First impressions make a difference in our society and our faces convey much about who we are. Many men and women seek to enhance or restore their facial appearance to a more youthful and rejuvenated look in step with who they are on the inside.

The following are questions that I am frequently asked by men and women considering Facelift Surgery.

1. I don’t want to look strange or unnatural – is this avoidable in Facelift surgery?

In the hands of an experienced and talented Cosmetic Surgeon, natural and rejuvenated results are achievable with Facelift surgery.

Often the images that spring to mind when thinking about facelift surgery are the well known celebrities that look like they’ve spent a month in a wind tunnel and have distorted and unbalanced faces pulled too tightly and unnaturally. Other looks most patients wish to avoid are known as “moonface” or “catwoman”.

A skilled and knowledgeable Cosmetic Surgeon is able to deliver results that are natural and long lasting, taking potentially 10-15 years from your apparent age. Thorough preparation involving repeated consultations between the Cosmetic Surgeon and the patient are crucial in establishing a positive rapport, trust and a consensus as to appropriate expectations regarding the results and a foundation for an optimal outcome.

2. What should I expect from the recovery process from Facelift surgery?

Immediately after surgery, the Cosmetic Surgeon will apply dressings and bandaging that require replacing on a daily basis for the first two weeks. A bandage that wraps around the head, under the chin and over the ears, should be worn for 24 hours for the first six weeks after surgery, and then at night or at home for another 6 weeks. Stitches inserted by the Cosmetic Surgeon are usually removed within 1 – 2 weeks, depending on your healing and recovery.

Initial pain and discomfort is addressed with pain relief prescribed by the Cosmetic Surgeon and Anaesthetist. Initial bruising should resolve within one to two weeks after surgery. Swelling takes longer to resolve; up to 6 to 12 weeks.

You need to sleep on your back for approximately 6 weeks, supported by pillows at your sides to prevent you from turning on your side.

Improvements in your appearance can be noticeable as early as a week to two weeks, but optimal results are not seen until further down the track in your recovery as swelling resolves and the tissues heal.

3. Will the scars from the Facelift surgery be visible?

Again, this is depending on the skill and technique of the Cosmetic Surgeon (and one reason it pays to do your research and seek several opinions prior to choosing a Surgeon to perform your surgery). In the right hands, your incisions are carefully placed and hidden to avoid detection.

4. Does facelift surgery include lifting the eyes?

Facelift surgery addresses the loose and sagging skin and tissue of the face. Surgery to the eyes, known as Blepharoplasty, can be performed on either or both the upper and lower eyelids. This is often performed in conjunction with a Facelift to achieve the overall refreshed appearance sought by the patient. Facelift surgery may also be combined with neck lift surgery, specifically addressing the sagging skin and tissue on the neck area. A Browlift may also be recommended in conjunction with Facelift surgery to achieve a lift of the forehead and eye area.

These different procedures will be discussed with you at length by the Cosmetic Surgeon in light of what you want to achieve, your present appearance, and what procedure/s is/are most suitable to achieve your goals.

5. How long does Facelift surgery take?

Facelift surgery can take anywhere between 2 and 4 hours depending on what your particular surgery entails. It is usually performed under general anaesthetic.

6. I’ve heard of thread lift surgery for the face; is this a better and less invasive option to Facelift surgery?

In short this is not a better or less Invasive procedure.

Thread lift surgery involves the insertion of threads into the facial tissue which are then pulled tightly in an attempt to lift the skin and tissue. The threads have barbs placed along their length in order to provide grip on the tissues.

Unfortunately, whilst thread lifts are heavily promoted and marketed, patients who have pursued the procedure are inevitably unhappy with the results. This is partly due to thread lifts being performed on many patients who are not suitable candidates for the procedure. The procedure is also performed by medical practitioners who are not adequately qualified in performing surgery and lack a thorough understanding of the facial tissues, underlying muscles, nerve supply and blood supply.

Many of these patients then seek Facelift surgery to achieve the results they were originally seeking. Unfortunately, this poses significant difficulty for the Cosmetic Surgeon performing a Facelift as the threads are extremely difficult and time consuming to remove, adding time and complication to the Facelift procedure.

7. Will I require further procedures after the Facelift surgery?

No facelift surgery can offer an absolutely perfect result, and usually the Cosmetic Surgeon will discuss with you prior to surgery what further procedures may be required following surgery to enhance or maintain the results. For example, Dermal Fillers may be recommended after surgery to add volume to areas of the face such as the cheeks or lips to enhance a youthful appearance. Another recommendation may be the use of a Cosmetic Facial peel to resurface and rejuvenate the skin. Only ever pursue further facial treatments on the advise and recommendation of your Cosmetic Surgeon.

Looking after your skin and face will contribute to long lasting results. Discussing with your Cosmetic Surgeon your ongoing skincare regime and other treatments is important to achieving and maintaining the best results.

The over-riding message if you are considering Facelift surgery is to do your research, seek several surgical opinions. Choose a fully qualified  and experienced Cosmetic Surgeon with previous results that appeal to you and with whom you can build confidence and trust.

For a Face Lift or Neck Lift consultation contact Dr. Bobby Kumar at the Bare Aesthetics Cosmetic Surgery Clinics in Sydney or Adelaide on (02) 9571 4850 or 0430 491 009 or send us a request at www.bareaesthetics.com.au/contact-us.php

The Top Cosmetic Surgery procedures for Men

Typically cosmetic surgery is normally associated with women having procedures such as Breast Augmentation, breast reductions and liposuction. If we discuss men having cosmetic surgery we normally think about well known male actors and celebrities such as Sylvester Stallone, Michael Jackson and Mickey Rourke. These men are not great examples of natural and aesthetic cosmetic surgery results. However; men do have great Cosmetic surgery results it is just that we hear about the extreme and ridiculous results performed on the infamous celebrities.

Statistics released in March 2011 by the American Society of Plastic Surgeons (ASPS) demonstrate that many more men are now becoming more conscious about their appearances and maintaining their appearances that they are now considering some form of Cosmetic surgery. The statistics revealed that the overall increase in cosmetic procedures in men increased by 2% in 2010 when compared to the previous year. Some procedures in particular like Facelift surgery rose by 14% and Liposuction increased by 7% in 2010.

The ASPS statistics for 2010 show that men underwent an increased number of Surgical and minimally invasive procedures; the increase in surgical procedures grew faster than the traditional minimally invasive treatments.

The increase in men having cosmetic surgery may be related to a number of factors; such as an increase in the general fashion and cosmetic industry and therefore an increase in the participation of men in requiring cosmeceuticals and that their requirements do not seem to be unusual or the domain of women. Also with the changes in workplace perceptions and socially men may feel the need to have a rejuvenated and youthful appearance as well as being fit and healthy. Men and women have shifted the age for when they are choosing to have children. As such men may feel that they are now ready, mature and financially capable enough to make the decision to have Cosmetic plastic Surgery.

Interestingly once the minimally invasive procedures such as Botox® or dermal fillers were popular with men. It is apparent that as men age, so do the tissues and the addition of gravity means that the tissues sag. Consequently a much more comprehensive surgical procedure is required and is necessary to lift and rejuvenate the body to show any significant improvement.

Top Ten Cosmetic Procedures for Men (as an increase in percentage)

The list comprises the fastest growing cosmetic procedures between 2009 and 2010.

1. Facelift – 14% increase

2. Otoplasty (Ear Surgery) – 11% increase

3. Dermal Fillers – 10% increase

4. Botox® – 9% increase

5. Liposuction – 7% increase

6. Male breast reduction (Gynaecomastia) – 6% increase

7. Eyelid surgery (Blepharoplasty) – 4% increase

8. Dermabrasion – 4% increase

9. Laser hair removal -4% increase

10. Laser vein treatment – 4% increase

Top Ten Cosmetic Procedures for Men in 2010 (By Volume)

The top 5 Cosmetic Surgical Procedures (Invasive)

1) Rhinoplasty (Nose surgery) - 64,000
2) Eyelid Surgery (Blepharoplasty) – 31,000
3) Liposuction/Liposculpture – 24,000
4) Male Breast Reduction (Gynaecomastia surgery) – 18,000
5) Hair Transplantation – 13,000

The Top Five Cosmetic Minimally-Invasive Procedures

1) Botox ® – 337,000
2) Laser Hair Removal – 165,000
3) Microdermabrasion – 158,000
4) Chemical Peel – 90,000
5) Dermal Fillers – 78,000

The majority of cosmetic surgery clinics show that whilst there are high profile men having cosmetic surgery, clearly many more men are “average” males who are looking to improve their looks and therefore to look as good as they feel. Many of these men are normally seen as tough male role models such as firemen, plumbers and bricklayers.

There are the men who are still quite physically active, perhaps approaching retirement who still wish to have a rejuvenated appearance to go along with their active lifestyle. It is not unusual in my practice to perform a combined Facelift, neck lift as well as an eyelid lift for mature men seeking to reverse the effects of the sun, genetic aging and gravity and to create a rejuvenated face and neck.

After having performed the cosmetic surgery procedure, it is not uncommon to observe a new invigorated male patient. The procedure itself appears to have provided a greater sense of self confidence; male breast reduction is such an example. Many males with large breasts commonly known as “man boobs” are often reluctant to go to the beach or engage in any social activity where they need to remove their shirt.

Following male breast reduction surgery most patients are motivated to join gyms to improve their general health, wellbeing and fitness levels. They have an increased desire to lose weight and build muscle to match their improved chest/breast area.

Many of these men have very supporting partners often of similar age, which is contrary to the popular perception that these are men with much younger partners. In my practice many of these women will not have had any cosmetic procedures or surgery, and so this has not been a natural or expected transition for their male partner to consider cosmetic surgery. It is a choice that these men make to help them maintain a rejuvenated, natural and aesthetically pleasing appearance for themselves and sometimes for their partners as well.

If you are looking for an experienced and skilled Cosmetic Surgeon who performs male cosmetic surgery procedures and non-invasive procedures such as Botox® and dermal fillers then contact Dr. Bobby Kumar today on (02) 9571 4850 or 0430 491 009 for an appointment at the Bareaesthetics Cosmetic Surgery clinics (Sydney,Port Macquarie or Adelaide).

Breast implants are most commonly used as an aesthetic enhancement in an individual who is lacking in natural breast tissue due to genetically predisposition or environmentally induced factors. Because breast tissue is primarily composed of fat cells, physicians in the past have attempted to inject fat (obtained through liposuction) into the breast. However, today, this is completely unacceptable due to calcification (complete hardening of the breast). Hormonal therapy may increase the natural breast size, slightly, but not enough for the majority of women.

Currently, the most common procedure to increase breast size is via breast implants. A breast implant is a sac of silicone elastomer that is either filled with saline or silicone, and is surgically implanted under the breast tissue. The proportion of the breast to body height and weight is taken into consideration, as is the chest width, location of nipple/areola complex, and cleavage. Because the concepts of aesthetics are constantly changing, there are many factors such as implant type, size, and site that should be tailored to the individuals’ specificity.

TYPE OF BREAST IMPLANT (Saline,Silicone or “Furry Brazilian”):
Silicone vs. saline? This discussion is going to remain for many years. The advantage of silicone implants is that it is softer and appears more natural. However, leaks may be found in secondary tissue. Generally, saline is a bit firmer, but it is without the supposed health risks because a leak is simply absorbed by the body. There has recently been the use of another type of Silicone Implant known as the “Furry Brazilian” or Polyurethane Implant. These Breast Implants are specifically designed for a small group of women. The decision should be made after consultation with an experienced Cosmetic surgeon.

LOCATION OF BREAST IMPLANT:
The breast implant can be placed either under the pectoralis major muscle (sub muscular) or on top of the muscle and under the breast glands (sub glandular). Sub muscular implants are more popular because they are less palpable, have lower risk of capsular contracture, and do not inhibit mammography. However, it requires more invasive surgery and longer healing time. Bodybuilders prefer sub-glandular insertion because the heavily developed pectoralis muscle might flatten the implant and there will be less projection of the breast. Women with sagging or drooping breasts may opt for a sub glandular placement to utilise the increased projection. Disadvantages of sub glandular implants include impairment of adequate mammography and an increased risk of capsular contraction.

Subglandular or Subpectoral

LOCATION OF INCISIONS:
There are four areas of incision:

1. Periareolar (lower part of areola 1-1/2 inches)

2. Inframammary (on the lower breast crease)

3. Axillary (armpits)

4. Transumbilical (from the bellybutton)

Each has advantages and disadvantages but the preferred incision is Inframammary because it is less noticeable. Arguments against the other approaches are that they are harder to perform; there is decreased sensation of the areola and violation of the breast tissue when approached via the Periareolar technique, there is increased risk of rupture, Infection and Capsular contracture with these other techniques.

SHAPE OF THE BREAST IMPLANT:
Most surgeons have experience with teardrop (natural implants) and with the round implants. Preference is toward the round implant because it appears more natural. Previously, there were high profile implants (which projected more) and low profile implants (less projection). Recently, medium profile implants were introduced.

HOW LONG DO BREAST IMPLANTS LAST:
There is no expiration date for implants. You should be checked by your Cosmetic Surgeon if there are any symptoms or changes that are not expected including deflation, infection, change of location, etc. Mammography, ultrasound, or MRI should be performed if any of these symptoms or signs occurs. Patients over the age of 50 years of age should have their standard Breast checks. Typically many women will consider replacing their Implants or having revisional surgery for breast changes that have occurred by 10-12 years; such as breast droop or a change in Implant size.

RISKS (not common but possible):
1. Capsular contraction: Scar tissue forms around the implant to form a hard shell. There are several steps to prevent it, such as, size and location of the implant.

2.Infection.

3. Shifting (moving) of the implant. The pocket for the implant should be adjusted for the patient (this will usually, prevent shifting).

4. Scars: Less conspicuous in the Inframammary incision.

5. Sensation: May be initially decreased. Usually 90% of sensation will return within 1-2 years of surgery.

6. Breast Feeding: About 50% of women won’t be able to successfully breast feed, particularly those with Periareolar incision.

7. Synmastia (also known as “kissing breast”), sometimes related to technique.

Synmastia or "Uni boob"

In general complications occur less when using an experienced and certified Cosmetic surgeon.

RESULTS:
Cosmetic Surgery is an art form in combination with science. Each patient and surgeon has a different sense of what is aesthetically pleasing (although the basics are common). During a consultation with a Cosmetic Surgeon, the goals of both the patient and surgeon should coincide and be realistic. The results are not entirely dependent on the surgeon. It is important to understand that everybody starts with differing anatomical breasts (some patients are better candidates than others) and there are always unforeseen factors.

Dr. Bobby A Kumar is a board certified cosmetic surgeon and he specialises in Breast Augmentation surgery. He has used all types of Breast Implants and is skilled in choosing the appropriate Implant to provide the optimal and aesthetically pleasing result for each patient and therefore does not prescribe to the “one size fits all” approach.

Bare Aesthetic Cosmetic Surgery Clinics are located in Sydney,Port Macquarie and Adelaide. For an appointment today contact our friendly practice manager Wendy on (02) 9571 4850 or 0430 491 009.

Bare Aesthetics Cosmetic Surgery Clinics

If you are considering pursuing breast augmentation surgery, you are not alone. Each year across Australia (Sydney, Adelaide & Port Macquarie clinics), thousands of women undergo surgery. Thanks to advances in technology and the surgical techniques, breast augmentation patients have more choices than ever before. Here are some frequently asked questions by women considering breast implants:

Q:        What is Breast Augmentation or Breast Enlargement?

A:         Breast augmentation is the enhancement of size and shape of breasts through the surgical insertion of breast implants.

Q:        Who are good candidates for Breast Augmentation or Breast Enlargement?

A:         Women who are dissatisfied with the size of their breasts who are generally healthy and well. It is important to discuss your medical history with your Cosmetic Surgeon, including any medical condition that may impact your recovery and healing. You should also disclose any medications, prescription or over the counter, vitamins or natural supplements you take as sometimes these may affect the outcome. The surgeon will also ask about lifestyle habits, such as smoking and drinking as these too can have an impact on your recovery and results.

Ideal Breast Enlargement or Breast Augmentation patient

Q:        What type of Breast Implants should I get?

A:         Your Cosmetic Surgeon will provide you with information regarding the variations in implants (including type, size, shape, texture, projection and profile) and discuss with you the best options in light of the outcome you desire.

Breast Implants Styles or types

Q:        What are the risks involved with Breast Augmentation or Breast Enlargement?

A:         As with any form of surgery, patient undergoing breast augmentation face risks such as infection, bleeding and a reaction to anaesthesia. After surgery, risks associated with breast augmentation include hardening of the breasts due to capsular contracture, rippling or distortion and implant rupture. Your Cosmetic Surgeon should provide thorough information on the potential risks and complications prior to surgery and advice on ways in which you can minimise your risks (such as stopping smoking).

Rippling with Saline Breast Implants

Q:        How long is the Breast Augmentation or Breast Enlargement surgery?

A:         Breast augmentation surgery typically takes between 1½ and 2 hours depending on the type of breast implant and the technique used. It is performed in a hospital under sedation or general anaesthetic, typically as a day procedure.

Q:        How long is the recovery period?

A:         Most women are returning to their normal routine and work within 1 to 2 weeks, though there may be some residual soreness and swelling. Some activities such as lifting and upper body exercise are to be avoided for 6 weeks.

Q:        What is the cost of Breast Augmentation or Breast Enlargement surgery?

A:         This information is usually provided in your consultation with the Cosmetic Surgeon. The costs involved include the surgical fee, theatre fees, anaesthetist fees and implant costs. Other additional costs to remember are medications, such as antibiotics prior to surgery and pain relief medication after surgery, and supportive bras.

Q:        Is there a payment plan available?

A:         The Department of Health has instructed medical practices to remain at arms length from financial arrangements in order that they are not seen in any way to induce patients to undergo surgery. Reputable medical practices advise seeking financial advice from your personal banking institution or financial organisations. Payments are required in full prior to surgery.

Q:        Can I have a consult over the phone or internet?

A:         In these days of technology and people’s time constraints, some medical practitioners are offering consultation via the phone or internet. This is inadvisable and an inappropriate way to prepare for surgery. A face to face consultation is the only way a surgeon can perform the necessary medical examinations and take measurements, discuss the advantages and risks of surgery and answer all your questions. A consultation also provides you with the opportunity to see and trial breast implants in order to make a decision about the best breast implants for you.

If you are serious about proceeding with breast augmentation surgery you need to make the necessary time for appropriate pre surgery consultations in order to facilitate the best outcome. Also bear in mind you will be required to attend post operative checkups to enable the Cosmetic Surgeon to monitor your recovery and outcome.

Q:        Can I travel after Breast Augmentation or Breast Enlargement surgery?

A:         You need to allow time to recover from surgery. Immediately after surgery, driving is not recommended for 2 weeks due to the strain it places on the chest area. Air travel should be avoided for a minimum of 6 weeks, usually 12 weeks after chest surgery to avoid risks such as a Pneumothorax.

Q:        How do I choose a Cosmetic Surgeon?

A:         Choose a Cosmetic Surgeon that has undergone training and is specifically qualified in the area of Cosmetic Surgery. In Australia, this requires attaining a Fellowship in Cosmetic Surgery through the Australasian College of Cosmetic Surgery, demanding and thorough two year training and mentoring programme. You can check a Surgeon’s qualifications and registration with the Australasian College of Cosmetic Surgery on their website. In your consultation, you can also ask the Cosmetic Surgeon about their experience and see examples of their work. It is recommended that you seek several opinions before deciding on a surgeon, as this choice is crucial in the success of your eventual surgical outcome.

For a thorough and comprehensive consultation and appointment to discuss Breast Enlargement surgery with Cosmetic Surgeon Dr. Bobby A Kumar contact us on (02) 9571 4850 or 0430 491 009. Otherwise visit www.bareaesthetics.com.au

Dr. Bobby A Kumar Cosmetic Surgeon

Botox® is often referred to as an anti-wrinkle, wrinkle reduction or muscle relaxant treatment. It is a neurotoxin (botulinium toxin type A) the clinical use of which is the result of more than 100 years study. The quantities used cosmetically to effectively treat facial wrinkles are not sufficient to cause any systemic harm (to cause harm several thousand units would be required).

Botox® works by blocking nerve impulses to a muscle, thereby inhibiting the muscles ability to contract causing lines and wrinkles. By inhibiting the muscle movement, lines are smoothed and diminished, resulting in a more youthful appearance. Facial lines and wrinkles that are typically treated include the Glabellar lines (vertical frown lines between the eyebrows that look like the number ‘11’), crows feet (wrinkles around the outer corners of the eye) or forehead worry lines.

The use of Botox® is not an exact science; the appropriate treatment or dose for one person may differ from another person, very much depending on skin type, depth of lines and frequency of muscle movement. When receiving Botox®, it is important to discuss this with the Cosmetic Surgeon so you understand and consent to the quantity and placement of the Botox® treatment. Some Cosmetic Surgeons take the conservative approach, starting with a smaller amount and monitoring effectiveness, rather than starting with a large amount that may not have been required in the first instance. Some clinics charge per unit of Botox® so you pay for exactly the amount you receive. Some clinics charge per area, for example, the brow area. Some clinics provide free consultation, but then often a client feels obligated to pursue treatment. Other clinics will have a consultation fee, but this will be waived in the event you pursue treatment with the product costs being the only fee.

Individual results with Botox® may vary between clients. Optimal results are usually seen by 2 weeks post treatment, but some clients will start to see results within 2-3 days of treatment. On some occasions, an adjustment dose may be required as you and the Cosmetic Surgeon find the quantity that works best for you to achieve maximum effectiveness.

The effects of Botox® last initially for 3 – 4 months before clients begin to notice the return of muscle activity. Subsequent Botox® injections often result in longer lasting results as the muscles atrophy and weaken over time. A common misconception about Botox® is that it is addictive. Clients decide whether or not to return for further treatments. However, the overwhelming majority of clients enjoy the results and their rejuvenated, refreshed appearance and thus seek to maintain their results.

Botox® is a medical treatment and should only be performed or supervised by a qualified Cosmetic Surgeon. Prior to treatment, the Cosmetic Surgeon should fully discuss with you your medical history and answer any questions or concerns you may have about treatment. There are some medications and conditions which can make you an unsuitable candidate for Botox®, so it is important to disclose your medical history, including any medications, vitamins and herbal treatments you may be taking. Such products as aspirin or ibuprofen, for example, cause blood thinning that increases the likelihood of bleeding and/or bruising after treatment. Botox® treatment typically takes 10 to 30 minutes. Techniques such as the use of a small needle and ice packs help to minimise discomfort.

Actual patients Botox results Before and After

Complications of Botox® include localised pain, discomfort, tenderness, inflammation, redness, bleeding and/or bruising. In inexperienced or untrained hands, there is the risk of complications such as eyelid droop or a down turned mouth.

Men and women are choosing to have Botox® in order to achieve a rejuvenated, refreshed and youthful appearance.

For an appointment contact Sydney rooms on (02) 9571 4850 or 0430 491 009 and Port Macquarie rooms on (02) 6583 3588.

Our face is the first part of our body people notice and first impressions can be lasting. With the process of aging written all over our faces, it is common for both men and women to seek ways to rejuvenate and refresh their appearance. This may range from the use of beauty products that promise to restore a youthful complexion, to the use of facial peels, and products such as Botox® and Dermal Fillers.

Botox® is often referred to as an anti-wrinkle, wrinkle reduction or muscle relaxant treatment. It is a neurotoxin (botulinium toxin type A) the clinical use of which is the result of more than 100 years study. The quantities used cosmetically to effectively treat facial wrinkles are not sufficient to cause any systemic harm (to cause harm several thousand units would be required).

Botox® works by blocking nerve impulses to a muscle, thereby inhibiting the muscles ability to contract causing lines and wrinkles. By inhibiting the muscle movement, lines are smoothed and diminished, resulting in a more youthful appearance. Facial lines and wrinkles that are typically treated include the Glabellar lines (vertical frown lines between the eyebrows that look like the number ‘11’), crows feet (wrinkles around the outer corners of the eye) or forehead worry lines.

The use of Botox® is not an exact science; the appropriate treatment or dose for one person may differ from another person, very much depending on skin type, depth of lines and frequency of muscle movement. When receiving Botox®, it is important to discuss this with the Cosmetic Surgeon so you understand and consent to the quantity and placement of the Botox® treatment. Some Cosmetic Surgeons take the conservative approach, starting with a smaller amount and monitoring effectiveness, rather than starting with a large amount that may not have been required in the first instance. Some clinics charge per unit of Botox® so you pay for exactly the amount you receive. Some clinics charge per area, for example, the brow area. Some clinics provide free consultation, but then often a client feels obligated to pursue treatment. Other clinics will have a consultation fee, but this will be waived in the event you pursue treatment with the product costs being the only fee.

Individual results with Botox® may vary between clients. Optimal results are usually seen by 2 weeks post treatment, but some clients will start to see results within 2-3 days of treatment. On some occasions, an adjustment dose may be required as you and the Cosmetic Surgeon find the quantity that works best for you to achieve maximum effectiveness.

The effects of Botox® last initially for 3 – 4 months before clients begin to notice the return of muscle activity. Subsequent Botox® injections often result in longer lasting results as the muscles atrophy and weaken over time. A common misconception about Botox® is that it is addictive. Clients decide whether or not to return for further treatments. However, the overwhelming majority of clients enjoy the results and their rejuvenated, refreshed appearance and thus seek to maintain their results.

Botox® is a medical treatment and should only be performed or supervised by a qualified Cosmetic Surgeon. Prior to treatment, the Cosmetic Surgeon should fully discuss with you your medical history and answer any questions or concerns you may have about treatment. There are some medications and conditions which can make you an unsuitable candidate for Botox®, so it is important to disclose your medical history, including any medications, vitamins and herbal treatments you may be taking. Such products as aspirin or ibuprofen, for example, cause blood thinning that increases the likelihood of bleeding and/or bruising after treatment. Botox® treatment typically takes 10 to 30 minutes. Techniques such as the use of a small needle and ice packs help to minimise discomfort.

Complications of Botox® include localised pain, discomfort, tenderness, inflammation, redness, bleeding and/or bruising. In inexperienced or untrained hands, there is the risk of complications such as eyelid droop or a down turned mouth.

Men and women are choosing to have Botox® in order to achieve a rejuvenated, refreshed and youthful appearance.

Breast augmentation using breast implants, typically silicone implants, is currently the most popular and common cosmetic surgery performed in Sydney. This procedure involves the insertion of implants to enlarge and enhance a woman’s breasts. This requires only a few days of recovery and has very good rates of success and high satisfaction.

Liposuction has been so far the most popular cosmetic surgery procedure in Sydney to achieve immediate sculptured and defined bodies, particularly following weight loss programs. It is not surprising therefore, that both men and women consider Cosmetic Surgery to improve their self confidence and more importantly for some, for health reasons. Sydney patients importantly consider the length of time to recover and any possible adverse effects and consequently they achieve realistic and desired results. Liposuction as a form of cosmetic surgery is commonly performed on women and men on their abdomen, buttocks, hips, thighs, and upper arms.

Another procedure in Sydney that is very popular among women following weight loss and pregnancy and men after significant weight loss is a tummy tuck (Abdominoplasty). This is performed when liposuction or other cosmetic surgery, weight loss or exercise alone will not address the sagging abdominal skin and spreading abdominal muscles. A Tummy Tuck tightens the lax skin and abdominal muscles, creating a defined abdomen. The scar is located below the underwear line and is easily hidden by clothing. Tummy Tuck scars typically fade to a fine scar with care and appropriate scar management.

Rhinoplasty, commonly called a “nose job”, is another popular cosmetic surgery in Sydney where the nose is reshaped, producing an aesthetic and attractive nose and therefore facial features. The nose is an important and central feature of the face. Trauma or normal aberrations of the nose can result in a loss of self confidence by patients seeking Rhinoplasty surgery. Patients in Sydney who undergo Rhinoplasty either want to enhance, change the shape or augment their nose.  Rhinoplasty alone may not correct breathing problems; these patients will need to seek the advice from an Ear, Nose and Throat surgeon to help improve breathing difficulties.

Other common cosmetic surgeries in Sydney are face and neck lift and breast reduction (reduction mammaplasty). Face and neck lift surgery are performed for patients seeking a longer term result while breast reduction decreases the breast volume and shape to a natural, perky shape. It removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body weight.

For most patients in Sydney, the decision to undergo cosmetic surgery is a significant and important step. Often it is an attempt to enhance, improve or correct a patient’s self image but it could also be to resolve an underlying medical condition. More importantly, the patient makes an informed decision and is under the care of a professional who is qualified to perform cosmetic surgery be it in Sydney or elsewhere in Australia.

Patients often find they appear rejuvenated to others, with final results being aesthetic and natural. Unlike the excesses of Cosmetic Surgery performed overseas in countries such as the USA, patients in Sydney and Australia prefer an enhanced, rejuvenated, beautiful and natural result.

Non-surgical and less invasive facial rejuvenation treatments, such as Botox® or Dermal Fillers, are temporary measures to address the signs of aging such as wrinkles, frown lines and volume loss. Face lift surgery offers longer lasting refreshed and rejuvenated results.

There are a number of techniques to perform Face lift surgery, with varied results and success. Macs lift; S Lift and Thread lift offer quick “lunch time” Face lifts. They temporarily address the sagging skin but not the sagging underlying primary soft tissues. These procedures are also restricted by the kind of patient for whom they are appropriate. They are normally youthful patients with minimum wrinkles, sagging or sun damage and thick skin. However, as the results are only temporary, many patients are unsatisfied longer term and seek correction with a comprehensive Face lift at a later date.

A comprehensive and thorough face lift should give an excellent and long-term result for most patients. The surgery is typically performed under deep sedation or general anaesthesia. The recovery period is expected to be between 2 to 3 weeks

Face lifts can be effectively combined with eyelid surgery (also known as blepharoplasty) and other facial procedures. Blepharoplasty specifically addresses the sagging tissue around the eye that can be very aging and give patients a sad or tired appearance.

Face lifts are beneficial in addressing sagging and wrinkled skin creases in the cheeks, jowls and neck. Lines around the mouth, such as marionette lines and nasolabial folds may not be completely addressed by surgery and Botox® and dermal fillers may be used to enhance the Face lift results. Excess pulling and tightening of the skin causing a “windswept” look is to be avoided.

As correct Face lift techniques also address the deeper tissues and structures of the face and neck, there is less tension at the closure of the incisions. The incisions are concealed within the tucks and natural folds. Efforts to prevent hair loss due to traction, injury or strain to hair follicles are observed during the procedure.

Following Face lift surgery, continued care of the skin is important, especially from the damaging effects of ultraviolet light and the sun.

Patients who have undergone Face lift surgery describe their appearance as refreshed, rejuvenated and revitalized. Friends and family often ask where they have been on holiday!

Before surgery

As with any surgical procedure, the certified Cosmetic Surgeon will see you for a consultation to evaluate your needs and goals. This includes a physical examination and a thorough review of your medical history and status. In your consultation, your Cosmetic Surgeon will discuss and describe the appropriate technique and plan for you. The amount of skin and fatty tissue requiring removal and underlying muscle weakness can be determined through a physical examination. The Matarasso Classification is used to identify the types of tummy tuck required. The presence of underlying hernias may also be investigated with referral for an ultrasound. An ideal and stable weight is desirable prior to surgery with a history of a healthy diet and regular exercise. Tummy tuck surgery should not be viewed as a weight loss strategy.

During the surgery

Tummy tucks are performed by a certified Cosmetic Surgeon under general anaesthetic. The incision will be made a few inches below the belly button; for women an old caesarian incision can be utilized. Excess skin and fatty tissue between the incision and the belly button is then removed. To produce a tighter appearance, the muscle from each side of the tummy will be pulled and stitched together. Depending on the amount of skin and fatty tissue removed, the belly button may be reshaped and created to fit the newly tightened stomach. The tummy tuck procedure can take between 2 and 4 hours depending on the complexity and extent of the surgery.

After the surgery

Recovery from tummy tuck surgery usually takes up to 6 to 8 weeks. Usually patients take a couple of weeks off work. It is important to rest following surgery. It is also important not to place the incision and stitches under any tension or pressure. The wound and tummy may be painful and tight (often described as if you had just done a thousand sit ups) and cause the patient to bend at the hips to sleep and walk. It may take a couple of weeks for this pain to subside and the patient to feel comfortable standing up straight. Following surgery, a compression garment is to be worn for 6 to 8 weeks (or more) to provide support to the tummy and provide maximum adherence of the skin and underlying tissue; this facilitates a successful result. The incision scars are placed in areas usually covered by underwear. Eventually these scars will lighten.

Typically patients who have had a tummy tuck describe a high degree of satisfaction with their new body shape and tone, giving them increased confidence in their appearance and choosing flattering clothes.

For more information, contact a certified Cosmetic Surgeon.

Our faces age for many reasons. Heredity plays a role, as does gravity, which tends to pull soft facial tissues downward. In time our cheeks begin to sag, the crease running from the nostrils to the sides of the mouth is accentuated, and our jaw line and chin lose their smooth, refined appearance. As we age we also tend to lose some of out facial fat and our skin loses some of its elasticity, leading to more sagging of our features.

Exposure to ultraviolet light plays a role as well. Indeed, people who live in tropical climates, where the sun is strongest, often have prematurely aged skin, irrespective of their ethnic characteristics. In these areas, people may seek face lifts in their forties or even younger.

First described over 60 years ago, face lifts smooth and redefine the contour of the neck and jaw line to create a younger, more vital appearance.Years of research and experience have led to an increasingly sophisticated understanding of the ageing process, the more subtle elements in facial anatomy and the technical ways to restore a balanced and more youthful appearance.

• In addition, thanks to advances in both surgical technique and anaesthesia, face lift procedures have become safer and more comfortable and their results even more satisfying.
• It is important, however, to remember that while a face lift can help refresh your appearance it will not erase permanent creases, particularly around your lips. Additional procedures like Dermabrasion, laser resurfacing and chemical peels can improve those lines and can be performed in conjunction with your face lift.

Your consultation: talking it through

When you meet with your surgeon, you’ll have an opportunity to share your feelings about the results you want to achieve, learn about what will happen during your surgery and help design a procedure that meets your individual needs. It is often helpful to bring a photograph of yourself from the time when you thought you looked your best.

• Your surgeon will take a medical history and ask about any previous facial surgery.
• You’ll learn about normal differences in facial symmetry you’ve probably never noticed before.
• Your surgeon will gently lift your facial skin to assess what you might be able to expect after your surgery.
• He will also explain some of the other effects of surgery, like the fact that the position of your hair in front of your ear may be elevated and that, in men, the beard may be advanced under and behind the ear requiring shaving in that area.
• You’ll discuss the extent and position of scars you can expect.

Your surgeon will also explain some of the modifications that have improved the overall results of face lift surgery. These modifications, all of which can be individually tailored to suit your needs, include deep (S.M.A.S.) lifts, chin fat removal, and remodelling of the neck muscles.

In addition, you’ll learn about procedures that can be done at the same time as your face lift, including correction of eye bags (Blepharoplasty), forehead lift and the use of fat from other parts of your body to restore lost volume to the central part of your face. You’ll also learn about situations where face lifts & neck lifts can be combined with chin augmentation if the jaw contour is somewhat weak, or Midface lifts for more pronounced definition of the cheekbone area.

Your operation: what to expect

Before your surgery you will receive advice about what to do and what to avoid. For example, if you routinely colour or perm your hair it’s wise to have it done immediately before your procedure so it will be some weeks before you need to have it done again.

In most cases your face lift will be done under general anaesthetic and you will spend the night in the hospital. More limited procedures can be carried out under a local anaesthetic and sedation, but for a full face lift there is no real benefit from sedation.

Once you are comfortably asleep, the surgeon will make an incision that starts high in the temple area (hidden by the hair at this point) and courses down following the curves in front of the top and bottom of the ear and behind the middle part (tragus). The incision then continues round the earlobe and up behind the ear before curving gently back into the hair. In some cases a second incision in made under the chin where it will also be well hidden. Its purpose is to assist with definition of the chin and neck.

Using these incisions on both sides of the face, the skin and deep tissues are remodelled and re-draped. The incisions are then closed with stitches in front of the ear and metal clips in the hair. Small drainage tubes are may be inserted under the skin during the operation. These are often removed at the practice, several days after your surgery, so that bruising and swelling around the face and neck are minimal, and return to work and social activities is accelerated. Some surgeons also apply a light bandage around your head at the end of the surgery.

After your surgery :

Your bandages will be removed the morning after your surgery. After that, your hair will be washed and you’ll be allowed to leave the hospital.

Once at home, it’s important to take certain precautions:

• To prevent post-operative bleeding it’s important not to engage in vigorous activity for the first five days after your surgery.
• Aspirin should be avoided. Any discomfort can be controlled by taking a mild analgesic such as Paracetamol.
• You may gently wash your hair with a mild shampoo, exercising care in the suture area.

As your convalescence continues, you can expect certain things:

• Your sutures will usually be removed seven days after surgery. It is advisable not to apply any strong chemicals like bleach or ammonia to the area for four weeks following surgery.
• Your scars will usually be very faint at first, however you can expect them to thicken and become red for a few months after your surgery before they return to a more natural skin colour and texture.

• It is normal to experience some bruising, swelling and numbness after a face lift. These symptoms are temporary and should mostly disappear after two weeks. Numbness takes longer to settle down, and it will require approximately a month for the cheeks and three to four months for the underside of the chin. To help lessen post-operative bruising, we suggest taking Arnica for one week prior to your surgery and two weeks after. After the surgery, products like Lasonil® will be very useful to reduce and clear the bruises.

Complications from Face Lift are rare

• Should infection occur it can usually be readily treated with antibiotics.
• If a haematoma (a collection of blood under the skin) should occur, a revisit to the operating theatre may be necessary. However, if a haematoma is dealt with promptly it should not affect the long-term results of the surgery.
• Occasionally, delayed wound healing may occur. This is particularly true in diabetic patients or patients who smoke. If you smoke, please discuss your habit with your surgeon.
• Damage to the nerves which control the facial muscles is extremely rare with face lift surgery. In the majority of cases where this does occur there is a full recovery.
• With any surgery that takes more than about an hour there is an increased risk of clots in the leg veins (deep vein thrombosis). Because of this, it is important that, apart from the measures taken during the hospital stay, you continue gentle mobilisation, exercising your feet lightly but regularly in the week following your operation. This will help restore your circulation and reduce the chance of clots forming.