Louisa McKay and Dr Rohit Kumar Costhetics Interview
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Interview with Louisa McKay Managing Director Costhetics and Costhetics Plastic Surgeon Dr Rohit Kumar
What are non-surgical treatments?
Louisa McKay: Non-surgical cosmetic treatments are anything that doesn't require an incision to break the skin. Some examples of non-surgical treatments; are injectable fillers, botulinum toxin, chemical peels, laser resurfacing and body contouring with devices such as CoolSculpting.
What are the advantages of these cosmetic treatments over cosmetic surgery?
Dr Rohit Kumar: Both cosmetic treatments (non-surgical) and cosmetic surgery have their benefits and disadvantages and are often used in conjunction rather than alone as they serve to complement an overall result rather than compete in providing an identical result. Most non-surgical cosmetic treatments are focused on treating the face and neck whereas cosmetic surgery can rejuvenate other areas of the body as well.
The two key factors that need to be considered are the degree (extent) of treatment that is required and secondly the duration that a patient wishes for these effects to last. Other factors, that play a significant part in making a decision between the two is the amount of time the procedure takes, whether an anaesthetic is required and how long the recovery period after the procedure to either see results or get back to work etc.
Non-Surgical treatments include anti-wrinkle injections, dermal fillers, facial peels, skin needling and laser therapy. Some of these can be combined together. These treatments are usually aimed at smaller and more specific areas of rejuvenation such as the eyes (eyelids), lips, forehead or when a larger degree of 'resurfacing" is required on the face. They usually give noticeable result that last for anywhere from three months to one year depending on what modality is used. Some treatments like laser treatments can last longer than this.
All these treatments can be performed in a relatively short period of time and it's not uncommon for patients to present during their lunch break to have their anti-wrinkle injections or dermal filling done. For nearly all these treatments, anaesthetic is not required but many dermal fillers now come combined with a local anaesthetic and a skin numbing cream is often applied for dermal needling to make the experience even more comfortable. Recovery in most circumstances is immediate and for more invasive treatments such as dermal needling or lasers, skin redness can persist for 24 hours to a few days after the treatments. In nearly all situations patients can return to work within 24 hours of their treatments.
Cosmetic Surgery on the other hand can treat areas that are too large to address properly with non-surgical means or have progressed to a point that non-surgical treatments would make little or no difference. This includes large and deep furrows around the face, bags under the eye, excess skin in the upper eyelids and the overall hollowing and sag that occurs around our facial skeleton as we age. Cosmetic Surgery is able to reverse these changes for much longer periods of time and in some areas a near permanent change can be achieved. The procedures are usually more invasive requiring a general anaesthetic and are performed in accredited operating theatres. The procedures at minimum require a day stay in hospital while others may require admission for a few days minimum. Most patients take a week off work post surgery and results are usually visible from two weeks to four weeks post surgery and may continue to change for up to six months post surgery.
Both surgical and non-surgical treatments carry their own specific set of risks and these need to be weighed up as well when making a decision.
Can you explain what CoolSculpting is?
Louisa McKay: CoolSculpting is a non-surgical fat reduction treatment that uses controlled cooling to banish stubborn fat that diet and exercise can't budge in troublesome areas like these:
How often and why should we have Microdermabrasion?
Dr Rohit Kumar: Microdermabrasion works to remove dead skin cells gently and thoroughly. -Diamond Head Microdermabrasion' tends to provide some of the best results. The method used for microdermabrasion combines a delicate circular motion and suction to remove layers of damaged skin. Each session should be tailored to each individual patient's skin type to assure the very best result. Microdermabrasion is used to increase cell regeneration, these new skin cells leave the face glowing with a smooth appearance. It can also aid with skin that is congested or with blackheads and pimples, hyper-pigmentation, uneven skin tone and also the reduction of scars from acne, surgery or any raised scar. There is an instant improvement in the skin but four to six sessions are required for the best results, each of these sessions are usually scheduled two to four weeks apart.
Why is it most important to have these non-surgical cosmetic treatments performed by a professional?
Dr Rohit Kumar: While some of the procedures are relatively straightforward, the potential complications are not. Products can and have been injected into the wrong area including blood vessels and nerves of the face. This can lead to thrombosis (clotting) of these vessels and the surrounding area of skin that was dependent on that particular blood supply, can die. This can be catastrophic for the patient. Anti-wrinkle injection into nerves or the wrong muscles can lead to that area not working for 3-4 months which is not only disfiguring but can have an effect on function as well. Anti-wrinkle injections and fillers in particular, require a very thorough knowledge of facial anatomy that can only be achieved by a medical professional or someone trained by a professional. There needs to be a global understanding of the face and how these muscles interact with each other. Even within the professionals who are legally allowed to inject these products there can be a large spread of skill level. If a person has spent their lifetime training and working around the mouth then, while they may have the anatomical knowledge of the muscles of the rest of the face, they are unlikely to know how these contribute to the ageing process.
The patient must choose wisely as not only do you need a professional who understands all the complexities of non-surgical treatments but they also need to have a reasonable degree of artistic skill as well. This is an area of treatment that combines science and art. Above all, the patient should be comfortable in the knowledge that the person performing the procedure or treatment has the skills and training to treat any complications that may arise from the treatment and if the person treating them can't provide this then you should look elsewhere.
What is the lifespan of a filler?
Dr Rohit Kumar: There are a variety of 'fillers" on the market. Depending on the type chosen and the site injected the results will last anywhere from four months to a year in most cases. There are some permanent fillers as well, however, they are not used anywhere as commonly as the other varieties.
Can you talk us through what is involved in getting lips similar to that of Kylie Jenner?
Dr Rohit Kumar: Firstly, in Australia it is against the law to perform cosmetic procedures on patients under the age of 18. Doing so requires at minimum the consent of the patient's parents and a formal submission to the medical board is usually required. So most doctors, including myself in Australia would not have performed the procedure on her or any patient until they are over 18. If a patient above 18 requests the procedure then there are several options available to them. There are the hyaluronic acid fillers that last up to a year or so and there are more permanent options such as injection of fat. The procedure itself is fairly straightforward. Once a decision has been made on the type of filler to be used and the 'look" that the patient is hoping to achieve, the lip is slowly injected with the product. The procedure does not need to be performed in an operating theatre. Most fillers now are combined with a local anaesthetic so after the first injection, further passes of the needle are almost if not completely painless. A thin needle is used to inject the filler in small amounts and this is gradually built up in the tissue to the volume that is desired. Sometimes the injected product is gently massaged and moulded to improve contour. There can be some swelling and bruising after the procedure and this usually settles after around 48 hours.
Fat injections require harvesting of fat from another part of the patients body via liposuction techniques and injecting it into the required area. This is usually done under general anaesthetic. The recovery time is longer, the patient may need two or sometimes three procedures to get the right volume. The results however, are permanent and so there is no need for yearly injections.
Interview by Brooke Hunter