Melbourne Cosmetic Medicine  treats a wide range of common concerns of the ageing skin and other appearance related conditions.

 

 

 

 

Acne is not just a teenage problem. Many people suffer from acne well beyond this age. There are now many medical options to help acne, including correct skincare advice, and topical and oral therapies. Treatment could prevent the life-long complication of acne scarring, if it is begun in time. Acne is caused by a combination of genetic, hormonal and local factors. The bacterium named P.acnes has also been implicated as a cause of acne.

 

There are many products available to treat acne. Popular over-the-counter options include Proactiv, Clearasil and Benzac. Topical  prescribed treatments consist of antibiotics (eg. Eryacne or Clindatech), vitamin A derivatives (eg. Differin, Retin-A or Stieva-A) and combination products (eg. Duac or Clindabenz). Hormonal manipulation to decrease the male acne-causing hormone androgens is achieved by using contraceptive pills such as Diane-35 or Yasmin. More serious acne is usually treated with a 6 month course of oral antibiotics such as Doxycycline, Minocycline or Bactrim DS. The most severe cases of acne may respond to a 6 month course of Roaccutane or Oratane, which is associated with significant side effects such as severe dry skin and lips, liver impairment, depression etc, and can cause serious birth defects.

 

For milder acne, a combination of glycolic acid products from ASAP skincare and topically prescribed combination products should be sufficient. Moderate cases of acne may in addition require oral antibiotics and/or the contraceptive pill. If there are side effects, or for optimal results, a course of blue light intense pulse light (IPL) treatments to kill the acne causing bacteria may be beneficial.

 

Besides Roaccutane, severe cases of cystic or inflammatory acne may respond to Photodynamic Therapy (PDT), where a compounded pharmaceutical called 5-AminoLevulinic Acid (5-ALA) is applied for up to an hour, which is preferentially absorbed by the sebaceous (oil) glands and acne causing bacteria. 5-ALA is activated and destroys these cells when exposed to blue light IPL. PDT is extremely ideal for those intolerant of Roaccutane and it's side effects, or who have failed a course of Roaccutane. PDT is not suitable if you are pregnant or breast feeding, have a history of keloid scarring or photo-sensitivity, or have taken Roaccutane in the last  6 months. It is very important to wear sunscreen and stay out if the sun for 48 hours after PDT treatment.

 

 

All scars are permanent features of the skin, however their appearance maybe reduced or modified by the use of lasers. A big step forward in treating acne scars occurred with the advent of fractional lasers. These treat pixel-fashion (rather like a digital photo) by affecting the skin down into it's deeper layers to produce more collagen fibres and incorporate the scars better into surrounding tissue.

 

A series of treatments is required with results increasing for several months afterwards. A few days of swelling and some redness is expected but the skin is intact and is treated as normal after each session. Other forms of treatment for acne scarring include dermal fillers, skin needling and various forms of resurfacing procedures.

 

At Melbourne Cosmetic Medicine, the fractional laser we use is the highly acclaimed ProFractional. The treatment is fast and comfortable, and we recommend a series of 3-5 treatments, spaced about a month apart, to produce about a 50% improvement in acne scarring. As the skin is sun sensitive after treatment, it is important to avoid direct sun exposure until fully healed.

 

 

 

Sweating is a normal function of human skin but excessive sweating can be extremely debilitating. The armpits are most frequently affected, with palms and soles of feet being next in line. Other areas of the body may also sweat excessively. Sufferers of hyperhidrosis often go to a great extent to conceal their condition, with multiple changes of clothing, avoiding white shirts, frequent showers, trying multiple anti-perspirants, and having much higher laundry and dry cleaning bills.

 

The most common self-prescribed treatment is an anti-perspirant, which should ideally be used twice a day, for maximal efficacy. The most effective over-the-counter product is called Driclor, which contains 20% aluminium chloride, and is for overnight use only. Probanthine, a prescribed medication, produces variable results, and is often associated with side effects such as drowsiness and blurred vision.

 

Iontophoresis has proven effective for hyperhidrosis of the hands and feet with limited use for the armpits. Iontophoresis is defined as the topical introduction of ionised drugs into the skin using direct current. The way iontophoresis stops excessive sweating is unknown. It is speculated the treatment causes the sweat duct to be blocked by formation of a thick plug.

 

Surgical options for treating excessive underarm sweating include liposuction. An older operation called endoscopic thoracic sympathectomy, which surgically disrupts the nerves causing sweating, has fallen out of popularity, due to the risk of compensatory hyperhidrosis of untreated areas, eg. face or chest.

 

The most popular treatment today for underarm hyperhidrosis is the injection of botulinum toxin, which is commonly used for treating wrinkles of the face, but can also decrease sweat production to more normal levels in the underarms. Usually a vial of 100 units of botulinum toxin is required. There is no downtime, and results last 6-8 months.

 

For more information on hyperhidrosis: www.botoxseveresweating.com

Attractive female role models portrayed in the media usually conform to the universal image of beauty: flawless skin, wide eyes, high cheek bones, full lips and a slender jawline. Having a square jaw caused by having a bulky muscle mass over the angle of the jaw (mandible), is frequently perceived as masculine by some females, and is more common in those of Asian descent. The traditional method of treatment is an extremely invasive operation called mandibular angle osteotomy, which reduces the bony mass of the jaw. The most popular treatment today is to inject 25 units of botulinum toxin into each muscle bulk, called the masseter,  which decreases the muscle mass, and thus the squareness of the jaw. For those who suffer from bruxism and grind their teeth at night, this procedure is also ideal. This treatment has no downtime, and lasts about 4 months.

 

 

Unwanted hair can be quite normal but undesirable (eg. bikini lines, armpits etc), or can be abnormal in amount, thickness or location. It is important to diagnose contributing medical conditions prior to beginning any treatment to remove unwanted hair.

 

Laser hair removal opens the door to carefree swimsuit wearing or baring bodies in the gym, as well as getting rid of hair growing in places you mum did not warn you about. The advantages: no more shaving, waxing, ingrown hairs, red irritated skin or time consuming rituals. Although waxing is still the most popular method of hair removal, laser hair removal is gaining in popularity. The benefits of laser hair removal includes:

- Less painful than waxing, plucking or electrolysis

- Faster than waxing and electrolysis

- Permanent hair reduction

- Hair growing back is reduced even after only one treatment

 

Most of what is thought of as laser hair removal is now a laser like technology called intense pulsed light (IPL) or Broadband Light (BBL). This is newer, faster, more comfortable than the original laser hair removal techniques. A course of 4-6 BBL treatments every 6-8 weeks can results in long term hair reduction, reducing the need for shaving, plucking and electrolysis. A series of treatments is needed as there are three phases of hair growth, and only hair in the active growth phase, anagen, can be successfully treated. This treatment is less ideal for darker skins due to the risk of pigmentation. For best results, do not pluck, wax or tan the intended area for at least a month before treatment.

 

 

When most people hear the words lip enhancement, they think of the very pouting lips of Hollywood starlets, eg. Angelina Jolie. However for the vast majority of women who seek lip enhancement, they simply want a tasteful filling, or return in balance and volume, for fuller natural looking lips. For some women, they have naturally thin lips, while many others have lips that thin with age, especially the upper lip. Thin lips and associated upper lip lines appear ageing, and cause lipstick to bleed.

 

By using a non-permanent natural product like hyaluronic acid to restore lip volume, more luscious and kissable lips can be achieved instantly. Results tend to last 4-6 months. Permanent fillers are not recommended on the lips and face as they change shape with age, and that which appears natural and beautiful today, may lead to an unnatural looking mass when tissue volume loss caused by ageing occurs. Permanent fillers are also associated with permanent side effects, which can lead to significant scarring and distortion of the facial anatomy.

 

 

While diet and exercise are the mainstay of any good weight loss regimen, for those who are at their desired weight, there may still be some undesired bulges which just won't shift. Lipodissolve or lipolysis actually dissolves fat, helping to remove even stubborn fat without the need for liposuction. People need to keep in mind that this treatment is not a method of weight loss, and is not suitable for large fat deposits. It is simply designed to treat specific localised deposits of fat, which cannot be reduced with appropriate diet or sincere efforts at exercise. It also does not replace liposuction.

 

Areas which are suitable for injection lipolysis include the abdomen, the area in the back below the bra strap, loose skin under the arms, love handles, saddle bags, inner thighs and the knees. For example, many middle-aged women have difficulties with their upper abdomen. With menopause they often develop two very well defined rolls of fat right under the rib cage. They find these annoying because the rolls show under clothing when they sit, and even with lots of exercises, these fat deposits refuse to shift. Except for liposuction, up until now there was no effective method to treat this localised fat. Now injection lipolysis can be used to dissolve that fat.

 

The benefits of injection lipolysis are it's effectiveness, ease of treatment and quick recovery. It is also a significantly cheaper option than liposuction. People may notice some bruising, but unlike liposuction, will not need any time off work, or need to wear compression garments for several weeks. There is no need for anaesthesia and discomfort after treatment lasts for only a few hours. Contra-indications include diabetes, pregnancy, breast feeding, morbid obesity and various medical conditions or allergies.

 

For optimal results, we recommend combining lipodissolve or lipolysis treatments with a healthy diet and an exercise regimen. A course of 2-4 treatments about 2 months apart is usually needed.

 

 

Skin sags and becomes loose due to loss of volume from underlying tissues (age, weight loss), loss of skin tone (age, sun damage) or loss of muscle tone (injury or disease). While surgery may be an option, it may not be desirable, practical or appropriate, and non-surgical options may be sought.

 

Lasers, light sources and radio-frequency devices may be used to produce a gradual contracting effect on skin and deeper tissues. This effect is never as great as can be produced through surgery and generally the lifting effect increases gradually over a period of 6 months. The face as well as the body (neck, upper arms, abdomen etc) maybe treated, with best results occurring on areas that do not have excess fat. These procedures are usually relatively comfortable with no, or little, appreciable downtime. There is no special prior preparation or aftercare involved with these treatments.

 

At Melbourne Cosmetic Medicine, we use an infrared light called SkinTyte to tighten the skin by causing deep collagen contraction, which is safe for all skin types and all areas of the body, with no downtime. SkinTyte is ideal as a non-surgical face-lift  to treat the lower face and neck, and thus helping to define the jawline better by tightening the jowls. SkinTyte is also used to tighten loose abdominal skin after pregnancy and weight loss.

 

 

Excessive sun exposure or inflammatory skin conditions such as rosacea or acne may lead to either coarse or crepey skin. The greatest enemies of the ageing skin are the sun and cigarettes. Treatments to improve this may vary from improved skincare to IPL / laser treatments. .

 

The best skincare and anti-ageing product available in the market today is the SPF 30+ sunscreen, preferably containing a physical block such a Zinc Oxide or Titanium Dioxide. Sunscreens should be applied at least 20 mins before sun exposure, and reapplied every 2 hours. It is also recommended to follow the 'slip, slop, slap' advice by wearing a hat, sunglasses and protective clothing, and staying out of the sun between the hours of 11am and 3pm. The best tan is a spray tan or a from a bottle of self-tanning lotion. Tanning in the sun or the solarium not just accelerates skin ageing, but is also associated with deadly skin cancers like melanoma.

 

Stopping smoking is the next best skincare secret. Smoking is not just associated with cardiovascular diseases and multiple cancers, but also accelerated skin ageing due to skin damage and tissue loss from the nicotine. Smokers often have thin dry skin and a sallow complexion, and can look up to ten years older than their non-smoking counterparts. Strategies to quit smoking include contacting the Quit helpline on 131 848, nicotine replacement with patches and gums, prescribed medications like Zyban or Champix, hypnosis and acupuncture.

 

At Melbourne Cosmetic Medicine, we recommend the ASAP range of skincare products, which contain an alpha hydroxy acid called glycolic acid as it's main ingredient, and is ideal for acne and sun damaged skin. We also recommend prescribed topical vitamin A and topical vitamin C. Compounded prescription medications are also available to treat pigmentation problems from sun damage.

 

Professional peels performed in the clinic not only complement, but also enhances the results obtained from the ASAP home skincare routine. We recommend both the Glycolic Acid and Modified Jessner's peels, which are superficial chemical peels with little downtime following treatment. A series of regular peels will benefit clients suffering from acne, blocked pores, fine lines and wrinkles, dry and scaly skin, superficial scarring and irregular pigmentation.

 

 

Ageing of the face is often associated with dull skin, brown marks, red veins and wrinkles. Most of these changes occur as a result of sun exposure over many years.  For tired looking skin with enlarged pores, poor texture, fine lines, small veins, redness, age spots and other blemishes associated with ageing and an active lifestyle, significant improvements can be achieved with a series of pulse light treatments, targeted to treat the appropriate concerns.

 

At Melbourne Cosmetic Medicine, the technology we use is called Broadband Light (BBL), an improved version of the Intense Pulse Light (IPL). After a series of treatments, your skin should appear smoother, more vibrant, and have a more youthful appearance. We recommend 2-5 treatments, at monthly intervals, to produce the desire results. This treatment is non-invasive and simple, with virtually no downtime. When combined with MicroLaser Peels and fractional resurfacing with ProFractional, the improvements seen can be more dramatic.

 

 

There are many types of brown spots and these must be medically assessed before any treatment is performed. While most are quite safe, some are not. For example, melanoma is a serious life-threatening form of skin cancer which must be surgically treated as a matter of the utmost emergency. Many other types of  pigmented spots such as freckles can be treated non-surgically.

 

Background pigmentation can arise from a variety of causes, including excess sun exposure, inflammation of the skin, or hormonal stimulation. It may also be a birthmark. Methods of treatment for brown spots include various forms of laser and light source treatment and some special creams.

 

Most sun or age spots caused by excessive sun exposure can be reduced by a series of 2-5 monthly  Broadband Light (BBL) treatments, which is sometimes combined with prescribed compounded depigmenting or bleaching creams. Deeper pigmentation like melasma (associated with the contraceptive pill) can be helped with MicroLaser Peels and fractional laser resurfacing with ProFractional. It is important to wear sunscreen and stay out of the sun to maintain the results achieved.

 

 

Red cheeks or visible blood vessels maybe a result of chronic environmental damage (usually sun), trauma (accidental or surgical), or could be a sign of a medical condition called rosacea. Rosacea is characterised by redness of the face, especially the cheeks and nose. The cause of rosacea is unknown, and it is frequently associated with acne pustules, in a condition called acne rosacea. Sufferers of this condition appear constantly red on the face, with visible broken capillaries.

 

Rosacea is commonly triggered by stress, hot and spicy foods, alcohol, sunlight etc, and the first step in treatment is to avoid these triggers. It is helpful to wear a SPF 30+ sun block, and to use gentle skincare products, eg. Cetaphil. Topical prescribed treatments include an antibiotic gel called Rozex, and an anti-inflammatory gel called Finacea. Oral antibiotics such as Doxycycline and Minocycline have also been used with success, if there is inflammation present. In severe acne rosacea, Roaccutane has been used, but is associated with significant side effects like dry skin and lips etc.

 

The modern treatment for rosacea, facial redness and broken capillaries is to use Broadband Light (BBL), with filters selected to shut down the blood vessels causing the redness. A series of 2-6 treatments, about a month apart, can produce significant reduction in redness. This treatment is non-invasive and gentle, with virtually no downtime.

 

 

 

Wrinkles begin as fine depressions in the skin surface. They are initially "dynamic", only present with movement, and later become "static", also present at rest. With more time and sun exposure, they can become fibrosed, and still be present despite stretching the skin. Excessive sun and environmental damage may also lead to other wrinkles which are not movement-related.

 

Some types of wrinkles include:

- Crow's Feet: wrinkles at the corners of the eyes

- Frown Lines: wrinkles between the eyebrows

- Forehead Lines: wrinkles in the forehead, usually horizontal

- Smile / Nasolabial Lines: wrinkles from the side of the nose past the corner of the mouth

- Sleep Lines: wrinkles almost perpendicular to crow's feet, forehead lines and adjacent to the nose

- Bunny Lines: wrinkles due to nose scrunching

- Chin Lines: horizontal creases above the chin

- Smoker's Lines: vertical lines around the mouth due to a pursing action

 

Lines on the face are of two basic types: static and dynamic. Dynamic lines are created by movement of the facial muscles immediately under the skin. It has been shown that by reducing or even totally stopping the movement of the muscle, that the lines will soften or even totally disappear. The most effective areas to treat are the upper part of the face: the frown lines, forehead lines, and the smile lines around the eyes called crow's feet.

 

Reducing the movement can be achieved by injecting into the facial muscle a tiny amount of botulinum toxin. The dose of botulinum toxin required depends on the areas treated and the extent of the wrinkles, and will be individually titrated during the consultation. As a general guide for women, the average quantity of botulinum toxin for frown lines is 20-30 units, forehead lines 10-20 units, and crow's feet 12-30 units. There is virtually no downtime after botulinum toxin injections, and results are expected to last 3-4 months.

 

For deeper static wrinkles on the lower face due to tissue loss, significant filling of these wrinkles can be achieved by using a natural product called hyaluronic acid to enhance the volume of the face. Hyaluronic acid holds water, hydrating and giving volume to the skin. Hyaluronic acid is a non-permanent filler, and it creates volume for the treatment of lips, lines, wrinkles and facial folds. Downtime is minimal, and results are expected to last 4-6 months.