The Newsletter of the Cosmetic and Restorative Surgery Clinic

Volume 1 Number 4: Autumn 1999

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Contents

Operation Restore Hope treats 71 patients!

A Letter from Dr Hodgkinson

The Doctor is in!

Holistic Wellness: It's all in the face

Simple things to improve your skin

New options for lip enhancement

Wake up fresher with the Diprifusor

New Statue in Reception

Operation Restore Hope treats 71 patients in the Philippines

Dr Hodgkinson's team brings brighter future to disadvantaged Cebu kids

Operation Restore Hope's 1999 mission that took place in Cebu during the first week of March was the charity's largest mission ever.

The team completed 71 operations, all successfully. The majority of the patients were children, most of whom had cleft lips or palates. This year's team had a broader expertise base, and so was able to do more burn and hand cases as well. Accompanying Dr Hodgkinson were three other plastic surgeons, three oral and maxillo-facial surgeons, one ENT surgeon, four anaesthetists, one paediatric intensivist and six surgical nurses. The team composition by nationality was 14 Australians, two Japanese, one American, one German and one Singaporean. The support and donations from both Australia and the Philippines were most appreciated and plans are already being made for when Dr Hodgkinson and his team will return in 2000. To find out more about Operation Restore Hope please phone Kim Castrey or Katherine Hassler at the Clinic on (02) 9362 7400.

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A Letter from
Dr Hodgkinson

In tne last few months, after completing a very successful North American meeting in Park City, Utah, and our Operation Restore Hope mission with 17 medical colleagues in Lapu Lapu City, The Philippines, we have been very busy at the Cosmetic and Restorative Surgery Clinic and Double Bay Day Surgery dealing with the vast array of fascinating cases our patients bring us. We have also recently celebrated our 1000th case in the Day Surgery, and our patients continue to be highly complimentary about the facility.

I am about to embark on some more overseas commitments, giving a course in Body Contour Surgery at the American Spciety of Aesthetic Surgery meeting in Dallas, after visiting and >

1000th patient treated at the Double Bay Day Surgery

operating at the Chesapeake Plastic Surgical Clinic in Baltimore, Maryland, with my colleague, Dr Gil Armiger. In June, we will fly again to San Francisco to give a paper and a poster presentation at the International Society of Plastic Surgery. These will be short trips, after which we are trying to reduce our overseas commitments and dedicate ourselves to the busy July to November surgical schedule.

We look forward to hearing from you and will keep you posted on new procedures and products that we will bring back from the United States in the coming months.

Sincerely yours,

Dr Darryl J. Hodgkinson
M.B. MS. (Hons) F.R.C.S.(C) F.A.C.S.

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Dr Hodgkinson answers your questions

Q: I'm 44 years of age and have noticed some excess wrinkling around my eyes, jowling, and some thickness in my neck and under my chin. My friends say I am looking tired. Am I too young for a facelift?

A: The trend over the past ten years has been for more and more patients in their late thirties and early forties to actively consider facelifting. Using less invasive techniques such as the endoscope, a growing number of patients are having a limited incisional facelift to tighten up the jowl and neck area.

By having the browlifting procedure, the corners of the eyebrows are elevated, thereby tightening the upper cheek area.Often, especially in the Australian environment, some kind of skin rejuvenation program as well as laser resurfacing or chemical peels are sought.

No, you are not too young to consider facelifting, the newer procedures today do not lead to that stretched, over-operated-on Hollywood appearance.

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New options for lip enhancement

Lip enlargement is a popular procedure at the Cosmetic and Restorative Surgery Clinic and we can provide a number of excellent ways of enhancing your lips, either temporarily or permanently. The newest injectable filler normally lasts longer than Collagen, which has now been in use for almost twenty years.

For permanent enhancement, Dr Hodgkinson uses a dermal fat graft or a patient's own fat.

With the trend towards more cosmetic dentistry, we find using the above techniques to frame an attractive smile has become a very popular procedure with people of all age groups.

For more information about lip enhancement, call us at the Clinic on (02) 9362 7400 or visit us online at our website, http://www.cosmeticsurgeryaust.com.

After treatment

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What simple things can be done to improve my skin?

by Dr John A Doyle

First and foremost a healthy lifestyle is important. In today's hectic life, stresses - whether they be at home or in the workplace - will tend to make a person's face blotchy and prone to break-out. A healthy and well-balanced diet is also important, as in some individuals fatty foods, alcohol and spices can stimulate an acne tendency.

Sunlight avoidance is also important, but this relates more to freckling and wrinkling that we associate with increasing age. Fortunately, there are many very effective topical agents that can improve the texture and tone of the skin.

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And there are a number of effective topical antibiotic preparations which can avoid the need for oral antibiotics. Retin-A remains a very effective topical therapy, not only for acne, but also in terms of correcting the irregular pigmentation and loss of collagen that are inevitable as one passes from the twenties into the thirties.

Oral therapies now available

Oral therapies available include low dose and mild oral antibiotics; mild hormonal blocking agents, including various forms of the oral contraceptive pill; and in severe and resistant cases in which scarring is beginning to develop Roaccutane can also be considered. Don't feel depressed. Adult acne is an all-too-common affliction, but there are now many simple and effective therapies available.

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Just the thing to soothe your face's delicate skin

Whether you stayed out too long in the sun, or are just recovering from laser resurfacing or a chemical peel, the Oxy-Vital Lift-off Mask from Pevonia Botanica soothes and diffuses redness, leaving your skin cool, fresh and hydrated. One of a new range of products now stocked at the CRSC, this sheet mask is rich in polysaccharides and amino acids and permeated with Aloe Vera: nature's best energetic vehicle for healing. Talk to Gail at the Clinic if you'd like to know more about this or other Pevonia Botanica products..

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Wake up fresher with the Diprifusor

by Dr Howard Roby

TIVA (Total Intravenous Anaesthesia) is a new innovation in anaesthesia that allows a computer (called a Diprifusor), programmed by the anaesthetist, to keep the patient asleep by altering the rate at which potent anaesthetic drugs flow into the patient's vein.

With conventional anaesthesia, the patient is 'put under' by the injection of a drug into their vein. This keeps the patient asleep for about five minutes only. During these five minutes, the anaesthetist performs a number of procedures to alow the patient to breathe a mixture of gases and vapours anaesthetised.throughout the

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operation. It is this mixture of gases and vapours that keeps the patient anaesthetised.

With TIVA, there is no need for the patient to breathe anaesthetic gases as they are kept under solely by the infusion of drugs into their vein. The advantage of TIVA to the patient is that they awaken faster with less hangover and are less prone to nausea and vomiting.

Although TIVA is new to Australia, it has been used in Europe and South America for several years where its safety has been demonstrated over hundreds of thousands of anaesthetics. The Double Bay Day Surgery is the first group of operating theatres in Australia to be given access to the Diprifusor.

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New statue in reception

In the main waiting area, you will note a beautiful bronze statue called "Ballerina" by Larissa Smagarinsky. Since we obtained it we have had lots of comments and questions about the piece and its creator. Larissa is one of Australia's foremost sculptors, having had several major commissions for civic display.

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Holistic Wellness:
It's all in the face (Pt IV)

by Dr Jennifer Hunter
B.Med; MScPH. D.L.S.H.T.M.

For a thousand years, Chinese doctors, herbalists and acupuncturists have observed the correlations between certain facial features and our internal health. They use Meridian theory to understand the health of the whole person - body, mind and soul. There are 14 Meridians and each has a separate function. This is the fourth of a series of five articles where I will review the face diagnosis of two of the ten main Meridians.

If we have a problem in an area, what do all those wrinkles, sags and blemishes mean?

The Heart Meridian

The main facial features can be seen on the tip of the nose. An enlarged tip or broken capillaries and redness are two common examples. (continued p.4 col 1) The Heart Meridian also governs the tongue, speech and communication. Problems with the Meridian may result in heart disease, including heart attacks and ischaemic heart disease, cardiomyopathies and palpitations. Speech impediments such as a stutter or a lisp can also reflect a problem with the Meridian. The Heart Meridian governs joy and laughter. It feeds our creativity and the opposite, destruction, enabling us to feel connected with the world around us.

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The Small Intestine Meridian

The main facial features can be seen over the cheekbone. Facial features may include redness and broken capillaries, a high full cheek or lack thereof. This Meridian governs the small intestine and hence the absorption of digested food. Problems with the Meridian may include diseases of the small intestine, anaemia secondary to vitamin deficiency, a stiff neck, strength of body and mind, intellectual thought processes, obsessiveness and even problems with insomnia.

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