Cosmetic Surgery and Beauty Magazine #65

Cosmetic Surgery and Beauty is the must read magazine for anyone contemplating a cosmetic procedure. In this issue we feature surgery after massive weight loss, 5 things you need to know about breast augmentation, the best body implants, makeup marvels and what to eat for amazing skin.

Cosmetic Surgery and Beauty is the must read magazine for anyone contemplating a cosmetic procedure.
In this issue we feature surgery after massive weight loss, 5 things you need to know about breast augmentation, the best body implants, makeup marvels and what to eat for amazing skin.


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ISSUE 65 • AUG-OCT 2014<br />

BEAUTY<br />

ALERT<br />

MAKEUP<br />


WHAT TO<br />

EAT FOR<br />


SKIN<br />

5THINGS<br />



BREAST<br />


plus<br />



The<br />

biggest loser<br />

syndrome<br />



acTual rhiNoplasTy paTiENT’s oF dr William mooNEy<br />


ENT & Facial cosmETic surgEoN<br />

sydNEy’s rhiNoplasTy spEcialisT<br />

www.drwilliammooney.com.au<br />


• Laser Therapy • skin Care<br />

• CosmeTiC injeCTabLes<br />

www.faceplus.com.au<br />

Ph: (02) 9389 4497<br />


EXc E llENc E<br />

sydNEy ’ s rhiN oplasT y spE cialisT<br />

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

Prosthodontics<br />

& Implant <strong>Surgery</strong><br />


Centre for cosmetic, reconstructive<br />

<strong>and</strong> implant dentistry<br />

Dr Sarkis Nalb<strong>and</strong>ian completed his Bachelor of Dental <strong>Surgery</strong> with<br />

Honours in 1983 <strong>and</strong> Diploma in Clinical Dentistry (Oral Implants) in<br />

2000 at The University of Sydney. He also completed his Masters in<br />

Prosthodontics in 2004 at the prestigious King’s College, University<br />

of London with distinction. He is a fellow of the Royal Australasian<br />

College of Dental Surgeons.<br />

B.D.S. (Hons.) Uni.Syd.<br />

FRACDS<br />

Grad. Dip. Clin. Dent. (Oral Implants) Uni.Syd.<br />

M.Clin.Dent (Prosthodontics) King’s College Uni. London<br />

Dr Nalb<strong>and</strong>ian specialises in Dental Implants <strong>and</strong> Prosthodontics<br />

for treating simple to complex dental, functional <strong>and</strong> aesthetic<br />

problems.<br />

He lectures on topics including Dental Implantology, Prosthodontics<br />

<strong>and</strong> Implant <strong>Surgery</strong>.<br />

He maintains a specialised practice in Sydney limited to Aesthetics,<br />

Prosthodontics & Implant <strong>Surgery</strong>.<br />

Dr Sarkis Nalb<strong>and</strong>ian<br />

B.D.S. (Hons.) Dip. Clin. Dent. (Oral Implants) Uni.Syd. FRACDS<br />

M.Clin.Dent (Prosthodontics) King’s College Uni.London<br />

Designer Smiles<br />

17 Gerard Street Cremorne NSW 2090<br />

For more information call<br />

02 9953 4189<br />

Fax 02 9953 4358<br />




HARMONY,<br />

BALANCE,<br />

Reduce the signs of ageing with<br />

natural-looking results for a<br />

refreshed <strong>and</strong> youthful appearance<br />


Dr amira Sanki<br />

Plastic Surgeon<br />

MBBS Hons (UNSW)<br />

FRACS (Plastics)<br />

PhD (USyd)<br />

HARMONY,<br />

BALANCE,<br />


CMYK<br />

TM<br />

TM<br />




Plastic <strong>Surgery</strong><br />

by<br />

Dr John Flood<br />

Look <strong>and</strong> feel younger<br />

Dr John Flood is a fully<br />

qualified plastic <strong>and</strong><br />

reconstructive surgeon<br />

with more that 15 years’<br />

experience in cosmetic<br />

plastic surgery of the<br />

face, breast <strong>and</strong> body,<br />

specialising in eyelid<br />

surgery <strong>and</strong> liposuction.<br />

He trained in Sydney<br />

<strong>and</strong> Texas, USA <strong>and</strong> also<br />

has a special interest in<br />

stem cell therapy for<br />

regenerative medicine.<br />

Mona Vale, Hornsby & Greenwich<br />

Ph: 9476 8066<br />


Look <strong>and</strong> feel good, from top to toe<br />

Dr Joseph Georghy & Dr Vera Georghy have<br />

over 65 years of clinical experience between them.<br />


Dr Georghy is a world pioneer in PhotoTherm ® , a revolutionary<br />

procedure used to improve the appearance of rosacea, acne <strong>and</strong> acne<br />

scarring, freckles, moles, age spots, large pores, wrinkles, vitiligo,<br />

pigmentation, cellulite, scars <strong>and</strong> keloids.<br />

Dr Georghy has developed HelioTherm ® , an exciting new procedure<br />

designed to reduce fat deposits <strong>and</strong> improve the tone <strong>and</strong> texture of the<br />

skin. Ideal for reshaping the abdomen, thighs, buttocks <strong>and</strong> other areas<br />

with no downtime. Call today for more information.<br />

Other services include<br />

• Superbug acne therapy<br />

• Scarless facelift<br />

• HelioTherm ® Facelift<br />

• Wrinkle reduction<br />

• LipoSculpture<br />

• Stretch mark treatment<br />

• Breast reduction (non-surgical)<br />

• Hair-laser stimulation<br />

• Skin cancer treatment<br />

• Labiaplasty & Hymenoplasty<br />

• Excessive sweating correction<br />

• Ultroid non-surgical haemorrhoid<br />

therapy<br />


Discover the smile of your dreams thanks<br />

to dental services from Dr Vera Georghy<br />

• Painless dentistry<br />

• Porcelain veneers, crowns <strong>and</strong> bridges<br />

• White fi llings<br />

• Old fi llings replaced<br />

• Preventative dentistry<br />

• Home bleaching<br />

• Mouth guards<br />


Consultation<br />

Cleaning, scaling &<br />

Teeth<br />

Whitening<br />


AMEC Specialist Surgeon (Ljubljana, Slovenia)<br />

B.Sc. General <strong>Surgery</strong> (Zagreb, Croatia) Fellow<br />

of the European Society of Aesthetic <strong>Surgery</strong>,<br />

<strong>Cosmetic</strong> Physician; FFMACCS, Degree in Anti-<br />

Aging & Regenerative Medicine (Germany) Member<br />

of the American Academy of <strong>Cosmetic</strong> <strong>Surgery</strong><br />


Dental Surgeon, University of Adelaide,<br />

Fellow, Diplomate & Lifetime Member in<br />

the World Congress of Minimally Invasive<br />

Dentistry (WCMID).<br />

Voted Clinician of the Year 2009 San<br />

Francisco, USA<br />



313 Pacifi c Highway<br />

North Sydney NSW 2060 (Opposite Hazelbank Rd)<br />

02 9956 7200<br />

www.northshorecosmetic.com.au<br />

email: doctors@sydneycosmetic.com


Skinboosters deliver deep skin hydration by holding water within<br />

the dermal layer. Natural moisture levels are replenished from the<br />

inside, creating smooth, firm <strong>and</strong> luminous skin on the outside.<br />

For skin that glows from within, talk to your cosmetic practitioner<br />

about Skinboosters or visit WWW.WRINKLECLINICFINDER.COM.AU<br />

Galderma Australia, 13B Narabang Way, Belrose 2085, Australia. ABN 12 003 976 930.<br />

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you have youth in your blood<br />

Regen PRP pioneering platelet rich plasma since 2003<br />

RegenLab has been pioneering the use of autologous platelet rich plasma for skin cell renewal<br />

since 2003.<br />

The proven Regen ACR PRP system concentrates powerful growth factors contained in our<br />

blood, before reinjecting them back into the skin.<br />

By harnessing the growth factors contained in our blood, it’s possible to accelerate <strong>and</strong><br />

increase tissue regeneration by stimulating collagen production, stem cell migration,<br />

differentiation, <strong>and</strong> proliferation, <strong>and</strong> stimulation of new blood vessels, nutrients, antioxidants<br />

<strong>and</strong> the other components of the extracellular matrix.<br />

www.amsl.com.au • www.regenlab.com • 1800 201 760

Body Balance<br />

Dr John Flynn<br />

cosmedic&<br />

Dr John Flynn<br />

skin clinic<br />

Reshaping can create<br />

cosmedic&<br />

the look you want<br />

skin clinic<br />

Breast augmentation can<br />

enhance the natural size<br />

<strong>and</strong> shape of your breasts<br />

Refi nement in <strong>Cosmetic</strong> <strong>Surgery</strong><br />

With breast augmentation, your natural form can be<br />

enhanced <strong>and</strong> complemented. This results in a balanced<br />

<strong>and</strong> symmetrical effect that suits your individual body type<br />

<strong>and</strong> achieves a feminine silhouette.<br />

Liposuction to Shape <strong>and</strong> Contour<br />

With liposuction, Dr John Flynn can reshape <strong>and</strong> contour<br />

your form to achieve balance between your body’s<br />

proportions. Areas such as the abdomen <strong>and</strong> inner <strong>and</strong><br />

outer thighs respond particularly well to this procedure.<br />




Dr John Flynn<br />

M.B., B.S., Dip. R.A.C.O.G., F.R.A.C.G.P.<br />

Dip. P. Dermatology., F.A.C.C.S.<br />

Fellow of the Australasian College of <strong>Cosmetic</strong> <strong>Surgery</strong><br />

Certifi ed by the American Board of Laser <strong>Surgery</strong><br />

Dr John Flynn has over 20 years of experience as<br />

a medical practitioner on the Gold Coast<br />

AD Flynn.indd 1<br />




20/4/09 9:01:39 AM<br />

AD Flynn.indd 1<br />

For more information or to make an<br />

appointment call Cosmedic <strong>and</strong> Skin Clinic<br />

1300 88 13 88<br />

Southport | Gold Coast<br />

Suite 2, 98 Marine Pde, Southport 4215<br />

www.cosmedic.com.au | info@cosmedic.com.au<br />

Dr John Flynn<br />

20/4/09 9:01:39 AM<br />

cosmedic& skin clinic<br />

Dr John Flynn

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48 Are you getting the best<br />

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58 The biggest loser syndrome<br />

<strong>Surgery</strong> after massive weight loss<br />

61 8 ways to keep the weight off<br />

76 5 essential factors<br />

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94 Feed your face<br />

Welcome to the next generation<br />

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140 Why quality skincare works<br />

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148 Makeup marvels<br />

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62 Body contouring after<br />

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68 A woman’s insight<br />

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70 The “Western Society”<br />

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72 The latest in laser<br />

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138 Rethink the ink<br />

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82 The saline solution for<br />

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84 Breast surgery for men<br />

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86 Natural-looking contours<br />

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88 Take action <strong>and</strong> explore<br />

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92 Girl talk<br />

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98 <strong>Beauty</strong> through the ages<br />

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104 Facelifting<br />

The science <strong>and</strong> expertise<br />

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106 Lowering the hairline for<br />

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108 Options in facelifting<br />

112 Minor surgeries,<br />

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118 An educated approach<br />

All about anti-wrinkle injections<br />

122 Turn back the clock with PRP<br />

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LETTER<br />


Welcome to the 65th issue of <strong>Cosmetic</strong> <strong>Surgery</strong> &<br />

<strong>Beauty</strong> <strong>Magazine</strong>. Since the launch of this magazine<br />

16 years ago we have maintained our position<br />

as Australia’s most trusted resource for cosmetic medicine<br />

<strong>and</strong> surgery.<br />

We pride ourselves on our relationship with our readers, <strong>and</strong><br />

our knowledge of what you’re searching for. We will continue<br />

to deliver you authoritative, comprehensive articles in all<br />

formats – both paper <strong>and</strong> digital. To this end, in addition to<br />

the print version, CSBM is now available for free online at<br />

www.cosbeauty.com.au. In the online version you’ll also fi nd<br />

loads of exciting extras, such as “behind the scenes” videos<br />

of the making of the magazine with the Bella Media team plus interactive features<br />

<strong>and</strong> links.<br />

And it doesn’t stop there – on www.cosbeauty.com.au you’ll fi nd a whole lot of extra<br />

content, including product <strong>and</strong> treatment road tests, blogs <strong>and</strong> beauty updates. The site<br />

has had a huge increase in visitor traffi c since its redesign earlier this year, thanks to our<br />

loyal readers. There are hundreds of unique articles online, a comprehensive before <strong>and</strong><br />

after photo gallery <strong>and</strong> a h<strong>and</strong>y directory of practitioners <strong>and</strong> services – <strong>and</strong> it continues<br />

to grow each day.<br />

Whether you’re thumbing through this issue or reading one of our stories online, we<br />

take great pride in bringing you independent, unbiased <strong>and</strong> informative articles. In this<br />

issue of CSBM we examine the topics making headway both here <strong>and</strong> around the globe.<br />

Turn to page 58 to read our in-depth article on a procedure growing in popularity: body<br />

surgery after massive weight loss. We also highlight the fi ve essential considerations of<br />

breast implants on page 76, <strong>and</strong> delve into the many benefi ts of medical-grade skincare<br />

on page 140.<br />

We also bring you the latest in beauty, body <strong>and</strong> hair care from page 148, as well as<br />

the foods to eat for glowing skin that defi es your age on page 94.<br />

Connect with us on Facebook <strong>and</strong> Instagram to get real-time updates <strong>and</strong> share your<br />

feedback on www.cosbeauty.com.au. Happy reading!<br />

Michelle Kearney<br />

Editor-in-Chief<br />

michelle@bellamedia.com.au<br />

Michelle Kearney is sole director of The Bella Media Group <strong>and</strong> no other parties or individuals have any fi nancial interest in the<br />

company or in Australian <strong>Cosmetic</strong> <strong>Surgery</strong> & <strong>Beauty</strong> <strong>Magazine</strong> (ACSBM). Reproduction in whole or in part is not permitted without<br />

the written authorisation of the publisher. All reasonable efforts have been made to trace copyright holders. All manuscripts <strong>and</strong><br />

articles submitted for publication remain the property of The Bella Media Group. This magazine contains general information only <strong>and</strong><br />

does not purport to be a substitute for medical advice. All readers are advised to seek medical advice from a doctor if considering<br />

cosmetic surgery. The publisher <strong>and</strong> the authors do not accept any liability whatsoever in respect of an action taken by readers in<br />

reliance on the recommendations set out in this magazine. Except where specifi ed in captions, photographs depict models who have<br />

not necessarily received treatments described in this magazine.<br />

Advertising Policy ACSBM follows <strong>and</strong> upholds the Australian Competition <strong>and</strong> Consumer Commission (ACCC) Guidelines to<br />

Advertising Medical Services, the Therapeutic Goods Administration (TGA) advertising regulations for therapeutic goods <strong>and</strong> services,<br />

<strong>and</strong> individual state Medical Board guidelines. All reasonable effort is made by ACSBM to ensure that all advertisements accepted<br />

for publication follow these guidelines. Copies of these guidelines are available from the individual agencies <strong>and</strong> boards. ACSBM<br />

reserves the right to reject advertising that is in breach of these guidelines. All ACSBM advertisers assume sole responsibility <strong>and</strong><br />

liability for statements contained in their advertising copy, <strong>and</strong> hold harmless <strong>and</strong> indemnify ACSBM, Bella Media, <strong>and</strong> offi cers,<br />

directors <strong>and</strong> employees from <strong>and</strong> against all liability, loss, claim, damages, costs or expenses arising out of matter contained in the<br />

advertising. Advertisers accept these terms <strong>and</strong> responsibilities when signing an advertising contract with ACSBM.<br />

Read the online edition at<br />

www.cosbeauty.com.au<br />

Issue 65<br />

AUG - OCT 2014<br />

Editor-in-Chief<br />

Michelle Kearney<br />

Editorial Director<br />

Aimée Surtenich<br />

Production Coordinator<br />

Camila Kawashita<br />

Art Director<br />

Debbie Pilarinos<br />

Writers<br />

Caitlin Bishop, Tara Casey,<br />

Camila Kawashita<br />

Aimée Surtenich<br />

Photographers<br />

Debbie Pilarinos, ShutterStock<br />

Distribution &<br />

Subscription Enquiries<br />

Bill Dunk<br />

Phone 02 9398 2755 Fax 02 9398 2855<br />

Email acsmag@bellamedia.com.au<br />

Advertising Enquiries<br />

Michelle Kearney<br />

Phone 02 9398 2755 Mob 0419 624 246<br />

Email michelle@bellamedia.com.au<br />

Editorial Enquiries<br />

Michelle Kearney, Aimée Surtenich<br />

Phone 02 9398 2755 Fax 02 9398 2855<br />

Email acsmag@bellamedia.com.au<br />

Produced & Published by Bella Media<br />

ABN 86 082 157 695<br />

Managing Director<br />

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Chief Operating Officer<br />

Bill Dunk<br />

Public Relations, Marketing<br />

& Event Organisation<br />

Phone 02 9398 2755 Fax 02 9398 2855<br />

find us on<br />

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Office address<br />

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R<strong>and</strong>wick, NSW, 2031<br />

Phone +61 2 9398 2755 Fax +61 2 9398 2855<br />

www.bellamedia.com.au<br />

All ‘before <strong>and</strong> after’ photographs in<br />

<strong>Cosmetic</strong> <strong>Surgery</strong> & <strong>Beauty</strong> <strong>Magazine</strong><br />

articles are of genuine patients. It is<br />

important to underst<strong>and</strong> that they represent<br />

one person’s experience <strong>and</strong> there is<br />

no guarantee that any other patient will<br />

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Contributors<br />

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Ricky Allen Dr Buddy Beaini Dr John Flood<br />

Dr John Flynn Dr Joseph Georghy Dr Paul Gerarchi Val Glover-Hovan<br />

Dr Darryl Hodgkinson Dr Jim Leavesley Dr Steven Liew Dr Richard Maxwell<br />

Dr William Mooney Dr Colin Moore Dr Sarkis Nalb<strong>and</strong>ian Dr Warwick Nettle<br />

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newsfront<br />



The Facts of Light:<br />


Sponsored by Cynosure<br />

The two-day event on 28-29 June attracted more than<br />

100 cosmetic practitioners convened at Point Piper<br />

Yacht Club in Sydney for the Facts of Light Advanced<br />

Symposium. It featured renowned dermatologists <strong>and</strong><br />

doctors from across Australia who spoke on topics<br />

including picosecond laser tattoo removal, fractional<br />

laser for skin rejuvenation, a comparison of ablative <strong>and</strong><br />

non-ablative laser techniques, <strong>and</strong> a novel approach to<br />

treating hair removal, acne scar removal <strong>and</strong> treatment<br />

of gynaecomastia.<br />

HAPPY 20TH<br />


On September 20, 2014, Advanced Skin Technology, a<br />

distributor of clinical skincare products <strong>and</strong> treatments,<br />

celebrates its 20th anniversary. Founder <strong>and</strong> managing<br />

director Trish Winchester established AST in 1994. Trish’s<br />

foresight on what trends were<br />

evolving in the anti-ageing sector<br />

in the USA saw her embark on a<br />

journey to distribute Australia’s fi rst<br />

medical grade glycolic acid range<br />

in Australia. Trish then pioneered<br />

<strong>and</strong> developed ‘Aspect’ <strong>and</strong><br />

‘Aspect Dr’, her own Australianowned<br />

cosmeceutical range that<br />

has become one of Australia’s<br />

bestselling skincare br<strong>and</strong>s within<br />

the cosmeceutical market.<br />

Look Good...Feel Better<br />

Cancer fundraising & awareness<br />

campaign – Dream Week<br />

Dream Week: 7 Days of Hope, held on 31 August to<br />

6 September, 2014 is a national campaign engaging<br />

partners of the cosmetic, retail <strong>and</strong> publishing<br />

industries to raise awareness <strong>and</strong> funds for the Look<br />

Good…Feel Better program.<br />

The week-long campaign is an opportunity for the<br />

Australian public to help the 10,000 cancer patients<br />

who will attend a Look Good…Feel Better workshop<br />

this year. Here’s how you can get on board:<br />

PURCHASE A LIPSTICK During Dream Week<br />

$1 from every lipstick or lip gloss sold at David Jones<br />

<strong>and</strong> Myer stores nationally will be donated to Look<br />

Good…Feel Better.<br />


designed carry bags, coin purses, makeup bags,<br />

bracelets, pins <strong>and</strong> umbrellas will be available to<br />

purchase via a pop-up outpost at Westfi eld Sydney<br />

City. You can also purchase a pin at two information<br />

posts in Westfi eld Bondi Junction <strong>and</strong> Chadstone in<br />

Melbourne, as well as Terry White chemists around<br />

the country.<br />

SOCIAL MEDIA Supporters are encouraged<br />

to show support of the 24-year strong program by<br />

engaging followers <strong>and</strong> fans to get involved in planned<br />

campaigns on Facebook, Twitter <strong>and</strong> Instagram.<br />

Connect with @LGFBAustralia #dreamweek14<br />

30 www.cosbeauty.com.au

ICAPS REPORT by Dr Darryl Hodgkinson<br />

Twenty-fi ve of the world’s top<br />

plastic surgeons convened<br />

for the three-day International<br />

Consortium of Aesthetic<br />

Plastic Surgeons meeting in<br />

Vienna, Austria on 11-17 May,<br />

2014. Two surgeons from<br />

Australia participated, myself<br />

<strong>and</strong> my close associate Dr<br />

Bryan Mendelson.<br />

Some of the latest trends were re-evaluated. Dr W Wu<br />

Dr Hodgkinson (right) with fellow ICAPS<br />

members from Italy, Jordan <strong>and</strong> Austria<br />

of Singapore presented the use of fat grafting around the<br />

forehead <strong>and</strong> implants to advance the chin in Asian patients<br />

while Dr Mendelson <strong>and</strong> Dr Martin from the United States<br />

emphasised augmentation enhancement of the brow <strong>and</strong><br />

periorbital regions to improve rejuvenation of the upper face.<br />

Various techniques for face <strong>and</strong> neck lifting by surgeons<br />

from the US <strong>and</strong> Europe were discussed <strong>and</strong> it was reemphasised<br />

that no single technique alone suffi ces. Both<br />

assessment <strong>and</strong> performance of various techniques by<br />

experienced surgeons (greater than 25 years) produce<br />

gratifying results for patients <strong>and</strong> surgeons alike. The tight,<br />

hard face look is now avoidable <strong>and</strong> no longer acceptable<br />

for surgeons with adequate experience <strong>and</strong> expertise using<br />

a variety of techniques.<br />

Dr De La Pena of Mexico, who inspired me to embrace<br />

the INFINI microneedling radiofrequency treatments,<br />

updated his continuing success with this technology.<br />

The major topic in rhinoplasty also highlighted the need<br />

for experience <strong>and</strong> expertise in individualising the result.<br />

In particular ethnic noses, especially Middle Eastern <strong>and</strong><br />

South American noses were discussed with the emphasis<br />

on different aesthetic goals <strong>and</strong> anatomical variations<br />

between different ethnic groups.<br />

Other topics included fat grafting of the face as an<br />

adjunct for surgical procedures <strong>and</strong> buttock implants,<br />

which are becoming increasingly popular in Italy where the<br />

quartz Silimed implant is preferred. Abdominoplasty (tummy<br />

tucks) <strong>and</strong> total body lifts after massive weight loss are also<br />

a growing area of plastic surgery.<br />

By this collegiate contact <strong>and</strong> interaction with the leaders<br />

in our fi eld <strong>and</strong> staying on the leading edge of plastic surgery<br />

<strong>and</strong> non-surgical equipment, patients benefi t by being<br />

offered the very latest surgical techniques in the industry.<br />

“WE MADE $7000<br />







1300 667 374

newsfront<br />

Australia India<br />

Travel & Tourism<br />

Council (AITTC)<br />

Creates New Role<br />

for Medical Tourism<br />

Venus Concept<br />

& The Global<br />

<strong>Beauty</strong> Group<br />

VLounge Event<br />

Friday the 13th of June marked the<br />

VLounge Event for aesthetic medical<br />

practitioners, hosted by Venus Concept<br />

<strong>and</strong> The Global <strong>Beauty</strong> Group. Held<br />

at the Park Royal Darling Harbour in<br />

Sydney, the exclusive event delved into<br />

the science behind the Venus Freeze<br />

<strong>and</strong> Venus Legacy, two non-invasive<br />

body contouring systems.<br />

Internationally recognised aesthetic<br />

physician Dr Tami Meraglia from the<br />

US gave an informative presentation on<br />

integrating technology to optimise the<br />

performance of aesthetic practices.<br />

Dr Hemani Thukral, managing director of MyMedicalChoices, has been<br />

named as Director of Medical Tourism for the AITTC, a newly created role<br />

to help facilitate Australians considering India as a suitable destination for<br />

medical treatment.<br />

Since its establishment in 2012, the AITTC has been contributing to the<br />

leisure <strong>and</strong> tourism sectors <strong>and</strong> now adds medical tourism which is a new<br />

<strong>and</strong> growing segment of the industry.<br />

‘My vision is to devlelop medical tourism in a systematic manner through<br />

ongoing dialogue <strong>and</strong> collaboration between Australia <strong>and</strong> India to achieve<br />

better outcomes for Australians seeking treatment in India <strong>and</strong> benefi t<br />

the system overall,’ said Dr Thukral. ‘It is my view that this will in turn<br />

raise the bar for the quality of care provided to patients internationally <strong>and</strong><br />

acoss the nation.’<br />


Sydney International Spa & <strong>Beauty</strong> Expo<br />

Held on 23-24 August at the Sydney Exhibition Centre, Glebe Isl<strong>and</strong>,<br />

the Sydney International Spa & <strong>Beauty</strong> Expo is Australia’s largest<br />

event for the spa <strong>and</strong> beauty industries. Spa <strong>and</strong> beauty professionals<br />

have a unique opportunity to source <strong>and</strong> experience the latest beauty<br />

products, treatments, ideas <strong>and</strong> equipment from Australia’s largest<br />

gathering of leading br<strong>and</strong>s <strong>and</strong> suppliers.<br />

See www.internationalbeautyexpo.com.au for more information.<br />

2014 Skin Symposium<br />

Held across four Australian states from 25 August, the 2014 Skin<br />

Symposium, run by Face Facts, is a one-day event delving into skin<br />

analysis <strong>and</strong> health. Gay Wardle, a leading educator in the fi eld of<br />

advanced skin analysis, will host the Symposium. The program is<br />

designed to give attendees a holistic, comprehensive <strong>and</strong> proactive<br />

insight into anti-ageing <strong>and</strong> optimising skin health.<br />

For more information contact 02 8424 6625<br />

3rd International Symposium<br />

on Corneotherapy 2014<br />

Held on 17-19 November, 2014 at the Ambassador Hotel, Kaohsiung,<br />

Taiwan, the guiding theme for the symposium will be The Compromised<br />

Skin & Corneotherapy. Keynote speakers include Prof Lars Norlen<br />

(Sweden) <strong>and</strong> Dr Hiroshi Ikeno (Japan), as well as presentations by<br />

chairperson of the International Association for Applied Corneotherapy<br />

(IAC) Florence Barrett-Hill <strong>and</strong> other esteemed IAC members.<br />

See www.corneotherapy.org/iac-news for more information.<br />

32 www.cosbeauty.com.au

The Australasian College of <strong>Cosmetic</strong> <strong>Surgery</strong><br />

Raising St<strong>and</strong>ards,<br />

Protecting Patients<br />

Dedicated to quality, ethical<br />

<strong>and</strong> responsible practice.<br />

Accreditation is Important<br />

All Fellows of the Australasian College of <strong>Cosmetic</strong><br />

<strong>Surgery</strong> (FACCS) are specifically trained in cosmetic<br />

surgery <strong>and</strong> are required by the College to maintain<br />

their skills through a Continuing Professional<br />

Development programme.<br />

All Fellows of the Faculty of Medicine (FFMACCS)<br />

are specifically trained in cosmetic medicine <strong>and</strong><br />

are required by the College to maintain their skills<br />

through a Continuing Professional Development<br />

programme.<br />




If doctors display this Seal,<br />

you can be assured they<br />

comply with the College’s<br />

exemplary st<strong>and</strong>ards of its<br />

Code of Practice, available<br />

at www.accs.org.au<br />

How qualified is your doctor?<br />

Do they have the right to display these symbols?<br />

For further information about the College<br />

<strong>and</strong> its members <strong>and</strong> Fellows in your state call:<br />

1800 804 781<br />

admin@accs.org.au<br />


industry<br />

2014<br />

Non-Surgical Symposium<br />

The 3rd Annual Non-Surgical Symposium, hosted<br />

by ASAPS <strong>and</strong> the CPSA, descended upon Sydney this<br />

May. Caitlin Bishop reports.<br />

Advancements in technology, alongside a rise in<br />

popularity of minimally invasive cosmetic treatments,<br />

have fuelled the growth of non-surgical rejuvenation.<br />

The Australasian Society of Aesthetic Plastic <strong>Surgery</strong> (ASAPS)<br />

<strong>and</strong> the <strong>Cosmetic</strong> Physicians Society of Australasia (CPSA) cohosted<br />

the third annual Non-Surgical Symposium at Sydney’s<br />

Hilton Hotel this May.<br />

Plastic surgeons, dermatologists <strong>and</strong> cosmetic doctors <strong>and</strong><br />

physicians from around the globe attended. Keynote speakers<br />

included American dermatologists Dr Ashish Bhatia, Dr Vivian<br />

Bucay, Dr Rebecca Fitzgerald, Dr Mitchel Goldman, Dr Hema<br />

Sundaram <strong>and</strong> Dr Mark Nestor. As well as this, Chicago plastic<br />

surgeon Dr Steven Dayan <strong>and</strong> Dutch cosmetic doctor Dr Tom<br />

van Eijk shared their expertise in achieving optimum results in<br />

minimally invasive cosmetic enhancement.<br />

Both Dr Dayan <strong>and</strong> Dr Fitzgerald spoke on facial aesthetics,<br />

specifically their approach to treating the ageing face, <strong>and</strong><br />

different methods for defining <strong>and</strong> establishing beauty<br />

through treatment. Both speakers stressed the importance<br />

of addressing the multiple elements of volume, texture <strong>and</strong><br />

support in facial rejuvenation.<br />

‘The face is a 3D platform, <strong>and</strong> ageing affects all areas<br />

interdependently,’ Dr Fitzgerald said. ‘In the past, fixing only the<br />

most obvious signs of ageing was the norm, but this often left<br />

incongruous <strong>and</strong> sometimes unnatural-looking results. Now we<br />

look at more than just one contributing factor – sometimes bony<br />

support is needed, rather than adding extra volume, or the empty<br />

fat compartments need filling instead of the actual wrinkle.’<br />

Similarly, Dr Dayan showcased his subtle approach to<br />

aesthetic rejuvenation – emphasising the importance of striving<br />

for natural-looking results. He demonstrated how minimal<br />

changes can achieve significant <strong>and</strong> aesthetically pleasing<br />

results in facial rejuvenation.<br />

Dr van Eijk spoke about the importance of tailoring each<br />

treatment to the patient’s aesthetic requirements. He also<br />

demonstrated his revolutionary injectable method called<br />

the Fern Pattern injectable technique, which is designed to<br />

afford more movement post-procedure, <strong>and</strong> the Lip Tenting<br />

Photos courtesy of Woodrow Wilson<br />

34 www.cosbeauty.com.au

industry<br />

technique, which helps establish natural-looking results in lip<br />

augmentation with dermal fillers.<br />

‘The Non-Surgical Symposium is a great opportunity to<br />

explain the main principles of these techniques to newcomers,<br />

as well as go over the latest approaches that I have worked on<br />

since the last meeting,’ Dr van Eijk said.<br />

A significant portion of the scientific program was dedicated<br />

to laser <strong>and</strong> light therapies. Dr Bucay spoke extensively on using<br />

radiofrequency <strong>and</strong> ultrasound energy to stimulate collagen<br />

production, which helps lift <strong>and</strong> tighten skin. She showed how<br />

light therapy can help firm the facial contours <strong>and</strong> give the<br />

face a youthful lift, without the need for general anaesthesia,<br />

incisions or extensive downtime.<br />

Amongst the workshops, demonstrations <strong>and</strong> panel<br />

discussions, the Non-Surgical Symposium hosted a range<br />

of social activities to infuse the conference with a sense of<br />

adventure, collaboration <strong>and</strong>, most of all, fun. The opening<br />

Cocktail Reception, held at Sydney’s Ivy Bar, kicked the<br />

conference off to a lively start, while the Gala Dinner, at Doltone<br />

House in Darling Harbour, was an extravaganza that was the<br />

perfect conclusion to a successful meeting. With a full program<br />

of lectures, trade presentations <strong>and</strong> social events, the 2014<br />

Non-Surgical Symposium helped shape the future of nonsurgical<br />

innovations in cosmetic enhancement. csbm<br />

www.cosbeauty.com.au 35

industry<br />

Cosmetex<br />

round-up<br />

An international faculty of renowned doctors descended on the<br />

Gold Coast to present advancements in cosmetic medicine at<br />

Cosmetex 2014. AimÉe Surtenich reports.<br />

The lush hinterl<strong>and</strong> of the Gold Coast played host to<br />

this year’s annual Cosmetex conference, attracting<br />

cosmetic surgeons, dermatologists <strong>and</strong> cosmetic<br />

practitioners from far <strong>and</strong> wide to attend the largest aesthetic<br />

medicine conference in the Southern Hemisphere.<br />

Cosmetex, run by the Australian College of <strong>Cosmetic</strong><br />

<strong>Surgery</strong> (ACCS), has a well-earned reputation for inviting<br />

acclaimed speakers from around the world <strong>and</strong> this<br />

year was no exception. With a strong faculty of keynote<br />

speakers hailing from the US, UK, Canada, Germany <strong>and</strong><br />

Israel, delegates were enlightened with the many <strong>and</strong> varied<br />

informative sessions <strong>and</strong> interactive workshops.<br />

Held at the Royal Pines Resort, the meeting spanned<br />

three days with a main focus on non-surgical facial<br />

rejuvenation – specifically using fillers, neurotoxins <strong>and</strong><br />

light-based devices to create facial harmony <strong>and</strong> beauty.<br />

Also on the agenda was the latest developments in<br />

energy assisted body contouring <strong>and</strong> breast surgery, as well<br />

as a comprehensive skin health <strong>and</strong> paramedical program.<br />

The science behind beauty was investigated at length.<br />

US facial plastic surgeon <strong>and</strong> author Dr Steven Dayan<br />

explored the unifying theories of beauty – <strong>and</strong> how beauty<br />

is the most primitive language we have had throughout<br />

time <strong>and</strong> among different species. Merging ideas from<br />

neuropsychiatry, evolutionary biology <strong>and</strong> cosmetic<br />

medicine, he shared his thought-provoking views on how<br />

the tools of aesthetic medicine can result in subtle changes<br />

that make a significant difference in the symmetry, contours<br />

<strong>and</strong> curves of the face. ‘Less is more – but in the right<br />

places,’ he cautioned.<br />

Another advocate of the “less is more” approach is<br />

Canadian plastic surgeon Dr Arthur Swift, pioneer of the<br />

BeautiPHIcation approach where the golden ratio, or Phi,<br />

is used to establish the most attractive results in facial<br />

rejuvenation – for every face. He specially addressed the<br />

idea of creating harmony in the upper face, <strong>and</strong> specific<br />

36 www.cosbeauty.com.au

industry<br />

areas such as the nose <strong>and</strong> mouth, using injectables. He<br />

stressed that ageing occurs at different rates across all<br />

parts of the face <strong>and</strong> that each area should be looked<br />

at individually for the most aesthetically pleasing results.<br />

‘There are 25 or so pockets of fat in the face – <strong>and</strong> they are<br />

all ageing at different rates,’ he said.<br />

Treating areas of the face individually was also a<br />

technique shared by keynote speaker Dr Mark Nestor, a<br />

dermatologist from the US. ‘Treating areas as “zones”,<br />

rather than wrinkles <strong>and</strong> lines will yield far more naturallooking<br />

<strong>and</strong> beautiful results,’ he explained. Indeed, directly<br />

injecting a wrinkle will not create optimal results – it’s more<br />

about building the scaffolding framework from within to add<br />

volume which, in turn, smooths away the wrinkle.<br />

UK cosmetic dermatologist Dr Raj Acquilla agreed, <strong>and</strong><br />

believes just a few small artfully placed filler injections will<br />

result in a more beautiful appearance than using more<br />

product in more areas of the face. ‘Applying geometric<br />

principles of facial beauty can restore symmetry <strong>and</strong><br />

proportion to the face,’ he said. The aim of the game is<br />

not necessarily to look younger, but to look better <strong>and</strong><br />

more beautiful.<br />

New cosmetic medicine <strong>and</strong> technology was also<br />

presented at the meeting, with a large exhibition hall for<br />

companies to showcase their cutting edge products<br />

<strong>and</strong> services.<br />

Any Cosmetex conference wouldn’t be complete<br />

without a must-attend social calendar, culminating in the<br />

Mad Men-themed Gala Dinner in a bespoke outdoor setting<br />

held at the Royal Pines.<br />

Cosmetex provides ACCS fellows, delegates <strong>and</strong><br />

sponsors a unique opportunity to learn new techniques<br />

<strong>and</strong> technology on the cutting edge of aesthetic surgery<br />

<strong>and</strong> medicine, to network <strong>and</strong> meet old friends again, <strong>and</strong><br />

most importantly to work together to promote the safety<br />

<strong>and</strong> efficacy of cosmetic medical practice. csbm<br />

www.cosbeauty.com.au 37

feature<br />

Change<br />

the way<br />

you<br />

age<br />

Could stem cells represent the elixir of youth?<br />

Dr John Flood is trail-blazing the use of stem cells in<br />

aesthetic rejuvenation. Caitlin Bishop reports.<br />

Stem cells signify the cutting edge in all corners of the medical world. The<br />

ability of stem cells to regenerate <strong>and</strong> revitalise human tissue holds boundless<br />

potential for the world of restorative <strong>and</strong> cosmetic medicine. Sydney plastic<br />

surgeon Dr John Flood is at the forefront of these discoveries in Australia, <strong>and</strong> is<br />

investigating the possibilities of using stem cells to alleviate pain, regenerate tissue<br />

<strong>and</strong> rejuvenate the appearance.<br />

He explains that an evolution in stem cell research has opened up a new realm<br />

of opportunities. Where once the focus was on the differentiation paths of stem<br />

cells – or which cell types they would give rise to – now the capabilities of stem cells,<br />

regardless of their type, is being investigated.<br />

‘Ten years ago, the research into stem cells revolved around adult stem cell<br />

differentiation, or stem cell renewal – for example, adipose (fat) stem cells renew into<br />

fat cells <strong>and</strong> dermal stem cells renew into dermal cells,’ Dr Flood explains.<br />

‘Now, the thinking has evolved <strong>and</strong> we realise that adult stem cells – no matter<br />

what their origin – will stimulate the activity of the surrounding stem cells, regardless<br />

of their differentiation paths. The implications of this are profound. For example,<br />

when stem cells – usually derived from the patient’s adipose tissue (fatty tissue)<br />

38 www.cosbeauty.com.au

feature<br />

Case study<br />

– are injected into the skin, they release chemical factors to increase blood vessel<br />

formation <strong>and</strong> boost nutrient <strong>and</strong> blood infusion into the area. As well as increasing<br />

vascularity, the injected stem cells also stimulate the surrounding stem cells – in<br />

this case, dermal stem cells – to regenerate <strong>and</strong> rejuvenate the tissue.<br />

Dr Flood has been using this technique in his rehabilitative patients. He uses<br />

autologous, adipose-derived stem cells, which are usually taken from the patient’s<br />

love h<strong>and</strong>les, to treat damaged tissue in injured athletes.<br />

‘We harvest the stem cells while the patient is under local anaesthetic – usually<br />

from the love h<strong>and</strong>les, where most people have pockets of fat,’ he explains. ‘The<br />

sample is centrifuged in a lab <strong>and</strong> the stem cells are purified. Importantly, we use a<br />

regulated <strong>and</strong> certified lab, where there is no chance of bacterial contamination or<br />

cross contamination. The stem cells are then inserted into syringes <strong>and</strong> returned for<br />

use in the clinic.’<br />

According to Dr Flood, the multiple actions of stem cells in the skin – from<br />

increasing vascularity to stimulating existing stem cells – not only helps regenerate<br />

injured tissue but can also act as an anti-ageing elixir.<br />

‘Adipose stem cells could signify the holy grail of anti-ageing; they work to increase<br />

blood flow, stimulate activity of the surrounding stem cells <strong>and</strong>, because they renew<br />

into fat cells, they provide added plumping to the treated area,’ he explains. ‘They<br />

act like a conductor of an orchestra – triggering <strong>and</strong> accelerating natural tissue<br />

regeneration, to treat the skin from within.’<br />

Notably, the potential of stem cells is not restricted to st<strong>and</strong>-alone anti-ageing<br />

procedures. Dr Flood says stem cells could also assist in the use of implants <strong>and</strong><br />

grafts in aesthetic <strong>and</strong> reconstructive surgeries. ‘Their capacity to improve vascularity<br />

can potentially aid in graft or implant adherence to the surrounding tissue,’ he says.<br />

‘The whole process of ageing is related to wear, oxidation <strong>and</strong> inflammation –<br />

stem cells release factors to counter this wear, reduce inflammation <strong>and</strong> fight free<br />

radicals. Autologous adipose-derived stem cells work to regenerate the tissue,<br />

improve vascularity, combat ageing <strong>and</strong> give rise to new fat cells to return lustre <strong>and</strong><br />

vibrancy to the treatment area,’ he concludes. csbm<br />

Dr Flood works with stem cells to treat patients with<br />

neuropathic facial pain, a condition of chronic pain that<br />

has no detectable cause. It was one patient, who had<br />

developed facial pain unexpectedly in her mid-20s, who<br />

kick-started Dr Flood’s investigation into the cosmetic use<br />

of stem cells.<br />

She had tried a number of different therapies, including<br />

muscular relaxant injections, to sooth her facial pain <strong>and</strong><br />

associated muscular contortion. However, no treatment<br />

was successful <strong>and</strong> she developed right hemifacial<br />

atrophy – where the tissue on one side of her face had<br />

shrunk <strong>and</strong> degenerated.<br />

‘We injected stem cells into her right temporal region,<br />

from where she felt the pain originated,’ he says. ‘After<br />

three months she could sleep better, she was taking less<br />

pain medication <strong>and</strong>, surprisingly, her facial atrophy had<br />

corrected <strong>and</strong> her brow spasm had resolved. We’d not<br />

been expecting that when we started treatment.’<br />

What’s more, the stem cell treatment also helped<br />

rejuvenate her outward appearance. ‘The tissue appeared<br />

fuller, <strong>and</strong> she was ecstatic,’ Dr Flood says. ‘As well as<br />

correcting her distortion, the stem cell treatment filled<br />

<strong>and</strong> refined her facial contours. She felt her appearance<br />

had returned to what it was before she developed the<br />

facial pain.’<br />

Dr Flood <strong>and</strong> his colleagues have seen approximately<br />

50 percent reduction in facial pain in patients after stem<br />

cell treatment. Their work has been accepted for<br />

publication in an international journal.<br />

‘Many patients relied on medication because they<br />

couldn’t bear the pain, but then they couldn’t h<strong>and</strong>le<br />

the side effects of medication,’ says Dr Flood. ‘The stem<br />

cell injections stopped this reliance <strong>and</strong> greatly improved<br />

quality of life. People went from not being able to sleep<br />

<strong>and</strong> experiencing depression, to having their life back due<br />

to pain relief.’<br />

www.cosbeauty.com.au 39

feature<br />

BREAST<br />

CANCER<br />


40 www.cosbeauty.com.au

feature<br />

Breast cancer is the number-one cancer for Australian women,<br />

<strong>and</strong> with Breast Cancer Awareness month approaching, there’s no<br />

better time to get educated. Aimée Surtenich reports.<br />

Recent statistics show that one in eight women in Australia will be<br />

diagnosed with breast cancer before the age of 85, <strong>and</strong> by 2020 the<br />

number of new breast cancer cases among women is predicted to rise<br />

by around 20 percent.<br />

But with this omnipresence has come overwhelming support for breast cancer<br />

awareness. The colour pink is now synonymous with breast cancer support, with<br />

everything from supermarket products to iconic Australian l<strong>and</strong>marks taking on a<br />

pink guise in support of breast cancer research.<br />

Celebrities such as Kylie Minogue, Christina Applegate <strong>and</strong> Sheryl Crow who<br />

have suffered publicly from breast cancer use their fame to become ambassadors<br />

for the cause, putting their name to government initiatives <strong>and</strong> fundraising efforts.<br />

what is<br />

breast<br />

cancer?<br />

treatment<br />

‘Breast cancer, like other cancers, occurs because of an interaction between the<br />

environment <strong>and</strong> a defective gene,’ explains German anti-ageing specialist Dr<br />

Michael Klentze. ‘Specifically, breast cancer occurs when a build up of genetic<br />

mutations in critical genes – those that control cell growth <strong>and</strong> division, or the<br />

repair of damaged DNA – allow cells to grow <strong>and</strong> divide uncontrollably to form<br />

a tumour.’<br />

‘Breast cancer, like prostate cancer, is a hormone-dependent cancer, which<br />

can develop under oestrogen influence,’ he explains.<br />

Although it is much more common in women, men can also develop<br />

breast cancer.<br />

There is a medical distinction made between early breast cancer <strong>and</strong><br />

secondary breast cancer. Early breast cancer is cancer that is contained within<br />

the breast <strong>and</strong> may or may not have spread to the lymph nodes (located<br />

under the armpit). Secondary breast cancer is cancer that has spread outside<br />

the breast area. This distinction helps dictate the best treatment option.<br />

‘Breast cancer is commonly treated by various combinations of surgery,<br />

radiation therapy, chemotherapy <strong>and</strong> hormone therapy,’ says Dr Klentze. There<br />

are a number of factors that influence the selection of breast cancer treatment.<br />

According to Dr Klentze, these include the age <strong>and</strong> menopausal status of the<br />

patient, the stage of the disease <strong>and</strong> whether the tumour is aggressive or likely<br />

to spread.<br />

Another influential factor is whether the tumour contains oestrogen receptors<br />

(ER+) or progesterone receptors (PR+). These receptors indicate if hormones<br />

are causing the cancer to grow bigger; there are specific hormone-blocking<br />

medications for each that can be used during treatment.<br />

www.cosbeauty.com.au 41

feature<br />

reducing your risk<br />

While there is no known way of preventing breast cancer, making<br />

lifestyle changes such as quitting smoking, reducing alcohol intake,<br />

reducing fat mass <strong>and</strong> increasing exercise can all help to reduce the risk<br />

of breast cancer.<br />

You may also wish to consider getting tested to find out if you are<br />

susceptible to breast cancer, especially if there is a family history of the<br />

disease. Having a first degree relative, such as your mother or sister,<br />

with breast cancer puts you at higher risk for the disease. The risk is<br />

even greater if they developed breast cancer before menopause, <strong>and</strong> in<br />

both breasts.<br />

Women with breast cancer usually undergo a lumpectomy (the surgical<br />

removal of a cancerous nodule) or a mastectomy (removal of the entire breast/s)<br />

to excise the cancer from the breast, which can be followed by radiation therapy<br />

<strong>and</strong>/or chemotherapy to kill any remaining cancer cells.<br />

the<br />

angelina<br />

jolie<br />

effect<br />

Recent genetic research has provided some valuable information that can help<br />

identify whether a person is more susceptible to breast cancer in the first place,<br />

therefore increasing the chance of early detection.<br />

BRCA1 <strong>and</strong> BRCA2 are major genes related to hereditary breast cancer.<br />

Women, <strong>and</strong> also men, who have inherited certain mutations in these genes<br />

have a higher risk of developing breast cancer, ovarian cancer <strong>and</strong> several other<br />

types of cancer during their lifetimes.<br />

This breakthrough means that people can now be tested for these particular<br />

genes – <strong>and</strong> those who carry them can be aware of their susceptibility <strong>and</strong><br />

closely monitor their breasts for any suspicious changes.<br />

Perhaps the most famous carrier of the BRCA1 or BRCA2 gene mutation<br />

is actress Angelina Jolie. The news that Jolie – one of the world’s most<br />

glamorous women – had undergone a double mastectomy at the age of 37<br />

stunned the world in 2013 <strong>and</strong> brought this very relevant debate to the forefront<br />

of international media.<br />

Faced with an 87 percent chance of developing breast cancer in the future,<br />

Jolie underwent her procedure as a preventative measure – one that brought<br />

her risk of developing the disease down to just five percent.<br />

It’s thought around five percent of Australians – both men <strong>and</strong> women – carry<br />

the BRCA1 <strong>and</strong> BRCA2 gene. The availability of genetic testing varies across<br />

the country. Contact the Cancer Council Australia for more information.<br />

42 www.cosbeauty.com.au

feature<br />

check yourself<br />

To ensure the best possible outcome, early detection is<br />

all-important. As with all types of cancer, the risk of breast<br />

cancer spreading from the breasts to other parts of the body<br />

increases dramatically if it is not detected early on. The good<br />

news is that the knowledge, technology <strong>and</strong> medical expertise<br />

is all readily available here in Australia to help women take<br />

charge of their breast health.<br />

It is critical every woman knows how to do breast selfexamination.<br />

As of age 20, self-checking using the points<br />

below should be a monthly routine:<br />

• Most doctors recommend lying down with one arm behind<br />

your head. With the other h<strong>and</strong>, feel each breast with<br />

your middle three fingers for any irregular lumps, cyst-like<br />

formations, thickening or unusual dimpling. Be sure to feel<br />

the entire breast area – from the top of the chest, under<br />

each arm, around the breast mound <strong>and</strong> down towards<br />

the rib cage.<br />

• You can also look at your breasts in the mirror, both with<br />

your h<strong>and</strong>s on your hips <strong>and</strong> in the air. Check for changes<br />

in colour, shape, nipple location, dimpling or anything that<br />

is irregular.<br />

• Use your thumb <strong>and</strong> forefinger to gently press the nipple<br />

<strong>and</strong> check for any irregular discharge.<br />

• It is not a cause for panic if you do come across an<br />

anomaly – 80 percent of lumps turn out to be benign –<br />

but you should consult with your doctor as soon as<br />

possible to be sure.<br />

• For pre-menopausal women especially, aim to perform the<br />

self-exam at the same time each month, ideally after your<br />

period. As your breasts change as you go through your<br />

menstrual cycle, by examining them at the same point in<br />

your cycle, you can make a more accurate comparison.<br />

Some changes to look for:<br />

• A new lump, or lumpiness, especially if it is in one breast.<br />

• Nipple discharge.<br />

• Change in the size or shape of the breast or nipple.<br />

• Change in the skin over the breast, such as redness<br />

or dimpling.<br />

• Unusual persistent pain, especially if it is one breast<br />

• If you’re concerned by a family history of breast cancer, or<br />

by any changes to your breasts, speak to a doctor as soon<br />

as possible.<br />

www.cosbeauty.com.au 43

feature industry<br />

The ACCS mark<br />

of distinction<br />

The Australasian College of <strong>Cosmetic</strong> <strong>Surgery</strong> continues to champion<br />

patient safety in the cosmetic industry. Caitlin Bishop reports.<br />

<strong>Cosmetic</strong> medical <strong>and</strong> surgical enhancement – or <strong>Cosmetic</strong> Medical<br />

Practice – is a popular option for many Australians looking to reverse<br />

or waylay the visible signs of ageing. With the rise of people seeking<br />

cosmetic medical procedures, it has never been more essential to ensure<br />

patients are receiving suitable, effective treatments with minimal risk.<br />

The Australasian College of <strong>Cosmetic</strong> <strong>Surgery</strong> (ACCS) plays a vital role in<br />

regulating the provision of <strong>Cosmetic</strong> Medical Practice, <strong>and</strong> upholding the<br />

st<strong>and</strong>ards of practice that patients in Australia have come to expect. ACCS<br />

members are held to an international Code of Practice, which acts as a stamp<br />

of distinction for patients considering their options in cosmetic enhancement.<br />

‘The Code covers, among other things, advertising <strong>and</strong> promotional conduct,<br />

<strong>and</strong> has an extensive governance regime including independent compliance<br />

audits <strong>and</strong> reports to the ACCS,’ says Dr John Flynn, the College’s Censorin-Chief.<br />

‘Additionally, our Patient Information Brochure, found on the AACS<br />

website, outlines the things that patients should be asking their doctor, <strong>and</strong> the<br />

information they should expect to receive before proceeding with treatment.’<br />

The Code was formulated to ensure the safe delivery of both surgical <strong>and</strong> nonsurgical<br />

procedures to the Australian community. ‘The ACCS is the only college<br />

that incorporates medical, surgical <strong>and</strong> non-surgical approaches for aesthetic<br />

enhancement,’ says cosmetic physician <strong>and</strong> College Dean Dr Ron Feiner. ‘It<br />

encompasses the whole spectrum – invasive surgery is no longer the only option for<br />

aesthetic improvement.’<br />

The ACCS is dedicated to the ongoing education of its members. This helps<br />

ensure cosmetic doctors <strong>and</strong> nurses who are members of the College remain at<br />

the forefront of the latest technologies <strong>and</strong> techniques in cosmetic medicine <strong>and</strong><br />

surgery. ‘The ACCS holds training programs <strong>and</strong> exams to ensure its doctors<br />

can perform a broad spectrum of procedures according to the Code of Practice,’<br />

says cosmetic physician Dr Eddie Roos. ‘This education is ongoing, <strong>and</strong> means<br />

continuous improvement in ACCS members.’<br />

A major part of the ACCS education program is Cosmetex, an annual<br />

international conference on the latest innovations in cosmetic surgery. Each<br />

44 www.cosbeauty.com.au

industry<br />

The ACCS<br />

Code of Practice<br />

encompasses the<br />

whole spectrum<br />

of cosmetic<br />

enhancement<br />

– both surgical<br />

<strong>and</strong> non-surgical<br />

year, the Cosmetex meeting brings together leading practitioners in the world<br />

of cosmetic medicine <strong>and</strong> surgery <strong>and</strong> hosts a program of scientifi c discussions<br />

<strong>and</strong> workshops.<br />

‘The ACCS provides a collaborative forum, <strong>and</strong> conferences such as<br />

Cosmetex are an opportunity to hear from the best cosmetic medical practitioners<br />

from overseas <strong>and</strong> locally,’ Dr Roos explains. ‘The peer-to-peer discussions are<br />

great for learning <strong>and</strong> advancing new techniques <strong>and</strong> ideas.’<br />

Not just anyone can become an ACCS member. Since its inception in 1999,<br />

the aim of the college has been unequivocally based upon patient protection<br />

<strong>and</strong> safety in cosmetic surgery. In order to act as a mark of distinction for those<br />

patients thinking about a cosmetic procedure, the College has maintained a<br />

diligent screening process before granting membership.<br />

‘Before I was granted a Fellowship with the College, they visited my practice<br />

<strong>and</strong> assessed various aspects such as our record keeping systems, sterility<br />

systems <strong>and</strong> general set up,’ Dr Roos says. ‘I also had to sit an exam. For a<br />

doctor, this means a obtaining a Fellowship certainly gives you recognition for<br />

what you do.’<br />

‘To be recognised as a Fellow of the ACCS, doctors need to have undergone<br />

appropriate training, plus specifi c procedural training <strong>and</strong> they must also have<br />

demonstrated substantial clinical experience. We also ensure our Fellows are<br />

participating in continuing education <strong>and</strong>, where needed, recertifi cation,’ says<br />

Dr Flynn.<br />

The ACCS is dedicated to offering Australian patients assurance <strong>and</strong> peace<br />

of mind in undergoing cosmetic procedures. Its commitment to upholding<br />

st<strong>and</strong>ards <strong>and</strong> accountability, as well as the ongoing education of its members,<br />

means the level of treatment <strong>and</strong> care received at the h<strong>and</strong>s of ACCS members<br />

is the best it can be. csbm<br />


• Established in 1999, the Australasian College of <strong>Cosmetic</strong> <strong>Surgery</strong><br />

(ACCS) is a not-for-profi t, multi-disciplinary fellowship-based body of<br />

general surgeons, cosmetic surgeons, plastic surgeons, maxillofacial<br />

surgeons, cosmetic physicians, dermatologists, ear nose <strong>and</strong> throat<br />

surgeons, opthalmologists, general practitioners <strong>and</strong> other doctors who<br />

practice in cosmetic medicine <strong>and</strong> surgery – <strong>Cosmetic</strong> Medical Practice.<br />

• The primary goal of the ACCS is to ensure the safe provision of cosmetic<br />

medicine <strong>and</strong> cosmetic surgical procedures to the Australian general<br />

community through the supply of appropriately trained <strong>and</strong> certifi ed<br />

health care practitioners.<br />

• The ACCS is the only medical college to provide education <strong>and</strong> training<br />

leading to fellowship specifi cally in cosmetic medicine <strong>and</strong> surgery.<br />

Fellows of the College are medical doctors who have completed<br />

post-graduate education <strong>and</strong> training <strong>and</strong> demonstrated competency<br />

specifi cally in cosmetic medicine <strong>and</strong> surgery. To become an ACCS<br />

Fellow, doctors must typically complete a minimum of 12 years of<br />

medical <strong>and</strong> surgical education <strong>and</strong> training.<br />

www.cosbeauty.com.au 45

industry<br />

It’s all<br />

in the<br />

details<br />

Shortcuts business<br />

management<br />

Software takes the<br />

stress, guesswork<br />

<strong>and</strong> time out of<br />

managing your<br />

clinic. Caitlin<br />

Bishop reports.<br />

Shortcuts software optimises the performance of beauty salons <strong>and</strong><br />

medical clinics across the globe. With more than 14,000 clients worldwide,<br />

<strong>and</strong> with the largest research <strong>and</strong> development team in the industry,<br />

Shortcuts is on the cutting edge of business efficiency <strong>and</strong> success.<br />

St<strong>and</strong>ard features of the software include tools that have been designed<br />

especially with clinics in mind, including visual treatment records <strong>and</strong> photo<br />

history. Shortcuts also speeds up the checkout process, prompting you to rebook<br />

clients <strong>and</strong> track petty cash or clinic promotions. There are also several add-ons<br />

to Shortcuts software, for example automated marketing, online bookings <strong>and</strong> a<br />

loyalty program, which will help you grow your business.<br />

Importantly, with pre-determined protocols <strong>and</strong> benchmarks, these programs<br />

hold all staff accountable for day-to-day successful business practice, whether<br />

they are the business owner or not.<br />

Point of sale<br />

Point of sale is the hub of any clinic business, <strong>and</strong> Shortcuts includes a range<br />

of features that help process transactions while automatically compiling client<br />

history <strong>and</strong> performance statistics. Something as simple as ensuring you have<br />

the correct amount of float at the start of the day can save a lot of time <strong>and</strong><br />

energy for staff.<br />

‘The point of sale wizard is a h<strong>and</strong>y feature that makes balancing your till<br />

easy,’ explains Shortcuts educator Brooke Morkham-Calvert. ‘When cashing<br />

up at the end of the day, a simple wizard guides you through the process <strong>and</strong><br />

ensures you are accountable for balancing the till. It counts the amount of money<br />

in the till, <strong>and</strong> compares this to the amount the till should hold, based on the<br />

day’s sales. This helps you ensure no cash is missing, <strong>and</strong> that you have the right<br />

amount of float for the following day.’<br />

46 www.cosbeauty.com.au

industry<br />

Following this process, the wizard generates a balance report – which is a<br />

recorded snapshot of what was just done, including how many attempts it took<br />

the operator to balance, the duration of time to do this, <strong>and</strong> a summary of the<br />

balance itself. This statement cannot be changed <strong>and</strong> can be presented to the<br />

business owner or manager to ensure accountability.<br />

‘For a business owner who has passed cashing-up responsibilities onto staff,<br />

this balance report is gold,’ says Morkham-Calvert. ‘Also, this program can be<br />

run multiple times throughout the day. For example, the till could be counted <strong>and</strong><br />

balanced as managers change shifts on a long business day.’<br />

If the till cannot be balanced, no matter how many times it is attempted, the<br />

operator must enter a reason before shutting the system down. This reason is<br />

then recorded on the balance statement, <strong>and</strong> can be used to follow matters up<br />

or for future reference.<br />

Petty cash<br />

As the point of sale system keeps tabs on the money flowing into the till, the<br />

petty cash feature can help track money that’s flowing out.<br />

‘It can be hard for business owners to keep track of petty cash – they might<br />

take $20 out of the till, <strong>and</strong> then it won’t balance at the end of the day,’ Morkham-<br />

Calvert explains. ‘With two clicks, you can tell the system how much money is<br />

being taken out for petty cash. You can then register how much of that money<br />

you spent, <strong>and</strong> it will calculate the amount that needs to be returned to the till.’<br />

Importantly, all these calculations are taken into account during the endof-day<br />

balancing. By recording petty cash in the system, Shortcuts not only<br />

optimises end-of-day efficiency but also provides additional reporting around<br />

expenses for future analytics.<br />

Discounts<br />

Promotions are a valuable way to attract business <strong>and</strong> keep existing clients<br />

happy. However, keeping track of the success <strong>and</strong> reach of your promotions can<br />

be time-consuming <strong>and</strong> arduous. The discount feature built into Shortcuts helps<br />

track how <strong>and</strong> when client discounts are being used.<br />

Using the discounts feature, you can create specific discounts such as<br />

‘birthday’, which can be applied to a transaction. This is the perfect way to<br />

accurately monitor who is giving out discounts, who is receiving them, <strong>and</strong> why<br />

– ensuring your staff are not discounting too frequently. The discounts feature<br />

also allows business owners to track the success of promotions <strong>and</strong> specials,<br />

<strong>and</strong> see at a glance how many new <strong>and</strong> existing clients are responding to your<br />

marketing campaigns.<br />

‘The discount monitoring software can record how successful a promotional<br />

campaign has been,’ says Morkham-Calvert. ‘As well as this, the discount<br />

feature is important for clinic owners entrusting day-to-day business to their staff<br />

or managers – if you’re giving money away, you need to know why.’<br />

The feature records the reason for discount, the client who is receiving it,<br />

<strong>and</strong> the staff member who is approving it. This can help in market research –<br />

determining which clientele are most responsive to promotional marketing – <strong>and</strong><br />

also tracking employee diligence.<br />

The intricate, easy to use features of Shortcuts take care of all those details that<br />

constitute a successful, efficient <strong>and</strong> friendly business. For example, Shortcuts<br />

point of sale prompts employees to set up the client’s next appointment as they<br />

check out of their current one. It’s small details like this that help business owners<br />

rest easy, knowing their clinic is being run with accountability, responsibility <strong>and</strong><br />

proactivity maximised through everyday operating systems. csbm<br />

www.cosbeauty.com.au 47

feature<br />

Are you getting the<br />

best treatment?<br />

Quality education<br />

is vital in<br />

underst<strong>and</strong>ing,<br />

prescribing <strong>and</strong><br />

delivering dermal<br />

therapy treatments.<br />

Caitlin Bishop<br />

reports.<br />

The beauty world is no longer just the arena of facials <strong>and</strong> waxing – it now<br />

encompasses more invasive skin therapies <strong>and</strong> highly active, topical<br />

ingredients. Quality training is vital in prescribing <strong>and</strong> delivering treatments,<br />

<strong>and</strong> an underst<strong>and</strong>ing of the skin’s anatomy, <strong>and</strong> comprehensive knowledge of<br />

the various processes that occur within the dermis <strong>and</strong> epidermis, is essential in<br />

performing treatments to tighten, rejuvenate or brighten the complexion.<br />

This is where quality, professional training is essential, ensuring skin therapists<br />

underst<strong>and</strong>, <strong>and</strong> are experienced in using, a range of up-to-date modalities to<br />

reap the best results for their clients.<br />

‘From a patient’s perspective, you want to know that your therapist or nurse<br />

is not only going to provide a safe treatment but also an effective treatment,’<br />

says April Jorgensen, Director of the Australasian Academy of <strong>Cosmetic</strong> Dermal<br />

Science. ‘Some patients report that their treatment did not work or had minimal<br />

effect. This is often caused by untrained therapists using very conservative<br />

parameters out of fear of causing a complication, or a lack of knowledge about<br />

how best to use their equipment.’<br />

48 www.cosbeauty.com.au

feature<br />

The results of laser <strong>and</strong> light therapies, as well as the benefits of medicalgrade<br />

skincare, have gained these therapies traction in the beauty industry.<br />

But these modalities call for a heightened level of knowledge <strong>and</strong> experience<br />

in delivering treatment. Alongside increased effectiveness, there may also be an<br />

increased rate of downtime, irritation <strong>and</strong> possible complications.<br />

‘Dermal therapists should not only be trained in performing treatment in the<br />

st<strong>and</strong>ardised time slot but also in underst<strong>and</strong>ing the product, treatment <strong>and</strong> the<br />

way active ingredients work in the skin,’ explains Jacqueline Clayton of Grayclay<br />

Medical Aesthetics Education.<br />

Dermal therapists should underst<strong>and</strong> the<br />

product, treatment <strong>and</strong> the way active<br />

ingredients work in the skin<br />

This not only benefits the consumer, but also the clinic or salon. By building<br />

a relationship with the client – one that is based upon effective results <strong>and</strong><br />

educational engagement – this will help increase customer loyalty <strong>and</strong> generate<br />

a long-term rapport.<br />

Gay Wardle, Director of Masters Dermal Academy, explains investing in quality<br />

training at a recognised institution will reap continuous rewards for both the<br />

therapist <strong>and</strong> the consumer. ‘Dedicating yourself to ongoing education is the<br />

basis for achieving the most successful <strong>and</strong> rewarding career in the aesthetic<br />

www.cosbeauty.com.au 49

feature<br />

The term “dermal<br />

therapist” is used<br />

quite loosely, <strong>and</strong><br />

consumers should<br />

look for a<br />

qualifi cation in<br />

dermal therapies<br />

that is nationally<br />

accredited<br />

industry,’ says Wardle. ‘The therapist’s job will be much more rewarding when<br />

they are delivering meaningful results for their clients. The business will continue<br />

to grow on the strength of these loyal <strong>and</strong> satisfi ed clients.’<br />

Considering most dermal therapies are unregulated in Australia – with the<br />

exception of high-grade lasers in some states – a stamp of qualifi cation acts as a<br />

distinguishing factor when consumers are deciding to undergo treatment.<br />

Jorgensen encourages patients to evaluate the level <strong>and</strong> quality of training of<br />

a dermal therapist before undertaking treatment. She explains the same goes for<br />

clinic employers <strong>and</strong> budding therapists.<br />

‘The term “dermal therapist” is used quite loosely, <strong>and</strong> consumers, employers,<br />

therapists <strong>and</strong> nurses should be advised to seek a qualifi cation in dermal therapies<br />

that is nationally accredited <strong>and</strong> recognised as part of the Australian Qualifi cation<br />

Framework,’ she explains. ‘This qualifi cation should also be recognised by the<br />

cosmetic medical profession, as well as being nationally attributed.’<br />

With the rise <strong>and</strong> rise of non-invasive cosmetic procedures, dermal therapists<br />

have become increasingly sought after. Younger patients are seeking intervention<br />

earlier, <strong>and</strong> facial rejuvenation is now a long-term venture, spanning decades.<br />

Communication, people skills <strong>and</strong> an underst<strong>and</strong>ing of individual skin needs<br />

are essential attributes in the modern-day dermal therapist. These help build<br />

long-st<strong>and</strong>ing relationships with clients, <strong>and</strong> in delivering effective, results-driven<br />

treatments. Quality education, <strong>and</strong> experience with up-to-date parameters, is<br />

vital in boosting <strong>and</strong> maintaining the st<strong>and</strong>ards <strong>and</strong> credibility of dermal therapy<br />

in Australia. csbm<br />

Advanced skin analysis training for aesthetic professionals<br />

How much importance do you give to professional<br />

skin assessments conducted in your clinics?<br />

MDA courses will give you the power to grow your business through<br />

knowledge. These short post-graduate courses are designed to take<br />

away the conventional methods of skin analysis, with a focus on:<br />

Underst<strong>and</strong>ing the functions <strong>and</strong> anatomy of skin, cells <strong>and</strong> systems<br />

Relating skin disorders to malfunction of cells <strong>and</strong> systems<br />

Functions of wound healing <strong>and</strong> the effects if the body is not healthy<br />

Learning the importance of your most valuable skin treatment<br />

How to build your business, increase your income <strong>and</strong> your<br />

reputation just by providing a thorough skin evaluation<br />

Take your education <strong>and</strong> business to the next level.<br />

For bookings, call 0418 708 455<br />

www.mastersdermalacademy.com.au<br />

Masters Dermal Academy<br />

Masters<br />

Dermal<br />

Academy<br />

50 www.cosbeauty.com.au<br />

AD_gaywardleHP.indd 1<br />

28/07/14 5:01 PM

RTO Provider No. 51373<br />

Train for<br />

a career,<br />

not a piece<br />

of paper.<br />

When considering your qualification in dermal therapies,<br />

consider your return on investment:<br />

• Become a qualified Dermal<br />

Therapist in 6 to 12 months;<br />

• Curriculum developed by the<br />

cosmetic medical profession,<br />

NOT a beauty college;<br />

• Most recognised qualifications<br />

amongst the cosmetic medical<br />

profession;<br />

• Excellent return on investment;<br />

• 10-year history of placing<br />

graduates in rewarding<br />

careers through the AACDS<br />

recruitment division;<br />

• Available online, with<br />

practical training available<br />

in Perth, Sydney, Melbourne<br />

<strong>and</strong> Gold Coast;<br />

• Available on-campus in Perth<br />

<strong>and</strong> Gold Coast.<br />

Find out more on 08 9328 6760, enquiries@aacds.edu.au or visit aacds.edu.au<br />

Curriculum available online, with practical training available<br />

in Perth, Sydney, Melbourne <strong>and</strong> Gold Coast.

feature profile<br />

Welcome to<br />

The Face Institute<br />




We underst<strong>and</strong><br />

the desire for a<br />

youthful face that<br />

refl ects how vibrant<br />

<strong>and</strong> healthy you feel<br />

on the inside<br />

The team at The Face Institute have a long history of delivering natural-looking<br />

<strong>and</strong> long-lasting results in facial rejuvenation, <strong>and</strong> are experts in the shape,<br />

structure, function <strong>and</strong> aesthetics of the face. With a philosophy based<br />

on reliability, satisfaction <strong>and</strong> quality, The Face Institute offers a comprehensive<br />

array of surgical <strong>and</strong> non-surgical services to return youthfulness <strong>and</strong> vibrancy<br />

to the face.<br />

At the helm of The Face Institute is facial aesthetic <strong>and</strong> reconstructive<br />

surgeon Dr Paul Gerarchi. He is an Australian-trained surgeon with experience<br />

<strong>and</strong> expertise in the functional, reconstructive <strong>and</strong> aesthetic surgery of the nose,<br />

face <strong>and</strong> eyes. He has instilled within his team the importance of exacting <strong>and</strong><br />

professional care, while taking an individualised approach with each patient.<br />

‘Our staff adhere to professional <strong>and</strong> ethical st<strong>and</strong>ards, which ensure the<br />

patient is presented with realistic options, according to their needs,’ says Dr<br />

Gerarchi. ‘We strive to meet the patient’s need in a manner which combines<br />

professionalism <strong>and</strong> personalised care <strong>and</strong> attention.’<br />

Rhinoplasty, face <strong>and</strong> neck lifting surgery, eyelid <strong>and</strong> brow surgery, as well<br />

as otoplasty (ear surgery) constitute a number of the popular procedures<br />

performed at The Face Institute. These can be combined with non-surgical<br />

therapies, such as anti-wrinkle injections <strong>and</strong> dermal fi llers, to achieve a holistic<br />

<strong>and</strong> comprehensive anti-ageing result.<br />

‘We want to deliver patients an enhanced facial appearance while still<br />

looking like themselves,’ Dr Gerarchi explains. ‘Whatever the reason for seeking<br />

treatment, because of ageing or other factors, we are here to help. We underst<strong>and</strong><br />

the desire for a youthful face that refl ects how vibrant <strong>and</strong> healthy you feel on the<br />

52 www.cosbeauty.com.au

feature profile<br />

Meet the<br />

face doctor<br />

Dr Paul Gerarchi is a trained head<br />

<strong>and</strong> neck surgeon <strong>and</strong> Fellow of<br />

the Royal Australasian College of<br />

Surgeons (FRACS).<br />

He has participated in several<br />

international training posts with<br />

leading head <strong>and</strong> neck surgeons;<br />

facial plastic surgeons; <strong>and</strong> plastic<br />

<strong>and</strong> reconstructive surgeons. His<br />

subspecialties include:<br />

- Face lifting<br />

- Neck lifting<br />

- Rhinoplasty<br />

- Brow lifting<br />

- Eyelid surgery<br />

Dr Gerarchi’s extensive clinical<br />

experience in both facial plastic<br />

<strong>and</strong> head <strong>and</strong> neck surgery has<br />

led to a unique <strong>and</strong> specialised<br />

underst<strong>and</strong>ing of the nose, face<br />

<strong>and</strong> eyes.<br />

The Face Institute<br />

Phone 02 9412 4599<br />

Suite 4, 12 -14 Malvern Avenue<br />

Chatswood NSW 2067<br />

www.thefaceinstitute.com.au<br />

inside. Patients who undergo aesthetic surgery or the associated non-surgical<br />

treatments can look forward to gaining greater self-confi dence <strong>and</strong> a sense of<br />

well-being from looking, feeling <strong>and</strong> functioning at their best.’<br />

The reconstructive arm of The Face Institute encompasses correcting facial<br />

deformity, in hard or soft tissue, that may be a result of facial trauma, growth<br />

disorders, disease or facial palsy. As well as this, Dr Gerarchi also performs<br />

revision surgeries in cosmetic surgery patients.<br />

‘Being a specialist centre for all issues related to the face, we fi nd that<br />

correction of cosmetic surgery complications performed elsewhere signifi es<br />

a signifi cant part of what we do,’ Dr Gerarchi explains. ‘We work closely with<br />

patients to achieve the best possible outcome given their particular situation.’<br />

Before undergoing any procedure at The Face Institute, patients are given<br />

an opportunity to discuss their goals <strong>and</strong> concerns with Dr Gerarchi in an initial<br />

consultation. In this session, Dr Gerarchi will undertake a thorough examination to<br />

decide if surgery is appropriate <strong>and</strong> establish the best treatment plan, according<br />

to the patient’s desires.<br />

‘The success <strong>and</strong> safety of the surgery relies very much on an honest <strong>and</strong><br />

open consultation process,’ he explains. ‘Patients should be prepared to discuss<br />

the reasons for seeking surgery, their expectations in undergoing treatment <strong>and</strong><br />

details of their medical history.’<br />

Patients can consult with Dr Gerarchi as many times as they like before<br />

surgery, to ensure all questions have been answered <strong>and</strong> the patient is prepared<br />

for the recovery period.<br />

To assist in this, Dr Gerarchi provides detailed instructions outlining what<br />

to expect, <strong>and</strong> the measures that need to be taken, to improve the downtime<br />

following surgery.<br />

‘A smooth recovery period is an essential part of successful surgery,’ he<br />

explains. ‘It is essential that patients attend follow-up appointments, <strong>and</strong> they<br />

can contact our rooms at any time if any concerns arise.’<br />

In taking a holistic <strong>and</strong> multi-faceted approach to anti-ageing, Dr Gerarchi<br />

advises his patients to optimise their health before going ahead with surgery.<br />

‘Healthy patients recover more quickly, have fewer complications <strong>and</strong> achieve a<br />

more effective result,’ he says. ‘Lifestyle factors such as regular exercise <strong>and</strong> a<br />

sensible diet, smoking or alcohol intake, <strong>and</strong> health conditions <strong>and</strong> associated<br />

medications can all affect cosmetic surgery outcomes <strong>and</strong> the downtime<br />

involved.’ csbm<br />

www.cosbeauty.com.au 53

column<br />

The<br />

Medical History<br />

of<br />

Queen Anne<br />






TOPICS.<br />

This month, August 2014, sees the 300th anniversary of the death of Queen<br />

Anne, the last Stuart monarch of Engl<strong>and</strong>. Her reign from 1702 to 1714<br />

was described 240 years later by the great Sir Winston Churchill as one of<br />

the greatest in English history. What Sir Winston did not know, or at least did not<br />

mention, was Anne’s terrible medical history.<br />

She was the second daughter of the Catholic king James II by his fi rst wife<br />

Anne Hyde <strong>and</strong> when he was Duke of York. Protestantism was the offi cial<br />

religion of Engl<strong>and</strong> at the time <strong>and</strong>, despite their father’s acclaimed religion,<br />

both daughters were brought up as good little Protestants. Some years later<br />

James had a boy by his second wife, Mary of Modena, who, being male <strong>and</strong><br />

thus by succession, would have inherited the throne. The population could not<br />

contemplate the possibility of another Catholic on the throne so initiated the socalled<br />

Glorious Revolution <strong>and</strong> invited the Protestants William of Orange <strong>and</strong> his<br />

wife, James’ elder daughter Mary, to take the throne. James with his new son<br />

fl ed to France. William <strong>and</strong> Mary never did have any children. Mary died in 1694<br />

<strong>and</strong> William in 1702 whereupon, you will be at last glad to know, Anne assumed<br />

the throne.<br />

In 1653 Anne had married Prince George of Denmark, a man remarkable<br />

for the poverty of his infl uence on history. He was stout, dull, slow witted <strong>and</strong><br />

colourless. Anne’s uncle, Charles II, alleged he had tried George drunk <strong>and</strong><br />

tried him sober, but sober or drunk there was nothing in him. A contemporary<br />

remarked that the Prince was forced to breath hard lest he be taken for dead.<br />

But Anne liked him <strong>and</strong> in 25 years of marriage she conceived on 17<br />

occasions, so at least he took some of royal duties seriously. Incredibly, none of<br />

the pregnancies survived into adulthood which meant the Stuart dynasty ended<br />

with Queen Anne’s death on 1 August, 1714.<br />

54 www.cosbeauty.com.au

column<br />

In 25 years of<br />

marriage, Queen<br />

Anne conceived on<br />

17 occasions.<br />

Incredibly, none of<br />

the pregancies<br />

survived into<br />

adulthood<br />

With only two exceptions there was either a stillbirth or miscarriage or death in<br />

infancy every year from marriage until 1700, including two deaths in 1686, 1687<br />

<strong>and</strong> 1697. In fact, in one disastrous week in February 1697 two infants died.<br />

The first conception was a daughter <strong>and</strong> stillborn, an outcome attributed<br />

to Anne falling from a horse near term. The live second <strong>and</strong> third babies died<br />

during that terrible week, each from an acute infection, probably smallpox, then<br />

endemic in the country. Both were buried at Westminster Abby, one in the tomb<br />

of Mary Queen of Scots. Pregnancy four ended in miscarriage <strong>and</strong> Anne blamed<br />

it on a very lively French dance called a Rigadon which she has injudiciously<br />

joined in early in pregnancy.<br />

In July 1689 Anne’s seventh conception was delivered live <strong>and</strong> well <strong>and</strong><br />

was to become her most successful. It was a boy <strong>and</strong> named William, Duke of<br />

Gloucester; he lived for 11 years. He was recorded as being weakly at birth, but<br />

William defied the odds despite having fits. A change of wet nurse was deemed<br />

to be prudent <strong>and</strong> on word of this recently delivered women flocked to Hampton<br />

Court for a piece of the action.<br />

Husb<strong>and</strong> George in one of his few appearances in the footnotes of history<br />

is said to have slowly passed down the line of c<strong>and</strong>idates with their bare milksuffused<br />

breasts thrust forward <strong>and</strong> eventually selected Mrs Pack of Kingston<br />

Wick as the successful applicant. The dear lady had the child at the nipple within<br />

the hour <strong>and</strong> William is reported to have brightened up that night, as doubtless<br />

did a perspiring <strong>and</strong> smirking Prince George.<br />

But William developed into a weedy child <strong>and</strong> was only 100cm tall at the age<br />

of five, which nowadays would put him in the last five percent of the population<br />

for his age. On his eleventh birthday he contracted scarlet fever <strong>and</strong> died a few<br />

days later. The same year, 1700, the queen had her last pregnancy; it came to its<br />

almost inevitable end in yet another stillbirth.<br />

What caused all these tragic disasters? Anne’s brooding with thoughts of spells,<br />

witches <strong>and</strong> black cats <strong>and</strong> the like hinted at divine retribution for ab<strong>and</strong>oning<br />

her father’s Catholicism. Well, maybe. Syphilis has been mooted via the dreary<br />

George. Frankly, he does not seem to have been the type to contract such a<br />

social disease <strong>and</strong> was probably the diagnosis of the diagnostically destitute. The<br />

usual story with maternal syphilis infection is that the early pregnancies miscarry,<br />

then one or two are born alive but congenitally infected <strong>and</strong> later children appear<br />

normal. Anne had enough pregnancies to play out that little scenario <strong>and</strong> it did<br />

not fit. So the fault must have been in the development of the child.<br />

Rhesus incompatibility between the man <strong>and</strong> wife’s blood is a reasonable<br />

differential diagnosis. But death from that works in the reverse way to syphilis,<br />

in other words the first child is normal <strong>and</strong> healthy, but affected conceptions get<br />

worse the more pregnancies there are. In the monarch’s case, William was the<br />

seventh child <strong>and</strong> lived, so Rhesus is probably not the issue.<br />

Most likely, it is thought, the many deaths were due to placental insufficiency<br />

causing intra-uterine growth <strong>and</strong> retardation. We will never know for sure;<br />

diagnosing causes of death 300 <strong>and</strong> more years on is fraught with difficulties.<br />

As regards Anne herself, as she got older she became very obese, either from<br />

alcohol coupled with gluttony to perhaps to try <strong>and</strong> forget her many disappoints<br />

in life, or it may have been due to kidney failure causing fluid retention <strong>and</strong><br />

accumulation. Her legs became so swollen she had difficulty in walking <strong>and</strong> at her<br />

coronation in 1702 she was carried into the chamber in a wheelchair. Towards the<br />

end of her life she suffered from convulsions, eventually dying of a stroke aged 49.<br />

She was buried in an almost square coffin such was her grossness.<br />

Having had no children the throne passed to her nearest relative, a distant<br />

cousin – the Elector of Hanover, George I. From Germany, he never learnt English<br />

through the whole of his 13-year reign, but at least he produced an heir, George<br />

II, a great supporter of the Arts. csbm<br />

www.cosbeauty.com.au 55

feature<br />

www.cosbeauty.com.au<br />

cosmetic surgery<br />

& beauty<br />

online<br />

Want more beauty<br />

<strong>and</strong> cosmetic<br />

surgery news,<br />

views <strong>and</strong> reviews?<br />

Jump online to stay<br />

at the cutting edge!<br />

Make love, look younger<br />

I don’t know about you but we’re<br />

always keen to read the latest tips on<br />

what will help us look younger <strong>and</strong><br />

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we’ve done it all.<br />

The smarter way to work out<br />

When it comes to weight loss scientists<br />

believe it’s possible to exercise less, yet<br />

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Imagine a world where losing<br />

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you could burn more calories <strong>and</strong> lose<br />

New research, however, suggests<br />

it could take two to turn back the<br />

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could have you ...<br />

Read on at www.cosbeauty.com.<br />

au/antiageing-wellbeing/<br />

make-love-look-younger/<br />

more fat than you could after a week<br />

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Read on at www.cosbeauty.com.<br />

au/antiageing-wellbeing/<br />

work-out-smarter/<br />

Face lifting: a plastic surgeon’s perspective<br />

Sydney plastic surgeon Dr Warwick<br />

Nettle from Silkwood Medical in Bondi<br />

Junction says facelift surgery can<br />

achieve natural-looking, long-lasting<br />

results to reverse the signs of facial<br />

ageing <strong>and</strong> enhance natural beauty.<br />

By correcting skin issues <strong>and</strong><br />

addressing the visible signs of ageing,<br />

facelift surgery can achieve effective,<br />

reliable <strong>and</strong> long-lasting results in facial<br />

rejuvenation. While many patients can<br />

sometimes balk at the idea of surgery<br />

– fearful of appearing ‘overdone’ <strong>and</strong><br />

wary of those st<strong>and</strong>out photographs<br />

of over-tightened celebrities – Dr<br />

Nettle believes...<br />

Read on at www.cosbeauty.com.<br />

au/cosmetic-surgery/face-liftingplastic-surgeons-perspective/<br />

56 www.cosbeauty.com.au

feature<br />

RRP $14.95 (incl. GST) (NZ $15.95 incl. GST)<br />

ISSUE 65 • AUG-OCT 2014<br />

BEAUTY<br />

ALERT<br />

MAKEUP<br />


WHAT TO<br />

EAT FOR<br />


SKIN<br />

5<br />

THINGS<br />



plus<br />

BREAST<br />




The<br />

biggest loser<br />

syndrome<br />



Read the free<br />

online version of<br />

<strong>Cosmetic</strong> <strong>Surgery</strong><br />

& <strong>Beauty</strong><br />

<strong>Magazine</strong> at<br />

cosbeauty.com.au<br />


Acclaimed to assist in weight loss,<br />

optimise digestion <strong>and</strong> fuel your body<br />

with high concentrations of nutrients,<br />

juices <strong>and</strong> smoothies seem like the<br />

ideal solution to a quick <strong>and</strong> healthy<br />

breakfast. They are used as detox,<br />


as meal replacements <strong>and</strong> as snacks<br />

between mealtimes. But are they as<br />

healthy as they’re touted to be, or are<br />

they merely another hype in the world<br />

of wellness, diets <strong>and</strong> weight loss?<br />

Like almost any food at the centre<br />

of public attention, there are several<br />

opposing views...<br />

Read on at www.cosbeauty.<br />

com.au/antiageing-wellbeing/<br />

smoothies-health-or-hype<br />

The making<br />

of CSBM<br />





We love our products just as much (if<br />

not more) than the next girl. But we’ve<br />

put together 10 ways to be more<br />

beautiful that you won’t fi nd at the<br />

beauty counter.<br />

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We all yearn for skin with a luminous<br />

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hard work it takes to gain an exerciseinduced<br />

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The only workout you need for your<br />

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2. Diet<br />

Foods that are good for your health<br />

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build-up of toxins. A good diet is like<br />

using good fuel for your car, making<br />

your skin look fresh <strong>and</strong> glowing.<br />

Opt for a diet rich in nutrients <strong>and</strong><br />

vitamins with lots of colourful fresh fruit<br />

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A strict halo diet needn’t prevent<br />

you from indulging – many studies<br />

have shown that a glass of red wine a<br />

day may help you...<br />

Read on at www.cosbeauty.com.<br />

au/beauty/top-10-beauty-boosters/<br />

PLUS<br />

check<br />

out heaps<br />

of other<br />

cool stuff<br />

BEFORE<br />

AND<br />

AFTER<br />


www.cosbeauty.com.au 57

feature<br />

<strong>Surgery</strong><br />

after<br />

massive<br />

weightloss<br />

58 www.cosbeauty.com.au

feature<br />

<strong>Surgery</strong> after<br />

massive weight loss<br />

is an emerging field<br />

in plastic surgery.<br />

There are a number<br />

of procedures<br />

designed to improve<br />

the body’s contours<br />

following dramatic<br />

weight loss. Caitlin<br />

Bishop reports.<br />

The process of losing extraordinarily large amounts of weight, whether it’s<br />

through diet, exercise or bariatric surgery, can be a harrowing <strong>and</strong> seemingly<br />

endless venture for the individual. This is because once the weight is off<br />

the journey is still not over. Loose skin folds, fatty pockets <strong>and</strong> sagging tissue are<br />

often the result of massive weight loss, <strong>and</strong> these areas – which are frustratingly<br />

difficult to treat without surgery – can detract from an otherwise healthy figure.<br />

<strong>Surgery</strong> to correct this, <strong>and</strong> assist in skin contraction following weight loss, has<br />

become a major topic in the plastic surgery arena. Indeed the latest conferences,<br />

including the Advanced Aesthetic Plastic <strong>Surgery</strong> Workshop (AAPSW) in<br />

Melbourne earlier this year, have seen huge discussion on the possibilities in<br />

body contouring following massive weight loss.<br />

Body contouring surgery<br />

Circumferential abdominoplasty is considered the most effective solution for<br />

individuals who have experienced massive weight loss. Similar to a st<strong>and</strong>ard<br />

abdominoplasty, but extending around the entire circumference, it is a surgical<br />

procedure designed to remove excess skin, cellulite <strong>and</strong> fat from the abdomen,<br />

buttocks, chest, back thighs <strong>and</strong> breasts.<br />

US plastic surgeon Dr Simeon Wall Jr. spoke at AAPSW in Melbourne<br />

<strong>and</strong> outlined his approach to circumferential truncal contouring. It involves<br />

abdominoplasty, circumferential liposuction, fat resection <strong>and</strong> targeted fat grafting.<br />

During the procedure, a horizontal incision – that extends the whole way<br />

around the body – is made above the thighs <strong>and</strong> buttocks. Through this incision,<br />

excess fat <strong>and</strong> tissue are removed, sometimes with the aid of liposuction, <strong>and</strong><br />

the stomach muscles are surgically tightened. Excess skin is then excised for<br />

a tighter, toned look <strong>and</strong> the remaining skin is re-draped over the body’s newly<br />

defined contours.<br />

In some cases, a corset trunkplasty, which involves a different incision method,<br />

is more suitable for certain patients. US plastic surgeon Dr Alex Moya explained<br />

a corset trunkplasty can be very effective in highlighting the waistline.<br />

‘A corset trunkplasty can create an aesthetically please body shape – similar<br />

to that provided by a corset – <strong>and</strong> involves several carefully placed incisions<br />

which interconnect to form the appearance of a sideways capital “H”,’ Dr Moya<br />

explains. ‘The incisions are customised for each patient, <strong>and</strong> address excess<br />

skin in both the upper <strong>and</strong> lower abdomen.’<br />

To undergo either circumferential abdominoplasty or a corset trunkplasty,<br />

patients should be as close to their ideal weight as possible or, if that is<br />

unachievable, at a steady weight that they are likely to maintain. It is recommended<br />

patients wait at least one year following bariatric surgery before undergoing<br />

circumferential reduction surgery.<br />

In some cases, liposuction can be sufficient in removing excess fat <strong>and</strong> causing<br />

effective skin contraction in weight loss patients. Power-assisted liposuction,<br />

using radiofrequency, ultrasound or laser technology alongside liposuction, can<br />

help increase skin contracture <strong>and</strong> tone <strong>and</strong> tighten in the skin’s surface.<br />

Dr Wall Jr. shared his experience using the S.A.F.E liposuction technique at<br />

AAPSW in Melbourne. This acronym st<strong>and</strong>s for Separation, Aspiration <strong>and</strong> Fat<br />

Equalisation, <strong>and</strong> depicts a strategy for performing liposuction that results in<br />

slimmer, smoother <strong>and</strong> more even body contours.<br />

While Dr Wall Jr. avoids using power-assisted liposuction, he uses these three<br />

steps – separation, aspiration <strong>and</strong> equalisation – to achieve the best results in<br />

www.cosbeauty.com.au 59

feature<br />

liposuction patients. The key element in this technique is fat equalisation where,<br />

following fat removal via separation <strong>and</strong> aspiration, the layer of fat is manually<br />

equalised to ensure an even coverage across the treated layer. This helps prevent<br />

contour irregularities <strong>and</strong> optimise results following the procedure.<br />

Australia’s<br />

exp<strong>and</strong>ing<br />

waistline<br />

Figures by the National<br />

Health Reporting Authority<br />

for the Council of Australian<br />

Governments show<br />

Australia’s obesity rate<br />

has ballooned. Sixty-three<br />

percent of Australians are<br />

now either overweight or<br />

obese, up from 44 percent<br />

in 1989. Of this figure, 28<br />

percent were obese in 2012,<br />

up from 11 percent in 1989.<br />

According to the 2011/12<br />

Australian Health Survey<br />

by the Australian Bureau of<br />

Statistics, more than half of<br />

us (55.7 percent) are trying to<br />

lose weight.<br />

Body lifting<br />

Body contouring surgery after massive weight loss is commonly accompanied by<br />

a lifting procedure. This could be a lower body lift, a breast lift or a thigh lift.<br />

‘Although losing weight is rewarding, it can result in sagging skin,’ says Dr Wall<br />

Jnr. ‘Many people choose to have a lower body lift after weight loss. This removes<br />

excess skin <strong>and</strong> pulls the remaining skin closer for a more toned, healthy look.’<br />

A lower body lift is performed via an incision around the stomach <strong>and</strong> back, <strong>and</strong><br />

will help smooth <strong>and</strong> contour the lower body. It can also be effective in reducing<br />

excess skin hanging from the legs <strong>and</strong> buttocks.<br />

For those seeking a more direct approach, a thigh lift can help improve the<br />

contour <strong>and</strong> appearance of the upper leg. During the procedure, an incision is<br />

made in the upper inner thigh – in some cases this may extend to the groin line or<br />

buttock fold – <strong>and</strong> excess fat <strong>and</strong> tissue is removed via this incision.<br />

US plastic surgeon Dr Constantino Mendieta, who was a keynote speaker at the<br />

AAPSW conference, is considered an international expert in contouring the gluteal<br />

region. He spoke on using an individualised approach in buttock enhancement,<br />

<strong>and</strong> discussed his buttock lifting technique that can be performed following a<br />

circumferential tummy tuck without the need for further scarring.<br />

For the upper body, breast augmentation can sometimes be sufficient to<br />

counter the heaviness <strong>and</strong> sagginess resulting from massive weight loss.<br />

Oftentimes it is used to return shape to a flattened, sagging breast, but if it is<br />

combined with mastopexy (breast lift surgery) it can raise the breasts to a more<br />

aesthetically pleasing position. In other patients, breast reduction may be more<br />

suitable following weight loss, <strong>and</strong> again this can be combined with a mastopexy<br />

to achieve the best results.<br />

Notably, a mastopexy can help reduce the appearance of back rolls, or sagging<br />

skin on the sides <strong>and</strong> back of a weight loss patient. By pulling the tissue upwards,<br />

<strong>and</strong> excising a significant amount of skin in the process, breast lifting can also<br />

smooth, lift <strong>and</strong> tighten the skin around the patient’s rib cage.<br />

Brachioplasty is a procedure to improve the appearance of the upper arm.<br />

During the procedure, an incision is made on the inner surface of the upper arm,<br />

from armpit to the elbow. Liposuction is used to aid in the removal of fatty tissue,<br />

<strong>and</strong> sutures are placed on the muscle to smooth <strong>and</strong> define the shape of the<br />

upper arm. As in other surgeries, excess skin is cut away before stitches are used<br />

to close the incision.<br />

In some patients, sometimes on account of weight gain, the mons pubis – the<br />

fatty tissue over the pubic bone – can become bulky or saggy. It is an area that<br />

is very difficult to reduce with diet <strong>and</strong> exercise, <strong>and</strong> cosmetic surgery is often<br />

required to make a noticeable difference.<br />

In some cases, liposuction alone can be sufficient in achieving effective results.<br />

Sometimes, however, particularly where there has been excessive weight loss,<br />

excision of tissue is also required. In this, an incision is made – generally along the<br />

pubic hairline – <strong>and</strong> the excess skin <strong>and</strong> tissue is removed. The result is a flatter,<br />

tighter <strong>and</strong> lifted pubic area. The mons pubis area is usually always addressed<br />

during abdominoplasty, however can be treated as a separate procedure.<br />

Body contouring surgery can significantly improve the look of skin folds <strong>and</strong><br />

laxity following massive weight loss – helping to boost body confidence <strong>and</strong><br />

maximise weight loss results. csbm<br />

60 www.cosbeauty.com.au

feature<br />



1. Less is more<br />

It’s not uncommon to put on weight during winter – more food, heavier meals –<br />

so it’s time to make healthier choices. By eating smaller meals more often, you<br />

will boost your metabolism <strong>and</strong> help clean up your diet.<br />










2. Healthy colour<br />

One of the best ways to lighten your diet is to add fresh fruits <strong>and</strong> veggies in a<br />

wide variety of colours. Choosing berries, melons <strong>and</strong> leafy greens to mix into your<br />

balanced meal will increase your intake of essential vitamins <strong>and</strong> antioxidants,<br />

helps prevent disease <strong>and</strong> will also increase energy levels.<br />

3. Keep snacking<br />

A successful diet is not about cutting back on food, it’s about eating sensibly<br />

throughout the day so you’re not starving at the end of it. Eat fi ve small meals<br />

every day including some healthy snacks such as nuts <strong>and</strong> fruit.<br />

4. Fresh is best<br />

The secret to a fl avourful <strong>and</strong> healing diet is to emphasise foods that are as fresh<br />

as possible. Autumn’s offerings include new-season apples, rhubarbs, pears,<br />

quince, Asian greens, spinach, pumpkin <strong>and</strong> nuts.<br />

5. Detoxify<br />

Antioxidant-rich vegetables <strong>and</strong> adequate protein are needed for the removal of<br />

toxins from the system <strong>and</strong> enhance the liver’s natural detox process. They’ll also<br />

help your immune system to ward off colds <strong>and</strong> fl us.<br />

6. Keep meals simple<br />

Enjoy the merit of simplicity. By using just a few fresh or seasonal foods <strong>and</strong> no<br />

processed foods, easy, uncomplicated dishes take on the taste of gourmet.<br />

7. Water yourself<br />

Make a concentrated effort to drink purifi ed water often throughout the day,<br />

especially between meals. We need even more water when the body is fl ushing<br />

out excess toxins. Alcohol, hot drinks <strong>and</strong> juices don’t satisfy the body’s need for<br />

water: instead, they stress blood sugar <strong>and</strong> liver function <strong>and</strong> lead to weight gain.<br />

8. Get motivated to exercise<br />

If you fi nd you’re slow on giving up some of your dietary indulgences, try making<br />

your way to the gym a couple more times a week. It will motivate you to eat<br />

healthier so you’re not working out for nothing. csbm<br />

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after massive weight loss<br />




Body-contouring procedures after massive weight<br />

loss (MWL) can bring about truly life-changing<br />

results. You may have experienced weight loss<br />

through your own efforts or with the help of bariatric<br />

surgery, <strong>and</strong> want to complete your weight loss journey<br />

with a body-contouring procedure; you may have struggled<br />

with stubborn fat deposits resistant to diet <strong>and</strong> exercise,<br />

<strong>and</strong> want to tackle this issue head-on with the help of<br />

liposuction; or you may simply want to change the shape<br />

<strong>and</strong> size of certain areas of your body, helping to produce a<br />

more cosmetically appealing fi gure.<br />

Prior to losing a large amount of weight people are<br />

naturally focused on their weight loss goal <strong>and</strong> do not give<br />

much consideration to what shape their bodies will be in<br />

after their desired weight loss has been achieved.<br />

As a result, whilst the outcome on the scales is gratifying,<br />

the presence of signifi cant amounts of loose skin both look<br />

unsightly <strong>and</strong> can cause painful rashes (intertrigo) <strong>and</strong><br />

considerable discomfort when wearing clothes <strong>and</strong> walking.<br />

For these men <strong>and</strong> women, body contouring surgery<br />

provides them with a more shapely body to complement<br />

their reduced weight. There is a saying that ‘the bariatric<br />

surgery makes a patient healthy, but the body contouring<br />

surgery makes them happy’.<br />

Some weight loss patients only need to target one<br />

specifi c area of the body to achieve their body-contouring<br />

goals. Others may need to deal with a number of problem<br />

areas, with the surgery spread over a number of operations.<br />

A signifi cant proportion of patients undergo all of the major<br />

body contouring procedures in a number of operations<br />

spread out over 12 to 18 months. This requires a huge<br />

commitment from the patient, but the results can be amazing.<br />

The best results of body lifting/body contouring by<br />

far are achieved in patients who have reached or nearly<br />

reached their ideal weight, with a Body Mass Index (BMI)<br />

of 20 to 30. But very dramatic improvements can be made<br />

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in patients whose BMI is higher than 30. Body Mass Index<br />

is calculated by dividing your weight in kilograms by your<br />

height in metres squared:<br />

Normal: 20 – 25<br />

Overweight: 25 – 30<br />

Obese: 30 – 35<br />

Morbidly Obese: >35<br />

Patients who intend to lose more weight are advised to<br />

wait until they reach their target weight before treatment.<br />

Smoking is a contra-indication to MWL body contouring.<br />


Whilst the abdominoplasty procedure is most commonly<br />

performed on women following pregnancy, it is also<br />

often performed in the massive weight loss setting,<br />

both as an independent procedure <strong>and</strong> as the front half<br />

of a circumferential lower body lift. This is due in part to<br />

any previous pregnancies <strong>and</strong> in part to stretching of the<br />

abdominal wall by the large volume of fat deposited around<br />

the abdominal organs in the obese individual.<br />

Not infrequently, the weight loss (‘bariatric’) surgery<br />

requires an open rather than a keyhole procedure, which<br />

involves splitting the vertical tummy muscles (‘rectus<br />

muscles’). Due to these patients’ very large size, the repair<br />

of the separated muscles may come apart post-operatively,<br />

resulting in a ‘ventral’ (incisional) hernia in which some of<br />

the abdominal contents bulge out through the muscle gap.<br />

If the lower trunk skin/fat excess is confined mainly to the<br />

front, then an abdominoplasty suffices <strong>and</strong> a circumferential<br />

procedure is not required.<br />

The procedure<br />

A transverse wedge of skin <strong>and</strong> fat extending just above the<br />

umbilicus is excised, followed by suture repair of the rectus<br />

muscles with or without reinforcement with synthetic mesh or<br />

‘artificial dermal matrix’ (ADM). Sometimes a vertical wedge<br />

is also removed, producing an inverted T-scar pattern. This<br />

is called a ‘trefoil’ or ‘fleur-de-lys’ pattern abdominoplasty.<br />

Once the muscles have been repaired, the remaining<br />

abdominal skin is pulled down <strong>and</strong> sutured to the lower<br />

incision. Lastly, the umbilicus (‘belly button’) is brought back<br />

out to the surface through a new incision.<br />

Drains are not routinely used. A compression garment is<br />

typically worn for four to six weeks. The patient is usually<br />

discharged on the second to fourth post-operative day<br />

<strong>and</strong> walking is encouraged. Heavy lifting <strong>and</strong> gym work<br />

can be resumed after about eight weeks. Driving may be<br />

resumed after 10 days, <strong>and</strong> three to four weeks off work<br />

are usually required.<br />


The introduction of the circumferential ‘lower body lift’ (also<br />

known as a belt lipectomy) in the early 1990s revolutionised<br />

the surgical treatment of the massive weight loss patient.<br />

The Lower Body Lift is a circumferential procedure<br />

consisting of an abdominoplasty in the front, <strong>and</strong> lifting of<br />

the buttocks <strong>and</strong> the outer <strong>and</strong> back part of the thighs.<br />

Liposuction is often performed in conjunction.<br />

The buttocks in particular can be dramatically improved.<br />

The buttocks in these patients tend to be very flat in addition<br />

to drooping, <strong>and</strong> fat liposuctioned from other areas can be<br />

transferred (grafted) to the buttocks to produce a more<br />

rounded <strong>and</strong> pleasing shape.<br />

Not infrequently an additional vertical wedge of skin/<br />

fat is removed from the middle of the abdomen to deal<br />

with the laxity in the horizontal direction (fleur-de-lys<br />

abdominoplasty). The Lower Body Lift can be combined<br />

with other contouring procedures.<br />

The procedure<br />

A Lower Body Lift takes around four to six hours on a<br />

thinner patient <strong>and</strong> longer on a larger patient where<br />

liposuction has to be performed before the excess skin can<br />

be excised.<br />

All the wound closures are performed with buried<br />

dissolvable sutures. Drains are not routinely used which<br />

makes the post-operative recovery much easier.<br />

At the end of the procedure a compression garment is<br />

worn. Patients are encouraged to sit out of bed <strong>and</strong> walk a<br />

little on the first post-operative morning. A blood transfusion<br />

may be required to optimise recovery, especially where<br />

the body lift has been combined with another contouring<br />

procedure. Discharge from hospital is around the fifth postoperative<br />

day.<br />


This term includes breast rejuvenation surgery (reduction/<br />

lift/enlargement/gynaecomastia treatment in males) <strong>and</strong><br />

tightening of the sides of the chest <strong>and</strong> back if required.<br />

Some practitioners include arm reduction surgery<br />

(brachioplasty) in this grouping.<br />


Arm reduction surgery is an excellent procedure for<br />

individuals who are self-conscious about the appearance<br />

of excess tissue below their arms (so-called ‘tuck-shop<br />

arms’). The brachioplasty procedure restores more youthful,<br />

toned contours to the arms <strong>and</strong> gives patients greater selfconfidence<br />

in their appearance.<br />

Interestingly, many massive weight loss patients, in spite<br />

of the fact that they have extensive rolls of loose skin <strong>and</strong><br />

fat around the lower trunk, which one would think would<br />

be the top priority for treatment, request brachioplasty as<br />

the initial procedure. This is because they desire to wear<br />

short-sleeved tops which expose their arms <strong>and</strong> find it very<br />

hard to find clothes that fit, whereas the lower body/thighs<br />

can be easily hidden by clothes <strong>and</strong> so can be dealt with<br />

at a later date.<br />

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The procedure<br />

Patients presenting for brachioplasty underst<strong>and</strong>ably would<br />

like the incision to be placed in the armpit <strong>and</strong> the skin<br />

pulled up to that site <strong>and</strong> the excess removed, leaving a<br />

small hidden scar. Unfortunately the reality is that only the<br />

smallest amount of skin can be removed this way <strong>and</strong> that<br />

skin has to be located close to the armpit.<br />

C<strong>and</strong>idates for brachioplasty have skin/fat excess at<br />

least half-way down the arm <strong>and</strong> in many it extends as far<br />

as the elbow, <strong>and</strong> the only effective way to treat this is by<br />

making the incision <strong>and</strong> therefore the scar down the inner<br />

aspect of the arm, often all the way to the elbow.<br />

Body contouring surgery<br />

creates a more shapely body<br />

after significant weight loss<br />

If the skin excess extends past the armpit <strong>and</strong> onto the<br />

chest wall then the excision is extended to incorporate this.<br />

If the patient has excess fat in the arms – usually on the<br />

back of the arm up towards the shoulder – liposuction will<br />

be also be performed. Suction drains may be used.<br />

Compression sleeves are fitted at the end of the<br />

procedure <strong>and</strong> are worn for four weeks. The patient is<br />

typically discharged on the second post-operative day.<br />

After the surgery, moving the arms as pain permits is<br />

encouraged. Fluid may collect, especially just above the<br />

elbow, due to the interruption of lymphatic channels. This is<br />

called a ‘lymphocoele’. The fluid is drained painlessly in the<br />

rooms, usually on two or three occasions before it resolves.<br />

Unlike the scar in the tummy tuck procedure, the<br />

brachioplasty scar is not in a favourable anatomical location<br />

<strong>and</strong> often six to 12 months are required for the scars to<br />

fade. Occasionally the scar becomes tight, producing<br />

discomfort on stretching the arm above the head. In this<br />

case a scar revision is performed. The arm reduction<br />

procedure may need to be revised after a number of years<br />

due to recurrence of skin laxity due to ageing.<br />


Excess tissue between the thighs rubs together, causing<br />

discomfort when walking. The inner thigh lift, in most cases<br />

assisted by liposuction, produces smoother, shapelier <strong>and</strong><br />

much younger looking thighs which no longer cause friction.<br />

The procedure<br />

The general conception amongst patients is that the inner<br />

thigh lift is a simple, quick procedure, but in fact for the<br />

surgeon it is technically dem<strong>and</strong>ing due to the awkward<br />

site <strong>and</strong> the difficulty of access. The inner thigh lift for many<br />

years was performed through an incision from the groin<br />

through to the buttock fold.<br />

As in brachioplasty, patients underst<strong>and</strong>ably expected<br />

the lift to be done though this incision alone, but the reality<br />

was that this was suitable only for a few patients, <strong>and</strong><br />

the incision was invariably extended down the inner<br />

aspect of the thigh, often as far as the knee, producing a<br />

T-shaped scar.<br />

The horizontal resection represents a true lift, but gravity<br />

gradually drags the scar down so that the scar, initially<br />

hidden within the underpant line, becomes visible below<br />

this. More recently a vertical resection alone has become<br />

the procedure of choice, with the excision extended up<br />

alongside the pubic area when required. The three big<br />

advantages of the vertical excision are: 1. Much of the<br />

excess is located down the inner thigh; 2. The tightening<br />

is across gravity, rather than opposing it; 3. There is no<br />

T-junction in the groin region where tissue breakdown with<br />

delayed healing was very common with the older technique.<br />

Suction drains may be used, <strong>and</strong> the patient is encouraged<br />

to mobilise on the first post-operative day <strong>and</strong> is ready for<br />

discharge home the following day. A compression garment is<br />

worn for about four weeks (six weeks if a significant amount<br />

of liposuction has been performed).<br />

After an inner thigh lift, patients are encouraged to walk<br />

following discharge home. Jogging may be resumed after<br />

six weeks but upper body gym work can be resumed after<br />

about three weeks. Fluid may collect, especially just above<br />

the knee, due to the interruption of lymphatic channels,<br />

which is drained in the clinic until it resolves.<br />

The vertical scar down the thigh is not in a ‘favourable’<br />

skin line <strong>and</strong> therefore may remain pink <strong>and</strong> visible for some<br />

months but then settles down into a pale scar which is<br />

hard to see.<br />


Gynaecomastia refers to a condition in which men have<br />

enlarged breasts, also known rather unkindly as ‘man<br />

boobs’. Men who have developed enlarged breasts may<br />

feel embarrassed <strong>and</strong> may be hesitant to be seen in T-shirts<br />

or to take their shirts off in public such as at the beach.<br />

In the massive weight loss setting, the breast<br />

enlargement is due to an accumulation of fat <strong>and</strong> there may<br />

be little or no actual breast tissue. This is called ‘pseudogynaecomastia’<br />

<strong>and</strong> may respond to liposuction alone.<br />

The skin excess usually necessitates skin resection with<br />

transposition of the nipple or removal of the nipple at the<br />

start of the procedure <strong>and</strong> replacement of it as a graft at the<br />

end of the procedure. Removal of skin necessarily means<br />

scars on the male chest, which are avoided wherever<br />

possible. Suction drains are used in this procedure. A<br />

compression garment is then applied for four weeks.<br />

The patient is discharged on the second post-operative<br />

day. Arm motion is encouraged. As mentioned in relation<br />

to other body-contouring procedures, some fluid may<br />

collect in the subcutaneous space (a ‘seroma’), requiring<br />

aspiration in the clinic.<br />

66 www.cosbeauty.com.au



High quality<br />

care,<br />

beautiful<br />

results<br />

Mr Richard Maxwell is a widely<br />

respected plastic surgeon in the<br />

Melbourne, Victoria area.<br />

For 20 years, Dr Maxwell has used<br />

his plastic surgery skills to help patients<br />

enhance their appearance <strong>and</strong> improve<br />

their self-confi dence. He <strong>and</strong> his staff<br />

ensure safe <strong>and</strong> effective treatments for<br />

cosmetic enhancement <strong>and</strong> rejuvenation,<br />

with a particular interest in body<br />

contouring after massive weight loss.<br />


Body surgery – contouring after massive<br />

weight loss, liposuction, tummy tuck,<br />

body lift, gynaecomastia<br />

Breast surgery – augmentation,<br />

lift, reduction<br />

Face surgery – facelift, blepharoplasty,<br />

rhinoplasty, otoplasty<br />

Non-surgical – anti-wrinkle injections,<br />

fi llers, fat transfer<br />


info@maxwellplasticsurgery.com.au<br />

www.maxwellplasticsurgery.com.au 03 9509 9699

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insight<br />

a woman’s<br />

Sydney Plastic Surgeon<br />

Dr Amira Sanki underst<strong>and</strong>s firsth<strong>and</strong><br />

the motivations, concerns<br />

<strong>and</strong> desires of her female PATIents.<br />

Caitlin Bishop reports.<br />

The decision to undergo cosmetic surgery should be<br />

a personal, positive <strong>and</strong> educated one. A good<br />

rapport with your surgeon is key in optimising surgical<br />

outcomes <strong>and</strong>, in some cases, a woman’s underst<strong>and</strong>ing<br />

can help establish the best plan for your body <strong>and</strong> your<br />

expectations <strong>and</strong> motivations.<br />

Sydney plastic surgeon Dr Amira Sanki is one of a<br />

h<strong>and</strong>ful of female plastic surgeons in NSW. She has a<br />

personal insight into the needs, concerns <strong>and</strong> desires of her<br />

female patients, <strong>and</strong> is not afraid to bring her experiences<br />

into her consultations with female patients.<br />

‘A female plastic surgeon has experienced first-h<strong>and</strong> a<br />

lot of the concerns that her patients are going through,’<br />

Dr Sanki explains. ‘At university, I wanted flawless skin;<br />

when I was training as a plastic surgeon, I did everything I<br />

could to look less tired <strong>and</strong> run down; when I had children,<br />

I wanted my body to bounce back to where it used to be. I<br />

underst<strong>and</strong> the different stages a woman might go through<br />

in her life.’<br />

The same way she can relate to those concerns that<br />

are driving women to seek cosmetic surgery, Dr Sanki<br />

also underst<strong>and</strong>s the feelings of apprehension that might<br />

surround the surgery itself <strong>and</strong> the recovery period.<br />

‘Women are often the backbones of our homes <strong>and</strong><br />

workplaces, <strong>and</strong> want to get through our surgery as safely<br />

<strong>and</strong> predictably as possible,’ she says. ‘Women want to go<br />

on being a mother, a wife <strong>and</strong> a professional.’<br />

Further demonstrating her commitment to making her<br />

patients as comfortable as possible, Dr Sanki sometimes<br />

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works with an all-women surgical team, depending on her<br />

patient’s preferences.<br />

‘<strong>Surgery</strong> is quite a daunting thing to consider, <strong>and</strong> I will<br />

do all that I can for my patients so they feel comfortable <strong>and</strong><br />

secure,’ she says. ‘My anaesthetists, nurses <strong>and</strong> surgical<br />

assistants have all been working with me for years. They<br />

are part of my team, not just because they are women, but<br />

because I know they are the best in their professions. Also,<br />

they have all had some type of surgery at some point in<br />

their lives – I think this gives them unique insight into what it<br />

feels like to be a patient in an operating room.’<br />

Mummy makeover<br />

For many women, changes to the body that occur during<br />

childbearing can be difficult to reverse with diet <strong>and</strong><br />

exercise endeavours. A “mummy makeover” is a surgical<br />

procedure that combines abdominoplasty <strong>and</strong> breast<br />

surgery – augmentation, reduction <strong>and</strong>/or lift (mastopexy)<br />

– to achieve an all-over transformation.<br />

‘There are two distinct groups of patients who commonly<br />

seek “mummy makeover” surgery,’ Dr Sanki explains.<br />

‘There are women who want to restore their bodies to how<br />

they looked before having children – this group tends to<br />

want more natural-looking, modest results. The other group<br />

includes those who wish to seize the opportunity to create<br />

the body they’ve always wanted. These women usually<br />

have kids who are finishing or have finished school <strong>and</strong> they<br />

finally have time to make themselves more of a priority <strong>and</strong><br />

invest in how they look.’<br />

Before any surgery, patients undertake multiple<br />

consultations with Dr Sanki. This allows the patient to<br />

properly underst<strong>and</strong> all that is involved in the procedure<br />

<strong>and</strong> recovery period, <strong>and</strong> gives Dr Sanki an opportunity<br />

to accurately gauge the patient’s motivations, concerns<br />

before<br />

<strong>and</strong> expectations. ‘All of our patients have at least two<br />

consultations, so I can underst<strong>and</strong> who they are as people<br />

<strong>and</strong> what motivates them for undertaking the surgery, as<br />

well as educating them about all aspects of the operation,’<br />

she says. ‘After taking a list of my patient’s concerns <strong>and</strong><br />

health issues, we then decide together on their implant<br />

choice, <strong>and</strong> whether they need a combination procedure<br />

like a breast augmentation <strong>and</strong> a mastopexy (lift). In the<br />

second consultation, my patients have an opportunity to<br />

ask additional questions about their surgery. We then take<br />

them through all the expectations of their surgical process<br />

– who will drive them home after the surgery, their comfort<br />

plan, when they can resume work, etc.’<br />

Because it combines several procedures, a ‘mummy<br />

makeover’ can be quite an extensive operation. Dr Sanki<br />

usually performs the surgery in one session, however can<br />

tailor her surgical approach depending on the patient.<br />

‘In most patients, a mummy makeover can be achieved<br />

in one surgical session,’ she says. ‘In more complex<br />

makeovers, where there are multiple reconstructive <strong>and</strong><br />

cosmetic issues, it is generally preferable to stage the<br />

surgery. I always take into account the wishes of my<br />

patients <strong>and</strong> their lifestyle requirements.’<br />

The recovery period following surgery is crucial in<br />

securing the best result possible. Combination procedures<br />

typically involve a couple of nights in hospital, followed by<br />

one or two weeks rest at home. Dr Sanki is on call for her<br />

patients at any time of the day during their recovery, <strong>and</strong><br />

undertakes a minimum of three follow-up sessions with<br />

each patient to monitor their recovery <strong>and</strong> progress.<br />

‘It’s an amazing moment when my patients come in for<br />

their final follow-up, wearing a new outfit <strong>and</strong> feeling like<br />

a new person,’ Dr Sanki says. ‘I am always overwhelmed<br />

by that moment. That’s what plastic surgery is all about:<br />

improving self-confidence <strong>and</strong> transforming lives.’ csbm<br />

after<br />

BEFORE<br />

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The<br />

‘Western<br />

Society’<br />

Syndrome<br />





Metabolic syndrome is a medical condition that<br />

usually affects middle-aged men, but it can start<br />

at any time. It is characterised with central<br />

abdominal adiposity, or a growing waistline, occasionally<br />

forming an apron-like fold over the abdomen.<br />

Abdominal adiposity is also called visceral fat, which<br />

lies deep within the abdominal cavity <strong>and</strong> pads, the<br />

internal abdominal walls, <strong>and</strong> the attachments of the<br />

organs (particularly the small <strong>and</strong> large bowel).<br />

This internal fat, also known as white fat, is considered to<br />

be mainly responsible for the metabolic effects on<br />

insulin resistance (IR), cardio-metabolic syndrome, type 2<br />

diabetes, hypertension, depression, Vitamin D defi ciency,<br />

partial <strong>and</strong>rogen defi ciency in males (PADM), dyslipidaemia,<br />

osteoporosis, cognitive decline, erectile dysfunction,<br />

sleep apnoea, general cancer risk (breast, colon,<br />

prostate), kidney disease <strong>and</strong> kidney failure, <strong>and</strong> probably<br />

much more.<br />

Unfortunately, many young men are not recognised<br />

with metabolic syndrome <strong>and</strong> some are misdiagnosed <strong>and</strong><br />

treated for depression instead.<br />

What is insulin resistance?<br />

Insulin resistance (IR) is usually defi ned as a state<br />

characterised by the reduced glucose-lowering activity of<br />

insulin, but it can also be used as a shorth<strong>and</strong> label for a<br />

clinical syndrome encompassing signifi cant pathologies of<br />

metabolic syndrome. Insulin is a gene expression modulator<br />

involved in many biochemical processes in the body.<br />

Failure to diagnose IR in the younger population has<br />

a possible association with abdominal obesity (cardio<br />

metabolic syndrome is present in 6.7 percent of people<br />

aged 20 to 29 years <strong>and</strong> is increasing every year).<br />

How does metabolic syndrome<br />

develop?<br />

I believe low testosterone, low Vitamin D, low serotonin<br />

levels, lack of exercise, increased food intake (particularly<br />

carbohydrates <strong>and</strong> phytoestrogens) <strong>and</strong> family propensity<br />

to consume excess calories may trigger a cascade of<br />

effects leading to metabolic syndrome. It can start at any<br />

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time, even in teenagers, but the risk factor increases with<br />

age <strong>and</strong> it is more prevalent in the ageing population.<br />

Metabolic syndrome can be treated. An experienced<br />

medical practitioner can diagnose <strong>and</strong> treat the condition<br />

early with an integrative medical approach, including:<br />

• Lifestyle interventions (low GI Mediterranean diet,<br />

exercise, socialising, stress management)<br />

• Macro- <strong>and</strong> micro-nutritional management (green<br />

tea, cinnamon, fenugreek, Banaba, fish oil, Boswelia,<br />

Curcumin, Ubiquinol)<br />

• Supplementation (Vitamin D, Q-10 (in the form of<br />

Ubiquinol), Alpha Lipoic Acid)<br />

• 5-hydroxytryptophan (5-HTP) therapy. Researchers have<br />

found 5-HTP make people feel more full after eating, so<br />

they ate less. Since serotonin helps regulate mood <strong>and</strong><br />

behaviour, 5-HTP may have a positive effect on sleep,<br />

mood, anxiety, appetite <strong>and</strong> pain sensation.<br />

• Lipostructure of fat deposits<br />

• PhotoDynamic HelioTherm to treat internal white fat<br />

deposits (thermogenic effect) <strong>and</strong> probably much more.<br />

The combination of lifestyle modification, lipostructure<br />

<strong>and</strong> PhotoDynamic HelioTherm therapy is a new<br />

advancement in the treatment of metabolic syndrome. In<br />

my experience, it is painless, there is no downtime (literally<br />

walk in, walk out), provides an excellent skin retraction<br />

(particularly if combined with MicroPen microneedling <strong>and</strong><br />

platelet-rich plasma (PRP) therapy).<br />

The results can be permanent, provided the patient eats<br />

sensibly, exercises regularly <strong>and</strong> takes supplements <strong>and</strong><br />

prescribed medications. Most patients are very satisfied<br />

with the results. They feel more comfortable in a wide<br />

variety of clothes <strong>and</strong> more at ease with their bodies.<br />

As long as a patient’s expectations are realistic, they<br />

should be happy with their new shape.<br />

What is the future?<br />

BioRestorative Therapies Inc, a stem cell biotechnology<br />

company, is advancing its ThermoStem Program,<br />

designed to develop treatments using brown fat stem cells<br />

for metabolic disorders <strong>and</strong> obesity, focusing on potentially<br />

preventing the onset of type 2 diabetes.<br />

The ThermoStem Program is based on pre-clinical<br />

research that increased amounts of brown fat in the body<br />

may be responsible for additional caloric burning <strong>and</strong><br />

reduced glucose <strong>and</strong> lipid levels. Potential use may include<br />

inducing weight loss (a ‘biologic diet’) <strong>and</strong> the reduction of<br />

glucose <strong>and</strong> lipids – perhaps even leading to delaying or<br />

preventing the onset of type 2 diabetes.<br />

I believe that lifestyle modification, lipostructure (to<br />

selected fat deposits), PhotoDynamic HelioTherm (lipolysis<br />

<strong>and</strong> skin tightening) <strong>and</strong> adopting the ThermoStem<br />

Program (using brown fat stem cells) is the future treatment<br />

in managing metabolic syndrome. csbm<br />

Declaration of interest: The author is a designer <strong>and</strong> investor of<br />

PhotoDynamic HelioTherm Therapy <strong>and</strong> investor in BioRestorative<br />

Therapies - ThermoStem Program (Brown Fat Stem Cells).<br />

Case study<br />

This 80-year-old patient requested liposuction. He was told<br />

that he was an unsuitable c<strong>and</strong>idate as liposuction can<br />

remove external fat but not internal (visceral) fat.<br />

The patient is very happy with the result after<br />

Photodynamic HelioTherm, lifestyle modification, hormonal<br />

<strong>and</strong> supplements therapy. In total he has lost more than<br />

16cm of his circumference.<br />

He says his energy level <strong>and</strong> work productivity has<br />

increased dramatically <strong>and</strong> is planning to stay in the<br />

workforce for another 10 years <strong>and</strong> retire at the age of 90!<br />

BEFORE<br />

Six months AFTER BioRestorative ThermoStem Program by<br />

Dr Georghy<br />

12 months AFTER BioRestorative ThermoStem Program by<br />

Dr Georghy<br />

www.cosbeauty.com.au 71

tattoo removal<br />

The latest in<br />

tattoo<br />

removal<br />

PicoSure signifies a breakthrough in laser<br />

tattoo removal, affording superior results in<br />

fewer treatments. Caitlin Bishop reports.<br />

Once upon a time, tattoos were a lifetime commitment <strong>and</strong>, regrettable<br />

or not, the design was there to stay. Now, thanks to advancements<br />

in tattoo removal technology, those decisions don’t have to be so<br />

permanent. The new PicoSure laser from Cynosure is the first <strong>and</strong> only<br />

picosecond laser, delivering ultra-short pulses of energy to shatter tattoo pigment<br />

in the skin.<br />

‘The PicoSure delivers laser energy 100 times faster than traditional<br />

Q-Switched lasers, making laser tattoo removal safer <strong>and</strong> more effective than<br />

ever before,’ explains Dr John Relic, a dermatologist in Lake Macquarie, NSW.<br />

‘Traditional tattoo removal can take between five <strong>and</strong> 15 sessions, while the<br />

PicoSure can completely remove tattoos in as little as five sessions.’<br />

It is the extra short pulses – at a trillionth of a second – that distinguish PicoSure<br />

from traditional tattoo removal lasers. The system uses patented Pressure<br />

Wave technology to target <strong>and</strong> shatter the ink particles, meaning tattoos can<br />

be cleared in fewer treatments.<br />

‘The PicoSure delivers a lot more energy, in a shorter period of time, compared<br />

with traditional tattoo removal lasers,’ explains cosmetic dermatologist from<br />

Neutral Bay Dr Terence Poon, who specialises in laser treatments. ‘It is more<br />

effective in breaking up the tattoo particles – like breaking boulders into s<strong>and</strong><br />

grains. This helps the body’s immune system remove the particles more rapidly.’<br />

Because of the intensity created by the wave, lower fluencies (the energy<br />

72 www.cosbeauty.com.au

tattoo removal<br />

PicoSure is the<br />

treatment of<br />

choice for our<br />

tattoo removal<br />

clients, <strong>and</strong> we<br />

have seen some<br />

amazing results<br />

Because of the intensity created by the Pressure Wave, lower fluencies (the energy<br />

delivered per unit area) can be utilised to achieve ink particle fragmentation.<br />

‘The PicoSure causes a photomechanical action in the skin – which is the<br />

shattering of ink particles – as opposed to a photothermal action delivered by<br />

traditional lasers,’ Dr Relic says. ‘This means there is lesser risk to the surrounding<br />

tissue, <strong>and</strong> helps create those smaller particles that are easier for the body to clear.’<br />

PicoSure is equipped with an Alex<strong>and</strong>rite wavelength (755nm), which has the<br />

ability to target green, blue, purple, black <strong>and</strong> brown inks – colours that have been<br />

typically difficult to move. ‘Green inks are particularly difficult to remove, <strong>and</strong> the<br />

PicoSure is effective in targeting these,’ Dr Poon explains. ‘In some cases, the<br />

PicoSure might be used in conjunction with a traditional Q-Switched laser to combat<br />

some of the more stubborn colours, for example to help remove red ink.’<br />

The specified wavelength also reduces the risk of pigmentation or textural<br />

irregularities following treatment. The wavelength targets tattoo ink without affecting<br />

the surrounding melanin – the skin’s natural pigment. ‘The 755nm wavelength<br />

means there is very little, if any, absorption of melanin,’ Dr Relic explains. ‘This means<br />

the PicoSure can specifically target the tattoo ink, leaving the surrounding skin<br />

untouched. Some people may experience minor textural or pigmentation changes<br />

to the treatment site, but these are usually short-term.’<br />

The treatment itself is relatively comfortable, <strong>and</strong> does not require anaesthetic.<br />

Patients may experience some blistering <strong>and</strong> redness immediately post-laser, but<br />

this should subside over the next day or two.<br />

‘The sensation during treatment is similar to the snap of a hot rubber b<strong>and</strong> on the<br />

skin, <strong>and</strong> the process is usually very well tolerated,’ Dr Relic says. ‘We use a cooling<br />

system to cool the skin before <strong>and</strong> during treatment, to reduce any discomfort.’<br />

‘Immediately following treatment, the tattoo will turn a frosty white colour. This<br />

lasts approximately 30 minutes before the colour returns to normal,’ Dr Relic adds.<br />

‘Clients need to ice the treatment area, on <strong>and</strong> off, for up to four hours following<br />

PicoSure <strong>and</strong>, if the treatment area is on the legs or feet, we encourage our clients<br />

to keep the area elevated.’<br />

There are some potential risks associated with PicoSure treatment, <strong>and</strong> Dr<br />

Poon explains patients should consult an experienced operator before undergoing<br />

treatment. ‘There are risks involved with any laser treatment, <strong>and</strong> it is the experience<br />

of the operator that makes the difference,’ he says.<br />

Changes to the tattoo can usually be seen within the first week following<br />

treatment with PicoSure. These changes – particularly after the initial treatment –<br />

usually involve fading <strong>and</strong> “fuzzing” of the ink around the edges of the tattoo, before<br />

the ink completely disappears.<br />

‘We see a vast array of tattoos, <strong>and</strong> clients want them removed for a multitude<br />

of reasons,’ Dr Relic explains. ‘Some clients need to have their tattoos removed so<br />

they can start a career or, in some cases, so they can move on from a painful past.’<br />

‘PicoSure is the treatment of choice for our tattoo removal clients, <strong>and</strong> we have<br />

seen some amazing results. It can help clear stubborn tattoos, <strong>and</strong> the treatment<br />

period is significantly reduced. With PicoSure, our clients can have their tattoos<br />

completely removed much sooner,’ Dr Relic concludes. csbm<br />

BEFORE<br />

AFTER three treatments with PicoSure laser. Photos courtesy of Dr Relic at<br />

Newcastle Tattoo Removal.<br />

www.cosbeauty.com.au 73

picosuretattooremoval<br />

No more<br />

tattoo regrets...<br />

PicoSure for fast <strong>and</strong><br />

effective tattoo removal<br />

Erase unwanted tattoos with PicoSure, the world’s first picosecond<br />

aesthetic laser treatment available for fast <strong>and</strong> effective tattoo removal.<br />

PicoSure targets unwanted ink more effectively than ever before,<br />

successfully removing difficult ink colors, such as blues <strong>and</strong> greens,<br />

as well as previously treated tattoos. Fewer treatments, faster recovery<br />

time, <strong>and</strong> greater results are achievable with PicoSure’s ground-breaking<br />

picosecond technology.<br />

picosure.com.au<br />

cynosureaustralia.com<br />

© 2013 Cynosure, Inc. Cynosure is a registered trademark <strong>and</strong><br />

PicoSure is a trademark of Cynosure, Inc. ALL RIGHTS RESERVED.

Before<br />

After 20 treatments<br />

Q-Switched Nd:YAG<br />

Photo courtesy of Cynosure, Inc.<br />

After 6 treatments<br />

PicoSure<br />

Before & After 3 treatments<br />

Photo courtesy of K. Arndt, MD & J. Dover, MD<br />

Before & After 3 treatments<br />

Photo courtesy of Cynosure, Inc.<br />

Before & After 3 treatments<br />

Photo courtesy of R G. Geronemus, MD<br />

Visit picosure.com.au<br />

to find your nearest provider

feature<br />

BREAST<br />

5IMPLANTS:<br />



76 www.cosbeauty.com.au

feature<br />

Thinking about a breast enlargement? Here<br />

are the 5 most crucial aspects of breast<br />

implant surgery you need to know.<br />

Aimée Surtenich reports.<br />

Implant<br />

shape<br />

Choosing the right shape of breast implants is vital to the success of your surgery.<br />

Indeed, your choice of round, teardrop or conical will help determine your final<br />

breast shape after surgery.<br />

Choosing the right implant for you is dependent on your existing breast size,<br />

shape, symmetry <strong>and</strong> projection, body type, <strong>and</strong> your personal preferences.<br />

There is no one breast implant shape that is best for everyone. Your surgeon<br />

is the best resource for determining what breast implant is best for you <strong>and</strong> your<br />

body type.<br />

Round <strong>and</strong> teardrop implants are most commonly used, however conical<br />

implants are becoming more popular to help fill an ‘empty’ chest in certain cases.<br />

Round implants<br />

Round implants are circular with an even projection of volume. They are a good<br />

choice for those who want more fullness in the upper part of the breast <strong>and</strong> tend<br />

to give greater cleavage. Many surgeons agree round implants are typically the<br />

best choice for those patients with well-shaped natural breasts who desire a<br />

straightforward breast enhancement.<br />

Teardrop implants<br />

Teardrop, or anatomical, implants more closely resemble the natural shape of a<br />

breast, gradually sloping downwards to produce an attractive straight line from<br />

the collarbone to the nipple. Teardrop implants tend not to be as full as round<br />

implants but because they are fuller in the lower half they can also provide greater<br />

projection in proportion to the size of the base, making them particularly suitable<br />

for women with little natural breast tissue. Mild elevation of the breast <strong>and</strong> the<br />

nipple can also be achieved, making them particularly suitable for women who<br />

have mild droopy or tuberous breasts.<br />

Conical implants<br />

While not as well-known as round <strong>and</strong> teardrop shapes, the conical implant is<br />

gaining popularity for its ability to add volume to both the upper <strong>and</strong> lower poles<br />

of the breast while also creating a good elevation of the breast <strong>and</strong> nipple to<br />

counter ptosis or droopiness.<br />

It is essential that the right amount of volume, or fill, is selected – otherwise<br />

there is a risk the breasts will end up with a pointy appearance. They are available<br />

in polyurethane surface only.<br />

www.cosbeauty.com.au 77

feature<br />

Implant size<br />

Breast implant sizes are designated by their volume, which in Australia ranges from 90 to 900 cubic<br />

centimetres or millimetres (cc or mm), or by their weight. One gram of silicone is equivalent to slightly<br />

less than 1ml (1cc). The higher the number, the larger the implant.<br />

They are also made with different diameter bases to suit different widths of chest wall <strong>and</strong> with<br />

low to high profiles (amount of forward projection). For this reason, each manufacturer produces a<br />

number of ‘styles’.<br />

It’s important to take your natural breast width into consideration. Your surgeon will measure the<br />

base diameter of your chest to determine the ideal width of implant. If the implant is too wide for<br />

your chest, you may get ‘webbing’ between your breasts (symmastia) or too much ‘side boob’. If the<br />

implant is too narrow, it will not fill the chest appropriately <strong>and</strong> be difficult to create a shapely cleavage.<br />

The choice of implant projection is to a large extent a personal one. A woman with adequate breast<br />

tissue <strong>and</strong> a shape she is happy with may opt for a low-profile implant that will simply increase the<br />

size of her breasts. Another patient seeking to create cleavage, or a patient with some degree of sag,<br />

may prefer a high-profile implant that can help achieve these results.<br />

During your consultation, your surgeon will take into consideration the width of your chest <strong>and</strong><br />

breast tissue <strong>and</strong> advise you on the most suitable implant size <strong>and</strong> style for your individual anatomy.<br />

Implant material<br />

This next crucial factor looks at the type of fill (saline or<br />

silicone) as well as the shell of the implant wall (smooth or<br />

textured).<br />

Silicone vs saline<br />

Saline <strong>and</strong> silicone breast implants both have an outer<br />

silicone shell, however they differ in material, consistency<br />

<strong>and</strong> techniques used for placement. Both types of implants<br />

have their own advantages <strong>and</strong> risks.<br />

Silicone gel-filled implants are used more commonly in<br />

Australia. Silicone implants contain a cohesive gel, designed<br />

to mimic real breast tissue. It has a slightly firm, non-runny<br />

consistency, which can give a more natural feel. As the gel<br />

is not liquid, the risk of dispersal if the implant ruptures is<br />

minimised. It also typically maintains its shape better than<br />

a saline implant, especially in the upper part of the implant.<br />

Saline-filled implants use a medical grade saltwater<br />

solution, which makes the implant feel like a water-bed. This<br />

can be controlled to an extent by the volume of fill in the<br />

implant. If implant rupture occurs, the saline is absorbed by<br />

the body. However, saline implants feel firmer than silicone<br />

implants <strong>and</strong> have a higher risk of visible folds <strong>and</strong> ripples.<br />

Unlike silicone gel implants, saline implants can be filled<br />

through a valve during surgery. Because of this, the insertion<br />

of the implants generally requires a smaller incision than that<br />

associated with silicone gel implants. The amount of fill can<br />

also be adjusted after surgery, which is not possible with<br />

fixed silicone gel implants.<br />

Smooth vs textured<br />

Implant shells can be smooth or textured. Smooth-shelled<br />

implants are easy to insert <strong>and</strong> make the breast move <strong>and</strong><br />

feel more natural than a textured shell. However, they have<br />

increased risk of capsular contracture (hardening of the<br />

breast), which is a common reason for re-operation.<br />

Textured implants have a thicker shell <strong>and</strong> the very nature<br />

of their surface means they can grab onto <strong>and</strong> adhere to<br />

the surrounding tissue, causing less friction between the<br />

implant <strong>and</strong> breast pocket <strong>and</strong> therefore helping to reduce<br />

the risk of capsular contracture. Many surgeons also believe<br />

it offers them greater control over the ultimate shape of<br />

the breast.<br />

Round implants come in smooth <strong>and</strong> textured shells, but<br />

anatomical implants have textured surfaces only to allow for<br />

better integration with the surrounding breast tissue. The<br />

implant may still flip or move <strong>and</strong> distort the appearance of<br />

the breast, so the surgeon must be experienced with this<br />

type of implant.<br />

The polyurethane foam coated breast implant gained<br />

approval for use in Australia in 2008. Used in South America<br />

<strong>and</strong> Europe since the 1970s, it was designed to significantly<br />

reduce rates of capsular contracture. With the foam coating,<br />

the collagen fibres that surround the implant are not lined<br />

up, but sit in a circular pattern around the foam structure.<br />

This means they are less likely to slide over one another <strong>and</strong><br />

contract. There are differences in technique with this type<br />

of implant, such as the pocket size used to accommodate<br />

the breast implant needs to be typically bigger than usual.<br />

Regardless of the type of implant women choose, the<br />

shape, texture <strong>and</strong> size can be customised to reflect her<br />

individual body type <strong>and</strong> aesthetic goals.<br />

78 www.cosbeauty.com.au

feature<br />

Incision site<br />

There are four incision options: the inframammary crease (under the breast<br />

where it meets the chest), periareolar (around the nipple), transaxillary (inside the<br />

armpit) <strong>and</strong> transumbilical (through the navel).<br />

Inframammary<br />

The inframammary incision is the most common breast augmentation incision<br />

used today, made in the crease under the breast close to the inframammary fold.<br />

The surgeon creates a pocket for the breast implant, which is slid up through the<br />

incision, then positioned behind the nipple.<br />

This incision offers the best exposure for visualisation <strong>and</strong> allows the implant<br />

to be placed over, partially under or completely under the chest wall muscle. The<br />

scar is hidden in the crease under the breast <strong>and</strong> is not normally visible when<br />

wearing a bikini top.<br />

Periareolar<br />

The periareolar incision is another widely used method for placing breast<br />

implants, particularly for those . An incision is made just beyond the areola, which<br />

is the darker area of skin surrounding the nipple. The incision should be made at<br />

the very edge of the areola where the dark tissue meets the lighter breast tissue,<br />

which makes the scar least visible.<br />

Similar to the inframammary incision, the periareolar incision allows the<br />

surgeon to work close to the breast. It is possible for the surgeon to easily <strong>and</strong><br />

precisely place the breast implants in various positions in relation to the chest<br />

muscle. However, this is the only incision that involves cutting through breast<br />

tissue <strong>and</strong> ducts, <strong>and</strong> sensitivity in the nipple may be reduced.<br />

Transaxillary<br />

The transaxillary incision is made in the natural crease of the armpit <strong>and</strong> a channel<br />

is created down to the breast. This may be performed with an endoscope (a<br />

small tube with a surgical light <strong>and</strong> camera in the end) to provide visibility. The<br />

www.cosbeauty.com.au 79

feature<br />

implant is inserted <strong>and</strong> moved through the channel into a prepared pocket.<br />

The greatest advantage of an underarm breast augmentation incision is that<br />

no scar is left on the breasts. The scar is virtually invisible in the armpit fold <strong>and</strong><br />

lack of tension generally makes for straightforward healing.<br />

The transaxillary site is relatively far from the breast, where the surgeon needs<br />

to create a pocket for the implant, so visibility is limited. There is also a higher<br />

incidence of the implant being positioned too high <strong>and</strong> a greater risk of breast<br />

asymmetry after surgery.<br />

Transumbilical or navel (TUBA)<br />

The TUBA incision is made on the rim of the navel. An endoscope can be used to<br />

create a tunnel <strong>and</strong> to provide visibility to the surgeon. After a pocket is created<br />

in the breast, the implant is inserted through the incision <strong>and</strong> moved up into the<br />

breast area <strong>and</strong> positioned in the pocket.<br />

The resulting scar from the TUBA incision is typically virtually undetectable<br />

<strong>and</strong> does not appear on the breasts. Inserting breast implants through the navel<br />

requires only one incision (<strong>and</strong> scar) for both breasts, while other incision sites<br />

require separate incisions.<br />

However, this incision can only be used for saline implants as the filling is<br />

added after the implants are placed. Also, the distance of the incision from the<br />

breast can reduce the surgeon’s ability to control bleeding <strong>and</strong> to position the<br />

implant correctly.<br />

80 www.cosbeauty.com.au

feature<br />

The placement of breast implants can have a significant impact on the final<br />

outcome of breast augmentation <strong>and</strong> therefore it requires individual consideration.<br />

Experienced surgeons base their implant placement decisions on factors<br />

such as the individual patient’s quantity of breast tissue, natural breast size<br />

<strong>and</strong> symmetry, the dimension <strong>and</strong> shape of the chest wall, the amount of<br />

subcutaneous fat <strong>and</strong> the quality of breast skin.<br />

Generally, there are three placement options: subgl<strong>and</strong>ular (in front of the<br />

muscle), submuscular (behind the muscle) <strong>and</strong> dual plane (partially under the<br />

muscle). There are pros <strong>and</strong> cons for each position.<br />

Implant<br />

placement<br />

Subgl<strong>and</strong>ular<br />

The subgl<strong>and</strong>ular pocket is created between the breast tissue <strong>and</strong> the pectoral<br />

muscle. This position resembles the plane of normal breast tissue <strong>and</strong> the<br />

implant is placed in front of the muscle. Sometimes the implant is covered<br />

by a thin membrane, the fascia, which lies on top of the muscle. This is called<br />

subfascial placement.<br />

This position is suited to patients who have sufficient breast tissue to cover<br />

the top of the implant. This procedure is typically faster <strong>and</strong> may be more<br />

comfortable for the patient than submuscular placement. There is generally less<br />

post-operative pain <strong>and</strong> a shorter recovery period because the chest muscles<br />

have not been disturbed during surgery. The implant also tends to move more<br />

naturally in this position.<br />

However, subgl<strong>and</strong>ular breast implants may be more visible, especially if the<br />

patient has little breast tissue, little body fat <strong>and</strong> thin skin. With subgl<strong>and</strong>ular<br />

implants, there tends to be more of a pronounced ‘roundness’ to the breasts,<br />

which may look less natural than those placed under the muscle, but this is a<br />

matter of personal preference.<br />

Submuscular<br />

The implant is placed under the pectoralis major muscle after some release<br />

of the inferior muscular attachments. Most of the implant is positioned under<br />

the muscle. This position can create a natural-looking contour at the top of the<br />

breast in thin patients <strong>and</strong> those with very little breast tissue. The implant is fully<br />

covered, which helps to camouflage the edges of the implant, as well as rippling.<br />

With this placement, there is less chance of capsular contracture occurring.<br />

There may be more post-operative discomfort <strong>and</strong> a longer recovery period.<br />

The implants may appear high at first <strong>and</strong> take longer to ‘drop’.<br />

Dual plane<br />

The implant is placed partially beneath the pectoral muscle in the upper pole,<br />

where the implant edges tend to be most visible, while the lower half of the<br />

implant is in the subgl<strong>and</strong>ular plane. This placement is best suited to patients<br />

who have insufficient tissue to cover the implant at the top of the breast but who<br />

need the bottom of the implant to fully exp<strong>and</strong> the lower half of the breast due to<br />

sag or a tight crease under the breast.<br />

This position minimises the rippling <strong>and</strong> edge effect in thin patients while<br />

avoiding abnormal contours in the lower half of the breast. Generally, this<br />

placement is able to achieve a more natural shape to the upper portion of<br />

the breast instead of the ‘upper roundness’ that can be more common with<br />

subgl<strong>and</strong>ular implants. However, it involves more complex surgery, which if not<br />

performed correctly may result in visible deformities when the pectoral muscles<br />

are contracted. csbm<br />

www.cosbeauty.com.au 81

easts<br />

The<br />

saline<br />

solution<br />

for breast<br />

enhancement<br />

Sydney plastic surgeon<br />

Dr Darryl Hodgkinson<br />

explains the benefits of<br />

saline breast implants.<br />

After performing breast augmentation surgery for more<br />

than 30 years <strong>and</strong> having used every reputable type<br />

of breast implant through every incision possible, I<br />

have realised the benefits of breast augmentation but also<br />

the limitations of the procedure.<br />

Over the years the implant which has given me the least<br />

amount of problems <strong>and</strong> the most satisfied patients with<br />

the least amount of worry <strong>and</strong> angst has been the saline<br />

implant. While the saline implant is not necessarily good<br />

for everybody, I believe it holds numerous advantages over<br />

silicone implants.<br />

The main advantage of the saline implant is that there is<br />

very little reaction to the implant – you cannot have any fill<br />

in an implant less reactive than saline. Another advantage is<br />

that the saline implant has never been taken off the market;<br />

there has never been a saline scare <strong>and</strong> that is of great<br />

solace to patients having breast implant surgery.<br />

The third most significant advantage of the saline implant<br />

is that because it comes uninflated it can be inserted through<br />

small distant incisions, which means it can be used in the<br />

TUBA (transumbilical breast augmentation) incision <strong>and</strong><br />

through the axillary incisions in the armpits. It is particularly<br />

Asian patients (most commonly due to a higher incidence<br />

of keloid scarring on the breast) <strong>and</strong> models (who do not<br />

wish to have any telltale marks on their breasts) who like<br />

the incision hidden <strong>and</strong> therefore request the axillary <strong>and</strong><br />

sometimes TUBA approach. Only the saline implant can be<br />

used this way.<br />

There are also some particular aesthetic advantages to<br />

the saline implant. The implant, as one patient said, has<br />

“the jelly factor”, so that when the patient moves the implant<br />

adds a slight shimmy to the movement of the breast that<br />

is very much like natural breast tissue. Gel implants, on the<br />

other h<strong>and</strong>, have very little, if any, movement.<br />

82 www.cosbeauty.com.au

easts<br />

The saline implant remains much more popular in the<br />

United States than in Australia <strong>and</strong> I think that is basically<br />

because many of the surgeons in the US had to become<br />

familiar with the saline implant after the silicone implant was<br />

removed from the market in 1992. Once they became familiar<br />

with the implant, the surgeons were happy with the results.<br />

The rate of capsular contraction or hardness with the<br />

saline implants is also particularly low <strong>and</strong> therefore a further<br />

significant advantage to patients, meaning they are unlikely<br />

to develop a hardness around the implant <strong>and</strong> a deformity<br />

to the shape of the implant.<br />

The saline implant comes in exactly the same sizes<br />

<strong>and</strong> shapes as the silicone implant. The saline implant<br />

has exactly the same rate of rupture as the gel implant.<br />

The difference with the saline implant is, however, that the<br />

implant deflates so that the patient knows a rupture has<br />

occurred <strong>and</strong> can have the implant replaced as opposed<br />

to having it leak slowly over a period of time. The further<br />

advantage again is that the patient has a material in her<br />

body which is naturally occurring – sterile saltwater – as<br />

opposed to a foreign substance – silicone gel.<br />

We all know that having breast implants at an early age<br />

does not mean that it is a once in a lifetime procedure <strong>and</strong><br />

the suggestions are now that, especially with gel implants,<br />

the implants be monitored regularly with a view to having<br />

them changed on a regular basis every 10 years. There is<br />

not a suggestion to change without cause, such as deflation<br />

with the saline implant.<br />

Although there is no perfect implant, for patients who<br />

are realistic, do not want too big a result, <strong>and</strong> are not<br />

too thin, the saline implant is an ideal solution to breast<br />

enhancement. csbm<br />

BEFORE<br />

AFTER saline breast implant surgery by Dr Hodgkinson<br />

BEFORE<br />

AFTER saline breast implant surgery by Dr Hodgkinson<br />

www.cosbeauty.com.au 83

easts<br />

BREAST<br />


for both<br />

men<br />

&<br />

women<br />











REPORTS.<br />

Breast surgery is sought out by both men <strong>and</strong> women to help reverse the signs<br />

of ageing, or bring the body more into proportion. For men, gynaecomastia,<br />

or “man boobs”, can occur due to weight gain, supplement abuse or with<br />

hormonal changes during puberty. For women, breast augmentation can help<br />

counter the changes that occur with age <strong>and</strong> child bearing or, in younger patients,<br />

add volume <strong>and</strong> create a more balanced silhouette.<br />

No matter what the reasons for seeking breast surgery, both men <strong>and</strong> women<br />

experience similar concerns going into the consultation. ‘It may come as a<br />

surprise, but many of the same elements pertain to men as they do to women in<br />

breast surgery,’ says Dr John Flynn from Queensl<strong>and</strong>. ‘As we age, the gl<strong>and</strong>ular<br />

component in the breast decreases <strong>and</strong> is commonly replaced with fat. This can<br />

lead to loss of volume <strong>and</strong> sagging breasts in women, as well as gynaecomastia<br />

in some men, particularly those who are overweight. By balancing the fi gure,<br />

<strong>and</strong> establishing more youthful contours, breast surgery can make a signifi cant<br />

difference in both male <strong>and</strong> female patients.’<br />

Breast surgery in women can involve both breast augmentation <strong>and</strong> a breast<br />

lift. Depending on the patient’s concerns <strong>and</strong> existing anatomy, Dr Flynn will tailor<br />

his surgical approach to achieve the most suitable result.<br />

For younger patients, where the breast anatomy is still fi rm <strong>and</strong> gl<strong>and</strong>ular, a<br />

st<strong>and</strong>-alone augmentation can achieve optimal results. But, in older women,<br />

where collagen depletion in the skin has left the breasts drooping or sagging, a<br />

lift <strong>and</strong> augmentation may be needed to create the same effect.<br />

‘In the initial consultation, I take several measurements to help guide the<br />

implant shape <strong>and</strong> size selection. However, I fi nd the most effective approach<br />

is to let the patient simply try on different implants, to establish the size they are<br />

most comfortable with,’ Dr Flynn explains. ‘The shape (teardrop or round) <strong>and</strong><br />

positioning (above or below the muscle) of the implant is always decided based<br />

on the expectations, desires <strong>and</strong> existing anatomy of the individual patient.’<br />

The surgical approach for male patients also depends heavily on the<br />

composition of the existing tissue. In older patients, where the breast tissue is<br />

predominately fat, liposuction may be suffi cient in correcting gynaecomastia. If<br />

this is not suitable, Dr Flynn will use a surgical reduction, or a combination of<br />

both surgery <strong>and</strong> liposuction, to achieve the desired result.<br />

84 www.cosbeauty.com.au

easts<br />

By balancing the<br />

figure <strong>and</strong> creating<br />

more youthful<br />

contours, breast<br />

surgery can make a<br />

significant difference<br />

in both male <strong>and</strong><br />

female patients<br />

1<br />

‘In younger patients, the tissue is more gl<strong>and</strong>ular <strong>and</strong> gynaecomastia can<br />

occur due to the overuse of steroids <strong>and</strong> peptides or the onset of puberty,’ he<br />

says. ‘Older males will sometimes experience gynaecomastia with weight gain,<br />

however not all overweight males will suffer from it – it’s very selective.’<br />

‘After surgery there is sometimes a hollowness where there used to be<br />

swelling, <strong>and</strong> the skin is loose or lax,’ Dr Flynn explains. ‘We can use skintightening<br />

laser or radiofrequency treatments to improve this, but it is a possible<br />

outcome of which patients must be aware. Also, males are often less accepting<br />

of scars on their breasts than females. The surgeon’s experience is essential in<br />

managing all these components to achieve the best result for each patient.’<br />

To help reduce the appearance of scarring in female patients, Dr Flynn usually<br />

creates the incision in the inframammary crease, at the base of the breast in the<br />

breast fold. ‘The inframammary crease allows good surgical access but it is also<br />

is where the scar is best hidden,’ he says.<br />

The surgical outcomes in both male <strong>and</strong> female patients depends greatly<br />

on the recovery period. A well-planned recovery, involving a diligent follow-up<br />

process, is imperative in securing the optimum results following breast surgery.<br />

Because of the number of elements involved in breast surgery, <strong>and</strong> the<br />

different techniques required for male <strong>and</strong> female patients, Dr Flynn explains<br />

the surgeon’s experience is paramount in creating natural-looking results, with<br />

minimum risk of complications.<br />

‘It is essential the surgeon is aware of all aspects involved; fatty vs gl<strong>and</strong>ular<br />

tissue; the change to the skin’s collagen with age; <strong>and</strong> the differences between<br />

male <strong>and</strong> female patients,’ Dr Flynn explains. ‘In taking these elements into<br />

account, the surgeon can create optimum results in breast surgery <strong>and</strong> help<br />

restore or improve each patient’s body confidence <strong>and</strong> self-esteem.’ csbm<br />

BEFORE<br />

2<br />

AFTER female breast surgery (breast augmentation) by Dr Flynn<br />

BEFORE<br />

AFTER male breast surgery (gynaecomastia) by Dr Flynn<br />

www.cosbeauty.com.au 85

easts<br />

Natural-looking<br />

contours<br />

Sydney cosmetic<br />

surgeon Dr Colin<br />

Moore explains<br />

breast implant<br />

surgery can<br />

recreate more<br />

youthful breasts<br />

<strong>and</strong> contours. Tara<br />

Casey reports.<br />

In some cases, breast surgery acts as an anti-ageing procedure to return<br />

fullness to the breast <strong>and</strong> create more youthful contours. Following childbirth<br />

<strong>and</strong> with age, many women want to recapture how their breasts looked<br />

before having children, as breastfeeding commonly causes slight breast atrophy<br />

or ptosis.<br />

‘Rather than seeking a bust that is significantly larger than their own, many<br />

women simply want to balance their figure <strong>and</strong> create a more shapely silhouette,’<br />

says Sydney cosmetic surgeon Dr Colin Moore. ‘In such cases, it may be more<br />

beneficial to perform a breast lift (mastopexy) <strong>and</strong>, depending on the patient, this<br />

can then be combined with a small breast implant to restore lost volume.’<br />

A common concern in women considering breast augmentation is whether<br />

or not the results will look natural. Dr Moore explains that preparation <strong>and</strong> a<br />

thorough consultation process can help ensure the results are consistent with<br />

the patient’s existing anatomy <strong>and</strong> surgical expectations.<br />

‘Creating a natural-looking result comes down to accurately measuring the<br />

proportions of each patient, but I also believe that advances in breast implants<br />

mean that it is easier than ever to achieve natural-looking curves,’ Dr Moore<br />

explains. ‘By measuring the proportions of the body, as well as skin thickness<br />

<strong>and</strong> breast tissue composition, together the surgeon <strong>and</strong> patient can determine<br />

the best breast size for the patient.’<br />

During the initial consultation, Dr Moore takes several measurements to<br />

accurately gauge the best implant size <strong>and</strong> position.<br />

‘The basic dimensions of the breast are taken into account, including the<br />

breast base, height <strong>and</strong> overall width,’ he explains. ‘The distance from the<br />

nipple to the inframammary crease (underneath the breast) is influential in the<br />

appearance of a perky breast. Also, by measuring the relevant proportions of<br />

the body, it’s possible to determine the best breast size to enhance the patient’s<br />

overall figure.’<br />

Dr Moore prefers to use polyurethane-coated P-URE implants in breast<br />

augmentation surgery, as he believes they carry an excellent safety profile <strong>and</strong><br />

afford natural-looking results. ‘In my experience, polyurethane-coated breast<br />

implants produce very natural-looking results while minimising the risk of the<br />

most common complications associated with breast augmentation,’ he<br />

86 www.cosbeauty.com.au

easts<br />

says. ‘I believe polyurethane-coated P-URE implants have provided a significant<br />

breakthrough in breast implant surgery.’<br />

All types of breast implant comes with a risk of skin rippling, movement after<br />

insertion <strong>and</strong> capsular contracture – where the scar tissue that forms around the<br />

implant begins to contract, causing the implant to painfully distort <strong>and</strong> harden.<br />

Polyurethane-coated implants help reduce the rate of capsular contracture, as the<br />

textured implant surface forces the body’s collagen to surround the implant in a crisscross<br />

pattern, preventing contraction <strong>and</strong> lessening the chance of implant alteration.<br />

‘A number of studies have shown there is only a one percent risk of capsular<br />

contracture with polyurethane-coated implants, which is a significant improvement<br />

on the 10 percent risk associated with saline <strong>and</strong> silicone implants,’ says Dr Moore.<br />

With so many choices in terms of implant size, shape, projection <strong>and</strong> material,<br />

an experienced surgeon can help guide women on the best breast to enhance their<br />

body. ‘It comes down to the proportions of the figure <strong>and</strong> the desired result of each<br />

patient,’ concludes Dr Moore. ‘These days patients are much more educated about<br />

their options <strong>and</strong> are seeking an approach that will give them the most desirable<br />

results, no matter what their chosen aesthetic. Breast augmentation has one of the<br />

highest patient satisfaction rates, offering more natural-looking results than ever<br />

before.’ csbm<br />

1<br />

BEFORE<br />

2<br />

AFTER breast augmentation by Dr Moore<br />

BEFORE<br />

3<br />

AFTER breast augmentation by Dr Moore<br />

BEFORE (exisiting scar on left breast)<br />

AFTER breast augmentation by Dr Moore<br />

www.cosbeauty.com.au 87

genital<br />

Take<br />

action<br />

<strong>and</strong> explore<br />

your options<br />

Adelaide pelvic reconstructive surgeon Dr Oseka Onuma<br />

says genital surgery can restore confidence, self-image <strong>and</strong> quality<br />

of life in patients with aesthetic or functional concerns.<br />

Caitlin Bishop reports.<br />

Sexual <strong>and</strong> reproductive health is integral to a<br />

woman’s mental <strong>and</strong> physical wellbeing. Questions<br />

surrounding the appearance <strong>and</strong> function of the<br />

vagina <strong>and</strong> urinary system can plague women of all ages,<br />

yet talking openly about these concerns can be challenging<br />

for some women. A blanket of taboo means there is a lack<br />

of open <strong>and</strong> honest public dialogue that makes it difficult for<br />

some women to seek successful treatment – or even know<br />

there are treatment options available.<br />

Dr Oseka Onuma is a gynaecologist <strong>and</strong> pelvic<br />

reconstructive surgeon based in Adelaide. He explains<br />

that there is a widespread misunderst<strong>and</strong>ing of what<br />

is classified as ‘normal’ in both vaginal anatomy <strong>and</strong><br />

urogynaecological health.<br />

‘I never make assumptions, as there is such a wide<br />

spectrum of what is “normal”,’ he says. ‘The real problem<br />

may be more subtle than the patient’s main concern, so<br />

I need to know not only the symptoms but the length of<br />

time they’ve been endured <strong>and</strong> the way they have impeded<br />

upon the patient’s way of life.’<br />

According to Dr Onuma, this wide spectrum of normality<br />

means a thorough examination, with an experienced<br />

doctor, is paramount in achieving an accurate diagnosis<br />

<strong>and</strong> establishing the best treatment plan.<br />

‘A thorough examination is required to correlate the<br />

clinical findings with the symptoms, this results in high<br />

success rates – both in terms of the surgery <strong>and</strong> patient<br />

satisfaction,’ he explains.<br />

Treating urinary incontinence<br />

In cases of stress urinary incontinence, urethra<br />

function is usually compromised <strong>and</strong> the<br />

surrounding muscles <strong>and</strong> pelvic tissue are generally<br />

weakened. This means urine can escape during<br />

exercise or other movements such as coughing<br />

or laughing.<br />

There is a minimally invasive procedure to help<br />

correct stress urinary incontinence. The treatment<br />

uses tensionless vaginal tape (TVT), which is<br />

inserted through the vagina <strong>and</strong> positioned<br />

underneath the urethra to create a supportive sling.<br />

This is held in place by surrounding tissue – no<br />

stitches are needed – <strong>and</strong>, during movement or<br />

exercise, the mesh supports the urethra <strong>and</strong> helps<br />

maintain its seal.<br />

Functional <strong>and</strong> cosmetic rejuvenation<br />

In some cases, functional <strong>and</strong> cosmetic concerns go<br />

h<strong>and</strong>-in-h<strong>and</strong> in genital surgery. The shape <strong>and</strong> anatomy of<br />

genitalia is unique to every woman <strong>and</strong> the effects of child<br />

bearing <strong>and</strong> age can take their toll on some women more<br />

than others.<br />

Many women suffer problems with their genitalia<br />

after childbirth that can contribute to feelings of self-<br />

88 www.cosbeauty.com.au

consciousness <strong>and</strong> affect their relationship with sexual<br />

partners. ‘With childbirth, the shape <strong>and</strong> tone of vaginal<br />

tissue changes, sometimes results in embarrassment or<br />

loss of sexual satisfaction,’ Dr Onuma says. ‘After childbirth,<br />

there can sometimes be a reduced ability to contract<br />

the vaginal walls <strong>and</strong> a feeling of “looseness” or reduced<br />

sensation during intercourse.’<br />

Oversized, elongated or asymmetrical labia minora can<br />

also lead to aesthetic concerns <strong>and</strong> self-consciousness.<br />

It can cause discomfort during sex <strong>and</strong> hinder certain<br />

activities such as bike riding <strong>and</strong> horse riding, <strong>and</strong> often<br />

makes wearing certain clothes such as swimwear, jeans or<br />

tights uncomfortable.<br />

‘Genital surgery can increase a woman’s confidence in<br />

herself <strong>and</strong> her relationships,’ Dr Onuma explains. ‘Women<br />

may not find it easy to talk to strangers, doctors or friends<br />

about a loose vagina, labial discomfort or lack of vaginal<br />

sensation but these issues need to be raised <strong>and</strong> explored<br />

in order to provide the options for improving quality of life. ‘<br />

<strong>Surgery</strong> can improve the appearance of the labia minora,<br />

<strong>and</strong> is a viable option in treating protrusions or lumps within<br />

the vagina, removing scar tissue, countering discomfort or<br />

sagging at the vagina’s entrance <strong>and</strong> enhancing the tone of<br />

loose or weak vaginal muscles.<br />

While there is a range of surgical options, the approach<br />

must be tailored to the individual patient. The consultation<br />

process must address the specific concerns, anatomy <strong>and</strong><br />

expectations of each individual.<br />

‘Each patient will have different motivations, concerns<br />

<strong>and</strong> expectations in seeking genital surgery,’ he says. ‘It is<br />

important to listen to the concerns of the individual patient,<br />

assess them with appropriate examinations <strong>and</strong> offer a<br />

series of potential solutions.’<br />

Laser reduction labiaplasty can sculpt the labial minora<br />

to reduce size <strong>and</strong> asymmetry. ‘Labiaplasty techniques<br />

can reconstruct conditions that are a result of the ageing<br />

process, childbirth trauma or injury,’ he says.<br />

The procedure addresses the entire vulva – including<br />

the labia minora, labia majora, mons pubis, perineum<br />

<strong>and</strong> entrance to the vagina. These can all be surgically<br />

enhanced, both functionally <strong>and</strong> aesthetically. The hymen<br />

can be reconstructed in culturally sensitive cases or<br />

refashioned when causing discomfort or protruding from<br />

the vagina.<br />

Laser vaginal rejuvenation can effectively enhance<br />

muscle tone, strength <strong>and</strong> control. The laser technique<br />

typically affords greater accuracy <strong>and</strong> results in rapid<br />

healing, less pain <strong>and</strong> a faster recovery.<br />

‘Women today are less willing to accept changes in<br />

genital anatomy resulting from pregnancy, childbirth <strong>and</strong><br />

ageing,’ Dr Onuma explains. ‘There are a number of options<br />

available, both surgical <strong>and</strong> non-surgical, to address <strong>and</strong><br />

hopefully resolve these problems. Taking action, <strong>and</strong><br />

exploring the options, can help restore self-confidence,<br />

boost self-image <strong>and</strong> improve quality of life.’ csbm<br />

feature<br />

Laser Vaginal<br />

Rejuvenation TM<br />


• Aesthetic <strong>and</strong> functional<br />

labial surgery<br />

• Curing urinary incontinence<br />

• Restoring pelvic support<br />

• Enhancing sexual gratification<br />

• Resolving menstrual dysfunction<br />


To empower women<br />

with knowledge, choice<br />

<strong>and</strong> alternatives<br />

Dr Oseka Onuma<br />



Gynaecologist &<br />

Pelvic Reconstructive Surgeon<br />

Laser Vaginal Rejuvenation<br />

Institute of Adelaide<br />

Robe Terrace Specialist Centre Suite<br />

4 Robe Terrace, Medindie<br />

South Australia 5081<br />

Phone 08 8344 6085<br />

Facsimile 08 8344 6087<br />

Email rooms@dronuma.com<br />

www.dronuma.com<br />

www.cosbeauty.com.au 89

Vaginal tightening<br />

MonaLisa Touch is a surgery-free laser treatment that helps<br />

treat gynaecological concerns <strong>and</strong> restore vaginal tissue for an<br />

anti-ageing effect. Caitlin Bishop reports.<br />

The continuing developments in laser technology<br />

have seen major advancements in skin enhancement,<br />

body contouring <strong>and</strong> now gynaecology <strong>and</strong> vaginal<br />

rejuvenation <strong>and</strong> tightening.<br />

MonaLisa Touch, distributed in Australia by High Tech<br />

Laser, is a new non-surgical way to treat vaginal atrophy –<br />

a condition that causes symptoms including incontinence,<br />

poor lubrication, itching, dryness <strong>and</strong> pain during<br />

intercourse. MonaLisa Touch can also be used for aesthetic<br />

purposes, to counter the effects of ageing <strong>and</strong> achieve a<br />

rejuvenating effect by restoring vaginal tissue.<br />

‘MonaLisa Touch has been developed to help patients<br />

suffering from symptoms such as urinary incontinence,<br />

painful intercourse, dryness, itchiness, burning, vulval <strong>and</strong><br />

vaginal pain, prolapse <strong>and</strong> laxity or looseness,’ explains<br />

Dr Fariba Behnia-Willison, a gynaecologist from South<br />

Australia. ‘These symptoms are part of a common condition<br />

known as vaginal atrophy. Additionally, because of how the<br />

treatment works, it can be used for vaginal rejuvenation.’<br />

The versatility of MonaLisa Touch stems from the<br />

technology it uses to improve the genital mucosa <strong>and</strong> restore<br />

proper function in the treatment area. Using laser light, the<br />

MonaLisa Touch probe – which is inserted into the vagina –<br />

delivers thermal energy into the deeper layers of the vaginal<br />

tissue. This kick-starts the body’s natural processes to<br />

increase blood flow <strong>and</strong> stimulate the formation of collagen,<br />

which improves the integrity <strong>and</strong> elasticity of the genital<br />

mucosa. This can be effective in alleviating vaginal pain in<br />

those patients experiencing gynaecological problems or<br />

vaginal atrophy, or in simply tightening the vaginal walls for<br />

a rejuvenating effect.<br />

‘To put it in simple terms, the MonaLisa Touch procedure<br />

stimulates the body’s natural processes,’ Dr Behnia-Willison<br />

explains. ‘It creates more hydrated <strong>and</strong> healthy cells which<br />

help to increase vascularisation, hydration <strong>and</strong> acidity,<br />

which are important components of vaginal health.’<br />

According to Dr Behnia-Willison, a treatment to<br />

improve vaginal function is sought by a significant number<br />

of patients, of many different ages. ‘Although many of<br />

my patients are going through menopause or are postmenopausal,<br />

there are also many younger women suffering<br />

from similar symptoms,’ she says. ‘I have found the<br />

treatment particularly effective for women who find it painful<br />

to have sexual intercourse.’<br />

90 www.cosbeauty.com.au

genital<br />

without surgery<br />

MonaLisa Touch delivers thermal heating at<br />

specific depths in the tissue to achieve an optimum,<br />

targeted result. Also, the fractionated effect means there<br />

are areas of untouched tissue left between laser columns.<br />

This healthy tissue helps promote healing <strong>and</strong> reduce<br />

downtime after treatment.<br />

MonaLisa Touch is a new<br />

non-surgical way to treat vaginal<br />

atrophy, as well as achieving<br />

a rejuvenating effect by restoring<br />

vaginal tissue<br />

‘The advantage of the MonaLisa Touch procedure,<br />

for both results <strong>and</strong> safety, is that it uses a fractionated<br />

CO2 laser, which means the heat is deposited at the ideal<br />

depth in the tissue,’ Dr Behnia-Willison explains. ‘And<br />

because it is a fractional laser treatment it leaves most of<br />

the superficial layer untouched, which is important from a<br />

safety perspective.’<br />

The treatment itself is non-invasive <strong>and</strong> requires no<br />

anaesthesia. Often, a series of treatments is recommended<br />

to achieve the best results. ‘MonaLisa Touch is a<br />

straightforward <strong>and</strong> simple procedure. It involves a probe<br />

being placed inside the vagina <strong>and</strong> the fractionated CO2<br />

energy being delivered to the vaginal tissue,’ says Dr<br />

Behnia-Willison.<br />

‘The published research has shown that the best results<br />

are obtained from three MonaLisa Touch treatments,<br />

performed a month apart. Most patients notice a significant<br />

improvement after the first procedure. I also recommend to<br />

patients they may need a follow-up procedure every year or<br />

so, after the initial course of treatments.’<br />

As with any medical procedure, there are some<br />

potential risks with the MonaLisa Touch treatment. ‘In my<br />

experience, which is similar to that of overseas practitioners,<br />

the likelihood of post-treatment complications following a<br />

MonaLisa Touch treatment is minimal,’ she says. ‘The worst<br />

side effect I have seen has been some mild discomfort for<br />

12 to 24 hours following the procedure, but this is in only<br />

a h<strong>and</strong>ful of patients <strong>and</strong> I have now performed more than<br />

1,000 MonaLisa Touch treatments.’<br />

Whether you’re looking to relieve the symptoms of<br />

vaginal atrophy, or seeking a rejuvenating effect, MonaLisa<br />

Touch is a viable option, backed by clinical research <strong>and</strong> a<br />

history of success in a gynaecological setting.<br />

‘Almost all of my patients notice a significant improvement<br />

following the MonaLisa Touch procedure – some have<br />

even described the treatment as life-changing,’ says Dr<br />

Behnia-Willison. ‘I hope it becomes the new st<strong>and</strong>ard of<br />

care for the many women suffering from these often painful<br />

symptoms that can effect their everyday life. It certainly has<br />

in my practice.’ csbm<br />

www.cosbeauty.com.au 91

genital<br />

Girl talk<br />

Genital surgery is a popular option for Australian women hoping to<br />

improve vaginal comfort, function or aesthetics, says sydney cosmetic<br />

surgeon dr colin moore. Tara Casey reports.<br />

S<br />

Page 1<br />

GEMENT<br />

idening<br />

ds<br />

tomy Reversal<br />

ry<br />

(Lyn)<br />

.com<br />

OORE<br />

Genital surgery can help treat physical concerns<br />

or alleviate vaginal discomfort. In most cases,<br />

these results are seen alongside a return of selfconfidence<br />

<strong>and</strong> improve sexual satisfaction. Indeed, genital<br />

surgery is growing in popularity <strong>and</strong> there are a number of<br />

options to help rejuvenate vaginal aesthetics <strong>and</strong> counter<br />

the physical changes that can arise with age or childbearing.<br />

‘Women who seek vaginal surgery have often noticed<br />

changes to their vagina after giving birth or as a result of<br />

ageing,’ says Sydney cosmetic surgeon Dr Colin Moore.<br />

‘Depending on the patient’s concerns, I work with them to<br />

decide the most appropriate treatment option.’<br />

MEN’S & WOMEN’S<br />

<strong>Cosmetic</strong> <strong>Surgery</strong><br />

‘A New You’<br />

• Penis Enlargement – permanent<br />

• Circumcision • Abnormalities (bends)<br />

• Impotence • Vasectomy • Testicular Implants<br />

• Breast Enlargement/Reduction • Tummy Tuck<br />

• Face/Eye Lift • Vaginal <strong>Cosmetic</strong>/Surgical Repairs<br />


B R I S B A N E<br />

ITAL<br />

Y<br />

ent<br />

y<br />

gery<br />

(Lyn)<br />

.com<br />


Dr Colin Moore<br />


www.drcolinmoore.com.au<br />

To recieve an information pack call Lyn on<br />

0414 251 234 or 1300 malepenissurgery<br />



drcolinmoore.com/general/gallery.html<br />

Finance options available<br />

Stretched muscles <strong>and</strong> skin laxity often occurs after<br />

childbirth, <strong>and</strong> can significantly change the shape of the<br />

vagina both internally <strong>and</strong> externally. In such cases, Dr<br />

Moore takes a holistic approach to vaginal rejuvenation,<br />

addressing the loosened labial folds with a labiaplasty, <strong>and</strong><br />

the internal sling muscles through a vaginaplasty.<br />

Dr Moore says the surgeon’s experience is imperative<br />

to achieving the best results. ‘A vaginaplasty is a day<br />

procedure which involves tightening the sling muscles in<br />

the vagina by lifting the muscles, removing excess vaginal<br />

lining <strong>and</strong> reattaching the muscles,’ he explains. ‘However,<br />

it’s important that the patient knows that surgery will<br />

not make them 20 years younger, as over-tightening<br />

stretched vaginal muscles can cause cramps <strong>and</strong> spasms<br />

during intercourse. This is where a senior surgeon’s<br />

experience is essential.’<br />

A labiaplasty involves excising excess skin to return<br />

symmetry <strong>and</strong> improve aesthetics in the labia folds.<br />

According to Dr Moore, this is a popular procedure for<br />

younger patients <strong>and</strong> can be used as a st<strong>and</strong>-alone<br />

treatment, or in conjunction with other surgeries.<br />

‘Younger patients usually opt for labiaplasty alone to<br />

correct an uneven appearance of the labial folds,’ says Dr<br />

Moore. ‘Essentially, if a roughened edge is the issue, this<br />

needs to be removed. If not, we slightly reduce the edges of<br />

the labia minora back to the same level as the labia majora,<br />

<strong>and</strong> often reduce excess skin covering the clitoral hood.’<br />

In some cases, labiaplasty serves as a necessity in<br />

improving vaginal hygiene for some women.<br />

‘With large labia, urine can be trapped, allowing bacteria<br />

from the bowel to migrate <strong>and</strong> colonise in the urethra,’<br />

Dr Moore explains. ‘This can result in chronic urethral<br />

contamination or even cause infection to be flushed back<br />

into the bladder, causing bladder infections. For many<br />

women, labiaplasty can rectify this.’<br />

Typically, vaginal rejuvenation surgery is carried out as<br />

a day procedure under general anaesthetic. Like any<br />

medical procedure, there are potential complications<br />

associated with genital surgery <strong>and</strong> the surgeon’s skill <strong>and</strong><br />

specialised experience is imperative in ensuring the best<br />

results. csbm<br />

92 www.cosbeauty.com.au

ellafitness<br />

fitness<br />

5 workout myths<br />

keeping up appearances<br />

want to flaunt a toned <strong>and</strong> terrific bod this summer? here are some<br />

exercise essentials to help get you started. words by Jarrat wood<br />

Some people train for health, some people train for<br />

performance <strong>and</strong> some people train for appearance.<br />

Vanity aside, training for appearance is a realistic<br />

option. Everyone has a body part that they wish was bigger<br />

or smaller.<br />

If you plan to train for appearance then remember some<br />

important health <strong>and</strong> safety guidelines:<br />

• Training opposing muscle groups unevenly can lead to<br />

postural <strong>and</strong> functional deficiencies.<br />

If you’re looking to get your body beach-ready for summer<br />

• Health should be the number-one priority with an<br />

(which is only just around the corner...), now is the time<br />

exercise program <strong>and</strong> all exercise has an element of risk.<br />

to start. But before you hit the training circuit, pay some<br />

• There is a limit to how much you can vary your appearance.<br />

attention to those pesky ever-present locker room rumours<br />

Genetics will always be an overriding determinant of<br />

that can hamper your fitness progress.<br />

your appearance.<br />

Lifting weights will make women<br />

The following are some ‘cosmetic fitness’ suggestions for<br />

look bulky<br />

training outdoors as the summer months approach. Break<br />

Fact:<br />

down your<br />

This<br />

program<br />

myth couldn’t<br />

into body<br />

be any<br />

parts:<br />

further<br />

legs,<br />

from<br />

back,<br />

the<br />

chest<br />

truth.<br />

<strong>and</strong><br />

Naturally,<br />

abdominals.<br />

women don’t produce enough testosterone to<br />

gain huge amounts of muscle. In fact, strength training can<br />

assist<br />

Legs:<br />

in helping<br />

stair<br />

to<br />

running<br />

reduce your overall body fat percentage.<br />

Incorporating<br />

By running<br />

strength<br />

stairs you<br />

training<br />

will<br />

into<br />

pace<br />

your<br />

a higher<br />

exercise<br />

load<br />

routine<br />

on<br />

will<br />

the<br />

help<br />

hamstring,<br />

maintain<br />

gluteal<br />

muscle<br />

muscles<br />

mass, which<br />

<strong>and</strong> calves.<br />

is something<br />

Making<br />

that<br />

your<br />

can<br />

way<br />

be<br />

lost<br />

back<br />

when<br />

downhill<br />

you only<br />

slowly<br />

participate<br />

will load<br />

in<br />

the<br />

cardio.<br />

quadriceps ensuring an<br />

all-round leg workout. Try doing normal running or walking<br />

intervals with Doing some crunches variations as <strong>and</strong> you ab advance. workouts will<br />

get rid of belly fat<br />

Back: reverse flyes<br />

Fact: It’s difficult The unfortunate to train your truth back is without that spot heading training to the doesn’t gym,<br />

work but to when add it some comes definition to losing to specific your trapezius fat pockets. <strong>and</strong> rhomboids You can’t<br />

control (the major the places muscles of between fat reduction your when shoulder you blades) work out. try If a<br />

you reverse already fly <strong>and</strong> have extension. a high percentage of body fat covering<br />

your Lie abs, face you down will on need a bench, to raise reduce your your arms overall out to your body sides, fat<br />

percentage then move your before arms your in an abs arc are above revealed. your head. Ab Reverse exercises the<br />

don’t movement help you back lose to the belly starting fat – position. they simply For a help more define advanced the<br />

underlying workout use musculature. some dumbbells for extra resistance.<br />

Chest: push-ups<br />

There is really no better all-round exercise than the push-up<br />

when training outdoors. Place your h<strong>and</strong>s shoulder width<br />

or slightly wider with your wrists slightly above the nipple<br />

line but below your shoulders. If you wish to focus more on<br />

your chest muscles, place your h<strong>and</strong>s a little wider <strong>and</strong> move<br />

your elbows away from the body as you lower yourself.<br />

To focus more on the triceps bring your h<strong>and</strong>s a little<br />

closer to your body <strong>and</strong> keep your elbows close to your body<br />

Cardio burns the most calories<br />

as you lower yourself to the ground. Beginners should try<br />

push-ups from the knees. If this is too difficult try push ups<br />

Fact: It’s true that you will burn calories while doing<br />

on a raised bench with feet on the floor or against a wall<br />

cardio, but with strength training, even after you finish<br />

(the more upright you are the easier the push up will be.<br />

lifting weights, your body continues to burn calories for<br />

Advanced trainers should try a full length push up raising<br />

hours afterwards. The most important thing to remember<br />

is<br />

one<br />

controlling<br />

leg in the air<br />

your<br />

to increase<br />

calorie intake,<br />

the load<br />

as<br />

on the<br />

weight<br />

upper<br />

loss<br />

body.<br />

only<br />

occurs when you are burning more calories than you<br />

are<br />

Abdominals<br />

consuming.<br />

While defined abdominals is appealing to many people,<br />

the most<br />

Stretching<br />

significant effect<br />

is best<br />

that<br />

before<br />

abdominals<br />

working<br />

have on<br />

out<br />

our<br />

appearance is in regards to posture. Try the following sit-up<br />

Fact: variation<br />

Despite<br />

to assist<br />

what<br />

you<br />

we’ve<br />

with walking<br />

been led<br />

<strong>and</strong><br />

to<br />

sitting<br />

believe,<br />

tall.<br />

stretching<br />

before<br />

Lie flat<br />

a workout<br />

on the floor,<br />

while<br />

sit<br />

your<br />

up <strong>and</strong><br />

muscles<br />

raise<br />

are<br />

one<br />

cold<br />

knee<br />

is<br />

to<br />

ineffective.<br />

your chest,<br />

A<br />

meeting<br />

much more<br />

as your<br />

effective<br />

torso<br />

method<br />

<strong>and</strong> thigh<br />

to<br />

are<br />

precondition<br />

both almost<br />

your<br />

vertical.<br />

body<br />

before<br />

Focus on<br />

exercise<br />

staying<br />

is<br />

as<br />

to<br />

tall<br />

warm<br />

as possible<br />

up with<br />

without<br />

some light<br />

crumbling<br />

cardio <strong>and</strong><br />

your<br />

range<br />

posture.<br />

of<br />

Raise<br />

movement<br />

your straight<br />

drills specific<br />

leg at the<br />

to<br />

same<br />

the<br />

time<br />

activity<br />

so that<br />

you<br />

your<br />

are<br />

about<br />

heel is<br />

to<br />

just<br />

undertake.<br />

off the ground.<br />

This will<br />

Lower<br />

get<br />

to<br />

your<br />

the<br />

blood<br />

ground<br />

flowing<br />

<strong>and</strong> repeat.<br />

<strong>and</strong><br />

warm<br />

Try 8-10<br />

up<br />

repetitions<br />

your muscles<br />

on<br />

to<br />

each<br />

help<br />

leg.<br />

prevent<br />

For advanced<br />

injuries.<br />

trainers, try 2<br />

legs at a time. Beginners should complete the leg movements<br />

as above without More exercise the sit up. is always better<br />

You should always seek the advice of a registered fitness<br />

Fact: professional The number before undertaking of calories any you program. burn depends Visit your on local the<br />

intensity gym for the of your personalised training. guidance When it you comes require. to working bella out,<br />

it’s all about quality over quantity. In fact, high intensity<br />

interval Jarrat Wood training is a personal can burn trainer more <strong>and</strong> calories the gym in manager a short at amount Regenesis of<br />

time. Fitness A in few Edgecliff, days of Sydney. quality For exercise more information each week call will 02 9363 typically 0376<br />

achieve or visit www.regenesisfitness.com.au<br />

better results than every day light training. csbm<br />

Russell Cox from Regenesis Fitness debunks some workout myths<br />

that could be slowing down your weight loss journey.<br />

112 // bellaBEAUTY<br />

Re-energise with<br />

Regenesis Fitness, an<br />

exclusive, friendly <strong>and</strong><br />

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02 9363 0376 info@regenesisfitness.com.au<br />


feature<br />

Feed<br />

your<br />

face<br />

Welcome to the next<br />

generation of superfoods.<br />

AimÉe Surtenich reports.<br />

Not all foods are created equal. Certain foods have<br />

been given the title ‘super’ for their ability to fight<br />

disease, immune disorders <strong>and</strong> the signs of skin<br />

ageing. Here are some of the new kids on the superfood<br />

block – plus the foods that have earned cult health status.<br />

94 www.cosbeauty.com.au

feature<br />

Chia seeds<br />

These tiny but mighty edible seeds, which date back to Mayan <strong>and</strong> Aztec<br />

cultures, are an excellent source of fibre (three times more than oatmeal), protein,<br />

calcium, antioxidants <strong>and</strong> omega-3s. In fact, chia is the richest plant source of<br />

omega-3 oil, which is said to help lower cholesterol, reduce high blood pressure<br />

<strong>and</strong> fight against inflammation in the body.<br />

Chia can also help stabilise blood sugar levels <strong>and</strong> even help target pesky<br />

belly fat! The seeds can be soaked in liquid or sprinkled onto just about every<br />

meal to add a nutritious mildly nutty taste.<br />

Kale<br />

This nutritional powerhouse has become a household name over the past<br />

few years – <strong>and</strong> it’s no wonder. With more iron than beef per calorie, kale<br />

contains nine essential amino acids, as well as high levels of magnesium <strong>and</strong><br />

oxygen-rich chlorophyll.<br />

It’s the ultimate detox food as it’s also rich in fibre <strong>and</strong> sulphur, lowers<br />

cholesterol <strong>and</strong> is rich in antioxidant <strong>and</strong> anti-inflammatory properties to help<br />

ward off several types of cancer. Rich in Vitamins A, C <strong>and</strong> K, kale also does<br />

wonders for glowing, clear skin.<br />

Pistachios<br />

Move over walnuts, there’s a new nut rising up the nutrition leaderboard.<br />

So why are pistachios said to be superior to their nutty counterparts? To<br />

start, they contain fewer calories <strong>and</strong> more potassium <strong>and</strong> Vitamin K per serving<br />

than other nuts. Pistachios contain two carotenoids not found in most nuts<br />

– lutein <strong>and</strong> zeaxanthin – which are essential for eye health <strong>and</strong> defending<br />

tissues from free radicals. They are also a great source of Vitamins A, B6 <strong>and</strong> E,<br />

essential for healthy, smooth <strong>and</strong> beautiful skin, <strong>and</strong> are rich in phytoserols <strong>and</strong><br />

soluble fibre, two plant compounds that can lower cholesterol <strong>and</strong> reduce the<br />

risk of heart disease.<br />

Cacao<br />

Consumed raw, with all enzymes <strong>and</strong> goodness left in its unheated glory, cacao<br />

has more antioxidants than chocolate, red wine <strong>and</strong> blueberries combined! It is<br />

choc-full with nutrients <strong>and</strong> incredibly high in iron. It also helps to raise endorphins<br />

<strong>and</strong> boost our serotonin levels. Add it in powdered form to a smoothie or sprinkle<br />

some over oats to add a delicious (<strong>and</strong> nutritious) chocolate flavour to your<br />

morning porridge.<br />

Acai<br />

Pronounced ah-sigh-EE, studies have shown this Amazonian berry is one of the<br />

most nutritious foods in the world. Resplendent in amino acids, antioxidants,<br />

fibre, phytosterols <strong>and</strong> omega-3 fatty acids, it also has powerful cancer-fighting<br />

properties, is a stem cell producer <strong>and</strong> assists with weight loss.<br />

www.cosbeauty.com.au 95

feature<br />

Kelp<br />

Essentially mineral-rich seaweed <strong>and</strong> packed with high levels of demulcent fibre,<br />

kelp can actually help heal the digestive tract <strong>and</strong> is one of the best natural<br />

sources of iodine, which promotes thyroid <strong>and</strong> endocrine function. It also helps<br />

boost the immunity system <strong>and</strong> even improve memory.<br />

Pomegranate<br />

These Middle Eastern jewel-like seeds have earned their place as a superfood<br />

due to their high levels of polyphenols, powerful cancer-fighting <strong>and</strong> hearthealthy<br />

antioxidants.<br />

It is said that pomegranate seeds have more antioxidant power than cranberry<br />

juice or green tea. Pomegranate is rich in Vitamins A, C <strong>and</strong> E, <strong>and</strong> in iron, which<br />

helps the blood maintain an effective supply of oxygen to the body.<br />

Quinoa<br />

This supergrain, pronounced KEEN-wah, contains more protein than any other<br />

grain <strong>and</strong> is super-charged with iron, potassium <strong>and</strong> all nine essential amino<br />

acids while being naturally gluten-free.<br />

A cup of quinoa delivers five grams of fibre <strong>and</strong> aids in improving digestion,<br />

lowering cholesterol <strong>and</strong> promoting healthy blood sugar levels. Oh, <strong>and</strong> it’s great<br />

at keeping excess kilos at bay.<br />

These days, you’ll find it adorning many a cafe <strong>and</strong> restaurant menu, but you<br />

can easily create a delicious quinoa-inspired meal at home, too. Add to salads,<br />

soups or try it as an alternative to rice.<br />

96 www.cosbeauty.com.au

feature<br />


These superfoods may not be the new kids on the block, but they’ve stood the<br />

test of time in promoting inner health <strong>and</strong> external radiance.<br />

Oily fish<br />

Sardines, herring, trout <strong>and</strong> salmon are all rich sources of omega-3 fatty acids,<br />

which help prevent heart disease. They’re also good news for osteoporosis<br />

prevention <strong>and</strong> can improve the texture of the skin <strong>and</strong> hair.<br />

Oily fi sh is a good source of Vitamins A <strong>and</strong> D. Vegetarians can boost their<br />

intake of omega-3 by taking supplementary capsules daily.<br />

Essential fatty acids play an integral part in skin hydration, cell renewal <strong>and</strong><br />

protecting the epidermis against harmful bacteria. These unsaturated fatty<br />

acid chains maintain the permeability barrier of the stratum corneum – or the<br />

top layer of the epidermis. This barrier protects the skin from bacteria to prevent<br />

acne <strong>and</strong> inhibits trans-epidermal water loss to maintain skin hydration.<br />

Dark leafy greens<br />

Leafy green vegetables are packed full of goodness, <strong>and</strong> spinach is the best of<br />

the bunch. It contains Vitamins A <strong>and</strong> C <strong>and</strong> folic acid, as well as magnesium,<br />

which is thought to help fi ght cancer <strong>and</strong> lower the risk of heart disease <strong>and</strong><br />

stroke. It also blocks free radicals, which cause signs of ageing on the skin, <strong>and</strong><br />

may even help prevent osteoporosis.<br />

Green tea<br />

Most types of tea contain fl avonoids called polyphenols, however green tea<br />

contains less caffeine than black tea <strong>and</strong> is also thought to aid digestion <strong>and</strong><br />

may stimulate the metabolism. Many green tea drinkers also report that drinking<br />

a couple of cups a day helps to maintain clear skin.<br />

Cranberries & blueberries<br />

Cranberries have long been used to ward off urinary tract infections <strong>and</strong> are<br />

packed with antioxidants. More recently, it has been discovered that cranberries<br />

also contain anti-carcinogenic compounds, which can prevent or delay the<br />

development of cancer.<br />

Blueberries deliver high levels of antioxidants called anthocyanins, which have<br />

been shown to lower cholesterol, prevent blood clotting <strong>and</strong> protect body cells.<br />

They also contain Vitamins C <strong>and</strong> E, in addition to fi bre <strong>and</strong> folic acid, which is of<br />

benefi t to women who wish to fall pregnant.<br />

Avocados<br />

Up until a couple of decades ago, avocados had a relatively bad name, thanks<br />

to their higher levels of fat than most fruits <strong>and</strong> vegetables. However, word is<br />

defi nitely spreading that this fat is good fat: healthy monounsaturated fatty acids<br />

actually appear to lower ‘bad’ cholesterol levels <strong>and</strong> raise the ‘good’ levels.<br />

Avocados are also rich in antioxidants, which are thought to slow the body’s<br />

ageing process by destroying free radicals <strong>and</strong> slowing oxidation. Antioxidants<br />

also reduce allergies <strong>and</strong> the risk of heart disease <strong>and</strong> cancer. csbm<br />

www.cosbeauty.com.au 97

face<br />

<strong>Beauty</strong><br />

through<br />

the ages<br />

Sydney plastic surgeon<br />

Dr Steven Liew says a pesonalised<br />

beauty treatment program enables<br />

people to look their best at every<br />

age. AimÉe Surtenich reports.<br />

Sydney plastic surgeon Dr Steven Liew believes the<br />

new generation of advanced cosmetic non-surgical<br />

treatments are delivering such remarkable results<br />

that in the future most patients, if properly treated, will no<br />

longer require major facial cosmetic surgery. Instead, regular<br />

maintenance with non-surgical treatments will become the<br />

norm – combined with more minor surgical procedures<br />

where required.<br />

A global leader in the development of advanced cosmetic<br />

facial treatments, Dr Liew has developed the <strong>Beauty</strong> Through<br />

The Ages Program, a personalised beauty treatment plan that<br />

helps guide patients through each decade with the best <strong>and</strong><br />

latest procedures available at Dr Liew’s Shape Clinic.<br />

‘The new treatments deliver such natural-looking results<br />

that patients can be a more beautiful version of themselves<br />

at every age,’ says Dr Liew. ‘Regular non-surgical procedures<br />

to beautify the face <strong>and</strong> skin is far more effective than waiting<br />

until invasive surgery is needed to repair sagging jowls <strong>and</strong><br />

skin folds. But for patients with significant skin looseness of<br />

the eyelid, lower face <strong>and</strong> neck, then eye, face <strong>and</strong> neck lift<br />

surgery still <strong>and</strong> always will be the gold st<strong>and</strong>ard.’<br />

Treatment plans under the <strong>Beauty</strong> Through The Ages<br />

Program ensure a more targeted, effective approach for every<br />

age, including:<br />

Your 20s<br />

Most cosmetic treatments for people in their 20s are nonsurgical<br />

(wrinkle relaxers such as Botox, <strong>and</strong> fillers) <strong>and</strong> are<br />

aimed at beautifying the face.<br />

Apart from basic treatments such as lip enhancement,<br />

Shape Clinic also offers Dr Liew’s advanced, pioneering<br />

techniques – including his total facial reshaping procedure,<br />

a ‘glamorising’ treatment which can transform the ‘girl next<br />

door’ to a stunning beauty.<br />

Surgically, breast augmentation surgery is the most popular<br />

at this age group, says Dr Liew.<br />

Your 30s<br />

This is the decade when we start to notice the first signs of<br />

facial ageing: most commonly lines <strong>and</strong> wrinkles on our brow<br />

<strong>and</strong> mouth.<br />

‘Botox <strong>and</strong> other injectables to reduce frown <strong>and</strong> laugh<br />

lines <strong>and</strong> fillers to resculpture the cheek area will both<br />

beautify the face <strong>and</strong> maintain youthful radiance,’ says<br />

Dr Liew.<br />

Your 40s, 50s <strong>and</strong> Beyond<br />

At this age we are increasingly likely to combine non-surgical<br />

treatments with surgery.<br />

‘Face <strong>and</strong> neck lifts to reduce jowls <strong>and</strong> sagging neck skin<br />

are in high dem<strong>and</strong>, while eyelid surgery <strong>and</strong> brow lifts are also<br />

popular,’ says Dr Liew.<br />

‘Dermal fillers in this age group continue to be very effective<br />

in creating a natural-looking <strong>and</strong> more beautiful appearance,<br />

replacing lost volume to deflated cheeks, thinning lips <strong>and</strong><br />

softening the “marionette” lines around the mouth,’ Dr Liew<br />

concludes. csbm<br />

98 www.cosbeauty.com.au

face<br />

Non surgical 20s to 30s<br />

1<br />

BEFORE<br />

A beautifully tailored, sensuous <strong>and</strong> juicy lip with Juvederm filler<br />

AFTER lip enhancement with dermal filler by Dr Liew<br />

2<br />

BEFORE<br />

Non-surgical lower eyelift with dermal filler to remove the tired dark circles<br />

AFTER non-surgical enhancement by Dr Liew<br />

3<br />

BEFORE<br />

AFTER non-surgical enhancement by Dr Liew<br />

Non-surgical eyebrow <strong>and</strong> eye lift with Botox to lift the eyebrows <strong>and</strong> reduce heaviness of the upper eyelid to create<br />

brighter, more attractive eyes<br />

4<br />

BEFORE<br />

AFTER non-surgical enhancement by Dr Liew<br />

Total facial beautification to narrow <strong>and</strong> define the jawline with Botox <strong>and</strong> to define the cheek definition with dermal filler<br />

www.cosbeauty.com.au 99

face<br />

<strong>Beauty</strong> Through The Ages Program 20s to 30s<br />

1<br />

BEFORE<br />

AFTER surgical upper eyelift procedure (in-office) by<br />

Dr Liew<br />

2<br />

BEFORE<br />

AFTER Asian ‘double eyelid’ surgery (in-office) by<br />

Dr Liew<br />

3<br />

BEFORE<br />

AFTER surgical lower eyelift procedure (lower eyebags<br />

removed) by Dr Liew<br />

4<br />

BEFORE<br />

AFTER keyhole browlift <strong>and</strong> surgical fat removal of<br />

lower eyelids by Dr Liew<br />

100 www.cosbeauty.com.au

face<br />

1<br />

Non Surgical<br />

40s, 50s, 60s<br />

BEFORE<br />

AFTER non-surgical enhancement by Dr Liew<br />

Sunken <strong>and</strong> hollow cheeks created a sad <strong>and</strong> tired look. Dermal fillers were used to<br />

transform her facial contour to a beautiful <strong>and</strong> healthy appearance<br />

2<br />

BEFORE<br />

AFTER facial rejuvenation by Dr Liew<br />

Total facial rejuvenation creating a refreshed <strong>and</strong> aesthetically pleasing appearance<br />

3<br />

BEFORE<br />

AFTER facial rejuvenation by Dr Liew<br />

Total facial beautification with strategic use of laser for skin capillaries, Botox <strong>and</strong><br />

dermal fillers<br />

4<br />

BEFORE<br />

AFTER facial rejuvenation by Dr Liew<br />

Total facial beautification with strategic use of dermal fillers, transforming the facial<br />

structures <strong>and</strong> profile of the eyebrow, eyelid, nose, cheek <strong>and</strong> chin<br />

www.cosbeauty.com.au 101

face<br />

<strong>Beauty</strong> Through The Ages Program<br />

Looking The Best at Any Stage of Your Life<br />

BEFORE<br />

AFTER facial rejvenation by Dr Liew<br />

BEFORE<br />

AFTER facial rejvenation by Dr Liew<br />

<strong>Beauty</strong> Treatment Plan (combining surgery <strong>and</strong> non-surgical procedures): This patient underwent upper <strong>and</strong> lower eyelift surgery <strong>and</strong> face<br />

<strong>and</strong> necklift surgery at the age of 49 by Dr Liew. At age 60 she has maintained her beautiful radiance, looking the best for her age by simple<br />

skincare <strong>and</strong> strategically planned non-surgical treatments by Dr Liew.<br />

102 www.cosbeauty.com.au


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face<br />

Facelifting:<br />

The Science & Expertise<br />

Behind Natural-looking Results<br />

for outst<strong>and</strong>ing, natural-looking facelift results, Sydney<br />

plastic surgeon Dr Darryl Hodgkinson says surgical expertise<br />

<strong>and</strong> experience are paramount.<br />

No one wants a tight facelift or to face the public<br />

derision that so many celebrities face, especially<br />

men, when they have a tight, stretched <strong>and</strong><br />

unnatural-looking face after facelift surgery. Why is it that so<br />

many people have this ‘operated on’, tight look which is a<br />

giveaway they have been ‘under the knife’?<br />

The answer could be twofold: they have opted for lesser<br />

procedures such as S-lifts or skin lifts, or the surgeon lacks<br />

the experience <strong>and</strong> expertise in facelifting necessary to<br />

create a result that is both visible <strong>and</strong> natural in appearance.<br />

In the case of the lesser procedure, the skin lifts which<br />

are marketed under many different names, use the skin<br />

No two faces age exactly alike;<br />

some age around the brow or<br />

eyes, some in the mid face, <strong>and</strong><br />

others around the jowls.<br />

like cling wrap to pull back the tissues. These cases seem<br />

attractive at first as they take less time, less expertise, have<br />

potentially less downtime for the patient in healing <strong>and</strong><br />

therefore cost less.<br />

The problem arises in that when using the skin like a<br />

corset to hold back the sagging tissues underneath, these<br />

lax structures <strong>and</strong> fat pads which needed to be secured are<br />

still underneath, ready to bulge out like when you squeeze<br />

yourself into too-tight jeans <strong>and</strong> create a ‘muffin top’.<br />

Another problem is that this pulling back on the skin<br />

under tension places stress on the suture lines, which can<br />

cause scars to migrate <strong>and</strong> be more visible.<br />

Finally, to create this tension, more skin needs to be<br />

removed than is natural <strong>and</strong> if a secondary or corrective<br />

procedure is considered at a later date, it will be more<br />

difficult as there may not be enough skin <strong>and</strong> there may be<br />

wider scars to contend with.<br />

The second case is, of course, the experience <strong>and</strong><br />

expertise of the surgeon. As in all cosmetic plastic surgical<br />

procedures, the number-one factor in defining the quality of<br />

the result is the skill of the surgeon. Face lifting <strong>and</strong> neck<br />

lifting surgery is an area of expertise unto itself.<br />

The surgeon must have a highly detailed knowledge of<br />

the intricate facial anatomy to work in the deep plane to<br />

secure these tissues without damaging tissues or, worse,<br />

nerves which could lead to a facial palsy.<br />

Also, there are many techniques which can be deployed<br />

in conjunction with one another to create an overall more<br />

natural look as no two faces age exactly alike. Some faces<br />

age around the brow, with drooping <strong>and</strong> sagging or furling<br />

of the brow; some around the eyes with drooping, bulging<br />

<strong>and</strong> wrinkling; others through the mid face with hollowness<br />

created as the fat pads resorb from the cheeks; while<br />

others show ageing mostly around the jowls <strong>and</strong> neckline.<br />

Some people have a little of each of these aspects <strong>and</strong><br />

to adopt one approach to all faces will lead to the classic<br />

maligned facelift: a tight face with pulled earlobes <strong>and</strong> the<br />

tell-tale droopy neck.<br />

With a skilled surgeon, a natural-looking result can be<br />

achieved for each patient, addressing their unique signs of<br />

ageing <strong>and</strong> taking 10 years off the clock. csbm<br />

For more detailed information on the types of facelifts<br />

Dr Hodgkinson performs, visit www.cosmeticsurgeryoz.<br />

com.au/face-lifting-just-the-facts/<br />

104 www.cosbeauty.com.au

face<br />

1<br />

2BEFORE<br />

AFTER face <strong>and</strong> neck lift <strong>and</strong> upper <strong>and</strong> lower blepharoplasty by Dr Hodgkinson<br />

BEFORE<br />

AFTER face <strong>and</strong> neck lift <strong>and</strong> upper <strong>and</strong> lower blepharoplasty by Dr Hodgkinson<br />

www.cosbeauty.com.au 105

face<br />

lowering the hairline<br />

for facial harmony<br />

Sydney plastic surgeon Dr Warwick Nettle explains lowering<br />

the hairline to reduce an overly large forehead can make a significant<br />

improvement to facial beauty. Caitlin Bishop reports.<br />

A<br />

high hairline or elongated forehead can detract<br />

from facial balance <strong>and</strong> add to the appearance of<br />

an ageing face, particularly in women. According<br />

to Sydney plastic surgeon Dr Warwick Nettle, a hairline<br />

lowering procedure can help restore facial harmony,<br />

bringing the hairline <strong>and</strong> brow to more aesthetically<br />

pleasing proportions.<br />

‘Typically, the hairline should start at around the<br />

transition point between the vertical forehead <strong>and</strong> the point<br />

where the forehead starts to slope backwards towards the<br />

106 www.cosbeauty.com.au

face<br />

scalp – usually between 5 <strong>and</strong> 6cm above the eyebrows,’<br />

he explains. ‘It can look relatively unattractive if the hairline<br />

starts well above this transition point.’<br />

According to Dr Nettle, a higher hairline is usually of<br />

greatest concern in younger patients. Patients most suitable<br />

for surgery usually have flexible skin on their forehead, while<br />

hair density, the presence of any hair whorls or cowlicks,<br />

<strong>and</strong> hereditary hair loss must be taken into<br />

account before undergoing the procedure.<br />

‘If a patient has a relatively flexible<br />

scalp — in other words if they can wriggle<br />

it backwards <strong>and</strong> forwards quite freely —<br />

we can achieve a good lowering of the<br />

hairline <strong>and</strong> forehead reduction,’ he says.<br />

‘If the scalp is not flexible, however, it can<br />

be more difficult to advance the scalp to<br />

reduce the forehead <strong>and</strong> sometimes twostage<br />

surgery is needed.’<br />

Hairline lowering surgery is commonly<br />

performed at the same time as brow<br />

lifting surgery. It’s important for patients<br />

to underst<strong>and</strong> that hairline lowering does<br />

not necessarily elevate the brows, <strong>and</strong><br />

sometimes the surgeries need to be BEFORE<br />

performed in conjunction to achieve the<br />

best aesthetic result.<br />

During the hairline lowering surgery,<br />

an incision is made along the existing<br />

hairline <strong>and</strong> the hair-bearing scalp is lifted<br />

<strong>and</strong> moved forwards. The type of incision<br />

is essential in ensuring the best results<br />

– as the hair needs to grow through the<br />

incision during the recovery phase to help<br />

camouflage any scarring.<br />

‘The technique used in hair lowering<br />

surgery is called a trichophytic incision, <strong>and</strong><br />

allows hair to grow along the scar during<br />

recovery,’ he says. ‘It’s also important for<br />

the surgeon to underst<strong>and</strong> the direction<br />

of hair growth <strong>and</strong> preservation of scalp BEFORE<br />

blood supply. These are all technical<br />

details which help ensure optimal results.’<br />

The surgery is performed as a day<br />

surgery procedure, either under general<br />

anaesthesia or with intravenous sedation.<br />

Before the patient leaves the operating<br />

theatre, a light dressing is applied to assist<br />

in healing. The sutures are usually removed<br />

three to seven days post-operation.<br />

‘In my experience, the procedure is<br />

typically very well tolerated,’ says Dr<br />

Nettle. ‘The vast majority of my patients<br />

are able to return to work within three to<br />

seven days of the surgery. I always tell<br />

patients they need to be prepared to wear<br />

their hair in bangs to cover the incision line<br />

BEFORE<br />

for the first year. However my personal experience is that<br />

it is very unusual for anyone to need to keep their hairline<br />

covered beyond three months. In fact, many patients are<br />

able to wear their hair pulled back within weeks of the<br />

surgery.’<br />

‘Hairline lowering surgery can make a real difference in<br />

harmonising <strong>and</strong> feminising the face,’ he concludes. csbm<br />

AFTER hairline lowering surgery by Dr Nettle<br />

AFTER hairline lowering surgery by Dr Nettle<br />

AFTER hairline lowering surgery by Dr Nettle<br />

www.cosbeauty.com.au 107

face<br />

Options in facelifting<br />

Sydney facial surgeon Dr Paul Gerarchi explains the most<br />

popular types of facelifts – both surgical <strong>and</strong> non-surgical.<br />

Caitlin Bishop reports.<br />

The development <strong>and</strong> refinement of face lifting surgery<br />

has stemmed from a growing underst<strong>and</strong>ing of<br />

the ageing process. Sydney facial surgeon Dr Paul<br />

Gerarchi has built his practice upon the modern day facelift<br />

<strong>and</strong> addressing all elements – from skin laxity to volume<br />

loss – that contribute to an aged appearance.<br />

‘Today, face lifting surgery manipulates the supportive<br />

soft tissue underneath the skin to reverse the effect of<br />

ageing,’ Dr Gerarchi explains. ‘This should be achieved<br />

without putting unnatural tension on the skin itself, to avoid<br />

that “over-tightened” look.’<br />

A facelift is often touted to be the gold st<strong>and</strong>ard in<br />

improving a tired or aged facial appearance. It helps smooth<br />

the skin, removing folds <strong>and</strong> wrinkles, <strong>and</strong> re-establish<br />

more youthful-looking facial contours <strong>and</strong> definition along<br />

the neck <strong>and</strong> jaw line.<br />

‘It is a myth that there is a “right” age to have a facelift,’<br />

Dr Gerarchi explains. ‘Facelifts are suitable for most<br />

patients, men or women, young or old. If you feel that your<br />

facial features are heavy or sagging, particularly in the jaw<br />

line, a face lifting procedure will help refresh <strong>and</strong> brighten<br />

the appearance.’<br />

Dr Gerarchi offers a wide spectrum of face lifting<br />

procedures, from minimally invasive options to surgical<br />

intervention. Volumisation <strong>and</strong> short scar procedures afford<br />

an effective option for those who aren’t able to commit to<br />

the downtime involved in surgery.<br />

Alternatively, more extensive surgical lifts can achieve<br />

significant <strong>and</strong> long-lasting anti-ageing results. Dr Gerarchi<br />

will always tailor his approach according to the patient’s<br />

desires, expectations, anatomy <strong>and</strong> degree of ageing.<br />

Comprehensive facelift<br />

A traditional facelift procedure lifts <strong>and</strong> remodels the<br />

underlying facial soft tissue, before re-draping the skin over<br />

these newly defined contours. The superficial muscular<br />

aponeurotic system (SMAS), which is the underlying<br />

musculature of the face, is lifted <strong>and</strong> re-tightened during<br />

facelift surgery.<br />

In addition to the SMAS technique, other types of<br />

comprehensive face lifting procedures include the sub<br />

SMAS <strong>and</strong> Deep Plane procedures. They all involve an<br />

incision that runs from the hairline above the ear, around<br />

<strong>and</strong> behind the ear, <strong>and</strong> into the hair behind the ear. The<br />

length of incision allows the surgeon to operate more<br />

comprehensively on the muscles <strong>and</strong> ligaments beneath the<br />

skin, affording greater visibility. It also assists in addressing<br />

<strong>and</strong> reshaping the neck skin <strong>and</strong> soft-tissue.<br />

Face lifting surgery typically requires an overnight stay<br />

in hospital, <strong>and</strong> a minimum of two weeks off work. During<br />

recovery, a facial compression garment is worn, <strong>and</strong> pain<br />

medication is sometimes required in the days following<br />

the procedure.<br />

‘The traditional facelift can be very effective for elevating<br />

more advanced facial drooping <strong>and</strong> sagging,’ Dr Gerarchi<br />

explains. ‘Like other kinds of facelifts, they can be combined<br />

with complementary procedures such as a neck lift, brow<br />

lift or eyelid surgery.’<br />

Short-Scar Facelifts<br />

A short-scar facelift is best for those patients who notice that<br />

their face is beginning to droop, or their jowls are sagging,<br />

but who are not yet ready for the more comprehensive<br />

facelift procedure.<br />

During a short-scar facelift, an incision is made in the<br />

crease in front of the ear. This enables the surgeon to<br />

manipulate the underlying soft tissue to reverse moderate<br />

heaviness in the jowl <strong>and</strong> lower face. Because the incision<br />

<strong>and</strong> tissue adjustment is relatively minimal, patients can<br />

usually go home the same day of surgery, <strong>and</strong> one to two<br />

weeks of recovery time is required.<br />

‘I often combine short-scar facelifts with liposuction<br />

below the chin. This helps enhance the jaw line <strong>and</strong><br />

contributes to a more harmonious result,’ Dr Gerarchi<br />

108 www.cosbeauty.com.au

face<br />

explains. ‘Sometimes patients will need more volume in<br />

their upper cheeks <strong>and</strong> mid-face to accompany the lift. For<br />

these patients, I use a fat transfer procedure to improve the<br />

final rejuvenation result.’<br />

Volumetric Facelift<br />

Volume loss is one of the most noticeable hallmarks of<br />

ageing. As the face ages, <strong>and</strong> gravity takes its toll, volume<br />

drops from the cheeks <strong>and</strong> mid-face. This contributes to<br />

a thin, gaunt <strong>and</strong> hollow appearance, <strong>and</strong> often leads to<br />

heaviness in the jowl area.<br />

A volumetric facelift solely addresses volume loss. It<br />

rejuvenates the face, restores fullness <strong>and</strong> recreates more<br />

youthful facial contours <strong>and</strong> angles.<br />

During this procedure, fat is taken from the abdomen<br />

or the inside of the knees <strong>and</strong> reinjected into the cheeks,<br />

chin, temples <strong>and</strong> mid-face. Although synthetic fillers are<br />

sometimes used to achieve a similar result, Dr Gerarchi<br />

believes the patient’s own fat delivers a long-term<br />

rejuvenation with minimal complications.<br />

‘Using your own fatty tissue minimises the complications<br />

associated with the insertion of foreign materials into the<br />

body,’ he explains. ‘Any excess oil or fluid is extracted from<br />

the fat before insertion, <strong>and</strong> the purified fat is reinjected<br />

into the face. This replaces lost facial volume for a longterm<br />

result, though sometimes “top up” treatments are<br />

necessary to achieve maximum effect.’<br />

The fat transfer procedure has a good safety profile <strong>and</strong><br />

involves minimal down time. It is an attractive option for<br />

patients who do not want or need a surgical facelift, but<br />

who are looking to reverse or waylay the most noticeable<br />

signs of ageing.<br />

If you feel that your facial<br />

features are heavy or sagging, a<br />

face lifting procedure will help<br />

freshen the appearance<br />

‘Volumetric face lifting is an effective procedure<br />

which can achieve significant anti-ageing results,’ says<br />

Dr Gerarchi. ‘However, the procedure is not suitable for<br />

patients with excessive loose skin <strong>and</strong> jowling. In these<br />

cases, volume addition should be combined with a<br />

surgical facelift to achieve the desired result. Optimal facial<br />

rejuvenation results are achieved when the face is both<br />

lifted <strong>and</strong> filled.’ csbm<br />

1<br />

BEFORE<br />

AFTER face, mid-face <strong>and</strong> neck lift by Dr Gerarchi<br />

www.cosbeauty.com.au 109

face<br />

2<br />

BEFORE<br />

AFTER facelift <strong>and</strong> volumetric fat transfer by Dr Gerarchi<br />

3<br />

BEFORE<br />

AFTER facelift, neck lift <strong>and</strong> rhinoplasty by Dr Gerarchi<br />

4<br />

BEFORE<br />

AFTER facelift, neck lift, blepharoplasty <strong>and</strong> rhinoplasty<br />

by Dr Gerarchi<br />

110 www.cosbeauty.com.au


Rhinoplasty <strong>and</strong> Facelift Specialist<br />


Rhinoplasty <strong>and</strong> Facelift Specialist<br />

Model<br />

Model<br />

expert expert surgical & non-surgical facial facial rejuvenation<br />

The The Face Face Institute <strong>and</strong> <strong>and</strong> Dr Dr Paul Gerarchi, Suite 4, 12-14 Malvern Avenue, Chatswood, NSW. NSW.<br />

For For more more information, visit www.thefaceinstitute.com.au or or call call (02) (02) 9412 9412 4599. 4599.

face<br />

Minor surgeries,<br />

major results<br />

Sydney cosmetic physician Dr Buddy Beaini says less can definitely<br />

be more when it comes to cosmetic enhancement surgery.<br />

Caitlin Bishop reports.<br />

Minimally invasive options for facial rejuvenation can<br />

help reverse the signs of ageing <strong>and</strong> waylay the<br />

need for surgery. Sydney cosmetic physician Dr<br />

Buddy Beaini is experienced in delivering a comprehensive<br />

range of cutting-edge minor surgical treatments for his<br />

patients. In particular, thread lifting, blepharoplasty <strong>and</strong> bat<br />

ear correction (otoplasty) are minimally invasive procedures<br />

that can achieve significant results.<br />

‘Minimally invasive procedures are key to rejuvenating the<br />

appearance <strong>and</strong> reversing the signs of age for individuals of<br />

all ages,’ says Dr Beaini. ‘When selected appropriately <strong>and</strong><br />

used in combination, minimally invasive procedures can<br />

make the patient look five to 10 years younger.’<br />

With a range of light therapies, minor surgeries <strong>and</strong><br />

injectables at his clinic, Dr Beaini takes a personalised<br />

approach with every patient. He will work with a range of<br />

modalities to ensure the best result for each individual.<br />

‘Patients of all age ranges have been consulted <strong>and</strong><br />

treated with excellent results,’ he says. ‘With the current<br />

advanced technology <strong>and</strong> techniques, facial rejuvenation<br />

has developed dramatically, giving patients the options to<br />

look <strong>and</strong> feel younger without the need for major surgery.’<br />

‘During consultation, I ask my patients to describe<br />

their main concerns <strong>and</strong> I will outline the advantages,<br />

disadvantages, success rates, downtime <strong>and</strong> budget<br />

involved with a number of relevant treatment options,’ Dr<br />

Beaini adds. ‘For those patients who are less specific,<br />

<strong>and</strong> are hoping to look younger, fresher, rejuvenated or<br />

“happier”, I make an assessment of how we can improve<br />

the patient’s overall image <strong>and</strong> appearance.’<br />

Thread lifting<br />

Signifying a minimally invasive way to lift the skin, threads<br />

can be used to lift the brow, face <strong>and</strong> neck, as well as<br />

reposition the cheeks, reduce the jowl <strong>and</strong> enhance the lips.<br />

The procedure involves inserting dissolvable threads<br />

into the skin’s dermis, or support structure, to trigger the<br />

112 www.cosbeauty.com.au

face<br />

synthesis of collagen <strong>and</strong> elastin at the site. The threads act<br />

as scaffolding for the production of these new connective<br />

fibres, lifting <strong>and</strong> bolstering the tissue for an anti-ageing<br />

<strong>and</strong> rejuvenating effect.<br />

‘I have been performing mini-facelifts <strong>and</strong> neck lifts with<br />

threads over the past two years,’ Dr Beaini explains. ‘We<br />

have seen exceptional face lifting <strong>and</strong> rejuvenation results in<br />

more than 95 percent of our patients.’<br />

Thread lifting is suitable for those patients hoping to<br />

reverse the descent of facial soft tissue associated with<br />

ageing, or to waylay the need for a surgical facelift. It is<br />

performed under local anaesthetic, <strong>and</strong> incurs some mild<br />

swelling <strong>and</strong> possible bruising post-procedure.<br />

‘Thread lifting is commonly used to address mid-face<br />

drooping, deep cheek wrinkles, deep nasolabial lines,<br />

excessive jowling <strong>and</strong> neck laxity,’ Dr Beaini explains.<br />

‘Other concerns include brow droop, facial asymmetry <strong>and</strong><br />

loss of cheek positioning.’<br />

BEFORE<br />

AFTER Astarte Thread Lift by Dr Beaini<br />

Eyelid hooding surgery<br />

‘When we look at an individual’s face, our attention first<br />

focuses on the eyes, <strong>and</strong> any abnormality or asymmetry,’<br />

Dr Beaini explains. For this reason, blepharoplasty – or<br />

eyelid hooding surgery – can achieve significant results in<br />

rejuvenating the entire face.<br />

The procedure involves excising excess fat <strong>and</strong> skin from<br />

the upper <strong>and</strong>/or lower eyelids to open the eyes for a fresher,<br />

more alert appearance. The day surgery is performed under<br />

local anaesthesia, <strong>and</strong> can be used in conjunction with<br />

other treatments such as brow thread lifting, non-invasive<br />

skin tightening <strong>and</strong> laser skin rejuvenation.<br />

‘If an individual has droopy, tired <strong>and</strong> ageing eyes, the<br />

first impression is that is individual is sad, tired or unwell,’<br />

says Dr Beaini. ‘Eyelid surgery is a very effective <strong>and</strong> longterm<br />

solution for such individuals, <strong>and</strong> automatically has the<br />

effect of revitalising the entire face.’<br />

BEFORE<br />

AFTER Astarte Thread Lift by Dr Beaini<br />

Bat ear correction<br />

Dr Beaini offers a permanent non-surgical treatment to<br />

correct <strong>and</strong> reshape protruding ears (bat ear correction).<br />

He performs the procedure with a mild sedative <strong>and</strong> local<br />

anaesthesia; no hospitalisation, general anaesthetic or<br />

surgical incisions are required.<br />

‘Any abnormality <strong>and</strong> asymmetry in facial appearance will<br />

attract attention, which is particularly relevant to individuals<br />

with bat ears,’ Dr Beaini explains. ‘These patients were<br />

born with this problem <strong>and</strong>, in most cases, are burdened<br />

with underlying emotional issues relating to the appearance<br />

of their ears. The joy <strong>and</strong> relief they experience once<br />

their ears are corrected makes this treatment extremely<br />

desirable.’ csbm<br />

BEFORE<br />

BEFORE<br />

AFTER Astarte Thread Lift by Dr Beaini<br />

AFTER blepharoplasty by Dr Beaini<br />

www.cosbeauty.com.au 113

nose<br />

Nose for<br />

beauty<br />

Sydney ENT <strong>and</strong> facial cosmetic surgeon Dr William Mooney explains<br />

the art <strong>and</strong> science of rhinoplasty. Caitlin bishop reports.<br />

The nose is the anchor of the face. The length, width<br />

<strong>and</strong> symmetry of the nose contribute to facial balance<br />

<strong>and</strong> harmony, <strong>and</strong> have a significant impact upon<br />

facial aesthetics. Rhinoplasty, or nose surgery, is one of the<br />

most popular cosmetic procedures – designed to reduce,<br />

augment, narrow, widen, straighten or reshape the nose –<br />

but it is also one of the most complex.<br />

Rhinoplasty involves remodelling the bones <strong>and</strong> cartilage<br />

to optimise both aesthetics <strong>and</strong> functionality. Sydney ENT<br />

<strong>and</strong> facial cosmetic surgeon Dr William Mooney says that<br />

rhinoplasty combines the central pillars of cosmetic surgery:<br />

art <strong>and</strong> science.<br />

‘The nose is a vital, complicated organ. It’s a gateway to<br />

the upper respiratory tract, the egress to the nasal sinuses<br />

<strong>and</strong>, unfortunately, there are a lot of problems that can<br />

affect its functioning,’ he says. ‘When patients come to me<br />

because they’re unhappy with the shape of their nose, we<br />

also address the underlying functional problems. They often<br />

leave just as happy with their new improved nasal airways<br />

as they are with their appearance.’<br />

Because the anatomy is so intricate, <strong>and</strong> affects<br />

both aesthetics <strong>and</strong> functionality, rhinoplasty calls for a<br />

specialised <strong>and</strong> experienced eye. Dr Mooney favours the<br />

“open” surgical technique, which involves a small incision<br />

between the nostrils to afford maximum surgical access.<br />

Dr Mooney says that functional problems can contribute<br />

to an aged appearance <strong>and</strong>, by addressing nasal<br />

functionality, quality of life <strong>and</strong> aesthetics can be improved,<br />

114 www.cosbeauty.com.au

nose<br />

too. ‘Problems such as difficulty breathing, allergies,<br />

snoring <strong>and</strong> sleep apnea – not to mention post-traumatic<br />

obstructions – often occur alongside cosmetic concerns,’<br />

he explains. ‘Although these might seem like little things on<br />

their own, when combined they can really impinge upon<br />

quality of life. For example, if you don’t breath properly,<br />

particularly at night, this can lead to a tired <strong>and</strong> drawn<br />

appearance, <strong>and</strong> also affect your mood.’<br />

Before rhinoplasty, Dr Mooney will always assess each<br />

patient’s face as a whole, rather than focusing on the nose<br />

alone. This allows him to not only determine the ideal shape<br />

<strong>and</strong> size of the nose, depending on overall facial aesthetics,<br />

but also identify if the patient would benefit from additional<br />

procedures as well.<br />

‘It’s important to look at the patient’s face as a whole<br />

picture, rather than an isolated feature,’ he says. ‘We<br />

conduct a formal skin <strong>and</strong> cosmetic assessment to see if<br />

the patient has any problems with<br />

their skin <strong>and</strong> what we can do to<br />

1<br />

treat those problems.’<br />

For those patients concerned with<br />

ageing, Dr Mooney explains nose<br />

surgery can often help revitalise a<br />

heavy, aged or tired appearance.<br />

‘As we age, noses become bigger<br />

<strong>and</strong> more irregular,’ Dr Mooney says.<br />

‘Deviations in noses are like the<br />

leaning tower of Pisa – they often<br />

progress as time goes by. As well as<br />

this, the skin becomes thinner during<br />

ageing so any irregularities become<br />

more pronounced.’<br />

Dr Mooney says these signs<br />

of ageing can occur alongside tip<br />

ptosis – when the tip of the nose<br />

BEFORE<br />

droops downward <strong>and</strong> the angle<br />

2<br />

of the nose is affected. ‘Everything<br />

starts to go south as the years go<br />

by, <strong>and</strong> the nose is no exception,’ he<br />

explains. ‘So returning the tip to its<br />

lovely youthful position <strong>and</strong> reducing<br />

the size of the nose is a fantastic antiageing<br />

procedure.’<br />

Creating an aesthetic nose tip<br />

is regarded as one of the greatest<br />

challenges to nose surgeons. Dr<br />

Mooney has developed a specialised<br />

technique – termed the “Diamond<br />

Tip” technique – to provide superior<br />

results, customised to each patient.<br />

According to Dr Mooney, nose<br />

surgery is just one element in<br />

improving quality of life <strong>and</strong> overall BEFORE<br />

health. He encourages patients to make some easy lifestyle<br />

adjustments to improve the results of surgery.<br />

‘The first piece of advice I give all my patients is to get<br />

some sleep, stop smoking, get out of the sun, booze less<br />

<strong>and</strong> get happy,’ he says. ‘These are quick, cheap <strong>and</strong> easy<br />

steps every patient can take to maximise the results of their<br />

surgery, <strong>and</strong> which have wider impacts on their health <strong>and</strong><br />

wellbeing.’<br />

This holistic <strong>and</strong> all-encompassing approach is at<br />

the centre of Dr Mooney’s philosophy <strong>and</strong> extends to all<br />

aspects of his practice. Indeed, Dr Mooney might draw<br />

upon Chinese herbs, anti-swelling medication, cosmetic<br />

injectables, prescribed skincare, pressure treatments<br />

<strong>and</strong> scar management in optimising aftercare following<br />

surgery. ‘This attention to detail is what makes the<br />

difference between a good rhinoplasty, <strong>and</strong> a great one,’ he<br />

concludes. csbm<br />

AFTER rhinoplasty by Dr Mooney<br />

AFTER rhinoplasty by Dr Mooney<br />

www.cosbeauty.com.au 115

teeth<br />

A<br />

TRUE<br />



A<br />

strong, white, striking smile can convey confi dence,<br />

sincerity <strong>and</strong> youthfulness, while boosting self-image<br />

<strong>and</strong> confi dence in one’s own skin. Good dental<br />

hygiene is certainly key in maintaining smile aesthetics,<br />

however sometimes a more direct approach is necessary<br />

to grant your smile that extra lift.<br />

Sydney aesthetic reconstructive dentist Dr Sarkis<br />

Nalb<strong>and</strong>ian has built his clinic upon creating natural-looking<br />

results in smile rejuvenation. He believes a beautiful smile<br />

should imitate nature, involving a dynamic interplay of the<br />

teeth, lips <strong>and</strong> face.<br />

According to Dr Nalb<strong>and</strong>ian, a combination of wear <strong>and</strong><br />

tear, diet <strong>and</strong> teeth grinding can cause tooth erosion <strong>and</strong><br />

detract from a youthful, beautiful face.<br />

‘The increase in consumption of carbonated beverages<br />

has resulted in an excessive amount of tooth loss in people<br />

as young as 15. This compromises the structural integrity of<br />

the teeth,’ Dr Nalb<strong>and</strong>ian says. ‘Damage can also occur on<br />

account of “bruxing”, or teeth grinding, which is a habit that<br />

can impact both the canine <strong>and</strong> front teeth, wearing them<br />

down <strong>and</strong> leading to asymmetry.’<br />

While there are many options for smile rejuvenation – from<br />

orthodontics to reconstruction – Dr Nalb<strong>and</strong>ian believes a<br />

smile can be aesthetically <strong>and</strong> functionally transformed in<br />

just one visit to the dentist.<br />

‘While orthodontic alignment is often the ideal way to<br />

correct crowded or worn upper <strong>and</strong> lower teeth, for some<br />

patients this approach is just not an option,’ he says.<br />

‘There are many ways we can use non-invasive methods<br />

to improve a patient’s smile, restoring their confi dence <strong>and</strong><br />

Actual Patient<br />

allowing them to continue with their lives after just one visit.’<br />

A One-Visit Dental Facelift focuses on the speech<br />

area <strong>and</strong> aesthetic zone of the mouth. It calls upon noninvasive<br />

ultra-thin composite veneers, which can be<br />

sculpted to fi t each individual patient <strong>and</strong> require no<br />

injections, no drilling <strong>and</strong> no downtime. Importantly,<br />

composite veneers afford fl exible options for future revision,<br />

as Dr Nalb<strong>and</strong>ian explains.<br />

‘The beauty of this treatment is we can improve the<br />

patient’s smile while still keeping their options open for<br />

future orthodontic realignment,’ he says. ‘If a patient returns<br />

for orthodontics I can remove the composite veneers, but in<br />

many cases this isn’ needed. Composite veneers last three<br />

to fi ve years <strong>and</strong>, following that, they just need resurfacing,<br />

which can be performed in a 30 minute check-up.’<br />

Before treatment, Dr Nalb<strong>and</strong>ian photographs the<br />

patient from three angles – front, oblique <strong>and</strong> profi le – to<br />

capture the most important aspects of their smile. Dr<br />

Nalb<strong>and</strong>ian uses this information to prepare the most<br />

suitable treatment plan, helping to shape the veneers <strong>and</strong><br />

select the appropriate shade of colour.<br />

Unlike other cosmetic dentists, Dr Nalb<strong>and</strong>ian does not<br />

rely on digital smile design software, but instead works<br />

within the mouth to accurately diagnose smile aesthetics.<br />

‘Smile design is an art form <strong>and</strong> I work within the mouth<br />

directly to diagnose <strong>and</strong> plan the best treatments for my<br />

patients,’ Dr Nalb<strong>and</strong>ian says. ‘The challenge is to create<br />

natural smiles that complement the patient’s beauty <strong>and</strong><br />

facial aesthetic. This dem<strong>and</strong>s an individualised approach,<br />

<strong>and</strong> cannot be digitalised.’ csbm<br />

116 www.cosbeauty.com.au


Severe tooth discolouration caused by the antibiotic<br />

tetracycline results in yellow tooth discolouration, which can<br />

turn brown over a number of years.<br />

This patient initially presented for aesthetic improvement,<br />

due to severe tetracycline discolouration, affecting both<br />

upper <strong>and</strong> lower arches since childhood. As well as the<br />

discolouration, this patient had neglected her dental health,<br />

<strong>and</strong> many attempts of tooth whitening has resulted in<br />

minimal or no change to the whiteness of her teeth.<br />

Dr Nalb<strong>and</strong>ian discussed with her the options in tooth<br />

whitening over an extended period. However, due to her<br />

circumstances, this patient preferred a quicker option, that<br />

would also restore the tooth surface loss caused by bruxing<br />

(tooth grinding).<br />

teeth<br />

Following oral hygiene measures, plus a diagnostic<br />

assessment, Dr Nalb<strong>and</strong>ian formulated a correct treatment<br />

plan for this patient. Both arches were restored using<br />

ultrathin porcelain veneers developed by Dr Nalb<strong>and</strong>ian <strong>and</strong><br />

his technical team.<br />

This procedure requires minimal intervention, no local<br />

anaesthetic, <strong>and</strong> importantly the enamel integrity of the<br />

tooth is maintained. The procedure helped improve lip<br />

outline, thickness <strong>and</strong> symmetry, as well as tooth colour,<br />

shape <strong>and</strong> display.<br />

‘Biology drives the aesthetics <strong>and</strong> treatment outcome,<br />

<strong>and</strong> pictures tell the story. We have improved dentofacial<br />

aesthetics, <strong>and</strong> have a very happy <strong>and</strong> more confident<br />

patient,’ Dr Nalb<strong>and</strong>ian concludes.<br />

BEFORE<br />

AFTER ultrathin porcelain veneers by Dr Nalb<strong>and</strong>ian<br />

BEFORE<br />

AFTER ultrathin porcelain veneers by Dr Nalb<strong>and</strong>ian<br />

BEFORE<br />

AFTER ultrathin porcelain veneers by Dr Nalb<strong>and</strong>ian<br />

www.cosbeauty.com.au 117

face<br />

An<br />

educated<br />

approach<br />

118 www.cosbeauty.com.au

face<br />

thinking about anti-wrinkle injectables? before undertaking<br />

treatment, there are certain questions you should be asking.<br />

Caitlin Bishop reports.<br />

Injectables have become a modern day staple in the anti-ageing regimes of<br />

both men <strong>and</strong> women. Used as both a preventative <strong>and</strong> restorative measure,<br />

anti-wrinkle injections <strong>and</strong> dermal fillers are often the first port-of call for those<br />

considering cosmetic enhancement. According to Sydney cosmetic surgeon<br />

Dr Joseph Ajaka, anti-wrinkle injections in particular address the cause of one of<br />

the most lamented hallmarks of ageing.<br />

‘Anti-wrinkle injections target one of the major causes of ageing. They<br />

treat overactive muscles <strong>and</strong> prevent dynamic wrinkles from forming,’ Dr<br />

Ajaka explains. ‘I consider anti-wrinkle injections to be an integral part of any<br />

person’s anti-ageing regime, <strong>and</strong> they often signify the patient’s first venture into<br />

cosmetic enhancement.’<br />

Dynamic wrinkles are caused by facial muscle movement, not intrinsic skin<br />

ageing. As the muscles move, the skin contracts <strong>and</strong> the collagen fibres in<br />

the dermis break. The ability for the body to restore these fibres <strong>and</strong> generate<br />

new collagen depletes as we age, <strong>and</strong> the wrinkles stay in place, even when<br />

the muscles are relaxed. Anti-wrinkle injections are used to freeze this muscle<br />

movement, <strong>and</strong> prevent dynamic wrinkles from arising or worsening.<br />

A lot of patients seeking anti-wrinkle<br />

injections don’t ask questions before deciding<br />

to go ahead with treatment. But knowledge is<br />

power, <strong>and</strong> patients must underst<strong>and</strong> what<br />

measures need to be taken<br />

‘Anti-wrinkle injections are the most popular injectable in our clinic; they are<br />

extremely effective with minimal risk,’ Dr Ajaka says. ‘They have a very high level<br />

of satisfaction, <strong>and</strong> can make a huge difference in a single treatment.’<br />

However, alongside the popularity <strong>and</strong> effectiveness of anti-wrinkle injections<br />

– <strong>and</strong> because injectables have become so entrenched in contemporary beauty<br />

regimes – there is a danger that consumers will adopt a carefree attitude in<br />

undertaking treatment.<br />

Dr Ajaka finds many patients approaching him for an initial consultation do<br />

not consider, or ask about, the potential risks involved or the type of injectable<br />

product used.<br />

‘A lot of patients seeking anti-wrinkle injections don’t ask questions before<br />

deciding to go ahead with treatment,’ he says. ‘But knowledge is power, <strong>and</strong><br />

patients must underst<strong>and</strong> what measures need to be taken if the treatment does<br />

not go according to plan. They need to know this before going in.’<br />

According to Dr Ajaka, the consultation process is vital in establishing this<br />

rapport between patient <strong>and</strong> doctor. He encourages patients to ask to be shown<br />

www.cosbeauty.com.au 119

face<br />

1<br />

Informed <strong>Beauty</strong><br />

Informed<strong>Beauty</strong>.com.au is an online platform designed<br />

to educate patients <strong>and</strong> raise awareness around one<br />

essential fact – cosmetic injectables should not be<br />

taken lightly.<br />

The site was launched in March 2014 after a survey<br />

commissioned by Allergan found the majority of Australian<br />

women using anti-wrinkle injections are inadequately<br />

informed. It found more than 85 percent of anti-wrinkle<br />

injection users claimed they were careful in receiving<br />

treatment but 71 percent did not know that there were<br />

different kinds of anti-wrinkle injectables available.<br />

Informed<strong>Beauty</strong>.com.au is dedicated to setting “the<br />

facts straight on wrinkles”, <strong>and</strong> has fact sheets on<br />

wrinkles <strong>and</strong> ageing, a timeline of anti-ageing tips for<br />

every age group, <strong>and</strong> expert advice from plastic <strong>and</strong><br />

cosmetic surgeons..<br />

before <strong>and</strong> after photographs of other patients, as this will<br />

help form an idea of what to expect. But most importantly,<br />

2<br />

Dr Ajaka recommends patients ensure the br<strong>and</strong> of<br />

injectable is tested, researched <strong>and</strong> registered for use.<br />

‘The consultation is very important. The patient must<br />

know the type of product being used, why that product<br />

is being used <strong>and</strong> the background research behind that<br />

product – most importantly, it must be registered,’ he says.<br />

‘As well as this, patients should ask how long the results<br />

will last, the different side effects of the product, the type<br />

3<br />

of result to expect (with before <strong>and</strong> after photographs) <strong>and</strong><br />

what will happen if things go wrong.’<br />

With anti-injectables being such an effective <strong>and</strong> popular<br />

treatment for cosmetic rejuvenation, it is imperative patients<br />

consider the procedure with a responsible amount of<br />

caution. Certainly, when administered effectively, injectables<br />

can reap significant <strong>and</strong> long-lasting results. But, before<br />

going ahead with treatment, the patient must take the time<br />

4<br />

to ask questions, ensure the product is registered <strong>and</strong> build<br />

confidence in their practitioner.<br />

‘These days, anti-wrinkle injections are sought out by<br />

anyone <strong>and</strong> everyone,’ Dr Ajaka says. ‘The treatment can<br />

be applied to men, women, young, old from all walks of life.<br />

In order to maintain patient satisfaction, all patients must be<br />

educated <strong>and</strong> informed going into treatment.’ csbm<br />

BEFORE<br />

BEFORE<br />

BEFORE<br />

BEFORE<br />

AFTER injectable wrinkle treatment by Dr Ajaka<br />

AFTER injectable wrinkle treatment by Dr Ajaka<br />

AFTER injectable wrinkle treatment by Dr Ajaka<br />

AFTER injectable wrinkle treatment by Dr Ajaka<br />

120 www.cosbeauty.com.au

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or online www.cosbeauty.com.au

face<br />

Turn back<br />

the clock<br />

with PRP<br />








Platelet Rich Plasma (PRP) therapy helps kick-start<br />

the body’s natural processes that increase healing,<br />

repair <strong>and</strong> tissue strengthening, effectively reversing<br />

signs of ageing from within.<br />

With a history spanning decades in the medical industry,<br />

PRP is a regenerative <strong>and</strong> rejuvenating procedure with<br />

countless options for application. It has been used to<br />

combat autoimmune diseases such as Sjogren’s syndrome;<br />

in sports medicine for treating injured joints <strong>and</strong> muscles;<br />

<strong>and</strong>, now – thanks to companies such as Regen Lab – PRP<br />

has entered the cosmetic anti-ageing arena.<br />

Sydney cosmetic practitioner Dr Stephen Lowe works<br />

at Face Today Medi Clinic, where Regen PRP was fi rst<br />

launched in 2008. Since then, he says the results seen<br />

with Regen PRP demonstrate exciting potential for the<br />

world of cosmetic medicine. ‘The team at Face Today<br />

wanted to better underst<strong>and</strong> the applications for Regen<br />

PRP in cosmetic medicine, so they commenced a series of<br />

monthly skin treatments <strong>and</strong> assessed patient response,’<br />

Dr Lowe explains. ‘The results were beyond expectation.<br />

With correct patient selection <strong>and</strong> treatment parameters,<br />

patients were “growing themselves younger” before their<br />

very eyes.’<br />

The procedure involves extracting a sample of the<br />

patient’s blood, centrifuging this sample to concentrate<br />

the blood’s platelets <strong>and</strong> then re-injecting the concentrated<br />

solution into the treatment area.<br />

Stacey Power, an aesthetic nurse in New Zeal<strong>and</strong>,<br />

has been using Regen PRP since 2009 <strong>and</strong> says it can<br />

be used to treat a number of different concerns, including<br />

pigmentation, sagging skin, enlarged pores, fi ne lines,<br />

scarring <strong>and</strong> uneven skin tone. ‘I’ve found PRP to be<br />

amazing for scar healing, <strong>and</strong> I often inject it before <strong>and</strong><br />

after cosmetic surgery to optimise healing. I also use it in<br />

the backs of h<strong>and</strong>s, to treat loose skin at the top of the<br />

arms, as well as the face <strong>and</strong> neck.’<br />

Once PRP is injected into the body, the blood<br />

platelets release proteins called growth factors, which<br />

communicate with the body to trigger the natural healing<br />

process. This helps kick-start skin cell turnover, stimulate<br />

collagen production at the site <strong>and</strong> invigorate the area with<br />

heightened cellular activity.<br />

‘Regen PRP can play a role to improve damaged skin<br />

by stimulating collagen growth <strong>and</strong> skin blood supply <strong>and</strong><br />

help improve skin texture <strong>and</strong> elasticity,’ Dr Lowe explains.<br />

‘This can be a great option for younger patients seeking<br />

to reduce the early signs of skin ageing, but it is also ideal<br />

for older patients to incorporate Regen PRP with other<br />

treatment modalities to achieve even greater results. We<br />

think this is also a great treatment for men who want results<br />

that are subtle <strong>and</strong> discreet.’<br />

‘Regen PRP have refi ned the technology providing the<br />

optimal concentration from each blood sample,’ Dr Lowe<br />

explains. ‘Patients appreciate that they are harnessing their<br />

body’s own repair mechanisms, rather than injecting foreign<br />

materials into their body. As we are using patient’s own<br />

blood for the procedure, the risk of a reaction or infection<br />

is extremely low.’<br />

With PRP working within the skin to harness a natural<br />

rejuvenation, other treatments such as wrinkle relaxants<br />

can be used in conjunction to achieve an overall, synergistic<br />

rejuvenation. ‘I like to use dermal needling over the top of<br />

the skin to get a double effect,’ Power explains. ‘With some<br />

clients I also mix PRP with fi llers. This helps create a cross-<br />

122 www.cosbeauty.com.au

face<br />

mesh scaffolding to maximise collagen growth. We are<br />

finding this achieves even faster results than PRP alone.’<br />

PRP treatment can be tailored to each individual patient.<br />

Commonly, a series of three treatments, four to six weeks<br />

apart, are performed to achieve the best result.<br />

A thorough consultation process is required to establish<br />

the best treatment plan with Regen PRP. ‘We always have a<br />

thorough consultation with our patients to fully underst<strong>and</strong><br />

their concerns <strong>and</strong> expectations going into treatment,’ Dr<br />

Lowe explains. ‘We take this opportunity to explain the<br />

importance of a healthy lifestyle <strong>and</strong> UV skin protection to<br />

reduce future skin damage. We formulate a treatment plan,<br />

which may involve a single treatment with Regen PRP or a<br />

series over a few months, <strong>and</strong> decide if Regen PRP should<br />

be used in combination with other cosmetic treatments.<br />

After the treatment, we typically allow two to three days for<br />

any redness <strong>and</strong> swelling to settle; the occasional bruise<br />

may take a few days to fade but is usually easily covered<br />

with makeup.’<br />

The treatment itself is performed under topical<br />

anaesthesia, <strong>and</strong> takes about 30 to 45 minutes, depending<br />

on the area being treated. An improvement in skin tone<br />

<strong>and</strong> texture is expected in the weeks following treatment,<br />

with these initial results continuing to improve for six to nine<br />

months post-procedure, as new collagen is laid down in<br />

the dermis.<br />

Whether you’re looking to improve scar healing after<br />

surgery, treat an ageing neck or simply rejuvenate <strong>and</strong><br />

brighten the complexion, Regen PRP offers effective,<br />

natural-looking <strong>and</strong> long-lasting results.<br />

‘I have a client who has had regular PRP treatment for<br />

five years now. Her fine lines have resolved <strong>and</strong> her pores<br />

have disappeared, leaving a porcelain-like smoothness to<br />

her now glowing skin,’ says Power. ‘She decided to have a<br />

blepharoplasty, <strong>and</strong> I injected her with PRP before <strong>and</strong> after<br />

her surgery. Three months post-surgery, on inspection by<br />

the operating doctor, he stated that her healing was almost<br />

“embryonic”, with barely any scarring at all. A combination<br />

of an excellent plastic surgeon’s stitches, with regular PRP<br />

treatments, produces fantastic results for scarring.’ csbm<br />

1<br />

BEFORE<br />

2<br />

BEFORE<br />

3<br />

BEFORE<br />

4<br />

BEFORE<br />

AFTER 3 x Regen PRP treatment by<br />

Stacey Power<br />

AFTER 3 x Regen PRP treatment <strong>and</strong> 3 x<br />

Exilis RF treatment by Face Today Medi Clinic<br />

AFTER 3 x Regen PRP treatment by<br />

Stacey Power<br />

AFTER 3 x Regen PRP treatment by<br />

Face Today Medi Clinic<br />

Treating hair loss with PRP<br />

Hair loss in both men <strong>and</strong> women can be an embarrassing<br />

<strong>and</strong> traumatising experience. The regenerative properties of<br />

Regen PRP, <strong>and</strong> the way it works to accelerate <strong>and</strong> optimise<br />

the body’s natural processes, has led to the use of PRP to<br />

prevent – <strong>and</strong> even reverse – baldness.<br />

‘We are seeing some very effective results with hair<br />

growth from PRP,’ Power explains. ‘One client who<br />

shaves his head because of baldness, found his grey hair<br />

changing back to black, <strong>and</strong> experienced hair growth<br />

in places where he hadn’t had any growth in years. This<br />

was all as a result of injecting his face with PRP, a positive<br />

side-effect.’<br />

Similarly, Dr Lowe explains that Regen PRP can be<br />

used in conjunction with traditional methods to treat a<br />

balding head. ‘Hair loss is best treated with a combination<br />

approach of oral medication <strong>and</strong> topical medication on the<br />

scalp,’ he says.<br />

‘Adding Regen PRP to these treatments helps improve<br />

blood supply to the skin <strong>and</strong> can be a useful adjunct to hair<br />

loss treatment,’ he concludes.<br />

www.cosbeauty.com.au 123

skin<br />

the<br />

gold<br />

st<strong>and</strong>ard<br />

in skin<br />

rejuvenation<br />

Fraxel laser can achieve outst<strong>and</strong>ing results in smoothing, plumping<br />

<strong>and</strong> rejuvenating the skin. Caitlin Bishop reports.<br />

A<br />

decade ago, the Fraxel laser system pioneered the<br />

use of fractional laser technology in skin rejuvenation.<br />

Since then, more than 800,000 patients have been<br />

treated around the world with Fraxel to address cosmetic<br />

<strong>and</strong> anti-ageing concerns.<br />

Suitable for reducing the appearance of wrinkles,<br />

sun spots, melasma <strong>and</strong> scarring, Fraxel – distributed in<br />

Australia by iNova Aesthetics – is a system designed to<br />

improve skin tone, texture, elasticity <strong>and</strong> overall skin health.<br />

‘Fraxel can help diffuse pigmentation such as sunspots<br />

<strong>and</strong> brown pigmentation on the face, décolletage, neck<br />

<strong>and</strong> h<strong>and</strong>s,’ Victorian cosmetic physician Dr Sean Arendse<br />

explains. ‘Another common concern is textural issues such<br />

as wrinkles on the face, neck <strong>and</strong> chest. We also have a<br />

large group of patients with acne scarring who have been<br />

successfully treated with the Fraxel system.’<br />

Fraxel uses cutting-edge technology to deliver results in<br />

a simple, though very effective fashion. It uses laser light<br />

to penetrate the top skin layers <strong>and</strong> cause micro columns<br />

of thermal damage to the dermis. This triggers the body’s<br />

healing response <strong>and</strong> stimulates the production of new<br />

collagen at the treatment site.<br />

The ‘fractionated’ effect means only a fraction of the skin<br />

is treated, as there are areas of healthy, untouched tissue<br />

between each column of damage.<br />

‘The Fraxel system has a very high safety profile, which<br />

is partly due to the fact that the majority of the skin is left<br />

untreated,’ Dr Arendse explains. ‘The research that has<br />

gone into Fraxel, <strong>and</strong> the support <strong>and</strong> ongoing training<br />

offered by iNova, is another huge benefit of the system.’<br />

Fraxel treatment can be tailored to the individual patient,<br />

according to their concerns <strong>and</strong> current skin condition.<br />

There are two main wavelengths for Fraxel laser: 1550nm<br />

<strong>and</strong> 1927nm. Queensl<strong>and</strong> cosmetic practitioner Dr Eddie<br />

Roos, who has been using fractionated laser in his clinic<br />

for five years, believes Fraxel affords a wide range of skin<br />

treatment options.<br />

‘The 1550nm wavelength is used for rejuvenation <strong>and</strong><br />

scar remodelling. It penetrates deep into the dermis to<br />

achieve really significant results,’ Dr Roos explains. ‘The<br />

1927nm wavelength does not penetrate as deeply, <strong>and</strong> is<br />

used to treat pigment in the skin. It is ideal for improving<br />

sun-damaged skin that we see in Queensl<strong>and</strong> <strong>and</strong>, indeed,<br />

the rest of Australia.’<br />

Typically, a full-face treatment will take around one<br />

hour <strong>and</strong> topical anaesthetic cream will be applied to<br />

make the patient as comfortable as possible. The number<br />

of treatments required varies between patients, <strong>and</strong> is<br />

dependant on their skin condition <strong>and</strong> what they are aiming<br />

to achieve.<br />

124 www.cosbeauty.com.au

skin<br />

1<br />

‘During treatment the laser is rolled across your skin<br />

several times <strong>and</strong>, depending on the size <strong>and</strong> complexity of<br />

the treatment area, the actual procedure will take anywhere<br />

between 20 minutes <strong>and</strong> an hour,’ Dr Arendse explains.<br />

‘For pigmentation we would usually recommend one to two<br />

treatments, <strong>and</strong> for acne scarring <strong>and</strong> wrinkles three to five<br />

treatments are typically required.’<br />

Notably, the Fraxel system has an inbuilt cooling system<br />

to help keep the skin’s surface cool <strong>and</strong> comfortable during<br />

treatment. This allows higher levels of heat energy to be<br />

delivered deep into the skin’s layers, without compromising<br />

the upper epidermis.<br />

‘The Fraxel system delivers an even treatment combined<br />

with cold air blown onto the skin, making the procedure<br />

tolerable to patients,’ Dr Roos explains.<br />

‘The effect of laser treatments on the skin will vary from<br />

person to person,’ he continues. ‘The body’s response to<br />

fractionated trauma is explained in detail to patients before<br />

they go ahead, <strong>and</strong> we do emphasise that rejuvenation<br />

results will continue to improve for months following<br />

treatment – as the new collagen is created.’<br />

Some redness <strong>and</strong> swelling should be expected<br />

post-procedure, particularly with the 1927nm laser. Dr<br />

Arendse says there are several phases the skin will go<br />

through following treatment with Fraxel. ‘Immediately after<br />

treatment, the skin feels like it has mild sunburn <strong>and</strong> we<br />

provide ice packs <strong>and</strong> a specialised skincare pack for home<br />

use,’ he explains.<br />

‘The face may be red <strong>and</strong> a little swollen for the next two<br />

to three days, after which the skin will bronze. Following<br />

this, the bronzing will flake <strong>and</strong> exfoliate off, revealing the<br />

fresh new rejuvenated skin underneath. The redness can<br />

persist for one to three weeks, but with the use of a good<br />

mineral makeup this can be easily camouflaged.’<br />

The results of Fraxel treatment start to appear as the<br />

skin exfoliates, but continue to improve for the three to six<br />

months following the procedure. During this time, the new<br />

collagen synthesised in response to treatment is building<br />

<strong>and</strong> regenerating in the skin. As this occurs, the complexion<br />

becomes firmer <strong>and</strong> more resilient, with improved contours<br />

<strong>and</strong> texture.<br />

‘We have seen fantastic results using Fraxel laser,’ says<br />

Dr Arendse. ‘Once the redness <strong>and</strong> bronzing has settled<br />

down, you can see vast improvements in pigmentation<br />

<strong>and</strong> skin quality. Another advantage of the treatment is that<br />

results are cumulative, with the best results often seen six<br />

months after the treatment.’<br />

‘My patients often describe their skin as fresher <strong>and</strong><br />

more radiant following completion of their treatments, <strong>and</strong><br />

are amazed by the results they experience,’ Dr Arendse<br />

concludes. csbm<br />

BEFORE<br />

2<br />

BEFORE<br />

3<br />

BEFORE<br />

4<br />

BEFORE<br />

5<br />

BEFORE<br />

AFTER Fraxel treatment by Dr Arenndse<br />

AFTER Fraxel treatment by Dr Arenndse<br />

AFTER Fraxel treatment by Dr Roos<br />

AFTER Fraxel treatment by Dr Roos<br />

AFTER Fraxel treatment by Dr Roos<br />

www.cosbeauty.com.au 125

skin<br />

Revitalise<br />

your<br />

skin<br />

Laser skin resurfacing<br />

can help you stay<br />

looking younger <strong>and</strong><br />

more radiant for<br />

longer. The team at<br />

Skin Renu in Sydney<br />

tells us how. AimÉe<br />

Surtenich reports.<br />

Ageing is a multifaceted process, <strong>and</strong> can result in a number of changes<br />

to our appearance, including the emergence of fine lines <strong>and</strong> wrinkles,<br />

discolouration, uneven texture, surface veins <strong>and</strong> lax skin.<br />

A growing number of people are seeking more dramatic results than can<br />

be achieved with skincare products, peels or facials alone. One of the most<br />

popular ways of treating sun-damaged <strong>and</strong> ageing skin is fractionated laser skin<br />

resurfacing, to reveal smoother, more even <strong>and</strong> radiant skin, no matter the age<br />

of the patient. The skin professionals at Skin Renu laser <strong>and</strong> skin clinic in Sydney<br />

share their experience with two of the most popular laser procedures.<br />

Fraxel laser<br />

For skin needing a little more intensive care, Fraxel laser skin resurfacing can<br />

improve a wide range of skin concerns, such as lines <strong>and</strong> wrinkles, loose skin,<br />

pigmentation, acne scarring <strong>and</strong> moderate to severe sun damage.<br />

Rather than removing the top layer of skin (with significant downtime) like<br />

traditional ablative laser resurfacing of the past, Fraxel laser treats a fraction of<br />

skin at a time, creating thous<strong>and</strong>s of tiny microscopic sites of thermal impact,<br />

known as microthermal zones.<br />

These microscopic laser columns penetrate deep into the dermis to create<br />

tiny wounds, triggering the body’s natural response system to heal those<br />

wounds. This process expedites the body’s remodelling of collagen <strong>and</strong> elastin,<br />

resulting in tighter, fresher, more youthful-looking skin. It operates on the concept<br />

of damaging small amounts of tissue to stimulate collagen <strong>and</strong> elastin, activating<br />

new cells.<br />

There are three kinds of Fraxel laser treatments, depending on each patient’s<br />

needs <strong>and</strong> requirements. These vary in strength, downtime, the amount<br />

of procedures needed <strong>and</strong> the final results. A less aggressive treatment is<br />

Fraxel re:store, which can achieve impressive results for mild to moderately<br />

126 www.cosbeauty.com.au

skin<br />

damaged skin over the course of three to six treatments. There is typically no<br />

post-treatment wound care <strong>and</strong> downtime is minimal in most cases, with some<br />

swelling to be expected. It is particularly effective for treating pigmentation<br />

<strong>and</strong> scarring on the face <strong>and</strong> affected skin on other parts of the body, as well<br />

as sun damage, acne <strong>and</strong> acne scars, <strong>and</strong> broken capillaries. With each<br />

treatment, a signifi cant improvement is usually evident.<br />

Clear+Brilliant skin resurfacing<br />

For those not ready for more aggressive treatments, Clear+Brilliant offers an<br />

effective solution. Based on Fraxel technology, Clear+Brilliant is ideally suited for<br />

those in their 20s <strong>and</strong> 30s wanting to take control of their skincare <strong>and</strong> manage<br />

the appearance of ageing.<br />

This more gentle laser treatment is used to improve skin tone, texture <strong>and</strong><br />

radiance, as well as to act as a preventative measure for treating sun damage<br />

<strong>and</strong> premature ageing. It’s perfect for those with a good skincare system already<br />

in place who are looking for a level up in their beauty regime.<br />

Clear+Brilliant offers two different treatment heads: 1550nm to target<br />

premature ageing; <strong>and</strong> 1527nm to target pigmentation. Each treatment takes<br />

about 20 minutes, <strong>and</strong> there is typically no downtime, just some temporary<br />

pinkness or redness. Generally a short series of treatments will yield the most<br />

impressive results, but even after one treatment there should be a noticeable<br />

fading of light pigmentation <strong>and</strong> freckling, a more homogenised skin tone <strong>and</strong><br />

texture, as well a more luminous look to the skin.<br />

Initial results should appear within a few days as damaged skin is slowly<br />

replaced with healthy, younger looking tissue. Clear+Brilliant offers younger<br />

patients an ideal introduction to maintaining youthful-looking skin. csbm

Connecting<br />

the dots<br />

in skin<br />

rejuvenation<br />




Want to turn back time to reveal younger, more<br />

healthy looking skin without surgery or lengthy<br />

downtime? DOT Therapy is designed to deliver<br />

just that.<br />

Dermal Optical Thermolysis (DOT) Therapy is a fractional<br />

laser system designed to deliver the benefi ts of laser skin<br />

resurfacing while signifi cantly reducing the recovery time.<br />

Distributed by High Tech Laser, the SmartXide DOT<br />

fractionated laser can help reduce the appearance of<br />

wrinkles <strong>and</strong> acne scarring, while improving skin tone<br />

<strong>and</strong> texture. It calls upon the same technology used by<br />

traditional skin resurfacing lasers, but delivers the light<br />

energy in fractionated “dots” to help optimise healing <strong>and</strong><br />

reduce recovery time.<br />

‘DOT Therapy is really effective in treating irregularities<br />

on the skin’s surface such as dilated pores, discolouration<br />

<strong>and</strong> uneven contours from scarring,’ says Queensl<strong>and</strong><br />

cosmetic physician Dr Heather Jenkins. ‘It can work very<br />

well in tightening up crepeiness around the eyes in patients<br />

who aren’t quite ready for eyelid surgery. We also treat a lot<br />

of patients with acne scarring, with very pleasing results, as<br />

well as birthmarks, stretch marks <strong>and</strong> scars.’<br />

By creating precise microscopic columns of thermal<br />

damage in the skin, DOT Therapy triggers the body’s<br />

healing response to tighten skin <strong>and</strong> stimulate new collagen<br />

growth. Importantly, between each column of damage<br />

there are “isl<strong>and</strong>s” of healthy tissue, which help improve the<br />

healing process for a more rapid recovery.<br />

‘The areas of untouched tissue improve healing time<br />

<strong>and</strong> reduce rates of complication,’ says Dr John Flynn from<br />

Queensl<strong>and</strong>. ‘Also, the areas of untreated skin between the<br />

“dots” means more aggressive <strong>and</strong> effective parameters<br />

can be used during treatment, as these are bolstered <strong>and</strong><br />

comforted by the adjacent healthy tissue.’<br />

Patients will typically see an improvement in skin tone<br />

<strong>and</strong> texture in the days following treatment. However the<br />

results are cumulative <strong>and</strong> will continue to improve in the<br />

three to six months post-procedure, as the new collagen is<br />

laid down in the skin’s dermis.<br />

‘The procedure has an immediate effect because it acts<br />

like a controlled laser peel, which freshens <strong>and</strong> brightens the<br />

skin,’ Dr Jenkins explains. ‘There is also some tightening at<br />

the outset, <strong>and</strong> this continues to improve as new collagen<br />

forms over the subsequent three months or so.’<br />

Importantly, treatment with DOT Therapy can be tailored<br />

to individual patients, depending on their concerns <strong>and</strong><br />

current skin condition. ‘The treatment can be tailored to<br />

suit the patient’s needs by altering the depth of the dots,<br />

<strong>and</strong> distance between the dots <strong>and</strong> the amount of power<br />

delivered,’ Dr Jenkins explains.<br />

There are two main patient groups suitable for treatment<br />

with DOT Therapy: those looking for general facial<br />

128 www.cosbeauty.com.au

skin<br />

rejuvenation – an improvement in tone, texture <strong>and</strong> skin<br />

quality – <strong>and</strong> those with deeper lines, sun spots or scarring,<br />

who require deeper treatment parameters.<br />

‘The DOT Therapy system can be used as a fractionated<br />

laser peel for boosting skin health <strong>and</strong> granting a glow <strong>and</strong><br />

slight lift,’ Dr Flynn explains. ‘The heavier setting, which we<br />

DOT Therapy is effective in<br />

improving irregularities on the<br />

skin’s surface such as dilated<br />

pores, discolouration <strong>and</strong><br />

uneven contours from scarring<br />

call Hot DOT Therapy, is used to treat deeper lines, improve<br />

pigmentation <strong>and</strong> reduce problem scarring from acne,<br />

trauma or skin cancers.’<br />

As well as tailoring the treatment to each patient,<br />

DOT Therapy can also be used in conjunction with other<br />

modalities to achieve a universal rejuvenation result.<br />

‘DOT Therapy can be used<br />

alongside Intense Pulsed Light<br />

1<br />

(IPL), botulinum toxin treatments<br />

<strong>and</strong> dermal fillers,’ Dr Jenkins<br />

explains. ‘Before treatment,<br />

I always undertake an initial<br />

consultation with my patients<br />

to better underst<strong>and</strong> their main<br />

concerns <strong>and</strong> what they’re hoping<br />

to achieve.’<br />

The treatment itself is performed<br />

with topical anaesthetic, which<br />

is left on the skin for 45 minutes<br />

before treatment begins. During the<br />

procedure, the doctor can change<br />

the shape of the ‘dot’ pattern to<br />

more effectively accommodate<br />

the area being treated. This is<br />

particularly important when treating BEFORE<br />

delicate areas such as the wrinkles<br />

2<br />

around the mouth or eyes.<br />

‘Patients typically experience<br />

a tingling feeling directly after<br />

treatment, but this can be improved<br />

with cold compression,’ says Dr<br />

Flynn. ‘Patients should follow a<br />

prescribed skincare protocol in the<br />

first few days after the procedure,<br />

to help optimise healing. Once the<br />

BEFORE<br />

old skin has exfoliated, some redness may persist, but<br />

this can be covered with mineral makeup. The healing<br />

<strong>and</strong> collagen rebuilding will continue for up to six months<br />

post-procedure.’<br />

In some cases, multiple treatments may be required<br />

to achieve the best results. However, for general skin<br />

rejuvenation, Dr Jenkins explains an annual DOT Therapy<br />

session will usually suffice. ‘A light treatment may be<br />

repeated once a year; a stronger treatment may only need<br />

to be done once,’ she says.<br />

Whether you’re looking for general skin improvement,<br />

or to treat something more specific, DOT Therapy with the<br />

SmartXide laser can be a viable option in improving the<br />

complexion <strong>and</strong> restoring inner-confidence.<br />

‘One of my st<strong>and</strong>-out patients was a young man in his<br />

late 20s who had lived in a remote rural area during his<br />

teens <strong>and</strong> had suffered from untreated cystic acne,’ Dr<br />

Jenkins recalls. ‘He was left with considerable scarring<br />

but fortunately was a great c<strong>and</strong>idate for DOT Therapy.<br />

He had two treatments <strong>and</strong> did very well. He sent me a<br />

photo of himself six months later with a beaming, confident<br />

smile <strong>and</strong> his skin looking so much better. Improvement in<br />

confidence is the best outcome of all.’ csbm<br />

AFTER Dot Therapy using the SmartXide DOT laser. Photos<br />

courtesy of High Tech Laser.<br />

AFTER Dot Therapy using the SmartXide DOT laser. Photos<br />

courtesy of High Tech Laser.<br />

www.cosbeauty.com.au 129

skin<br />

Deep<br />

hydration<br />

Caitlin Bishop investigates how restylane<br />

skinboosters deeply hydrate skin to improve<br />

smoothness, elasticity <strong>and</strong> radiance.<br />

Restylane Skinboosters are an effective treatment designed to<br />

deeply hydrate the skin for an improved look <strong>and</strong> feel. Made with<br />

a hyaluronic acid gel, which closely resembles the hyaluronic acid<br />

found naturally in the body, the fillers offers long-lasting improvements in<br />

skin quality <strong>and</strong> textural condition.<br />

‘Myself, <strong>and</strong> most importantly my patients, have been consistently<br />

impressed with Skinboosters,’ says Victorian cosmetic practitioner<br />

Dr Dennis McCurdy. ‘We have found it to be a wonderful anti-ageing<br />

product, not only in improving skin health but also in slowing down the<br />

visible signs of the ageing process. Clients return almost yearly, asking for<br />

their “internal hydrator”.’<br />

Skinboosters do not act as a dermal filler, but a skin hydrator or ‘internal<br />

moisturiser’. The hyaluronic acid attracts <strong>and</strong> maintains hydration within<br />

the skin to improve the quality <strong>and</strong> appearance of the skin.<br />

‘Hydration is very important, <strong>and</strong> good skincare is essential to maintain<br />

younger, healthier looking skin,’ Dr McCurdy explains. ‘Restylane<br />

Skinboosters act to hold water in areas where it is most needed.’<br />

The product is usually injected across the face, <strong>and</strong> into the neck<br />

<strong>and</strong> décolletage area, to improve the quality <strong>and</strong> resilience of the skin. As<br />

well as this, Dr McCurdy uses Skinboosters on areas that clearly show<br />

ageing, such as the h<strong>and</strong>s, elbows <strong>and</strong> knees.<br />

‘Skinboosters primary function is to provide hydration to the deeper<br />

skin layers. Due to this hydration the skin is able to function more effectively<br />

<strong>and</strong> efficiently,’ he says. ‘Skin appears healthier looking <strong>and</strong> more flexible,<br />

<strong>and</strong> collagen production is stronger. In my experience, Skinboosters can<br />

130 www.cosbeauty.com.au

skin<br />

achieve effective results in the face, neck <strong>and</strong> décolletage as well as the backs<br />

of h<strong>and</strong>s, elbows <strong>and</strong> knees.’<br />

For best results, Skinboosters is injected into the deep dermis <strong>and</strong><br />

subcutaneous tissue. This affords deeper hydration, <strong>and</strong> helps optimise the<br />

performance of the dermal-epidermal membrane, ensuring the complexion<br />

remains hydrated <strong>and</strong> nourished.<br />

‘Skinboosters works best when injected into the deep dermis upwards to<br />

the subcutaneous layer. I personally prefer administering Skinboosters with a<br />

cannula, as opposed to using needles,’ says Dr McCurdy. ‘Although it takes a<br />

little longer, there is less discomfort <strong>and</strong> less bruising.’<br />

Treatment with Skinboosters can be tailored to the individual patient. In most<br />

cases, Dr McCurdy recommends using 3mm of Skinboosters initially on the<br />

face, with extra product used for the neck area. The procedure itself takes<br />

around 30 to 45 minutes, <strong>and</strong> some swelling should be expected in the days<br />

following the procedure.<br />

In some cases, Skinboosters can be used in conjunction with other treatments<br />

to create a more comprehensive result. ‘Although Skinboosters can achieve<br />

significant results, it doesn’t do the whole job,’ Dr McCurdy explains. ‘Using<br />

muscle relaxant injections, laser treatment <strong>and</strong> filler products to enhance deficits<br />

<strong>and</strong> improve features, is important for a full anti-ageing effect. Any rejuvenation<br />

method should also be accompanied by good skincare.’<br />

Results with Skinboosters are cumulative, <strong>and</strong> take around three to four<br />

months to appear. This gives time for the collagen <strong>and</strong> elastin to remodel <strong>and</strong><br />

develop, due to the deep hydration. These results are expected to last for six to<br />

nine months following treatment, however Dr McCurdy says it is often longer.<br />

‘I feel the benefits are visible for more than 12 months,’ he says. ‘At our<br />

clinic, we find Skinboosters results in decreased wrinkles, smaller pores, fewer<br />

blemishes <strong>and</strong> generally younger, healthier looking skin.’<br />

For those looking for a preventative or anti-ageing measure, that will achieve<br />

subtle but effective rejuvenation results, Skinboosters is a viable option in helping<br />

restore smoothness, vitality <strong>and</strong> hydration to the complexion.<br />

‘Skin hydration is beneficial for everyone, both male <strong>and</strong> female,’ says Dr<br />

McCurdy. ‘Because we live in air-conditioned <strong>and</strong> heated buildings, our skin<br />

dries out very quickly, so deep hydration is a must. We have young <strong>and</strong> old<br />

patients seeking treatment with Skinboosters, as more <strong>and</strong> more people become<br />

aware of the need to look after their skin to maintain a healthier, more fresh<br />

appearance.’ csbm<br />

BEFORE<br />

AFTER Skinboosters treatment<br />

www.cosbeauty.com.au 131

skin<br />

3-dimensional<br />

volume<br />






The<br />

T<br />

Infi ni is a minimally invasive solution to rejuvenate ageing skin, creating<br />

three-dimensional volumisation while reducing the appearance of wrinkles,<br />

scarring <strong>and</strong> sagging skin.<br />

How it works<br />

The Infi ni, distributed in Australia by Advanced Cosmeceuticals, uses cutting<br />

edge technology to cause skin tightening <strong>and</strong> collagen production in the<br />

dermis. The system uses both radiofrequency (RF) <strong>and</strong> skin needling to deliver<br />

controlled thermal damage to the dermis, without heating the upper layer of skin<br />

(the epidermis).<br />

A key benefi t of the Infi ni treatment is its effectiveness in addressing both the<br />

superfi cial <strong>and</strong> deeper layers of the skin. The technology combines microneedling<br />

fractional radiofrequency (MFR) <strong>and</strong> superfi cial fractional radiofrequency (SFR) to<br />

help fortify, tighten <strong>and</strong> rejuvenate the complexion.<br />

The MFR energy is delivered to the skin’s deeper layers via insulated gold-<br />

coated microneedles. This affords a double-fold effect, as both skin needling <strong>and</strong><br />

thermal heating can help boost collagen production <strong>and</strong> rejuvenate the skin from<br />

within. The MFR causes controlled areas of coagulation – or tissue shrinkage –<br />

leading to skin tightening <strong>and</strong> wrinkle reduction.<br />

Meanwhile, the SFR technology delivers thermal energy via two channels to<br />

both the epidermis <strong>and</strong> the dermis. This leads to a mild microablation of the skin’s<br />

surface to illuminate the complexion <strong>and</strong> homogenise the skin’s texture. When the<br />

microneedles <strong>and</strong> controlled thermal damage is applied, this triggers the skin’s<br />

132 www.cosbeauty.com.au

skin<br />

natural healing response <strong>and</strong> the treatment area is flooded with blood, oxygen<br />

<strong>and</strong> nutrients. Fibroblast production is enhanced, triggering the formation of new<br />

collagen, <strong>and</strong> the skin is volumised for a three-dimensional result.<br />

Treatment<br />

To achieve an all-over facial rejuvenation, treatment with Infini is usually applied<br />

‘layer by layer’ at different depths in the skin’s dermis. The number of passes, <strong>and</strong><br />

different needle depths, are adjusted according to patient desires <strong>and</strong> current<br />

skin condition. For example, more aggressive parameters are typically used<br />

on areas of concern – to refine the jaw line or combat wrinkles on the forehead –<br />

<strong>and</strong> lower parameters are applied on the skin’s superficial layers.<br />

A thorough consultation process is required to establish the most effective<br />

method for treatment with Infini. And, while the procedure is suitable for all skin<br />

types, an individual approach is necessary in ensuring the best results.<br />

Topical anaesthetic is applied to the skin <strong>and</strong> left on for 45 minutes<br />

before treatment. This increases comfort during the procedure, <strong>and</strong><br />

enables the delivery of higher parameters for a more noticeable<br />

result. The treatment itself is methodical, <strong>and</strong> the Infini headpiece is<br />

moved across the face in designated sections.<br />

Typically, patients can expect some swelling, redness <strong>and</strong> skin<br />

sensitivity in the days following treatment <strong>and</strong>, in some cases, mild<br />

bruising can arise under the eyes. Patients are encouraged to wash<br />

their face gently the night after treatment <strong>and</strong> avoid aggressive<br />

cleansers or any products with powerful scrubbing agents<br />

for a couple of weeks.<br />

BEFORE<br />

BEFORE<br />

BEFORE<br />

BEFORE<br />

AFTER acne treatment with Infini. Courtesy<br />

of Lutronic.<br />

AFTER acne scar treatment with Infini.<br />

Courtesy of S. Savant, MD, India<br />

AFTER scar revision with Infini. Courtesy of<br />

Devrim Gursoy, MD, Turkey<br />

AFTER skin laxity treatment with Infini.<br />

Courtesy of Devrim Gursoy, MD, Turkey<br />

Results<br />

In most cases, multiple Infini treatments are required to achieve the<br />

desired outcome, however changes in the skin can be seen after<br />

a single session. The Infini protocol calls for two treatments, four<br />

weeks apart, to generate optimal results, though some patients<br />

opt for more.<br />

Once the redness has faded – usually two days following<br />

treatment – patients should begin to notice a renewed freshness in<br />

their complexion. The release of growth factors <strong>and</strong> increased blood<br />

flow, which occur due to thermal damage, fuels the face with oxygen<br />

<strong>and</strong> nutrients as the skin starts to rebuild itself from within.<br />

New collagen fibres begin to form in the dermis around four<br />

weeks after treatment, <strong>and</strong> these results continue to improve for up<br />

to 10 weeks post-procedure. Patients should see a tightening <strong>and</strong><br />

firming of the skin after two to three weeks, <strong>and</strong> a holistic, universal<br />

rejuvenation should be evident after a series of Infini treatments has<br />

been completed.<br />

While it is effective in turning back the clock <strong>and</strong> revitalising the<br />

complexion, Infini can also help combat certain conditions that are<br />

usually extremely difficult to treat. Acne scars, stretch marks, traumarelated<br />

scars <strong>and</strong> melasma (pigmentation) can all be noticeably<br />

improved with Infini – not to mention the anti-ageing benefits integral<br />

to treatment. Whether it’s for general rejuvenation, or to combat a<br />

specific condition, treatment with Infini will leave your complexion<br />

more volumised <strong>and</strong> revitalised. csbm<br />

www.cosbeauty.com.au 133

skin<br />

Dependable<br />

results<br />

Treating acne<br />

Acne is one of the most common<br />

<strong>and</strong> debilitating skin conditions.<br />

It occurs when the sebaceous<br />

gl<strong>and</strong>s in the skin produce too<br />

much oil, creating a breeding<br />

ground for bacteria <strong>and</strong> leading<br />

to clogged pores, inflammation<br />

<strong>and</strong> redness.<br />

The Omnilux Blue is designed<br />

to prevent the spread of<br />

this bacteria, <strong>and</strong> works by<br />

penetrating the skin’s deeper<br />

layers <strong>and</strong> stimulating the<br />

production of bacteria-destroying<br />

chemicals. When used in acne<br />

treatment, the Omnilux system<br />

helps soothe painful inflammation<br />

<strong>and</strong> reduce the amount of<br />

bacterium to reduce the severity<br />

of acne.<br />

As well, Omnilux accelerates<br />

healing <strong>and</strong> strengthens the<br />

natural function of the skin to<br />

help prevent against future<br />

recurrence of acne irritation.<br />

Omnilux light therapy is a trusted<br />

solution in helping reverse the signs of<br />

ageing <strong>and</strong> treating acne-prone skin.<br />

Caitlin Bishop reports.<br />

Omnilux has a history of effectiveness that surpasses any other light<br />

therapy device on the market. It uses Light-Emitting Diodes (LEDs)<br />

to achieve significant results in skin rejuvenation, acne treatment <strong>and</strong><br />

anti-ageing – results that are clearly supported by clinical research. Indeed,<br />

the system was founded upon many years of research, is used by more than<br />

3,300 dermatologists <strong>and</strong> plastic surgeons across the globe, <strong>and</strong> has been<br />

documented in more than 60 peer-reviewed publications.<br />

‘Omnilux is the only proven TGA-approved LED device with years of<br />

research <strong>and</strong> written papers behind it,’ says Sydney cosmetic surgeon Dr Saras<br />

Sundrum, who has been using Omnilux in her clinics for the past 10 years.<br />

‘Our clients love the non-invasive nature of it <strong>and</strong> the immediate results. It’s also<br />

very relaxing.’<br />

The device, distributed by True Solutions in Australia, harnesses the body’s<br />

natural processes to treat certain skin conditions <strong>and</strong> rejuvenate the skin from<br />

within, causing an anti-ageing result. It calls upon light energy to trigger specific<br />

reactions below the skin’s surface, helping to reduce the appearance of acne,<br />

strengthen dermal integrity <strong>and</strong> reverse the signs of ageing.<br />

The Omnilux system uses three different wavelengths: infrared (Omnilux<br />

Plus), red (Omnilux Revive) <strong>and</strong> blue (Omnilux Blue). The various wavelengths<br />

are suitable for treating different skin conditions, <strong>and</strong> trigger cellular activity in the<br />

dermis <strong>and</strong> epidermis to promote healthy skin function.<br />

Founder of Clear Complexions Clinics <strong>and</strong> registered nurse Suzie Hoitink<br />

says she uses the Omnilux system to treat a number of different skin conditions<br />

<strong>and</strong> anti-ageing concerns in her patients. ‘If your skin is feeling tired <strong>and</strong> the<br />

effects of environmental damage are beginning to show, the Omnilux system is<br />

incredibly effective at rejuvenating your skin,’ Hoitink says.<br />

134 www.cosbeauty.com.au

skin<br />

Point of difference<br />

A key feature of Omnilux, that differentiates it from other systems, is the delivery<br />

of one precise wavelength per treatment – as opposed to using multiple<br />

wavelengths in a single treatment. This means the skin cells are stimulated in<br />

the same way during the entire treatment, preventing cell confusion or counter<br />

activity, <strong>and</strong> leading to more direct, consistent <strong>and</strong> effective results.<br />

Even so, Omnilux Plus <strong>and</strong> Omnilux Revive can be used in conjunction to<br />

achieve a more thorough rejuvenation. ‘The combination of Omnilux Plus<br />

<strong>and</strong> Omnilux Revive results in a noticeable softening of fine lines <strong>and</strong> a reduction<br />

in pore size,’ says Hoitink. ‘It also returns an overall, more youthful appearance<br />

to the skin.’<br />

Action within the skin<br />

Omnilux Revive targets fibroblasts in the skin’s dermis, which are the cells<br />

responsible for generating collagen <strong>and</strong> elastin – the antidotes to premature<br />

wrinkles <strong>and</strong> textural irregularities. The red wavelength also reduces inflammation<br />

in the skin, helping to promote regular, healthy <strong>and</strong> efficient cellular activity.<br />

In comparison, Omnilux Plus helps reduce the levels of toxicity in the skin<br />

<strong>and</strong> assists in healing. As well as this, the infrared wavelength targets the<br />

activity of fibro-myoblasts, which are the cells that work to tighten collagen<br />

bundles <strong>and</strong> create a neat, even <strong>and</strong> resilient structure of collagen fibres in<br />

the skin.<br />

‘As we age, the structural integrity of the skin is compromised, resulting in<br />

thinner skin, wrinkles <strong>and</strong> capillary damage,’ Hoitink explains. ‘Omnilux Plus<br />

<strong>and</strong> Omnilux Revive work to “kick” the skin back five years or so, to increase<br />

strength, elasticity <strong>and</strong> overall health.’<br />

Treatment protocol<br />

Studies have found 10 treatments with Omnilux is optimum to achieve the best<br />

rejuvenation results. In most cases, two treatments performed twice a week over<br />

a five-week period is preferred to establish maximum effect in improving skin<br />

health <strong>and</strong> seeing noticeable results.<br />

‘Each treatment is pain-free <strong>and</strong> lasts around 20 minutes in duration,’ says<br />

Hoitink. ‘Before treatment, we apply a preparatory solution to the skin to further<br />

enhance the light penetration.’<br />

Depending on patient concerns, other modalities might be used in conjunction<br />

with Omnilux to further enhance results. ‘We use Omnilux following Ultherapy,<br />

laser, IPL, skin needling <strong>and</strong> injectable treatments to reduce inflammation,’ Dr<br />

Sundrum explains.<br />

Because of its healing properties, Omnilux Plus is commonly used after<br />

cosmetic surgery to help accelerate <strong>and</strong> improve the recovery process. The<br />

infrared wavelength reaches 8 to 12mm under the skin to trigger the wound<br />

healing response, reduce healing time <strong>and</strong> help prevent scar formation.<br />

‘For anyone considering surgery, the Omnilux Plus is an absolute must,’ says<br />

Hoitink. ‘It can be used before surgery to prepare the skin, <strong>and</strong> after surgery to<br />

promote rapid wound healing <strong>and</strong> assist in scar reduction.’<br />

These same healing benefits have achieved significant results in treating<br />

rosacea, a skin condition that causes facial flushing, persistent redness, thickened<br />

skin, visible capillaries <strong>and</strong> painful inflammation. Treatment with Omnilux can<br />

boost immune function, clear damaged tissue <strong>and</strong> promote the production of<br />

new, healthy cells. csbm<br />

www.cosbeauty.com.au 135

hair removal<br />

Finally,<br />

hair removal<br />

for blondes<br />

Fair-haired people, rejoice!<br />

French IPL specialists<br />

EFB Beauté have brought their<br />

unique blonde hair removal<br />

technology to Australia.<br />

AimÉe Surtenich reports.<br />

By now we’ve pretty much all heard of the beauty benefits<br />

of permanent hair reduction. But there’s always been a<br />

catch – you need dark hair to absorb the light energy.<br />

Oh, <strong>and</strong> you also need to be fair skinned to achieve the best<br />

results. Until now.<br />

Innovative IPL technology by EFB Beauté has finally made<br />

it possible for blonde, red, grey <strong>and</strong> white hair (the notoriously<br />

hard ones to remove) to be treated for long-term hair removal.<br />

It’s also suitable for all skin types, making it the only hair<br />

reduction solution for all hair colours <strong>and</strong> all skin colours.<br />

The Adéna <strong>and</strong> Anthélia IPL systems by EFB Beauté are<br />

the only machines on the market able to treat white <strong>and</strong><br />

blonde hair, <strong>and</strong> a worldwide patent was registered with the<br />

World Intellectual Property Organization in 2005 <strong>and</strong> published<br />

in 2007.<br />

How does it work?<br />

Designed <strong>and</strong> manufactured in France, the EFB Beauté IPL<br />

systems use unique technology developed specifically for<br />

blonde, white, red <strong>and</strong> grey hair removal. The IPL systems<br />

are unique in that they do not rely only on the hair pigment to<br />

absorb the light energy, meaning it can effectively target those<br />

hair shades not so rich in melanin.<br />

During traditional dark hair photoepilation procedures, an<br />

applicator head that emits high intensity flashes of filtered light<br />

is placed on the treatment area. The energy from this light is<br />

absorbed by the chromophore melanin, which is responsible<br />

for hair pigment or colour. Dark hair, which is rich in melanin,<br />

136 www.cosbeauty.com.au

hair removal<br />

Multiple benefits<br />

The Adéna <strong>and</strong> Anthélia IPL systems can also be used<br />

for facial rejuvenation, helping to improve the appearance<br />

of ageing skin rosacea, acne, pigmentation <strong>and</strong> spider<br />

veins, making it a versatile multi-programmed system<br />

to address a wide range of cosmetic concerns. Both<br />

machines offer effective results; the Adéna is a more<br />

gentle treatment, while the Anthélia offers faster, more<br />

effective results.<br />

Both facial rejuvenation procedures <strong>and</strong> permanent<br />

hair removal of the legs or back can be completed in just<br />

a lunch break, with no work or social downtime.<br />

1. Photoepilation<br />

World-fi rst exclusive patent in permanent hair reduction<br />

for all hair colours, including blonde, white, grey <strong>and</strong> red.<br />

2. Skin tightening <strong>and</strong> anti-ageing<br />

Stimulation of the dermis for a restructuring, lifting <strong>and</strong><br />

tightening effect of the skin.<br />

3. Pigmentary treatment<br />

Removal of dark patches on the skin caused by sun<br />

damage <strong>and</strong> ageing.<br />

4. Vascular treatment<br />

Fast elimination of spider veins <strong>and</strong> broken capillaries by<br />

selective photo-coagulation.<br />

5. Acne treatment<br />

Weakens production of the sebaceous gl<strong>and</strong>s <strong>and</strong> treats<br />

infl ammatory <strong>and</strong> bacterial acne.<br />

readily absorbs this light <strong>and</strong> transfers it as heat into the<br />

surrounding capillaries, which supply blood to the papilla<br />

of growing hairs. When the papillae are destroyed in high<br />

temperatures, additional hair growth is prohibited.<br />

What makes the EFB Beauté systems different is that<br />

the Adéna <strong>and</strong> Anthélia machines target the blood vessels<br />

at the bottom of the follicle directly, preventing the growth<br />

of blonde, grey, white <strong>and</strong> red hairs.<br />

An independent clinical trial by DERMSCAN, an<br />

authorised clinical testing centre by the French Ministry<br />

of Health, found that after one session of photodepilation<br />

using Adéna an average decrease of 41 percent of white or<br />

blonde hair was observed.<br />

About the technology<br />

After 10 years of research, in 2011 the Adéna IPL system<br />

entered the market with its exclusive world-fi rst technology<br />

for removal of fair hair, as well as for darker skin types.<br />

EFB Beauté has now become synonymous around the<br />

world with blonde, red <strong>and</strong> white hair removal, offering a<br />

much-needed solution to treating these traditionally diffi cult<br />

to remove hair colours. It can also safely <strong>and</strong> effectively<br />

treat darker complexions without risk of burning or<br />

hypopigmentation.<br />

For practitioners, other EFB Beauté innovative benefi ts<br />

include the stability of delivered energy during treatment<br />

<strong>and</strong> a new absorption fi lter that won’t wear out during its<br />

lifetime.<br />

For fair-haired or dark-skinned people wishing to remove<br />

unwanted body hair or treat a variety of skin concerns, EFB<br />

Beauté offers a giant leap forward in IPL technology. csbm<br />

BEFORE<br />

AFTER pigmentation treatment<br />

BEFORE<br />

AFTER hair removal<br />

BEFORE<br />

AFTER skin tightening treatment<br />

BEFORE<br />

AFTER spider vein treatment<br />

www.cosbeauty.com.au 137

tattoo removal<br />

Rethink<br />

the<br />

Do you have tattoo regret? the SkinIal Non Laser Tattoo removal<br />

system ALLOWS YOU to undo what was once a permanent decision, says<br />

Sydney cosmetic tattooist Rita Porreca. tara casey reports.<br />

The number of tattoos is on the rise, with around one<br />

in four Australians under 30 sporting some form of<br />

‘body art’. But alongside the increasing number<br />

of inked bodies, there is also an ever-growing market for<br />

tattoo removal. Indeed, more than 25 percent of people<br />

with tattoos want them removed, according to consumer<br />

group Choice.<br />

The popularity of tattoos matched with the high<br />

prevalence of ‘tattoo regret’ means tattoo removal has<br />

become big business, with the industry rapidly refining<br />

procedures to keep up with dem<strong>and</strong> for tattoo removal. The<br />

most popular methods in recent times include IPL (intense<br />

pulsed light) <strong>and</strong> laser treatment.<br />

While these are effective methods for tattoo removal, a<br />

new procedure is offering comparable results with reduced<br />

risk of complications.<br />

The latest offering in the tattoo removal market is the<br />

Skinial Non Laser Tattoo Removal System, an innovative<br />

new reverse tattoo technology designed in Germany. ‘For<br />

those who might have grown out of their tattoos, <strong>and</strong> no<br />

longer want them, the Skinial Non Laser Tattoo Removal<br />

System can leave the skin ink free, without the risks<br />

associated with laser tattoo removal,’ says Rita Porreca<br />

from Sydney Permanent Makeup Centre.<br />

Invisible ink: how does it work?<br />

The Skinial Non Laser Tattoo Removal System uses a<br />

removal liquid based on lactic acid, a substance that is<br />

naturally produced by the body, which is administered to<br />

the skin by a micropigmentation device similar to a st<strong>and</strong>ard<br />

tattoo machine.<br />

138 www.cosbeauty.com.au

The body’s natural defence system recognises the ink<br />

under the skin as a foreign substance <strong>and</strong> the solution<br />

helps your body to reject the ink <strong>and</strong> push it to the surface<br />

where it becomes part of a scab.<br />

‘Skinial uses a micro pigmentation device with a lactic<br />

acid solution to trigger the body’s natural immune system<br />

to get rid of the foreign substance,’ Porreca explains. The<br />

pigmentation<br />

timeless<br />

device targets clusters<br />

<strong>and</strong><br />

of up to 20 small timeless <strong>and</strong><br />

spots in the tattoo at one time, releasing the solution into<br />

each site. The lactic acid eliminates macrophages (defence effortless beauty<br />

mechanism cells) from the large-volume colour particles,<br />

which, up until this point, have encased the particles of<br />

colour, shielding them from the body’s immune system.’<br />

‘In When 1984 it my comes dream to eyes, was to lips, create face, a<br />

With the macrophages removed, the body recognises Centre body, skin that <strong>and</strong> provided training, personalised we are the<br />

the ink as foreign, prompting the immune system to ‘flush’ beauty experts’ solutions expert. With with more natural than <strong>and</strong> 24<br />

the rejected skin cells <strong>and</strong> colour molecules to the skin’s lasting years’ experience results – a world we have above developed<br />

surface, where they aggregate to form a scab <strong>and</strong> ultimately traditional an excellent beauty reputation salons.’ with doctors<br />

fall off. Because the body naturally produces lactic acid to – <strong>and</strong> Rita surgeons. Porreca, We Founder also work & MDclosely<br />

timeless <strong>and</strong> effortless<br />

with surgeons in post-operative<br />

beauty<br />

maintain energy production during exercise, any residues<br />

care.<br />

left after treatment are easily metabolised.<br />

When – Rita it Porreca, comes to Founder Eyes, Lips, & MDFace, Body, Skin <strong>and</strong><br />

The individual spots targeted during treatment are Training<br />

SPCP,<br />

we<br />

AAM,<br />

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AACT,<br />

the experts'<br />

APAA<br />

expert. We also work closely<br />

approximately 0.5 x 0.8 cm in size <strong>and</strong> around 1mm is with surgeons on post-operative care.<br />

abraded from the top layer of skin. This means large tattoos<br />

will need a number of treatments, spaced several months ‘In 1984 my dream was to create a<br />


apart, in order to remove the entire tattoo. However, Centre that provided personalised<br />

because SERVICES of the WE minimal PROVIDE abrasion, the level of discomfort<br />

beauty solutions <strong>Cosmetic</strong> with natural Tattooing<br />

<strong>and</strong><br />

lasting results – a world above<br />

felt <strong>Cosmetic</strong> by patients Tattooing during the treatment is minimised, <strong>and</strong> the<br />

traditional beauty Medical salons.’ Tattooing<br />

risk Eyebrows of scarring Hair reduced. stroke to ‘This shaded procedure brows reduces to give the you risk more of a<br />

– Rita Porreca, Founder Skin & Needling<br />

for natural scars appearance<br />

enormously because small wounds usually heal<br />

MD<br />

without BEFORE<br />

Eyeliner scars,’ Subtle Porreca to Dramatic explains.<br />

Dermal Planning Peels<br />

or to define your eye shape<br />

‘In my experience the Skinial method of tattoo removal When it comes to Eyes, Lips, Face, Body, Skin <strong>and</strong><br />

Lips From lip liner to full lips & blends we make your lips look<br />

Training<br />

good with Non Laser Tattoo Removal<br />

can erase all kinds of shapes <strong>and</strong> colours of tattoos. Usually,<br />

we are the experts' expert. We also work closely<br />

an ideal shape <strong>and</strong> colour all the time.<br />

with surgeons <strong>Cosmetic</strong> on post-operative Tattooing care. Courses<br />

the treatment causes less discomfort than the tattooing<br />

itself. Medical However, Tattooing the level of discomfort varies depending on<br />

the Areola patient re-pigmentation <strong>and</strong> the treatment Is area,’ the final she says. stage of breast reconstruction <strong>and</strong> is AFTER FULL LIP TATTOOING<br />

also The considered time it takes by those to heal with between areola treatments colour loss. varies<br />


between Corrective individuals Camouflage <strong>and</strong> depends Can bring on the a client’s natural skin skin type colour back to scars<br />

<strong>and</strong> <strong>Cosmetic</strong> the burns strength Tattooing of their immune system. Healing typically<br />

Eyebrows Hair stroke to shaded brows to give you more of a BEFORE FULL LIP COLOUR<br />


takes between six <strong>and</strong> 10 weeks, with redness persisting<br />

longer natural Skin Needling<br />

appearance<br />

some patients.<br />

Eyeliner Needling Porreca Subtle treatment warns all to her Dramatic for patients wrinkles, or that to acne larger define scars tattoos your & eye present scar shape relaxation<br />

BEFORE<br />

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the<br />

leave<br />

rebuilding <strong>and</strong> a colour shadow<br />

of all new<br />

on the the<br />

collagen time. skin after<br />

<strong>and</strong><br />

removal.<br />

lightening pigmentation.<br />



‘Cases where previous laser treatments have been<br />

unsuccessful Medical IPL Hair Tattooing Removal or have resulted in permanent scarring are<br />

Areola Enables re-pigmentation hair removal from Is nearly the final every stage part of of breast the body reconstruction quickly <strong>and</strong> is AFTER FULL LIP TATTOOING<br />

more difficult, <strong>and</strong> are assessed individually to establish if<br />


Skinial <strong>and</strong> efficiently considered treatment is by worthwhile,’ those with she areola says. colour ‘The procedure loss.<br />

is Corrective also not suitable Camouflage for those Can prone bring to a natural hypertrophic skin colour or back to scars<br />

<strong>and</strong><br />

Medical<br />

burns<br />

Skin Peels/Microdermabrasion<br />



keloid scarring.’<br />

Skin treatments ranging from Green Peel, CosMedix Peels<br />

With a range of removal techniques available, including<br />

Skin & Microdermabrasion Needling to give you a natural healthy glow.<br />

the latest non-laser method, tattoos are no longer the<br />

Needling treatment for wrinkles, acne scars & scar relaxation<br />

lifetime-lasting<br />

02 9569 7799<br />

<strong>Cosmetic</strong> Dermal br<strong>and</strong>s Fillers they & once Mesotherapy were. ‘The Skinial<br />

BEFORE<br />

follow us on<br />

method Skin Rejuvenation<br />

represents a real step forward for those looking Bella Building, Shop 4/239<br />

<strong>Cosmetic</strong> Tattooing Courses<br />

for Is ideal an effective for the means rebuilding of erasing of new past collagen mistakes,’ <strong>and</strong> Porreca lightening pigmentation. Great North Rd, Five Dock<br />

Learn, up-skill <strong>and</strong> exp<strong>and</strong> with professional cosmetic tattooing training.<br />


concludes. csbm<br />

located in Cosmedic Professionals<br />

IPL Hair Removal<br />

Email: info@spmuc.com.au<br />

Enables hair removal from nearly every part of the body quickly<br />

www.cosbeauty.com.au<br />

Web: www.spmuc.com.au<br />


<strong>and</strong> efficiently<br />

SPMUC FP(NEW) 30/4/07 1:30 PM Page 1<br />

SPMUC FP(NEW) 30/4/07 1:30 PM Page 1

feature<br />

Why quality<br />

skincare works<br />

There are certain things surgery can’t help<br />

with, <strong>and</strong> clear, healthy <strong>and</strong> uniform skin is<br />

one of these. That’s where the benefits of a<br />

quality medical-grade skincare regime can be<br />

invaluable. AimÉe Surtenich reports.<br />

140 www.cosbeauty.com.au

feature<br />

Decoding<br />

skincare<br />

Retinol<br />

Retinol is a Vitamin A (retinoic acid)<br />

derivative that is a safe, effective<br />

<strong>and</strong> widely used anti-ageing<br />

solution. Retinoids encourage<br />

better cell turnover in the upper<br />

layers, normalising skin turnover.<br />

Hyaluronic acid<br />

Hyaluronic acid (HA) is used in<br />

hundreds of anti-ageing products<br />

due to its fast-working moisturising<br />

properties. Leading dermatologists<br />

recommend patients invest in a<br />

good anti-ageing moisturiser with<br />

HA, which is also found naturally<br />

in skin.<br />

Vitamin C<br />

Famously linked to vitamin pills <strong>and</strong><br />

oranges, its goodness is now found<br />

in beauty products, too. Vitamin<br />

C is an antioxidant that works to<br />

prevent free radical damage. These<br />

are volatile molecules so look for a<br />

stabilised Vitamin C product to help<br />

reinforce the skin’s own defences<br />

<strong>and</strong> prevent long-term damage.<br />

Vitamin B<br />

Vitamin B3 (Niacinamide) has really<br />

come to the fore in the anti-ageing<br />

war, taking its place alongside<br />

skincare veterans Vitamins A, C<br />

<strong>and</strong> E. Typically used in serum<br />

form, Vitamin B3 can effectively<br />

treat acne, fade hyperpigmentation<br />

<strong>and</strong> improve the skin barrier<br />

functions, as well as help reduce<br />

fine lines <strong>and</strong> wrinkles. It provides<br />

antioxidant properties for the skin<br />

<strong>and</strong> it has also been shown to<br />

have anti-inflammatory <strong>and</strong> healing<br />

properties, as well as help reduce<br />

skin sensitivity.<br />

Arguably the most important aspect of beauty is clear <strong>and</strong> healthy skin.<br />

Indeed, there is a new school of thought that a radiant, even complexion is<br />

a greater signifier of youth <strong>and</strong> beauty than a wrinkle-free face. The reason?<br />

Plump, healthy skin reflects light more uniformly (which the eye is attracted to),<br />

resulting in a homogeneous, more even complexion that appears to glow.<br />

So how do we significantly improve the appearance <strong>and</strong> function of our skin?<br />

Step in medical-grade skincare, which is specifically formulated to improve<br />

the quality <strong>and</strong> texture of skin, alleviating signs of ageing such as fine lines,<br />

pigmentation, skin tone <strong>and</strong> texture.<br />

Available in-salon <strong>and</strong> typically prescribed by a skincare professional, these<br />

‘cosmeceuticals’ represent the marriage of cosmetics <strong>and</strong> pharmaceuticals.<br />

What sets them apart is that they contain ingredients, at the right doses <strong>and</strong> in<br />

the right delivery systems, to influence the biological function of the skin.<br />

Cosmeceuticals have benefits beyond those of traditional products. They also<br />

improve appearance, but they do so by delivering nutrients <strong>and</strong> typically claim to<br />

improve skin tone, texture <strong>and</strong> radiance, while reducing wrinkling.<br />

Cosmeceuticals can improve the function of the skin <strong>and</strong> may be helpful in<br />

preventing premature ageing. Examples include hydroxy acids, retinoids <strong>and</strong><br />

antioxidants such as Vitamins A, B <strong>and</strong> C. Gone are the days when skincare<br />

need only sit on the surface of your skin <strong>and</strong> not work at the cellular level.<br />

These topical skincare formulations contain active ingredients which enable<br />

them to act on the skin’s cellular structure. In some cases, such as exfoliants, this<br />

action is limited to the surface of the skin, while other formulations can penetrate<br />

to deeper levels <strong>and</strong> enhance or inhibit natural activities.<br />

Many br<strong>and</strong>s have poured millions of dollars into research <strong>and</strong> development,<br />

employing highly skilled biochemists <strong>and</strong> scientists to create new products<br />

delivered in formulations designed to enhance their capabilities <strong>and</strong> the<br />

appearance of the skin at the same time.<br />

What to look for in cosmeceutical products are antioxidants, exfoliants, cellcommunicating<br />

<strong>and</strong> skin-lightening ingredients, <strong>and</strong> intercellular substances that<br />

mimic skin structure. For the products to work, these need to be at sufficient<br />

concentrations <strong>and</strong> synergies to allow them to retain their active properties.<br />

Essential ingredients to look out for<br />

Cosmeceutical products contain ingredients that induce healing <strong>and</strong> other<br />

changes in skin cells. Research shows that benefits for the skin can also be<br />

obtained from plant extracts <strong>and</strong> essential oils as well as vitamins, enzymes,<br />

phytochemicals <strong>and</strong> more.<br />

Antioxidants reduce free-radical damage <strong>and</strong> inflammation, counteracting<br />

cellular damage, collagen destruction <strong>and</strong> immune suppression. Antioxidants in<br />

combination, studies suggest, can exert a cumulative synergistic action on the<br />

skin that is more effective than single-ingredient formulations.<br />

Cell-communicating ingredients use receptor sites or cellular pathways to<br />

interact with skin cells to signal them to function optimally. Retinoids, which<br />

are derivatives of Vitamin A, are the best known. They act as antioxidants<br />

<strong>and</strong> neutralise the free radicals that result from exposure to ultraviolet light. In<br />

addition, they increase cellular turnover, stimulate a thickening of the epidermis<br />

<strong>and</strong> promote the removal of excess pigment.<br />

Other cell-communicating ingredients include peptides, which were developed<br />

for use in skincare to either increase the production of collagen or to reduce<br />

its breakdown.<br />

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feature<br />

Squalene<br />

Squalene is an organic, oil-free<br />

moisturiser that occurs naturally in<br />

the body. It can be derived from<br />

olives <strong>and</strong> is an excellent nongreasy<br />

moisturiser that instantly<br />

softens the skin <strong>and</strong> helps prevent<br />

cell damage. It is also non-irritating<br />

<strong>and</strong> non-comedogenic.<br />

Antioxidants<br />

Antioxidants help protect skin<br />

by combating free radicals,<br />

which attack healthy skin cells<br />

<strong>and</strong> collagen. This attack of the<br />

skin’s vital structures can cause<br />

damage, mutations, cell death<br />

<strong>and</strong> infl ammation, resulting in<br />

lines, wrinkles, uneven skin tone,<br />

sensitivity <strong>and</strong> even cancers.<br />

Ceramides<br />

Ceramides are a type of skin lipid<br />

that sit in the top layer of the skin<br />

<strong>and</strong> work to lock in essential oils<br />

<strong>and</strong> moisture. They are essential in<br />

maintaining both the structure <strong>and</strong><br />

strength of the lipid matrix.<br />

Idebenone<br />

Idebenone, respected for some<br />

time as a pharmaceutical agent in<br />

the form of a super antioxidant, is<br />

now an ingredient in quality antiageing<br />

skincare products to help<br />

prevent wrinkles. Idebenone helps<br />

protects the skin from the elements<br />

<strong>and</strong> reduces the appearance of<br />

fi ne lines, reduces dryness <strong>and</strong><br />

improves skin texture.<br />

Peptides<br />

‘Peptides’ has overtaken HAs as<br />

the new buzzword in skincare.<br />

But there’s substance behind the<br />

hype. The science behind peptides<br />

came from the discovery that when<br />

collagen is damaged by sunlight it<br />

is broken up into peptides. Certain<br />

peptides formed were able to act<br />

as a signal to skin cells to make<br />

new collagen, meaning wrinkled<br />

skin could be improved by fooling it<br />

Another essential ingredient to look for is Niacinamide, a water-soluble<br />

B-complex vitamin that has anti-infl ammatory properties <strong>and</strong> can assist with<br />

conditions such as acne vulgaris.<br />

Exfoliants encourage surface skin cells to shed, mimicking the function of<br />

young skin <strong>and</strong> increasing collagen production. The primary reason for skin<br />

cell build-up is sun damage. Exfoliant ingredients include alphahydroxy acids<br />

(AHAs) such as glycolic <strong>and</strong> lactic acid, polyhydroxy acids (PHAs) such as<br />

gluconolactone <strong>and</strong> lactobionic acid, <strong>and</strong> beta hydroxy acids (BHAs) such as<br />

salicylic acid. Salicylic acid is also used as a skin conditioner <strong>and</strong> is especially<br />

useful in patients with oily skin <strong>and</strong> acne.<br />

Skin-lightening ingredients, including hydroquinone, arbutin, azelaic acid,<br />

some forms of Vitamin C, rucinol <strong>and</strong> glycyrrhetinic acid, inhibit melanin formation<br />

at a molecular level, reducing the appearance of brown discolouration.<br />

Intercellular substances are ingredients that exist naturally in skin <strong>and</strong> can<br />

be depleted by ill health, ageing <strong>and</strong> environmental factors. Ingredients such<br />

as ceramides, cholesterol, fatty acids <strong>and</strong> glycosaminoglycans are key to skin<br />

function <strong>and</strong> should be included in moisturisers if they are to be effective in<br />

promoting skin functionality.<br />

Hyaluronic acid is known to hydrate <strong>and</strong> moisturise the skin from the inside,<br />

helping to smooth out wrinkles.<br />

A 2008 study published in the Journal of <strong>Cosmetic</strong> Dermatology analysed<br />

several cosmeceutical ingredients to see how successful they are in targeting<br />

specifi c skin imperfections related to age. The study indicated, for example, that<br />

skin surface irregularity can be improved through the topical application of niacin,<br />

<strong>and</strong> that the appearance of fi ne lines can be diminished with the application of<br />

moisturisers containing engineered peptides <strong>and</strong> retinoids.<br />

While the Australian Therapeutic Goods Administration regulates ‘products at<br />

the interface between cosmetic <strong>and</strong> therapeutic goods’ (that is, cosmeceuticals)<br />

<strong>and</strong> most manufacturers belong to self-regulating industry bodies, it is always<br />

safest to seek the advice of a dermatologist or skincare professional. csbm<br />

Prepping skin for<br />

surgery<br />

Healthy skin heals faster after surgery,<br />

<strong>and</strong> an essential factor for successful<br />

surgery is a good skincare regimen<br />

both before <strong>and</strong> after your surgery.<br />

Quality skincare can help regulate<br />

skin cell function <strong>and</strong> improve<br />

circulation, enabling the skin to<br />

renew, repair damage <strong>and</strong> act as an<br />

effective barrier – promoting skin that<br />

responds better to surgery or laser<br />

skin rejuvenation <strong>and</strong> heals faster.<br />

142 www.cosbeauty.com.au

feature<br />

into thinking it had been damaged<br />

by applying this peptide. Peptides<br />

offer a way for the skin to repair<br />

itself naturally <strong>and</strong> can potentially<br />

trigger specifi c things in the skin, so<br />

that they might improve wrinkles,<br />

fi rmness or age spots.<br />

Hexapeptide, in particular, is a<br />

popular component of anti-ageing<br />

products as it works to relax facial<br />

muscles for a more plump, youthful<br />

appearance.<br />

Stem Cells<br />

Skincare specialists are creating<br />

specialised peptides <strong>and</strong> enzymes<br />

that help stimulate the skin’s<br />

storage of stem cells. It is<br />

believed the skin contains a ratio<br />

of approximately one in 10 to<br />

one in 10,000 stem cells. These<br />

specialised cells are dormant until<br />

they receive signals from the body<br />

to begin the repair mode.<br />

The use of topical products<br />

stimulate the stem cell to split into<br />

two types of cells: a new, similar<br />

stem cell <strong>and</strong> a ‘daughter’ cell. This<br />

stem cell can receive the message<br />

to create proteins, carbohydrates<br />

<strong>and</strong> lipids to help repair fi ne lines<br />

<strong>and</strong> wrinkles <strong>and</strong> restore <strong>and</strong><br />

maintain fi rmness <strong>and</strong> elasticity.<br />

Coenzyme Q10<br />

CoQ10 occurs naturally in the body,<br />

however, factors such as stress,<br />

ageing <strong>and</strong> some medications can<br />

lower the levels. In most people<br />

over 30, levels of CoQ10 in the skin<br />

are below optimum, resulting in<br />

lesser ability to produce collagen,<br />

elastin <strong>and</strong> other important skin<br />

molecules. CoQ10 penetrates<br />

into skin cells to boost skin repair<br />

<strong>and</strong> regeneration <strong>and</strong> reduce free<br />

radical damage.<br />

A new form of Q10 called<br />

Ubiquinol is now available. In<br />

essence, Ubiquinol is the reduced,<br />

active antioxidant form of CoQ10<br />

produced naturally by the body,<br />

offering more effective uptake.<br />

CREAM<br />


There are some truly skin-transforming product<br />

ranges available, <strong>and</strong> ingredients <strong>and</strong> delivery<br />

systems continue to become more sophisticated.<br />

Here are some of our favourite skincare br<strong>and</strong>s<br />

making headway for their ability to effect signifi cant<br />

changes in the skin: HydroPeptide, Obagi,<br />

Mesoestetic, Dr. Spiller Biocosmetics, Fyto<br />

Cosmeceuticals <strong>and</strong> Synergie.<br />

www.cosbeauty.com.au 143

skin<br />

Why<br />

does<br />

clinical<br />

skincare<br />

st<strong>and</strong><br />

alone?<br />






Consumers are constantly bombarded by the<br />

global corporate br<strong>and</strong>s with marketing claims<br />

<strong>and</strong> media hype promising much <strong>and</strong> delivering<br />

little. Skin professionals <strong>and</strong> clinical therapists are highly<br />

skilled in the area of skin analysis <strong>and</strong> recommending<br />

clinical grade products containing active ingredients that<br />

actually make a difference.<br />

Of course, the condition of our skin is due to numerous<br />

factors, including genetics, environmental stress, nutrition,<br />

health status, topical skincare <strong>and</strong> clinical treatments. All<br />

of these factors must be considered both independently<br />

<strong>and</strong> in relation to each other.<br />

144 www.cosbeauty.com.au

skin<br />

What to look out for<br />

Does the range cater to most individual skin<br />

concerns: ageing, blemishes, uneven skin<br />

tone, sensitivity?<br />

Does the range offer key active ingredients<br />

such as stable active forms of Vitamin A,<br />

Vitamin B3 <strong>and</strong> Vitamin C along with broad<br />

spectrum UV protection?<br />

Does the manufacturer have a core<br />

br<strong>and</strong> philosophy that resonates with you,<br />

the consumer?<br />

Does the range offer optimal levels of<br />

cosmeceuticals supported by readily available<br />

clinical data?<br />

Are you offered guidance <strong>and</strong> information on<br />

the products by qualifi ed skin professionals or<br />

medical staff when making your choice?<br />

Is the manufacturer of the range able<br />

to readily adapt formulations to this<br />

dynamic industry?<br />

Is the manufacturer readily available for<br />

interaction with the consumer via email, social<br />

media or telephone should the consumer<br />

have <strong>and</strong> queries?<br />

There is one fi nal <strong>and</strong> fundamental factor<br />

in selecting good skin care: TRUST. If the<br />

customer trusts the advice of their skin<br />

therapist <strong>and</strong> the ethos <strong>and</strong> quality of the<br />

br<strong>and</strong> they have chosen, they will feel their<br />

decision is valid <strong>and</strong> positively embrace their<br />

new skin routine.<br />

A trained therapist will advise clients not<br />

only of the ideal products but also advice on<br />

lifestyle, nutrition <strong>and</strong> treatments to address<br />

their skin concerns. When a cosmeceutical<br />

home routine is adopted in a positive way, the<br />

very best results can be achieved.<br />

In my opinion, clinical grade skincare<br />

really does st<strong>and</strong> apart from the white noise<br />

of department store br<strong>and</strong>s. If the customer<br />

is prepared to take the time to research the<br />

best cosmeceutical br<strong>and</strong>s <strong>and</strong> the right<br />

skin therapist, great results – not seven day<br />

miracles – are possible.<br />

A cosmeceutical skin care regimen is an integral part of the<br />

equation. Mass market department store br<strong>and</strong>s are generally unable<br />

to offer the high grade of skincare that clinical skin professionals can<br />

offer for the following reasons:<br />

Packaging vs product<br />

High street br<strong>and</strong>s often spend more money on marketing <strong>and</strong><br />

packaging than on the actual product inside the bottle. Cost <strong>and</strong><br />

economics is the driving factor for this sector <strong>and</strong> the level of active<br />

ingredients may be insuffi cient to give results.<br />

Skilled professionals<br />

Skin professionals are trained in educating clients on managing skin<br />

concerns. Sales assistants in multi-br<strong>and</strong> mass-purchase department<br />

stores are not skilled therapists. They often lack detailed knowledge<br />

of skin <strong>and</strong> are unable to address individual skin concerns.<br />

Clinical grade skincare companies will pride themselves on<br />

supporting their clinics, <strong>and</strong> therapists will have a high level of training<br />

regarding key ingredients <strong>and</strong> benefi ts of cosmeceuticals.<br />

Dosage of active ingredients<br />

As a formulator, I have suppliers present ingredients to me on a regular<br />

basis. Many of these raw ingredients are novel <strong>and</strong> new. However,<br />

formulators supplying clinics must evaluate the ingredient in terms of<br />

its effi cacy <strong>and</strong> safety profi le. This involves a thorough analysis of both<br />

in vivo <strong>and</strong> in vitro clinical data.<br />

Furthermore, the formulating chemist must use the optimal dosage<br />

of active ingredients to ensure effi cacy. Many over-the-counter br<strong>and</strong>s<br />

add just a whiff of active ingredient simply to make marketing claims.<br />

Synergy <strong>and</strong> stability of combined ingredients<br />

<strong>Cosmetic</strong> scientists must also underst<strong>and</strong> the interactions of<br />

ingredients within the fi nal formula. Formulating is not simply a matter<br />

of adding a number of ingredients together <strong>and</strong> mixing them up.<br />

Ingredients must be compatible <strong>and</strong> must also work together<br />

in synergy. For example, retinol <strong>and</strong> niacinamide should not be<br />

formulated in an acidic environment. Additionally, adding acids<br />

such as AHAs, BHAs or L-ascorbic acid to formulas with these<br />

cosmeceuticals results in retinol being rendered ineffective <strong>and</strong><br />

niacinamide being hydrolysed.<br />

Ability to adapt<br />

Many non-clinical br<strong>and</strong>s are unable to react to market needs rapidly.<br />

The large corporates must create marketing campaigns well in<br />

advance <strong>and</strong> a need to adapt to new technology may take years.<br />

Smaller specialist companies can more readily react to dynamic<br />

changes in the appearance medicine industry. csbm<br />

www.cosbeauty.com.au 145

skin<br />

Transform your skin<br />




The capacity of Obagi to transform skin has created<br />

a long-st<strong>and</strong>ing <strong>and</strong> highly regarded reputation in<br />

the international skincare arena. Used by plastic<br />

surgeons, dermatologists <strong>and</strong> skincare therapists across<br />

the globe, Obagi has been shown to change skin at a<br />

cellular level, boosting skin health <strong>and</strong> regeneration.<br />

Its widespread professional use – from helping to optimise<br />

skin health before surgery to pigmentation reduction – acts<br />

as testimony to the effectiveness of Obagi skincare. ‘Obagi<br />

has always been considered the gold st<strong>and</strong>ard, <strong>and</strong> its<br />

international reputation was what led me to trial Obagi in<br />

the fi rst place,’ says Michelle Field, registered nurse <strong>and</strong><br />

director of the Skin Institute in Victoria.<br />

‘Obagi stimulates increased collagen production, <strong>and</strong><br />

better skin colour, tone <strong>and</strong> texture. It also helps improve<br />

the appearance of fi ne lines <strong>and</strong> wrinkles, <strong>and</strong> reverse some<br />

sagging <strong>and</strong> pigmentation.’<br />

Obagi, distributed in Australia by iNova Aesthetics, holds<br />

a full portfolio of skincare solutions to promote beautiful<br />

complexions for all skin types.<br />

The hero skincare system, NuDerm, is designed to<br />

correct skin damage <strong>and</strong> reveal a healthier, more youthfullooking<br />

complexion. ‘NuDerm is the most popular Obagi<br />

program <strong>and</strong> is very effective in treating photo damage,’<br />

says Perth medical aesthetician Anna Robinson from Assure<br />

Medispa in Perth. ‘It helps repair the cellular structure of<br />

the skin, <strong>and</strong> visible improvements typically occur in as little<br />

as four to six weeks.’<br />

This rapid response is due to the high-grade ingredients<br />

used in Obagi skincare. These ingredients have been<br />

clinically shown to deliver results.<br />

‘Obagi st<strong>and</strong>s out as a true “Dr Only” range,’ says Sydney<br />

cosmetic physician Dr Saras Sundrum. ‘The products are<br />

designed around prescription-strength retinoic acid, which<br />

146 www.cosbeauty.com.au

skin<br />

is one of the few substances clinically proven to improve<br />

skin quality.’<br />

Because the range uses such active <strong>and</strong> concentrated<br />

ingredients, it is described as a “medical grade” skincare<br />

line <strong>and</strong> some treatments must be prescribed by a qualifi ed<br />

<strong>and</strong> experienced practitioner.<br />

Obagi transforms the skin at<br />

a cellular level by targeting skin<br />

cells directly, restoring function<br />

to effectively target some of the<br />

most diffi cult skin conditions<br />

‘Some cosmetic procedures need to be complemented<br />

with prescription-based skincare for optimal results – <strong>and</strong><br />

in Australia these can only be prescribed by a medical<br />

practitioner,’ says Dr Christopher Leat from Envisage<br />

Clinic in Queensl<strong>and</strong>. ‘Obagi relies on published third-party<br />

research for their ingredients, <strong>and</strong> this is what distinguished<br />

the range for me in the fi rst place.’<br />

With different treatment “systems”, specifi cally targeted<br />

to certain skin complaints such as acne, pigmentation <strong>and</strong><br />

anti-ageing, Obagi offers a range for all skin types. Each<br />

specialised skincare line includes every skincare element –<br />

from cleansers to serums – required to make noticeable<br />

<strong>and</strong> long-lasting changes in the skin.<br />

‘I am quite fi rm with my patients about needing to start<br />

the programme as a complete system, which I believe is<br />

required for obtaining the high level of results,’ says Dr<br />

Linda Williams from Artisan <strong>Cosmetic</strong> & Rejuvenation<br />

Clinic in Queensl<strong>and</strong>. ‘Obagi therefore requires discussion,<br />

commitment <strong>and</strong> enthusiasm but this has not proved<br />

negative to any of my patients to date. If anything, the<br />

systems are easy to follow <strong>and</strong> the improvements in skin<br />

quality, pore size, tone <strong>and</strong> hydration are apparent within<br />

the fi rst week or so.’<br />

Adopting such a comprehensive skincare program,<br />

with high concentrations of active ingredients, can mean<br />

patients experience some irritation when fi rst starting use.<br />

This should fade with continued use, <strong>and</strong> is considered an<br />

indication that the line is working to cause changes within<br />

the skin.<br />

Obagi can also be used to boost skin health <strong>and</strong> improve<br />

the results following cosmetic surgery or laser procedures.<br />

‘Radiantly beautiful skin adds value to the outcome of any<br />

cosmetic surgery or non-surgical procedure,’ explains Perth<br />

plastic surgeon Dr Anh Nguyen. ‘Quality skincare systems<br />

are needed to prepare the skin before treatment, expedite<br />

wound healing after surgery, <strong>and</strong> protect the investment<br />

long term by delaying the visible signs of ageing <strong>and</strong> need<br />

for intervention.’<br />

Whether contemplating surgery or not, Obagi skincare<br />

can transform <strong>and</strong> beautify all skin types <strong>and</strong> help treat a<br />

range of skin conditions. Quality skincare can help protect,<br />

preserve <strong>and</strong> enhance the complexion <strong>and</strong> Obagi offers<br />

an all-encompassing solution to optimising skin health for<br />

the long term.<br />

‘Obagi transforms the skin at a cellular level by targeting<br />

skin cells directly to restore function,’ explains Perth plastic<br />

surgeon Dr Brigid Corrigan from Assure Medispa. ‘The<br />

fact that it is a prescription-only skincare line means it can<br />

effectively target some of the most diffi cult skin conditions<br />

to treat, such as pigmentation, sun damage, fi ne lines<br />

<strong>and</strong> wrinkles.’<br />

‘We all put “creams” on our skin on a daily basis, but it’s<br />

important to choose products with ingredients that make a<br />

difference <strong>and</strong> have the scientifi c pedigree to deliver what<br />

they promise,’ says Dr Williams. ‘Start looking after your<br />

skin as early as possible, using sun prevention, antioxidant<br />

protection, hydration <strong>and</strong> collagen stimulation. It’s never<br />

too early.’ csbm<br />

BEFORE<br />

BEFORE<br />

BEFORE<br />

8 weeks AFTER using Obagi NuDerm system<br />

1 week AFTER using Obagi CLENZIderm system<br />

4 weeks AFTER using Obagi-C Rx system<br />

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feature<br />

Makeup<br />

marvels<br />

Meet the star products changing faces <strong>and</strong> reinventing<br />

beauty rituals. AimÉe Surtenich reports.<br />

Makeup has the power to transform faces –<br />

highlighting your best features <strong>and</strong> disguising<br />

your worst. It can even give the illusion of more<br />

prominent cheekbones, a narrower nose <strong>and</strong> more<br />

defined jawline. It’s all about creating optical illusions so<br />

that it looks like you are constantly under the best lighting<br />

ever – <strong>and</strong>, to do this, light <strong>and</strong> shade will be your BFFs,<br />

highlighting <strong>and</strong> contouring to create a glamour-girl look.<br />

First, we need the right base, <strong>and</strong> where would we<br />

all be without a good primer? It minimises the look of<br />

pores, evens out skin colour <strong>and</strong> just feels so ridiculously<br />

smooth on your skin. A good BB cream has also become<br />

a staple in my daily beauty ritual; it mimics the texture of<br />

perfect skin <strong>and</strong> creates a great base for your foundation<br />

to glide right on.<br />

Now for the magic: contouring your face. Generally,<br />

the idea is to use an illuminator or lighter shade of<br />

foundation to highlight the areas of your face where light<br />

naturally hits – cheekbones, bridge of your nose, temple,<br />

brow bone <strong>and</strong> along your jaw line. Conversely, to add<br />

definition use a darker colour under your cheekbones (to<br />

really make your cheekbones pop) <strong>and</strong> under your jawline<br />

to add more definition to this oft-neglected area.<br />

Finish with a dusting of powder, some extra concealer<br />

under your eyes, a little shimmer or bronzer on your<br />

cheekbones <strong>and</strong> a dab of blush on the apples of your<br />

cheeks. csbm<br />

148 www.cosbeauty.com.au

Conceal it!<br />

I don’t believe there is a one-size-fits-all concealer. Instead, invest in a few good quality concealers<br />

– one specifically for under the eyes, a highlighter concealer to add as a mini illuminator on the<br />

run, <strong>and</strong> another to camouflage imperfections on the face. Remember, a little goes a long way!<br />

Another trick is to add a dab of concealer to your eyelids to help make eyeshadow stick.<br />

feature<br />

1. Colorescience Mineral Corrector Palette, RRP $79.20, 2. Laura Mercier Secret Camouflage, RRP<br />

$49, 3. Shiseido Pore Smoothing Corrector, RRP $40, 4. Calvin Klein CK One 3-in-1 Concealer, RRP<br />

$28, 5. Maybelline Dream Lumi Touch Highlighting Concealer, RRP $17.95, 6. Shiseido Sheer Eye<br />

Zone Corrector, RRP $42, 7. Glo-Minerals Luxe Liquid Foundation, RRP $72, 8. Shiseido Face Color<br />

Enhacing Trio in Apple, RRP $58, 9. Laura Mercier High Coverage Concealer, RRP $39, 10. Curtis<br />

Collection Mineral Photo Touch Concealer, RRP $33, 11. Shiseido Natural Finish Cream Concealer,<br />

RRP $50.<br />

4.<br />

3.<br />

7.<br />

8.<br />

2.<br />

5.<br />

6.<br />

1.<br />

9.<br />

Primers<br />

As Napoleon Perdis famously said: Not to prime is a<br />

crime! While we’re not suggesting a jail sentence for<br />

those who skip this essential step, primers do make<br />

a big difference to your finished product. It smoothes<br />

the look of pores away right before your very eyes,<br />

evens out the complexion <strong>and</strong> primes your face for<br />

foundation or finishing powder. You can also<br />

multitask with it if it’s a fancy hybrid one <strong>and</strong> use it<br />

as an illuminator.<br />

2.<br />

10.<br />

3.<br />

4.<br />

11.<br />

1. Dermalogica SkinPerfect Primer SPF30, RRP<br />

$67, 2. Napoleon Perdis Auto Pilot Pre-Foundation<br />

Skin Primer, RRP $59, 3. Laura Mercier Oil-Free<br />

Foundation Primer, RRP $45, 4. Skindinavia The<br />

Makeup Primer Spray, 20ml RRP $16.<br />

1.<br />

www.cosbeauty.com.au 149

feature<br />



BLUSH<br />


MATTE<br />




Highlighters<br />

& illuminators<br />

Contouring gives the illusion of more defi ned<br />

contours, smaller nose <strong>and</strong> chin, higher<br />

cheekbones. We’ve all seen the “in between”<br />

makeup shots of Kim Kardashian with light <strong>and</strong><br />

dark stripes strategically placed all over her face<br />

<strong>and</strong> neck. This clever makeup trick works wonders<br />

to create a more chiseled, defi ned face that refl ects<br />

light beautifully <strong>and</strong> gives an air brushed effect.<br />

1. Benefit Watt’s Up, RRP $53, 2. Benefit High<br />

Beam, RRP $45, 3. L’Oreal Lumi Magique<br />

Primer, RRP $29.95, 4. Calvin Klein CK One<br />

Skin Illuminator, RRP $35, 5. Lancôme Teint<br />

Miracle Natural Light Creator SPF 15, RRP $68,<br />

6. St. Tropez Skin Illuminator Gold, RRP $29.95<br />

Skin fixers<br />

Oh, BB Cream, in just a short period you have<br />

become one of the staples in every beauty devotee’s<br />

makeup kit. Used alone or under foundation, it<br />

really does fake the look of moisturised <strong>and</strong> healthy<br />

skin. And what’s not to love about that? Many also<br />

have additional benefi ts, improving not only the<br />

appearance of your skin but also skin health.<br />

1. Lancôme Visionnaire [1 Minute Blur], RRP $62, 2. L’Oreal Nude<br />

Magique Blur Cream, RRP $26.95, 3. L’Oreal Revitalift Magic<br />

Blur, RRP $24.95, 4. Estée Lauder Double Wear All-Day Glow BB<br />

Moisture Makeup, RRP $50, 5. L’Oreal Skin Perfection BB Cream<br />

5-in-1 Instant Blemish Balm, RRP $24.95.<br />

1. 2. 3. 4. 5.<br />

1.<br />

2.<br />

3.<br />

Mascaras<br />

- fake it ‘til<br />

you make it!<br />

4.<br />

Got short <strong>and</strong> sparse lashes? Not to<br />

worry! We can make those babies<br />

transform into beautiful lush lashes<br />

as quickly as you can say the word<br />

“mascara”. The technology that is<br />

being pumped into mascaras these<br />

days means we can rock a big fl utter<br />

<strong>and</strong> create that false lash effect.<br />

5. 6.<br />

1. Maybelline The Falsies Vlum Express<br />

Mascara, RRP $19.95, 2. Calvin Klein CK<br />

One Volumizing Mascara, RRP $30.<br />

1.<br />

2.<br />

150 www.cosbeauty.com.au

skin<br />

4<br />

steps to<br />

beautiful skin<br />




Packed full of antioxidants <strong>and</strong> collagen-promoting<br />

ingredients, Love Life skincare is formulated to deliver<br />

smoother, healthier <strong>and</strong> younger looking skin in just<br />

four easy-to-use products. While the steps involved may be<br />

simple, the science behind the range is anything but.<br />

Inspired by beauty industry maven Val Glover-Hovan,<br />

<strong>and</strong> developed in conjunction with one of Australia’s<br />

leading scientists, ingredients in the Love Life range have<br />

been selected for their ability to help protect skin cells from<br />

environmental damage, support skin metabolism, promote<br />

rejuvenation <strong>and</strong> achieve a more beautiful complexion.<br />

Designed to work in harmony with the skin, Love Life<br />

skincare is a potent yet gentle range that combines the best<br />

of science with the power of nature. csbm<br />

1. Moisturise & protect<br />

Perfect Day – Anti-Ageing Moisturiser<br />

Moisturising is crucial when it comes to warding off fi ne<br />

lines <strong>and</strong> keeping skin well hydrated. A potent herbal<br />

formula, Perfect Day Moisturiser helps to reduce the<br />

signs of ageing <strong>and</strong> enhance skin appearance. The<br />

formula contains a complex of collagen-promoting<br />

glucosaminoplycans <strong>and</strong> galactomannans; linoleic<br />

acids, which assist rapid penetration while helping<br />

to fi rm the skin; <strong>and</strong> stem cells of apple fruit to help<br />

stimulate the renewal of skin cells.<br />

3. Bright eyes<br />

Eyes Best – Exotic Eye Gel<br />

Eye creams are essential for helping to keep the thin,<br />

delicate under-eye area hydrated <strong>and</strong> smooth. This<br />

potent eye cream helps to reduce the dark areas<br />

under the eyes <strong>and</strong> the appearance of crow’s feet.<br />

The formula contains Tamanu oil, which is known for<br />

its healing properties, <strong>and</strong> a mix of herbs to stimulate<br />

collagen synthesis. It’s also fortifi ed with kiwifruit<br />

enzymes, antioxidant grape seed, Vitamin E <strong>and</strong><br />

green tea.<br />

2. Repair & renew<br />

Perfect Night – Retinol Renewal Complex<br />

Serums typically penetrate the skin deeper than creams,<br />

<strong>and</strong> contain more active ingredients to target specifi c<br />

beauty concerns. The Perfect Night Retinol Renewal<br />

Complex is a soothing night serum that addresses<br />

ageing concerns. The formula contains Vitamin A to<br />

enhance collagen synthesis; linoleic acid to promote<br />

<strong>and</strong> maintain skin health; Vitamin E <strong>and</strong> Tamanu oil to<br />

help restore skin health; seabuckthorn seed oil as an<br />

antioxidant; passionfl ower to soothe <strong>and</strong> calm; <strong>and</strong><br />

licorice to help reduce infl ammation <strong>and</strong> irritation.<br />

4. Lighten up<br />

<strong>Beauty</strong> Light Lightening Cream<br />

Hyperpigmentation can develop due to a variety of<br />

reasons – from sun damage <strong>and</strong> age to hormones during<br />

pregnancy – <strong>and</strong> is a common beauty concern. Alpha<br />

fruit acids <strong>and</strong> citrus extract in the <strong>Beauty</strong> Light Lightening<br />

Cream target darker skin spots to help reduce their<br />

appearance. The cream has a broad-spectrum sunscreen<br />

to help prevent further pigmentation <strong>and</strong> UV damage, as<br />

well as the triple action of urva-ursi (bearberry), arbutin<br />

<strong>and</strong> zinc glycinate to help stop the browning action of<br />

melanocyte production.<br />

www.cosbeauty.com.au 151

eauty & spa<br />

Rock Legend<br />





Jane iredale mineral makeup, a proven <strong>and</strong> trusted<br />

br<strong>and</strong> for 20 years, is recommended by thous<strong>and</strong>s of<br />

dermatologists, plastic surgeons <strong>and</strong> skin therapists<br />

around the world. It blurs the line between skincare <strong>and</strong><br />

makeup; cosmetics become an integral part of the solution<br />

to healthy skin, creating a more luminous, even <strong>and</strong> fl awless<br />

complexion.<br />

jane iredale was one of the fi rst br<strong>and</strong>s to offer pure mineral<br />

makeup. Indeed, it represents a refi nement of conventional<br />

makeup <strong>and</strong> has revolutionised a new makeup industry that<br />

combines beauty with skin health.<br />

In an industry that’s constantly changing <strong>and</strong> being<br />

bombarded by new products <strong>and</strong> ‘must-have’ ingredients,<br />

the jane iredale mineral makeup range continues to st<strong>and</strong><br />

the test of time <strong>and</strong> shine out from the crowd with its quality<br />

cosmeceutical ingredients <strong>and</strong> pure micronised minerals.<br />

152 www.cosbeauty.com.au

eauty & spa<br />

The<br />

jane iredale<br />

difference<br />



jane iredale uses the highest quality<br />

ingredients available with the most<br />

current technology to ensure optimal<br />

performance, coverage, application<br />

<strong>and</strong> texture. Products have broad<br />

spectrum sun protection <strong>and</strong> all<br />

vitamins <strong>and</strong> antioxidants used are<br />

pharmaceutical grade <strong>and</strong> certifi ed<br />

organic where available.<br />


Multi-tasking products, including<br />

the signature Amazing Base,<br />

PurePressed Base, Glow Time <strong>and</strong><br />

Dream Tint, provide four functions in<br />

one: foundation, concealer, sunscreen<br />

<strong>and</strong> active skincare ingredients.<br />


Because only pure mineral pigment<br />

is used in jane iredale products, with<br />

no fi llers such as talc, the foundations<br />

<strong>and</strong> concealers achieve exceptional<br />

coverage <strong>and</strong> require minimal<br />

touch-ups.<br />


All jane iredale foundations form a<br />

protective barrier on the skin that<br />

allows it to breathe <strong>and</strong> function<br />

normally. Lab tests confi rm that<br />

all products in the range are<br />

non-comedogenic <strong>and</strong> do not<br />

block pores.<br />


Five jane iredale products<br />

have earned the US Skin<br />

Cancer Foundation’s Seal of<br />

Recommendation. To earn this<br />

seal, a manufacturer must provide<br />

scientifi c data showing that its<br />

products suffi ciently <strong>and</strong> safely aid<br />

in the prevention of sun-induced<br />

skin damage.<br />


Minerals used in jane iredale products<br />

bond together upon application so<br />

they resist running, creasing <strong>and</strong><br />

smearing.<br />


All jane iredale products are safety<br />

tested, allergy tested, clinically tested<br />

<strong>and</strong> dermatologist tested to ensure<br />

avoidance of any ingredients that may<br />

be skin sensitisers.<br />


One of the jane iredale philosophies<br />

is to include soothing ingredients<br />

that help measurably contribute<br />

to skin health. The range is gentle<br />

enough to use on skin postprocedure,<br />

even on compromised<br />

skin after laser resurfacing.<br />


Where preservatives are needed, jane<br />

iredale uses a combination of natural<br />

preservatives, <strong>and</strong> always excludes<br />

parabens <strong>and</strong> phenoxyethanol.<br />


All jane iredale minerals are tested<br />

under laboratory conditions. Results<br />

show that there are no nano-size<br />

minerals in any of our products.<br />


There is a wide variety of foundation<br />

shades available to satisfy the<br />

needs of women’s skin in more<br />

than 40 countries.<br />


The nature of high quality minerals<br />

is to interact with light. This is<br />

what gives them their ‘soft-focus’<br />

effect. jane iredale offers a variety of<br />

foundations in a range of fi nishes –<br />

from sheer to full <strong>and</strong> luminescent<br />

to velvety.<br />

www.cosbeauty.com.au 153

eauty & spa<br />

Get prepped <strong>and</strong> pretty with this<br />

collection of the latest <strong>and</strong> greatest<br />

products. Ricky Allen reports.<br />

Fragrant<br />

concoctions<br />

Daisy Dream by Marc Jacobs RRP<br />

$90 for 50ml eau de toilette. Housed in<br />

a collectable beautiful bottle, this new<br />

Daisy fragrance delivers a distinctive<br />

floral <strong>and</strong> fruity scent. It brings out<br />

a sense of the youthful, spirited <strong>and</strong><br />

romantic side in all who wear it.<br />

Skincare<br />

Philosophy Miracle Worker Overnight RRP $80. This night cream contains<br />

a blend of vitamin, peptides <strong>and</strong> algae to help treat <strong>and</strong> hydrate all skin<br />

types overnight. Improvements start to appear almost overnight <strong>and</strong><br />

continue over time. (1)<br />

Dermalogica Dynamic Skin Recovery SPF50 RRP $87.50. Containing<br />

high-powered peptides, hyaluronic acid <strong>and</strong> algae extracts, this combo<br />

moisturiser <strong>and</strong> sunscreen is a very effective anti-ageing tool. It works on<br />

dryness, pigmentation <strong>and</strong> sun damage. (2)<br />

La Prairie Cellular Mineral Face Exfoliator RRP $145. This exfoliator<br />

tightens pores <strong>and</strong> increases radiance without any damage to the skin. The<br />

rosa centifolia flower <strong>and</strong> glycerin ensure skin stays soft <strong>and</strong> supple after<br />

each use. (3)<br />

La Prairie Foam Cleanser RRP $85. This water-activated cleansing mousse<br />

cleans <strong>and</strong> hydrates while not stripping the skin of nutrients. (4)<br />

1.<br />

2. 3. 4. 5.<br />

154 www.cosbeauty.com.au

1.<br />

Foundation<br />

highlights<br />

L’Oreal Paris Nude Magique Eau<br />

de Teint in Pure Ivory RRP $24.95. (1)<br />

Mirenesse Collagen Cushion<br />

Compact Airbrush Liquid Powder<br />

in Mocha RRP $79. (2)<br />

Gatineau Serenite Soothing Concentrate RRP $104. This intensive<br />

concentrate can be used on even the most sensitive of skins to help<br />

normalise texture <strong>and</strong> appearance. (5)<br />

Olay Regenerist Revitalising Night Cream Moisturiser RRP $32.49. This<br />

helps to renew the skin’s surface layers <strong>and</strong> reduce fine lines <strong>and</strong> wrinkles.<br />

Skin feels smoother, softer <strong>and</strong> much more hydrated. (6)<br />

Kiehl’s Micro Blur Skin Perfector RRP $47. This skin perfector contains lipo<br />

hydroxy acid <strong>and</strong> bark <strong>and</strong> lentil extracts to smooth the appearance of the<br />

skin <strong>and</strong> minimise the appearance of pores. (7)<br />

Jurlique Nutri-Define Superior Retexturising Facial Serum RRP $145. Made<br />

from natural botanicals, this facial serum contains an innovative liposomal<br />

technology which delivers deep hydration with no skin irritants. (8)<br />

La Mav Organic BB Crème RRP $39.95. This delivers hydration, sun<br />

protection <strong>and</strong> concealer, as well as mattifying the complexion. Suitable for<br />

all skin types, even sensitive. (9)<br />

2.<br />

6. 7. 8. 9.<br />

www.cosbeauty.com.au 155

eauty & spa<br />

1.<br />

2.<br />

Hair with fl air<br />

John Frieda Frizz Ease Extra<br />

Strength 6 Effects Serum RRP<br />

$16.99. A beautiful hair serum for<br />

hydrating the hair <strong>and</strong> eliminating<br />

frizz as well as smoothing <strong>and</strong><br />

taming hair. Apply on wet hair. (1)<br />

L’Oreal Elvive Fibralogy<br />

Thickening Shampoo RRP $5.95.<br />

This shampoo is part of the<br />

range of new thickening hair care<br />

products which instantly make<br />

even the thinnest hair look thicker<br />

while helping treat the cause of<br />

the thinness at the same time. (2)<br />

Nail it!<br />

DB Quick Colour Nail Polish in<br />

Aubergine RRP $7.99 (1)<br />

Rimmel Colour Rush 60 Second Nail<br />

Polish in Midnight Rendezvous RRP $7.95 (2)<br />

Giorgio Armani Nail Lacquer in<br />

No. 300 M<strong>and</strong>arine RRP $40 (3)<br />

Kosmea Rose H<strong>and</strong> Cream RRP $19.95 (4)<br />

1.<br />

2.<br />

3.<br />

4.<br />

High brow<br />

DB Extend A Brow<br />

RRP $12.99 (1)<br />

Inika Certifi ed<br />

Organic Brow Pencil<br />

RRP $29 (2)<br />

1.<br />

2.<br />

2.<br />

4.<br />

3<br />

Latest in lippie<br />

Estee Lauder Pure Colour Envy Lipstick in Rebellious<br />

Rose RRP $50 (1)<br />

Giorgio Armani Rouge Sheer in Coral RRP $52 (2)<br />

Giorgio Armani Rouge Sheer in 305 Coral RRP $52 (3)<br />

Lanolips Banana Balm 3 in 1 RRP $15.95 (4)<br />

Issada Mineral Lip Crayon RRP $48 (5)<br />

Rimmel Lasting Finish Colour Rush Intense Colour Balm in<br />

Drive Me Nude RRP $12.95 (6)<br />

1.<br />

5.<br />

6.<br />

156 www.cosbeauty.com.au

JOSEPH<br />

MOURAD<br />

Hair & <strong>Beauty</strong><br />

AWARD<br />





Joseph Mourad’s<br />

styling, colour <strong>and</strong><br />

hair extension<br />

techniques are<br />

sought the world<br />

over, with celebrity<br />

clients including<br />

singer <strong>and</strong> host<br />

Mel B <strong>and</strong> Grammywinning<br />

recording<br />

artist Mya.<br />


PRICES<br />

475 New South Head Rd Double Bay Sydney<br />

02 9328 2277<br />



eauty & spa<br />

Buff your body<br />




Winter has no doubt already left its mark – in the form of dry,<br />

dehydrated skin in need of some tender loving care in time for<br />

the body-bearing summer ahead. So how best to rehydrate <strong>and</strong><br />

reclaim your radiance?<br />

According to beauty expert Nicole Gruodiene from Nicole’s <strong>Beauty</strong> Salon<br />

in Sydney’s Double Bay, now is the optimal time to reclaim your radiance.<br />

Gruodiene believes a pre-summer treatment to combat dullness <strong>and</strong><br />

skin dehydration will remove the signs of mid-winter hot showers <strong>and</strong> airconditioned<br />

offi ces. ‘You may notice dry or fl aking skin, dull skin tone, <strong>and</strong><br />

more prominent wrinkles have appeared,’ she says.<br />

Nicole recommends using the next few months to restore your body’s<br />

moisture balance <strong>and</strong> treat it to some rejuvenating salon visits. ‘You should<br />

have an exfoliating <strong>and</strong> moisturising routine in place at home but a salon<br />

treatment can really boost your results,’ she says.<br />

‘Using a sea salt scrub to exfoliate the whole body will brighten tone, while<br />

stimulating blood fl ow <strong>and</strong> circulation,’ she adds. Indeed, exfoliation will help<br />

your skin rid itself of dead or damaged cells <strong>and</strong> help it absorb moisture <strong>and</strong><br />

nutrients more effectively. Exfoliation of the top layer has also been shown to<br />

stimulate the production of new collagen.<br />

Massage is a great way to stimulate lymphatic drainage <strong>and</strong> circulation<br />

in your body. ‘A Swedish massage uses a variety of techniques specifi cally<br />

tailored to promote muscle relaxation <strong>and</strong> ease tension by applying pressure<br />

against deeper muscles <strong>and</strong> bones,’ Gruodiene explains. ‘Even a simple,<br />