Her Majesty The Queen-Could We Have Retarded The Aging Process?

With minimally invasive and non-invasive techniques it seems certain that the advanced changes of ageing in our lovely queen  (as seen  in the following inventive You Tube link) may have been retarded or minimised.
http://www.youtube.com/watch?v=E8nJhG1xE5o&feature=em-share_video_user

The Queen over time demonstrates the ageing phenomenon of tissue involution at all facial levels with bone loss, muscle loss, fat loss, sub-cutaneous tissue loss/laxity and skin thinning.

Naturally in the era of the Queen's more youthful years only radical face lift surgery was available to her. Today we  would have had the opportunity to maintain her skin and volumise her soft tissue contraction with various fillers. Her lips would be injected with fillers to maintain their warmth.

Thin lips are unfortunately often associated with a mean appearance. Yet, in youth, the queen displayed fulsome lips that imparted the appearance and impression of a welcoming warmth.

As is the case with many females, it can be seen that the Queen displayed in her the late 40's (corresponding to an approaching menopause and diminished circulating hormones) a time of accelerated involutional changes. Intervention at this stage is very important and modern women have become very much aware of this.

Expert advice and treatment with minimally invasive procedures can maintain the youthful allure and warmth that underpins attractiveness. Our experience is that patients are generally ecstatic with the outcomes of minimally invasive interventions. Our intention is rejuvenate with naturally beautiful outcomes while avoiding an "operated on" appearance.

Excellent results depend more on the surgeon than the equipment

In cosmetic procedures, pleasing outcomes are achieved by the talented surgeon/proceduralist and not necessarily by the brand of equipment or product used. An excellent piano can enhance a great pianist's performance. However a mediocre pianist cannot generate a great performance even on the best of pianos. Technology and pharmaceutical filler companies  may well claim that their particular laser or filler generates exceptional cosmetic results. The truth is that excellent outcomes are in the hands of the proceduralist. It follows that a talented proceduralist will utilise quality equipment and products to optimise creative efforts.
Patients understandably can fall prey to commercial hype about injectables, fillers and equipment.
However a syringe or two of the same filler can be used creatively for facial enhancement or injudiciously to the detriment of a face. It depends so much more on the ability and quality of the proceduralist rather than the claimed merits of the injectable product or equipment used.
It has become apparent that successful cosmetic outcomes are being achieved consistently by experienced "boutique" based proceduralists, where every patient is assessed and treated as an individual challenge. This is the artist's studio rather than the factory floor sweatshop.
In my experience this standard is rarely seen in the outcomes of the cosmetic supermarket like clinics where time/profit work ratio standards rule.
Some cosmetic proceduralists  have achieved truly artisan levels of creativity in their minimally invasive work and deserve due recognition for their excellence. More about this in a future post.

Medical Aesthetics Incorporated

With the growth of corporate medical cosmetic clinics expanding dramatically here in Australia, one reads with surprise that in California USA (that epicentre of cosmetic surgery) regulations on who can own and run a medical clinic are quite tough.

For example regarding the "Corporate Practice of Medicine" :

The following types of medical practice ownership and operating structures also are prohibited:

• Non-physicians owning or operating a business that offers patient evaluation, diagnosis, care and/or treatment.
• Physician(s) operating a medical practice as a limited liability company, a limited liability partnership, or a general corporation.
• Management service organizations arranging for, advertising, or providing medical services rather than only providing administrative staff and services for a physician's medical practice (non-physician exercising controls over a physician's medical practice, even where physicians own and operate the business).
• A physician acting as "medical director" when the physician does not own the practice. For example, a business offering spa treatments that include medical procedures such as Botox injections, laser hair removal, and medical microdermabrasion, that contracts with or hires a physician as its "medical director."

from:
http://www.mbc.ca.gov/licensee/corporate_practice.html


Apparently here in Australia non-medical entrepreneur owned cosmetic surgery chains are enjoying great financial success.

Discerning patients should always reflect upon the issues of ethical care and management in treatment delivery in any potential clinical experience and  perhaps take a keen interest in who owns and operates a medical clinic before committing to a medical cosmetic procedure.

Cosmetex Cairns 2012 Conference

It is almost 2 weeks since our annual conference "Cosmetex"in Cairns.
http://www.professionalbeauty.com.au/2012/05/04/article/Cosmetex-2012-Kicks-Off/POBKUHOCNQ.html
 http://www.professionalbeauty.com.au/2012/05/08/article/Impressive-Attendance-at-Cosmetex-2012/SPOZSNKYFX.html

It was great to experience the warmth of topical Queensland and the camaraderie of our colleagues.

At last I have found time to report on the conference for this blog. The Australasian College of Cosmetic Surgery and its associate organisation the Cosmetic Physicians Society of Australasia are to be congratulated for another huge and successful cosmetic medicine and surgery event that is without parallel in Australia. The inexorable drift towards minimally invasive therapies over traditional surgery continues with externally delivered, non-invasive fat reduction ultrasonic and freezing treatments emerging as alternatives to internal cannula liposculpture techniques.
However equipment remains very expensive and outcomes still rather modest at this stage.

A new potentially long acting soft tissue filler from Holland was launched http://www.youtube.com/watch?v=6bRsYaK46GY&feature=related that is claimed lasts up to 4 years in the most durable its formulations. This is a significant advance and may now set the pace for filler innovation and development. We look forward to see how this integrates into injection filler strategies.

Otherwise the conference seemed to reflect that experienced Australian cosmetic practitioners remain  at the top of their game and equal in knowledge, ability and skills to colleagues anywhere in the world.

This bodes well for our patients who can access the best and appropriate therapies right here in Australia without compromising quality of care as can be the case in overseas vacation treatments.

The Failed Aesthetic Of Tear Trough Injection Treatment

Injection of commercial fillers into tear troughs has been one of the most unfortunate trends in recent cosmetic medical practice. The treatment often delivers an incomplete or failed aesthetic result and is frequently associated with long term swelling , lumpiness, bruising and a bluish skin discolouration known as Tyndall effect.
http://chemwiki.ucdavis.edu/Physical_Chemistry/Physical_Properties_of_Matter/Solutions/John_Tyndall

This filler treatment fails on the basis of a misappreciation of the ageing anatomy in this facial region that has been educationally promulgated by most of the filler companies via their medical advisers. This has resulted in an entire battalion of misguided injectors (including myself initially) out there causing grief to patients with poor aesthetic outcomes.
http://www.realself.com/review/australia-juvederm-juverderm-eye-bags-tear  http://www.realself.com/review/Restylane-Vey-Unhappy
http://www.realself.com/question/restylane-deep-tissue-bruising-tear-trough
http://www.plasticsurgerypractice.com/issues/articles/2009-09_03.asp

The anatomy of tear trough (nasojugal groove) ageing need to be understood. It is is a normal anatomical depression that runs from the inner aspect of the eye (near the nose) diagonally outwards down the cheek. The tear trough deepens with ageing due to the cheek (malar) fat pad below reducing in volume and also sagging downwards (ptosis). Another fat pad located under the circular muscles around the eye (oribularis oculi) called SOOF also reduces and sags with ageing.  

Essentially the popular rationale that promotes treating the tear trough by injecting fillers under the orbicularis muscle may somewhat augment the diminished the targeted SOOF fat pad. However such an approach is usually aesthetically insufficient as it is the whole cheek (malar) complex that requires  augmentation by much more volumising  and durable fillers. The outcome in the hands of skilled injectors results in a projected and somewhat elevated the cheek that is in aesthetic harmony with the eye (orbital) complex above it.

Cosmetex Meeting Cairns 2012

The annual scientific meeting of the Australasian College of Cosmetic Surgery (ACCS) and Cosmetic Physicians Society of Australasia (CPSA) will take place in May at the convention centre Cairns Queensland. http://www.cosmetex.org/cairns2012/program.php
This meeting is always a very informative event with many invited international speakers and also our own Australian contingent. Interestingly invasive surgical procedures remain a small component of the programing reflecting the preeminence of non-invasive treatments in aesthetic medical practice.
With 2 lecture session and 3 workshop sessions all running concurrently, the meeting can be quite challenging for the attendant. There are always some great technical tips to be gained from such meetings although generally it becomes apparent that one or two speakers emerge as standout educators.
However historically some speakers can incline to spruik or overly promote methods with outcomes that appear to fall well short of the hype. One is left to sort the wheat from the chaff in these presentations.
Hopefully after this meeting I will be in a position to report on some interesting developments. 

Filler Fever

I had the pleasure of attending 2 cosmetic medicine presentations this week featuring excellent practitioners reviewing and demonstrating filler and muscle relaxation techniques for facial rejuvenation. It remains apparent that much can be achieved with injectables to naturally improve faces naturally.
Choice of fillers can be determined by several factors, the most important being matching appropriate filler to the facial region targeted. Equally important is a keen appreciation of beauty principles that allow practitioners to inject in an aesthetically pleasing dynamic that can also prove cost effective.

My talented and charming Paddington cosmetic practitioner colleague, Dr. Naomi McCullum has written informatively on the highlights of one of these meetings. I am linking to her always compelling blog on the subject as follows:
www.drnaomi.com.au/blog/
Thank you Dr. Naomi!!