The 23rd Congress of ISAPS was held at the Miyakomesse Conference Center in Kyoto, Japan from October 23 through 27, 2016. More than 1,650 persons from 89 countries participated and the Congress was a great success. On October 23, basic procedures for aesthetic plastic surgery were presented under the title of ISAPS Course for Residents and Fellows.
Dr Bryan Mendelson has given over 100 presentations to surgeons around the world. His global audience has developed as a result of his 25 years of research into facial anatomy, facial aging and new techniques to provide natural and lasting rejuvenation for patients.
Dr Mendelson is in private practice at The Centre for Facial Plastic Surgery in MelbourneAustralia. He graduated from Monash University Medical School, Melbourne, and Interned at the Alfred Hospital Melbourne, then became a Demonstrator in Anatomy at Monash University for a year. In 1971 he moved to the USA to train in general surgery and plastic surgery at the Mayo Clinic, Rochester, Minnesota for six years. There followed a fellowship at the Institute of Reconstructive Plastic Surgery in Manhattan, New York under Doctors Converse, Rees, Aston and others. He is certified by the American Board of Surgery and The American Board of Plastic Surgery.
Extended Transconjunctival Lower Eyelid Blepharoplasty with Release of the Tear Trough Ligament and Fat Redistribution
Background: The transconjunctival lower eyelid blepharoplasty is advantageous for its quick recovery and low complication rates. Conventional techniques rely on fat removal to contour the lower eyelid. This article describes the authors’ extended transconjunctival lower eyelid blepharoplasty technique that takes dissection beyond the orbital rim to address aging changes on the midcheek.
Fat Injections are quickly becoming as popular as fillers and as a more natural and longer lasting option, it’s easy to see why. As one of Australia’s most prominent and highly regarded plastic surgeons, Dr Bryan Mendelson and his skin clinic are always at the forefront of the industry. They say fat injections in Melbourne are in demand and can be used in conjunction with other procedures such as facelifts; or as a stand alone procedure to restore volume to the ageing face. We asked Dr Mendelson’s team why fat injections are such a great alternative to traditional fillers.
Dr Mendelson: Hello. I’m Bryan Mendelson, a plastic surgeon from Melbourne. It’s a pleasure to be here today to talk with you.
PSH: Can you tell us about the difference between a good facelift and a poor facelift?
Dr Mendelson: The difference between a high-quality facelift and an ordinary facelift, there are several components. One is, and the most important overall thing is that it doesn’t look as though the person’s had a facelift, they just look fresh, well for their age. That’s not so easy to obtain because there is a tendency to overdo pulling, for example. The public think they can always pick a facelift. The reality is nearly all the patients that I do a facelift on will say, “You know what? No one has picked that I’ve had the facelift.” I’ll say, “Well, do they give you a compliment?” “Oh, they will say I’m looking well.” That’s really the best compliment you can have.
Now, there are cultural differences in different parts of the world. For example, in Los Angeles, if no one picked you had a facelift you would feel like you didn’t get a good result or Brazil, for example. In more sophisticated areas or culturally sophisticated, there’s not the want to be seen to have had a facelift, which is a status symbol, for us it’s just like a stigma.
Then you look at what is it about the face that’s detectable. Well, disproportionate tightness in certain areas, the windswept look which a good facelift just doesn’t do. Visible deformities like pulling earlobes is a classic thing or the neck underdone for the rest of the face or even overdone. Like, in California, some surgeons tighten the neck more than is natural for someone of a certain age. Usually with a good facelift you’re going to turn the age back eight to 10 years for someone in their late 40s or 50s, not someone in their 30s, otherwise they’d be looking like an infant.
Now, the other thing where patients worry, “How do I know you’re not going to unintentionally pull too tight?” The way to describe that is it’s to do with a technique of surgery. If the surgeon lifts the skin and pulls the skin tight it’s like pulling a piece of elastic. You tend to thin the skin, and pulling it tight often is necessary to get a good and lasting result but the more anatomically correct way of doing the surgery is to tighten the support layer which is … The function of the support layer is to support the skin so if you take the laxity out of the support layer the skin will look toned rather than stretched. Using that technique of surgery, it’s really impossible to be overdone there so you do not have to worry about the windswept look.
I give the analogy it’s like laxity of a chain, a chain necklace, you tighten it until there’s no more laxity and there’s no point in tightening it any more. The key question is what causes the ageing process because it’s a universal thing. Amongst all humans we can, always wondering about people’s age. Whereas if you’re an animal like your dog the only way you can tell a dog’s age is by its behaviour, if it’s acting like a puppy or an older dog and maybe some grey hairs. It doesn’t have the expression on the face of looking tired as humans get with ageing.
The question is what causes it? Discounting skin ageing with is environmental factors like some and other factors like that but there’s a loss of the bone structure on the face. I didn’t realise that until more recent years, particularly the bone around here and maybe some there a little bit along the jaw. As soon as you lose volume on the face the tissues are less tight. If someone loses weight, particularly if you notice it in someone a young age, they just don’t look quite the same. Then once there’s less volume there tends to be a bit of sag. Then when you move the muscles of your face with expression you’ll see older people when they smile, their smile lines, there’s so many more than there used to be. What’s happened with the sag, so the top of the cheek is sitting a bit lower. When they start smiling instead of smiling from there up they’re smiling up there, the ageing, before they start the smile lines so restoring volume is important.
Some people have fillers as we all know. People who have not lost very much volume yet, a little bit of filler is beneficial. Unfortunately, with more ageing, the fillers become less satisfying and less effective. The loss of volume is partly the bone and partly the soft tissue as well. Then sometimes the loss of volume is come from the sag because with the thicker tissue dropping down it’s lower down on the face and therefore it’s thinner up here. There’s a vicious cycle tends to occur, perpetuate, with more movement, more loss of volume, more thinning of the tissues. Obviously, the key to surgery is restoring the structures to the correct position on the face, restoring the volume of the bone of the face, then restoring the volume of the soft tissue and then it looks natural.
It’s a great cause of anxiety for many people about first day back at work because they’re so worried it’s going to be detected. If they prepare for that which firstly is having sufficient time. I would always encourage someone to put off the surgery until they have the time so that they can enjoy the recovery. The recovery enjoyment or how you feel about it is going to determine your satisfaction with the whole process. If the facelift experience was a good one you’ll always be happy about your appearance rather than you have to struggle because you didn’t have enough time. If you only had three weeks off, well two and a half weeks after surgery you could be looking in front of the mirror and thinking, “How on earth in three days is this going to look natural?” Very important, yeah.
Afterwards is so important and people can’t really discuss this with family members, particular husbands, they really need a good support network. Because they’re not going out to coffee with their girlfriends and others they haven’t got the normal chance to communicate and be part of the world. In the office we’ve got outstanding staff who really love what they do in supporting people. The nurses are really outstanding. I’m always being told, “Never let her go.” Then also we have the physiotherapist, Joan, who does lymphatic drainage and ultrasound. She’s been with me for 30 years, she’s wonderful. Also, she’s experienced so she knows that people are going through and they can chat.
Then we have the skin care specialist, Natasha, who just put the hands on the face because people for weeks haven’t been able to do that. Just to have, knowing someone else is doing it really helps. Then we have the heal light which is LED light that speeds up the rate of healing. It’s nice to know everything is working to support you rather than you having to look out for your own needs which tends to be what happens when people have surgery in overseas places. They’re staying in a hotel and they’re told to come back next week and it’s too much, they need constant support.
I hope this information is helpful to people who were concerned because they didn’t know enough about it and have pre-conceived ideas that might have been incorrect that was discouraging them. Information, it is really important to have information because so much of the fear is because of misinformation. We have outstanding patient advisors in the office. People are most welcome to call my office and come along and speak with a patient advisor, which we don’t charge for that. That’s a complimentary service because that will help people know whether it’s right for them. They can ask questions that they may be a little embarrassed to ask the surgeon. Just nice to know and be reassured. Then if the patient advisor, Jilda or Jennifer, feels that they can help then often they’ll expedite the patient to come to see me a little sooner because they get priority care. Thank you so much for this.
Modern day facelifts are a world away from those overstretched, all-too-obvious ones of the past. We have more knowledge of facial anatomy and how the face and all its muscles, including the skin, works as well as the tools and know-how to work with it. And no one understands this more so than Dr Bryan Mendelson, plastic surgeon from Toorak in Melbourne. Anyone who’s done any sort of research, or has anything to do with the aesthetics industry, should be aware of Dr Mendelson’s skill and ability to make his patients look completely natural, and his book In Your Face has been read by thousands around the country and indeed around the world. We take a look at what makes Dr Mendelson so successful when it comes to facelift surgery in Melbourne and his innate understanding of the face and its spaces.
Skin Deep – Not Any More
We know that simply pulling the skin up and sewing it higher or tighter just does not work. This is the stuff of horror celebrity facelifts of the 80s and 90s.
The way to a more natural looking facelift is to work on the internal support structures of the face. Dr Mendelson tells us, “It might look as if your skin has sagged, but actually it sits on a sagging support layer – and this is where the correction needs to take place.” This technique is known as the SMAS procedure. This method greatly reduces the chances of excessive bruising and swelling which means less downtime and allows you to get back to your everyday life a lot sooner. It also produces a long-lasting, more natural effect without the skin appearing “pulled”.
The Signs of Facial Ageing
The main signs of facial ageing are:
Dr Mendelson states that ideally a facelift will bring clarity around the eyes, attractive fullness over the cheekbones and clearer lines along the jaw and upper neck. He says, “The result of a well-performed facelift is natural, and it’s subtle, and the result is lasting. In addition to which it also slows the appearance of further ageing.”
The reason why modern facelifts are so much more successful than the outdated and almost laughable results of the past is because of our increased knowledge of facial anatomy. Surgeons have a much more detailed understanding of the deeper layers of the face, such as the muscles, tissues, skin and how it all works together. This enables them to better manipulate their appearance and identify how best to do that on a case by case basis. However, if you are considering a facelift, keep in mind that in order to get a natural result, you need to ensure your surgeon is one of the few who actually knows his stuff.
Dr Mendelson is an authority in facial anatomy. His research into the subject is recognised around the world and was included in the classic anatomy textbook, Gray’s Anatomy. His findings have led to the development of the advanced surgical techniques that we see being adopted around the world today. Dr Mendelson performs live demonstrative surgeries in countries such as Milan, Cologne, Barcelona, Madrid, Istanbul, Dallas, Moscow, Taipei and the list goes on, to teach other surgeons his techniques and how he produces such natural looking outcomes.
#Article Source: https://www.plasticsurgeryhub.com.au/understanding-the-face/
With pregnancy comes a whole new world of required knowledge. What can and can’t you eat or drink? What bras should you be wearing? What exercise are you ‘allowed’ to do? What preparatory classes should you be attending? How do you even look after a baby?? Literally, the list of questions goes on and on…
It’s a confusing old time, and can be quite frustrating trying to find the correct answers to many of your questions. At 28 weeks pregnant, I’ve had a lot of time to do a shed load of research/question asking, so over the next few months I will start sharing all of my knowledge with you, so you can use The Page as a ‘go-to’ for preggo related questions – and hopefully save you the hours of internet surfing that I’ve had to endure.
As a bit of a beauty obsessive, the whole issue of safety when it comes to certain skincare ingredients during pregnancy was one of the first things I wanted to find out about. Could I still get a bit of botox every now and then (the answer is no) and what lotions and potions could I use on my face and body?
First up, ditch the injectables – this is because not enough research has been done surrounding the effects of botox and fillers on unborn babies. It’s really not worth the risk, and actually it’s quite liberating to let it all go… try to focus on your inner health instead (eating right, drinking lots of water and exercising daily) and you’ll find you’ll radiate a new kind of beauty – the pregnancy glow. Plus you’ll save a shed load of money and the wrinkles that re-appear post the disappearing effects of botox are never as bad as you imagined they were to begin with. I’m actually undecided as to whether I’ll bother again after the baby is here (note while you’re breastfeeding the same skincare rules apply).
Admittedly for me, the healthy eating and exercise didn’t happen until I got past the morning sickness. Veggies and exercise were a no-go area until I was about 15 weeks, but that’s okay – just ride the wave, eat what you can stomach (orange juice, marmite on toast and skittles were all i could face) and know that you’ll get back on track just as soon as you feel a little better.
When it comes to skincare products, the main ingredients that seem to cause most concern during pregnancy are retinol (Vitamin A, which has quite amazing effects on the skin in terms of plumping and de-lining and helping with pigmentation) and salicylic acid (a brilliant beta hydroxy acid that helps tackle acne in a big, big way). Salicylic has been shown to cause growth problems and birth defects if taken in high dosages orally, and the same for Vitamin A.
That said, some experts and professionals say that these ingredients are perfectly safe at the (topically applied) levels you would see in shop-bought, non-prescription products. My own opinion? It’s not worth the risk. I’ve avoided both during my pregnancy, mainly because I think for the sake of 9 months, what are few extra fine lines or wrinkles between friends? Remember my mantra ‘let.it.goooo’.
I’m also a bit of anxious soul, and really can’t deal with any added stress, so worrying myself over the strength of an ingredient in a product is the last thing I need to be thinking about. That said, I have been lucky enough to experience blemish-free skin during my pregnancy but some women are, however, prone to acne and melasma as a result of hormonal changes. In this instance it’s best to seek advice and skincare guidance from the likes of Clearskincare Clinics Australia (nationwide), The Clinic in Sydney (see previous post on pregnancy friendly Blueberry peel as a pick-me up) or the Skin & Injecting Clinic on behalf of Dr Bryan C Mendelson in Melbourne.
Regular facials may be required to help keep skin as clear as possible and ingredient recommendations (from the research I have done) suggest using niacinamide or Vitamin B3 (5%) and azelaic acid (15 or 20%) for breakout prone skin or Vitamin C’s and Alpha hydroxy acids for pigmentation-prone skin – all safe for pregnancy.
As a final note, quit with the aerosols as these contain volatile organic compounds (VOCs) and artificial fragrances, which aren’t good for you or your baby especially when used indoors as they can cause VOCs to build up. AND if you change nothing else about your routine during pregnancy, add a daily sunscreen into the mix – it’s SO, SO important. As many as 40% of women develop melasma or the mask of pregnancy and something as simple as using a physical sunscreen containing zinc oxide properly on a daily basis can prevent it. Skin is much more sensitive to the sun during pregnancy, so staying out of it or covering up is key.
Another skin related problem to bear in mind are stretchmarks. Stretchmarks affect as many as 90% of women during pregnancy. As someone who already has a few from my early years I was expecting to get these, although I haven’t seen any yet. Apparently, however they are most likely to form during the last few months when you do the most belly growing so in preparation I’m being very generous with oils and creams, all of which I’ve listed below.
My go brand during pregnancy has been Dermalogica for my face and Sukin for my body – I have resolute trust in both brands and their products.
I also loved the fact I was able to book in for face mapping skin analysis and thorough 60 minute treatment with Dermalogica to get an idea of my problem areas and what was needed and why – head here to find your nearest store and consultant.
You only have to have a look at a few before and after photos of neck lifts to know it can completely change a person’s appearance. Lots of patients mistakenly think they need a full facelift, when in fact a good neck lift can turn back the clock years. Dr Bryan Mendelson, esteemed plastic surgeon based in Toorak, Melbourne, sees many patients each year who benefit hugely from neck lifts and lower facelifts. He helps us to understand why the neck lift or lower facelift is perhaps one of the most underestimated surgeries you can have if you are looking for a refreshed and more youthful appearance.
Jowls, or a lax jawline, is one of the first signs of ageing. Similarly, lines around the nose and mouth also appear before most of us are ready for them (are we EVER ready for them?!) and can make us feel as though we look older than we want to. Smiling, laughing, eating… whilst these are some of the best things about life, they also contribute to downward lines forming, and bring down an otherwise still youthful face.
Neck lifts can also be life changing for those without a defined neck. Whether it’s hereditary or not, having a thicker or less sculpted jaw/neck area can radically affect your whole appearance.
Either way, let’s talk about our options for dealing with the issue.
Premasseter Lower Facelift
The Premasseter Lower Facelift is a new technique that is being lauded as a breakthrough in giving restoration to a part of the face that was previously quite difficult to get significant aesthetic improvement. Dr Mendelson tells us that the technique can even be performed on the patient at a younger age for those with an overly full or poorly defined neck to provide benefits into the patient’s long term future.
Performed only by a few elite surgeons due to the specific surgical skills and expertise in anatomy required by the surgeon, Dr Mendelson says, “The Premasseter Lower Facelift is performed in the deeper facial anatomy along the side of the neck, where it firms the area from the jowls to the corner of the mouth and provides support for any tissue laxity in the upper neck; providing a cleaner jawline, and an improvement across the entire lower face and neck. The result is natural in appearance, and lasting. It also slows the rate of appearance of future ageing in that area.”
Dr Mendelson goes on to say that, “The Premasseter Lower Facelift allows the neck and jawline to be restored to an attractive contour, showing clean definition between the face and the neck. The procedure also tidies the area around the mouth, reducing the creases that make the mouth look compressed and downcast.”
Dr Mendelson’s Difference
In case you haven’t done your research and heard of Dr Mendelson yet, he’s one of the most highly respected plastic surgeons in Australia. His book, In Your Face, is a must read. One of the critical differences with Dr Mendelson and his techniques in surgery is that he performs all surgery beneath the skin. He says this is key in ensuring the quality of any facial surgery. Facelifts that rely on “pulling” the skin are a thing of the past and should remind you of the trend in Hollywood 20 years ago where patients looked like they’d been stuck on a rollercoaster going twice the speed for too long. Pulling the skin also doesn’t last as long as working under the skin with the muscles and tissue and deeper support layers. Skin stretches, so anything that just stretches the skin will need redoing at some stage down the track.
Why Does the Neck Age Quicker Than Other Areas?
The majority of us look after our faces regularly with lotions and beauty products, but many of us don’t extend this care to the neck area. The same goes for sunscreen – how many of you put it on your face but often forget to do your neck? On top of this is the fact that the neck has less fatty tissue so the skin stretches more quickly, and dries causing an ageing effect. Combine this with our enemy, gravity, and there’s more than a few of us experiencing that ‘crepey’ look.
Dr Bryan Mendelson is regularly invited to present his expertise at events all over the world. He is a real leader when it comes to effective techniques to give natural looking and beyond expected results. If you’d like to arrange a consult or find out more about what he might be able to do for you give his super lovely staff a call on 03 9826 0977.
Back in July, I completed a series of four Factor 4 treatments at the highly regarded Skin & Injecting Clinic on behalf of Dr Bryan C Mendelson. It was an incredible experience, but before I divulge just how effective this treatment was for me, let’s remind ourselves exactly what Factor4 is.
Factor4, an autologous conditioning serum (ACS), is a highly concentrated and super-rich blood serum, extracted from the patient’s blood. It’s like liquid gold to look at and it contains four times more growth factors than any brand blood-rich injection product or treatment available on the market.
When used in conjunction with Medical Skin Needling (also known as Collagen Induction Therapy), the area is treated with the body’s own potent growth factors. The result is faster healing and less down time.
Sometimes referred to as the Vampire Facial, the combination of Factor4 and Medical Skin Needling is powerful to say the least.
At the end of my last post I was a few weeks past my very first session with Dermal Clinician, Natasha Laouta. The reaction to my skin was surprising this early on. After a few intense days of redness and a little flaking, thanks to the Environ products provided as part of the treatment, my skin started to change dramatically and I still had three treatments to get through.
Heading into my second treatment, my nerves were steadier as I knew what to expect. The numbing cream was applied and I was in the chair ‘relaxing’ as Natasha took the Medical Skin Needling to the next level. Areas of concern like the open pores between my eyebrows and my concentration lines were focused on. I could feel the pressure, and it did result in a little bleeding, but it didn’t hurt.
Undergoing Factor4 in the cooler months is a blessing, if not an actual necessity. The fresh Melbourne air felt great on my warm post treatment skin as I left the clinic however by the morning, following use of the Environ products, the redness had significantly reduced.
Over the next four weeks I undertook two more Factor4 sessions (they can be done as closely as 5-7 days apart) with Natasha and each time she knew exactly the intensity required to achieve a good result. I always felt like I was in great hands. This combined with professional skin care products and the right medical make-up got me through the sessions with ease.
According to Natasha, results are at their best at five to six months post treatment, which is where I am right now, and I have to say I agree. My skin feels soft and smooth and the tone is still improving; glowing skin is not as hard to achieve as it was 12 months ago. In fact, I am no longer afraid to leave the house without makeup and I probably do it more now than I have in the past decade.
So, has turning back the clock made me want to throw in the routine and go to bed with my make up on like years gone by? Absolutely not! At home I now use a dermal roller and have stuck religiously to the Environ skincare routine Natasha started me on. In addition, there are maintenance programs of top up treatments at six months and annual boosters that I can take advantage of to continually improve my skin.
The Factor4 verdict
Overall, I would highly recommend Factor4 combined with Medical Skin Needling to anyone wanting to bring their skin back to peak condition. In fact, I would say don’t hesitate. So successful has been my treatment that a few friends and family are now planning their own visit to the Skin & Injecting Clinic for Factor4 treatments.
I honestly feel like I have discovered a treatment like no other in terms of results and wish to thank the Skin & Injecting Clinic, under the direction of on behalf of Dr Bryan C Mendelson, for such superb service and attention.
Skin & Injecting Clinic, Centre for Facial Plastic Surgery, 109 Mathoura Road, Toorak VIC 3142, Australia | +61 3 9826 0977 | firstname.lastname@example.org |https://www.facebook.com/skinbmendelson/
#Article Source: http://www.the-page.com.au/beauty/diary-factor4-treatment-part-2/