Wrinkle treatment by muscle relaxation injections.

We are not allowed to use the medical word that is the injected chemical  typically used for appearance improvement by relaxing muscles that generate frown and smile lines. One word would be a lot easier!
However one can say that every case demands a bespoke approach as we all express our faces a little differently. Additionally many patients are surprisingly asymmetrical. Subtle differences in injection technique are important to achieve an ideal result. It requires artistry and an appreciation of facial aesthetics. Anyone can inject but it is very common to see droopy brows, stiff expressionless faces and inappropriately weakened expressions when injections are performed by amateurs. Many injectors simply follow an injection pattern but not an individual patient's particular requirements. The following Y-tube educational video is very good and does demonstrate the issues of muscle balance in the face. http://www.youtube.com/watch?v=6XEK7AtomWY&feature=fvsr

Art of Liposculpture

I was very fortunate to embrace liposculpture in 2002 under the special tutelage in Paris by the renown liposculpture pioneer Dr. Pierre Fournier http://www.aaamed.org/files/12.pdf
One of my Sydney colleagues summarises well the history and genesis of Liposculpture in the following link.
http://www.s-lift.com.au/LIPOSCULPTURE.html
It should be appreciated that the art of  Liposculpture is literally dependent on sculpting the target fat deposits with various sizes of cannula instruments. In my opinion this fundamental concept in trained and experienced hands remains the gold standard for the attainment of pleasing outcomes. The art of Liposculpture cannot be copied or enhanced by the use of various heat technologies to melt or disrupt fat. Such technologies do not provide for true sculpting. Similarly a Michelangelo could not have carved his magnificent sculptures with a hot knife or blow torch! Despite all the hype and extravagant claims of skin tightening and alike by various manufacturers, the option of fat reduction using expensive laser, ultrasound and other  heat  technologies simply adds a layer of risk and expense without true benefit to the patient. An expensive machine does not necessarily improve the skills of the operator!
http://www.myshapelipo.com/2011/04/18/debate-on-laser-lipo-is-it-really-that-%E2%80%9Csmart-or-that-cool%E2%80%9D/
http://ezinearticles.com/?Are-There-Laser-Liposuction-Risks?&id=2608740
http://www.realself.com/review/smart-lipo-burns
http://www.beverlyhillslipolaser.com/risks.html

Anteis Injection System

Yesterday we evaluated an ingenious new Swiss designed electro-mechanical injection filler device and we were impressed with it. The device provided for a smooth delivery of tissue filler while also allowing for the injector to focus on the filler placement rather than having to press on the syringe plunger which is a bit like concentrating on the placement of an orange on an old fashioned juicer while also having to twist the orange at the same time. Some video links are available below.

http://www.youtube.com/watch?v=ysJ2OXxUZ4s

http://www.youtube.com/watch?v=OXgvi6gu8Gk&feature=related

Permanent Fillers-"Proportions not Distortions"

A permanent tissue filler may have an excellent place in an individual patient's facial rejuvenation strategy but only after non-permanent fillers have been tried and the patient is satisfied with the outcome. There are some very important issues to consider when injecting fillers. By far the most important is to respect the facial anatomy, injecting to restore the patient's own natural youthful contours. Frequently we see cosmetic treatment outcomes in celebrities that demonstrate distortion of their their features. http://freshpics.blogspot.com/2010/09/16-worst-celebrity-plastic-surgery.html
Such outcomes cannot be viewed as "beauty enhancement".

Leg Veins

The cooler months intensify demand for treatment of leg veins and winter 2011 is no exception. Most patients are unaware that the problem is caused by leaky venous valves in leg veins that fail to contain the pooling of venous blood fed by gravity. This is an predominately an inherited problem although exacerbated by pregnancies, standing occupations and several other associated factors.
For the past few years injection sclerotherapy rather than surgery is the treatment of choice. This is a good thing as it is a far more tolerable and indeed far less risky. Although strong compression stockings need to be worn for about 7 days post treatment, patients can resume a relatively normal life immediately after treatment. I have been injecting veins for for over 20 years now. Below is a link to a video of treatment with sclero-foam which we use on occasions to optimise the treatment effect. It is fascinating to observe how one injection can treat an area of interconnected veins for some 3-4 cm diameter.
http://www.youtube.com/watch?v=ySb9Wxd3A1A&feature=related
http://www.phlebology.com.au/australasian-college-of-phlebology
http://www.phlebology.org/

Skin Health and Maintenence

As I reflect on this week's consultations at our clinic I am impressed that skin health remains a fundamental point of discussion and enquiry. It is interesting that most patients volunteer that they "exfoliate and moisturise" but few apply active ingredients that actually improve skin quality. Vitamin A (Retinols) applied daily can dramatically rejuvenate skin. In my opinion creams containing Vitamin A should be part of every person's daily skin regime.
I first met plastic surgeon Dr Des Fernandes in 2002 when he was on a lecture tour in Australia and have visited his clinic in Capetown, South Africa to observe both his cosmetic surgery techniques and skin treatments. Dr. Fernandes is a true pioneer in both skin treatment and minimally-invasive cosmetic surgery and it is worth listening to what he has to say in the following Y-Tube interview. It is also interesting to hear Dr. Fernandes speaking about the importance of vitamin D in general health and the wisdom of controlled (but not absolute) sun protection. These views are now accepted in contemporary medicine, as the fashion of overly obsessive sun avoidance has resulted in a near epidemic of Vitamin D deficiency. In years past this was unheard of our sun-drenched Australia.
http://www.youtube.com/watch?v=rDaX1AWvsfQ
http://www.youtube.com/watch?v=1B1EShEAIBQ&feature=related
http://www.environskincareaustralia.com.au/articles.

Upper Eyelid Surgery (Blepharoplasty)

Went to a clinical meeting last night where I presented a de-identified audit  of my upper lid surgery cases to my surgical peers from the Australasian College of Cosmetic Surgery. There was much discussion about our various surgical techniques and preferences. Techniques may vary a little but outcomes for this type of minimally invasive surgery are very pleasing. Beautiful eyes light up a face and there are very few procedures that give so much pleasure to patients. We do all our cases under local anaesthesia in our treatment room facility and our audits reflect a safe experience with very little discomfort and a very high level of patient satisfaction.

Self-Injecting and the importation of suspect cosmetic injectables

Incredible to contemplate but reported to be true. A number of non-medically qualified people have seen it fit to import (and even inject into clients) very suspect cosmetic fillers and wrinkle-reducing injections into this country. This has made the news and underscores a big warning to patients to avoid the temptation of seeking out impossibly cheap treatments from "dodgy brothers" type operators. Reports have also emerged that a number of cosmetic clinic chains (more akin to gaudy emporiums) have opened up, apparently owned and operated by non-medical people whose only motivation is-guess what?
People who would not normally dream of having their cars serviced or repaired by an unqualified mechanic or panel beater seem to throw caution to the wind when it comes to "who injects what" into their faces!
It appears that most of this activity is not actually illegal.
A case of consumer beware!
http://www.smh.com.au/lifestyle/wellbeing/injecting-online-botox-a-health-risk-20110517-1erj0.html
http://www.cosmeticphysicians.org.au/pdf/media2011/CPSA%20warns%20risks%20of%20internet%20drug%20purchases_FINAL%2018.05.11.pdf

Excessive Armpit Sweating (Axillary Hyperhidrosis)

Know as "Axillary Hyperhidrosis" excessive sweating in the armpit region is a distressing problem that is not controlled by antiperspirants.

Botulinum injection treatment is an outstanding advance in controlling the problem and can last for some 6 months per treatment. However as an extension of our liposuction work we have been performing a technique called “Dermatosuction" for several years now that breaks up and sucks out the sweat glands, with the prospect of a long-term and perhaps permanent "normalisation" of armpit sweating.

Normalisation means armpit sweating that can be controlled by the use of topical antiperspirants.

I presented a paper at a European conference on this subject about 4 years ago that was published online: http://www.ijcs.org/12/47/723/index.php?pageFrom=1&pageTo=21&slide_cur=1

Although this is an established treatment overseas:
http://www.coloderm.com/
we are one of only a few clinics in Australia providing this treatment as an alternative to Botulinum toxin injections.

Advances in Facial Filler Injections-The Blunt Cannula Needle

A great recent advance in facial filler injections has been the adoption of the fine blunt cannula instead of sharp needles to inject the filler into the desired area (eg Cheeks, Lips, Nose, Brow Temporal hollows). The patient experience is much less painful and bleeding/bruising is significantly reduced as vascular structures are generally nudged out of the way instead of being cut though.

This blunt cannula technology is borrowed from the technique of fat transfer grafting, something we have already been performing for over 8 year now at our clinic.

A master exponent of this technique is the brilliant Brazilian plastic surgeon Dr. Mauricio de Maio:

Dr Mauricio de Maio is a member of the Brazilian Society of Plastic Surgery and the International Society of Aesthetic Plastic Surgery. He graduated from the Medical Faculty of Medicine, University of Sao Paulo in 1990. Specialist in Plastic Surgery in 1996, Master of Medicine in 1999 and Doctor of Science in 2006 at the Faculty of Medicine, University of São Paulo. Dr de Maio was Assistant Professor of Surgery at Harvard Medical School, University of São Paulo from 1996 to 2002. He has been a recognized consultant and teacher training experts in the areas of Plastic Surgery, Laser and Aesthetic Medicine since 1997. Recognized nationally and internationally, Dr Mauricio de Maio has published three books on Aesthetic Medicine, Editora Roca - Brazil, 2004; Fillers in Aesthetic Medicine, Publisher Springer-Verlag - Germany, 2006 and Botulinum Toxin in Aesthetic Medicine, Publisher Springer-Verlag - Germany, 2007. Dr de Maio is also a Minister for international courses in North America, Central and South America, Europe, Africa and Asia.

http://www.mauriciodemaio.com.br/ingles/naocirurgicos.htm
http://www.youtube.com/watch?v=2mdBMNkEsZg&feature=related
http://www.youtube.com/user/clinicamauricio
Dr. de Miao who was the "star turn" at our recent annual Australasian College of Cosmetic Surgery conference in Hobart.   http://www.iceaustralia.com/cosmetex2011/program.html

I had the wonderful opportunity to observe and discuss Dr. de Maio's filler injection technique with him as we were speaking on the same platform at the conference: http://www.iceaustralia.com/cosmetex2011/pdf/Cosmetex2011_Program.pdf
We found we had many treatment concepts in common.

I am very grateful to Dr. de Maio for some excellent treatment tips and techniques that he passed on to me and am delighted to be already using these advances at our clinic.

The New Era of Minimally-Invasive Cosmetic Surgery

We have entered a new era of minimally-invasive cosmetic surgery.

Statistics from the USA indicate that radical surgical techniques are fading as an option for enhancing appearance.
http://www.network-aestheticmeso.com/index.php?id=972&tx_mininews_pi1%5BshowUid%5D=1045&cHash=dad49a389c
http://www.ncbi.nlm.nih.gov/pubmed/18520867

We have established a reputation at our Castle Hill clinic founded on the achievement of aesthetic enhancement with natural results.

Furthermore every patient is treated as an individual. There are no "Fixed Menu" treatments!

All treatments are essentially "À La Carte" with the aim of creating beauty.
However patients remain very much like themselves and recognisable but with the benefit of a more youthful appearance.

I expect in time that much correspondence will ensue along this essential theme.