Skin Rejuvenation Medical Spas

Chemical Peels/ Skin Resurfacing

With inevitable aging and accumulated skin damage there is gradual development of facial wrinkles and photoaging or sun damage. Factors which accelerate skin damage include excessive exposure to the sun, overactive facial expression muscles, cigarette smoking, stress, poor nutrition and skin disorders. More people are seeking facial plastic surgery and cosmetic procedures to reverse the effects of sun damaged and aging skin. Skin resurfacing could improve the look of your skin and subsequently your self-confidence. This information aims to give you some guidelines on procedures available at Perth Facial Plastic & Cosmetic Surgery. Successful facial plastic surgery can result if there is a good rapport between you and Dr Pham. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Dr Pham can answer specific questions about your specific skin problems at consultation.

Skin Resurfacing Can Be Used For The Following Conditions:

  • Wrinkles - especially fine wrinkles - around the eyes, lips, cheeks and forehead
  • Blemishes and uneven skin
  • Sun damaged skin
  • Pigmentation (freckles, hyperpigmentation)
  • Benign skin lesions - keratoses
  • Scar improvements - acne, chicken pox, traumatic or surgical scars
  • Facial rejuvenation - sagging eyelids

Understanding the Procedure

The skin is composed of the epidermis and the dermis. Within the dermis are two layers, both of which are constructed of wrinkle fillers which are long fibres that loosen and stretch with age and sun damage. If the deepest layer, the reticular layer, is damaged, scars result, while the upper layer of the dermis, the papillary layer, heals from injuries without scarring. Skin resurfacing essentially involves removing the superficial skin layers up to the deeper dermis layer. This causes the growth of new skin cells and underlying wrinkle fillers which in turn leads to smoother, firmer and healthier skin.

Methods of Skin Resurfacing are:

  • Chemical peel
  • Laser
  • Dermabrasion

Chemical peel - Dr Pham or his staff apply one of several chemicals to the skin. Glycolic acid is the mildest. TCA (trichloroacetic acid) or Hetter Peel can be used in varying strengths for longer-lasting smoothness. The deepest peels are done with phenol.

Before any peel, the face is first thoroughly cleansed with a solution to remove oil and to prepare the skin for deeper penetration. As the chemical is applied, the epidermis is removed, and the chemical penetrates into the first layer of the dermis.

Dermabrasion - is a surgical technique whereby some deeper scars and wrinkles can be smoothed. Dr Pham uses a local anesthetic and/or a freezing agent to render the skin numb. Using a high speed rotating brush, Dr Pham then removes the top layer of skin to the appropriate level. The size and depth of scars and the degree of wrinkling determine the length of the surgery.

Laser surgery - A laser is a high-energy beam of light that can selectively transfer its energy into tissue to treat skin and tissues. It is used to resurface facial skin with wrinkles caused by excess sun exposure, "crow's feet," and acne scarring. The high energy amplified light waves of a substance (eg carbon dioxide (CO2), Erbium) vaporise the top layer of skin instantly, with minimal bleeding and minimal trauma to the surrounding skin. Lasers can also be used to incise the skin or tissues, vaporize tumours, close blood vessels, selectively reduce pigmentation and remove hair.

There are many different lasers which are used medically and some are specific for certain conditions. Many procedures cannot be done without the laser. Likewise, many procedures are better performed without the laser or are as effective as a laser. It is a tool and the choice of using a laser as against any other surgical method is carefully evaluated by Dr Pham so that the best outcome can be expected.

Decision to have Skin Resurfacing The most basic requirement for any surgery is good health. Other requirements are more subtle and should be carefully considered in discussions with Dr Pham. Expectations from the surgeon and surgery must be realistic. Skin resurfacing procedures cannot produce perfect skin; rather the goal is to improve the appearance of the skin as much as possible.

Skin type and color, ethnic background, and age are important factors that should be discussed prior to surgery. If you have dark skin or problems such as allergies, previous burns, a history of poor scars (hypertrophic or keloid), or radiation exposure, you may need special evaluation to determine if you are a candidate for these procedures. If you have had episodes of cold sores and blisters around the mouth, past and current medications including Roaccutane, Retin-A, previous electrolysis and chemical peels please inform Dr Pham.

Before undergoing a skin resurfacing procedure, Dr Pham may recommend a skin care regimen beforehand. If you have extensive damage from aging or injury, more than one procedure may be necessary.

The Procedure

Dr Pham will discuss options and risks of each resurfacing technique and will inform you of the most suitable procedure for you. You will also receive information relating to each procedure. Please note that neither dermabrasion nor chemical peels can correct sagging skin or halt the aging process. Furthermore, resurfacing may lighten skin colour and you must make a commitment to use sunblock.

Skin resurfacing can be performed under local anaesthetic, sedation with local anaesthesia or general anaesthesia depending on the extent and your choice. After a thorough medical history, Dr Pham will advise you where the procedure will take place and the costs for the procedure. Most skin resurfacing procedures are day procedures.

Dr Pham may also suggest other surgery, either before or after your resurfacing procedure in order to enhance your overall appearance.

During surgery, if you are under local anaesthetic or sedation you may hear the laser or dermabrader noise. Your eyes and some parts of your face will be protected.

Preoperative (Before Surgery) Instructions

  • Start skin program if applicable
  • Dr Pham recommends prophylactic anti-viral treatment for cold sores / Herpes Simplex for all types of skin resurfacing procedures especially if you have a prior history. You should start the treatment 24 hours before surgery and continue for 7 to 10 days after.
  • Please cease Aspirin, Aspirin-containing products, Plavix and non-steroidal anti-inflammatories (such as Ibuprofen) for 10 days prior to and two weeks following your surgery. If you are on any medications that affect bleeding (such as Warfarin) please notify Dr Pham.
  • Smoking tobacco and alcohol increase anaesthetic and surgical risks. Please cease them for three to four weeks prior to and four weeks following surgery. They cause delayed wound healing, skin necrosis and other complications.
  • Please notify us of all your routine medications and significant health history. You can remain on your daily medications, except for blood thinners unless instructed otherwise.
  • Arnica, a natural herb that significantly decreases bruising, can be taken before and after surgery along with Vitamin C (ascorbic acid), which helps promote healing.
  • If you are having a morning procedure you must not eat or drink after midnight the evening before. If you are having an afternoon procedure you must not eat or drink after 6.00am on the morning of surgery. You may, however, take your normal medications and brush your teeth.
  • Please shower and remove any make-up and nail polish before arriving for your procedure.
  • Unless you are remaining in hospital someone will need to drive you home after surgery and stay with you that evening.
  • If you have any concerns please call the office (08) 9380 4488. Remember, we are all here to give you the best possible care.

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Postoperative Resurfacing Instructions

Immediately following skin resurfacing, Dr Pham may apply a dressing to your skin. Swelling, weeping, itchiness and “crusting” of the skin are normal, and ointments to keep the skin supple should be applied for seven to 10 days following surgery. Swelling typically peaks on days 2 -5 after the procedure then gradually improves. The redness of skin that persists after the initial healing phase will usually fade in about 4 weeks. Do not pick at the crusts as this may increase wound infection.

Skin Care: It is very important that you regularly clean your skin 4 times a day and applies moisturiser (Vaseline for first 2-3 days then water base emollient for 2 weeks). Once the skin has resurfaced you can apply moisturizer twice a day and sun block for the next 6 months. You may wish to use our recommended skin care products (hydrator, moisturizer, depigmentation, light peel) for ongoing skin maintenance. You can shower normally.

Medications: You will need antiviral medication Zovirax, Acyclovir or Famciclovir the day before until 7 days after the procedure. Take antibiotic for 7 days. Pain relief such as Paracetamol +/- Codeine, Tramadol or Oxycodone, Cerebrex will be prescribe.

We recommend a normal diet, avoidance of extremes in temperature and any activities that would cause stress to healing skin for 3 to 4 weeks. It is imperative that you follow the post-operative instructions provided by Perth Facial Plastic & Cosmetic Surgery. Should you experience any increase in redness or itching in the days after surgery, notify the office immediately.

One to two weeks after surgery new skin will emerge that is pinkish, finer, and free of many wrinkles. But it will take several weeks for all the redness to vanish. Follow-up care involves using sunblock (SPF 30 or more) and avoiding sun exposure in order to protect the skin while new pigment is created. This is recommended for 6 months or more after the procedure. You can apply make up after 10-12 days. Use only the cream recommended by Perth Facial Plastic & Cosmetic Surgery. Patients will notice that the skin remains lighter for a long time after surgery, but this will usually subside when the skin’s pigment level has been restored.

Final results following skin resurfacing are not apparent for up to 3 months following surgery. We request that you please follow-up with us for at least 6-12 months for assessment and postoperative photographs. Remember to maintain a healthy lifestyle and please continue a good skin care program for the best long term results.

Please Inform Dr Pham’s office or the hospital where the procedure was performed if you have the following:

  • High fever, chills or a temperature of more than 38 degrees
  • Heavy bleeding from the wounds
  • Severe pain or tenderness
  • Significant redness, or discharge around the wounds

If you have any concerns you can contact Dr Pham’s office on 9380 4488. Remember, we are all here to give you the best possible care.

Risks of Surgery

Modern surgery is safe but does have risks. Complications can occur despite the highest standards and world’s best practice principles used by Dr Pham.

It is not possible to list all the risks but you should be informed of the common side effects and benefits so that you can make an informed consent. Dr Pham will discuss these in greater detail at consultation. You should write down any particular questions or specific concerns.

The potential risks are

General risk of surgery

  • Wound infection or breakdown – may require antibiotics
  • Bruising and swelling
  • Bleeding, seroma and crusting
  • Slow healing especially in smokers
  • Pain and itchiness

Specific Risks

  • Herpes cold sores, pimples and whiteheads, acne outbreak
  • Persistent swelling and inflammation
  • Inflammation of surrounding areas such as the eyes – conjunctivitis, may require antibiotic eye drops
  • Scars that become raised (hypertrophic or keloid), pink and sometimes itchy. May take 12 -18 months to settle and may require steroid injections
  • Changes to skin pigmentation – lighter (hypopigmentation) or darker (hyperpigmentation)
  • Asymmetry and contour irregularities including depressions or wrinkling of the skin
  • Subjective dissatisfaction with the final outcome
  • Allergic reaction or skin sensitivity to skin creams and sun
  • Some patients have trouble sleeping or feel depressed
  • Anxiety regarding staying indoors or avoiding public places during the healing period

Insurance does not generally cover procedures that are performed purely for cosmetic reasons. Surgery to correct or improve major deformities or accidental skin injuries may be reimbursable in part. It is the patient’s responsibility to check with his/her health insurance fund for information on the degree of coverage.

Please contact us for your consultation on Skin Resurfacing / Chemical Peel or other cosmetic surgery and non surgical cosmetic procedures

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FEES AND INSURANCE

After conducting a thorough medical history, Dr Pham and his staff will offer information regarding anaesthesia, the surgical facility to be used, and the costs for the procedure. Every procedure is individual and unique to each patient. Because of this, determining your specific needs and the fees associated relies upon a variety of factors, such as the complexity of the operation, where the surgery will take place and type of anaesthetic to be administered.

Your Quote

A quote will be provided and is usually an estimate as the actual surgery may differ from the proposed treatment due to an unexpected finding. Dr Pham will never compromise your health or surgical outcome to conform to previously anticipated or communicated anaesthesia and facility time. Accordingly, if further treatment is required (either through complexity, unforeseen complications or additional procedures you request) then extra costs are likely to apply.

Total Fee

The total fee will comprise of

    • Surgeon Fee (Dr Pham)- this will be provided in the quote
    • Anaesthetist Fee- you will need to consult the Doctor / Anaesthetist involve for a quote
    • Hospital or Day Surgery Fee- you will need to contact the hospital involve for a quote

Consultation Fee

The fee for the initial consultation with Dr Pham is $190.00. Please remember that a referral letter from your General Practitioner will be required for a Medicare Rebate of $70.

Your first cosmetic consultation is free with a Nurse Coordinator.

Fees for cosmetic plastic surgery are paid prior to surgery.

Deposits

A non-refundable deposit of 10% or $500 is required once surgery has been scheduled. This deposit reserves the surgery date and is credited towards the balance due.

The balance of fees due is to be paid in full at the pre-operative appointment or three weeks prior to the scheduled surgery, whichever is first. Perth Facial Plastic & Cosmetic Surgery generally does not provide refunds. Once a procedure is scheduled and the fee collected, and you cancel or reschedule the surgery within 2 weeks, there will be a fee of 25% of the total cost. Of course, exceptions are made for life threatening emergencies or medical illnesses prior to the procedure. In these instances, the rescheduling fee does not apply.

Payment

Acceptable forms of payment include:

  • Cash
  • Bank Cheques
  • Visa or MasterCard

We do not offer payment plans

Health Insurance

As a rule, cosmetic plastic surgery is considered “elective surgery” and is not covered by most health insurance funds or Medicare. Some operations that have a significant functional aspect may be considered reconstructive rather than cosmetic and, as such, may attract a small rebate. These include Rhinoplasty for deformity or nasal obstruction, and breast reduction if the weight of your breasts causes pain or interferes with normal activities. Dr Pham will advise you to contact your health fund and Medicare if this is the case.

Because Facial Plastic & Cosmetic Surgery is artistic, on occasion, revisions may be necessary. Such revisions are performed within one year of the original surgery, and although there is generally a minimum charge for the surgery, facility and anaesthesia fees still apply for such procedures. Perth Facial Plastic & Cosmetic Surgery reserves the right to determine whether a revision is appropriate and what the procedure will entail. If you have any questions regarding this policy, please ask Dr Pham.

TABLE OF FEES

These prices are approximate only. You will be provided with a firm quote after consultation with Dr Pham. Most cosmetic surgery’s fee will attract a GST.

ProcedureDr Pham’s FeeAnaesthetist FeeHospital fee (Private Health Insurance may apply)Churchill Day Surgery fee
Rhinoplasty (Nose Reshaping / Nose Job / Nose Surgery)7000-7500

 

8000-9500  (costal/rib cartilage)

1500-20003500-45002500-3000 (selected case)
Mini Face Lift, Minimum Incision Facelift6000-7000 +GST2000-25004500-55004000-4500
Face and Neck lift9000-10,000 +GST2500-30006000-80005500-6000
Neck lift6000-7000 +GST2000-25004000-45003500-4000
Brow lift3500-4000 +GST1200-15002500-30002000
Eyelid Upper2500-3500800-10002000-25001800
Eyelid Lower2500-3500800-10002000-25001800
Eyelid Upper and Lower5000-60001500-18003000-40002800-3000
Mini-Face lift, upper & lower blepharoplasty10000-12,000 + GST2500-30006000-80005000-6000
Face Neck lift, upper lower blepharoplasty12000-14000 + GST3500-40007000-90006000-7000
Face Neck Brow lifts, upper lower blepharoplasty15000-16000 + GST4000-45008500-95007500-8000
Otoplasty / Ear Pinning / Prominent Ear5000-60001200-15002500-35002500-2800
Chin implant / Augmentation2500-3500 + GST Implant 700 +GST800-10002000-25001800
Cheek Implant / Augmentation3000- 3500 + GST Implant 700 +GST800-10002000-25001800
Breast Augmentation / Breast Enhancement5000-6000 +GST Implant 2000 +GST1200-15002500-35001800-2000
Breast Reduction / Breast Lift8000-90001500-22003500-4500NOT Available
Gynaecomastia – Male Breast Reduction4000-50001200-15003000-35002000-2500
Tummy Tuck (Lipectomy / Abdominoplasty)8000-90002000-35004000-5000NOT Available
Mini Tummy Tuck (Lipectomy /Abdominoplasty)4500-60001200-18002500-30002000-2500
LiposculptureDepends on area. Approximately 1000-1500 per area +GSTNeed quoteNeed quote. Each area include: Upper abdomen, Lower abdomen, Flanks, Medial thigh, Lateral thigh, Buttock, Axillae, Back, Upper armNeed quote
Chemical Peel2000-2500 +GST Depend on areaIf required sedation or general anaestheticNeed quote1000
Dermabrasion2000-2500 +GSTIf required sedation or general anaestheticNeed quote1000
Wrinkle Relaxer550-600 for 25-30 units or 300 per area +GST
Fillers – temporary- Juvederm650/ampoule +GST
Fillers – semi permanent1200/cc +GST
Platelet-Rich Plasma800-1000 + GST

 

YOUR AREAS of CONCERN

 

Brow and Forehead: lines, angry or tired, sad look
  • Wrinkle Relaxer
  • Wrinkle Fillers
  • Blepharoplasty / Eye lift / Eye lid surgery
  • Endoscopic Brow Lift /Forehead Lift
Eyes: hooded, droopy, puffy, fullness, block vision
  • Blepharoplasty / Eye lift (upper and lower eyelid reshaping)
  • Endoscopic Brow Lift / Forehead Lift
Eyes- crow feet
  • Wrinkle relaxers
Ears: protruding, batty, large, prominent ear
  • Otoplasty (Ear Pinning)
Jowls and Sagging Cheeks & neck
  • Face lift (Rhytidectomy)
  • Mini Facelift, S-lift, MACS lift
  • Face Neck lift
Neck: sagging, excess skin, bands, fullness
  • Neck Surgery (Neck Lift and Liposuction / Liposculpture)
Wrinkles and Lines
  • Wrinkle Relaxer
  • Wrinkle Fillers
  • Laser & Chemical Resurfacing
  • Dermabrasion
  • Platelet Rich Plasma
  • Skin Care Products

 

Nose: prominent, large, twisted, too small, nasal hump, too long
  • Rhinoplasty (Nose Surgery)
Blocked nose, crooked nose, fractured nose
  • Septoplasty / Septo-rhinoplasty (Nasal Surgery for breathing and deformity)
Cheeks: hollow
  • Implants – Cheek implant
  • Wrinkle Fillers
  • Fat transfer
Chin: small, protruding
  • Chin Surgery – Chin implant, Genioplasty / Mentoplasty
  • Wrinkle Fillers
  • Fat transfer

 

Cosmetic Breast Surgery: breast enhancement / implant, sagging breast, heavy breast, male breast
  • Breast implant / Breast enhancement / Breast Augmentation (Augmentation Mammoplasty
  • Breast Lift (Mastopexy)
  • Breast Reduction (Reduction Mammoplasty)
  • Correction of Enlarged Male Breasts (Gynaecomastia)
Body Contouring: sagging tummy, too much fat
·         Tummy Tuck (Abdominoplasty)

·         Mini Tummy Tuck (Lipectomy)

·         Liposuction / Liposculpture

 

Facial Reconstructive: scars, skin cancer, moles
·         Skin Cancer of the Face, Head & Neck

·         Mole Removal