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).

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.

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!

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.