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.

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

ISSUE 65 • AUG-OCT 2014


















biggest loser




acTual rhiNoplasTy paTiENT’s oF dr William mooNEy


ENT & Facial cosmETic surgEoN

sydNEy’s rhiNoplasTy spEcialisT


• Laser Therapy • skin Care

• CosmeTiC injeCTabLes

Ph: (02) 9389 4497


EXc E llENc E

sydNEy ’ s rhiN oplasT y spE cialisT

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


& Implant Surgery


Centre for cosmetic, reconstructive

and implant dentistry

Dr Sarkis Nalbandian completed his Bachelor of Dental Surgery with

Honours in 1983 and Diploma in Clinical Dentistry (Oral Implants) in

2000 at The University of Sydney. He also completed his Masters in

Prosthodontics in 2004 at the prestigious King’s College, University

of London with distinction. He is a fellow of the Royal Australasian

College of Dental Surgeons.

B.D.S. (Hons.) Uni.Syd.


Grad. Dip. Clin. Dent. (Oral Implants) Uni.Syd.

M.Clin.Dent (Prosthodontics) King’s College Uni. London

Dr Nalbandian specialises in Dental Implants and Prosthodontics

for treating simple to complex dental, functional and aesthetic


He lectures on topics including Dental Implantology, Prosthodontics

and Implant Surgery.

He maintains a specialised practice in Sydney limited to Aesthetics,

Prosthodontics & Implant Surgery.

Dr Sarkis Nalbandian

B.D.S. (Hons.) Dip. Clin. Dent. (Oral Implants) Uni.Syd. FRACDS

M.Clin.Dent (Prosthodontics) King’s College Uni.London

Designer Smiles

17 Gerard Street Cremorne NSW 2090

For more information call

02 9953 4189

Fax 02 9953 4358





Reduce the signs of ageing with

natural-looking results for a

refreshed and youthful appearance


Dr amira Sanki

Plastic Surgeon


FRACS (Plastics)

PhD (USyd)










Plastic Surgery


Dr John Flood

Look and feel younger

Dr John Flood is a fully

qualified plastic and

reconstructive surgeon

with more that 15 years’

experience in cosmetic

plastic surgery of the

face, breast and body,

specialising in eyelid

surgery and liposuction.

He trained in Sydney

and Texas, USA and also

has a special interest in

stem cell therapy for

regenerative medicine.

Mona Vale, Hornsby & Greenwich

Ph: 9476 8066

Look and feel good, from top to toe

Dr Joseph Georghy & Dr Vera Georghy have

over 65 years of clinical experience between them.


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

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

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

pigmentation, cellulite, scars and keloids.

Dr Georghy has developed HelioTherm ® , an exciting new procedure

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

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

with no downtime. Call today for more information.

Other services include

• Superbug acne therapy

• Scarless facelift

• HelioTherm ® Facelift

• Wrinkle reduction

• LipoSculpture

• Stretch mark treatment

• Breast reduction (non-surgical)

• Hair-laser stimulation

• Skin cancer treatment

• Labiaplasty & Hymenoplasty

• Excessive sweating correction

• Ultroid non-surgical haemorrhoid



Discover the smile of your dreams thanks

to dental services from Dr Vera Georghy

• Painless dentistry

• Porcelain veneers, crowns and bridges

• White fi llings

• Old fi llings replaced

• Preventative dentistry

• Home bleaching

• Mouth guards



Cleaning, scaling &




AMEC Specialist Surgeon (Ljubljana, Slovenia)

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

of the European Society of Aesthetic Surgery,

Cosmetic Physician; FFMACCS, Degree in Anti-

Aging & Regenerative Medicine (Germany) Member

of the American Academy of Cosmetic Surgery


Dental Surgeon, University of Adelaide,

Fellow, Diplomate & Lifetime Member in

the World Congress of Minimally Invasive

Dentistry (WCMID).

Voted Clinician of the Year 2009 San

Francisco, USA



313 Pacifi c Highway

North Sydney NSW 2060 (Opposite Hazelbank Rd)

02 9956 7200



Skinboosters deliver deep skin hydration by holding water within

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

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

about Skinboosters or visit WWW.WRINKLECLINICFINDER.COM.AU

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Regen PRP pioneering platelet rich plasma since 2003

RegenLab has been pioneering the use of autologous platelet rich plasma for skin cell renewal

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The proven Regen ACR PRP system concentrates powerful growth factors contained in our

blood, before reinjecting them back into the skin.

By harnessing the growth factors contained in our blood, it’s possible to accelerate and

increase tissue regeneration by stimulating collagen production, stem cell migration,

differentiation, and proliferation, and stimulation of new blood vessels, nutrients, antioxidants

and the other components of the extracellular matrix. • • 1800 201 760

Body Balance

Dr John Flynn


Dr John Flynn

skin clinic

Reshaping can create


the look you want

skin clinic

Breast augmentation can

enhance the natural size

and shape of your breasts

Refi nement in Cosmetic Surgery

With breast augmentation, your natural form can be

enhanced and complemented. This results in a balanced

and symmetrical effect that suits your individual body type

and achieves a feminine silhouette.

Liposuction to Shape and Contour

With liposuction, Dr John Flynn can reshape and contour

your form to achieve balance between your body’s

proportions. Areas such as the abdomen and inner and

outer thighs respond particularly well to this procedure.




Dr John Flynn

M.B., B.S., Dip. R.A.C.O.G., F.R.A.C.G.P.

Dip. P. Dermatology., F.A.C.C.S.

Fellow of the Australasian College of Cosmetic Surgery

Certifi ed by the American Board of Laser Surgery

Dr John Flynn has over 20 years of experience as

a medical practitioner on the Gold Coast

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For more information or to make an

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Dr John Flynn

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26 Editor’s letter

28 Contributors

30 Newsfront

54 Column: A medical history

of Queen Anne

121 How to subscribe

170 Directory


38 Change the way you age

Could stem cells signify the

elixir of youth?

48 Are you getting the best


58 The biggest loser syndrome

Surgery after massive weight loss

61 8 ways to keep the weight off

76 5 essential factors

of breast augmentation

94 Feed your face

Welcome to the next generation

of superfoods

140 Why quality skincare works

Results-driven medical-grade


148 Makeup marvels

Products to transform your face


62 Body contouring after

massive weight loss

Complete your weight

loss journey

68 A woman’s insight

Mummy makeover surgery

70 The “Western Society”


A new treatment approach to

metabolic syndrome

tattoo removal

72 The latest in laser

tattoo removal

Superior results in fewer


138 Rethink the ink

Do you have tattoo regret?


82 The saline solution for

breast enhancement

The benefits of saline implants

84 Breast surgery for men

and women

86 Natural-looking contours

Recreate more youthful breasts

intimate surgery

88 Take action and explore

your options

90 Vaginal tightening without


A new, surgery-free

laser treatment

92 Girl talk

Improve vaginal comfort,

function and aesthetics


98 Beauty through the ages

Look your best at every age

104 Facelifting

The science and expertise

behind natural-looking results

106 Lowering the hairline for

facial harmony

108 Options in facelifting

112 Minor surgeries,

major results

118 An educated approach

All about anti-wrinkle injections

122 Turn back the clock with PRP


114 Nose for beauty

The art and science of rhinoplasty



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Each pack LOVE life contains:

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116 A true smile

Aesthetic and functional

smile rejuvenation


124 The gold standard in skin


A closer look at Fraxel laser

126 Revitalise your skin

Look younger and more

radiant for longer

128 Connecting the DOTS in

skin rejuvenation

Fractionated laser treatment

130 Deep hydration

Improve smoothness, elasticity

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132 3-dimensional volume

Using light-based technology to

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134 Dependable results

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144 Cosmeceuticals

hair reduction

136 Finally, hair removal

for blondes

Permanent hair reduction

for fair-haired people

beauty & spa

151 4 steps to beautiful skin

152 Rock legend

Makeup that’s good for

your skin

154 Beauty buzz

The latest and greatest

beauty products

158 Buff your body

Reclaim your radiance

160 Body work

Protect your skin from the

winter elements

162 Go with the faux

Keep your gold summer

glow all year long

166 Luscious locks

168 Editor’s favourites

cover stories

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

ISSUE 65 • AUG-OCT 2014

















biggest loser




58 The biggest loser

syndrome – surgery after

massive weight loss

76 5 things you need

to know about breast


94 What to eat for

amazing skin

148 Beauty alert!

Makeup marvels

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Welcome to the 65th issue of Cosmetic Surgery &

Beauty Magazine. Since the launch of this magazine

16 years ago we have maintained our position

as Australia’s most trusted resource for cosmetic medicine

and surgery.

We pride ourselves on our relationship with our readers, and

our knowledge of what you’re searching for. We will continue

to deliver you authoritative, comprehensive articles in all

formats – both paper and digital. To this end, in addition to

the print version, CSBM is now available for free online at In the online version you’ll also fi nd

loads of exciting extras, such as “behind the scenes” videos

of the making of the magazine with the Bella Media team plus interactive features

and links.

And it doesn’t stop there – on you’ll fi nd a whole lot of extra

content, including product and treatment road tests, blogs and beauty updates. The site

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

loyal readers. There are hundreds of unique articles online, a comprehensive before and

after photo gallery and a handy directory of practitioners and services – and it continues

to grow each day.

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

take great pride in bringing you independent, unbiased and informative articles. In this

issue of CSBM we examine the topics making headway both here and around the globe.

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

surgery after massive weight loss. We also highlight the fi ve essential considerations of

breast implants on page 76, and delve into the many benefi ts of medical-grade skincare

on page 140.

We also bring you the latest in beauty, body and hair care from page 148, as well as

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

Connect with us on Facebook and Instagram to get real-time updates and share your

feedback on Happy reading!

Michelle Kearney


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

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

the written authorisation of the publisher. All reasonable efforts have been made to trace copyright holders. All manuscripts and

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

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

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

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

not necessarily received treatments described in this magazine.

Advertising Policy ACSBM follows and upholds the Australian Competition and Consumer Commission (ACCC) Guidelines to

Advertising Medical Services, the Therapeutic Goods Administration (TGA) advertising regulations for therapeutic goods and services,

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

for publication follow these guidelines. Copies of these guidelines are available from the individual agencies and boards. ACSBM

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

liability for statements contained in their advertising copy, and hold harmless and indemnify ACSBM, Bella Media, and offi cers,

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

advertising. Advertisers accept these terms and responsibilities when signing an advertising contract with ACSBM.

Read the online edition at

Issue 65

AUG - OCT 2014


Michelle Kearney

Editorial Director

Aimée Surtenich

Production Coordinator

Camila Kawashita

Art Director

Debbie Pilarinos


Caitlin Bishop, Tara Casey,

Camila Kawashita

Aimée Surtenich


Debbie Pilarinos, ShutterStock

Distribution &

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Bill Dunk

Phone 02 9398 2755 Fax 02 9398 2855


Advertising Enquiries

Michelle Kearney

Phone 02 9398 2755 Mob 0419 624 246


Editorial Enquiries

Michelle Kearney, Aimée Surtenich

Phone 02 9398 2755 Fax 02 9398 2855


Produced & Published by Bella Media

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Michelle Kearney

Chief Operating Officer

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Public Relations, Marketing

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Office address

Level 1, 42a Frenchmans Road

Randwick, NSW, 2031

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

All ‘before and after’ photographs in

Cosmetic Surgery & Beauty Magazine

articles are of genuine patients. It is

important to understand that they represent

one person’s experience and there is

no guarantee that any other patient will

experience similar results.


Expertise is Everything

More than 30 Years Experience in Cosmetic Plastic Surgery

Specialising in all Facial, Breast and Body Surgery

The Cosmetic and

Restorative Surgery Clinic

20 Manning Road,

Double Bay

02 9362 7400

Fax: 02 9328 6036


Dr Darryl J Hodgkinson


American Board of Plastic Surgery

Cosmetic Plastic Surgeon

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

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







Ricky Allen Dr Buddy Beaini Dr John Flood

Dr John Flynn Dr Joseph Georghy Dr Paul Gerarchi Val Glover-Hovan

Dr Darryl Hodgkinson Dr Jim Leavesley Dr Steven Liew Dr Richard Maxwell

Dr William Mooney Dr Colin Moore Dr Sarkis Nalbandian Dr Warwick Nettle

Dr Oseka Onuma Rita Porreca Dr Amira Sanki Terri Vinson


Brought to you by MD Cosmedical Solutions

Total Facial Makeover

Minor Surgical & Local Anaesthetic Procedures

Astarte Threadlift Facelifts

Non-Surgical Mini Facelifts & Neck lifts

• Revolutionary new Absorbable Threads

• Simple non-surgical clinic procedure

• Minimal discomfort or downtime

• No general anesthesia or skin incisions

• Immediate results lasting 3 – 5 years

• Treatment for Facelifts, Neck Lifts, Brow

Lifts, Jowl Correction, Cheek Augmentation BEFORE AFTER

Eyelid Hooding Surgery

Blepharoplasty Eyelid Surgery

• Treatment of unsightly Eyelid Hooding

• Minor surgery with minimal bruising,

discomfort or downtime

• Treatment performed under light sedation

& local anaesthetic

• No hospitalization or general aneasthetic

• May be combined with Threadlift Facelift

Bat Ear Correction Procedure

Non-Surgical Bat Ear Correction

• Reduction of unsightly Bat Ears

• Simple procedure utilizing the most

advanced techniques

• Minimal bruising, discomfort or downtime

• No risks of unsightly scars

• Treatment performed under local anaesthetic

• No hospitalization or general aneasthetic

Why choose

MD Cosmedical Solutions …

• Over 5,500 Facelift Treatments

• Over 35,000 Laser Treatments

• 100% Safety Record

• Renowned Worldwide Reputation

• Australia’s Leading Cosmetic

Medical Team





Anti-Ageing &

Rejuvenation Specialties

• Threadlift Facelifts

• Thermage CPT Facelifts

• Eyelid Hooding Surgery

• Bat Ear Correction Procedures

Fraxel Repair CO2 Laser

• Fraxel Repair Dual Laser

• Fraxel Restore Laser

• Wrinkle Injections & Fillers

• Vein Removal Lasers

• Lipomedix Body Contour

• Mesotherapy Injections

• Acne & Scar Treatments

• Pigment Treatments

• Stretch Marks Treatments

• Excessive Sweat Injections

• Tattoo Removal

Cosmetic Tattooing

• IPL Photorejuvenation

• Laser Hair Removal

• Hair Stylists

• Make-Up Courses

NEW Blepharoplasty Eyelid Surgery



Specialist Doctors & Registered

Nurses performing cosmetic medical

treatments Dr Buddy Paul Beaini


Australia’s Leading Cosmetic Clinics


Sydney CBD Sheraton & Wahroonga

P. 1300 885 808

Award winning Threadlift Facelift, Thermage CPT & Fraxel Clinics




The Facts of Light:


Sponsored by Cynosure

The two-day event on 28-29 June attracted more than

100 cosmetic practitioners convened at Point Piper

Yacht Club in Sydney for the Facts of Light Advanced

Symposium. It featured renowned dermatologists and

doctors from across Australia who spoke on topics

including picosecond laser tattoo removal, fractional

laser for skin rejuvenation, a comparison of ablative and

non-ablative laser techniques, and a novel approach to

treating hair removal, acne scar removal and treatment

of gynaecomastia.



On September 20, 2014, Advanced Skin Technology, a

distributor of clinical skincare products and treatments,

celebrates its 20th anniversary. Founder and managing

director Trish Winchester established AST in 1994. Trish’s

foresight on what trends were

evolving in the anti-ageing sector

in the USA saw her embark on a

journey to distribute Australia’s fi rst

medical grade glycolic acid range

in Australia. Trish then pioneered

and developed ‘Aspect’ and

‘Aspect Dr’, her own Australianowned

cosmeceutical range that

has become one of Australia’s

bestselling skincare brands within

the cosmeceutical market.

Look Good...Feel Better

Cancer fundraising & awareness

campaign – Dream Week

Dream Week: 7 Days of Hope, held on 31 August to

6 September, 2014 is a national campaign engaging

partners of the cosmetic, retail and publishing

industries to raise awareness and funds for the Look

Good…Feel Better program.

The week-long campaign is an opportunity for the

Australian public to help the 10,000 cancer patients

who will attend a Look Good…Feel Better workshop

this year. Here’s how you can get on board:


$1 from every lipstick or lip gloss sold at David Jones

and Myer stores nationally will be donated to Look

Good…Feel Better.


designed carry bags, coin purses, makeup bags,

bracelets, pins and umbrellas will be available to

purchase via a pop-up outpost at Westfi eld Sydney

City. You can also purchase a pin at two information

posts in Westfi eld Bondi Junction and Chadstone in

Melbourne, as well as Terry White chemists around

the country.

SOCIAL MEDIA Supporters are encouraged

to show support of the 24-year strong program by

engaging followers and fans to get involved in planned

campaigns on Facebook, Twitter and Instagram.

Connect with @LGFBAustralia #dreamweek14


ICAPS REPORT by Dr Darryl Hodgkinson

Twenty-fi ve of the world’s top

plastic surgeons convened

for the three-day International

Consortium of Aesthetic

Plastic Surgeons meeting in

Vienna, Austria on 11-17 May,

2014. Two surgeons from

Australia participated, myself

and my close associate Dr

Bryan Mendelson.

Some of the latest trends were re-evaluated. Dr W Wu

Dr Hodgkinson (right) with fellow ICAPS

members from Italy, Jordan and Austria

of Singapore presented the use of fat grafting around the

forehead and implants to advance the chin in Asian patients

while Dr Mendelson and Dr Martin from the United States

emphasised augmentation enhancement of the brow and

periorbital regions to improve rejuvenation of the upper face.

Various techniques for face and neck lifting by surgeons

from the US and Europe were discussed and it was reemphasised

that no single technique alone suffi ces. Both

assessment and performance of various techniques by

experienced surgeons (greater than 25 years) produce

gratifying results for patients and surgeons alike. The tight,

hard face look is now avoidable and no longer acceptable

for surgeons with adequate experience and expertise using

a variety of techniques.

Dr De La Pena of Mexico, who inspired me to embrace

the INFINI microneedling radiofrequency treatments,

updated his continuing success with this technology.

The major topic in rhinoplasty also highlighted the need

for experience and expertise in individualising the result.

In particular ethnic noses, especially Middle Eastern and

South American noses were discussed with the emphasis

on different aesthetic goals and anatomical variations

between different ethnic groups.

Other topics included fat grafting of the face as an

adjunct for surgical procedures and buttock implants,

which are becoming increasingly popular in Italy where the

quartz Silimed implant is preferred. Abdominoplasty (tummy

tucks) and total body lifts after massive weight loss are also

a growing area of plastic surgery.

By this collegiate contact and interaction with the leaders

in our fi eld and staying on the leading edge of plastic surgery

and non-surgical equipment, patients benefi t by being

offered the very latest surgical techniques in the industry.

“WE MADE $7000







1300 667 374


Australia India

Travel & Tourism

Council (AITTC)

Creates New Role

for Medical Tourism

Venus Concept

& The Global

Beauty Group

VLounge Event

Friday the 13th of June marked the

VLounge Event for aesthetic medical

practitioners, hosted by Venus Concept

and The Global Beauty Group. Held

at the Park Royal Darling Harbour in

Sydney, the exclusive event delved into

the science behind the Venus Freeze

and Venus Legacy, two non-invasive

body contouring systems.

Internationally recognised aesthetic

physician Dr Tami Meraglia from the

US gave an informative presentation on

integrating technology to optimise the

performance of aesthetic practices.

Dr Hemani Thukral, managing director of MyMedicalChoices, has been

named as Director of Medical Tourism for the AITTC, a newly created role

to help facilitate Australians considering India as a suitable destination for

medical treatment.

Since its establishment in 2012, the AITTC has been contributing to the

leisure and tourism sectors and now adds medical tourism which is a new

and growing segment of the industry.

‘My vision is to devlelop medical tourism in a systematic manner through

ongoing dialogue and collaboration between Australia and India to achieve

better outcomes for Australians seeking treatment in India and benefi t

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

raise the bar for the quality of care provided to patients internationally and

acoss the nation.’


Sydney International Spa & Beauty Expo

Held on 23-24 August at the Sydney Exhibition Centre, Glebe Island,

the Sydney International Spa & Beauty Expo is Australia’s largest

event for the spa and beauty industries. Spa and beauty professionals

have a unique opportunity to source and experience the latest beauty

products, treatments, ideas and equipment from Australia’s largest

gathering of leading brands and suppliers.

See for more information.

2014 Skin Symposium

Held across four Australian states from 25 August, the 2014 Skin

Symposium, run by Face Facts, is a one-day event delving into skin

analysis and health. Gay Wardle, a leading educator in the fi eld of

advanced skin analysis, will host the Symposium. The program is

designed to give attendees a holistic, comprehensive and proactive

insight into anti-ageing and optimising skin health.

For more information contact 02 8424 6625

3rd International Symposium

on Corneotherapy 2014

Held on 17-19 November, 2014 at the Ambassador Hotel, Kaohsiung,

Taiwan, the guiding theme for the symposium will be The Compromised

Skin & Corneotherapy. Keynote speakers include Prof Lars Norlen

(Sweden) and Dr Hiroshi Ikeno (Japan), as well as presentations by

chairperson of the International Association for Applied Corneotherapy

(IAC) Florence Barrett-Hill and other esteemed IAC members.

See for more information.


The Australasian College of Cosmetic Surgery

Raising Standards,

Protecting Patients

Dedicated to quality, ethical

and responsible practice.

Accreditation is Important

All Fellows of the Australasian College of Cosmetic

Surgery (FACCS) are specifically trained in cosmetic

surgery and are required by the College to maintain

their skills through a Continuing Professional

Development programme.

All Fellows of the Faculty of Medicine (FFMACCS)

are specifically trained in cosmetic medicine and

are required by the College to maintain their skills

through a Continuing Professional Development





If doctors display this Seal,

you can be assured they

comply with the College’s

exemplary standards of its

Code of Practice, available


How qualified is your doctor?

Do they have the right to display these symbols?

For further information about the College

and its members and Fellows in your state call:

1800 804 781



Non-Surgical Symposium

The 3rd Annual Non-Surgical Symposium, hosted

by ASAPS and the CPSA, descended upon Sydney this

May. Caitlin Bishop reports.

Advancements in technology, alongside a rise in

popularity of minimally invasive cosmetic treatments,

have fuelled the growth of non-surgical rejuvenation.

The Australasian Society of Aesthetic Plastic Surgery (ASAPS)

and the Cosmetic Physicians Society of Australasia (CPSA) cohosted

the third annual Non-Surgical Symposium at Sydney’s

Hilton Hotel this May.

Plastic surgeons, dermatologists and cosmetic doctors and

physicians from around the globe attended. Keynote speakers

included American dermatologists Dr Ashish Bhatia, Dr Vivian

Bucay, Dr Rebecca Fitzgerald, Dr Mitchel Goldman, Dr Hema

Sundaram and Dr Mark Nestor. As well as this, Chicago plastic

surgeon Dr Steven Dayan and Dutch cosmetic doctor Dr Tom

van Eijk shared their expertise in achieving optimum results in

minimally invasive cosmetic enhancement.

Both Dr Dayan and Dr Fitzgerald spoke on facial aesthetics,

specifically their approach to treating the ageing face, and

different methods for defining and establishing beauty

through treatment. Both speakers stressed the importance

of addressing the multiple elements of volume, texture and

support in facial rejuvenation.

‘The face is a 3D platform, and ageing affects all areas

interdependently,’ Dr Fitzgerald said. ‘In the past, fixing only the

most obvious signs of ageing was the norm, but this often left

incongruous and sometimes unnatural-looking results. Now we

look at more than just one contributing factor – sometimes bony

support is needed, rather than adding extra volume, or the empty

fat compartments need filling instead of the actual wrinkle.’

Similarly, Dr Dayan showcased his subtle approach to

aesthetic rejuvenation – emphasising the importance of striving

for natural-looking results. He demonstrated how minimal

changes can achieve significant and aesthetically pleasing

results in facial rejuvenation.

Dr van Eijk spoke about the importance of tailoring each

treatment to the patient’s aesthetic requirements. He also

demonstrated his revolutionary injectable method called

the Fern Pattern injectable technique, which is designed to

afford more movement post-procedure, and the Lip Tenting

Photos courtesy of Woodrow Wilson



technique, which helps establish natural-looking results in lip

augmentation with dermal fillers.

‘The Non-Surgical Symposium is a great opportunity to

explain the main principles of these techniques to newcomers,

as well as go over the latest approaches that I have worked on

since the last meeting,’ Dr van Eijk said.

A significant portion of the scientific program was dedicated

to laser and light therapies. Dr Bucay spoke extensively on using

radiofrequency and ultrasound energy to stimulate collagen

production, which helps lift and tighten skin. She showed how

light therapy can help firm the facial contours and give the

face a youthful lift, without the need for general anaesthesia,

incisions or extensive downtime.

Amongst the workshops, demonstrations and panel

discussions, the Non-Surgical Symposium hosted a range

of social activities to infuse the conference with a sense of

adventure, collaboration and, most of all, fun. The opening

Cocktail Reception, held at Sydney’s Ivy Bar, kicked the

conference off to a lively start, while the Gala Dinner, at Doltone

House in Darling Harbour, was an extravaganza that was the

perfect conclusion to a successful meeting. With a full program

of lectures, trade presentations and social events, the 2014

Non-Surgical Symposium helped shape the future of nonsurgical

innovations in cosmetic enhancement. csbm 35




An international faculty of renowned doctors descended on the

Gold Coast to present advancements in cosmetic medicine at

Cosmetex 2014. AimÉe Surtenich reports.

The lush hinterland of the Gold Coast played host to

this year’s annual Cosmetex conference, attracting

cosmetic surgeons, dermatologists and cosmetic

practitioners from far and wide to attend the largest aesthetic

medicine conference in the Southern Hemisphere.

Cosmetex, run by the Australian College of Cosmetic

Surgery (ACCS), has a well-earned reputation for inviting

acclaimed speakers from around the world and this

year was no exception. With a strong faculty of keynote

speakers hailing from the US, UK, Canada, Germany and

Israel, delegates were enlightened with the many and varied

informative sessions and interactive workshops.

Held at the Royal Pines Resort, the meeting spanned

three days with a main focus on non-surgical facial

rejuvenation – specifically using fillers, neurotoxins and

light-based devices to create facial harmony and beauty.

Also on the agenda was the latest developments in

energy assisted body contouring and breast surgery, as well

as a comprehensive skin health and paramedical program.

The science behind beauty was investigated at length.

US facial plastic surgeon and author Dr Steven Dayan

explored the unifying theories of beauty – and how beauty

is the most primitive language we have had throughout

time and among different species. Merging ideas from

neuropsychiatry, evolutionary biology and cosmetic

medicine, he shared his thought-provoking views on how

the tools of aesthetic medicine can result in subtle changes

that make a significant difference in the symmetry, contours

and curves of the face. ‘Less is more – but in the right

places,’ he cautioned.

Another advocate of the “less is more” approach is

Canadian plastic surgeon Dr Arthur Swift, pioneer of the

BeautiPHIcation approach where the golden ratio, or Phi,

is used to establish the most attractive results in facial

rejuvenation – for every face. He specially addressed the

idea of creating harmony in the upper face, and specific



areas such as the nose and mouth, using injectables. He

stressed that ageing occurs at different rates across all

parts of the face and that each area should be looked

at individually for the most aesthetically pleasing results.

‘There are 25 or so pockets of fat in the face – and they are

all ageing at different rates,’ he said.

Treating areas of the face individually was also a

technique shared by keynote speaker Dr Mark Nestor, a

dermatologist from the US. ‘Treating areas as “zones”,

rather than wrinkles and lines will yield far more naturallooking

and beautiful results,’ he explained. Indeed, directly

injecting a wrinkle will not create optimal results – it’s more

about building the scaffolding framework from within to add

volume which, in turn, smooths away the wrinkle.

UK cosmetic dermatologist Dr Raj Acquilla agreed, and

believes just a few small artfully placed filler injections will

result in a more beautiful appearance than using more

product in more areas of the face. ‘Applying geometric

principles of facial beauty can restore symmetry and

proportion to the face,’ he said. The aim of the game is

not necessarily to look younger, but to look better and

more beautiful.

New cosmetic medicine and technology was also

presented at the meeting, with a large exhibition hall for

companies to showcase their cutting edge products

and services.

Any Cosmetex conference wouldn’t be complete

without a must-attend social calendar, culminating in the

Mad Men-themed Gala Dinner in a bespoke outdoor setting

held at the Royal Pines.

Cosmetex provides ACCS fellows, delegates and

sponsors a unique opportunity to learn new techniques

and technology on the cutting edge of aesthetic surgery

and medicine, to network and meet old friends again, and

most importantly to work together to promote the safety

and efficacy of cosmetic medical practice. csbm 37



the way



Could stem cells represent the elixir of youth?

Dr John Flood is trail-blazing the use of stem cells in

aesthetic rejuvenation. Caitlin Bishop reports.

Stem cells signify the cutting edge in all corners of the medical world. The

ability of stem cells to regenerate and revitalise human tissue holds boundless

potential for the world of restorative and cosmetic medicine. Sydney plastic

surgeon Dr John Flood is at the forefront of these discoveries in Australia, and is

investigating the possibilities of using stem cells to alleviate pain, regenerate tissue

and rejuvenate the appearance.

He explains that an evolution in stem cell research has opened up a new realm

of opportunities. Where once the focus was on the differentiation paths of stem

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

regardless of their type, is being investigated.

‘Ten years ago, the research into stem cells revolved around adult stem cell

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

fat cells and dermal stem cells renew into dermal cells,’ Dr Flood explains.

‘Now, the thinking has evolved and we realise that adult stem cells – no matter

what their origin – will stimulate the activity of the surrounding stem cells, regardless

of their differentiation paths. The implications of this are profound. For example,

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



Case study

– are injected into the skin, they release chemical factors to increase blood vessel

formation and boost nutrient and blood infusion into the area. As well as increasing

vascularity, the injected stem cells also stimulate the surrounding stem cells – in

this case, dermal stem cells – to regenerate and rejuvenate the tissue.

Dr Flood has been using this technique in his rehabilitative patients. He uses

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

love handles, to treat damaged tissue in injured athletes.

‘We harvest the stem cells while the patient is under local anaesthetic – usually

from the love handles, where most people have pockets of fat,’ he explains. ‘The

sample is centrifuged in a lab and the stem cells are purified. Importantly, we use a

regulated and certified lab, where there is no chance of bacterial contamination or

cross contamination. The stem cells are then inserted into syringes and returned for

use in the clinic.’

According to Dr Flood, the multiple actions of stem cells in the skin – from

increasing vascularity to stimulating existing stem cells – not only helps regenerate

injured tissue but can also act as an anti-ageing elixir.

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

blood flow, stimulate activity of the surrounding stem cells and, because they renew

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

act like a conductor of an orchestra – triggering and accelerating natural tissue

regeneration, to treat the skin from within.’

Notably, the potential of stem cells is not restricted to stand-alone anti-ageing

procedures. Dr Flood says stem cells could also assist in the use of implants and

grafts in aesthetic and reconstructive surgeries. ‘Their capacity to improve vascularity

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

‘The whole process of ageing is related to wear, oxidation and inflammation –

stem cells release factors to counter this wear, reduce inflammation and fight free

radicals. Autologous adipose-derived stem cells work to regenerate the tissue,

improve vascularity, combat ageing and give rise to new fat cells to return lustre and

vibrancy to the treatment area,’ he concludes. csbm

Dr Flood works with stem cells to treat patients with

neuropathic facial pain, a condition of chronic pain that

has no detectable cause. It was one patient, who had

developed facial pain unexpectedly in her mid-20s, who

kick-started Dr Flood’s investigation into the cosmetic use

of stem cells.

She had tried a number of different therapies, including

muscular relaxant injections, to sooth her facial pain and

associated muscular contortion. However, no treatment

was successful and she developed right hemifacial

atrophy – where the tissue on one side of her face had

shrunk and degenerated.

‘We injected stem cells into her right temporal region,

from where she felt the pain originated,’ he says. ‘After

three months she could sleep better, she was taking less

pain medication and, surprisingly, her facial atrophy had

corrected and her brow spasm had resolved. We’d not

been expecting that when we started treatment.’

What’s more, the stem cell treatment also helped

rejuvenate her outward appearance. ‘The tissue appeared

fuller, and she was ecstatic,’ Dr Flood says. ‘As well as

correcting her distortion, the stem cell treatment filled

and refined her facial contours. She felt her appearance

had returned to what it was before she developed the

facial pain.’

Dr Flood and his colleagues have seen approximately

50 percent reduction in facial pain in patients after stem

cell treatment. Their work has been accepted for

publication in an international journal.

‘Many patients relied on medication because they

couldn’t bear the pain, but then they couldn’t handle

the side effects of medication,’ says Dr Flood. ‘The stem

cell injections stopped this reliance and greatly improved

quality of life. People went from not being able to sleep

and experiencing depression, to having their life back due

to pain relief.’ 39







Breast cancer is the number-one cancer for Australian women,

and with Breast Cancer Awareness month approaching, there’s no

better time to get educated. Aimée Surtenich reports.

Recent statistics show that one in eight women in Australia will be

diagnosed with breast cancer before the age of 85, and by 2020 the

number of new breast cancer cases among women is predicted to rise

by around 20 percent.

But with this omnipresence has come overwhelming support for breast cancer

awareness. The colour pink is now synonymous with breast cancer support, with

everything from supermarket products to iconic Australian landmarks taking on a

pink guise in support of breast cancer research.

Celebrities such as Kylie Minogue, Christina Applegate and Sheryl Crow who

have suffered publicly from breast cancer use their fame to become ambassadors

for the cause, putting their name to government initiatives and fundraising efforts.

what is




‘Breast cancer, like other cancers, occurs because of an interaction between the

environment and a defective gene,’ explains German anti-ageing specialist Dr

Michael Klentze. ‘Specifically, breast cancer occurs when a build up of genetic

mutations in critical genes – those that control cell growth and division, or the

repair of damaged DNA – allow cells to grow and divide uncontrollably to form

a tumour.’

‘Breast cancer, like prostate cancer, is a hormone-dependent cancer, which

can develop under oestrogen influence,’ he explains.

Although it is much more common in women, men can also develop

breast cancer.

There is a medical distinction made between early breast cancer and

secondary breast cancer. Early breast cancer is cancer that is contained within

the breast and may or may not have spread to the lymph nodes (located

under the armpit). Secondary breast cancer is cancer that has spread outside

the breast area. This distinction helps dictate the best treatment option.

‘Breast cancer is commonly treated by various combinations of surgery,

radiation therapy, chemotherapy and hormone therapy,’ says Dr Klentze. There

are a number of factors that influence the selection of breast cancer treatment.

According to Dr Klentze, these include the age and menopausal status of the

patient, the stage of the disease and whether the tumour is aggressive or likely

to spread.

Another influential factor is whether the tumour contains oestrogen receptors

(ER+) or progesterone receptors (PR+). These receptors indicate if hormones

are causing the cancer to grow bigger; there are specific hormone-blocking

medications for each that can be used during treatment. 41


reducing your risk

While there is no known way of preventing breast cancer, making

lifestyle changes such as quitting smoking, reducing alcohol intake,

reducing fat mass and increasing exercise can all help to reduce the risk

of breast cancer.

You may also wish to consider getting tested to find out if you are

susceptible to breast cancer, especially if there is a family history of the

disease. Having a first degree relative, such as your mother or sister,

with breast cancer puts you at higher risk for the disease. The risk is

even greater if they developed breast cancer before menopause, and in

both breasts.

Women with breast cancer usually undergo a lumpectomy (the surgical

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

to excise the cancer from the breast, which can be followed by radiation therapy

and/or chemotherapy to kill any remaining cancer cells.





Recent genetic research has provided some valuable information that can help

identify whether a person is more susceptible to breast cancer in the first place,

therefore increasing the chance of early detection.

BRCA1 and BRCA2 are major genes related to hereditary breast cancer.

Women, and also men, who have inherited certain mutations in these genes

have a higher risk of developing breast cancer, ovarian cancer and several other

types of cancer during their lifetimes.

This breakthrough means that people can now be tested for these particular

genes – and those who carry them can be aware of their susceptibility and

closely monitor their breasts for any suspicious changes.

Perhaps the most famous carrier of the BRCA1 or BRCA2 gene mutation

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

glamorous women – had undergone a double mastectomy at the age of 37

stunned the world in 2013 and brought this very relevant debate to the forefront

of international media.

Faced with an 87 percent chance of developing breast cancer in the future,

Jolie underwent her procedure as a preventative measure – one that brought

her risk of developing the disease down to just five percent.

It’s thought around five percent of Australians – both men and women – carry

the BRCA1 and BRCA2 gene. The availability of genetic testing varies across

the country. Contact the Cancer Council Australia for more information.



check yourself

To ensure the best possible outcome, early detection is

all-important. As with all types of cancer, the risk of breast

cancer spreading from the breasts to other parts of the body

increases dramatically if it is not detected early on. The good

news is that the knowledge, technology and medical expertise

is all readily available here in Australia to help women take

charge of their breast health.

It is critical every woman knows how to do breast selfexamination.

As of age 20, self-checking using the points

below should be a monthly routine:

• Most doctors recommend lying down with one arm behind

your head. With the other hand, feel each breast with

your middle three fingers for any irregular lumps, cyst-like

formations, thickening or unusual dimpling. Be sure to feel

the entire breast area – from the top of the chest, under

each arm, around the breast mound and down towards

the rib cage.

• You can also look at your breasts in the mirror, both with

your hands on your hips and in the air. Check for changes

in colour, shape, nipple location, dimpling or anything that

is irregular.

• Use your thumb and forefinger to gently press the nipple

and check for any irregular discharge.

• It is not a cause for panic if you do come across an

anomaly – 80 percent of lumps turn out to be benign –

but you should consult with your doctor as soon as

possible to be sure.

• For pre-menopausal women especially, aim to perform the

self-exam at the same time each month, ideally after your

period. As your breasts change as you go through your

menstrual cycle, by examining them at the same point in

your cycle, you can make a more accurate comparison.

Some changes to look for:

• A new lump, or lumpiness, especially if it is in one breast.

• Nipple discharge.

• Change in the size or shape of the breast or nipple.

• Change in the skin over the breast, such as redness

or dimpling.

• Unusual persistent pain, especially if it is one breast

• If you’re concerned by a family history of breast cancer, or

by any changes to your breasts, speak to a doctor as soon

as possible. 43

feature industry

The ACCS mark

of distinction

The Australasian College of Cosmetic Surgery continues to champion

patient safety in the cosmetic industry. Caitlin Bishop reports.

Cosmetic medical and surgical enhancement – or Cosmetic Medical

Practice – is a popular option for many Australians looking to reverse

or waylay the visible signs of ageing. With the rise of people seeking

cosmetic medical procedures, it has never been more essential to ensure

patients are receiving suitable, effective treatments with minimal risk.

The Australasian College of Cosmetic Surgery (ACCS) plays a vital role in

regulating the provision of Cosmetic Medical Practice, and upholding the

standards of practice that patients in Australia have come to expect. ACCS

members are held to an international Code of Practice, which acts as a stamp

of distinction for patients considering their options in cosmetic enhancement.

‘The Code covers, among other things, advertising and promotional conduct,

and has an extensive governance regime including independent compliance

audits and reports to the ACCS,’ says Dr John Flynn, the College’s Censorin-Chief.

‘Additionally, our Patient Information Brochure, found on the AACS

website, outlines the things that patients should be asking their doctor, and the

information they should expect to receive before proceeding with treatment.’

The Code was formulated to ensure the safe delivery of both surgical and nonsurgical

procedures to the Australian community. ‘The ACCS is the only college

that incorporates medical, surgical and non-surgical approaches for aesthetic

enhancement,’ says cosmetic physician and College Dean Dr Ron Feiner. ‘It

encompasses the whole spectrum – invasive surgery is no longer the only option for

aesthetic improvement.’

The ACCS is dedicated to the ongoing education of its members. This helps

ensure cosmetic doctors and nurses who are members of the College remain at

the forefront of the latest technologies and techniques in cosmetic medicine and

surgery. ‘The ACCS holds training programs and exams to ensure its doctors

can perform a broad spectrum of procedures according to the Code of Practice,’

says cosmetic physician Dr Eddie Roos. ‘This education is ongoing, and means

continuous improvement in ACCS members.’

A major part of the ACCS education program is Cosmetex, an annual

international conference on the latest innovations in cosmetic surgery. Each




Code of Practice

encompasses the

whole spectrum

of cosmetic


– both surgical

and non-surgical

year, the Cosmetex meeting brings together leading practitioners in the world

of cosmetic medicine and surgery and hosts a program of scientifi c discussions

and workshops.

‘The ACCS provides a collaborative forum, and conferences such as

Cosmetex are an opportunity to hear from the best cosmetic medical practitioners

from overseas and locally,’ Dr Roos explains. ‘The peer-to-peer discussions are

great for learning and advancing new techniques and ideas.’

Not just anyone can become an ACCS member. Since its inception in 1999,

the aim of the college has been unequivocally based upon patient protection

and safety in cosmetic surgery. In order to act as a mark of distinction for those

patients thinking about a cosmetic procedure, the College has maintained a

diligent screening process before granting membership.

‘Before I was granted a Fellowship with the College, they visited my practice

and assessed various aspects such as our record keeping systems, sterility

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

doctor, this means a obtaining a Fellowship certainly gives you recognition for

what you do.’

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

appropriate training, plus specifi c procedural training and they must also have

demonstrated substantial clinical experience. We also ensure our Fellows are

participating in continuing education and, where needed, recertifi cation,’ says

Dr Flynn.

The ACCS is dedicated to offering Australian patients assurance and peace

of mind in undergoing cosmetic procedures. Its commitment to upholding

standards and accountability, as well as the ongoing education of its members,

means the level of treatment and care received at the hands of ACCS members

is the best it can be. csbm


• Established in 1999, the Australasian College of Cosmetic Surgery

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

general surgeons, cosmetic surgeons, plastic surgeons, maxillofacial

surgeons, cosmetic physicians, dermatologists, ear nose and throat

surgeons, opthalmologists, general practitioners and other doctors who

practice in cosmetic medicine and surgery – Cosmetic Medical Practice.

• The primary goal of the ACCS is to ensure the safe provision of cosmetic

medicine and cosmetic surgical procedures to the Australian general

community through the supply of appropriately trained and certifi ed

health care practitioners.

• The ACCS is the only medical college to provide education and training

leading to fellowship specifi cally in cosmetic medicine and surgery.

Fellows of the College are medical doctors who have completed

post-graduate education and training and demonstrated competency

specifi cally in cosmetic medicine and surgery. To become an ACCS

Fellow, doctors must typically complete a minimum of 12 years of

medical and surgical education and training. 45


It’s all

in the


Shortcuts business


Software takes the

stress, guesswork

and time out of

managing your

clinic. Caitlin

Bishop reports.

Shortcuts software optimises the performance of beauty salons and

medical clinics across the globe. With more than 14,000 clients worldwide,

and with the largest research and development team in the industry,

Shortcuts is on the cutting edge of business efficiency and success.

Standard features of the software include tools that have been designed

especially with clinics in mind, including visual treatment records and photo

history. Shortcuts also speeds up the checkout process, prompting you to rebook

clients and track petty cash or clinic promotions. There are also several add-ons

to Shortcuts software, for example automated marketing, online bookings and a

loyalty program, which will help you grow your business.

Importantly, with pre-determined protocols and benchmarks, these programs

hold all staff accountable for day-to-day successful business practice, whether

they are the business owner or not.

Point of sale

Point of sale is the hub of any clinic business, and Shortcuts includes a range

of features that help process transactions while automatically compiling client

history and performance statistics. Something as simple as ensuring you have

the correct amount of float at the start of the day can save a lot of time and

energy for staff.

‘The point of sale wizard is a handy feature that makes balancing your till

easy,’ explains Shortcuts educator Brooke Morkham-Calvert. ‘When cashing

up at the end of the day, a simple wizard guides you through the process and

ensures you are accountable for balancing the till. It counts the amount of money

in the till, and compares this to the amount the till should hold, based on the

day’s sales. This helps you ensure no cash is missing, and that you have the right

amount of float for the following day.’



Following this process, the wizard generates a balance report – which is a

recorded snapshot of what was just done, including how many attempts it took

the operator to balance, the duration of time to do this, and a summary of the

balance itself. This statement cannot be changed and can be presented to the

business owner or manager to ensure accountability.

‘For a business owner who has passed cashing-up responsibilities onto staff,

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

run multiple times throughout the day. For example, the till could be counted and

balanced as managers change shifts on a long business day.’

If the till cannot be balanced, no matter how many times it is attempted, the

operator must enter a reason before shutting the system down. This reason is

then recorded on the balance statement, and can be used to follow matters up

or for future reference.

Petty cash

As the point of sale system keeps tabs on the money flowing into the till, the

petty cash feature can help track money that’s flowing out.

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

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

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

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

you spent, and it will calculate the amount that needs to be returned to the till.’

Importantly, all these calculations are taken into account during the endof-day

balancing. By recording petty cash in the system, Shortcuts not only

optimises end-of-day efficiency but also provides additional reporting around

expenses for future analytics.


Promotions are a valuable way to attract business and keep existing clients

happy. However, keeping track of the success and reach of your promotions can

be time-consuming and arduous. The discount feature built into Shortcuts helps

track how and when client discounts are being used.

Using the discounts feature, you can create specific discounts such as

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

accurately monitor who is giving out discounts, who is receiving them, and why

– ensuring your staff are not discounting too frequently. The discounts feature

also allows business owners to track the success of promotions and specials,

and see at a glance how many new and existing clients are responding to your

marketing campaigns.

‘The discount monitoring software can record how successful a promotional

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

feature is important for clinic owners entrusting day-to-day business to their staff

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

The feature records the reason for discount, the client who is receiving it,

and the staff member who is approving it. This can help in market research –

determining which clientele are most responsive to promotional marketing – and

also tracking employee diligence.

The intricate, easy to use features of Shortcuts take care of all those details that

constitute a successful, efficient and friendly business. For example, Shortcuts

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

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

rest easy, knowing their clinic is being run with accountability, responsibility and

proactivity maximised through everyday operating systems. csbm 47


Are you getting the

best treatment?

Quality education

is vital in


prescribing and

delivering dermal

therapy treatments.

Caitlin Bishop


The beauty world is no longer just the arena of facials and waxing – it now

encompasses more invasive skin therapies and highly active, topical

ingredients. Quality training is vital in prescribing and delivering treatments,

and an understanding of the skin’s anatomy, and comprehensive knowledge of

the various processes that occur within the dermis and epidermis, is essential in

performing treatments to tighten, rejuvenate or brighten the complexion.

This is where quality, professional training is essential, ensuring skin therapists

understand, and are experienced in using, a range of up-to-date modalities to

reap the best results for their clients.

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

is not only going to provide a safe treatment but also an effective treatment,’

says April Jorgensen, Director of the Australasian Academy of Cosmetic Dermal

Science. ‘Some patients report that their treatment did not work or had minimal

effect. This is often caused by untrained therapists using very conservative

parameters out of fear of causing a complication, or a lack of knowledge about

how best to use their equipment.’



The results of laser and light therapies, as well as the benefits of medicalgrade

skincare, have gained these therapies traction in the beauty industry.

But these modalities call for a heightened level of knowledge and experience

in delivering treatment. Alongside increased effectiveness, there may also be an

increased rate of downtime, irritation and possible complications.

‘Dermal therapists should not only be trained in performing treatment in the

standardised time slot but also in understanding the product, treatment and the

way active ingredients work in the skin,’ explains Jacqueline Clayton of Grayclay

Medical Aesthetics Education.

Dermal therapists should understand the

product, treatment and the way active

ingredients work in the skin

This not only benefits the consumer, but also the clinic or salon. By building

a relationship with the client – one that is based upon effective results and

educational engagement – this will help increase customer loyalty and generate

a long-term rapport.

Gay Wardle, Director of Masters Dermal Academy, explains investing in quality

training at a recognised institution will reap continuous rewards for both the

therapist and the consumer. ‘Dedicating yourself to ongoing education is the

basis for achieving the most successful and rewarding career in the aesthetic 49


The term “dermal

therapist” is used

quite loosely, and

consumers should

look for a

qualifi cation in

dermal therapies

that is nationally


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

they are delivering meaningful results for their clients. The business will continue

to grow on the strength of these loyal and satisfi ed clients.’

Considering most dermal therapies are unregulated in Australia – with the

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

distinguishing factor when consumers are deciding to undergo treatment.

Jorgensen encourages patients to evaluate the level and quality of training of

a dermal therapist before undertaking treatment. She explains the same goes for

clinic employers and budding therapists.

‘The term “dermal therapist” is used quite loosely, and consumers, employers,

therapists and nurses should be advised to seek a qualifi cation in dermal therapies

that is nationally accredited and recognised as part of the Australian Qualifi cation

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

cosmetic medical profession, as well as being nationally attributed.’

With the rise and rise of non-invasive cosmetic procedures, dermal therapists

have become increasingly sought after. Younger patients are seeking intervention

earlier, and facial rejuvenation is now a long-term venture, spanning decades.

Communication, people skills and an understanding of individual skin needs

are essential attributes in the modern-day dermal therapist. These help build

long-standing relationships with clients, and in delivering effective, results-driven

treatments. Quality education, and experience with up-to-date parameters, is

vital in boosting and maintaining the standards and credibility of dermal therapy

in Australia. csbm

Advanced skin analysis training for aesthetic professionals

How much importance do you give to professional

skin assessments conducted in your clinics?

MDA courses will give you the power to grow your business through

knowledge. These short post-graduate courses are designed to take

away the conventional methods of skin analysis, with a focus on:

Understanding the functions and anatomy of skin, cells and systems

Relating skin disorders to malfunction of cells and systems

Functions of wound healing and the effects if the body is not healthy

Learning the importance of your most valuable skin treatment

How to build your business, increase your income and your

reputation just by providing a thorough skin evaluation

Take your education and business to the next level.

For bookings, call 0418 708 455

Masters Dermal Academy





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feature profile

Welcome to

The Face Institute




We understand

the desire for a

youthful face that

refl ects how vibrant

and healthy you feel

on the inside

The team at The Face Institute have a long history of delivering natural-looking

and long-lasting results in facial rejuvenation, and are experts in the shape,

structure, function and aesthetics of the face. With a philosophy based

on reliability, satisfaction and quality, The Face Institute offers a comprehensive

array of surgical and non-surgical services to return youthfulness and vibrancy

to the face.

At the helm of The Face Institute is facial aesthetic and reconstructive

surgeon Dr Paul Gerarchi. He is an Australian-trained surgeon with experience

and expertise in the functional, reconstructive and aesthetic surgery of the nose,

face and eyes. He has instilled within his team the importance of exacting and

professional care, while taking an individualised approach with each patient.

‘Our staff adhere to professional and ethical standards, which ensure the

patient is presented with realistic options, according to their needs,’ says Dr

Gerarchi. ‘We strive to meet the patient’s need in a manner which combines

professionalism and personalised care and attention.’

Rhinoplasty, face and neck lifting surgery, eyelid and brow surgery, as well

as otoplasty (ear surgery) constitute a number of the popular procedures

performed at The Face Institute. These can be combined with non-surgical

therapies, such as anti-wrinkle injections and dermal fi llers, to achieve a holistic

and comprehensive anti-ageing result.

‘We want to deliver patients an enhanced facial appearance while still

looking like themselves,’ Dr Gerarchi explains. ‘Whatever the reason for seeking

treatment, because of ageing or other factors, we are here to help. We understand

the desire for a youthful face that refl ects how vibrant and healthy you feel on the


feature profile

Meet the

face doctor

Dr Paul Gerarchi is a trained head

and neck surgeon and Fellow of

the Royal Australasian College of

Surgeons (FRACS).

He has participated in several

international training posts with

leading head and neck surgeons;

facial plastic surgeons; and plastic

and reconstructive surgeons. His

subspecialties include:

- Face lifting

- Neck lifting

- Rhinoplasty

- Brow lifting

- Eyelid surgery

Dr Gerarchi’s extensive clinical

experience in both facial plastic

and head and neck surgery has

led to a unique and specialised

understanding of the nose, face

and eyes.

The Face Institute

Phone 02 9412 4599

Suite 4, 12 -14 Malvern Avenue

Chatswood NSW 2067

inside. Patients who undergo aesthetic surgery or the associated non-surgical

treatments can look forward to gaining greater self-confi dence and a sense of

well-being from looking, feeling and functioning at their best.’

The reconstructive arm of The Face Institute encompasses correcting facial

deformity, in hard or soft tissue, that may be a result of facial trauma, growth

disorders, disease or facial palsy. As well as this, Dr Gerarchi also performs

revision surgeries in cosmetic surgery patients.

‘Being a specialist centre for all issues related to the face, we fi nd that

correction of cosmetic surgery complications performed elsewhere signifi es

a signifi cant part of what we do,’ Dr Gerarchi explains. ‘We work closely with

patients to achieve the best possible outcome given their particular situation.’

Before undergoing any procedure at The Face Institute, patients are given

an opportunity to discuss their goals and concerns with Dr Gerarchi in an initial

consultation. In this session, Dr Gerarchi will undertake a thorough examination to

decide if surgery is appropriate and establish the best treatment plan, according

to the patient’s desires.

‘The success and safety of the surgery relies very much on an honest and

open consultation process,’ he explains. ‘Patients should be prepared to discuss

the reasons for seeking surgery, their expectations in undergoing treatment and

details of their medical history.’

Patients can consult with Dr Gerarchi as many times as they like before

surgery, to ensure all questions have been answered and the patient is prepared

for the recovery period.

To assist in this, Dr Gerarchi provides detailed instructions outlining what

to expect, and the measures that need to be taken, to improve the downtime

following surgery.

‘A smooth recovery period is an essential part of successful surgery,’ he

explains. ‘It is essential that patients attend follow-up appointments, and they

can contact our rooms at any time if any concerns arise.’

In taking a holistic and multi-faceted approach to anti-ageing, Dr Gerarchi

advises his patients to optimise their health before going ahead with surgery.

‘Healthy patients recover more quickly, have fewer complications and achieve a

more effective result,’ he says. ‘Lifestyle factors such as regular exercise and a

sensible diet, smoking or alcohol intake, and health conditions and associated

medications can all affect cosmetic surgery outcomes and the downtime

involved.’ csbm 53



Medical History


Queen Anne







This month, August 2014, sees the 300th anniversary of the death of Queen

Anne, the last Stuart monarch of England. Her reign from 1702 to 1714

was described 240 years later by the great Sir Winston Churchill as one of

the greatest in English history. What Sir Winston did not know, or at least did not

mention, was Anne’s terrible medical history.

She was the second daughter of the Catholic king James II by his fi rst wife

Anne Hyde and when he was Duke of York. Protestantism was the offi cial

religion of England at the time and, despite their father’s acclaimed religion,

both daughters were brought up as good little Protestants. Some years later

James had a boy by his second wife, Mary of Modena, who, being male and

thus by succession, would have inherited the throne. The population could not

contemplate the possibility of another Catholic on the throne so initiated the socalled

Glorious Revolution and invited the Protestants William of Orange and his

wife, James’ elder daughter Mary, to take the throne. James with his new son

fl ed to France. William and Mary never did have any children. Mary died in 1694

and William in 1702 whereupon, you will be at last glad to know, Anne assumed

the throne.

In 1653 Anne had married Prince George of Denmark, a man remarkable

for the poverty of his infl uence on history. He was stout, dull, slow witted and

colourless. Anne’s uncle, Charles II, alleged he had tried George drunk and

tried him sober, but sober or drunk there was nothing in him. A contemporary

remarked that the Prince was forced to breath hard lest he be taken for dead.

But Anne liked him and in 25 years of marriage she conceived on 17

occasions, so at least he took some of royal duties seriously. Incredibly, none of

the pregnancies survived into adulthood which meant the Stuart dynasty ended

with Queen Anne’s death on 1 August, 1714.



In 25 years of

marriage, Queen

Anne conceived on

17 occasions.

Incredibly, none of

the pregancies

survived into


With only two exceptions there was either a stillbirth or miscarriage or death in

infancy every year from marriage until 1700, including two deaths in 1686, 1687

and 1697. In fact, in one disastrous week in February 1697 two infants died.

The first conception was a daughter and stillborn, an outcome attributed

to Anne falling from a horse near term. The live second and third babies died

during that terrible week, each from an acute infection, probably smallpox, then

endemic in the country. Both were buried at Westminster Abby, one in the tomb

of Mary Queen of Scots. Pregnancy four ended in miscarriage and Anne blamed

it on a very lively French dance called a Rigadon which she has injudiciously

joined in early in pregnancy.

In July 1689 Anne’s seventh conception was delivered live and well and

was to become her most successful. It was a boy and named William, Duke of

Gloucester; he lived for 11 years. He was recorded as being weakly at birth, but

William defied the odds despite having fits. A change of wet nurse was deemed

to be prudent and on word of this recently delivered women flocked to Hampton

Court for a piece of the action.

Husband George in one of his few appearances in the footnotes of history

is said to have slowly passed down the line of candidates with their bare milksuffused

breasts thrust forward and eventually selected Mrs Pack of Kingston

Wick as the successful applicant. The dear lady had the child at the nipple within

the hour and William is reported to have brightened up that night, as doubtless

did a perspiring and smirking Prince George.

But William developed into a weedy child and was only 100cm tall at the age

of five, which nowadays would put him in the last five percent of the population

for his age. On his eleventh birthday he contracted scarlet fever and died a few

days later. The same year, 1700, the queen had her last pregnancy; it came to its

almost inevitable end in yet another stillbirth.

What caused all these tragic disasters? Anne’s brooding with thoughts of spells,

witches and black cats and the like hinted at divine retribution for abandoning

her father’s Catholicism. Well, maybe. Syphilis has been mooted via the dreary

George. Frankly, he does not seem to have been the type to contract such a

social disease and was probably the diagnosis of the diagnostically destitute. The

usual story with maternal syphilis infection is that the early pregnancies miscarry,

then one or two are born alive but congenitally infected and later children appear

normal. Anne had enough pregnancies to play out that little scenario and it did

not fit. So the fault must have been in the development of the child.

Rhesus incompatibility between the man and wife’s blood is a reasonable

differential diagnosis. But death from that works in the reverse way to syphilis,

in other words the first child is normal and healthy, but affected conceptions get

worse the more pregnancies there are. In the monarch’s case, William was the

seventh child and lived, so Rhesus is probably not the issue.

Most likely, it is thought, the many deaths were due to placental insufficiency

causing intra-uterine growth and retardation. We will never know for sure;

diagnosing causes of death 300 and more years on is fraught with difficulties.

As regards Anne herself, as she got older she became very obese, either from

alcohol coupled with gluttony to perhaps to try and forget her many disappoints

in life, or it may have been due to kidney failure causing fluid retention and

accumulation. Her legs became so swollen she had difficulty in walking and at her

coronation in 1702 she was carried into the chamber in a wheelchair. Towards the

end of her life she suffered from convulsions, eventually dying of a stroke aged 49.

She was buried in an almost square coffin such was her grossness.

Having had no children the throne passed to her nearest relative, a distant

cousin – the Elector of Hanover, George I. From Germany, he never learnt English

through the whole of his 13-year reign, but at least he produced an heir, George

II, a great supporter of the Arts. csbm 55


cosmetic surgery

& beauty


Want more beauty

and cosmetic

surgery news,

views and reviews?

Jump online to stay

at the cutting edge!

Make love, look younger

I don’t know about you but we’re

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Face lifting: a plastic surgeon’s perspective

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Nettle from Silkwood Medical in Bondi

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– fearful of appearing ‘overdone’ and

wary of those standout photographs

of over-tightened celebrities – Dr

Nettle believes...

Read on at




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out heaps

of other

cool stuff












Surgery after

massive weight loss

is an emerging field

in plastic surgery.

There are a number

of procedures

designed to improve

the body’s contours

following dramatic

weight loss. Caitlin

Bishop reports.

The process of losing extraordinarily large amounts of weight, whether it’s

through diet, exercise or bariatric surgery, can be a harrowing and seemingly

endless venture for the individual. This is because once the weight is off

the journey is still not over. Loose skin folds, fatty pockets and sagging tissue are

often the result of massive weight loss, and these areas – which are frustratingly

difficult to treat without surgery – can detract from an otherwise healthy figure.

Surgery to correct this, and assist in skin contraction following weight loss, has

become a major topic in the plastic surgery arena. Indeed the latest conferences,

including the Advanced Aesthetic Plastic Surgery Workshop (AAPSW) in

Melbourne earlier this year, have seen huge discussion on the possibilities in

body contouring following massive weight loss.

Body contouring surgery

Circumferential abdominoplasty is considered the most effective solution for

individuals who have experienced massive weight loss. Similar to a standard

abdominoplasty, but extending around the entire circumference, it is a surgical

procedure designed to remove excess skin, cellulite and fat from the abdomen,

buttocks, chest, back thighs and breasts.

US plastic surgeon Dr Simeon Wall Jr. spoke at AAPSW in Melbourne

and outlined his approach to circumferential truncal contouring. It involves

abdominoplasty, circumferential liposuction, fat resection and targeted fat grafting.

During the procedure, a horizontal incision – that extends the whole way

around the body – is made above the thighs and buttocks. Through this incision,

excess fat and tissue are removed, sometimes with the aid of liposuction, and

the stomach muscles are surgically tightened. Excess skin is then excised for

a tighter, toned look and the remaining skin is re-draped over the body’s newly

defined contours.

In some cases, a corset trunkplasty, which involves a different incision method,

is more suitable for certain patients. US plastic surgeon Dr Alex Moya explained

a corset trunkplasty can be very effective in highlighting the waistline.

‘A corset trunkplasty can create an aesthetically please body shape – similar

to that provided by a corset – and involves several carefully placed incisions

which interconnect to form the appearance of a sideways capital “H”,’ Dr Moya

explains. ‘The incisions are customised for each patient, and address excess

skin in both the upper and lower abdomen.’

To undergo either circumferential abdominoplasty or a corset trunkplasty,

patients should be as close to their ideal weight as possible or, if that is

unachievable, at a steady weight that they are likely to maintain. It is recommended

patients wait at least one year following bariatric surgery before undergoing

circumferential reduction surgery.

In some cases, liposuction can be sufficient in removing excess fat and causing

effective skin contraction in weight loss patients. Power-assisted liposuction,

using radiofrequency, ultrasound or laser technology alongside liposuction, can

help increase skin contracture and tone and tighten in the skin’s surface.

Dr Wall Jr. shared his experience using the S.A.F.E liposuction technique at

AAPSW in Melbourne. This acronym stands for Separation, Aspiration and Fat

Equalisation, and depicts a strategy for performing liposuction that results in

slimmer, smoother and more even body contours.

While Dr Wall Jr. avoids using power-assisted liposuction, he uses these three

steps – separation, aspiration and equalisation – to achieve the best results in 59


liposuction patients. The key element in this technique is fat equalisation where,

following fat removal via separation and aspiration, the layer of fat is manually

equalised to ensure an even coverage across the treated layer. This helps prevent

contour irregularities and optimise results following the procedure.




Figures by the National

Health Reporting Authority

for the Council of Australian

Governments show

Australia’s obesity rate

has ballooned. Sixty-three

percent of Australians are

now either overweight or

obese, up from 44 percent

in 1989. Of this figure, 28

percent were obese in 2012,

up from 11 percent in 1989.

According to the 2011/12

Australian Health Survey

by the Australian Bureau of

Statistics, more than half of

us (55.7 percent) are trying to

lose weight.

Body lifting

Body contouring surgery after massive weight loss is commonly accompanied by

a lifting procedure. This could be a lower body lift, a breast lift or a thigh lift.

‘Although losing weight is rewarding, it can result in sagging skin,’ says Dr Wall

Jnr. ‘Many people choose to have a lower body lift after weight loss. This removes

excess skin and pulls the remaining skin closer for a more toned, healthy look.’

A lower body lift is performed via an incision around the stomach and back, and

will help smooth and contour the lower body. It can also be effective in reducing

excess skin hanging from the legs and buttocks.

For those seeking a more direct approach, a thigh lift can help improve the

contour and appearance of the upper leg. During the procedure, an incision is

made in the upper inner thigh – in some cases this may extend to the groin line or

buttock fold – and excess fat and tissue is removed via this incision.

US plastic surgeon Dr Constantino Mendieta, who was a keynote speaker at the

AAPSW conference, is considered an international expert in contouring the gluteal

region. He spoke on using an individualised approach in buttock enhancement,

and discussed his buttock lifting technique that can be performed following a

circumferential tummy tuck without the need for further scarring.

For the upper body, breast augmentation can sometimes be sufficient to

counter the heaviness and sagginess resulting from massive weight loss.

Oftentimes it is used to return shape to a flattened, sagging breast, but if it is

combined with mastopexy (breast lift surgery) it can raise the breasts to a more

aesthetically pleasing position. In other patients, breast reduction may be more

suitable following weight loss, and again this can be combined with a mastopexy

to achieve the best results.

Notably, a mastopexy can help reduce the appearance of back rolls, or sagging

skin on the sides and back of a weight loss patient. By pulling the tissue upwards,

and excising a significant amount of skin in the process, breast lifting can also

smooth, lift and tighten the skin around the patient’s rib cage.

Brachioplasty is a procedure to improve the appearance of the upper arm.

During the procedure, an incision is made on the inner surface of the upper arm,

from armpit to the elbow. Liposuction is used to aid in the removal of fatty tissue,

and sutures are placed on the muscle to smooth and define the shape of the

upper arm. As in other surgeries, excess skin is cut away before stitches are used

to close the incision.

In some patients, sometimes on account of weight gain, the mons pubis – the

fatty tissue over the pubic bone – can become bulky or saggy. It is an area that

is very difficult to reduce with diet and exercise, and cosmetic surgery is often

required to make a noticeable difference.

In some cases, liposuction alone can be sufficient in achieving effective results.

Sometimes, however, particularly where there has been excessive weight loss,

excision of tissue is also required. In this, an incision is made – generally along the

pubic hairline – and the excess skin and tissue is removed. The result is a flatter,

tighter and lifted pubic area. The mons pubis area is usually always addressed

during abdominoplasty, however can be treated as a separate procedure.

Body contouring surgery can significantly improve the look of skin folds and

laxity following massive weight loss – helping to boost body confidence and

maximise weight loss results. csbm





1. Less is more

It’s not uncommon to put on weight during winter – more food, heavier meals –

so it’s time to make healthier choices. By eating smaller meals more often, you

will boost your metabolism and help clean up your diet.










2. Healthy colour

One of the best ways to lighten your diet is to add fresh fruits and veggies in a

wide variety of colours. Choosing berries, melons and leafy greens to mix into your

balanced meal will increase your intake of essential vitamins and antioxidants,

helps prevent disease and will also increase energy levels.

3. Keep snacking

A successful diet is not about cutting back on food, it’s about eating sensibly

throughout the day so you’re not starving at the end of it. Eat fi ve small meals

every day including some healthy snacks such as nuts and fruit.

4. Fresh is best

The secret to a fl avourful and healing diet is to emphasise foods that are as fresh

as possible. Autumn’s offerings include new-season apples, rhubarbs, pears,

quince, Asian greens, spinach, pumpkin and nuts.

5. Detoxify

Antioxidant-rich vegetables and adequate protein are needed for the removal of

toxins from the system and enhance the liver’s natural detox process. They’ll also

help your immune system to ward off colds and fl us.

6. Keep meals simple

Enjoy the merit of simplicity. By using just a few fresh or seasonal foods and no

processed foods, easy, uncomplicated dishes take on the taste of gourmet.

7. Water yourself

Make a concentrated effort to drink purifi ed water often throughout the day,

especially between meals. We need even more water when the body is fl ushing

out excess toxins. Alcohol, hot drinks and juices don’t satisfy the body’s need for

water: instead, they stress blood sugar and liver function and lead to weight gain.

8. Get motivated to exercise

If you fi nd you’re slow on giving up some of your dietary indulgences, try making

your way to the gym a couple more times a week. It will motivate you to eat

healthier so you’re not working out for nothing. csbm 61



after massive weight loss




Body-contouring procedures after massive weight

loss (MWL) can bring about truly life-changing

results. You may have experienced weight loss

through your own efforts or with the help of bariatric

surgery, and want to complete your weight loss journey

with a body-contouring procedure; you may have struggled

with stubborn fat deposits resistant to diet and exercise,

and want to tackle this issue head-on with the help of

liposuction; or you may simply want to change the shape

and size of certain areas of your body, helping to produce a

more cosmetically appealing fi gure.

Prior to losing a large amount of weight people are

naturally focused on their weight loss goal and do not give

much consideration to what shape their bodies will be in

after their desired weight loss has been achieved.

As a result, whilst the outcome on the scales is gratifying,

the presence of signifi cant amounts of loose skin both look

unsightly and can cause painful rashes (intertrigo) and

considerable discomfort when wearing clothes and walking.

For these men and women, body contouring surgery

provides them with a more shapely body to complement

their reduced weight. There is a saying that ‘the bariatric

surgery makes a patient healthy, but the body contouring

surgery makes them happy’.

Some weight loss patients only need to target one

specifi c area of the body to achieve their body-contouring

goals. Others may need to deal with a number of problem

areas, with the surgery spread over a number of operations.

A signifi cant proportion of patients undergo all of the major

body contouring procedures in a number of operations

spread out over 12 to 18 months. This requires a huge

commitment from the patient, but the results can be amazing.

The best results of body lifting/body contouring by

far are achieved in patients who have reached or nearly

reached their ideal weight, with a Body Mass Index (BMI)

of 20 to 30. But very dramatic improvements can be made





AFTER body contouring by Dr Maxwell



AFTER body contouring by Dr Maxwell



AFTER body contouring by Dr Maxwell 63


in patients whose BMI is higher than 30. Body Mass Index

is calculated by dividing your weight in kilograms by your

height in metres squared:

Normal: 20 – 25

Overweight: 25 – 30

Obese: 30 – 35

Morbidly Obese: >35

Patients who intend to lose more weight are advised to

wait until they reach their target weight before treatment.

Smoking is a contra-indication to MWL body contouring.


Whilst the abdominoplasty procedure is most commonly

performed on women following pregnancy, it is also

often performed in the massive weight loss setting,

both as an independent procedure and as the front half

of a circumferential lower body lift. This is due in part to

any previous pregnancies and in part to stretching of the

abdominal wall by the large volume of fat deposited around

the abdominal organs in the obese individual.

Not infrequently, the weight loss (‘bariatric’) surgery

requires an open rather than a keyhole procedure, which

involves splitting the vertical tummy muscles (‘rectus

muscles’). Due to these patients’ very large size, the repair

of the separated muscles may come apart post-operatively,

resulting in a ‘ventral’ (incisional) hernia in which some of

the abdominal contents bulge out through the muscle gap.

If the lower trunk skin/fat excess is confined mainly to the

front, then an abdominoplasty suffices and a circumferential

procedure is not required.

The procedure

A transverse wedge of skin and fat extending just above the

umbilicus is excised, followed by suture repair of the rectus

muscles with or without reinforcement with synthetic mesh or

‘artificial dermal matrix’ (ADM). Sometimes a vertical wedge

is also removed, producing an inverted T-scar pattern. This

is called a ‘trefoil’ or ‘fleur-de-lys’ pattern abdominoplasty.

Once the muscles have been repaired, the remaining

abdominal skin is pulled down and sutured to the lower

incision. Lastly, the umbilicus (‘belly button’) is brought back

out to the surface through a new incision.

Drains are not routinely used. A compression garment is

typically worn for four to six weeks. The patient is usually

discharged on the second to fourth post-operative day

and walking is encouraged. Heavy lifting and gym work

can be resumed after about eight weeks. Driving may be

resumed after 10 days, and three to four weeks off work

are usually required.


The introduction of the circumferential ‘lower body lift’ (also

known as a belt lipectomy) in the early 1990s revolutionised

the surgical treatment of the massive weight loss patient.

The Lower Body Lift is a circumferential procedure

consisting of an abdominoplasty in the front, and lifting of

the buttocks and the outer and back part of the thighs.

Liposuction is often performed in conjunction.

The buttocks in particular can be dramatically improved.

The buttocks in these patients tend to be very flat in addition

to drooping, and fat liposuctioned from other areas can be

transferred (grafted) to the buttocks to produce a more

rounded and pleasing shape.

Not infrequently an additional vertical wedge of skin/

fat is removed from the middle of the abdomen to deal

with the laxity in the horizontal direction (fleur-de-lys

abdominoplasty). The Lower Body Lift can be combined

with other contouring procedures.

The procedure

A Lower Body Lift takes around four to six hours on a

thinner patient and longer on a larger patient where

liposuction has to be performed before the excess skin can

be excised.

All the wound closures are performed with buried

dissolvable sutures. Drains are not routinely used which

makes the post-operative recovery much easier.

At the end of the procedure a compression garment is

worn. Patients are encouraged to sit out of bed and walk a

little on the first post-operative morning. A blood transfusion

may be required to optimise recovery, especially where

the body lift has been combined with another contouring

procedure. Discharge from hospital is around the fifth postoperative



This term includes breast rejuvenation surgery (reduction/

lift/enlargement/gynaecomastia treatment in males) and

tightening of the sides of the chest and back if required.

Some practitioners include arm reduction surgery

(brachioplasty) in this grouping.


Arm reduction surgery is an excellent procedure for

individuals who are self-conscious about the appearance

of excess tissue below their arms (so-called ‘tuck-shop

arms’). The brachioplasty procedure restores more youthful,

toned contours to the arms and gives patients greater selfconfidence

in their appearance.

Interestingly, many massive weight loss patients, in spite

of the fact that they have extensive rolls of loose skin and

fat around the lower trunk, which one would think would

be the top priority for treatment, request brachioplasty as

the initial procedure. This is because they desire to wear

short-sleeved tops which expose their arms and find it very

hard to find clothes that fit, whereas the lower body/thighs

can be easily hidden by clothes and so can be dealt with

at a later date.





AFTER body contouring by Dr Maxwell



AFTER body contouring by Dr Maxwell



AFTER body contouring by Dr Maxwell



AFTER body contouring by Dr Maxwell 65


The procedure

Patients presenting for brachioplasty understandably would

like the incision to be placed in the armpit and the skin

pulled up to that site and the excess removed, leaving a

small hidden scar. Unfortunately the reality is that only the

smallest amount of skin can be removed this way and that

skin has to be located close to the armpit.

Candidates for brachioplasty have skin/fat excess at

least half-way down the arm and in many it extends as far

as the elbow, and the only effective way to treat this is by

making the incision and therefore the scar down the inner

aspect of the arm, often all the way to the elbow.

Body contouring surgery

creates a more shapely body

after significant weight loss

If the skin excess extends past the armpit and onto the

chest wall then the excision is extended to incorporate this.

If the patient has excess fat in the arms – usually on the

back of the arm up towards the shoulder – liposuction will

be also be performed. Suction drains may be used.

Compression sleeves are fitted at the end of the

procedure and are worn for four weeks. The patient is

typically discharged on the second post-operative day.

After the surgery, moving the arms as pain permits is

encouraged. Fluid may collect, especially just above the

elbow, due to the interruption of lymphatic channels. This is

called a ‘lymphocoele’. The fluid is drained painlessly in the

rooms, usually on two or three occasions before it resolves.

Unlike the scar in the tummy tuck procedure, the

brachioplasty scar is not in a favourable anatomical location

and often six to 12 months are required for the scars to

fade. Occasionally the scar becomes tight, producing

discomfort on stretching the arm above the head. In this

case a scar revision is performed. The arm reduction

procedure may need to be revised after a number of years

due to recurrence of skin laxity due to ageing.


Excess tissue between the thighs rubs together, causing

discomfort when walking. The inner thigh lift, in most cases

assisted by liposuction, produces smoother, shapelier and

much younger looking thighs which no longer cause friction.

The procedure

The general conception amongst patients is that the inner

thigh lift is a simple, quick procedure, but in fact for the

surgeon it is technically demanding due to the awkward

site and the difficulty of access. The inner thigh lift for many

years was performed through an incision from the groin

through to the buttock fold.

As in brachioplasty, patients understandably expected

the lift to be done though this incision alone, but the reality

was that this was suitable only for a few patients, and

the incision was invariably extended down the inner

aspect of the thigh, often as far as the knee, producing a

T-shaped scar.

The horizontal resection represents a true lift, but gravity

gradually drags the scar down so that the scar, initially

hidden within the underpant line, becomes visible below

this. More recently a vertical resection alone has become

the procedure of choice, with the excision extended up

alongside the pubic area when required. The three big

advantages of the vertical excision are: 1. Much of the

excess is located down the inner thigh; 2. The tightening

is across gravity, rather than opposing it; 3. There is no

T-junction in the groin region where tissue breakdown with

delayed healing was very common with the older technique.

Suction drains may be used, and the patient is encouraged

to mobilise on the first post-operative day and is ready for

discharge home the following day. A compression garment is

worn for about four weeks (six weeks if a significant amount

of liposuction has been performed).

After an inner thigh lift, patients are encouraged to walk

following discharge home. Jogging may be resumed after

six weeks but upper body gym work can be resumed after

about three weeks. Fluid may collect, especially just above

the knee, due to the interruption of lymphatic channels,

which is drained in the clinic until it resolves.

The vertical scar down the thigh is not in a ‘favourable’

skin line and therefore may remain pink and visible for some

months but then settles down into a pale scar which is

hard to see.


Gynaecomastia refers to a condition in which men have

enlarged breasts, also known rather unkindly as ‘man

boobs’. Men who have developed enlarged breasts may

feel embarrassed and may be hesitant to be seen in T-shirts

or to take their shirts off in public such as at the beach.

In the massive weight loss setting, the breast

enlargement is due to an accumulation of fat and there may

be little or no actual breast tissue. This is called ‘pseudogynaecomastia’

and may respond to liposuction alone.

The skin excess usually necessitates skin resection with

transposition of the nipple or removal of the nipple at the

start of the procedure and replacement of it as a graft at the

end of the procedure. Removal of skin necessarily means

scars on the male chest, which are avoided wherever

possible. Suction drains are used in this procedure. A

compression garment is then applied for four weeks.

The patient is discharged on the second post-operative

day. Arm motion is encouraged. As mentioned in relation

to other body-contouring procedures, some fluid may

collect in the subcutaneous space (a ‘seroma’), requiring

aspiration in the clinic.




High quality




Mr Richard Maxwell is a widely

respected plastic surgeon in the

Melbourne, Victoria area.

For 20 years, Dr Maxwell has used

his plastic surgery skills to help patients

enhance their appearance and improve

their self-confi dence. He and his staff

ensure safe and effective treatments for

cosmetic enhancement and rejuvenation,

with a particular interest in body

contouring after massive weight loss.


Body surgery – contouring after massive

weight loss, liposuction, tummy tuck,

body lift, gynaecomastia

Breast surgery – augmentation,

lift, reduction

Face surgery – facelift, blepharoplasty,

rhinoplasty, otoplasty

Non-surgical – anti-wrinkle injections,

fi llers, fat transfer




a woman’s

Sydney Plastic Surgeon

Dr Amira Sanki understands firsthand

the motivations, concerns

and desires of her female PATIents.

Caitlin Bishop reports.

The decision to undergo cosmetic surgery should be

a personal, positive and educated one. A good

rapport with your surgeon is key in optimising surgical

outcomes and, in some cases, a woman’s understanding

can help establish the best plan for your body and your

expectations and motivations.

Sydney plastic surgeon Dr Amira Sanki is one of a

handful of female plastic surgeons in NSW. She has a

personal insight into the needs, concerns and desires of her

female patients, and is not afraid to bring her experiences

into her consultations with female patients.

‘A female plastic surgeon has experienced first-hand a

lot of the concerns that her patients are going through,’

Dr Sanki explains. ‘At university, I wanted flawless skin;

when I was training as a plastic surgeon, I did everything I

could to look less tired and run down; when I had children,

I wanted my body to bounce back to where it used to be. I

understand the different stages a woman might go through

in her life.’

The same way she can relate to those concerns that

are driving women to seek cosmetic surgery, Dr Sanki

also understands the feelings of apprehension that might

surround the surgery itself and the recovery period.

‘Women are often the backbones of our homes and

workplaces, and want to get through our surgery as safely

and predictably as possible,’ she says. ‘Women want to go

on being a mother, a wife and a professional.’

Further demonstrating her commitment to making her

patients as comfortable as possible, Dr Sanki sometimes



works with an all-women surgical team, depending on her

patient’s preferences.

Surgery is quite a daunting thing to consider, and I will

do all that I can for my patients so they feel comfortable and

secure,’ she says. ‘My anaesthetists, nurses and surgical

assistants have all been working with me for years. They

are part of my team, not just because they are women, but

because I know they are the best in their professions. Also,

they have all had some type of surgery at some point in

their lives – I think this gives them unique insight into what it

feels like to be a patient in an operating room.’

Mummy makeover

For many women, changes to the body that occur during

childbearing can be difficult to reverse with diet and

exercise endeavours. A “mummy makeover” is a surgical

procedure that combines abdominoplasty and breast

surgery – augmentation, reduction and/or lift (mastopexy)

– to achieve an all-over transformation.

‘There are two distinct groups of patients who commonly

seek “mummy makeover” surgery,’ Dr Sanki explains.

‘There are women who want to restore their bodies to how

they looked before having children – this group tends to

want more natural-looking, modest results. The other group

includes those who wish to seize the opportunity to create

the body they’ve always wanted. These women usually

have kids who are finishing or have finished school and they

finally have time to make themselves more of a priority and

invest in how they look.’

Before any surgery, patients undertake multiple

consultations with Dr Sanki. This allows the patient to

properly understand all that is involved in the procedure

and recovery period, and gives Dr Sanki an opportunity

to accurately gauge the patient’s motivations, concerns


and expectations. ‘All of our patients have at least two

consultations, so I can understand who they are as people

and what motivates them for undertaking the surgery, as

well as educating them about all aspects of the operation,’

she says. ‘After taking a list of my patient’s concerns and

health issues, we then decide together on their implant

choice, and whether they need a combination procedure

like a breast augmentation and a mastopexy (lift). In the

second consultation, my patients have an opportunity to

ask additional questions about their surgery. We then take

them through all the expectations of their surgical process

– who will drive them home after the surgery, their comfort

plan, when they can resume work, etc.’

Because it combines several procedures, a ‘mummy

makeover’ can be quite an extensive operation. Dr Sanki

usually performs the surgery in one session, however can

tailor her surgical approach depending on the patient.

‘In most patients, a mummy makeover can be achieved

in one surgical session,’ she says. ‘In more complex

makeovers, where there are multiple reconstructive and

cosmetic issues, it is generally preferable to stage the

surgery. I always take into account the wishes of my

patients and their lifestyle requirements.’

The recovery period following surgery is crucial in

securing the best result possible. Combination procedures

typically involve a couple of nights in hospital, followed by

one or two weeks rest at home. Dr Sanki is on call for her

patients at any time of the day during their recovery, and

undertakes a minimum of three follow-up sessions with

each patient to monitor their recovery and progress.

‘It’s an amazing moment when my patients come in for

their final follow-up, wearing a new outfit and feeling like

a new person,’ Dr Sanki says. ‘I am always overwhelmed

by that moment. That’s what plastic surgery is all about:

improving self-confidence and transforming lives.’ csbm



AFTER breast augmentation by Dr Sanki 69










Metabolic syndrome is a medical condition that

usually affects middle-aged men, but it can start

at any time. It is characterised with central

abdominal adiposity, or a growing waistline, occasionally

forming an apron-like fold over the abdomen.

Abdominal adiposity is also called visceral fat, which

lies deep within the abdominal cavity and pads, the

internal abdominal walls, and the attachments of the

organs (particularly the small and large bowel).

This internal fat, also known as white fat, is considered to

be mainly responsible for the metabolic effects on

insulin resistance (IR), cardio-metabolic syndrome, type 2

diabetes, hypertension, depression, Vitamin D defi ciency,

partial androgen defi ciency in males (PADM), dyslipidaemia,

osteoporosis, cognitive decline, erectile dysfunction,

sleep apnoea, general cancer risk (breast, colon,

prostate), kidney disease and kidney failure, and probably

much more.

Unfortunately, many young men are not recognised

with metabolic syndrome and some are misdiagnosed and

treated for depression instead.

What is insulin resistance?

Insulin resistance (IR) is usually defi ned as a state

characterised by the reduced glucose-lowering activity of

insulin, but it can also be used as a shorthand label for a

clinical syndrome encompassing signifi cant pathologies of

metabolic syndrome. Insulin is a gene expression modulator

involved in many biochemical processes in the body.

Failure to diagnose IR in the younger population has

a possible association with abdominal obesity (cardio

metabolic syndrome is present in 6.7 percent of people

aged 20 to 29 years and is increasing every year).

How does metabolic syndrome


I believe low testosterone, low Vitamin D, low serotonin

levels, lack of exercise, increased food intake (particularly

carbohydrates and phytoestrogens) and family propensity

to consume excess calories may trigger a cascade of

effects leading to metabolic syndrome. It can start at any



time, even in teenagers, but the risk factor increases with

age and it is more prevalent in the ageing population.

Metabolic syndrome can be treated. An experienced

medical practitioner can diagnose and treat the condition

early with an integrative medical approach, including:

• Lifestyle interventions (low GI Mediterranean diet,

exercise, socialising, stress management)

• Macro- and micro-nutritional management (green

tea, cinnamon, fenugreek, Banaba, fish oil, Boswelia,

Curcumin, Ubiquinol)

• Supplementation (Vitamin D, Q-10 (in the form of

Ubiquinol), Alpha Lipoic Acid)

• 5-hydroxytryptophan (5-HTP) therapy. Researchers have

found 5-HTP make people feel more full after eating, so

they ate less. Since serotonin helps regulate mood and

behaviour, 5-HTP may have a positive effect on sleep,

mood, anxiety, appetite and pain sensation.

• Lipostructure of fat deposits

• PhotoDynamic HelioTherm to treat internal white fat

deposits (thermogenic effect) and probably much more.

The combination of lifestyle modification, lipostructure

and PhotoDynamic HelioTherm therapy is a new

advancement in the treatment of metabolic syndrome. In

my experience, it is painless, there is no downtime (literally

walk in, walk out), provides an excellent skin retraction

(particularly if combined with MicroPen microneedling and

platelet-rich plasma (PRP) therapy).

The results can be permanent, provided the patient eats

sensibly, exercises regularly and takes supplements and

prescribed medications. Most patients are very satisfied

with the results. They feel more comfortable in a wide

variety of clothes and more at ease with their bodies.

As long as a patient’s expectations are realistic, they

should be happy with their new shape.

What is the future?

BioRestorative Therapies Inc, a stem cell biotechnology

company, is advancing its ThermoStem Program,

designed to develop treatments using brown fat stem cells

for metabolic disorders and obesity, focusing on potentially

preventing the onset of type 2 diabetes.

The ThermoStem Program is based on pre-clinical

research that increased amounts of brown fat in the body

may be responsible for additional caloric burning and

reduced glucose and lipid levels. Potential use may include

inducing weight loss (a ‘biologic diet’) and the reduction of

glucose and lipids – perhaps even leading to delaying or

preventing the onset of type 2 diabetes.

I believe that lifestyle modification, lipostructure (to

selected fat deposits), PhotoDynamic HelioTherm (lipolysis

and skin tightening) and adopting the ThermoStem

Program (using brown fat stem cells) is the future treatment

in managing metabolic syndrome. csbm

Declaration of interest: The author is a designer and investor of

PhotoDynamic HelioTherm Therapy and investor in BioRestorative

Therapies - ThermoStem Program (Brown Fat Stem Cells).

Case study

This 80-year-old patient requested liposuction. He was told

that he was an unsuitable candidate as liposuction can

remove external fat but not internal (visceral) fat.

The patient is very happy with the result after

Photodynamic HelioTherm, lifestyle modification, hormonal

and supplements therapy. In total he has lost more than

16cm of his circumference.

He says his energy level and work productivity has

increased dramatically and is planning to stay in the

workforce for another 10 years and retire at the age of 90!


Six months AFTER BioRestorative ThermoStem Program by

Dr Georghy

12 months AFTER BioRestorative ThermoStem Program by

Dr Georghy 71

tattoo removal

The latest in



PicoSure signifies a breakthrough in laser

tattoo removal, affording superior results in

fewer treatments. Caitlin Bishop reports.

Once upon a time, tattoos were a lifetime commitment and, regrettable

or not, the design was there to stay. Now, thanks to advancements

in tattoo removal technology, those decisions don’t have to be so

permanent. The new PicoSure laser from Cynosure is the first and only

picosecond laser, delivering ultra-short pulses of energy to shatter tattoo pigment

in the skin.

‘The PicoSure delivers laser energy 100 times faster than traditional

Q-Switched lasers, making laser tattoo removal safer and more effective than

ever before,’ explains Dr John Relic, a dermatologist in Lake Macquarie, NSW.

‘Traditional tattoo removal can take between five and 15 sessions, while the

PicoSure can completely remove tattoos in as little as five sessions.’

It is the extra short pulses – at a trillionth of a second – that distinguish PicoSure

from traditional tattoo removal lasers. The system uses patented Pressure

Wave technology to target and shatter the ink particles, meaning tattoos can

be cleared in fewer treatments.

‘The PicoSure delivers a lot more energy, in a shorter period of time, compared

with traditional tattoo removal lasers,’ explains cosmetic dermatologist from

Neutral Bay Dr Terence Poon, who specialises in laser treatments. ‘It is more

effective in breaking up the tattoo particles – like breaking boulders into sand

grains. This helps the body’s immune system remove the particles more rapidly.’

Because of the intensity created by the wave, lower fluencies (the energy


tattoo removal

PicoSure is the

treatment of

choice for our

tattoo removal

clients, and we

have seen some

amazing results

Because of the intensity created by the Pressure Wave, lower fluencies (the energy

delivered per unit area) can be utilised to achieve ink particle fragmentation.

‘The PicoSure causes a photomechanical action in the skin – which is the

shattering of ink particles – as opposed to a photothermal action delivered by

traditional lasers,’ Dr Relic says. ‘This means there is lesser risk to the surrounding

tissue, and helps create those smaller particles that are easier for the body to clear.’

PicoSure is equipped with an Alexandrite wavelength (755nm), which has the

ability to target green, blue, purple, black and brown inks – colours that have been

typically difficult to move. ‘Green inks are particularly difficult to remove, and the

PicoSure is effective in targeting these,’ Dr Poon explains. ‘In some cases, the

PicoSure might be used in conjunction with a traditional Q-Switched laser to combat

some of the more stubborn colours, for example to help remove red ink.’

The specified wavelength also reduces the risk of pigmentation or textural

irregularities following treatment. The wavelength targets tattoo ink without affecting

the surrounding melanin – the skin’s natural pigment. ‘The 755nm wavelength

means there is very little, if any, absorption of melanin,’ Dr Relic explains. ‘This means

the PicoSure can specifically target the tattoo ink, leaving the surrounding skin

untouched. Some people may experience minor textural or pigmentation changes

to the treatment site, but these are usually short-term.’

The treatment itself is relatively comfortable, and does not require anaesthetic.

Patients may experience some blistering and redness immediately post-laser, but

this should subside over the next day or two.

‘The sensation during treatment is similar to the snap of a hot rubber band on the

skin, and the process is usually very well tolerated,’ Dr Relic says. ‘We use a cooling

system to cool the skin before and during treatment, to reduce any discomfort.’

‘Immediately following treatment, the tattoo will turn a frosty white colour. This

lasts approximately 30 minutes before the colour returns to normal,’ Dr Relic adds.

‘Clients need to ice the treatment area, on and off, for up to four hours following

PicoSure and, if the treatment area is on the legs or feet, we encourage our clients

to keep the area elevated.’

There are some potential risks associated with PicoSure treatment, and Dr

Poon explains patients should consult an experienced operator before undergoing

treatment. ‘There are risks involved with any laser treatment, and it is the experience

of the operator that makes the difference,’ he says.

Changes to the tattoo can usually be seen within the first week following

treatment with PicoSure. These changes – particularly after the initial treatment –

usually involve fading and “fuzzing” of the ink around the edges of the tattoo, before

the ink completely disappears.

‘We see a vast array of tattoos, and clients want them removed for a multitude

of reasons,’ Dr Relic explains. ‘Some clients need to have their tattoos removed so

they can start a career or, in some cases, so they can move on from a painful past.’

‘PicoSure is the treatment of choice for our tattoo removal clients, and we have

seen some amazing results. It can help clear stubborn tattoos, and the treatment

period is significantly reduced. With PicoSure, our clients can have their tattoos

completely removed much sooner,’ Dr Relic concludes. csbm


AFTER three treatments with PicoSure laser. Photos courtesy of Dr Relic at

Newcastle Tattoo Removal. 73


No more

tattoo regrets...

PicoSure for fast and

effective tattoo removal

Erase unwanted tattoos with PicoSure, the world’s first picosecond

aesthetic laser treatment available for fast and effective tattoo removal.

PicoSure targets unwanted ink more effectively than ever before,

successfully removing difficult ink colors, such as blues and greens,

as well as previously treated tattoos. Fewer treatments, faster recovery

time, and greater results are achievable with PicoSure’s ground-breaking

picosecond technology.

© 2013 Cynosure, Inc. Cynosure is a registered trademark and

PicoSure is a trademark of Cynosure, Inc. ALL RIGHTS RESERVED.


After 20 treatments

Q-Switched Nd:YAG

Photo courtesy of Cynosure, Inc.

After 6 treatments


Before & After 3 treatments

Photo courtesy of K. Arndt, MD & J. Dover, MD

Before & After 3 treatments

Photo courtesy of Cynosure, Inc.

Before & After 3 treatments

Photo courtesy of R G. Geronemus, MD


to find your nearest provider








Thinking about a breast enlargement? Here

are the 5 most crucial aspects of breast

implant surgery you need to know.

Aimée Surtenich reports.



Choosing the right shape of breast implants is vital to the success of your surgery.

Indeed, your choice of round, teardrop or conical will help determine your final

breast shape after surgery.

Choosing the right implant for you is dependent on your existing breast size,

shape, symmetry and projection, body type, and your personal preferences.

There is no one breast implant shape that is best for everyone. Your surgeon

is the best resource for determining what breast implant is best for you and your

body type.

Round and teardrop implants are most commonly used, however conical

implants are becoming more popular to help fill an ‘empty’ chest in certain cases.

Round implants

Round implants are circular with an even projection of volume. They are a good

choice for those who want more fullness in the upper part of the breast and tend

to give greater cleavage. Many surgeons agree round implants are typically the

best choice for those patients with well-shaped natural breasts who desire a

straightforward breast enhancement.

Teardrop implants

Teardrop, or anatomical, implants more closely resemble the natural shape of a

breast, gradually sloping downwards to produce an attractive straight line from

the collarbone to the nipple. Teardrop implants tend not to be as full as round

implants but because they are fuller in the lower half they can also provide greater

projection in proportion to the size of the base, making them particularly suitable

for women with little natural breast tissue. Mild elevation of the breast and the

nipple can also be achieved, making them particularly suitable for women who

have mild droopy or tuberous breasts.

Conical implants

While not as well-known as round and teardrop shapes, the conical implant is

gaining popularity for its ability to add volume to both the upper and lower poles

of the breast while also creating a good elevation of the breast and nipple to

counter ptosis or droopiness.

It is essential that the right amount of volume, or fill, is selected – otherwise

there is a risk the breasts will end up with a pointy appearance. They are available

in polyurethane surface only. 77


Implant size

Breast implant sizes are designated by their volume, which in Australia ranges from 90 to 900 cubic

centimetres or millimetres (cc or mm), or by their weight. One gram of silicone is equivalent to slightly

less than 1ml (1cc). The higher the number, the larger the implant.

They are also made with different diameter bases to suit different widths of chest wall and with

low to high profiles (amount of forward projection). For this reason, each manufacturer produces a

number of ‘styles’.

It’s important to take your natural breast width into consideration. Your surgeon will measure the

base diameter of your chest to determine the ideal width of implant. If the implant is too wide for

your chest, you may get ‘webbing’ between your breasts (symmastia) or too much ‘side boob’. If the

implant is too narrow, it will not fill the chest appropriately and be difficult to create a shapely cleavage.

The choice of implant projection is to a large extent a personal one. A woman with adequate breast

tissue and a shape she is happy with may opt for a low-profile implant that will simply increase the

size of her breasts. Another patient seeking to create cleavage, or a patient with some degree of sag,

may prefer a high-profile implant that can help achieve these results.

During your consultation, your surgeon will take into consideration the width of your chest and

breast tissue and advise you on the most suitable implant size and style for your individual anatomy.

Implant material

This next crucial factor looks at the type of fill (saline or

silicone) as well as the shell of the implant wall (smooth or


Silicone vs saline

Saline and silicone breast implants both have an outer

silicone shell, however they differ in material, consistency

and techniques used for placement. Both types of implants

have their own advantages and risks.

Silicone gel-filled implants are used more commonly in

Australia. Silicone implants contain a cohesive gel, designed

to mimic real breast tissue. It has a slightly firm, non-runny

consistency, which can give a more natural feel. As the gel

is not liquid, the risk of dispersal if the implant ruptures is

minimised. It also typically maintains its shape better than

a saline implant, especially in the upper part of the implant.

Saline-filled implants use a medical grade saltwater

solution, which makes the implant feel like a water-bed. This

can be controlled to an extent by the volume of fill in the

implant. If implant rupture occurs, the saline is absorbed by

the body. However, saline implants feel firmer than silicone

implants and have a higher risk of visible folds and ripples.

Unlike silicone gel implants, saline implants can be filled

through a valve during surgery. Because of this, the insertion

of the implants generally requires a smaller incision than that

associated with silicone gel implants. The amount of fill can

also be adjusted after surgery, which is not possible with

fixed silicone gel implants.

Smooth vs textured

Implant shells can be smooth or textured. Smooth-shelled

implants are easy to insert and make the breast move and

feel more natural than a textured shell. However, they have

increased risk of capsular contracture (hardening of the

breast), which is a common reason for re-operation.

Textured implants have a thicker shell and the very nature

of their surface means they can grab onto and adhere to

the surrounding tissue, causing less friction between the

implant and breast pocket and therefore helping to reduce

the risk of capsular contracture. Many surgeons also believe

it offers them greater control over the ultimate shape of

the breast.

Round implants come in smooth and textured shells, but

anatomical implants have textured surfaces only to allow for

better integration with the surrounding breast tissue. The

implant may still flip or move and distort the appearance of

the breast, so the surgeon must be experienced with this

type of implant.

The polyurethane foam coated breast implant gained

approval for use in Australia in 2008. Used in South America

and Europe since the 1970s, it was designed to significantly

reduce rates of capsular contracture. With the foam coating,

the collagen fibres that surround the implant are not lined

up, but sit in a circular pattern around the foam structure.

This means they are less likely to slide over one another and

contract. There are differences in technique with this type

of implant, such as the pocket size used to accommodate

the breast implant needs to be typically bigger than usual.

Regardless of the type of implant women choose, the

shape, texture and size can be customised to reflect her

individual body type and aesthetic goals.



Incision site

There are four incision options: the inframammary crease (under the breast

where it meets the chest), periareolar (around the nipple), transaxillary (inside the

armpit) and transumbilical (through the navel).


The inframammary incision is the most common breast augmentation incision

used today, made in the crease under the breast close to the inframammary fold.

The surgeon creates a pocket for the breast implant, which is slid up through the

incision, then positioned behind the nipple.

This incision offers the best exposure for visualisation and allows the implant

to be placed over, partially under or completely under the chest wall muscle. The

scar is hidden in the crease under the breast and is not normally visible when

wearing a bikini top.


The periareolar incision is another widely used method for placing breast

implants, particularly for those . An incision is made just beyond the areola, which

is the darker area of skin surrounding the nipple. The incision should be made at

the very edge of the areola where the dark tissue meets the lighter breast tissue,

which makes the scar least visible.

Similar to the inframammary incision, the periareolar incision allows the

surgeon to work close to the breast. It is possible for the surgeon to easily and

precisely place the breast implants in various positions in relation to the chest

muscle. However, this is the only incision that involves cutting through breast

tissue and ducts, and sensitivity in the nipple may be reduced.


The transaxillary incision is made in the natural crease of the armpit and a channel

is created down to the breast. This may be performed with an endoscope (a

small tube with a surgical light and camera in the end) to provide visibility. The 79


implant is inserted and moved through the channel into a prepared pocket.

The greatest advantage of an underarm breast augmentation incision is that

no scar is left on the breasts. The scar is virtually invisible in the armpit fold and

lack of tension generally makes for straightforward healing.

The transaxillary site is relatively far from the breast, where the surgeon needs

to create a pocket for the implant, so visibility is limited. There is also a higher

incidence of the implant being positioned too high and a greater risk of breast

asymmetry after surgery.

Transumbilical or navel (TUBA)

The TUBA incision is made on the rim of the navel. An endoscope can be used to

create a tunnel and to provide visibility to the surgeon. After a pocket is created

in the breast, the implant is inserted through the incision and moved up into the

breast area and positioned in the pocket.

The resulting scar from the TUBA incision is typically virtually undetectable

and does not appear on the breasts. Inserting breast implants through the navel

requires only one incision (and scar) for both breasts, while other incision sites

require separate incisions.

However, this incision can only be used for saline implants as the filling is

added after the implants are placed. Also, the distance of the incision from the

breast can reduce the surgeon’s ability to control bleeding and to position the

implant correctly.



The placement of breast implants can have a significant impact on the final

outcome of breast augmentation and therefore it requires individual consideration.

Experienced surgeons base their implant placement decisions on factors

such as the individual patient’s quantity of breast tissue, natural breast size

and symmetry, the dimension and shape of the chest wall, the amount of

subcutaneous fat and the quality of breast skin.

Generally, there are three placement options: subglandular (in front of the

muscle), submuscular (behind the muscle) and dual plane (partially under the

muscle). There are pros and cons for each position.




The subglandular pocket is created between the breast tissue and the pectoral

muscle. This position resembles the plane of normal breast tissue and the

implant is placed in front of the muscle. Sometimes the implant is covered

by a thin membrane, the fascia, which lies on top of the muscle. This is called

subfascial placement.

This position is suited to patients who have sufficient breast tissue to cover

the top of the implant. This procedure is typically faster and may be more

comfortable for the patient than submuscular placement. There is generally less

post-operative pain and a shorter recovery period because the chest muscles

have not been disturbed during surgery. The implant also tends to move more

naturally in this position.

However, subglandular breast implants may be more visible, especially if the

patient has little breast tissue, little body fat and thin skin. With subglandular

implants, there tends to be more of a pronounced ‘roundness’ to the breasts,

which may look less natural than those placed under the muscle, but this is a

matter of personal preference.


The implant is placed under the pectoralis major muscle after some release

of the inferior muscular attachments. Most of the implant is positioned under

the muscle. This position can create a natural-looking contour at the top of the

breast in thin patients and those with very little breast tissue. The implant is fully

covered, which helps to camouflage the edges of the implant, as well as rippling.

With this placement, there is less chance of capsular contracture occurring.

There may be more post-operative discomfort and a longer recovery period.

The implants may appear high at first and take longer to ‘drop’.

Dual plane

The implant is placed partially beneath the pectoral muscle in the upper pole,

where the implant edges tend to be most visible, while the lower half of the

implant is in the subglandular plane. This placement is best suited to patients

who have insufficient tissue to cover the implant at the top of the breast but who

need the bottom of the implant to fully expand the lower half of the breast due to

sag or a tight crease under the breast.

This position minimises the rippling and edge effect in thin patients while

avoiding abnormal contours in the lower half of the breast. Generally, this

placement is able to achieve a more natural shape to the upper portion of

the breast instead of the ‘upper roundness’ that can be more common with

subglandular implants. However, it involves more complex surgery, which if not

performed correctly may result in visible deformities when the pectoral muscles

are contracted. csbm 81





for breast


Sydney plastic surgeon

Dr Darryl Hodgkinson

explains the benefits of

saline breast implants.

After performing breast augmentation surgery for more

than 30 years and having used every reputable type

of breast implant through every incision possible, I

have realised the benefits of breast augmentation but also

the limitations of the procedure.

Over the years the implant which has given me the least

amount of problems and the most satisfied patients with

the least amount of worry and angst has been the saline

implant. While the saline implant is not necessarily good

for everybody, I believe it holds numerous advantages over

silicone implants.

The main advantage of the saline implant is that there is

very little reaction to the implant – you cannot have any fill

in an implant less reactive than saline. Another advantage is

that the saline implant has never been taken off the market;

there has never been a saline scare and that is of great

solace to patients having breast implant surgery.

The third most significant advantage of the saline implant

is that because it comes uninflated it can be inserted through

small distant incisions, which means it can be used in the

TUBA (transumbilical breast augmentation) incision and

through the axillary incisions in the armpits. It is particularly

Asian patients (most commonly due to a higher incidence

of keloid scarring on the breast) and models (who do not

wish to have any telltale marks on their breasts) who like

the incision hidden and therefore request the axillary and

sometimes TUBA approach. Only the saline implant can be

used this way.

There are also some particular aesthetic advantages to

the saline implant. The implant, as one patient said, has

“the jelly factor”, so that when the patient moves the implant

adds a slight shimmy to the movement of the breast that

is very much like natural breast tissue. Gel implants, on the

other hand, have very little, if any, movement.



The saline implant remains much more popular in the

United States than in Australia and I think that is basically

because many of the surgeons in the US had to become

familiar with the saline implant after the silicone implant was

removed from the market in 1992. Once they became familiar

with the implant, the surgeons were happy with the results.

The rate of capsular contraction or hardness with the

saline implants is also particularly low and therefore a further

significant advantage to patients, meaning they are unlikely

to develop a hardness around the implant and a deformity

to the shape of the implant.

The saline implant comes in exactly the same sizes

and shapes as the silicone implant. The saline implant

has exactly the same rate of rupture as the gel implant.

The difference with the saline implant is, however, that the

implant deflates so that the patient knows a rupture has

occurred and can have the implant replaced as opposed

to having it leak slowly over a period of time. The further

advantage again is that the patient has a material in her

body which is naturally occurring – sterile saltwater – as

opposed to a foreign substance – silicone gel.

We all know that having breast implants at an early age

does not mean that it is a once in a lifetime procedure and

the suggestions are now that, especially with gel implants,

the implants be monitored regularly with a view to having

them changed on a regular basis every 10 years. There is

not a suggestion to change without cause, such as deflation

with the saline implant.

Although there is no perfect implant, for patients who

are realistic, do not want too big a result, and are not

too thin, the saline implant is an ideal solution to breast

enhancement. csbm


AFTER saline breast implant surgery by Dr Hodgkinson


AFTER saline breast implant surgery by Dr Hodgkinson 83




for both















Breast surgery is sought out by both men and women to help reverse the signs

of ageing, or bring the body more into proportion. For men, gynaecomastia,

or “man boobs”, can occur due to weight gain, supplement abuse or with

hormonal changes during puberty. For women, breast augmentation can help

counter the changes that occur with age and child bearing or, in younger patients,

add volume and create a more balanced silhouette.

No matter what the reasons for seeking breast surgery, both men and women

experience similar concerns going into the consultation. ‘It may come as a

surprise, but many of the same elements pertain to men as they do to women in

breast surgery,’ says Dr John Flynn from Queensland. ‘As we age, the glandular

component in the breast decreases and is commonly replaced with fat. This can

lead to loss of volume and sagging breasts in women, as well as gynaecomastia

in some men, particularly those who are overweight. By balancing the fi gure,

and establishing more youthful contours, breast surgery can make a signifi cant

difference in both male and female patients.’

Breast surgery in women can involve both breast augmentation and a breast

lift. Depending on the patient’s concerns and existing anatomy, Dr Flynn will tailor

his surgical approach to achieve the most suitable result.

For younger patients, where the breast anatomy is still fi rm and glandular, a

stand-alone augmentation can achieve optimal results. But, in older women,

where collagen depletion in the skin has left the breasts drooping or sagging, a

lift and augmentation may be needed to create the same effect.

‘In the initial consultation, I take several measurements to help guide the

implant shape and size selection. However, I fi nd the most effective approach

is to let the patient simply try on different implants, to establish the size they are

most comfortable with,’ Dr Flynn explains. ‘The shape (teardrop or round) and

positioning (above or below the muscle) of the implant is always decided based

on the expectations, desires and existing anatomy of the individual patient.’

The surgical approach for male patients also depends heavily on the

composition of the existing tissue. In older patients, where the breast tissue is

predominately fat, liposuction may be suffi cient in correcting gynaecomastia. If

this is not suitable, Dr Flynn will use a surgical reduction, or a combination of

both surgery and liposuction, to achieve the desired result.



By balancing the

figure and creating

more youthful

contours, breast

surgery can make a

significant difference

in both male and

female patients


‘In younger patients, the tissue is more glandular and gynaecomastia can

occur due to the overuse of steroids and peptides or the onset of puberty,’ he

says. ‘Older males will sometimes experience gynaecomastia with weight gain,

however not all overweight males will suffer from it – it’s very selective.’

‘After surgery there is sometimes a hollowness where there used to be

swelling, and the skin is loose or lax,’ Dr Flynn explains. ‘We can use skintightening

laser or radiofrequency treatments to improve this, but it is a possible

outcome of which patients must be aware. Also, males are often less accepting

of scars on their breasts than females. The surgeon’s experience is essential in

managing all these components to achieve the best result for each patient.’

To help reduce the appearance of scarring in female patients, Dr Flynn usually

creates the incision in the inframammary crease, at the base of the breast in the

breast fold. ‘The inframammary crease allows good surgical access but it is also

is where the scar is best hidden,’ he says.

The surgical outcomes in both male and female patients depends greatly

on the recovery period. A well-planned recovery, involving a diligent follow-up

process, is imperative in securing the optimum results following breast surgery.

Because of the number of elements involved in breast surgery, and the

different techniques required for male and female patients, Dr Flynn explains

the surgeon’s experience is paramount in creating natural-looking results, with

minimum risk of complications.

‘It is essential the surgeon is aware of all aspects involved; fatty vs glandular

tissue; the change to the skin’s collagen with age; and the differences between

male and female patients,’ Dr Flynn explains. ‘In taking these elements into

account, the surgeon can create optimum results in breast surgery and help

restore or improve each patient’s body confidence and self-esteem.’ csbm



AFTER female breast surgery (breast augmentation) by Dr Flynn


AFTER male breast surgery (gynaecomastia) by Dr Flynn 85




Sydney cosmetic

surgeon Dr Colin

Moore explains

breast implant

surgery can

recreate more

youthful breasts

and contours. Tara

Casey reports.

In some cases, breast surgery acts as an anti-ageing procedure to return

fullness to the breast and create more youthful contours. Following childbirth

and with age, many women want to recapture how their breasts looked

before having children, as breastfeeding commonly causes slight breast atrophy

or ptosis.

‘Rather than seeking a bust that is significantly larger than their own, many

women simply want to balance their figure and create a more shapely silhouette,’

says Sydney cosmetic surgeon Dr Colin Moore. ‘In such cases, it may be more

beneficial to perform a breast lift (mastopexy) and, depending on the patient, this

can then be combined with a small breast implant to restore lost volume.’

A common concern in women considering breast augmentation is whether

or not the results will look natural. Dr Moore explains that preparation and a

thorough consultation process can help ensure the results are consistent with

the patient’s existing anatomy and surgical expectations.

‘Creating a natural-looking result comes down to accurately measuring the

proportions of each patient, but I also believe that advances in breast implants

mean that it is easier than ever to achieve natural-looking curves,’ Dr Moore

explains. ‘By measuring the proportions of the body, as well as skin thickness

and breast tissue composition, together the surgeon and patient can determine

the best breast size for the patient.’

During the initial consultation, Dr Moore takes several measurements to

accurately gauge the best implant size and position.

‘The basic dimensions of the breast are taken into account, including the

breast base, height and overall width,’ he explains. ‘The distance from the

nipple to the inframammary crease (underneath the breast) is influential in the

appearance of a perky breast. Also, by measuring the relevant proportions of

the body, it’s possible to determine the best breast size to enhance the patient’s

overall figure.’

Dr Moore prefers to use polyurethane-coated P-URE implants in breast

augmentation surgery, as he believes they carry an excellent safety profile and

afford natural-looking results. ‘In my experience, polyurethane-coated breast

implants produce very natural-looking results while minimising the risk of the

most common complications associated with breast augmentation,’ he



says. ‘I believe polyurethane-coated P-URE implants have provided a significant

breakthrough in breast implant surgery.’

All types of breast implant comes with a risk of skin rippling, movement after

insertion and capsular contracture – where the scar tissue that forms around the

implant begins to contract, causing the implant to painfully distort and harden.

Polyurethane-coated implants help reduce the rate of capsular contracture, as the

textured implant surface forces the body’s collagen to surround the implant in a crisscross

pattern, preventing contraction and lessening the chance of implant alteration.

‘A number of studies have shown there is only a one percent risk of capsular

contracture with polyurethane-coated implants, which is a significant improvement

on the 10 percent risk associated with saline and silicone implants,’ says Dr Moore.

With so many choices in terms of implant size, shape, projection and material,

an experienced surgeon can help guide women on the best breast to enhance their

body. ‘It comes down to the proportions of the figure and the desired result of each

patient,’ concludes Dr Moore. ‘These days patients are much more educated about

their options and are seeking an approach that will give them the most desirable

results, no matter what their chosen aesthetic. Breast augmentation has one of the

highest patient satisfaction rates, offering more natural-looking results than ever

before.’ csbm




AFTER breast augmentation by Dr Moore



AFTER breast augmentation by Dr Moore

BEFORE (exisiting scar on left breast)

AFTER breast augmentation by Dr Moore 87




and explore

your options

Adelaide pelvic reconstructive surgeon Dr Oseka Onuma

says genital surgery can restore confidence, self-image and quality

of life in patients with aesthetic or functional concerns.

Caitlin Bishop reports.

Sexual and reproductive health is integral to a

woman’s mental and physical wellbeing. Questions

surrounding the appearance and function of the

vagina and urinary system can plague women of all ages,

yet talking openly about these concerns can be challenging

for some women. A blanket of taboo means there is a lack

of open and honest public dialogue that makes it difficult for

some women to seek successful treatment – or even know

there are treatment options available.

Dr Oseka Onuma is a gynaecologist and pelvic

reconstructive surgeon based in Adelaide. He explains

that there is a widespread misunderstanding of what

is classified as ‘normal’ in both vaginal anatomy and

urogynaecological health.

‘I never make assumptions, as there is such a wide

spectrum of what is “normal”,’ he says. ‘The real problem

may be more subtle than the patient’s main concern, so

I need to know not only the symptoms but the length of

time they’ve been endured and the way they have impeded

upon the patient’s way of life.’

According to Dr Onuma, this wide spectrum of normality

means a thorough examination, with an experienced

doctor, is paramount in achieving an accurate diagnosis

and establishing the best treatment plan.

‘A thorough examination is required to correlate the

clinical findings with the symptoms, this results in high

success rates – both in terms of the surgery and patient

satisfaction,’ he explains.

Treating urinary incontinence

In cases of stress urinary incontinence, urethra

function is usually compromised and the

surrounding muscles and pelvic tissue are generally

weakened. This means urine can escape during

exercise or other movements such as coughing

or laughing.

There is a minimally invasive procedure to help

correct stress urinary incontinence. The treatment

uses tensionless vaginal tape (TVT), which is

inserted through the vagina and positioned

underneath the urethra to create a supportive sling.

This is held in place by surrounding tissue – no

stitches are needed – and, during movement or

exercise, the mesh supports the urethra and helps

maintain its seal.

Functional and cosmetic rejuvenation

In some cases, functional and cosmetic concerns go

hand-in-hand in genital surgery. The shape and anatomy of

genitalia is unique to every woman and the effects of child

bearing and age can take their toll on some women more

than others.

Many women suffer problems with their genitalia

after childbirth that can contribute to feelings of self-


consciousness and affect their relationship with sexual

partners. ‘With childbirth, the shape and tone of vaginal

tissue changes, sometimes results in embarrassment or

loss of sexual satisfaction,’ Dr Onuma says. ‘After childbirth,

there can sometimes be a reduced ability to contract

the vaginal walls and a feeling of “looseness” or reduced

sensation during intercourse.’

Oversized, elongated or asymmetrical labia minora can

also lead to aesthetic concerns and self-consciousness.

It can cause discomfort during sex and hinder certain

activities such as bike riding and horse riding, and often

makes wearing certain clothes such as swimwear, jeans or

tights uncomfortable.

‘Genital surgery can increase a woman’s confidence in

herself and her relationships,’ Dr Onuma explains. ‘Women

may not find it easy to talk to strangers, doctors or friends

about a loose vagina, labial discomfort or lack of vaginal

sensation but these issues need to be raised and explored

in order to provide the options for improving quality of life. ‘

Surgery can improve the appearance of the labia minora,

and is a viable option in treating protrusions or lumps within

the vagina, removing scar tissue, countering discomfort or

sagging at the vagina’s entrance and enhancing the tone of

loose or weak vaginal muscles.

While there is a range of surgical options, the approach

must be tailored to the individual patient. The consultation

process must address the specific concerns, anatomy and

expectations of each individual.

‘Each patient will have different motivations, concerns

and expectations in seeking genital surgery,’ he says. ‘It is

important to listen to the concerns of the individual patient,

assess them with appropriate examinations and offer a

series of potential solutions.’

Laser reduction labiaplasty can sculpt the labial minora

to reduce size and asymmetry. ‘Labiaplasty techniques

can reconstruct conditions that are a result of the ageing

process, childbirth trauma or injury,’ he says.

The procedure addresses the entire vulva – including

the labia minora, labia majora, mons pubis, perineum

and entrance to the vagina. These can all be surgically

enhanced, both functionally and aesthetically. The hymen

can be reconstructed in culturally sensitive cases or

refashioned when causing discomfort or protruding from

the vagina.

Laser vaginal rejuvenation can effectively enhance

muscle tone, strength and control. The laser technique

typically affords greater accuracy and results in rapid

healing, less pain and a faster recovery.

‘Women today are less willing to accept changes in

genital anatomy resulting from pregnancy, childbirth and

ageing,’ Dr Onuma explains. ‘There are a number of options

available, both surgical and non-surgical, to address and

hopefully resolve these problems. Taking action, and

exploring the options, can help restore self-confidence,

boost self-image and improve quality of life.’ csbm


Laser Vaginal

Rejuvenation TM


• Aesthetic and functional

labial surgery

• Curing urinary incontinence

• Restoring pelvic support

• Enhancing sexual gratification

• Resolving menstrual dysfunction


To empower women

with knowledge, choice

and alternatives

Dr Oseka Onuma



Gynaecologist &

Pelvic Reconstructive Surgeon

Laser Vaginal Rejuvenation

Institute of Adelaide

Robe Terrace Specialist Centre Suite

4 Robe Terrace, Medindie

South Australia 5081

Phone 08 8344 6085

Facsimile 08 8344 6087

Email 89

Vaginal tightening

MonaLisa Touch is a surgery-free laser treatment that helps

treat gynaecological concerns and restore vaginal tissue for an

anti-ageing effect. Caitlin Bishop reports.

The continuing developments in laser technology

have seen major advancements in skin enhancement,

body contouring and now gynaecology and vaginal

rejuvenation and tightening.

MonaLisa Touch, distributed in Australia by High Tech

Laser, is a new non-surgical way to treat vaginal atrophy –

a condition that causes symptoms including incontinence,

poor lubrication, itching, dryness and pain during

intercourse. MonaLisa Touch can also be used for aesthetic

purposes, to counter the effects of ageing and achieve a

rejuvenating effect by restoring vaginal tissue.

‘MonaLisa Touch has been developed to help patients

suffering from symptoms such as urinary incontinence,

painful intercourse, dryness, itchiness, burning, vulval and

vaginal pain, prolapse and laxity or looseness,’ explains

Dr Fariba Behnia-Willison, a gynaecologist from South

Australia. ‘These symptoms are part of a common condition

known as vaginal atrophy. Additionally, because of how the

treatment works, it can be used for vaginal rejuvenation.’

The versatility of MonaLisa Touch stems from the

technology it uses to improve the genital mucosa and restore

proper function in the treatment area. Using laser light, the

MonaLisa Touch probe – which is inserted into the vagina –

delivers thermal energy into the deeper layers of the vaginal

tissue. This kick-starts the body’s natural processes to

increase blood flow and stimulate the formation of collagen,

which improves the integrity and elasticity of the genital

mucosa. This can be effective in alleviating vaginal pain in

those patients experiencing gynaecological problems or

vaginal atrophy, or in simply tightening the vaginal walls for

a rejuvenating effect.

‘To put it in simple terms, the MonaLisa Touch procedure

stimulates the body’s natural processes,’ Dr Behnia-Willison

explains. ‘It creates more hydrated and healthy cells which

help to increase vascularisation, hydration and acidity,

which are important components of vaginal health.’

According to Dr Behnia-Willison, a treatment to

improve vaginal function is sought by a significant number

of patients, of many different ages. ‘Although many of

my patients are going through menopause or are postmenopausal,

there are also many younger women suffering

from similar symptoms,’ she says. ‘I have found the

treatment particularly effective for women who find it painful

to have sexual intercourse.’



without surgery

MonaLisa Touch delivers thermal heating at

specific depths in the tissue to achieve an optimum,

targeted result. Also, the fractionated effect means there

are areas of untouched tissue left between laser columns.

This healthy tissue helps promote healing and reduce

downtime after treatment.

MonaLisa Touch is a new

non-surgical way to treat vaginal

atrophy, as well as achieving

a rejuvenating effect by restoring

vaginal tissue

‘The advantage of the MonaLisa Touch procedure,

for both results and safety, is that it uses a fractionated

CO2 laser, which means the heat is deposited at the ideal

depth in the tissue,’ Dr Behnia-Willison explains. ‘And

because it is a fractional laser treatment it leaves most of

the superficial layer untouched, which is important from a

safety perspective.’

The treatment itself is non-invasive and requires no

anaesthesia. Often, a series of treatments is recommended

to achieve the best results. ‘MonaLisa Touch is a

straightforward and simple procedure. It involves a probe

being placed inside the vagina and the fractionated CO2

energy being delivered to the vaginal tissue,’ says Dr


‘The published research has shown that the best results

are obtained from three MonaLisa Touch treatments,

performed a month apart. Most patients notice a significant

improvement after the first procedure. I also recommend to

patients they may need a follow-up procedure every year or

so, after the initial course of treatments.’

As with any medical procedure, there are some

potential risks with the MonaLisa Touch treatment. ‘In my

experience, which is similar to that of overseas practitioners,

the likelihood of post-treatment complications following a

MonaLisa Touch treatment is minimal,’ she says. ‘The worst

side effect I have seen has been some mild discomfort for

12 to 24 hours following the procedure, but this is in only

a handful of patients and I have now performed more than

1,000 MonaLisa Touch treatments.’

Whether you’re looking to relieve the symptoms of

vaginal atrophy, or seeking a rejuvenating effect, MonaLisa

Touch is a viable option, backed by clinical research and a

history of success in a gynaecological setting.

‘Almost all of my patients notice a significant improvement

following the MonaLisa Touch procedure – some have

even described the treatment as life-changing,’ says Dr

Behnia-Willison. ‘I hope it becomes the new standard of

care for the many women suffering from these often painful

symptoms that can effect their everyday life. It certainly has

in my practice.’ csbm 91


Girl talk

Genital surgery is a popular option for Australian women hoping to

improve vaginal comfort, function or aesthetics, says sydney cosmetic

surgeon dr colin moore. Tara Casey reports.


Page 1




tomy Reversal





Genital surgery can help treat physical concerns

or alleviate vaginal discomfort. In most cases,

these results are seen alongside a return of selfconfidence

and improve sexual satisfaction. Indeed, genital

surgery is growing in popularity and there are a number of

options to help rejuvenate vaginal aesthetics and counter

the physical changes that can arise with age or childbearing.

‘Women who seek vaginal surgery have often noticed

changes to their vagina after giving birth or as a result of

ageing,’ says Sydney cosmetic surgeon Dr Colin Moore.

‘Depending on the patient’s concerns, I work with them to

decide the most appropriate treatment option.’


Cosmetic Surgery

‘A New You’

• Penis Enlargement – permanent

• Circumcision • Abnormalities (bends)

• Impotence • Vasectomy • Testicular Implants

• Breast Enlargement/Reduction • Tummy Tuck

• Face/Eye Lift • Vaginal Cosmetic/Surgical Repairs











Dr Colin Moore


To recieve an information pack call Lyn on

0414 251 234 or 1300 malepenissurgery



Finance options available

Stretched muscles and skin laxity often occurs after

childbirth, and can significantly change the shape of the

vagina both internally and externally. In such cases, Dr

Moore takes a holistic approach to vaginal rejuvenation,

addressing the loosened labial folds with a labiaplasty, and

the internal sling muscles through a vaginaplasty.

Dr Moore says the surgeon’s experience is imperative

to achieving the best results. ‘A vaginaplasty is a day

procedure which involves tightening the sling muscles in

the vagina by lifting the muscles, removing excess vaginal

lining and reattaching the muscles,’ he explains. ‘However,

it’s important that the patient knows that surgery will

not make them 20 years younger, as over-tightening

stretched vaginal muscles can cause cramps and spasms

during intercourse. This is where a senior surgeon’s

experience is essential.’

A labiaplasty involves excising excess skin to return

symmetry and improve aesthetics in the labia folds.

According to Dr Moore, this is a popular procedure for

younger patients and can be used as a stand-alone

treatment, or in conjunction with other surgeries.

‘Younger patients usually opt for labiaplasty alone to

correct an uneven appearance of the labial folds,’ says Dr

Moore. ‘Essentially, if a roughened edge is the issue, this

needs to be removed. If not, we slightly reduce the edges of

the labia minora back to the same level as the labia majora,

and often reduce excess skin covering the clitoral hood.’

In some cases, labiaplasty serves as a necessity in

improving vaginal hygiene for some women.

‘With large labia, urine can be trapped, allowing bacteria

from the bowel to migrate and colonise in the urethra,’

Dr Moore explains. ‘This can result in chronic urethral

contamination or even cause infection to be flushed back

into the bladder, causing bladder infections. For many

women, labiaplasty can rectify this.’

Typically, vaginal rejuvenation surgery is carried out as

a day procedure under general anaesthetic. Like any

medical procedure, there are potential complications

associated with genital surgery and the surgeon’s skill and

specialised experience is imperative in ensuring the best

results. csbm




5 workout myths

keeping up appearances

want to flaunt a toned and terrific bod this summer? here are some

exercise essentials to help get you started. words by Jarrat wood

Some people train for health, some people train for

performance and some people train for appearance.

Vanity aside, training for appearance is a realistic

option. Everyone has a body part that they wish was bigger

or smaller.

If you plan to train for appearance then remember some

important health and safety guidelines:

• Training opposing muscle groups unevenly can lead to

postural and functional deficiencies.

If you’re looking to get your body beach-ready for summer

• Health should be the number-one priority with an

(which is only just around the corner...), now is the time

exercise program and all exercise has an element of risk.

to start. But before you hit the training circuit, pay some

• There is a limit to how much you can vary your appearance.

attention to those pesky ever-present locker room rumours

Genetics will always be an overriding determinant of

that can hamper your fitness progress.

your appearance.

Lifting weights will make women

The following are some ‘cosmetic fitness’ suggestions for

look bulky

training outdoors as the summer months approach. Break


down your



myth couldn’t

into body

be any












women don’t produce enough testosterone to

gain huge amounts of muscle. In fact, strength training can



in helping




reduce your overall body fat percentage.


By running


stairs you






a higher













mass, which

and calves.

is something











you only



will load




quadriceps ensuring an

all-round leg workout. Try doing normal running or walking

intervals with Doing some crunches variations as and you ab advance. workouts will

get rid of belly fat

Back: reverse flyes

Fact: It’s difficult The unfortunate to train your truth back is without that spot heading training to the doesn’t gym,

work but to when add it some comes definition to losing to specific your trapezius fat pockets. and rhomboids You can’t

control (the major the places muscles of between fat reduction your when shoulder you blades) work out. try If a

you reverse already fly and have extension. a high percentage of body fat covering

your Lie abs, face you down will on need a bench, to raise reduce your your arms overall out to your body sides, fat

percentage then move your before arms your in an abs arc are above revealed. your head. Ab Reverse exercises the

don’t movement help you back lose to the belly starting fat – position. they simply For a help more define advanced the

underlying workout use musculature. some dumbbells for extra resistance.

Chest: push-ups

There is really no better all-round exercise than the push-up

when training outdoors. Place your hands shoulder width

or slightly wider with your wrists slightly above the nipple

line but below your shoulders. If you wish to focus more on

your chest muscles, place your hands a little wider and move

your elbows away from the body as you lower yourself.

To focus more on the triceps bring your hands a little

closer to your body and keep your elbows close to your body

Cardio burns the most calories

as you lower yourself to the ground. Beginners should try

push-ups from the knees. If this is too difficult try push ups

Fact: It’s true that you will burn calories while doing

on a raised bench with feet on the floor or against a wall

cardio, but with strength training, even after you finish

(the more upright you are the easier the push up will be.

lifting weights, your body continues to burn calories for

Advanced trainers should try a full length push up raising

hours afterwards. The most important thing to remember




leg in the air


to increase

calorie intake,

the load


on the






occurs when you are burning more calories than you




While defined abdominals is appealing to many people,

the most


significant effect

is best





have on



appearance is in regards to posture. Try the following sit-up

Fact: variation


to assist




with walking

been led








Lie flat

a workout

on the floor,




up and










your chest,



much more

as your




and thigh




both almost





Focus on








as possible

up with


some light


cardio and







your straight

drills specific

leg at the






so that





heel is




off the ground.

This will









and repeat.



Try 8-10



your muscles







For advanced


trainers, try 2

legs at a time. Beginners should complete the leg movements

as above without More exercise the sit up. is always better

You should always seek the advice of a registered fitness

Fact: professional The number before undertaking of calories any you program. burn depends Visit your on local the

intensity gym for the of your personalised training. guidance When it you comes require. to working bella out,

it’s all about quality over quantity. In fact, high intensity

interval Jarrat Wood training is a personal can burn trainer more and calories the gym in manager a short at amount Regenesis of

time. Fitness A in few Edgecliff, days of Sydney. quality For exercise more information each week call will 02 9363 typically 0376

achieve or visit

better results than every day light training. csbm

Russell Cox from Regenesis Fitness debunks some workout myths

that could be slowing down your weight loss journey.

112 // bellaBEAUTY

Re-energise with

Regenesis Fitness, an

exclusive, friendly and

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Welcome to the next

generation of superfoods.

AimÉe Surtenich reports.

Not all foods are created equal. Certain foods have

been given the title ‘super’ for their ability to fight

disease, immune disorders and the signs of skin

ageing. Here are some of the new kids on the superfood

block – plus the foods that have earned cult health status.



Chia seeds

These tiny but mighty edible seeds, which date back to Mayan and Aztec

cultures, are an excellent source of fibre (three times more than oatmeal), protein,

calcium, antioxidants and omega-3s. In fact, chia is the richest plant source of

omega-3 oil, which is said to help lower cholesterol, reduce high blood pressure

and fight against inflammation in the body.

Chia can also help stabilise blood sugar levels and even help target pesky

belly fat! The seeds can be soaked in liquid or sprinkled onto just about every

meal to add a nutritious mildly nutty taste.


This nutritional powerhouse has become a household name over the past

few years – and it’s no wonder. With more iron than beef per calorie, kale

contains nine essential amino acids, as well as high levels of magnesium and

oxygen-rich chlorophyll.

It’s the ultimate detox food as it’s also rich in fibre and sulphur, lowers

cholesterol and is rich in antioxidant and anti-inflammatory properties to help

ward off several types of cancer. Rich in Vitamins A, C and K, kale also does

wonders for glowing, clear skin.


Move over walnuts, there’s a new nut rising up the nutrition leaderboard.

So why are pistachios said to be superior to their nutty counterparts? To

start, they contain fewer calories and more potassium and Vitamin K per serving

than other nuts. Pistachios contain two carotenoids not found in most nuts

– lutein and zeaxanthin – which are essential for eye health and defending

tissues from free radicals. They are also a great source of Vitamins A, B6 and E,

essential for healthy, smooth and beautiful skin, and are rich in phytoserols and

soluble fibre, two plant compounds that can lower cholesterol and reduce the

risk of heart disease.


Consumed raw, with all enzymes and goodness left in its unheated glory, cacao

has more antioxidants than chocolate, red wine and blueberries combined! It is

choc-full with nutrients and incredibly high in iron. It also helps to raise endorphins

and boost our serotonin levels. Add it in powdered form to a smoothie or sprinkle

some over oats to add a delicious (and nutritious) chocolate flavour to your

morning porridge.


Pronounced ah-sigh-EE, studies have shown this Amazonian berry is one of the

most nutritious foods in the world. Resplendent in amino acids, antioxidants,

fibre, phytosterols and omega-3 fatty acids, it also has powerful cancer-fighting

properties, is a stem cell producer and assists with weight loss. 95



Essentially mineral-rich seaweed and packed with high levels of demulcent fibre,

kelp can actually help heal the digestive tract and is one of the best natural

sources of iodine, which promotes thyroid and endocrine function. It also helps

boost the immunity system and even improve memory.


These Middle Eastern jewel-like seeds have earned their place as a superfood

due to their high levels of polyphenols, powerful cancer-fighting and hearthealthy


It is said that pomegranate seeds have more antioxidant power than cranberry

juice or green tea. Pomegranate is rich in Vitamins A, C and E, and in iron, which

helps the blood maintain an effective supply of oxygen to the body.


This supergrain, pronounced KEEN-wah, contains more protein than any other

grain and is super-charged with iron, potassium and all nine essential amino

acids while being naturally gluten-free.

A cup of quinoa delivers five grams of fibre and aids in improving digestion,

lowering cholesterol and promoting healthy blood sugar levels. Oh, and it’s great

at keeping excess kilos at bay.

These days, you’ll find it adorning many a cafe and restaurant menu, but you

can easily create a delicious quinoa-inspired meal at home, too. Add to salads,

soups or try it as an alternative to rice.




These superfoods may not be the new kids on the block, but they’ve stood the

test of time in promoting inner health and external radiance.

Oily fish

Sardines, herring, trout and salmon are all rich sources of omega-3 fatty acids,

which help prevent heart disease. They’re also good news for osteoporosis

prevention and can improve the texture of the skin and hair.

Oily fi sh is a good source of Vitamins A and D. Vegetarians can boost their

intake of omega-3 by taking supplementary capsules daily.

Essential fatty acids play an integral part in skin hydration, cell renewal and

protecting the epidermis against harmful bacteria. These unsaturated fatty

acid chains maintain the permeability barrier of the stratum corneum – or the

top layer of the epidermis. This barrier protects the skin from bacteria to prevent

acne and inhibits trans-epidermal water loss to maintain skin hydration.

Dark leafy greens

Leafy green vegetables are packed full of goodness, and spinach is the best of

the bunch. It contains Vitamins A and C and folic acid, as well as magnesium,

which is thought to help fi ght cancer and lower the risk of heart disease and

stroke. It also blocks free radicals, which cause signs of ageing on the skin, and

may even help prevent osteoporosis.

Green tea

Most types of tea contain fl avonoids called polyphenols, however green tea

contains less caffeine than black tea and is also thought to aid digestion and

may stimulate the metabolism. Many green tea drinkers also report that drinking

a couple of cups a day helps to maintain clear skin.

Cranberries & blueberries

Cranberries have long been used to ward off urinary tract infections and are

packed with antioxidants. More recently, it has been discovered that cranberries

also contain anti-carcinogenic compounds, which can prevent or delay the

development of cancer.

Blueberries deliver high levels of antioxidants called anthocyanins, which have

been shown to lower cholesterol, prevent blood clotting and protect body cells.

They also contain Vitamins C and E, in addition to fi bre and folic acid, which is of

benefi t to women who wish to fall pregnant.


Up until a couple of decades ago, avocados had a relatively bad name, thanks

to their higher levels of fat than most fruits and vegetables. However, word is

defi nitely spreading that this fat is good fat: healthy monounsaturated fatty acids

actually appear to lower ‘bad’ cholesterol levels and raise the ‘good’ levels.

Avocados are also rich in antioxidants, which are thought to slow the body’s

ageing process by destroying free radicals and slowing oxidation. Antioxidants

also reduce allergies and the risk of heart disease and cancer. csbm 97




the ages

Sydney plastic surgeon

Dr Steven Liew says a pesonalised

beauty treatment program enables

people to look their best at every

age. AimÉe Surtenich reports.

Sydney plastic surgeon Dr Steven Liew believes the

new generation of advanced cosmetic non-surgical

treatments are delivering such remarkable results

that in the future most patients, if properly treated, will no

longer require major facial cosmetic surgery. Instead, regular

maintenance with non-surgical treatments will become the

norm – combined with more minor surgical procedures

where required.

A global leader in the development of advanced cosmetic

facial treatments, Dr Liew has developed the Beauty Through

The Ages Program, a personalised beauty treatment plan that

helps guide patients through each decade with the best and

latest procedures available at Dr Liew’s Shape Clinic.

‘The new treatments deliver such natural-looking results

that patients can be a more beautiful version of themselves

at every age,’ says Dr Liew. ‘Regular non-surgical procedures

to beautify the face and skin is far more effective than waiting

until invasive surgery is needed to repair sagging jowls and

skin folds. But for patients with significant skin looseness of

the eyelid, lower face and neck, then eye, face and neck lift

surgery still and always will be the gold standard.’

Treatment plans under the Beauty Through The Ages

Program ensure a more targeted, effective approach for every

age, including:

Your 20s

Most cosmetic treatments for people in their 20s are nonsurgical

(wrinkle relaxers such as Botox, and fillers) and are

aimed at beautifying the face.

Apart from basic treatments such as lip enhancement,

Shape Clinic also offers Dr Liew’s advanced, pioneering

techniques – including his total facial reshaping procedure,

a ‘glamorising’ treatment which can transform the ‘girl next

door’ to a stunning beauty.

Surgically, breast augmentation surgery is the most popular

at this age group, says Dr Liew.

Your 30s

This is the decade when we start to notice the first signs of

facial ageing: most commonly lines and wrinkles on our brow

and mouth.

‘Botox and other injectables to reduce frown and laugh

lines and fillers to resculpture the cheek area will both

beautify the face and maintain youthful radiance,’ says

Dr Liew.

Your 40s, 50s and Beyond

At this age we are increasingly likely to combine non-surgical

treatments with surgery.

‘Face and neck lifts to reduce jowls and sagging neck skin

are in high demand, while eyelid surgery and brow lifts are also

popular,’ says Dr Liew.

‘Dermal fillers in this age group continue to be very effective

in creating a natural-looking and more beautiful appearance,

replacing lost volume to deflated cheeks, thinning lips and

softening the “marionette” lines around the mouth,’ Dr Liew

concludes. csbm



Non surgical 20s to 30s



A beautifully tailored, sensuous and juicy lip with Juvederm filler

AFTER lip enhancement with dermal filler by Dr Liew



Non-surgical lower eyelift with dermal filler to remove the tired dark circles

AFTER non-surgical enhancement by Dr Liew



AFTER non-surgical enhancement by Dr Liew

Non-surgical eyebrow and eye lift with Botox to lift the eyebrows and reduce heaviness of the upper eyelid to create

brighter, more attractive eyes



AFTER non-surgical enhancement by Dr Liew

Total facial beautification to narrow and define the jawline with Botox and to define the cheek definition with dermal filler 99


Beauty Through The Ages Program 20s to 30s



AFTER surgical upper eyelift procedure (in-office) by

Dr Liew



AFTER Asian ‘double eyelid’ surgery (in-office) by

Dr Liew



AFTER surgical lower eyelift procedure (lower eyebags

removed) by Dr Liew



AFTER keyhole browlift and surgical fat removal of

lower eyelids by Dr Liew




Non Surgical

40s, 50s, 60s


AFTER non-surgical enhancement by Dr Liew

Sunken and hollow cheeks created a sad and tired look. Dermal fillers were used to

transform her facial contour to a beautiful and healthy appearance



AFTER facial rejuvenation by Dr Liew

Total facial rejuvenation creating a refreshed and aesthetically pleasing appearance



AFTER facial rejuvenation by Dr Liew

Total facial beautification with strategic use of laser for skin capillaries, Botox and

dermal fillers



AFTER facial rejuvenation by Dr Liew

Total facial beautification with strategic use of dermal fillers, transforming the facial

structures and profile of the eyebrow, eyelid, nose, cheek and chin 101


Beauty Through The Ages Program

Looking The Best at Any Stage of Your Life


AFTER facial rejvenation by Dr Liew


AFTER facial rejvenation by Dr Liew

Beauty Treatment Plan (combining surgery and non-surgical procedures): This patient underwent upper and lower eyelift surgery and face

and 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

skincare and strategically planned non-surgical treatments by Dr Liew.




Now you can read every editorial and view every before and after photo from your

trusted cosmetic surgery source for free online at Look out for

bonus content plus exclusive behind-the-scenes videos of the current issue!


















biggest The







The Science & Expertise

Behind Natural-looking Results

for outstanding, natural-looking facelift results, Sydney

plastic surgeon Dr Darryl Hodgkinson says surgical expertise

and experience are paramount.

No one wants a tight facelift or to face the public

derision that so many celebrities face, especially

men, when they have a tight, stretched and

unnatural-looking face after facelift surgery. Why is it that so

many people have this ‘operated on’, tight look which is a

giveaway they have been ‘under the knife’?

The answer could be twofold: they have opted for lesser

procedures such as S-lifts or skin lifts, or the surgeon lacks

the experience and expertise in facelifting necessary to

create a result that is both visible and natural in appearance.

In the case of the lesser procedure, the skin lifts which

are marketed under many different names, use the skin

No two faces age exactly alike;

some age around the brow or

eyes, some in the mid face, and

others around the jowls.

like cling wrap to pull back the tissues. These cases seem

attractive at first as they take less time, less expertise, have

potentially less downtime for the patient in healing and

therefore cost less.

The problem arises in that when using the skin like a

corset to hold back the sagging tissues underneath, these

lax structures and fat pads which needed to be secured are

still underneath, ready to bulge out like when you squeeze

yourself into too-tight jeans and create a ‘muffin top’.

Another problem is that this pulling back on the skin

under tension places stress on the suture lines, which can

cause scars to migrate and be more visible.

Finally, to create this tension, more skin needs to be

removed than is natural and if a secondary or corrective

procedure is considered at a later date, it will be more

difficult as there may not be enough skin and there may be

wider scars to contend with.

The second case is, of course, the experience and

expertise of the surgeon. As in all cosmetic plastic surgical

procedures, the number-one factor in defining the quality of

the result is the skill of the surgeon. Face lifting and neck

lifting surgery is an area of expertise unto itself.

The surgeon must have a highly detailed knowledge of

the intricate facial anatomy to work in the deep plane to

secure these tissues without damaging tissues or, worse,

nerves which could lead to a facial palsy.

Also, there are many techniques which can be deployed

in conjunction with one another to create an overall more

natural look as no two faces age exactly alike. Some faces

age around the brow, with drooping and sagging or furling

of the brow; some around the eyes with drooping, bulging

and wrinkling; others through the mid face with hollowness

created as the fat pads resorb from the cheeks; while

others show ageing mostly around the jowls and neckline.

Some people have a little of each of these aspects and

to adopt one approach to all faces will lead to the classic

maligned facelift: a tight face with pulled earlobes and the

tell-tale droopy neck.

With a skilled surgeon, a natural-looking result can be

achieved for each patient, addressing their unique signs of

ageing and taking 10 years off the clock. csbm

For more detailed information on the types of facelifts

Dr Hodgkinson performs, visit www.cosmeticsurgeryoz.





AFTER face and neck lift and upper and lower blepharoplasty by Dr Hodgkinson


AFTER face and neck lift and upper and lower blepharoplasty by Dr Hodgkinson 105


lowering the hairline

for facial harmony

Sydney plastic surgeon Dr Warwick Nettle explains lowering

the hairline to reduce an overly large forehead can make a significant

improvement to facial beauty. Caitlin Bishop reports.


high hairline or elongated forehead can detract

from facial balance and add to the appearance of

an ageing face, particularly in women. According

to Sydney plastic surgeon Dr Warwick Nettle, a hairline

lowering procedure can help restore facial harmony,

bringing the hairline and brow to more aesthetically

pleasing proportions.

‘Typically, the hairline should start at around the

transition point between the vertical forehead and the point

where the forehead starts to slope backwards towards the



scalp – usually between 5 and 6cm above the eyebrows,’

he explains. ‘It can look relatively unattractive if the hairline

starts well above this transition point.’

According to Dr Nettle, a higher hairline is usually of

greatest concern in younger patients. Patients most suitable

for surgery usually have flexible skin on their forehead, while

hair density, the presence of any hair whorls or cowlicks,

and hereditary hair loss must be taken into

account before undergoing the procedure.

‘If a patient has a relatively flexible

scalp — in other words if they can wriggle

it backwards and forwards quite freely —

we can achieve a good lowering of the

hairline and forehead reduction,’ he says.

‘If the scalp is not flexible, however, it can

be more difficult to advance the scalp to

reduce the forehead and sometimes twostage

surgery is needed.’

Hairline lowering surgery is commonly

performed at the same time as brow

lifting surgery. It’s important for patients

to understand that hairline lowering does

not necessarily elevate the brows, and

sometimes the surgeries need to be BEFORE

performed in conjunction to achieve the

best aesthetic result.

During the hairline lowering surgery,

an incision is made along the existing

hairline and the hair-bearing scalp is lifted

and moved forwards. The type of incision

is essential in ensuring the best results

– as the hair needs to grow through the

incision during the recovery phase to help

camouflage any scarring.

‘The technique used in hair lowering

surgery is called a trichophytic incision, and

allows hair to grow along the scar during

recovery,’ he says. ‘It’s also important for

the surgeon to understand the direction

of hair growth and preservation of scalp BEFORE

blood supply. These are all technical

details which help ensure optimal results.’

The surgery is performed as a day

surgery procedure, either under general

anaesthesia or with intravenous sedation.

Before the patient leaves the operating

theatre, a light dressing is applied to assist

in healing. The sutures are usually removed

three to seven days post-operation.

‘In my experience, the procedure is

typically very well tolerated,’ says Dr

Nettle. ‘The vast majority of my patients

are able to return to work within three to

seven days of the surgery. I always tell

patients they need to be prepared to wear

their hair in bangs to cover the incision line


for the first year. However my personal experience is that

it is very unusual for anyone to need to keep their hairline

covered beyond three months. In fact, many patients are

able to wear their hair pulled back within weeks of the


‘Hairline lowering surgery can make a real difference in

harmonising and feminising the face,’ he concludes. csbm

AFTER hairline lowering surgery by Dr Nettle

AFTER hairline lowering surgery by Dr Nettle

AFTER hairline lowering surgery by Dr Nettle 107


Options in facelifting

Sydney facial surgeon Dr Paul Gerarchi explains the most

popular types of facelifts – both surgical and non-surgical.

Caitlin Bishop reports.

The development and refinement of face lifting surgery

has stemmed from a growing understanding of

the ageing process. Sydney facial surgeon Dr Paul

Gerarchi has built his practice upon the modern day facelift

and addressing all elements – from skin laxity to volume

loss – that contribute to an aged appearance.

‘Today, face lifting surgery manipulates the supportive

soft tissue underneath the skin to reverse the effect of

ageing,’ Dr Gerarchi explains. ‘This should be achieved

without putting unnatural tension on the skin itself, to avoid

that “over-tightened” look.’

A facelift is often touted to be the gold standard in

improving a tired or aged facial appearance. It helps smooth

the skin, removing folds and wrinkles, and re-establish

more youthful-looking facial contours and definition along

the neck and jaw line.

‘It is a myth that there is a “right” age to have a facelift,’

Dr Gerarchi explains. ‘Facelifts are suitable for most

patients, men or women, young or old. If you feel that your

facial features are heavy or sagging, particularly in the jaw

line, a face lifting procedure will help refresh and brighten

the appearance.’

Dr Gerarchi offers a wide spectrum of face lifting

procedures, from minimally invasive options to surgical

intervention. Volumisation and short scar procedures afford

an effective option for those who aren’t able to commit to

the downtime involved in surgery.

Alternatively, more extensive surgical lifts can achieve

significant and long-lasting anti-ageing results. Dr Gerarchi

will always tailor his approach according to the patient’s

desires, expectations, anatomy and degree of ageing.

Comprehensive facelift

A traditional facelift procedure lifts and remodels the

underlying facial soft tissue, before re-draping the skin over

these newly defined contours. The superficial muscular

aponeurotic system (SMAS), which is the underlying

musculature of the face, is lifted and re-tightened during

facelift surgery.

In addition to the SMAS technique, other types of

comprehensive face lifting procedures include the sub

SMAS and Deep Plane procedures. They all involve an

incision that runs from the hairline above the ear, around

and behind the ear, and into the hair behind the ear. The

length of incision allows the surgeon to operate more

comprehensively on the muscles and ligaments beneath the

skin, affording greater visibility. It also assists in addressing

and reshaping the neck skin and soft-tissue.

Face lifting surgery typically requires an overnight stay

in hospital, and a minimum of two weeks off work. During

recovery, a facial compression garment is worn, and pain

medication is sometimes required in the days following

the procedure.

‘The traditional facelift can be very effective for elevating

more advanced facial drooping and sagging,’ Dr Gerarchi

explains. ‘Like other kinds of facelifts, they can be combined

with complementary procedures such as a neck lift, brow

lift or eyelid surgery.’

Short-Scar Facelifts

A short-scar facelift is best for those patients who notice that

their face is beginning to droop, or their jowls are sagging,

but who are not yet ready for the more comprehensive

facelift procedure.

During a short-scar facelift, an incision is made in the

crease in front of the ear. This enables the surgeon to

manipulate the underlying soft tissue to reverse moderate

heaviness in the jowl and lower face. Because the incision

and tissue adjustment is relatively minimal, patients can

usually go home the same day of surgery, and one to two

weeks of recovery time is required.

‘I often combine short-scar facelifts with liposuction

below the chin. This helps enhance the jaw line and

contributes to a more harmonious result,’ Dr Gerarchi



explains. ‘Sometimes patients will need more volume in

their upper cheeks and mid-face to accompany the lift. For

these patients, I use a fat transfer procedure to improve the

final rejuvenation result.’

Volumetric Facelift

Volume loss is one of the most noticeable hallmarks of

ageing. As the face ages, and gravity takes its toll, volume

drops from the cheeks and mid-face. This contributes to

a thin, gaunt and hollow appearance, and often leads to

heaviness in the jowl area.

A volumetric facelift solely addresses volume loss. It

rejuvenates the face, restores fullness and recreates more

youthful facial contours and angles.

During this procedure, fat is taken from the abdomen

or the inside of the knees and reinjected into the cheeks,

chin, temples and mid-face. Although synthetic fillers are

sometimes used to achieve a similar result, Dr Gerarchi

believes the patient’s own fat delivers a long-term

rejuvenation with minimal complications.

‘Using your own fatty tissue minimises the complications

associated with the insertion of foreign materials into the

body,’ he explains. ‘Any excess oil or fluid is extracted from

the fat before insertion, and the purified fat is reinjected

into the face. This replaces lost facial volume for a longterm

result, though sometimes “top up” treatments are

necessary to achieve maximum effect.’

The fat transfer procedure has a good safety profile and

involves minimal down time. It is an attractive option for

patients who do not want or need a surgical facelift, but

who are looking to reverse or waylay the most noticeable

signs of ageing.

If you feel that your facial

features are heavy or sagging, a

face lifting procedure will help

freshen the appearance

‘Volumetric face lifting is an effective procedure

which can achieve significant anti-ageing results,’ says

Dr Gerarchi. ‘However, the procedure is not suitable for

patients with excessive loose skin and jowling. In these

cases, volume addition should be combined with a

surgical facelift to achieve the desired result. Optimal facial

rejuvenation results are achieved when the face is both

lifted and filled.’ csbm



AFTER face, mid-face and neck lift by Dr Gerarchi 109




AFTER facelift and volumetric fat transfer by Dr Gerarchi



AFTER facelift, neck lift and rhinoplasty by Dr Gerarchi



AFTER facelift, neck lift, blepharoplasty and rhinoplasty

by Dr Gerarchi



Rhinoplasty and Facelift Specialist


Rhinoplasty and Facelift Specialist



expert expert surgical & non-surgical facial facial rejuvenation

The The Face Face Institute and and Dr Dr Paul Gerarchi, Suite 4, 12-14 Malvern Avenue, Chatswood, NSW. NSW.

For For more more information, visit or or call call (02) (02) 9412 9412 4599. 4599.


Minor surgeries,

major results

Sydney cosmetic physician Dr Buddy Beaini says less can definitely

be more when it comes to cosmetic enhancement surgery.

Caitlin Bishop reports.

Minimally invasive options for facial rejuvenation can

help reverse the signs of ageing and waylay the

need for surgery. Sydney cosmetic physician Dr

Buddy Beaini is experienced in delivering a comprehensive

range of cutting-edge minor surgical treatments for his

patients. In particular, thread lifting, blepharoplasty and bat

ear correction (otoplasty) are minimally invasive procedures

that can achieve significant results.

‘Minimally invasive procedures are key to rejuvenating the

appearance and reversing the signs of age for individuals of

all ages,’ says Dr Beaini. ‘When selected appropriately and

used in combination, minimally invasive procedures can

make the patient look five to 10 years younger.’

With a range of light therapies, minor surgeries and

injectables at his clinic, Dr Beaini takes a personalised

approach with every patient. He will work with a range of

modalities to ensure the best result for each individual.

‘Patients of all age ranges have been consulted and

treated with excellent results,’ he says. ‘With the current

advanced technology and techniques, facial rejuvenation

has developed dramatically, giving patients the options to

look and feel younger without the need for major surgery.’

‘During consultation, I ask my patients to describe

their main concerns and I will outline the advantages,

disadvantages, success rates, downtime and budget

involved with a number of relevant treatment options,’ Dr

Beaini adds. ‘For those patients who are less specific,

and are hoping to look younger, fresher, rejuvenated or

“happier”, I make an assessment of how we can improve

the patient’s overall image and appearance.’

Thread lifting

Signifying a minimally invasive way to lift the skin, threads

can be used to lift the brow, face and neck, as well as

reposition the cheeks, reduce the jowl and enhance the lips.

The procedure involves inserting dissolvable threads

into the skin’s dermis, or support structure, to trigger the



synthesis of collagen and elastin at the site. The threads act

as scaffolding for the production of these new connective

fibres, lifting and bolstering the tissue for an anti-ageing

and rejuvenating effect.

‘I have been performing mini-facelifts and neck lifts with

threads over the past two years,’ Dr Beaini explains. ‘We

have seen exceptional face lifting and rejuvenation results in

more than 95 percent of our patients.’

Thread lifting is suitable for those patients hoping to

reverse the descent of facial soft tissue associated with

ageing, or to waylay the need for a surgical facelift. It is

performed under local anaesthetic, and incurs some mild

swelling and possible bruising post-procedure.

‘Thread lifting is commonly used to address mid-face

drooping, deep cheek wrinkles, deep nasolabial lines,

excessive jowling and neck laxity,’ Dr Beaini explains.

‘Other concerns include brow droop, facial asymmetry and

loss of cheek positioning.’


AFTER Astarte Thread Lift by Dr Beaini

Eyelid hooding surgery

‘When we look at an individual’s face, our attention first

focuses on the eyes, and any abnormality or asymmetry,’

Dr Beaini explains. For this reason, blepharoplasty – or

eyelid hooding surgery – can achieve significant results in

rejuvenating the entire face.

The procedure involves excising excess fat and skin from

the upper and/or lower eyelids to open the eyes for a fresher,

more alert appearance. The day surgery is performed under

local anaesthesia, and can be used in conjunction with

other treatments such as brow thread lifting, non-invasive

skin tightening and laser skin rejuvenation.

‘If an individual has droopy, tired and ageing eyes, the

first impression is that is individual is sad, tired or unwell,’

says Dr Beaini. ‘Eyelid surgery is a very effective and longterm

solution for such individuals, and automatically has the

effect of revitalising the entire face.’


AFTER Astarte Thread Lift by Dr Beaini

Bat ear correction

Dr Beaini offers a permanent non-surgical treatment to

correct and reshape protruding ears (bat ear correction).

He performs the procedure with a mild sedative and local

anaesthesia; no hospitalisation, general anaesthetic or

surgical incisions are required.

‘Any abnormality and asymmetry in facial appearance will

attract attention, which is particularly relevant to individuals

with bat ears,’ Dr Beaini explains. ‘These patients were

born with this problem and, in most cases, are burdened

with underlying emotional issues relating to the appearance

of their ears. The joy and relief they experience once

their ears are corrected makes this treatment extremely

desirable.’ csbm



AFTER Astarte Thread Lift by Dr Beaini

AFTER blepharoplasty by Dr Beaini 113


Nose for


Sydney ENT and facial cosmetic surgeon Dr William Mooney explains

the art and science of rhinoplasty. Caitlin bishop reports.

The nose is the anchor of the face. The length, width

and symmetry of the nose contribute to facial balance

and harmony, and have a significant impact upon

facial aesthetics. Rhinoplasty, or nose surgery, is one of the

most popular cosmetic procedures – designed to reduce,

augment, narrow, widen, straighten or reshape the nose –

but it is also one of the most complex.

Rhinoplasty involves remodelling the bones and cartilage

to optimise both aesthetics and functionality. Sydney ENT

and facial cosmetic surgeon Dr William Mooney says that

rhinoplasty combines the central pillars of cosmetic surgery:

art and science.

‘The nose is a vital, complicated organ. It’s a gateway to

the upper respiratory tract, the egress to the nasal sinuses

and, unfortunately, there are a lot of problems that can

affect its functioning,’ he says. ‘When patients come to me

because they’re unhappy with the shape of their nose, we

also address the underlying functional problems. They often

leave just as happy with their new improved nasal airways

as they are with their appearance.’

Because the anatomy is so intricate, and affects

both aesthetics and functionality, rhinoplasty calls for a

specialised and experienced eye. Dr Mooney favours the

“open” surgical technique, which involves a small incision

between the nostrils to afford maximum surgical access.

Dr Mooney says that functional problems can contribute

to an aged appearance and, by addressing nasal

functionality, quality of life and aesthetics can be improved,



too. ‘Problems such as difficulty breathing, allergies,

snoring and sleep apnea – not to mention post-traumatic

obstructions – often occur alongside cosmetic concerns,’

he explains. ‘Although these might seem like little things on

their own, when combined they can really impinge upon

quality of life. For example, if you don’t breath properly,

particularly at night, this can lead to a tired and drawn

appearance, and also affect your mood.’

Before rhinoplasty, Dr Mooney will always assess each

patient’s face as a whole, rather than focusing on the nose

alone. This allows him to not only determine the ideal shape

and size of the nose, depending on overall facial aesthetics,

but also identify if the patient would benefit from additional

procedures as well.

‘It’s important to look at the patient’s face as a whole

picture, rather than an isolated feature,’ he says. ‘We

conduct a formal skin and cosmetic assessment to see if

the patient has any problems with

their skin and what we can do to


treat those problems.’

For those patients concerned with

ageing, Dr Mooney explains nose

surgery can often help revitalise a

heavy, aged or tired appearance.

‘As we age, noses become bigger

and more irregular,’ Dr Mooney says.

‘Deviations in noses are like the

leaning tower of Pisa – they often

progress as time goes by. As well as

this, the skin becomes thinner during

ageing so any irregularities become

more pronounced.’

Dr Mooney says these signs

of ageing can occur alongside tip

ptosis – when the tip of the nose


droops downward and the angle


of the nose is affected. ‘Everything

starts to go south as the years go

by, and the nose is no exception,’ he

explains. ‘So returning the tip to its

lovely youthful position and reducing

the size of the nose is a fantastic antiageing


Creating an aesthetic nose tip

is regarded as one of the greatest

challenges to nose surgeons. Dr

Mooney has developed a specialised

technique – termed the “Diamond

Tip” technique – to provide superior

results, customised to each patient.

According to Dr Mooney, nose

surgery is just one element in

improving quality of life and overall BEFORE

health. He encourages patients to make some easy lifestyle

adjustments to improve the results of surgery.

‘The first piece of advice I give all my patients is to get

some sleep, stop smoking, get out of the sun, booze less

and get happy,’ he says. ‘These are quick, cheap and easy

steps every patient can take to maximise the results of their

surgery, and which have wider impacts on their health and


This holistic and all-encompassing approach is at

the centre of Dr Mooney’s philosophy and extends to all

aspects of his practice. Indeed, Dr Mooney might draw

upon Chinese herbs, anti-swelling medication, cosmetic

injectables, prescribed skincare, pressure treatments

and scar management in optimising aftercare following

surgery. ‘This attention to detail is what makes the

difference between a good rhinoplasty, and a great one,’ he

concludes. csbm

AFTER rhinoplasty by Dr Mooney

AFTER rhinoplasty by Dr Mooney 115







strong, white, striking smile can convey confi dence,

sincerity and youthfulness, while boosting self-image

and confi dence in one’s own skin. Good dental

hygiene is certainly key in maintaining smile aesthetics,

however sometimes a more direct approach is necessary

to grant your smile that extra lift.

Sydney aesthetic reconstructive dentist Dr Sarkis

Nalbandian has built his clinic upon creating natural-looking

results in smile rejuvenation. He believes a beautiful smile

should imitate nature, involving a dynamic interplay of the

teeth, lips and face.

According to Dr Nalbandian, a combination of wear and

tear, diet and teeth grinding can cause tooth erosion and

detract from a youthful, beautiful face.

‘The increase in consumption of carbonated beverages

has resulted in an excessive amount of tooth loss in people

as young as 15. This compromises the structural integrity of

the teeth,’ Dr Nalbandian says. ‘Damage can also occur on

account of “bruxing”, or teeth grinding, which is a habit that

can impact both the canine and front teeth, wearing them

down and leading to asymmetry.’

While there are many options for smile rejuvenation – from

orthodontics to reconstruction – Dr Nalbandian believes a

smile can be aesthetically and functionally transformed in

just one visit to the dentist.

‘While orthodontic alignment is often the ideal way to

correct crowded or worn upper and lower teeth, for some

patients this approach is just not an option,’ he says.

‘There are many ways we can use non-invasive methods

to improve a patient’s smile, restoring their confi dence and

Actual Patient

allowing them to continue with their lives after just one visit.’

A One-Visit Dental Facelift focuses on the speech

area and aesthetic zone of the mouth. It calls upon noninvasive

ultra-thin composite veneers, which can be

sculpted to fi t each individual patient and require no

injections, no drilling and no downtime. Importantly,

composite veneers afford fl exible options for future revision,

as Dr Nalbandian explains.

‘The beauty of this treatment is we can improve the

patient’s smile while still keeping their options open for

future orthodontic realignment,’ he says. ‘If a patient returns

for orthodontics I can remove the composite veneers, but in

many cases this isn’ needed. Composite veneers last three

to fi ve years and, following that, they just need resurfacing,

which can be performed in a 30 minute check-up.’

Before treatment, Dr Nalbandian photographs the

patient from three angles – front, oblique and profi le – to

capture the most important aspects of their smile. Dr

Nalbandian uses this information to prepare the most

suitable treatment plan, helping to shape the veneers and

select the appropriate shade of colour.

Unlike other cosmetic dentists, Dr Nalbandian does not

rely on digital smile design software, but instead works

within the mouth to accurately diagnose smile aesthetics.

‘Smile design is an art form and I work within the mouth

directly to diagnose and plan the best treatments for my

patients,’ Dr Nalbandian says. ‘The challenge is to create

natural smiles that complement the patient’s beauty and

facial aesthetic. This demands an individualised approach,

and cannot be digitalised.’ csbm



Severe tooth discolouration caused by the antibiotic

tetracycline results in yellow tooth discolouration, which can

turn brown over a number of years.

This patient initially presented for aesthetic improvement,

due to severe tetracycline discolouration, affecting both

upper and lower arches since childhood. As well as the

discolouration, this patient had neglected her dental health,

and many attempts of tooth whitening has resulted in

minimal or no change to the whiteness of her teeth.

Dr Nalbandian discussed with her the options in tooth

whitening over an extended period. However, due to her

circumstances, this patient preferred a quicker option, that

would also restore the tooth surface loss caused by bruxing

(tooth grinding).


Following oral hygiene measures, plus a diagnostic

assessment, Dr Nalbandian formulated a correct treatment

plan for this patient. Both arches were restored using

ultrathin porcelain veneers developed by Dr Nalbandian and

his technical team.

This procedure requires minimal intervention, no local

anaesthetic, and importantly the enamel integrity of the

tooth is maintained. The procedure helped improve lip

outline, thickness and symmetry, as well as tooth colour,

shape and display.

‘Biology drives the aesthetics and treatment outcome,

and pictures tell the story. We have improved dentofacial

aesthetics, and have a very happy and more confident

patient,’ Dr Nalbandian concludes.


AFTER ultrathin porcelain veneers by Dr Nalbandian


AFTER ultrathin porcelain veneers by Dr Nalbandian


AFTER ultrathin porcelain veneers by Dr Nalbandian 117







thinking about anti-wrinkle injectables? before undertaking

treatment, there are certain questions you should be asking.

Caitlin Bishop reports.

Injectables have become a modern day staple in the anti-ageing regimes of

both men and women. Used as both a preventative and restorative measure,

anti-wrinkle injections and dermal fillers are often the first port-of call for those

considering cosmetic enhancement. According to Sydney cosmetic surgeon

Dr Joseph Ajaka, anti-wrinkle injections in particular address the cause of one of

the most lamented hallmarks of ageing.

‘Anti-wrinkle injections target one of the major causes of ageing. They

treat overactive muscles and prevent dynamic wrinkles from forming,’ Dr

Ajaka explains. ‘I consider anti-wrinkle injections to be an integral part of any

person’s anti-ageing regime, and they often signify the patient’s first venture into

cosmetic enhancement.’

Dynamic wrinkles are caused by facial muscle movement, not intrinsic skin

ageing. As the muscles move, the skin contracts and the collagen fibres in

the dermis break. The ability for the body to restore these fibres and generate

new collagen depletes as we age, and the wrinkles stay in place, even when

the muscles are relaxed. Anti-wrinkle injections are used to freeze this muscle

movement, and prevent dynamic wrinkles from arising or worsening.

A lot of patients seeking anti-wrinkle

injections don’t ask questions before deciding

to go ahead with treatment. But knowledge is

power, and patients must understand what

measures need to be taken

‘Anti-wrinkle injections are the most popular injectable in our clinic; they are

extremely effective with minimal risk,’ Dr Ajaka says. ‘They have a very high level

of satisfaction, and can make a huge difference in a single treatment.’

However, alongside the popularity and effectiveness of anti-wrinkle injections

and because injectables have become so entrenched in contemporary beauty

regimes – there is a danger that consumers will adopt a carefree attitude in

undertaking treatment.

Dr Ajaka finds many patients approaching him for an initial consultation do

not consider, or ask about, the potential risks involved or the type of injectable

product used.

‘A lot of patients seeking anti-wrinkle injections don’t ask questions before

deciding to go ahead with treatment,’ he says. ‘But knowledge is power, and

patients must understand what measures need to be taken if the treatment does

not go according to plan. They need to know this before going in.’

According to Dr Ajaka, the consultation process is vital in establishing this

rapport between patient and doctor. He encourages patients to ask to be shown 119



Informed Beauty is an online platform designed

to educate patients and raise awareness around one

essential fact – cosmetic injectables should not be

taken lightly.

The site was launched in March 2014 after a survey

commissioned by Allergan found the majority of Australian

women using anti-wrinkle injections are inadequately

informed. It found more than 85 percent of anti-wrinkle

injection users claimed they were careful in receiving

treatment but 71 percent did not know that there were

different kinds of anti-wrinkle injectables available. is dedicated to setting “the

facts straight on wrinkles”, and has fact sheets on

wrinkles and ageing, a timeline of anti-ageing tips for

every age group, and expert advice from plastic and

cosmetic surgeons..

before and after photographs of other patients, as this will

help form an idea of what to expect. But most importantly,


Dr Ajaka recommends patients ensure the brand of

injectable is tested, researched and registered for use.

‘The consultation is very important. The patient must

know the type of product being used, why that product

is being used and the background research behind that

product – most importantly, it must be registered,’ he says.

‘As well as this, patients should ask how long the results

will last, the different side effects of the product, the type


of result to expect (with before and after photographs) and

what will happen if things go wrong.’

With anti-injectables being such an effective and popular

treatment for cosmetic rejuvenation, it is imperative patients

consider the procedure with a responsible amount of

caution. Certainly, when administered effectively, injectables

can reap significant and long-lasting results. But, before

going ahead with treatment, the patient must take the time


to ask questions, ensure the product is registered and build

confidence in their practitioner.

‘These days, anti-wrinkle injections are sought out by

anyone and everyone,’ Dr Ajaka says. ‘The treatment can

be applied to men, women, young, old from all walks of life.

In order to maintain patient satisfaction, all patients must be

educated and informed going into treatment.’ csbm





AFTER injectable wrinkle treatment by Dr Ajaka

AFTER injectable wrinkle treatment by Dr Ajaka

AFTER injectable wrinkle treatment by Dr Ajaka

AFTER injectable wrinkle treatment by Dr Ajaka


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Turn back

the clock

with PRP








Platelet Rich Plasma (PRP) therapy helps kick-start

the body’s natural processes that increase healing,

repair and tissue strengthening, effectively reversing

signs of ageing from within.

With a history spanning decades in the medical industry,

PRP is a regenerative and rejuvenating procedure with

countless options for application. It has been used to

combat autoimmune diseases such as Sjogren’s syndrome;

in sports medicine for treating injured joints and muscles;

and, now – thanks to companies such as Regen Lab – PRP

has entered the cosmetic anti-ageing arena.

Sydney cosmetic practitioner Dr Stephen Lowe works

at Face Today Medi Clinic, where Regen PRP was fi rst

launched in 2008. Since then, he says the results seen

with Regen PRP demonstrate exciting potential for the

world of cosmetic medicine. ‘The team at Face Today

wanted to better understand the applications for Regen

PRP in cosmetic medicine, so they commenced a series of

monthly skin treatments and assessed patient response,’

Dr Lowe explains. ‘The results were beyond expectation.

With correct patient selection and treatment parameters,

patients were “growing themselves younger” before their

very eyes.’

The procedure involves extracting a sample of the

patient’s blood, centrifuging this sample to concentrate

the blood’s platelets and then re-injecting the concentrated

solution into the treatment area.

Stacey Power, an aesthetic nurse in New Zealand,

has been using Regen PRP since 2009 and says it can

be used to treat a number of different concerns, including

pigmentation, sagging skin, enlarged pores, fi ne lines,

scarring and uneven skin tone. ‘I’ve found PRP to be

amazing for scar healing, and I often inject it before and

after cosmetic surgery to optimise healing. I also use it in

the backs of hands, to treat loose skin at the top of the

arms, as well as the face and neck.’

Once PRP is injected into the body, the blood

platelets release proteins called growth factors, which

communicate with the body to trigger the natural healing

process. This helps kick-start skin cell turnover, stimulate

collagen production at the site and invigorate the area with

heightened cellular activity.

‘Regen PRP can play a role to improve damaged skin

by stimulating collagen growth and skin blood supply and

help improve skin texture and elasticity,’ Dr Lowe explains.

‘This can be a great option for younger patients seeking

to reduce the early signs of skin ageing, but it is also ideal

for older patients to incorporate Regen PRP with other

treatment modalities to achieve even greater results. We

think this is also a great treatment for men who want results

that are subtle and discreet.’

‘Regen PRP have refi ned the technology providing the

optimal concentration from each blood sample,’ Dr Lowe

explains. ‘Patients appreciate that they are harnessing their

body’s own repair mechanisms, rather than injecting foreign

materials into their body. As we are using patient’s own

blood for the procedure, the risk of a reaction or infection

is extremely low.’

With PRP working within the skin to harness a natural

rejuvenation, other treatments such as wrinkle relaxants

can be used in conjunction to achieve an overall, synergistic

rejuvenation. ‘I like to use dermal needling over the top of

the skin to get a double effect,’ Power explains. ‘With some

clients I also mix PRP with fi llers. This helps create a cross-



mesh scaffolding to maximise collagen growth. We are

finding this achieves even faster results than PRP alone.’

PRP treatment can be tailored to each individual patient.

Commonly, a series of three treatments, four to six weeks

apart, are performed to achieve the best result.

A thorough consultation process is required to establish

the best treatment plan with Regen PRP. ‘We always have a

thorough consultation with our patients to fully understand

their concerns and expectations going into treatment,’ Dr

Lowe explains. ‘We take this opportunity to explain the

importance of a healthy lifestyle and UV skin protection to

reduce future skin damage. We formulate a treatment plan,

which may involve a single treatment with Regen PRP or a

series over a few months, and decide if Regen PRP should

be used in combination with other cosmetic treatments.

After the treatment, we typically allow two to three days for

any redness and swelling to settle; the occasional bruise

may take a few days to fade but is usually easily covered

with makeup.’

The treatment itself is performed under topical

anaesthesia, and takes about 30 to 45 minutes, depending

on the area being treated. An improvement in skin tone

and texture is expected in the weeks following treatment,

with these initial results continuing to improve for six to nine

months post-procedure, as new collagen is laid down in

the dermis.

Whether you’re looking to improve scar healing after

surgery, treat an ageing neck or simply rejuvenate and

brighten the complexion, Regen PRP offers effective,

natural-looking and long-lasting results.

‘I have a client who has had regular PRP treatment for

five years now. Her fine lines have resolved and her pores

have disappeared, leaving a porcelain-like smoothness to

her now glowing skin,’ says Power. ‘She decided to have a

blepharoplasty, and I injected her with PRP before and after

her surgery. Three months post-surgery, on inspection by

the operating doctor, he stated that her healing was almost

“embryonic”, with barely any scarring at all. A combination

of an excellent plastic surgeon’s stitches, with regular PRP

treatments, produces fantastic results for scarring.’ csbm









AFTER 3 x Regen PRP treatment by

Stacey Power

AFTER 3 x Regen PRP treatment and 3 x

Exilis RF treatment by Face Today Medi Clinic

AFTER 3 x Regen PRP treatment by

Stacey Power

AFTER 3 x Regen PRP treatment by

Face Today Medi Clinic

Treating hair loss with PRP

Hair loss in both men and women can be an embarrassing

and traumatising experience. The regenerative properties of

Regen PRP, and the way it works to accelerate and optimise

the body’s natural processes, has led to the use of PRP to

prevent – and even reverse – baldness.

‘We are seeing some very effective results with hair

growth from PRP,’ Power explains. ‘One client who

shaves his head because of baldness, found his grey hair

changing back to black, and experienced hair growth

in places where he hadn’t had any growth in years. This

was all as a result of injecting his face with PRP, a positive


Similarly, Dr Lowe explains that Regen PRP can be

used in conjunction with traditional methods to treat a

balding head. ‘Hair loss is best treated with a combination

approach of oral medication and topical medication on the

scalp,’ he says.

‘Adding Regen PRP to these treatments helps improve

blood supply to the skin and can be a useful adjunct to hair

loss treatment,’ he concludes. 123





in skin


Fraxel laser can achieve outstanding results in smoothing, plumping

and rejuvenating the skin. Caitlin Bishop reports.


decade ago, the Fraxel laser system pioneered the

use of fractional laser technology in skin rejuvenation.

Since then, more than 800,000 patients have been

treated around the world with Fraxel to address cosmetic

and anti-ageing concerns.

Suitable for reducing the appearance of wrinkles,

sun spots, melasma and scarring, Fraxel – distributed in

Australia by iNova Aesthetics – is a system designed to

improve skin tone, texture, elasticity and overall skin health.

‘Fraxel can help diffuse pigmentation such as sunspots

and brown pigmentation on the face, décolletage, neck

and hands,’ Victorian cosmetic physician Dr Sean Arendse

explains. ‘Another common concern is textural issues such

as wrinkles on the face, neck and chest. We also have a

large group of patients with acne scarring who have been

successfully treated with the Fraxel system.’

Fraxel uses cutting-edge technology to deliver results in

a simple, though very effective fashion. It uses laser light

to penetrate the top skin layers and cause micro columns

of thermal damage to the dermis. This triggers the body’s

healing response and stimulates the production of new

collagen at the treatment site.

The ‘fractionated’ effect means only a fraction of the skin

is treated, as there are areas of healthy, untouched tissue

between each column of damage.

‘The Fraxel system has a very high safety profile, which

is partly due to the fact that the majority of the skin is left

untreated,’ Dr Arendse explains. ‘The research that has

gone into Fraxel, and the support and ongoing training

offered by iNova, is another huge benefit of the system.’

Fraxel treatment can be tailored to the individual patient,

according to their concerns and current skin condition.

There are two main wavelengths for Fraxel laser: 1550nm

and 1927nm. Queensland cosmetic practitioner Dr Eddie

Roos, who has been using fractionated laser in his clinic

for five years, believes Fraxel affords a wide range of skin

treatment options.

‘The 1550nm wavelength is used for rejuvenation and

scar remodelling. It penetrates deep into the dermis to

achieve really significant results,’ Dr Roos explains. ‘The

1927nm wavelength does not penetrate as deeply, and is

used to treat pigment in the skin. It is ideal for improving

sun-damaged skin that we see in Queensland and, indeed,

the rest of Australia.’

Typically, a full-face treatment will take around one

hour and topical anaesthetic cream will be applied to

make the patient as comfortable as possible. The number

of treatments required varies between patients, and is

dependant on their skin condition and what they are aiming

to achieve.




‘During treatment the laser is rolled across your skin

several times and, depending on the size and complexity of

the treatment area, the actual procedure will take anywhere

between 20 minutes and an hour,’ Dr Arendse explains.

‘For pigmentation we would usually recommend one to two

treatments, and for acne scarring and wrinkles three to five

treatments are typically required.’

Notably, the Fraxel system has an inbuilt cooling system

to help keep the skin’s surface cool and comfortable during

treatment. This allows higher levels of heat energy to be

delivered deep into the skin’s layers, without compromising

the upper epidermis.

‘The Fraxel system delivers an even treatment combined

with cold air blown onto the skin, making the procedure

tolerable to patients,’ Dr Roos explains.

‘The effect of laser treatments on the skin will vary from

person to person,’ he continues. ‘The body’s response to

fractionated trauma is explained in detail to patients before

they go ahead, and we do emphasise that rejuvenation

results will continue to improve for months following

treatment – as the new collagen is created.’

Some redness and swelling should be expected

post-procedure, particularly with the 1927nm laser. Dr

Arendse says there are several phases the skin will go

through following treatment with Fraxel. ‘Immediately after

treatment, the skin feels like it has mild sunburn and we

provide ice packs and a specialised skincare pack for home

use,’ he explains.

‘The face may be red and a little swollen for the next two

to three days, after which the skin will bronze. Following

this, the bronzing will flake and exfoliate off, revealing the

fresh new rejuvenated skin underneath. The redness can

persist for one to three weeks, but with the use of a good

mineral makeup this can be easily camouflaged.’

The results of Fraxel treatment start to appear as the

skin exfoliates, but continue to improve for the three to six

months following the procedure. During this time, the new

collagen synthesised in response to treatment is building

and regenerating in the skin. As this occurs, the complexion

becomes firmer and more resilient, with improved contours

and texture.

‘We have seen fantastic results using Fraxel laser,’ says

Dr Arendse. ‘Once the redness and bronzing has settled

down, you can see vast improvements in pigmentation

and skin quality. Another advantage of the treatment is that

results are cumulative, with the best results often seen six

months after the treatment.’

‘My patients often describe their skin as fresher and

more radiant following completion of their treatments, and

are amazed by the results they experience,’ Dr Arendse

concludes. csbm










AFTER Fraxel treatment by Dr Arenndse

AFTER Fraxel treatment by Dr Arenndse

AFTER Fraxel treatment by Dr Roos

AFTER Fraxel treatment by Dr Roos

AFTER Fraxel treatment by Dr Roos 125





Laser skin resurfacing

can help you stay

looking younger and

more radiant for

longer. The team at

Skin Renu in Sydney

tells us how. AimÉe

Surtenich reports.

Ageing is a multifaceted process, and can result in a number of changes

to our appearance, including the emergence of fine lines and wrinkles,

discolouration, uneven texture, surface veins and lax skin.

A growing number of people are seeking more dramatic results than can

be achieved with skincare products, peels or facials alone. One of the most

popular ways of treating sun-damaged and ageing skin is fractionated laser skin

resurfacing, to reveal smoother, more even and radiant skin, no matter the age

of the patient. The skin professionals at Skin Renu laser and skin clinic in Sydney

share their experience with two of the most popular laser procedures.

Fraxel laser

For skin needing a little more intensive care, Fraxel laser skin resurfacing can

improve a wide range of skin concerns, such as lines and wrinkles, loose skin,

pigmentation, acne scarring and moderate to severe sun damage.

Rather than removing the top layer of skin (with significant downtime) like

traditional ablative laser resurfacing of the past, Fraxel laser treats a fraction of

skin at a time, creating thousands of tiny microscopic sites of thermal impact,

known as microthermal zones.

These microscopic laser columns penetrate deep into the dermis to create

tiny wounds, triggering the body’s natural response system to heal those

wounds. This process expedites the body’s remodelling of collagen and elastin,

resulting in tighter, fresher, more youthful-looking skin. It operates on the concept

of damaging small amounts of tissue to stimulate collagen and elastin, activating

new cells.

There are three kinds of Fraxel laser treatments, depending on each patient’s

needs and requirements. These vary in strength, downtime, the amount

of procedures needed and the final results. A less aggressive treatment is

Fraxel re:store, which can achieve impressive results for mild to moderately



damaged skin over the course of three to six treatments. There is typically no

post-treatment wound care and downtime is minimal in most cases, with some

swelling to be expected. It is particularly effective for treating pigmentation

and scarring on the face and affected skin on other parts of the body, as well

as sun damage, acne and acne scars, and broken capillaries. With each

treatment, a signifi cant improvement is usually evident.

Clear+Brilliant skin resurfacing

For those not ready for more aggressive treatments, Clear+Brilliant offers an

effective solution. Based on Fraxel technology, Clear+Brilliant is ideally suited for

those in their 20s and 30s wanting to take control of their skincare and manage

the appearance of ageing.

This more gentle laser treatment is used to improve skin tone, texture and

radiance, as well as to act as a preventative measure for treating sun damage

and premature ageing. It’s perfect for those with a good skincare system already

in place who are looking for a level up in their beauty regime.

Clear+Brilliant offers two different treatment heads: 1550nm to target

premature ageing; and 1527nm to target pigmentation. Each treatment takes

about 20 minutes, and there is typically no downtime, just some temporary

pinkness or redness. Generally a short series of treatments will yield the most

impressive results, but even after one treatment there should be a noticeable

fading of light pigmentation and freckling, a more homogenised skin tone and

texture, as well a more luminous look to the skin.

Initial results should appear within a few days as damaged skin is slowly

replaced with healthy, younger looking tissue. Clear+Brilliant offers younger

patients an ideal introduction to maintaining youthful-looking skin. csbm


the dots

in skin





Want to turn back time to reveal younger, more

healthy looking skin without surgery or lengthy

downtime? DOT Therapy is designed to deliver

just that.

Dermal Optical Thermolysis (DOT) Therapy is a fractional

laser system designed to deliver the benefi ts of laser skin

resurfacing while signifi cantly reducing the recovery time.

Distributed by High Tech Laser, the SmartXide DOT

fractionated laser can help reduce the appearance of

wrinkles and acne scarring, while improving skin tone

and texture. It calls upon the same technology used by

traditional skin resurfacing lasers, but delivers the light

energy in fractionated “dots” to help optimise healing and

reduce recovery time.

‘DOT Therapy is really effective in treating irregularities

on the skin’s surface such as dilated pores, discolouration

and uneven contours from scarring,’ says Queensland

cosmetic physician Dr Heather Jenkins. ‘It can work very

well in tightening up crepeiness around the eyes in patients

who aren’t quite ready for eyelid surgery. We also treat a lot

of patients with acne scarring, with very pleasing results, as

well as birthmarks, stretch marks and scars.’

By creating precise microscopic columns of thermal

damage in the skin, DOT Therapy triggers the body’s

healing response to tighten skin and stimulate new collagen

growth. Importantly, between each column of damage

there are “islands” of healthy tissue, which help improve the

healing process for a more rapid recovery.

‘The areas of untouched tissue improve healing time

and reduce rates of complication,’ says Dr John Flynn from

Queensland. ‘Also, the areas of untreated skin between the

“dots” means more aggressive and effective parameters

can be used during treatment, as these are bolstered and

comforted by the adjacent healthy tissue.’

Patients will typically see an improvement in skin tone

and texture in the days following treatment. However the

results are cumulative and will continue to improve in the

three to six months post-procedure, as the new collagen is

laid down in the skin’s dermis.

‘The procedure has an immediate effect because it acts

like a controlled laser peel, which freshens and brightens the

skin,’ Dr Jenkins explains. ‘There is also some tightening at

the outset, and this continues to improve as new collagen

forms over the subsequent three months or so.’

Importantly, treatment with DOT Therapy can be tailored

to individual patients, depending on their concerns and

current skin condition. ‘The treatment can be tailored to

suit the patient’s needs by altering the depth of the dots,

and distance between the dots and the amount of power

delivered,’ Dr Jenkins explains.

There are two main patient groups suitable for treatment

with DOT Therapy: those looking for general facial



rejuvenation – an improvement in tone, texture and skin

quality – and those with deeper lines, sun spots or scarring,

who require deeper treatment parameters.

‘The DOT Therapy system can be used as a fractionated

laser peel for boosting skin health and granting a glow and

slight lift,’ Dr Flynn explains. ‘The heavier setting, which we

DOT Therapy is effective in

improving irregularities on the

skin’s surface such as dilated

pores, discolouration and

uneven contours from scarring

call Hot DOT Therapy, is used to treat deeper lines, improve

pigmentation and reduce problem scarring from acne,

trauma or skin cancers.’

As well as tailoring the treatment to each patient,

DOT Therapy can also be used in conjunction with other

modalities to achieve a universal rejuvenation result.

‘DOT Therapy can be used

alongside Intense Pulsed Light


(IPL), botulinum toxin treatments

and dermal fillers,’ Dr Jenkins

explains. ‘Before treatment,

I always undertake an initial

consultation with my patients

to better understand their main

concerns and what they’re hoping

to achieve.’

The treatment itself is performed

with topical anaesthetic, which

is left on the skin for 45 minutes

before treatment begins. During the

procedure, the doctor can change

the shape of the ‘dot’ pattern to

more effectively accommodate

the area being treated. This is

particularly important when treating BEFORE

delicate areas such as the wrinkles


around the mouth or eyes.

‘Patients typically experience

a tingling feeling directly after

treatment, but this can be improved

with cold compression,’ says Dr

Flynn. ‘Patients should follow a

prescribed skincare protocol in the

first few days after the procedure,

to help optimise healing. Once the


old skin has exfoliated, some redness may persist, but

this can be covered with mineral makeup. The healing

and collagen rebuilding will continue for up to six months


In some cases, multiple treatments may be required

to achieve the best results. However, for general skin

rejuvenation, Dr Jenkins explains an annual DOT Therapy

session will usually suffice. ‘A light treatment may be

repeated once a year; a stronger treatment may only need

to be done once,’ she says.

Whether you’re looking for general skin improvement,

or to treat something more specific, DOT Therapy with the

SmartXide laser can be a viable option in improving the

complexion and restoring inner-confidence.

‘One of my stand-out patients was a young man in his

late 20s who had lived in a remote rural area during his

teens and had suffered from untreated cystic acne,’ Dr

Jenkins recalls. ‘He was left with considerable scarring

but fortunately was a great candidate for DOT Therapy.

He had two treatments and did very well. He sent me a

photo of himself six months later with a beaming, confident

smile and his skin looking so much better. Improvement in

confidence is the best outcome of all.’ csbm

AFTER Dot Therapy using the SmartXide DOT laser. Photos

courtesy of High Tech Laser.

AFTER Dot Therapy using the SmartXide DOT laser. Photos

courtesy of High Tech Laser. 129




Caitlin Bishop investigates how restylane

skinboosters deeply hydrate skin to improve

smoothness, elasticity and radiance.

Restylane Skinboosters are an effective treatment designed to

deeply hydrate the skin for an improved look and feel. Made with

a hyaluronic acid gel, which closely resembles the hyaluronic acid

found naturally in the body, the fillers offers long-lasting improvements in

skin quality and textural condition.

‘Myself, and most importantly my patients, have been consistently

impressed with Skinboosters,’ says Victorian cosmetic practitioner

Dr Dennis McCurdy. ‘We have found it to be a wonderful anti-ageing

product, not only in improving skin health but also in slowing down the

visible signs of the ageing process. Clients return almost yearly, asking for

their “internal hydrator”.’

Skinboosters do not act as a dermal filler, but a skin hydrator or ‘internal

moisturiser’. The hyaluronic acid attracts and maintains hydration within

the skin to improve the quality and appearance of the skin.

‘Hydration is very important, and good skincare is essential to maintain

younger, healthier looking skin,’ Dr McCurdy explains. ‘Restylane

Skinboosters act to hold water in areas where it is most needed.’

The product is usually injected across the face, and into the neck

and décolletage area, to improve the quality and resilience of the skin. As

well as this, Dr McCurdy uses Skinboosters on areas that clearly show

ageing, such as the hands, elbows and knees.

‘Skinboosters primary function is to provide hydration to the deeper

skin layers. Due to this hydration the skin is able to function more effectively

and efficiently,’ he says. ‘Skin appears healthier looking and more flexible,

and collagen production is stronger. In my experience, Skinboosters can



achieve effective results in the face, neck and décolletage as well as the backs

of hands, elbows and knees.’

For best results, Skinboosters is injected into the deep dermis and

subcutaneous tissue. This affords deeper hydration, and helps optimise the

performance of the dermal-epidermal membrane, ensuring the complexion

remains hydrated and nourished.

‘Skinboosters works best when injected into the deep dermis upwards to

the subcutaneous layer. I personally prefer administering Skinboosters with a

cannula, as opposed to using needles,’ says Dr McCurdy. ‘Although it takes a

little longer, there is less discomfort and less bruising.’

Treatment with Skinboosters can be tailored to the individual patient. In most

cases, Dr McCurdy recommends using 3mm of Skinboosters initially on the

face, with extra product used for the neck area. The procedure itself takes

around 30 to 45 minutes, and some swelling should be expected in the days

following the procedure.

In some cases, Skinboosters can be used in conjunction with other treatments

to create a more comprehensive result. ‘Although Skinboosters can achieve

significant results, it doesn’t do the whole job,’ Dr McCurdy explains. ‘Using

muscle relaxant injections, laser treatment and filler products to enhance deficits

and improve features, is important for a full anti-ageing effect. Any rejuvenation

method should also be accompanied by good skincare.’

Results with Skinboosters are cumulative, and take around three to four

months to appear. This gives time for the collagen and elastin to remodel and

develop, due to the deep hydration. These results are expected to last for six to

nine months following treatment, however Dr McCurdy says it is often longer.

‘I feel the benefits are visible for more than 12 months,’ he says. ‘At our

clinic, we find Skinboosters results in decreased wrinkles, smaller pores, fewer

blemishes and generally younger, healthier looking skin.’

For those looking for a preventative or anti-ageing measure, that will achieve

subtle but effective rejuvenation results, Skinboosters is a viable option in helping

restore smoothness, vitality and hydration to the complexion.

‘Skin hydration is beneficial for everyone, both male and female,’ says Dr

McCurdy. ‘Because we live in air-conditioned and heated buildings, our skin

dries out very quickly, so deep hydration is a must. We have young and old

patients seeking treatment with Skinboosters, as more and more people become

aware of the need to look after their skin to maintain a healthier, more fresh

appearance.’ csbm


AFTER Skinboosters treatment 131











Infi ni is a minimally invasive solution to rejuvenate ageing skin, creating

three-dimensional volumisation while reducing the appearance of wrinkles,

scarring and sagging skin.

How it works

The Infi ni, distributed in Australia by Advanced Cosmeceuticals, uses cutting

edge technology to cause skin tightening and collagen production in the

dermis. The system uses both radiofrequency (RF) and skin needling to deliver

controlled thermal damage to the dermis, without heating the upper layer of skin

(the epidermis).

A key benefi t of the Infi ni treatment is its effectiveness in addressing both the

superfi cial and deeper layers of the skin. The technology combines microneedling

fractional radiofrequency (MFR) and superfi cial fractional radiofrequency (SFR) to

help fortify, tighten and rejuvenate the complexion.

The MFR energy is delivered to the skin’s deeper layers via insulated gold-

coated microneedles. This affords a double-fold effect, as both skin needling and

thermal heating can help boost collagen production and rejuvenate the skin from

within. The MFR causes controlled areas of coagulation – or tissue shrinkage –

leading to skin tightening and wrinkle reduction.

Meanwhile, the SFR technology delivers thermal energy via two channels to

both the epidermis and the dermis. This leads to a mild microablation of the skin’s

surface to illuminate the complexion and homogenise the skin’s texture. When the

microneedles and controlled thermal damage is applied, this triggers the skin’s



natural healing response and the treatment area is flooded with blood, oxygen

and nutrients. Fibroblast production is enhanced, triggering the formation of new

collagen, and the skin is volumised for a three-dimensional result.


To achieve an all-over facial rejuvenation, treatment with Infini is usually applied

‘layer by layer’ at different depths in the skin’s dermis. The number of passes, and

different needle depths, are adjusted according to patient desires and current

skin condition. For example, more aggressive parameters are typically used

on areas of concern – to refine the jaw line or combat wrinkles on the forehead –

and lower parameters are applied on the skin’s superficial layers.

A thorough consultation process is required to establish the most effective

method for treatment with Infini. And, while the procedure is suitable for all skin

types, an individual approach is necessary in ensuring the best results.

Topical anaesthetic is applied to the skin and left on for 45 minutes

before treatment. This increases comfort during the procedure, and

enables the delivery of higher parameters for a more noticeable

result. The treatment itself is methodical, and the Infini headpiece is

moved across the face in designated sections.

Typically, patients can expect some swelling, redness and skin

sensitivity in the days following treatment and, in some cases, mild

bruising can arise under the eyes. Patients are encouraged to wash

their face gently the night after treatment and avoid aggressive

cleansers or any products with powerful scrubbing agents

for a couple of weeks.





AFTER acne treatment with Infini. Courtesy

of Lutronic.

AFTER acne scar treatment with Infini.

Courtesy of S. Savant, MD, India

AFTER scar revision with Infini. Courtesy of

Devrim Gursoy, MD, Turkey

AFTER skin laxity treatment with Infini.

Courtesy of Devrim Gursoy, MD, Turkey


In most cases, multiple Infini treatments are required to achieve the

desired outcome, however changes in the skin can be seen after

a single session. The Infini protocol calls for two treatments, four

weeks apart, to generate optimal results, though some patients

opt for more.

Once the redness has faded – usually two days following

treatment – patients should begin to notice a renewed freshness in

their complexion. The release of growth factors and increased blood

flow, which occur due to thermal damage, fuels the face with oxygen

and nutrients as the skin starts to rebuild itself from within.

New collagen fibres begin to form in the dermis around four

weeks after treatment, and these results continue to improve for up

to 10 weeks post-procedure. Patients should see a tightening and

firming of the skin after two to three weeks, and a holistic, universal

rejuvenation should be evident after a series of Infini treatments has

been completed.

While it is effective in turning back the clock and revitalising the

complexion, Infini can also help combat certain conditions that are

usually extremely difficult to treat. Acne scars, stretch marks, traumarelated

scars and melasma (pigmentation) can all be noticeably

improved with Infini – not to mention the anti-ageing benefits integral

to treatment. Whether it’s for general rejuvenation, or to combat a

specific condition, treatment with Infini will leave your complexion

more volumised and revitalised. csbm 133




Treating acne

Acne is one of the most common

and debilitating skin conditions.

It occurs when the sebaceous

glands in the skin produce too

much oil, creating a breeding

ground for bacteria and leading

to clogged pores, inflammation

and redness.

The Omnilux Blue is designed

to prevent the spread of

this bacteria, and works by

penetrating the skin’s deeper

layers and stimulating the

production of bacteria-destroying

chemicals. When used in acne

treatment, the Omnilux system

helps soothe painful inflammation

and reduce the amount of

bacterium to reduce the severity

of acne.

As well, Omnilux accelerates

healing and strengthens the

natural function of the skin to

help prevent against future

recurrence of acne irritation.

Omnilux light therapy is a trusted

solution in helping reverse the signs of

ageing and treating acne-prone skin.

Caitlin Bishop reports.

Omnilux has a history of effectiveness that surpasses any other light

therapy device on the market. It uses Light-Emitting Diodes (LEDs)

to achieve significant results in skin rejuvenation, acne treatment and

anti-ageing – results that are clearly supported by clinical research. Indeed,

the system was founded upon many years of research, is used by more than

3,300 dermatologists and plastic surgeons across the globe, and has been

documented in more than 60 peer-reviewed publications.

‘Omnilux is the only proven TGA-approved LED device with years of

research and written papers behind it,’ says Sydney cosmetic surgeon Dr Saras

Sundrum, who has been using Omnilux in her clinics for the past 10 years.

‘Our clients love the non-invasive nature of it and the immediate results. It’s also

very relaxing.’

The device, distributed by True Solutions in Australia, harnesses the body’s

natural processes to treat certain skin conditions and rejuvenate the skin from

within, causing an anti-ageing result. It calls upon light energy to trigger specific

reactions below the skin’s surface, helping to reduce the appearance of acne,

strengthen dermal integrity and reverse the signs of ageing.

The Omnilux system uses three different wavelengths: infrared (Omnilux

Plus), red (Omnilux Revive) and blue (Omnilux Blue). The various wavelengths

are suitable for treating different skin conditions, and trigger cellular activity in the

dermis and epidermis to promote healthy skin function.

Founder of Clear Complexions Clinics and registered nurse Suzie Hoitink

says she uses the Omnilux system to treat a number of different skin conditions

and anti-ageing concerns in her patients. ‘If your skin is feeling tired and the

effects of environmental damage are beginning to show, the Omnilux system is

incredibly effective at rejuvenating your skin,’ Hoitink says.



Point of difference

A key feature of Omnilux, that differentiates it from other systems, is the delivery

of one precise wavelength per treatment – as opposed to using multiple

wavelengths in a single treatment. This means the skin cells are stimulated in

the same way during the entire treatment, preventing cell confusion or counter

activity, and leading to more direct, consistent and effective results.

Even so, Omnilux Plus and Omnilux Revive can be used in conjunction to

achieve a more thorough rejuvenation. ‘The combination of Omnilux Plus

and Omnilux Revive results in a noticeable softening of fine lines and a reduction

in pore size,’ says Hoitink. ‘It also returns an overall, more youthful appearance

to the skin.’

Action within the skin

Omnilux Revive targets fibroblasts in the skin’s dermis, which are the cells

responsible for generating collagen and elastin – the antidotes to premature

wrinkles and textural irregularities. The red wavelength also reduces inflammation

in the skin, helping to promote regular, healthy and efficient cellular activity.

In comparison, Omnilux Plus helps reduce the levels of toxicity in the skin

and assists in healing. As well as this, the infrared wavelength targets the

activity of fibro-myoblasts, which are the cells that work to tighten collagen

bundles and create a neat, even and resilient structure of collagen fibres in

the skin.

‘As we age, the structural integrity of the skin is compromised, resulting in

thinner skin, wrinkles and capillary damage,’ Hoitink explains. ‘Omnilux Plus

and Omnilux Revive work to “kick” the skin back five years or so, to increase

strength, elasticity and overall health.’

Treatment protocol

Studies have found 10 treatments with Omnilux is optimum to achieve the best

rejuvenation results. In most cases, two treatments performed twice a week over

a five-week period is preferred to establish maximum effect in improving skin

health and seeing noticeable results.

‘Each treatment is pain-free and lasts around 20 minutes in duration,’ says

Hoitink. ‘Before treatment, we apply a preparatory solution to the skin to further

enhance the light penetration.’

Depending on patient concerns, other modalities might be used in conjunction

with Omnilux to further enhance results. ‘We use Omnilux following Ultherapy,

laser, IPL, skin needling and injectable treatments to reduce inflammation,’ Dr

Sundrum explains.

Because of its healing properties, Omnilux Plus is commonly used after

cosmetic surgery to help accelerate and improve the recovery process. The

infrared wavelength reaches 8 to 12mm under the skin to trigger the wound

healing response, reduce healing time and help prevent scar formation.

‘For anyone considering surgery, the Omnilux Plus is an absolute must,’ says

Hoitink. ‘It can be used before surgery to prepare the skin, and after surgery to

promote rapid wound healing and assist in scar reduction.’

These same healing benefits have achieved significant results in treating

rosacea, a skin condition that causes facial flushing, persistent redness, thickened

skin, visible capillaries and painful inflammation. Treatment with Omnilux can

boost immune function, clear damaged tissue and promote the production of

new, healthy cells. csbm 135

hair removal


hair removal

for blondes

Fair-haired people, rejoice!

French IPL specialists

EFB Beauté have brought their

unique blonde hair removal

technology to Australia.

AimÉe Surtenich reports.

By now we’ve pretty much all heard of the beauty benefits

of permanent hair reduction. But there’s always been a

catch – you need dark hair to absorb the light energy.

Oh, and you also need to be fair skinned to achieve the best

results. Until now.

Innovative IPL technology by EFB Beauté has finally made

it possible for blonde, red, grey and white hair (the notoriously

hard ones to remove) to be treated for long-term hair removal.

It’s also suitable for all skin types, making it the only hair

reduction solution for all hair colours and all skin colours.

The Adéna and Anthélia IPL systems by EFB Beauté are

the only machines on the market able to treat white and

blonde hair, and a worldwide patent was registered with the

World Intellectual Property Organization in 2005 and published

in 2007.

How does it work?

Designed and manufactured in France, the EFB Beauté IPL

systems use unique technology developed specifically for

blonde, white, red and grey hair removal. The IPL systems

are unique in that they do not rely only on the hair pigment to

absorb the light energy, meaning it can effectively target those

hair shades not so rich in melanin.

During traditional dark hair photoepilation procedures, an

applicator head that emits high intensity flashes of filtered light

is placed on the treatment area. The energy from this light is

absorbed by the chromophore melanin, which is responsible

for hair pigment or colour. Dark hair, which is rich in melanin,


hair removal

Multiple benefits

The Adéna and Anthélia IPL systems can also be used

for facial rejuvenation, helping to improve the appearance

of ageing skin rosacea, acne, pigmentation and spider

veins, making it a versatile multi-programmed system

to address a wide range of cosmetic concerns. Both

machines offer effective results; the Adéna is a more

gentle treatment, while the Anthélia offers faster, more

effective results.

Both facial rejuvenation procedures and permanent

hair removal of the legs or back can be completed in just

a lunch break, with no work or social downtime.

1. Photoepilation

World-fi rst exclusive patent in permanent hair reduction

for all hair colours, including blonde, white, grey and red.

2. Skin tightening and anti-ageing

Stimulation of the dermis for a restructuring, lifting and

tightening effect of the skin.

3. Pigmentary treatment

Removal of dark patches on the skin caused by sun

damage and ageing.

4. Vascular treatment

Fast elimination of spider veins and broken capillaries by

selective photo-coagulation.

5. Acne treatment

Weakens production of the sebaceous glands and treats

infl ammatory and bacterial acne.

readily absorbs this light and transfers it as heat into the

surrounding capillaries, which supply blood to the papilla

of growing hairs. When the papillae are destroyed in high

temperatures, additional hair growth is prohibited.

What makes the EFB Beauté systems different is that

the Adéna and Anthélia machines target the blood vessels

at the bottom of the follicle directly, preventing the growth

of blonde, grey, white and red hairs.

An independent clinical trial by DERMSCAN, an

authorised clinical testing centre by the French Ministry

of Health, found that after one session of photodepilation

using Adéna an average decrease of 41 percent of white or

blonde hair was observed.

About the technology

After 10 years of research, in 2011 the Adéna IPL system

entered the market with its exclusive world-fi rst technology

for removal of fair hair, as well as for darker skin types.

EFB Beauté has now become synonymous around the

world with blonde, red and white hair removal, offering a

much-needed solution to treating these traditionally diffi cult

to remove hair colours. It can also safely and effectively

treat darker complexions without risk of burning or


For practitioners, other EFB Beauté innovative benefi ts

include the stability of delivered energy during treatment

and a new absorption fi lter that won’t wear out during its


For fair-haired or dark-skinned people wishing to remove

unwanted body hair or treat a variety of skin concerns, EFB

Beauté offers a giant leap forward in IPL technology. csbm


AFTER pigmentation treatment


AFTER hair removal


AFTER skin tightening treatment


AFTER spider vein treatment 137

tattoo removal



Do you have tattoo regret? the SkinIal Non Laser Tattoo removal

system ALLOWS YOU to undo what was once a permanent decision, says

Sydney cosmetic tattooist Rita Porreca. tara casey reports.

The number of tattoos is on the rise, with around one

in four Australians under 30 sporting some form of

‘body art’. But alongside the increasing number

of inked bodies, there is also an ever-growing market for

tattoo removal. Indeed, more than 25 percent of people

with tattoos want them removed, according to consumer

group Choice.

The popularity of tattoos matched with the high

prevalence of ‘tattoo regret’ means tattoo removal has

become big business, with the industry rapidly refining

procedures to keep up with demand for tattoo removal. The

most popular methods in recent times include IPL (intense

pulsed light) and laser treatment.

While these are effective methods for tattoo removal, a

new procedure is offering comparable results with reduced

risk of complications.

The latest offering in the tattoo removal market is the

Skinial Non Laser Tattoo Removal System, an innovative

new reverse tattoo technology designed in Germany. ‘For

those who might have grown out of their tattoos, and no

longer want them, the Skinial Non Laser Tattoo Removal

System can leave the skin ink free, without the risks

associated with laser tattoo removal,’ says Rita Porreca

from Sydney Permanent Makeup Centre.

Invisible ink: how does it work?

The Skinial Non Laser Tattoo Removal System uses a

removal liquid based on lactic acid, a substance that is

naturally produced by the body, which is administered to

the skin by a micropigmentation device similar to a standard

tattoo machine.


The body’s natural defence system recognises the ink

under the skin as a foreign substance and the solution

helps your body to reject the ink and push it to the surface

where it becomes part of a scab.

‘Skinial uses a micro pigmentation device with a lactic

acid solution to trigger the body’s natural immune system

to get rid of the foreign substance,’ Porreca explains. The



device targets clusters


of up to 20 small timeless and

spots in the tattoo at one time, releasing the solution into

each site. The lactic acid eliminates macrophages (defence effortless beauty

mechanism cells) from the large-volume colour particles,

which, up until this point, have encased the particles of

colour, shielding them from the body’s immune system.’

‘In When 1984 it my comes dream to eyes, was to lips, create face, a

With the macrophages removed, the body recognises Centre body, skin that and provided training, personalised we are the

the ink as foreign, prompting the immune system to ‘flush’ beauty experts’ solutions expert. With with more natural than and 24

the rejected skin cells and colour molecules to the skin’s lasting years’ experience results – a world we have above developed

surface, where they aggregate to form a scab and ultimately traditional an excellent beauty reputation salons.’ with doctors

fall off. Because the body naturally produces lactic acid to – and Rita surgeons. Porreca, We Founder also work & MDclosely

timeless and effortless

with surgeons in post-operative


maintain energy production during exercise, any residues


left after treatment are easily metabolised.

When – Rita it Porreca, comes to Founder Eyes, Lips, & MDFace, Body, Skin and

The individual spots targeted during treatment are Training






the experts'


expert. We also work closely

approximately 0.5 x 0.8 cm in size and around 1mm is with surgeons on post-operative care.

abraded from the top layer of skin. This means large tattoos

will need a number of treatments, spaced several months ‘In 1984 my dream was to create a


apart, in order to remove the entire tattoo. However, Centre that provided personalised

because SERVICES of the WE minimal PROVIDE abrasion, the level of discomfort

beauty solutions Cosmetic with natural Tattooing


lasting results – a world above

felt Cosmetic by patients Tattooing during the treatment is minimised, and the

traditional beauty Medical salons.’ Tattooing

risk Eyebrows of scarring Hair reduced. stroke to ‘This shaded procedure brows reduces to give the you risk more of a

– Rita Porreca, Founder Skin & Needling

for natural scars appearance

enormously because small wounds usually heal


without BEFORE

Eyeliner scars,’ Subtle Porreca to Dramatic explains.

Dermal Planning Peels

or to define your eye shape

‘In my experience the Skinial method of tattoo removal When it comes to Eyes, Lips, Face, Body, Skin and

Lips From lip liner to full lips & blends we make your lips look


good with Non Laser Tattoo Removal

can erase all kinds of shapes and colours of tattoos. Usually,

we are the experts' expert. We also work closely

an ideal shape and colour all the time.

with surgeons Cosmetic on post-operative Tattooing care. Courses

the treatment causes less discomfort than the tattooing

itself. Medical However, Tattooing the level of discomfort varies depending on

the Areola patient re-pigmentation and the treatment Is area,’ the final she says. stage of breast reconstruction and is AFTER FULL LIP TATTOOING

also The considered time it takes by those to heal with between areola treatments colour loss. varies


between Corrective individuals Camouflage and depends Can bring on the a client’s natural skin skin type colour back to scars

and Cosmetic the burns strength Tattooing of their immune system. Healing typically

Eyebrows Hair stroke to shaded brows to give you more of a BEFORE FULL LIP COLOUR


takes between six and 10 weeks, with redness persisting

longer natural Skin Needling


some patients.

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



a Lips greater

Skin From risk

Rejuvenation lip of liner scarring to full and lips those & blends with deep we make or uneven your lips look good with

penetration an Is ideal for shape can



rebuilding and a colour shadow

of all new

on the the

collagen time. skin after



lightening pigmentation.



‘Cases where previous laser treatments have been

unsuccessful Medical IPL Hair Tattooing Removal or have resulted in permanent scarring are

Areola Enables re-pigmentation hair removal from Is nearly the final every stage part of of breast the body reconstruction quickly and is AFTER FULL LIP TATTOOING

more difficult, and are assessed individually to establish if


Skinial and efficiently considered treatment is by worthwhile,’ those with she areola says. colour ‘The procedure loss.

is Corrective also not suitable Camouflage for those Can prone bring to a natural hypertrophic skin colour or back to scars




Skin Peels/Microdermabrasion



keloid scarring.’

Skin treatments ranging from Green Peel, CosMedix Peels

With a range of removal techniques available, including

Skin & Microdermabrasion Needling to give you a natural healthy glow.

the latest non-laser method, tattoos are no longer the

Needling treatment for wrinkles, acne scars & scar relaxation


02 9569 7799

Cosmetic Dermal brands Fillers they & once Mesotherapy were. ‘The Skinial


follow us on

method Skin Rejuvenation

represents a real step forward for those looking Bella Building, Shop 4/239

Cosmetic Tattooing Courses

for Is ideal an effective for the means rebuilding of erasing of new past collagen mistakes,’ and Porreca lightening pigmentation. Great North Rd, Five Dock

Learn, up-skill and expand with professional cosmetic tattooing training.


concludes. csbm

located in Cosmedic Professionals

IPL Hair Removal


Enables hair removal from nearly every part of the body quickly



and efficiently

SPMUC FP(NEW) 30/4/07 1:30 PM Page 1

SPMUC FP(NEW) 30/4/07 1:30 PM Page 1


Why quality

skincare works

There are certain things surgery can’t help

with, and clear, healthy and uniform skin is

one of these. That’s where the benefits of a

quality medical-grade skincare regime can be

invaluable. AimÉe Surtenich reports.






Retinol is a Vitamin A (retinoic acid)

derivative that is a safe, effective

and widely used anti-ageing

solution. Retinoids encourage

better cell turnover in the upper

layers, normalising skin turnover.

Hyaluronic acid

Hyaluronic acid (HA) is used in

hundreds of anti-ageing products

due to its fast-working moisturising

properties. Leading dermatologists

recommend patients invest in a

good anti-ageing moisturiser with

HA, which is also found naturally

in skin.

Vitamin C

Famously linked to vitamin pills and

oranges, its goodness is now found

in beauty products, too. Vitamin

C is an antioxidant that works to

prevent free radical damage. These

are volatile molecules so look for a

stabilised Vitamin C product to help

reinforce the skin’s own defences

and prevent long-term damage.

Vitamin B

Vitamin B3 (Niacinamide) has really

come to the fore in the anti-ageing

war, taking its place alongside

skincare veterans Vitamins A, C

and E. Typically used in serum

form, Vitamin B3 can effectively

treat acne, fade hyperpigmentation

and improve the skin barrier

functions, as well as help reduce

fine lines and wrinkles. It provides

antioxidant properties for the skin

and it has also been shown to

have anti-inflammatory and healing

properties, as well as help reduce

skin sensitivity.

Arguably the most important aspect of beauty is clear and healthy skin.

Indeed, there is a new school of thought that a radiant, even complexion is

a greater signifier of youth and beauty than a wrinkle-free face. The reason?

Plump, healthy skin reflects light more uniformly (which the eye is attracted to),

resulting in a homogeneous, more even complexion that appears to glow.

So how do we significantly improve the appearance and function of our skin?

Step in medical-grade skincare, which is specifically formulated to improve

the quality and texture of skin, alleviating signs of ageing such as fine lines,

pigmentation, skin tone and texture.

Available in-salon and typically prescribed by a skincare professional, these

‘cosmeceuticals’ represent the marriage of cosmetics and pharmaceuticals.

What sets them apart is that they contain ingredients, at the right doses and in

the right delivery systems, to influence the biological function of the skin.

Cosmeceuticals have benefits beyond those of traditional products. They also

improve appearance, but they do so by delivering nutrients and typically claim to

improve skin tone, texture and radiance, while reducing wrinkling.

Cosmeceuticals can improve the function of the skin and may be helpful in

preventing premature ageing. Examples include hydroxy acids, retinoids and

antioxidants such as Vitamins A, B and C. Gone are the days when skincare

need only sit on the surface of your skin and not work at the cellular level.

These topical skincare formulations contain active ingredients which enable

them to act on the skin’s cellular structure. In some cases, such as exfoliants, this

action is limited to the surface of the skin, while other formulations can penetrate

to deeper levels and enhance or inhibit natural activities.

Many brands have poured millions of dollars into research and development,

employing highly skilled biochemists and scientists to create new products

delivered in formulations designed to enhance their capabilities and the

appearance of the skin at the same time.

What to look for in cosmeceutical products are antioxidants, exfoliants, cellcommunicating

and skin-lightening ingredients, and intercellular substances that

mimic skin structure. For the products to work, these need to be at sufficient

concentrations and synergies to allow them to retain their active properties.

Essential ingredients to look out for

Cosmeceutical products contain ingredients that induce healing and other

changes in skin cells. Research shows that benefits for the skin can also be

obtained from plant extracts and essential oils as well as vitamins, enzymes,

phytochemicals and more.

Antioxidants reduce free-radical damage and inflammation, counteracting

cellular damage, collagen destruction and immune suppression. Antioxidants in

combination, studies suggest, can exert a cumulative synergistic action on the

skin that is more effective than single-ingredient formulations.

Cell-communicating ingredients use receptor sites or cellular pathways to

interact with skin cells to signal them to function optimally. Retinoids, which

are derivatives of Vitamin A, are the best known. They act as antioxidants

and neutralise the free radicals that result from exposure to ultraviolet light. In

addition, they increase cellular turnover, stimulate a thickening of the epidermis

and promote the removal of excess pigment.

Other cell-communicating ingredients include peptides, which were developed

for use in skincare to either increase the production of collagen or to reduce

its breakdown. 141



Squalene is an organic, oil-free

moisturiser that occurs naturally in

the body. It can be derived from

olives and is an excellent nongreasy

moisturiser that instantly

softens the skin and helps prevent

cell damage. It is also non-irritating

and non-comedogenic.


Antioxidants help protect skin

by combating free radicals,

which attack healthy skin cells

and collagen. This attack of the

skin’s vital structures can cause

damage, mutations, cell death

and infl ammation, resulting in

lines, wrinkles, uneven skin tone,

sensitivity and even cancers.


Ceramides are a type of skin lipid

that sit in the top layer of the skin

and work to lock in essential oils

and moisture. They are essential in

maintaining both the structure and

strength of the lipid matrix.


Idebenone, respected for some

time as a pharmaceutical agent in

the form of a super antioxidant, is

now an ingredient in quality antiageing

skincare products to help

prevent wrinkles. Idebenone helps

protects the skin from the elements

and reduces the appearance of

fi ne lines, reduces dryness and

improves skin texture.


‘Peptides’ has overtaken HAs as

the new buzzword in skincare.

But there’s substance behind the

hype. The science behind peptides

came from the discovery that when

collagen is damaged by sunlight it

is broken up into peptides. Certain

peptides formed were able to act

as a signal to skin cells to make

new collagen, meaning wrinkled

skin could be improved by fooling it

Another essential ingredient to look for is Niacinamide, a water-soluble

B-complex vitamin that has anti-infl ammatory properties and can assist with

conditions such as acne vulgaris.

Exfoliants encourage surface skin cells to shed, mimicking the function of

young skin and increasing collagen production. The primary reason for skin

cell build-up is sun damage. Exfoliant ingredients include alphahydroxy acids

(AHAs) such as glycolic and lactic acid, polyhydroxy acids (PHAs) such as

gluconolactone and lactobionic acid, and beta hydroxy acids (BHAs) such as

salicylic acid. Salicylic acid is also used as a skin conditioner and is especially

useful in patients with oily skin and acne.

Skin-lightening ingredients, including hydroquinone, arbutin, azelaic acid,

some forms of Vitamin C, rucinol and glycyrrhetinic acid, inhibit melanin formation

at a molecular level, reducing the appearance of brown discolouration.

Intercellular substances are ingredients that exist naturally in skin and can

be depleted by ill health, ageing and environmental factors. Ingredients such

as ceramides, cholesterol, fatty acids and glycosaminoglycans are key to skin

function and should be included in moisturisers if they are to be effective in

promoting skin functionality.

Hyaluronic acid is known to hydrate and moisturise the skin from the inside,

helping to smooth out wrinkles.

A 2008 study published in the Journal of Cosmetic Dermatology analysed

several cosmeceutical ingredients to see how successful they are in targeting

specifi c skin imperfections related to age. The study indicated, for example, that

skin surface irregularity can be improved through the topical application of niacin,

and that the appearance of fi ne lines can be diminished with the application of

moisturisers containing engineered peptides and retinoids.

While the Australian Therapeutic Goods Administration regulates ‘products at

the interface between cosmetic and therapeutic goods’ (that is, cosmeceuticals)

and most manufacturers belong to self-regulating industry bodies, it is always

safest to seek the advice of a dermatologist or skincare professional. csbm

Prepping skin for


Healthy skin heals faster after surgery,

and an essential factor for successful

surgery is a good skincare regimen

both before and after your surgery.

Quality skincare can help regulate

skin cell function and improve

circulation, enabling the skin to

renew, repair damage and act as an

effective barrier – promoting skin that

responds better to surgery or laser

skin rejuvenation and heals faster.



into thinking it had been damaged

by applying this peptide. Peptides

offer a way for the skin to repair

itself naturally and can potentially

trigger specifi c things in the skin, so

that they might improve wrinkles,

fi rmness or age spots.

Hexapeptide, in particular, is a

popular component of anti-ageing

products as it works to relax facial

muscles for a more plump, youthful


Stem Cells

Skincare specialists are creating

specialised peptides and enzymes

that help stimulate the skin’s

storage of stem cells. It is

believed the skin contains a ratio

of approximately one in 10 to

one in 10,000 stem cells. These

specialised cells are dormant until

they receive signals from the body

to begin the repair mode.

The use of topical products

stimulate the stem cell to split into

two types of cells: a new, similar

stem cell and a ‘daughter’ cell. This

stem cell can receive the message

to create proteins, carbohydrates

and lipids to help repair fi ne lines

and wrinkles and restore and

maintain fi rmness and elasticity.

Coenzyme Q10

CoQ10 occurs naturally in the body,

however, factors such as stress,

ageing and some medications can

lower the levels. In most people

over 30, levels of CoQ10 in the skin

are below optimum, resulting in

lesser ability to produce collagen,

elastin and other important skin

molecules. CoQ10 penetrates

into skin cells to boost skin repair

and regeneration and reduce free

radical damage.

A new form of Q10 called

Ubiquinol is now available. In

essence, Ubiquinol is the reduced,

active antioxidant form of CoQ10

produced naturally by the body,

offering more effective uptake.



There are some truly skin-transforming product

ranges available, and ingredients and delivery

systems continue to become more sophisticated.

Here are some of our favourite skincare brands

making headway for their ability to effect signifi cant

changes in the skin: HydroPeptide, Obagi,

Mesoestetic, Dr. Spiller Biocosmetics, Fyto

Cosmeceuticals and Synergie. 143













Consumers are constantly bombarded by the

global corporate brands with marketing claims

and media hype promising much and delivering

little. Skin professionals and clinical therapists are highly

skilled in the area of skin analysis and recommending

clinical grade products containing active ingredients that

actually make a difference.

Of course, the condition of our skin is due to numerous

factors, including genetics, environmental stress, nutrition,

health status, topical skincare and clinical treatments. All

of these factors must be considered both independently

and in relation to each other.



What to look out for

Does the range cater to most individual skin

concerns: ageing, blemishes, uneven skin

tone, sensitivity?

Does the range offer key active ingredients

such as stable active forms of Vitamin A,

Vitamin B3 and Vitamin C along with broad

spectrum UV protection?

Does the manufacturer have a core

brand philosophy that resonates with you,

the consumer?

Does the range offer optimal levels of

cosmeceuticals supported by readily available

clinical data?

Are you offered guidance and information on

the products by qualifi ed skin professionals or

medical staff when making your choice?

Is the manufacturer of the range able

to readily adapt formulations to this

dynamic industry?

Is the manufacturer readily available for

interaction with the consumer via email, social

media or telephone should the consumer

have and queries?

There is one fi nal and fundamental factor

in selecting good skin care: TRUST. If the

customer trusts the advice of their skin

therapist and the ethos and quality of the

brand they have chosen, they will feel their

decision is valid and positively embrace their

new skin routine.

A trained therapist will advise clients not

only of the ideal products but also advice on

lifestyle, nutrition and treatments to address

their skin concerns. When a cosmeceutical

home routine is adopted in a positive way, the

very best results can be achieved.

In my opinion, clinical grade skincare

really does stand apart from the white noise

of department store brands. If the customer

is prepared to take the time to research the

best cosmeceutical brands and the right

skin therapist, great results – not seven day

miracles – are possible.

A cosmeceutical skin care regimen is an integral part of the

equation. Mass market department store brands are generally unable

to offer the high grade of skincare that clinical skin professionals can

offer for the following reasons:

Packaging vs product

High street brands often spend more money on marketing and

packaging than on the actual product inside the bottle. Cost and

economics is the driving factor for this sector and the level of active

ingredients may be insuffi cient to give results.

Skilled professionals

Skin professionals are trained in educating clients on managing skin

concerns. Sales assistants in multi-brand mass-purchase department

stores are not skilled therapists. They often lack detailed knowledge

of skin and are unable to address individual skin concerns.

Clinical grade skincare companies will pride themselves on

supporting their clinics, and therapists will have a high level of training

regarding key ingredients and benefi ts of cosmeceuticals.

Dosage of active ingredients

As a formulator, I have suppliers present ingredients to me on a regular

basis. Many of these raw ingredients are novel and new. However,

formulators supplying clinics must evaluate the ingredient in terms of

its effi cacy and safety profi le. This involves a thorough analysis of both

in vivo and in vitro clinical data.

Furthermore, the formulating chemist must use the optimal dosage

of active ingredients to ensure effi cacy. Many over-the-counter brands

add just a whiff of active ingredient simply to make marketing claims.

Synergy and stability of combined ingredients

Cosmetic scientists must also understand the interactions of

ingredients within the fi nal formula. Formulating is not simply a matter

of adding a number of ingredients together and mixing them up.

Ingredients must be compatible and must also work together

in synergy. For example, retinol and niacinamide should not be

formulated in an acidic environment. Additionally, adding acids

such as AHAs, BHAs or L-ascorbic acid to formulas with these

cosmeceuticals results in retinol being rendered ineffective and

niacinamide being hydrolysed.

Ability to adapt

Many non-clinical brands are unable to react to market needs rapidly.

The large corporates must create marketing campaigns well in

advance and a need to adapt to new technology may take years.

Smaller specialist companies can more readily react to dynamic

changes in the appearance medicine industry. csbm 145


Transform your skin




The capacity of Obagi to transform skin has created

a long-standing and highly regarded reputation in

the international skincare arena. Used by plastic

surgeons, dermatologists and skincare therapists across

the globe, Obagi has been shown to change skin at a

cellular level, boosting skin health and regeneration.

Its widespread professional use – from helping to optimise

skin health before surgery to pigmentation reduction – acts

as testimony to the effectiveness of Obagi skincare. ‘Obagi

has always been considered the gold standard, and its

international reputation was what led me to trial Obagi in

the fi rst place,’ says Michelle Field, registered nurse and

director of the Skin Institute in Victoria.

‘Obagi stimulates increased collagen production, and

better skin colour, tone and texture. It also helps improve

the appearance of fi ne lines and wrinkles, and reverse some

sagging and pigmentation.’

Obagi, distributed in Australia by iNova Aesthetics, holds

a full portfolio of skincare solutions to promote beautiful

complexions for all skin types.

The hero skincare system, NuDerm, is designed to

correct skin damage and reveal a healthier, more youthfullooking

complexion. ‘NuDerm is the most popular Obagi

program and is very effective in treating photo damage,’

says Perth medical aesthetician Anna Robinson from Assure

Medispa in Perth. ‘It helps repair the cellular structure of

the skin, and visible improvements typically occur in as little

as four to six weeks.’

This rapid response is due to the high-grade ingredients

used in Obagi skincare. These ingredients have been

clinically shown to deliver results.

‘Obagi stands out as a true “Dr Only” range,’ says Sydney

cosmetic physician Dr Saras Sundrum. ‘The products are

designed around prescription-strength retinoic acid, which



is one of the few substances clinically proven to improve

skin quality.’

Because the range uses such active and concentrated

ingredients, it is described as a “medical grade” skincare

line and some treatments must be prescribed by a qualifi ed

and experienced practitioner.

Obagi transforms the skin at

a cellular level by targeting skin

cells directly, restoring function

to effectively target some of the

most diffi cult skin conditions

‘Some cosmetic procedures need to be complemented

with prescription-based skincare for optimal results – and

in Australia these can only be prescribed by a medical

practitioner,’ says Dr Christopher Leat from Envisage

Clinic in Queensland. ‘Obagi relies on published third-party

research for their ingredients, and this is what distinguished

the range for me in the fi rst place.’

With different treatment “systems”, specifi cally targeted

to certain skin complaints such as acne, pigmentation and

anti-ageing, Obagi offers a range for all skin types. Each

specialised skincare line includes every skincare element –

from cleansers to serums – required to make noticeable

and long-lasting changes in the skin.

‘I am quite fi rm with my patients about needing to start

the programme as a complete system, which I believe is

required for obtaining the high level of results,’ says Dr

Linda Williams from Artisan Cosmetic & Rejuvenation

Clinic in Queensland. ‘Obagi therefore requires discussion,

commitment and enthusiasm but this has not proved

negative to any of my patients to date. If anything, the

systems are easy to follow and the improvements in skin

quality, pore size, tone and hydration are apparent within

the fi rst week or so.’

Adopting such a comprehensive skincare program,

with high concentrations of active ingredients, can mean

patients experience some irritation when fi rst starting use.

This should fade with continued use, and is considered an

indication that the line is working to cause changes within

the skin.

Obagi can also be used to boost skin health and improve

the results following cosmetic surgery or laser procedures.

‘Radiantly beautiful skin adds value to the outcome of any

cosmetic surgery or non-surgical procedure,’ explains Perth

plastic surgeon Dr Anh Nguyen. ‘Quality skincare systems

are needed to prepare the skin before treatment, expedite

wound healing after surgery, and protect the investment

long term by delaying the visible signs of ageing and need

for intervention.’

Whether contemplating surgery or not, Obagi skincare

can transform and beautify all skin types and help treat a

range of skin conditions. Quality skincare can help protect,

preserve and enhance the complexion and Obagi offers

an all-encompassing solution to optimising skin health for

the long term.

‘Obagi transforms the skin at a cellular level by targeting

skin cells directly to restore function,’ explains Perth plastic

surgeon Dr Brigid Corrigan from Assure Medispa. ‘The

fact that it is a prescription-only skincare line means it can

effectively target some of the most diffi cult skin conditions

to treat, such as pigmentation, sun damage, fi ne lines

and wrinkles.’

‘We all put “creams” on our skin on a daily basis, but it’s

important to choose products with ingredients that make a

difference and have the scientifi c pedigree to deliver what

they promise,’ says Dr Williams. ‘Start looking after your

skin as early as possible, using sun prevention, antioxidant

protection, hydration and collagen stimulation. It’s never

too early.’ csbm




8 weeks AFTER using Obagi NuDerm system

1 week AFTER using Obagi CLENZIderm system

4 weeks AFTER using Obagi-C Rx system 147




Meet the star products changing faces and reinventing

beauty rituals. AimÉe Surtenich reports.

Makeup has the power to transform faces –

highlighting your best features and disguising

your worst. It can even give the illusion of more

prominent cheekbones, a narrower nose and more

defined jawline. It’s all about creating optical illusions so

that it looks like you are constantly under the best lighting

ever – and, to do this, light and shade will be your BFFs,

highlighting and contouring to create a glamour-girl look.

First, we need the right base, and where would we

all be without a good primer? It minimises the look of

pores, evens out skin colour and just feels so ridiculously

smooth on your skin. A good BB cream has also become

a staple in my daily beauty ritual; it mimics the texture of

perfect skin and creates a great base for your foundation

to glide right on.

Now for the magic: contouring your face. Generally,

the idea is to use an illuminator or lighter shade of

foundation to highlight the areas of your face where light

naturally hits – cheekbones, bridge of your nose, temple,

brow bone and along your jaw line. Conversely, to add

definition use a darker colour under your cheekbones (to

really make your cheekbones pop) and under your jawline

to add more definition to this oft-neglected area.

Finish with a dusting of powder, some extra concealer

under your eyes, a little shimmer or bronzer on your

cheekbones and a dab of blush on the apples of your

cheeks. csbm


Conceal it!

I don’t believe there is a one-size-fits-all concealer. Instead, invest in a few good quality concealers

– one specifically for under the eyes, a highlighter concealer to add as a mini illuminator on the

run, and another to camouflage imperfections on the face. Remember, a little goes a long way!

Another trick is to add a dab of concealer to your eyelids to help make eyeshadow stick.


1. Colorescience Mineral Corrector Palette, RRP $79.20, 2. Laura Mercier Secret Camouflage, RRP

$49, 3. Shiseido Pore Smoothing Corrector, RRP $40, 4. Calvin Klein CK One 3-in-1 Concealer, RRP

$28, 5. Maybelline Dream Lumi Touch Highlighting Concealer, RRP $17.95, 6. Shiseido Sheer Eye

Zone Corrector, RRP $42, 7. Glo-Minerals Luxe Liquid Foundation, RRP $72, 8. Shiseido Face Color

Enhacing Trio in Apple, RRP $58, 9. Laura Mercier High Coverage Concealer, RRP $39, 10. Curtis

Collection Mineral Photo Touch Concealer, RRP $33, 11. Shiseido Natural Finish Cream Concealer,

RRP $50.











As Napoleon Perdis famously said: Not to prime is a

crime! While we’re not suggesting a jail sentence for

those who skip this essential step, primers do make

a big difference to your finished product. It smoothes

the look of pores away right before your very eyes,

evens out the complexion and primes your face for

foundation or finishing powder. You can also

multitask with it if it’s a fancy hybrid one and use it

as an illuminator.






1. Dermalogica SkinPerfect Primer SPF30, RRP

$67, 2. Napoleon Perdis Auto Pilot Pre-Foundation

Skin Primer, RRP $59, 3. Laura Mercier Oil-Free

Foundation Primer, RRP $45, 4. Skindinavia The

Makeup Primer Spray, 20ml RRP $16.

1. 149











& illuminators

Contouring gives the illusion of more defi ned

contours, smaller nose and chin, higher

cheekbones. We’ve all seen the “in between”

makeup shots of Kim Kardashian with light and

dark stripes strategically placed all over her face

and neck. This clever makeup trick works wonders

to create a more chiseled, defi ned face that refl ects

light beautifully and gives an air brushed effect.

1. Benefit Watt’s Up, RRP $53, 2. Benefit High

Beam, RRP $45, 3. L’Oreal Lumi Magique

Primer, RRP $29.95, 4. Calvin Klein CK One

Skin Illuminator, RRP $35, 5. Lancôme Teint

Miracle Natural Light Creator SPF 15, RRP $68,

6. St. Tropez Skin Illuminator Gold, RRP $29.95

Skin fixers

Oh, BB Cream, in just a short period you have

become one of the staples in every beauty devotee’s

makeup kit. Used alone or under foundation, it

really does fake the look of moisturised and healthy

skin. And what’s not to love about that? Many also

have additional benefi ts, improving not only the

appearance of your skin but also skin health.

1. Lancôme Visionnaire [1 Minute Blur], RRP $62, 2. L’Oreal Nude

Magique Blur Cream, RRP $26.95, 3. L’Oreal Revitalift Magic

Blur, RRP $24.95, 4. Estée Lauder Double Wear All-Day Glow BB

Moisture Makeup, RRP $50, 5. L’Oreal Skin Perfection BB Cream

5-in-1 Instant Blemish Balm, RRP $24.95.

1. 2. 3. 4. 5.





- fake it ‘til

you make it!


Got short and sparse lashes? Not to

worry! We can make those babies

transform into beautiful lush lashes

as quickly as you can say the word

“mascara”. The technology that is

being pumped into mascaras these

days means we can rock a big fl utter

and create that false lash effect.

5. 6.

1. Maybelline The Falsies Vlum Express

Mascara, RRP $19.95, 2. Calvin Klein CK

One Volumizing Mascara, RRP $30.






steps to

beautiful skin




Packed full of antioxidants and collagen-promoting

ingredients, Love Life skincare is formulated to deliver

smoother, healthier and younger looking skin in just

four easy-to-use products. While the steps involved may be

simple, the science behind the range is anything but.

Inspired by beauty industry maven Val Glover-Hovan,

and developed in conjunction with one of Australia’s

leading scientists, ingredients in the Love Life range have

been selected for their ability to help protect skin cells from

environmental damage, support skin metabolism, promote

rejuvenation and achieve a more beautiful complexion.

Designed to work in harmony with the skin, Love Life

skincare is a potent yet gentle range that combines the best

of science with the power of nature. csbm

1. Moisturise & protect

Perfect Day – Anti-Ageing Moisturiser

Moisturising is crucial when it comes to warding off fi ne

lines and keeping skin well hydrated. A potent herbal

formula, Perfect Day Moisturiser helps to reduce the

signs of ageing and enhance skin appearance. The

formula contains a complex of collagen-promoting

glucosaminoplycans and galactomannans; linoleic

acids, which assist rapid penetration while helping

to fi rm the skin; and stem cells of apple fruit to help

stimulate the renewal of skin cells.

3. Bright eyes

Eyes Best – Exotic Eye Gel

Eye creams are essential for helping to keep the thin,

delicate under-eye area hydrated and smooth. This

potent eye cream helps to reduce the dark areas

under the eyes and the appearance of crow’s feet.

The formula contains Tamanu oil, which is known for

its healing properties, and a mix of herbs to stimulate

collagen synthesis. It’s also fortifi ed with kiwifruit

enzymes, antioxidant grape seed, Vitamin E and

green tea.

2. Repair & renew

Perfect Night – Retinol Renewal Complex

Serums typically penetrate the skin deeper than creams,

and contain more active ingredients to target specifi c

beauty concerns. The Perfect Night Retinol Renewal

Complex is a soothing night serum that addresses

ageing concerns. The formula contains Vitamin A to

enhance collagen synthesis; linoleic acid to promote

and maintain skin health; Vitamin E and Tamanu oil to

help restore skin health; seabuckthorn seed oil as an

antioxidant; passionfl ower to soothe and calm; and

licorice to help reduce infl ammation and irritation.

4. Lighten up

Beauty Light Lightening Cream

Hyperpigmentation can develop due to a variety of

reasons – from sun damage and age to hormones during

pregnancy – and is a common beauty concern. Alpha

fruit acids and citrus extract in the Beauty Light Lightening

Cream target darker skin spots to help reduce their

appearance. The cream has a broad-spectrum sunscreen

to help prevent further pigmentation and UV damage, as

well as the triple action of urva-ursi (bearberry), arbutin

and zinc glycinate to help stop the browning action of

melanocyte production. 151

eauty & spa

Rock Legend





Jane iredale mineral makeup, a proven and trusted

brand for 20 years, is recommended by thousands of

dermatologists, plastic surgeons and skin therapists

around the world. It blurs the line between skincare and

makeup; cosmetics become an integral part of the solution

to healthy skin, creating a more luminous, even and fl awless


jane iredale was one of the fi rst brands to offer pure mineral

makeup. Indeed, it represents a refi nement of conventional

makeup and has revolutionised a new makeup industry that

combines beauty with skin health.

In an industry that’s constantly changing and being

bombarded by new products and ‘must-have’ ingredients,

the jane iredale mineral makeup range continues to stand

the test of time and shine out from the crowd with its quality

cosmeceutical ingredients and pure micronised minerals.


eauty & spa


jane iredale




jane iredale uses the highest quality

ingredients available with the most

current technology to ensure optimal

performance, coverage, application

and texture. Products have broad

spectrum sun protection and all

vitamins and antioxidants used are

pharmaceutical grade and certifi ed

organic where available.


Multi-tasking products, including

the signature Amazing Base,

PurePressed Base, Glow Time and

Dream Tint, provide four functions in

one: foundation, concealer, sunscreen

and active skincare ingredients.


Because only pure mineral pigment

is used in jane iredale products, with

no fi llers such as talc, the foundations

and concealers achieve exceptional

coverage and require minimal



All jane iredale foundations form a

protective barrier on the skin that

allows it to breathe and function

normally. Lab tests confi rm that

all products in the range are

non-comedogenic and do not

block pores.


Five jane iredale products

have earned the US Skin

Cancer Foundation’s Seal of

Recommendation. To earn this

seal, a manufacturer must provide

scientifi c data showing that its

products suffi ciently and safely aid

in the prevention of sun-induced

skin damage.


Minerals used in jane iredale products

bond together upon application so

they resist running, creasing and



All jane iredale products are safety

tested, allergy tested, clinically tested

and dermatologist tested to ensure

avoidance of any ingredients that may

be skin sensitisers.


One of the jane iredale philosophies

is to include soothing ingredients

that help measurably contribute

to skin health. The range is gentle

enough to use on skin postprocedure,

even on compromised

skin after laser resurfacing.


Where preservatives are needed, jane

iredale uses a combination of natural

preservatives, and always excludes

parabens and phenoxyethanol.


All jane iredale minerals are tested

under laboratory conditions. Results

show that there are no nano-size

minerals in any of our products.


There is a wide variety of foundation

shades available to satisfy the

needs of women’s skin in more

than 40 countries.


The nature of high quality minerals

is to interact with light. This is

what gives them their ‘soft-focus’

effect. jane iredale offers a variety of

foundations in a range of fi nishes –

from sheer to full and luminescent

to velvety. 153

eauty & spa

Get prepped and pretty with this

collection of the latest and greatest

products. Ricky Allen reports.



Daisy Dream by Marc Jacobs RRP

$90 for 50ml eau de toilette. Housed in

a collectable beautiful bottle, this new

Daisy fragrance delivers a distinctive

floral and fruity scent. It brings out

a sense of the youthful, spirited and

romantic side in all who wear it.


Philosophy Miracle Worker Overnight RRP $80. This night cream contains

a blend of vitamin, peptides and algae to help treat and hydrate all skin

types overnight. Improvements start to appear almost overnight and

continue over time. (1)

Dermalogica Dynamic Skin Recovery SPF50 RRP $87.50. Containing

high-powered peptides, hyaluronic acid and algae extracts, this combo

moisturiser and sunscreen is a very effective anti-ageing tool. It works on

dryness, pigmentation and sun damage. (2)

La Prairie Cellular Mineral Face Exfoliator RRP $145. This exfoliator

tightens pores and increases radiance without any damage to the skin. The

rosa centifolia flower and glycerin ensure skin stays soft and supple after

each use. (3)

La Prairie Foam Cleanser RRP $85. This water-activated cleansing mousse

cleans and hydrates while not stripping the skin of nutrients. (4)


2. 3. 4. 5.





L’Oreal Paris Nude Magique Eau

de Teint in Pure Ivory RRP $24.95. (1)

Mirenesse Collagen Cushion

Compact Airbrush Liquid Powder

in Mocha RRP $79. (2)

Gatineau Serenite Soothing Concentrate RRP $104. This intensive

concentrate can be used on even the most sensitive of skins to help

normalise texture and appearance. (5)

Olay Regenerist Revitalising Night Cream Moisturiser RRP $32.49. This

helps to renew the skin’s surface layers and reduce fine lines and wrinkles.

Skin feels smoother, softer and much more hydrated. (6)

Kiehl’s Micro Blur Skin Perfector RRP $47. This skin perfector contains lipo

hydroxy acid and bark and lentil extracts to smooth the appearance of the

skin and minimise the appearance of pores. (7)

Jurlique Nutri-Define Superior Retexturising Facial Serum RRP $145. Made

from natural botanicals, this facial serum contains an innovative liposomal

technology which delivers deep hydration with no skin irritants. (8)

La Mav Organic BB Crème RRP $39.95. This delivers hydration, sun

protection and concealer, as well as mattifying the complexion. Suitable for

all skin types, even sensitive. (9)


6. 7. 8. 9. 155

eauty & spa



Hair with fl air

John Frieda Frizz Ease Extra

Strength 6 Effects Serum RRP

$16.99. A beautiful hair serum for

hydrating the hair and eliminating

frizz as well as smoothing and

taming hair. Apply on wet hair. (1)

L’Oreal Elvive Fibralogy

Thickening Shampoo RRP $5.95.

This shampoo is part of the

range of new thickening hair care

products which instantly make

even the thinnest hair look thicker

while helping treat the cause of

the thinness at the same time. (2)

Nail it!

DB Quick Colour Nail Polish in

Aubergine RRP $7.99 (1)

Rimmel Colour Rush 60 Second Nail

Polish in Midnight Rendezvous RRP $7.95 (2)

Giorgio Armani Nail Lacquer in

No. 300 Mandarine RRP $40 (3)

Kosmea Rose Hand Cream RRP $19.95 (4)





High brow

DB Extend A Brow

RRP $12.99 (1)

Inika Certifi ed

Organic Brow Pencil

RRP $29 (2)






Latest in lippie

Estee Lauder Pure Colour Envy Lipstick in Rebellious

Rose RRP $50 (1)

Giorgio Armani Rouge Sheer in Coral RRP $52 (2)

Giorgio Armani Rouge Sheer in 305 Coral RRP $52 (3)

Lanolips Banana Balm 3 in 1 RRP $15.95 (4)

Issada Mineral Lip Crayon RRP $48 (5)

Rimmel Lasting Finish Colour Rush Intense Colour Balm in

Drive Me Nude RRP $12.95 (6)







Hair & Beauty






Joseph Mourad’s

styling, colour and

hair extension

techniques are

sought the world

over, with celebrity

clients including

singer and host

Mel B and Grammywinning


artist Mya.



475 New South Head Rd Double Bay Sydney

02 9328 2277



eauty & spa

Buff your body




Winter has no doubt already left its mark – in the form of dry,

dehydrated skin in need of some tender loving care in time for

the body-bearing summer ahead. So how best to rehydrate and

reclaim your radiance?

According to beauty expert Nicole Gruodiene from Nicole’s Beauty Salon

in Sydney’s Double Bay, now is the optimal time to reclaim your radiance.

Gruodiene believes a pre-summer treatment to combat dullness and

skin dehydration will remove the signs of mid-winter hot showers and airconditioned

offi ces. ‘You may notice dry or fl aking skin, dull skin tone, and

more prominent wrinkles have appeared,’ she says.

Nicole recommends using the next few months to restore your body’s

moisture balance and treat it to some rejuvenating salon visits. ‘You should

have an exfoliating and moisturising routine in place at home but a salon

treatment can really boost your results,’ she says.

‘Using a sea salt scrub to exfoliate the whole body will brighten tone, while

stimulating blood fl ow and circulation,’ she adds. Indeed, exfoliation will help

your skin rid itself of dead or damaged cells and help it absorb moisture and

nutrients more effectively. Exfoliation of the top layer has also been shown to

stimulate the production of new collagen.

Massage is a great way to stimulate lymphatic drainage and circulation

in your body. ‘A Swedish massage uses a variety of techniques specifi cally

tailored to promote muscle relaxation and ease tension by applying pressure

against deeper muscles and bones,’ Gruodiene explains. ‘Even a simple,

relaxing back massage helps reduce stress and anxiety, relieves muscle

tension and increases circulation.’

If the festive season took its toll on you, it’s likely your body will also benefi t

from a little detox. ‘A full body wrap is an ideal treatment to detoxify, hydrate

and slim the body,’ Gruodiene says. ‘Body wraps are perfect either as a one

off treatment or as a course to gain optimum results.’ Gruodiene favours

the International Body Wrap, which not only hydrates the body but also

guarantees a circumference loss of at least 15cm. ‘People use it to squeeze

into a “special occasion” dress or to kick start a weight loss program,’

she says.

For a fi nal boost and a little extra TLC, Gruodiene recommends a hangover

rehab treatment, which uses medical-grade oxygen to stimulate red blood

cells and help the body eliminate waste products.

Whichever treatment you choose, for the best results ensure you visit a

highly trained, qualifi ed aesthetician and you can look forward to a speedy

return to radiance. csbm



Nicole’s Beauty Salon offers only the very best treatments available,

including the International Body Wrap which improves the appearance

of cellulite, stretch marks and scar tissue and is guaranteed to take 15

centimetres off your entire body size - or your money back!

With highly trained aestheticians and stunning surroundings, any

treatment you have at Nicole’s Beauty Salon will be a luxurious

experience you’ll long for time and time again.

02 9327 7728

mobile 0410 627 767

Shop 8, 401 - 407 New South Head Rd,

Double Bay NSW 2028

eauty & spa



Protect your skin from the

winter elements with these

surefire ways to keep skin

soft, supple and flake-free.

Ricky Allen reports.

You may be more covered up in the winter months,

but that’s no excuse to neglect the skin on your

body. It’s actually imperative this time of year to

show your skin some extra loving care to ward off dry and

flaky skin. And this is no mean feat – especially when we

are in heated air conditioning most of the time and having

longer, hotter showers.

Feed your skin

In your quest for soft and dewy skin the whole

year round, you need to get back to basics. First,

check you’re not deficient in Vitamin A or B, which

can cause dry skin. Eat plenty of fruits to ramp

up your Vitamin C intake, and look for foods rich

in zinc such as seafood, lamb, pumpkin seeds,

wheatgerm and egg yolks. Vitamin C and zinc

work together to help to strengthen and hydrate

the skin.

Vitamin E is also good for hydrating skin and

can be found in sources such as olives, nuts and

avocados. Kelp, which is a form of seaweed, is

also very beneficial to improve dry skin.

An age-defying vegetable that is often

overlooked is the sweet potato. This contains the

most usable form of hyaluronic acid which the

skin stores naturally and needs in large quantities

for hydration.

Last but not least, drinking around eight

glasses of water a day is essential, not just for our

skin but also for our general wellbeing.


eauty & spa

Prep work: scrubs & washes

Body scrubs will help to get rid of dry surface skin

which allow moisturisers to work more effectively.

Scrubs should be used before a shower or bath.

Great ones to try: Dermalogica Exfoliating Body

Scrub RRP $49.50, Kiehl’s Crème de Corps Soy

Milk & Honey Body Polish RRP $40, Premium Spa

SOS Wattle Seed, Walnut and Rice Bran Wonder

Scrub RRP $14.95 and Molton Brown Warming

Eucalyptus & Ginger Body Scrub RRP $70.

When showering or bathing, make sure the

water isn’t too hot as this is a surefire way to further

dehydrate the skin. Using a hydrating body wash is

therefore extra important in winter.

A new product which can be used in the shower and

leaves the skin feeling really soft and hydrated is the

Nivea In-Shower Body Lotion Skin Conditioner

RRP $7.99. Also try Philosophy Raspberry Sorbet

Shower Gel and Bubble Bath RRP $30 and Molton

Brown Pink Pepperpod Body Wash RRP $39.

Body brushing is another excellent skin smoothing

and exfoliating treatment, and is best performed on dry

skin. Aveda and Crabtree & Evelyn both make

excellent body brushes.


Hydration, hydration, hydration!

Follow up with a hydrating body product to really maximise

results. A good one to try is Bottega Veneta Satin Body Oil

RRP $80 which deeply moisturises as well as veils the skin

in a beautiful fragrance. Other great body hydrators include

Lancôme Paris Nutrix Royal Body Intense Restoring

Lipid-Enriched Lotion RRP $102, Kosmea Skin Clinic

Rescue Body Cream RRP $29.95 and Dermalogica

Ultra Rich Body Cream RRP $68. If you want a double

duty moisturiser that also helps firm and tone, Premium

Spa Shea Butter, Jojoba and Goji Berry Ultra Firming

Body Balm RRP $9.95 and Nivea Body Contouring

Cream are both great RRP $9.92.

For a really special finish to your body care routine nothing

can beat a sprinkling of Bottega Veneta Shimmery Body

Powder RRP $90. It delivers just a delicious hint of shimmer

along with a beautiful fragrance.

With just a few steps and specialty body products, you can

bare your body with confidence no matter what the season. 161

eauty & spa







The key to tanning is having a perfectly prepped

canvas on which to apply colour. Self-tanners

work by staining the top layer of your skin, so

by sloughing off dead skin cells you not only extend

your tan’s life but also prevent patchy results. Use a

buff, loofah or grainy body scrub to exfoliate, paying

extra attention to drier areas such as elbows, knees

and ankles that soak up colour more intensely.

Make sure your skin is cool and dry; moisture from

wet or perspiring skin interferes with the performance

of self-tanners. Pull your hair back from your

face and shoulders and apply moisturiser to your

elbows, knees, ankles and inside your belly button

to prevent staining.

With the surge in the self-tanner market, there’s

no doubt you’ll fi nd a product to suit you and that

you love working with – whether spray, lotion, gel or

mousse. Self-tanning products with a guide colour

make spotting pesky streaks and missed patches a

breeze, and using a pair of latex gloves to apply your

tan is a must to avoid the telltale orange palm effect.

1. 2. 3.







If you’re a self-tanning novice, go for a tanning mousse, which is virtually foolproof.

Sprays are good for people who are experienced self-tanners.

If you don’t like tanning your face, bronzing makeup should do the trick.


beauty & spa

Avoid getting the self tanner blocked in your pores by exfoliating your body every

second day, twice a week on your face, with a very gentle scrub.



You still need sun protection when you’ve fake tanned – any time of the year! Choose

a sunscreen with broad-spectrum protection and an SPF of 30 or higher.

Less is more. It’s easier to add layers to a conservative tan than lighten a too-dark job

– be careful not to be overzealous with your tanner, especially in the cooler months.

1. Xen-Tan Face Tanner RRP $24, 2. Xen-Tan Perfect Blend Custom Self Tan

RRP $57, 3. Dermalogica Sheer Tint SPF20 RRP $77, 4. Sisley Self-Tanning

Hydrating Body Skincare RRP $120, 5. Sisley Tinted Body Sun Glow Gel RRP

$120, 6. Kiehls Sun-Free Self-Tanning Formula RRP $28, 7. Pure Tan Pure Bronze

Instant Tanning Foam RRP $34.95, 8. Pure Tan Pure Bronze Wash Off Instant

Bronzer RRP $25.95, 9. St. Tropez Self Tan Sensitive Brozing Lotion RRP $49.95,

10. Garnier Ambre Solaire Natural Bronz Up Self Tanning Milk RRP $13.95

4. 5. 6. 7. 8. 9. 10. 163

eauty & spa








For the ultimate sun-kissed

glow and radiant bloom,

these bronze-hued beauty

products will be your go-to

no matter the season.


If you’re working with a spray, hold it around 20cm away

from your body and distribute evenly. For lotions and gels,

dispense around a dollar coin-sized amount on your palm,

and for mousses use a small egg amount. Massage into your

skin in both horizontal and vertical motions from your toes to

your neck (and your face if you opt to include it).

Be sparing with your knees, elbows and ankles, and

extend your neck when applying, blending with moisturiser

around the jaw line so there’s no visible line.

After you’ve applied your self-tan, the fi rst thing to do is

wash your hands in warm soap and water. Use a nail brush

to scrub your nails, then dip a cotton tip in moisturiser to

remove any residue colour between your fi ngers and toes.

Use a tissue to blot any excess from your knees and elbows.

Even for the most conscientious tanners, missed patches

and streaks are a possibility. Many brands offer a tan

remover to remedy these little nasties, so purchasing the

complementing remover with your tanner is a good option.

To follow up, a bronzed shimmer lotion, body foundation

or bronzing powder both hides sins and enhances a tan,

which means masking those imperfections is a cinch.

Lastly, keeping your skin soft and hydrated by using an

all-over body moisturiser each day will prolong your tan and

promote even fading. Reapplication once or twice a week

will keep you looking tanned and terrifi c (just remember to

exfoliate before each subsequent application). csbm

1. Benefit Coralista Blush RRP $51, 2. Benefit

Sun Beam RRP $45, 3.Maybelline Dream Terra

Sun Bronzing Powder RRP $15.95, 4. L’Oreal

Glam Bronze La Terra RRP $29.45, 5. Estée

Lauder Bronze Goddess Powder Bronzer RRP

$58, 6. Éminence Mocha Berry Bronzer Mineral

Illuminator RRP $66, 7. Colorescience Face Primer

Skin Bronzing RRP $72.60, 8. Laura Mercier

Bronzing Gel RRP $50, 9. Shiseido Bronzer RRP

$60, 10. Sisley Phyto-Ombre Glow Amber RRP

$55, 11. Lancôme Star Bronze Intense RRP $79,

12. Napoleon Perdis Mosaic Powder Bronzing

RRP $60, 13. L’Oreal Le Blush in Rosewood

RRP $25.95





7. 8. 9.






Did that get

your attention?


Print ads rank #1 for commanding

consumer attention*

Print magazines are the #1

preferred place to look at an ad*

Print magazines rank #1 for

advertising acceptance**

Magazines are #1 for reader




Capture and engage your clients with

a personalised e-Book to showcase

your services. Having your own

bespoke eBook – either with or

without hardcopy – enhances your

profi le and turns your publication into

a viral marketing campaign!




* Source: Adobe Systems Click Here Study, October 2012

** Source: ORC Caravan, February 2013

Why integrate print and digital?

It’s never been more important to have an integrated print

and digital marketing strategy. International research has

proven that print media – notably magazines – drive online

search and purchases. The two mediums exist side by side

to capture and engage an optimum audience.

At Bella Media, we have embraced this next-generation

marketing by integrating print and digital marketing to

enhance the client and consumer experience.

Hair Restoration by

Dr Russell Knudsen


Cover.indd 1 12/05/14 4:02 PM

Call our expert team to fi nd out more about our bespoke

print and online services:

Tel: 02 9398 2755


Plastic Surgery by

Dr Warwick Nettle

eauty & spa






Hair extensions allow you to have long, thick, lustworthy

hair in a matter of hours. Hair maestro and

extensions expert Joseph Mourad from Joseph

Mourad’s Hair & Beauty in Sydney’s Double Bay, transforms

lank and listless hair to super sexy with his highly sought

after hair extension techniques.

Indeed, his hair extension methods are highly coveted

the world over – with celebrity clientele including entertainer

Mel B and Grammy award-winning recording artist Mya.

‘Hair extensions are about giving people beautiful and

strong hair,’ says Mourad. ‘Extensions provide volume,

length and manageability – and make getting ready for

a night out or special occasion so much easier. It’s also

surprisingly affordable.’

Mourad prides himself on using only the highest quality

human hair extensions. He is skilled in all hair extension

techniques but his preferred method is the innovative

ultrasonic cold fusion technique.



Sydney hair extension specialist

Joseph Mourad with Mya and Mel B

The cold fusion method uses ultrasound technology to

attach the hair extension to the client’s natural roots. The

result is natural-looking hair extensions that are virtually



The ultrasonic cold fusion technique allows for multistrand

bonding, making the whole process effi cient and,

importantly. Bonding clinical keratin with keratin found in

the hair shaft, the extensions are attached to the natural

hair very close to each other so there are no telltale signs.

‘The technology is so advanced and the bonding so

seamless,’ says Mourad. ‘It achieves impeccable results

and the extensions can be completely undetectable to the

eye. And, because there is no use of heat, glue or clips

to bond the extensions, the client’s natural hair is not

compromised or damaged.’

When applying the extensions, emphasis is placed on

properly blending colour and thickness with the natural hair.

Attached strand by strand, the extensions can be attached

to long, short, straight or wavy hair as long as the natural

length is more than 2cm.

Each strand has about 20 hairs in it and a full head can

take from 100 to 300 strands, depending on the required

thickness. In just a few hours, hair is transformed from

short, thin strands to thick, long locks. ‘The latest advances

provide long and voluminous hair without the need to wait

for natural hair to grow out,’ says Mourad. ‘It can completely

transform your look.’

Extensions can last anywhere between six and 12

months. Once attached, the extensions can be treated

as normal. ‘Care for your extensions the way you would

your natural hair,’ Mourad advises. ‘It’s important to be

particularly careful when combing and blow-drying your

hair. However, hair extensions can be cut and coloured just

like your natural hair.’

When applied by a hair extension specialist, you can

enjoy a full head of fl owing, thicker hair – and look forward

to a good hair day, every day. csbm

Visit for details.

Featureflash /

s_bukley / 167

eauty & spa

Benefit Bella Bamba

Blush, RRP $51.

Laced with shimmering

gold undertones, this

blush takes eyepopping

pretty to the

third dimension.

YSL Supreme Bouquet Eau

de Parfum 80ml, RRP $125. A

bouquet of white fl owers, a blend

of whimsical tuberose, exotic

ylang and enigmatic jasmine.

L’Occitane Néroli &

Orchidée Eau de Toilette,

75ml, RRP $82. Faceted with

fruity head notes, the fragrance

evolves into a warm base of

musk and iris.





L’Occitane Fragrance

Beautifying Cream,

125g, RRP $60. This

beautifully fragrant body

cream moisturises while

imparting a long-lasting

subtle scent.

L’Oréal Paris La

Manicure Grow

Beautiful Serum,

RRP $8.95. This

new product

nourishes and

protects fragile or brittle

nails and promotes

healthy growth.

You By Sia Delicate

Clenz – Gentle

Foaming Wash, 200ml,

RRP $70. Formulated

with natural and effective

cleansing ingredients to

remove makeup and

dirt from the skin without

stripping the protective

epidermal barrier. One

of the best cleansers

we’ve used!




RRP $59.95.

Increases the

diameter of

each existing

hair strand.

Truly amazing!

Priori Cellular Recovery

Serum with DNA Enzyme

Complex, 50ml, RRP

$199. Leaves the skin with

a wonderful matte fi nish,

making it ideal for use as a

primer while boosting the

anti-ageing performance

and effectiveness of any

skincare regimen for faster,

more visible results.


Pelactiv Facial Refiner Deep

Cleansing Scrub, 150ml,

RRP $49. A gentle dual action

facial scrub that combines the

softening and decongesting

benefi ts of lactic acid together

with perfectly rounded

exfoliating granules.

Glo Minerals Protective

Liquid Foundation –

Satin II, 40ml, RRP $52.

Enhanced with skin benefi ts

to treat and protect the skin,

this liquid foundation goes

on fl awlessly for a medium

yet featherlight coverage. Its

exclusive blend of antioxidants,

minerals and caviar extract

combined with two new

and innovative ingredients,

Malachite and Venuceane, help

improve skin health.

beauty & spa

Dermalogica Age Smart Dynamic

Skin Recovery SPF50, 50ml, RRP

$87.50. Contains a combination of

hyaluronic acid and algae extracts to

help fi ght fi ne lines associated with

dryness as well as a skin smoothing

complex to stimulate natural exfoliation.

DNA Defense Moisturiser with Sun

Protection 50ml, RRP $70. Fast absorbing,

non-greasy lotion protects skin against the

sun’s harmful UVA and UVB rays to counter

photoaeging and cellular skin damage.

Lonvitalites C4 Coconut Milk Mask,

RRP $36. This mask penetrates into the

deep layers of the skin to strengthen the

underlying layers.

Redken Blonde

Idol Custom Tone

Conditioner 196ml,

RRP $39.95. This

dual chamber

conditioner releases

a custom blend of


and conditioning

formulas that help

refresh colour to

preserve cool or

platinum blonde hair.

Shiseido Automatic Fine

Eyeliner, RRP $60.

All day, smudge-proof

formula delivers intense,

lustrous defi nition. Creates

a strong beautiful line with

deep glossy colour.

Jurlique Rose

Moisture Plus

Daily Moisture

Balancing Serum

30ml, RRP $70.

An antioxidantrich,


serum designed to

absorb easily and

provide the skin

with essential fatty

acids for a smoother

and more plumped


Amy Jean Eye Couture Lash Elevate Mascara,

RRP $35. Perfect for creating a falsies-like effect, this

mascara helps lift and lengthen lashes while elegantly

coating each individual lash for a fan-like fi nish.


Brow Shaping

& Lash Lift

Well-shaped, symmetrical eyebrows can

make you look younger, sexier and more

sophisticated. And there’s no better brow

guru to turn to than Amy Jean, aka The

Arch Angel.

With a long list of celebrity clients on the

books, including Naomi Campbell and Dannii

Minogue, Amy Jean Eye Couture takes brow

sculpting to new heights. Recently I was

lucky enough to experience Amy Jean’s

brow shaping and lash lifting techniques

fi rsthand at her exquisite Sydney salon.

Jump online to read my experience at

roadtests or for more info visit Amy Jean’s

website at 169


Allergan Australia

Phone +61 02 9498 0100

Australasian Academy of

Cosmetic Dermal Science (AACDS)

Phone +61 08 9328 6760

Australasian College of

Cosmetic Surgery (ACCS)

Phone 1800 804 781

Dr Buddy Beaini

MD Cosmedical Solutions

Phone 1300 885 808

Bella Media

Phone +61 02 9398 2755

EFB Beauté

Phone 1300 737 393

Dr John Flood

Phone +61 02 9476 8066

Dr John Flynn

Cosmedic & Skin Clinic

Phone 1300 881 388


iNova Pharmaceuticals

Phone +61 02 9999 1081


Phone 1800 144 944

Dr Joseph Georghy

North Shore Cosmetic Clinic

Phone +61 02 9956 7200

Dr Paul Gerarchi

The Face Institute

Phone +61 02 9412 4599

Val Glover-Hovan

Cosmetic Tattoo Australia

Phone +61 02 9938 2111


Phone +61 07 5531 3738

Dr Darryl J Hodgkinson

Cosmetic & Restorative Surgery Clinic

Phone +61 02 9362 7400

Infini by Lutronic

Advanced Cosmeceuticals

Phone 1800 242 011

Jane Iredale

Phone 1300 850 008

Joseph Mourad Hair & Beauty

Phone +61 02 9328 2277

Dr Steven Liew

Shape Clinic

Phone +61 02 8356 2888

Like Your Look

High Tech Laser Australia

Phone 1300 309 233

Master Dermal Academy

Gay Wardle

Phone +61 0418 708 455

Dr Richard Maxwell

Maxwell Plastic Surgery

Phone +61 03 9509 9699

Dr William Mooney

Phone 1300 DR WILL (1300 379 455)

Dr Colin Moore

The Australian Centre of Cosmetic Surgery

Phone 0414 251 234

Dr Sarkis Nalbandian

Designer Smiles

Phone +61 02 9953 4189

Dr Warwick Nettle

Silkwood Medical

Phone 1300 SILKWOOD (1300 745 596)

Nicole’s Beauty

Phone +61 02 9327 7728

Phone 0410 627 767


iNova Pharmaceuticals

Phone +61 02 8918 6322


True Solutions International

Phone 1800 808 993

Dr Oseka Onuma

Laser Vaginal Rejuvenation Institute of Adelaide

Phone +61 08 8344 6085



Regen PRP

Australasian Medical & Scientific

Phone 1800 201 760

Regenesis Fitness

Phone +61 02 9363 0376

Dr Amira Sanki

Silkwood Medical

Phone 1300 SILKWOOD (1300 745 596)


Phone 1300 66 73 74

Silkwood Medical

Phone 1300 SILKWOOD (1300 745 596)

Sydney Permanent

Makeup Centre

Rita Porreca

Phone +61 02 9569 7799

Synergie Minerals

Terri Vinson

Phone 1300 689 619


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Finding a cure.

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