Cosmetic acupuncture is a non-surgical alternative to Botulinum Toxin Therapy, dermal skin fillers, microdermabrasion, IPL photo rejuvenation, chemical peels, fractional resurfacing or other cosmetic skin clinic procedures using the finest smoothest needles to reduce the signs of ageing. Cosmetic acupuncture is a complete system of facial rejuvenation and extension of acupuncture treatment, aiming at correcting the signs of ageing not only by using a local treatment but also by treating the underlying causes of ageing to revitalize overall health.

Extremely fine acupuncture needles are inserted into specific areas such as the face, neck, and head using gentle pain free techniques to stimulate and balance energy (qi) flow and ensure you have the most comfortable acupuncture experience. Depending on your constitution by the Traditional Chinese Medicine diagnosis, body acupuncture treating underlying health conditions is always applied as an added benefit of cosmetic acupuncture.  The insertion of needles in the distal parts of your body such as your hands or legs can balance the effect on the head and also helps with other physical conditions by addressing the imbalances in the body. Many people feel deeply relaxed during a cosmetic acupuncture treatment due to the effect acupuncture has on the hormonal system and therefore increasing relaxing hormones such as serotonin and endorphin.

Cosmetic acupuncture treatments may also incorporate other modalities and techniques such as the use of jade rollers (dermal skin rollers), gua sha and acupressure. Diet and nutrition advice, herbal formulas prepared to balance your body from the inside out may also be provided. The best results are experienced when all aspects of your health are re-balanced through the holistic approaches.

What are the benefits of Cosmetic Acupuncture?
Cosmetic acupuncture can erase years off your face within a couple of treatments, eliminating fine lines and drastically softening deeper lines. Sagginess, puffiness and drooping diminish and a fresh tightened sensation is often felt after each treatment. From a western medicine point of view cosmetic acupuncture enhances blood circulation to the tissues, which in turn nourishes and heals skin and increases the production of collagen and elastin.

What will Cosmetic Acupuncture treatment involve?
Cosmetic Acupuncture is actually a part of Traditional Chinese Medicine (TCM) and acupuncture. Each treatment will be an extended acupuncture treatment. It starts with a traditional Chinese medicine consultation and diagnosis such as questioning, pulse/tongue diagnosis, facial diagnosis to identify the imbalances in the body and treat the major organ imbalances that cause ageing and skin imperfections. A comprehensive cosmetic acupuncture treatment will be followed to specifically address on your cosmetic area of concerns. During the treatment, acupuncture needles will be inserted into body acupuncture points first to rebalance your energy, followed by local facial acupuncture points to focus on your area of concern. After the acupuncture needles are removed, dermal techniques such as gua sha, jade roller are used, which have an action of invigorating blood flow to the area. After the treatment, your skin maybe slightly reddened and this will fade quickly. It is recommended that you relax after your treatment, so organise times where you can take it easy and enjoy your feeling of balance for the rest of the day.

How many Cosmetic Acupuncture treatments will you need?
Each person responds differently to treatment but usually an improvement in skin tone and colour after the first session can be expected. More substantial and visible results are usually seen after about 6-8 treatments. A series of 12-15 treatments is recommended, with 1-2 sessions per week. Each treatment takes about 90 minutes. In-between you will be encouraged to perform facial massage, take herbal remedies and nutritional support in conjunction with lifestyle improvement such as regular exercise and dietary changes. Once the procedure is completed, results can last for a couple of years. Maintenance treatments at once a month can also be very helpful in maintaining the benefits.

What are the side effects and contraindications to Cosmetic Acupuncture?
Cosmetic acupuncture is gentle and safe treatment. The most likely post-treatment effect is feeling flushing of the face. This is quite normal and related to the increased blood circulation to the face. Occasionally minor and temporary bruising may occur at the site of needle insertion. This is usually painless and resolves itself after a couple of days. Cosmetic acupuncture is contraindicated if you have problems easily bleeding or bruising, migraine headaches, pregnancy, during cold and flu and during herpes simplex flare-up. However, we may perform body acupuncture treatment alone to treat the conditions before focusing on the cosmetic concerns.

If you would like to find out more regarding this service at Aquarius Health and Medispa, please call 0730095111 now or contact our friendly staff via email by clicking here or come into our Brisbane City CBD Day Spa at 70 Mary St, Brisbane.

The plantar fascia is a ligament that connects the heel bone to the toes and supports the foot arch and when it is inflammed can cause pain ranging from mildly uncomfortable to stabbing and debilitating. It is often  worse first thing in the morning when getting out of bed and initially applying pressure on the foot.

Traditionally it is treated with orthotic shoe inserts, stretching exercises and corticosteroid injections however a recent study suggested that Botox is superior to corticosteroid injections in the long-term.
Cosmetic Image Clinics is ordering a review of the available literature and may soon be offering this treatment. We love injecting Botox into people’s faces to rejuvenate and refresh and we also use it for the treatment of headaches and migraines, vaginismus, muscular twitches such as blepharospasm and excessive sweating in foreheads, hands and feet.

To further minimise pain, a vibrating instrument is often applied to the area being treated which limits the transmission of pain impulses to the pain fibres. This technique was recommended by the inventor of cosmetic Botulinum therapy, Dr Carruthers when attending a conference within Australia. This technique is now being trialled in some children’s hospitals to help with the discomfort associated with having injections.

We often use ice as well to minimise discomfort.

Taking two paracetamol tablets one hour prior to the procedure can also help. Avoid ibuprofen (Advil or Nurofen) as this can increase bruising.

If you are particularly anxious and have ‘needle phobia’, a short acting ‘Valium’ type medication can be prescribed one hour prior to the procedure at the clinic, however you cannot drive under the influence of these tablets until the effect of the relaxant has worn off.

For more invasive procedures, some people have used ‘Penthrox’ which is otherwise known as the ‘green whistle’ and has been commonly used by ambulance officers for the relief of pain. You cannot drive for 24 hours after the use of Penthrox.

We also have Nitrous Oxide or ‘laughing gas’ available at Cosmetic Image Clinics within Aquarius Health and Medispa which is an inhalant commonly used during childbirth. This is breathed in through a mask during the procedure and lessens pain and also has a temporary relaxant effect. The effects of this gas wear off very quickly after the procedure.

We know that most people are very nervous prior to their procedure and we endeavour to make you as comfortable as possible.

If you have any concerns regarding pain relief during your procedure, please don’t hesitate to ask us.

Facial slimming or jaw-line reduction with Botulinum therapy is a very common procedure in Asia and is becoming increasingly common within Australia. Botulinum therapy is used to slim down the jawline by reducing the volume of the chewing muscle known as the masseter.  (This is also performed to reduce teeth grinding, otherwise known as ‘bruxism’, and to help improve the pain of temporo-mandibular joint dysfunction).  The Botulinum therapy acts to cause a ‘thinning’ of the muscle, or atrophy of the chewing muscle or masseter. Facial slimming or jaw-line reduction can be performed by surgery however many people prefer to avoid a surgical approach if possible.

Facial slimming is much more common among people of Asian ancestry because of their predisposition to a more square and well-defined jawline due to a larger masseter muscle mass compared to people of European ancestry.  Facial slimming nonetheless is becoming popular world wide as people become more aware of the availability of this procedure.  Facial slimming creates a more oval or more feminine shape to the face instead of a more square shaped, or masculine type facial structure.  An oval face is often seen as a characteristic of beauty and femininity.  It also tends to make people look thinner despite there being no actual weight loss.

How long does Facial Slimming take to work?

It works differently compared to Botulinum therapy in other cosmetic treatments because it does not simply cause a relaxation of the muscle, which is commonly seen in two weeks, but rather an atrophy or thinning of the muscle mass which tends to take considerably longer.  Some people notice an improvement within two weeks due to the relaxation of the masseter muscle however this is not in fact very common.  It usually takes six weeks to two months before the weakness or atrophy of the masseter muscle sets in which means the cosmetic affect can take that long before the slimming of the face begins to occur. This is a cosmetic procedure that takes patience, similar to collagen stimulation of the skin.

What is involved with the procedure?

The treatment with Botulinum therapy is relatively pain free and only takes a few minutes to complete once the procedure has been explained.  Numbing cream is very rarely used because it is a very comfortable procedure.  Sometimes a vibrating instrument can minimize any discomfort associated with the treatment, and also ice can be used as well.

What are the risks?

As with any treatment with Botulinum therapy, there is a potential risk of asymmetry and drooping, however this is uncommon.  There is also a risk of narrowing of the smile however this is relatively uncommon in the treatment of Facial Slimming or jaw-line reduction.  Of course bruising is a possibility with any needle within the skin and can occur within approximately  25% of cases in this area however it is easily managed, and is usually small and subsides relatively quickly.

How much will it cost approximately?

The amount of Botulinum toxin is much higher than is commonly used in the treatment of the frown or crow’s feet because the muscle mass is considerably larger and it also works differently because instead of merely relaxing the muscles, it is necessary to cause a weakness or atrophy within the muscle.  Therefore doses are much higher than commonly used in cosmetic treatments, especially with commencement of the treatment.  Often doses of 60 up to even 100 units of the Botox trademark brand of Botulinum therapy (other brands include Dysport or Xeomin) are used initially to create atrophy of the masseter muscle.  This dosage can often be reduced at a later date to continue the cosmetic effect of facial slimming and to maintain the result. Often the longer you use Botulinum therapy, the longer it tends to last. Interestingly Caucasians or Australians tend to need less Botox to create a facial slimming effect compared to people of Asian extraction do due to their thinner muscle mass.

Often the cost of the Botulinum therapy for Facial Slimming commences around  $800 to $1000, however those on a budget can sometimes start in the $600 bracket however their cosmetic effect will take longer to kick in and they will need a top up sooner. The higher the dose of Botulinum therapy, the longer it tends to last and the stronger the effect.

How long does Facial Slimming last?

The more Botulinum therapy you have, the longer it lasts. The sooner you repeat it, the more dramatic the results. Having said this, most people are on a budget and commonly repeat the first dose 4 months after the initial procedure. After this, it is commonly repeated twice a year or so on average. The longer you use it, the longer the facial slimming procedure tends to last. Each person is individual and there is a bell curve of sensitivity to Botox, in other words, some people need a smaller dose than others do.

What are the after-care instructions for Facial Slimming?

After care instructions are negligible. You can lie down after the treatment with Botulinum therapy in this area and indeed you can resume exercise within a few hours of treatment if required. Alcohol can be consumed soon after this procedure and may slightly increase the risk of bruising however this is a negligible concern with Facial Slimming.  Chewing gum for an hour afterwards is recommended as utilizing the muscles where the Botox is injected into maximizes the absorption of the Botox into the correct musculature.  Some people express concern that the dose of Botulinum toxin in Botox jaw reduction is quite high in this procedure of facial slimming however this dose is still much lower than that used in children with cerebral palsy. Indeed much higher units than 60 units of Botox are often used by a well known plastic surgeon in Singapore who commonly uses 40 units every month for three or four months to increase the rate of onset of Facial Slimming.

If you have any questions or would like a free consultation please ring Cosmetic Image Clinics on  07 3003 4000 or email  us at info@cosmeticimageclinic.com.au or refer to our website at www.cosmeticimageclinics.com.au.

Do you have small breasts?

Do you experience feelings of self-consciousness, embarrassment or shyness due to breast size?  Do you experience difficulty in buying clothing due to imbalance in body proportions – wanting to be not too big but have “something?”

These are the complaints most commonly expressed by women requiring breast augmentation.

Breast augmentation or as it may be called “breast enlargement” is the enhancement of breast size by the placement of an implant.  The operation continues to be refined and is now a common procedure offering choices in implant size, shape, composition and placement.  All modern implants have a silicone outer shell but have various surface textures, fillings, sizes and shapes.

Many women have benefited from this procedure.  The most common request is from women who either never really developed what they considered enough breast, or women who have had children, then especially after breast-feeding, found their breasts empty and maybe sagging and “wanted them back again.”

Changing your breasts will not by itself change you.  If it gives you a higher self-esteem, or more self-confidence, or makes you just feel better about yourself then you will have achieved a significant benefit.

What do you do in a first visit?

Your individual concerns are discussed, so that your surgical choices can be fully explained including the risks, limitations and potential complications.  Pre-operative assessment is undertaken and the proposed surgery is explained.  After you have been fully informed of all aspects of the procedure including all expenses, you are encouraged, after having assimilated a large amount of information too re-present, if appropriate with your partner, and any aspect can be re-discussed, until you feel fully informed and comfortable to proceed.

How big will I be?

The size of the augmentation is dependent on your wishes, your breast shape and size and what is safe. At the consultation you will be given sizing implants to put in your bra to determine approximately what you would like.  Your chest measurements and breast envelope are measured and from this we can determine a range of appropriate sizes.  The final decision on size naturally rests with the patient and this process with guidance usually results in an appropriate outcome.

How is the procedure performed?

Once the important decisions have been made, surgery is booked.  The procedure usually takes about 1½ hours. On admission to the operating suite, the nurse will check all of your details and give you a quick pre-op assessment. The Anaesthetist will also examine you prior to the procedure and your pre-op photos are taken and you are marked out for the surgery. On completion of the surgery you will be in recovery for at least an hour until you are properly awake and ready to go home. You must have a Carer who will help look after you. You will also have an appointment for your first post-op check the next day.

An antibiotic is given to even further reduce the possibility of capsular contraction, which may be associated with infection.  You will experience some post-operative pain naturally but this is managed with oral medication.  Placing the implant under the muscle may have a slightly more difficult recovery due to the reaction of the muscle which may spasm and cramp from time to time.  An anti-spasmodic medication is usually given in this case.  There are times when placement either in front or behind the muscle is appropriate and this needs to be discussed before the procedure.

After the procedure

Naturally there will some post-op pain and a feeling of ‘tightness’ for a few days after the procedure. Oral medication is usually all that is required. Light activities and showering recommence the day after surgery and normally you can resume driving a car after a few days. You should avoid vigorous activity such as gym or cardio workouts or jogging or running for about six weeks.

What sort of scarring can I expect?

Depending on your choice and surgical necessity, an incision is made either around the lower part of the nipple, beneath the breast (usually in a skin crease) or under the arm.  There are advantages and disadvantages with all these options and they need to be discussed properly beforehand. Scarring varies considerably between individuals and ranges from almost invisible to being raised and itchy or reddened.  Most women are between these two extremes and scars will continue to improve for up to 12–18 months. To minimize scarring we use buried and dissolving sutures and where necessary special supportive garments and taping of the suture lines. The average scar is around 5cm.

How long does it take to recover?

Breast augmentation is usually performed as a day procedure.  You will be encouraged to walk a little from day one. You can shower normally on the first post-op day. Everyone feels better after a shower and washing your hair. Gentle every day activities, including driving a car can usually be resumed after a few days, as long as they don’t cause discomfort.   Any sporting activities that could stretch the incisions and cause a wider scar are to be avoided for six weeks.  All sutures used are buried and dissolving but to minimize scarring, the suture lines are supported with tape and a bra or supportive garment is best worn for the following six weeks.  The intention is from day one to start commencing a healthier active lifestyle, but to get the best healing you do need to look after yourself and not rush into anything.

Some Common Questions

Smooth, textured, or polyurethane implants?

This really relates to the type of surface on the shell of the implant and the effect if any on capsular contraction. There has been much debate about smooth or textured implants and whether or not there is any difference in capsular contraction rates. In extensive studies there does not seem to be any significant difference with either of these. The polyurethane implants do have substantial data to show a marked reduction in contracture rates. These are sometimes referred to as “furry” or “Brazilian” implants. All types are available in our practice and this is one issue which should be discussed.

In Front or Behind?

This concerns the placement of the implants and whether they should go “in front of the muscle” or “behind the muscle”. The “muscle” is the pectoralis or “chest muscle”. The natural position of the breast is in front of the muscle but in some very slim people putting the implant behind the muscle is preferred because it helps to disguise the appearance of the implant. There is also a technique called “Dual Plane” which can have some advantages in certain circumstances. Each technique has its own advantages and potential disadvantages and needs to be discussed.

What should I tell my partner?

We strongly recommend your partner to be part of the consultation, and whilst it is totally your choice we believe it important they know what is going on.  It must however be strongly emphasized that no surgery is ever performed at the request of the partner, as this is purely your personal decision.  However we have found that invariably the partner has been highly supportive and encouraging, as they too have concerns and a supportive home environment makes the process a little easier.

What should I do if I want to have more children?

If you definitely intend having more children soon we would certainly advise you defer surgery until you have completed your family.  It is not that the surgery would be dangerous but that everything would stretch and you could lose the benefits of the procedure.  Breast augmentation should not affect breast-feeding.

Does it hurt?

You are likely to be uncomfortable for several days.  Any post-operative pain is usually easily controlled with medication and this is also organized for when you go home.

Are there any risks?

As with any surgical procedure there are risks, limitations and potential complications. Any surgery carries risks, which include infection and post-operative blood clots.

The most troublesome complication of breast augmentation is capsular contraction which affects around five to ten per cent of patients. All patients form a capsule around their implants. Most commonly it is of a soft, silky texture. Sometimes this capsule becomes thickened and may contract, causing the implant to feel hard and uncomfortable. This may also cause the implants to become more obvious. Secondary surgery may be required to manage this problem.

Implant rupture can occur and the incidence is usually quoted as being approximately 10% at 10 years post operatively.  Implant rupture requires corrective surgery.

Sometimes there may be rippling with implants. Infection is very uncommon but if it does occur then it can be quite serious and may require the implants to be removed. They can be replaced after about three months. Displacement downwards or toward the armpit is possible but uncommon and may require secondary surgery. Nipple sensitivity may be altered or they may become completely numb. This could be a temporary problem but sometimes this is a permanent change. Numbness may also be seen in the lower portion of the breast.

Most of us are not symmetrical, that is we are different from left to right. This occurs with breasts as well and so asymmetry may be noted after the surgery. If there is a large asymmetry noted before surgery then this might be corrected by using different sizes of implants.

Anaesthetic may cause nausea and/or vomiting so if you have had this problem with anaesthesia in the past then make sure you let us know to properly manage this, chest problems and rarely death may occur as a risk of operation.

A very important part of your consultation is a detailed, full explanation of these potential complications.  As with any procedure you need to be as fully informed as possible so that you can make an informed decision.

Will I have to wear special garments?

Usually a supportive bra without under wire is recommended. You will need to wear it for 6 weeks to encourage a nice shape to the breasts.  We will supply a post-op support bra for you. The suture lines are supported with tape usually for 6 weeks but these are water resistant and will not affect your ability to shower.

Dr John Flynn
Cosmetic Surgeon
Cosmetic Image Clinics
70 Mary St
Brisbane Qld
0730034000
www.cosmeticimageclinics.com.au

What are some of the most common benefits of a chemical peel?

A chemical peel can restore a more youthful appearance to wrinkled, unevenly pigmented, sun-damaged, or blotchy skin. However, a peel cannot reverse the ageing process or completely remove deep scars. Wrinkled skin that is loose and sagging may also require a face-lift, laser resurfacing treatment, radio-frequency fractional resurfacing such as the Fractora, or a combination of procedures for best results.

How is a chemical peel performed?

All chemical peels involve applying a chemical solution to remove the outer layers of skin so that a smoother, more evenly pigmented, glowing layer of skin can appear. There are a few basic categories of chemical peels (Alpha Hydroxy Peels, Beta Hydroxy peels including the Jessner’s Peel, Retinoic Acid peels, Trichloroacetic Acids and Phenol Peels).  Each type works differently and produces different results.  Our clinician may choose from the following types of chemical peel however our preference now is to replace the Phenol peel with alternatives such as the Fractora fractional resurfacing radiofrequency machine by Invasix. Our clinician or therapist will tailor the treatment to the needs of the patient’s skin. In general, the stronger the chemical, the deeper the peel; thus, the more impressive the results will be. However, the deeper the peel, the more discomfort the patient is likely to experience and the longer the recovery time will be.

Light peels: Alpha Hydroxy Acids (AHAs) or Beta Hydroxy Acids (BHA’s) or “lunch hour” peels are the mildest of the chemical peels. These peels include glycolic, lactic and fruit acid peels (AHA or Alpha Hydroxy Acids) or Salicylic Acid (BHA or Beta Hydroxy Acid) and Jessner’s Peel. They burn off only the outer layers of the skin (epidermis) to smooth out fine wrinkles and/or rough, dry skin. AHA and BHA peels may also be used to improve the texture of sun-damaged skin, balance out skin pigmentation and diminish some types of acne scars. Salicylic Peels tend to be better suited for skins prone to acne and Lactic acid peels better for sun-damaged skin. The Jessner’s peel is ideally suited to treat pigmentation or melasma and chloasma. These peels are often repeated several times over a short period to achieve the desired results.

The application of AHA, BHA, or Jessner’s peels is relatively fast and simple. No sedation or anaesthesia is required, since the patient only experiences a slight stinging when the solution is applied. The treatment usually takes about 10 to 15 minutes, but the clinician may vary the concentration of the chemical solution or the length of time of the treatment.

The clinician will begin by thoroughly cleansing the area to be treated. Next, he/she will apply the chemical peel solution, wait up to 15 minutes and then remove it if required. After the procedure, no ointments or salves will be necessary to cover the treated area. Monthly or bi-weekly repetition is common. Make-up can be applied immediately after the treatment and many people go straight back to work after the treatment.

Medium peels: Trichloroacetic Acids (TCA): A TCA solution is used for medium depth peels. This peel is generally used to treat skin with moderate sun damage, surface wrinkles and/or uneven tone or pigment abnormalities. Full-face TCA peels take approximately 2 to 15 minutes.

Before applying the chemical solution, the clinician will thoroughly cleanse the area to be treated.  TCA peels often do not require anaesthesia because the solution itself has a numbing effect on the skin. At first the patient may feel a warm or burning sensation followed by stinging. Sometimes two or more TCA peel treatments are necessary to achieve the desired results, usually at intervals over one to two months. The TCA peel can be used in varying concentrations, the higher concentrations may require oral or liquid anaesthesia medication.

Deep peels: Phenol Acid:  Phenol acid is the strongest chemical peel solution and it is used for the deepest possible chemical peel. Phenol peels are used to treat skin with coarse wrinkles and blotchiness. They may also be effectively used to treat patients with pre-cancerous growths.

Phenol peels should be used with caution because they can cause permanent lightening of the skin and they have an increased risk of scarring due to the depth of the peel. For this reason, Phenol peels are not performed generally in Cosmetic Image Clinics.

Common Questions relating to Peels

How long does it take?

AHA and BHA peels (glycolic acid, lactic acid, salicylic acid and Jessner’s Peel) and TCA peels for the full face generally take 10 – 15 minutes.

Where will the procedure be performed?

They are all performed in Cosmetic Image Clinics. If performed in conjunction with another procedure, such as a facelift, the chemical peel may be performed in the hospital.

How much pain is there?

During the procedure, most people feel a brief burning sensation, followed by a feeling of numbness or stinging. The sensation will vary depending on the type of peel as well as the possibility of pain medications in the case of deep peels. The AHA and TCA peels are uncomfortable only during treatment.

The recovery period is different for each type of peel.

Light peels: Alpha Hydroxy Acids (or AHAs such as glycolic acid, lactic, malic) peels and Beta Hydroxy Acids (or BHA’s such as salicylic acid and Jessner’s Peel) generally cause some flaking, redness and dryness, or skin irritation. These side effects diminish over time. Once the body heals itself naturally, the outer layer of skin will fall away. Patients are usually able to engage in normal activities straight away after a light chemical peel.

Medium peels: Trichloroacetic acids (TCA) peels may cause significant redness and exfoliation depending on the potency of the chemical solution that was used. The exfoliation process will subside within a week. There is no need to take time off work to have this peel.

Deep peels:  After a deep peel, the physician may prescribe a mild pain medication to relieve any discomfort. If a waterproof adhesive is applied to the treated area, it will be removed in 1-2 days, and you’ll be instructed to cover the area with antiseptic powder several times a day. A scab will form and, within 7-10 days, new skin will form. While the skin will be red at first, the colour will lighten over a few weeks to a few months.

Following any peel, it is critically important that the skin be protected from the sun. After the procedure, the clinician may recommend that the patient stop smoking for at least a week. Smoking decreases circulation of the blood in the skin, which can slow your recovery.

How much does the procedure cost?

Alpha Hydroxy, Beta Hydropxy peels and Jessner’s peels cost approximately $90 for each treatment. Patients will require a series of treatments to achieve the desired results. The clinician will discuss the number of treatments that you will require.

TCA peels may cost between $90 to $500 for the series of peels.

Note:  Cosmetic Image Clinics does not offer any Phenol Peels because of the invasive nature of the peel.  At Cosmetic Image Clinics, we prefer using Fractora Radiofrequency Resurfacing (by Invasix) to achieve a controlled rejuvenation which can provide a lighter or deeper peel, according to the energy settings.

I occasionally like to do an half ampule to give a lovely, subtle and natural look to the lip, which is cost effective for people on a budget. (The cost is $400).

A small amount is injected into the lip line border and the Cupid’s bow is enhanced with a subtle ‘micropearl’ drop into the top of the central columns of the Cupid’s bow.  The central portion of the bottom lip is often augmented to give a slightly more voluminous look. Often this smaller amount requires no lip or dental block (some numbing cream beforehand is used) and the swelling is usually  minimal with a half ampule.  Indeed, people often can get this done at the end of the working day and be back at work the next morning.

Sometimes people come in showing us photos of movie stars or models whose lips they admire.  To be perfectly honest, it is not really possible to dramatically change the shape of a lip with filler. You can modify the shape of your lip and enhance certain features.  You can lift up the corners and add volume, increase the Cupid’s bow and make the lip border more distinct and increase the volume of the body of the lip, however you cannot truly drastically alter the shape.

A lot of people don’t have their lips injected because they fear it’s going to be very painful. I often give a lip block (sometimes known as a dental block) and infiltrate a small amount of local anaesthetic just on the inside of the gum line which numbs the lips generally very well. Also, some numbing gel can be placed on the gum beforehand so the needle prick is less uncomfortable. (I also like to use a vibrating tool on the chin or cheek to minimise the discomfort as well).

Sometimes you can feel a little bit of discomfort in the corners of the mouth or in the centre of the lip, however, overall usually the lip feels very numb.

The next thing that people often say when they come in for the consultation is that they don’t want to have “fish lips” or “trout pout”.  This happens when too much filler is injected into the lip border, especially in younger people who have distinct and already full lip borders.

In more mature people, the lip shrinks considerably as we age and the lip line border can become softer and more poorly defined, especially in smokers, wind instrument players, whistlers or even people who unconsciously store tension in their lip.

Injecting into the lip border in these circumstances really adds volume and creates a more youthful looking lip.  However one should never overdo this.  It is best to inject the body of the lip more, rather than infiltrate too much in the lip border.

The ratio of the top lip to the bottom lip is said ideally to be 1: 1.6.  This means, the bottom lip should be approximately 50% bigger than the top lip.

Asiatic people have a tendency to admire lips where the top and bottom lip are in equal proportion.  Australians have a tendency to admire a more voluptuous bottom lip compared to the top lip.

Not only is the lip body important, the lip corners are, as well.

As we mature, our lips turn down in the mouth somewhat, so we can look stern, serious or glum.  Some filler injected into the corners of the mouth can elevate the corners and give a playful subtle smile to the mouth which can significantly change the overall expression in the face.

Also, above the lip is important as well.  The vertical lines in the upper lip in a mature aged person are often called the ‘barcode’ to a woman’s age.  These occur when people have smoked or they are chronic pursers of their lip. Some people just carry more tension in their lips and purse them more often and it’s these people who tend to have more vertical lip lines.  These can be softened with filler.  It’s impossible to make them go away altogether, however you can improve them.

Permanent fillers can be used in the lip; however there is an old cosmetic adage saying, “permanent fillers, permanent problems”.  I have used a permanent filler in the past, however had one patient that ended up with a chronic red and inflamed area due to an immune reaction to the filler.  It’s very difficult to remove permanent fillers and my inclination is not to use them.  However the incidence of problems are really low and I know many reputable injectors and surgeons who use permanent fillers . It is my personal choice not to. There are however surgeons in our practice who use permanent fillers if you would like them.

Whichever way you go, it is important to see someone who has had lots of experience in injecting lips. There is an artistry to it and the secret to success is making them look natural.  There is nothing worse than a person’s lips entering the room before they do.

The good news though is, if you don’t like your lips, you can always use an injection to remove or dissolve the hyaluronic acid dermal filler called hyaluronidase.. This does cause swelling though and potentially bruising like any injection to the lip.  Remember, though, it takes time for the swelling to settle and also it takes some time to get ‘used to’ the new look.  It is often like a new hairstyle. When you first get it, you want to go home and wash it out.  It is the same with lips, it takes a while to get used to the new look.  Initally the swelling is difficult to deal with, then people tend to get used to the swelling and then miss it when it disappears. A little swelling even persists for up to two weeks and when that disappears, people have often already forgotten how their lips used to look and feel as if they cannot even see the difference after the lip filler. The self image adjusts very quickly to the new look and memory is short of how we used to look. That is one of the reasons why it is very important to take a photo prior to the procedure.  We will do that in the clinic however it is a good idea for you to take one , even on your mobile phone, prior to coming in.

Another new technique I am using more often is the new needlefree microcannula. This is a very small blunt cannula or tube which is gently inserted into the lip and has a lower incidence of discomfort, swelling and bruising. It is $20 more to purchase the cannula however for many it is money well spent.

Excessive sweating causes social embarrassment due to the sweat marks which are evident on their clothes.  Often people find they can only wear certain coloured clothing because of the ‘tide marks’ of sweat.  Also for some, a malodour associated with perspiration is problematic. Others report an acute problem when they are publicly speaking or when they are under stress.

It is always prudent to undergo a thyroid function blood test to ensure that the thyroid hormone is not overactive as this can cause excessive sweating.  Many people try numerous types of anti-perspirants without success. Also some consider undergoing an operation called a ‘Lateral Sympathectomy’ which is a surgical laparoscopic procedure that severs some of the nerves running along the spine which control the sweating reflex.  Many people find this option rather intimidating and prefer to use botulinum therapy (Botox or Dysport) to minimize their sweating.

Excessive sweating can occur under the arms, on the hands, on the forehead and on the feet.  The simplest area to treat with botulinum therapy is the under-arms.  The Allergan (the company that produces Botox) recommended standard dose for this area is 100 units. Less can be used and some elect to have a half dose, however it is not as strong and the anti-perspirant affect does not last quite as long. The average duration of treatment is approximately seven months.  It takes three to five days for the Botulinum therapy to begin to work, and two weeks before it has fully kicked in.  Generally people notice hardly any sweating whatsoever for the first couple of months after treatment however thereafter some mild perspiration is noted. This is generally less than what an average person would experience with respect to sweating under the arms.

Usually people elect to have numbing cream applied to their under-arms prior to their Botulinum therapy injections.  This is generally applied approximately half an hour prior to the procedure.  Often a ‘starch iodine’ test is used prior to the injections to assess where the sweat glands are concentrated.

Side effects from the treatment of hyperhidrosis under the arms are usually mild.  There are some raised mosquito bite marks for approximately an hour after treatment.  Also mild bruising is often encountered at the injection site.  A very rare side effect is muscular weakness however the muscles are very deep in relation to the under-arm area and this is highly unusual.  Allergies to Botulinum therapy are rare.  There are also rare occurrences of antibodies or immunity developing to Botulinum therapy but this unusual phenomenon and usually only occurs when doses of more than 100 units are used.

There is no aftercare required for treatment of excessive sweating under the arms.  It is recommended antiperspirant is avoided for 24 hours prior to treatment and for 24 hours after.

Botulinum therapy is a simple and effective treatment for excessive sweating or hyperhidrosis and can improve affected people’s quality of life.

These natural growth factors are injected into your scalp after an application of numbing cream, using a fine ‘needle free’ cannula which irrigates your scalp with your own plasma to stimulate and thicken your own hair. The procedure takes about an hour.

Click here for an article in Cosmetic Surgery Magazine on cannulas.

Our Cosmetic Doctor has brought this latest procedure for restoring hair loss in men and women from Dubai to Cosmetic Image Clinics in Brisbane and provides an artistic approach to creating a natural result using local anaesthetic only.

This method replaces hair follicle units one by one to avoid the clumpy, artificial hair transplant look and is virtually pain-free. The procedure is done as a day case in our clinic in Mary St, Brisbane. You can relax and watch a movie while your hair is being restored.