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This month, Dr. Mark Lee was honoured to be awarded the 2021 Plastic and Recovery Surgery – Global Open (PRS) ‘’Best Oceanic Paper’’ Award for his paper on Breast Implant Illness: A Biofilm Hypothesis. Dr. Lee pursued his interest in the impact of Biofilm on Breast Implant Illness alongside his esteemed co-authors, Ganesa Ponraja, Kevin McLeod and Smathi Chong and collectively, they were excited to be recognised by this prestigious body.

After following 50 patients, the doctors identified microbiological and histological abnormalities in a significant number of patients who identified as having one or many of the broad symptoms of Breast Implant Illness. Whilst 84% of the symptomatic patients self-reported a resolution or improvement of symptoms, you may be interested in their conclusion that Breast Implant Illness is a genuine entity worthy of further study.

To choose the winner, the PRS combined the data for all manuscripts submitted since the beginning of 2020 and compared them in the judgement process, with this paper appearing as the best in its category, ‘by a distinct margin’.

To learn more about this award and Dr. Mark Lee’s breast implant research, see the public announcement here.

While the reality of the COVID-19 pandemic has varied for many, it is likely that you have transitioned to a new normal of lockdowns, Zoom calls and the now ubiquitous face mask. Signing into work may mean staring down a webcam or masking up, so now more than ever all eyes are on, well, the eyes.

For those whose focus has shifted upwards on their face and want to explore a cosmetic enhancement, we have listed five common eye procedures you may wish to consider.

Eyelid Rejuvenation Surgery (Blepharoplasty)

This procedure is commonly performed to target hooded upper eyelids and protruding ‘pads’ underneath the eyes that can leave you looking tired or impact your vision.  For upper eyelids, your surgeon will work to adjust the eyelid fold to sit parallel to the upper lashes, minimising any skin or fat removal that can lead to an unnatural result. A similar approach is taken for the lower eyelids when removing ‘pads’ from under the eyes, the result should leave you with a more rested and youthful appearance. These procedures can be performed together, or in isolation, both offering a relatively quick and simple way to see dramatic improvements.

Canthoplasty

Often referred to as ‘almond eye surgery’, a canthoplasty is performed with the goal to reshape the lateral canthus or the outer corner of the eye. The most common desired result is a more upturned, elongated cat-eye shape, correcting the down-turned eye shape that can be associated with sleepiness or aging. This is achieved by tightening the lower eyelid, removing sagging or excess skin to give the eye a larger and brighter appearance, with no winged eyeliner required.

Wrinkle Relaxers

The least invasive way to refresh the upper half of the face is by relaxing, or smoothing out, the expression lines of the forehead and the delicate skin surrounding the eye. Several small injections of wrinkle relaxer can be precisely injected into target areas to block the signal from the nerve in the facial muscle, stopping them contracting and in turn, relaxing the lines that appear more and more with age. You will require no downtime after injections, so your video can stay switched on in your next Zoom call.

Tear Trough Fat Injection

Your undereye circles, or tear troughs, are often associated with looking youthful, fresh and well rested. This area can appear dark and hollowed out naturally, or with age, but adding volume back into the area using targeted fat injections is an effective way to refresh your overall appearance. Less is more here, a natural result will have you looking well rested, not puffy.

Mid Face Lift

Aging goes beyond skin wrinkles alone, there are changes that happen gradually to the deep ligaments and muscles of the face that can’t be refreshed with non-surgical enhancements. If you are seeking an enhancement that addresses the deeper structure, you may consider a face lift for a natural looking, long-term change. For those stuck staring at the top-half of their face, sometimes a tight ponytail just doesn’t cut it. There are mid face lift options that address your mask-free territory, the upper two thirds of the face. There is an endoscopic option for this procedure that only requires a few, small incisions or more traditional alternatives that can be used based on your individual desired outcome and needs.

Learn more about the full range of eyelid surgery procedures Dr. Mark Lee offers or book in a free consultation to discuss what’s right for you.

 

You have likely seen someone on social media, tv or in the magazines recently that look frozen and unnatural, this could be due to excess fillers. With the rise in popularity of this treatment, the number of clinics offering this service has surged. Unfortunately, this can mean some clinics provide the service without their staff having sufficient training in facial anatomy.

In this article we’ll cover some of the risks associated with dermal fillers, how to choose the right provider, what to expect from the procedure and the benefits when it is administered correctly.

Choosing the right plastic surgeon

Choosing the right plastic surgeon is critical to achieving natural, long lasting results. At Mark Lee Specialist Plastic Surgeon, our dermal fillers are administered by highly experienced, accredited and registered nurses and overseen by one of our plastic surgeons.

Before the procedure we offer a comprehensive consultation, which assesses your suitability for the treatment. We analyse your face, discuss your treatment goals and ask about any medical conditions you may have or any medications that you may be taking. We then determine the best product for your treatment and address any concerns that you may have.

Choosing the right procedure

Dr Mark Lee works closely with each of our patients to ensure we provide the right procedure to achieve the desired results. For example, a non-surgical nose job, could be a great option for some depending on their desired results. However, if this is not administered correctly it can cause disproportionate widening of the nasal bridge – dubbed Avatar nose.

Other procedures that we often see go wrong are overfilling of the chin resulting in an unnatural, sharp chin, overfilling of the forehead which removes natural contours, and filler fatigue. To avoid filler fatigue which requires patients to have frequent top-ups to avoid saggy looking skin, as well as other complications, choosing the right surgeon who tailors the treatment to your skin and unique concerns is vital.

What to expect during the procedure

Depending upon the extent of your treatment, the procedure will last anywhere from a few minutes to one hour. The area will be cleaned and a topical anaesthetic or an injection of local anaesthetic will be administered to numb the treatment area. Then a precise amount of hyaluronic acid filler will be injected beneath the skin. The treatment area is then massaged and the results are evaluated. If needed, additional filler will be added.

After the procedure, you may experience some mild redness, stinging, swelling or bruising on the treatment area. This is temporary and should subside within a few days, with most patients able to resume normal activities, such as work, immediately afterwards. In some cases, you may be asked to refrain from strenuous exercise for 48 hours following the treatment.

Possible Risks

When considering both surgical and non-surgical cosmetic procedures, it’s critical to understand what you are committing to, including all of the benefits and risks associated with the treatment. In rare cases, dermal fillers have caused some individuals to become blind or have a stroke. This occurs when the injection hits the blood vessel and blocks it. Other complications include allergic reactions, vascular complications, scarring, asymmetry, inflammation, and bump formation.

The benefits when administered correctly

There is a reason that dermal fillers are one of the most popular facial rejuvenation techniques out there today. When administered correctly, the results are immediate, they smooth out your wrinkles and re-volumise your face. Patients often look significantly younger after their treatment, yet still natural and like themselves, with the results lasting anywhere from six to eighteen months.

To learn more, view our 3D simulation on Hyaluronic Acid Fillers or book in for a free consultation with Dr Mark Lee to discuss your individual needs

Updated: 27 April 2021

An Important Message for our Patients Regarding COVID-19

As we continue to move into the next phase of easing restrictions, patient and staff health remains the utmost priority for the clinic. We continue to observe strict hygiene safety guidelines for our in-clinic appointments to ensure our patients, staff and visitors are safe.

We are open for both patient reviews and new patient referrals and are taking bookings for elective surgery, however please note that all elective surgeries booked for 27 – 30 April 2021 will be postponed and rescheduled to the next available surgery date.

It is critical that you do not avoid any medical appointments that may have an impact on your immediate or long-term health. Check-ups with your GP, regular skin checks, blood tests, mammograms and other medical appointments should continue as usual to ensure you remain as healthy as possible.

Please don’t hesitate to get in touch for any further information.

In the spirit of Breast Cancer Awareness Month, we thought it would be valuable to raise awareness around post-mastectomy reconstruction options. While one in eight Australian women are diagnosed with breast cancer before the age of 85, of those that have a mastectomy (40%), the rate of Breast Reconstruction is between 9% and 12%.

Despite a low uptake of breast reconstruction in Australia, current clinical guidelines worldwide recommend that Breast Reconstruction should be offered to all suitable women requiring or choosing mastectomy.

A big part of a surgeon’s role is to provide appropriate options and all the information needed around these procedures to make your decision-making process as easy, informative, and certain as possible.

Dr Lee has significant breast reconstructive surgery experience and has previously developed innovative, minimally invasive techniques for the procedure, such as the scarless latissimus dorsi breast reconstruction procedure.

The breast reconstruction procedure can be done at the time of your mastectomy (immediate reconstruction), or it can be done later (delayed reconstruction). Breast reconstruction often requires multiple operations, even if you choose immediate reconstruction.

Along with the timing of the procedure, there are three different Breast Reconstruction options

  • Implant based reconstruction
  • Tissue based reconstruction
  • A combination of implants and tissue

Implant based reconstruction

There are 2 types of breast reconstruction options using implants, Tissue Expander/ Implant Reconstruction, and Direct-to-Implant Reconstruction.

Tissue Expander/ Implant Reconstruction (Two Stage)

This is the more commonly performed technique in Australia. Step one of this procedure involves a tissue expander being inserted into the pocket created under your skin and chest muscle.

The expander is partially inflated with saline during the operation after insertion and over a period of weeks to months more saline is inserted to gradually fill the expander. This process helps to gradually stretch the muscle and skin to the breast size desired. Once the skin over the breast has been stretched to the desired size, the expander is exchanged for a permanent implant.

Direct-to-Implant (DTI) (One Stage) Reconstruction

In some cases, there is enough skin to insert an implant under the chest muscle to replace the removed breast tissue. In these cases, there in an option to insert an implant directly without the need for tissue expanders.

Tissue flap reconstruction

There are two main types of tissue flap reconstruction – attached flaps and free flaps.

Attached Flaps

This method uses skin, fat and muscle from your back or abdomen, where a portion of tissue and muscle is tunneled under the skin from your back or abdomen to your chest. The new breast is then formed using this tissue.

Free Flaps

This method uses skin, fat and muscle removed from your abdomen or buttock, cutting the arteries and veins, then re-attaching to the blood supply of the chest wall. The breast is then formed from this tissue.

 

A combination of implants and tissue

In some cases, it may be necessary to use an implant and tissue to achieve the desired results. Your surgeon will be able to discuss your desired goals and the right procedure to work towards your goals.

 

Breast reconstruction is a highly individual procedure and may not be suitable for everyone, however Dr Lee and his team are always more than happy to talk about your options.

 

Resources

Increasing breast reconstruction rates by offering more women a choice, Article in ANZ Journal of Surgery, January 2014

Did you know eyelid surgery (known in the medical world as Blepharoplasty) is in the top 5 most commonly performed procedures worldwide?

While it remains most popular in Eastern Asian countries due to its aesthetic and vision aiding benefits for Asian facial structures, the procedure continues to be popular through the West, delivering great results for those who have droopy upper or lower lids.

Ageing upper eyelids and lower lid bags can make people look “tired and angry” even when they feel very differently on the inside.

What types of procedures are there?

  • Upper Eyelid Surgery is mainly used to improve vision loss and the appearance of the eye due to aging or genetics. This type of surgery can restore the function of the eye or provide a more rounded, open appearance. As the name implies, this procedure focuses on the upper eyelid only.
  • Lower Eyelid Surgery focuses on removing wrinkles in the skin, correcting baggy eyes and / or improving the overall appearance of the lower eyelid. As the name implies, this procedure focuses on the lower eyelid only.
  • Double Eyelid Surgery creates a crease in the upper eyelid, making a wider, larger-looking eye. This is the procedure that’s most popular in East Asia, and the one most often referenced in relation to blepharoplasty as a whole.

The eyelid procedure you’re best suited for may vary depending on the shape of your eyes and other health conditions, so it’s best to consult with your surgeon prior to making any decisions.

Who is a candidate for blepharoplasty?

Eyelid surgery may be an option for you if droopy or sagging eyelids keep your eyes from opening completely or pull your lower lids down.

Blepharoplasty may be an option if you have

  • Baggy or droopy upper eyelids
  • Excess skin of the upper eyelids that interferes with your peripheral vision
  • Excess skin on the lower eyelids
  • Bags under your eyes

Are blepharoplasty procedures covered under Medicare?

Medicare does not typically cover cosmetic surgery, however if your eyelids are impacting your vision you may be eligible to claim some of the procedure on Medicare. Speak with your surgeon about your options, and what’s the most appropriate path for you.

Decades ago, Face Lifts were considered an extreme surgical procedure, often associated with the ‘Hollywood-gone-bad’ look. However, new techniques have brought the face lift back in vogue. With less scarring and downtime, coupled with a more natural look, it’s not surprising that more patients are opting for face lift procedures.

Dr Mark Lee provides a range of face lift procedures, with one of the most popular being the Mini Face Lift.

What’s the difference between a Mini Face Lift and a Full Face Lift?

The aim of a Face Lift is to reduce the signs of ageing by improving the contours of the face.

The Full Face Lift considers and addresses jowls, the midface area and full neck, while the Mini Face Lift typically only addresses the jawline and neck laxity. The Mini Face Lift is generally less invasive than the Full Face Lift.

Importantly, the results of a Mini Face Lift are much more subtle than those of the Full Face Lift.

A Face Lift, full or mini, does not alter the bone structure of the face. Some patients combine their Face Lift with other surgical procedures such as a brow lift, eyelid surgery or nose reconstruction.

Who should consider a Mini Face Lift?

The mini face lift is a great option for women and men who have noticed aging in their faces and want to improve in their appearance without a drastic transformation. Most face lifts are performed on people aged between 40 and 55, but often older or younger people may also consider the procedure.

A Mini Face Lift may be a good option for you if you:

  • Have mild to moderate face laxity (ie. Jowls)
  • Mild upper neck laxity along with face laxity concerns
  • Are aged between 40 – 55 years old

Why should I consider a mini facelift?

The Mini Face Lift produces subtle, refreshed look results in those with mild to moderate facial laxity and ageing.

The procedure generally has a short down time, with most people being able to return to usual activities in 7-10 days. Complications are rare, and there is generally a lower risk for the Mini Face Lift procedure than the Full Face Lift procedure, however as with all surgical procedures there are risks, we encourage you discuss this with us before proceeding with your procedure.

The Mini Face Lift procedure may or may not be right for you. We’re here to help guide you through your journey and will always discuss the recommended procedures and realistic outcomes.

Considering a Face Lift? Book an appointment with Dr Mark Lee and the team.

Dr Mark Lee and the team always ensure patients, past, present and prospective, are empowered to make informed choices about their healthcare and understand the risks and benefits of their preferred procedure.

Read on to find out more about the proposed regulatory action from the Therapeutic Goods Administration (TGA) for breast implants and what it means for you.

Why is there a proposed cancellation or suspension?

The TGA is currently monitoring the association between breast implants and anaplastic large cell lymphoma (ALCL), a rare cancer of the immune system. This cancer is often called BIA-ALCL, or breast implant associated anaplastic large cell lymphoma. While the factors that cause the cancer are not confirmed, there are certain risk factors that increase the likelihood of BIA-ALCL including:

  • textured implants
  • bacterial contamination during surgery
  • the patient’s genetic predisposition
  • length of time the patient has had the implant.

The TGA has proposed the cancellation or suspension based on this rare complication and has identified possible implants that need to be further investigated to ensure the utmost safety for patients moving forward.

At this stage, this is just a proposed cancellation and leading implant manufacturers are conducting thorough data reviews and safety checks to establish any patient risks.

Does this affect all types of breast implants?

The TGA has proposed regulatory action in relation to a number of textured implants only. This includes all MENTOR® SILTEX® Microtextured Breast Implants and Expanders, as well as various other providers.

All reported cases of BIA-ALCL in Australia involve patients who have had a textured implant at some point in their life. Experts believe, based on the evidence currently available, breast implant associated cancer is not related to either the contents (saline/silicone) or shape (round/teardrop) of the implant.

What happens from here?

The companies who make the affected implants need to provide additional information including safety research and data to the TGA for assessment along with the results from their own laboratory tests. The outcome of this will determine whether the implants will continue to be used, be suspended for further research or be cancelled. When more information is available, we will make this available on our blog and social media pages.

I already have breast implants, do I need to get them removed?

Generally, if you have implants and you have not noticed any significant changes to your body, it is unlikely there is any reason to worry. Any changes you may notice are unlikely to be BIA-ALCL. Given BIA-ALCL is so rare, experts do not recommend preventative removal of breast implants, unless there are specific concerns or complications with the implant.

Our strongest recommendation is to consistently monitor your breasts and overall health, and always discuss any concerns or changes you have noticed with your GP or surgeon.

I’m looking at getting breast implants, what should I do next?

It’s important you understand any surgical or invasive procedure carries risks, and no medical device is completely without risk.

If you are considering breast implants, we recommend booking an appointment with Dr Lee to discuss your desired outcome, explore the benefits and risks of the different types of implants, and determined the right type of implant for you.

If you would like to learn more about the possibility of breast implant removal surgery, or have any concerns about your current breast implants, Dr Lee and his team are always more than happy to talk about your options.

Useful links

Therapeutic Goods Administration – Breast Implant Hub

TGA’s review of textured breast implants and preliminary outcomes

Dr Mark Lee is proud to be part of a global network of doctors who donates hundreds of thousands of hours toward the care of children around the world each year. An astounding 98 surgeries have been completed as part of his recent Operation Smile Australia mission in Vijayawada, India, this month.

Reconstructive Surgery for child’s Cleft Palate in India

India remains one of the most populous areas of the world with an estimated population of 1.1 billion. This yields an estimated 24.5 million births per year and the prevalence of children born with a cleft palate is somewhere between 27,000 and 33,000 per year.

In many cases, parents cannot afford the surgeries required to live a normal life – with their children facing difficulties with speaking, eating and socialising. Operation Smile Australia believes every child should have access to world-class surgical care – enlisting the support of medical professionals like Dr Lee all across the world.

Over the past 13+ years, Operation Smile medical volunteers have treated more than 22,000 patients in India alone.

Mark has been volunteering with Operation Smile and various other aid missions around the world for nearly 20 years.

Here is Dr Lee with one of his patients in India.

Dr Lee smiling with one of his little patients in India after the cleft palate surgery

Breast augmentation and lifts are two of the most popular cosmetic surgery procedures performed in Western Australia today.

Depending on what your individual body shape is and what you’re hoping to achieve, a breast lift or a breast augmentation (or even both) may be right for you.

How are they different?

Breast augmentation or enlargement is designed to increase breast size, with various options in terms of implant size and shape that we will work through with you in your initial consultation. A breast augmentation will only impact the size of the breast, not the positioning. This is where breast lifts have become increasingly popular. A lift is designed to correct breast ‘drooping’ – commonly occurring with age, weight fluctuations and pregnancy. A lift will raise and firm the breasts by removing excess skin and reshaping the breast tissue to achieve enhanced contours.

Is a breast lift right for me?

If your breasts have lost their shape and volume over time, a lift may be the ideal cosmetic procedure for you. Remember a breast lift will not significantly change the breast size, so if you want your breasts to either look fuller or smaller – an augmentation or reduction may be a better option. Women planning a pregnancy should also be aware that this may impact the results of the lift.

Can I have an augmentation and lift at the same time?

Yes, sometimes a breast lift is performed in conjunction with breast augmentation so the position, shape and volume are enhanced during the one procedure. Depending on what your goals are (ie a change in size, position or both), Dr Lee will advise you if an augmentation and lift is the right fit for you.

What do I do before the procedure?

When you first meet with Dr Lee to discuss your lift, he will request your relevant medical history and undertake a physical exam to ensure this is the best procedure to help you achieve your goals. The consultation before you undergo a breast lift procedure is one of the most important stages of the process. This is the time to ask any questions you have around recovery time, clarify your expectations of the end result and ensure you’re completely comfortable with your decision.

What happens after my breast lift?

After your procedure, you’ll be given a post-surgical bra to promote healing and support your breasts. You’ll have some discomfort for the first few days and likely require some pain medication to keep you comfortable. Some women experience numbness in various places around the breast for up to six weeks, while any form of straining or lifting is strongly discouraged. Stitches (if not dissolvable) will be removed around 1-2 weeks following the lift.

Contact our friendly staff for more information, or to book a consultation.