revealed a unique and effective way to
treat acne scarring using fillers and biopsies, while a talk
by Melbourne cosmetic scientist Terri Vinson explored the
‘future of cosmeceuticals’.
However, it was not all hard work and discussion. The
conference was opened by a cocktail reception at the
Hilton’s Zeta bar and the four days were concluded with
a gala dinner at Sydney’s Town Hall. The record-breaking
attendance of both delegates and trade alike made for a
vibrant and lively atmosphere throughout the conference.
The level of enthusiasm from both national and
international speakers conveyed the passion that stems
from the extensive possibilities, and powerful collaborations,
in the world of aesthetics. Indeed, if the second annual
Non-Surgical Symposium is anything to go by – the future
of both surgical and non-surgical rejuvenation is
impressively bright.
‘In the future we will see younger people taking earlier
action by improving skin quality and correcting the signs
of ageing as they arise,’ Dr Liew explains. ‘If we start using
non-surgical methods earlier, we may reduce the need for
some surgery. We will be seeing a strong combination of
non-surgical and surgical approaches in the future.’ csbm
www.cosbeauty.com.au 41

column
Queen Elizabeth I:
toxic beauty?
42 www.cosbeauty.com.au

column
Where did that come from? In his regular column Dr Jim Leavesley
examines the history and origins of a medical topic.
The use of cosmetics goes back centuries, to Ancient
Egypt and beyond. For one renowned woman of
history, her use of cosmetics almost killed her. I refer
to Queen Elizabeth I of England.
Her mother, Anne Boleyn, was already pregnant to her
lover, Henry VIII, who had already had an affair with Anne’s
sister, when Anne and Henry married. Elizabeth (and not the
longed-for son) was born in 1533. As it was, Anne Boleyn
was beheaded for infidelity three years later and Elizabeth
was declared illegitimate. Nonetheless, she succeeded to the
throne in 1558.
Before becoming queen, Elizabeth had contracted
smallpox, a serious infectious disease with a significant
death toll at the time. If you survived, it left you scarred and
pockmarked for life. Elizabeth survived and the disease is
now extinct.
Beneath the flawless skin and
rich red hair was a face and body
poisoned by makeup
Not unnaturally, the young monarch wished to be all
glorious, glamorous and a celebrated beauty throughout
the courts of Europe and to this end used many cosmetics
for the rest of her life. She died in 1603 aged 69, and to the
end maintained her ageless glamour by displaying the then
fashionable stark white flawless skin with the aid of heavy
makeup and a red wig.
The hair bit was simple, with the flaming wig easily
sitting on her balding head. As she aged her black teeth,
foul smelling from lack of even rudimentary dental hygiene,
were less easily hidden and their appearance restricted her
indulging in conversation. Her grossly smallpox-pitted skin
and wrinkles around her ageing eyes were skilfully hidden
with layer upon layer of caustic cosmetic applications
comprising white lead and vinegar.
The vinegar was bad enough, but it was the white lead
that was the killer and threatened her life for many years.
Lead is highly toxic, especially if in constant contact with
the skin from which it is easily absorbed, or inhaled in dust
from dry-up creams. It leads to gross anaemia from the
destruction of red blood cells or the interference with their
manufacture in the marrow.
When this ‘beauty treatment’ was removed at night, she
looked (as indeed she was) haggard, drawn and pale, but
it was only her ladies-in-waiting who ever saw the sorry
sight. In the morning it was the job of these trusted few to
reconstruct the regal face to enable the queen to confront
her adoring public. As time went on, the lead compound
was applied more thickly. Vivid red colour was also added
to her lips and cheeks, derived from chemical red mercury
sulphide. Mercury products are even more dangerous than
lead, so every time the tired anaemic Elizabeth closed her
lips, she ingested the toxic substances.
With the advancing years she began to display symptoms
of mercury poisoning such as lack of coordination, memory
loss, irritability, depression, fatigue from the lead-induced
anaemia and peripheral nerve changes from the mercury.
In 1599, Robert Devereux, the Earl of Essex, broke
protocol and one morning burst into the royal apartment.
He was gobsmacked to see his queen’s wrinkled skin, the
few wispy grey hairs around several bald patches and a
face pale au natural rather than white from lead paste.
There was no gutter press then so there was no front
page display embellished by images from a hidden camera
hidden in Essex’s doublet. But he could hardly be expected
to keep such a coup to himself, resulting in news spreading
quickly. The Earl got his comeuppance, however, when he
was cited for treason and after languishing in the Tower of
London for some time was executed in 1601.
Queen Elizabeth kept going in the knowledge that with
her strength of character and resolve to carry on regardless,
she represented what England was all about. Early in her life
she spoke in public fluently, eloquently and with conviction.
Her speech at Tilbury in 1588, given as the Spanish Armada
approached, has lived on in world literature: ‘I know I have
the body of a weak and feeble woman, but I have the heart
of a king, and a king of England, too’.
She may have foreseen how her body was reacting
to the toxic cosmetics. As more teeth fell out, her diction
could not be easily understood and the royal court became
a much quieter and less jolly place.
Eventually, she refused to be undressed and put
to bed, fearing that once she lay down she would
never get up again; the emollients had affected
her reason and brain. To divert attention from her
decaying body, she took to wearing numerous
strings of pearls and other jewellery.
So the magnificent paintings we know of the
feisty lady are really a lie. Beneath the apparently
flawless skin and rich red hair was a face and
body poisoned with makeup worn to
maintain the fiction of a fearless
and youthful queen.
Nevertheless, Elizabeth I
remains one of England’s
most famous and highly
regarded monarchs. csbm
www.cosbeauty.com.au 43

industry
Reap the rewards
BOTH CLINICS AND THEIR CUSTOMERS ARE SET TO BE REWARDED WITH THE
LATEST LOYALTY SOFTWARE FROM SHORTCUTS. CAITLIN BISHOP REPORTS.
It’s that element that drives people through the door
time and time again, it’s at the heart of every business’s
continued success and, without it, the momentum of any
cosmetic clinic, surgery or hair salon would falter. Customer
loyalty is the key to a thriving business and, with the latest
software from Shortcuts, clinics of any size can reap the
rewards of boosting customer dedication.
Shortcuts is in the process of launching a new loyalty
feature, signifying a step up from the standard loyalty
system already on offer. The new program affords greater
fl exibility, heightened integration and a stronger consumer
focus. Clinics can customise the program to specifi cally suit
their customer, product and service.
‘The sky is the limit,’ says Shortcuts educator Brooke
Morkham-Calvert. ‘Our designers work with clinics to
establish a program that is suitable for their customers,
services and branding. Clients can give us their vision for
an “ideal package” and we work with that.’
How does a loyalty program work?
The loyalty program acts like a frequent fl yer system,
where points are earned for a certain amount of money
spent in-clinic.
The system encourages clients to return for future
services or purchases, in order to be rewarded with
44 www.cosbeauty.com.au

industry
additional points. These points can then be redeemed
according to the guidelines established by the clinic.
While the program can be customised for each salon or
clinic, there are certain pre-defi ned packages available for
easy implementation and adoption.
One option affords 10 points for every dollar spent on
services, and fi ve points for every dollar spent on product.
Another package affords 15 points for every $100 dollars
spent in-clinic. These can be accompanied with additional
specials, such as double points on Tuesdays or when a
series of appointments are made.
Adding a touch of exclusivity to the points-based
system, the loyalty program can also be built around a
customisable multi-tiered system.
Customer loyalty is key, and
businesses of any size can
reap the rewards of boosting
customer satisfaction
5
reasons to boost your
customer loyalty
• Customer loyalty drives repeat business
and helps shield your practice against
price competition
• Loyal customers act as brand ambassadors
and can become an invaluable marketing
asset for your practice or clinic
• By rewarding customers and cultivating
loyalty, it becomes easier to up-sell and
cross-sell between products and services
• It’s more cost-effective to keep existing
clients than attracting new business
• Loyal customers are more likely to provide
timely, honest and valuable feedback
‘Clinics can move clients into different tiers of loyalty
depending on their spending or visiting habits,’ Morkham-
Calvert says. ‘The Bronze Club may represent a basic
loyalty program, while the Gold or Platinum tiers could afford
higher rewards, double points or additional promotions.
The possibilities are endless!’
The loyalty feature works in perfect conjunction with the
existing Shortcuts software. Points and promotions can be
seamlessly incorporated into the Shortcuts personalised
marketing system, Set & Forget Marketing. At the same
time, data from Spotlight, the Shortcuts automated ratings
and reviews system, can be used to effectively customise
and target the rewards system.
Shortcuts provides extensive training during the
implementation of all software, and this guidance is backed
up by a 24-hour support system. Importantly, the rewards
program can be universalised across franchises, meaning
clients can earn and redeem points at different branches of
the same company. Because the data is not held in-store,
but rather in a Shortcuts ‘cloud’, the loyalty information is
accessible and applicable across stations.
‘Customer loyalty is so important,’ Morkham-Calvert
says. ‘Clinics are often selling a product or service that
customers could potentially receive down the road. A loyalty
program encourages clients to come back – even just for a
simple service – because they are rewarded for doing so.’
In a world where competition no longer has physical
bounds – indeed, products can be bought over the internet
and consumers are willing to travel for their cosmetic and
beauty procedures – customer loyalty is one way to ensure
business remains not only sustainable but also thriving.
The Shortcuts loyalty system not only continues to drive
existing customers through the door but also encourages
them to share and talk about the benefi ts associated
with receiving services, and reaping the rewards, at your
clinic. csbm
For more information visit www.shortcuts.com.au
www.cosbeauty.com.au 45

industry
Cosmetex 2014
Cosmetex will bring the latest in cosmetic medicine and cosmetic
surgery to the Gold Coast in may, 2014. Caitlin Bishop reports.
46 www.cosbeauty.com.au

industry
An amalgamation of cosmetic and plastic surgeons
will descend upon the Gold Coast in May 2014
for the annual Cosmetex conference. Each
year, Cosmetex forms a hotbed for cosmetic medical
practitioners to exchange information, uncover possibilities
and cultivate ideas to advance the world of aesthetics.
The conference, which is run by the Australasian College
of Cosmetic Surgery (ACCS), is celebrating its 5th year
under the Cosmetex banner and will be held at the Royal
Pines Resort on the Gold Coast. The resort is located 15
minutes from the iconic Surfers Paradise and will bring a
touch of tropical luxuriousness to the cutting-edge medical
program and buzzing social agenda.
Meetings such as Cosmetex
are important for the sharing of
ideas within a multidisciplinary
and multicultural environment
of experts
The 2014 meeting will welcome Chicago plastic surgeon
and author of New York Times bestseller ‘Subliminally
Exposed’ Dr Steven Dayan, as a keynote speaker.
Dr Dayan is internationally recognised for his investigation
into the elements that define beauty. He remains on
the front-line of cosmetic techniques and is integral in
infiltrating these developments into the wider field of
aesthetic medicine.
‘Meetings such as Cosmetex are important for the
sharing of ideas within a multidisciplinary and multicultural
environment of experts,’ Dr Dayan says. ‘Every time I travel
to Australia I come back with some new way of thinking
that either changes the way I practice now or sparks me
towards another way of thinking.’
With a program that covers everything from laser
treatments to breast augmentation, Cosmetex will host
presentations and workshops by experts from a variety
of fields. Dr Dayan explains combining surgical and nonsurgical
options can go great lengths in achieving optimum
and holistic patient care.
‘Where surgery starts and non-surgery leaves off is a
relative, and often arbitrarily, set marker,’ he explains. ‘I look
at the patient as a whole and do my best to determine what
treatments are most likely to help them reach their goals.
Sometimes that means surgery; other times it will mean
non-surgical treatments or skincare.’
Perhaps one of the most exciting outcomes of meetings
like Cosmetex is the opportunity for collaboration between
The Royal Pines Resort
Smart, contemporary and set on a world-class golf
course, RACV Royal Pines Resort offers everything
needed for a sun-kissed holiday on the Gold Coast,
Queensland’s most famous stretch of coastline.
Positioned at the heart of the region’s sand
belt, the 100-hectare resort is midway between
the sparkling coastline and the lush beauty of the
hinterland rainforests.
The resort itself stands at the centre of beautiful
established gardens, with 331 stylish rooms and
premium spa suites offering views across the
hinterlands and Gold Coast skyline. Free internet
access will help you stay connected during your
stay at the resort.
A golfer’s dream, there’s also plenty to help you
unwind after a busy day, with a renowned Day Spa
and lagoon pool to lap up the autumn sun.
professionals and, in turn, advancements in surgical
techniques, treatment options and patient care. ‘I foresee
a future of minimally invasive interventions with less pain,’
says Dr Dayan. ‘I believe that pain is one of the final frontiers
to conquer in aesthetic medicine.’
Talks on using stem cells and fat transfer for more
effective results will punctuate discussions on facial surgery,
breast surgery and skin rejuvenation. ‘I am fascinated and
very enthused about new developments with fat transfer
and stem cells,’ Dr Dayan says.
A segment on ‘Business and Marketing’ is also on the
agenda, and will grant insight into industry innovations,
marketing possibilities and managing social media.
‘Unlike a generation ago, just being good at what you
are doing is not enough,’ Dr Dayan says. ‘Today, with the
overload of information and misinformation that bombards
consumers, it can be difficult to be heard. Understanding
some of the mechanisms of how to run a small business is
critical to continuing to practice our craft in the way in which
we envision.’
Cosmetex will also have a jam-packed social program.
A track record of lively cocktail events and spectacular gala
dinners promises an enjoyable and sociable three days.
In combining a comprehensive educational program, expert
delegates and an exciting social agenda, Cosmetex 2014 is
sure to fuel registrants with new ideas and fresh inspiration to
enhance their work in cosmetic medicine. csbm
www.cosbeauty.com.au 47

industry
Q&A with
ACCS President
Dr Soo-Keat Lim
The Australasian College of Cosmetic Surgery’s
(ACCS) new president Dr Soo-Keat Lim discusses
the values and goals of the college.
Q
Over the past decade or so, cosmetic surgery has
gone from marginal to mainstream. What role does
the ACCS play in protecting patients and raising
standards in the industry?
A
The ACCS plays an important role in the
cosmetic enhancement industry in Australia and
the Asia Pacific. First, it is the only college of
its kind in this region to have a well-developed training
program dedicated to producing highly skilled cosmetic
surgeons and physicians who are trained to the highest
international standards.
Second, through its Continuing Medical Education
(CME) program, the College assists its Fellows to maintain
their high standard of care and skill through continuance
study, attendances at of local and international cosmetic
conferences, and participating in relevant Masterclasses.
Third, the College has developed a code of practice
that gives its Fellows the tools to provide their patients
with greater protection than that found in other regulations
or guidelines.
And last, looking towards the future, the College has
laid the foundation for a re-certification or re-validation
program, as part of CPD, to maintain standards and skills
of its Fellows after 10 years from original certification. This
will ensure our Fellows’ ongoing fitness and competence in
their chosen fields.
Q
Why does the ACCS believe cosmetic medical
practice should be recognised as its own medical
specialty?
A
Cosmetic medical practice is broadly divided into
two separate fields: invasive (surgical) and noninvasive
(medical).
Cosmetic surgery involves procedures such as breast
augmentation, facelifts, rhinoplasty, blepharoplasty,
abdominoplasty (tummy tuck) and neck lift.
The non-invasive, or medical area, covers such
procedures as filler, used in lip enhancement and nonsurgical
facelifts; anti-wrinkle injections; sclerotherapy
(treatment of varicose and spißder veins by injections);
facial veins treatment; laser therapy and other forms of
light-based therapy for facial rejuvenation, hair removal,
tattoo removal and acne management; PRP (Platelet
Rich Plasma) treatment; stem cell therapy; and fat cell
reduction therapy.
Liposuction and liposculpture under tumescent local
anaesthetic is often placed in this field or in a separate
section referred to as minimally invasive.
Practising cosmetic procedures at the highest standard
requires special knowledge and skill not normally found
in doctors working in general medicine or in specialists
working in general surgery or even in some cases of
plastic surgery.
Cosmetic Medical Practice is a well defined and unique
medical specialty, practiced by medical practitioners from
various specialties including dermatology, general surgery,
general practice, plastic and reconstructive surgery, oral
and maxillofacial surgery, ophthalmology, otolaryngology
and gynaecology.
The factor which unifies this divergent group
of practitioners is that they all need to obtain
additional specialised education, training and experience
beyond their original area of postgraduate specialisation
and training before becoming competent in cosmetic
medical practice.
If a new specialty is recognised, any organisation of
doctors or training facility in the country will be able to
apply to have their training scheme, qualifications and
48 www.cosbeauty.com.au

industry
accreditation processes assessed against the requirements
of the specialty as set out by the AMC, in order to be an
accrediting organisation in the specialty of Cosmetic
Medical Practice.
Q
What are some initiatives the College has
undertaken to further raise standards in the industry
and protect patients?
A
The ACCS has made an application to the AMC
(Australian Medical Council) to have Cosmetic
Medical Practice recognised as a Medical Specialty
so that doctors wishing to practice in this specialty will be
required to obtain a high level of knowledge and skill from
a recognised college which can provide the training to the
highest international standards.
Over the past 10 years or so, the ACCS has convened
an internationally recognised annual conference called
Cosmetex, where it has invited international experts in the
cosmetic industry to share their knowledge and technical
skill with Australian cosmetic medical practitioners.
Cosmetex is the biggest cosmetic conference in our
region (over 600 delegates) and features highly in the
international cosmetic conference calendar, catering for
doctors of many disciplines who wish to enhance their
cosmetic surgery and medicine skills and knowledge.
The ACCS has developed procedure-specifi c registers
to list Fellows who have performed 50 or more cases in a
specifi c procedure to demonstrate their level of experience
in that procedure.
The ACCS publishes a patient information brochure
to advise consumers on questions to consider before
deciding to have a cosmetic medical or surgical procedure
and where to seek assistance if something goes wrong
or they are dissatisfi ed. This brochure is available from
the surgeries of our Fellows or from the college website:
www.cosmeticsurgery.org.au
Q
What advice would you give to prospective
patients who are interested in undergoing cosmetic
enhancement procedures?
A
My advice to prospective patients is to look beyond
the hype of glossy advertisements and colourful
websites. Word of mouth is one way to choose the
right doctor. Another is to choose a doctor who has the
letters FACCS or FFMACCS behind their names, because
these are Fellows of the Australasian College of Cosmetic
Surgery who have been trained and certifi ed to a high
standard in cosmetic surgery or medicine.
FACCS are Fellows who have been trained primarily in
Cosmetic Surgery and FFMACCS are Fellows who have
been trained primarily in Cosmetic Medicine and those with
The Australasian
College of Cosmetic
Surgery (ACCS)
The ACCS is a multi-disciplinary body including
general surgeons, dermatologists, ear nose and
throat surgeons, ophthalmologists and other doctors
who specialise in cosmetic surgery.
The factor that unifi es this divergent group is
that they all need to obtain additional specialised
education, training and experience beyond their
original area of postgraduate specialisation before
becoming competent in cosmetic medical practice.
Vision
To have Cosmetic Medical Practice recognised as
a new medical specialty, performed only by certifi ed
cosmetic practitioners.
Mission
To ensure the safe provision of cosmetic surgery
and non-surgical procedures (such as laser and
light treatments, dermal fi llers and wrinkle relaxant
injections) to the Australian general community
through supply of appropriately trained and certifi ed
medical practitioners.
Diploma of Lipoplasty (ACCS) are Fellows with additional
training in tumescent liposuction and liposculpture under
local anaesthesia.
You can also contact the college on 1800 804 781 to
check if they are listed under a procedure-specifi c register
of the procedure you are interested in to further assure
yourself of the experience and skill of the doctor.
More information can be obtained about how to get the
most out of your consultation with your doctor by looking at
the College’s website: www.cosmeticsurgery.com.au.
www.cosbeauty.com.au 49

easts
Size
me up!
FINDING THE PERFECT BRA AFTER BREAST AUGMENTATION JUST GOT
EASIER, THANKS TO THE NEWLY LAUNCHED ‘UNREAL’ RANGE FROM
BRAS N THINGS. AIMÉE SURTENICH REPORTS.
Shopping for new bras is an exciting prospect for
many women following breast implant surgery, but
it can be challenging to fi nd a bra that fi ts your new
proportions. In response to growing demand, Bras n Things
has designed the ‘Unreal’ bra collection specifi cally for
women with breast implants – the fi rst of its kind in Australia.
Whether you’re after lacy, racy or practical, the ‘Unreal’
collection offers a variety of styles, shapes and colours.
The new range is also suited for women with naturally
large busts who want support without the excess coverage
typically found with bigger cup sizes.
‘We spoke extensively to women with breast implants
about their experience, their requirements and what they
feel was lacking in the lingerie market right now,’ says
Bras n Things design director Marie Savvas.
‘Augmented breasts don’t require the same level of
infrastructure, coverage and support other bras require in
fuller cup sizing,’ she explains. ‘The ‘Unreal’ range omits
chunky, cumbersome shoulder straps, heavy-weight
fabrics and linings which can feel like a harness. It’s a well
thought-out selection of great bras in full cups with smaller
body sizing that cater perfectly to augmented breasts as
well as a fi rm natural bust.’
The styles and shapes vary, and there’s one to suit every
occasion – from everyday comfort bras to sexy sheers in
underwire and non-underwire options. The silhouette is also
taken into consideration, with an assortment of plunge and
demi shapes to best suit teardrop and round profi le implants.
‘We have a super comfy essentials bra for everyday
wear with a light contour cup and light padded strap to
ease the extra weight being carried over the shoulder,’ says
Marie. ‘The collection also features ultra-sexy unpadded
or padded lacy bras and corsets, available with or without
underwire. It’s important to note that all underwires are
slightly wider than most bras to cater for an implant with a
wider base, which means no digging or pinching the skin.’
The new collection also includes bras for post-surgical
wear. ‘For a period of time after surgery non-wired bras
are prescribed,’ says Marie. ‘We’ve countered the typical
crop top worn after surgery with our non-wire triangle bra
with contoured cups (for no-show nipple). It features a
plunging neckline so the wearer can still feel fabulous in an
unstructured garment.’
All bras undergo a rigorous wear test to ensure the
highest standard in quality and fi t. Bras come in a size range
from 8D-14E, with more specialty shapes such as strapless
and convertible styles set to hit the shelves in the near future.
A new bust size means a new bra wardrobe, and the
new ‘Unreal’ range from Bras n Things means shopping
just got a whole lot easier! csbm
50 www.cosbeauty.com.au

Beauty
& the
Breast
52 www.cosbeauty.com.au

feature
Symbols of fertility, sexuality and life-giving sustenance, breasts
have long been regarded as objects of feminine beauty.
AimÉe Surtenich reports
Few would deny the power breasts can yield – from
symbolising maternal love to appealing to our
aesthetic sensibilities.
Breasts have been objects of adoration throughout
the centuries. Artists, sculptors, poets, novelists, later
filmmakers and television producers have never tired of
extolling the beguiling hypnotism breasts.
Breasts, no matter the size, have also been powerful
cultural and fashion icons, helped launch social movements
and boosted showbusiness careers. From the flattened
breasts of the 1920s flappers to the exaggerated contours
of Pamela Anderson, breast ‘fashions’ have altered over
time in the Western world depending on the cultural,
political and moral standards across the decades. What
remains consistent, however, is the mysterious allure the
human female breast bestows.
Breasts have long been
powerful cultural and fashion
icons, representing the political
and moral standards of the time
These powerfully symbolic organs are more than just
the sum of their parts; they also represent notions of
maternal love and sustenance, with the ability to succour
newborns with nutrient-rich milk. Indeed, breasts are
such an important part of the human anatomy that they
take shape in the unborn embryo within a couple of months
of conception.
Human females are the only mammals with permanently
enlarged breasts. In his ground-breaking 1967 book, The
Naked Ape, British zoologist Desmond Morris proposed
that the breasts we know today are an evolutionary sideeffect
of bipedal locomotion. He asserted that their more
rounded shape means they are mainly a sexual signalling
device rather than simply for providing milk for infants.
According to Morris’s hypothesis, as humans began to
walk upright on two legs, enlarged female breasts evolved
as a mimic of the female rear – a relic from the days when
humans walked on all fours and buttocks were the primary
sexual signal.
Evolutionary studies have found that female figures with
slender bodies, a low waist-to-hip ratio (the ratio of the
circumference of the waist to that of the hips) and large
breasts are rated as the most attractive, healthy, femininelooking
and desirable.
Polish research has shown that women with large breasts
and a small waist had larger amounts of female hormones
than women who did not have these attributes. It’s no
surprise then that this physique is considered attractive
because a low WHR (in other words, a curvaceous body)
is believed to correspond to the optimal fat distribution for
high fertility. In evolutionary terms, put simply, the more
fertile a woman appears, the more attractive they are in the
eyes of their beholder.
Research shows that a WHR of 0.7 and a WBR (waistto-breast
ratio) of 0.7 are considered the ideal (though
only a small percentage of women are born with this
combination!). This can be represented as equivalent to two
equal inverted triangles.
Of course, in addition to biology, we are also influenced
by popular culture. Research has shown that television not
only reflects societal preferences but also shapes them.
What makes an
alluring breast?
While everyone’s perception of beauty differs, there
are some general characteristics of an attractive
breast, including:
• A gentle slope from the shoulder to the peak of
the breast at the nipple
• The nipple is located on the centre of the breast
mound and tilted slightly outwards and upwards
• A gentle arc from the nipple to underneath
the breast
• A good cleavage
• A silhouette line so that when standing fronton,
a gentle bulge is evident on the side of the
chest wall
www.cosbeauty.com.au 53

feature
Breasts
and
cosmetic
surgery
Many women view their breasts as a vital
component of their gender identity, as the
female breast is one of the prime visual cues
of femininity, motherhood and sensuality.
It’s no surprise then that breast
augmentation is one of the most popular
cosmetic procedures. Some women seek
implant surgery to correct congenital or
developmental abnormalities, while others
wish to repair the toll of breastfeeding or
the natural ageing process by restoring their
breasts to a more youthful shape and position.
Other women want to have a larger bust size
which is more proportionate to their overall
body shape.
Surgery, however, is not a decision to be
taken lightly. A thorough understanding of
what to expect on the day of surgery, and
in the weeks, months and years afterwards
is important for anyone considering breast
augmentation. Preparation – psychologically
and emotionally as well as physically – is
essential to a successful breast augmentation
that meets your expectations.
You should thoroughly discuss your
goals and motivations with a skilled and
experienced surgeon you can trust and
with whom you feel comfortable. Listening
to the surgeon’s feedback and advice can
help ensure expectations and motivations
are realistic. Your satisfaction with breast
augmentation results ultimately depends on
your understanding of the capabilities and
limitations of the procedure.
Studies on viewers’ ideal body proportions by Professor
Kristen Harrison, from the University of Michigan’s
Department of Communication Studies in the US, have
shown that the television ‘worldview’ of the ideal female
waist and hips could be described as relatively extreme:
thinner is better.
In contrast, the television worldview of the ideal female
bust is more moderate: medium is ideal. Harrison’s work
was the first to empirically link the curvaceously thin female
body ideal with media exposure.
The evolution, psychology and overall mystique of the
female breast continues to fascinate, the cause of which is
triggered from innate biological cues and societal norms of
the day. csbm
Breast components
Nipple – the most anterior part of the breast, it is a
small projection of skin containing the outlets for the
lactiferous ducts
Areola – skin around the nipple that contains the glands
that help to lubricate the nipple during breastfeeding
Lobules – milk glands that produce and supply milk
Milk ducts – small tubes that transfer milk from the lobules
to the nipples
Fat and connective tissue – provides the volume for the
breasts and supports the milk-producing areas of the breast
54 www.cosbeauty.com.au

feature
Your
breasts
your
options
From the shape and type of the breast implant through to
the incision site and placement, there are many components
of breast augmenation. AimÉe Surtenich reports.
56 www.cosbeauty.com.au

feature
There is no one breast implant type, size, shape,
texture, location placement and incision site for
everyone. A thorough consultation with your surgeon
– taking into account your body shape, existing breasts
and individual circumstances – is essential to best achieve
your goals, desires and expectations.
Types of implant
Breast implants are either saline filled or silicone gel filled and
are typically produced in round and teardrop (anatomical)
shapes, with a smooth, textured or polyurethane foamcovered
surface.
Saline-filled implants
Saline implants have a silicone outer shell that is filled with
a medical-grade saltwater solution which is completely
biocompatible. Saline implants generally feel firmer than
silicone gel implants and, due to their thinner consistency,
tend to wrinkle more readily. Deflation is also a potential
problem and requires replacement if this occurs. However, if
this does occur, the leaking saline solution will be absorbed
by your body without posing any health risks.
Silicone gel-filled implants
Most implants used in Australia are silicone gel filled. The
silicone gel is cohesive, meaning it is pre-shaped with a
viscous, Turkish Delight-type consistency. Because the gel
is not runny or liquid in property, its use in breast implants
minimises the risk of leakage problems. Many surgeons
and patients also find silicone implants generally feel softer
and more like natural breasts than saline implants.
Just like saline implants, there is a risk of rupture. If the
implant leaks, it is more difficult to replace, often requiring
removal of the capsule around the implant as well.
Size
Your body shape and individual preferences are the main
determinants of implant size. Breast implants do not come
in cup sizes but instead come in cubic centimetres (cc).
Discussing your desired breast size, trying on different
implant sizes and shapes in your bra and looking at
before and after photographs from breast augmentation
procedures can all help you to choose the most appropriate
size for your body.
Shapes and forms
There are generally two different forms of breast implants:
round or teardrop (anatomical) shaped.
Round implants, depending on their fill, can give a
defined round shape or assume more of a teardrop form
when the patient is upright. They tend to provide more
upper pole fullness than anatomical implants, which are
fuller in the lower pole.
Anatomical implants demand a greater degree of
accuracy in positioning and if they shift after surgery, the
shape of the breast may be distorted. They normally have
a textured surface to avoid rotation. Teardrop implants can
provide greater projection in proportion to the size of the
base, making them particularly suitable for women with
little natural breast tissue.
While the size of the base of the implant is limited by
your chest wall, the choice of projection is to a large extent
a personal one. If you have adequate breast tissue and a
shape you are happy with, you may opt for a low-profile
implant that will simply increase the size of your breasts.
Your body shape, breast tissue
and individual goals are the main
determinants of implant size
If you wish to create cleavage or if your breasts have
some degree of sag, a high-profile implant might be a
more suitable option. Your surgeon can help you with this
important aspect of implant selection.
Textures: smooth vs textured
The shell of a breast implant can be either smooth
or textured. Smooth implants may give a smoother look
and feel in some patients, but generally have a greater risk
of capsular contracture. It occurs when the body forms
a capsule of fibrous tissue around the implant which can
make the implant feel hard and often distort its shape.
Textured implants tend to minimise the incidence of
capsular contracture and promote tissue adherence which
may help maintain proper implant positioning.
Polyurethane foam-coated implants have a unique
foam surface that significantly decreases the risk of
capsular contracture – the foam covering becomes part
of the capsule and makes it less prone to contracting. As
the polyurethane-foam coating grips the tissue, it means
there is a less likelihood of rotation and displacement.
Incision sites
1. Inframammary
The inframammary incision is made in the crease under the
breast. The surgeon creates a pocket for the breast implant,
which is slid up through the incision, then positioned behind
the nipple. The scar is hidden in the crease under the breast
and is not normally visible when wearing a bikini top.
There is some uncertainty involved in placing the incision
with regard to its position on the augmented breast. While
this is not a problem for an experienced surgeon, it can
present difficulties when there is little breast tissue or
natural crease.
www.cosbeauty.com.au 57

feature
2. Periareolar
The periareolar incision is made around the nipple at the
outer limit of the areola so that there is areola skin on both
sides of the incision where scarring is least visible.
The breast implant is inserted through the incision into a
prepared pocket, then positioned behind the nipple.
One advantage is that there may be no visible scar
because of the colour and texture of the areola. This
incision allows the implant to be placed precisely in the
pocket formation.
The disadvantage is that it involves cutting through
breast tissue and ducts, and sensitivity in the nipple may
therefore be reduced.
3.Transaxillary
The transaxillary incision is made in the natural crease of the
armpit and a channel is created down to the breast. This
may be performed with an endoscope (a small tube with a
surgical light and camera in the end) to provide visibility. The
implant is inserted and moved through the channel into a
prepared pocket, then positioned behind the nipple.
The scar is virtually invisible in the armpit fold and lack
of tension makes for straightforward healing. There is no
scar on the breasts.
Disadvantages include the fact that the transaxillary site
is relatively far from the breast, where the surgeon needs
to create a pocket to house the implant, so visibility is
limited. If the scar heals poorly, it is noticeable in bikinis and
sleeveless tops. If capsular contracture develops, another
incision will be necessary for treatment.
4.Transumbilical or navel (TUBA)
The TUBA incision is made on the rim of the navel. A tunnel
is made under the skin through the subcutaneous fat
layer on the torso into the layer of loose tissue between
the breast and pectoral muscles.
After a pocket is created in the breast, the implant is
inserted through the incision and moved up into the
breast area, then positioned behind the nipple.
There are no incisions or scars in the breast area,
however this site can only be used for saline implants.
The distance of the incision from the breast can reduce
the surgeon’s ability to control bleeding and to position
implant correctly.
Implant placements
Experienced surgeons base their implant placement
decisions on factors such as the quantity of breast tissue,
natural breast size and symmetry, the dimension and shape
of the chest wall, the amount of subcutaneous fat and the
quality of breast skin.
It is important you are well-informed about all of the
options available, as well as the suitability of each option
for your individual body type, preferences and your ultimate
desired result.
In general, there are three placement options:
subglandular (in front of the muscle), submuscular (behind
the muscle), and dual plane (partially under the muscle).
Subglandular
The subglandular pocket is created between the breast
tissue and the pectoral muscle. This position resembles the
plane of normal breast tissue and the implant is positioned
in front of the muscle.
Sometimes the implant is covered by a thin membrane,
the fascia, which lies on top of the muscle. This is called
subfascial placement.
The subglandular position is suitable if you who have
sufficient breast tissue to cover the top of the implant. This
procedure is faster and may be more comfortable for the
patient than submuscular placement.
If you are thin and do not have sufficient breast tissue,
the edge of the implant may be visible. Any rippling of
the implant will be more noticeable in this position. With
smooth implants, some studies have reported an increase
in capsular contracture with this position.
Submuscular
The implant is placed under the pectoralis major muscle
after some release of the inferior muscular attachments.
Most of the implant is positioned under the muscle.
This position creates the most natural-looking contour
at the top of the breast in thin patients and those with very
little breast tissue. There is a decreased chance of visible
and palpable implant edges or rippling.
There may be more postoperative discomfort and a
longer recovery period. The implants may appear high at
first and take longer to drop. The ‘Snoopy’ deformity where
breast tissue falls downwards and forwards away from the
implant is more common with this placement.
Dual plane
The implant is placed partially beneath the pectoral muscle
in the upper pole, where the implant edges tend to be
most visible, while the lower half of the implant is in the
subglandular plane.
This placement is best suited if you have insufficient
tissue to cover the implant at the top of the breast but
need the bottom of the implant to fully expand the lower
half of the breast due to sag or a tight crease under
the breast.
This position minimises the rippling and edge effect in
thin patients while helping to avoid abnormal contours in
the lower half of the breast. It does, however, involve more
complex surgery, which if not performed correctly may result
in visible deformities when the pectoral muscles are
contracted. csbm
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feature
What is capsular
contracture?
Capsular contracture, or hardening of the breast, is thought
to be the most common complication of breast implant
surgery. It can occur at any time but more commonly in the
months immediately after surgery.
During surgery, a pocket is made for the implant in the
breast tissue. After the implant has been inserted, the
body naturally forms a capsule of fibrous tissue around the
implant. This lining or capsule is formed by the body’s living
tissue, and is the body’s natural response. The capsule
allows the implant to look and feel quite natural. In some
cases, however, the capsule begins to tighten, causing
a shrink-wrap effect and squeezing the implant that it
surrounds. Depending on the severity, the breast can feel
firm or hard, become distorted and cause pain.
It is not actually the implant that has hardened – the
shrinking of the capsule compresses the implant and
causes it to feel hard, but if the implant is removed it is still
in its original soft state.
Though the exact causes of capsular contracture
are unknown, there are factors that may lead to this
complication, including seroma (the development of
extra fluid around the implant), haematoma, infection and
smoking. Another contributing factor is the placement of
the implant above the chest muscle. When the implant is
placed below the muscle, capsular contracture is said to be
typically less likely to occur.
To treat capsular contracture, there are both surgical
and non-surgical options, although generally most cases
of capsular contracture will require secondary surgery to
remove the implant. If the implants are replaced, to prevent
reoccurrence a new pocket should be made as fresh tissue
needs to be in contact with the implant.
Open capsulectomy is the most successful treatment
for capsular contracture. In this procedure, the surgeon
removes the scar capsule through a submammary or
periareolar incision. Once the capsule is removed, the body
forms a fresh capsule around the breast implant.
Open capsulotomy requires the surgeon to make an
incision in the tissue pocket and cut the capsule to release
the tension on the implant. The scar tissue is not removed.
It is possible to perform this procedure via a transaxillary
incision as well as the inframammary and periareolar
incisions. There is a high recurrence rate with this procedure.
For both open capsulectomy and open capsulotomy,
patients are given a local anaesthetic with intravenous
sedation or general anaesthesia.
Closed capsulotomy involves the surgeon squeezing
the capsule and implant with the aim of opening up the
scar tissue. Implant manufacturers do not recommend this
as it can lead to possible rupture of the implant.
Although not a cure, many surgeons suggest that
patients take a regular dose of Vitamin E for the first year
after breast augmentation as it can help to keep tissue soft.
Additionally, external ultrasound may help reduce swelling
and inflammation and increase blood circulation to the
implant capsule.
Finally, accolate is an anti-inflammatory used in the
treatment of asthma and has been shown, in minor
studies, to help reverse early capsular contracture. This is
a relatively new and experimental treatment with no longterm
statistical data so if elected it should be proceeded
with cautiously.
Other risks
and complications
There are risks with all surgeries, and breast augmentation
is no exception. While breast implant surgery is typically a
predictable and safe procedure, it’s wise to know what can
potentially go wrong.
In addition to capsular contracture, long-term risks
and complications can include rippling of the implant,
sensation loss or change of the breasts and nipples,
implant displacement or rotation, rupture of the implant,
interference with standard mammography, and breastfeeding
difficulties.
Breast implants have a limited lifespan and will most
likely need to be replaced or removed at some stage.
Further surgery may also be required to address problems
that may occur. csbm
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PIP
Implant
Crisis:
Lessons
Learned
Three years on from the PIP implant scandal, we ask: what lessons
can be learned by the cosmetic community and public alike?
Lizzy Fowler reports.
In April 2010, French authorities banned the use of
implants manufactured by Poly Implant Prothèse (PIP),
having discovered the company had been using nonauthorised,
industrial-grade silicone.
In Australia, the news was quietly announced on
the Therapeutic Goods Administration’s (TGA) website.
However, many of the 5,000+ Australian women with PIP
implants remained unaware of the situation until 18 months
later, when headlines around the world carried the news
that a French woman had been left with a rare and fatal
form of blood cancer following the rupture of her faulty
PIP implants.
While some plastic and cosmetic surgeons who had
been using PIP implants had made an effort to contact their
patients following the April 2010 recall, others had not. For
many women, the shocking headlines of December 2011
were the first they heard of their potentially risky implants.
Six months later, the UK Health Department broke the
news that its own study into the implants had concluded
PIP implants were two to six times more likely to rupture
than other brands within five years of surgery. The French
government was quick to announce it would pay to remove
the implants from the 30,000 affected women in France,
and some other European nations followed suit.
Around 400,000 women from 65 countries around
the world were thought to have received PIP implants.
In Australia, where 13,000 PIP implants were supplied
between 1998 and 2010, the official line was – and remains
– not to remove the implants if they showed no sign
of rupture.
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Three years since PIP implants were recalled, this
advice is based on extensive testing by the TGA and
other international regulatory bodies, which have found no
evidence that the risks involved with the use of PIP breast
implants are any greater than those for any other brand of
silicone gel-filled breast implants.
Indeed, the TGA has performed and reported on a large
number of tests on the chemical and properties, physical
properties and the biological safety of the gels and shells
of PIP breast implants and, in an effort to try to determine
whether the gel in PIP implants may be toxic, the TGA and
other agencies have conducted cytotoxicity, intradermal
irritation and mutagenicity tests on the implants.
According to the TGA, the tests proved negative in every
case, yet to provide further assurance of a lack of toxicity,
and on the recommendation of the Chief Medical Officer’s
Clinical Advisory Committee, the TGA commissioned further
chemical screening tests from two separate laboratories.
The screening tests were conducted on samples from 10
different batches of PIP implants and no concerning organic
compounds were detected in any of the gels from the 10
batches tested.
Although tests performed by the TGA on ruptured
implants taken from Australian patients were found to
contain traces of the cyclosiloxanes D4, D5 and D6
(chemical compounds used in the manufacture of silicones
and a variety of personal care products), a toxicological
assessment determined that these compounds at the
levels detected does not pose a health threat.
Although the prophylactic removal of the implants is
therefore not recommended, the TGA does advise all
women who know they have PIP implants to contact their
surgeon for detailed consultation.
‘It is important that decisions made by patients and
their treating doctors about the need for further surgery
are formed by the best available evidence, and take each
individual patient’s circumstances fully into account,’ a
statement released by the TGA in February 2013 reads.
‘People with PIP implants, and those who are unsure
about the brand of their breast implants, are strongly
encouraged to consult their GP or surgeon for individual
clinical assessment and advice.’
Having used PIP implants exclusively between 2005
and 2008, Perth plastic surgeon Dr Tim Cooper has taken
a more proactive approach to managing his patients’
concerns. Since the implants were recalled in April 2010,
he has contacted each of his 145 patients with PIP
implants, advising them of the risks and inviting them for an
ultrasound to check the integrity of their implants. ‘Some
had gone interstate or overseas, but I managed to contact
around 80 percent of my patients who had undergone
breast augmentation with PIP implants,’ he says.
Unlike the TGA, Dr Cooper believes it is preferable for
patients with PIP implants to have them removed, and
Dual concerns
According to Dr Cooper, there are two issues with the
PIP implants. The first concern is the quality of the
silicone encased within the shell.
‘No one knows the carcinogenic potential of the
silicone,’ he says. ‘My consistent message is, “Get
them out”. If you’re going to withdraw it from sale, why
leave it in the body?’
The second is the high rupture rate. Having
conducted tests at the Royal Perth Hospital on the
physical and mechanical properties of the implants,
Dr Cooper found that the shell wall of the implants
varied in thickness, leaving some surfaces weaker than
others. In the same vein, the manufacturer’s stamp,
present on each implant, breached the shell of the
implant, leaving it more prone to rupture, according to
Dr Cooper.
Although no implant can be expected to last more
than 10 years, and all carry a risk of rupture, Dr Cooper’s
tests identified a 17 percent overall rate of rupture over
4.5 years – considerably higher than other brands.
around 50 percent of his patients without ruptured implants
opted to have them removed anyway. ‘They are a defective
product and my advice to all women with PIP implants is to
have them removed,’ he says.
While the PIP implant crisis has been of personal
concern to hundreds of thousands of women, it has also
highlighted a need for an official record of the women
carrying the faulty implants.
In response to a Senate Committee inquiry into the
handling of the PIP scandal, the Australian Federal
Government embraced the recommendation by the
Committee that an opt-out Breast Implant Registry be
established as a priority.
In the May 2013 Budget, the government allocated
$5.1 million to establish and maintain two clinical registries
– one for breast implants, the other for cardiac devices.
‘The government agrees that an opt-out approach will
be adopted by the new breast implant register, in line with
the recommendation of the Australian Commission on
Safety and Quality in Health Care,’ it said.
The government also agreed to extend until 11
March 2015 the access of women with PIP implants to
Medicare rebates for MRI scans to detect any leakages or
abnormalities involving the implants.
Ultimately, the PIP implant crisis highlighted the need
for greater visibility and accountability when it comes to
the administration of medical devices, and a mandatory
national database will make managing any future, similar
situations somewhat easier. csbm
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ACTUAL PATIENT OF DR TAVAKOLI
Your guide to breast
augmentation 2014
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Sydney plastic surgeon Dr Kourosh Tavakoli explains his approach
to achieving an attractive, natural-looking breast augmentation.
Breast augmentation procedures continue to rise
year on year, and the demand for natural-looking
breasts is even more apparent. As a plastic surgeon
specialising in breast augmentation and lifting procedures,
I have been privileged to treat a large number of patients
in my Sydney clinics and have drawn from this wide
experience to perfect my formula for breast augmentation.
A well-augmented breast has a natural fullness, with
gentle sloping off the chest wall. There should be natural
cleavage without webbing between the breasts and only a
certain amount of perkiness.
There are three main telltale signs of unnatural-looking
breast augmentation: a visible implant margin, resembling
the ‘Posh Spice’ or ‘Pamela Anderson’ look; an implant
that is too large for a person’s frame; and a breast that is
too perky and sits up like rigid peaks with no small amount
of natural droop.
Before undergoing surgery, it is beneficial for patients to
review photographic examples of the breasts they would
like and to convey their wants to the surgeon so there is
a clear, visual understanding of the desired result. Please
note that these photos can only be used as a guide.
Incision placement
There are three choices about where to make the skin
incisions for breast enlargement. They can be in the breast
fold (inframammary), around the nipple (periareolar) or
underneath the armpit (transaxillary).
These incisions can all produce scarring, ranging from
barely perceptible to significant. But patients are ultimately
far more concerned with the final shape and size of their
breasts than the location of their scar. In fact, the rate of scar
revision for unsatisfactory scarring in breast augmentation
is less than 0.05 percent. My clinic also has the Fraxel
laser, which works very well in most scars to eliminate the
redness and improve the scar’s texture.
Generally, the majority of my patients opt for the
inframammary incision (breast fold). I also find this incision
has the least amount of interference with breastfeeding and
nipple sensation and it generally heals very well.
Implant shape
The choice of implant varies from round to teardrop shapes.
The round implant comes in both low- and high-profile
varieties. The shape variation is in the width and projection
of the implant for any given size.
The spectrum of breast implants available can therefore
provide great versatility in achieving a more natural look.
The majority of patients in my practice elect to have roundshaped
implants. The round implant tends to be ideal for
those patients with well-shaped natural breasts who desire
a straightforward enlargement.
In general, breast augmentation
should be in proportion or
slightly out of proportion to the
overall body shape
Use of the teardrop (anatomical) shape depends on
the patient’s desire, as well as her breast shape. It can be
the ideal choice for women who have mild droopy and/or
tuberous breasts. Mild elevation of the nipple in relation to
the breast mound can be achieved without the need for
extra scars on the actual breast (unlike breast lift scars).
In moderate to severe cases of droopiness, a breast lift
must be performed at the same time as breast augmentation
in order to restore aesthetic shape.
Implant size
Breast implant size is one of the most important decisions
in breast augmentation. Because of this, a good surgeon
will take several approaches to help the patient make the
best decision based on her anatomy, personal preferences
and the appearance she wishes to achieve.
In general, attractive breast augmentation should be
in proportion or slightly out of proportion to the woman’s
overall body shape.
Final breast implant size is a complex function of the
elasticity of a patient’s skin envelope, chest wall diameter
and implant dimensions but most importantly pre-existing
breast volume. I measure the patient’s breast and chest
shape, paying particular attention to the base and projection
of the breasts. This gives me an idea of what size implant
will help achieve the patient’s desired size. In most cases,
there is a breast implant that will be an ideal match for the
diameter of the patient’s natural breast.
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Choosing a breast implant smaller than the patient’s
natural breast shape will not provide the proper cleavage
and shape following the procedure. Similarly, choosing
a breast implant too large for the patient’s natural chest
shape is more likely to give an unnatural appearance. It is
noteworthy that very large implants can create more issues
and future complications such as stretch marks, implant
migration and symmastia.
Pocket position
The next consideration is where to place the breast implant
– on top of or behind the muscle. In general, I prefer to
place breast implants behind the muscle so they are
partially covered.
I find the pectoralis muscle allows a smooth take-off
from the chest wall. It is also my opinion that placing the
implant under the muscle will, in the long run, help negate
breast droopiness. A further advantage of the submuscular
pocket is a lower rate of capsular contracture.
In most cases, there is a breast
implant that will be an ideal
match for the diameter of the
patient’s natural breast
One negative of the submuscular pocket is that it may
create ‘winking’ on animation or flexing of the pectoralis
muscle. Implant migration and displacement is also more
likely in this pocket.
In women with mildly droopy (ptotic) breasts, I use the
dual-pocket technique of dissecting both on top of and
underneath the pectoral muscle, but inserting the breast
implant behind the muscle.
In rare cases of moderate droopy breasts where the
patient does not wish to undergo a breast lift procedure
for fear of scarring, I will consider placement of the implant
on top of the muscle. This pocket is referred to in the
plastic surgery literature as ‘subglandular’ or ‘subfascial’.
Generally speaking, it has excellent short-term benefits but
in my opinion far less long-term advantages compared with
the ‘submuscular’ or ‘subpectoral’ pocket placement.
Implant coating
Implant surfaces can be smooth, textured or polyurethanefoam
coated. The reason for the invention of differing
implant surfaces has been to create the ‘perfect’ implant
that has a low capsular contracture rate and yet feels soft
and natural. No matter what the coating on the outside of
Essential Clinical Parameters
There are six main clinical parameters for breast
implants on initial consultation:
1. Patient’s body build and height
2. Patient’s own breast size, shape and symmetry
3. Nipple position in relation to the breast mound
4. The quality of the breast skin (such as thickness
and occurrence of stretch marks)
5. Chest wall shape and dimension (hollowed vs
‘pigeon chest’ walls)
6. Patient’s desire for new cup size: under-proportion,
in-proportion or over-proportion augmentation
the implants is, the inside material of all the implants I use
are still silicone gel.
Generally speaking, textured or rough surface implants
are said to reduce the rate of capsular hardening or
contracture and have a lower rate of migration, but they
are also known to create more wrinkling and rippling issues
later on. This wrinkling is normally felt in the lower edge of
the breast where the implant is closest to the skin surface.
Smooth implants may give a smoother look and softer
feel in many cases, particularly in thinner patients, but the
downside is that the patient needs to massage the implants
for three months to help prevent capsular hardening.
My recommendation is to use textured implants in
patients predisposed to capsulisation and also for extremely
fit, athletic women who may shift the implant pocket due
to overexertion.
Going forward, polyurethane implants are a viable
alternative to textured implants. Polyurethane-coated
implants (P-URE) from the manufacturer Silimed are
proving to be very effective in the prevention of capsular
contracture. Currently, I prefer to use these implants in
selected primary cases and all revisional cases of capsular
contracture.
Silicone vs saline
I very commonly use the cohesive silicone gel and rarely the
saline-filled breast implants. The new generation siliconegel
breast implant is very safe and generally feels and looks
more like a natural breast.
Most breast augmentation operations in Australia are
performed with silicone-gel breast implants (98 percent).
The gel usually comes in low and high cohesiveness (soft
touch or firm touch). Typically, the firmer gel implants are
‘form responsive’ like the gel found in the teardrop implants.
The round implants can be soft (80 percent fill) or firm (100
percent fill), depending on the manufacturer. csbm
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BEFORE (29 year old female, 6’, nil pregnancies)
AFTER breast augmentation by Dr Tavakoli (440 FX anatomical (teardrop)
implant, submuscular pocket, full C cup)
BEFORE (27 year old female, nil 5’8”, pregnancies)
AFTER breast augmentation by Dr Tavakoli (350g anatomical Brazilian
P-URE implant, full C cup)
BEFORE (20 year old female, 4’9”, nil pregnancies)
AFTER breast augmentation by Dr Tavakoli (230cc ultra high implant,
submuscular pocket, A to C cup)
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easts
BEFORE (28 year old female, 5’5”, nil pregnancies)
AFTER breast augmentation by Dr Tavakoli (350g moderate plus profile, round
gel submuscular (subpectoral) pocket, full C cup)
BEFORE (23 year old female, 5’8”, nil pregnancies)
AFTER breast augmentation by Dr Tavakoli (400cc high round gel
implant, submuscular pocket, A to C+ cup)
BEFORE (22 year old female, 5’1”, single pregnancy, no breastfeeding)
AFTER breast augmentation by Dr Tavakoli (260g moderate profile, round gel
submuscular (subpectoral) pocket, average C cup)
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easts
BEFORE (21 year old female, 5’2”, nil pregnancies)
AFTER breast augmentation by Dr Tavakoli (250 high profile round implant,
submuscular pocket, moderate chest wall, A cup to D cup)
BEFORE (25 year old female, 5’6”, nil pregnancies)
AFTER breast augmentation by Dr Tavakoli (420 high profile anatomical implants,
submuscular pocket, moderate chest wall, A cup to full C cup)
BEFORE (32 year old female, 5’6”, three pregnancies)
AFTER breast augmentation by Dr Tavakoli (320 moderate profile anatomical
implants, submuscular pocket, average chest wall width, A cup to full C cup)
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easts
BEFORE (24 year old female, 5’7”, nil pregnancies)
AFTER breast augmentation by Dr Tavakoli (390g moderate profile, submuscular
(subpectoral) pocket, full C cup)
BEFORE (40 year old female, 5’6”, two pregnancies)
AFTER breast augmentation by Dr Tavakoli (320 FX anatomical (teardrop) implant,
submuscular pocket, A- to large B cup)
BEFORE (24 year old female, 5’2”, nil pregnancies)
AFTER breast augmentation by Dr Tavakoli (380g ultra high profile smooth
gel, submuscular (subpectoral) pocket, full C cup)
68 www.cosbeauty.com.au

BREAST AUGMENTATION SPECIALIST
MBBS, BSc (MED), MS (UNSW),
FRACS (PLAST)
Dr Tavakoli is a renowned cosmetic
plastic surgeon who is a Fellow
of the Royal Australasian College
of Surgeons and a Member of
the Australian Society of Plastic
Surgeons. He subspecialises in all
aspects of cosmetic breast surgery
and is considered an industry
leader in primary and corrective
breast augmentation surgery.
Follow Dr Tavakoli on
New premises: Suite 1, 376 New South Head Road, Double Bay
1300 368 107 | drtavakoli.com.au

easts
Breast curves:
creating the
perfect shape
and fit for you
SYDNEY PLASTIC SURGEON
DR STEVEN LIEW SHARES HIS
EXPERTISE IN CREATING BEAUTIFUL,
NATURAL-LOOKING CURVES.
One of the critical decisions to be made when
considering breast augmentation is not just the cup
size but also the degree of fullness in the upper part
of the breast.
Sydney plastic surgeon Dr Steven Liew says that as
surgical procedures and implant types have become
more advanced over the past decade, a good surgeon
can effectively customise a breast shape to match the
requirements of each patient.
Dr Liew says patients, too, are more sophisticated in
their approach to breast augmentation. Where previously
they were focussed almost entirely on breast size, most
patients are now more aware of the fi ner aesthetics involved
– such as the degree of perkiness and breast fullness in the
upper chest – in producing their perfect breast shape.
The three types of upper breast fullness include:
• A gentle slope from the chest to the nipple, almost a
straight line
• A gentle curve with some degree of fullness
• A very full convex curve, the so-called ‘Wonderbra’ look.
‘Breast augmentation is such a personal decision,’
says Dr Liew, ‘so surgeons need to take time and care to
work with each patient – including family members where
requested – to ensure they understand the physical and
emotional impacts involved.’
Different body types, personalities and the kind of
clothes the patient likes to wear are all factors to be
considered, says Dr Liew, to ensure the new breast shape
is the perfect fi t for each individual. csbm
Actual patient of Dr Liew
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BEFORE
AFTER breast augmentation by Dr Liew
BEFORE
AFTER breast augmentation by Dr Liew
BEFORE
AFTER breast augmentation by Dr Liew
This young female requested a very natural-looking breast enhancement, with conservative natural upper pole fullness. A
teardrop implant was chosen to create gentle upper pole fullness with a gentle slope from the chest to the nipple.
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BEFORE
AFTER breast augmentation by Dr Liew
BEFORE
AFTER breast augmentation by Dr Liew
BEFORE
AFTER breast augmentation by Dr Liew
A full D cup enhancement with high profile round implant, to create the fullness and ‘Wonderbra’ look as requested by the
patient. ‘I never want to wear a pushup bra again,’ she said.
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BEFORE
AFTER breast augmentation by Dr Liew
AFTER breast augmentation by Dr Liew (glamour shot)
A moderate profile round implant is used to create a moderate amount of upper pole fullness, resulting in beautifully proportioned youthful-looking breasts.
BEFORE
AFTER breast augmentation by Dr Liew
AFTER breast augmentation by Dr Liew (glamour shot)
A high profile round implant is used to create a full upper pole fullness as requested. The end result demonstrates a convex curve to the upper part of the breasts, well demonstrated
in the creative ‘after’ shot.
BEFORE
AFTER breast augmentation by Dr Liew
AFTER breast augmentation by Dr Liew (glamour shot)
A DD cup enhancement with extra high profile round implant to create the extreme fullness and ‘Wonderbra’ look as requested.
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A personal
journey
in breast
augmentation
One patient describes how breast
augmentation with Dr Vlad Milovic
helped boost her confidence and
bring her body into proportion.
Caitlin Bishop reports.
Actual patient of Dr Milovic
From lost volume to an asymmetrical shape, breast
augmentation surgery is undergone for a variety
of reasons, and the surgery, implant choice and
recovery process is an individual journey for each patient.
Canberra plastic surgeon Dr Vlad Milovic has built his
practice around this philosophy. He understands that
achieving the desired outcome in breast augmentation
takes time, communication and a personalised approach.
One patient, Sam, who was looking to bring her body
into proportion by increasing her bust size, approached Dr
Milovic after spending years considering the decision.
‘I finally decided I would go ahead – it was a decision I
made for myself, for confidence reasons,’ Sam explains.
‘I approached several doctors but decided on Dr Vlad
because I’d heard he was highly experienced and achieved
great results.’
As part of the consultation process, Dr Milovic uses
3D breast simulation to demonstrate the look of different
implants on the patient’s body. This can assist in selecting
the shape and size of implant and can help establish
realistic patient expectations going into surgery.
‘The 3D imaging really made a difference for me – it
was great to see such a realistic version of my body with
implants,’ Sam says. ‘Initially, it was one of the factors that
helped me decide to go ahead with Dr Vlad. Now, looking
back, it’s amazing because the result is almost identical to
the 3D simulation.’
Dr Milovic typically opts for silicone gel implants,
with either a textured or smooth surface, in his breast
augmentation surgeries. He says the cohesive gel implants
hold together uniformly and afford a more natural look and
feel once inserted.
In the pre-surgery consultation, Dr Milovic discussed
options in implant size, surface, shape and profile. While
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Sam had an idea of the cup size she was after, she ended
up selecting an implant one size bigger than originally
anticipated. ‘Dr Vlad recommended a bigger implant to
bring my body more effectively into proportion,’ Sam says.
‘He advised I could be disappointed with the result using
smaller implants. The 3D simulation helped in making me
comfortable with this decision.’
Coming into surgery, Sam’s main concerns involved
the possibility of scarring and stretch marks following the
operation. Dr Milovic works with his patents to minimise
scarring and, during surgery, he keeps the incision sites as
inconspicuous as possible. He also provides patients with
a post-operative treatment plan to accelerate healing and
reduce the appearance of scarring. The plan can include
several options, from silicone gel creams to laser therapy,
depending on patient preferences.
‘Dr Vlad worked with me in the six months leading up to
surgery to help prepare me both physically and mentally,’
Sam says. ‘In the final appointment before the operation,
he walked me through the whole process once more and
reminded me of things to prepare to help with recovery.’
On the day of the surgery, Sam arrived at the hospital
at 7am. By 8:30am she was under anaesthetic. She saw
Dr Milovic as soon as she awoke, around two hours later,
and opted to return home that day. ‘The hospital was
fantastic,’ Sam says. ‘All the staff were accommodating,
kind and comforting.’
Depending on the patient’s age and medical history,
breast augmentation is commonly a day surgery, with no
overnight stay required. Prescribed painkillers and easy-touse
compression garments mean recovery can begin in the
comfort of the patient’s home. Importantly, Dr Milovic gives
patients his direct number with instructions to call should an
urgent situation arise.
‘Following surgery I had a bad reaction to the painkillers
I was prescribed,’ Sam says. ‘Around 4am the next
morning I felt really unwell so I called Dr Vlad; he answered
the phone straightaway and told me what to do to manage
the situation.’
A week after surgery, Sam returned to Dr Milovic to have
her stitches removed. He advised using Siltape and Bio-Oil
on the incision sites to help reduce scarring. It took around
three weeks for the swelling to go down after surgery, and
Sam says she began to feel comfortable once the swelling
had decreased. Now, just over a year later, Sam confirms
she is happy with the results and her decision to undergo
breast augmentation.
‘I’m so happy with the results; it’s one of the best
decisions I’ve ever made,’ Sam says. ‘I’ve had no problems
in recovery and I’m very happy with how my scars have
healed – I’ve recommended Dr Vlad to several other
girlfriends. It’s been over a year since the operation, but I
am still so excited about the results. I’m excited for summer
– I can properly fit swimwear now! csbm
BEFORE
BEFORE
BEFORE
AFTER breast augmentation by Dr Milovic
AFTER breast augmentation by Dr Milovic
AFTER breast augmentation by Dr Milovic
www.cosbeauty.com.au 75

easts
breast
benefits
Sydney cosmetic surgeon
Dr Colin Moore believes
polyurethane implants are
the gold standard. AimÉe
Surtenich reports.
Breast augmentation has one of the highest patient
satisfaction rates, offering more natural-looking
results than ever before. Importantly, technological
advancements to the implants themselves have also meant
the procedure offers greater long-term safety.
Sydney cosmetic surgeon Dr Colin Moore believes
polyurethane-coated P-URE implants offer the best of both
worlds: enhanced, natural-looking breasts with an excellent
safety profile.
‘In my experience, polyurethane-coated breast implants
produce very natural-looking results while minimising the
risk of the most common complications associated with
breast augmentation,’ he says. ‘I believe polyurethanecoated
P-URE implants have provided a significant
breakthrough in breast implant surgery.’
A natural look
Most women considering breast augmentation surgery
don’t want a significant increase in volume. Rather, they are
seeking to enhance their natural bust size, create a more
proportionate overall figure, or restore the shape and size
of their breasts after breastfeeding or the ageing process.
‘A key concern for a lot of women thinking about breast
augmentation is whether or not their breasts will look
“natural” following surgery,’ says Dr Moore. ‘While ensuring
a natural-looking result comes down to accurately measuring
the proportions of each patient, I also believe that advances
in breast implants mean that it is easier than ever to achieve
natural-looking curves.’
Whether or not a natural look is desired, extensive
consultation is essential in deciding upon the final shape,
size and placement of the implant. ‘Sometimes patients
describe an aesthetic which is not achievable because of
their physical limitations,’ explains Dr Moore. ‘By measuring
the proportions of the body, as well as skin thickness and
breast tissue composition, together the surgeon and patient
can determine the best breast size for the patient.’
Long-term safety
All breast implants come with the risk of rippling, moving
and capsular contraction, but Dr Moore believes the risk of
these is significantly less with P-URE implants.
Part of the success of polyurethane implants is their
ability to reduce the rate of capsular contracture, which
is the hardening and distortion of implants as the body
forms a scar capsule around them. The textured surface of
P-URE implants forces the body’s collagen to surround the
implant in a criss-cross pattern, preventing contraction and
lessening the chance of implant distortion.
‘A number of studies have shown there is only a one
percent risk of capsular contracture with polyurethanecoated
implants, which is a significant improvement on
the 10 percent risk associated with saline and silicone
implants,’ says Dr Moore.
‘This is one of the many reasons I believe patients should
choose P-URE implants. With the right surgeon and the
proper patient consultation, I believe these implants can
create superior results.’
With careful planning and correct implant selection, Dr
Moore believes an experienced surgeon can help women
achieve the breast shape and size that best complements
their overall figure and aesthetic goals. csbm
76 www.cosbeauty.com.au

easts
1
BEFORE
AFTER breast augmentation by Dr Moore
2
BEFORE
AFTER breast augmentation by Dr Moore
3
BEFORE (exisiting scar on left breast)
AFTER breast augmentation by Dr Moore
4
BEFORE (tubular breast deformity)
AFTER breast augmentation by Dr Moore
www.cosbeauty.com.au 77

easts
Balanced
proportions
Dr John Flynn from Queensland
TAkes an individualised approach to
achieve a balanced and harmonious
contour in breast rejuvenation
surgery. Caitlin Bishop reports.
Breast rejuvenation surgery – whether augmentation,
reduction or lift (mastopexy) – can significantly
boost a woman’s self-esteem and confidence when
chosen for the right reasons.
John Flynn from Queensland understands many breast
rejuvenation patients are simply looking to bring their
body into proportion, perhaps due to underdevelopment,
asymmetry or changes associated with pregnancy and
breastfeeding, as well as the natural ageing process.
‘The overall aim of breast rejuvenation procedures is to
balance the body’s proportions into a pleasing, feminine
silhouette,’ Dr Flynn explains. ‘Although changing your
breasts will not, in itself, change you, it can be effective in
restoring self-esteem and body confidence.’
As we age, gravity, a loss in skin quality and a reduction
in renewal processes can leave all parts of the body – not
just the face – somewhat deteriorated. Such age-related
changes to the breast, for example a loss in volume and an
‘empty’ look or a change in shape, are common reasons for
women seeking surgery.
‘There are a number of issues associated with ageing
that affect the breasts,’ says Dr Flynn. ‘The issues to
consider are loss of volume, the texture and tone of breast
tissue and the inevitable sagging of the breasts. All women
will be affected by some of these issues during their lives,
because of the natural ageing process.’
Procedures that restore volume, but also lift the breast
tissue, can be effective in creating a more youthful and
natural-looking result in breast rejuvenation. A breast lift, or
mastopexy, can improve the shape and positioning of the
breasts, while also adjusting the nipple areola complex.
The overall aim is to balance
the body’s proportions into a
pleasing, feminine silhouette
All surgeries can be performed on-site at Dr Flynn’s fully
licensed and registered day hospital on the Gold Coast.
‘Certainly, restoring volume using breast implants is
a key measure, however there are times when lifting and
tightening of the breast tissue is of equal importance and
sometimes I perform a combination of these procedures,’
Dr Flynn says. ‘The principle purpose is to create body
balance, where the proportions are in harmony.’
A breast lift, combined with augmentation or reduction,
encompasses a total rejuvenation of breast tissue. The
78 www.cosbeauty.com.au

easts
size and shape of the breasts are adjusted, excess skin is
removed and the tissue is remodelled.
‘In a mastopexy, the available breast tissue can be
compressed and lifted to help restore a fullness of texture
and tone,’ Dr Flynn says. ‘The lifted breasts will have a
more pert, youthful appearance. This can be combined
with volume reduction, in a reduction mastopexy, or implant
insertion, in an augmentation mastopexy.’
Dr Flynn explains patients should be aware that
mastopexy involves a different type of scarring from
traditional breast implant surgery: ‘Typically, the surgical
approach is through an incision around the nipple, and
in some cases there may also be a vertical scar from
the nipple to the inframammary fold (the breast crease),’
he says.
In deciding upon surgery, education
and realistic expectations are paramount
to achieving a positive result. Dr Flynn
believes women who are well informed
of the procedure, and realistic in their
expectations, are most likely to be pleased
with the result.
‘We recognise that patients may
differ in what they regard as ideal body
proportions, so this is something that
needs to be discussed with their chosen
doctor at consultation,’ he says. ‘In an
BEFORE
initial consultation, the surgical options
should be fully explored, including the risks,
limitations and potential complications.’
In helping shape these expectations,
and to better understand each patient’s
concerns and desires himself, Dr Flynn
uses 3D imaging technology during the
pre-operative consultation process.
‘Each woman is different, and it
is important to find a personalised,
customisable solution to suit each
individual patient,’ Dr Flynn explains. ‘The
3D simulation software provides a clear
interface for surgeons and patients to
communicate with each other.’
For patients looking to also recontour
their lower half, Dr Flynn has refined the
“Body Balance” approach, where the
patient’s own fat is harvested to help
improve body shape. In this, fat is removed
during liposuction and then redistributed
into the breasts for an enhanced effect.
According to Dr Flynn, an emerging
concept in this area involves the use of
stem cells in fat transfers, which help
BEFORE
improve the consistency of the result.
Whether it is to fill volume, reduce tissue or lift heavy
breasts, there is a range of surgical options to help achieve
a more youthful and aesthetic contour. In balancing
proportions, correcting asymmetry or rejuvenating the
breasts, results can help boost confidence and heighten
body image. Dr Flynn believes breast rejuvenation is a
highly personalised process and everything – from the initial
consultation to choosing the most suitable implant type –
should be a personal decision.
‘Each woman is different in their reasons for, and
expectations of, breast rejuvenation surgery. Even in
deciding upon an implant, there are a variety of shapes
and sizes to choose from because every patient is unique,’
Dr Flynn explains. ‘It is important to find a personalised
solution to suit each individual.’ csbm
AFTER breast augmentation by Dr Flynn
BEFORE AFTER breast reduction by Dr Flynn
AFTER breast lift by Dr Flynn
www.cosbeauty.com.au 79

easts
Sticking
power
Dr Hamish Farrow finds Silimed polyurethane implants can help
reduce the risk of post-surgical complications. Caitlin Bishop reports.
In a clinic mainly dedicated to breast surgery, offering
augmentations, lifts and reconstructions, the
importance of using reliable implants, with a low risk of
complication, is paramount to achieving optimum results.
Dr Hamish Farrow, a plastic surgeon from Hawthorn in
Victoria, believes Silimed implants offer the best option
in certain cases and are effective in lowering the risk of
capsular contracture.
‘I believe Silimed polyurethane implants are less likely
to give problems in the future,’ Dr Farrow says. ‘They
significantly lower the risk of capsular contracture and
effectively retain their positioning after surgery.’
Distributed in Australia by Device Technologies, Silimed
implants were designed to address the most common
complication associated with breast implant surgery
– capsular contracture. This is when the scar capsule
that naturally forms around the breast implant begins to
contract, causing the implant to become distorted, hard and
sometimes painful. The textured surface of polyurethane
implants prevents the collagen fibres of the scar tissue
aligning, inhibiting contraction and implant interference.
Dr Farrow says this benefit is particularly important in
reconstruction surgery following a mastectomy, when much
of the breast tissue has been removed
‘Following a mastectomy, the chances of capsular
contracture are drastically increased due to excessive
scarring,’ he says. ‘Polyurethane-coated implants have less
than a one percent chance of capsular contracture at 10
years and beyond after surgery, making them an invaluable
option in these reconstructive cases.’
In aesthetic breast augmentation, the choice to undergo
surgery is always a personal one – perhaps to add volume,
correct asymmetry or reshape tuberous breasts. Dr Farrow
says the choice of implant depends on patient concerns and
expectations, as well as their skin quality and breast tissue.
‘I see a range of patients for aesthetic surgery, with a
variety of concerns,’ he says. ‘There are younger patients,
around 18 to 25 years old, or those who are a little older
and hoping to bring their body back to what it was before
having children and breastfeeding. These patient groups
have different expectations and are usually suited to
different implants, because of the changes in skin quality
during ageing.’
As well as reducing capsular contracture, the
polyurethane texture also means a stronger adherence
to the surrounding breast tissue. While this leaves limited
room for error in implant positioning during surgery, it can
be effective in reducing implant movement, rotation or
displacement postoperatively.
‘Silimed polyurethane implants hold their shape and
position very effectively,’ Dr Farrow says. ‘This is of enormous
value in thinner or saggier skin, when the surrounding
tissue is likely to droop but the implants will still retain their
positioning. In younger and firmer skin, however, I generally
80 www.cosbeauty.com.au

easts
opt to use a smooth, round implant – simply because the
polyurethane implants can appear quite defined, and ample
breast tissue is needed to achieve a natural-looking result.’
Because of their capacity to adhere to surrounding
tissue, Dr Farrow commonly uses Silimed implants in
revision surgery, particularly in cases of malpositioned
implants. ‘When I correct malpositioned implants, I always
A thorough consultation is
essential in deciding upon
implant type, size, surfacing and
positioning before breast
augmentation surgery
use Silimed polyurethane implants,’ he says. ‘For example,
I recently revised one case where smooth, round implants
had not held to the tissue and had drifted towards the
midline. In cases like this, there is nothing better than using
an implant that will stick.’
Because of this ‘sticking power’, the level of natural
movement afforded by polyurethane implants after surgery
is somewhat less than those of a smooth or textured
surface. For this reason, Dr Farrow typically places Silimed
polyurethane implants in the subglandular plane – between
the mammary gland and the pectoralis muscle.
‘I generally place polyurethane implants above the
muscle, because that way the muscle movement provides
some movement to the implant, achieving a more naturallooking
result,’ he explains. ‘However, there must be
adequate breast tissue for this approach to work.’
While Silimed implants afford a viable option in many
breast augmentation cases, and can be effective in reducing
common complications following surgery, Dr Farrow
believes it is important to take an individualised approach
with each patient in implant selection. He recommends
patients bring photographs of breasts they find attractive
to the initial consultation; to help him better understand the
size, shape and proportion they are looking to achieve, as
well as their expectations.
‘Silimed implants have quite a defined shape, so can
appear quite obvious without sufficient tissue coverage,
however they do hold position nicely and reduce the risk
of capsular contracture and implant displacement following
surgery,’ Dr Farrow says. ‘A thorough consultation process,
to determine what the patient sees as a positive and
negative result, is essential in deciding upon implant type,
size, surfacing and positioning before breast augmentation
surgery.’ csbm
1
BEFORE
after breast augmentation by Dr Farrow
2
BEFORE
after breast augmentation by Dr Farrow
www.cosbeauty.com.au 81

easts
Breast
appeal
Melbourne plastic surgeon Dr Carmen Munteanu believes silimed
P-URE breast implants offer a safer choice. Caitlin Bishop reports.
There are several factors to consider when deciding
on breast augmentation: the size, shape and type of
implant; the site of the incision; the surgical position of
the implant; and how to prepare for recovery.
At the forefront of these decisions is optimum results
and expedited healing, patient satisfaction and, of particular
importance, to minimise potential risks and complications.
Silimed implants, distributed in Australia by Device
Technologies, are designed to counter the risk of one of
the most common complications in breast augmentation –
capsular contracture.
Capsular contracture is seen in the hardening and
distortion of breast implants following breast augmentation
surgery. When an implant is inserted into the breast
pocket, scar tissue forms around the implant as part of the
body’s natural healing response. If this scar tissue begins
to contract, the implant itself is squashed, leading to a
hardened, distorted appearance.
The polyurethane-foam coated implants from Silimed
have been designed to counter this, reducing the risk
from around 10 percent to about one percent. By using
a polyurethane-foam coating, Silimed implants prevent
the alignment of collagen fibres in scar tissue, therefore
significantly inhibiting contracture.
Melbourne plastic surgeon Dr Carmen Munteanu uses
Silimed implants in her clinic and says she has achieved
effective results in reducing incidences of capsular
contracture, as well as protecting against a range of other
potential complications.
‘I use both textured and polyurethane-foam coated
implants from Silimed – although the polyurethane implants
have become more and more appealing due to a number of
qualities,’ Dr Munteanu explains. ‘In addition to decreasing
the risk of capsular contracture, downward displacement
and rotation are reported to be the lowest in polyurethanecoated
implants.’
As well as reducing the risk of capsular contracture,
the polyurethane-foam coating helps the implant better
adhere to the surrounding tissue, helping to prevent
movement following insertion.
‘These implants have a high adherence to the surrounding
tissue, which leaves little room for error in planning and
placing the implants,’ Dr Munteanu says. ‘I also use a
number of “implant stabilisers”, such as garments and
bandeaus, following surgery.’
All Silimed breast implants are filled with soft cohesive
silicone gel. This is designed to maintain shape and
softness and allows for more natural movement following
surgery, according to Dr Munteanu.
Polyurethane-foam coated
implants have become more and
more appealing due to a number
of qualities
Silimed breast implants come in a selection of shapes:
round, anatomical (teardrop) or conical. Dr Munteanu has
recently introduced the conically shaped polyurethanefoam
coated implants to her clinic, alongside the round and
anatomical selections.
‘Conical shaped implants combine the advantages of
an anatomical shaped implant – a nice, natural-looking
contour, lift of the breast and nipple areola complex –
while minimising the potential disadvantage of rotation and
insufficient fullness,’ Dr Munteanu explains.
While Silimed implants offer a viable option in breast
augmentation surgery, Dr Munteanu works with patients
individually to decide on an implant that is best suited to
their body, breast tissue and expectations.
‘I am very particular and thorough in choosing the
implants for each patient,’ she says. ‘To achieve beautifying,
natural-looking and stable results, a personalised approach
is absolutely essential.’ csbm
82 www.cosbeauty.com.au

Desired
WHAT IS YOUR
LOOK?
Getting back to what you had or obtaining the look you always wanted.
Silimed offers an extensive range of shapes and sizes, textured or polyurethane
breast implants to suit any desire.
Talk to your surgeon about your desired look and experience the Silimed difference.
Always read the label. Use only as directed. Your surgeon will advise you whether this product is suitable for you.
silimed@device.com.au | www.pureimplants.com.au

easts
Restoring shapely breasts
Sydney plastic surgeon Dr Pouria Moradi explains the functional and
cosmetic benefits of breast reduction. AimÉe Surtenich reports.
For many women, overly large or sagging breasts can
be a burden both physically and psychologically.
Sydney plastic surgeon Dr Pouria Moradi sees
firsthand how breast reduction surgery can be a life-altering
event for women suffering from physical discomfort and low
self-confidence due to their large bust size.
‘In my experience, women seek a breast reduction for
two main reasons: function and aesthetics,’ he says. ‘From
a functional point of view, many women want smaller breasts
to alleviate neck and back pain, postural problems, bra strap
grooves, chronic sweating and infection under the breast
crease, as well as physical discomfort when participating in
sports and other activities.’
Aesthetically, patients want to reclaim more youthful and
shapely breasts and not have their chest dominate their
appearance. ‘From a cosmetic perspective, women want
to restore the shape, size and position of their breasts. The
change in breast shape may have been caused by pregnancy,
breastfeeding, the ageing process, or after losing a large
amount of weight,’ Dr Moradi explains. ‘By removing excess
breast tissue, reshaping the breast and repositioning the
nipple-areola complex higher on the breast mound, a more
youthful and aesthetically pleasing result can be achieved.’
The consultation process is a vital part of any cosmetic
surgery. ‘The first step is establishing a great rapport between
the patient and surgeon and to start an honest and open
dialogue about the goals of the patient – some want to keep
the size of their breasts but want a lift; others, particularly
after breastfeeding, want a smaller bust size,’ he says.
‘Ultimately, the final goal has to fit with the patient’s overall
body shape to create a more proportionate silhouette, and
also fit their personality with a breast size they are most
comfortable and confident with. To this end, I also use 3-D
digital imaging tools, so together we can get a realistic picture
of what the final result will likely be.’
Breast reduction (reduction mammoplasty) is a surgical
procedure that reduces, lifts and reshapes the breast. ‘The
procedure is aimed at removing excessive breast and fatty
tissue, leaving the patient with a smaller and better-shaped
breast,’ Dr Moradi explains.
According to Dr Moradi, in the past a breast reduction
relied more on repositioning the skin, whereas today’s
preferred surgical technique is to focus on moulding the
breast tissue internally (medically called a glanduloplasty)
and then redraping the skin accordingly. He says the benefits
of this approach are good long-term fullness, better shape
and minimised scarring.
Depending on the amount of breast tissue to be removed,
many reduction procedures usually call for just one vertical
incision around the areola down to the breast crease (vertical,
or ‘lollipop’ technique), or an additional incision along the
crease as well (inverted-T, or ‘anchor’ technique).
Importantly, Dr Moradi says modern breast reduction
techniques should not affect a woman’s ability to breastfeed
in the future, nor will it interfere with mammogram readings.
Dr Moradi’s preferred surgical approach is the inverted-T
incision. ‘I believe this offers the best results in terms of the
final breast shape and wound healing. However, for a smaller
84 www.cosbeauty.com.au

easts
reduction or for someone with good skin laxity, a vertical scar
only may be more appropriate.’
‘For me, there are three key elements in breast reduction
surgery: maintaining nipple sensation and function; creating
the most appropriate skin envelope for reshaping the breast
and discreet scarring; and shaping of the breast itself.’
Breast reduction is performed under general anaesthetic.
Recovery takes around two weeks, but most patients can
resume work after a week or so, depending on the level of
activity required in their job. Full activity, including sports and
exercise can usually be resumed after six weeks.
Like any surgery, a breast reduction comes with certain
risks and complications, which makes it especially important
for patients to choose a skilled and experienced surgeon.
Dr Moradi believes these risks can be minimised with
a detailed pre-operative assessment, meticulous surgical
planning and proper postoperative care. ‘I devise a preoperative
plan for each of my patients to optimise their
1
health and healing capacity before surgery,’ he explains.
‘We look at what medications or over-the-counter vitamins
they are taking, and get their blood pressure under control
if necessary. It’s also essential that patients stop smoking
well in advance of surgery.’
To ensure optimal long-term results and to expedite
healing, special dressings and garments are worn during the
recovery period. Advanced scar management techniques
are also employed so that, over time, the scars should
become barely perceptible.
‘Most of my patients realise just how much their heavy
breasts were a physical and emotional burden on their lives,’
says Dr Moradi. ‘A lot of patients have even lost weight after
the surgery, as they are now able to exercise without the
physical limitations they once had.’
With proper planning, surgical technique and aftercare, a
breast reduction can represent a new lease on life for many
women. csbm
2
BEFORE
One year AFTER breast reduction by Dr Moradi
3
BEFORE
Two months AFTER breast reduction by Dr Moradi
BEFORE
Three months AFTER breast reduction by Dr Moradi
www.cosbeauty.com.au 85

easts
Optimise your recovery
CareFix garments provide support, increase comfort and accelerate
the healing process after surgery. Caitlin Bishop reports.
Enhancing comfort and paving the way to a speedy
recovery is paramount in the days following surgery.
Compression garments are used to provide support
after procedures such as breast augmentation, liposuction,
abdominoplasty and facelift surgery. Effective in improving
comfort and regulating blood flow, compression garments
act to reduce swelling and bruising post-operatively and are
a key component in expediting the healing process.
The CareFix range of compression garments, distributed
in Australia by Statina Healthcare, is built upon the pillars
of comfort, functionality and ease of use. By comfortably
pressing the skin and underlying tissue together directly
after an operation, CareFix compression garments help
prevent sagging in the skin and promote smoother and
faster healing after surgery.
Canberra plastic surgeon Dr Vlad Milovic uses the
CareFix range of post-surgical bras in his clinic. He believes
the medical-grade textiles of the CareFix range provide
more comfort to his patients than some other garments,
an important factor considering the bras are worn when
the skin is tender and sensitive directly after breast surgery.
‘The CareFix range has been designed with maximum
comfort in mind, without compromising on functionality,’
he explains. ‘In my experience, the material itself is
better tolerated by patients than some other brands, which
can be quite abrasive.’
Alongside the comfort factor, CareFix post-surgical
bras assist in achieving optimal long-term results. For
example, one of the main risks associated with breast
augmentation is implant displacement, when the implant
shifts or rotates from its desired position. This can occur
if the implant has been positioned incorrectly, when the
surrounding tissue is excessively stretched or in response
to trauma. Typically, implant displacement is more likely in
cases of larger implants, as gravity acts upon the weight
of the implant.
In guarding against this risk of displacement, Dr Milovic
encourages his clients to wear compression bras for six
weeks following surgery. ‘Compression garments are
designed to provide support,’ he says. ‘Patients can’t rely
on regular underwear or sports bras to provide the strength
and support they need after breast augmentation.’
Although the bras needs to be worn 24/7 in the weeks
post-operatively, the garments can be taken off to shower
and have a front-closure clasp for convenience – perfect for
women who are tender after surgery.
The CareFix range has been
designed with maximum comfort
and functionality in mind
The most recent addition to the CareFix range is the
Breast Implant Stabiliser Band, which is designed to help
stabilise and position the implant in the first two weeks
following surgery. This allows the implant to settle into its
position more quickly and can reduce recovery time.
While the label ‘compression garment’ doesn’t sound so
enticing, the CareFix garments are anything but dowdy. The
bras come in a range of colours and, as they’re latex free,
the risk of irritation during use is eliminated.
No matter what the surgery, prompting a fast and
comfortable recovery is essential in the weeks following
surgery, as these steps can have a significant impact on
the final result. Thanks to compression garments such as
those by CareFix, patients can look forward to recovering
from surgery in comfort and functional ease. csbm
86 www.cosbeauty.com.au

feature
STOP
THE
PRESS!
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your attention?
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Magazines are #1 for reader
engagement**
Next-generation
marketing
Capture and engage your clients with
a personalised e-Book to showcase
your services. Having your own
bespoke eBook – either with or
without hardcopy – enhances your
profi le and turns your publication into
a viral marketing campaign!
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Why integrate print and digital?
It’s never been more important to have an integrated print
and digital marketing strategy. International research has
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search and purchases. The two mediums exist side by side
to capture and engage an optimum audience.
At Bella Media, we have embraced this next-generation
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enhance the client and consumer experience.
Hair Restoration by
Dr Russell Knudsen
Your name here
Call our expert team to fi nd out more about our bespoke
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Plastic Surgery by
Dr Warwick Nettle

feature
Decoded
Diets
The Paleo, 5:2 and Atkins diets are popular methods for weight loss.
Caitlin Bishop investigates whether they really do work.
As science develops, attitudes change and trends
evolve, emerging ideals are continually used in an
attempt to find an answer to weight loss. Different
diets, with various approaches and philosophies, are
endlessly tried and tested. Here, three of the most highly
trending diets – the Paleo diet, 5:2 diet and Atkins diet – are
dissected, and the principles behind them unravelled.
Paleo diet
The Paleo diet is built on the premise that humans existed
for thousands of years without the artificial and processed
foods so prevalent in the modern-day diet. This approach
strips the diet from any refined sugars, refined grains and
processed foods to mimic the way our ancient ancestors
ate thousands of years ago.
It partners high amounts of protein and fat with low
levels of carbohydrates, similar to the way Homo Sapiens
thrived in the Palaeolithic era, or stone age. This intake is
supplemented with a high levels of whole grains, fruits and
vegetables in a ‘plant and animal’ derived design.
In their book, The Paleo Diet for Athletes, Loren Cordain
and Joe Friel associate the diet with both weight loss and
overall health benefits.
‘Seventy percent of the US diet is made up of food that
modern man has created, and this food is made up of the
same ingredients: refined grains, refined sugars, processed
vegetable oil, salt, artificial flavouring and perhaps some
88 www.cosbeauty.com.au

feature
processed dairy product,’ the authors say. ‘These foods
have displaced more healthful fruits, vegetables, lean meats
and seafood in our diets, and it’s hurting our health.’
They go on to explain the Paleo diet typically results in
weight loss, because of the way naturally derived foods work
harmoniously in the body. This diet is high in animal proteins,
which deliver high concentrations of branched chain amino
acids (BCAA) that help build and repair muscle. It is touted
to prevent the blood from getting too acidic, which is a
common by-product of eating too much processed foods.
And it is said to boost the immune system by combining
trace nutrients, such as antioxidant vitamins and minerals
that come from fruits, vegetables and lean meats.
The way we fuel our bodies –
in the quantities and types of
food we ingest – always incurs a
larger systemic effect
The diet has received criticism for its practicality and
the soundness of its background science. Critics have
suggested the diet of our Palaeolithic ancestors relied
much more heavily on starches, and therefore the premise
is invalidated. Additionally, some scientists have pointed out
that our ancestors simply did not live long enough to suffer
the diseases of the modern day – questioning the reliability
of the diet’s heralded heath benefits.
5:2 (intermittent fasting) diet
Developed by medical journalist Dr Michael Mosley, the
fast diet, or 5:2 diet, takes an unusual approach to dieting.
Typically, weight loss regimes involve calorie counting,
stringent food types and regular meals. The Fast Diet turns
this platform on its head, with people eating normally for
five days and then ‘fasting’ – or cutting calorie intake to
a quarter of the normal level – for two days. It is touted to
assist in weight loss (believed to induce an average loss of
0.46kg per week) and is believed to benefit overall health
and longevity.
This effect on overall health, and not just body weight,
is associated with a reduction in inflammation, brought on
by periods of fasting. The way we fuel our bodies – in the
quantities and types of food we ingest – always incurs a
larger systemic effect.
Meals high in saturated fat and calories have been
associated with an increase in inflammatory markers in
the body which, if continued, can lead to widespread
chronic inflammation and disease. Intermittent fasting is
said to be effective in relieving the body of this inflammation,
leading to reduced oxidative damage and increased
immune resistance.
‘Intermittent fasting and caloric restriction enhance
cardiovascular and brain functions and improve several risk
factors for coronary artery disease and stroke, including a
reduction in blood pressure and increased insulin sensitivity,’
explains Dr Mark Mattson in his article published in The
Journal of Nutritional Biochemistry.
Similarly, Dr Mark Donohoe, who spoke at the
AustralAsian Academy of Anti-Ageing Medicine conference,
explains periods of low food intake can impact our intestinal
bacteria to strengthen the immune system.
‘During a time of low food availability, the gut microbes
experience a starvation effect,’ he explains. ‘Only the
stronger bacterium survive starvation, and these become
dominant in the gut, boosting general immunity.’
Dr Donohoe did concede there’s no evidence to suggest
24 hours of fasting is sufficient to achieve this widespread
effect, however further research is needed.
Atkins diet
One of the problems commonly associated with dieting is
the tendency to stick with the food plan for a certain amount
of time, before reverting back to old habits. The Atkins diet
attempts to change these habits, establishing a long-lasting
and relatively easy-to-maintain approach to eating. In fact,
it combines this promise of longevity alongside a food plan
that includes the unthinkable – real butter, cream cheese,
eggs and bacon and extra avocado, in a seemingly win-win
dietary regime.
The aim of the Atkins diet is to break the carb and blood
sugar cycle, where carbohydrates are used for energy, and
excess carbohydrates are turned to insulin or fat in the body.
Instead, by filling the diet with proteins, fibres and fats and
drastically cutting the amount of carbohydrates consumed,
the diet forces the body to adopt a fat-burning state. In this,
fats are stored more efficiently and those stubborn pockets
of fatty tissue are gradually broken down.
While this diet, like many carb-cutting diets, has been
shown to achieve effective results in weight loss, the high
reliance on foods high in fat has received some criticism
for its implications on wider health. Some researchers
have concerns whether a long-term adoption of the Atkins
diet could be associated with increased risk of heart
disease, stroke or cancer, because of the replacement of
carbohydrates with a high-fat intake. csbm
www.cosbeauty.com.au 89

feature
the
smarter
way to
work
out
90 www.cosbeauty.com.au

feature
When it comes to weight loss, scientists believe it’s possible to
exercise less, yet lose more weight. Lizzy Fowler reports.
Imagine a world where losing weight didn’t involve hours
spent sweating in the gym, and excess kilos simply fell
off. Where in 20 minutes you could burn more calories
and lose more fat than you could after a week packed with
time-consuming jogs.
Believe it or not, this idea isn’t far-fetched. This is the
reality of high intensity interval training (HIIT) – an exercise
regimen that asks for little of your time yet delivers maximum
results. Scientists and exercise professionals around the
world have built on years of research, and have proven the
benefits of short bursts of intensive exercise.
How much exercise is enough?
Over half of all Australian adults are overweight or obese. It’s
perhaps not surprising, therefore, that the diet and weight
loss industries are thriving. From healthy home-delivered
meal plans to enticing gym memberships and personal
trainers promising long-lasting results, we’re constantly
exposed to options to help us cut our calories and trim fat
from our physique.
When it comes to getting physical, the Australian
government recommends adults (those aged between 18
and 64) integrate at least 30 minutes of moderate-intensity
physical activity on most, preferably all, days of the week.
While the health benefits of moderate exercise are plentiful,
when it comes to losing weight, an increasing body of
research suggests you will do better to cut back on the
length of time you commit to exercise whilst increasing the
intensity of your workout.
A study published in the Journal of the American
Medical Association followed the exercise habits of more
than 34,000 women. It concluded that it took about an
hour a day of moderate exercising to maintain weight.
This research backed up by the findings of the (US-based)
National Weight Control Registry, which reported that 90
percent of people who have successfully lost weight, and
kept it off, exercise on average for an hour a day.
However, this research also tells us that even one hour
of moderate intensity exercise every day is not enough to
lose weight.
Workout for weight loss
A much more effective way to work out is to take part in
high-intensity circuit and interval training. High intensity
interval training refers to short bursts of high intensity
exercise periods broken up by rest or relief periods and
can be applied to any cardiovascular workout. In one study,
Sydney scientists reported that sprint training for just 60
minutes a week burns the same amount of body fat as
jogging for seven hours a week.
Sprint training for just 60
minutes a week burns the same
amount of body fat as jogging
for seven hours a week
‘We’ve been searching for about 10 years for the
minimum amount of exercise you can do with the biggest
health impact factor,’ Dr Steve Boutcher, the lead researcher
said when the study was published.
Dr Boutcher, who is an exercise physiologist and
associate professor at the University of NSW, believes the
high-intensity training regime followed in the study provides
the ideal amount of exercise intensity for health benefits,
including weight loss, in a short time period.
As part of the program, participants sprinted on an
exercise bike for eight seconds, and raised their heart rate
to between 80 percent and 90 percent of its maximum rate,
followed by 12 seconds of slow peddling.
‘In three 20-minute sessions a week, they’re only
working hard for eight minutes,’ Dr Boutcher said.
www.cosbeauty.com.au 91

feature
Sample Workout
According to Sydney personal trainer and fi tness
expert Scotty Gooding, the ‘Tabata’ interpretation
of interval training offers an easy way to integrate
intervals into your workout regime.
‘The exercise physiologist Izumi Tabata
devised an exercise protocol based on 20
seconds of intensive training followed by 10
seconds of recovery for four minutes,’ he says.
‘Analysis of the results showed both anaerobic
and aerobic improvements.’ While you can apply
the Tabata technique to any exercise, Gooding
recommends the following exercises. ‘The key
is to give it 100 percent during each 20 second
interval,’ he says.
If you have any history of injuries, please
consult your physical therapist and personal
trainer before performing any of these exercises.
1. Killer sprawls: The sprawl is a full
body movement that involves some
of the largest muscles in the body.
Start with a tuck jump, bend down
and move into a push up position.
Jump your legs back in and return
to standing.
2. Mountain climbers: In a push up
position, bring one leg forwards whilst
keeping the other extended. Start the
workout by kicking the extended leg
forwards, moving the other back. To
make the workout harder, keep the
front foot fl oating off the ground.
3. Split lunges: Stand with your
toes facing forward and your feet
approximately one foot apart. Step your
right foot out approximately three feet
in front of your body. Slowly bend your
right knew, lowering your body down
to the ground. Push yourself back up
to standing. Bring the right foot back
to the starting position and repeat with
your left foot.
Over the course of 12 weeks, most participants lost an
average of 2kg of fat and gained 1.1kg of muscle mass in
their trunk and legs.
During the study, scientists found that fast sprinting
caused the body to release high levels of a specifi c group of
hormones, called catecholamines, which drive the release
of fat, especially abdominal and visceral fat, from fat stores
so it can be burned by working muscles.
According to Dr Boutcher, lower intensity activities
such as walking and swimming would not be capable of
achieving the same results.
Why is HIIT more effective?
Exercise scientists used to believe that ‘steady state’ cardio
exercise was superior for fat loss because relatively more
fat is used by the body as fuel at lower exercise intensities
than at higher intensities. You may burn more fat relative to
glycogen when you go for a walk, but the total amount of
fat lost during a walk is considerably less than if you train at
higher intensities.
During these intensive workouts, the fat/glycogen ratio
is lower, but you burn much more fat. Add this to the fact
that interval training allows you to exercise at very high
intensities for a much longer period of time, and you can
see why HIIT is such a hit when it comes to weight loss.
As an added bonus, some research suggest there’s also
an afterburn effect known as excess post-exercise oxygen
consumption (EPOC), which means your metabolism and
ability to burn calories increases for up to 24 hours after
interval training.
Intervals also benefi t your health
Whilst Boutcher’s research focused on the weight loss, a
more recent British study revealed that short, sharp bursts
of exercise are better at warding off heart disease than
longer, less strenuous sessions.
Comparing men who took part in high-intensity sprints
on an exercise bike with those who walked for half an hour
on a treadmill, Dr Gray from Aberdeen University found that
short bursts of intensive exercise spur the liver into taking in
more fat from the blood, before storing it, or burning it off.
‘Our study showed that higher intensity shorter intervals
of exercise might be a more effective method to improve
health and reduce the time commitment to exercise,’ said
Dr Gray.
As obesity continues to affect the nation’s health,
the discovery that shorter bursts of activity can achieve
outstanding results – both in terms of weight loss and
overall health – gives hope that more of us may be inclined
to exercise. csbm
92 www.cosbeauty.com.au

ellafitness
body
keeping up Benefits appearances of
resistance
want to flaunt a toned and terrific bod this summer? here are some
exercise essentials to help get you started. words by Jarrat wood
training
Some people train for health, some people for Chest: push-ups
performance and some people train for appearance. There is really no better all-round exercise than the push-up
Vanity aside, training for appearance is a realistic when training outdoors. Place your hands shoulder width
option. Everyone has a body part that they wish was bigger or slightly wider with your wrists slightly above the nipple
Strength training can provide an array
or smaller.
line but below your shoulders. If you wish to focus more on
If you plan to train for appearance then remember
of health
some your
benefits,
chest muscles,
including
place your hands
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a
faster
little wider and move
important health and safety guidelines: metabolism your and elbows better away from the flexibility, body as you lower says yourself.
• Training opposing muscle groups unevenly Russell can lead to Cox To focus from more Regenesis on the triceps bring Fitness. your hands a little
postural and functional deficiencies.
closer to your body and keep your elbows close to your body
• Health should be the number-one priority with an as you lower yourself to the ground. Beginners should try
exercise program and all exercise has an element of risk. push-ups from the knees. If this is too difficult try push ups
• There is a limit to how much you can vary your appearance. on a raised bench with feet on the floor or against a wall
Genetics will always be an overriding determinant of (the more upright you are the easier the push up will be.
your appearance.
Advanced trainers should try a full length push up raising
So you want to get into shape – maybe it’s part of your shape of your physique. Precise controlled movements
New Year’s resolution or maybe you just want to look offer
one leg
a conditioning
in the air to increase
effect, resulting
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in firmer
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betterdefined
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approach.
incorporating
Break Abdominals
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into
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body parts: legs, back, chest and
balanced
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to
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many people,
abdominals.
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the most
should
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effect
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portion of
have
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or even your own body weight to strengthen and condition routine
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to
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sit-up
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musculoskeletal
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system, improving muscle tone and Consult
variation
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to assist
local
you
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with walking
professional
and sitting
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tall.
customised
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improve
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muscles and calves. Making your way
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posture. Raise your straight leg at the same time so that your
workout,
intervals
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for
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afterwards.
you advance.
heel Reap is just off the the rewards ground. Lower of to the ground and repeat.
Including weights training in your exercise routine is a
Try resistance 8-10 repetitions training: on each leg. For advanced trainers, try 2
bit Back: like investing reverse in the flyes future. The benefits of increased
legs
•
at
Increased
a time. Beginners
calorie burn
should
for
complete
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calorie It’s difficult burning to train due your to exercise back without extend heading way beyond to the gym, the as above after without completing the sit your up. workout
period but to of add time some you definition spend exercising, to your trapezius with your and metabolism rhomboids • You Increased should always base metabolic seek the advice rate (BMR) of a registered so you fitness
being (the major elevated muscles for a between couple of your hours shoulder after your blades) workout. try a professional burn more before calories undertaking 24/7 any program. Visit your local
This reverse means fly and you extension. burn more calories all day, every day, even gym • for Enhanced the personalised physique guidance with a targeted you require. program bella
when Lie you’re face down sitting on on a bench, the couch raise your relaxing. arms And out to a your boosted sides, • Stronger bones
metabolism then move your can lead arms to in reduced an arc above overall your body head. fat. Reverse the Jarrat • Greater Wood is a flexibility personal trainer and the gym manager at Regenesis
movement The second back major to the benefit starting to position. resistance For a training more advanced is that Fitness • Better in Edgecliff, injury Sydney. prevention For more information call 02 9363 0376
you workout can target use some particular dumbbells muscle for extra groups resistance. to enhance the or visit www.regenesisfitness.com.au
Re-energise with
Regenesis Fitness, an
exclusive, friendly and
professional club, without
the crowds. Flexible
membership options
available.
Cnr New South Head Rd & Ocean Ave, Edgecliff
02 9363 0376 info@regenesisfitness.com.au
www.regenesisfitness.com.au
112 // 93 bellaBEAUTY
AUSTRALIAN COSMETIC SURGERY

ody
Get your
body
beach-ready
With summer shining upon us,
the desire to shape up is high.
Head to Titan Fitness and make
the most of your motivATIon.
Nicola Donovan reports.
With the warmer seasons well and truly upon us,
so is the season of the bikini. And while the
idea of stripping down to a swimsuit can be
daunting to some, it can also ignite a desire to shape up.
The team at Titan Fitness acknowledges that everybody
has individual needs. Because of this, they’ve set out to
provide programs, facilities and services that will help gym
members target their specific body concerns. The four
storeys of expansive fitness rooms are decked out with
advanced gym equipment where you can train solo or enjoy
the latest group fitness programs.
Personal training
Titan Fitness personal trainers are dedicated to helping
you achieve results. Ensuring you make the most of your
time in the club, the certified trainers are on hand to advise,
assist and motivate.
Former professional rugby league player Daniel Conn
is one of the personal trainers at Titan Fitness. Having
played for the Sydney Roosters, Gold Coast Titans and the
Canterbury Bulldogs, Conn knows precisely what it takes
to reach your fitness goals.
‘There’s a lot of information thrown around a gym – from
diet advice to how someone should be training,’ he says.
‘But not all of it’s correct, and certainly doesn’t apply to
everyone. A personal trainer will assess your individual level
of fitness, and take into consideration any limitations posed
by injury or lifestyle.’
Group fitness
The gym is packed with cardiovascular and weighttraining
equipment. However, for those who thrive off the
motivation of others when working out, a variety of group
fitness classes are offered at Titan. These include Les Mills
Body Pump, Body Combat and Body Balance, Spin Class,
Boxing and Zumba. Group fitness programs can provide an
enjoyable environment for you to exercise in, with classes
like Zumba providing a fun yet challenging workout.
There are also freestyle classes on offer, including 30Min
Hit, Total Body, Fat Burner, Killer Kardio and MMAXFIT.
Nutrition
Including exercise into your daily routine will invite numerous
health benefits into your life. However, if you’re after specific
fitness results, nutrition also plays a fundamental role. The
team at Titan Fitness recognises that you can’t rely solely
on exercise, and aims to eliminate any confusion you may
have with nutrition by providing easy-to-understand advice.
To this end, Titan offers diet plans which focus on simple,
healthy meals that, when united with regular exercise, will
help you to achieve your fitness goals. csbm
94 www.cosbeauty.com.au

JOIN TITAN FITNESS
FOR 14 DAYS
FOR FREE AND
TRANSFORM
YOUR BODY *
29-31 ALFREDA STREET,
COOGEE NSW 2034
PH: (02) 9665 4058
FAX: (02) 9664 1881
WWW.TITANFITNESS.COM.AU
FREE 14 DAY MEMBERSHIP WORTH
SIMPLY DETACH THIS VOUCHER AND TAKE IT WITH YOU TO
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$
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OFFER ENDS 31/12/13.

ody
Defining
touch
IMPLANTECH
body implants
to enhance
musculature for
both medical
and aesthetic
purposes. Caitlin
Bishop reports.
Body implants are used to create definition and
volume to a range of areas on the body. Considered
an international industry leader, Allied Biomedical,
an Implantech company has been designing and
manufacturing facial and body implants for more than
20 years. Their products are distributed in Australia by
Precise Medical Supplies.
Using state of the art design technology, the implants are
anatomically shaped and symmetrical, with a predictable
volume and tapered edges. These factors are important
in achieving consistent, natural-looking results, without
noticeable or palpable margins.
Sydney plastic surgeon Dr Howard De Torres says
Implantech implants are effective in adding volume and
definition to numerous areas of the body. ‘Body implants
can be used to treat a range of medical and aesthetic
concerns,’ he explains. ‘For example, I use calf implants
to treat muscle atrophy, withered legs, club feet or in cases
where the muscle simply hasn’t developed.’
Dr De Torres also says the solid consistency of
Implantech products can help protect against post-surgical
complications. ‘In using calf implants, you are putting
an implant into a very tight spot and it takes some time
before the implant settles into the tissue,’ he explains.
‘Because the implants from Implantech are quite solid
in consistency, any bulging or distortion after surgery is
almost impossible.’
Body implants are commonly used in aesthetic
augmentation to shape, emphasise and define musculature.
Sydney plastic surgeon Dr Robert Drielsma, who has been
using Implantech for around 15 years, commonly uses calf
implants to reshape the lower leg.
‘In my experience, the most common patient demand
for body contouring is calf augmentation – for which these
implants are ideal,’ Dr Drielsma says. ‘In males, body
building is a common underlying factor when general body
building has achieved great results everywhere except the
calves, which have remained relatively under-defined. In
women, aesthetic contour of the calves is the primary goal.’
The appropriate size, shape and positioning of the
96 www.cosbeauty.com.au

implant must be expertly determined before insertion. Dr
Drielsma explains the consultation process is important
in establishing the right fit for each patient. ‘For calf
augmentation, the sex of the patient, and their concerns
and goals, are important factors, and also whether single
or double calf implants are desired or needed,’ he says.
‘It is helpful to strap “tester” implants on the calves to
help determine the ideal size.’
Importantly, the solid silicone consistency of
Implantech products means they are ‘carvable’, or can
be adjusted before surgery for an optimum fit for each
individual patient.
In my experience, once
Implantech body implants are
in, patients can generally
forget about them; they can last
20 to 30 years with no
complications
Dr De Torres explains how Implantech products can
be customised to each patient. ‘There are a range of sizes
from Precise Medical. I decide on the most appropriate
size of implant after measuring the calf, or any other
area to be treated, during the initial consultation with my
patient,’ he says.
‘Because the implants are solid, it is possible to trim
the edges for a more effective fit. In these cases, I will opt
for larger sized implants and trim them according to the
patient’s individual needs.’
Following calf augmentation, once the implants have
settled in, Dr De Torres explains the results are usually
long lasting with minimal complications.
‘With body implants from Implantech, the results
are usually “set and forget”,’ Dr De Torres explains. ‘In
my experience, once the implants are in, patients can
generally forget about them; they typically last 20 to 30
years with no complications.’
In an industry where quality, predictability and
endurance is paramount, excellence in both implant
design and technology is essential. Implantech implants
from Precise Medical Supplies are a viable option to
achieve optimum results with minimal complications in
body implant surgery.
‘Implantech implants come in a variety of shapes,
sizes and degrees of firmness that suit a range of body
augmentation applications,’ Dr Drielsma says. ‘The fact
they are solid silicone and carvable means they can be
easily modified at the time of surgery to conform more
effectively and precisely to the patient’s body.’ csbm
SOMETIMES NO AMOUNT
OF WEIGHT TRAINING
CAN GET YOU THE RESULT
YOU DESIRE
PRE-FORMED & CUSTOM
BODY IMPLANTS
Enjoy a more clearly defi ned physique
and musculature with body implants
from Allied Biomedical, an Implantech
company.
These implants may also be used to
help correct muscle atrophy resulting
from injury or illness.
Implantech Body Implants can defi ne
and add volume to:
• CALVES • FACE • CHEST
•ARMS • BUTTOCKS
TO FIND A PRACTITIONER NEAR YOU CALL:
PRECISE MEDICAL SUPPLIES
1800 689 400
WWW.PRECISEMEDICAL.COM.AU
www.cosbeauty.com.au 97

ody
The modern tummy tuck
Sydney plastic surgeon Dr Alex Phoon describes how abdominoplasty
can help restore the shape and silhouette of pre-baby bodies.
Abdominoplasty is the medical term for what is
commonly known as a tummy tuck. Traditionally,
it involves the removal of some or all of the
lower abdominal skin and fat below the belly button and
tightening of the central core abdominal muscles. Modern
abdominoplasty has now evolved to use the complementary
technique of liposculpture to contour the waist, lower back
and upper abdomen at the same time. It is one of the most
common plastic surgical procedures performed today,
particularly for women after they have had children.
Changes to the body after pregnancy are entirely normal
and are partly due to the ageing process, as well as how
women’s bodies have to adapt for pregnancy. The extent of
these changes can vary from one person to the next; one
woman may have almost no changes at all after pregnancy,
while the next may have profound muscle weakness,
hernias and stretch marks.
There is no doubt pressure in society for women to
achieve their pre-pregnancy figure in the shortest possible
time. This is potentially unhealthy for both the mother and
child. In such a busy and exhausting time of their lives,
women should be allowed to focus on returning to good
health and looking after their children without people
pushing the idea they should be at their pre-baby size.
But what happens when, despite all the healthy dieting
and exercise, women are still unhappy with their figure? This
decision is a very personal one for any woman to make, but
abdominoplasty may be the answer.
Part of the problem is that skin will often contract to a
point but beyond that may remain loose. Any stretch marks
tend to be permanent. With an appropriate exercise plan,
some women will have their abdominal muscles come back
together but others will find there will be a gap, or what is
known medically as a ‘diastasis’ of the rectus abdominus
muscles. In the most extreme cases, there may also be
hernias, such as the patient in Case 1. When there is excess
skin combined with a separation of the central abdominal
muscles, there can be both a functional and cosmetic
problem where surgery may be the only thing that might help.
Abdominoplasty involves removing this excess skin and
fat from below the belly button and tightening the abdominal
muscles at the same time. The final scar is made as low as
possible, ideally at the level of the bikini or the underwear line.
The belly button is repositioned once the skin is pulled down.
The procedure involves a general anaesthetic
and a few days in hospital post-operatively. Most
patients can resume work after a couple of weeks
and can return to light activities after about one week.
Long-term results can be maintained with a healthy lifestyle.
For the right patient, an
abdominoplasty, or tummy tuck,
can make a huge impact on their
quality of life
Wherever possible I also include liposculpture to the
‘muffin top’ or flank area to accentuate a woman’s silhouette
at the same time. These areas can be difficult to target
through diet and exercise alone. My personal philosophy
is to create the best tummy possible for each patient while
improving post-operative pain and healing.
I routinely use quilting stitches internally to minimise the
length of time my patients have drains and the latest Pain-
Buster anaesthetic pump device. This local anaesthetic
infusion device has revolutionised my patient care, with
the vast majority of patients not needing anything more
than Panadol in the first few days post-op. This means a
98 www.cosbeauty.com.au

ody
lower reliance on drugs such as morphine which can cause
nausea as well as bloating, sleepiness and discomfort.
Scar management techniques are also employed postoperatively
to minimise the appearance of the scar.
Like any surgery, abdominoplasty comes with inherent
risks and complications, which makes it especially important
for patients to choose a skilled and experienced surgeon.
The consultation is also a key component to ensuring
optimal results. Together, the patient and surgeon devise
1
an operative plan to achieve the best results possible. I also
use 3D Vectra digital imaging, which enables us to map out
the finer details of the operation and get an idea of what the
final result will most likely be.
For the right patient, an abdominoplasty can make
a huge impact on their quality of life. A good diet and
exercise will always be the mainstay of a healthy lifestyle,
but a tummy tuck may be a viable option when these simply
aren’t enough. csbm
BEFORE
Two weeks AFTER surgery by Dr Phoon
This woman had twins and, despite being very fit and active, her central muscles had split and she had a resultant hernia at the
level of the belly button and lower abdominal bulge. Excess loose skin, the hernia and the separated muscle were all treated with an
abdominoplasty without liposuction.
2
BEFORE
Three weeks AFTER surgery by Dr Phoon
This woman had six children and wanted an abdominoplasty to improve the contour around her waist. A standard abdominoplasty was
performed with liposuction to the flank and lower back (3L removed).
3
BEFORE
Four weeks AFTER surgery by Dr Phoon
This woman had lost a significant amount of weight. She has had no previous pregnancies but a previous breast reduction and she
now felt her bust was too small and out of balance for her frame. She had abdominoplasty and liposuction with additional breast
augmentation at the same time.
Photos taken from 3D images of real before and after photos.
www.cosbeauty.com.au 99

feature body
refine
your
shape
Melbourne and sydney
dermatologist
Dr Michael Rich says
microcannula liposuction
offers optimum body
contouring results.
Caitlin Bishop reports.
Trained by Dr Jeffrey Klein, one of the world pioneers in
liposuction technique, Melbourne cosmetic surgeon
Dr Michael Rich is considered an expert in body
contouring and has been performing liposuction for more
than 20 years. A leader in the Australian field, Dr Rich
performs his procedures with a microcannula – as opposed
to a regular cannula – and has a long-standing history of
effective, reliable and consistent results.
‘The most important facet in achieving pleasing
outcomes in liposuction is a natural-looking result with
no irregularities and no divets,’ Dr Rich explains. ‘Without
clothes on, no one should be able to tell the patient has had
liposuction performed.’
In addition to liposuction, Dr Rich performs a wide variety
of surgical and non-surgical procedures from his clinic
‘EnRich’ in Melbourne, as well as Dr Garry Cussell’s ‘The
Facial Rejuvenation Clinic’ in Sydney.
Technique
Dr Rich explains the use of a microcannula in liposuction
is key to achieving the desired natural-looking results.
Traditionally, liposuction was performed with a larger
cannula to aid the extraction of larger volumes of fat.
‘The use of a microcannula takes longer and requires
more precise work, as it is a true sculpturing procedure,’
Dr Rich explains. ‘A large cannula enables the operator to
perform the liposuction more quickly, but at the expense
of accuracy. The large cannula can cause more bruising
and more bleeding, and there is a higher risk of grooves,
depressions and irregularities in the final result.’
Dr Rich uses the ‘tumescent’ technique in his liposuction
procedures. This involves infiltrating the treatment area –
or fatty pockets – with ‘tumescent fluid’ before suctioning
the fat out. The tumescent fluid is a combination of
anaesthetic, to numb the area, a small amount of adrenaline,
to constrict blood vessels and reduce post-procedure
bleeding, and sodium bicarbonate to soften the fat and
assist in extraction.
Having trained with Dr Klein, who pioneered the
tumescent technique in 1985, Dr Rich believes it affords
more consistent results and presents a lower risk of
complications. ‘Dr Klein’s ground-breaking work into
tumescence revolutionised liposuction and drastically
lowered the risk of complication,’ Dr Rich says.
‘I’ve looked at every single other technique over the
years, including how to use different laser devices and
cannulas in liposuction, and I believe the best procedure,
100 www.cosbeauty.com.au

ody
with the lowest risk of complication, is the way Dr Klein
states it should be performed.’
Dr Rich uses liposuction to treat several areas of the
body, including the chin, jowls, neck, breasts, chest, arms,
full body torso, thighs, knees and ankles. He explains fat
deposition varies between genders, and fat accumulation
– particularly stubborn, difficult-to-shift fatty pockets –
increases naturally with age.
‘Women usually have more gynoid fat, which is just
below the skin, and men typically have more android fat,
which is inside the abdominal cavity,’ he explains. ‘The most
common treatment areas in females include the abdomen,
hips, outer and inner thighs, and neck. In men, common
concerns are male breasts, the stomach and love handles.
With age, there tends to be weight gain and increased fat
deposition in both males and females.’
Skin retraction
Skin retraction, which is the even moulding of skin to
the body’s new contours, is a common concern in
liposuction patients. Dr Rich explains
the skin’s elasticity should be sufficient
to incur adequate skin retraction in
most liposuction patients, however
adjunctive treatments can be used to
optimise the result.
‘In most patients, superficial
liposuction is more than adequate to
achieve sufficient skin retraction,’ Dr
Rich says. ‘In patients who have lost a lot
of weight or older patients with skin that
doesn’t retract as well, radiofrequency
devices can be used to heat the skin
and cause added retraction. When a
large volume of fat is extracted during
liposuction, removing the excess skin
via surgery may be necessary.’
BEFORE
remove isolated pockets of fat, for example in the chin,
to achieve an aesthetic result – the procedure should not
be considered an “easy way out” or a replacement for
lifestyle changes.’
For those looking to undergo liposuction, Dr Rich
explains establishing realistic expectations and explicit trust
in their doctor is essential coming into the procedure.
‘Possibly, the most important question for each patient
is: “are my expectations realistic?” It is very important to
understand that, while liposuction can remove the bulk
of fat and achieve skin retraction, it will not necessarily
improve other aspects in their life,’ Dr Rich says. ‘The
patient must have a rapport with, and confidence in, the
surgeon performing their procedure, and should research
the doctor’s experience before going ahead.’
‘I encourage my patients to write down every question
and apprehensive thought they have before making a
decision. These should include: will I have adequate benefit,
will my skin retract, will I be able to function adequately
post-procedure and, most importantly, will I achieve what I
want to achieve?’ Dr Rich concludes. csbm
AFTER microcannula liposuction by Dr Rich
results &
Expectations
While Dr Rich performs liposuction on
a variety of patients who have differing
concerns, expectations and body
types, he explains liposuction should
not be seen as an alternative to a
healthy lifestyle.
‘The person who is most suitable
for liposuction is not overweight but
may have stubborn fatty pockets that
they wish to remove,’ Dr Rich says.
‘While an overweight patient can still
undergo liposuction – particularly to
BEFORE
AFTER microcannula liposuction by Dr Rich
www.cosbeauty.com.au 101

ody
Refine
your figure
Liposonix is a non-invasive option for body contouring, designed to
shed one dress size in just one treatment. Caitlin Bishop reports.
Despite a steady commitment to dieting, or
unwavering dedication to an exercise program,
some pockets of fatty tissue can be difficult to
budge. It could be that you’re genetically predisposed to
love handles or excess abdominal fat, or perhaps your
body is simply determined to hold onto those fatty pockets
on the thighs, upper arms or hips. Whatever the reasons,
Liposonix, distributed by Solta Medical, provides a nonsurgical
alternative to conquering these problem areas.
Liposonix uses targeted, high-energy ultrasound to melt
fat in the subcutaneous fat layer (the fat layer directly under
the skin) without harming the skin’s superficial layers. This
helps to tighten, slim and tone the body’s contours, and
can be effective in reducing fat on the abdomen, waistline,
arms, thighs and buttocks.
‘Liposonix melts away fat, leaving the skin unharmed.
This technology has been used for many years to dissolve
kidney stones and has a proven safety record,’ says Sydney
plastic surgeon Dr Charles Cope.
‘In my opinion, Liposonix has two main advantages
over other non-surgical fat reduction systems: only one
treatment is required; and there is a lower risk of contour
irregularity problems that can occur with other systems on
the market.’
The aim of Liposonix is to
reshape and contour the body.
It is designed for people who
have tried everything and
can’t lose localised, stubborn
pockets of fat
Designed to shed one dress size in just one treatment,
Liposonix targets high-intensity ultrasound energy at a
specific depth in the fat layer to cause a rapid, but localised,
rise in temperature. Above a temperature of 56 degrees
Centigrade, irreversible cell death occurs and the targeted
fat cells are permanently destroyed.
102 www.cosbeauty.com.au

ody
Sydney cosmetic surgeon Dr Jack Ting explains Liposonix
should not be considered an alternative to weight loss, but
can achieve effective results in shifting problem areas.
‘Liposonix focuses on one particular area at a certain
depth, and a pinch of one inch of fat is required at the
treatment site,’ Dr Ting explains. ‘The aim of Liposonix is to
reshape the body; it is not a substitute for losing weight. It
is designed for people who have tried everything and can’t
lose localised, stubborn pockets of fat.’
A consultation is required to determine if a patient is
suitable for treatment with Liposonix and,
1
typically, just one treatment is sufficient to
achieve effective results. The procedure takes
around one hour and can be used in conjunction
with other modalities, as Dr Cope describes.
‘The treatment takes between 60 and 90
minutes and, for the best results, patients take
oral analgesia, so the patient can tolerate higher
treatment settings,’ he explains. ‘Liposonix
can also be used in conjunction with a medical
2
grade laser, to improve the texture and surface
of the skin, especially stretch marks.’
Dr Ting uses a ‘stacking’ technique to
achieve optimum results in Liposonix treatment.
‘I use a high energy dosage for more effective
results,’ Dr Ting explains. ‘Stacking means I treat
the same section repeatedly, without letting the
area cool down – as opposed to moving across
the treatment area and returning to re-treat the
section later. I commonly perform three passes
3
on each section.’
Although there is minimal downtime,
treatment with Liposonix may induce mild
discomfort in the days following the procedure,
though no bed rest is needed.
‘Patients can return to work and normal
everyday activities the day after treatment,’ Dr
Cope says. ‘The area may be sore for a few days,
especially when performing vigorous exercise,
but there is no need to restrict any activities.’
Following treatment, the liquefied fat
cells are removed from the body via natural
4
metabolic processes. Once these fat pockets
are removed, it is difficult to increase fat in the
same area. Because of this, and to avoid any
possible contour irregularities, it is important to
maintain a healthy exercise and diet regimen
after treatment with Liposonix.
‘The improved contour from a Liposonix
treatment can be maintained with a healthy diet
and exercise program, which should be part of
BEFORE
BEFORE
BEFORE
BEFORE
everyone’s lifestyle,’ continues Dr Cope. ‘There have never
been any reported cases of contour irregularities with the
Liposonix treatment.’
Liposonix offers a viable option in improving the body’s
contours without the downtime associated with surgery.
Just as summer calls for bikinis and sundresses, exercise
or diet programs can sometimes require a helping hand in
achieving desired results. Liposonix can go great lengths in
optimising the outcome of healthy hard work, and refining
and reshaping the figure. csbm
6 weeks AFTER treatment with Liposonix
12 weeks AFTER treatment with Liposonix
8 weeks AFTER treatment with Liposonix
4 weeks AFTER treatment with Liposonix
www.cosbeauty.com.au 103

ody
Trim
& tone
EXILIS TREATMENT IS EFFECTIVE IN REDUCING FAT,
REFINING CONTOURS AND TIGHTENING SKIN ON BOTH THE
FACE AND BODY. CAITLIN BISHOP REPORTS.
Designed to conquer stubborn fatty pockets,
refi ne contours and regenerate the skin’s support
structure, Exilis from Device Technologies offers
a trimming, tightening and toning effect. From slimming
the waistline to refi ning the jaw angle, the non-invasive
treatment can be used on several areas and combines
monopolar radiofrequency (RF) and ultrasound technology
for faster, more effective results.
‘We have been using Exilis for a year, and have achieved
circumferential reduction, improvement in skin laxity on
both the face and body, and smoother, tighter skin,’ says
Queensland plastic surgeon Dr Mark Magnusson.
By targeting the radiofrequency and ultrasound energy
at specifi c depths in the subcutaneous fat layer, Exilis
induces deep thermal heating to increase metabolic activity
and initiate lipolysis – the death of fat cells.
As the fat cell volume decreases, the surrounding
collagen is also affected. The collagen fi bres unravel in the
heat, triggering the body’s natural healing response and
stimulating the production of new collagen at the site. This
results in skin tightening, alongside fat reduction.
For fat reduction, Exilis targets different levels of
subcutaneous fat and a contact cooling system is used
to protect the epidermis. It is effective in circumferential
reduction and reducing isolated fatty pockets.
‘Fat reduction with Exilis is best suited to patients who
are a healthy, level weight,’ says Tasmanian plastic surgeon
Dr Gary Kode. ‘It is used to treat pockets of stubborn fatty
tissue that are not affected by exercise or diet. It’s a noninvasive
treatment that can achieve great results in refi ning
the fi gure and contours.’
For fat removal, each layer of fat is targeted separately.
The fi rst pass targets deep fat, with the machine set to full
power. The settings can then be reduced to target the middle
layers, and then reduced again for a third pass, targeting
superfi cial fat. A fourth pass using just radiofrequency is
then made to tighten the skin.
Treatment with Exilis should not incur any downtime,
and no anaesthesia is required during treatment. ‘During an
Exilis treatment you will experience an intense heat but my
patients don’t report any discomfort,’ says Dr Magnusson.
‘Most people say it feels relaxing like a hot stone massage.’
Multiple sessions are often required to maximise results
in Exilis treatment. Typically, four treatments are performed,
one to two weeks apart.
Exilis can also be used in combination with more
aggressive cosmetic procedures for a synergistic effect.
For example, using Exilis after fractional CO2 skin
resurfacing can greatly improve the skin tightening effect
of laser skin rejuvenation.
The full results of Exilis are usually seen three months
after treatment, once collagen synthesis has occurred
and the dead fat cells have been naturally metabolised by
the body. In fat reduction, each treatment takes 30 to 45
minutes and multiple passes are made on the specifi c body
area to target different levels in the subcutaneous tissue.
In a revolutionary combination of radiofrequency and
ultrasound technology, Exilis offers an effective and noninvasive
way to help slim and tone the body. csbm
BEFORE
BEFORE
AFTER Exilis treatment (photos courtesy of
Device Technologies)
AFTER Exilis treatment (photos courtesy of
Device Technologies)
104 www.cosbeauty.com.au

MAKE EVERYDAY
“A Skinny Jeans Day”
Exilis redefines Non-Invasive body & facial treatments.
Melt away centimetres, the non-surgical way.
BEFORE
AFTER BEFORE AFTER
Your Exilis Specialist Clinic
NEW SOUTH WALES
Elixxir Medispa
Dr Michael Miroshnik
Bondi Junction
1300 854 610
www.elixxirmedispa.com.au
Face Today Mediclinic
Chatswood
1300 668 573
www.facetoday.com.au
Alpha Cosmetic Clinic
Dr Phil Caraiscos
Hurstville
02 9579 2777
www.alphacosmedicclinic.com.au
QUEENSLAND
Face Today Mediclinic
Cairns
07 4053 3021
www.facetoday.com.au
Allure Clinic
Dr Mark Magnusson
Toowoomba
1300 662 960
www.allurecosmeticclinic.com.au
Sunshine Vein Clinic
Dr Hugo Pin
Peregian Beach
1300 698 346
www.sunshineveinclinic.com.au
VICTORIA
Rejuvenex Medical Aesthetic
& Laser Clinic
Blackburn South
03 9877 2366
www.rejuevenex.com.au
TASMANIA
Launceston Plastic Surgery
Dr Gary Kode
Launceston
03 6334 9313
WESTERN AUSTRALIA
Bramis Facial Rejuvenation Clinic
Dr Mela Brankov
Subiaco
08 6161 5425
www.bramis.com.au
Dermedica
Dr Joanna Teh
Scarborough
08 9205 1995
www.dermedica.com.au
E: exilis@device.com.au | W: www.device.com.au/exilis

intimate surgery
Speaking
out
Gynaecologist and pelvic
reconstructive surgeon
Dr Oseka Onuma says vaginal
rejuvenation can be an
empowering option for many
women. AimÉe Surtenich reports.
Talking openly about concerns relating to the vagina
can be challenging for women. The question ‘am I
normal?’ can plague women of all ages, particularly
when it comes to the appearance and function of the
vagina and urinary system.
Dr Oseka Onuma, a gynaecologist and pelvic
reconstructive surgeon, says one of the most pertinent
issues in the field of gynaecology is the lack of open and
honest dialogue, both in mainstream society and the
medical community, which leads to many obstacles in
women seeking treatment. One of the effects of not having
an open forum for gynaecological concerns is a widespread
misunderstanding of what is classified as ‘normal’ – both in
terms of vaginal anatomy and urogynaecological problems.
‘There is a very wide spectrum of what is “normal”,’ says
Dr Onuma. ‘I never make assumptions; the real problem
may be more subtle than the one being expressed. I want
to know not only the symptoms but also the length of time
they have been endured and how the patient’s quality of
life is being affected. After a thorough examination, the
correlation of the clinical findings with the symptoms results
in higher success rates – both in terms of the surgery and
patient satisfaction.’
Functional and cosmetic rejuvenation
All women are born with differently shaped genitalia, and
with the effects of childbirth and age, many can suffer from
problems with their genitalia that can make them feel very
self-conscious and unhappy, often affecting relationships
with sexual partners.
‘Childbirth can change the shape and tone of vaginal
tissue, sometimes resulting in embarrassment and
occasionally loss of sexual satisfaction,’ Dr Onuma says.
‘After childbirth, sufferers often try to ignore any reduced
ability to contract the vaginal walls, the feeling of “looseness’
and reduced sensation during intercourse.’
Women seeking vaginal rejuvenation are usually
concerned about both the appearance and the discomfort
caused by oversized, elongated or asymmetrical labia
minora. Other concerns that can be addressed by surgery
include protrusions or a lump within the vagina, scar tissue,
discomfort or sagging at the entrance to the vagina, and
loose or weak vaginal muscles, mainly caused through the
muscles stretching during childbirth.
There is a range of surgical options available which can
correct these problems. One is laser reduction labioplasty,
which can sculpt the elongated or unequal labial minora
as desired. ‘Labioplasty techniques can reconstruct
conditions that are a result of the ageing process, childbirth
trauma or injury,’ says Dr Onuma.
The procedure can provide a more aesthetically attractive
vulva. The vulvar structures (including the labia minora,
labia majora, mons pubis, perineum, entrance to the vagina
and hymen) can be surgically enhanced, both functionally
and aesthetically.
Female urinary incontinence
Female stress urinary incontinence is caused predominantly
by an improperly functioning urethra, not the bladder.
Normally, the urethra, when properly supported by strong
106 www.cosbeauty.com.au

feature
Laser Vaginal
Rejuvenation TM
pelvic floor muscles and healthy connective tissue,
maintains a tight seal to prevent involuntary urine loss.
When a woman suffers from stress urinary incontinence,
weakened muscle and pelvic tissue don’t support the
urethra adequately. As a result, the urethra doesn’t maintain
a tight seal during exercise or other movement such as
coughing or laughing, and urine escapes.
‘Women with stress incontinence generally have a
reduced impression of their own wellbeing and attraction to
others, and this can affect their relationships with intimate
partners,’ says Dr Onuma.
No one should suffer conditions
that can be treated. Part of being
a woman is taking control by
having access to choice
One technique Dr Onuma employs is the tensionless
vaginal tape, or TVT, sling. It is a minimally invasive procedure
during which a Prolene tape sling is inserted to correct
stress urinary incontinence. It requires a short operation and
recovery is typically rapid. Rejection and infection are rare.
The Prolene mesh is inserted through the vagina and
positioned underneath the urethra, creating a supportive
sling, which is held in place by surrounding tissues rather
than sutured into position. During movement or exercise,
the mesh supports the urethra, allowing it to maintain its
seal to prevent urine loss.
‘It’s important to listen to the concerns of the individual
patient, assess them with examination and appropriate
investigations to establish a diagnosis, and then offer a
series of potential solutions with detailed discussion about
how each approach might impact positively or negatively if
adopted,’ says Dr Onuma.
‘During consultation, I encourage my patients to express
themselves openly and, importantly, to make them feel more
comfortable with what are usually very normal concerns,’
he says.
Providing knowledge, choices and alternatives is an
essential part of delivering a quality medical service to
improve the function of the vagina and urinary system – and
the quality of life of each patient.
‘No woman needs to suffer conditions that can be
treated. Part of being a woman is not “putting up with it”,
but taking control by having access to choice,’ Dr Onuma
concludes. csbm
SPECIALISING IN
• Aesthetic and functional
labial surgery
• Curing urinary incontinence
• Restoring pelvic support
• Enhancing sexual gratification
• Resolving menstrual dysfunction
OUR MISSION
To empower women
with knowledge, choice
and alternatives
Dr Oseka Onuma
BSc MJur MBBS FRCOG
FRANZCOG
Gynaecologist &
Pelvic Reconstructive Surgeon
Laser Vaginal Rejuvenation
Institute of Adelaide
Robe Terrace Specialist Centre Suite
4 Robe Terrace, Medindie
South Australia 5081
Phone 08 8344 6085
Facsimile 08 8344 6087
Email rooms@dronuma.com
www.dronuma.com
www.cosbeauty.com.au 107

intimate surgery
What lies beneath
Sydney cosmetic surgeon Dr Colin Moore explains the cosmetic and
functional benefits of genital surgery. AimÉe Surtenich reports.
S
Page 1
GEMENT
idening
ds
tomy Reversal
ry
(Lyn)
.com
OORE
There’s more to vaginal rejuvenation than creating a
‘designer vagina’. In addition to improved aesthetics,
it can alleviate discomfort, pain and hygiene issues,
as well as improve sexual pleasure.
‘Importantly, vaginal abnormalities can often inhibit a
woman’s self-confidence and sexual satisfaction and, left
untreated, can result in both physical and psychological
concerns,’ says Sydney cosmetic surgeon Dr Colin Moore.
Women who seek vaginal surgery often notice changes
to their vagina after giving birth or as a result of the ageing
process. Depending on the patient’s concerns, there are a
number of surgical options that can correct aesthetic and
functional concerns.
‘After giving birth, some women experience stretched
muscles and skin that can significantly change the shape
of the vagina, both internally and externally,’ says Dr Moore.
‘In such cases, it’s important to adopt a holistic approach:
MEN’S & WOMEN’S
Cosmetic Surgery
‘A New You’
• Penis Enlargement – permanent
• Circumcision • Abnormalities (bends)
• Impotence • Vasectomy • Testicular Implants
• Breast Enlargement/Reduction • Tummy Tuck
• Face/Eye Lift • Vaginal Cosmetic/Surgical Repairs
EARS EXPERIENCE
B R I S B A N E
ITAL
Y
ent
y
gery
(Lyn)
.com
THE AUSTRALIAN CENTRE FOR COSMETIC SURGERY
Dr Colin Moore
MBBS, FRCS, FRACS, FACCS
www.drcolinmoore.com.au
To recieve an information pack call Lyn on
0414 251 234 or 1300 malepenissurgery
VISIT THE BEFORE ANd AFTER
pHOTO GALLERY AT
drcolinmoore.com/general/gallery.html
Finance options available
tightening both the weakened vaginal muscles and trimming
excess labial tissue. I work with each patient to decide on the
most appropriate treatment option for vaginal rejuvenation.’
Vaginoplasty vs labioplasty
A vaginoplasty is a day procedure which involves tightening
the sling muscles in the vagina by lifting the muscles,
removing excess vaginal lining and reattaching the muscles.
‘It’s important, though, that patients have realistic
expectations; surgery will not make them a teenager again,’
explains Dr Moore. ‘We can’t over-tighten stretched vaginal
muscles as this can cause muscle cramps and spasms
during intercourse. This is where a senior surgeon’s
experience is essential.’
A labioplasty involves excising and sealing excess,
roughened tissue that can cause the labial folds to look
asymmetrical or stretched. According to Dr Moore, younger
patients usually opt for labioplasty alone to correct an
uneven appearance of the labial folds.
‘Essentially, labioplasty involves either removing a
roughened edge or reducing the edges of the labia minora
back to the same level as the labia majora, and often
reducing excess skin covering the clitoral hood.’
A labioplasty can also improve vaginal hygiene. ‘With
large labia, urine can become trapped, allowing bacteria
from the bowel to migrate and colonise in the urethra,’ Dr
Moore explains. ‘For many women, labioplasty surgery can
rectify this.’
G-spot augmentation
For women seeking to improve their sexual satisfaction,
G-spot augmentation offers a long-lasting solution.
The G-spot lies on the front wall of the vagina and can
cause significant pelvic floor contraction during orgasm.
‘G-spot augmentation usually involves a transurethral injection
of dermal filler into the middle layer of the vaginal wall to make
a G-spot orgasm more intense, which can be very liberating
for some women,’ says Dr Moore.
According to Dr Moore, there is one main limitation to
this surgery: the ability to experience a G-spot orgasm
needs to be developed beforehand as augmentation of the
area does not guarantee a G-spot orgasm.
As with any surgery, there are potential risks and
complications, but when performed by an appropriately
trained and skilled surgeon, the risks are minimal. csbm
108 www.cosbeauty.com.au

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ody
Arrived in
Australia –
The Isavela
compression
range
The Isavela compression range
is launching in Australia,
revolutionising post-surgical care
in a selection of comfortable,
functional and effective garments.
Caitlin Bishop reports.
After any cosmetic surgery, the importance of postoperative
care should not be overlooked. One way
to maximise comfort and improve healing after
surgery is to choose quality compression garments.
The Isavela range of compression garments, recently
launched in Australia, uses the latest technology to improve
comfort and hygiene and provide post-operative support
to the treated area. Distributed by Statina Healthcare, the
garments provide support, enhance comfort and boost
circulation following surgery.
The use of compression garments can go a long way in
expediting the recovery process. By increasing blood flow
to the treated area, compression garments are believed to
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ody
reduce swelling and bruising, and aid in accelerating and
normalising the healing process.
The Isavela brand was born in the US and prides itself
on remaining at the forefront of compression science. The
range includes everything from breast support to abdominal
binders. All Isavela garments are made with Naturexx fabric,
which regulates moisture to keep the wearer cool and
dry. The system is designed to evaporate body moisture
and prevent the production of bacteria during use – an
important factor in post-operative care. The fabric itself
is soft and smooth, designed to heighten comfort while
providing optimal, post-surgical support.
Surgical bras
There is an extensive range of Isavela bras suitable for
recovery from breast augmentation, reduction, mastopexy
and reconstruction. Particularly in breast augmentation,
compression garments are worn post-operatively to aid in
healing and help counter the risk of implant displacement.
By applying gentle and homogenous pressure to the skin
and underlying tissue directly following surgery, the implant
settles more quickly into the tissue pocket, and a smoother
result, without skin rippling, is more easily achieved.
Designed to provide support and lift, as well as
compression, the Isavela bras have no underwiring and
enhance body shape in comfortable functionality.
Body contouring
Following an abdominoplasty (tummy tuck) or liposuction,
compression garments or girdles are often worn to improve
blood circulation, reduce the risk of fluid accumulation and
accelerate healing. A compression garment also helps the
healing skin to drape more naturally over the body’s new,
slimmer contours.
Isavela has a range of mid- and full-body compression
garments, alongside a specialised line of abdominal binders.
Each compression garment is adjustable with straps, and
there are several design options, varying in length and
bust style. Notably, the material used in the abdominal
binders stretches in all directions to afford homogenised
compression while allowing the body to move naturally.
Facial wear
In recovering from face or neck surgery, compression is
again needed to regulate blood flow and accelerate the
healing process. However, the extent of movement in
the facial muscles, and the possibility of sudden, violent
movements – for example, sneezing and coughing – can
make compression difficult.
The Facial Compression and Chin Support garments
from Isavela are designed to minimise discomfort and
soften the impact of facial muscle movement. Some of
the designs have the option of a support strap around the
back of the neck or across the forehead, as well as differing
lengths of neck compression.
No matter what the line, the Isavela garments are elegant
in both design and style. With subtle seams, smooth
material and stylish cuts, wearers can enjoy the feel of their
reshaped body or breasts in outfits that complement and
enhance their figure.
Increasing comfort and kick-starting the healing process
is essential in those first weeks following surgery and, now,
with the newest compression range at Statina Healthcare,
comfort and functionality can be enjoyed more effectively
than ever before. csbm
Why are compression
garments necessary
after surgery?
• Increases blood circulation
• Reduces propensity of swelling and bruising
• Helps prevent fluid accumulation
• Helps prevent implant displacement
• Increases comfort post-operatively
Visit www.isavela.com.au for more information.
www.cosbeauty.com.au 111

teeth
Ultra-thin
porcelain
veneers:
preserving your
teeth & enhancing
your smile
SYDNEY AESTHETIC RECONSTRUCTIVE DENTIST DR SARKIS NALBANDIAN
EXPLAINS A MINIMALLY INVASIVE APPROACH TO TOOTH REJUVENATION IS
SOMETIMES THE BEST WAY TO BALANCE FACIAL AESTHETICS AND RESTORE A
BEAUTIFUL SMILE. CAITLIN BISHOP REPORTS.
In a personalised approach to smile rejuvenation, Sydney
aesthetic reconstructive dentist Dr Sarkis Nalbandian
uses minimally invasive techniques to preserve and
optimise the patient’s natural smile.
He believes taking a highly individualised approach
– considering the patient’s dental and facial aesthetic
parameters, alongside comfort and function – achieves the
best result in cosmetic dentistry.
‘Smile rejuvenation is all about the face, not just the
teeth,’ Dr Nalbandian explains. ‘It is of utmost important
to understand how smile design should complement the
patient’s facial aesthetics.’
Though Dr Nalbandian is experienced in using a variety
of methods for smile rejuvenation, he often recommends
ultra-thin porcelain veneers to achieve a signifi cant, though
minimally invasive, smile transformation.
These ultra-thin porcelain veneers are specially
designed by Dr Nalbandian and his technical team. They
can be sculptured to fi t each patient and are designed to
build upon, and preserve, the natural teeth. These can be
applied in Dr Nalbandian’s ‘one visit smile lift’ and cause
little disruption to natural tooth enamel.
‘Once tooth enamel is gone, it’s gone for good,’ he
explains. ‘Minimal intervention is key, as it is important to
preserve enamel and work with what nature gave us.’
Once tooth enamel is gone, it’s
gone for good – which is why
minimal intervention is key in
preserving tooth enamel
Importantly, treatment with ultra-thin porcelain veneers
can achieve immediate results and affords fl exible options
for future revision. ‘The beauty of this treatment is that
we can improve the patient’s smile while still keeping
their options open for future orthodontic realignment,’ Dr
Nalbandian explains.
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teeth
While veneers signify the faster route to
aesthetic smile rejuvenation, careful planning
is still required prior to the procedure. Dr
Nalbandian believes that digital smile design
software doesn’t reflect the patient’s true smile
and the way rejuvenation might impact the
patient’s speech, smile dynamics and comfort.
Instead, Dr Nalbandian works within the
mouth to accurately prepare the most suitable
treatment for each patient.
‘Smile design is an art form and I work within
the mouth directly to diagnose and plan the
best treatments for my patients,’ Dr Nalbandian
says. ‘The challenge is to create natural smiles
that complement the patient’s beauty and
facial aesthetic. This demands an individualised
approach, and cannot be digitalised.’
Ultra-thin porcelain
veneers can achieve a
beautiful result with minimal
tooth intervention
Before treatment, Dr Nalbandian takes
photographs of the patient from three angles
– front, oblique and profile – to establish the
most important aspects of their smile, and
evaluate the interplay between their lips, gums
and teeth.
Importantly, Dr Nalbandian recognises the
smile and facial aging go hand-in-hand. He
believes the impact of facial ageing and time
are important elements to consider in any
cosmetic dentistry.
Ultra-thin porcelain veneers can address the
gaps, chips, discolouring and misalignment
caused by age, certain foods and teeth
grinding. Dr Nalbandian explains the ‘one visit
smile lift’ can achieve effective results in both
beautifying and preserving the patient’s smile.
‘Patients of all ages can undergo this
treatment, providing there is correct diagnosis
and extensive planning prior to the procedure,’
he explains. ‘Ultra-thin veneers can create
beautiful, natural-looking smiles. After
treatment, patients often tell me “everyone
comments on how nice I look, but no one can
pin-point that my teeth have changed!”’ csbm
CASE STUDY
For suitable candidates, Dr Nalbandian performs the ‘One Visit Smile
Lift’ using ultra-thin porcelain veneers. Depending on the patient,
this approach could involve anything from tooth veneers and gum
contouring to teeth whitening and reshaping.
One such patient approached Dr Nalbandian after a long
history of limited success in using porcelain veneers to rejuvenate
her smile.
‘This particular patient was concerned about the colour and
shape of her teeth, as well as her smile arch and gum asymmetry,’
Dr Nalbandian explains. ‘She approached me after having had
a few cases of porcelain veneers placed and then ultimately removed
by another dentist.’
The patient was concerned that the veneers she’d had in the
past appeared artificial, and she did not wish to have people notice
she’d undergone cosmetic dentistry.
She approached Dr Nalbandian for a more individualised
rejuvenation, and the result was achieved in two treatment sessions
following thorough diagnostics.
‘An aesthetic result should imitate nature and, using ultrathin
porcelain veneers, we can achieve a beautiful, natural-looking
result,’ Dr Nalbandian concludes.
BEFORE
BEFORE
AFTER cosmetic dentistry by Dr Nalbandian
AFTER cosmetic dentistry by Dr Nalbandian
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teeth
Brighten your smile
The Smartbleach 3LT is a revolutionary teeth-whitening system designed
to brighten, rejuvenate and beautify your smile. Caitlin Bishop reports.
There’s nothing like a bright, white and healthy smile
for boosting self-confidence and refreshing our
appearance. Yet as we age – alongside those sweet
treats, black coffees and red wines – our smile can become
yellowed, marked and dull. Smartbleach 3LT signifies
the latest in teeth whitening technology in a non-laser,
photochemical whitening system.
Smartbleach 3LT, distributed by High Tech Laser, is
built on the same principles as the original Smartbleach
whitening system – where a photo-reactive gel is applied to
the teeth and exposed to light of a certain wavelength. The
reaction between the light and the gel breaks down stained
molecules on the teeth, homogenising colour and reducing
the appearance of discolouration.
Sydney cosmetic dentist Dr Mark Levi uses Smartbleach
at his clinic, and believes it affords more consistent results
with less discomfort than other systems.
‘In teeth whitening, it all comes down to the reaction
between the gel and the light source,’ Dr Levi explains.
‘Smartbleach 3LT optimises this reaction in a unique gellight
combination for more consistent and predictable
results with minimal discomfort.’
The system has been designed to effectively treat all
kinds of tooth stains, including tetracycline stains, which
can occur after taking antibiotics during childhood, when
the development of tooth structure is affected.
Queensland cosmetic dentist Dr David Cox uses
Smartbleach to treat a variety of teeth stains. ‘We treat
almost any type of tooth discolouration using Smartbleach,’
he says. ‘It can be effective in treating coffee marks, genetic
yellowing and even the more stubborn stains caused by
certain antibiotics.’
Smartbleach uses a unique
gel-light combination for
more predictable results with
minimal discomfort
Smartbleach uses a specialised alkaline gel for superior
whitening results. This delivers a high concentration of
oxygen radicals – which break down stains – without
damaging the enamel. Importantly, the reaction between
the light and gel is photochemical, not photothermal, as
seen in other systems. This protects the teeth against
thermal damage, as Dr Cox explains.
‘Photothermal reactions heat the tooth and there can
be damage to the nerve if overheated even by a few
degrees,’ he says. ‘Smartbleach 3LT uses a photochemical
reaction, which creates oxygen radicals with no associated
heat. There is also a photodynamic reaction to increase
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teeth
the concentration of oxygen radicals for more effective
teeth whitening.’
A treatment with Smartbleach 3LT takes under an
hour. Before treatment, the teeth are polished and buffed
in preparation. A coating is applied around the teeth to
protect the gums and no anaesthetic is needed.
One patient of Dr Levi, Sharon, recently had a tooth
whitening treatment with Smartbleach and was happily
surprised with the results. ‘I was very apprehensive about
getting my teeth whitened,’ she says. ‘I was doubtful if
it would work, as I had discoloured teeth from antibiotic
stains. I’ve just finished my second treatment, and am
extremely pleased with the results. I could see improvement
straightaway, which I didn’t think was possible! I went back
to my regular dentist and she was as surprised as I was.’
While Sharon opted to have two treatments, and is
considering a third, Dr Levi says one treatment is typically
sufficient to achieve an effective result.
‘In my experience, there is always an effective result
with Smartbleach, and one treatment is usually all that is
required,’ Dr Levi says. ‘In Sharon’s case, the results have
been amazing – my team and I are blown away.’
There is no downtime following treatment with
Smartbleach and results should be evident immediately.
Patients are encouraged to avoid deeply coloured foods
such as black coffee, red wine and tomato sauce for the
first 48 to 72 hours following treatment.
Dr Cox explains results will vary but can last up to several
years. ‘For intrinsic staining, which is inside the tooth as
opposed to on the surface, the results can last many years,
if not indefinitely,’ he says. ‘As for surface staining, the
results will depend on dietary habits but can last for years.’
‘The level of whitening varies between patients, but
I believe the Smartbleach system is in a class of its own
for treating the more stubborn discolourations,’ Dr Cox
concludes. csbm
1
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2
AFTER Smartbleach 3LT by Dr Levi
BEFORE
3
AFTER Smartbleach 3LT by Dr Levi
BEFORE
AFTER Smartbleach 3LT by Dr Levi
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face
Refresh
your
outlook
SYDNEY PLASTIC SURGEON
DR DARRYL HODGKINSON EXPLAINS
HIS APPROACH TO CREATING
REFRESHED AND NATURAL-LOOKING
RESULTS IN FACELIFT PROCEDURES.
CAITLIN BISHOP REPORTS.
While non-invasive methods for facial rejuvenation
can go a long way in bridging the path to
surgery, the results achieved in a surgical facelift
are superior in countering skin laxity, reducing wrinkles
and folds, and improving a tired-looking appearance. Yet
the decision to undergo surgery can be a big one, and
natural-looking results are a common concern for people
considering a facelift.
Sydney plastic surgeon Dr Darryl Hodgkinson has
more than 30 years’ experience in facelift surgery. With a
philosophy to leave his facelift patients looking and feeling
like themselves – only more youthful, refreshed and vibrant
– Dr Hodgkinson is skilled in a variety of facelift techniques
and takes an individualised approach with each patient.
One patient, Trish Riley, who has worked with Dr
Hodgkinson as a theatre sister for the past six years, has
recently undergone a facelift procedure by him.
‘It has been two months since surgery,’ says Trish. ‘I’m
very pleased with the results and the best thing is, people
don’t realise I’ve had it done. They look at me and say, “You’re
looking great” but can never pick what has changed.’
As part of the ageing process, fat pockets in the midcheeks
tend to loose volume and drop, leading to sagging
jowls. This is accompanied by shrinking of the facial skeleton
and a weakening in the skin’s structure, contributing to
wrinkles, deeps folds and a loss of skin resilience. A facelift
is a surgical procedure that elevates and re-drapes the
facial skin and its underlying structures to eliminate this
drooping effect.
In Trish’s case, she simply wanted her appearance
rejuvenated, something she believes is an important career
move. ‘I felt like I was beginning to look more and more like
my mother – not that there’s anything wrong with that! I just
felt my appearance needed refreshing,’ she says. ‘I think
keeping up appearances is important in order to stay in the
workforce for longer.’
In preparing for her surgery, Trish had consultations with
Dr Hodgkinson to address her areas of concern, establish
her expectations and discuss what results were possible.
Before the operation, pre-operative photographs were
taken and Trish was marked up for surgery.
During a face lifting procedure, incisions are made along
the hairline, or in the crease in front of and behind the ear, and
under the chin. Dr Hodgkinson typically combines a deep
plane facelift and neck lift, where the fat, muscles and skin
are re-suspended to create a more youthful-looking neck
and jaw contour. It is important that the skin is re-draped
gently across the newly sculpted tissue, to avoid any tension
at the incision sites and reduce the risk of scarring.
Two months after my facelift, I
know it’s one of the best things
I’ve ever done for myself
Post-operatively, facelift patients generally experience
swelling, mild bruising and some numbness. Trish found
her recovery to be more comfortable and less debilitating
than she expected.
‘I needed paracetamol in the fi rst fi ve days following the
operation. The fi rst 24-48 hours were very quiet; I couldn’t
move my mouth much and there was some discomfort and
tension around my cheeks,’ she explains. ‘I went back to
work 10 days after my operation. I was a bit swollen but
only had one minor bruise on my chin.’
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face
Now, two months after her operation, Trish is pleased with
the results and happy with her decision to undergo surgery:
‘My jaw line is more defined and the wrinkles in my neck are
reduced. Every day, as the swelling goes down, the results
keep getting better.’
Dr Hodgkinson takes a holistic approach when it comes
to facial rejuvenation and often combines procedures
such as a facelift, brow lift, neck lift, eyelid surgery, skin
resurfacing and cheek or chin implants to create the best
results possible for facial harmony and balance.
In taking an individualised approach, Dr Hodgkinson
works with each patient to determine their concerns and
establish the best way to achieve natural- and youthfullooking
results.
‘Because I’d worked with Dr Hodgkinson for six years,
I was confident in his expertise in creating a naturallooking
facelift,’ Trish explains. ‘I may not have considered
surgery if I hadn’t worked in the industry, but I’m so happy
I did because it’s one of the best things I’ve ever done for
myself.’ csbm
BEFORE
Two months AFTER facelift by Dr Hodgkinson
BEFORE
Two months AFTER facelift by Dr Hodgkinson
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face
Bespoke beauty
Sydney facial surgeon Dr Paul Gerarchi says an
individualised approach to facial rejuvenation is key to beautiful,
natural-looking results. Tara Casey reports.
Any facial surgery should enhance a person’s
features while maintaining their individuality. ‘I firmly
believe in adopting a tailored approach to facial
surgery, paying particular attention to the individual features
of each patient and their desired results,’ says Sydney facial
surgeon Dr Paul Gerarchi.
A key component in achieving natural-looking results is
to find a surgeon skilled and experienced in facial surgery.
Of equal importance is selecting a surgeon with whom
the patient feels comfortable discussing his or her issues,
expectations and desired outcomes.
‘Patients looking to undergo facial surgery – whether a
facelift, necklift or rhinoplasty – should feel they can talk
openly and honestly with their surgeon and confident they
can achieve the desired result,’ says Dr Gerarchi.
With age, the appearance of the face changes in three
key ways. First, the skin loses its elasticity and ligaments
lose their tone, causing the face to descend and sag.
‘The cheeks fall, deep nasolabial folds appear, jowling
and laxity in the neck occur, and fat begins to accumulate
under the chin,’ Dr Gerarchi explains. ‘The muscle in the
neck also starts to weaken, producing distinctive horizontal
(platysmal) bands.’
Second, facial volume starts to deplete with age, which
can be particularly evident in the cheek area and around
the chin.
‘I often combine a microfat fat transfer procedure with
a facelift in order to increase the volume of the cheeks
and other areas of the face that have become deficient,’
explains Dr Gerarchi.
Third, the quality of the skin itself deteriorates due
to intrinsic and extrinsic ageing. ‘To help iron out any
pigmentation, fine wrinkles and some of the deeper
wrinkles, a fractionated carbon dioxide laser can rejuvenate
the skin and help restore overall freshness to the face.
‘By paying attention to these three areas of the ageing
face, we can restore contours and angles of the face to
revitalise both the patient’s appearance and their selfconfidence,’
says Dr Gerarchi.
Facelift and necklift
Facial surgery deals with the intrinsic ageing that occurs in
the facial shape. By paying attention to the three areas of
the face – the skin, volume and face shape – we can restore
contours and angles of the face to revitalise the patient’s
appearance and confidence.’
Facial surgery can restore
contours and angles of the face to
revitalise the patient’s
appearance and confidence
All of Dr Gerarchi’s face- and necklifting techniques
involve repositioning the superficial musculoaponeurotic
system (SMAS) and deeper plane. ‘In order to achieve
a natural-looking result, it’s important to resuspend the
structures beneath the skin, and then just allow the skin to
re-drape in a non-tensioned fashion over the re-elevated
and rejuvenated deeper structures of the face,’ Dr Gerarchi
explains.
The SMAS technique concentrates on the underlying
connective tissue and muscle layer of the facial anatomy
known as the superficial musculoaponeurotic system. By
tightening this foundational tissue before repositioning
and removing excess skin, the shape of the face can be
improved without creating noticeable tension.
The neck is another area that often betrays an aged
appearance. ‘Over time, the jaw loses definition and fat
accumulates under the chin,’ Dr Gerarchi explains. ‘The
skin loosens and the angle between the chin and the throat
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face
can no longer be seen well. The neck may also develop
prominent bands as the platysma weakens.’
Dr Gerarchi tailors his approach to necklifting depending
on the exact concerns of each patient, such as the degree
of laxity, skin excess and extent of fatty tissue, as well as
any other concerns they may have. He targets the deeper
SMAS, as well as tightens the muscles at the anterior part
of the front of the neck. ‘Tissue and skin are elevated to
a more youthful position. Resultant scars are usually
inconspicuous and fade significantly over time. Importantly,
the effect achieved with comprehensive necklift surgery is
long lasting,’ he says.
1
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AFTER face, neck and mid-face lift by Dr Gerarchi
2
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AFTER facelift, necklift and fat transfer by Dr Gerarchi
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face
Rhinoplasty
‘Creating a nose that is suited to each patient comes down
to three steps: knowing the limitations of what can be
achieved in that patient whilst still achieving an excellent
outcome; really listening to a patient’s desires; and by using
computer imaging to help the patient visualise how their
appearance will change,’ Dr Gerarchi explains.
To achieve optimal results that are in proportion with
the patient’s other facial features, Dr Gerarchi believes
a heightened aesthetic sensibility is essential. ‘I also use
digital imaging to show how the nose will most likely look
after surgery, which helps the patient and surgeon to
discuss (and see) what’s achievable,’ he adds.
Dr Gerarchi performs the majority of his rhinoplasty
procedures using the open technique: ‘Because the inner
structures of the nose are exposed, the surgeon has
greater visibility than with closed rhinoplasty, and is able to
work with more precision and freedom. Open rhinoplasty is
therefore often chosen for more complicated cases, where
considerable work may be required in order to achieve the
desired outcome.’
‘The open technique is all about longevity and preserving
the appearance and structure of the nose for the longer
term,’ Dr Gerarchi concludes. csbm
3
BEFORE
AFTER revision rhinoplasty by Dr Gerarchi
4
BEFORE
AFTER rhinoplasty by Dr Gerarchi
120 www.cosbeauty.com.au

FACE & NECK LIFTS.
RHINOPLASTY.
EYELID SURGERY.
Dr Paul Gerarchi
FACIAL AESTHETIC SURGEON
EXPERIENCE & QUALITY
The Face Institute
Phone 02 9412 4599
Suite 4, 12 -14 Malvern Avenue
Chatswood NSW 2067
www.thefaceinstitute.com.au

face
in
profile
Sydney plastic surgeon
Dr Warwick Nettle explains how
nose reconstruction improved
both the appearance and
function of this patient’s nose.
AimÉe Surtenich reports.
Nose reconstruction can do more than change a
person’s look – it can also change their outlook.
When someone has lived with a nose they don’t
feel comfortable with, have chronic difficulty breathing or
have a nose that doesn’t fit their personality, rhinoplasty can
significantly boost a person’s self-esteem.
‘An abnormally shaped nose can affect a person
psychologically,’ says Sydney plastic surgeon Dr Warwick
Nettle. ‘Often this can go beyond simply feeling insecure
about your looks and stem from a lifetime of experiences
and adverse reactions from other people.’
In this case study, for example, the patient felt his ‘boxerlike’
nose belied his true personality. Having suffered trauma
to his nose at seven years old, he had become used to
people making false assumptions about him based on his
appearance. This was a particular concern to him as a
customer service representative.
‘The flattened appearance of his nose was further
accentuated by a very prominent chin, which he was teased
about throughout his youth,’ says Dr Nettle.
Additionally, due to the structural problems of his nose
and resultant blockages, the patient had difficulty breathing.
He wanted a dual outcome: to be able to breathe normally,
and to have a more proportionate nose and chin to achieve
a more pleasing overall facial aesthetic.
Appearance and function
Cosmetically, injury to this patient’s nose as a child and
numerous nasal reconstructions prior to visiting Dr Nettle
had left him with a misshapen and ‘smashed-in’ nose.
Functionally, there was a significant deformity of the
internal nose – including the bridge, nasal cartilage and
airway – which made breathing through the nose difficult.
‘Nose reconstruction is as much about improving a
patient’s breathing and functionality of the nose as it is
about creating a more balanced facial aesthetic,’ says Dr
Nettle. ‘In this case, revision rhinoplasty was necessary to
make both functional and cosmetic changes to correct the
outcomes of his previous surgeries.’
The procedure is more complicated than primary
rhinoplasty, and patients should choose a surgeon who
has extensive experience in revisions. ‘This is inherently
a difficult procedure, striving for the complex interrelationships
between structure and breathing functionality
and proportion and shape to create facial balance and
harmony,’ he says.
The exact procedure will vary from one patient to
the next, and the issues that need to be corrected will
vary. Some people require minor touch-ups, while other
cases are more complicated and involve deformities of
the underlying bones and cartilages, as was the case for
this patient.
‘In revision rhinoplasty, the nose generally needs to
either be built up or shaved down,’ Dr Nettle explains.
‘More often than not, as in this patient’s case, it needs to be
built up as excessive tissue has been removed.’
If this occurs, it’s preferable to use the patient’s own
material, ideally taken from the septum (midline cartilage in
the nose) as it is the most malleable. However, if it has been
removed in the primary rhinoplasty, ear cartilage and even
synthetic materials can also be used.
In this case study, Dr Nettle performed an open
rhinoplasty (where the incision is made at the base of the
columnella) to completely reconstruct the bridge, cartilage
and airway. He used the patient’s septal cartilage as a type
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face
of scaffolding to give structure and strength to the nose, as
well as ear cartilage to improve the nasal tip.
‘Open rhinoplasty involves carefully working with the
inner structure of the nose. This commonly involves
straightening the septum, reducing the size of the turbinates
(the small bones which control and humidify airflow) and
valves without affecting how the patient breathes or, in
cases where the function of the nose was an initial concern,
enhancing their breathing ability,’ he explains. ‘I perform the
majority of my nose surgeries using the “open” technique.
I believe it affords greater control when manipulating the
underlying bones and cartilages, as well as better longer
term results.’
In the same surgery, Dr Nettle also reduced the size of
this man’s chin to create a more balanced appearance. ‘In
a lot of cases, we build up the chin using a chin implant to
make a large nose look smaller, but in this case we wanted
to create the opposite effect. Through an incision made in
the natural crease of the chin, I removed excess soft tissue,
muscle and fat to slim down his prominent chin and make
his nose appear larger.’
The procedure was performed under general anaesthetic,
lasting around three-and-a-half hours. The patient stayed
overnight and went home with a splint on his nose, which
he wore for about five days. Stitches were removed on day
six and he returned to work within two weeks.
Dr Nettle said his patient is extremely happy with his
results: ‘He feels like the shape of his nose no longer
dominates his appearance and he can finally breathe
properly! It really has offered him a new lease on life.’
‘Importantly, the aesthetics of the face aren’t dependent
on one or two facial features; it’s about how these features
complement and enhance each other, as well as the
patient’s personality. By reconstructing this patient’s nose
and reducing the size of his chin, we were able to create
better facial harmony, which is one of the most important
and fulfilling aspects of any face surgery procedure,’ Dr
Nettle concludes. csbm
BEFORE
AFTER revision rhinoplasty and chin reduction surgery by Dr Nettle
BEFORE
AFTER revision rhinoplasty and chin reduction surgery by Dr Nettle
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face
let’s
hear it
for the
boys
Skin Clinic@Blyss offers a
range of targeted treatments to
rejuvenate the male complexion.
Caitlin Bishop reports.
Keeping up appearances and warding off the signs of
ageing can be important for a number of reasons,
not least the confidence that comes with looking as
young, healthy and vibrant as you feel.
But it’s not just the domain of women. As cosmetic
treatments continually move from marginal to mainstream,
more and more men are seeking ‘a little help’ to hold back
the signs of ageing and stay competitive in the workforce
for longer, among other reasons. According to statistics
from the American Society of Plastic Surgeons, the number
of cosmetic procedures performed on men has increased
more than 106 percent over the past 15 years, with similar
trends seen here in Australia.
Skin Clinic@Blyss, located in Clovelly, in Sydney’s
Eastern Suburbs, has heeded the rise in male cosmetic
procedures by recently introducing ‘Man Time’, a timeslot
solely dedicated to treating males with a range of
specialised skin rejuvenation techniques.
‘We’ve implemented “Man time” at Blyss to change the
feel of what is traditionally seen as a female domain,’ says
Jodie King, who established Skin Clinic@Blyss15 years
ago. ‘Some common male concerns include blackheads
or congestion of the skin, shaving rashes or irritations,
and acne, which is often more severe in men due to their
higher levels of testosterone.’
The differences between male and female skin call for
a different approach to skin therapy and rejuvenation. The
practitioners at Skin Clinic@Blyss are expertly trained in
providing the best treatment for individual skin types.
‘Men have an oilier and thicker skin (up to 25 percent
thicker) than women, therefore it can be much more robust,’
King explains. ‘Also, as men are constantly shaving and are
less likely to protect their skin with sunblock or hydrating
products, a different treatment approach is needed to gain
the best results.’
Non-invasive treatments, which incur minimal or no
down time, are popular options for men hoping to boost
skin health and combat signs of premature ageing. For
example, microhydrabrasion – a two-part exfoliation
technique – is effective in cleansing and unclogging the
124 www.cosbeauty.com.au

skin, while certain light therapies, such as LED or Intense
Pulsed Light (IPL), stimulate cellular activity in the dermis to
improve the appearance of photoaged skin.
‘The male skin responds very well to any resurfacing
treatments, unclogging pores and brightening the skin,’
King explains. ‘Most people these days, including men, do
not want downtime following a treatment. For this reason,
microhydrabrasion is one of our biggest male procedures
as well as LED treatments and IPL for treating vascular
lesions, pigmentation, rosacea and large pores’
As is evident in the ‘Man Time’ innovation, the practitioners
at Skin Clinic@Blyss understand the importance of
discretion when dealing in cosmetic procedures. King
says the therapists aim for a ‘fresh, not frozen’ look and
are experienced in using anti-wrinkle injections, platelet rich
plasma (PRP), IPL therapy and chemical peels to achieve
effective, but natural-looking, results.
We have recently implemented
‘Man time’ at the clinic, to change
the feel of what is traditionally
seen as a female domain
‘When performing anti-wrinkle injections, we prefer to
use smaller amounts of product so the patient’s expression
is not restricted,’ King explains. ‘Treatment with PRP is
another viable option for improving tone and texture by
utilising the body’s natural cells. PRP is an extract of growth
factors from the patients’ own blood and is injected to
regenerate skin at a cellular level.’
Notably, the team at Skin Clinic@Blyss takes a holistic
approach to skin rejuvenation. With each treatment, advice
on optimising results through home care and possible
lifestyle measures ensures each patient gains the utmost
from their in-clinic procedure.
‘As well as a balanced diet, reducing alcohol consumption
and quitting smoking, we recommend each client has a
strong skincare
pure
regimen, which includes
blyss
a good quality
physical sunblock, antioxidants and Vitamin A,’ King says.
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Put your best
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• ionzyme treatments
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TreaT DaD This
FaTher’s Day To The
King For a Day ‘Man

feature face
great
skin at
any age
Sydney facial plastic surgeon
Dr William Mooney shares his
‘layer cake approach’ to skin
radiance and facial rejuvenation.
AimÉe Surtenich reports.
Face Plus Medispa by Sydney facial plastic surgeon
Dr William Mooney offers a bespoke selection of
the latest anti-ageing, skincare and facial aesthetic
treatments. It’s a serene, modern and luxurious haven for
those looking to achieve the ultimate in skin health and
beauty – with natural-looking results that enhance, not
change, your individual look.
‘Whether it’s good quality skincare, laser skin resurfacing,
injectables or medical-grade facials, my philosophy to
achieving the best possible results involves what I refer to
as ‘the layer cake’ approach. In my experience, smaller,
incremental changes that target different layers of the
skin yield the most satisfying and natural-looking results,’
says Dr Mooney.
‘Subtlety is key. ‘Natural” is always going to be more
attractive than looking artificial or “too done”,’ he continues.
‘By addressing the skin in layers, much like the cake
metaphor, we can correct areas of concern and get the skin
looking and functioning its best – for many years to come.’
At Face Plus, Dr Mooney and his team of qualified
nurses and aestheticians tailor an innovative treatment
menu according to each client’s needs. ‘We offer a free
skin assessment, whereby we discuss the current state
of the patient’s skin, their areas of concern, the aesthetic
treatments most appropriate for them, as well as their
lifestyle habits.’
‘Importantly, not everything has to be done at once;
patients can pick and choose from their customised
menu the treatments or skincare products they wish to
use according to their wishes and budgets. We draw up a
Dr Mooney’s top 3 tips
when visiting a medispa
1. Go somewhere reputable, with a highly skilled
and experienced team that offers the whole
suite of cutting-edge, evidence-based aesthetic
treatments and results-driven skincare.
2. Aim for a natural look – smaller incremental
changes are paramount to achieving this.
3. Do something that’s within your budget – stress
and worry are some of the biggest premature
agers around, so make sure your treatment plan
is within your means.
longer term treatment and skincare plan for them – what’s
right for them in their 20s and 30s won’t necessarily be as
effective in their 40s and 50s.’
According to Dr Mooney, the benefits of a long-term
anti-ageing skincare plan, incorporating smaller changes
into a person’s beauty regimen now, can help avoid the
need for invasive cosmetic surgery and lengthy downtimes
further down the track, while also allowing them to retain
their natural look and individuality.
‘The concept of waiting until gravity and the ageing
process have really taken hold is antiquated. Now, with
such advances in skincare and non-surgical treatments, we
can help turn back the clock on ageing, sun-damaged skin
126 www.cosbeauty.com.au

feature face
so that each client looks good for their age in their 30s, 40s,
50s and beyond,’ he says.
The first step, says Dr Mooney, is to repair and optimise
the skin itself. ‘There’s no doubt that Australia has a beachloving
culture – but unfortunately all those years spent
baking in the sun become evident more and more over
time,’ he explains. ‘Sun-damage is the number-one culprit
of poor skin quality, especially among those 40 and older.
So, using the layer cake analogy, we first optimise the
surface of the skin to fix solar damage and improve nonuniform
skin, pigmentation, redness and dyschromia. Then
we start looking at correcting the deeper skin layers.’
‘Whether you’re in your 20s or 50s, we always start with
a skincare plan targeted to your particular needs, severity
of skin ageing and skin type. This always includes a good
quality broad-spectrum sunblock to help prevent further
damage,’ says Dr Mooney.
skin care In your 20s
In your 20s, incorporating nourishing facials, such as the
Dr. Spiller Biocosmetics Enzyme Facial, into a skin treatment
program is beneficial to help even skin tone and texture,
improve acne and acne scarring, and enhance the overall
health and look of the skin.
skin care in your 30s
‘In your 30s, it may be appropriate to start alternating facials
with laser skin rejuvenation,’ says Dr Mooney. ‘Face Plus
offers the Laser Genesis, a non-ablative laser that resurfaces
the skin and stimulates new collagen production. Not only
does it improve the general appearance of your skin but
it also reduces pore size and blackheads, targets active
acne, tightens skin, diminishes the appearance of scars
and reduces rosacea. Many people in this age bracket also
start to consider subtle use of injectables to minimise fine
lines and wrinkles.’
skin care in your 40s+
In this decade and beyond, the signs of ageing can really
begin to manifest. Loss of volume, skin laxity and deeper
lines and wrinkles on the face all become more noticeable.
With ageing, fat pads diminish in the face and can cause
hollowing in the cheeks, and a sunken or gaunt look.
Dr Mooney explains there are many innovative nonsurgical
treatments that can achieve significant results that
replace lost volume and turn back the clock.
‘In addition to the Laser Genesis, the Titan skin tightening
laser targets the deeper layers of the skin to tighten, tone
and lift sagging, loose skin without surgery, while also
improving the condition of the skin and minimising fine lines
and wrinkles,’ he says.
Platelet-rich plasma (PRP) therapy is another modality
the medispa offers. This is a treatment that harnesses the
patient’s own blood platele ts to stimulate new cell growth.
Extracted from the patient’s blood, platelet rich plasma
contains high concentrations of growth factors, which
are bioactive stimulators known to accelerate the natural
healing process. Injected into areas such as the face and
décolletage, PRP activates the skin’s stem cells, enhancing
the formation of new collagen at the site. The result is a
natural rejuvenation from the inside out that continues to
improve over time.
‘With PRP, we are enhancing the structure and integrity
of the skin from within,’ Dr Mooney explains. ‘Once we
have the optimised foundation for the skin, we may look at
addressing specific areas with fillers and muscle relaxants.
I find, though, after other skin rejuvenation techniques have
been employed such as PRP or laser therapy, a much
smaller amount of injectables is required to achieve the
best result.’
‘Judicious use of injectable fillers can replace the
volume that has been lost – nothing more, nothing
less – we want you to look like “you”, just years younger,’
he continues.
With a ‘less is more’ philosophy, Dr Mooney believes
the key to achieving – and maintaining – a youthful- and
natural-looking appearance is offering subtle, incremental
treatments tailored to each individual. csbm
www.cosbeauty.com.au 127

face
Building
beauty
from
within
Sculptra is a deep facial
injectable designed to fortify
facial structure and stimulate
collagen production in the
dermis. Caitlin Bishop reports.
As we age, the natural production of collagen slows,
resulting in a loss in volume and an increase in
skin laxity. By stimulating the production of dermal
collagen, and rebuilding the facial foundations, Sculptra
from iNova can regenerate the skin and refine facial
contours for a natural-looking, more youthful result.
Sculptra, which is a deep facial injectable, targets
the underlying causes of ageing in redefining the facial
structure and stimulating the production of new
collagen in the skin. Dr Kate Howsan from Queensland
explains this two-fold effect can achieve effective results
in facial rejuvenation.
‘I believe Sculptra is the most potent collagen
stimulator we have,’ says Dr Howsan. ‘As we age, there is
a loss in the facial skeleton and deep fat. Sculptra is
effective in replacing this, to create a more youthful version
of the facial structure.’
Sculptra Aesthetic is made from poly-L-lactic acid,
which is biocompatible and biodegradable. Dr Howsan
128 www.cosbeauty.com.au

face
injects Sculptra deeply on to the bone, and explains the
product can be used on all areas of the face.
‘The results are outstanding because Sculptra can be
injected so deeply; the product communicates with the
skin to produce collagen and create a youthful looking
glow,’ she continues. ‘It really is a global, whole face
treatment. I divide the face into upper, middle and lower
thirds to decide which areas need the most attention.’
As Sculptra settles into the tissue and begins to stimulate
the production of new collagen – or neocollagenesis – in the
dermis, the foundation of the face is fortified. This restores
volume and gradually counters the appearance of shallow
and deep facial wrinkles on the skin’s surface.
I believe Sculptra is the most
potent collagen stimulator we
have; it regenerates skin and
fortifies the facial structure
‘Because Sculptra builds upon the natural facial
foundations, it is applicable to a wide variety of cases,’
Dr Howsan explains. ‘The skeletal and deep fat reduction
associated with ageing begins in the late 20s, though, due
to skin resilience and elasticity, the effects are generally not
seen until a decade later. I advise we begin to rebuild the
facial structure before the loss is even noticed. Optimum
results are usually seen in patients between 30 and 50
years of age.’
The amount of treatments needed varies between
patients, and is typically dependent on age. Dr Howsan
commonly recommends between five and seven vials of
product per patient, which would be administered over three
to four treatments, around six weeks apart.
During treatment, topical anaesthetic is applied
before injection, though Dr Howsan explains the
level of discomfort is not severe.
‘Topical anaesthetic helps psychologically,
but I don’t think it has too much effect on
the level of discomfort, simply because the
injections are so deep,’ Dr Howsan explains.
‘In my experience, the treatment feels more like
an ache, it isn’t a sharp pain; it just feels like a
little bit of pressure applied to the bone.’
Following treatment, patients generally
experience some swelling – which usually gives
BEFORE
an indication of the final result, as the swelling
mirrors the pattern of the deeper injections.
Some redness, bruising and numbness can be expected
post-procedure, but Dr Howsan explains the downtime is
typically minimal. ‘Because the injections are administered
so deeply, I find bruising is quite rare after Sculptra,’ she
says. ‘Some people can experience slight numbness but
most patients can return to work straight after treatment.’
The volumising, regenerative and refining effect
takes time to appear following treatment with Sculptra.
Neocollagenesis typically takes around 12 weeks to occur,
and patients can expect results to continue to improve in
the four to five months after the procedure.
Results typically last up to two years, and Dr Howsan
generally recommends re-treatment after 15 to 18 months.
In a more thorough approach to facial rejuvenation,
Sculptra can be used alongside other procedures for a
more universal result.
‘I often use Sculptra in association with other modalities,’
Dr Howsan says. ‘Sculptra cannot be used in the lip,
so I may use filler to plump the lips. Similarly, not much
Sculptra is used on the forehead so I will use fillers and
anti-wrinkle injections to counter fine surface lines in this
area. It is important to balance all aspects of the face, so
I commonly use a combination of injectables to achieve a
natural-looking, all-encompassing result.’
Sculptra simulates the body’s natural regenerative
response and reforms a more youthful facial support
structure. It replaces lost collagen to boost skin integrity and
resilience, while also recreating more aesthetic contours.
‘I like to explain it to my patients as a table and tablecloth
effect,’ Dr Howsan says. ‘The skeletal structure and
deep fatty tissue represent the table, and these elements
determine the state of the tablecloth. Using Sculptra,
the table is fortified and the tablecloth is refreshed and
rejuvenated also, in an all-encompassing and long-lasting,
anti-ageing effect.’ csbm
25 months AFTER Sculptra treatment (5 vials)
Photos courtesy of iNova. Individual results may
vary. Photos untouched.
www.cosbeauty.com.au 129

face
The skin revolution
One pATIent shares how treatment with Infini helped improve her skin
tone and texture, counter skin laxity and refine facial contours.
Caitlin Bishop reports.
As the quality of collagen in the dermis deteriorates
with age, the resilience and integrity of the skin’s
support structure declines also, leading to volume
loss, skin laxity and facial folds and wrinkles.
Seeking a solution to combat this process, Desi
approached the Australian Skin Face Body clinic in Geelong.
After an extensive consultation she was recommended
a new procedure, designed to leave the skin refreshed,
smoothed and volumised.
The Infini from Lutronic is new to Australian shores and
signifies the world’s first dual-mode fractional radiofrequency
(RF) platform, delivering both microneedling fractional RF
and superficial fractional RF.
‘My major concern was that, over time, I had begun to
lose volume from the fat pads in my face, which left me
with an aged appearance,’ says Desi. ‘Because Infini has
two modes, it grants rejuvenation both inside and out. I
therefore hoped it would improve both the contour of my
face and the texture of my skin.’
Infini is unique in its approach to treating both the
superficial and deeper layers of the skin. It combines
microneedling fractional radiofrequency (MFR) and
superficial fractional radiofrequency (SFR) to create a
stronger skin structure, and a firmer and more youthfullooking
complexion.
MFR uses insulated microneedles to deliver RF energy
to the dermis (the connective tissue layer of the skin located
below the epidermis). This causes controlled areas of
coagulation, or tissue shrinkage, and triggers the body’s
natural healing response, promoting collagen production
without damaging the skin’s superficial layers.
Complementing this, the SFR technology delivers
thermal energy via two channels to penetrate both the
epidermis and the dermis. SFR also provides micro ablation
on the skin’s upper layers, to illuminate the complexion and
homogenise skin texture.
By combining radiofrequency energies, at different levels
in the skin, a thorough and effective regeneration can be
130 www.cosbeauty.com.au

face
achieved. This is complemented by the use of microneedles
in MFR, as microneedling, even without radiofrequency
technology, can stimulate collagen production in the dermis
and improve skin tone, structure and texture. In this unique
amalgamation of technologies and delivery levels, Infini
affords a 3-D facial rejuvenation.
‘Infini treatments commonly address wrinkles, facial
and neck skin quality, and acne scars, though it’s also
been tested on stretch marks and skin laxity,’ says Dr
Calderhead, director of scientific affairs at Lutronic. ‘Infini
Two to three weeks after one
Infini treatment I saw a
tightening and firming of my
skin and overall rejuvenation
is not the answer to everything, however it I believe it is a
bridge between non-surgical and surgical procedures.’
During treatment, multiple passes of the Infini are
performed to target different levels in the skin and address
the patient’s skin complaints. More aggressive parameters
are used on areas of concern – for example to refine the jaw
line or combat wrinkles on the forehead.
‘Before treatment, a dermal therapist examined my skin
and I explained the areas I really wanted to improve,’ Desi
says. ‘Going into treatment, my face was cleansed, dried
and I was given high-grade, topical anaesthetic. This was
left on for 45 minutes underneath a coating of cling wrap,
which was removed just before the treatment began. The
practitioner then methodically treated sections of my face,
using more aggressive settings on those areas I was most
concerned about.’
Similarly, the parameters are adjusted according to
the depth of targeted tissue. It is important to use lower
parameters on the skin’s superficial layers, to avoid
damaging the epidermis, while higher energy is used to
trigger a healing response in the deeper dermal layer.
‘In the first pass, the needle depth could be anywhere
between 0.5 and 3.5mm,’ Dr Calderhead explains.
‘Typically, females have 2 to 2.5mm of facial skin, so we
would normally start at 2mm for the cheeks and 1.5mm for
areas over bony tissue. After the first pass, the physician
will go to the next depth, which might be 1mm deep, and
use slightly lower parameters.’
Patients can generally expect some swelling, redness
and sensitivity in the days following treatment. In some
cases, Infini will induce mild bruising – particularly under
the eyes.
Dr Calderhead recommends some aftercare following
the procedure, to optimise results and assist in healing.
‘The tiny microneedle wounds should heal within 12
hours, so the patient can go home and gently wash at
night before giving themselves a thorough wash the
following day,’ Dr Calderhead says. ‘We discourage
patients from using aggressive cleansers or any products
containing powerful scrubbing agents for a couple of weeks
following treatment.’
As with most non-invasive therapies, multiple
treatments are generally required to achieve the desired
outcome. Typically, two treatments, four weeks apart, are
recommended for optimal results, though patients will often
select to undergo more treatments to further enhance results.
According to Dr Calderhead, new collagen fibres begin
to form around four weeks after treatment and results from
Infini should be evident within 10 weeks.
Desi chose to undergo four treatments with Infini
and now, as the results of new collagen production and
remodelling become clear, she is more than satisfied with
the results.
‘Even after one Infini treatment, I noticed a difference in
my complexion,’ she says. ‘After two to three weeks I saw
a tightening and firming of my skin. I’ve found it to be a
fantastic treatment for overall facial rejuvenation.’ csbm
BEFORE
BEFORE
BEFORE
AFTER acne scar treatment with Infini.
Courtesy of S. Savant, MD, India
AFTER scar revision with Infini. Courtesy of
Devrim Gursoy, MD, Turkey
AFTER skin laxity treatment with Infini.
Courtesy of Devrim Gursoy, MD, Turkey
www.cosbeauty.com.au 131

Introducing
INFINI
Sydney plastic surgeon Dr Darryl Hodgkinson says the non-surgical
Infini treatment uses breakthrough technology to deliver amazing
results for all skin types.
Infini is a non-surgical, minimally invasive treatment to
induce skin tightening, skin remodelling, as well as collagen
and elastin stimulation for optimal skin rejuvenation.
Recently introduced to Australia – and currently only
available in NSW at the Cosmetic and Restorative Surgery
Clinic – Infini from Lutronic is the world’s first 2-in-1 fractional
radiofrequency (RF) platform, capable of delivering both
microneedling fractional RF and superficial fractional RF.
In my experience, what makes INFINI different to other
fractional radiofrequency systems is that it provides complete
control over treatment depth and energy levels to enable a
multi-layered treatment approach with no electrothermal
damage to the skin, making it a treatment that can be used
year round as opposed to some treatments which are best
avoided in the summer months.
Infini’s two handpieces allow for the delivery of the RF
energy to be precisely targeted and controlled into a specific
layer of the dermis up to 3.5mm in depth. csbm
One machine, two treatments
Infini MFR. Micro needling fractional radiofrequency
(MFR) has fine needles which puncture the skin
to deliver the radiofrequency to the deeper levels
of the dermis, providing a 3-D delivery of energy
to maximise skin volumisation while dramatically
tightening and rejuvenating the skin.
Infini SFR. Superficial fractional radiofrequency
(SFR) employs a minimally invasive delivery of
radiofrequency to the epidermis and dermis for
resurfacing the skin and stimulating the production of
collagen for more toned and refined skin.
By combining both technologies, Infini targets the
superficial and deeper layers of the skin and can be
tailored to address a variety of skin concerns.
Infini treatment can
be used for:
• Photoaged skin
• Skin rejuvenation
• Skin tightening and lifting
• Skin laxity
• Large pores
• Active inflammatory acne
• Acne scars
• Excessive sebum secretion
BEFORE
AFTER treatment with Infini
(photo courtesy of Franco Lauro, MD, Italy)
132 www.cosbeauty.com.au

face
Energise
your skin
Healite II from Lutronic
can rejuvenate the skin and
accelerate healing after more
invasive procedures. Caitlin
Bishop reports.
Healite II is a therapeutic system that boosts skin
health, heightens cellular activity, increases blood
flow and stimulates collagen production in the
dermis. It calls upon light energy to kick-start cellular
processes in the skin and underlying tissue. It is effective in
facial rejuvenation and commonly used to optimise healing
following more invasive procedures.
The system, by medical device company Lutronic and
distributed by Allure Medical Group, harnesses light energy
at a certain wavelength to stimulate cellular activity and
enhance microcirculation. Blood, oxygen and nutrients
flood the treatment area, increasing cellular activity for a
non-ablative, and painless, skin rejuvenation. Healite II is
used to help treat active acne, reduce the appearance of
wrinkles, scarring and photoageing, and improve skin tone,
texture and luminosity.
134 www.cosbeauty.com.au

face
Treatment
Rejuvenation with Healite II uses both yellow and infrared
light. The yellow light, at 590nm, is designed to ‘precondition’
the tissue before treatment with infrared, at 830nm. This
‘preconditioning’ enhances dermal responsiveness and
maximises treatment effi cacy.
During treatment, the fi rst minute involves only yellow
light, which targets the epidermis. Following this, infrared
is introduced to afford deeper penetration. Total treatment
time with Healite II is 11 minutes.
‘Yellow light is delivered at a low intensity and low dose
to activate cells in the epidermis,’ explains Dr
Glen Calderhead, director of scientifi c affairs
at Lutronic. ‘We aim for keratinocytes and
merkel cells, as both of these are highly
endowed with mitochondria – which release energy.
Following this, the infrared at 830nm is introduced. This
penetrates the deeper dermis and beyond.’
Healite II uses a system called ‘optical lens array
technology’ to concentrate the light energy and achieve
faster, effective and consistent results.
‘Optical lens array technology allows us to achieve the
optimum level for tissue regeneration, which is 60 joules
per square centimetre, more quickly,’ Dr Calderhead says.
‘Studies have shown greater light concentration, over a
shorter time period, induces a signifi cantly higher increase
in cell activity compared with other systems. Eleven
minutes with Healite II, compared with 20 minutes with
another system, is good for the patient and for the doctor.’
Healing benefits
Because Healite II is considered a therapeutic and healing
treatment, it is commonly used following more invasive
procedures such as laser treatment or cosmetic surgery.
It assists in reducing post-procedure bruising, swelling and
redness and can help prevent scar formation. Because of
its regenerative properties, Healite II can help maximise
results and minimise recovery time after certain procedures.
Yet the benefi t of Healite doesn’t end at the treatment
site. Dr Calderhead explains Healite II has a systemic effect
that can impact the body as a whole.
‘Healite II incurs a larger systemic effect due to blood
fl ow,’ Dr Calderhead says. ‘During treatment, all sorts of
interesting photoproducts, such as growth factors, are
produced. These get picked up in the blood and carried
throughout the body. Patients leave a treatment feeling
revitalised and relaxed.’
About Healite II
Non-invasive Low-Level Light
Therapy
Skin rejuvenating treatment
Powerful enough to penetrate the
dermis and beyond
Works at a subcellular, cellular and
tissue level
Can be used alone or as an
adjunct to therapy such as PDT
Can help in wound healing, hair
regrowth, facial rejuvenation and
treating active acne
Long-term results
Arguably, one of the most remarkable results of treatment
with Healite II is the way it boosts the body’s natural
reservoirs of anti-ageing constituents. When it targets
fi broblasts (which produce collagen and elastin), Healite
II doesn’t just improve skin structure but also boosts the
reservoir of collagen-producing stem cells. Similarly, the
infrared light triggers the release of antioxidants in the
dermis, which provide protection against UV stress.
‘When the infrared light hits mast cells in the dermis, they
release a product called Superoxide dismutase (SOD),’ Dr
Calderhead says. ‘This is a super antioxidant that remains
in the tissue for up to six months. The minute you’re
exposed to some UV oxidative stress, the damaging effect
is quenched because the SODs are waiting.’
Treatment with Healite improves skin radiance and
fuels the body with energising cellular activity. By targeting
the body’s natural regenerative processes, Healite II
enhances skin structure, texture and resilience. ‘Healite II
improves skin health, stimulates collagen production and
increases cellular activity. The great thing is; the skin is
doing it naturally, Healite II just accelerates the process,’ Dr
Calderhead concludes. csbm
For more information visit alluremedical.com.au
www.cosbeauty.com.au 135

face
Face
of the
future
The Angel Lift uses your own cells
to restore volume and revitalise skin.
AimÉe Surtenich reports.
Used in medical applications the world over for tissue
rejuvenation, sports medicine and advanced wound
care, platelet-rich plasma (PRP) treatment such as
the Angel Lift is gaining popularity across the globe for its
ability to restore volume and rejuvenate the skin.
Platelet-rich plasma is a biological skin rejuvenation
treatment that uses the patient’s own cells (in the form
of platelet-rich plasma) to repair and regenerate new skin
tissue and increase collagen production.
Extracted from the patient’s own blood, PRP spurs the
skin’s stem cells into action and contains high concentrations
of growth factors, which are bioactive stimulators known
to accelerate the natural healing process. Injected into
areas such as the face, décolletage and upper arms, PRP
triggers the skin’s stem cells, enhancing the formation of
136 www.cosbeauty.com.au

face
new collagen at the site. The result is a natural rejuvenation
that continues to improve over time.
While it’s possible to use a range of devices to extract
and concentrate PRP, a growing body of research suggests
that the actual concentration of platelets in the PRP is
critical to achieving optimal results.
Recently introduced to Australia, the Angel Whole
Blood Separation System used in the Angel Lift employs
cutting-edge technology to extract only the highest quality
and concentration of platelets. This customisable cellseparation
technology affords clinicians greater control over
the platelet concentrations they use, enabling them to tailor
treatment to each patient’s individual needs.
Platelet-rich plasma treatment
uses the patient’s own cells to
regenerate new skin tissue and
increase collagen production
The Angel Lift is suitable for full-face rejuvenation,
treating fine lines and wrinkles, improving skin tone, texture
and contours, and adding lost volume.
‘In my experience, the Angel PRP system achieves a
highly effective regeneration of connective tissue,’ says
Sydney facial plastic surgeon Dr William Mooney. ‘As a
result of Angel’s rich platelet count, patients are seeing
restored volume in their skin, greatly improved skin texture
and tone, improvement to their fine lines and wrinkles, as
well as improved facial contours.’
During the procedure, blood is taken from the patient,
spun in the Angel Whole Blood Separation System
centrifuge to extract the platelets, before being reinjected
into the treatment area. There, the activated platelets
release growth factors, which facilitate cell growth, the
formation of blood capillaries and, most importantly, the
building of new collagen.
In order to be effective in activating stem cells, the
injected PRP concentration must be four to six times the
patient’s whole blood platelet count. The Angel system
achieves this benchmark using a double spin centrifuge
system, while also affording an individualised approach to
skin rejuvenation. ‘PRP is an exact science and cannot be
guessed,’ Dr Mooney says. ‘Angel separates the red blood
cells, white blood cells, plasma and platelets into separate
compartments, enabling the clinician to design the exact
recipe required for the condition of the skin presented.’
The fragile nature of platelets means injections must
be performed with care and precision. The injections
themselves are necessary because, in order to function,
the growth factors in PRP must connect to cell membrane
receptors below the skin. The method of injection can also
be suited according to patient concerns; injections into the
subcutaneous tissue can be effective in restoring volume,
while shallow injections can improve the appearance of
lines and degenerated skin texture.
An added advantage of the Angel Lift is that the higher
concentrations of platelets mean results can be achieved
in fewer treatments. ‘With Angel, patients are seeing more
significant results that are visible sooner,’ Dr Mooney
explains. ‘This is because Angel produces very rich PRP
concentrations – up to six times the body’s blood platelet
count – which stimulates stem cells in the skin. We are
also noticing patients require fewer treatments to see
improvement in their collagen and elastin.’
The procedure itself takes about an hour and some
patient preparation is required. It is important to be hydrated
on the day of the procedure, as this makes it easier to take
blood from the arm. ‘We will review a patient’s medical
history before proceeding with the treatment and apply
topical anaesthetic or local anaesthetic if required,’ says
Dr Mooney. ‘A face rejuvenation will take approximately 45
minutes, however larger areas such as the upper arms may
take longer.’
Results are typically seen after one treatment, and will
continue to improve over time. After this, maintenance
treatments are usually recommended annually, although,
depending on the patient’s skin complaint, a series of
treatments closer together may be recommended.
There is typically minimal downtime and, because the
patient produces their own treatment serum (their own
blood plasma), the risk of allergy or transmissible diseases
with the Angel Lift is non-existent.
Using technology that allows for an individual approach
to facial rejuvenation, Angel’s system is designed to be
time-efficient and effective, flexible in treating different
conditions and precise in tailoring each treatment to the
patient. The blood volume separation can be adjusted
according to patient concerns, and the double centrifuge
system ensures a high concentration of platelets will induce
effective results with minimal downtime.
It’s useful for full-face
rejuvenation, treating fine lines
and wrinkles, improving skin
tone and adding lost volume
The Angel Lift triggers a natural rejuvenation from
within the skin, to brighten the complexion, improve the
appearance of fine lines and wrinkles and boost the skin’s
support structure. ‘I believe treatment with Angel PRP is an
effective option for anyone looking to improve the integrity
and overall look of their skin,’ Dr Mooney concludes. csbm
www.cosbeauty.com.au 137

Platelet
Rich
Plasma:
The Gold
Standard in PRP
Only Angel PRP offers
customisable cell
separation for superior skin
rejuvenation results.
Angel PRP brings the most
sophisticated autologous PRP system
to Australia. It uses cutting edge
technology to extract the highest
concentrations of platelets for
long-lasting skin rejuvenation.
• Whole face rejuvenation
• Crow’s feet and heavy eyelids
• Frown lines and wrinkles
• Lower face, jaw and lip lines
• Chest, neck ageing and lines
• Hands, upper and lower arms
• Legs, thighs, knees
• Abdomen, post-pregnancy and
skin tightening
• Legs, thighs, knees
• Loss of elasticity and collagen
• Post-surgery healing
• Sports medicine
info@medtel.com.au
Call Medtel – Regenerative Medicine
for more information
1300 886 385
www.medtel.com.au • www.prprejuvenate.com • www.cytomedix.com

face
tailored
results
Skin Renu clinic offers a combination of minimally invasive treatments
to rejuvenate the ageing face. Tara Casey reports.
Ageing is a multi-faceted process, and can result in
a number of changes to the appearance, including
the emergence of fine lines, wrinkles, discolouration,
surface veins and lax skin. At Skin Renu laser and skin
clinic in Sydney, the staff take a holistic approach to antiageing
and skin rejuvenation, not only offering patients a
range of procedures to achieve the results they desire, but
also offering skin cancer checks to ensure skin retains its
optimum health and radiance. By targeting each of the
concerns together, patients can look forward to an overall
rejuvenated appearance.
‘It makes sense as sun-lovers here in Australia to
incorporate skin heath with rejuvenation treatments,’ says
Dr Nada Kolak, one of Skin Renu’s doctors. ‘Healthy skin is
beautiful skin. I like to make sure beauty is more than skin
deep and to this end I offer all my patients skin checks.’
Given each age group has its common skin concerns,
an experienced therapist who is familiar with procedures
utilising the latest proven technology can help achieve the
skin radiance a client is seeking.
The Thermage non-surgical skin tightening system
is one treatment the clinic employs to tighten existing
collagen and stimulate the production of new collagen. The
treatment can be used to address issues such as skin laxity
and fine lines. Thermage can strengthen existing collagen
and stimulate the production of new collagen to renew
contours and improve the texture of the skin’s surface.
According to Dr Kolak, the results of this non-invasive
treatment vary from subtle to dramatic, depending on the
individual person and the extent of ageing.
Dr Kolak views injectables as another cornerstone of
anti-ageing treatments. Volume loss and wrinkles are some
of the major and inevitable changes that occur to our faces
over time. Fillers and muscle relaxants can help restore
facial volume, add contour to the face and relax away
wrinkles and fine lines.
A series of injectable wrinkle treatments to soften lines
and prevent new ones forming can be performed in the one
visit. These are particularly beneficial for correcting frown
lines and crow’s feet at the corners of the eyes.
The goal is improve the client’s
appearance in a natural way
so they look refreshed rather
than overworked
Experienced injectors such as Dr Kolak say their goal is
to improve their client’s appearance in a natural way so that
friends and family see a refreshed rather than overworked
result. Skin Renu’s philosophy is to improve a person’s
appearance, not change their overall look.
‘To achieve a refreshed, natural-looking result, subtlety
is the key,’ says Dr Kolak. ‘Non-surgical anti-ageing
combination therapies which offer little or no downtime
can effectively help delay the signs of ageing and turn back
the clock to reveal a more healthy and beautiful-looking
complexion.’ csbm
www.cosbeauty.com.au 139

cosmetic tattoo
RESTORING
CONFIDENCE
SYDNEY COSMETIC TATTOOIST
RITA PORRECA SAYS PERMANENT
MAKEUP AND RESTORATIVE COSMETIC
TATTOO TECHNIQUES CAN ENHANCE
BEAUTY – AND SELF-CONFIDENCE.
AIMÉE SURTENICH REPORTS.
Permanent makeup has become a well-known and
popular treatment in the beauty industry, but the
benefi ts of cosmetic tattooing extend well beyond
enhancing facial features.
Medical tattooing
Cosmetic tattooing can also be useful for people recovering
from a medical condition or procedure. According to
Sydney cosmetic tattooist Rita Porreca, paramedical tattoo
techniques are often used to recreate the areola of women
who have undergone reconstructive breast surgery.
Areola re-pigmentation is often the fi nal stage of breast
reconstruction and is also considered by those with areola
colour loss. After the breast reconstruction is completed,
the tattooing process may begin around six to 12 weeks
after surgery.
‘In my experience, paramedical cosmetic tattooing can
help restore a woman’s self-confi dence, particularly for
those who have undergone a mastectomy. It can signify a
big step forward in the healing process, both physically and
psychologically,’ she says.
To this end, Porreca also offers Multitrepannic Collagen
Actuation (MCA). This skin relaxation treatment helps to
rejuvenate scar tissue and stimulate the skin to produce its
own melanin in areas where surface scar tissue is present,
further improving the appearance of skin post-surgery or
improving the appearance of burns.
Cosmetic tattooing can also improve the appearance
of skin conditions such as vitiligo, a disease characterised
by patches of skin discolouration where there is a loss of
natural skin pigmentation. Intricate paramedical tattooing
140 www.cosbeauty.com.au

SPMUC FP(NEW) 30/4/07 1:30 PM Page 1
techniques can camouflage the depigmentation, with longlasting
results.
It can also recreate the look of hair for alopecia sufferers,
timeless and
timeless
a health condition deriving from the immune
and
system (white
effortless beauty
blood cells), which results in the arrest of the hair growth
stage, including facial hair and eyelashes.
Cosmetic tattooing
effortless beauty
SPMUC FP(NEW) 30/4/07 1:30 PM Page 1
‘In When 1984 it my comes dream to eyes, was to lips, create face, a
Also called permanent makeup, cosmetic tattooing is most Centre body, skin that and provided training, personalised we are the
well known for its ability to define eyebrows, contour and beauty experts’ solutions expert. With with more natural than and 22
colour lips and emphasise the eyes with eyeliner.
lasting years’ experience results – a world we have above developed
‘With a range of pigments to choose from, eyeliner traditional an excellent beauty reputation salons.’ with doctors
tattooing provides permanent makeup that allows the – and Rita surgeons. Porreca, We Founder also work & MDclosely
timeless and effortless
with surgeons in post-operative
beauty
wearer to sleep, swim and exercise without the smudge
care.
factor,’ says Porreca. ‘Eyebrow cosmetic tattooing also When – Rita it Porreca, comes to Founder Eyes, Lips, & MDFace, Body, Skin and
can restore vibrancy to the entire eye area and help Training
SPCP,
we
AAM,
are
AACT,
the experts'
APAA
expert. We also work closely
those who have plucked too much, or have scars or gaps with surgeons on post-operative care.
in their eyebrows.’
Similarly, lip tattooing can be ideal for women lacking a ‘In 1984 my dream was to create a
SERVICES WE PROVIDE
defined lip shape, have pale lips or just want to enhance the
Centre that provided personalised
SERVICES WE PROVIDE
beauty solutions with natural and
look of their pout.
Cosmetic Tattooing
lasting results – a world above
Cosmetic ‘Whether Tattooing for cosmetic or paramedical reasons, when
traditional beauty Medical salons.’ Tattooing
performed Eyebrowsby Hair an experienced stroke to shaded and highly brows skilled to practitioner, give you more of a
– Rita Porreca, Founder Skin & Needling
MD
long-lasting natural appearance cosmetic tattoo treatments can significantly
enhance BEFORE
Eyeliner a Subtle person’s to Dramatic appearance or to and, define turn, your their eye selfesteem,’
Porreca concludes. csbm
When it comes
Dermal Planning Peels
shape
Lips From lip liner to full lips & blends we make your lips look good with Non to Laser Eyes, Lips, Tattoo Face, Removal
Body, Skin and
Training we are the experts' expert. We also work closely
an ideal shape and colour all the time.
with surgeons Cosmetic on post-operative Tattooing care. Courses
Medical Tattooing
Areola re-pigmentation Is the final stage of breast reconstruction and is AFTER FULL LIP TATTOOING
also What considered by is those permanent
with areola colour loss.
SERVICES WE PROVIDE
Corrective Camouflage Can bring a natural skin colour back to scars
Cosmetic and makeup?
burns Tattooing
Eyebrows Hair stroke to shaded brows to give you more of a BEFORE FULL LIP COLOUR
AFTER FULL LIP COSMETIC TATTOOING
natural Skin Permanent Needling appearance makeup, also called cosmetic tattooing
Eyeliner Needling Subtle treatment to Dramatic for wrinkles, or to acne define scars your & eye scar shape relaxation
BEFORE
or micro-tattoo, is the placement of solid particles
BEFORE
Lips Skin
of From Rejuvenation
colour lip (pigment) liner to full below lips the & blends skin to we create make the your lips look good with
an Is ideal impression for shape the of rebuilding and cosmetics, colour of all new either collagen time. on the and face lightening to pigmentation.
BEFORE EYE LINER TOP AND BOTTOM
AFTER EYE LINER TOP AND BOTTOM
enhance eyebrows, the lips or the eye line, or all
Medical IPL over Hair the Tattooing Removal body to diminish the appearance of scars
Areola Enables re-pigmentation hair removal from Is nearly the final every stage part of of breast the body reconstruction quickly and is AFTER FULL LIP TATTOOING
and other skin imperfections. The pigment is placed
also AFTER EYEBROW TATTOOING
and in efficiently considered
the skin with
by
a fine
those
needle.
with areola colour loss.
Corrective A primary Camouflage aim of permanent Can bring makeup a natural is to achieve skin colour back to scars
and
Medical
burns
Skin Peels/Microdermabrasion
BEFORE EYEBROW TATTOOING
AFTER EYEBROW TATTOOING
balance of the facial features by accentuating your
Skin treatments ranging from Green Peel, CosMedix Peels
best features, deaccentuating your worst and
Skin & Microdermabrasion Needling to give you a natural healthy glow.
harmonising skin tones.
Needling treatment for wrinkles, acne scars & scar relaxation
Cosmetic Clients Dermal should Fillers seek & the Mesotherapy
help of a cosmetic 02 9569 BEFORE 7799 follow us on
Skin tattooist Rejuvenation with extensive experience in cosmetic and
Cosmetic Tattooing Courses
Level 1, 157 Great North Road
Is ideal paramedical for the rebuilding tattooing to of achieve new collagen optimal results. and lightening pigmentation.
Learn, up-skill and expand with professional cosmetic tattooing Five training.
AFTER AEROLA TATTOOING
Dock NSW 2046
IPL Hair Removal
Email: info@spmuc.com.au
Enables hair removal from nearly every part of the body quickly Web: www.spmuc.com.au
www.cosbeauty.com.au
AFTER EYEBROW TATTOOING
and efficiently

feature
skincare for all ages
WITH A TUNED-IN SKIN ROUTINE IT’S POSSIBLE TO HAVE YOUR SKIN LOOKING ITS
BEST, NO MATTER WHAT YOUR AGE. TARA CASEY REPORTS.
We all know that age is just a number, but when it
comes to our skin, time waits for no one. Certain
skin concerns are more prevalent during different
decades in our life – from pimples as a teen to battling dark
eye circles thanks to those late nights of our 20s. The fi rst
signs of ageing creep up in our 30s, with wrinkles becoming
fi rmly entrenched in our 40s, and the inevitable effects of
gravity starting to take their toll in our 50s.
But the news isn’t all bad. Caring for your skin and
putting your best face forward has never been easier
with the huge range of targeted skincare products and
treatments available.
Teens
Getting into a good skincare regime in your teens not only
helps resolve some of the teen angst-causing skin issues
but it also forms good habits for the coming decades. First
up, ditch the bar of soap and switch to a facial cleanser that
suits your skin type!
Many teens fi nd oily skin is their main concern, so a gelbased
cleanser is ideal – perhaps one that includes salicylic
acid to help clear acne. Cleanse morning and at night –
sleeping in your makeup after getting home from a party is
a huge no-no.
Whoever spread the rumour that those with oily skin
don’t need a moisturiser is just plain wrong. Use a light,
non-comedogenic, oil-free moisturiser after you cleanse.
A clay mask applied once a week will deep-clean your
pores, and use an exfoliator twice a week to remove the
build-up of dead skin cells. Make sure you’re gentle – if you
over scrub, your skin may break out.
Not to sound like a mother, but you simply must use sun
protection – the younger you start, the better. Not only does
it protect your skin from the sun but 90 percent of premature
ageing is caused by UV exposure – you’ll be thankful for
this advice in 15 years.
If you suffer from acne, a topical treatment using salicylic
acid or tea tree oil can work wonders. For severe cases, a
prescribed treatment from a GP may be a good option.
20-something
If skin has a heyday, your 20s is it. The worst of teen
problem skin is typically behind you and you’re yet to
bear the hallmarks of ageing. However, this decade is all
about damage control. Your hormones are still balancing
themselves, so stick to oil-free, gentle cleansers,
moisturisers and makeup.
Try adding some products with antioxidants to combat
free radicals and balance the effects those nights out have
on your skin. Green tea, soy, lycopene and Vitamin C are
all good options.
Foamy gel cleansers and light moisturisers are suffi cient
at this age, perhaps a milky cleanser if you’re prone to dry
skin. Sunscreen is essential, so apply a day cream with SPF
and UV protection to your face and décolletage.
Of an eve, use a hydrating fl uid or an oil-free moisturiser
along with a mild hydrating eye gel to stave off early signs
of ageing.
142 www.cosbeauty.com.au

feature
Exfoliating speeds up the natural sloughing process of
the skin and helps keeps you baby-faced and blackheadfree.
A grainy mechanical exfoliator or something with alpha
hydroxy acids (AHAs) will do the job.
Many dermatologists suggest starting on Vitamin
A-derivative retinoids, which are considered by many as the
gold standard for reducing fi ne lines, stimulating collagen
and treating acne.
Microdermabrasion treatments and Vitamin C facials
will keep your skin glowing. Secondly, introducing some
products with Vitamin A derivatives is key at this age.
Retinol can be found in low doses in many over-thecounter
night creams and serums or, for stronger dose
retinoids, creams and gels may be prescribed by your
aesthetician, dermatologist or GP in some cases.
Use your UVA/UVB sunscreen religiously, as it’s in your
30s that the effects of more than three decades in the sun
begin to become apparent in lost collagen and elasticity
and the resulting fi ne lines around the eyes and lips.
30-something
Even if you’ve taken good care of your skin, it becomes
a little drier and sun damage may begin to appear in your
30s, so it’s motivation to start getting with the times.
As you age, keep adjusting your routine. Your midto-late
30s is a great time to start using nutrient-packed
serums and active night creams.
Use a creamy cleanser, perhaps with AHAs to encourage
exfoliation in the morning; in the evening a calming milky
cleanser can work wonders. Use creamy moisturisers to
lock in hydration (apply over damp skin) and continue with
eye creams at night.
40-something
Kick it up a notch as the signs of ageing deepen. In your
40s you should seek products with plumping and fi rming
benefi ts. Those beach holidays have started to catch up
and your skin may lose tightness, begin to look dull and
pores may enlarge.
Spots and discolouration may appear and, because it
doesn’t refl ect light evenly, your complexion is losing some
of its glow. The gradual loss of collagen and elasticity is
part of intrinsic ageing and becomes more apparent in the
furrows and frown lines of 40-something skin. Vitamin C
can boost the synthesis of collagen, especially when it is
applied in a potent and active form.
www.cosbeauty.com.au 143

feature
Additionally, prescription retinoids containing Vitamin A
acid used topically help fi ght nasty free radicals and can
reduce brown spots, increase exfoliation and collagen
production, thicken the epidermis and improve sun
damage. If your skin can’t tolerate a retinoid every night,
use it every other night.
You may also be considering anti-wrinkle injections to
smooth your complexion and as a preventative method
for future wrinkle formation. Injectables help diminish and
softens lines and wrinkles on the face and can refresh your
overall appearance.
Vitamin A derivatives are
considered by many as the gold
standard for reducing fine lines
Chemical peels are also good for refi ning the skin’s
surface, and fi ller injections can replenish volume and boost
collagen production.
Of course, it’s essential you continue using rich face and
eye serums on a nightly basis, with moisturising properties
such as hyaluronic acid, shea butter or oils. Along with
your broad-spectrum moisturiser, add in a couple of
creams, lotions or serums containing at least two types of
antioxidants. For crepey skin try a formula with peptides,
which have been shown to strengthen collagen.
50-something and onwards
This is the time to put your skincare regime into high gear.
Loss of oestrogen, which gives your skin its elasticity and
hydration, sees deeper wrinkles form, drooping eyelids and
expression lines around the mouth and forehead.
Cell turnover is much slower and you’ll notice dryness
and loss of suppleness. Expression lines start to remain
static and pores are more visible. You also may have
developed spider veins and hyperpigmentation (age spots),
as well as pre-cancerous spots from sun damage.
Wash morning and night with a creamy cleanser and
apply a serum containing peptides or an antioxidant such
as Vitamin C when your face is still damp. Anti-ageing
or wrinkle-reducing prescription formulas containing
retinol or glycolic acid products can reduce fi ne lines and
wrinkles, improve skin texture, tone and colour and help
boost hydration.
Glycolic acid has been found to trigger new formation of
collagen to plump cells and reduce wrinkles on the skin’s
surface. Consider taking a coenzyme Q10 supplement
every day. Studies have shown this may help prevent skin
cancer, which commonly appears in this decade.
Laser skin resurfacing can offer an effective solution
to diminish wrinkles, scarring and age spots, as well as
improving the overall appearance of your skin. This is
also the age where cosmetic surgical procedures may be
seriously considered to help restore your more youthful
looks of yesteryear. csbm
144 www.cosbeauty.com.au

fit for a princess
Give your skin the royal treatment
with Princess Skincare
DAILY YOUTH
Moisturising Gel
ANTI-AGEING
Vitalizing Serum
RECOVERY
Soothing Essence
REJUVENATION
Hyaluronic Acid Mask
Green Tea Mask
Made with 100 percent rayon,
non-woven fabrics
CONTACT: INSIGHT AESTHETICS
Ph: 1300 737 393
info@insightsurgical.com.au
www.insightsurgical.com.au

skin
The royal
suite of
skincare
PRINCESS SKINCARE OFFERS
AN ALL-ENCOMPASSING APPROACH
TO FACIAL ANTI-AGEING AND
REJUVENATION. CAITLIN
BISHOP REPORTS.
Stemming from a holistic philosophy, Princess
Skincare, distributed in Australia by Insight
Aesthetics, provides a high-quality and
professional pathway to skin health.
With a history spanning 30 years, Princess
was born when CROMA – a European leader
in ophthalmology, orthopaedics and viscoelastics –
decided to expand its expertise into the fi eld of aesthetics.
Today, complete with a skincare range, treatment masks
and dermal fi llers, Princess affords an all-encompassing
approach to skin health and aesthetic rejuvenation.
In a cutting-edge skincare line, Princess has infused
a range of serums and gels with active ingredients
designed to boost skin health and combat the signs
of ageing. Princess has been diligent in including only
ingredients that are shown to truly benefi t the skin, and
the range is effective in helping to address a variety of
skin concerns and conditions.
Designed to extend the youthfulness of your skin,
the Daily Youth Moisturising Gel provides gentle, longlasting
hydration to homogenise skin texture and
achieve a luminescent glow. The experts at Princess
Skincare advise a quality moisturiser should be applied
daily to replenish the skin and prevent the wrinkles and
unevenness commonly associated with dehydration.
In a two-fold effect, the Daily Youth Moisturising Gel
is also designed to enhance the production of collagen
146 www.cosbeauty.com.au

skin
and elastin in the skin, to improve skin integrity, structure
and resilience. For a more direct, concentrated approach,
the Anti-Ageing Vitalising Serum helps promote younger
looking skin and reduce the common signs of skin ageing.
The serum is formulated to brighten and tone – reducing
the appearance of pores and uneven texture. Because of
their consistency, serums achieve a higher penetration into
the epidermal layers, meaning the ingredients are delivered
deeply to act within the skin. This benefi t means the Anti-
Ageing Vitalising Serum can help minimise the appearance
of fi ne lines and wrinkles and increase the skin’s resilience
to environmental stressors.
One of the most compounding factors in skin ageing is
sun exposure. Damage from ultra violet (UV) radiation works
to magnify and accelerate the intrinsic ageing process,
leading to pigmentation, increased skin laxity, wrinkles and
uneven texture. To fi ght these premature signs of ageing,
and counter the dermal stress brought on by sun exposure,
the Recovery Soothing Essence from Princess Skincare
improves skin health and is designed to relax, soothe and
rejuvenate the complexion.
Scientifi cally designed to complement the everyday
skincare range, Princess Skincare Masks are an integral
part of the Princess approach to anti-ageing. There are
two Princess Masks: the Hyaluronic Acid Mask and Green
Tea Mask. They can be used to optimise skin health and
radiance, as well as to prime skin before surgery or to help
Princess Skincare addresses
a wide variety of skin concerns
and conditions
expedite healing post-procedure. These are cloth masks,
designed to hydrate the skin, minimise the look of wrinkles,
smooth the skin’s texture and brighten the complexion.
The Hyaluronic Acid Mask uses hyaluronic acid
(HA), a component that occurs naturally in the body,
to boost hydration and activate cellular proliferation in
the skin. It combines HA with Imperata Cylindrica for
intense moisturisation, alongside liquorice root and algae
extracts, which are high in antioxidant vitamins. This mask
demonstrates high anti-ageing potential and helps maintain
the skin’s elasticity and fi rmness.
The Green Tea Mask has a soothing, revitalising and
protective effect for general skin rejuvenation. It combines
green tea with additional antioxidants to hydrate, strengthen
and protect the skin against external stressors. csbm
The Princess suite of injectables
Sometimes, even with the most diligent, proactive and
suitable skincare regimens, a slightly more aggressive
approach is required to maintain facial youthfulness.
During ageing, there is a loss in both the facial
skeleton and deeper fatty tissue, meaning the
skin’s structure is depleted and a loss in volume
becomes evident.
Dermal fi llers can be effective in replenishing
this volume and reducing the appearance of deep
wrinkles and folds. Insight Aesthetics has a range
of Princess dermal fi llers, suitable for treating the
lips, facial lines, wrinkles and facial folds. They are
designed to typically last between six to twelve
months and are effective in refi ning the facial contour
and revolumising the face.
In a collection of active skincare and complementary
treatments, Princess from Insight Aesthetics affords
an all-encompassing approach to anti-ageing and
facial rejuvenation.
The skincare is designed to boost skin health, and
is effective both as a standalone treatment and to
boost results following more invasive modalities. With
skincare, facial masks and dermal fi llers, Princess
signifi es a ‘one-stop-shop’ to facial rejuvenation and
anti-ageing results.
www.cosbeauty.com.au 147

skin
Spot-on skin
Suzie Hoitink from Clear Complexions Clinics says customised skincare
and treatment plans can go a long way in treating skin pigmentation.
AimÉe Surtenich reports.
According to Suzie Hoitink, registered nurse and
founder of the award-winning Clear Complexions
Clinics, there’s no silver bullet when it comes to
healthy, beautiful skin.
‘It’s about knowing how to put the right combination
of skincare and treatments together for each individual,
and establishing a plan that keeps their skin healthy going
forward,’ she says.
A common skin complaint, particularly after a long hot
Australian summer, is hyperpigmentation, or ‘sun spots’ on
the face. Caused by increased melanin (the skin’s natural
pigment), hyperpigmentation is triggered by sun damage,
hormones, trauma and some diseases.
‘Hyperpigmentation is typically caused by four factors:
sun exposure; hormones (melasma); post-inflammatory
hyperpigmentation caused by trauma to the skin such as
acne scarring, surgery and over-aggressive skin treatments;
and congenital or autoimmune diseases,’ Suzie explains.
Darker pigmented spots on the skin are the end result
of hyperpigmentation, but the true damage is seen below
the surface. Patches of melanin can accumulate below
the skin’s upper layer without any visible, tell-tale signs
presenting on the surface.
‘Pigmentation starts below the surface,’ Suzie continues.
‘It’s usually only when people start to see brown patches or
sun spots on the surface of their skin that they start looking
at treatment options.’
‘Rarely in Australia do we have a patient who doesn’t
have hyperpigmentation, and vascular or capillary damage
as well,’ she continues. ‘Skin starts to act and look
older than it should, leading to more wrinkles, more skin
discolouration, and uneven skin texture and tone.’
Hyperpigmentation is one of the most difficult and
volatile skin conditions to treat and, while there is no one
‘cure’, with the right skincare and treatment plan, it can be
controlled and managed.
The first step is to have a thorough and detailed
consultation with the client. Clear Complexions nurses
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skin
address patient history, concerns, previous treatments
and expectations. They also utilise the latest diagnostic
software, which looks at the skin below the surface.
‘Essentially, we want a “map” of the skin to ascertain
exactly what is needed to bring it back to optimal health
and radiance,’ says Suzie. ‘With the imaging results as a
guide, the patient will be educated in understanding the
true state of their skin and provided with a path forward in
skin care and treatment. The process of diagnostic imaging
is not only about safety and choosing the right treatment
for the client but also about education. The patient needs
to understand how and why we’re going to repair, maintain
and prevent further damage to their skin.’
We don’t just want to improve
your skin now; we want you
to look good for your age in
10 years time
As no two skins are alike, Clear Complexions Clinics
provide an individualised multi-modality approach to
treating skin concerns. ‘Our nurses are trained in, and have
access to, different ways to treat hyperpigmentation. We
don’t want to just improve your skin now; we want you to
look good for your age in 10 years time,’ Suzie says
For example, Intense Pulsed Light (IPL) treatment
can be used to gently lighten the appearance of visible
pigmentation spots, while prescribed at-home skincare
loaded with antioxidants such as Vitamin A can calm
overactive melanocytes and slow down the surfacing of
pigmentation. Mild peels can also be used to accelerate the
removal of dead, pigmented skin cells. These treatments
are complemented with advice on lifestyle changes to
reduce the risk of hyperpigmentation stimulation.
Suzie says Clear Complexions Clinic patients can
expect to see and feel real improvements following any
treatment. ‘Whether it’s treating hyperpigmentation,
using injectables to help combat wrinkles or lost volume,
or employing laser therapies and platelet-rich plasma
treatment for all-over facial rejuvenation, we hold ourselves
accountable,’ she says.
‘The main focus of my team and I is improving the
health and beauty of our clients’ skin. We are not just in
the business of skincare; we are committed to our clients
and believe real beauty comes from feeling confident in
the skin you’re in,’ says Suzie. ‘Our personalised multimodality
approach to skin health and beauty has made a
real difference to the complexion of our clients.’ csbm
BEFORE
BEFORE
Intrinsic vs extrinsic causes
Hormonal hyperpigmentation. Also called
melasma, this type can appear around the lips, eyes
or in a band across or down the forehead. Referred
to as the ‘mask of pregnancy’, melasma arises in
response to oestrogen and progesterone fluctuations,
as these stimulate melanocytes, which are pigmentproducing
cells.
Sun-induced hyperpigmentation. Pigmentation
caused by sun damage is similar to freckling in
appearance and sits more superficially on the skin
compared with melasma. It occurs when melanin
levels increase to protect against sun exposure.
Post-injury hyperpigmentation. Acting like an
‘umbrella’ to protect against DNA mutation, melanin
levels rise in reaction to skin trauma, such as after
surgery. These protective peaks of melanin can cause
hyperpigmentation damage. Notably, these incidences
of melasma, sun damage and post-inflammatory
hyperpigmentation initially appear underneath the
skin’s surface, invisible to the naked eye.
AFTER pigmentation treatment (actual client
of Clear Complexions Clinic)
AFTER two IPL treatments for pigmentation
(actual client of Clear Complexions Clinic)
www.cosbeauty.com.au 149

skin
Vitiligo linked
with Vitamin D
Sydney cosmetic surgeon Dr Joseph Georghy believes he has
untangled the mystery of what causes vitiligo and has pioneered a new
medical treatment for the skin condition. AimÉe Surtenich reports.
Vitiligo is a skin disorder that causes depigmentation
from areas of the skin, resulting in white spots or
patches. It occurs when melanocytes, the cells
responsible for skin pigmentation, are ‘poisoned’ and die or
are unable to function properly and produce melanin.
Despite research, the cause of vitiligo is considered
unknown. Dr Georghy believes that he’s got the answer:
Vitamin D deficiency may be one, if not the main, cause
of vitiligo. He has carried out numerous blood tests on his
patients who suffer from vitiligo and has found that virtually
all of them had Vitamin D deficiency.
Dr Georghy proposes that the severity of the disease is
directly related to the severity of the Vitamin D deficiency.
‘Genetic predisposition and stress may be aggravating
factors,’ he says. ‘However, from my research, children
developing vitiligo early in their life have one or both parents
who are Vitamin D deficient.’ He believes that children who
develop vitiligo at a very young age are also Vitamin D
deficient or they may have inherited ‘defective’ DNA from
their parents. He attributes these findings to intrauterine
Vitamin D deficiency, lack of sun exposure during developing
years and nutritional deficiency or combination of both.
‘Vitamin D is essential for normal melanocyte function,’
Dr Georghy explains, ‘so a deficiency may cause abnormal
DNA methylation and genetic alteration, resulting not only in
vitiligo but in numerous skin conditions.’
New combined treatment for vitiligo
‘I use PhotoDynamic HelioTherm combined with MicroPen
micro-needling and platelet-rich plasma treatment,’ says
Dr Georghy. ‘This triggers a cascade of bio-stimulating
processes that ultimately results in skin repigmentation.
Patients are also treated with high doses of Vitamin D,
CoQ-10 or other supplements they may be deficient in.’
Platelet-rich plasma (PRP). This plasma is a naturally
occurring component extracted from your own blood. The
concentrated platelets found in PRP have huge amounts of
growth factors, bioactive and signalling proteins, which are
released when PRP is injected into tissue.
MicroPen micro-needling. ‘I believe the MicroPen has
revolutionised the practice of treating skin conditions,’ says
Dr Georghy. ‘It is a slim, cordless, light and ergonomic design
which fits in the palm of your hand. During the procedure, tiny
needles are used to create controlled micro-injuries to the skin
in order to produce collagen and elastin. In my experience, it
is much faster than any other device on the market, allowing
a more comfortable treatment for my patients.’
PhotoDynamic HelioTherm. PhotoDynamic Therapy
(PDT) is a treatment that uses a substance called a
HelioTherm photosensitiser. It helps the light and the heat
to be absorbed and accumulated in the skin and underlying
tissues, resulting in better skin contraction and collagen
formation. ‘I use a sensitiser I specifically developed, which
is applied topically. PDT does not cause photosensitivity
and overall has a good safety profile,’ says Dr Georghy.
‘HelioTherm employs light and heat energy delivered
simultaneously to the treated areas. It is the only device on the
market that results in deep and homogenous heat penetration
to the underlying skin structures: fat, muscles, ligaments,’
he continues. Dr Georghy believes that HelioTherm in
combination with Vitamin D therapy, bio-stimulates the
‘dormant’ melanocytic stem cells (stimulates your own stem
cells), corrects the faulty DNA by improving DNA methylation
and eliminates ‘oxidative stress’.
The biological effects of HelioTherm have been published
in the textbook of The American Academy of Anti-Aging
Medicine, Anti-Aging Therapeutics, Vol IX. ‘The biological
effects of this unique treatment are countless. The sky is
the limit,’ he says.
Dr Georghy says this combined treatment kickstarts
a cavalcade of biological effects: immediate antiinflammatory
effects, formation of new blood vessels,
improvement of oxygen supply and metabolic turnover at
a cellular level, resulting in stimulation or re-activation of
your own dormant stem cells to produce new, active and
functional melanocytes.
‘Skin texture starts improving within several days. Repigmentation
will begin within few months, with best results
seen after 12 to 18 months,’ he concludes. csbm
150 www.cosbeauty.com.au

skin
1
BEFORE
2
BEFORE
3
BEFORE
4
BEFORE
5
AFTER IPL (PhotoTherm) and Photodynamic HelioTherm by Dr Georghy
AFTER IPL (PhotoTherm) and Photodynamic HelioTherm by Dr Georghy
AFTER IPL (PhotoTherm) and Photodynamic HelioTherm by Dr Georghy
AFTER IPL (PhotoTherm) and Photodynamic HelioTherm by Dr Georghy
BEFORE
AFTER IPL (PhotoTherm) and Photodynamic HelioTherm by Dr Georghy
www.cosbeauty.com.au 151

skin
On
a
roll
The cordless Eclipse MicroPen is the latest advancement in skin
needling technology and can correct a variety of skin concerns.
AimÉe Surtenich reports.
Composed of medical-grade stainless steel, the
Eclipse MicroPen is the first completely cordless
fractional automated microneedling device for
treating various dermatologic indications.
For the right patient, microneedling with the MicroPen
offers an effective alternative to common skin resurfacing
techniques such as laser therapy and dermal rollers.
‘I am very enthusiastic about the new MicroPen skin
needling device,’ says Sydney cosmetic surgeon Dr
Joseph Georghy, one of the first adopters of the MicroPen
in Australia. ‘I believe it has the potential to revolutionise
the practice of treating many skin conditions, as well as for
overall facial rejuvenation,’ he continues. ‘Its slim, light and
ergonomic design fits in the palm of your hand, enabling a
more efficient and comfortable treatment.’
How does microneedling work?
Microneedling creates multiple microscopic injuries in the
epidermis, sometimes referred to as collagen induction
therapy. The micro injuries trigger the production of collagen
and elastin, the building blocks of smoother, healthier
looking skin. The result is a more even toned, tighter and
radiant skin as the new healthy skin cells work to rejuvenate
skin from the inside out.
In this way, it works like any fractionated procedure,
perforating multiple pin-point holes at various depths in the
skin to trigger the body’s natural healing response.
The MicroPen’s fractionated turbo safety needle
is designed to cause minimal trauma to the skin and
surrounding tissue while still achieving desired end points
necessary for collagen remodelling.
Benefits include improved skin
tone and texture, and overall
younger looking skin
The MicroPen consists of 12 32-gauge medical grade
needles arranged in a fractionated pattern in order to cause
the necessary skin injury while leaving healthy skin in tact in
between each micro perforation.
The turbo safety pistol pulsates at a rate of 8500 RPM
to ensure optimal patient comfort and shorter treatment
time. Needle depth is adjustable from 0 to 2.75mm, allowing
the practitioner to adjust the level of treatment according to
the patient’s needs.
During the procedure, the pen is gently pressed
against the skin while simultaneously gliding in one direction
152 www.cosbeauty.com.au

skin
until the entire treatment area has been covered. The
procedure takes around 15 to 30 minutes, depending on
the area treated.
‘Importantly, the MicroPen’s cordless, portable design
allows the practitioner to move more freely during treatment,
affording greater control and accessibility to the patient’s
target areas,’ says Dr Georghy.
The tiny microchannels created by the MicroPen are also
ideal for the absorption of topical skincare products such
as hyaluronic acid, lightening serums or wound-healing
topicals, allowing diffusion of product into those deeper
skin layers at a cellular level.
Microneedling is also ideal to use in conjunction with
platelet-rich plasma (PRP) treatment, to maximise the skin
rejuvenation results of PRP.
Results and safety
The benefits of microneedling include a reduction in the
appearance of fine lines and wrinkles, improved skin tone
and texture, and an overall younger looking skin.
Micro-needling also has a positive effect on
hyperpigmentation as well as on hypopigmentation, acne
and surgical scars, and stretch marks.
The MicroPen is safe to use on numerous parts of the
body, including the face, neck, décolletage, arms, hands,
legs, abdomen and back.
Patients can typically resume their everyday activities
straight after treatment. Mild redness and some
inflammation of the skin is typical, but this should dissipate
after a day or two in most cases and can be covered by
mineral makeup if desired.
Visible changes to the skin develop over the course
of several days and weeks. Results are cumulative, and
continue to improve up to six months after treatment as
collagen production continues.
Some patients only require a single treatment, once
per year to achieve, and maintain, optimal results. However,
it is recommended for most patients to receive a series
of two to three treatments spaced around six to eight
weeks apart. For patients with deep-set wrinkles, advanced
photoageing, stretch marks or acne scars, it is advised to
receive six to eight sessions at six-week intervals.
The MicroPen has an excellent safety profile, featuring
a disposable tip and a cross-infection protection system
to offer safe, reliable and consistent results. ‘I believe
the MicroPen heralds a technological breakthrough in
microneedling treatment,’ Dr Georghy concludes. csbm
ROLL BACK THE YEARS
WITH THE ECLIPSE MICROPEN
A breakthrough for beautiful skin
The Eclipse MicroPen uses tiny sterile needles to create
controlled micro-injuries to the skin for radiant results.
The MicroPen is a slim, portable, cordless design which fi ts
in the palm of your hand. It gives the practitioner superior
control during micro-needling treatment, while affording a
faster and more comfortable procedure for the client.
The skin benefi ts of micro-needling include:
• Improving fi ne lines
• Tightening skin and improving tone
• Promoting collagen and elastin production
• Reducing the appearance of acne scarring,
pigmentation and stretch marks
To learn more about the unique
benefi ts of the Eclipse MicroPen call
1300 068 357
www.aventionglobal.com
www.cosbeauty.com.au 153

skin
Your best skin ever
Sydney aesthetician Eva Karpati says a personalised approach to skin
rejuvenation yields the best results. AimÉe Surtenich reports.
Sydney aesthetician Eva Karpati takes an individualised
approach to skin rejuvenation. ‘There’s no set routine
when it comes to beautifying the skin,’ she says. ‘I
work with each client to assess their specific skin type and
concerns and then devise a bespoke treatment plan to
achieve ultimate skin radiance.’
The first step is a thorough consultation to accurately
assess the condition of each client’s skin and to listen to
their concerns. ‘The consultation process is paramount,’
explains Karpati. ‘It is so important for me – and the client
– to first thoroughly understand what we are dealing with
and how to deal with it effectively. To this end, I always use
visual imaging software in my consultations to ascertain the
extent of the problem and the best way to address it. Every
person needs an individualised approach. What’s right for
someone in their 20s and 30s may not be right for someone
in their 40s and 50s.’
The Karpati Medispa offers an array of treatments
utilising the latest in advanced non-surgical IPL and LED
machinery to treat a variety of skin conditions.
‘To achieve optimal results that really target specific
concerns, a state of the art and powerful machine is
necessary,’ says Karpati. ‘The laser I use has two fractional
heads: the 1410nm is effective for fine lines and open
pores, while the 1540nm is useful for skin tightening and
reducing the appearance of acne scarring.’
The non-ablative microfractional laser offers three
treatment depths, enabling the practitioner to customise
each treatment according to the client’s individual
cosmetic concerns.
‘We use different wavelengths, which allow us not only to
meet different needs – whether it’s to address pigmentation,
vascular spots, acne scarring or overall skin rejuvenation –
but also to treat different skin types safely, from the darkest
to the lightest,’ says Karpati.
Fractional skin resurfacing uses laser energy to create
microscopic injuries in the skin. In non-ablative treatments,
the laser coagulates the affected tissue, and the body’s
natural healing mechanisms kick in to create new, healthy
tissue to replace the coagulated tissue. The result is
healthier, younger looking skin.
According to Karpati, fractional laser systems have
revolutionised skin rejuvenation. ‘Rather than “burning”
the surface of the skin, fractional lasers work in the deeper
layers to promote collagen renewal, leaving the surface
virtually untouched,’ she says.
‘Unlike ablative laser procedures, which vaporise, rather
than coagulate the tissue, in most cases non-ablative
procedures involve minimal to no redness and swelling,
and patients can return to their day-to-day activities
immediately,’ she adds.
Patients will typically see a noticeable improvement to
the appearance of their skin after just one laser therapy
session, although Karpati usually recommends four to six
treatments spaced four to six weeks apart in order to see
maximum benefit.
‘Results will continue to improve over time as new
collagen is produced,’ she says. ‘Best of all, as patients
have more treatments, results will just keep getting better
and better.’
‘With age, the cumulative effects of lifestyle choices can
take their toll on the face. Skin loses firmness and radiance,
wrinkles can become ingrained and uneven pigmentation
can mar the complexion,’ says Karpati.
‘Advances in laser technology over the past five
years have meant the visible signs of chronological
and environmental ageing can be significantly reduced
and sometimes reversed, with treatments that take the
equivalent of a lunch hour and require little or no downtime,’
she concludes. csbm
154 www.cosbeauty.com.au

Hair removal revolution for
blonde, red, grey and white hair
Until recently, the effectiveness of laser and IPL
permanent hair reduction depended on factors such
as darker hair colour and paler skin types.
With the Adéna IPL system, there’s now a solution
to treating grey, blonde, white and red hair, as well
as darker skin types – heralding a breakthrough in
these notoriously difficult-to-treat hair colours and
skin types.
The Adéna is able to target blonde, grey, white and
red hairs because it doesn’t rely on the hair pigment
to absorb the light energy. Instead, the Adéna IPL
directly targets the blood vessels at the bottom of
the hair follicle.
Unlike other light depilation treatments, hairs are
not vaporised by IPL. Rather, the heat coagulates the
blood vessels in the bottom of the hair follicle but the
hairs remain in the skin and often become attached
to the epidermis. They will fall out after one to three
weeks as the epidermis renews itself.
Because the additional wavelengths emitted by the
Adéna system target haemoglobin and not melanin,
it can also effectively work on darker complexions
without risk of burning or hypopigmentation.
‘For fair-haired or dark-skinned people wishing to
remove unwanted body hair, the Adéna offers a giant
leap forward in permanent hair reduction technology,’
concludes Karpati.
BEFORE
AFTER non-ablative fractional rejuvenation
BEFORE
AFTER non-ablative fractional rejuvenation
www.cosbeauty.com.au

skin
Tattoo
removal
revolution
PICOSURE SIGNALS A BREAKTHROUGH
IN LASER TATTOO REMOVAL, OFFERING
FEWER AND FASTER TREATMENTS
WITH SUPERIOR RESULTS.
AIMÉE SURTENICH REPORTS.
Thanks to the advancement in tattoo removal
technology, regrettable tattoos don’t have to last a
lifetime. The new PicoSure laser from Cynosure is the
fi rst and only picosecond laser for tattoo removal and is set
to become the new standard in clearing tattoos.
Signifying a breakthrough in laser technology, PicoSure
delivers ultra-short bursts of energy to the skin in trillionths
of a second.
‘I believe the PicoSure laser is the new technological
advancement in laser tattoo removal,’ says US dermatologic
cosmetic surgeon Dr Raminder Saluja. ‘In my experience,
it provides safer and more effective treatment for patients
looking for tattoo and pigment removal.’
In the past, tattoo removal has typically been diffi cult,
involving multiple treatments and falling short at completely
removing stubborn blue and green inks. ‘PicoSure’s main
BEFORE
AFTER seven treatments with traditional Q-switched
nanosecond laser
AFTER one treatment with PicoSure laser
(photos courtesy of Dr Raminder Saluja)
156 www.cosbeauty.com.au

skin
advantage is that energy is pulsed in the trillionths of
seconds,’ says Dr Saluja. ‘Its primary mode of shattering
the ink is from the intense photo-mechanical wave that is
created, and not as much from photothermal effects as
seen with traditional nanosecond lasers. Clinically, what
makes it superior for me (and my patients) is the greater
degree of clearance of ink per treatment, which means less
time going from having a tattoo to clearing the tattoo.’
Because of the intense wave that is created, lower
fluences (the energy delivered per unit area) can be utilised
to achieve ink particle fragmentation. ‘We have found
that the smaller the particles are, the more efficient the
body’s ability to clear the ink particles,’ explains Dr Saluja.
‘Additionally, because of the lower fluences used, the risk of
scarring and fibrosis is also reduced.’
I believe the PicoSure is the
new technological advancement
in laser tattoo removal
PicoSure is equipped with an Alexandrite wavelength
(755nm). This wavelength has the ability to target difficult
colours, including green, blue, purple, black and brown
inks. ‘I find the PicoSure laser to be exceptional in treating
green, blue, purple and black ink,’ says Dr Saluja. ‘I do
caution my patients, however, that while I cannot promise
total disappearance of the tattoo, the PicoSure is the best
technology we have in trying to achieve that outcome.’
PicoSure uses the patented PressureWave technology
to shatter the smallest of target ink particles, meaning it
can remove tattoos in fewer treatment sessions than with
traditional lasers. ‘Tattoos can be cleared in as little as one
to three treatments, depending on the location, layering
and colour of the tattoo,’ says Dr Saluja. ‘I fire the laser at
a repetition rate of 10hz so the treatment itself is very fast.’
Dr Saluja says that while PicoSure is more comfortable
than previous lasers, patients may still experience some
discomfort. ‘I typically use cold air on the area being treated
to make patients more comfortable, and if I am treating a
tattoo around the axillary area, flank or spine, I may also use
a topical anaesthetic.’
Patients may experience some blistering immediately
post-laser, purpura (purple or red-coloured patches at the
treatment site) and skin redness, especially if it is their first
treatment, but this should subside over the next day or two.
‘If a patient does blister, in my experience these heal well,
with no residual scarring seen thus far,’ says Dr Saluja.
‘All in all, I believe PicoSure has transformed the
category of tattoo treatment,’ she continues. ‘Patients
have been very happy, especially those that have had 12
or more treatments with a Q-switched nanosecond laser
and know the amount of lightening they typically achieved
BEFORE
AFTER two PicoSure treatments (photos
courtesy of Dr Alex Kaplan)
between their previous laser treatments. When they have
one PicoSure treatment, they are amazed at the level of ink
reduction in comparison to their previous treatments.’
‘I always ask my patients what their initial motivation was
to have their tattoo placed and, equally, what motivated
them to now have it removed.
‘My most amazing story was an inner city teenager who
cleaned up her life and decided to go into the military. She
had a tattoo on her neck and needed to have it removed to
continue on her career path. She is the first in her family to
set goals and create a vision towards a better life. To be a
small part in helping her achieve her goals is both humbling
and rewarding.’ csbm
On the pulse
What is PicoSure?
PicoSure is the first picosecond aesthetic laser
specifically designed to treat tattoos. It delivers ultrashort
pulse bursts of energy to the skin in trillionths of
a second, making it 100 times shorter than traditional
tattoo removal lasers.
How does it work?
PicoSure creates an intense photo-mechanical
impact to shatter the target ink with fewer treatments
and less fluence.
How does it compare?
Traditional Q-switched nanosecond lasers typically
rely on photothermal action to deliver heat to the
pigment and surrounding tissue and generally
produce a small fraction of the power generated by
a picosecond laser.
PicoSure uses the patented PressureWave
technology to shatter the smallest of ink particles,
clearing even stubborn blue and green inks, as well
as previously recalcitrant tattoos that failed to clear.
www.cosbeauty.com.au 157

skin
First line
of defence
Allmedic skincare protects
the skin against environmental
damage and helps slow the
natural ageing process.
Caitlin Bishop reports.
From prohibiting infection to regulating water loss, the
body’s largest organ – the skin – plays a diverse and
essential role in protecting the body and maintaining
its homeostasis.
Yet the skin’s frontline role in immunity makes it extremely
prone to damage from environmental factors, the effects
of which can accelerate the ageing process.
Quality skincare plays a pivotal role in delaying and
even reversing the appearance of ageing. The allmedic
products, which are specifically designed to strengthen
the epidermis, go a long way in combating age spots,
blemishes, dry and scaly skin, and fine lines brought on by
environmental damage.
‘The allmedic range has been formulated with several
goals in mind: to help repair and normalise the skin and to
help protect and maintain the skin in a healthy condition,’
says Queensland cosmetic physician Dr Douglas Grose.
‘They are designed to help stabilise the skin’s pH, remove
dead skin cells, as well as repair, protect and strengthen
the epidermis.’
Cornified
envelope
Epidermis
stratum
corneum
Cornified
envelope
stratum
corneum
Epidermis
dermis
dermis
Micrograph of the stratum corneum showing dry, rough and scaly skin
Micrograph of a normal, stable and stratified stratum corneum
158 www.cosbeauty.com.au

The acid mantle
The acid mantle is a slightly acidic film on the skin’s
surface. It’s controlled by the skin’s sebaceous glands
and is responsible for the dewy, smooth and even tone of
healthy skin. Dr Grose explains the acidity of the acid mantle
– with a pH between 4.5 and 5.5 – is vital in the process
of skin cell renewal. ‘The epidermis is continually renewing
itself from the bottom layer up,’ he says. ‘The old skin cells
fall off as part of this renewal process, and this is achieved
by an enzyme called stratum corneum chymotryptic enzyme
(SCCE). For this enzyme to function regularly, it requires a
skin pH on the acidic side.’
When the skin becomes more alkaline, as opposed to
acidic, its ability to preserve water is reduced because the
bilipid layer responsible for retaining water in the skin requires
an acidic environment. This layer, found in the outermost layer
of the skin, is designed to retain moisture in the skin and at
the same time repel noxious chemicals. Normal function is
essential to skin health. Breakdown of this layer results in the
dry, itchy skin commonly seen in people as they get older.
Dr Grose says allmedic’s face and body cleanser, and
the non-soap bar, bring the skin to the correct pH. This
helps maintain the natural epidermal barrier, without causing
dehydration, while effectively cleansing the skin of any makeup,
dirt and grime in the process.
Exfoliation
As the skin renews itself, and keratinocytes (skin cells)
move up through the epidermal layer, the removal of dead
cells from the skin’s surface is essential. When this process
slows down, the epidermis becomes thinner and a buildup
of damaged skin cells can occur, causing unevenness,
dehydration and, in some cases, triggering the process
of skin cancer formation. Both chemical and mechanical
exfoliation can assist in increasing skin cell turnover,
removing damaged cells and thickening the epidermis.
The allmedic scrub is a mechanical exfoliator that uses
cellulose beads to gently remove dead skin cells. This can
be combined with either allmedic Body Repair Cream or
Face Repair Cream, which are chemical exfoliants that
contain active concentrations of alpha hydroxy acids.
These are naturally occurring compounds, which help break
the bonds that hold skin cells together and speed up the
process of skin renewal.
Sun protection
Environmental damage manifests itself in everything from
wrinkles to skin laxity through a process called photoageing.
By either reflecting or absorbing UV radiation, ingredients in
sunscreens work to protect the skin against sun damage and
inhibit the effects of photoageing. The allmedic SPF 50+ Face
and Body Moisturising Sunscreen provides broad-spectrum
UVA and UVB protection but also contains Niacinamide, or
Vitamin B, which works to help hydrate the skin, reduce the
appearance of skin pigmentation and improve its elasticity,
tone and texture. csbm
www.cosbeauty.com.au
Doctor Designed,
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feature
Safeguard
your skin
There’s no such thing as a safe tan. Here’s how
to choose the best sunscreens for blocking
damaging UV rays. Nicola Donovan reports.
With Australia’s warm and sunny climate, many
of us are intrinsically drawn to lying in the sun –
but be warned. According to the Department of
Health and Ageing, approximately two in three Australians
will be diagnosed with skin cancer before the age of 70.
One of the best ways to protect yourself against the sun’s
harmful rays is by using a sunscreen. But it’s important to
know the differences in how they work in order to choose
the best option for your skin.
Organic vs inorganic sunscreens
Inorganic sunscreens, also known as ‘mineral’ or ‘physical’
sunscreens, work by reflecting or scattering UV rays and
radiation. Some sunscreens combine both organic and
inorganic components. Two types of inorganic sunscreens
available are zinc oxide and titanium dioxide. Both provide
broad-spectrum UVA and UVB protection and are gentle
enough for everyday use. Zinc oxide is especially useful for
people with sensitive skin, as it rarely causes skin irritation.
Organic, or ‘chemical’, sunscreens are composed of
several active ingredients because no single chemical
ingredient blocks the entire UV spectrum (unlike inorganic
spectrum). Instead, most chemicals only block a narrow
region of the UV spectrum – the majority of chemical agents
used in sunscreens work in the UVB region but only a few
chemicals block UVA rays.
The choice between organic and chemical is a personal
preference and may depend on your usage and skin type.
What does SPF 50+ mean?
Last summer saw Australia introduced to SPF 50+ sun
protection. But how much stronger is this super-strength
sun protection really? According to Ric Williams, research
and development manager at NexGen Pharmaceuticals, a
sunscreen with SPF 15 blocks 93.3 percent of UVB rays,
whilst a sunscreen with SPF 50 blocks as much as 98
percent. However, that doesn’t mean that it should be used
less or not applied as often.
‘The difference of 4.7 percent between an SPF 15 and
SPF 50 would not seem significant to most people,’ says
Williams. ‘However, the higher the SPF, the better protected
you are from UVA, and especially UVA II radiation.
Although UVB is the primary cause of sunburn and skin
cancer, UVA radiation is what causes photoageing – ageing
from the sun that can result in wrinkles, sunspots and
uneven skin tone and texture, and pigmentation.
No matter what level of protection you choose however,
the best advice is to apply your sunscreen properly. ‘The
prudent course of action is to reapply your sunscreen at
regular intervals during the day to ensure an adequate film
is maintained,’ says Williams.
The purpose of routinely reapplying sunscreen is to
ensure that it is still covering the skin properly. Even if a
SPF 30 sunscreen is reapplied regularly, if the intensity of
the UV radiation is high enough and if the skin is exposed
for long enough, invisible damage, or even sunburn, could
occur.’ csbm
What is SPF?
Sunscreens are merely filters, and all of them will let
some UV radiation through at varying rates indicated
by the Sun Protection Factor (SPF) rating. The level
of SPF given to each sunscreen is measured using
a complex mathematical equation, and refers to
the amount of ultraviolet radiation required to cause
sunburn with the sunscreen on, as a multiple of the
amount required without the sunscreen.
The protection given to individuals by a certain level
of sunscreen will vary depending on:
• The amount applied
• The frequency of application
• The skin type of the user
• Immersion in water through swimming
• The extent a person sweats
• Amount of sunscreen absorbed by the skin
160 www.cosbeauty.com.au

skin
CHANGE
YOUR SKIN
A LEADER IN SKIN HEALTH AND
BEAUTY, OBAGI SKINCARE
LOOKS SET TO REVOLUTIONISE
COSMECEUTICALS IN AUSTRALIA.
CAITLIN BISHOP REPORTS.
Built on the philosophy of changing the skin to
optimise skin health, Obagi Skincare, distributed
by iNova, brings established credibility, cuttingedge
science and a selection of revolutionary ranges to
Australian skincare.
‘Originally, Obagi was developed by a small group of
physicians in the US who wanted to prepare a patient’s skin
for cosmetic procedures,’ says International Obagi Trainer,
Aimee DeMarais. ‘So the very origination of the brand as
a skincare line was to boost skin health and help maintain
results following treatment.’
The Obagi ideology is built
around changing skin, and
boosting skin health, from the
inside out
Today, it’s become a great standalone product; the
Obagi ideology is built around changing skin, and increasing
skin health, from the inside out,’ she continues.
Effective in treating a range of skin concerns, Obagi is
formulated to help reduce and prevent pigmentation and
improve the appearance of fi ne lines, wrinkles and scarring.
The products are designed to counter skin laxity and
enhance skin tone and texture. Certain ranges are specially
formulated to effectively treat adult acne and combat
specifi c signs of ageing.
SKIN TRANSFORMATION
Obagi’s transformation ranges are complete skincare
regimes designed to effectively address and improve all
elements of skin health. The Nu-Derm, Clenzi Derm and
Obagi-C RX System ranges all incorporate active ingredients
that work within the skin to purify the complexion and help
combat the signs of ageing.
Nu-Derm is an anti-ageing therapy designed to transform
skin behaviour at a cellular level. The range is used to help
reduce the appearance of age spots, fi ne lines and wrinkles,
skin laxity, pigmentation, uneven texture and redness.
The Clenzi-derm is specifi cally formulated to remedy
adult acne, and the Obagi-C RX System uses Vitamin C
to help counter the early signs of ageing.
These transformation systems are available alongside
targeted solution creams, which are formulated to address
more specifi c areas of concern – for example, décolletage
treatments and eye contour products.
‘It is the combination and balance of active ingredients,
growth factors, antioxidants and alpha hydroxy acids that
ensure each component in an Obagi product is working
at an optimum level. By partnering different ingredients
and products, Obagi changes skin from the inside out,’
DeMarais concludes. csbm
VITAMIN C:
A SKINCARE ESSENTIAL
Used to boost results as an adjunct to the
transformation systems, the Obagi Professional-C
Serums protect the skin against environmental
damage and help reduce the signs of skin ageing.
The serums are available in three strengths
– 10, 15 and 20 percent – and are formulated to
deliver maximum antioxidant protection against
harmful free radicals. Professional-C Serums can
be tailored to suit any skin type, for a brightening,
protective and rejuvenating effect.
www.cosbeauty.com.au 161

skin
Reprogram
your skin
DNAEFG Renewal is the latest skincare range from Advanced
Cosmeceuticals and is designed to reprogram the skin to look, act
and feel more youthful. Caitlin Bishop reports.
While dynamic wrinkles can be linked to overexpressive
brow muscles, sunspots to ultraviolet
radiation and skin laxity to those ever-deteriorating
collagen fibres, the way these factors manifest to impact the
rate and extent of skin ageing is related to DNA damage.
During the process of ageing, damage occurs to the DNA
of skin cells and, as these damaged cells renew, the quality,
resilience and integrity of the skin deteriorates.
In targeting this process and helping the skin to look and
feel more youthful, US dermatologist and former president
of the American Academy of Dermatology Dr Ronald Moy
has developed a results-driven skincare line. The range,
called DNAEGF Renewal, is distributed by Advanced
Cosmeceuticals and is formulated to help repair and correct
for anti-ageing effects.
‘The link between DNA damage and ageing is seen in
all the components of the skin,’ Dr Moy explains. ‘When
collagen fibroblasts are damaged in their DNA, they will
replicate and continue making abnormal or insufficient
collagen, which causes the skin to become thinner. The
162 www.cosbeauty.com.au

skin
enhance natural skin regeneration. While the use of GFs in
skincare is not new, skincare products typically use growth
factors derived from E. Coli, or bacteria. DNAEGF Renewal
is the first range to use barley-derived growth factors, which
are touted to be more stable, pure and effective in repairing
damaged skin.
‘E-coli products should be refrigerated because they’re
not very stable,’ says Dr Moy. ‘This is due to contaminants
called endotoxins that develop in bacteria over time. We
were the first to look at barley-derived growth factors from
a cosmetic perspective. They’re stable, don’t have to be
refrigerated and, quite simply, they just work.’
The range is clinically
proven to help decrease wrinkles
and pore size, as well as lift
and tighten the skin of the eyes
and lower face
same process is seen when DNA damage occurs in
pigment cells, which eventually become pigmented lesions.
The range stemmed from Dr Moy’s work into preventing
the development of skin cancers in sun-damaged skin.
In using DNA repair enzymes to reverse pre-cancerous
sunspots, Dr Moy found the treatment held significant antiageing
benefits.
‘It was really the prevention of cancer that we started
with, as there are several articles on the treatment and
prevention of cancer using DNA repair enzymes,’ Dr
Moy explains.
‘When we started using the first version of the creams,
we found it to be effective in helping to prevent skin cancers
but we also saw dramatic anti-ageing results,’ he says.
‘Ageing and cancer go hand-in-hand: DNA damage leads
to cosmetic concerns, and DNA damage in its severest
stage leads to cancer. This range cosmetically enhances
the skin, while also helping to slow down skin ageing and
unwanted skin conditions.‘
Alongside DNA repair enzymes, the range uses growth
factors (GF) to help stimulate the skin’s stem cells and
Yet the key to any skincare range, Dr Moy explains, is
concentration. The use of active, anti-ageing ingredients
is immaterial if the concentration of these ingredients isn’t
strong enough to make a difference.
‘The concentration has to be sufficient,’ he continues.
‘I established the GF concentration by reviewing literature
– GFs have been used in wound healing and I chose the
concentration that was found to be an optimal dose for
effective results in wound-healing studies.’
The DNAEGF Renewal range features seven products:
Growth Factor Serum; Intensive Renewal; Night Renewal;
Eye Renewal; Intensive Moisturiser with Sun Protection;
Foaming Cleanser; and Scar Therapy.
Because of its protective nature and blanket influence
– helping to reverse damage in everything from pigment
to collagen – the range is suitable for all skin types and
results are 
typically seen within a month of regular use.
The ingredients possess anti-inflammatory ingredients,
meaning the products can be adopted easily and irritation
is rare. The effects of DNAEGF Renewal can be seen in the
tone, texture and integrity of the skin.
‘By helping to replenish those DNA repair enzymes
that have been compromised by our environment and
bad habits, DNAEGF Renewal is clinically proven to help
decrease wrinkles and pore size, as well as lift and tighten
the skin of the eyes and lower face,’ Dr Moy says.
‘At the end of the day, youthful skin is the result of
repairing the damage already done and preventing further
damage in the future,’ he concludes. csbm
www.cosbeauty.com.au 163

skin
The SEED
principle of
formulating
skincare
SYNERGIE FOUNDER AND COSMETIC
CHEMIST TERRI VINSON SHARES HER
APPROACH TO FORMULATING QUALITY
COSMECEUTICAL SKINCARE.
164 www.cosbeauty.com.au

skin
Formulating cosmeceutical skincare is based on
complex chemistry. It’s not simply throwing together
various active ingredients and expecting a result.
Any cosmetic formulator must respect and have a deep
understanding of:
• How ingredients interact with human cells
• How ingredients react with each other
• Clinical data (both in vivo and in vitro) to support scientific
claims
• Advances in technology and cosmetic science.
Most over-the-counter (OTC) products are created for a
budget and often more money is spent by the manufacturer
on marketing and packaging than the contents on the
bottle! Consumers are now becoming aware of the media
hype and are savvier than ever in understanding ingredients.
When I begin a new formulation, I always refer to my
‘SEED’ acronym, a principle I have followed for many years.
In short, for a finished product to exert the desired benefits,
each active ingredient must adhere to my SEED principle of
formulating. These are the fundamental parameters I require
in each active ingredient when I consider formulating with
it. In my opinion, viable ingredients and finished products
must exhibit the factors outlined below.
The SEED principle
Stability. The ingredient/finished product must not be prone
to oxidation or breakdown under normal environmental
conditions. This includes UV light, heat, oxygen or water.
For example, when considering Vitamin A topicals, pure
retinol and retinaldehyde are relatively unstable forms of
Vitamin A. However, Retinol Molecular, the next generation
of retinol, is stabilised into a molecular film which is highly
penetrating and does not break down.
Vitamin C, according to White Paper data, is most
effective as L-ascorbic acid and not the derivatives (such as
MAP and ascorbyl palmitate). However, the pure L-ascorbic
acid molecule is highly unstable in water and in solution; it
begins to oxidise within hours, rendering it ineffective. The
ideal method of delivering stable Vitamin C is by keeping
the L-ascorbic crystals dry and adding the aqueous
liquid at time of application. There is also a new oil-based
(anhydrous) L-ascorbic acid which is highly stable due to
encapsulation and protection from air and water.
Effectiveness. The ingredient/finished product must
exhibit skin benefits and actually work! The benefits are
as diverse as the needs of the client and include reducing
fine lines and sun damage, and improving blemishes,
pigmentation, redness, irritation and dryness. Clinical data
must be available to support the benefits. I strongly advise
all skin professionals to read and evaluate clinical data
when considering new products.
Elegance. The finished formulation must have that elegant
‘feel good’ tactile quality and must not have an offensive
fragrance. No matter how good the product is, the customer
simply must find using it a pleasant experience. I learnt this
valuable lesson long ago!
Delivery. The cosmeceutical active ingredients must be
able to reach the target cell to create the desired biological
effects. The delivery method depends on a number of
factors, including:
• The depth and location of the target cells (epidermis
or dermis)
• The size and structure of the cosmeceutical molecule.
Large protein particles such as collagen and stem
cells do not penetrate the outer layers.
• The acidity/alkalinity of the ingredient and finished
product. Formulating guidelines must be adhered to
and the final pH of the product must be compatible
with all other ingredients. For example, Niacinamide
(Vitamin B3) is a very stable molecule at a certain pH
level. However, it must not be included in a highly
acidic solution as it will hydrolyse to nicotinic acid and
become ineffective. Furthermore, low molecular weight,
highly acidic or highly alkaline ingredients more readily
penetrate the skin. However, this may also lead to skin
irritation so it must be carefully evaluated.
Developing cosmeceutical skincare isn’t simply taking a
collection of ingredients, mixing them together and sealing
the bottle! It is an exacting science whereby formulators
must understand the chemistry and synergy of ingredients
and perform extensive research and trials before eventual
release to the market.
My SEED principle summarises and highlights what
I base my formulating principles on. It is also what skin
professionals should base their decisions on and educate
their clients with, to ensure the most effective skincare
results. csbm
www.cosbeauty.com.au 165

skin
Renew your
complexion
The new Love Life skincare
range from Hovan’s Group helps
optimise skin HEALTH and fight the
signs of an ageing complexion.
Nicola Donovan reports.
The most significant step in creating a flawless
complexion is first ensuring your skin is in good
health. Besides a nutritious diet and drinking enough
water, your largest organ relies on a quality skincare regime
to guarantee it looks its best.
As we age, our skin requires extra care and support, and
the new Love Life skincare range from Hovan’s Group can
go great lengths in keeping the signs of ageing at bay.
The Love Life range offers four results-driven anti-ageing
products. Inspired by industry veteran Val Glover-Hovan,
the cosmetics have been formulated after years of research
with Australian bioscientists, offering ‘results not promises’.
Ingredients have been hand-selected for their ability to
protect skin cells from environmental stresses, support skin
metabolism and promote rejuvenation from within.
Perfect Day –
Anti-Ageing Moisturiser
Moisturising is crucial when it comes to warding off fine lines
and keeping skin well hydrated. A potent herbal formula,
Perfect Day Moisturiser helps to reduce the signs of ageing
and enhance skin appearance. The formula contains
a complex of collagen-promoting glucosaminoplycans
and galactomannans; linoleic acids, which assist rapid
penetration while helping to firm the skin; and stem cells of
apple fruit to help stimulate the renewal of skin cells.
Perfect Night –
Retinol Renewal Complex
Serums typically penetrate the skin deeper than creams,
and contain more active ingredients to target specific beauty
concerns. The Perfect Night Retinol Renewal Complex is a
soothing night serum that addresses ageing concerns. The
formula contains Vitamin A to enhance collagen synthesis;
linoleic acid to promote and maintain skin health; Vitamin
E and Tamanu oil to restore skin health; seabuckthorn
seed oil as an antioxidant; passionflower to sooth and calm;
and licorice to reduce inflammation and irritation.
Eyes Best –
Exotic Eye Gel
Eye creams are essential for helping to keep the thin,
delicate under-eye area hydrated and smooth. The Eyes
Best Gel formulation is a potent eye cream that helps to
reduce the dark areas under the eyes, while reducing the
appearance of crow’s feet. The formula contains Tamanu oil,
which is known for its healing properties, and a mix of herbs
to stimulate collagen synthesis. It’s also fortified with kiwifruit
enzymes, antioxidant grape seed, Vitamin E and green tea.
Beauty Light –
Lightening Cream
Hyperpigmentation can develop due to a variety of reasons
– from sun damage to hormones during pregnancy. Often
making skin tone uneven, pigmentation is a common beauty
concern. Alpha fruit acids and citrus extract in the Beauty
Light Lightening Cream target darker skin spots to help
reduce their appearance. The cream has a broad-spectrum
sunscreen to help prevent further pigmentation, as well as
the triple action of urva-ursi (bearberry), arbutin and zinc
glycinate to help stop the browning action of melanocyte
production. csbm
166 www.cosbeauty.com.au

SUBSCRIBE NOW!
The fi rst 10 subscribers receive a free pack
from Synergie Skin valued at $129 each
Synergie Skin offers the ultimate Anti-Ageing Skincare Kit
The pack contains the essentials needed to help promote overall skin
health and radiance: Gentle Cleanser; Ultimate A Serum; Vitamin B
Serum; Pure-C Crystals; and Reclaim Anti-Ageing Moisturiser.
Synergie Skin’s newest product, SuperSerum, is also included in the
kit. It combines the power of scientifi cally generated peptides and
microbial biotechnology to create the ultimate anti-ageing serum,
with clinical data to support results. This revolutionary serum is the
culmination of years of scientifi c research into the biology and
natural ageing processes of skin.
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eauty & spa
That’s a wrap!
LOSE 15 CENTIMETRES FAST WITH THE INTERNATIONAL BODY WRAP FROM
NICOLE’S BEAUTY SALON. AIMÉE SURTENICH REPORTS.
If you want a last-minute centimetre-stripping option for
a special occasion or to kick-start your body after the
party-fuelled festive season, the International Body Wrap
offers a solution. It’s guaranteed to take 15cm off your total
body circumference. And the best part? The treatment is
free if you don’t blitz the minimum 15cm.
Detox your body
The International Body Wrap uses Dead Sea clay to cleanse
and detoxify your body of impurities such as toxins and
free radicals.
Your body is fi rst measured and marked up so that your
exact centimetre loss can be calculated after the treatment.
Then you are wrapped from head to toe with bandages
soaked in natural Dead Sea clay.
‘The all-natural clay solution acts like a giant poultice
and draws out toxins and impurities from your body while
cleansing your skin and leaving it softer, smoother and
more toned,’ says Nicole Gruodiene from Nicole’s Beauty
Salon in Double Bay, Sydney. ‘As the clay particles become
hydrated, they expand and absorb many times their own
weight in body toxins.’
After an hour, the wraps are removed to reveal skin
that is more radiant and toned with an improved overall
appearance. Skin tissue is compressed and the soft fatty
tissues are compacted, resulting in a reduction of body
circumference. The result? Your body ends up trimmer and
more toned without any weight loss. The centimetres lost
are not a result of water loss and therefore results should
last at least 30 days – and signifi cantly longer if you watch
your weight and lead a healthy lifestyle.
‘A full body wrap is a great treatment to detoxify, hydrate
and slim the body,’ adds Gruodiene. ‘It produces results
after just one treatment, or you can opt for a course to gain
even greater results.’
The benefi ts don’t stop there. Detoxifying the body offers
a host of beauty and health advantages, including improved
circulation, refi ned skin texture and higher energy levels.
Detox your skin
If the festive season is taking a toll on your body, it’s
likely your face will also benefi t from a little detox. A
summer treatment plan incorporating sea salt scrubs and
moisturisi