NEW AND UNUSUAL USES FOR DERMAL FILLERS-IMCAS review

NEW AND UNUSUAL USES FOR DERMAL FILLERS- IMCAS review


Treatment of Flat Inverted Nipples

I viewed a presentation by a visiting dermatologist at IMCAS, Paris earlier this year, who was discussing the use of dermal fillers for the treatment of flat inverted nipples.

He suggested the careful placement of filler around the edge of the nipple itself, and felt that it worked very well in those clients treated, as the surgical correction of this problem is fraught with difficulty and often doesn't have satisfactory outcomes.

It all sounded quite interesting so I thought I'd ask him some questions about the procedure afterwards, thinking that there are no doubt a number of female patients in Australia who may be interested in this.

My first question was whether the filler procedure had caused any breastfeeding or mammography problems.  You know, my number one concern with any new treatment is ALWAYS: IS IT SAFE?

He responded that he had only done the procedure in younger women, under the age of needing screening mammography, so couldn't comment on whether it caused any radio-opacity.

As for the breast-feeding/mastitis concern, his response surprised me:

"the milk only comes out of the duct in the centre of the nipple, so it shouldn't effect breast-feeding, though I'm not sure how many of the women I've treated like this have needed to breast feed.."

I'm afraid that's when he lost all credibility in my eyes.

As a woman who has breast fed my child, I can assure anyone reading this post who perhaps hasn't yet found themselves in that situation, or witnessed their wife expressing breast milk, that breast milk doesn't come out of a central duct in the nipple.  It comes out of multiple ducts throughout the nipple.

Given that the dermatologist has only treated "about 20" women with this procedure, and has no followup safety data to present to the captivated audience (judging by the number of eager male doctors asking for detailed 'how to' instructions at the end of his presentation) I had some real concerns about whether this procedure should be promoted in any way at this time.

Don't get me wrong..I'm all for treatments that help women to overcome problems that affect their self-confidence.  But experimenting on women's breasts without any regard for functional side effects or mammogram safety is really not on.  Ductal carcinoma in-situ is a relatively common cause of (sometimes bilateral) mastectomy, and it would be an absolute tragedy to have either unnecessary surgery or missed diagnosis because of a cosmetic procedure that hadn't been investigated enough before being marketed to the world.  Having said that, I think this procedure would have a place helping those who have already undergone major breast reconstruction, and need their new nipples to look a bit more 3 dimensional.  Might have to suggest it to a couple of clients who fit this category.  Will let you know how they go!

Minimising Earlobe Creases

This is something that I already perform on patients who make the request, and it really is very easy, straightforward and effective.

Interestingly, the results appear to be quite long lasting without any particular side effects of note, other than the usual possibility of bruising and temporary excessive swelling.

Earlobe creases appear in older patients, and when I was a medical student were thought to be related to heart disease, so it is interesting that some patients notice them and complain of their cosmetic appearance.  However, if you want to have your earlobe creases injected, it might also be a good idea to make sure that your GP is monitoring you for other much more reliable signs of coronary artery disease.  We wouldn't want to overlook the onset of angina would we?   

FACIAL REJUVENATION FOR MEN..REVERSING SUNDAMAGE!

FACIAL REJUVENATION FOR MEN..REVERSING SUNDAMAGE!

Are men finally catching up with women when it comes to looking after their skin? Apparently yes!

Data from multiple sources show a clear upwards trend in the numbers of men seeking medical advice for a variety of cosmetic skin problems, and given the extremely high rates of severe sun damage amongst Australian men, it's little wonder.

In my opinion this isn't because Australian men have fallen prey to the dreams of Dorian Grey immortality.  Rather, Australian men are increasingly sophisticated enough to realise just how far behind the game they have fallen.

Sophisticated!  I hear you scoff!  It isn't a word one usually hears uttered in the same sentence as "Australian male".  And perhaps by some markers of sophistication there's still room for much progress!  However I like to consider basic sophistication as an awareness of others' cultural norms brought about by repeated global travel..and that's something that Australians are very very fond of.  Thanks to a relatively high Australian dollar, falling air travel costs over the last 40 years and a penchant for extended overseas work postings, Australians are increasingly globally aware citizens.

My oldest patient is almost ninety years old and happens to be a delightful farmer from a warmer part of the state.  He first came to see me 9 years ago following the removal of several small skin cancers on his face, and looking to do something about the remaining severe sun damage visible from the opposite side of the street.  His children (all in their 60s themselves) initially thought it was hysterically funny that their salt of the earth father would care so much about his weathered face to see a cosmetic medical skincare specialist.  However, they've now come to love the way he looks vibrant and spritely, with very few other skin cancers requiring excision over the last decade.  If they realised how many operations and chunks of skin excisions/grafting their father would have faced if he hadn't taken action 9 years ago, they'd probably be coming in themselves!  The reality is that for many Australian men, recurrent facial skin cancer ultimately causes extreme disfigurement.  Even the most stoic and ocker of us would rather not have to watch ourselves slowly morph into an image that is unrecognisable from our former selves.     

Farmers and other outdoor workers aside, there is another much more urban source of male skincare customer.  Visit any golf, tennis, cricket, surf life saving or sailing club in Australia and you'll see them there by the dozens amongst the senior members.  They're the men whose lifelong sporting obsessions have brought much enjoyment (&sometimes elite success) but along the way the stubborn refusal of many men to wear sunscreen on a regular (read daily) basis, has left their delicate pale complexion blotchy, reddened, scaly and persistently "dry".  Here are a few typical examples of the sort of sundamage that many of you may recognise amongst your own friends and relatives:

The top of the head is a classic area of sundamage for those who are bald!

I love looking after unhealthy skin.  There are few things that appeal to my medical/motherly need to fix someone's evidence of chronic self-neglect than a mature man in need of some very practical and very inexpensive skincare quickfix solutions!   

These men are often remarkably well educated in their field of expertise, have travelled widely and have seen with their two eyes how much more youthful looking their fellow fair-skinned Caucasians are in their native countries.

In Paris recently I found myself sitting next to a well known New York dermatologist who gasped in wonder when I confessed to being Australian.  "But you don't have enough sun damage to be an Australian!" he replied.

"Especially for a 44year old"  I thought to myself.  "I've been looking after my skin for a very long time" I replied.

Another patient, an Australian born male who recently returned after working in London for the last decade, reported how he'd noticed on moving there that his colleagues all looked very youthful for their age, but on returning to Melbourne he is horrified to see how much his school friends have aged.

Rejuvenating men's skin isn't necessarily about using injectable treatments such as anti-wrinkle injections or dermal fillers.

Most men can be remarkably rejuvenated with medicated prescription skincare alone. 

Pre treatment-actual Skin Temple client

Post treatment-actual Skin Temple client, medicated prescription skincare only!

Some may require laser treatment if significant pigmentation or broken capillaries exist.

Significant facial redness due to extensive broken capillaries is a Medicare rebatable laser treatment, when performed by a medical practitioner.

The downtime post laser treatment is really quite minimal, though significant healing is required with some of the medicated prescribed skincare.

So, if you're reading this and identifying strongly with some of these descriptions, perhaps its time you did yourself a favour and consulted a cosmetic medical specialist today.  There's no time like the present to make up for yesterday's sun damage!