What the heck are these dark patches that have just appeared on my face Doc?

There is a chance it's "Melasma". It’s a common question and yes, there is treatment available.

The dark patches may well be Melasma which is a form of facial pigmentation. It can be a difficult condition to treat as it can quite often reappear and if not treated correctly, it can result in the condition worsening.

So what causes it?

There are a number of triggers that can cause Melasma

melasma

Melasma is thought to be triggered by the female hormone Oestrogen around times when the Oestrogen exposure is more prominent like when taking the contraceptive pill,
pregnancy and sun exposure can make Melasma appear or worsen.

Those who have naturally darker skin or tan more easily tend to be more prone to the condition also however it may not be limited to the above - Skin trauma, some medications and even just ageing can trigger this sometimes embarrassing and unwanted blemish.

Treatment usually requires a particular skin regime complimented with a specific and gentle laser treatment to breakup the pigmented cells but not over-inflame the Melasma - Which in some cases can make it worse.

Treated correctly the appearance of Melasma can be heavily reduced but at the same time it is prudent to avoid trigger factors where possible and be vigilant in sun avoidance. In short Melasma can be managed and controlled.

Pigmentation can be troubling, but it doesn't have to be. Feel free to come and have a chat about what we can do to help.

Dr Silvan

Sleep Wrinkles - Iron Out The Problem

ConceptCosmeticMedicineSkin

Another major factor contributing to the phenomena of ageing is the loss of elasticity in the skin due to collagen reduction. To restore elasticity in the skin remains one of the leading research elements in the science of Anti ageing.

When we lie down to sleep, a major area of the face comes in contact with an antagonising surface causing a compression force against it. This compression persists till the time the posture is changed during sleep. This force causes an unusual positioning of the facial musculature and overlying skin. The repetitive, consistent and persisting positioning during sleep causes the creases referred normally as sleep wrinkles. Studies show that sleep wrinkles are caused mostly in the cases of sleeping on stomach or sideways. If you experience asymmetrical and obvious stubborn lines on the face not responding to anti wrinkle injections then these could be sleep wrinkles. They mainly appear on the forehead, cheeks or the angles of mouth. As these lines are not caused by the physiological contraction and relaxation of facial muscles so they do not respond to anti wrinkle injections. The same reason causes them to be at angles different from the regular expression lines.

 

Laugh and the world laughs with you, snore and you sleep alone.
—  Anthony Burgess

A good example can be the compression marks around the waist area after wearing a tight trousers/dress. After a few hours of removing the dress, the compression marks are gone due to the elastic nature of the skin and ample fat padding in that area. Imagine if you wear the same dress everyday for 7-8 hours for numerous years with the gradual loss of skin elasticity and loss of structural fat as it happens in the face, the marks carry a huge tendency to become permanent. Now to avoid the sleep wrinkles, the easiest advise can be to change the sleep posture, just like not wearing that dress again. However, it can be an impractical advice as we may choose to begin our sleep in a posture free of any compression against the face, but as we dwell into the deeper aspects of sleep, the posture does not remain our choice.

A few everyday recommendations to avoid sleep wrinkles can be to go to bed well hydrated, use appropriate cosmeceuticals to provide skin its moisture during sleep and maybe try special anti wrinkle pillows designed to minimise facial contact with the pillow surface.

Hyaluronic Acid (HA) based Dermal Fillers have a role in treating Sleep wrinkles. They not only fill up the sleep wrinkles mechanically, but the physiological stimulation of collagen synthesis by HA contributes to the thickening of the skin over time and improving the elasticity. However, It would need multiple treatments and the results may vary depending on the extent and depth of sleep wrinkles. It is of importance to be mindful that the dynamic factor of sleep position would remain the major contributory factor in the mechanism of sleep wrinkle formation. So the mainstay of the treatment of sleep wrinkles through HA Dermal Fillers would be to achieve softening of the wrinkles giving out beautiful aesthetically pleasing results.

EMBARRASSED BY HYPERHIDROSIS? DON'T SWEAT IT.

Excessive sweating of the palms, underarms, face and various other parts of the body is a common problem and can cause a great deal of discomfort - It has a name: Hyperhidrosis.

If you do not have the condition it’s difficult to understand the impact it can have on someone’s life day-to-day and it will always be at its worst just when you don’t want it to be. Holding a partner’s hand while watching a tense movie, giving a work presentation while presenting underarm sweat patches, hands slipping on the steering wheel in difficult driving conditions and so on has a huge impact on one’s self-confidence.

Hyperhidrosis.jpg

HYPERHIDROSIS

THERE ARE TREATMENTS AVAILABLE

There are a number of causes for excessive sweating. Many would have tried daily topical medications to reduce one's sweating, some people spray just about every part of their body in anti-perspirant, some have even resorted to sticking pantyliners on the inside of their clothing! It’s an ordeal and a drain on life. 

Botulinum Toxin A, which is also used to relax wrinkles is highly effective in treating hyperhidrosis. A very fine needle is used to distribute the Botulinum Toxin A intradermally to block the nerve impulses that cause you to sweat.

Does it hurt? That depends on your own pain threshold but at CCM we provide the option of Nitrous Oxide (aka as Happy Gas) which makes the procedure more comfortable.

Will it last forever? No, Botulinum Toxin A is used in a wide range of treatments in the medical world and as wonderful as it is you will need a top up within 3 months time. 

We love talking about what we do at Concept Cosmetic Medicine so if you are troubled by hyperhidrosis feel free to get in touch and we'll answer any questions you have and the possible treatment options available to you.

DR SILVAN

NEW TREATMENT FOR THE DREADED DOUBLE CHIN

The "double chin" is not an uncommon problem. A lot of people, at some point in their life find collars hard to button up or have a double chin mysteriously appear in photos.

The triangular shaped area of skin that starts at the top of our neck and follows through to our chin is typically known as the sub-mental region. If you were to use your index finger and thumb and basically pinch the area underneath your tongue you will be holding the skin of your sub-mental triangle.

Unfortunately this area also holds a layer of fat and from post puberty until later in life we have the same number of fat cells in this area. If you find yourself with one day with a double chin it’s not because there are more fat cells, they have simply grown bigger and historically this area is one of the most stubborn places reduce the appearance of fat.

Until now, there has been little to no surgical treatment options available in Australia to reduce the fat underneath the chin/jaw area. 

Injectable Fat Dissolving Treatment is a procedure similar to having anti-wrinkle injections - but through a series of tiny injections to the fat in the sub-mental area we can safely dissolve this under jaw fat.

The injectable fat dissolving treatment uses deoxycholic acid which is naturally found in our body and it’s used to help digest fat. When injected into the area under the chin the fat cells simply dissolve and with a reduced surface area the skin the tightens.

The treatment itself only takes around 20 mins but some light swelling and bruising in the area, which usually remains for several days you can notice the fat under the chin shrink over the next 4-6 weeks, while also tightening the skin.

Most patients with mild to moderate sub-mental fullness will see visible improvement of their jawline after just 2 treatments. Some may need more than 2 treatments to achieve optimal results. At CCM, we are able to perform this procedure comfortably with cool packs, and happy gas, or numbing gel if one wishes, this will depend on your own pain tolerance but generally speaking it’s not an overly painful experience

Below are before and after photos of what you could expect if you had mild to moderate submental fat which had been bothering her for many years.

If you are interested in non surgical treatment options for unwanted fat, please feel free to come in for a chat.

by Dr Silvan Lee

SUNSCREEN ISN'T JUST FOR SUMMER

I'm a strong advocate for using sunscreen, not only for fighting the obvious - like skin cancer, but also in the fight against premature ageing.

If you were to calculate the total amount of time we expose parts of our skin to the sun during our lives you may well come up with a number that'll shock you. Any amount of time our skin spends, small or large exposed to the sun it adds up, it's not just long days at the beach during summer that ages us.

And if you have any doubt as to whether the small trips to the shop, pegging clothes on the line or your early morning walks with the dog don't affect your skin you just need to compare the skin that never sees the light of day (wherever that may be) to somewhere like your forearms or the back of your hand and compare the difference in wrinkles, softness and overall quality.

In this video below I explain the different types of sunscreen and the best practice for using it in the fight against premature ageing.

Doctor Rachel.

All About Acne

As a teenager, I suffered from terrible acne. I understand how it can create a terrible cycle of self-consciousness and poor self-image. Fortunately, my mother, who had also been an acne sufferer, quickly got me on to medical treatment for the problem and within a year it had cleared up completely. However, this was not without some side effects: nose bleeds, low mood, etc. It was all worth it though, because I have rarely had a blemish since and I was very lucky to avoid the residual scarring sometimes sometime left behind.

What is acne?

Acne is a skin disease where the hair follicle opening becomes blocked by a plug of skin cells from the follicular lining. This prevents oil from the sebaceous gland that attaches to the root of the hair from escaping, leading to a build-up of oil, bacterial growth and inflammation. This manifests as black heads, whiteheads, red bumps, pimples and most severely, cystic acne. 

These can occur on the face, neck, chest, back, shoulders, and even the upper arms. Onset is usually during adolescence with increased sex hormones, that stimulate and enlarge the oil (sebaceous) glands of the skin. Acne is experienced by both teenagers and adults all the way through their 40’s. 

How can we fix this?

There is a lot of misunderstanding about how to treat acne. I know of many teenagers who are told to simply stop eating so much chocolate and it will go away. How ridiculous! Whilst a good diet will improve general skin quality, it is not enough to control this disease. At Concept Cosmetic Medicine our goal is to clear your skin, stop future breakouts, reduce existing scars and prevent future scarring. 

Step 1

Skin care at home:

Wash face twice a day with a wash that contains alpha hydroxy acids (eg. Glycolic acid) or beta hydroxy acids (eg. Salicylic acid). Some people find the latter more effective.
At night use a cream that contains one of the above.
If this doesn’t improve the situation after 2 months, speak to your GP about adding a prescription cream containing adaptalene and benzoyl peroxide combination; or a retinoic acid cream.

Step 2

If Step 1 fails, there are two good options next:

Your GP may be able to prescribe oral antibiotics. These are usually a tetracycline antibiotic which are a broad spectrum antibiotic however very effective and commonly used in the treatment of acne. Improvement is usually seen after 2-3 months. It is relatively cheap however, having antibiotics in your system for extended periods can quite often be accompanied with the possible side effects.
Blue light therapy is a good alternative for those who can’t or don’t want to take antibiotics. Like the antibiotics, the blue light destroys the acne causing bacteria on the skin and can significantly improve the appearance of moderate acne in around 6-10 treatments. It is quick (under 15 mins), efficient and painless and there’s no downtime.

It is however, more expensive than oral antibiotics.

Step 3

Treatment Resistant Severe Acne:

Photodynamic therapy (PDT) is effective treatment and involves the application of a photosensitising agent to your skin and then going under an Omnilux light to activate the agent. This targets acne causing cells deep in the sebaceous glands, so its’ very effective for cystic acne. PDT treatment requires up to a week of down time. The discomfort could be likened to “sun burn” for the first few days and it gradually improves over the rest of the week. 1-2 treatments are usually adequate for most people, who will see significant reduction of acne lesions and an improved appearance in scarring and skin quality. This is a great option for people who want to avoid the nasty side effects of taking oral retinoic acid for several months.
Oral retinoic acid is a Prescription only medication that’s an extremely effective treatment, but it does have some bad side effects that vary between patients. You will need to be closely monitored by your GP and dermatologist whilst on this medication to minimise any harmful side effects.

If you are interested in Blue-light therapy, PDT for acne or even just want further information about problem skin then please, we love talking about it and we’re only too happy to have a no obligation chat - Simply phone us.

by Dr Phoebe Jones

PUBLIC SHAMING TIME!

EXHIBIT "A"

EXHIBIT "A"

Ladies and gentlemen of the CCM jury, I ask you . . .

<< Do you think this is:
(a)   Careless beach-goer
(b)   CCM staff member
(c)   CCM Doctor
(d)   The owner of CCM

You can probably tell by the flow of answers where I'm leading you....

YES! (d) The owner of our wonderful clinic.

GASP and cue dramatic revelation music!

Now above said example of bad sunburn was on holidays with above said's children who from this point will be called Exhibit "B".

Exhibit "B"

Exhibit "B"

Now Exhibit "B" were, at the time advising Exhibit "A" to protect one's skin. Exhibit "B" are much younger with less life experience but to them it was obvious the danger Exhibit "A" was in.

Exhibit "B" later saw their warnings on that fateful afternoon had been ignored, and in the days following revealed in their subsequent lectures to Exhibit "A" on sun protection.

Exhibit "C"

Exhibit "C"

<< Next I present to you Exhibit "C", friend of Exhibit "A".

Ironically Exhibit "C" was being warned by Exhibit "A" of the dangers she was facing and at one stage was told to remove oneself from a sun lounge to avoid any further "thermonuclear assaults".

Next I present to you an item that may very well leave you in shock and disbelief. Evidence that will prove to you beyond any reasonable doubt that this act of carelessness goes beyond what you may deem possible by most people, let alone the owner of a clinic that treats people with sun damaged skin - Ladies and gentlemen.... Exhibit "D"! 

Exhibit "D"

Exhibit "D"

While Exhibit "A" and Exhibit "C" were not only getting burnt from the sun, Exhibit "B" took great joy in roasting Exhibits "A" & "C" even further - This was all the while . . . in a final twist, Exhibit "D" sat in the shed patiently waiting for a purpose.

Admittedly Exhibit "D" is merely a shade cloth umbrella from Bunnings and is not capable of the same level of protection of its more expensive relatives but, both ladies exposed themselves to the biggest killer of beautiful skin and have now paid the price.

Any protection (including an "el-cheapo" Bunnings umbrella) would have been better than the vulnerable position these ladies put themselves in while on holidays.

Were they careless and could they've easily done more to protect themselves?

Should they have led by example and shown the younger witnesses they were indeed sun smart?

Was this sunburn so easily avoidable . . . it's criminal?

You be the judge.

 

;) Dr. Neal.

THE CHIN - A STAR'S SECRET TO THE PERFECT PROFILE

The power of a well proportioned chin is often an under-looked and a neglected facial feature.

As our skeletons age our bones lose mass. This happens to all of us and there’s no avoiding it however, it should be noted the loss of mass in the chin is relatively more significant and subject to a more noticeable affect on the appearance of ageing.  

The loss of mass around the chin leads to the appearance of worsening jowls, marionette lines, and fine lines around the mouth. Replacement of this bone loss with a thick filler can provide a strut to help make this seemingly “lazy” skin more taught. You could think of it like the “little plastic table” in the middle of your pizza…. Otherwise known as a Pizza Saver - except we like to engineer the process with a little more precision.

In younger people, who have not yet suffered the bony losses of age, chin fillers can be used to help correct a weak looking chin, improve the profile and jawline and improve the appearance of a round face shape. This can be seen in photos of Ivanka Trump. Whilst she appears to have had a rhinoplasty, she has also had chin volumisation. The combination has resulted in a beautiful profile and a less rounded face. This clever contouring has created the desirable upside down triangle shaped face that is thought to be a true sign of beauty, and I couldn’t agree more.

Even Angelina Jolie, who has long been considered to be one of the most beautiful women in the world has had a little help in the chin and jawline department. The results are subtle and she still looks like herself. Even Angelina understands the power of a good chin.

If you have any questions about non-surgical chin augmentation or any other procedure then please get in touch - we love talking about cosmetic medicine. 

Dr Phoebe Jones

INJECTABLE MOISTURISERS - BEFORE & AFTER

 

I'm asked a lot about injectable moisturisers - Will it hurt and do they work?

Generally speaking, there's only some discomfort. We apply numbing cream to the area prior and use very fine gauge needles for the actual injections. In addition there's gas on-hand also should you be sensitive.

Does it work? We think so.

While the effects are not as prominent as some other procedures, the overall glow and luminosity is certainly noticeable along with the reduction of fine lines.

In the video below you can watch me perform the procedure and talk further in detail about the benefits of injectable moisturisers.

If you've ever considered injectable moisturisers or would just like more information, we love talking all things cosmetic medicine - Feel free to get in touch.

 

Dr. Phoebe Jones.

THE BENEFITS OF COSMETIC MAINTENANCE - DR SARA LINTON & LIZZIE RENKERT

Former editor of Madison Magazine, Lizzie Renkert knows beauty and the important role cosmetic maintenance plays in sustaining your natural beauty. No one is perfect and like many, Lizzie has been faced with problematic skin earlier in life however, as a regular client of CCM Lizzie found our mantra of regular and subtle cosmetic treatments to be the silver bullet to those annoying imperfections that plague many of us.

I've known Lizzie for a long time and it's always a compliment knowing your client (who's job is to have an eye for beauty) trusts you unreservedly with their own. It really is an honour but even more so when this trust is extended even further for a one-on-one interview.

I recently sat down with Lizzie at CCM HQ for a chat about her treatments vs results, improvement in technology over time and dispelling some of the negative chatter on cosmetic medicine and minimally invasive cosmetic surgery.

I hope you enjoy the video and if you have any questions about our procedures, techniques or would just like further information on any of your beauty concerns - just get in touch for a no obligation chat.

I love talking all things cosmetic medicine and only to happy too help.

Dr. Sara Linton