Dr Bryan Mendelson,FRCSE, FRACS, FACS,guest editor and head ofthe expert advisory board

Welcome to the fourth biannual cosmetic enhancement andanti-ageing guide, which I am honoured to be guest editing.

People often ask, "What advice would you give someone considering

an aesthetic facial procedure?" My answer is simple: "Focus on quality."

Your face is too important for anything less than the best. There are

many surgical, non-surgical and skincare products, as this guide shows.

Do your homework and ask: "What do I really want from this procedure

or product?" You probably did a lot of research and checked out many

houses before buying one; it makes sense to do the same for the face.

l'd like to propose a different way of thinking about surgical

maintenance. My suggestion is to think incrementally about facial.

ageing, or, to put it another way, to align your specific faeiril abeing

with "small steps" surgery. l'll explain what I mean. Faces tend not toage at the same rate all over. Most probably, your eyes will age first oryour jawline, and often they age well before any other area.

Modern surgical methods now allow people to correct just one

area, such as those early-ageing upper eyelids, in a subtle and natural

manner, and to retain that degree of benefit over future decades. For

some people, it may be all they ever need.

You may be thinking, "Yes, this is a good idea but what is so new

about it?" The new part is the surgery itself. Modern, quality surgeryis quite different because it takes place in the support layers ofthe face, which lie beneath the skin, b,ecause this is where ageingoccurs. People will think you are simply "ageing well", which is

the optimal outcome.Please enjoy this guide, and always remember, the time you spend

researching procedures and looking for quality will be reflected inyour happiness in the years ahead.

COSIYETIC GUIDE B

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RICKYALLENfd ror, Cosmelic

Enhancement anc! Anti-ageing SpecialBSc, BHSc, Dip PA. Dip HM

EMILY BENNETTVictoria Key Account Manager

(o3) 9292 21A1

EXPERT ADVISORY BOARD

DR BRYAN MENDELSONGuest editor and head of the

expert advisory boardFRCSE, FRACS (Plastlc Surgery), FACS

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DRWARWICKNETTLEN4BBS, FRACS(Plastic Surgery)

DRAMIRASANKIMBBS, FRACS, PhD(Plastic Surgery)

DR PAUL GERARCHIMBBS, FRACS(ENT Surgety)

DRJASS NARULLAN4BBS, DRACOG,FACAM, president ACAMCosmetic physician

MR CRAIG RUBINSTEINMBBS, MS,

FRACS (Plastic Surgery)

DRYVONNE KINGBDS, N4Sc (Aesthetic Dentistry)Cosmetic dentist

NIGEL STANISLAUSMaybelline New Yorkmake-up directorfor Australia

CATERINA DI BIASECreative director forHeading Out salons

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The highly trained and specialised cliniciansyour best. They achieve this with surgical

at Silkwood Medical have one aim - to make you lookand non-surgical procedures, tailored just for you.

The team at Silkwood Medical really understands your need

to look your best. Under the directorship of Dr'Warwick Nettleis a team of highly trained and dedicated clinicians whose aimis to deliver the best cosmetic enhancement to all of theirpatients. The results speak for themselves.

Silkwood is a purpose-built clinic where the staff has a deep

understanding of beauty needs. The clinic contains some of the

most sophisticated, advanced equipment and products available.

ffi #$q -$# ffi # atrs.L ?ffi ffi ,&.Yffi ffi ruYsNon-surgical treatments are carried out in the SilkwoodMedical Skin Clinic division under the supervision of a plasticsurgeon - either Dr\farwick Nettle or Dr Amira Sanki. Allpatients receive a full evaluation of their skin, and a treatmentplan based on their specific skin needs is devised. A Vectramachine is used for skin analysis, which looks at pigmentationas well as blood vessels. This assessment is important because

as we age melanin, or pigment, cells are laid down unevenly,causing the skin to look more weathered and blotchy. Bloodvessels also become enlarged, causing severe discolouration.

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ffix,*.,r"4p1*ffis *r il)re F,iffiTTl*ffi-s w#reKFacelift, upper and lower eyelid surgery

and fat transfer to the face Revision rhinoplasty

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PROMOTION

The Vectra picks up early changes not seen by the naked eye,

facilitating preventative care and allowing appropriate

treatments to be offered.

A full range of aesthetic injections is available, and lasers

for skin tightening and skin improvement are recommended

as part of a treatment plan, if necessary.

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On the surgical side, Dr'Warwick Nettle is internationally

recognised as a highly skilled specialist in facial surgery.

Dr Nettle believes that specialisation in surgical procedures

gives patients the best results. Procedures such as face, eye

and brow lifts and rhinoplasty (nose iobs) are part of

his repertoire. Facial ageing was once considered to be

relatively superficial and confined to the skin and tissues

just below the skin. However, with increasing scientific

knowledge and understanding, we now know that facial

ageing involves changes to the facial skeleton, the muscles

that attach to the facial skeleton, the ligaments that are

attached, and the fat in the subcutaneous layer.

Y&K*r1{# tr&ffiffi *fi ffi*ffiY pffi#*ffi*#&ffi$Dr Amira Sanki carries out all body procedures, including

"mummy makeovers", breast augmentation and liposuction.

She finds it a real advantage being a woman when dealing

with areas that many women find very embarrassing to

discuss with a male doctor. Dr Sanki approaches each patient

as a true individual and tailors her surgical procedures to

meet their specific needs. Her gentle understanding manner,

coupled with her high level of surgical prowess, endears

her to all her patients. Dr Sanki is constantly attending

workshops to ensure that she always offers the very latest

.linrsurgieal techniques'

From left: Nurses Martlyn and Ginelleand aesthetician lvlaureen are three ofthe caring clinicians workrng at SilkwoodMedical. Your needs are their prioritv.

Silkwood Medical and Silkwood Medical Skin Clinic, Level 4, 75 Grafton Street, Bondi Junction, NS'$7.

For more information, visit silkwoodmedical.com.au or call t300 95t 486.

Breast augmentationby Dr Craig Rubinstein, MelbourneBreast-augmentation surgery has

enjoyed many huge improvementsin areas such as pain management.ln the past this was often a

concern, but with local anaestheticblocks and individually tailoredanalgesta, pain can now be kePtto a minimum.

Early mobilisation has beentaken into account as well, andpatients now start to mobiliseas soon as they wake uP afterthe anaesthetic.

Surgical techniques are also

being improved, and one of thelatest advancements is a no-touchmethod of implant insertion usinga lubricated sleeve. This minimisesstress to the implant. increasingits longevity.

The type of implant and thesurgical approach is taken intoaccount as much as possibleto tailor the procedure to theindividual. The Vectra M3 3Dcomputer imaging system allowsthe prospective patient to see howher implants will look followingsurgery. This has eliminated a lotof pre-surgery stress and anxietYover the finished result. There arealso more sophisticaLed sizingsystems that aid in seleciing thebest size for your body shape andproportions.

You can still breast-feed afterbreast augmentation. However, forlonger-lasting results it's betterto wait until after you've had Yourchildren and Finished nursing,

It's vital to choose a doctorwith the appropriate surgical

COSI.4ETIC GUIDE 20

qualifications. Travelling overseasfor breast surgery doesn't alwaYsguarantee that only aPProvedimplants and surgical methodsare being used, Price should not bethe primary consideration whenchoosing your surgeon, but ratherexperience and a proven surgicaltrack record, Top breast-augmentation doctors in Australiawill usually have performedhundreds of surgeries every year.

The future of breastaugmentation includes such newtechnologies as stem cell and fattransfer. These procedures are still

being scientifically assessed,

Facial surgeryby Dr Warwick Nettle, SYdneYA new and fascinating scientificunderstandlng of the mechanismsof facial ageing is emerging andit has led to a re-evaluation offacial-rejuvenation techniques.

We now know that much offacial ageing involves changes tothe facial skeleton, muscle, deep fatand fat pockets. We used to think itwas mainly about the skin, but it is

actually more about the volumeshift below the skin than skin laxity.

Using this knowledge, doctorsare now able to customise facialsurgical techniques. Two of lhe

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newest methods are stackingand fat transfer. Stacking is usedto change the relative volume oflax soft tissue from the lower faceand move it into the mid-faceand cheekbone area. Fat transferis now being used to replace fatand increase mid- and upper-facialvolume, which tends to disappearas you age.

Another advantage of fattransfer is that millions of stem cellsare transferred at the same time.They contribute significantly tolong-term improvements, as

they work on "de-ageing" allphysiological aspects of the face.

Mummy makeoversby Dr Amira Sanki, SydneyThe combination of surgeriesto improve the appearance ofa woman's breasts, trunk andabdomen are called a mummymakeover because these are theareas of the body that are mostaffected by giving birth.

A woman's abdominal musclesseparate in the midline to allow thebaby to grow. The breasts droopand deflate once breastfeedingstdps. An individualised surgical

Mummy makeoversare not trivial

despite the cutename. Postnatal

body changes canoccur no matter how

athletic ydu are.l'"

plan is essential, as no two womenwill have exactly the same post-childbirth concerns. They may onlyneed breast augmentation tocorrect any slight droop, or theymay need a full lift and even abreast reduction. For the abdomenthey may only need a mini-abdominoplasty, or a full one maybe necessarv. Most mothers do nothave the luxury of long recoverytimes, so these surgeries are usuallyperformed at the same time.This group of surgeries is not

trivial despite the cute name.Postnatal body changes can occurno matter how athletic you are.

Rhinoplasty(Cosmetic nose surgery)by Dr Paul Gerarchi, SydneyRhinoplasty is definitely also ananti-ageing tool. Everything dropsas you age, and this includes the tipof your nose. lt's amazing how muchyounger someone can look whenthe tip of their nose has been lifted.

The advances in .r.hinoplasty

mainly relate to creating a natural-looking nose and a skucture thatallows for maintaining the result inthe long term. Often this may bedone using a person's own cartilage,as grafting that will keep the formand function of the nose, eliminatingthat pinched appearance.

During the initial consultation,a morphing program and 2Dimaging are used to show whatthe patient can expect from thesurgery. These tools are also veryimportant when patients bring in

a picture of a nose they want,which, when placed on the face,may look totally wrong.

Open and closed rhinoplastiesshould be available, dependingon the nature of the work andthe expected result. More minorprocedures are usually achievedthrough a closed rhinoplasty; moredifficult changes require an open.

Two weeks after surgery mostpatients will be back to their normalactivities, but the appearance of thenose will continue to refine overthe next year - particularly at the tip.

For further information, call theAustralian Society of Plastic Surgeonsinformation hotline on 13OO 367 446or visit www.plasticsurgery.org.au.

COSIVETIC GUIDE 21

*-

BEFORE (age 48); iowls and neck fullness'AFTER (age 58): the bene6t of surgery rs

still evident 10 Years later'

Ln th;e

i:. AFTER (age 49): facelift and neck lift

BEFORE (age 40): hooded eyes and low brow

The pho.tos-sq itcosmettc d,octors

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We have some of the world's

- -beSt g-q:mgltc -e,!hq!qemet:t-

doctors right here in Australia.This photo album shows thesuccess stories of doctors

around the country,'i+#L,

- -4!fSB (age--4-1): browlift and lower

Iid blepharoplasty.

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Results may vary from person to person. Photographs on

this page are actual patients of Dr Bryan Mendelson.

BEFORE (age 30): heavy eyelids.

AFTER (age 60): two decades after surgery

AFTER (age 33): eight years after upperlid blepharoplasty using tarsal fixation.

A!-TER (age 31): uppet lid blepharoplasty

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AFTER (age 55): results still visible25 years following surgery.

BEFORE (age 25): hooded eYelids'

COSMETIC GUIDE 56

BEFORE

. . :.r:.].i .:.:..Afl LR: breasr augmcnrarionhy-DrAmira 5anLi.

BEFORE

AFTER: facelift and eye lift byDr'Warwick Nettle.

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AFTFR: rhinoplasty h1 Dr Paul Cerarchi.

,] BF,FORF

BEFORE

AFTF,R: breast augmentationby Dr Kourosh Tavakoli.

AFTER: mummy makeover byDr Alastair Taylor.

AFTER: breast augmentation- h1 DiCiaig Rubinstein.

I

:

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AFTER: rhinoplasty byDr !0arwick Nettle-

:: BEFORE

AF tfR: non-surgical I iposonixBEFORE

Results may vary from person to person

COSMETIC GUIDE 57