Cosmetic Surgery and Beauty Magazine #61


Cosmetic Surgery & Beauty Magazine is the definitive guide to the aesthetic medicine industry for anyone considering a treatment, therapy or surgical procedure. This quality quarterly publication contains comprehensive information about practitioners, equipment, techniques, processes and options, presented clearly and completely. The strong emphasis on input by industry professionals provides profiles of the practitioners and understanding of their approach to each procedure, enabling readers to make informed choices in their initial approaches to deciding what will best suit their needs. Hundreds of untouched before-and-after photographs provided by the practitioners themselves graphically illustrate both treatable conditions and the results that can be obtained. Cosmetic Surgery & Beauty Magazine is essential reading for anyone wishing to inform themselves about the options available in aesthetic medicine in Australia.
This issue includes:
- Love your skin
- Nose surgery - common techniques
- Shape up for summer
- Big decisions - get the most from your consultation
- Your guide to anti-ageing
- Breast surgery patients tell all
- How to master Hollywood hair

RRP $14.95 (incl. GST) (NZ $15.95 incl. GST)

ISSUE 61 • AUG-OCT 2013




































Make the


to how you

look and feel

Dr Vlad Milovic MD FRACS (PLAST.) , well-known

Plastic and Cosmetic Surgeon, with over

20 years of training and experience in

Australia and across the world, offers the

latest and most up-to-date approach to

breast enhancement for the most natural

and youthful look and feel.

Contact us today for your personal

appointment with Dr Vlad.

PHONE 02 6260 4882











• Laser Therapy • skin Care

• CosmeTIC InjeCTabLes

Ph: (02) 9389 4497




suite 1902 Level 19, Westfield Tower 2, 101 Grafton st bondi Junction sydney nsW 2022

© 2013 Palomar Medical Technologies, Inc. Palomar and Palomar Emerge are

registered trademarks of Palomar Medical Technologies, Inc. ALL RIGHTS RESERVED.



Beautiful skin is

easier than ever

with the EMERGE

Fractional Laser

The EMERGE Fractional Laser is the latest laser skin resurfacing technology

from Palomar that treats undesirable skin imperfections on your face and body.

EMERGE is quick and easy to use and can improve a multitude of skin flaws

and give you youthful, radiant and more beautiful skin all over!



EMERGE can improve the appearance of:

To see more amazing results from Emerge

visit the website

Age spots

Sun damage

Skin tone & texture


Surgical scars

Acne scars

Stretch marks

EMERGE Fractional Laser will reveal your beautiful skin from within!

Scan the QR code and

find your provider today!

The solution to stamp away wrinkles and scars


Wrinkles, Wrinkles, Wrinkles! I look in the mirror and it’s all I see.

I honestly don’t want to have a laser resurfacing treatment. The

thought of this, seems extreme, aggressive and I’m not ready for

that (just yet). I really want something more but my

skincare isn’t refining my skin enough.

What is the middle ground?

Collagen Induction Therapy (CIT)

Dermastamp - Collagen Induction Therapy procedure works by stimulating

your own body’s collagen. Your body will start to naturally regenerate the skin. It

will only take up to 6 weeks before visible signs of regeneration are seen & the

process will continue over the following months, providing you with a gradual &

long lasting enhancement. The Dermastamp also utilises INFUSE-AS-YOU-GO

technology to instantly infuse anti ageing ingredients deep into the skin to give it

an instant hit of stimulation. You will arise with instantly softer, more supple skin!

You’re going to love this treatment!

• Results can be seen within 6 weeks

• Instant Collagen Stimulation

• Instantly Hydrating




133 Balgownie Rd, Balgownie

02 4284 5602


10 Henrietta St, Double Bay

1300 138 797


127 Orina St, Gosford

(02) 4365 0406


Annandale, Double Bay, Miranda

02 9692 9929


L1, 357 Military Rd, Mosman

02 9904 3500


330 Oxford St, Paddington

02 9368 0100


4/59-75 Grafton St Bondi Junction

(02) 9387 3900


L22/520 Oxford St, Bondi Junction

02 9386 1533


Shop 2, 220 Elgin St, Carlton

1300 513 913


Suite 10, 51-55 City Rd, Southbank

(03) 9699 3177


475b St Kilda St, Elwood

03 9537 7355


414 Toorak Rd, Toorak

03 9827 9243



1/1001 Point Nepean Rd, Rosebud

03 5982 0610


Ground, Equinox 2, 70 Kent St, Deakin

02 6281 3294

The solution to stamp away wrinkles and scars


Acne Scars are a real concern for many. In this day and age of

perfection, it’s the one thing that is instantly noticeable in photos,

instantly noticeable on your first date and instantly on your mind when

you think of your skin…

Did you know that to fix this issue is actually very simple

and very inexpensive to treat.

Scar Reduction Therapy (SRT)

Dermastamp - Scar Reduction Therapy procedure works by releasing old

fibrotic scar tissue deep within the skin. Scar tissue is what creates visible

scars on the skin’s surface. The treatment will repair the skin naturally,

working below the surface in the dermis. This takes time as new collagen

& elastin fibres are formed, softening scars, generating new skin cells &

enhancing blood supply.

• Results can be seen within 6 weeks

• Treatment time can take 5 mins

• Inexpensive to treat

• 70-80% improvement of scars

• No downtime







173 Davey St, Hobart

03 6223 8981


206 Sterling Highway, Claremont

08 9285 5100


Suite 102, 15 Scott St Toowoomba

07 4638 2700


81 Phillip St, Mount Pleasant

07 4942 9910


Centro On Nathan - Crn Fulham

& Nathan St Townsville www. 07 4779 3333


Suite 16, 11 High St, Launceston

03 6331 0377


Shop 4, 4 Sleat Rd, Applecross

08 9316 3836


Capalaba Medical Centre

189 Old Cleveland Rd, Capalaba

07 3245 9600


2 Short St, Southport

07 5509 4488


L2, 4 Vulcan Lane, Auckland City

0800 226 869


covering perth + surrounding

0478 616 781


PRACTITIONERS Village 15/1932

Logan Rd Upper Mt Gravatt www. 07 38494111


Suite 2, 200 Mulgrave rd Cairns

07 4041 5770


7/28 Remuera Rd, Newmarket

09 550 2664

Statina Healthcare is committed to

providing high quality post-surgical

garments and scar treatments to

ensure optimum results.


Raineywear garments are a primary resource for

post-surgical compression garments for plastic

and cosmetic surgery.

Gentle support and compression

Breathable DuPont Power Lycra fabric

Suitable for Breast Augmentation, Facelift,

Liposuction, Arm (brachioplasty), Tummy

Tuck (abdominoplasty) and Male Chest

Reduction (gynecomastia).

Carefi x

Carefi x garments have been created to provide

functional comfort for the recovery period

following a surgical procedure.

Seamless design

Front closure

Suitable for Breast Augmentation,

Reduction, Reconstruction, Mastopexy,

Lumpectomy and Radiation.


Biodermis provides the most comprehensive

range of scar management products providing

its silicone gel technology to dermatologists and

plastic surgeons world-wide.

Statina Healthcare Australia P 1300 365 404 F 1300 308 259 W





Reduce the signs of ageing with

natural-looking results for a

refreshed and youthful appearance




Gain confidence in your body

again with Liposonix.

The Liposonix treatment uses noninvasive,

high-intensity focused ultrasound to target

fat around your trunk and lower extremities

(abs, flanks, hips, thighs, and buttocks)

without surgery.

Find a practitioner in your area:

Make sure every day is your

skin’s premiere with Thermage.

Thermage procedures can help smooth and

contour your skin for an overall younger

looking appearance in a single treatment.

Find a practitioner in your area:

© 2013 Solta Medical, Inc. All rights reserved. Thermage and Liposonix are registered trademarks of Solta Medical, Inc. or its subsidiaries.

Thermage side effects are generally mild and may include redness, swelling and mild/moderate pain during treatment. Potential risks include itching, blanching, blisters, bumps, burns,

scabbing, scarring, bruising pigment changes, altered sensations, surface irregularities, and herpes reactivation.

The Liposonix system is for use when there is at least 1.0 cm of subcutaneous adipose tissue beyond the selected focal depth setting of the system in the area to be treated. Most frequently

reported side effects during Liposonix treatment are discomfort, pain, cold, prickling, tingling, or warmth. Treatment is contraindicated for patients who are pregnant or suspected to be

pregnant. The most frequently reported side effects after Liposonix treatment are pain (discomfort), bruising, redness, and swelling, which are generally described (or rated) as mild.

Dr Alex Phoon

MBBS BSc (Med)

MS (Plast)


Plastic Surgeon




Silkwood Medical

Level 4, 75 Grafton Street Bondi Junction NSW 2022

Telephone 1300 SILKWOOD or 1300 745 596

Dr Pouria Moradi

MBBS BSc (Med)

MRCS (Eng)


Plastic Surgeon




Silkwood Medical

Level 4, 75 Grafton Street Bondi Junction NSW 2022

Telephone 1300 SILKWOOD or 1300 745 596

Body Balance

Dr John Flynn


Dr John Flynn

skin clinic

Use your fat to redefi ne


your body shape

skin clinic

Rediscover youthful contours

and subtle curves with

stem cell enriched fat transfer

Cutting Edge Cosmetic Enhancement

Stem cell therapies help us build on the results we can

already achieve with fat transfer procedures. We can harvest,

activate and reinject these powerful cells from your

own body to help restore volume lost with age or add subtle

shape to the face, breasts and buttocks

Scientifi c Backing

With access to the latest in stem cell technology and

research from Monash University, our adjoining laboratory

has a strong scientifi c backing, helping us achieve outstanding





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




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 |

Dr John Flynn

20/4/09 9:01:39 AM

cosmedic& skin clinic

Dr John Flynn

| 38 Automotive Drive Wangara WA 6065 Tel 08 9409 5433

| 1800 242 011 | SA | NT | NSW | WA | QLD | VIC | Available at selected clinics and professionals


“A Skinny Jeans Day”

Exilis redefines Non-Invasive body & facial treatments.

Melt away centimetres, the non-surgical way.



Your Exilis Specialist Clinic


Elixxir Medispa

Dr Michael Miroshnik

Bondi Junction

1300 854 610

Face Today Mediclinic


1300 668 573

Alpha Cosmetic Clinic

Dr Phil Caraiscos


02 9579 2777


Face Today Mediclinic


07 4053 3021

Allure Clinic

Dr Mark Magnusson


1300 662 960

Sunshine Vein Clinic

Dr Hugo Pin

Peregian Beach

1300 698 346


Rejuvenex Medical Aesthetic

& Laser Clinic

Blackburn South

03 9877 2366


Launceston Plastic Surgery

Dr Gary Kode


03 6334 9313


Bramis Facial Rejuvenation Clinic

Dr Mela Brankov


08 6161 5425


Dr Joanna Teh


08 9205 1995

E: | W:


yourself this

spring with our

special offer

433 Crown Street

Surry Hills

NSW 2010

02 9699 2667

*Valid for fi rst time customers only. Offer closes

December 31 2013. Colour service includes half

head of highlights or semi-permanent colour only.

Are you bored with your current look?

Why not freshen up in time for summer

with our discounted pampering package.

Enjoy a wash, cut, blowdry, conditioning

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Look and feel good, from top to toe

Dr Joseph Georghy & Dr Vera Georghy have

over 65 years of clinical experience between them.


Dr Georghy is a world pioneer in PhotoTherm ® , a revolutionary

procedure used to improve the appearance of rosacea, acne and acne

scarring, freckles, moles, age spots, large pores, wrinkles, vitiligo,

pigmentation, cellulite, scars and keloids.

Dr Georghy has developed HelioTherm ® , an exciting new procedure

designed to reduce fat deposits and improve the tone and texture of the

skin. Ideal for reshaping the abdomen, thighs, buttocks and other areas

with no downtime. Call today for more information.

Other services include

• Superbug acne therapy

• Scarless facelift

• HelioTherm ® Facelift

• Wrinkle reduction

• LipoSculpture

• Stretch mark treatment

• Breast reduction (non-surgical)

• Hair-laser stimulation

• Skin cancer treatment

• Labiaplasty & Hymenoplasty

• Excessive sweating correction

• Ultroid non-surgical haemorrhoid



Discover the smile of your dreams thanks

to dental services from Dr Vera Georghy

• Painless dentistry

• Porcelain veneers, crowns and bridges

• White fi llings

• Old fi llings replaced

• Preventative dentistry

• Home bleaching

• Mouth guards



Cleaning, scaling &




AMEC Specialist Surgeon (Ljubljana, Slovenia)

B.Sc. General Surgery (Zagreb, Croatia) Fellow

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


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



313 Pacifi c Highway

North Sydney NSW 2060 (Opposite Hazelbank Rd)

02 9956 7200


Because nothing is more natural than you TM

Because nothing is more natural than you TM

Get your skin

glowing this spring



Improve fine lines, skin tone and texture

A treatment for your skin based

on your body’s own processes

Selphyl treats the root cause of skin aging

by triggering tissue regeneration and collagen

production without the use of any synthetic

or artificial components.

Platelet-rich plasma is extracted from a small

amount of your blood and used to treat desired

areas. Giving an overall improvement to the skin.

Selphyl helps restore the youthful appearance

of the face, neck, décolleté and hands.

Ask your physician today if Selphyl is right for you

For more information please contact us






26 Editor’s letter

28 Contributors

36 Newsfront

44 Where does that come from?

Typhoid Mary

189 How to subscribe

210 Directory


62 The never ending story

Is hGH the key to anti-ageing?

70 Love the skin you’re in

Discover ultimate skin perfection

74 Skin SOS

Is your skin crying out for help?

78 Diet and the skin

80 Smoking and your skin

Kick the habit and see results

140 By a nose

Your guide to rhinoplasty

155 A combined approach

Thermage and Ulthera

206 Reveal a radiant complexion

Exfoliators and face masks: your

new beauty essentials


46 ASAPS 2013

Behind the scenes at Port Douglas

50 Cosmetex 2013

54 Petition for safety

Raising standards for patients

58 Ready, set socialise!

Why clinics are embracing

social media

60 Putting age management

on the agenda

The Sydney Spa & Beauty Expo


62 The never ending story

64 Forever young

The role of IGF-1 in


66 Generation Regeneration


70 Love the skin you’re in

Discover ultimate skin perfection

74 Skin SOS

Is your skin crying out for help?

78 Diet and the skin

80 Smoking and your skin

Kick the habit and see results

82 Best face forward

84 3D Rejuvenation

90 See the light

Photodynamic Therapy

94 A journey of positivity

Facing up to pigmentation

96 Skin needling

Discover the latest advances in

skin needling technology

102 A facial like no other

104 Stem cells and skincare

Facing up to pigmentation

106 Skin deep

114 Heal over

Scar management

116 Unlock your beauty potential


120 Patient case studies

128 Tailored to fit

How procedures are tailored to

each patient

130 Consult for success

Your breast augmentation

consult explained

134 Big decisions

136 Compression garments


140 By a nose

Your guide to rhinoplasty

144 With great finesse

146 Structural rhinoplasty

Creating long-lasting noses

148 A nose for detail

Why the nose is often just the

beginning of your rejuvenation

150 Reshaping the nose


152 Full face rejuvenation

Modern facelift techniques


The fi rst 10 subscribers receive a free home

care Dermaroller valued at $150 each

Did you know that as little as three per cent of

the skincare products you apply to your skin

actually penetrate the surface? By rolling the

Dermaroller across your skin after applying

serums, the penetration of skincare can

dramatically increase by more than 200 times.

Use every night or every second night to start

to see softening of fi ne lines and wrinkles.

Visit to

fi nd out more.


see page 189

154 Composite facelift

156 Beauty through the ages

What to do in your 30s, 40s, 50s

and beyond

160 Joined Forces

162 The TAN-Facial

Embracing the golden ratio

164 Guided by the light

The iGuide neck lift

166 Anti-wrinkle injections

168 The Angel Lift


176 Ignite your smile

Give your smile a makeover in

one visit to the dentist


178 Shape up

Some of the most popular body

shaping procedures

180 Target stubborn areas

Non-surgical approach to

body contouring

186 The personal touch

Invest in a personal trainer


192 When bigger is better

Male enhancement surgery

194 Speak out!

Tackling common female



196 Extended benefits

Get longer locks, fast!

198 I am woman

Red-carpet glamour everyday

beauty & spa

202 Beauty Buzz

The latest products to hit

beauty shelves near you

205 Editor’s favourites

206 Reveal a radiant complexion

Exfoliators and face masks: your

new beauty essentials

234 The body beautiful

Keep your body smooth and

supple with these skincare faves

cover stories

RRP $14.95 (incl. GST) (NZ $15.95 incl. GST)

ISSUE 61 • AUG-OCT 2013



























62 Forever young

70 Love your skin

120 Real patients tell all

130 Big decisions

140 Nose surgery

178 Shape up for summer

196 Hollywood hair

Now you can subscribe online at

A medical approach

to flawless skin with

treatments performed

by qualified nurses

and doctors.

“Clear Complexions is about healthy skin.

We fill a niche between a beautician and a

dermatologist and treat everyday skin conditions

with a medical approach. Our nurses achieve

real improvement in your skin and teach you

how to keep it healthy going forward.”

Suzie Hoitink RN, founder

of the Clear Complexions Clinics

Associate Member of the


To book your consultation with a nurse,

call the clinic today.







Sun Spots


Leg Veins


Aged & Tired Skin

Permanent Hair Reduction

Acne & Acne Scarring


Skin Tags



T 02 6251 8889


T 02 6231 0003



T 02 6241 7660





T 02 9555 7287



As you know, our last issue marked the 15 year milestone in the

life of Cosmetic Surgery and Beauty Magazine and I’ve been

overwhelmed by the interest and support shown by all of you

following our 60th issue.

The months that have passed since have been jam packed, not

only with a seemingly endless stream of interviews (scan the QR code

below to watch my interview on Sky News Business), but also with a

number of important industry events. We are as committed as ever to

our goal of bringing you the latest information on cosmetic procedures

as we were when we fi rst published our magazine, back in 1998, and

we’ve reported on each of these events in this issue. From page 46

you’ll fi nd photos and news from the 36th Annual ASAPS event, as well as Cosmetex 2013.

Earlier this year we asked you what you were most concerned about when it came to

your appearance. The vast majority of you fl agged your skin as your number one concern.

We listened, and this issue is packed with everything you need to ensure your body’s largest

organ – your skin – is in tip-top condition. Turn to page 70 to fi nd out how you can change

your diet and lifestyle to see visible improvements in your skin, and learn which procedures

are best suited to optimising its condition.

Our survey also revealed just how many of you have considered – or undergone –

rhinoplasty. It is consistently within the top fi ve most popular cosmetic procedures, so in this

issue we take a closer look at the techniques used to improve and correct the appearance

of the nose (page 140).

Our beauty shelves have been overfl owing with new products set to hit stands this spring

so our beauty and spa section is full of features you’ll love. Uncover the latest products

designed to keep your skin smooth and supple, and learn how and why you should be

introducing face masks and exfoliation into your beauty regime.

Don’t forget to join us online and let us know what you think of our latest issue. You can

fi nd us on Facebook (/cosmeticsurgeryandbeautymagazine) and, until the next issue, keep

up with the latest cosmetic news on

Michelle Kearney


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.


Read the digital edition at

Issue 61

AUG - OCT 2013


Michelle Kearney

Editorial Director

Lizzy Fowler

Production Coordinator

Camila Kawashita

Art Directors

Debbie Pilarinos,

Stéphanie Blandin de Chalain


Lauren Alexander, Caitlin Bishop, Tara Casey,

Nicola Donovan, Evelyn Duffy, Lizzy Fowler


Debbie Pilarinos, ShutterStock, Picdesk

Distribution & Subscription Enquiries

Bill Dunk

Phone 02 9398 2755 Fax 02 9398 2855


Advertising Enquiries

Michelle Kearney

Phone 02 9398 2755 Mob 0419 624 246


Editorial Enquiries

Michelle Kearney, Lizzy Fowler

Phone 02 9398 2755 Fax 02 9398 2855


Produced & Published by Bella Media

ABN 86 082 157 695

Managing Director

Michelle Kearney

General Manager

Bill Dunk

Public Relations, Marketing

& Event Organisation

Phone 02 9398 2755 Fax 02 9398 2855

Office address

Level 1, 42a Frenchmans Road

Randwick, NSW, 2031

Phone +61 2 9398 2755 Fax +61 2 9398 2855

find us on


australian cosmetic

surgery magazine,

bella beauty magazine,

cosmetic beauty


follow us

on Twitter



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.

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


Dr Darryl J Hodgkinson


American Board of Plastic Surgery

Cosmetic Plastic Surgeon

The definitive website for all your cosmetic surgical queries. More than 50

megabytes of information and hundreds of Dr Hodgkinson’s outstanding results.


Ricky Allen Dr Leslie Baumann Dr Glenn Calderhead Dr John Flynn Dr Joseph Georghy Dr Doug Grose

Suzie Hoitink Val Glover-Hovan Dr Darryl Hodgkinson Eva Karpati Dr Jim Leavesley Dr Steven Liew

Dr George Marcells Dr Jennifer Martinik Dr Vlad Milovic Dr William Mooney Dr Colin Moore Dr Pouria Moradi

Dr Sarkis Nalbandian Dr Warwick Nettle Dr Benjamin Norris Dr Oseka Onuma Dr Alex Phoon Rita Porreca

Dr Arthur Swift Dr Tony Tan Dr Howard de Torres Dr Kourosh Tavakoli Terri Vinson





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

Suite 10, 6 Meridian Place, Norwest Business Park, Bella Vista

1300 368 107 |




Skinboosters deliver deep skin hydration by holding water within

the dermal layer. Natural moisture levels are replenished from the

inside, creating smooth, firm and luminous skin on the outside.

For skin that glows from within, talk to your cosmetic practitioner

about Skinboosters or visit WWW.WRINKLECLINICFINDER.COM.AU

Galderma Australia, 13B Narabang Way, Belrose 2085, Australia. ABN 12 003 976 930.

Tel: 1800 144 944. Fax: 9986 1699. EMVGAL0082b Last revised July 2013.

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





If doctors display this Seal,

you can be assured they

comply with the College’s

exemplary standards of its

Code of Practice, available


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


& Implant Surgery


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.


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


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






Discover the

logic behind

looking beautiful



Dr Tan and his team at Beauty Logic

offer a combination of non-surgical and

surgical treatments in an exclusive,

relaxing environment.

‘‘My aim is to release a patient’s natural beauty potential...

to create the best version of you, rather than a different you’’

• Dermal Fillers

• Anti-Wrinkle Injections

• Platelet Rich Plasma

• Thread Lifting

• Chemical Peels

• Microdermabrasion

• Micro Needling Therapy

• Sclerotherapy

• IPL Therapy

• Laser Hair Removal

• Intravenous Nutrients

• Acne Management

• Non Surgical

Body Contouring

• Blepharoplasty

• Liposuction

Dr Tony Tan

Specialist Cosmetic Physician

MB BS, Bachelor of Science



• Associate member of the Cosmetic Physicians

Society of Australasia (CPSA)

• Member of the American Academy of Aesthetic

Medicine (AAAM)

• Member of the Australasian College of


• Member of the A4M

• Member of the ACNEM

Phone 1300 196 196

196 The Boulevarde Fairfi eld Heights NSW 2165




Pink hope

The news that Angelina Jolie – one of the world’s most glamorous women –

had undergone a double mastectomy at the age of 37 stunned the world and

brought a very relevant debate to the forefront of international media in May

this year. As a carrier of the BRCA1 gene, Jolie had been faced with an 87%

chance of developing breast cancer in the future. She therefore opted to undergo

her procedure as a preventative measure – bringing her risk of developing the

disease down to just 5%

It’s a similar journey to that undertaken by Krystal Barter, founder and director

of Pink Hope, whose national campaign ‘Bright Pink Lipstick Day’ will take

place on September 20th. ‘I never thought in a million years that I would have

something in common with Angelina Jolie,’ Barter says. ‘When I found out it

stopped me in my tracks. For someone like her to share her story gives hope to

those affected by the gene.’

Barter founded Pink Hope in 2009, after her experience meant she had to seek

help and advice from overseas. She hopes her experience, along with Angelina

Jolie’s announcement, will give hope for the future of those suffering from the

rare genetic disorder. Since Jolie’s revelation, Cancer Council Victoria says there

has been a massive 1033% increase in the number of calls its helpline receives.

‘Angelina coming out with this publicly has seen hundreds of helpline calls from

women mentioning her name as a basis for their call,’ says Cancer Council NSW

helpline program manager Lorna O’Brien. ‘People are really wanting to live well

and be healthy, and they see that she’s done it, so they realise that they can.’



Eleven per cent of the global burden of disease can

be treated with surgery, yet two billion people around

the world have no access to basic surgical care. In

fact, healthcare systems in some of Australia’s closest

neighbouring countries simply aren’t robust enough to

meet the extensive needs of the population.

Principal plastic surgeon and founder of Australian

Skin Face Body (ASFB) clinics, Mr Ian Holten, is donating

his services to help bridge this gap and change the lives

of children in the Pacifi c region.

Mr Holten volunteers his services through Interplast,

a not-for-profi t organisation that, since 1983, has been

working in developing countries such as Papua New

Guinea and Burma to help bring about change.

‘My work with Interplast is some of the most rewarding

I do,’ says Mr Holton, who has recently returned from

volunteering in Interplast’s partner countries in the

Pacifi c, including Vanuatu and Fiji.

‘The people we treat, mainly children, have the most

beautiful spirit,’ he adds. ‘There are many patients and

families who are so grateful. I see the families years later

and hear about how happy the children are and the

difference the surgery has made to their lives.’

Mr Holten regards working for Interplast as a privilege

and an honour, and takes time out from his day-to-day

role as principal surgeon at Australian Skin Face Body

clinics to perform a number of vital services whilst

volunteering overseas.

‘Interplast work is about teaching and being taught,’

says Mr Holten. ‘It provides an opportunity to learn

about new cultures and hear about both devastating and

inspirational stories. It’s life changing work.’


Sydney surgeon

presents at ICAPS

Sydney plastic surgeon Dr Darryl Hodgkinson

was recently honoured to attend the International

Consortium of Aesthetic Plastic Surgeons (ICAPS)

meeting in Singapore. A gathering of international

surgeons, Dr Hodgkinson was pleased to spend time

with like-minded, world class colleagues discussing

peer-reviewed literature and research.

Whilst at the conference, Dr Hodgkinson gave

presentations on his face and neck lifting procedures

as well as breast augmentation and diffi cult cases

with chest wall deformity. He also presented papers

on rhinoplasty and nasal reconstruction.

Optimal skincare:

take the quiz

Best selling author and internationally

renowned dermatologist, Professor

Leslie Baumann, took time out of

her busy schedule to chat to CSBM

during her recent trip Down Under.

She told us of the importance of

selecting a home skincare regime specifi cally tailored to

your own skin type – something discussed at length in her

book The Skin Type Solution. If you’re not sure what your

skin type is, pick up a copy of the book or head to Professor

Baumann’s website, where you’ll fi nd a comprehensive quiz

designed to accurately diagnose skin type.

‘The quiz will tell you whether you’re oily or dry, sensitive

or resistant, wrinkled or fi rm and pigmented or not,’

Professer Baumann says. ‘My favourite thing in the world is

when someone comes up to me and tells me what skin type

they are: I get so happy because it means we’re starting to

all speak the same language. When we start speaking the

same language, doctors, department store physicians and

clinic nurses will all be able to communicate more effectively.

At the moment there is no consistency across skin care.’

With a vision to establish a universal language in

addressing skin types, Professor Baumann hopes to

transform skincare into something uniform and seamless

between clinics, surgeries and retailers around the world.


Drink more water,

lose more weight

It’s the simple solution dieters have been waiting for: a fast and

proven way to lose more weight, that doesn’t involve exhausting

workouts or expensive meal plans. Simply by upping their

intake of water, dieters can look forward to greater weight loss,

according to a new review of existing studies.

Published in the American Journal of Clinical Nutrition, the

review was led by Rebecca Muckelbauer, a researcher at the

Berlin School of Public Health, Charité University Medical Center

in Germany.

As a nutrition researcher, Muckelbauer was often asked by

patients whether they should drink water to lose weight, yet

she didn’t have an accurate response. She therefore decided to

examine all the existing studies on weight and water consumption.

Of the 11 studies that fi t her criteria, Muckelbauer discovered

that three showed an increase in water intake among dieters was

tied to greater weight loss. One showed that those who drank

two cups of water before a meal lost four pounds more than

those who didn’t drink extra water; whilst another showed that

women who increased their water consumption whilst dieting lost

more weight than those who consumed less than a litre a day.

Although the study does not reveal exactly how water helps

people shed pounds, Professor Brenda Davy, who was involved

in some of the earlier studies, believes water quashes feelings

of hunger, helping study participants reduce their calorifi c intake.

Muckelbauer agrees that increased fullness is the most likely

explanation, but says that another possibility is something called

‘water-induced thermogenesis’. ‘Drinking water itself increases

energy expenditure of your body,’ she explains. ‘It has an energy

consuming effect. This is not very well studied.’





An estimated 65% of healthcare professionals now

regularly take clinical photos with smart phones. Yet

most are not aware of the legal ramifi cations of such

a practice. Melbourne-based app development

and brand-building company, ProjectProject, has

recently released a unique mobile photography

app designed to help healthcare professionals

comply with electronic health record and patient

privacy legislation. PicSafe Medi allows healthcare

professionals to safely snap, transmit and securely

store patient-consented clinical photos.

‘PicSafe Medi was designed to meet a real-time

problem head on. With the majority of healthcare

professionals surveyed out there now using their

own camera-equipped smart devices in their

practices, these devices clearly benefi t our patients

by helping us do our jobs better and more effi ciently,’

says Dr Ted Carner, a key founder of the PicSafe

Medi solution and system.

Pre-PicSafe Medi, however, no secure,

standardised system existed for safely using these

devices within a medical setting.

Farewell to the Father of Topical Antioxidants

The dermatology community lost a leader in the fi eld of antioxidant technology and skin

cancer protection earlier this year when Dr Sheldon Pinner, often referred to as the founding

father of topical antioxidants, passed away aged 76.

Dr Pinnell, who was an internationally eminent scientist and dermatologist, passed away

peacefully in Durham, North Carolina on Thursday, July 4, 2013.

Dr Pinnell’s investigative research has changed the way the world uses topical antioxidants

today, and he leaves behind an impressive legacy. The fi rst to patent a stable form of vitamin C

proven through peer-reviewed research to effectively penetrate skin, delivering eight times the

skin’s natural antioxidant protection, Dr Pinnell also led major advances in the understanding

of skin biology and the pathogenesis of skin diseases.

Dr Sheldon Pinnell


Clear Complexions arrives in Sydney

A fi nalist in last year’s Telstra Business Women’s

Awards, Suzie Hoitink has this year expanded her

Clear Complexions Clinics from its base in Canberra to

Sydney’s inner west, opening a new clinic in Balmain.

‘We have plans for more clinics in Sydney and are

exploring those options now,’ says Hoitink, who was

driven to create her award-winning business because of

her own personal struggle with poor skin.

Now a registered nurse, Hoitink founded Clear

Complexions in 2005 and it proved an instant success.

‘I made it mandatory that only nurses or doctors treat

clients,’ she says. ‘This has allowed us to source

equipment that wasn’t available to those individuals

without a medical background.’

The new clinic is located on Balmain’s Rowntree

Street, and is open Monday to Saturday.

Celebrating 18 years!

The Double Bay Day Surgery, located in Sydney’s exclusive

Double Bay, is celebrating its 18th Birthday! Twenty years

ago, Dr Darryl Hodgkinson bought a two storey building

in Double Bay and converted it into a fully licensed and

accredited day surgery hospital. Since then, more than

10,000 cases have passed through the Double Bay Day

Surgery and it has continued to expand.

Nearly two decades since the doors fi rst opened and

some members of the original operating room staff are

still assisting Dr Hodgkinson in performing facelifts and

eyelid surgery, rhinoplasties, breast surgery, liposuction

and tummy tucks as well as reconstructive procedures

such as skin cancer resection and reconstruction with a

pathologist on-site.


From Italy with Love

Italian surgeon Dr Ciro Accardo made his annual

trip to Australia in June this year to share his latest

techniques in thread lift surgery. Hosted by Mara

Aesthetics, Dr Accardo spent time at YOU Clinic

in Mosman, demonstrating to Australian surgeons

his advanced thread lift procedures for neck lifting

and lip augmentation as well as a new microsuturing

matrix technology.

Dr Accardo also addressed a packed out

crowd at a symposium held at the InterContinental

in Sydney where he provided an overview on the

latest advancements in absorbable thread lifting

techniques from Europe.

The power

of one

Earlier this year, more than 100 Australian Dermalogica

Skin Therapists returned from what they described

as an ‘absolutely incredible’ symposium in Kuala

Lumpur, Malaysia. Held in June, the conference was an

opportunity for the extended Dermalogica team to gain

insight from some of the most infl uential professionals in

the skincare industry.

The Symposium covered the latest cosmeceutical

ingredients and treatments in the medical setting and

also offered business advice for salon owners.

The Power of One Symposium offi cially opened with

a poolside cocktail party on the evening of Sunday 9th

June. The guest speaker line-up included the inspiring

CEO and Founder of Dermalogica, Jane Wurwand,

Vice President of Research and Development, Dr Diana

Howard and Education Manager of Australia, Asia and

New Zealand, Emma Hobson.

To celebrate a successful symposium, the Malaysian

Team hosted a Gala Dinner for all international guests,

including attendees from New Zealand, Thailand,

Vietnam and the UAE. Traditional Malay Drum

musicians entertained throughout the eight course

banquet, and a live band had everyone on the dance

fl oor well into the evening.

You heard it here fi rst!

A new paramedical clinic called Cosmedic

Professionals is due to open in Five Dock in

September this year. This exciting new venture is

set to help men and women in the local area with

all their inner and outer needs. Look out for more

information in our next issue!



Check out

the new

Bella Media


To coincide with our 15 year anniversary, we’ve given our

corporate website, a facelift.

The launch of the new website, which offers easier

access to our latest news, service offerings and vast content

network, is part of our ongoing efforts to enhance the quality

and availability of information to new and existing clients as

well as to you, our loyal magazine and website subscribers.

The updated website is also a refl ection of the

considerable advances we have made in the last 12 months

with the launch of our digital lifestyle channels SAGE Living,

Single File and Destination Bali; and of our expanded service

offerings, with web design, custom publishing and social

networking now a key focus.

‘I am thrilled with the launch of the new website. Having

launched Bella Media 15 years ago, we felt it was time to

update the look and feel of our corporate website to better

refl ect the quality and diversity of work we perform for our

clients,’ says Cosmetic Surgery and Beauty Magazine’s

editor-in-chief, Michelle Kearney.

‘Although we’re well known as the publishers of Cosmetic

Surgery and Beauty Magazine, many people aren’t aware of

our integrated marketing and PR services, our experience

in event management, our custom publishing branch and

our digital expertise,’ she adds. ‘I believe the new website

will help communicate these services with both new and

existing clients and with our loyal magazine subscribers.’

What’s keeping Hollywood

looking and feeling young?

The Secret that ALL Hollywood Stars Know About is Rewind High Potency IGF-1




Celebrities and Elite Athletes alike have known for some time

that the answer is IGF-1. Using IGF-1 they are losing weight and

have the energy levels of someone 20 years younger. But not just

‘Vigor in a bottle’. Research suggests IGF-1 can also improve your

immune system and heart health as well as aid with arthritis and

bone density. You’ll likely look younger, feel stronger and have the

energy to do all the things you used to enjoy when you were young.

As endorsed by award winning biologist Dr. Bill Andrews.

So how does Rewind work?

Research suggests most of the feel good, look good benefits of hGH

come when it converts to IGF-1. The Hollywood stars and wellto-do

have been paying thousands for

hGH therapy. It is costly and invasive

and now with the discovery that

IGF-1 is actually the magic behind

this hormone’s anti-aging properties

there is no need to take synthetic

injectables. Rewind is a naturally

sourced, high potency IGF-1

supplement. Simply take one

yummy tasting sub-lingual

lozenge a day. And you won’t

believe how affordable it is!

Use only as directed. Always read the label.





The Gold

Standard in PRP

Angel PRP brings the most sophisticated

autologous PRP system to Australia.

Angel PRP uses cutting edge technology

to extract the highest concentrations of

platelets, affording longer-lasting results.

The Angel Lift will stimulate your skin’s

stem cells and release growth factors

using the clinically proven therapeutic

dose of PRP required to regenerate

connective tissue.

• 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

Call Medtel – Regenerative Medicine

for more information

1300 886 385 • •

Dr Howard C. De Torres


Fellow of the Royal Australian College of Surgeons

Member of the Australasian Society of Aesthetic Plastic Surgeons

Member of the Australian Society of Plastic Surgeons

Registered specialist plastic surgeon

specialising in cosmetic surgery

Over 30 years experience

Rhinoplasty &

Facelift Specialist

• Face & neck lifts

• Nose surgery

• Breast enlargement

• Breast reduction & lift

• Eyelid surgery

• Brow lifts

• Bat ears

• Liposuction

• Abdominoplasty

• Calf implants

• Labiaplasty

• Skin Cancer Treatment

Ph 02 9327 5599


Main Office Suite 504

Eastpoint Tower

180 Ocean Street, Edgecliff NSW 2027

(Above Edgecliff Station)

And also at 92 Old Prospect Road

Wentworthville NSW 2145

(near the junction of the M4

and Cumberland Highway)


Typhoid Mary



In 1938, when I was a young schoolboy troubled by

recurrent asthma, my doctor called to see me. Doctors

did lots of home visits in those days and, after checking

me over, out of the blue he said, ‘Mary Mallon has died’. It

meant nothing to me. ‘Mary who?’ I asked, as would have

most people. Although the name stayed with me, it wasn’t

until I was a final year medical student in 1953 that I found out

the impact this mystery woman had made on medical history.

The story goes that for over 30 years Mary Mallon had

made her way through New York society like a latter-day

grim reaper, dispensing with deadly and feckless abandon

the serious and often fatal bowel infection, typhoid. She

became known as Typhoid Mary.

Although the name stayed with

me it wasn’t until I was a final

year medical student I learned of

the impact of Mary Mallon on

medical history

The disease was not universally fatal but, up until around

1947 when antibiotics became available, about five per

cent of those who recovered from typhoid fever remained

long term carriers of the causative bacteria, which happily

shed germs into the bowel from their life-long hiding place

in the former sufferer’s gallbladder.

The bacillus was not fussy about its victims and over

the centuries has afflicted some notable historic figures.

Queen Victoria’s consort, Prince Albert, died of typhoid and

her son, Edward VII almost succumbed. In fact, of all the

deaths that occurred during the American Civil War, typhoid

accounted for almost 33 per cent. In passing, another third

died of other diseases and only a third of the deaths were

as a result of heroic circumstances: which brings us to New

York in 1900.

In September that year, a young man died of typhoid

in a house in which Mallon was working as a general

maidservant. The following year she was employed by a

lawyer in Maine and, within a fortnight, seven of the eight

members of the household came down with the disease.

Mary worked unstintingly in the sick bay situation she

had unwittingly created and was given a US$50 bonus

for her trouble. It was only years later after widespread

investigations that she and the disease were connected.

Ignorant of her role in infecting others, Mary moved from

house to house as a cook. As a wit wrote of the saga, ‘The

cook was a good cook as cooks go. And as good cooks

go, she went’.

Whilst working on Long Island in 1909, six of the 10

residents fell ill, and still there was no connection. With

3,467 cases in New York that year and 639 deaths, a 60

per cent death toll in one house was not regarded as a

public health scandal at the time. However, a Dr Soper did

smell a few drains at the house, toilets and the local clams,

but nothing stood out. ‘Well’, he reportedly wondered

aloud, ‘Has anyone eaten any exotic food ?’

The cook’s tangy ice cream was everyone’s favourite. It

raised the good doctor’s suspicions, but by now Mary had



left and it took Soper six months of working through houses

grief stricken from typhoid deaths to fi nd her. By now he

knew she was a 40-year-old single women from Northern

Ireland and he eventually found her in a Park Avenue top

drawer abode.

Knowing Mallon’s quick temper, as he approached her

he wondered aloud in a well-rehearsed circumlocutory

way if she could see any possible connection between

herself and the trail of people with hectic temperatures,

greenish diarrhoea, rose coloured spots and prostration

she left behind her. Symptoms that could be taken for, ‘Er,

um’, typhoid?

Her answer was short, to the point and impressive: she

attacked him with a meat cleaver. He bolted and so did she;

he to the police and she to the outside toilet.

New York’s fi nest turned up and the sergeant shouted

through the toilet door that he believed Miss Mallon could

help with their enquires. Her answer was uncompromising,

succinct and hurtful to police sensitive about their

parentage. The door was broken down and the suspect

was removed kicking and screaming to the Riverside

Hospital for Communicable Diseases. Her stools were

examined and it came as no surprise to anyone they were

teeming with typhoid bacilli.

It fell to Dr Soper to inform Mary she was the carrier

of a dangerous condition from germs lodging in her gall

bladder. Further – and he must have braced himself for this

– the treatment was simple: removal of the gall bladder. The

negative response can be well imagined; fortunately anything

that could be used as a missile had been removed.

Mary Mallon was kept brooding in the hospital for three

years. She worked in the laundry (not kitchen, mercifully)

while she honed to perfection a heart rending, derring-do

story for which her country folk were famous. The upshot

was that she was released, promising with all the vehemence

she could muster only to work in a laundry and report to the

Health Department every three months for tests.

She promptly disappeared, changed her name to Mrs

Brown and got a job as, somewhat unsurprisingly, a cook,

plying her trade round New York city where unsuspecting

gourmet trenchermen wolfed down her terrifi c ice cream

and other typhoid-ridden gobbets.

In 1915 there was a serious outbreak at the Sloane

Hospital for Women where she worked. In a moment of

ingenuous banter another cook called her Typhoid Mary

whereupon to everyone’s surprise she fl ed. She was caught

on Long Island and gave up like a lamb. Returning to

Riverside Hospital she was given a life sentence of custodial

care, gall bladder intact. Mary worked in the laboratory

and the management even built her a small cottage in the

ground. The fi ght had gone out of her and she had a stroke

in 1932, dying, as I say, in 1938 secreting the lethal bacilli

to the end.

Her peripatetic history was traced and it seems for certain

she was associated with 10 outbreaks of the fever involving

53 cases and three deaths, and possibly responsible for the

1904 outbreak at Ithaca, New York State with 1400 cases.

Typhoid Mary touched scores of lives with her unique

brand of ice-cream, terrorised dozens of policemen,

insulted numerous health workers and put the breeze up

countless doctors. You cannot ask for much more than that

out of life. csbm 45


ASAPS 2013






The wind-swept palm trees, azure ocean and inviting

climes of north Queensland were a welcoming

backdrop when a mix of plastic surgeons from

Australia and overseas descended on Port Douglas for

the 36th Annual Australasian Society of Aesthetic Plastic

Surgeons (ASAPS) conference in July this year.

The conference’s theme, entitled ‘The Great Barrier Reef:

Multi-Modalities in Facial Rejuvenation’ promised much

in the way of educational talks and inspiring discussions,

not-to-mention exciting social events. July 9th saw plastic

surgeons from around the world arrive at the Sheraton

Mirage in Port Douglas where a luxurious scene – complete

with poolside sun beds and beachside villas – was set for

the five-day meeting.

The ASAPS 2013 keynote speakers included three US

surgeons, including plastic surgeon and urologist, Dr Gary

Alter, plastic and reconstructive surgeon, Dr A Jay Burns

and plastic and aesthetic surgeon, Dr Timothy Marten.

Unfortunately, due to flight delays, Dr Marten was unable to

attend the conference in person and instead gave his talks,

covering all aspects of facelifting, via Skype.


industry 47


As part of a comprehensive delegate program, Dr Burns

spoke about the surgical and non-surgical options for

treating the ageing face. He spoke about his experiences

using various lasers for facial rejuvenation, different

techniques for surgical facelifting and minimally invasive

approaches for treating fat, cellulite and ageing skin. With

an audience of experienced surgeons, these talks were

met with lively discussion and a dynamic question time.

Dr Burns shared his tips for managing both the surgical

and non-surgical elements of his practice, showing equal

passion and enthusiasm for each facet of his clinic.

Encompassing a somewhat contrasting theme, Dr

Alter, who is internationally recognised for his work in

genital reconstruction and rejuvenation, spoke on genital

aesthetics, surgery and reassignment. He gave talks on

his approach to labiaplasty, his techniques for clitoral hood

augmentation and his approach to correcting the buried or

hidden penis.

Describing genital surgery as a speciality that is

sometimes overlooked, he encouraged the surgeons in

the audience to learn from his sessions, ensuring they are

equipped to answer the questions and, in some cases,

address the concerns of patients seeking genital surgery.

While the program covered everything from

blepharoplasty to breast augmentation, the social program

was similarly assorted. The traditional welcome reception

involved cocktails by the pool and was accompanied by

live music, sumptuous canapés and flowing beverages.

From here, the program diversified. Yoga on the beach,

‘Pinot and Putting’ on the golf course and star gazing on

the dunes saw surgeons and their families, media and trade

relax and enjoy the social setting; a scene enhanced by the

stunning, tropical backdrop.

As part of the conference, delegates were also treated

to a low isles cruise to the Great Barrier Reef – an afternoon

of snorkelling, stand up paddle boarding, beach walking



and sun bathing proving the perfect antidote to hours of

concentration in the lecture hall.

Back to business and Saturday marked the close of

the conference program with informal presentations given

by Dr Alter and Dr Burns. Revealing the contrast between

their personal and professional lives, those in the audience

were left with a greater appreciation of the personalities,

professionalism and experience of the surgeons who had

travelled so far to take part in ASAPS 2013.

The conference came to an end with a successful Gala

Dinner, which saw delegates welcomed by men on horse

back to a paddock surrounded by reeds, as the sun set

over the hills.

A happy end to a successful week, the ASAPS

conference dispersed on Sunday, July 15, with surgeons,

trade and media returning to their cooler-clime hometowns.

After five days of discussion, networking and education,

Australia’s plastic surgeons left the meeting inspired to

incorporate fresh ideas and renewed passion into their

practice in aesthetic plastic surgery. csbm 49


Cosmetex 2013



As the first chills of winter crept into Melbourne,

cosmetic and plastic surgeons, dermatologists,

cosmetic physicians and nurses descended on the

Victorian capital to take part in Cosmetex 2013.

Organised by the Australian College of Cosmetic

Surgery (ACCS), Cosmetex welcomed an authoritative

team of keynote speakers from around the globe, including

Canadian plastic surgeon Dr Arthur Swift and Professor

Leslie Baumann, a US cosmetic dermatologist and author

of New York Times bestseller The Skin Type Solution.

‘Cosmetex is the biggest cosmetic surgery conference in

the Southern Hemisphere and this year was our biggest so

far,’ said ACCS President, Dr Colin Moore.

This year, the emphasis of the conference was on two

prevalent issues: new techniques in the field of fillers and

injections and how best to step away from ‘the alien face’

of cosmetic surgery.

‘There’s a heavy emphasis on not over-doing things,

especially around the face,’ said Dr Moore, ‘The emphasis

this year is doing less – less is more.’

Less is More

A fierce proponent of the ‘less is more’ approach to

cosmetic enhancement, Dr Swift’s keynote presentation

highlighted something he believes is often overlooked by

practitioners – that of an aesthetic stopping point.

In his talk on BeautiPHIcation: A Caliper Approach to

Global Facial Enhancement, Dr Swift explained his principle

using the golden ratio, or Phi, to establish the most natural

and aesthetically pleasing result in facial rejuvenation. He

urged physicians to stop striving for perfection and instead

focus on proportions.

‘Physicians try to push a result so far they actually go

past the point of creating the best version of someone, and

actually start detracting from their patient’s beauty,’ he said

in an exclusive interview with Cosmetic Surgery and Beauty

Magazine (CSBM). ‘Take symmetry for example: some

physicians try so desperately to make the two sides of the

face look like twins, but if you see somebody who has the

left side of their face reflected onto the right side by mirror

imaging, it looks quite boring and alien like. The two sides

of the face should be sisters, not twins.’

An advocate of the use of Phi in aesthetic medicine, Dr

Swift believes it’s possible to define a ‘stopping point’ for

cosmetic enhancement based on mathematics and the

golden ratio, 1.618. Inspired by the occurrence of Phi in

historical art, architecture and nature, Dr Swift researched

the possibility of applying the same principle of divine

proportions to the face. After three years of research, Dr

Swift established that the distance across the nose, from

the corner of one eye to the other, doesn’t change with

age. With this measurement as his constant, Dr Swift

began using the phi ratio of this distance, or 1.618 times

this distance, to guide his work in non-facial rejuvenation.

‘I was always surprised to see how people could discern

an attractive face so quickly. If you’re walking down the

street and you see someone walking by, even if you only

see them for a second, you’re able to tell if it’s a beautiful

face or not,’ Dr Swift says. ‘I started to apply the phi ratio

to all different areas of the face and it seems our eye picks

up on how close those ratios are to 1 to 1.618. The closer

they are, the more beautiful the person seems to be. Now,

instead of injecting dermal filler and saying “I think that looks

right,” I use filler to bring faces closer to the phi proportion.’


industry 51


With a guiding measurement established, Dr Swift

addressed the importance of treating the face holistically for

the best results in facial rejuvenation. Identifying the difficulty

presented by the ‘moving canvas’ of an ageing face, Dr

Swift recommends dividing the face into thirds (upper third,

middle third and lower third) and treating one of three things

in each section – either the lines, the feature or the volume.

By dividing the face like this, Dr Swift believes nothing is

missed, everything is considered in proportion and the

often overwhelming task of rejuvenating an entire face is

somewhat simplified.

‘Our phi destination is unique for each female; it’s

a daunting task, especially when we’re dealing with a

landscape that’s always changing – the fat is reabsorbing,

the nose is lengthening, the bones are shifting – it’s really

not fair,’ Dr Swift explains. ‘Many injectors will treat the areas

they know how to treat, focusing on the lips or cheeks and

forgetting about the other areas. When you restore the face

you must focus on the whole face. If you divide the face

into thirds, and treat the feature, lines or volume in each

area, you’re not faced with that blank piece of paper that

gives you writer’s block, you’re faced with specific areas to

concentrate on.’

Dermal fillers – countering the risks

Building on Dr Swift’s thoughts on using dermal fillers

and toxin injections for facial rejuvenation, Professor

Baumann discussed the possible risks associated with

fillers and the importance of being prepared to counter

these complications should they arise. Touching on the

occurrence of vascular necrosis after filler injections,

Professor Baumann explained the complication, how it

can be fixed and the simple necessity of having the tools

available to treat it.

‘Blood vessels bring blood and oxygen to the skin’s

surface; if these vessels are compromised the skin cells will

start to die, which is called necrosis,’ Professor Baumann

explains. ‘There are two ways fillers can cause this. Firstly,

if someone injects it into an artery, the filler will block the

blood flow and necrosis will begin. It can also happen if they

inject too close to the blood vessel and the filler swells and

pushes in on the artery.’

According to Professor Baumann, this is why choosing a

doctor with experience is so important. ‘Anyone can inject

filler but not anyone can inject it into the right place and

treat the problem,’ she says.

While managing vascular necrosis is the responsibility of

the physician, Professor Baumann says the risk of bruising

after cosmetic injections can also be moderated, this time

by the patient. Professor Baumann urges her clients to

follow a nutrition regime leading up to the procedure, in a

bid to lower the chance of bruising following the injections.

‘There are several things patients can do to reduce

the chance of bruising, which is a common side effect

following injections,’ Professor Baumann says. ‘These

include no alcohol for 24 hours, no Omega-3 fatty acids

for 10 days, no aspirin for 10 days, no anti-inflammatory

medications like Ibuprofen for 10 days, as all these things

– minus the alcohol – are good for your heart. They prevent

platelets from sticking together, reducing the risk of blood

clots and heart disease, but they also increase the severity

of bruising.’

Alongside these inspiring presentations, Cosmetex 2013

played host to the first annual cosmetic nurses’ meeting in a

specifically tailored paramedical program. Registered nurse

and founder of Clear Complexions Clinic, Suzie Hoitink,

spoke throughout the paramedical program and, in an

exclusive interview with CSBM, explained the importance

of professional collaboration at conferences like Cosmetex.

‘As nurses, we need to talk about our experiences and

learn from each other,’ says Hoitink. ‘We should be thinking

of the client first, alongside public safety and education. We

should be aiming for the best results for our clients and

sharing our knowledge to achieve this.’

As the event came to a close, delegates, faculty and

exhibitors alike revelled in the celebratory atmosphere of

the Gala Dinner. The night presented an opportunity for

Cosmetex attendees to relax and absorb the information,

advice and fresh perspectives afforded by the conference.

In bringing together professionals from around the globe,

Cosmetex presented a rare opportunity for collaboration

across nations and specialties, fuelling physicians with fresh

motivation to continue to enhance their practice in surgical

and non-surgical rejuvenation. csbm







A C C.


. .


Call for Abstracts Open 6th August!

All abstracts are to be submitted online. Please ensure you have read the submission guidelines and sample abstract prior to

submitting your abstract. For detailed information and to submit your abstract, please visit

- Energy Based Treatments/Lasers

- Breasts

- Skin Symposium

- Body Contouring

- Periorbital

- Business and Marketing

- Facial Surgery

- Liposuction

- Rhinoplasty

- Facial Rejuvenation

- Stem Cells and Fat Transfer

- General

- Business

- Marketing

- General

Stay at the forefront of all things Cosmetic Surgery with cutting edge technology and techniques delivered by highly acclaimed

and world-class Cosmetic, Plastic, Facial and Reconstructive Surgeons; Dermatologists; Cosmetic and Aesthetic Physicians and

Skincare Scientists

Keep up to date with conference announcements and up-to-the-minute information about the conference, including the

program, speakers, registration, venue and program at

International Conferences & Events (ICE)

183 Albion Street, Surry Hills, NSW 2010


T: +61 2 9368 1200

F: +61 2 9368 1500







With the latest statistics revealing Australians spend

in excess of $350 million each year on anti-wrinkle

injections alone, and with total expenditure on

cosmetic surgical and medical related treatments estimated

to be around $1 billion, it’s more important than ever before

Australians can rely on their surgeons and practitioners.

Founded in 1999, the Australasian College of Cosmetic

Surgery (ACCS) aims to ensure the safe provision of cosmetic

surgery and non-surgical procedures to the Australian general

community through the supply of appropriately trained and

certifi ed medical practitioners. This aim has remained true

to the College as, over the last 14 years, it has grown to

embrace hundreds of cosmetic specialists from across

Australasia and as the popularity of cosmetic procedures in

Australia and beyond has sky rocketed.

‘Australians should be able to have confi dence that

the practitioner they choose for their procedure has been

appropriately trained,’ says College president, Dr Colin

Moore. The College is therefore committed not only to

providing the relevant training to cosmetic practitioners, but

to raising the standards for patient safety.

The July issue of Marie Claire magazine hit Australian

news stands with a campaign calling on its readers to sign

a petition to the Minister for Health, Tanya Plibersek MP to

help make cosmetic medical procedures safer.

ACCS president, Dr Colin Moore said he welcomed

Marie Claire’s initiative.

Cosmetic Medical Practice is a well-defi ned medical

discipline and the ACCS has set the benchmark for training

and standards in cosmetic medicine and surgery,’ says

Dr Moore, who is concerned many Australians routinely,

unknowingly undergo cosmetic procedures by a variety

of doctors and specialists who may be unable to provide

evidence of appropriate, specifi c education and training.

‘Australians should be able to have confi dence that

the practitioner they choose for their procedure has been


appropriately trained. A lack of recognition exposes the

patient to avoidable risks,’ Dr Moore warned.

‘Our College has also continuously expressed its

concern to authorities that there is a misperception in the

Australian community that practitioners who may have

recognised, specialist qualifi cations such as plastic surgery

are specifi cally trained in and therefore a “specialist” in

cosmetic surgery,’ Dr Moore says.

‘If a new cosmetic medical specialty is recognised in

Australia, then medical colleges will be able to have their

training assessed against the requirements of the specialty.

It will help remove the confusion about the training and skills

of different types of doctors.

‘Recognition will ensure that the same high standards

applied to other areas of medicine are matched in the

training for and provision of cosmetic medicine and surgery.

Marie Claire and its readers are right to demand nothing

less,’ adds Dr Moore.

The College has also made a full application to the

Australian Medical Council to have Cosmetic Medical

Practice recognised as a new Medical Specialty.

The ACCS is the only group in Australia with a single

focus on cosmetic surgery and medicine and is the only

one to offer formal training and accreditation to its members

in both these specialist areas.

One of the key roles of the ACCS is to accredit cosmetic

surgeons and physicians – ensuring those who practice

cosmetic medicine are suffi ciently trained and helping to

uphold the high standards Australian patients have come

to expect. In fact, to become a Fellow of the ACCS, doctors

must complete a minimum of 12 years of medical and

surgical education and training.

‘To be recognised as a fellow of the ACCS, doctors

need to have undergone appropriate training, plus specifi c

procedural training and they must also have demonstrated

substantial clinical experience,’ says Dr John Flynn, a

spokesperson for the College. ‘We also ensure our fellows

are participating in continuing education and, where

needed, recertifi cation.’

In addition to their annual certifi cation program, the

College maintains a procedural register as a resource

to prospective patients. ‘Not everyone is an expert in

every cosmetic procedure,’ says Dr Flynn. ‘However, if

someone is listed on the procedural register, patients can

be assured that surgeon has performed at least 100 of

those procedures.’

The procedural register isn’t the only initiative aimed at

reassuring patients and encouraging safe practice. In 2009,

the ACCS introduced a Code of Practice – endorsed by

the Australian Competition and Consumer Commission

(ACCC) – provide patients with additional reassurance their

surgeon or physician meets relevant standards.

‘The Code covers, among other things, advertising and

other promotional conduct, informed

consent guidelines, monitoring of the

code and has an extensive governance

regime including independent

compliance audits and reports to the

ACCC,’ explains Dr Flynn.

The Code is available for patients

to read in full on the College website,

alongside another initiative Dr Flynn

believes is of signifi cant value to

prospective patients. ‘Our Patient

Information Brochure is also available

on the College website to anyone

considering a cosmetic procedure,’ he

says. ‘This important resource outlines

the things patients should be asking

their surgeon, and the information

they should expect to receive before

deciding to proceed with their

treatment. It also gives information on how to lodge and

handle a complaint should they need.’

More recently, the ACCS introduced its Code of

Practice Seal, which can be displayed by any member who

complies with the College’s Code of Practice. Launched at

the Cosmetex annual conference in 2012, Dr Flynn says the

Seal should give patients a sense of confi dence about the

person they’re intending to consult.

As well as reassuring patients, the Seal is also designed

to protect those who uphold high ethical standards. ‘It

protects them through a high level of standards that

increase transparency and information,’ says Dr Moore.

With the latest census suggesting cosmetic medical

practices are growing by as much as 20 to 30 per cent

year on year, the signifi cance of a governing body can’t

be underestimated.

And, as more men and women choose to undergo

cosmetic enhancement, initiatives such as the Code of

Practice, Code of Practice Seal and Patient Information

Brochure provide reassurance the ACCS is fulfi lling its

commitment to ensuring the safe provision of cosmetic

surgery and non-surgical procedures. csbm

Scan the QR code below to download the ACCS Patient

Information Brochure. 55


Cosmetex 2014

Goes for Gold



Just a few months after the close of their successful

2013 event, the wheels are already in motion for next

year’s Cosmetex. Scheduled to take place between

30 April and 3 May 2014, the conference, which is

hosted by the Australasian College of Cosmetic Surgery

(ACCS), will next year make a return to Queensland,

taking advantage of the late summer sun.

Set just a few short strides from the white, sandy

beaches of Surfer’s Paradise, the RACV Royal Pines

Resort will play host to the speakers, delegates and

exhibitors already set to attend the popular event.

A 100-hectare resort set amongst a champion golf

course, the venue boasts a relaxing and peaceful vibe

and is the perfect location to host what has become

Australasia’s largest scientific conference devoted

exclusively to cosmetic medicine and cosmetic surgery.



A forum for debate

Since it was launched more than 10 years ago, Cosmetex

has grown to become the largest aesthetic medicine

conference in the Southern Hemisphere, bringing together

leading cosmetic and plastic surgeons, dermatologists,

cosmetic physicians and nurses all in the pursuit of

continued education.

Cosmetex is the only conference in the field of cosmetic

surgery and medicine to offer a multidisciplinary agenda,

affording professionals an unparalleled environment to

meet with and learn from peers.

The Royal Pines Resort boasts

a relaxed and peaceful vibe and

is the perfect environment for the

free exchange of ideas

The annual event has a well-earned reputation for

inviting acclaimed speakers from around the world to

deliver keynote presentations. Earlier this year, more

than 900 cosmetic surgeons practitioners and exhibitors

descended on Melbourne to attend the 2013 event. With

a faculty of internationally renowned speakers as well as an

enjoyable social program Cosmetex 2013 went a long way

to reinforce the event’s reputation as a forum for the free

exchange of information and ideas.

Looking ahead to 2014

Whilst the academic program is yet to be finalised, next

year’s event on the Gold Coast is set to be no different, with

even more surgery sessions to enhance the value of the

conference to all practitioners.

During the conference, doctors will be invited to attend

live workshops, ranging from injectables and lasers to

surgical procedures, and there will be a comprehensive

paramedical program with presentations from industry

leading practitioners.

Whilst general sessions will cover injectables, lasers and

energy-based treatments, skincare and anti-ageing, the

expanded surgical program will cover the latest advances

in techniques and technologies, touching on stem cells,

autologous fat transfer, breast surgery, body contouring, facial

rejuvenation surgery, peri-orbital surgery and liposuction.

The popular Interactive Panels delegates have come to

enjoy will continue, pitting expert against expert in offering

comparisons of how they manage specific cases. And with

an exhibition hall and social program to rival earlier events,

it’s time to mark your calendar for Cosmetex 2014. csbm

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 late summer sun. 57


Ready, set, socialise!




Businesses and business owners who embrace social

media are reaping rewards beyond building closer

relationships with customers, suppliers, partners

and others – the fi nancial rewards, too, can be great.

Indeed, according to research revealed earlier this year,

small and medium businesses who embrace social media

were much more likely to see a revenue rise than a fall in the

year to February 2013.

There’s no denying that, to attract more customers, share

your positive reviews and generate the most coveted form of

public endorsement – that of your clients – social media is the

answer. But with so many channels, and already stretched

resources, where do you start?

As the leading providers of business technology to salons,

spas and clinics, the latest software from Shortcuts Smarter

Business Technology can help create a seamless transition

between your clinic and your online presence.

Experts in using social media to boost bookings,

spread awareness and share glowing client testimonials,

Shortcuts have refi ned their software to make social media

engagement intuitive, easy and relevant.

‘The great thing about social media marketing is it’s free

and you have the ability to reach so many people if you

use it well,’ says Shortcuts specialist Brooke Morkham-

Calvert. ‘Through other people’s shares you are exposed to

a broader audience – more people than through either text

message or email marketing.’

Shortcuts provides clinics with key tools such as Set &

Forget Marketing, BookME and Spotlight, each of which

is designed to optimise social media presence, as well as



performing specifi c roles for the business.

By generating newsletters and promotions, while

maintaining automated, personalised and topical email contact

with clients, Set & Forget Marketing connects with clients and

encourages their recommendations through social media.

Built-in ‘share’ or ‘like’ plug-ins attached to personalised

marketing emails mean client participation is only a click

away, while clinics can opt for their promotional emails to be

automatically shared on social media platforms.

Alongside ‘likes’ and ‘shares’, client feedback can be a

powerful form of endorsement. Using Shortcuts’ Spotlight

software these recommendations can be used to their full

potential. Clients receive a feedback email 24 hours after their

visit, sent automatically using the email address entered at the

initial visit. The email gives clients the option to rate their visit

or leave a written comment, which can be shared on social

media and used to enhance search engine optimisation.

The great thing about social

media is it’s free and you have

the ability to reach so many

people if you use it well

‘Client referral is the best way to get other clients through

the door,’ says Morkham-Calvert. ‘Lots of businesses don’t

ordinarily promote their ratings but using Spotlight they can

easily share reviews on their Facebook page and website.

Facebook also offers a platform for clients to like posts and

share their experiences.’

Finally, Shortcuts takes the onus off businesses in keeping

up with the ever-changing trends of social media. In tailoring

their software to refl ect public behaviour, Shortcuts have

extended their BookME software to allow bookings through

Facebook. This was designed after research revealed

Facebook users prefer to stay on the social media platform

when they’re online, meaning business postings that take

the user to an external website have a lower performance

rate than those that stay in Facebook.

‘The Facebook booking application means clients can

make bookings straight away, directly after viewing client

recommendations or reading a marketing newsletter that

has been shared on Facebook,’ says Morkham-Calvert.

‘Moreover, when clients book themselves in anywhere –

on the website, through Facebook or in the clinic - they

can share the fact they’ve booked in for an appointment

through social media. This is often done for hair, skin and

cosmetic appointments.’

If you’re yet to take the social media plunge, it seems the

high level of integration and automation offered by Shortcuts

means your social media presence will soon be taking care

of itself, and your clinic’s name, endorsements and marketing

material will be the talk of the town in no time. csbm

Shortcuts At-A-Glance

Clinics can choose the following modules to add to their core

Shortcuts business technology.


An online, interactive, national directory of hair, beauty, spa

and clinic businesses, mylocalsalon affords businesses the

opportunity to have an online presence without investing in

a website. For those with their own website, mylocalsalon is

another means for existing and future clients to book their

next appointment.


‘BookME is the most powerful online booking solution on

the market,’ says Morkham-Calvert. ‘It’s easy-to-use and

fully integrated with Shortcuts. BookME allows you to take

appointments without overlapping and double-booking, 24

hours a day, 365 days a year. It opens your business up to

endless opportunities for new appointments around the clock.’


Access your appointment book and rosters from your smart

phone, tablet or PC. ‘Anywhere offers the convenience of

remote access to you and your staff,’ says Morkham-Calvert.


‘Our most popular module, Set & Forget Marketing is the

ultimate marketing tool to help you control how you connect

with your clients,’ says Morkham-Calvert. Easy, automatic,

targeted and effective, it offers text message and email that

only needs to be set up once.


Spotlight is a comprehensive feedback management system

designed to open up communication channels between

clinics and their clients. ‘With Spotlight, clinic owners can

take control of the online conversation about their business,’

says Morkham-Calvert.


‘Gift cards are the perfect way to grow your client base as

well as being a strong branding tool,’ says Morkham-Calvert.

GiftME is a fully-integrated, online gift card solution for single

and multi-site businesses.


With a vast client base in the hair, spa and clinic industry,

Shortcuts has a unique insight into market trends. Scorecard

affords clinics the opportunity to see how they compare to

industry standards. ‘If a clinic suffers a dip one month, they

can quickly see whether this dip is industry wide, or whether

they might need to address an issue in their own business,’

explains Morkham-Calvert. 59


Putting age management

on the agenda




trip to your local spa or beauty salon is no longer

simply about taking time out to relax and unwind. An

increasing number of Australian men and women

are turning to their salon owner for trusted advice when it

comes to a wealth of aesthetic concerns. And, topping the

list, is the ongoing fight against the signs of ageing.

As treatments become less about relaxation and more

about results, this year’s Sydney International Spa and

Beauty Expo is adding to its already packed program,

introducing an invaluable Age Management seminar

series designed to equip salon and spa owners with the

knowledge they need to keep up with demand. Because,

with so many treatments available, confusion may reign

when it comes to knowing which treatment or therapy will

best serve the needs of new and existing clients.

Spread across the last day of the Expo, which runs from

August 25th to the 26th, these beneficial seminars are

aimed at demystifying the options and technologies on offer

to spa and salon businesses. From skincare to non-invasive

cosmetic procedures, attendees will leave with a clearer

understanding of the science, technology and business

considerations surrounding the most popular treatments

and products currently on the market.

Brought together by an expert panel of speakers, the

two-part seminar series – one on skincare and the other on

technology – will be lead by skincare expert and co-founder

of the Clear Complexions clinics, Suzie Hoitink, who was

also a 2012 National Finalist in the Telstra Business Women’s

Awards. Chosen for her unique approach to skincare, she

will advise delegates on the changes facing the industry

and the crucial considerations owners should be aware of

before integrating these therapies into their salons.

‘The Age Management sessions at this year’s Sydney

International Spa & Beauty Expo have been designed to

bridge the gap between knowledge and practice so attendees

make the most informed investment decision for both their

customers and business performance,’ says Suzie.

The Age Management sessions

are aimed at demystifying the

options and technologies on offer

to spa and salon businesses

Director of the Expo, Julia Erben believes the new Age

Management seminar will prove invaluable for salon and

spa owners. ‘Whether you’re looking to increase your

revenue, customer base or be a step ahead of competition,

the Age Management seminars are unmissable,’ she says.

‘They will not only provide the know-how to make

the best investment decisions for your business, but

enable you to learn from others and potentially help you

avoid detrimental, costly mistakes when choosing new

technology and skincare for your salon or business.’ csbm







SPA& &










With results-oriented treatments growing by 25%*,

many businesses are experiencing incredible

successes with the new technology treatments and

procedures. The Sydney International Spa & Beauty

Expo With brings results-oriented together suppliers treatments in this growing sector by and 25%*,

dedicates many businesses a new feature are experiencing area for these incredible products.

Come successes to the with expo the in new August technology and: treatments and

• procedures. Learn about The the Sydney latest innovations International Spa & Beauty




the newest



suppliers in this sector and

dedicates a new feature area for these products.

• Talk directly to the supplier

• Come Get to advice the expo on how in August to maximise and: your profits

• Learn about the latest innovations

• Increase your product offering

• Try the newest products

• Talk directly to the supplier

SUN • Get 25 advice & on MON how to 26 maximise AUGUST your profits 2013

SYDNEY • Increase CONVENTION your product offering & EXHIBITION CENTRE

*IBIS World Report 2012 Illustration by Sarah Hankinson

SUN 25 & MON 26 AUGUST 2013




*IBIS World Report 2012 Illustration by Sarah Hankinson









elIxIR we’ve BeeN seARCHING FOR.


It’s long been suspected that human growth hormone,

or hGH, is a key player not only in the health and

ageing of our skin, but in the wider context of antiageing.

Its capacity to arrest the signs of ageing – both

externally and internally – has sparked a frenzy of

scientific research and debate, not-to-mention an entire

underground industry supporting our apparent desire to

look leaner, better, younger.

Human growth hormone, which is a natural hormone

produced by the pituitary gland, has a number of positive

effects throughout the body. It prompts the liver into making

a substance called insulin-like growth factor one, or IGF-1,

which, along with other, similar compounds, is intricately

involved in bone growth and the maintenance of optimum

cellular performance. hGH is also known as the major

hormone involved in repair and acts on many different

tissues to promote a healthy metabolism. Yet, with age,

our levels of hormones, including hGH, decline, and so too

does our bodies’ ability to repair the damage caused by

everyday stress, illness and disease. The result? Old age.

Could hGH therefore be the elixir of youth scientists

and longevity experts have long been searching for? By

boosting levels of hGH in the body, will the ageing process

slow and even reverse?


There’s no denying hGH has courted controversy since it

first hit mainstream headlines in 1990, thanks to a study

published in the New England Journal of Medicine in which

12 men over the age of 60 saw an increase in lean muscle

and a decrease in fatty tissue when treated with growth

hormone injections. The medical and scientific community

was quick to translate these results as evidence supporting

the role of hGH in slowing or reversing ageing and, as a

result of the study, the American Association of Anti-Ageing

Medicine (A4M) was founded.

Not everyone agreed with the interpretation, however,

and some of the methods advocated by anti-ageing

experts still do not have support from a consensus of the

wider medical community – some claiming anti-ageing

medicine as a specialty can cause serious side effects such

as diabetes or pre-diabetic conditions.

One of the undisputable side effects of treatment with

hGH is the lean look it creates – something that was

highlighted in Daniel Rudman’s 1990 study. Injections with

growth hormone help build lean muscle whilst fat simply

melts away to give tremendous muscle definition. This in

itself has spawned an underground industry in which hGH



– known in Australia as somatropin or recombinant human

growth hormone – is sold without a prescription on the

black market as a body-building supplement to improve

physique and enhance athletic performance.

It is legal to use hGH in Australia when prescribed by

a doctor, however, the use of hGH for these purposes is

considered ‘off-label’. In 2007 Hollywood actor Sylvester

Stallone was famously arrested in Australia for possessing

almost 50 vials of hGH, which he credits with helping him

prepare for the physically demanding roles of Rocky and

Rambo. More recently, the professional sporting community

was rocked when evidence of its use of performance

enhancing drugs including peptides and human growth

hormone was unveiled following a 12 month investigation

by the Australian Crime Commission.

Despite the need for a prescription, seizures of

performance enhancing drugs including hGH by Customs

and Border Protection have soared in the last year. ‘The

easy access to these substances over the internet makes

people believe that it is legally acceptable in Australia,’ a

representative from Customs said.

In Australia, somatropin is approved by the Therapeutic

Goods Administration (TGA) for use in children and

adults suffering from growth hormone deficiency. In a

statement given to CSBM by the Australian Government, a

representative said, ‘Growth hormone is subsidised by the

Australian Government through the Australian Government

Pharmaceutical Benefits Scheme (PBS) Growth Hormone

Program for neonates, children and adolescents; for a

range of clinical conditions associated with short stature.’


Growth hormone deficiency in adulthood (GHDA) is a

condition that often develops as a result of childhood GHD.

It is also possible to be hGH insufficient. Human growth

hormone insufficiency has many characteristics, which

include an increase of the intra-abdominal fat as part of

obesity, the loss of muscle mass and the gaining of fat mass,

decreased bone mineral density, a loss of emotional stability

and a decreased exercise capacity. There is a deterioration

of skin including thinning and drying, a decrease in tissue

elasticity and reduced skin healing ability. The skin is also

more prone to the effects of gravity, increased sagging and

increased lines.

It has been known for over 40 years that children

suffering from GHD can benefit from hGH replacement.

However, it was not until biosynthetic hGH was introduced

20 years ago that its use was no longer restricted to severe

growth retardation in hypopituitary children.

The treatment of growth hormone deficiency in

adulthood using hGH has been shown to have minimal

side effects when practised according to a replacement

therapy protocol. Indeed, it can offer patients enhanced

physical and emotional wellbeing by correcting the

reduction of growth hormones responsible for many of the

GHDA symptoms. Since hGH works in sync with other

hormones, it is advisable for levels of testosterone, DHEA

and oestrogen to be assessed, so they can be replaced at

the same time, creating a synergy of hormone replacement,

resulting in comprehensive improvement.

The only published measured benefits recorded

from hGH therapy are via injection and this may only be

administered by a licensed doctor or through a medical

clinic. There are a number of companies that promote

various pills, elixirs, sprays and creams claimed to have

useful amounts of hGH. However, the effectiveness of such

treatment methods should be viewed with scepticism, as

molecules as large as hGH cannot be absorbed into the

body across skin or mucous membranes and, being a

very fragile molecule, hGH is digested or broken down into

simpler compounds if it is ingested and not injected.

There are also ways to increase levels of hGH in the

body without the need for injection. That is, to stimulate the

hHG is the major hormone

involved in repair and acts on

many different tissues to promote

a healthy metabolism

body to increase the amount of hormone it produces itself,

or enhance the function of the hormone that has already

been produced. These methods include secretagogues,

hGH precursors and anti-somatostatin therapy.

Human growth hormones secretagogues work by directly

stimulating the pituitary to release hGH and by affecting

contiguous endocrine organs, like the hypothalamus.

Human growth hormone precursors work on the concept

that if the body is supplied with the constituent parts of hGH,

then it may be more apt to decide to use that fortuitous

blend of amino acids to more easily make hGH.

Anti-somatostatin therapy tries to identify compounds

or hormones that counteract the effect of human growth

hormone, and tries to negate them.

Unfortunately, in the case of the first two, substantive

effectiveness is notable predominatntly in young (under

25 years of age) and highly athletic people, while the third

typically only achieves a one per cent rise in IGF-1 levels.

Human growth hormone is one of many endocrine

hormones, including oestrogen, progesterone, testosterone,

melatonin and DHEA. When testing hGH levels, it is

important to assess the levels of the other hormones,

which can, if necessary, be treated simultaneously,

creating a symphony of hormone replacement resulting

in comprehensive improvement. Ultimately, hGH can offer

patients enhanced physical and emotional wellbeing by

correcting the reduction of growth hormones responsible

for many of the GHDA symptoms. Whether it is the answer

to eternal youth is yet to be determined. csbm 63




Turning back the

clock may no longer

be the stuff of sci-fi

movies. We meet the

Nobel prize winning

sicientist whose

goal it is to cure

ageing or die trying.

Lizzy fowler reports.



When Mel Gibson hit our screens in 1992 as

Captain Daniel McCormick, a man who had

been frozen in time for more than 50 years, we

all believed it was the stuff of science fiction. Yet, according

to one Nobel Prize winning scientist, the concept touched

on in Gibson’s Forever Young – that of halting, even

reversing the ageing tide – could be a reality in as little as

three years time.

‘My obsession with ageing dates back to when I was

10 years old,’ recalls Dr Bill Andrews who, now aged 61,

regularly competes in (and wins) ultra marathons and

endurance events. ‘I wanted to know how to cure ageing,

and remember thinking there must be a clock we can stop

or reverse – nothing else made sense.’

Dr Andrews, one of the most highly respected scientists in

America, went on to learn about telomeres and, thanks to his

role in discovering telomerase – a discovery that led to him

being awarded the Nobel Prize – has been described as ‘The

Man Who Would Stop Time’, by Popular Science Magazine.

The Telomere Connection

The so-called ‘clock’ Dr Andrews had conceived aged just

10 turned out to be located in every dividing cell of our

bodies, at the tip of our chromosomes, in a region known

as the telomere. ‘I like to use the analogy of a shoelace,

where a chromosome is a long shoelace and the telomere

is the protective cap at the end that stops the shoelace

from fraying,’ explains Dr Andrews.

‘As we age, that protective cap at the end – the telomere

– gets shorter, and the shoelace – or chromosome – is more

likely to fall apart.’ The end result, according to Dr Andrews,

is an increased susceptibility to almost every disease there

is, including cancers, heart disease and Alzheimer’s.

Whilst telomeres and the role their shortening plays in

ageing have been studied since the 1930s, Dr Andrews

believed there must be a way to halt or reverse the

shortening of telomeres. ‘I learned that the telomeres

present in reproductive cells don’t shorten, and it was this

that led me to discover telomerase – an enzyme that has

the potential to not only prevent telomeres from shortening,

but to lengthen them.’

Having made his Nobel Prize winning discovery in the

mid 1990s, Dr Andrews says that, since then, Harvard

scientists have gone on to successfully reverse ageing in

mice. It’s this recent advance that leads Dr Andrews to

believe his ultimate goal – to cure ageing (or die trying) – is

just three years away.

‘I believe we’re on the brink of the biggest change

this planet has ever seen,’ Dr Andrews says. ‘We’ll see

a decrease in almost every disease imaginable because

telomeres effect just about every human process, not just

ageing. If we can lengthen telomeres, people will enjoy a

reduced risk of cancer, and those who have cancer will be

better equipped to fight it off. Scientists have even been

able to reverse Alzheimer’s in mice – something I hadn’t

thought possible before.’

hGH and IGF-1

Whilst Dr Andrews and his team at Sierra Sciences

in Reno, Nevada are still several years away from being

able to offer the ‘solution’ to ageing, Dr Andrews is a firm

advocate there are steps we can take now to prevent the

premature shortening of telomeres and to address some of

the symptoms of ageing.

‘It appears as we age, our telomeres are not the only

things that are depleting,’ says Dr Andrews. ‘As we get

older our bodies produce less IGF-1. A lack of this essential

hormone is responsible for many of the negative symptoms

of ageing, so it makes sense to correct this deficiency for

optimal health.’

Dr Andrews explains that IGF-1, or insulin-like growth

factor 1, stimulates bone cell and muscle cell proliferation

in the body. Alongside a general depletion in hormones as

we age, the drop in IGF-1 can leave people suffering an

array of symptoms. ‘People will notice they have weakened

muscles and bone density and a general lack of energy,’

says Dr Andrews. ‘Cognitive skills decline and people

report an overwhelming decline in sex drive.’

An advocate of human growth hormone, or hGH, (which

produces IGF-1), Dr Andrews says many people today are

enjoying the benefits of synthetic hGH and IGF-1. ‘In terms

of feeling youthful and restoring all your hormone levels

back to your younger days, you can’t beat IGF-1,’ he says.

‘In my experience, people taking IGF-1 report an increase

in sex drive, their muscles get bigger, their skin improves

and they gain more benefit from exercise.’

Although the results are only noticeable in those who are

experiencing a decline in their hormones, Dr Andrews says

people who are in need of IGF-1 supplements will see a

significant result within just a few days or weeks. ‘It’s a case

of fixing problems that are broken,’ he says. ‘If nothing is

broken, you won’t see a result, but those who need it will

become sharper mentally and will look and feel a lot better

in a relatively short space of time.’

New to the market, Rewind Youth – a daily lozenge

containing a high dose of IGF-1 – has recently been

launched in Australia and is designed to promote all the

feel-good benefits of naturally-occurring IGF-1. An easyto-take

and cost-effective supplement that helps support

the immune system and heart health as well as maintain

bone mobility and density, Dr Andrews believes Rewind is

a sensible option for those interested in supporting their

energy levels and wellbeing.

Whilst he may not yet have reached his ultimate goal

of ‘curing’ ageing, Dr Andrews believes sensible lifestyle

choices combined with cutting edge scientific research can

certainly help those wanting to look – and feel – like they did

10 or even 20 years ago. csbm 65


Generation Regeneration


RegeneRAtIve medIcIne thIs sePtemBeR As PARt of the 5TH INTERNATIONAL


Once described as ‘undoubtedly the most beautiful

city built by man,’ the canals and bridges that

divide the city of Venice will, this September, be

home to some of the world’s greatest minds in the field of

regenerative medicine.

As supporters of BioBridge – a foundation dedicated to

funding research and ongoing education in regenerative

medicine, Regen Lab will host the 5th International BioBridge

Foundation Conference in Venice, Italy from September 23

to 24th. An invitation only event, the conference is set

to gather thought leaders in regenerative medicine from

around the globe, the Giorgio Cini Foundation providing

an impressive back drop bound to spark discussion,

debate and learning.

Known in Australia as the manufacturers and

distributors of Regen Platelet-Rich-Plasma (PRP), Regen

Lab has long been committed to promoting the field of

regenerative medicine. Indeed, in 2011, approximately

100,000 patients were treated with Regen Lab’s technical

and science based solutions with a 50 per cent increase

expected year on year.

Regen Lab, who were the first to market in the cosmetic

medicine industry in Australia, gaining TGA approval ifor Regen

PRP back in 2007, will host its 5th International Biobridge

Foundation Conference in Venice, Italy this September.

Venice has a rich history as a trade hub to Asia and was an

important arts and culture centre during the Renaissance and

is the perfect setting for this important event.



An emerging field

With stem cells and PRP both hot topics in the emerging

field of regenerative medicine, the two-day BioBridge event

is bound to stimulate debate from both the faculty and

delegates, eager to learn and discuss the latest advances

in what is a relatively new specialty.

In Australia, regenerative medicine has fast been gaining

traction, with scientists and researchers turning to look

at the body’s own ability to repair and replace damaged

human tissue and organs. Focusing on recapturing the

remarkable regenerative capacity of tissue that’s present in

everyone before birth, regenerative medicine incorporates

the use of cells, factors and other biological building blocks,

along with bio-engineered materials and technology.

According to the Australian Regenerative Medicine

Institute, we are constantly undergoing structural renewal

by replacing molecular components of our tissues, yet the

human body gradually loses effective regenerative capacity

as we age. The field of regenerative medicine brings

together stem cell physiology, knowledge of cell growth

and death, stimulation of cell replacement and the factors

that regulate these, as well as knowledge of the supporting

structures between cells.

Leaders in the development of autologous tissue repair,

replacement and regeneration therapies and products,

Regen Lab provides innovative technical and sciencebased

solutions to customers and patients both in Australia

and overseas.

Autologous Platelet-Rich-Plasma

One of these solutions is Regen PRP, which is used in

various medical disciplines including orthopaedics, sports

medicine, wound healing, neurosurgery, dentistry and

ophthalmology, as well as more recently in cosmetic,

plastic, maxillofacial and cardiothoracic surgery.

Autologous platelet-rich-plasma refers to a

concentration of human platelets in a small volume of

plasma. In the field of regenerative medicine, platelets

are now well-known as vehicles for the delivery of growth

factors, which can induce the proliferation of fibroblasts,

osteoblasts and endothelial cells, promoting and

accelerating healing of hard and soft tissues.

Autologous platelet-rich-plasma also contains fibrin,

fibronectin and vitronectin, which act as cell adhesion

molecules for osteoconduction and as a matrix for bone,

connective tissue and epithelial migration. Ultimately,

therefore, PRP is a naturally derived product that has a vast

potential for regeneration and healing.

Platelet-rich-plasma has been used in a medical setting

for several decades – for example in sports medicine to

facilitate the healing of tendons, muscle tears and joint

injuries. Blood platelets, which are already well known

for their role in clotting, release signals known as growth

factors. These proteins communicate with the body to

initiate the natural healing process – when injected into a

torn muscle, the healing process is therefore expedited and

recovery comes that little bit quicker for the athlete.

Regen Lab’s core competence is in the ability of the

Regen system to prepare PRP simply and efficiently.

Platelet-rich-plasma is a small portion of the blood made

up of a high concentration of platelets and more than

600 published clinical studies can be found on PubMed,

investigating the effectiveness of autologous plateletrich-plasma

in various medical disciplines such as sports

medicine, wound healing, surgery and aesthetics.

PRP and cosmetic medicine

Whilst the role PRP therapy plays within wound healing, sports

medicine and orthopaedics will form a significant part of the

debate when the 5th International BioBridge Foundation

Conference kicks off, the latest concepts surrounding PRP

and cosmetic medicine will also be discussed.

It’s thanks to companies such as Regen Lab that

treatment with PRP has more recently been able to move

into a cosmetic setting, supplying cosmetic surgeons and

physicians with the equipment they need to concentrate

platelets in the comfort and convenience of their own clinics.

A number of leading Australian surgeons will be

attending BioBridge when the conference convenes in 67


September. Dr Phillip Lim from Northside Physical Medicine

will present on PRP as the ‘Missing Link in Musculoskeletal

Medicine’ whilst cosmetic physician Dr Herbert Hooi from

Aesthetic Medicine Australia and Nicole Belle RN from Face

Today Mediclinic will give their presentation on ‘Autologous

Growth Factors in Cosmetic Medicine’ and share in the

Australian experience of using Regen PRP.

Also set to attend the conference as a speaker, Dr Ross

Clevens from the US, explains that one of the advantages

of PRP is its versatility. ‘We use Regen PRP in a wide variety

of facial plastic and reconstructive procedures,’ he says.

‘In surgical procedures such as facelift and rhinoplasty, we

have found Regen PRP aids in healing, reduces bruising

and swelling and shortens the recovery period.’

Dr Clevens also uses Regen PRP in combination with

laser-based procedures, such as skin resurfacing. ‘In

this situation, Regen PRP can enhance the effects of the

laser, resulting in improved outcomes with respect to the

reduction in lines and wrinkles and the improvement of skin

tone, colour and texture.’

The potential for PRP to be used in conjunction with

fat transfer procedures is bound to be a hot topic in Italy.

Indeed, Dr Clevens has found Regen PRP improves graft

take and survival and, in rhinoplasty, Regen PRP can

facilitate graft placement and adhesion. ‘Finally, in the

reconstructive arena, we employ Regen PRP in numerous

graft, flap and post-MOHS reconstructive scenarios.’

As scientists and researchers come together to share

their expertise in Italy, there’s no doubt the future of

PRP in regenerative medicine – cosmetic or otherwise

– is bright. With a vast body of research already well

established, we can look forward to a future in which

the incredible healing powers of the body are better

understood, harnessed and applied. csbm

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


• 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


• 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

SOURCE: Australian Regenerative Medicine Institute


you have youth in your blood

Regen PRP pioneering platelet rich plasma since 2003

RegenLab has been pioneering the use of autologous

platelet rich plasma to regenerate ageing skin, since 2003.

The proven Regen ACR PRP system concentrates powerful

growth factors contained in our blood, before reinjecting

them back into the skin.

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.

• Full face rejuvenation

• Neck, décolletage, eyes

• Fine lines

• Textural improvement

• Body areas

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• In combination with laser

• In surgical procedures • • 1800 201 760



skin the

youre n






Having spent 20 years working as a high profile

makeup artist, and with a clientele that boasts

Angelina Jolie amongst other famous faces,

Jennifer Gerace is used to being asked questions about

how to look good. Yet it’s not the finishing touches people

seem to be interested in. ‘The number one thing I’m asked

is not what makeup should I use, but how do I make my

skin look better,’ she says.

Flawless skin is perhaps the most sought-after beauty

must-have by women around the world, with many of us

clamouring as much for the luminous complexions models

parade down the runway as the clothes they are draped in.

Indeed, nothing radiates health and good looks in quite the

same way as an impeccable skin tone.

Yet not all of us are blessed with the faultless looks of

internationally renowned models – in fact, even supermodels

struggle to maintain their superior skin, with Helena

Christensen recently admitting to succumbing to freckles

and sunspots no matter how well she protects her skin from

the sun. With acne, dehydration, pigmentation, eczema,

rosacea, fine lines and wrinkles all on hand to wreak havoc

with our looks, it can be hard to love the skin we’re in.

Today, however, we’re blessed with an armoury of

weapons designed to help reduce pore size, perfect

skintone, even blemishes and leave a long-lasting glow.

From laser resurfacing to microdermabrasion and active

cosmeceuticals, we run down the skincare essentials you’ll

need to fast track your way to flawlessness.

Laser & light based therapies

Today’s lasers can significantly diminish and even reverse

many of the tell-tale signs of ageing, from early lines, uneven

pigmentation and broken capillaries to deep wrinkles and

severe sun damage. They can reach much deeper levels

and affect far more significant changes than would be

possible with most other common modalities of treatment,

and without needing to invest significant money. Moreover,

a procedure can often be performed in less than an hour

and may require little or no downtime.

One of the most influential advances in aesthetic laser

technology only became available for consumer use in

2006. Fractional laser resurfacing (ablative and non-ablative)

can achieve skin rejuvenation results that approximate

conventional ablative laser but with less aggressive

treatment protocols and, so, fewer potential side effects.

With traditional ablative laser (selective photothermolysis),

the whole of a selected target area is damaged – in effect

burnt – usually requiring significant downtime and prolonged

redness or pinkness of the treatment area for up to three

months, and even more.

Fractional laser (fractional photothermolysis), on the

other hand, seeks to only damage certain zones. The laser

beam is fractionated into thousands of tiny little shafts of

light. These penetrate the deeper layers of the skin, causing

tiny injuries to the skin, whilst leaving the surrounding skin

perfectly intact.

The skin then repairs those tiny shafts by pushing out

the old, damaged skin and replacing it with new skin. The

targeted heat damage also helps to shrink existing collagen

for an immediate firming effect.

This process only causes fractional damage and allows

the skin to heal much faster than if the whole area was

treated. It causes no visible wounds and requires less

downtime than traditional ablative lasers.

With light therapies such as intense pulsed light (IPL)

also available to help ward off the signs of ageing, there is

a dizzying array of choice – and much potential confusion

for the consumer. It’s always best, therefore, to seek the

advice of a doctor or clinician who is fully qualified and

experienced in using laser and light devices and who will be

able to advise which treatment is best for you.


Packed full of growth factors, platelet-rich-plasma (PRP)

is fast becoming one of the most popular tools for those

looking to restore a youthful tone, texture and firmness to

their skin.

Drawing on the body’s own healing capabilities, PRP

uses a patient’s own cells to regenerate and rejuvenate

the skin, helping to improve the appearance of sagging

skin, fill lines and wrinkles and plump areas that have lost

volume over time. PRP therapy targets the growth factors

found in the patient’s blood, which are then injected back

into the patient to stimulate the body into producing new 71


See the light

It’s easy to get confused over which laser or light

based treatment is good for your skincare needs.

Here’s a run down of the most popular procedures

Non-ablative laser is good for younger patients

(approximately aged between 30 and 50 years) who

have early wrinkles or for those who truly can’t take

any time off from family or work commitments to

have traditional ablative laser. There is minimal or no

downtime involved. A series of treatments (three to

six) may be necessary to see the desired results.l.

While not a laser, Intense Pulsed Light (IPL)

penetrates deeper into the skin than a non-ablative

laser. It does not injure the surface, so there is usually

no downtime. It can improve skin texture and colour

as well as reduce pore size. IPL can effectively treat

some types of hyperpigmentation, including age

spots and freckles.

Photodynamic Therapy (PDT) is a two-step

procedure and is commonly used to treat skin

complaints such as acne and acne scarring. First, a

solution that makes the skin more sensitive to light

is applied to the treatment area and left on for 30

minutes or longer. Next, a light source is beamed

onto the treatment area. This process can improve

the appearance of redness, age spots and freckles

and improves the overall texture and appearance of

the skin. It’s important to look after the skin posttreatment,

protecting it from the sun and other

sources of bright light. Sun exposure after PDT can

be painful and may result in sunburn and blistering.

Ablative fractional laser offers deeper

rejuvenation. It is best for improving the appearance

of age spots, wrinkles and skin discolourations.

It can be used on the delicate skin around the

eyes and mouth. It is also effective for treating

precancerous growths (actinic keratoses). Recovery

time is generally between one and three days.

Traditional ablative laser heats the skin to

cause a visible wound, which means up to 14 days’

downtime. While invasive and performed only by

doctors, with a longer and more uncomfortable

recovery process, the results of traditional ‘flat

beam’ laser are still regarded by many professionals

as the gold standard for improving deeper wrinkles,

severe sun damage and crepiness around the eyes

and on the neck.

It is best for patients who are in their late 40s

to 70s. During the recovery period the treated

area will be red and swollen, and may then scab

and ooze before healing. There will be a period of

between four and six weeks when the skin may

appear red or pink.

collagen and hyaluronic acid. During a typical treatment,

blood is collected and then spun in a centrifuge in order

to concentrate the blood plasma. The platelet rich plasma

is then injected into the treatment area. Depending on the

areas being treated, different amounts of plasma will need

to be collected.

Because the raw material is taken from the patient’s

own body, PRP is considered a non-allergenic, ‘body’s

own’ physiological product as opposed to animal derived

or human donor products, synthetic fillers or neurotoxins.

When being used aesthetically to invigorate the

appearance of the skin, patients may benefit from a number

of treatments, spaced several weeks apart.

During the procedure, numbing cream or local

anaesthetic is applied in order to numb the area before

injection, and patients should expect to experience slight

bruising, swelling and redness after the procedure. Any side

effects tend to settle over the course of 24 hours.

Patients typically see some results two to three weeks

after their first treatment, but for optimum results a course

of three or four treatments is required, spaced a minimum

of eight weeks apart. Results will continue to improve over

the course of a few months.


With age, the rate at which our skin sloughs off dead cells slows

down dramatically, which leads to a build-up of hardened

cells on the top layer of the skin. Microdermabrasion removes

the outer layer of the stratum corneum (outermost layer of

the skin) to aid this process, improving the appearance of

fine lines, sun damage and scars, and creates a more even

tone and texture on the skin.

There are a number of different types of microdermabrasion.

Most commonly, however, an exfoliating

material is used to buff away the top layer of the skin whilst

a handpiece vacuums the stripping agent and skin particles

from the treatment area.

The treatment is generally well tolerated and can be

adjusted according on the sensitivity of the skin and the

individual complaint.

After treatment, the skin can feel hot and appear slightly

red but this usually settles over a few hours.

It’s generally recommended that a course of six

treatments is carried out to improve problems such as age

spots, but it can also be effective to treat blocked pores and

blemishes with two to three treatments.

Skin Peels

Peels are solutions applied to the surface of the skin to

strip away the outermost layers, revealing fresh new skin

beneath. Used to treat a variety of conditions, peels can


5steps to healthier skin

Of course, there are a number of free, easy steps everyone can take to safeguard their skin and

maintain a flawless complexion.

1. Protect yourself from the sun

From wrinkles and pigmentation to skin cancer, over-exposure to the sun is to blame, so cover

up with a quality SPF and stay in the shade between 10am and 4pm.

2. Stub it out

If you want to fast forward your way to older-looking skin, light up a cigarette. Smoking

decreases blood flow to the skin and damages collagen and elastin. The result? Aged, sagging

and wrinkled skin long befor your time.

3. Be gentle

Daily cleansing, shaving and baths can all take their toll on the skin. Be kind – choose a mild

cleanser, use warm, not hot, water and pat your skin dry rather than rubbing it.

4. Eat a healthy diet

A diet rich in fruits, vegetables, whole grains and lean proteins will all help you look (and feel)

your best.

5. Stress less

Stress isn’t just bad for your health, it’s bad for your skin, too, so take steps today to manage

your stress. Try regular meditation or yoga and scale back if you feel you have too much on.


improve problems ranging from lines and wrinkles to

dryness or dullness, acne, rosacea and pigmentation.

Ingredients range from naturally-occurring chemicals

and herbal extracts to synthetic chemicals, and their effects

range from mildly brightening to aggressive resurfacing.

Depending on the strength, peels can be administered

by dermatologists, cosmetic practitioners and skincare

professionals, and in most cases are recommended as a

course of treatments.

Natural peels are relatively mild and only affect the

superficial layers of the dermis. Alpha hydroxy acid (AHA)

peels are the mildest option, available in salon treatments

and can be used on most skin types. They use lactic, fruit

or glycolic acids to treat dryness and improve skin texture.

Beta hydroxy acid (BHA) peels use salicylic acid to speed

the skin cell shedding process and improve blemished skin.

Chemical peels are higher strength solutions that use

different grades of acid to strip the skin of dead skin cells and

promote the production of collagen and elastin in the skin.

Chemicals ranging from alpha hydroxy, kojic and salicylic

acids to extremely potent trichloroacetic acid (TCA) and

phenol also vary in their depth of penetration, causing them

to directly target specific concerns.

Typically, the stronger the peel the deeper the penetration

and the more severe the post-treatment side effects.

The treatments typically cause stinging during application

and various degrees of flaking after treatment – from fine

flaking to sheeting – as the new layers of skin start to form.

Chemical peels can be quite aggressive, so skin analysis

during consultation is required to find out which peel is

most suitable, and whether any allergic reactions will occur.

Dryness, redness and peeling can be expected for up to a

week after most peels, which feels similar to sunburn. It is

imperative the peeling skin is not picked at or rubbed as it

may cause scarring.

Active skincare

Of course, the results of any skin treatment need to

be backed up with a skincare regime that will maintain

and enhance your results. Rather than heading for the

skincare aisle in your local supermarket, it’s best to

discuss your specific skincare needs with a specialist,

who will not only prescribe a skincare range suited to you

and your needs, but who will also lean towards a range

packed with active ingredients.

Also known as cosmeceutical or clinical skincare, active

skincare is often prescription based thanks to the high

percentage of active ingredients contained in the products.

As well as more traditional creams, active ranges typically

centre around a number of different serums, each designed

to address a specific concern.

Packed with potent ingredients such as retinol, topical

vitamin C and AHAs, it’s best to introduce these ranges

slowly to your skincare regime, and under guidance, to

ensure against any reaction. With time and guidance,

however, there’s no doubt your skin will benefit from your

investment in actives. csbm 73










It’s easy to tell when your skin sends out an SOS. Your

once clear complexion may have erupted in a seemingly

unstoppable outbreak of acne; it may appear red and

fl ushed or dry and cracked. Too long spent in the sun might

have fast tracked your path to fi ne lines and wrinkles, and

pigmentation may be starting to rear its head. Here, we

get to know some of the most common skin concerns,

investigating the causes, symptoms and cures.

Ais for Acne

Thought to affect up to 80 per cent of girls aged

15 to 16 and 95 per cent of boys aged 17 to

18, acne vulgaris is the bacterial infection of

the pilosebaceous unit, or the hair follicle and its adjacent

sebaceous glands. And its not just adolescents who are

affected by the dreaded outbreaks, with women far more

likely than men to continue to suffer acne into adulthood.

Acne develops within the skin’s pores. Fine hairs grow



pustules and cysts are all forms of acne and can ultimately

lead to scarring, not to mention destroying self-confidence.

From toothpaste cleansers to oatmeal paste masks, it

seems every remedy type has been tried and tested in a bid

to clear the spots of acne. Mild acne can usually be treated

with regular skin cleansing, topical moisturisers and dietary

adjustments. Moisturisers rich in active ingredients will

strengthen the skin’s protective oil/water layer and improve

the integrity of its structure, making it more resistant to

infection and more efficient in shedding dead skin cells.

In more severe cases, medical grade treatment is often

required. Prescription ointments can reduce levels of the

Propionibacterium acne, the bacteria responsible for

most acne infections, while antibiotics can fight the same

bacteria or reduce testosterone hormone levels in the

body. However, these treatments dehydrate the skin and

can cause redness, irritation and sensitivity to sunlight.

Laser therapy, chemical peels, microdermabrasion and

light induction therapy can also be effective in reducing the

appearance of acne scarring.

through these pores, alongside sebaceous glands that

produce oil to lubricate the hair and protect the skin. In

response to a number of factors, most predominantly the

rise of testosterone levels in both males and females during

puberty, these sebaceous glands can begin to secrete

excessive oil, termed sebum. This oil, combined with a

build up of dead skin cells, can plug the pore, creating an

optimum breeding ground for bacteria. As hypercolonisation

of bacteria occurs, so too does the formation of a pusstrapped,

inflamed pimple. Black heads, white heads,

Dis for dehydration

As much as 60 per cent of the body is

comprised of water and, with the skin its

largest organ, it makes sense you need to keep

your skin hydrated. Tired, aged, wrinkled and pimpled skin

are all signs of dermal dehydration, where enzyme activity

is impaired and skin health has deteriorated. Quite simply,

to regain and retain hydration the skin’s oil barrier, known

as the acid mantle, must be restored. The acid mantle –

the outermost layer of the epidermis – is secreted by the

sebaceous glands to keep water and nutrients circulating

between skin cells in the epidermis, preventing water loss

and protecting against pathogens. When the acid mantle is

depleted, ‘transepidermal water loss’ occurs and enzyme

activity, which is dependent on water and responsible for

the correct functioning of skin cells, is compromised.

Water intake, humidity, lymphatics and essential fatty

acids can influence dehydration and enzyme activity.

Increasing the amount of water consumed, upping your

exercise regime and supplementing your diet with omega

oils can boost the amount of water reaching the epidermis

through the dermal-epidermal junction and maintain

hydration within the skin. These changes, complemented

with a diligent skincare regime can restore enzyme activity

and reduce the premature signs of ageing associated

with dehydration. A home-care range for dry skin should

incorporate hyaluronic acid to attract water, antioxidants to

regenerate and repair, and vitamin A to stimulate the dermis

and normalise cell function. 75


Eis for eczema

A form of dermatitis, eczema is the inflammation

of the skin’s outer layer, resulting in rashes that

can exhibit dryness, redness, swelling, crusting

and flaking. These symptoms can cause itchiness, oozing

infection and bleeding, which sometimes leads to scarring.

With no known cause, some researchers speculate

limited exposure to environmental pathogens as a child

can lead to a heightened susceptibility to eczema. For

this reason Flohr, Pascoe and Williams urge caution in

prescribing antibiotics to children, particularly those with

a family history of ‘atopic dermatitis’, or eczema. Others

speculate eczema may be triggered by an allergic reaction

after exposure to proteins in meat or vegetables, whilst

some researchers speculate eczema may be linked to dust

mites and celiac disease.

With no single causal factor, eczema cannot be ‘cured’

but the skin irritations can be managed. Once again an

array of home remedies have been put forward to reduce

inflammation, and certainly modifying your diet and

exposure to certain irritants can go lengths in achieving

relief from eczema symptoms.

Though a study by Hoare, Li Wan Po and Williams found

the use of immunosuppressant medication, corticosteroid

creams (using chemicals that resemble steroid hormones

produced in the body) and ultraviolet light therapy were

most effective in eczema treatment.

Gis for Glycation

If you indulge in sugary delights, you’re

probably fully aware of the havoc it will reap on

your hips and waistline, yet as sugar bombards

your system your skin can suffer too. Glycation presents

itself as aged skin, leading to cross-hatched wrinkles on

the chin and around the eyes. It is caused by the bonding

of sugar molecules onto protein or lipid molecules without

the controlling action of an enzyme. The end result is an

abundance of ‘advanced glycation end products’, or AGEs,

which stiffen and weaken the collagen and elastin in our

skin. When this happens, the elasticity, plumpness and

youthfulness of skin deteriorate, and the tell tale fine lines

start to appear.

To a certain extent, glycation is inevitable, as AGEs will

exist in even the cleanest of diets. To slow the process, you

can avoid foods that include pre-formed AGEs, caused by

cooking sugar alongside protein or fat. ‘Browned’ products

like chips and baked goods achieve their colour through

dietary glycations, while soft drinks and caramelised

treats also contain the pre-formed toxins. To help ward

off glycation’s effect on the skin, many cosmetic skincare

ranges include antiglycation agents. Retinoids promote

new collagen formation to eradicate the damage caused

by sugar, and pharmaceutical companies are working on

products to break the AGE cross-links after they’re formed.


is for Pigmentation

Hyperpigmentation, or the darkening of the

skin in localised areas such as the cheeks,

forehead and around the eyes, can be

triggered by several factors and can spoil an otherwise

clear complexion. The appearance of dark, often brown

spots is caused by the overproduction of melanin by

melanocytes in the basal layer of the epidermis. This

can occur in response to hormonal changes, pregnancy,

inflammation and sun damage.

The most avoidable form of pigmentation, particularly

common in Australia, is caused by sun exposure, when

melanin is produced to protect skin cells from harmful UV

rays. Acting like an umbrella, melanocytes release pigment



into the skin cells to surround and protect the cell’s nucleus.

This causes skin darkening and concentrated spots of

melanin, often termed ‘sun spots’. Certain products such

as perfumes, soaps or cosmetics contain ‘phototoxic’

ingredients, which induce a sensitised reaction to sun

exposure and trigger excessive melanin secretion.

Presenting in a more ordered, symmetrical pattern,

hormonal melasma is caused by overstimulation of

melanocytes in response to increased levels of oestrogen

and progesterone. Most common in women, hormonal

melasma can arise after pregnancy, in women with a

history of taking the oral contraceptive pill or in those

undergoing hormonal therapy. Finally, post-inflammatory

pigmentation occurs as a result of injury to the epidermal/

dermal junction. This can appear in skin conditions like

eczema, acne or chronic dermatitis, or in some cases

after harsh cosmetic treatments.

Pigmentation of all forms can lie unnoticed in the lower

layers of the epidermis for years before appearing on the

face. Because of this, and the fact it is so sensitive to

inflammation, treating visible signs of pigmentation can be

difficult with no guarantee of complete eradication.

Regardless of the cause, all pigmentation is treated with

a similar approach. Topical treatments are the first step,

with a skincare range incorporating vitamin A to normalise

cell function, vitamin C to protect DNA and niacinamide (the

active form of vitamin B) to inhibit the synthesis of melanin

and lighten existing pigmentation. This treatment can be

combined with collagen induction therapy (skin needling),

light-emitting diode (LED) therapy and chemical peels.

It is best to work with a dermatologist when fighting the

appearance of pigmentation, as it is often a long process

involving multiple aspects.

Ris for rosacea

Evident as redness, pimples, flushing and

pustules, rosacea is a vascular disorder that

can arise in the centre plane of the face,

across the cheeks, neck, chest and around the eyes. A

flushed appearance occurs on account of mildly inflamed

superficial vasculature, and the redness can be dotted

with small bumps called papules or, in more severe cases,

inflamed pustules.

Rosacea symptoms can flare up in response to various

triggers, including sun exposure, heat, alcohol, spicy foods

and certain cosmetics. Treatment for rosacea will usually

begin with a patient journal to identify the triggers most

troublesome to the individual so that lifestyle adjustments

can be made to avoid these irritants.

Skincare with anti-inflammatory ingredients can be

effective in combating the appearance of rosacea, with aloe

vera, provitamin B5, green tea, red algae, and zinc just some

of the ingredients shown to sooth skin irritation. Salicylic

acid can help with rosacea, and retinaldehyde, the milder

version of retinoid, is usually appropriate to promote skin

integrity in rosacea patients, though progressive adoption is

recommended. Alongside topical treatments, oral antibiotics

can be used to reduce inflammation and eradicate the

papules and pustules that can sometimes arise.

Though steroid treatment will succeed in promoting

short-term relief of rosacea symptoms, it will usually

increase capillary formation and result in amplified redness

and flushing in the long-term. While some cosmetic

treatments like chemical peels and microdermabrasion will

inflame rosacea symptoms, other procedures like vascular

laser therapy or intense pulsed light (IPL) treatment can

successfully relieve redness and flushing. By targeting

the capillaries in the dermis, these treatments use light to

destroy the tiny blood vessels and reduce flushing. csbm 77


Eat your

way to









Bloated, energised or lethargic, the effects of how you

fuel your body are obvious when it comes to your

digestive comfort and, of course, your weight. Yet how

many of you have considered the way your diet is reflected in

your skin? Although you may readily spend money and time

establishing a promising skincare regime, its easy to forget to

nourish your skin from within.

But what you put in your mouth may be having as big

an impact on the appearance of your skin as what you put

on your outer-most organ on a day-to-day basis. From

loose, sagging skin to wrinkles, dullness and other signs of

premature ageing, there’s no doubt a diet devoid of nutrients

can take its toll on your complexion. Radiant skin, on the

other hand, is an expression of inner health, largely built on

the foundations of a healthy diet. Here, we take a look at

what vitamins, minerals, fibre and other nutrients you need

to consume in order to look as good on the outside as you’ll

be feeling on the inside.

Eat your wrinkles away

If you’re choking on your greens, or dragging your feet all

the way to the fruit market, you might be interested to know

that, according to an international study by Martalena Purba

et al, there is a direct correlation between nutrient intake

and skin wrinkling. The results of the study revealed there

was less skin damage with a higher intake of vegetables,

olive oil, fish and legumes. On the other hand, more severe

sun damage and skin wrinkling was seen in diets containing

higher concentrations of butter, margarine, milk products

and sugar products.

In a similar vein, ultra violet (UV) exposure is a source of

oxidative stress, which causes free radicals to reap toxic

havoc on the membranes, proteins and DNA of skin cells.

To protect against this fast-track path to skin ageing, it’s

imperative to load your diet with antioxidants, which help

fight free radicals. Maurizio Podda and Marcella Grundmann-

Kollmann reported low-molecular weight antioxidants, found

in fruits and vegetables, promote skin integrity and protect

against the wrinkles, pigmentation and loss of elasticity

associated with sun damage or ‘photo ageing’.

Dr Leslie Baumann, well-known dermatologist and



author of the book The Skin Type Solution, encourages

avoidance of, and protection against, extrinsic ageing

factors in achieving healthy skin. ‘This entails avoiding

exposure to the sun, using sunscreen when sun avoidance

is impossible, avoiding cigarette smoke and pollution and

eating a diet high in fruits and vegetables,’ she explains.

She also suggests using oral anti-oxidant supplements or

topical anti-oxidant treatments to enhance this protection.

Red is for radiance

Whilst the consumption of fruits and vegetables has

obvious benefits for the skin, those who only fill their diet

with plant-based ingredients are at risk of developing an

iron deficiency, which can manifest itself on the skin.

Dark circles under the eyes, a pale complexion, skin

irritations and cracks at the corner of the mouth are all

symptoms of an iron deficiency. The highest concentrations

of iron are found in meats, as molluscs, red meat and liver

exhibit ‘heme’ iron from red blood cells, the type readily

absorbed by the body.

For those of the vegetarian persuasion, however,

‘nonheme’ iron, derived from non-animal sources, is also

beneficial to the body but not absorbed as rapidly. It can be

found in dark green vegetables, beans, wholegrain and soy

derived products like tofu.

Fight acne with food

The glycemic-index (GI) rating of certain foods is a concept

widely toted in diet regimes and weight loss programs, yet

this index can also influence the inflammation of acne and

the production of sebum, or oil, in the epidermis. A GI is a

measure of how quickly blood sugar levels rise after eating

certain foods, with ‘high’ GI foods rapidly breaking down

and flooding our system with glucose, and ‘low’ GI foods

releasing sugar more steadily into the blood stream.

Elsa H. Spencer et al explain foods with a high GI

are associated with increased sebum production and

heightened blood testosterone levels, which can contribute

to the inflammation of acne. On the other hand, foods

with a low GI have been shown to increase the blood

concentration of sex hormone-binding globulins (SHBG),

which bind to testosterone and inhibit its function, therefore

reducing acne inflammation.

To moderate the rate of glucose flooding your blood

stream, and inhibit the break out of unwanted spots across

your complexion, fill your diet with more whole grains,

beans, seeds, fruits and vegetables and avoid white bread,

most white rice, processed breakfast cereals and foods

high in glucose.

To further stave off the spots, it is best to avoid dairy

foods and diets high in protein. Spencer et al cite authors

who have found selective hormones in milk, including insulin

growth factor-1 (IGF-1), may survive milk processing to

affect the pilosebacious unit (the pore, hair and surrounding

sebaceous gland), causing acne. Similarly, the amino acids

found in protein enhance testosterone secretion, meaning a

high-protein, low carbohydrate diet can result in a hormoneinduced


Fatten up

Essential fatty acids play an integral part in skin hydration,

cell renewal and protecting the epidermis against harmful

bacteria. These unsaturated fatty acid chains maintain the

permeability barrier of the stratum corneum – or the top

layer of the epidermis. This barrier protects the skin from

bacteria to prevent acne and inhibits trans-epidermal water

loss to maintain skin hydration.

Remarkably, Meagen McCusker and Jane Grant-

Kels found Omega 3 and Omega 6 can promote wound

healing, elevate the sunburn threshold and trigger cell

death in malignant cells, including melanoma. With such

extensive benefits, it is important to fill your diet with

sources of essential fatty acids, as the body does not

produce them naturally. Fish, shellfish, flaxseed, chia seeds,

sunflower seeds, leafy vegetables and walnuts are all good

natural sources of Omega 3 and Omega 6, while fish oil

supplements will also leave your skin glowing, healthy and

free from harmful bacteria.

Banish the booze

Filling your diet with fruits, vegetables and omegas will go

a long way to clear, beautify and nourish your complexion.

Unfortunately, this good work can easily be undone by

alcohol. While it seems counter intuitive, those relaxing

glasses of wine inflict stress upon the body, stimulating the

secretion of cortisol. This hormone thins the skin, making

it more susceptible to infection, causes fat storage around

the face, creating a bloated appearance, and provokes

increased water retention, adding to facial puffiness.

Regular drinking will overstimulate the salivary glands,

swelling the jowls even further, and collapse the skin’s

collagen and elastin into wrinkles – an effect caused by

excess sugar in the blood stream, a common by-product

of beverage indulgence.

Ultimately, if your diet is unbalanced or rich in unhealthy

foods, your skin could be paying the price and, no matter

what skincare products you invest in, the wrinkles and

dullness won’t improve. However, by making just a few

simple changes to your dietary habits, your skin will no

doubt radiate health. csbm 79


Smoking & your skin

If you’re guilty of smoking, you could be guilty of killing your

complexion. FIND OUT WHY The skin is often the first place on the body

TO SHOW THE detrimental effects of smoking. Lizzy FOWLER reports.



Despite knowing you shouldn’t smoke – the hardhitting

advertising campaigns are almost impossible

to avoid – it can be a tough habit to kick. And, the

longer you spend puffing on cigarettes, the more likely

you are to experience the detrimental effects of smoking.

Although the number of smokers in Australia has been

dropping since 1945, when approximately 72 per cent of

the population smoked, smoking is still considered the single

most preventable cause of ill health and death in the country.

The harm smoking inflicts on the skin might seem

superficial compared to heart disease or lung cancer –

two common, not to mention deadly, consequences of a

smoking habit – but it is usually the first, and most visible,

sign of the damage smoking can cause.

The good news is this damage is reversible. The bad

news, however, is that the longer you leave it before

quitting, the more likely the sagging, wrinkled complexion

you’ve been left with will be permanent.

How smoking affects the skin

The exact ways in which tobacco smoke changes or

damages the skin are not yet fully understood. However,

scientific studies suggest a number of mechanisms may

be involved.

Some research suggests exposure to tobacco smoke

decreases blood flow in the arteries and capillaries, resulting

in damage to the connective tissues that help maintain

healthy skin. Fibroblasts – the cells in connective tissue that

form collagen and elastin – are also thought to be damaged

by tobacco smoke.

There is also evidence that tobacco smoke is

phototoxic, becoming more damaging – or toxic – in

the presence of ultraviolet (UV) light. The skin of a heavy

smoker would therefore be more prone to UV damage

than that of a non-smoker.

Smoke is also thought to sap the body of vitamin C –

a key component in the manufacturing of collagen, which

underpins the structure of the skin. Not only this, but

smoking is thought to disturb the production of matrix

metalloproteinase – an enzyme that, in non-smokers,

regulates the production of collagen.

Of course, all that sucking puts the skin around the

mouth under stress, too, resulting in the hollow cheeks,

crow’s feet and puckered upper lip characteristic to the

heavy smoker.

Wrinkles and smoking

Although you may be more used to reading about wrinkles

that appear on the face, smoking doesn’t discriminate,

contributing towards the emergence of fine lines and

wrinkles all over the body – including often-exposed areas

such as the normally delicate inner arms.

But what causes the wrinkles? The blame ultimately lies

with the nicotine in cigarettes, which causes narrowing of

the blood vessels in the outermost layers of the skin. This

impairs blood flow to the skin, restricting not only the amount

of oxygen but also the amount of important nutrients such

as vitamin A that reach the dermis. Of course, the cocktail

of more than 4,000 chemicals in tobacco smoke also

damage collagen and elastin, both of which give the skin its

strength and elasticity. The end result is skin that begins to

sag and wrinkle prematurely.

There is evidence that the more you smoke, the more

accelerated the ageing effect will be, with heavy smokers

experiencing more premature wrinkles than those who

dabble in the odd cigarette. But how much older can a

smoker expect to look? One study, in which eight judges

individually rated the age of smokers and non-smokers

from their photographs, reported that smokers were, on

average, rated as being 2.7 years older than their actual

age, while non-smokers were rated at 0.7 years younger

than their actual age.

Smoking and sun damaged skin

Of course, sunlight is already known to prematurely age

the skin, so what happens when a smoker is exposed

to sun damage? Some research suggests individuals

exposed to both tobacco smoke and sunlight prematurely

wrinkle more than individuals exposed to tobacco smoke

or sunlight alone.

One study found that smokers were 5.8 times more

likely to develop wrinkles than non-smokers, while those

with excessive sun exposure (defined in the study as more

than two hours per day) were only 2.65 times more likely

to wrinkle than those who were not excessively exposed

to sunlight.

Individuals who smoked heavily (defined as ‘35 pack

years’) and who had excessive sun exposure were 11.4

times more likely than non-smokers with less than two

hours per day of sun exposure to develop wrinkles. This

is a much greater risk than the combined individual risks of

smoking and sun exposure alone. Given the phototoxicity of

tobacco smoke, this synergistic relationship is unsurprising.

Reverse the damage

The good news is many experts believe much of the

damage done to the skin by tobacco smoke is reversible.

In fact, as soon as you stop smoking, the body begins to

function better and can take steps to repair itself, the skin

showing noticeable signs of improvement after as little as

six weeks without a cigarette.

Although kicking the habit is the first – and perhaps

hardest – step in reversing the damage, you can also give

your skin a little helping hand. Replenish your stores of

vitamins A and C – both topically through your skincare

and internally through your diet; stay hydrated and limit

your intake of alcohol and caffeinated drinks. Lastly, make

an appointment to see your dermatologist – some of the

damage caused by smoking may be harder to heal and,

depending on the degree of wrinkling, you may want to

consider treatment options such as anti-wrinkle injections,

dermal fillers or dermabrasion. csbm 81


Best face


REigniTE yoUR coMPLExion anD

FigHT THE SignS oF agEing WiTH



If beauty is only skin deep, it pays to keep the skin healthy

and radiant. However, as the body’s largest organ, and its

first line of defence against the outside world, the skin is

prone to discolouration, dehydration, acne, wrinkling and

a wealth of other common complaints. Beauty, then, can

often seem a long way off.

Fortunately, a number of technologies exist to help

improve the appearance of skin complaints such as wrinkles,

pigmentation and textural irregularities. Fractional laser is one

of these technologies, affording non-ablative skin resurfacing

to brighten, refresh and reinvigorate the complexion with

minimal downtime and little to no discomfort.

The new Palomar Emerge Fractional Laser delivers

pulses of heat in micro-beams to the skin’s epidermis

and dermis. Used commonly to treat the skin on the face,

this creates controlled columns of damage to trigger the

body’s natural healing response. The resultant increase in

oxygen, nutrients and hydration promotes the production

of collagen and elastin in the treatment area – the building

blocks of youthful skin.

‘Due to the body’s natural healing process, the columns

of damage are replaced by new, healthy tissue. This

results in fresher, younger looking skin with a reduction

in pigmentation, fine lines and wrinkles,’ explains Sydney

dermatologist Dr Michelle Hunt, who has been using the

Palomar Emerge for the last year. ‘The upper level of the

skin remains intact, allowing for minimal downtime, and

reduced risk of side effects such as infection.’

While the Emerge is suitable for use all over the body,

Sydney facial plastic surgeon, Dr Tobias Pincock, commonly

uses it to address ageing characteristics around the face.

‘Primarily, we use the Emerge to treat the ageing face,

as it stimulates collagen induction, decreases pore size,

reduces wrinkles, homogenises texture and rejuvenates



the skin,’ Dr Pincock explains. ‘We’ve also achieved some

great results in scar revision and treating stretch marks.’

With five specialised parameters, the Emerge can be

tailored to suit each patient, depending on the severity of

facial wrinkles, prevalence of pigmentation and the need for

skin resurfacing.

Before the procedure, therefore, an extensive

consultation is required in order to gauge the particular

concerns and circumstances of each patient. It also

provides an opportunity for the physician to capture

photographs of the patient so results can be compared

before and after treatment.

Although the laser treatment itself is typically well

tolerated, Dr Pincock says patients can opt for topical

anaesthetic to be applied to the treatment area ahead of

the procedure.

‘We generally use cold rollers and topical numbing

cream when preparing patients for their treatment,’ says

cosmetic nurse specialist JC Neveu-Collins who works with

Dr Pincock.

more stubborn pigmentation,’ Dr Hunt explains. ‘Often

patients like to return after six to 12 months for a “refresher”

treatment, or prior to special events.’

Some patient care is needed before and after treatment.

Sun exposure should be avoided for two weeks both before

and after treatment, while gentle skincare, incorporating

anti-inflammatory agents and peptides, is recommended

in the days following the procedure. Retinoids, or serums

containing vitamin A, should be avoided directly after

treatment and sunscreen should be used regularly while

undergoing a series of Emerge procedures.

For those looking to conquer stretch marks, tighten

wrinkles or return their skin to an even glow and texture,

the Emerge affords a fast and tailored approach. Used

either alone of alongside other rejuvenation procedures,

the Emerge will leave skin renewed from within, with

heightened collagen induction and enhanced quality for a

fortified, revitalised and refreshed complexion. csbm

The Emerge stimulates

collagen induction, decreases

pore size, reduces wrinkles and

rejuvenates the skin

‘Any discomfort is bearable but the level of anaesthetic

always depends on the patient,’ he adds. ‘Treatment with

the Emerge is commonly used to tighten the skin under

the eyes, which is an area that can noticeably deteriorate

with age. Around this area – the periorbital rim, temples and

cheekbones – there is less tissue and the level of discomfort

will typically be greater.’

According to Dr Pincock, the procedure itself can usually

be performed within just half an hour. Although a short

procedure with minimal downtime, patients should expect

some redness and swelling and may also experience

peeling skin. ‘The redness tends to fade within 24 hours,

while any dryness may persist for a couple of days,’ notes

Dr Pincock.

For the best results, a series of four to six treatments

is recommended to rigorously enhance skin health, with

each treatment spaced two weeks apart. New collagen

formation can be seen after three months following the

procedure and these results can be maintained and,

according to Dr Hunt, can be improved with diligent home

skincare and complementary procedures.

‘The Emerge laser can be used alone, but it is a great

adjunct to other cosmetic procedures such as muscle

relaxing injections, dermal fillers and even other lasers for




AFTER 3 treatments with the Palomar Emerge

by Dr Hunt

AFTER 3 treatments with the Palomar Emerge

by Dr Hunt

AFTER 5 treatments with the Palomar Emerge

by Dr Hunt 83





MuLtIpLe MoDeS to enhAnCe the StRuCtuRe AnD SMooth the textuRe oF

heR SkIn. CAItLIn BIShop RepoRtS.

Like many patients, Desi was hoping to address the

loss of volume and skin laxity she had experienced

with age. Having approached the Australian Skin

Face Body clinic in Geelong, after thorough consultation

she was recommended a new procedure, designed to

leave the skin refreshed, soothed and volumised.

Recently introduced to Australia, the Infini from Lutronic

is the world’s first dual-mode fractional radiofrequency (RF)

platform, capable of 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 on the inside and out. I

therefore hoped it would improve both the contours of my

face and the texture of my skin.’

By combining both microneedle fractional radiofrequency

(MFR) and superficial fractional radiofrequency (SFR),

the Infini offers a rigorous approach to skin rejuvenation,

tackling both the superficial and deeper layers of the skin.

With MFR, insulated microneedles deliver radiofrequency

energy deep into the dermis inducing controlled areas of

coagulation – or tissue shrinkage – and triggering the body’s

natural healing response. This promotes collagen production

and skin tightening, without damaging the epidermis, to

create a firmer, stronger and more youthful complexion.

SFR, on the other hand, uses two channels to deliver

thermal energy deep into the epidermis and dermis, while

also providing micro ablation on the skin’s upper layers.

This illuminates the skin and homogenises its texture, which

is particularly effective for scar revision.

By combining the two technologies, the Infini platform

can be used to address a number of patient concerns.

‘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

Claderhead, director of scientific affairs at Lutronic. ‘Infini

is not the answer to everything, however it is a bridge

between non-surgical and surgical procedures.’

During the procedure, multiple passes of the Infini

can be used to treat the skin’s superficial layers as well

as the epidermis and the dermis and the treatment will


e tailored according to each patient’s skin complaints.

The highest energy is typically used on the skin’s deeper

layers, with more aggressive settings selected for those

areas of patient concern.

‘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 Glad Wrap, which

was removed just before the treatment began. The physician

methodically treated sections of my face, using more

aggressive settings on those areas I was concerned about.’

The treatment itself usually takes around 40 minutes to

complete, with the starting energy level and needle depth

selected according to the patient’s skin condition.

To ensure a three-dimensional improvement, levels are

adjusted with each pass of the handpiece across the face.

‘In the fi rst 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 fi rst pass, the physician

will go to the next depth, which might be 1mm deep, and

use slightly lower parameters.’

The level of discomfort felt during the procedure, as well

as the down time experienced afterwards, varies between

patients. Patients can usually expect some swelling,

redness and sensitivity in the days after treatment and,

in some cases, Infi ni will induce mild bruising, particularly

under the eyes.

Dr Calderhead explains any infl ammation should peak

12 hours after treatment and is usually gone within 24 to 48

hours. He also recommends some patient care following

the procedure, to limit irritation and assist in healing.

‘The tiny microneedle wounds 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.’

Typically, a series of Infi ni treatments is recommended

to achieve the desired outcome. Two treatments, spaced

four weeks apart, are typically needed for optimal results,

with some patients opting for more treatments to further

enhance results.

According to Dr Calderhead, new collagen fi bres begin

to form four weeks after treatment, with results showing

within 10 weeks.

Having undergone two treatments with Infi ni, and with

another two to go, Desi is already more than satisfi ed

with her own results and is looking forward to continued


‘Even after my fi rst treatment with Infi ni, I noticed a

difference in my complexion,’ she says. ‘After two to three

weeks I saw a tightening and fi rming of my skin. I’ve found it to

be a fantastic treatment for general facial rejuvenation.’ csbm



Lutronic has developed a single

device for all skin types and for

a vast range of needs. Indicated

for skin tightening, skin laxity, skin

rejuvenation and acne scarring,

the two-in-one fractional radio

frequency (RF) system combines

microneedle fractional RF and

superfi cial fractional RF in one

platform, offering versatility to

both patients and practitioners.



• Skin tightening

• Skin laxity

• Skin rejuvenation

• Excessive sebum secretion

• Active infl ammatory acne

• Enlarged pores

• Acne scarring

• Hyperhidrosis




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 85







SiGnS Of aGEinG anD ThE PErSiSTEnCE Of

PiGmEnTaTiOn. CaiTLin BiShOP rEPOrTS.

With such a wealth of common skin complaints, the

ability of a treatment protocol to adapt to different

concerns is essential. From non-ablative skin

resurfacing to tattoo removal and acne scars, the Spectra

from Lutronic is a versatile laser that can be tailored to treat

a variety of concerns. Signifying the first ‘Q-Switch’ laser

approved by the Therapeutic Goods Administration (TGA)

for treating melasma, the Spectra also presents a wide

range of options for more generalised skin rejuvenation.

Originally designed for tattoo removal, the Spectra’s 1064

nanometre ‘Q-Switch’ laser – which uses pulsed light at high

energies – is capable of blasting apart the skin cells that hold

tattoo pigment, without affecting the surrounding tissue.

This same principle also applies when treating pigmentation.

‘We can destroy the deeper pigments in both tattoos

and sun spots using the 1064 Q-Switch,’ explains Dr

Glenn Calderhead, director of scientific affairs at Lutronic.

‘Each melanin particle is blown apart by the laser, but it

doesn’t disrupt the tissue surrounding it; it only destroys

the containing cell.’

While this is suitable for reservoirs of pigment situated

deeper into the dermis, the 1064 Q-Switch can’t be used

on skin cells nearer the surface. Instead, the use of the

1064 Q-Switch has been refined in a new technique termed

‘laser toning’. Particularly effective in treating melasma,

laser toning uses low energies and multiple passes to gently

correct pigmentation closer to the skin’s surface.

‘Using 0.9 joules as the starting level on every skin type,

we perform multiple passes with a 7 or 8mm headpiece,’ Dr

Calderhead explains. ‘This has been found to destroy the

melanin but not destroy the cells containing the melanin.’

Sometimes dubbed ‘the mask of pregnancy’, melasma

is common in women who have recently had a baby or

have a history of taking the contraceptive pill. Appearing in

bands of pigmentation across the face, melasma can arise

suddenly and is frustratingly difficult to treat.

‘With conventional treatments, the pigmentation will

either worsen after treatment or return in eight to 12 weeks,’

Dr Calderhead says. ‘With laser toning we can ensure the

skin doesn’t become overly warm or red, as this indicates

increased inflammation. Over six to 10 treatments we can

remove melasma and it stays away for up to 18 months.’

The Spectra is a versatile laser

that can be tailored to treat a

variety of concerns

Combining the two approaches, Lutronic has developed

a ‘Spectra mask’ designed to treat acne, reduce enlarged

pores and improve skin texture. This uses a carbon

facemask, a 300 micrometres pulsed laser and the 1064

Q-Switch laser to create a mild-epidermal peel.

‘The 300 micrometres laser heats the skin and this can

be effective for skin rejuvenation and treating fine pores,’ Dr

Calderhead says. ‘When we immediately follow this with the

1064 Q-Switch treatment, while the carbon lotion is on the

face, we can treat acne, enlarged pores and uneven texture.’

With different parameters for treating rosacea,

pigmentation, burst capillaries and enlarged pores,

the Spectra system affords a holistic approach to skin

rejuvenation. With adjustable energy levels and exposure

times, the laser can be as aggressive or as mild as needed,

ensuring each patient receives an individualised, effective

treatment suited to his or her concerns. csbm



Ditch the down time




Wrinkles, open pores, fine lines, scars and stretch

marks can cast their shadow on all of us,

causing unnecessary heart ache when severe or

located on visible parts of the body. Today, however, nonablative

fractional rejuvenation can significantly improve

the appearance of these conditions and more, with no

downtime and in just a few treatments.

According to Sydney aesthetician and owner of Karpati

Medispa, Eva Karpati, non-ablative fractional skin resurfacing

can be used to improve a number of common dermatological

and cosmetic skin conditions. Best of all, with minimal to

no downtime, men and women can return to their busy

schedules immediately, whilst seeing a real improvement in

their complaint within just a few treatment sessions.

‘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.’

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, non-ablative procedures involve

minimal to no redness and swelling and patients can

return to their day-to-day activities immediately,’ she adds.

The treatment is also much better tolerated with minimal

discomfort experienced by most patients, and no need for

any topical anaesthesia.

Although multiple treatments are needed in order to

see an improvement in the appearance of common skin

complaints such as open pores, fine lines and wrinkles,

stretch marks and scars, Karpati says the treatments are

both fast and effective. ‘I can treat a full face or an entire

chest in around 12 minutes,’ she says. ‘This is a great

advantage to those who don’t have a lot of time to give to

either their procedure or their recovery.’

Of course, the key is to accurately assess the condition

of each client’s skin, and to prescribe the optimal course

of treatment. ‘I will spend as much as an hour talking to

each client, taking photos and analysing their skin before

any treatment is undertaken,’ says Karpati. ‘I do not charge

for this. 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. It’s my philosophy every person

needs an individualised approach.’

Karpati uses different laser wavelengths to address a

number of different cosmetic concerns. ‘We use different


wavelengths, which allow us not only to meet different

needs – be it laser hair removal, pigmentation, vascular

spots or skin rejuvenation – but also to treat different skin

types safely, from the darkest to the lightest.’

According to Karpati, the 1540 laser, which has a

wavelength of 1540 nm, is particularly beneficial. ‘This is a

fractional, non-ablative laser that can effectively rejuvenate

skin on areas such as the face, décolletage and hands.

Moreover, it can improve problematic scars such as those

that might be left post-surgery, as well as stretch marks.’

Patients will typically see a noticeable improvement

in the appearance of these conditions after just one

treatment 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 manufactured,’ says Karpati. ‘Best of all,

as patients have more treatments, results will just keep

getting better and better.’ csbm


AFTER non-ablative fractional rejuvenation


AFTER non-ablative fractional rejuvenation


AFTER non-ablative fractional rejuvenation 89


See the light




If you’re one of the many Australian adolescents or

adults suffering persistent acne, you might have heard

of photodynamic therapy (PDT). A non-invasive and

effective means of treating a number of skin complaints,

PDT combines light with a special light-activated solution to

target abnormal skin cells and unveil clear, radiant skin. As

well as helping to treat acne, PDT has become particularly

popular in Australia, where sun-damage can result in large

areas of scaly, hardened and wrinkled skin. However,

treating anything larger than a localised area of the body with

PDT has, until now, been both a costly and time consuming

process, frustrating both surgeons and patients whose skin

complaint might be spread across large or multiple areas of

the body such as the back or face and scalp.

For the last fi ve years, the team of skincare experts

at allmedic has been working to address this frustration,

developing a new LED machine capable of treating large

areas of the body in just a short space of time.

Known as the allmedic Super ContourFlex LED, the device

has been designed by experts in LED (light emitting diode)

technology, skin cancer specialists and dermatologists, to

overcome the limitations of old technology.

Unlike some LED machines, the allmedic Super

ContourFlex LED incorporates red and blue LEDs into a

large fl exible head, which not only allows for the treatment

of multiple or large areas in a single illumination, but which

can also be moulded around the contours of the body to

improve treatment effi ciency.

Integrating optimal power with a blue LED wavelength,

which affords maximum absorption and activation of

PDT provides


results for acne,

as well as a

wide range of

other skin

conditions such

as sun damaged

and aged skin


AFTER treatment with Photodynamic Therapy and allmedic

everyday product range


Doctor Designed,

Developed & Recommended



is better

Introducing the New allmedic TM

Super ContourFlex LED


AFTER treatment with Photodynamic Therapy

and allmedic everyday product range

ALA – the photosensitiser that is selectively absorbed by

active cells such as the sebaceous gland – means the

length of time patients need to be exposed to illumination

is dramatically reduced. The result is not only shorter

treatment times and, therefore, greater patient compliance,

but also optimal treatment outcomes and a reduced risk of

immunosuppression as a result of the treatment.

Dr Doug Grose, managing director at allmedic,

explains that during the procedure a product containing

the photosensitizer (either 5-ALA or m-ALA) is applied to

the skin of the treatment area. ‘The active ingredient is

selectively absorbed into damaged cells such as sun spots

or active cells such as in the sebaceous glands of acne

patients. Once inside the cells the product changes in a way

which makes it very sensitive to light,’ he says.

After the incubation phase, the photosensitiser is

then activated by the light emitted by the allmedic Super

ContourFlex LED. ‘By exciting the photosensitiser, intracellular

reactive oxygen species are produced, which in turn

leads to the apoptosis and necrosis of the abnormal cells,’

Dr Grose explains.

According to Dr Grose, teatment with PDT can reduce

the oiliness of the skin and improve the appearance of large

pores. ‘In my experience, PDT provides exceptional results

for acne, as well as a wide range of other skin conditions,

including rosacea, sun-damaged and aged skin, fine lines,

and pigmentation,’ says Dr Grose.

PDT can also have a positive impact on the texture,

luminosity and firmness of the skin by increasing the

production of collagen. ‘PDT treatment not only effects

the epidermis, or the top-most layer of the skin, it also

has an indirect effect on the dermis, as cytokine induction

stimulates the creation and inducement of new collagen,

which has a cosmetic effect on the appearance of the skin,’

says Dr Grose.

Ultimately, PDT offers a non-surgical, long-lasting and

cost effective solution to a number of skin complaints

and now, thanks to the advances made with the allmedic

Super ContourFlex LED, treatment is more accessible than

ever before. csbm




o Exclusive supply to doctors only

o Supported by science and research

o Red and Blue LEDs in a large, flexible head, which

moulds around the treatment area so PDT can be

performed on large or multiple areas in one

illumination (shorter treatment time)

üo Optimal power and illumination for reduced risk of

immunosuppression, incubation and patient

discomfort during PDT

üo Blue LED wavelength matches peak absorbtion

and activation of ALA

üo Soft touch control panel and distance sensor for

convenience and ease of use

Convenience · Optimal Results · Reduced Risk

· Improved Satisfaction

Contact us on:

1300 652 969

Follow us on



Key Benefits of the allmedic Super ContourFlex LED Machine

The allmedic Super ContourFlex LED has been developed to overcome the limitations of traditional LED machines.

The new machine has a large, flexible treatment head, which means larger treatment areas such as the back and

legs can be targeted in one PDT illumination. Because of its flexibility, the LED machine can also be moulded

around the treatment area, affording better results. The optimal power emitted by the machine also limits the risk of

immunosupression whilst also reducing any significant patient discomfort.

1. The large treatment head, incorporating red and blue LEDs, means multiple or large areas of the body can be treated in a single illumination without having to change the LED head.

2. The flexible head ensures it can be moulded around the treatment area, which optimises PDT.

3. The blue LED wavelength matches the peak absorption and activation wavelength of photo-sensitive ALA and a soft-touch control panel and distance sensor ensures ease-of-use.



Why you need a

winter peel



As the temperatures dip below 20 degrees, Sydney

plastic surgeon Dr Darryl Hodgkinson says it’s

the perfect time to think about treating your

skin to a resurfacing procedure. ‘Winter is the best time

for skin resurfacing, whether by laser, chemical peel or

dermabrasion,’ he says. ‘This is because, no matter what

technique is used for resurfacing the skin, the new, tender

skin that is exposed after the procedure will be pink and/

or red and, when exposed to the sun – especially in the

summer months – can become brown or hyperpigmented.’

Dr Hodgkinson offers three types of resurfacing: laser

resurfacing, which he refers to as ‘laserbrasion’; peel

resurfacing (chemical peels); and

dermabrasion. ‘At my clinic in

Sydney’s Double Bay, we use

all of these techniques in order

to improve skin that has often

been damaged by the sun,’ he

says. ‘Given expertise, all these

techniques can be combined and,

when used appropriately, can

address a myriad of problems.’

For example, according to Dr

Hodgkinson, fine wrinkles such

as those around the eyes can be

improved with laserbrasion; deeper

wrinkles around the mouth such

as ‘smokers lines’ might best be


addressed with dermabrasion; and

the hyperpigmentation and browny

splotchiness of the skin and a sallow complexion are best

reinvigorated by chemical peeling.

For people with less severe pigmentation or who do not

have the time to recover from a complete skin resurfacing,

lighter forms of peeling are available, which include low

percentage trichloroacetic acid (TCA) or alpha-hydroxy acid

peels. ‘These are appropriate for more minor pigmentation

and, when used in conjunction with microdermabrasion, can

give the skin a fresher, cleaner look,’ says Dr Hodgkinson.

‘The KTP laser is a good option for improving the appearance

of broken capillaries on the face, but again, for the best

results, a combination of procedures can be used.’ csbm


Full face resurfacing to improve severe damage from the sun. An upper eyelid blepharoplasty also helped refresh the appearance. 93











There’s no denying the impact scars can have on body

confidence. Unsightly and often conspicuous, scars

can cramp self esteem, detract from confidence and

prompt the desire to cover up with clothes or makeup,

no matter their type or location. Yet registered nurse and

founder of Clear Complexions skin clinics, Suzie Hoitink,

says scarring shouldn’t be something patients learn to

live with. Although it may take time, Suzie believes the

appearance of scarring can be improved, and assures it’s a

journey that will reap significant, life changing results.

‘We might be treating a client for a year and half, even

two years, but, compared to the rest of their life, this is a

blink,’ she says. ‘The end results are permanent so I see it

as a long-term, life-changing journey to positive change.’

With clinics scattered around Canberra and now Sydney,

the medically trained registered nurses who work at Clear

Complexions are committed to helping their clients find a

long-lasting resolution to their skin issues.

An hour-long consultation signifies the beginning of this

journey – a session that is compulsory before undergoing

any treatment at Clear Complexions.

‘Everybody is different and every scar is different,’

says Suzie. ‘We need to know their age, ethnicity, and

gender; how they got the scar and how it healed; and the

medications they were on at the time; as these factors

effect how we treat the scar. We must take an individualised

approach and it’s only with a detailed consultation we can

formulate a tailored treatment plan.’

According to Suzie, aged skin, for example, will respond

more slowly to treatment, due to the reduced amount of

quality collagen in the skin. Darker skin tones, on the other

hand, are more prone to hyperpigmentation and will need

gentler treatment over a longer period of time.

The consultation also allows the registered nurse to

assess the type of scar in need of treatment. ‘Hypertrophic

scars can be identified by a raised red bump, which arises

due to an over-production of collagen at the scar site,’

explains Suzie. ‘Keloid scars are a type of hypertrophic scar

but are more severe and can expand from the wound site.

An atrophic scar, often associated with acne or chickenpox

scarring, is a sunken recess, while stretch marks occur




Surgical Scars

With surgical scars one of the most common

concerns seen in patients at Clear Complexions, Suzie

recommends Omnilux photodynamic therapy (PDT)

to prevent scar formation in those patients who know

they are going into surgery. A non-invasive treatment,

PDT uses a combination of light wavelengths to activate

certain cells, depending on the desired result. Treatment

with Omnilux can enhance skin health, which results

in an advanced healing response – and reduced scar

formation - after surgery.

‘If we know the patient needs surgery, for example

they’re undergoing a face lift or having a skin cancer

removed, we will give them a treatment of Omnilux to

enhance skin health before the treatment,’ says Suzie.

‘Post surgery, we begin Omnilux as soon as we can

reach the scar and perform the procedure twice a week

for about one month. This stimulates collagen renewal

and prevents fibrous tissue formation. Diligent Omnilux

treatment will either stop the scar forming or, if it does

form, makes it much easier to manage.’


Evident as pitted lesions, pox-marked spots or lingering

pigmentation, acne scars can be difficult to hide, even

using makeup, and can have a profoundly negative

effect upon self-confidence. Suzie explains there is an

abundance of misleading advice regarding treating acne

scars, some of which can prompt unwise decisions with

adverse results.

‘Lots of people try microdermabrasion to treat severe

acne scarring but effective treatment needs something

more aggressive,’ she says. ‘We can accelerate the

healing process using PRP, fractional laser or Genesis

laser and establish an individualised treatment program

best suited to you.’

and patients are afforded faster, more effective results.’

For any type of scar, Suzie recommends seeking

treatment sooner rather than later. For example, new

stretch marks exhibit a reddish colour and can be treated

with PRP alone, but as they age and turn white, more

thorough treatment, involving multiple modalities, is

usually required.

No matter the type, severity, cause or location, the

nurses at Clear Complexions understand how scars can

manifest themselves as negative self-confidence barriers.

By embarking on what Suzie refers to as a ‘journey

of positivity’ at Clear Complexions, your concern will be

addressed in a thorough, individualised and personal

approach, using contemporary medical treatments

performed by qualified and passionate professionals.

‘Of all the treatments and conditions we see in the

clinic, treating scarring is the most rewarding,’ Suzie says.

‘It doesn’t matter if the scar is on the face, if it is visible or

not, scars of any kind can absolutely effect self-confidence

and self-esteem. The most important thing to remember

is that treating scars requires a medical approach and the

sooner you take action, the better.’ csbm


AFTER Fraxel treatment

when the skin is stretched rapidly.’

According to Suzie, Fraxel laser resurfacing is the ‘gold

standard’ treatment for reducing the appearance of scars.

During the procedure, a laser device targets fractional

sections of the dermis and epidermis to break down the

fibrous tissue within the scar and stimulate the production

of new collagen to restore and rejuvenate the skin. While

this practice is widely used, Clear Complexions combines it

with other treatments to afford enhanced results.

‘We use fractional laser in conjunction with other

modalities such as platelet rich plasma (PRP) and intense

pulsed light (IPL) for a faster result,’ explains Suzie. ‘This

means we don’t need to use as many laser treatments



AFTER Fraxel treatment

AFTER Fraxel treatment 95











We may not be able to halt the inevitability of

ageing, but we can exercise some control over

how old we look, thanks to evolving technologies

in skincare. Skin needling is one of those technologies,

inducing the remodelling of collagen and elastin in order to

deliver the hallmarks of a youthful complexion: hydrated,

clear and radiant skin.

German engineered and designed, the Dermaroller

was launched in Europe more than 10 years ago. A

market leader in skin needling, the Dermaroller has helped

thousands of men and women address the hallmarks

of ageing and see a clear improvement in conditions

such as acne scarring and hyperpigmentation. Today,

however, and skin needling technology has evolved, with

the newly released Dermastamp, distributed in Australia

by Clinic Care, clinically proven to induce collagen and

reduce scarring.

The evolution of skin needling

The launch of the Dermaroller in 2000 revolutionised the

concept of skin needling and Collagen Induction Therapy

(CIT), transforming it into an accessible and viable

restorative and rejuvenating treatment. In part inspired by

a Canadian doctor who was treating the appearance of

scars with a tattoo gun – minus the ink – to break up the

fi brous tissue, Dr Liebl improved upon the single needle,

tattoo-gun-approach by developing a device with multiple

micro needles positioned on a drum-like, rotating head. The

device was christened the Dermaroller.



‘Since then there have been thousands of procedures,

very successful results and minimal adverse effects using

the Dermaroller,’ says Sean Abel from Clinic Care.

Listed by the Australian Register of Therapeutic Goods

(ARTG) as a collagen induction device that can reduce the

appearance of wrinkles and scars, the Dermaroller can also

be used to treat stretch marks, pigmentation and some of

the most common signs of ageing.

The concept is relatively simple: when rolled on the

surface of the skin, the needles on the medical grade

Dermaroller create microchannels, which not only aid in the

absorption of topical active ingredients, but also cause mild

trauma to the dermis.

This stimulates the body’s natural healing response

to promote the production of collagen, enhance skin cell

renewal and attract blood, oxygen and hydration to the site.

As new skin cells are generated, and blood flow enhanced,

patients can look forward to an enhanced appearance

within six weeks.

In treating scars, the same rejuvenating effect is achieved,

though the micro needles also work to pierce and release

the fibrous scar tissue, softening the appearance of scars

and making way for improved cell renewal and increased


‘It is a constructive treatment – not an ablative procedure

– so it builds the skin from within, without causing trauma

to the surface,’ Mr Abel explains. ‘It stimulates type three

collagen, which matures into type one collagen. This

maturation process can take anywhere from six weeks

to six months, and patients will see gradual improvement

throughout this maturation.’

A study into skin needling found one Dermaroller

treatment induced, on average, a 206 per cent increase

in new collagen and elastin fibres in the skin. This was

determined using biopsy, where a control biopsy was taken

adjacent to the site of skin needling and a second biopsy

was taken, six to eight weeks later, at the skin-needling site.

In fact, the greatest improvement recorded in this study

was a 1000 per cent increase in new fibres.

Dermastamp: the next frontier

Technology doesn’t stay static for long, and skin needling

has recently taken another step forward with the introduction

of Dermastamp.

Moving away from the traditional design of the Dermaroller,

the Dermastamp comprises a vibrating stamp of micro needles,

affording greater control in a clinical setting.

Unlike the Dermaroller, the Dermastamp is completely

automated, which means physicians can select how many

channels are made in the skin per second and the degree of

penetration for each facial site, according to the condition

being treated. This differs to the Dermaroller, where the

number of channels is dependant on manual application

and a different roller is used for different areas of the face.

‘The Dermastamp is unique in that physicians can

manipulate how many channels are made per second,’ Mr

Abel explains. ‘They can select 50 to 150 micro channels

per second and, with six needles on the tip, this can result

in 900 perforations per second.’

The depth of the Dermastamp needles can also be

adjusted, meaning physicians can vary the depth according

to the area being treated, customising the procedure for each

patient. ‘Literally, one Dermastamp treats all,’ says Mr Abel.

In keeping with this philosophy, the Dermastamp needles

are supported on a ball and socket joint, meaning their

positioning is continuously attuned to match the contours

of the face.

Remarkably, though the Dermastamp treatment is more

thorough than the traditional Dermaroller treatment, the fact

it vibrates means the Dermastamp is more comfortable

than its predecessor.

Dermastamp bridges the gap

between home skincare and more

aggressive treatments

‘Because Dermastamp vibrates, it distracts the nervous

system and our research shows it is approximately 70 per

cent better tolerated than the Dermaroller,’ Mr Abel says.

‘We’ve performed the treatment on patients who

say, “I can’t tolerate pain”. Yet, after treatment with the

Dermastamp, these patients usually tell us they didn’t feel

a thing.’

Before the procedure, topical anaesthetic is applied,

and some practitioners use water microdermabrasion to

increase the effect of the numbing cream.

The procedure will usually result in some blood spotting

during treatment and Mr Abel says most patients will

leave the clinic with a flushed, sunburnt appearance. ‘This

redness will generally persist for 12 to 24 hours following

the procedure, depending on the patient,’ he adds.

Three treatments, spaced four to six weeks apart,

are recommended for those wanting to see an overall

improvement in the appearance of their skin. For those with

scarring, however, the number of treatments will vary.

Suitable for most skin types including fine and sensitive

skins, Mr Abel believes the Dermastamp should be

considered the first step in facial rejuvenation and, when

complemented with the Dermaroller home care system,

can induce long-lasting improvements.

‘It is for those patients who are concerned about their

wrinkles, but don’t want to opt for an extreme treatment

just yet,’ he says. ‘Dermastamp bridges the gap between

home skincare and more aggressive treatments.’ csbm 97


5Steps to

a Clear






No matter what the extent of your skin damage,

registered nurse and founder of Clear Complexions

Clinics, Suzie Hoitink, believes improvement can be

achieved using a professional and dedicated approach to

skin rejuvenation.

‘A clear complexion can still be a reality even if you

have damaged skin, but it is never achieved with one

miracle cure,’ she says. ‘Damage like pigmentation has

multiple causes and lies at different depths. Clearing the

skin of pigmentation requires a variety of technologies, the

combination of which will be different for every individual.’

Under the surface

By taking a look at what lies below the skin’s surface, a more

holistic and effective skincare program can be established.

Vascular damage, pigmentation and ultraviolet (UV) damage

can be better assessed using diagnostic imaging and, while

this may reveal some alarming truths about the condition of

your skin, Suzie believes it’s the first step in an effective skin

transformation plan.

‘You must be aware of what lies beneath your skin’s

surface. This can only be achieved with a skin assessment

conducted by a professional and using skin imaging

technology,’ she explains. ‘There is no point in clearing

pigment if you will be seeing rebound pigmentation two

months later. We want a map of the skin to know exactly

what we’re dealing with.’


Once this ‘map’ has been uncovered, suitable treatments

to counter the damage can be chosen. With several

treatments on offer, from laser and Intense Pulsed Light (IPL)

to peels and microdermabrasion, Suzie’s clinics provide an

all-encompassing approach to skin rejuvenation.

‘IPL, laser and fractional laser are all effective in treating

pigment, and can be used to address pigmentation at

different depths,’ Suzie explains. ‘At Clear Complexions

we have access to multiple modalities, or different ways for

treating different conditions, because we don’t just want to

improve your skin now, we want you to look good in ten

years’ time.’


In fighting the ongoing process of ageing, it is important

to maintain the enhanced health and improved integrity

of your skin after these initial treatments. Through home

skincare and regular clinic treatments, the health, resilience

and youthfulness of your skin can be preserved.

‘I advise clients to maintain their results using less

aggressive and less expensive treatments monthly,’ Suzie

says. ‘It is beneficial to combine resurfacing treatments with

those that build the structural quality of your skin.’

Prevention and protection

In preventing further damage, home skincare plays an

essential role in protecting the skin and countering the

activity of melanocytes – or the cells that produce pigment.

According to Suzie, a home skincare regime should include

antioxidants – most importantly vitamins A, B3 and C – and

a daily dose of sunscreen.


Alongside home care and monthly maintenance

treatments, regular reassessment should be conducted

for a preemptive approach to anti-ageing. ‘We review

clients at least twice a year to keep them abreast of new

technology and ensure they are using the best treatments

and skincare available,’ Suzie explains.

‘You have to put time and effort into the health of your

skin, if you do this, you’ll reap the rewards for the rest of

your life.’ csbm


You can get skin

rejuvenation results like

this with the complete



HOT in


*Images are courtesy of Dr.T.Chu

(After 5 treatments)



The Dermapen complete treatment uses AOVN TM

technology and includes the DP Dermaceuticals

Hyla Active and Lycogel breathable camouflage,

giving you the best results with less downtime

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about the complete



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Dermapen TM and AOVN TM are trademarks of Equipmed. 283 Mona Vale Rd, Terrey Hills, 2084, NSW Australia, Ph:1300 668 755. EQUD3M1010.07/13



from the

inside out


coMbAT THE AppEArAncE oF FinE

LinES, wrinkLES AnD ScArS by

rEgEnErATing your Skin FroM

wiTHin. cAiTLin biSHop rEporTS.

With skin laxity, fine lines and a weakened skin texture

all inevitable players in the ageing game, skin needling

can help counter these symptoms and grant your

skin the boost it needs. Effective in improving the appearance of

scars, wrinkles and uneven texture, Dermapen from Equipmed

optimises skin-needling technology to rejuvenate, brighten and

smooth your complexion.

Designed for facial rejuvenation, Dermapen features

multiple needles which vertically pierce the skin. This allows for

deeper absorption of active ingredients, whilst simultaneously

triggering the body’s natural healing response – stimulating the

production of new collagen fibres. Effective in tightening skin,

boosting facial contours and improving the appearance of fine

lines, wrinkles and scars, the Dermapen works by renewing

your skin from within, as Melbourne medical practitioner Dr

Filomena Lucente explains.

‘Today, people are seeking more natural ways to improve

their skin, and what better way than inducing your own growth

factors and collagen fibres?’ she says. ‘Dermapen triggers the

body’s reaction to trauma, increasing the production of collagen

and tightening skin. This is particularly effective in treating

scars, as scars often cause a depression in the skin and the

new collagen induced by Dermarpen can fill that depression.’

Affording an holistic approach to enhancing skin health,



treatment with Dermapen involves three steps. First,

patients are encouraged to incorporate Beauté Pacifique

products into their home skincare regime. Scientifically

shown to repair, renew and strengthen skin, Beauté

Pacifique improves skin density by up to 80 per cent

when used consistently. These results are then enhanced

with Dermapen skin needling, which is used alongside

Dermaceutical Hyla Active gel to afford smoother gliding

and enhanced absorption. Finally, directly after treatment

with Dermapen, a covering of Lycogel Cover and Recovery

will seal the skin and conceal any post-procedure redness.

‘I ask my patients to use Beauté Pacifique skincare before

treatment with Dermapen, as the range is scientifically

proven to increase the thickness of the epidermis and boost

collagen production in the dermis,’ Dr Lucente explains.

The Dermapen itself allows an individualised approach

to skin rejuvenation, as the needle depth can be adjusted

according to the patient’s skin type, the nature of their

concern and the treatment area. Dermapen uses an

automatic vibrating function to allow maximum penetration,

while the needles themselves are disposable, countering

any risk of cross-infection.

‘The needle depth is controlled by the operator. This

is important because the needles must be adjusted

according to the section of the face or body that is being

treated,’ Dr Lucente explains. ‘For example, a shallow

needle is needed under the eyes, where the skin is much

thinner, and a deeper needle is used in treating acne

scars, as this optimises collagen induction and fills the

indentations from below.’

Before treatment with Dermapen, Dr Lucente conducts a

thorough consultation. During this one-on-one session, any

medical concerns, like active acne or potential sun cancers,

are addressed and the patient’s suitability for treatment is

established. Afterwards, Dr Lucente recommends patients

allow at least an hour for the procedure itself.

‘To prepare the patient for their treatment I will ask them

to lie down and then apply topical anaesthetic, which takes

around 20 minutes to work,’ Dr Lucente says. ‘I then wipe

off the anaesthetic and cleanse the skin with alcohol based

antiseptic. Using the Dermapen, I perform three passes

across the face, changing the needle depth as needed.’

After treatment, patients typically experience redness,

dryness and mild swelling. While this can be somewhat

improved using Lycogel, Dr Lucente assures the symptoms

themselves should not persist for long.

‘Patients are left with a mildly sunburnt appearance,’ Dr

Lucente says. ‘There is minimal swelling and this should

fade within 24 hours. I provide patients with the correct

Beauté Pacifique products to use that evening and the next

day. Particularly when using Lycogel, patients can resume

regular activity immediately after treatment.’

Generally, a series of Dermapen treatments is necessary

to achieve optimum results. Dr Lucente recommends four

treatments, six weeks apart and says results can usually be

seen in one week following treatment.

‘Patients will see an improvement in skin tone and

texture in six to eight days following treatment,’ Dr Lucente

says. ‘From this, the results will continue to improve, with

skin becoming smoother and tighter’

While Dermapen can be used in conjunction with other

facial rejuvenation treatments, for example anti-wrinkle

injections or volumising fillers, Dr Lucente believes it should

be considered the first step in facial enhancement.

‘I use Dermapen as the first approach to skin rejuvenation,

as it takes a holistic approach in combining quality skincare

and science,’ Dr Lucente says.

‘If patients are still considering particular injectables

following treatment with Dermapen, then these injections

will just be the “cherry on top”. Dermapen represents an

important step in improving the quality and health of the

skin, as it uses science to achieve natural results in facial

rejuvenation.’ csbm




AFTER 3 treatments for skin rejuvenation with

the Dermapen

AFTER 4 treatments with the Dermapen for

acne rolling and box scars

AFTER 5 treatments for acne scarring and skin

rejuvenation with the Dermapen 101


A facial

like no other




When it comes to achieving healthy, radiant

skin, there’s no shortcut or quick fix. However,

integrating regular facials into your beauty regime

will give your skin the extra deep-cleanse it often needs,

boosting the inner health of your skin so it radiates health

on the outside, too.

Recently launched in Australia, the HydraFacial from

High Tech Laser is designed to detoxify, rejuvenate and

protect the skin. It combines exfoliation, acid peels, pore

extractions and antioxidant infusions in a completely

non-invasive procedure. Suitable for every skin type, the

HydraFacial treatment claims to achieve ‘Skin Health For

Life’, and grants a brighter, cleaner and more youthful

complexion without the irritation or downtime associated

with more aggressive resurfacing procedures.

Sydney cosmetic physician Dr Garry Cussell has found

the HydraFacial an effective method to rejuvenate and

hydrate his patient’s skin, with immediate results.

‘In my experience the HydraFacial is an excellent, 30

minute treatment that leaves the skin particularly clean,’

he says. ‘It increases shine and lustre, while taking away

dullness and is therefore the perfect treatment to refresh

your complexion before a special occasion, weekend

away or overseas holiday.’

The HydraFacial incorporates a series of specialised

treatments to deeply clean and nourish the skin. The five-step

process involves cleansing and exfoliation to remove dead skin

cells, an acid peel to soften grime lodged in the pores and a

vortex suction extraction system to unclog the pores.

To complete the process, an active, hydrating serum

comprised of peptides and antioxidants is applied to nourish

and protect the skin. The serum also contains hyaluronic

acid to increase and maintain hydration.

‘Every stage of the HydraFacial is essential to the

outcome,’ explains Dr Cussell. ‘The infusion of antioxidants

and active ingredients is extremely valuable, while the

peel, exfoliation and deep extractions involved induce

complementary effects.’

The HydraFacial applicator is equipped with a series

of patented tips that use vortex fusion technology to



5 The

Step 1 Cleansing and Exfoliation

Dead skin calls are removed to reveal

healthy new skin


Step 2 Acid Peel

This gentle peel helps loosen dirt and debris

from pores without irritation

Step 3 Extractions

Automated extractions use vortex suction

to clean out pores

Step 4 Hydration

Antioxidants and Hyaluronic Acid are

Vortex-Fused to nourish and protect the skin

Step 5 Protection

The HydraFacial Daily Essentials help

maintain and protect results

‘It’s a relatively inexpensive treatment and people can

have it once a week, every fortnight or occasionally, perhaps

when leading up to a special event,’ he says. ‘However,

ideally it should be considered a “gym for your skin” as

regular visits will ensure ongoing skin health.’

The HydraFacial can also be used in conjunction with

other skin rejuvenation procedures and Dr Cussell will

frequently perform the procedure before and after laser

resurfacing to enhance skin health and enhance the results.

‘While the HydraFacial works on the skin’s surface, laser

therapy targets the skin’s deeper layers and Thermage uses

radiofrequency energy to stimulate collagen production in

the dermis, or the skin’s deepest layer,’ Dr Cussell explains.

‘Using them together creates an all-encompassing

approach to anti-ageing.’

Whether you’re looking for a facial to integrate into your

monthly beauty regime, or something to complement a

more invasive procedure, the HydraFacial will leave your

skin clean, smooth and bright in next to no time. ‘The

HydraFacial is for those patients hoping to look fi tter,

younger and more vibrant,’ Dr Cussell concludes. csbm

simultaneously cleanse and nourish the skin during the

different stages of the treatment. Each head has multiple

edges in a unique spiral design to exfoliate the skin multiple

times during each pass.

According to Dr Cussell the treatment is ideal for

anyone looking to enhance his or her complexion. ‘The

HydraFacial deeply cleanses inside the facial pores and

hair follicles, which is something not achieved in homecare

cleansing and exfoliations,’ Dr Cussell says. ‘This

treatment is suitable for virtually anyone. It doesn’t matter

if you’re a supermodel or just an average person – your

complexion can always be brightened.’

To extend the results and retain the skin’s hydration

and brightness between treatments, the fi nal step in the

HydraFacial is the introduction of the ‘Daily Essentials’

skincare pack. Tailored to certain skin complaints, the

range incorporates a topical moisturiser, antioxidant serum

and a refi ning eye gel. Each product is infused with select

concentrations of the same active ingredients found in the

salon treatment, providing detoxifi cation, rejuvenation and

protection in between visits.

According to Dr Cussell, patients see and feel the results

from the HydraFacial for up to a week and, as their skin health

improves, with continued treatments the results last longer.

Because of its gentle, multi-modal approach, Dr Cussell says

patients can undergo the procedure as often as they wish.

A patient receives a HydraFacial treatment 103






you can








Stem cells have fast become a buzz word in skincare.

The mainstay of cell renewal, stem cells are being

harnessed from plant extracts to help stimulate, repair

and protect the skin and fi ght the most common signs of

ageing: deep wrinkles and skin elasticity.

Combining plant stem cells and growth factors, the

Mesoestetic Stem Cell solution, distributed in Australia by

Advanced Cosmeceuticals, works inside the skin’s cells

to strengthen, enhance and revitalise. Designed for those

aged in their 30s, the range, which includes a series of fi ve

professional treatments and three at-home maintenance

products, targets deep wrinkles, skin elasticity and skin

cell renewal.

According to managing director of Advanced

Cosmeceuticals, Catherine Biedermann, while it’s important

to commit to a series of professional treatments – she



recommends five treatments spaced seven to 10 days

apart – as much as 70 per cent of the improvement clients

will see in their skin comes down to using the at-home

skincare range to support and maintain results.

‘It’s a bit like gym membership: you could go to gym once

a week and you’d only get moderate results. If you went to

the gym once a week and walked every day or did push ups

at home you’d see improved results,’ she explains.

At-home maintenance

The Mesoestetic Stem Cell home maintenance products

include an active growth factor 24-hour cream, a nanofiller

lip contour cream and a restructuractive serum, which,

when used together, help skin retain its salon-induced glow

for weeks following professional treatment.

‘This comprehensive approach to skincare gives your

skin the nourishment it needs,’ Biedermann notes.

Each of the three take-home products exhibit high

concentrations of active ingredients. While the plant stem

cell extract is the standout ingredient, the addition of growth

factors works to establish a structured and resilient defence

against ageing.

‘One of the things that differentiates this skincare range

from others is that it combines stem cells with growth

factors – most products contain either one or the other,’

Biedermann says.

The stem cells are obtained using biotechnology and

automatically renew into many types of differentiated cells.

They infuse the Mesoestetic line with phytonutrients and

proteins, which stimulate fibroblasts to generate collagen in

the epidermis, improving skin integrity and structure.

Moreover, there are naturally occurring adult stem cells

residing in our epidermis that are responsible for skin

homeostasis, skin repair and hair regeneration. The plant

stem cells extract in the Mesoestetic range protects and

reactivates these stem cells, strengthening connective

tissue and improving skin quality, structure and texture.

Salon treatment

In order to achieve these results, the ingredients must

be delivered deep into the skin’s external layers. This is

accomplished through salon treatments and, in the case of

the home care range, primarily through the serum.

‘The salon treatment uses a crystal fibre mask to

increase the absorption of ingredients into the epidermis,’

Biedermann explains. ’This results in a boost in skin health

and triggers adult stem cell proliferation.’

While each take-home product exhibits the plant stem

cells extract, the serum holds the highest concentration.

Packaged in five 3ml pipettes, the ultra-concentrated serum

is applied once a week, at night, directly after cleansing.

Each applicator contains 10 per cent plant stem cell extract

and high quantities of vitamins A and E.

While the serum’s water-based structure affords

unmatched absorption of ingredients into the skin, the 24-

hour active growth factor cream offers high performance

ingredients to gradually and effectively enhance skin health.

‘No topically applied cream is going to allow for the

same absorption as a serum because of its formulation,’

says Biedermann. ‘But the 24-hour maintenance cream

includes additional growth factors for further benefit.’

Small fragments of biologically active proteins, the

growth factors dexpantenol, matrixyl and lipochroman-6

fuel the 24-hour moisturiser to regenerate the skin and

boost cell reproduction in healthy cells. They stimulate the

generation of fibroblasts to strengthen skin, enhance the

repair process in the dermal matrix and use antioxidant

properties to protect skin cells from further damage.

Finally, the nanofiller lip contour cream is specifically

designed for treating the lip area. It affords both a

regenerative and filler effect using plant stem cells extract

and hyaluronic acid, which attracts and retains hydration.

The range’s protocol recommends the five salon

treatments be performed every seven to 10 days,

accompanied by weekly use of the serum and daily use

of the 24-hour cream and nanofiller contour cream. ‘This

intense regime will give your skin the health boost it needs

and can be followed with diligent home care and monthly

salon maintenance after the five treatments are concluded,’

says Biedermann.

As well as general use, Biedermann recommends

integrating the stem cell treatment into a long-term

management plan, perhaps alongside chemical peels,

intense pulsed light (IPL) or laser treatments. The skincare

element will strengthen the skin and lead to advanced

results in any complementary procedure.

‘This range has brought a bit of luxury into the salon; it

enhances skin health and causes the renewal of healthy cells

– it’s a positive cycle,’ Biedermann says. ‘The Stem Cell line

is a pharmaceutical treatment, offering active ingredients,

visible results and a little bit of indulgence.’ csbm 105









Although we all know the rules to follow when it

comes to looking after our skin and guarding

against the premature appearance of lines and

wrinkles, it’s easy to spend too long in the sun, indulge in

that extra glass of wine or neglect our rigorous skincare

regime. The result can be a worn appearance long before

our time. Fortunately, skincare salons such as Skin Clinic@

Blyss are here to help, offering a diverse array of procedures

designed to restore health, vitality and youth to even the

most tired of complexions.

A boutique clinic specialising in non-surgical skin

treatments, Blyss offers a wide range of treatments suitable

for all skin types and budgets. ‘We’re passionate about

skin health and are committed to helping clients maintain

skin that is fresh, bright and luminous,’ says Jodie King,

who established Blyss 15 years ago, moving to the current

location in Sydney’s Clovelly 10 years ago.

Core to King’s philosophy is that no two skins are alike.

‘What works for one person won’t necessarily work for

another,’ she says. It’s therefore important to King and her

team of skincare experts to not only spend a long time

getting to know the skin concerns of each patient, but

also to stay on top of the latest skincare technologies and

devices available.

Amongst the wealth of procedures offered by Blyss,

King says cosmetic injectables are commonly requested.

Indeed, recently revealed statistics showed that more

Australians than ever before are turning to dermal fillers and

anti-wrinkle injections to help maintain or restore a sense

of youth.

‘Our cosmetic injector, Dr Stephanie Hyams, has more

than 16 years experience and will discuss the best options

for each patient when it comes to cosmetic injections,’

says King. ‘We believe in a “fresh not frozen” approach and

always aim to ensure patients leave with a natural-looking

youthful appearance.’

Whilst anti-wrinkle injections and dermal fillers are often

at the forefront of people’s minds, King says patients

typically benefit from a holistic approach to rejuvenation.

‘Looking youthful isn’t just about eliminating fine lines and

wrinkles,’ she says. ‘It’s also important to address the

underlying health of the skin, improving its tone and texture

and evening any pigmentation.’

King therefore often recommends a range of

procedures, which, depending on the concerns of each

patient, may include chemical peels, microdermabrasion,

photorejuvenation, skin needling and more.

‘Skin needling is a popular treatment for those wanting

to improve the appearance of scars or simply to improve

the health and appearance of the skin,’ says King. ‘We

use the Dermaroller, which is suitable for all skin types and

colours and is well tolerated by patients. Those with scars

can typically expect an improvement of up to 80 per cent in

their appearance following three to five treatments spaced

six to eight weeks apart.’

According to King, another universally appealing


treatment is photodynamic therapy (PDT). ‘PDT is particularly

effective for teens and adults struggling with persistent acne

and has been proven to cure 60 per cent of cases after

just two treatments,’ says King. ‘One of the advantages

of PDT, however, is that it can be used to improve a wide

range of skin complaints, including rosacea, psoriasis and

pigmentation as well as fine lines and large pores.’

With such a wide array of cutting-edge treatments,

King is confident she can help men and women restore

and maintain a healthy complexion. ‘As the body’s largest

organ, it’s imperative we don’t neglect the health of our

skin,’ she concludes. ‘Keeping to regular appointments

with your local skin clinic will help improve skin health and

ensure you look as great as you feel.’ csbm





AFTER skin rejuvenation by Skin Clinic@Blyss

Specialising in advanced non-surgical

treatments for problem skin, anti-ageing,

and damaged skin, Blyss Skin Clinic Clovelly

uses the latest technology in medical

needling, IPL, Photofacials, Resurfacing and

Ionzyme treatments. Our highly qualified

skin care therapists have been achieving

amazing results for over 15 years using

trusted techniques.

Our relaxed and discreet atmosphere will

leave you feeling refreshed and confidant.




• Ionzyme Treatments

• Platelet-Rich Plasma

• LED Photofacials

• IPL Photorejuvenation

• Photodynamic Therapy

• Facials

AFTER skin rejuvenation by Skin Clinic@Blyss • Resurfacing

• Dermaroller

pure blyss

• Anti-wrinkle Injections

• Dermal Fillers

• Eye Treatments

• Permanent Hair


• Electrolysis

• Waxing







AFTER skin rejuvenation by Skin Clinic@Blyss

phone 02 9664 8011

Shop 2/214 Clovelly Road,

Clovelly NSW 2031





K is for






Ageing is a fact of life – however, it is often not age

itself that bothers people, but the visible signs that

come with it. The health and appearance of our skin

– whether on our face or on our body – plays a huge part in

how old we perceive ourselves and is often the basis upon

which others judge our age. As the body’s largest organ,

our skin is hugely influenced by our general health and

wellbeing – if our body is out of balance, chances are that it

will reflect on the condition of our skin.

The skin is a complex organ with multiple roles to play.

As the outermost layer of the skin, the epidermis serves as

a barrier to protect the body against pathogens, oxidative

stress and chemical compounds whilst also acting to hold

moisture and keep the skin looking healthy. Categorised

into five layers – the stratum garminativum; the stratum

spinosum; the stratum granulosum; the stratum lucidum

and the stratum corneum – the epidermis is predominantly

made up of keratinocytes, or epidermal skin cells, which

are formed in the deepest layer of the epidermis. As the

epidermis essentially renews itself every 28 days, these

keratinocytes continually replace those being shed from the

upper layers of the epidermis. Known as skin cell renewal,

it’s this process that gradually slows as we age.

As the keratinocytes move towards the stratum corneum

– the outermost layer of the epidermis – they begin to take

on a flattened shape. Also known as the ‘horny layer’, the

stratum corneum consists of 25 to 30 layers of flattened

keratinocytes and represents the real protective layer of

the skin. Continuously shed by friction and replaced by

newer cells formed in the deeper sections of the epidermis,

the keratinocytes are interspersed with epidermal lipids,

which together form a waterproof barrier that minimises

keratinocytes transepidermal water loss (TEWL), locking

moisture in the skin. It’s this moisture barrier, or acid mantle,

that protects against invading microorganisms, chemical

irritants, and allergens. If the integrity of the moisture barrier

is compromised, the skin will become vulnerable to dryness,

itching, redness, stinging, and other skin care concerns.

Maintaining a slightly acid pH helps the acid mantle

perform its job correctly: if the skin’s surface becomes

alkaline, keratin fibres loosen and soften, losing their

protective properties. When the pH level of the acid mantle

is disrupted – often a side effect of common soaps—the

skin becomes prone to infection, dehydration, roughness,

irritation, and noticeable flaking.

If the integrity of the skin’s

moisture barrier is compromised,

the skin will become vulnerable

to dryness, itching and redness

It’s therefore imperative to select skincare products that not

only keep your keratinocytes as healthy as possible, but that

also ensure a healthy cell renewal process.

Developed by French biologist and gerontologist Dr Albert

Laporte, Gernétic skincare is not only designed to adjust

the pH of the skin to its correct level, but includes specific

formulations to slow the ageing process and ensure the timely

replacement of keratinocytes so that your complexion never

looks dry, dull or lifeless.

Nutritive creams such as Synchro and Cytobi supply

the keratinocyte cells with essential nutrition so the DNA of

cells is protected and mistakes are less likely to occur when

they reproduce; whilst Gernétic’s Immuno Mask has been

formulated to encourage cell desquamation and renewal. Its

powerful active ingredients act to rejuvenate the basal cells

and stimulate the skin’s own defences by fighting bacteria,

eliminating irritation and restoring the moisture barrier.

By assisting your skin’s own functions and renewal

process with Gernétic’s powerful skincare range, you will

achieve results, that will make you beautiful on the outside

and from within. csbm


a doctor’s expertise.

our bio-technology.

perfect results fast.

Gernétic performs at the cellular level to speed dermal recovery,

reduce scarring and enhance results from cosmetic procedures.

(02) 9452 6230

feature skin


darker side

of skin






In its various forms, skin hyperpigmentation affects over

80 per cent of women over the age of 25 and is the

number two skin concern besides facial wrinkling. The

skin lightening market is growing at an exponential rate and

formulators are continually challenged with creating products

to address this major concern. But is pigmentation curable and

what ingredients really work to address this condition?

What is hyperpigmentation?

Hyperpigmentation refers to changes in the melanin content

and distribution of the skin. There are considered to be three

major types of skin pigmentation:



Solar lentigines

These are non-cancerous, UV-induced pigmented lesions

with a clearly defined edge. This damage is primarily

superficial and present in the upper layers of the skin

(epidermis). Lentigines may evolve slowly over years or

appear suddenly and may occur anywhere on the body

and vary in colour from light brown to black. These spots

are caused by UV sun-exposure and the degree depends

on how much UV light the melanin pigments are exposed

to. These must be monitored as they may develop into skin

cancer and melanoma.

Post-inflammatory hyperpigmentation (PIH)

This is a response to injury of the skin and can be the

result of acne, burns, friction or overly aggressive clinical

treatments such as chemical peels, dermabrasion, laser

and IPL. This condition often resolves with time and generally

responds well to topical products.

Melasma / Chloasma

This is pigmentation that is deeper in the skin’s dermis. It

appears on the face as larger brown patches, which are

often symmetrical, with a non-distinct border. This type of

pigmentation mostly affects Asian and fair skinned people

and is more common in women. Though causes are

unknown, it is often linked to hormonal imbalances and can

be made worse with UV exposure, overheating the blood,

some medications, pregnancy and stress. Unfortunately

melasma is not curable. However, with the correct treatments

and topical home care, it can be reduced and controlled.

Treating hyperpigmentation

Topical treatments

In terms of home skin maintenance the following nonprescription

ingredients will help reduce pigmentation:

• Vitamin A – In the form of stabilised retinol (retinol

molecular) enables surface hyperpigmented cells to be

sloughed of evenly in addition to reversing the damaging

effects of UV light on the skin cells, which result in

hyperpigmentation. Retinoids are also responsible for

tyrosinase inhibition, reducing clumping of melanin and

reducing melanosome size.

• Vitamin B3/Niacinamide – Prevents transfer of the

melanin pigment from the melanocyte to the keratinocyte

in the epidermis.

• Vitamin C – In the form of L-ascorbic acid (dry crystals

or stabilised) acts on the melanin pathway by converting

O-Dopaquinone back to Dopa. This results in reduced

formation of oxidised melanin. It also inhibits the enzyme

tyrosinase which causes melanin production.

Specific hyperpigmentation active ingredients will help

reduce uneven skin tone and skin discolouration without

harmful ingredients, which may inflame the skin. These

ingredients include:

• Dimethyl methoxy chrominyl palmitate – a cutting edge

tyrosinase inhibitor that also increases skin cell viability.

Clinical studies show this ingredient to be as effective as

Hydroquinone and more effective than arbutin and kojic

acid in lightening skin tone.

• Alpha Hydroxy acids (lactic and glycolic acid) – help

to remove surface cells and therefore superficial

pigmentation due to increase exfoliation.

• Kojic acid – derived from mushrooms, this acid is a

potent tyrosinase inhibitor but may occasionally result in

skin irritation.

• Soy protein – acts by inhibiting uptake of melanosomes

by keratinocytes. However, the molecular size of this

molecule makes delivery to target cells difficult.

• Liquorice extract – a tyrosinase inhibitor. However,

cosmetic elegance is a concern as pure liquorice powder

at the recommended dosage turns formulations a dark

green/brown tone.

Prescription products such as hydroquinone/

corticosteroid/retinoic acid compounds (e.g. Kligmans

formula) offer effective results but are not recommended for

long term application due to potential cellular toxicity and

must be prescribed by a doctor only.

Prevention and protection with sunscreen really is

the vital key to preventing sunspots and protecting the

skin from harsh UVA and UVB rays. To prevent future

pigmentation use natural mineral sunscreen containing at

least 20 per cent zinc oxide. Mineral (physical) sunscreen

is also less likely to result in skin sensitivity compared to

organic (chemical absorbing) sunscreens.

Clinical treatments

Treating hyperpigmentation is highly complex and depends

on a number of factors including the type of pigmentation

(epidermal/dermal/hormonal/UV-induced) and the skin type

and ethnicity of the client. Caution should be exercised

with skin of colour (Fitzpatrick 4+), as darker skin tones

are prone to post inflammatory hyperpigmentation (PIH).

Galvanic infusion of L-ascorbic acid, superficial peels,

fractional laser, topical products and low level laser can

be used conservatively for higher Fitzpatrick skin types.

Lower Fitzpatrick skin tones can tolerate more aggressive

chemical peels, IPL, laser and microdermabrasion.

The best results are always achieved with combination

therapy including cosmeceutical grade skincare, lifestyle

modification, individualised clinical treatment and hormonal

analysis if required. Not all forms of hyperpigmentation can

be permanently removed, however, with education and a

clear understanding of the client’s skin, good results can

be achieved and maintained in successfully treating this

complex skin condition. csbm 111




your skincare

must have



Having built up a comprehensive range of high-grade

skincare products that are both scientifi cally effective

and free of questionable ingredients, Australian

biomedical scientist and cosmetic chemist Terri Vinson

turned her hand to developing the ultimate age-defying

serum. Combining the power of scientifi cally generated

peptides and microbial technology, Vinson now believes

she has developed a revolutionary serum with clinical data

to support the results it claims to achieve.

The culmination of years of scientifi c research into the

biology and natural ageing processes of the skin, the

‘Synergie SuperSerum’ contains fi ve key ingredients that

set the product apart from other anti-ageing products.

According to Vinson, the inclusion of the new peptide

Juvefox-O TM stimulates DNA repair and protection whilst

slowing cell ageing. ‘It is vital to protect DNA for cell survival.

Our DNA is constantly attacked by internal and external

damage including ultra-violet (UV) light and toxins, which

results in cell mutation, ageing and possible malignant

damage,’ explains Vinson. ‘DNA mutation can be copied to

all future cells unless the error can be repaired before being

passed onto daughter cells.’

A natural transcription factor, FOXO3a in the human cell

nucleus, is able to control this process by either repairing

the DNA or inducing programmed cell death if the DNA

cannot be repaired. ‘This vital “master regulator” has been

mimicked in Synergie SuperSerum with the production of

the JuvefoxO hexapeptide,’ says Vinson. ‘This peptide

is an analogue of the same molecule responsible for

immortality of the marine Hydra.’

A second stand-out ingredient is a marine phycosaccharide,

which rebuilds and repairs the epidermis by activating the skin’s

natural growth factors and stem cells. ‘This stable, sugar chain

molecule is secreted by the brown seaweed Laminaria digitata

and is harvested through marine biotechnology,’ says Vinson.

‘It is able to precisely target epidermal damage and microdepressions

such as wrinkles by enhancing the production

of Endothelial Growth Factor (EGF), which then initiates the

division of healthy epidermal stem cells.’

During skin ageing the formation of wrinkles involves

the same process as an injury. According to Vinson,

phycosaccharide AI stimulates the activity of epidermal stem

cells to rapidly restore and reconstruct the skin matrix. This

results in repair and subsequent smoothing of fi ne lines.

Three further ingredients – Trylagen peptide complex,

Hyanify and Snap-8 peptide – work to promote the collagen

cycle, boost the synthesis of the skin’s own hyaluronic

acid and relax muscles, to cumulatively reduce expression

wrinkles and improve hydration of the skin.

‘I believe the Synergie SuperSerum should be the

number one skincare product for those looking to fi ght

signs of ageing,’ concludes Vinson.

‘The powerful ingredients not only assist in repairing

damage and improving the appearance of some of the

most common ageing characteristics, but can also help to

prevent further ageing.’ csbm


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Heal Over






Scar-prevention and the management of scarring post-surgery

is an important aspect of any cosmetic procedure. Although

scarring is to a large extent inevitable, there are steps both

patients and surgeons can take to minimise the appearance of

scarring and improve healing post-procedure.

The way a scar develops depends on both internal and external

factors. For example, genes determine how slowly or quickly the

body can produce new cells and collagen. If the skin renewal

process is slow, then the scars tend to be more prominent, and

take longer to heal.

Scars are also affected by the location of the wound – scars form

quickly on the chin, jaw, neck, shoulders, chest and upper back, for

example, because the skin in these regions is thinner compared to

elsewhere on the body.

No matter where or how the scar forms, there is no doubt their

appearance can have an impact on those affl icted and Sydney

ENT and facial cosmetic surgeon Dr William Mooney goes to some

lengths to both minimise the incidence of scarring and facilitate

healing post-surgery.

‘Everyone heals differently and, in my experience, the incidence

of keloid and hypertrophic scarring, in particular, is increasing, partly

due to the diverse ethnicities we see in Australia,’ he says. ‘Although

there are steps I, as a surgeon, can take during the surgery itself to

prevent scarring – putting as little tension as possible on the wound

closure and using meticulous suturing, for example – the introduction

of scar-treatment products post-procedure has radically improved

outcomes in my clinic.’

Dr Mooney has been using two breakthrough scar-treatment

products in his clinic since they were launched in Australia in

2011. Developed by Swiss company Stratpharma and introduced

to Australia by SciGen Australia, Stratamed is the fi rst siliconebased

scar therapy gel approved for use in open wounds and

compromised skin, and is designed for use immediately after

surgery. Strataderm, on the other hand, is designed for scars old

and new, helping to improve the appearance of scars a patient

may have endured for years.

‘The fi rst line of treatment for any scar post-procedure is the use of

chloromycetin ointment,’ says Dr Mooney. ‘However, we now follow

this with the immediate application of Stratamed. In my experience,



Stratamed promotes faster wound healing, decreases the

redness at the scar line and decreases the vertical height

of the scar.’

A silicone gel, Stratamed is applied to the affected area and

forms a fl exible, protective layer that is both gas permeable


and semi-occlusive. This layer weakly bonds to the injured

skin and protects it from chemical and microbial invasion, but

it does not penetrate into the epidermis or dermis.

Stratamed consists of inert silicone polymers, which have

no measurable pH value, and therefore do not affect the

protective acid mantle of the skin and do not react with the

newly forming epithelial tissues. This leads to a reduction in

the infl ammatory response, an effective healing of the wound

and therefore enhanced therapeutic results.

Dr Mooney advises each of his patients to apply

Stratamed twice a day for the fi rst month following their

procedure. ‘We then follow this protocol with two months

during which the second scar therapy gel, Strataderm, is

applied,’ he says.

For patients who might have lived with a scar for many

years, Dr Mooney says introducing Strataderm for a couple

of months can visibly improve the appearance of scarring.

‘Patients might think the only option is scar revision, during

which the old scar is excised, and a new wound created,’

he says. ‘However, with Strataderm, patients often see a

decrease in the redness of their scar within one month – no

surgery needed.’

Easy to use and affording fast results, it seems there’s no

longer any need for patients to learn to live with the scars

they thought would last a lifetime. csbm



AFTER treatment with Strataderm

AFTER treatment with Stratamed

Strataderm - effective and affordable

silicone scar therapy for old and new scars

• Softens and flattens raised scars

• Relieves the itching and discomfort

associated with scars

• Reduces redness and discoloration

• Prevents abnormal and excessive

scar formation

Available now

in Pharmacies

Visit our website for more information about scar management and Strataderm scar therapy gel:

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Rita Porecca, founder and managing director of

Sydney Permanent Makeup Centre, believes the

key to beauty is making everything about you the

best it can be. And whether that means improving your

skin’s tone and texture, enhancing the appearance of your

lips, or removing regrettable, conspicuous tattoos, Porecca

has built a range of services designed to do exactly that:

unlock your beauty potential.

Permanent Makeup

Well known for her artistry in permanent makeup, Porecca

offers a range of cosmetic tattoo services designed to

aesthetically enhance the appearance of features such

as the eyes and lips, or disguise skin complaints such as

vitiligo and alopecia.

Over recent years, cosmetic tattoo treatments have

grown in popularity, and today offer hassle-free mornings

to those whose lifestyles don’t allow the luxury of free time

between work and kids. For women who have undergone

reconstructive breast surgery, cosmetic tattooing can also

add the all-important finishing touches.

‘When performed by an experienced practitioner and

tailored to the facial proportions and symmetry of each

patient, cosmetic tattooing can complement and enhance

a client’s features,’ says Porreca.

Permanent eyeliner combined with eyebrow tattooing

can restore vibrancy to the entire eye area and help those

who have over-plucked, or who have scars or gaps in their

brows. Similarly, lip tattooing can be ideal for women who

lack a definite shape, have pale lips or who simply want to

enhance the appearance of their pout.

‘Whether for cosmetic or paramedical reasons, when

performed by an experienced and highly skilled practitioner,

long-lasting cosmetic tattoo treatments can significantly

enhance a person’s appearance and, in turn, their self

esteem,’ says Porecca.

Skin Needling

Although it’s been around since the 1940s, skin needling

has recently experienced a surge in popularity as more and

more people are discovering the anti-ageing benefits of this

unique procedure.

Skin needling is performed with a roller studded with

micro-fine needles or single needle application, depending


on what needs to be treated. It is primarily used to plump

up the skin by stimulating the production of new collagen

SPMUC FP(NEW) 30/4/07 1:30 PM Page 1

and elastin, helping to reduce fine lines and wrinkles, even

out the complexion and improve the appearance of scars.

The efficacy of the treatment is further enhanced when

applied in conjunction with quality anti-ageing serums.

Porreca has been treating clients with skin needling

for the past 10 years with impressive results. ‘The beauty timeless and

timeless and of skin needling is that it continues to work long after the

treatment itself,’ she says. ‘Although some immediate effortless beauty

improvement is noted, over the next six to nine months

inner healing of the dermis continues to smooth and tighten

SPMUC the FP(NEW) skin as collagen 30/4/07 begins 1:30 to PM lay down Page 1in a smoother, more ‘In When 1984 it my comes dream to eyes, was to lips, create face, a

regular manner.’

Centre body, skin that and provided training, personalised we are the

Skin needling can be performed on all skin types and beauty experts’ solutions expert. With with more natural than and 22

colours anywhere on the body. In sensitive areas topical lasting years’ experience results – a world we have above developed

anaesthetic can be applied to numb the area and alleviate traditional an excellent beauty reputation salons.’ with doctors

any discomfort. Up to four to eight treatments are required – and Rita surgeons. Porreca, We Founder also work & MDclosely

timeless and effortless

for maximum results and a maintenance session can be with surgeons in post-operative



performed every six weeks.

When – Rita it Porreca, comes to Founder Eyes, Lips, & MDFace, Body, Skin and

‘This treatment is ideal for people who want to improve Training






the experts'


expert. We also work closely

the appearance of lines and wrinkles without botulinum with surgeons on post-operative care.

toxin or filler injections,’ says Porreca. ‘Clients also like the

fact results are gradual and long lasting.’

‘In 1984 my dream was to create a


Centre that provided personalised


beauty solutions Cosmetic with natural Tattooing


Tattoo removal

lasting results – a world above

Cosmetic Tattooing

traditional beauty Medical salons.’ Tattooing

For Eyebrows those wanting Hair stroke to remove to shaded traces brows of artistic to tattoos give you that more of a

– Rita Porreca, Founder Skin & Needling


may natural not appearance

have been thoroughly thought through, Porecca

has a new solution. ‘Using a normal tattoo gun loaded

Dermal BEFORE Planning Peels

Eyeliner Subtle to Dramatic or to define your eye shape

with a special solution manufactured in Germany, we can When it comes

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

reverse the appearance of a tattoo,’ she explains.

Training we are the experts' expert. We also work closely

an ideal shape and colour all the time.

Porecca meets plenty of people who have fallen out of with surgeons Cosmetic on post-operative Tattooing care. Courses

love Medical with tattoos Tattooing they thought a good idea in their youth

and Areola introduced re-pigmentation the Skinial system Is the to final her stage clinic of to meet breast the reconstruction and is AFTER FULL LIP TATTOOING

rising also considered demand for tattoo by those removal. with areola colour loss.


Corrective Skinial uses Camouflage a micro pigmentation Can bring device a natural with skin a weak colour back to scars

Cosmetic solution and burns of lactic Tattooing acid to trigger the body’s natural immune

Eyebrows system. The Hair pigmentation stroke to device shaded targets brows clusters to give of up you to 20 more of a BEFORE FULL LIP COLOUR


natural small Skin spots Needling appearance

the tattoo at one time, releasing the solution

into Needling each site. treatment The lactic for acid wrinkles, eliminates acne macrophages scars & scar from relaxation


Eyeliner Subtle to Dramatic or to define your eye shape


Lips the


large-volume From Rejuvenation lip liner colour to full particles, lips & which, blends up we until make this point, your lips look good with

an have Is ideal encased for shape the the rebuilding and particles colour of all colour, new the collagen time. shielding and them lightening from pigmentation.



the body’s immune system.

Medical IPL With Hair the Tattooing Removal macrophages removed, the body recognises

Areola the Enables ink as re-pigmentation hair foreign, removal prompting from Is the nearly the immune final every stage system part of of breast to the ‘flush’ body reconstruction quickly and is AFTER FULL LIP TATTOOING


the and rejected efficiently considered

skin cells

by those

and colour

with areola





the skin’s

Corrective surface, where Camouflage they aggregate Can to form bring a scab a natural and ultimately skin colour back to scars


Medical Skin Peels/Microdermabrasion

fall off. burns



Because the body naturally produces lactic acid to

Skin treatments ranging from Green Peel, CosMedix Peels

maintain energy production during exercise, any residues

Skin & Microdermabrasion Needling to give you a natural healthy glow.

left after treatment will be easily metabolised.

Needling treatment for wrinkles, acne scars & scar relaxation

Cosmetic According Dermal to Porecca, Fillers the & Mesotherapy

technology represents a 02 9569 BEFORE 7799 follow us on

Skin real step Rejuvenation forward in tattoo removal, and is just another

Cosmetic Tattooing Courses

Level 1, 157 Great North Road

Is weapon ideal for in her the armoury rebuilding to help of new you collagen enhance your and natural, lightening pigmentation.

Learn, up-skill and expand with professional cosmetic tattooing

underlying beauty. csbm

Five training.


Dock NSW 2046

IPL Hair Removal


Enables hair removal from nearly every part of the body quickly Web:


and efficiently

cosmetic tattoo

Looks that last the long haul


hoW PermAnent mAkeuP CAn Add the finishing touChes to your look.

lizzy foWler rePorts.

From the runways in New York, London and Paris to the

red carpet in Cannes, models, actors and celebrities

all tend to have two things in common – well defined,

full brows complemented by a set of plump, prominent lips.

Yet for many women, years of over plucking can leave their

brows sparse and, thanks to the natural ageing process,

once clearly defined lips can become faded.

‘As our body ages we can lose definition of our features;

they no longer appear as prominent and sharp as they

were in youth,’ says Sydney cosmetic tattoo practitioner Val

Glover-Hovan who, for the last 26 years, has helped women

redefine their features using permanent makeup. ‘When

done well, cosmetic tattoo can have a significant antiageing

effect and can help re-instil a sense of confidence

and youthfulness.’

Having performed cosmetic tattoo procedures on

thousands of women, Glover-Hovan understands that no

two women are alike, and that each needs the procedure

tailored to enhance their underlying beauty. ‘We all have

different needs, lifestyles and tastes, and the cosmetic

tattoo needs to reflect this,’ she says.

According to Glover-Hovan, two of the most popular

procedures are those to enhance the brows and lips.

‘Permanent lip line is suited to people who have no definite

lip shape, or for pale, sun damaged or uneven lips and those

that have lost shape as a result of cold sores or injury,’ she

explains. Permanent lip line can also simply add definition

for women who want to put more emphasis on their lips.

To further enhance the appearance of the lips, Glover-

Hovan explains clients can choose between a lip line and

blend, which outlines the mouth and blends the colour onto

part of the lips, making the lip line more subtle; or a full lip

colour, with more than 100 shades to choose from. ‘This

is one of the most popular treatments,’ she says. ‘You can

kiss without leaving a trace – no more worry about lipstick

marks on your teeth, glassware or other people.’

According to Hovan, many women ask whether they

can wear lipstick over the top of their cosmetic tattoo, and

are surprised to learn that they can, pale or dark tones

complementing the enhanced lips.

Cosmetic tattoo can also bring definition to the brows,

enhancing facial symmetry and framing the eyes. With

techniques that allow her to mimic the appearance of hair,

Glover-Hovan believes cosmetic tattooing can result in a

real transformation.

As a specialist and educator in cosmetic tattoo, Glover-

Hovan carefully evaluates facial proportions and symmetry,

as well as hair and skin colouring, before creating a design

that will complement and enhance each client’s features.

Fully informing the client about all the aspects of

cosmetic tattoo treatments and ensuring they have the right

expectations is a very important part of this service. csbm


AFTER full lip tattoo treatment by Val Glover-Hovan


AFTER eyebrow tattooing treatment by

Val Glover-Hovan


9:40 AM Page 1

9:40 AM Page 1

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CONSULTATIONS Gold Coast, Melbourne




Tattoo 696


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RTHER Like us on Facebook Like us on Twitter

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02 Brookvale, 9938 2111 CONTACT






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Case Study:

My Revision

Breast Augmentation




Before she met Sydney plastic surgeon, Dr Kourosh

Tavakoli, Renee had thought she would have to

live with the distorted nipples, misaligned implants

and aggressive scars she’d been left with after an

earlier augmentation for the rest of her life. After years of

deliberation, she went to see Dr Tavakoli, hoping he could

return her breasts to a more natural-looking appearance.

‘I was going to live with my breasts after the first

operation, even though I felt embarrassed about their

appearance,’ says Renee, who had undergone her first

augmentation aged just 18. ‘It wasn’t until I got married

that I made the decision to have them revised.’

According to Dr Tavakoli, some of the issues Renee

experienced following her initial augmentation were due to

the placement of the implants. ‘Renee’s original implants

had been positioned above the pectoral muscle, which

is sometimes associated with a greater risk of implant

movement and capsular contracture, where the implant

hardens and distorts,’ he says. ‘In Renee’s case, the

implants had moved laterally and caused the skin to ripple

and fold.’

‘I had skin folds at the top of the implants, towards the

chest, and on the sides of the implants, towards the middle

of the cleavage,’ Renee recalls. ‘They were visible when



I was wearing a bikini and made the implants extremely

noticeable and unsightly.’

Unfortunately the scars Renee had been left with

beneath the breast crease had not healed well, and had

widened due to the movement of the implants.

‘The scars had tripled in length and increased in width;

they were shiny white lesions over 1cm wide and around

10cms long,’ recalls Renee. ‘When I was lying down,

if someone saw me naked, I couldn’t have been more

embarrassed – they were so obvious.’

Finally, because Renee’s nipples weren’t correctly

positioned in her original surgery, her areolas had extended

to cover a larger area than normal.

‘With my original implants I would have been between

a B and a C cup, but as the years progressed my nipples

started to distort until they almost look bigger than my

breasts,’ Renee says.

It was with the help and support of her husband that

Renee ultimately decided to have her breasts corrected.

Having decided to approach Dr Tavakoli, Renee wasn’t

concerned by the prospect of surgery – she had been

through it before – but wanted to know if, and how, her

problems could be addressed. Fortunately, Dr Tavakoli was

able to answer all Renee’s questions.

‘He explained he could fix my implants, improve the

appearance of my scars and correct my nipples but it

sounded as if I was falling apart – he had so much work to

do,’ Renee says. ‘That’s the only thing that slightly scared

me. I was familiar with the procedure and the time leading

up to surgery, but I had not grasped how much work was

necessary to correct the previous surgery.’

Renee had a number of consultations with Dr Tavakoli,

during which they discussed the surgery itself, how long

it would take, the downtime that would follow and the

reasons behind some of the existing complications. It was

only after these in-depth conversations that Renee was

reassured and became comfortable with what lay ahead.

According to Renee, Dr Tavakoli’s team of expert nurses

and relaxing clinic environment also helped put her at ease.

‘It was as if I was at a five-star hotel; the nurses were so

nice and the rooms are amazing,’ says Renee. ‘My initial

consultation was the last appointment of the day and even

though I arrived at 4pm, the nurses made me feel like I was

the first appointment of the day.’

It was this attention to detail that left a lasting impression

on Renee. As the nurses prepared her for surgery and Dr

Tavakoli measured and marked her body, any last minute

doubts Renee might have had were blown away by the

quality of treatment.

‘I couldn’t believe it; they gave me a robe to wear and

it was actually heated, like it had just come from the dryer.

When they laid me down, instead of giving me a normal

blanket, they gave me a specialised compression blanket

before asking if I needed medication to calm my nerves,’

Renee laughs. ‘I almost forgot I was in there for surgery, it

felt like I was in a day spa!’

Ultimately, however, it was the results of her surgery that

Renee was most concerned about.

Although recovery took longer than expected, given the

extent of correction required, Renee saw Dr Tavakoli weeky

in the months following surgery.

‘I made an additional appointment to see Dr Tavakoli

to ask why I wasn’t recovering well,’ says Renee. ‘He

reiterated the extent of my reconstruction, which involved

disturbing the muscle, making a pocket, disrupting the

gland, fixing the scars and adjusting the nipple – that’s a lot

to recover from.’

Two months after her procedure and Renee is feeling

energised and comfortable. The swelling has reduced and

the outcome of Dr Tavakoli’s work is made clear.

‘I couldn’t be happier,’ Renee says. ‘The results are

great and only now do I realise how much my breasts were

affecting my self-confidence. I keep asking myself why I

didn’t do it years ago!’ csbm


AFTER revision breast augmentation by Dr Tavakoli 121


Case Study:

Jessica’s Journey



Like many women, it took a long time for Jessica to

make the decision to speak to an expert about her

desire for bigger breasts – and longer still before

deciding to proceed with a breast augmentation. Surrounded

by a loving and supporting family who encouraged her

to accept her body the way it was, Jessica still struggled

with the appearance of her ‘fl at chest’ and, after four

years of deliberation, she took the next step in her journey,

approaching Sydney plastic surgeon Dr Kourosh Tavakoli.

‘I had always been fl at chested and didn’t even fi ll an A

cup bra. I had no cleavage or shape in my breasts and they

were completely out of proportion with the rest of my body,’

Jessica recalls.

Despite her obvious desire for a bigger bust, it was

important to Jessica she found the right surgeon to perform

her augmentation. ‘I always wanted to see a specialist with a

good reputation,’ she says. ‘Dr Tavakoli was recommended

to me by a friend and I’d seen him in the media and knew

he had performed a lot of revision work with good results.’

In her fi rst consultation with Dr Tavakoli, Jessica was

shown several before and after photographs to help her

become familiar with the appearance of different size and

shape implants on different body shapes. Dr Tavakoli took

extensive measurements and discussed Jessica’s reasons

for choosing to undergo breast augmentation surgery.

‘He measured the width between my nipples as well as

the height of my breasts,’ Jessica says. ‘He measured my

waist because I specifi cally requested implants that were

in proportion with the rest of my body. We also discussed

the reasons why I wanted a breast augmentation and I

was able to tell Dr Tavakoli it was a personal decision I had

considered extensively.’

Jessica was able to ‘try on’ a number of different cup

sizes to get a better feel for the kind of result she would be

happy with. Given her desire for a more proportioned body

shape, Dr Tavakoli suggested an implant size bigger than

that Jessica had originally anticipated. After measuring her

body, Dr Tavakoli suggested the bigger size would be more

effective in bringing her hips and shoulders into proportion.

‘I have quite broad shoulders, so I could afford to go a size

bigger than I’d anticipated,’ Jessica explains. ‘Dr Tavakoli

actually ordered two different sized implants for my surgery. In

the operating theatre he initially inserted the 400cc implants

but, because I had so little breast tissue, they stretched the

skin too much. The 375cc looked more natural, though it

was still a size bigger than I had originally thought.’



Leading up to surgery, Jessica still had a number of

questions and was able to speak to both Dr Tavakoli and

his nurses following her initial consultation in order to lay

any final concerns to rest.

‘It was quite a quick process, and was only about three

to four weeks from the initial consultation to the operation,’

Jessica says. ‘Through this time I was still debating whether

I wanted the bigger size and I often called the nurses at Dr

Tavakoli’s clinic asking them different questions. They were

very patient and extremely kind.’

Although she had uncertainties over the size of

implants, the surgery itself didn’t faze Jessica. ‘I wasn’t too

nervous coming into the surgery,’ she says. ‘Dr Tavakoli

had explained everything in detail, which made me feel

comfortable throughout. I never felt rushed, as he would

always sit down with me and ask, “Do you have any

questions?” or, “Is there anything you want to ask me?”

This was great for someone who’d never experienced any

cosmetic procedures before.’

Jessica tackled her recovery, too, with ease. Having

been prepared to spend days in bed, Jessica was surprised

to find she was out of bed after day one, and not in need of

the pain-killers she’d been prescribed.

Now, three months after her operation, Jessica is back

at the gym and this, alongside regular cycling and walks

with her dog, is aiding her speedy recovery.

‘After surgery I had prepared myself to be immobile and

uncomfortable,’ Jessica says. ‘The first day I was a little

sick due to the anaesthetic but other than that I was fine.

Everything was much neater than I had expected – the

wounds had no leakage, they didn’t even look like wounds,

they were so clean and neat.’

Now able to see the final results of her surgery, Jessica is

happy with the size of her breasts and feels confident in her

long-debated decision. ‘It was one of the best things I’ve

done. It’s the little things, like trying on clothes I’d bought

before the operation and being able to fill them out, having

tops fit properly and having clothes look right on my body –

it’s really helped my confidence,’ Jessica says.

‘It’s funny, everyone who told me I didn’t need surgery

has had a complete attitude change. My mum and dad

now realise I was doing it for the right reasons - to bring my

body back into proportion. I don’t know why I didn’t do it

ages ago.’ csbm


AFTER breast augmentation by Dr Tavakoli


AFTER breast augmentation by Dr Tavakoli 123


Case Study:

Treating Symmastia

One patient describes how Sydney plastic surgeon Dr Kourosh

Tavakoli restored her breasts both anatomically and aesthetically.

Caitlin Bishop reports.



Having undergone both a breast augmentation and a

corrective operation on her breasts in the last year,

Sarah’s breast tissue had begun to tear from her

breastbone, causing progressive discomfort and increasing

disfigurement. The condition, termed symmastia, is a rare

complication of breast augmentation surgery and occurs

following the over-dissection of breast tissue. As the muscle

and fat detach from the breastbone, the breast tissue of

both breasts begins to merge, creating the appearance of

a ‘uni-breast’.

After calling a dozen Sydney plastic surgeons hoping

to find one trained in treating her condition, Sarah came

across Sydney plastic surgeon Dr Tavakoli.

‘In treating symmastia, a revision surgery is required

to reattach the chest muscles to the breastbone using

permanent internal sutures,’ explains Dr Tavakoli. ‘This is

accompanied by a procedure to reposition the implant,

often using sutures in the breast pocket to prevent implant

migration from occurring again.’ Although some doctors

use two surgeries to achieve this restoration, Dr Tavakoli

performs it in one.

After extensive research into the condition and the

specialised surgery required to correct it, Sarah approach

Dr Tavakoli, who explained during her first consultation what

sort of implants were needed and suggested a different size

and shape of implant to better suit Sarah’s body.

‘I needed a lift, reduction, new implants and the muscle

reattached,’ Sarah recalls. ‘During two consultations

Dr Tavakoli showed me the type of implant he would

use to prevent further complications. He took extensive

measurements and suggested I opt for smaller implants,

before outlining exactly what the surgery would involve and

what to expect afterwards.’

Because of the urgent nature of her condition, Sarah

was taken through the preparation period as quickly as

possible and found herself in the operating theatre just two

weeks after her initial consultation.

‘The level of discomfort and the amount of damage

still being caused to my muscle meant it was an urgent

procedure,’ Sarah says. ‘Dr Tavakoli wanted to treat it as

quickly as possible, to prevent further damage.’

Remarkably, Sarah arrived at Dr Tavakoli’s day surgery

at 7am on the morning of her operation and left the clinic

no later than midday. ‘I’d spent so long in hospitals and

day surgeries because of my breasts, I just really wanted

to go home.’

Not letting her leave without ensuring she was equipped

with all those things needed for a successful recovery, Dr

Tavakoli gave Sarah medication to manage the discomfort

and confirmed she had someone to transport her home

and monitor her from there.

After recovering quickly from her previous operations,

Sarah did not expect to be incapacitated for long.

Considering the extent of her operation, Dr Tavakoli

predicted she would be in bed for three days following

surgery, but Sarah was up and moving after day one.

‘The first day I was in bed the whole day, which I expected,

but I was up the second day and it only took about a week

for me to move normally without discomfort,’ she says.

‘I’m still recovering now, four and a half weeks after

surgery, but I’m back in the gym and training regularly,’

Sarah says. ‘The only thing that causes me difficulty is my

chest muscle because its not working fully yet. I still use the

treadmill and lift weights and Dr Tavakoli says it will take up

to eight weeks before I can use my chest muscle again.’

At four and a half weeks post-procedure, the swelling

has now subsided and the results of the procedure are

now visible.

‘I’m so pleased with the results,’ says Sarah, who adds

that she was happy the second she walked out of the

surgery. ‘Before Dr Tavakoli’s surgery it looked like I had one

big breast, it was shocking. I’d had thousands of dollars

worth of work done on my breasts, yet I couldn’t even wear a

V-neck top. It was devastating.’ Now, the situation has been

reversed and the prospect of wearing low-cut tops during

the impending summer months poses no problem. csbm


AFTER revision breast augmentation by Dr Tavakoli 125







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

Suite 10, 6 Meridian Place, Norwest Business Park, Bella Vista

1300 368 107 |


Tailored to fit




Regardless of what drives a woman to seek breast

augmentation surgery, Canberra plastic and

cosmetic surgeon Dr Vlad Milovic says the ultimate

goal of the procedure is to create the most natural-looking,

optimally sized breasts afforded by the patient’s anatomy

and aesthetic goals. And, more often than not, this doesn’t

involve a great increase in the size of a patient’s assets.

‘Although breast augmentation can increase the size of

the breasts considerably, and some women do request an

augmented look, most women are much more driven to

achieve breasts that are in proportion with the rest of their

body,’ he says. ‘We don’t really see the same trend as in some

other countries, where the tendency is to emphasise fullness.’

Indeed, according to Dr Milovic, in around 90 per cent of

the patients he sees, women want an improvement in the

shape and firmness of their breasts, and a modest increase

in size that doesn’t look unnatural or draw glaring attention

to the fact they have had an augmentation.

Achieving natural-looking breasts that balance a

patient’s existing curves, however, involves a number

of important stages. ‘Successful breast augmentation

demands not only a skillful surgeon with significant

experience, but also diligent planning,’ explains Dr Milovic.

‘Before surgery, it’s important to conduct a thorough clinical

examination and full assessment, and to involve the patient

in what their results will look and feel like through the use of

3D imaging and pre-operative volume inserts.’

Having introduced 3D breast scanning technology to

his Canberra clinic some years ago, Dr Milovic is a strong

advocate for the use of imaging prior to augmentation,

believing it gives patients a very good impression of what

impact their surgery will have on their appearance.

As well as helping the plastic surgeon and patient work

together to select an implant they both feel comfortable

with, thereby facilitating communication between the two

parties, Dr Milovic believes imaging can take away some of

the anxiety associated with ‘the unknown’.

‘No matter how much a patient may want a procedure,

cosmetic surgery can have a profound psychological as

well as physical impact,’ he says. ‘In my experience, 3D

visualisation helps alleviate much of this anxiety.’

Dr Milovic finds imaging particularly beneficial when it

comes to breast surgery, where patients might be unsure

about the size of implant they want, or when performing

breast reconstruction after mastectomy or other surgeries

where tissue has been removed.



‘At my clinic, a patient’s upper body is scanned with a

bra or bikini top and they can “try on”, in a virtual sense,

different implant sizes, shapes and placements to see how

their new look would complement their figure and lifestyle

before proceeding with surgery. This part of the consultation

process facilitates discussion and allows me to tailor the

operation to their needs.’

From a surgical point of view, imaging also allows Dr

Milovic to identify any nuances that may be significant

during surgery.

‘It’s easier to notice minor asymmetries that naturally

occur between the breasts when using imaging,’ he

explains. ‘It’s also possible to determine the existing volume

of each breast before simulating the appearance of different

types of implant on the patient.’

Although he will adapt his surgical technique depending

on the particular circumstances of each patient, Dr Milovic

performs the majority of his procedures via the inframammary

incision with a dual plane placement. ‘An incision is made in

the crease under the breast, through which the implant is

then positioned,’ explains Dr Milovic.

‘This affords the surgeon the best control over the implant

pocket and where and how the implant is positioned.’

Breast augmentation surgery is typically performed as a

day procedure but Dr Milovic offers his patients the option

to stay at Caberra’s only five star Medihotel, a favourite for

interstate and local patients alike.

After surgery, Dr Milovic says that some swelling and

bruising is to be expected, but that this should settle within

two to six weeks. ‘It’s important for patients to rest during

this time and follow the post-operative instructions, which

we provide to all patients,’ he says.

Patients can also look forward to comprehensive postoperative

follow up, with Dr Milovic, which is included in

the cost of their surgical fees. ‘I see my breast surgery

patients the day after surgery, as well as one, two and six

weeks after their procedure

‘I then like to follow up with each of my patients after

three and six months and will perform an ultrasound one

year after surgery to check the implant,’ he says.

With careful planning leading up to surgery, and attentive

follow-up post-procedure, Dr Milovic believes his patients

can look forward to breasts that are in balance with both

their body shape and lifestyle. csbm


AFTER breast augmentation by Dr Milovic


AFTER breast augmentation by Dr Milovic 129



for success




It’s often said that the most important aspect of

communication is hearing what isn’t said, and it’s this

philosophy that Sydney plastic surgeon Dr Benjamin Norris

carries into his consultations with patients. An experienced

plastic surgeon specialising in breast augmentation, Dr

Norris believes that, no matter what the surgery, optimal

outcomes depend on an open and honest relationship

between patient and surgeon.

‘To ensure a successful outcome and a satisfied patient

there needs to be an intensive consultation at the outset

and consistent follow-up in the weeks and months after the

procedure,’ says Dr Norris. ‘The surgery itself is just one

stop along the way.’

For those contemplating surgery, the initial consultation

– undertaken with a qualified surgeon – should clarify any

misconceptions or queries the patient might have. It’s the

ideal forum, and the first opportunity a patient has, to openly

and confidently discuss their desires and expectations,

while learning more about what might be possible surgically

and the limitations presented by their own body shape, sin

type and physiology.

Indeed, Dr Norris fiercely believes in educating his

patients so they are informed, reassured and prepared

going into surgery. ‘In order to make an informed decision,

it’s important patients are furnished with all the information

and reassured their surgeon will be there every step of the

way,’ he says.

According to Dr Norris, it’s only when a patient speaks

freely about their concerns, expectations and goals that

determining the optimal shape and size of breast implant

is possible.

‘A patient usually arrives at the consultation with her

own ideas to contribute, and it’s the responsibility of a good

surgeon to gauge exactly what these are,’ he says. ‘My job is

to extract that information through effective communication

and by listening to both the verbal and nonverbal cues the

patient projects.’

Clearly, patient desires must be accompanied by the

doctor’s keen eye for balance, detail and harmony. ‘An

important part of the discussion is considering proportion

as well as size,’ he says. ‘This kind of communication

helps the patient better understand the procedure and

take an active role in the decision-making regarding the

eventual outcome.’

Because of their significance, Dr Norris conducts all

initial consultations himself. He will take measurements,

discuss medical history, offer different implants to ‘trial’ in

the case of a breast augmentation and run through the

procedure itself, including the possible risks, complications

and outcomes.

‘My consultations take the form of an informal chat that

can last anywhere up to an hour. This way a patient has

the opportunity to relax and open up to me, asking any

questions they need to. It also gives me more insight into

their motivations for surgery and the concerns they have

about their body.’

In a unique effort to further understand patient priorities,

Dr Norris often asks which cosmetic procedure they would

choose if they were only able to have one in their lifetime. ‘I

find that posing this hypothetical question helps the patient

focus on their priorities,’ he explains.

Following this, Dr Norris outlines all the suitable surgical

options and explains what to expect leading up to, and in

recovering from, the procedure.

When it comes to planning the surgery itself, Dr Norris is

diligent in raising all those practical issues often overlooked

by patients, which can impact their experience during the

recovery period.



‘I raise topics such as what help they intend to organise

for the kids, the cooking and housework; how they will

navigate potentially tricky situations in the workplace;

what exercise they should and shouldn’t do until they’ve

healed – even simple things like remembering to put a gym

membership on hold until they are physically able to use it

again,’ Dr Norris says.

‘If matters like these aren’t addressed beforehand they

can cause all sorts of problems. While it might not impact

on the physical healing, it may leave the patient feeling the

overall experience was a less than satisfactory one.’

Importantly, Dr Norris says he is absolutely opposed to

pressuring patients into opting for surgery when they are

not fully convinced or don’t feel ready. Because of this, he

prefers to see all his patients for a second consultation to

reinforce the information provided at the initial meeting and

address any additional concerns.

‘When a patient is considering a cosmetic surgery

enhancement, they are often vulnerable and not always

entirely convinced what they want, or whether they want it

at all,’ he explains.

Yet it’s not just before surgery that open communication

is key. Dr Norris stresses a strong doctor-patient relationship

is just as vital in the time following the procedure.

During recovery, significant trust and understanding

must be present in monitoring patient progress and any

complications that might arise. ‘It’s imperative the lines

of communication remain open post-surgery. I am happy

to see a patient as often as he or she wishes after their

procedure,’ Dr Norris says.

This approach to surgery, where communication is

paramount in achieving a successful result, is something

Dr Norris abides by with all his patients, no matter what the

procedure. ‘Patients put their faith in me and therefore I feel

an obligation to be involved in all parts of the process, not

simply turning up for surgery,’ he concludes. csbm

BEFORE AFTER breast augmentation by Dr Norris

BEFORE AFTER breast augmentation and breast lift by Dr Norris 131


BEFORE AFTER breast augmentation by Dr Norris


AFTER breast augmentation and breast lift by Dr Norris

BEFORE AFTER breast augmentation by Dr Norris


Beautiful Breasts.


Dr Benjamin norris

Cosmetic and Plastic Surgeon




Big decisions







Last year breast augmentation came out on top

as the most popular cosmetic procedure for US

women, with just shy of 350,000 procedures

performed in total. And whilst we wait for statistics to

be released in Australia, it’s a trend that’s likely to be

replicated at home.

Breast augmentation is undoubtedly one of the most

popular cosmetic procedures sought by women, yet

despite record numbers of surgeries performed year on

year, Sydney plastic surgeon Dr Alexander Phoon says

it’s not a decision that should be undertaken lightly.

‘It’s important to realise that proceeding with a breast

augmentation is a big decision for any woman,’ he says.

‘It’s therefore crucial I take the time to listen to their

concerns, their lifestyle and their priorities.’

According to Dr Phoon, a successful breast



augmentation begins with a quality consultation between

patient and surgeon. ‘The consultation provides the

opportunity to build trust and understanding – something

that’s crucial to ensuring patients are satisfied with their final

results,’ he says.

By understanding the patient and the wider context of

why they’re seeking breast augmentation, Dr Phoon is able

to marry the patient’s objectives with the implant shape,

size, projection and placement that will ensure the best

possible outcome for each patient.

It’s important to realise that

proceeding with breast

augmentation is a big decision

for any woman. It’s therefore

crucial I take the time to listen to

a patient’s concerns, their

lifestyle and their priorities

Dr Phoon believes that taking time to get to know each

patient also forges trust and understanding between the

surgeon and patient. ‘I can’t stress enough the importance

of taking time during consultation to get to know each

patient,’ he says. ‘I get upset when I hear about clinics

where patients are treated more like a production line. One

breast augmentation definitely does not fit all, and it’s our

philosophy at Silkwood Medical that a beautiful breast is

one that’s customised to the patient, their lifestyle, goals

and body shape.’

Dr Phoon uses three-dimensional imaging technology to

help patients ‘see’ how their results might look after surgery.

‘Using 3D imaging allows the patient to realistically see what

any size implant might look like on their body,’ he explains.

‘I have found the technology is both incredibly accurate

and informative and patients enjoy the process – they get

the opportunity to sit comfortably, with their clothes on, and

review the effect different implant shapes and sizes will have

on their appearance.’

Indeed, Dr Phoon finds many patients change their mind

about what it is they want thanks to the time they spend

reviewing their options with him. ‘Many women come in

with an idea of what they’d like, but it’s only when they

consult with a fully qualified plastic surgeon that they can

get an idea of what they need,’ says Dr Phoon.

It’s this expertise that Dr Phoon says helps women cut

through the myriad of options available to them. ‘There is so

much choice today in terms of implant brands, shapes and

sizes, it’s easy for women to get confused. The consultation

is therefore an opportunity to learn more about what’s right

for them.’

Dr Phoon also believes it’s important to furnish his

patients with information regarding the risks, limitations and

complications associated with breast augmentation. ‘Any

surgery has risks, and it’s important patients are informed

as to the potential risks of anaesthesia,’ says Dr Phoon.

‘Breast augmentation also carries the risk for certain

complications such as rotation, displacement and

capsular contracture. Fortunately these are becoming

increasingly infrequent in Australia thanks to advances in

implant technology.’

Whilst many surgeons have a preferred implant – be it

textured, smooth, silicone, saline or polyurethane, Dr Phoon

believes in selecting the implant that is right for each patient.

‘Some women may benefit from round implants, others from

anatomical. Some need polyurethane implants, whereas this

isn’t the right choice for others,’ he explains. ‘In the light of

the PIP implant crisis, the take home message is safety first.

We offer our patients a wide range of implants, but only the

most reliable, with a long, proven history of safety.’

At Silkwood Medical, all breast augmentation patients

are invited to a minimum of two consultations before their

procedure. ‘It’s vital patients take the time to attend two

consultations so that any concerns can be addressed

and the procedural plan fine tuned,’ explains Dr Phoon.

‘It’s common for women to come back to the second

consultation with plenty of questions that can then be

answered well ahead of surgery.’

Dr Phoon also spends time with each of his patients

before their procedure on the day of surgery. ‘It’s important

patients know I’m there with them on this journey,’ he says.

‘I can also answer any last minute questions.’

Dr Phoon adopts a meticulous approach to surgery

to minimise the extent of bruising and swelling. ‘Patients

should expect minimal swelling but will be able to anticipate

the final results after a couple of weeks,’ he says.

At Silkwood Medical, all the surgeons share the same

philosophy towards patient care and excellence in plastic

and cosmetic surgery. ‘I personally strive to create breasts

that make the patient feel feminine, confident and age

appropriate,’ concludes Dr Phoon. ‘The most beautiful

breast is one that makes the patient feel beautiful’. csbm 135


Care &






Comfort is a number one concern in the days that

follow any surgery, helping to make those early

days as easy as possible. But as well as providing

comfortable support after procedures such as liposuction,

abdominoplasty, breast augmentation and facelift surgery,

post-operative compression garments also play an

important role in speeding recovery.

Surgeons commonly prescribe compression garments

to reduce swelling and bruising and increase circulation,

promoting faster healing and therefore recovery. By

compressing the treatment area immediately postprocedure,

some sagging of the skin might be prevented by

comfortably pressing the skin and muscle tissues together.

The compression aids the skin and tissue in reattaching

itself smoothly as well as providing support to sutures by

preventing stretching.

The CareFix range of compression garments, distributed

in Australia by Statina Healthcare, is based on the key

values of comfort, functionality and ease-of use.

Canberra plastic surgeon Dr Vlad Milovic has recently

introduced the CareFix range of post-surgical bras to his

clinic. Designed to be worn by breast surgery patients in the

weeks immediately following surgery, when the skin is still

tender and sensitive, Dr Milovic chose CareFix because he

believes the medical-grade textiles provide more comfort to

his patients than some other garments.

‘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 others, which can be

quite abrasive.’

One of the main risks associated with breast augmentation



is implant displacement. This is when the implant shifts from

its desired position and is more likely to occur in women who

have teardrop-shaped or very large or high-profile round

implants. It can result from erroneous positioning in the tissue

pocket, excessively stretched tissue or trauma and is also

thought more likely to occur with a larger implant as gravity

acts on the weight of the implant.

According to Dr Milovic, compression bras should be

worn for six weeks post-surgery in order to guard against

this risk of displacement. ‘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.’

By restricting movement of the implant, it’s also thought

compression garments can help minimise any bruising,

swelling and discomfort experienced post-surgery.

However, Dr Milovic says surgeons shouldn’t rely on

compression garments to minimise swelling.

‘External compression reduces swelling a little bit,

however it’s more important for the surgeon to create a

careful pocket dissection when placing the implant,’ he

says. ‘This has a much greater impact on the extent of

swelling experienced by the patient.’

Dr Milovic fits each of his breast augmentation patients

with their bra during consultation, before their surgery. ‘We

place the bra onto the patient as soon as their surgery is

over – they wake up in the compression garment – so it’s

important to fit the bra ahead of surgery,’ he says. ‘Fitting

the bra before the procedure also means the patient can

get used to the material and design of the garment.’

Whilst the support needs to be worn 24/7, they can be

taken off to shower and have a convenient front closure

mechanism to ease their removal – something that’s of

significant value if a woman is tender post-op.

Although patients have to wait for six weeks before

fitting into the new, stylish underwear they will have no

doubt picked out to complement their post-augmentation

breasts, the CareFix range certainly isn’t dowdy. The bras

come in a range of colours and, as they’re latex free, they

eliminate any risk of latex reaction.

Recently, CareFix launched their Breast Implant Stabiliser

Band, which is designed to help stabilise and position the

breast implant in the first two weeks post surgery, speeding

up the time it takes for the implant to settle into it’s position.

There’s no doubt that, no matter what the surgery,

the steps taken in the days and weeks that follow can

have a significant impact on results. Indeed, planning for

the recovery period should never be overlooked and it’s

thanks to compression garments such as those by CareFix

patients can look forward to recovering with greater ease

and comfort than ever before. csbm

Post-Surgical Bras

CareFix Post-Op Care Bra Celia

CareFix Post-Op Care Bra Bella

CareFix Post-Op Care Bra Bianca 137


Bigger breasts

á la Brazil





Signifying what many believe is a breakthrough in breast

augmentation, polyurethane-coated P-URE implants

use a textured surface to reduce the risk of common

complications and help create a natural-looking contour.

With subtle enhancement a common request from women

wanting breast augmentation, Sydney cosmetic surgeon Dr

Colin Moore believes P-URE implants – fondly termed ‘furry

Brazilians’ – offer the best results for these patients.

‘In my experience, polyurethane-coated implants can

produce the most natural-looking results whilst minimising

the risk of the most common complications associated with

breast augmentation,’ he says.

With overly enlarged breasts no longer a popular trend,

many women interested in breast augmentation are simply

seeking to enhance their natural assets, balance their figure

and improve their breast contours. ‘A key concern for

women considering breast surgery is whether or not their

breasts will look “natural” following surgery,’ says Dr Moore.

Accurate measurements to define body proportions are

the number one step in achieving natural looking results.

Yet Dr Moore suggests advances in implant technology

can go lengths in achieving aesthetically attractive, natural

looking curves.

Part of the success of P-URE implants is their ability

to reduce the rate of capsular contracture, which is the

rippling, 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 an uneven pattern, preventing contraction

and lessening the chance of implant distortion.

‘A number of recent studies have shown that there

is only a one per cent risk of capsular contracture with

polyurethane-coated implants, which is very minimal and a

significant improvement on the 10 per cent risk associated

with saline and silicone implants,’ says Dr Moore. ‘This

is one of the many reasons I believe patients should

choose polyurethane implants. With the right surgeon and

the proper patient consultation, I believe they can create

superior results.’

Whether or not a natural outcome is desired, extensive

consultation is essential in deciding upon the final shape

and size of implant. With expectations, desires and body

shape varying drastically between patients, a lengthy and

in-depth consultation process will prepare the patient for

surgery, address the preferred outcomes and establish

the limitations posed by body shape, skin thickness and

tissue composition.

‘Sometimes patients describe an aesthetic which is

unachievable because of their physical limitations,’ says Dr

Moore. ‘By measuring the proportions of the figure we can

determine the best breast size for the patient to enhance

the rest of her body.’

Dr Moore completes a number of measurements during

a consultation. ‘The basic dimensions of the breast are

taken into account, including the breast base, height and

overall width,’ he says. ‘The distance from the nipple to the

inframammary crease (underneath the breast) is influential

in the appearance of a perky breast,’ he says.

These measurements, alongside an understanding

of what each patient hopes to achieve, will guide the

surgeon in selecting the most suitable implant size and

shape for that individual. Planning, diligent measurements

and careful implant selection will see breast augmentation

result in natural-looking, beautified breasts. csbm





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by a nose




Nose surgery, or rhinoplasty, has long been one of

the most frequently performed plastic surgery

procedures. While some want their nose reshaped

because they are unhappy with the nose they were born

with, others become unhappy as ageing changes the

appearance of their nose. For others, an injury may have

bent or distorted the nose, or they may have grown tired of

functional concerns. Whatever the complaint, one thing is

clear: nothing has a greater impact on how a person looks

than the size and shape of the nose.

Because the nose is the most defining characteristic of

the face, a slight alteration can greatly improve a person’s

appearance. Similarly, a slight imperfection – caused by

injury, ageing or genetics – can have an overwhelmingly

negative impact on the rest the face. Fortunately, surgeons

are equipped with a number of techniques that allow them

to disguise imperfections and restore a nose that is not only

beautiful, but in keeping with the rest of the face.

The techniques used to augment or sculpt the nose differ

depending on the desired outcome, the preference of the

surgeon and the functional properties of the nose. Before

the 1970s, the procedure was generally performed via the

intranasal approach, referred to as ‘closed rhinoplasty’. In

1973, however, Dr Wilfred S Goodman initiated a shift in

technique when he published the paper External Approach

to Rhinoplasty, detailing what has become known as ‘open

rhinoplasty’. Today, both open and closed techniques are

widely used by surgeons, each having their own relative

merits and disadvantages.

Although the end-goal is often the same – either to

build-up (augment) or reduce the size of the nose – the

two techniques differ primarily in their access to the nasal

structure. In open rhinoplasty, the surgeon will make a small

incision between the nostrils, and go on to make a number

of additional incisions inside the nose. Closed rhinoplasty,

on the other hand, involves incisions made only to the

interior of the nose.

Rhinoplasty for cosmetic purposes grew in popularity

throughout the 20th Century and, consequently,

techniques were continually evolving. However, it wasn’t

until Dr Goodman’s paper in 1973 that open rhinoplasty

as a technique became more readily available. This new

approach was further popularised and refined by Dr Jack

Anderson, who wrote Open Rhinoplasty: An Assessment in

1982. Although the technique was initially used for first-time

rhinoplasty, towards the late 1980s the open technique

started to become more prevalent in secondary, or revision

rhinoplasty, encouraged by the work of Dr Jack P Gunter.

During open rhinoplasty, an incision is made at the

base of the columella – the tissue and skin that separate

the nostrils at the base of the nose. The nasal skin is then

carefully lifted back, allowing the surgeon to work on the

cartilage and tissue inside the nose.

Because the nose is the most

defining characteristic of the

face, a slight alteration can result

in a great improvement

Because the inner cartilage network and underlying

structure of the nose is exposed, the surgeon has greater

visibility than with closed rhinoplasty, and is able to work

on the inner structure of the nose 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, for example, can be helpful

when performing cleft lip operations, or during revision

rhinoplasty when an earlier procedure has left a nose

pulled too high and structural grafts are required. In these

scenarios, surgeons will tend to favour open rhinoplasty 141


due to the extra visibility given by revealing the internal

structure of the nose.

The open technique also helps ensure the basic

foundation of the nasal structure is kept strong, facilitating

a natural-looking outcome. It also leads to a more stable

shape post-surgery, helping to safeguard against collapse.

Because an incision is made at the base of the columella,

the open technique will leave a small scar on the underside

of the nose. This will fade over time and, in most cases,

become barely noticeable. The patient may also experience

swelling, bruising and numbness for a more drawn out

period of time than with the closed approach to rhinoplasty.

Recently, non-surgical

techniques have been adopted in

order to help correct minor

irregularities in the nose

Whereas the open technique may be used to tackle

complex cases, closed rhinoplasty is generally used to

address minor defects. The operation is much quicker,

typically taking between one and two hours – around half

the time taken to perform closed rhinoplasty and because

all incisions are made inside the nostrils, the procedure

does not result in visible scarring. Given this minimally

invasive approach, healing and recovery time is also less,

as are swelling, bruising and numbness of the nasal tip


Often, the type of surgery selected will come down to

the preference of the surgeon. Where some prefer open

surgery because it unveils the underlying structure of the

nose, others prefer the closed approach because it offers

better ability to judge the final shape and contour of the

nose. This is because there are no external incisions

compromising the appearance of the nose.

The closed technique offers surgeons considerable

freedom to reshape the nose. Bone and cartilage can both

be removed using this technique or in some cases taken

from other parts of the body and used to better shape and

support the nose. However, despite offering plenty of scope

to address minor modifications, the main disadvantage of

the closed technique is its limited use. Although suitable for

reshaping the contours of the nose, complex cases cannot

be tackled as effectively with closed rhinoplasty.

Relatively recently, non-surgical techniques have also

been adopted in order to correct minor irregularities in the

nose, allowing suitable candidates to alter their appearance

without having to undergo surgery.

Already known for their ability to ease the appearance

Anatomy & Function

There’s a good reason rhinoplasty is often referred to

as the most intricate of facial surgeries. An intricate

network of bones, cartilage, cells, blood vessels, nerves

and skin, rhinoplasty needs to not only improve the

appearance of the nose, but also maintain or improve

upon its function. Different parts work together to filter

the air that then enters the lungs, and to send messages

to the brain to enable the sense of smell.

The nose can be divided into two main parts – the

external and the cavity. A ‘wall’ called the nasal septum

divides these sections vertically.

‘External’ refers to the actual structure of the nose,

comprising bone, cartilage and tissue. At the very top

of the nose, two nasal bones link the nose to the frontal

bone of the forehead. These bones form the ‘bridge’

of the nose, or dorsum. The lower part of the external

structure is made up of cartilage and tissue, which give

shape to the nose. The nasal bones give way to septal



of wrinkles, fi llers are increasingly being used to refi ne facial

contours. Indeed, nasal irregularities can be corrected

using either temporary or long-lasting dermal fi llers, allowing

suitable patients to alter their appearance without the need

for surgery.

Non-surgical rhinoplasty can correct minor external

nasal deformities, depressions, asymmetries, collapsed

nasal bridges and saddle noses. It can also be an effective

technique for making corrections post-surgery where the

results of earlier rhinoplasty have been unsatisfactory.

A relatively quick procedure, non-surgical rhinoplasty

requires no anaesthesia and involves minimal downtime.

Most fi llers will leave residual redness and slight tenderness

for up to a few days and patients can expect slight swelling

and bruising. Unlike closed and open rhinoplasty, the results

are immediately evident.

Sometimes, surgeons are called on to address

complications from earlier rhinoplasty procedures.

Considered one of the most diffi cult forms of cosmetic

surgery to perform, revision rhinoplasty, or ‘secondary’

rhinoplasty, involves the correction of previous cosmetic

procedures. Despite the best efforts of any skilled surgeon,

revision rhinoplasty is necessary in fi ve to 12 per cent of

rhinoplasty cases. Whilst some may require only minor

adjustments, others may need major modifi cation, and may

be a result of too much or too little bone, cartilage or tissue

having been removed, resulting in a nose that is too large or

too small for their face.

The techniques adopted for secondary rhinoplasty will

vary from one patient to the next and according to the

issues that need to be corrected. Implants or grafts may be

needed to fi ll in dips and smooth the contours of the nose,

or breathing diffi culties caused by the initial rhinoplasty may

need to be addressed.

Because the procedure takes place after an original

surgery, the presence of scar tissue makes secondary

rhinoplasty diffi cult. Because of this, it is usually recommended

that patients requiring revision rhinoplasty wait at least one

year from the date of their last nasal operation.

Ultimately, the technique used for any rhinoplasty

surgery will come down to the goals and desired results of

the patient, as well as the surgeon’s preference.

However, with so many variables, the most suitable

approach to each individual’s rhinoplasty should only be

decided after careful and detailed discussion between the

patient and surgeon.

No matter which technique is adopted, there’s no

doubt a well performed rhinoplasty can result in siginifi cant

changes to not only the appearance of the nose, but to the

face as a whole. csbm

cartilage, which forms the dividing wall of the nose. Further

down, major alar cartilage runs from the tip to either side of

the nose, forming the nostrils.

The internal structure of the nose centres around the

nasal cavity, which can be thought of as a tunnel with an

opening on the face and an opening at the top of the throat.

The nasal septum divides the cavity vertically. The upper

part of the nasal cavity is lined by the olfactory epithelium,

which contains receptor cells that detect odours and enable

the sense of smell.

Three small bones called turbinates protrude into the

nasal cavity on either side, which help to maintain the

temperature, humidifi cation and fi ltration of the air as it

passes through the nostrils. The lungs need to be supplied

with air that is around 35 degrees centigrade and 95 percent

humidity, and therefore the nose is structured to not only

receive the air but also to warm and fi lter it prior to entering

the lungs.

Both the nostrils and the nasal cavity are lined with

mucous membranes and small hairs called cilia. Together

with the mucous produced by the membranes, the cilia

fi lter the air and prevent the entry of dust, germs and

other unwanted particles into the respiratory system.

Should something become stuck in the nose, a sneeze is

triggered to clear it out. The mucous also helps moisten

the air, and blood capillaries located beneath the mucous

membrane help to warm it before it reaches the lungs.

Paranasal sinuses, located behind the bones above

and behind the eyes and behind the ethmoids, assist

with air fi ltration by producing mucous. Hollow air cavities

lined with mucous membranes, sinuses help warm and

humidify the air that passes through the nasal cavity,

while also improving vocal resonance. 143







Rhinoplasty is often referred to as the most

complicated of facial surgeries. The delicate balance

needed to address both aesthetic and functional

concerns demands considerable skill and an eye for beauty.

Sydney plastic surgeon Dr Darryl Hodgkinson refers to this

need to balance the shape and size of the nose with the

other features of a patient’s face as ‘Finesse Rhinoplasty’.

‘The goal of “Finesse” Rhinoplasty is to achieve a nose

that complements the patient’s appearance, giving ideal

proportion to the profile so that the other, more expressive

features of the face such as the eyes, the brows and the

mouth are emphasised,’ he says. ‘I believe Rhinoplasty is

probably the most challenging of all aesthetic facial surgical

procedures and I have been performing rhinoplasty for 30

years yet still find it very demanding.’


According to Dr Hodgkinson, each patient has an idea

of what they want their nose to look like post-surgery,

although they can find it hard to communicate that goal.

‘We use Alter-Image, which is a very accurate computer

imaging program, to not only help us illustrate the possible

outcome of surgery but to help us communicate with the

patient,’ he says. ‘With my input as to what is surgically

possible and the patient’s input as to what they would like



to achieve, we are able to come up with the most ideal,

individualised nose for each patient.’

Dr Hodgkinson believes that using digital imaging also

helps the patient form realistic expectations and better

understand that there isn’t a ‘one-size-fits-all’ solution when

it comes to rhinoplasty. ‘Simply making a nose smaller is not

the answer as every nose must be as unique as every face,’

explains Dr Hodgkinson. ‘A successful rhinoplasty does not

just alter the size of the nose but nearly always changes the

shape of multiple aspects of the nose: the tip; the bridge;

the position of the nostrils; and the width of the nose.’


Many patients may be unaware that the aesthetic issues they

see on the exterior of the nose are often reflected internally,

resulting in functional concerns. Dr Hodgkinson therefore

tests all his rhinoplasty patients to assess their breathing.

‘If compromised they may require septal surgery or

turbinate surgery in order to improve the breathing,’ he

says. ‘The breathing tests point to what is causing the nasal

obstruction if one exists and the septal surgery or “septoplasty”

can be performed at the same time as the rhinoplasty.’


AFTER rhinoplasty by Dr Hodgkinson


According to Dr Hodgkinson, there are three distinct groups

of patients who seek rhinoplasty to address anomalies in

their nose common to their ethnicity.

‘Caucasians often have a large bump on their nose and

the tip can over-project or appear too broad,’ he says.

‘Asians often have a too flat and broad nose; and Middle

Eastern patients often have a hump, and the tip is not

supported and droopy.’

No matter what the individual concern or end-goal, Dr

Hodgkinson says all procedures to correct the nose and the

breathing are carried out under light general anaesthesia,

and typically take between one and two hours. ‘A small

splint is placed on the nose and if work has been done on

the septum there will be a splint positioned internally, also,’

he says.


For patients who have previously undergone an

unsatisfactory rhinoplasty, Dr Hodgkinson offers secondary,

or revision surgery.

‘These patients have typically had an earlier rhinoplasty

elsewhere and are unsatisfied with the result or the healing

has distorted the nose,’ he explains. ‘Secondary rhinoplasty

tends to be more complex and the patient’s recovery might



AFTER rhinoplasty by Dr Hodgkinson

AFTER rhinoplasty by Dr Hodgkinson

be more extended but in general the time off work for either

primary or a secondary rhinoplasty is no more than seven to

ten days with a return to full activities and four to six weeks.’

Most importantly, Dr Hodgkinson says rhinoplasty

is an operation that, when performed by a qualified and

experienced surgeon, only needs to be done once. ‘The

largest variable in the quality of the outcome will be the

expertise of the surgeon,’ he concludes. csbm 145


Creating a








The end goal of any rhinoplasty is to create a nose that

not only suits the patient’s face and enhances their

breathing, but that will stand the test of time.

According to Sydney facial plastic surgeon, Dr George

Marcells, rhinoplasty has one of the highest rates of revision

of any cosmetic procedure. ‘If the nose is not given enough

support during surgery, it will twist and bend over time and

patients will be left needing revision surgery,’ he says. ‘Of

course, at that stage it’s harder to go in and make changes

because you will be operating through scar tissue, and

there is less cartilage left in the nose.’

To counter the risk of needing revision surgery, Dr

Marcells believes it’s important to adhere to what he

refers to as ‘Structured Techniques’. ‘Just as when you’re

building a house, it’s important to lay the foundations of a

structurally sound nose,’ he says. ‘The structural approach

refers to the techniques we use to reinforce the framework

of the nose – it’s all about architecture and engineering: if

you build the nose well you’ll achieve a long-lasting result.’

These techniques include using cartilage grafts to

straighten the nose and to refine the tip. In revision cases,

where too much cartilage has been removed, Dr Marcells

increasingly may draw on cartilage taken from the patient’s

rib. ‘There’s plenty of it and it can easily be made into thin,

straight grafts,’ he says. ‘The grafts are taken at the same

time as the rhinoplasty, under general anaesthetic so there’s



no extra inconvenience for the patient.’

One of the reasons rhinoplasty is such a

complicated procedure is the need to balance

outward aesthetics with improved function.

Although most patients are driven to seek nose

surgery for aesthetic reasons, Dr Marcells says

he often identifies functional issues.

‘Nasal obstruction can result in difficulties

breathing and sleeping,’ he says. ‘Improving the

function of the nose may lessen the impact of

some allergies.’

To determine if there are any functional

issues, Dr Marcells gives each of his patients a

thorough examination and organises a base line

CAT scan and nasal airway assessment.

‘During the assessment we measure flow

rates in the nose, resistance and the cross

sectional areas,’ adds Dr Marcells, who is

also involved in a number of research projects

investigating the objective measurements and

functional outcomes of breathing in patients

having cosmetic and functional rhinoplasty.

Of course, even for those whose number

one concern is improving their breathing, it’s

important to consider the appearance of the

nose and Dr Marcells conducts a very involved

consultation to ensure he gets to the bottom of

what each patient wants to achieve. Dr Marcells

uses computer imaging to demonstrate the

impact certain changes to the shape and size of

the nose will have on the patient’s appearance

but, whilst he believes imaging provides a reliable

guide, he says patients should never rely on the

imaging as a promise of what can be delivered.

‘Ultimately it’s down to the surgeon’s skill as to

what can actually be achieved,’ he says.

Although most procedures are performed

as day surgery, Dr Marcells says for more

complicated patients an overnight stay may be

involved. ‘I advise all my rhinoplasty patients to

take two weeks off work to recover,’ he says.

‘After this the nose begins to look like normal and

they will be able to resume their regular activities.’

Whilst most patients are back up and

functioning normally within two weeks, Dr

Marcells points out that ongoing care is needed

for the next one to two years. ‘We provide

comprehensive follow up, and I encourage

my patients to maintain appointments for up

to two years so we can review the longevity of

the results,’ he says. ‘In most cases, because

we have built a stable framework, patients can

expect their results to last a lifetime.’ csbm


Case 1: Renee underwent structural nasal surgery to improve her

breathing and the appearance of her nose.



AFTER structural nasal surgery by Dr Marcells

AFTER structural nasal surgery by Dr Marcells

Case 2: James underwent structural nasal surgery to improve his

breathing and the appearance of his nose.

AFTER revision structural nasal surgery by Dr Marcells

Case 3: Tania underwent revision structural rhinoplasty with Dr

Marcells who used rib graft to reconstruct her nose after previous

failed surgery left her with nasal deformity and breathing problems. 147


A nose

for detail




Although it’s often a concern with the appearance of

their nose that drives patients to see Sydney ENT

and facial cosmetic surgeon Dr William Mooney,

rhinoplasty is more often than not just the starting point on

a longer journey to facial enhancement.

‘Patients often come in with a specific concern about

their nose, but it’s interesting it’s rarely just the thing that

they present with that we end up treating,’ says Dr Mooney

who, as an ENT surgeon, specialises in conditions affecting

the ears, nose and throat.

According to Dr Mooney, whilst a patient might be

concerned about a dorsal hump or a bulbous tip, with

further consultation and the use of computer-aided

imagery, it often becomes obvious there are other concerns

at play. ‘Aesthetically, it’s common to identify concerns

such as asymmetry, crookedness or a tip that’s poorly

defined. Even though these issues might be secondary to

the primary problem that brought the patient to see me,

it’s important to address them at the same time,’ he says.

‘That’s what makes the difference between a “good” and

a “great” rhinoplasty – it’s a case of crossing all the Ts and

dotting all the Is.’

The nose, however, is not just a cosmetic organ, and

more often than not Dr Mooney will identify functional

concerns that need to be addressed during rhinoplasty.

‘I strongly believe patients should trust their nose to

an experienced rhinoplasty surgeon and preferably an

ear nose and throat trained surgeon,’ he says. ‘The nose

isn’t just decoration on the front of the face – the nose is a

complicated and important organ. It’s important for sense

of smell; it’s the opening of the respiratory tract; it’s the

resonance chamber for the voice; it’s the portal of exit and

entry for all the sinuses; and it’s intimately associated with

the eyes and brain. Quality of life is significantly impinged if

the nose doesn’t work.’

However, patients aren’t always aware there’s anything

wrong with the way their nose functions. ‘It’s often a gradual

deterioration, prompted by trauma in youth, so that by the

time they come to see me, patients have got used to their

nasal obstruction,’ says Dr Mooney.



Addressing both the aesthetic and functional

concerns identified by the patient is not always

the end of the story, however. Although this can

improve the appearance and function of the

nose, Dr Mooney says it‘s just as important to

assess the other features of a patient’s face.

‘Getting the balance right is not just as

simple as altering the nose. Sometimes other

facial features have problems we need to

address at the same time,’ he says.

According to Dr Mooney, it’s common for

men in particular to present thinking they have a

large nose when this is not, in fact, the case. ‘In

reality, they have a moderately large nose, but

the size of their chin is deficient,’ he explains.

‘In this instance, a chin augmentation alongside

a moderate change to the size or shape of the

nose can give strength and masculinity to the

face that often goes unnoticed by friends and

family yet makes a real improvement to the

overall appearance.’

Other procedures can also be performed at

the same time as rhinoplasty to result in a more

significant improvement to the patient’s overall

look. ‘A patient may benefit from having their

ears pinned back, or from minor liposuction

around the neck,’ says Dr Mooney. ‘More

commonly I may perform simple anti-ageing

procedures at the same time as rhinoplasty such

as dermal fillers and muscle relaxants or more

invasive procedures such as blepharoplasty or

thread lifts. The patient benefits by combining

procedures as they only have to endure one

anaesthesia and hospital stay and only have to

take time off work once to recover.’

However, not everyone is suited to

undergo multiple procedures at once and, if

they are, Dr Mooney recommends multiple

consultations ahead of surgery. ‘Conducting

multiple preoperative consultations is key when

someone is having a number of procedures,’

he says. ‘It can be a lot to take in if the patient

has walked in the door thinking they just need

a rhinoplasty and they walk out with a quote for

having their ears, eyes and skin treated, too.’

For anyone considering facial enhancement,

Dr Mooney advises a few simple rules. ‘Go to

someone reputable, aim for a natural, balanced

look and work within a budget,’ he says. ‘If

patients follow these rules, I believe rhinoplasty

can often be just the first step towards a lovely

cosmetic and functional change.’ csbm




AFTER Rhinoplasty and chin augmentation by Dr Mooney

AFTER Rhinoplasty and chin augmentation by Dr Mooney

AFTER Rhinoplasty and chin augmentation by Dr Mooney 149


Reshaping the nose

Sydney plastic surgeon Dr Pouria Moradi gets to the bottom of what

makes a beautiful nose. Lizzy FOWLER reports.

It takes centre stage on the face and, if international

statistics are to be believed, an overwhelming number

of us are unhappy with its appearance. But, thanks to

rhinoplasty, which has appeared amongst the top five most

popular cosmetic procedures around the world for the last

five years, thousands of men and women look more fondly

at their noses every year.

In Australia alone, it’s estimated that plastic surgeons

perform around 4,000 rhinoplasty procedures each year,

making it the country’s 4th most popular aesthetic surgical

procedure, behind liposuction, breast augmentation and

eyelid surgery. Yet, according to Sydney plastic surgeon

Dr Pouria Moradi, it can result in some of the happiest

outcomes – perhaps because of the overall impact a

misshapen or oversized nose can have on the rest of a

patient’s face and, consequently, on their self-esteem.

‘When performing rhinoplasty my ultimate goal is to

achieve a happy patient. But this process begins long

before the surgery itself,’ says Dr Moradi, who is based at

Silkwood Medical in Sydney’s Bondi Junction. ‘A successful

surgical outcome is obviously key to a happy patient, but

just as important is the consultation that takes place before

the operation, and the ability of the surgeon to tailor the

operation to address the concerns a patient has with their

nose, whether cosmetic or functional.’

It’s during the initial consultation that Dr Moradi gets

to the bottom of what these concerns are – and they will

vary widely for each patient. ‘The initial consultation takes

around one hour, during which I will take a detailed clinical

and medical history focusing on the exact concerns of

the patient and paying particular attention to any previous

trauma, operations or medications the patient may be on

and any breathing difficulties they may have,’ he says.

Dr Moradi then performs a clinical examination. ‘We look

at the internal structure and the external appearance of the

nose,’ he says.

‘It’s also important to assess the harmony and relationship

of the nose with the rest of the face – for example, is the



nose really “too big” or is the real issue that the chin is too

small?’ he adds.

It’s important for Dr Moradi that each patient is aware of

what a rhinoplasty involves, and that they understand why

he recommends certain adjustments. As well as discussing

the possible risks and complications inherent to rhinoplasty

and surgery in general, Dr Moradi draws the anatomy of the

patient’s nose – including details of the cartilages and bone

structure – to better describe the operative manoeuvres he

believes will address their concerns.

According to Dr Moradi, visualising the changes that are

going to take place helps a patient feel comfortable and

confident in proceeding with surgery. He’s therefore invested

in the latest digital imaging software to help patients predict

what their outcome will look like.

‘We use the Vectra to capture three dimensional

photographs of the patient’s face, profile and nose,’

he explains. ‘I can then use sophisticated software to

simulate the surgical manoeuvres I described earlier in the

consultation. This allows the patient to see an accurate

representation of how they might look after their operation.’

Using digital imaging also allows Dr

Moradi to assess the patient’s nasal

dimensions in relation to their facial

measurements. ‘By cross checking the size

of the nose with the height and width of the

face I can ensure that a rhinoplasty is in fact

the correct procedure and not a genioplasty,

where I might increase or decrease the size

of the chin,’ he says.

According to Dr Moradi it’s important

each patient has time to digest all the

information they’re given during the initial

consultation before they decide to proceed.

‘I give each patient my personal email address

and encourage them to contact me with any

further questions,’ he says. ‘Should they want


another consultation I always offer this free of

charge and, if they decide to proceed, there

will be a further meeting where we review the

3D model again and discuss the risks and

complications once more.’ Patients are also

invited to spend time with the practice nurse

at Silkwood, who discusses the procedure

with the patient.

Rhinoplasty is commonly performed

using either the open or closed technique.

Although the latter means that no incisions

are made on the outside of the nose,

Dr Moradi prefers the open technique,

especially where he needs to make any

adjustments to the tip of the nose. During

an open rhinoplasty, a small incision is made

at the base of the nose, between the nostrils


before the surgeon carefully lifts the nasal

skin back in order to work on the cartilage and other tissues

inside the nose.

‘Although the swelling may take longer to settle postop,

this technique gives absolutely the best view of the

anatomy of the nose and allows you to accurately perform

all your surgical manoeuvres with precision,’ says Dr

Moradi. ‘It takes away the guess work involved with a

closed rhinoplasty.’

However, the approach Dr Moradi takes depends very

much on each patient. ‘For example, a man who has

broken his nose playing football and needs the nose and

septum straightened, a closed rhinoplasty would be a

better approach.’

Although Dr Moradi says all patients should expect to

experience swelling and bruising, he says that after four

weeks the swelling will settle. The end result? ‘Having

delved to the bottom of what was troubling each patient

about the appearance of their nose and having prepared

them for the changes they were going to see, the ultimate

outcome is a happy patient,’ Dr Moradi concludes. csbm

AFTER rhinoplasty by Dr Moradi

AFTER rhinoplasty by Dr Moradi 151


Full face




There’s no denying facelift surgery had, for a short

while, a certain stigma attached to it. Thanks to the

odd photograph of over-tightened ageing celebrities,

men and women became understandably fearful of

appearing ‘overdone’ after surgery. Yet, as Sydney plastic

surgeon Dr Warwick Nettle points out, there has been a

quantum leap in the techniques and execution involved

in facial rejuvenation surgery in the last 10 years, thanks

largely to a better knowledge and understanding of facial

ageing. Today, he says, that ‘wind-tunnel’ look is, thankfully,

a thing of the past.

‘We used to believe that the common signs of ageing

were the result of loose, sagging skin alone,’ explains

Dr Nettle whose clinic, Silkwood Medical, is located in

Sydney’s Bondi Junction. ‘Today, however, we understand

ageing characteristics are largely due to the deflation that

takes place in the face, resulting in changes to the curves,

volumes and proportions of the face as a whole.’

Likening a youthful face to a sailboat with the wind

billowing in its sails, Dr Nettle explains that, with age, the

wind wanes, leaving the sail loose. ‘Changes take place

from the inside out, not just to the skin,’ he says. ‘Over time,

changes take place in the bone, muscle, fat and skin – each

one impacting on the other. This causes a deflation wave

that results in the appearance of sagging.’

Whereas the solution, once-upon-a-time, was to

simply tighten the skin, Dr Nettle explains that today the

emphasis is on the preservation and relocation of tissue

layers. Rather than simply pulling the skin tight, Dr Nettle

makes adjustments to the underlying muscle and tissues,

before carefully redraping the skin. ‘During the consultation

I will talk a lot with my patients about the techniques I use

to avoid the “tight” look, which I believe is 100 per cent

avoidable,’ he says.

Of course, the techniques Dr Nettle draws on vary

depending on the unique circumstances of each patient.

Typically, however, Dr Nettle says patients are concerned

by the appearance of the upper and lower eye region, their

neck and jawline. ‘Women are also commonly troubled by

wrinkles that appear on their upper lip, which are unrelated

to smoking,’ he says.

It’s therefore not uncommon for Dr Nettle to recommend

a number of procedures in order to achieve full-facial

rejuvenation. ‘Most people recognise the major issues

that need addressing – the eyelids, neck and jawline,

for example – but if you neglect the mid-face and leave

a noticeable naso-labial fold the results will be less than

satisfactory,’ he explains. It’s by combining a number of

procedures such as a face and neck lift, blepharoplasty

and microdermabrasion, Dr Nettle says the most naturallooking

results are achieved.

During full-facial rejuvenation, Dr Nettle may also extract



fat from the stomach for reinjection into the mid-face. ‘Fat

transfer used to be a popular technique for adding volume

to the face, however today we inject even small volumes

of fat in order to achieve rejuvenation of the skin,’ he says.

‘The fat is rich in stem cells, which makes a huge difference

to the appearance of the skin after the procedure.’

To address wrinkling in the upper lip – something that is

unique to women – Dr Nettle might perform dermabrasion

during surgery. ‘In my experience, this is more effective

than laser and carries less risk of causing pigmentation,’ he

says. ‘We aim to achieve a 60 to 70 per cent improvement

in the appearance of wrinkling on the upper lip.’

Although a face and neck lift can, according to Dr Nettle,

reset the clock 10 years ahead of where a patient was

before surgery, he’s careful to tell his patients that the clock

will continue to tick.

‘We advise all our patients to make sure they eat a

healthy diet and exercise to maintain their results,’ he says.

‘Some patients may use anti-wrinkle injections, laser and

dermal fillers following their rejuvenation surgery, and we

also recommend an effective skincare regime, including

vitamins A and C to help maintain youthful skin.’ csbm

Case Study

This patient, aged in her early-50s, was concerned with the appearance of her upper eyelids, wrinkling on her upper lip

and sagging around her neck and jawline. Dr Nettle performed full facial rejuvenation, including an upper blepharoplasty,

face and neck lift, micro fat transfer and dermabrasion to the upper lip. The result is a fresher, more youthful appearance.


AFTER full face rejuvenation by Dr Nettle


AFTER full face rejuvenation by Dr Nettle 153







Traditional or conventional facelifting techniques don’t

always take into account the three-dimensional

changes that take place in the face over time. Whilst

tightening the skin can remove the sagging, loose skin

associated with ageing, it’s just as important to replace

volume that can be lost in the mid-face.

‘The majority of my patients present with concerns

around the mid-face, where the plumpness associated with

youth has been lost,’ says Canberra plastic and cosmetic

surgeon Dr Vlad Milovic. ‘This is often combined with heavy

jowls and some degree of neck laxity, which together

contribute to an aged appearance.’

Fortunately, Dr Milovic says recent advances in facelifting

techniques have helped surgeons achieve more naturallooking

results for their patients.

‘I’ve adapted my approach to facelifting to achieve

results that stand the test of time, tailoring the procedure

to each patient.’

He believes the composite facelift technique, when

combined with adjunct procedures such as neck lifting

and advanced upper blepharoplasty where required, can

achieve the most natural-looking, long-lasting results.

Balance is central when it comes to facelift surgery

and, while other procedures only reposition facial tissue

horizontally, Dr Milovic says the composite lift counters the

natural descent of the face with a vertical lift.

‘The composite facelift is a next-generation alternative

to standard procedures,’ he says. ‘It is a sophisticated

technique that requires experience to perform, but it can

successfully restore a youthful appearance.’

The composite facelift is similar to a deep plane lift, with

the addition of an extra step to include the muscle around

the eyelid. Like the deep plane lift, the composite lift involves

the elevation and resection of the superficial musculo

aponeurotic system (SMAS), as well as the orbicularis

muscle and cheek fat pad.

During the lift, the orbicularis oculi muscle (around the

eye) is separated from its attachment to the cheekbone

through an incision in the lower eyelid and then lifted and

sutured into place.

‘The whole face can be lifted to achieve more youthful

contours without that telltale “pulled” appearance that

people might experience with conventional procedures,’

says Dr Milovic.

Dr Milovic explains that, as well as creating a smoother

neck and more defined jawline, the composite lift can

recreate the full, plump cheeks of youth – something that

can’t be achieved with other facelifting techniques alone.

An added advantage is that the composite lift also helps

blend the dividing line between the lower eyelid and cheek,

which can appear with age.

With adjunct procedures such as micro-fat grafts

harvested from the inner thigh and skin preparation

including facial peels, Dr Milovic says patients can look

forward to a refreshed and rejuvenated appearance with

none of the tell-tale signs of surgery. csbm



5 weeks AFTER facelift by Dr Milovic

4 weeks AFTER face and neck lift by

Dr Milovic









Ulthera and Thermage are both designed to enhance

the skin’s integrity by promoting the production of new

collagen fibres in the dermis. With similar outcomes

and treatment areas, it’s common for patients to select one

of the two procedures. However, in a recent seminar on the

benefits and contrasting approaches of the two treatments,

Canadian plastic surgeon Dr Arthur Swift suggested

combining the two for optimum outcomes, recommending

Thermage two weeks before a treatment with Ulthera.

While Thermage uses radio frequency energy to heat

the epidermis and dermis, Ulthera draws on ultrasound

technology to specifically target deeper areas in the

dermis, without disrupting the skin’s outer layers. Dr Swift

believes the two treatments, which he compares by using a

‘grilling’ versus ‘microwaving’ analogy, are complementary,

proposing the effect of using both modalities, one a few

weeks after the other, is cumulative.

In both cases, the inflammation caused by heat

stimulates the body’s natural healing response, triggering

an increased production of collagen in the dermis. The

result is a lifting and tightening of the treatment area.

Dermatologist and author of The Skin Type Solution,

Dr Leslie Baumann, tends to use Ulthera in her practice.

Following Dr Swift’s presentation, however, she conceded

there might be a benefit in combining the targeted heat of

Ulthera with the more overall heat of Thermage.

Recently, a senior team member at Cosmetic Surgery and

Beauty Magazine decided to undergo both Thermage and

Ulthera, and booked in to Sydney’s Skin Renu for treatment

with Thermage. Two weeks later, a second appointment was

made at Sydney’s Silkwood Medical for Ulthera.

Before treatment with Thermage, dermal clinician, Daniela

Liga, from Skin Renu, reviewed the patient’s medical history,

current concerns and skin condition during an in-depth

consultation. Daniela shared information about the procedure

and spoke about its ability to improve the appearance of the

jowl area, which was the primary concern.

During the procedure, the automated Thermage device

directed Daniela in guiding the hand piece over the face. The

radiofrequency energy level was tailored to suit the patient’s

concerns, with higher energy used along the jawline.

Throughout the treatment, Daniela outlined exactly what

was going on, discussing how many passes were needed

on each part of the face and warning that certain areas –

around the nose, eyes and temples, for example – may be

more uncomfortable than others.

After the procedure there was slight redness, mild

swelling and tingling along the jaw, which all faded within

24 to 48 hours. ‘Swelling is a positive sign,’ says Liga, ‘It

means the body’s healing response has been adequately

stimulated, and suggests the future collagen induction will

mirror the swelling pattern.’

After just two weeks, it was time for the second stage

of Dr Swift’s recommended treatment protocol. Silkwood

Medical’s Maureen Cole, a paramedical aesthetician,

administered Ulthera after a thorough analysis of the

patient’s skin using 3D imaging.

‘We perform several Ulthera treatments each week, with

younger patients opting for treatment to waylay the signs of

ageing and others using it as a bridge between non-surgical

and surgical methods of facial rejuvenation,’ says Cole.

After the procedure, the patient experienced mild swelling

and redness, which resolved within just 48 hours. The facial

bones, however, continued to be sensitive for a few weeks.

Now, three months after the last procedure, the results

are visible and the patient is thrilled with the outcome. The

jowls have visibly improved and the skin around the eyes is

noticeably tighter.

While it’s not possible to quantify the improvement

afforded by combining the two treatments, there’s no doubt

that Thermage followed by Ulthera, grants unmistakable

results. And with both procedures involving little to no

downtime and tolerable discomfort, it’s likely Dr Swift’s

protocol will soon take off. csbm 155




the ages

Don’t wait until your later years to

improve your appearance. Sydney

plastic surgeon Dr Steven Liew

explains how to look your best at

any age. Tara Casey reports.

It’s a promise Sydney plastic surgeon Dr Steven Liew

makes to all of his patients: that they can be a more

beautiful version of themselves, no matter what their age.

‘For years the cosmetic industry has been fixated on

the idea it’s all about making everyone look younger,’ says

Dr Liew. ‘The truth is we can make a 50-year-old look a few

years younger, but they will still have 50-year-old skin. What

all my patients really want is to look their best at any stage

of their life – to be more handsome, more beautiful. That is

just as true whether you are a 23 or 63.’

Dr Liew is renowned for staying abreast of the very latest

non-surgical and surgical cosmetic treatments. These include

treatments that he says can totally transform the face, be

it to achieve a slimmer jawline, a more sculpted cheek, or

reshaping and beautifying the eyes, nose and mouth.

Contemporary cosmetic surgery techniques have also

become more refined, allowing surgeons to deliver the

most natural-looking results.

Dr Liew says that, despite the folklore, there really is

nothing graceful about ageing. ‘Good genes and a healthy

lifestyle certainly help,’ he says. ‘But maintaining our

appearance as we pass into each decade requires some

careful science and aesthetic skill.’

It was with this philosophy in mind that Dr Liew devised

his Beauty Through The Ages TM program, which he offers

at his clinic in Sydney. ‘Under the program each patient

is given a treatment plan that sets the most effective nonsurgical

and/or surgical treatments – that can be staged

over several years,’ he explains.

Here, Dr Liew showcases some of the more popular

procedures involved in the Beauty Through The Ages TM

program. csbm



Age 20s and 30s


AFTER lip enhancement with dermal filler

AFTER lip enhancement with dermal filler

28-year-old patient. Soft, beautifying lip enhancement with dermal filler by Dr Liew


AFTER non-surgical facial rejuvenation

AFTER non-surgical facial rejuvenation

Non-surgical Total Facial Beautification with anti-wrinkle injections and dermal fillers by Dr Liew


AFTER breast augmentation

AFTER breast augmentation

31-year-old patient. Beautiful, proportioned and natural-looking breast enlargement with silicone breast implants by Dr Liew 157


Age 40s

BEFORE AFTER non-surgical facial rejuvenation AFTER non-surgical facial rejuvenation

Non-surgical Total Facial Beautification. A refreshed and more beautiful appearance with the use of dermal fillers and anti-wrinkle injections by Dr Liew

BEFORE AFTER upper blepharoplasty AFTER upper blepharoplasty

Surgical upper eyelift, giving the eyes a refreshed appearance and creating natural beautification of the upper face by Dr Liew

BEFORE AFTER a ‘Mummy Makeover’ AFTER a ‘Mummy Makeover’

43-year-old patient. ‘Mummy Makeover’ including a breast augmentation and lift combined with liposuction and tummy tuck by Dr Liew



Age 50s

BEFORE AFTER non-surgical facial rejuvenation AFTER non-surgical facial rejuvenation

59-year-old patient. Total Non-surgical Facial Beautification resulting in a softer, more beautiful and feminine facial appearance by Dr Liew


AFTER surgical upper blepharoplasty and non-surgical

lower eye lift

56-year-old patient. Surgical upper eyelift and non-surgical lower eyelift with dermal filler by Dr Liew. Creates a soft and beautiful facial appearance

AFTER surgical upper blepharoplasty and non-surgical

lower eye lift

BEFORE AFTER facelift, neck lift and micro fat transfer AFTER facelift, neck lift and micro fat transfer

55-year-old patient. Face-, neck lift and micro-fat grafting by Dr Liew. Creates a natural looking, beautiful face 159


Joined Forces




When it comes to shopping, people often set out

knowing what it is they want – a new pair of

shoes to match the dress they bought last week,

for example. Yet, when it comes to cosmetic enhancement,

Dr John Flynn from Queensland urges women to have a

more open mind.

‘Patients often come to see me wanting more information

about the latest procedure they’ve heard about,’ he says.

‘However, that procedure may not be suited to the actual

concerns that patient has. Rather than focusing on a single

procedure, I believe it’s better to focus on what the actual

problem is that needs addressing and, in most cases, a

combination of procedures is likely the best route to success.’

Just as ageing is a multi-faceted process, Dr Flynn

believes multiple procedures are needed to address its

telltale characteristics. ‘Ageing affects us all in three broad

areas,’ he explains. ‘However, the extent to which each

affects us varies from person to person. Different people will

therefore benefit from different combinations and degrees

of treatments depending on their unique concerns.’

Firstly, with age tissues begin to sag as gravity sinks

in. Whilst facelift procedures can effectively reposition

the underlying structures of the face and remove excess,

sagging skin, performed alone, it will do little to address

the second and third stages of ageing: volume loss and

deterioration of the skin itself.

‘A facelift can lift, tighten and redistribute, but it won’t add

volume to the face where collagen, elastin and eventually

fat have depleted,’ says Dr Flynn. ‘Nor will dermal fillers,

when performed alone, do anything to improve the texture

or tone of the skin, or reposition sagging brows or jowls.’

The answer, therefore, is to join forces, combining

a number of procedures depending on the extent of

rejuvenation required, to address each of the concerns

exhibited by the patient.

‘Today there is a lot we can do to address each of the stages

of ageing, and it doesn’t have to involve surgery,’ says Dr Flynn.

‘A modern-day facelift is no longer a surgical procedure alone:

it might also involve less-aggressive procedures to replace lost

volume and improve the texture of the skin.’



When it comes to replacing lost volume, Dr Flynn says

bio-stimulant and volumising dermal fillers are not the only

option. Stem-cell enriched fat transfer can also effectively

shape and contour the face whilst also resulting in an

increase in fat, collagen and elastin.

Similarly, there is a wide range of procedures that can

improve the tone and texture of the skin. ‘Laser and light

based therapies, collagen induction therapy, chemical peels

and platelet-rich plasma, for example, can all improve the

appearance of the skin, whilst home skincare and lifestyle

choices will also make a difference,’ says Dr Flynn.

With such a wide array of options, Dr Flynn says

it’s not just a case of selecting the right combination of

treatments for each patient, but also selecting the optimal

modality. ‘Will the patient benefit more from fractional laser

resurfacing than they would from collagen induction laser?

Would their volume loss be better addressed with a fat

transfer procedures than it would from dermal fillers?’ Dr

Flynn poses as examples.

Combining procedures doesn’t necessarily mean a longer

wait to see results. Frequently, complementary procedures

can be performed at the same time. ‘It’s not uncommon for

laser procedures to be performed at the same time as dermal

fillers,’ says Dr Flynn, who reiterates that it depends on the

procedure, the individual and to some extent their budget

as to what can be performed at once, rather than in stages.

Of course, in fighting the common signs of ageing Dr

Flynn says there is no combination of treatments that can

do more than taking steps to stop smoking and protect

against the harmful rays of the sun.

‘Smoking is a complexion killer,’ he says. ‘If more people

realised the damage smoking can have on the skin I believe

far fewer people would smoke.’ And as for exposure to the

sun, Dr Flynn says you should just take a look outside. ‘If

you look at timber furniture that’s been left in the sun as

opposed to that in your dining room you get some idea of

the damage being done by exposure to the sun.’

Ultimately, Dr Flynn’s message is that no two people are

the same, and that something as multi-faceted as ageing

demands an equally sophisticated approach. ‘Fortunately,

today we’re blessed with a diverse array of treatments –

from minimally invasive to surgical procedures – which

can be combined in order to address ageing properly,’ he

concludes. csbm


AFTER facelift and laser resurfacing by Dr Flynn


AFTER thread lifts by Dr Flynn 161


Say ‘No’

to ageing!

Sydney coSmeTic pHySician


cHoice, and one THaT can be 100%


There’s no denying that ageing takes place. As we

blow another candle out on the cake each year,

changes are taking place in the underlying structures

of our faces. Yet, according to Sydney cosmetic physician

Dr Tony Tan, ageing, just like anything else, is a choice. Best

of all, Dr Tan believes ageing is 100 per cent preventable

and, perhaps better still, reversible.

‘I believe you can choose to grow old, but not to look

old,’ says the dynamic founder of Beauty Logic in Sydney’s

Fairfield Heights. ‘The only limiting factor is your budget.’

Dr Tan is already well known for his advocacy of the

Golden Ratio in facial aesthetics. Studied by the Ancient

Greeks and apparent throughout nature, the ‘golden

ratio’ refers to a geometric relationship – which has been

applied to mathematics and the arts for hundreds of years

– universally acknowledged as attractive. Countless famous

faces, from Angelina Jolie to Tom Cruise adhere to this ratio,

displaying a balanced proportion between their nose, cheek

and chin, and it’s therefore considered by many, including

Dr Tan, to provide a framework against which to enhance

someone’s beauty.

‘A lot of cosmetic injectors who do not understand the

golden ratio fail to see there is an end point, at which point

the beauty of the face has been maximised,’ he explains. ‘By

applying the golden ratio to my clients’ faces I can work towards

an end goal, at which point the client will be as beautiful as

possible.’ According to Dr Tan, going beyond this end-point

will only only deplete from a person’s beauty potential.

Core to Dr Tan’s approach to reversing the signs of

ageing and enhancing his client’s beauty is his belief that

the face should be treated as a whole, rather than as

individual elements – something he refers to as the ‘TAN-

Facial Approach’.



The TAN-Facial Approach

‘Treating the face as a whole, rather than as a set of

individual features is very important,’ says Dr Tan. ‘This is

because ageing occurs in all layers of the face – it is a three

dimensional, not two dimensional process.’

Dr Tan refers to the ‘four Ds’ of ageing – each of which

can be addressed in order to both stop ageing in its tracks

and enhance a patient’s underlying beauty. ‘With time, a

person’s face will deflate as they lose volume; the texture

and quality of the skin will deteriorate; because of a loss of

structure, the features of the face will descend; and the face

might appear disproportional,’ explains Dr Tan.

According to Dr Tan, addressing each of these elements

as a whole using the TAN-Facial approach will result in the

restoration of natural-looking youth.

Taking its name from the better known ‘Pan-facial’

approach to facial rejuvenation, there are four fundamental

steps in Dr Tan’s TAN-facial technique: relax, refill, resurface

and resuspend.

‘This combination is designed to release a patient’s

natural beauty potential, addressing each of the signs of

ageing whilst creating the best version of you, rather than a

different you,’ explains Dr Tan.

Relax, Refill, Resurface, Resuspend

Whilst botulinum toxin injections

can be used to ‘relax’ certain areas

of the face, Dr Tan uses dermal fillers

to ‘refill’ those areas that have lost

volume thanks to ageing.

‘I use dermal fillers to restore

volume loss in different tissue

layers and combine this with other

therapies,’ he continues. ‘In effect, I

rebuild the facial structures starting

from the deepest layer to the

superficial zone – that is, I address

volume loss in bony regions first.

This creates structural support and

contour enhancement associated

with a youthful and beautiful face.’

Dr Tan begins any TAN-facial

rejuvenation by measuring a patient’s

face with a phi caliper to help him

determine which treatments they will

benefit from. Based on the golden

ratio, Dr Tan believes using these

calipers help him achieve naturallypleasing


‘These measurements help me

determine the optimal dimensions

of a person’s face, and also ensure

I don’t over-correct certain areas,’

he says.

Dr Tan may use a combination of



hyaluronic acid (HA) and bio-stimulant fillers to restore the

desired volume to various areas of the face. ‘Different types

of filler complement each other in my facial beautification

process,’ he says.

‘Volumising fillers with high viscosity and elasticity can be

used to volumise and lift, helping to create structural support.

They are best suited to the mid and lower face where there is

continuous muscle activity and skin laxity.’

Towards the outer layers of the face, however, Dr Tan

uses a different type of filler to create smooth contours. ‘I

will use a bio-stimulant filler if I have to correct both volume

depletion and skin laxity. Also, I only use HA in the forehead,

glabellar region and lips,’ he adds.

In order to maximise each patient’s beauty potential, Dr

Tan will combine dermal fillers with other procedures as part

of the TAN-Facial procedure.

If sagging is pronounced Dr Tan may recommend thread

lifts to gently lift the brow and contour the lower face,

thereby reducing jowls and laser or IPL procedures may be

used to improve the texture and tone of the skin, as well as

reduce lines and wrinkles.

Ultimately, Dr Tan believes that by combining these

procedures, patients can look forward to gorwing old,

without looking old. csbm

AFTER TAN-facial rejuvenation by Dr Tan

AFTER TAN-facial rejuvenation Dr Tan




by the






Excess loose skin, poor definition and pockets of fat

around the neck and jawline can not only leave you

looking older than your years, they can also add the

illusion of extra kilos to your true weight. And whilst neck lift

surgery may be suitable for some older patients with significant

laxity, younger patients lacking definition around the jaw may

not be prepared – or suitable – for invasive surgery.

Until recently, the only solution to rid yourself of this excess

skin was to opt for neck lift surgery. However, today, a less

invasive solution exists. A minimally invasive procedure known

medically as the ‘trampoline platysmaplasty’ (TPP), the betterknown

iGuide Neck Lift effectively tightens loose and sagging

skin around the jaw and neck without the need for surgery.

‘The iGuide involves a suture, which is woven under the

skin in a shoelace pattern,’ explains Sydney cosmetic surgeon

Dr Joseph Ajaka, who has been successfully treating patients

with iGuide for the last two years. ‘Anchored to the jawline, the

sutures pull the neck tight, and also stimulate the area’s healing

response to further tighten the skin.’

Developed in America by US plastic surgeon Dr Gregory

Mueller, the iGuide has been approved for use in the US since

2007 and was introduced to Australia by Device Technologies

in 2011. Dr Ajaka himself was taught to use the device by Dr

Mueller, and believes it offers a number of advantages over

other procedures.

‘Traditionally, a neck lift involved cutting the skin and muscle

to create a defined jawline. This meant a large risk of damage to

internal structures in the delicate area around the neck as well

as visible scarring. The iGuide has neither of these potential

complications,’ he says.

The iGuide device itself facilitates positive outcomes thanks

to its in-built ‘guiding light’.

‘The device emits a light source to tell you you’re in the right

plane,’ explains Dr Ajaka. ‘The LED light in the hand piece helps

guide the placement of the sutures so they are positioned above



the muscle, as you don’t want to pull through the muscle.’

Although it’s not as invasive as a neck lift procedure,

Dr Ajaka believes the results the iGuide can achieve are

comparable. ‘The results are immediate and patients will be

able to see a visible improvement as soon as compression

garments are removed three days after the procedure.’

During the procedure, Dr Ajaka explains that tiny, discreet

punctures are made along the jawline to allow the suture to

be passed under the skin. ‘These tiny marks heal quickly

and don’t leave any visible scarring,’ he says.

The suture is then woven back and forth in a ‘shoelace’

pattern across the neck before being tightened.

‘This tightening effect elevates the skin, muscle and soft

tissue of the neck as a whole unit, giving beautiful definition

to the neck and jawline contours,’ says Dr Ajaka. ‘Because

the sutures are permanent, the natural healing process

keeps the neck elevated in the higher position.’

Since it was first developed in 2007, the iGuide Neck Lift

technique has already been developed to add an additional

stage to the traditional TPP. ‘We now include what’s called

a Neck Defining Suture (NDS) in the procedure to afford

further tightening,’ says Dr Ajaka. ‘This second stage

provides more definition – for example around the Adam’s

Apple area – than can be achieved with TPP alone.’

According to Dr Ajaka, the procedure has proven popular

with both men and women, with men particularly drawn

to the technique thanks to its promise of leaving no scars.

However, Dr Ajaka says it’s not for everyone. ‘For those with

an excessive amount of fat and loose skin, a surgical neck

lift may still be the best solution,’ he says. ‘An iGuide Neck

Lift is suitable for most healthy people who are concerned

with the appearance of their moderately saggy, turkey neck

and simply want to redefine their neck and jawline.’

A consultation ahead of treatment will help determine

if you’re the right candidate for an iGuide Neck Lift, and

whether or not you’d benefit from any adjunct procedures.

Whilst it’s an effective procedure in its own right, Dr Ajaka

says the iGuide is also excellent when combined as part of

a wider treatment protocol. ‘We commonly incorporate the

iGuide as part of a wider rejuvenation program that might

include laser treatment, liposuction and the iGuide,’ he says.

Performed on its own and the iGuide is a two hour

procedure, during which the patient is under light sedation,

conscious and talking to the surgeon. ‘There will be

some discomfort afterwards and patients need to wear a

compression band for three days,’ says Dr Ajaka. ‘They

will need to stick to soft food for one week and also may

experience a tight sensation for the first few weeks.’

With minimal discomfort and immediately visible results,

however, Dr Ajaka concludes that the iGuide is ideal for

those wanting a cost-effective and fast solution to their

troublesome neck region. csbm


AFTER iGuide neck lift by Dr Ajaka


AFTER iGuide neck lift by Dr Ajaka 165

feature face


is the best approach



While a stringent skincare regime may enhance

skin health, brighten the complexion and help

fi ght fi ne lines and shallow wrinkles, often these

topical creams and serums are not enough to counter the

strength and severity of our facial muscles.

Frowning, talking and squinting contract muscles all over

the face, particularly the muscles above and between the

eyebrows. This consistent contraction breaks the collagen

fi bres between these muscles, leading to deep frown lines

above the nose. Because these are dynamic wrinkles – or lines

caused by facial movement – they can appear on younger

individuals and are not necessarily associated with age. Left

to their own devices, and these early wrinkles can develop

over time, forging deep furrows in an otherwise smooth and

youthful-looking brow.

First introduced to Australia in the 1990s, wrinkle

relaxants have fast become a staple of the modern woman’s

beauty regime, providing a fast and effective solution to

the appearance of these dynamic lines and wrinkles, and

helping to prevent the worsening of frown lines.



A form of botulinum toxin, Dysport is used by hundreds

of women to solve one of the most lamented hallmarks of

the ageing process: wrinkles.

‘I commonly see females or males in their mid 20s to

mid 30s who are just starting to develop wrinkles and are

wanting to stop them in their tracks,’ says Sydney ENT and

facial plastic surgeon, Dr Michael Zacharia. ‘Dysport is the

ideal solution for these patients.’

It’s not just younger patients who will benefit from muscle

relaxants such as Dysport, however. ‘Older patients will

also see excellent results but often require more treatments

more regularly. I am also seeing many more men in my

practice who want to soften their lines using less-obvious

treatments,’ says Dr Zacharia.

A type of botulinum toxin, Dysport is injected into the

treatment area to block the signal from the nerves to

the muscles. This temporarily reduces muscle activity,

preventing the contractions that cause wrinkles on the

face. However, only the muscles involved in the wrinkle

are affected, meaning the rest of the face will retain its

usual expression.

Dysport is one of the two anti wrinkle treatments

currently approved for use in Australia and they both work

in the same way. ‘For Dysport, a key benefit is that it works

very quickly and patients will usually begin to notice the

effect within just two to three days,’ says Sydney cosmetic

physician Dr Joseph Hkeik.

Before treatment with Dysport, an initial consultation

is needed to establish the patient’s concerns and

expectations. The procedure itself will typically last less than

half an hour.

‘During the initial consultation I usually discuss with

patients their particular needs and desires.

Those who have used botulinum toxin

before might know exactly what they want,

however, new patients may need guidance

as to what areas should be treated to

achieve the best result,’ says Dr Zacharia.

‘Before treatment, Dysport is mixed

with preserved saline to decrease the mild

sting of the injection. I will apply ice to the

area immediately before treatment and

the injections are usually over within 15

minutes or less.’

Results typically last between three and

six months, and there should be at least

a 90-day period between treatments. Dr

Zacharia encourages patients to return

after two weeks, to ensure the injections

are working, and also after three months,


to determine if further treatment is needed.

While Dysport is effective in combating wrinkles as a

stand-alone treatment, it can be used in conjunction with

other modalities to achieve an improved result in general

facial rejuvenation.

‘Dysport is an effective treatment to reduce lines and

wrinkles caused by repetitive muscle movements, however

this is only one of the causes of ageing,’ says Dr Hkeik.

‘Dysport works well in conjunction with other treatments,

such as dermal fillers – to treat deeper lines, folds and

general volume loss – and also lasers, to improve skin

quality. I routinely use Dysport in combination with a variety

of treatments in my clinic, which ensures a holistic approach

to addressing the needs of my patients.’

Following treatment with Dysport, patients may

experience swelling, occasional bruising and small spotting

at the site of injection. While the risks are relatively low,

adverse reactions are possible and Dr Zacharia insists

any cosmetic injectable should be administered by an

experienced doctor.

‘The most common side effect after Dysport is immediate

swelling and occasional bruising,’ Dr Zacaharia explains. ‘If

the botulinum toxin is injected in the incorrect position, the

patient may experience a brow or eyelid droop and this is

why it is so important to have an experienced injector give

the treatment.’

Whether seeking comprehensive facial rejuvenation,

or looking to combat those persistent wrinkles, Dysport

affords an effective and time efficient approach to wrinkle

prevention. As with anything in anti-ageing, prevention

is key and, using Dysport, the first, dynamic signs of

ageing can be waylaid, leaving the complexion smoothed,

refreshed and more youthful. csbm

AFTER treatment with Dysport 167


An Angelic







Fuelling the skin with platelets, stem cells and growth

factors, the Angel Lift is the latest procedure to draw

on the body’s own resources in order to rejuvenate,

brighten and smooth the complexion.

Extracted from a patients’ own blood, platelet rich

plasma (PRP) 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 can spur the skin’s

stem cells into action, enhancing the formation of new

collagen at the site. The result is a natural rejuvenation that

continues to improve over time.

The Angel Whole Blood Separation System is used

to concentrate the platelets ready for reinjection into the

treatment area. Suitable for full-face rejuvenation, treating

fine lines and wrinkles and improving skin tone and texture,

the ‘Angel Lift’ will strengthen the skin and lend a youthful,

radiant and revitalised appearance.

Although there are a number of devices capable of

extracting and concentrating PRP, Dr Alison Jamieson from

Queensland prefers the Angel system for the control it gives

her when defining platelet concentration.

‘We need to ensure our patients receive the best results

and have discovered Angel delivers a highly effective

regeneration of connective tissue,’ she says.

‘As a result of Angel’s rich platelet count, patient’s are

seeing restored volume in their skin, greatly improved skin

texture and improved contours.’

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. While Angel achieves

this benchmark using a double spin centrifuge system, it

also affords an individualised approach to skin rejuvenation.

‘PRP is a true science and cannot be guessed,’ Dr

Jamieson says. ‘Angel will separate 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.

The procedure itself takes under 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,’ says Dr Jamieson. ‘We will review

a patient’s medical history before proceeding with the

treatment and apply topical anaesthetic or local anaesthetic

if required. A face rejuvenation will take approximately 45

minutes, however larger areas such as the upper arms may

take longer.’

Results are typically seen after just on 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.

According to Dr Jamieson, patients should expect

some swelling to last for a day or two after their procedure.

‘This swelling is essential to the regeneration of the skin

tissue,’ she says. ‘Bruising is rare and can be minimised by

excluding green tea and blood thinners from your diet a few

days before the procedure.’

The Angel Lift draws on the

body’s own resources to

rejuvenate, brighten and smooth

the complexion

Using technology that affords an individual approach in

facial rejuvenation, Angel’s system is designed to be timeefficient

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 down time.

‘With Angel, patients are seeing more significant results

that are visible sooner,’ Dr Jamieson 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 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, ‘Anyone looking to maintain their skin

integrity or regenerate an ageing complexion is suitable for

treatment with Angel PRP,’ concludes Dr Jamieson. ‘And,

once patients see the results in their face they often request

further treatment of the neck, abdomen, chest, arms and

more.’ csbm 169









Having spent his career pioneering laser, light and

heat based therapies for improved skin health,

Sydney cosmetic surgeon Dr Joseph Georghy

understands better than most the impact common skin

complaints can have both on a person’s appearance and

their self esteem. Ageing skin and the early emergence of

wrinkles, the conspicuous presence of acne scarring and

an overall lack of tone and texture can all take their toll. Yet

today there are a number of convenient treatments that can

result in spectacular change.

Dr Georghy has been using platelet-rich-plasma (PRP) for

medical and aesthetic purposes since 2004. ‘The revitalising

properties of platelets are well known and have been used

since the 1970s. Being an autologous product – from your

own blood – tolerance is excellent and no serious adverse

effects have been observed to date,’ he says. ‘Once injected

into the dermal layer, the platelets are activated, they inflate

and signalling proteins and growth factors are released.’

To complement his already comprehensive range of

devices designed to help those struggling with aesthetic

skin concerns, Dr Georghy has recently welcomed the

latest PRP device to his clinic – the Angel Whole Blood

Separation System. A fully automated and closed loop

platelet purification system, the Angel system gives Dr

Georghy the ability to tailor each treatment according to

each patient’s needs.

Whilst 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 good results.

‘Extensive studies show, in comparison to other PRP

purification devices, Angel renders the highest platelet counts

and biologically active growth factors,’ says Dr Georghy.

He therefore embraced the Angel Whole Blood

Separation System, which not only extracts concentrations

of platelets four to five times that of other devices, but

also affords control over the concentration of platelets

depending on the patient, and the concern being treated.

‘You need a specific concentration of platelets in order

to actually generate a reaction in the tissue and see results

in the patient,’ explains Dr Georghy. ‘Depending on the

patient and their unique concerns, you might need a higher

or lower concentration of platelets – with Angel you can

extract exactly what you need for optimal results.’

Having most recently hit headlines when US reality TV

star, Kim Kardashian, allowed her film crew to record her

procedure, the ‘Angel Lift’ is designed to reduce wrinkles,

improve the skin’s glow and reduce blemishes such as

acne scars. Indeed, when integrated as part of an ongoing

beauty regime, Dr Georghy believes the ‘Angel Lift’ can

result in a long lasting improvement in the overall condition

of the skin, improving both tone and texture and reversing

the age of the skin.

During the procedure, Dr Georghy first extracts a small

sample of blood from the patient before processing in the

Angel System. The concentrated plasma is then re-injected

into the treatment area, which may be localised areas of the

face, neck, décolletage, hands or arms.

‘Patients suitable for the Angel Lift are typically starting to

show mild to moderate sagging of the skin around the orbital

region and cheeks, which might be exacerbating the nasolabial

fold and marionette lines,’ says Dr Georghy. ‘By injecting the

platelets into the treatment area we can restore natural-looking

contours, making the face look remarkably radiant and fresh.’

Whilst the treatment is relatively quick, typically lasting

one hour, Dr Georghy recommends a series of treatments

in order to enjoy the best results. ‘In my experience the

effects are longer lasting if someone has a series of three

treatments,’ he says. ‘Although it will take a few weeks or

months before the improvements in skin tone and texture

become obvious, the results typically last between one

and two years. With additional treatments, the results will

continue to improve.’

To further enhance results, Dr Georghy recommends

combining the Angel Lift with his proprietary treatment,

PhotoDynamic HelioTherm. According to Dr Georghy,

this combination of PRP followed by PhotoDynamic

HelioTherm is one of the most natural means of improving

the condition of the skin. ‘This is a unique combination

of treatments only available at North Shore Cosmetic,’ he

says. ‘Combining the body’s own unique growth factors

(PRP) with the power of heat and light (HelioTherm), the

skin is enhanced, new blood vessels are developed and

stem cells are reactivated.’

According to Dr Georghy, the end result is skin that is

thicker, more elastic and tighter, with a smoother texture

and a reduction in fine lines and wrinkles. ‘This is achieved

because the underlying foundation of supportive collagen,

elastin and retinaculum fibres in the skin’s dermis is

increased,’ he explains.

Indeed, Dr Georghy believes that, in the future, PRP

combined with PhotoDynamic HelioTherm may become

the first line of treatment for a number of common skin

concerns, as well as for more debilitating conditions such

as osteoarthritis and rheumatoid arthritis. ‘The potential is

enormous,’ he concludes. ‘The sky really is the limit.’ csbm 171




5 years AFTER combined facial rejuvenation by Dr Georghy

This 65-year-old patient was left with poor results after an unsuccessful surgical facelift and laser resurfacing procedure. Over the course of five years her

appearance was rejuvenated with a combination of liposcraping, PRP, Nd:YAG laser, dermal fillers and PhotoDynamic HelioTherm


8 years AFTER combined facial rejuvenation by Dr Georghy

This patient complained of ‘bad skin’ and suffered from a lack of tone and nodular acne. After treatment with PRP, dermal fillers and PhotoDynamic

HelioTherm the skin texture has improved and the overall shape of the face is more balanced


11 years AFTER combined facial rejuvenation by Dr Georghy

This 21-year-old patient suffered frequent outbursts of acne and facial freckles. After treatment with PRP, dermal fillers and PhotoDynamic HelioTherm the

freckles and acne were both greatly improved





12 years AFTER combined rejuvenation by Dr Georghy

This 55-year-old patient had a long history of sun damage and solar keratosis. After a combination of treatments including Nd:YAG laser, dermal fillers, PRP

and PhotoDynamic HelioTherm over several years the decolletage is much improved.


10 years AFTER combined rejuvenation by Dr Georghy

This 53-year-old woman had a long history of sun damage and frequent skin cancers. The sun-damaged skin was improved after a combination of treatments

including liposcraping, PRP, Nd:YAG laser, dermal fillers, gold threads and PhotoDynamic HelioTherm over several years.


11 years AFTER combined rejuvenation by Dr Georghy

This 55-year-old patient presented with sun damaged skin, common to Australian women. After a combination of treatments including Nd:YAG laser, PRP and

PhotoDynamic HelioTherm the skin has been visibly improved. 173




PeoPle cAn Fight the eARly SignS oF Ageing with the SELPHYL SYSTEM.

lizzy FowleR RePoRtS.

Once faced with the prospect of either growing

old gracefully or opting for facelift surgery, today

Australian women – and men – are turning to

cosmetic injectables in record numbers in order to waylay

and even prevent some of the most common signs of

ageing. Anti-wrinkle injections, dermal fillers and skin

resurfacing treatments are all commonly included as part of

a woman’s regular beauty regime and, now, an increasing

number are following in the footsteps of celebrities such

as Angelina Jolie and Kim Kardashian and adding plateletrich-plasma

(PRP) treatments into the mix.

Melbourne plastic surgeon Dr Douglas McManamny

believes most people who display signs of ageing can

benefit from the use of an activated platelet treatment.

‘Activated platelets release a multitude of growth factors

and cell stimulating proteins. They promote collagen

formation and stem cell transformation among other

things,’ he explains. ‘In practical terms this means there is

an increase in volume in the area where the PRP is injected

and a rejuvenating effect on the skin.’

The Selphyl system is one of the tools used by doctors

and surgeons to harness a patient’s blood platelets

and prepare them for reinjection into the treatment area,

where the growth factors contained in PRP stimulate the

production of collagen and keratin.

Although Dr McManamny says anyone displaying the

early signs of ageing will benefit from treatment with Selphyl,

he says the procedure is particularly effective when used to

address ageing around the eyes. ‘The hollows beneath the

lower eyelids respond very well to PRP treatment,’ he says.

‘However, it can be used elsewhere on the face to improve

skin tone and texture and fill out volume loss and fine lines

around the corners of the mouth, the nasolabial folds and

the forehead area.’

Unlike some other PRP solutions, the Selphyl system

prepares the plasma as a ‘fibrin matrix’ – known as PRFM

– rather than as straightforward plasma. ‘The combination

of platelets in a fibrin matrix offers a couple of theoretical

advantages,’ says Dr McManamny. ‘The formation of

a fibrin matrix means that there will be a greater volume

at the injection site and hence there should be a greater

improvement. Also, platelet activation is enhanced in the

presence of fibrin.’

Selphyl is proving popular for a number of reasons – not

only is it a fast procedure (the entire process takes between

30 and 45 minutes), there is no risk of allergy or adverse

outcomes given it’s the patient’s own tis sue involved in

the procedure. Whilst Dr McManamny says patients should

expect some swelling and possible bruising and redness,

he says this typically only lasts two to three days.

For the best results, Dr McManamny believes three

treatments should be scheduled, spaced six weeks apart.

‘Sometimes a satisfactory result will be obtained with just

two treatments and rarely more than three treatments will

be required,’ he says.

As for the results, Dr McManamny says most patients

can look forward to a subtle but lasting improvement that

remains for up to 12 months. csbm



A touch of


PErth fACiAL PLAstiC surgEON Dr JAysON OAtEs


yOuthfuL vOLumE tO his PAtiENts’ fACEs.

Lizzy fOwLEr rEPOrts.

One of the greatest advances in facial aesthetics

came with the understanding that ageing, once

thought of as a two-dimensional process, resulted

in volume-loss as well as the sagging of skin. Replacing this

lost volume via dermal fillers and fat transfer procedures

helps restore the plump cheeks and fuller face that are

characteristic of youth.

Ellansé, a recent addition to the Australian market, is a

unique and innovative dermal filler with dual benefits. Not

only does it result in the immediate correction of wrinkles

and folds, but it also stimulates the production of collagen,

leading to longer-lasting benefits. Better still, patients can

choose from one of four different formulas, depending on

their unique concerns, and on how long they want their

results to last.

Perth facial plastic surgeon Dr Jayson Oates has been

using Ellansé to address some of the most common

characteristics of ageing in his patients.

‘Ellansé is ideal for correcting deep volume loss such

as submalar hollowing, malar augmentation, temporal

recession, chin augmentation,’ he says.

Indeed, most of Dr Oates’ patients present in their 40s,

when they are beginning to see the result of the loss of

fat in their face. ‘Many would not generally consider an

injectable filler as they want something that lasts longer,’ he

says. ‘Some of the patients may otherwise have considered

a surgical implant like a cheek implant for permanent

correction - but now there is a nonsurgical option – Ellansé.’

According to Dr Oates, one of the main benefits of

Ellansé is having flexibility when it comes to the duration of

results. ‘Having products that last two, three or four years

is very attractive to many clients,’ he says. ‘Unlike some

stimulatory fillers that have nothing to show the next day,

Ellansé results in an immediate 1:1 volume replacement.

What you see is what you get, for years.’

Found naturally in skin, collagen helps maintain tightness,

elasticity and suppleness. In ageing, the skin gradually loses

its natural collagen, leading to facial laxity and the formation

of wrinkles and folds.

Replacing lost volume via

dermal fillers and fat transfer

procedures helps restore the

fullness characteristic of youth

‘Ellansé is comprised of perfectly smooth, spherical balls

of polycaprolactone (PCL) – a very similar material to that

used for other medical purposes for decades,’ says Dr

Oates. ‘Because of the size and shape of this well known

and studied material, the body produces a very predictable

collagen response from the skin’s fibroblasts.’

According to Dr Oates, Ellansé is the only product that

will give a long-lasting replenishment of collagen and, best

of all, it’s the patient’s own body that produces the collagen,

which he says many patients feel comfortable with.

The procedure itself is relatively simple, convenient and

takes approximately 30 minutes and, if selecting Ellansé-L

or Ellansé-E, Dr Oates says patients can look forward to

three or four years of volume replacement without the need

for retreatment. csbm 175











Sincerity, self confi dence and vivacity are all qualities

conveyed by a strong, white, striking smile. And

while diligent brushing and fl ossing can help keep

teeth clean and bright between dental visits, sometimes a

more direct approach is needed to give a smile that extra

level of beauty.

Sydney aesthetic reconstructive dentist Dr Sarkis

Nalbandian describes a smile as a dynamic interplay of the

teeth and the lips and believes a smile can be transformed

in just one visit to the dentist.




‘While orthodontic alignment is often the ideal way

to correct crowded or worn upper and lower teeth, for

some patients this approach is just not an option,’ he

says. ‘There are many ways we can use non-invasive

methods to improve a patient’s smile, restoring their

confidence and allowing them to continue with their

day to day activities after just one visit.’

According to Dr Nalbandian, a combination

of wear and tear, diet and teeth grinding can

cause tooth erosion and detract from a youthful,

beautiful face. ‘The increase in consumption of

carbonated beverages has resulted in an excessive

amount of tooth loss in people as young as 15. This

compromises the structural integrity of the teeth,’ Dr

Nalbandian says.

‘Damage can also occur on account of “bruxism”,

or teeth grinding, which is a habit that can impact

both the canine and front teeth, wearing them down

and leading to asymmetry.’

Addressing the gaps, chips, discolouring and

misalignment caused by several of these factors,

Dr Nalbandian’s ‘one visit dental facelift’ focuses on

the speech area and aesthetic zone of the mouth,

primarily the six front teeth.

Though he is experienced in using a variety of

methods for smile rejuvenation, Dr Nalbandian often

recommends non-invasive composite veneers,

which can be sculpted to fit each individual patient

and afford flexible 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 says. ‘If a patient returns for orthodontics

I can remove the composite veneers but, in many

cases, this is not needed. Composite veneers will

last three to five years and, following that, they just

need resurfacing, which can be performed in a halfan-hour


While a minimally invasive approach signifies the

faster route to aesthetic rejuvenation, it requires

careful planning prior to the procedure. Dr Nalbandian

says the preparation process should involve a

thorough consultation where the patient’s concerns

and expectations are established.

‘Patients of all ages can undergo this treatment,

providing there is correct diagnosis and extensive

planning prior to the procedure,’ Dr Nalbandian

explains. ‘Today’s patients have very high aesthetic

expectations and while we try to meet those

expectations, we also need to preserve their teeth

for the best possible outcome for the future.’ csbm


‘One Visit Dental Facelift’

This 22-year-old patient approached Dr Nalbandian concerned

that the appearance of her smile was detracting from an otherwise

youthful f