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How can it help?
Anti-Wrinkle injections use neuromuscular blocking toxins to stop those muscles from contracting. The toxin attaches itself to the neuromuscular endplate (the connecting point of the nerve fibre to the muscle fibre). Acetylcholine, the neurotransmitter that normally causes muscle contractions to occur, is prevented from reaching the nerve fibre. The muscle is effectively paralysed. The treatment is particularly effective in treating deep, central frown lines and nasolabial (cheek) folds and “crow’s feet” (smile lines) at the side of the eyes. Dr. Arianayagam uses the brands Botox or Dysport for anti-wrinkle injections.
Consultation
During the initial consultation Dr Arianayagam will carefully and thoroughly examine your face, mapping out the area to be treated by examining your ability to move certain facial muscles. He will also ask you a variety of questions about your current health situation, medications, allergies and any past medical treatments. He will then discuss the options available and his recommendations. You should feel free to frankly discuss your goals and expectations and ask plenty of questions.
Procedure
The treatment is done in the Scarba Street Clinic. Based on the plan agreed at your initial consultation Dr. Arianayagam will mark strategic points on your face. A large number of small injections are made to target the muscles causing your wrinkles. The injection will only take about 10 minutes.
Recovery
Anti Wrinkle injections require almost no downtime. You should be able to return to work the same day as your treatment. There may be some redness and swelling in the injection area, but this usually subsides very quickly. It will take 3-7 days for all swelling to subside and the end result to become apparent.
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The mini facelift procedure restores deeper sagging tissues to reduce sagging, creating a more youthful appearance.
Both the mini facelift and short scar facelift suit various requirements. A consultation is the first step to determine which, if either, are right for you.
Step 1
The initial consultation with Dr Chandran Arianayagam features a thorough examination of your current situation, along with a discussion about your aesthetic goals to determine the procedure best suited to achieving them.
Step 2
Dr Arianayagam will consider your current health, any medications you may be taking, allergies, and past medical treatments, giving you his recommendations.
Step 3
You’ll have time to consider the procedure recommended to you, along with the opportunity to speak to past patients who have received the same procedure to understand their experiences with PCLS.
Step 4
The procedure will be performed at the Baringa Private Hospital or the Scarba Street Clinic.
Step 5
A full aftercare process will be explained to you with the PCLS team on-hand to support you through it every step of the way to a full recovery and your refreshed new look.
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In more severe ptosis cases, the pupil can be covered, causing an obstruction of the patient's vision, creating a hollowed appearance in the upper lid.
Ptosis correction is performed under local anaesthetic and is classified as day surgery.
Step 1
To ensure that this is the best path forward for you, a consultation with Dr Arianayagam will be booked to assess your eyelid and confirm that this procedure will rectify the issue for you.
Step 2
Dr Arianayagam will present you with the best available option, making a professional recommendation while providing you with all of the information you need about the procedure and recovery process.
Step 3
You will be given the opportunity to speak with previous patients who have undergone ptosis correction to prepare and gain peace of mind in the skills of the PCLS team by hearing personal stories.
Step 4
A second consultation will follow a week or so later for any final questions and to confirm your decision.
Step 5
Surgery is performed under local anaesthesia and sedation as a day procedure. All of your aftercare instructions will be supplied by our team who are also on hand should you need them during your recovery.
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Consultation
Dr. Arianayagam will ask you a variety of questions about your current health situation, medications, allergies and any past medical treatments. He will carefully examine and assess your brow, looking at the degree of elevation and the activity of the brow muscles.
Based on his examination, your history and personal goals he will discuss the options available and his recommendations.
Ideally, a second consultation is had a week or two later to give you the opportunity to come back with more questions and to confirm your decision.
Procedure
The exact surgical technique used will depend on many factors, including the position of your eyebrows, amount of excess upper eyelid skin and the height of your hairline.
The two most common procedures are the classic brow lift and the endoscopic lift. With a classic lift an incision is made along the hairline. Excess skin and redundant muscle is removed and the skin of the forehead is redraped upwards. An endoscopic lift involves 4-5 short incisions above the hairline. The connected endoscope allows the doctor to see beneath the skin during the procedure.
In your initial consultation Dr. Arianayagam will discuss in detail the specific procedure recommended for you.
All procedures are performed under general anaesthesia at Coffs Harbour Day Surgery or Baringa Private Hospital. The procedure takes up to 2 hours and is generally done as a day procedure, and you will be able to go home the same day.
Recovery
You should expect some bruising and swelling immediately after surgery. The worst of the swelling generally clears in the first 72 hours, but it can take 3-6 months for things to completely settle.
Usually a dressing is applied immediately after surgery and remains in place for at least 2 days. Most patients feel comfortable returning to work after about 2 weeks. You should refrain from strenuous exercise for 4 weeks.
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How can it help?
Injections of dermal fillers place synthetic collagen in the dermis, softening facial lines and grooves. This treatment is popular for enhancing cheekbones, plumping the lips and correcting wrinkles. Occasionally these are used for contour correction.
Dr. Arianayagam works with three brands of dermal filler: Restylane, Perlane and Sub Q. The latter is a ”heavy duty” subcutaneous filler which is used to improve deep contour defects in the face or body.
Consultation
During the initial consultation Dr. Arianayagam will carefully and thoroughly examine your face, mapping out the area to be treated. He will also ask you a variety of questions about your current health situation, medications, allergies and any past medical treatments.
He will then discuss the options available and his recommendations and a treatment plan will be devised. Dermal fillers are often done in combination with anti-wrinkle injections.
You should feel free to frankly discuss your goals and expectations and ask plenty of questions.
Treatment
The treatment is done in the Scarba Street Clinic.
Based on the plan agreed at your initial consultation, strategic points will be marked on your face as appropriate injection sites. The injection usually takes only a few moments per site. Depending on the number of areas to be treated the whole process may be anywhere from 15 to 30 minutes.
Recovery
Dermal Fillers require almost no downtime. You should be able to return to work the same day as your treatment. There may be some redness and swelling in the injection area, but this usually subsides very quickly.
It will take 3-7 days for all swelling to subside and the end result to become apparent.
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How can it help?
Take a look at your eyes in a mirror – the lower eyelid is static and comes into play only when you close your eye forcibly. Most of the movement in opening and closing the eye is by the upper eyelid, going up or down like a curtain. The movement of the upper eyelid going up is mainly by the Levator Palpebrae Superioris (The elevator of the upper eyelid) muscle. With aging, the weight of the upper eyelid increases due to the downward migration of skin, superficial muscle and fat, increasing the load on the Levator muscle and making it work harder. In time the attachment of this muscle to cartilage in the upper eyelid weakens and affects function, resulting in reduced lifting capacity which causes droopy upper eyelids.
- Effects of compromised LPS muscle action
- The upper eyelid gets droopy, getting worse during the day.
- There is a sense of heaviness in the upper eyelids and difficulty keeping the eyes open as the day progresses.
- There is an appearance of tiredness and the sufferer is often annoyed to be told by many around him or her that more sleep is needed!
Procedure
Treatment of the problem is by reversing the changes. Weight reduction of the upper eyelid is done with a blepharoplasty operation, in which excess skin, superficial muscle and protruding palpebral fat is reduced.
At the same time the LPS muscle is shortened and its attachment to the upper eyelid cartilage tightened. A very significant improvement in appearance and function is achieved with the above surgery.
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How can it help?
For a satisfactory outcome, excision needs to be followed by a strict and planned period of earlobe compression up to 6 months.
This is a difficult site to keep compressed and works best with a pair of custom made earrings. For about 10 years we have had excellent, attractive silver earrings made by Mac of Mac Art Jewellery in Bellingen. The earrings use two connected discs with a tightening mechanism which allows adequate pressure to be maintained.
Procedure
To achieve the best results, each custom made pair of earrings are made before scheduling the surgery as the compression must be started a week after surgery.
As in all keloid scar management, compression therapy is usually very effective. A bonus is that the patient is the proud owner of a new attractive pair of silver earrings!
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How can it help?
Eyelid surgery freshens the eyes, reducing loose skin, fatty bulges and “bags” and tightening the muscles around the eyes. The result is a natural, bright-eyed, fresher appearance.
Consultation
Dr. Arianayagam will ask you a variety of questions about your current health situation, medications, allergies and any past medical treatments. He will undertake a detailed and thorough exam of your eyes and how they relate to your face as a whole.
Based on his examination, your history and personal goals he will discuss the options available and his recommendations.
Ideally, a second consultation is had a week or two later to give you the opportunity to come back with more questions and to confirm your decision.
Procedure
Depending on your specific needs, surgery may be done on the upper, lower or both lids.
Upper lid surgery involves the removal of stretched skin and muscle, and where appropriate, the removal of eyelid fat. The procedure corrects heavy lids and loose skin draping over the upper eyelashes, as well as reducing any bulging pockets of fat.
Lower eyelid surgery involves the surgical tightening of the lid. Skin removal is hardly ever done to avoid downward displacement of the eyelid. Usually a carbon dioxide laser is used to improve skin quality.
Fat reduction, when necessary, is done through a transconjunctival approach. This means a cut is made on the inside of the lower eyelid for fat removal to avoid a scar on the skin of the eyelid.
Eyelid surgery is a day procedure done under sedation and local anaesthesia (“twilight anaesthesia”) or under deeper anaesthesia where necessary. You will be able to go home within a few hours of surgery.
Recovery
Recovery is usually rapid, requiring rest and cold compresses. Bruising and swelling varies from person to person, but will usually settle within 1 to 2 weeks.
The ability of the eyelids to effectively lubricate the eyes may be compromised in the short term and you may need to apply regular ointment or drops.
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How can it help?
By removing excess skin and repositioning fat and muscle upward, the procedure reduces jowls, elevates the cheeks and eliminates wrinkles and sagging. The result is a firmer, fresher facial appearance.
Consultation
The first step when you are considering a face lift is a consultation with Dr. Arianayagam. You should frankly discuss your goals and expectations at this consultation. Dr. Arianayagam will ask you a variety of questions about your current health situation, medications, allergies and any past medical treatments. He will carefully examine your face and take measurements. He will then discuss the options available and his recommendations. Ideally, a second consultation is had a week or two later to give you the opportunity to come back with more questions and to confirm your decision.
Procedure
Dr. Arianayagam prefers the MACS Lift (Minimal Access/Cranial Suspension). This revolutionary procedure uses a much smaller incision and has a much faster recovery time than the traditional full face lift. With the MACS lift, an incision is made in the crease just in front of the ear, then extended upward along the hairline and downward around the earlobe. The skin is detached from the cheeks up to the end of the cheek. The underlying deep fascia is tightened and lifted vertically using loops of sutures. The procedure is performed under general anaesthesia at Baringa Private Hospital. The procedure takes 3 hours approximately.
Recovery
You should expect some bruising and swelling immediately after surgery. Most of the swelling generally clears in the first week, but it can take 3-6 months for things to completely settle. Usually a dressing is applied immediately after surgery and remains in place for at least 2 days. Most patients feel comfortable returning to work after about 2 weeks. You should refrain from strenuous exercise for 4 weeks.
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How can it help?
Though the problem is common and multiple treatments available, the consensus is that there is a need for a combination of treatment methods, with an initial intense treatment period followed up by long-term maintenance treatment.
Treatments
PHOTOPROTECTION is the cornerstone of all treatments, to protect the skin from the effects of ultraviolet light ( UVB and UVA) and visible light, all of which stimulate melanocytes and in some instances overstimulate them. Broad spectrum skin protection against UVA ( 315 – 400nm ) and UVB (290 – 315 nm ) is critical. In addition, adequate clothing and hats add to the protection.
TOPICAL THERAPIES
Hydroquinone (HQ) is a widely used topical depigmenting agent ( acting by reducing the amount of melanin produced ) and works best when combined with a Retinoid (which inhibits melanin transfer into epidermal cells and increases pigment removal by increasing the turn over of pigment containing epidermal cells ) and a Corticosteroid.
The combination treatment is initially for daily use for up to 3 months, followed by a long-term maintenance therapy.
The Nd: YAG LASER
This laser has a longer wavelength ( 1064nm) and penetrates deeper while sparing the surface epidermis, making it safe to treat darker skin types and deep dermal pigmentation. The treatment is quick and well tolerated and with no”downtime”. It is repeated at for weekly intervals for at least 10 sessions of treatment.
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