FAQs

View our frequently asked questions below, our range of Cosmetic Surgery and non-surgical cosmetic medicine procedures available, or see the Gallery / Before & After Photos. If you wish to learn more about Cosmetic Surgery and Facial Plastic Surgery please contact us to schedule a consultation with our Facial Plastic and Cosmetic Plastic Surgeon or Nurse Coordinator.

The term ‘plastic’ covers a variety of surgical and chemical procedures that alter, rebuild or remodel the body’s outward appearance. It covers both cosmetic and reconstructive surgery to shape certain body parts such as the nose, face or breasts. Some procedures soften skin tone, reduce or eliminate wrinkles, and some help correct certain problems resulting from congenital defects, accidents or diseases. Dr Pham specialises in Facial Plastic Surgery, Rhinoplasty and Cosmetic Surgery of the Face.

We recognise that when considering undergoing Cosmetic Plastic Surgery and Facial Plastic & Reconstructive surgery it is important to make decisions based on informed choices. At Perth Facial Plastic & Cosmetic Surgery we hope to:

  • Provide information on the most proven and safest treatment options and surgical techniques.
  • Help you to make the best and most informed decisions.
  • Provide you knowledge of the qualifications, training and experience of your surgeon.

Dr Tuan Pham is a highly qualified and trained Specialist Facial Plastic and Cosmetic Plastic Surgeon in Australia.

We offer innovative treatments and personalised care to create a natural look that is harmonious with the age and general appearance of individual patients – the goal of any good cosmetic procedure.

The aim of cosmetic surgery is to provide a good, natural and healthy look with a long lasting improvement. While cosmetic surgery is effective in rejuvenation of the face and body, it does not stop the body clock or the natural aging process. This natural aging process will continue after surgery but hopefully at an earlier starting time. It is important to have realistic expectations and outcomes with regards to cosmetic surgery. The decision to undergo cosmetic surgery should only be made after comprehensive discussions with Dr Tuan Pham.

For cosmetic surgery or any rejuvenation procedure such as Rhinoplasty, face lift, eyelid or blepharoplasty, brow lift, neck lift, wrinkle relaxer or wrinkle fillers for fine lines or skin resurfacing, which “turns back the clock”; how long the results last really depends on many factors, from type of procedure to genetics, general medical condition and health, life style habits such as drinking and smoking, exposure to sun, or stress and other causes.

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Many people seek cosmetic and/or reconstructive surgery to restore younger looks, which reflect their general health, corporate competitiveness and energy levels. Cosmetic surgery and/or reconstructive surgery also improve deformity to relative normality. A youthful, healthy and natural looking face and body can increase personal confidence, self-esteem, professional success and contentment. Most of us aspire to look the best that we possibly can and be the best we can possibly be. We all know that when we look good, we feel good.

Examples of people who seek cosmetic surgery and facial plastic surgery are:

However certain aspects of facial plastic and cosmetic surgery which cannot be ignored are the patient’s mental and emotional attitudes. Not all patients are candidate for cosmetic surgery and some only require minor rejuvenation such as Wrinkle Relaxers or Wrinkle Fillers.

View the available treatments for your areas of concern

Yes. Many men seek cosmetic and/or reconstructive surgery to restore younger looks which reflect their general health, corporate competitiveness and energy levels. Common procedures requested are rhinoplasty / nose job, blepharoplasty / eye lift / eye lid rejuvenation, mini face lift or face lift or neck lift, brow lift / forehead lift, liposuction / liposculpture of the neck and body. Non-surgical rejuvenation procedure are also requested are wrinkle relaxers or wrinkle fillers and skin resurfacing.

Facial Plastic and Cosmetic Plastic Surgery have a very high success rate especially if a good rapport is established between the patient and cosmetic surgeon. Most procedures are generally safe and relatively painless when performed by an experienced cosmetic surgeon. As with all surgical procedures, there are certain degrees of risk and uncertainty. Good health and realistic expectations are prerequisites. Trust, based on realistic expectations and exacting medical expertise, develops in the consultation stages prior to surgery. During an initial consultation we will discuss your procedure/s with you in detail, outline possible risks involved and explain the realistic potential outcome.

Cosmetic Surgery and non-surgical rejuvenation procedures can be performed using local anaesthesia, local anaesthesia with intravenous sedation or general anaesthesia. In some cases such as wrinkle relaxers or wrinkle fillers no anaesthesia is required.

The type of anaesthesia to be used for your procedure will be discussed with you during your initial consultation.

Yes. For a number of reasons certain types of cosmetic surgery may not be suitable.

For some patients. These include:

  • Major Medical conditions
  • Bleeding disorders
  • Inability to have anaesthetic
  • Multiple previous surgeries and scarring
  • Unrealistic expectations
  • Major psychiatric conditions

Depending on the type of surgery desired and previous medical history, Dr Pham will recommend theatre in one of the major private hospitals where he is accredited.

Dr Pham is a Consultant Surgeon at Royal Perth Hospital and operates at St John of God Hospital, Hollywood Private Hospital and Subiaco Private Hospital.

The majority of Dr Pham’s patients are from referrals by General Practitioners or other Specialists. However, many patients are now seeing Dr Pham because of word of mouth referrals from previous patients. These referrals are often the best referrals. Friends, relatives or co-workers who have had facial and cosmetic plastic surgery are often willing to share their experiences. It is often helpful to talk to these people before contemplating surgery.

A referral from your doctor is usually needed if you have a functional component such as crooked nose, blocked nose. You may qualify for Medicare or private health insurance rebates. Most cosmetic procedures do not require a referral and do not qualified for Medicare rebates.

Here are a few:

  • Am I a good candidate for this procedure?
  • What is a realistic outcome for me after surgery?
  • How long will the operation take?
  • What is the recovery time?
  • What are the risks involved?
  • Is post-operative medication necessary?
  • What is the charge for the procedure?

Many patients like to write down the answers Dr Pham provides for review later. The consultation also provides you with an opportunity to meet Dr Pham as it is important you feel comfortable with him as your surgeon.

It is important that you are candid with Dr Pham and his staff regarding your medical history so that he can plan the best possible treatment. This information is strictly confidential. Please inform him of any:

  • Previous facial and/or cosmetic surgery (nose, eyelids, breasts etc.)
  • Past and current medical conditions such as heart, lung and kidney disease, prolonged bleeding or excessive bruising, blood clots in the legs or lungs, or gastric reflux.
  • Current medications especially Aspirin, Anti-inflammatories, Warfarin, blood thinners, Insulin, and oral contraceptive pills. Over the counter products such as vitamins and herbal medications may also be important.
  • Allergies or adverse reactions to antibiotics, anaesthetic drugs or other medications.
  • Psychological and psychiatric illnesses.
  • Past keloid scarring or poor healing.
  • Connective tissue disorders such rheumatoid arthritis, lupus erythematosis, scleroderma or similar.
  • Previous radiotherapy to the head, neck or breast areas.

PREOPERATIVE (BEFORE SURGERY) INSTRUCTIONS

  • Please cease Aspirin, Aspirin-containing products, Plavix, Iscover and non-steroidal anti-inflammatory (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 one to two weeks prior to, and three weeks following surgery. They cause delayed wound healing, skin redness 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 on (08) 9322 1960. Remember, we are all here to give you the best possible care.

The fee / cost of a procedure or operation are comprised of surgeon/doctor fee, anaesthetist fee (if you need a general anaesthesia or sedation) and hospital or facility fee (if applicable). An estimated fee can be view in the Table of Fees.

Yes in some cases. As a rule, plastic surgery for cosmetic reason 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. These reconstructive procedures have Medicare Item Numbers and this will be on your quote. Dr Pham will advise you to contact your health fund and Medicare if this is the case.

There are a number Surgical Societies and Academies that Specialists and Surgeons are affiliated with. No particular Societies, Academies or College can claim to be the best or the only organisation to do cosmetic surgery.

Most Specialist Surgeons and Doctors are trained in University and Public Hospital systems to obtain their specialist qualifications. However Cosmetic Plastic Surgery is usually not performed in the Public Health System. Further training and experience are required, usually in a private post graduate fellowship.

In general, Specialist Surgeons who are recognized by The Royal Australasian College of Surgeons and those who have obtained further post graduate Fellowship training in Cosmetic Surgery in centres of excellence are qualified and experienced in cosmetic surgery. You should entrust your face and body to a Facial Plastic Surgeon and Cosmetic Plastic Surgeon with whom you feel most comfortable. Never choose a surgeon solely based on lower costs or surgeons that claim only they are the only group that can perform cosmetic surgery.

Dr Pham completed 3 1/2 years of Clinical Fellowships in Facial Aesthetic & Cosmetic Plastic Surgery, Facial Plastic & Reconstructive Surgery, Head & Neck Oncology and Anterior Skull Base Surgery at centre of excellence internationally and nationally.

Dr Pham is a member of the following Professional Associations:

  • Royal Australasian College of Surgeons (www.surgeons.org).
  • Australasian Academy of Facial Plastic Surgery (www.aafps.com.au).
  • Australian Society of Otolaryngology Head & Neck Surgery (www.asohns.org.au).
  • International Federation of Facial Plastic Surgical Societies (www.aafprs.org/links/whatis.html).
  • Australian Medical Association (www.ama.com.au).

Surgery to reshape the nose (Rhinoplasty) is one of the more common plastic surgery procedures and is performed to improve the external appearance and/or internal breathing, which may have been a result of birth deformity, trauma, genetic influences, infection, aging, tumours or other diseases. Nothing has a greater impact on how a person looks than the size and shape of the nose. Because the nose is the most defining characteristic of the face, a slight alteration can greatly improve one’s appearance.

Dr Pham specialises in Rhinoplasty using well-proven up to date techniques. Dr Pham is recognised as one of the most experienced nasal aesthetic and reconstructive surgeons in Western Australia. This procedure can:

  • Change the size or shape of your nose
  • Remove an unwanted hump
  • Alter the shape of the tip or bridge of your nose
  • Alter the shape of the tip or bridge of your nose
  • Narrow or expand the width of your nostrils.
  • Improve symmetry
  • Change the angle between your nose and upper lip
  • Improve breathing
  • Improve the profile or augmentation of the dorsum of the nose – augmentation rhinoplasty / nasal implant / nasal augmentation.

Before deciding on rhinoplasty, Dr Pham may advise if any additional surgery is recommended to enhance the appearance of your face. Many patients have Chin Surgery – Chin implant, Genioplasty / Mentoplasty in conjunction with rhinoplasty to create better balanced features. Rhinoplasty can be combined with other types of rejuvenation surgery such as blepharoplasty, brow lift or facelift.

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You can see more examples of rhinoplasty at Gallery / Before and After Photos.

Before your nose is altered, you must have reached full growth, which is usually around 15 -16 years for females and 16-17 years for males. Exceptions are made in cases where breathing is severely impaired. The age that rhinoplasty can be performed range from 15 to 70 years old.

In certain ethnic backgrounds (such as East Asian) or due to genetic, developmental or acquired conditions such as trauma or previous excessive rhinoplasty, the nasal dorsum or profile is under developed or low. This may be associated with a small round nasal tip and wide nasal base or ala. The nose can be augmented or enhanced to improve the nose aesthetically, by harmonizing it with other facial features. This is performed by using

  • Autologous material (from your own body) – cartilage (septal or nasal, conchal or ear, costal or rib), bone (rib, calvarial) or fascia (temporalis), or combination
  • Alloplastic or synthetic – Gortex, Silicone, Silastic or Medpor

Each material has its advantages and disadvantages. Dr Pham usually prefers to use autologous material first and synthetic material as an addition if required.

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Yes. Functional nasal airway surgery to straighten a crooked septum (called septoplasty) or trim the turbinates can be performed with cosmetic rhinoplasty. A combined procedure of internal septoplasty and external rhinoplasty is called Septorhinoplasty.

Incisions are usually made on the inside of the nose, although external excisions may be required to make the nostrils smaller or for added exposure (external rhinoplasty). These incisions are usually imperceptible.

Rhinoplasty or nose reshaping is usually done under general anaesthesia. The majority of rhinoplasty procedures last for one to two hours. Some complex cases take longer. A soft nasal pack in placed inside the nose to stop any bleeding and is removed the next morning. A small external nasal cast (thermal splint) will be applied for 1 week.

A small cast will be applied to the nose for the first week and most of the swelling will be gone by the time the cast is removed. 80% of the swelling should be improved at 6 weeks, 90% at 3 months and 95% at 6 months. The final cosmetic result is not achieved until 12 months to two years after the operation when the skin has reformed to its new framework.

Immediately after surgery, a small splint will be placed on your nose to protect it and to keep the structures stable for at least five to eight days. If packing is placed inside your nose during surgery, it is removed the morning following surgery. Your face will feel puffy, especially the first day after surgery. Pain medication may be required. Dr Pham will advise you to cleanse your nose with nasal irrigation or douches and avoid vigorous blowing your nose for seven days after surgery. In the immediate days following surgery, you may experience bruising and minor swelling in the eye area. Cold compresses often reduce the bruising and any discomfort. Absorbable sutures are usually used so they do not have to be removed. Nasal dressings and splints are usually removed six to seven days after surgery.

It is crucial that you follow Dr Pham directions, especially those regarding head elevation for a certain period after surgery. Some activities will be prohibited in the weeks after your procedure. Sun exposure, exertion, and risk of injury must be avoided. If you wear glasses, special precautions must be made to ensure that the glasses do not rest on the bridge of the nose. Tape and other devices are sometimes used to permit wearing glasses without stressing the area where surgery was performed.

Please inform Dr Pham 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 wound
  • Severe pain or tenderness
  • Significant redness, or discharge around the incision
  • Significant swelling

Take what is prescribed by Dr Pham. You can take pain killers such as Panadol / Paracetamol, Panadiene forte, Di-Gesic, Tramadol or Oxycodone and antibiotic. Avoid Aspirin, Aspirin-containing products, Plavix and non-steroidal anti-inflammatory (such as Ibuprofen) for two weeks following your surgery. If you are on any medications that affect bleeding (such as Warfarin) please notify Dr Pham.

It is essential that you keep the internal mucosa of the nose clean and moist by regularly irrigating the nose with buffered salt water 4- 6 times / day. You can buy the solution FESS, Flo or similar at the chemist or use Dr Tuan Pham’s formula:

  • 500 ml of boiled water, let it cool
  • 1 teaspoon of sea salt
  • 1 teaspoon of baking soda
  • mixed them together and use a 5ml syringe or a squeeze bottle
  • If you have a FESS /Flo bottle than keep it and fill the bottle with the solution above for reuse.

Bend over the sink and irrigate each nostril and allow the solution to drain through the nostril. Do not inhale or attempt to swallow the solution. DO THIS 4 times each nostril, 4 times per day for 4 weeks. Nasal blowing / sneezing after 1 week you can gently blow your nose. If you sneeze than sneeze with your mouth open to reduce the risk of bleeding. You can be more vigorous after 2 weeks and by 3 weeks you can resume your normal activity.

To redrape, tighten underlying muscle and soft tissue and remove excess skin associated with facial skin laxity or sagging (jowls, mid face), deep folds (melolabial) or neck laxity and bandings. Most people who seek facelift procedures are aged between 40 and 65 years of age, but younger or older people also have facelifts. It is now one of the most requested facial plastic cosmetic procedures.

Overall a facelift address “saggy” skin and skin resurfacing procedures addresses textural fine wrinkles and imperfections, whereas wrinkle relaxers and wrinkle fillers address wrinkles due to hyper dynamic lines and fine to moderate static wrinkles.

The types of face lift frequently described are:

  • Face and neck lift involve both the face and neck incisions and dissections.
  • Face lift alone or mini face lift, s-lift, MACS lift, minimum incision or short scar face lift involves incision in the face starting at the ear lobule and end in the temple.
  • Endoscopic mid face lift or subperiosteal face lift uses an endoscope to help with the elevation and redraping of soft tissue, especially the mid face. The scars are hidden in the hair or inside the mouth.
  • Neck lift alone addresses the neck only with the incision from the ear lobule, follows the back of the ear into the hairline.

Face lift is usually performed under intravenous sedation or general anaesthesia or local anaesthetic with sedation. Dr Pham will inform you of the best methods of anaesthesia, the surgical facility where your procedure will take place and the benefits and risks involved in surgery.

After surgery your head will be wrapped in a soft bulky dressing. There will be a moderate degree of discomfort and some swelling and bruising. Ice packs on the area may help reduce any puffiness or swelling. You may have some drains in situ and these will normally be removed one day after surgery. Staples and sutures will be removed within 5-7 days. There will also be some numbness in the skin in front of the ears and this may take up to 6 months to get back to normal.

Hair can be washed on the second day with incisions, sutures and staples can get wet as water, soap and shampoo trickle over them. The incisions should not be directly scrubbed or irritated. Applying Vaseline four times a day to the sutures and staples is an essential part of the healing process. Sutures that have been kept lubricated with ointment are less painful to remove.

Unless you are staying at the hospital you will be asked to see Dr Pham at his clinic 1-3 days after your surgery for a dressing change and wound inspection. You will be asked to return four to five days later for suture removal.

Vaseline, Bio-Oil or moisturiser is applied to all wounds at least 4 times a day. Bruising can be camouflaged with makeup after one week. Most of the swelling should resolve over the first 2 weeks but complete resolution may take 4 weeks.

Always protect your face from the sun by wearing a hat and sunglasses. Following surgery, our staff will tell you when it is okay to apply sunscreen, cosmetics and facial creams. Avoid unprotected prolonged sun exposure for three months following a Facelift to prevent pigmentation of incision lines

Take what is prescribed by Dr Pham. You can take pain killers such as Panadol / Paracetamol, Panadeine Forte, Tramadol or Oxycodone and antibiotic. Avoid Aspirin, Aspirin-containing products, Plavix and non-steroidal anti-inflammatories (such as Ibuprofen) for two weeks following your surgery. If you are on any medications that affect bleeding (such as Warfarin) please notify Dr Pham.

After surgery it is best to rest for the entire day. Sleep with the head of your bed elevated or use two to three pillows for one week after surgery. You should do nothing that involves excessive bending, lifting or straining. If you have small children, bend at the knees or sit on the floor and let them climb on to your lap. Swelling, bruising, mild pain and disrupted sleep are very normal postoperative symptoms and will decrease as the healing process occurs. Assistance with daily activities during the first two to three days after surgery is strongly recommended.

You can resume your normal daily activities a few days after surgery but do not smoke or consume large amounts of alcohol, as these will affect wound healing. Do not drive for one week following surgery. One to two weeks off work is recommended.

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 wound
  • Significant redness, or discharge around the incision
  • Significant swelling

Final results following a Facelift are not fully apparent for 6 to 12 months following surgery. Most of the swelling will subside in 6 weeks to 3 months. There will numbness in front of the ear and this will improve with time.

Fortunately the risks of facelifting are uncommon. Complications can occur despite the highest standards and the world’s best practice principles used by Dr Pham.

GENERAL RISK OF SURGERY

  • Wound infection – may require antibiotics
  • Bleeding, blood clots or seroma
  • Sore throat from the breathing tube
  • Scars that become raised (hypertrophic or keloid)

SPECIFIC RISKS

  • Loss of skin due to impaired blood supply – worse in smokers. Usually small and heal spontaneously. Only very rarely is a skin graft required.
  • Hair loss at site of incision – usually temporary but may be permanent
  • Worsening and/or unsatisfactory appearance
  • Nerve damage – numbness of cheeks and ears, usually temporary and takes a few months to recover.
  • Facial nerve damage – occasionally temporary, rarely permanent in 1 in 100 people. This can result in a lopsided appearance.
  • Painful or unattractive scarring
  • Deformity of ear lobes
  • Slight asymmetry between left and right sides of the face
  • Subjective dissatisfaction with final outcome
  • Recurrence of the original condition which may require revision surgery

OTOPLASTY CAN BE PERFORMED TO:

  • Even up the size and shape of ears that do not match
  • Pin back protruding ears / bat ear
  • Reduce excess cartilage in the ears

Dr Pham recommends children to wait until they are at least 6 years old as the ear is near adult size. Bat ears or very protuberant ears can attract unkind comments from peers in early childhood and may cause parents to concern of the effect on their child. An advantage in performing otoplasty in children is that the cartilage is still soft and easily moulded, as cartilage becomes firmer with age. However, otoplasty is still very effective in teenagers and adults.

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Usually an elliptical or dumbbell of skin is removed at the back of the ear. The scar is hidden and not visible. The cartilage is then sculpted creating a more natural looking shape and stitched into place, or alternatively, a portion of cartilage may be removed and the ear folded back to its new permanent position. Stitches along the incision line will be either dissolvable or removed in 7-10 days. The surgery lasts 1-1½ hours either under sedation or general anaesthesia. Patients are normally ready to go home after a few hours. Children must stay with a responsible adult for 24 hours if the child is discharged home on the same day.

Sterile dressings and bandages will be applied and removed after 2-5 days. There will be some degree of swelling and bruising. Head elevation will help to reduce this. It is not uncommon to have unevenness in the ears in the first few days but this normally resolves after a few days. Once the dressings and bandages have been removed it is important to continue applying the ointment to the wounds on a regular basis (at least 4 times per day) because sutures that have been kept well lubricated are easier to remove. Hair can be washed on the second day but it is important to dry sutures thoroughly afterwards.

It takes times for any swelling and bruising to subside. Most adults can return to work after 5 days and children after 7 days. Children should be careful in the playground and avoid sporting activities for up to 6 weeks. Please avoid wearing earrings until several weeks after surgery and protect your face from the sun by wearing a hat and sunglasses. A soft elastic headband should be worn at night for 4 to 6 weeks.

GENERAL RISK OF SURGERY

  • Wound infection – may require antibiotics
  • Bleeding, blood clots or seroma
  • Chest infection
  • Sore throat from the breathing tube
  • Scars that become raised (hypertrophic or keloid)

SPECIFIC RISKS

  • Asymmetry is common as no two ears are the same.  Occasionally minor revision surgery will be recommended.
  • Re-protrusion may occur in 5% of cases.
  • Reduced sensation around the ears is common but this is temporary and should return to normal in 6 months.
  • Nausea and loss of balance is temporary.
  • Skin necrosis is very uncommon.

Chin surgery can change the shape of the chin to reduce a prominent chin or to extend the chin from the face. The contour of the chin can be reshaped to be smoother, or more angular in appearance. Often a small, weak chin can make a nose appear larger so patients are sometimes advised to have chin surgery in conjunction with rhinoplasty to create a better balance of features. Patients can also have neck liposuction to remove excess fat from under the chin to redefine the chin line. Chin augmentation can make a major difference to the overall appearance of the face.

Dr Pham usually performs chin augmentation via an external incision well hidden under the chin and uses a silastic / silicone implant. Chin surgery is normally performed under general anaesthesia or local anaesthesia with IV sedation and takes 45-60 minutes.

In surgery for chin reduction Dr Pham makes small incisions either inside the mouth or under the chin and sculpts and repositions the facial bones to create a more harmonious look.

Blepharoplasty can be performed to:

  • Remove excess droopy skin from the upper or lower eyelids
  • Tighten the underlying muscles and soft tissues
  • Remove excess fat “bags” from under the lower eyelids or in the upper eyelids

Eyelid surgery can improve one’s appearance by restoring a youthful and less fatigued look. The procedure can correct drooping upper eyelids that tend to sag with age and time and impair vision, and reduce puffy bags that may develop below the eyes. Whether eyelid surgery is performed for medical or cosmetic reasons the aim is to improve the aesthetic appearance while retaining natural shape and maintaining or improving function. The result can be a refreshed appearance with a firmer eye area. Blepharoplasty does not alter dark circles, sagging eyebrows or fine lines and wrinkles around the eyes but it does improve drooping eyelids.

The surgery can be performed as a single procedure or in conjunction with a browlift / forehead lift, facelift / mini facelift, skin resurfacing, wrinkle relaxers and wrinkle fillers so that any other problem areas may be addressed simultaneously.

In upper eyelid surgery incisions are made in the natural skin folds so that fine scars are less visible. Excess and loose skin can then be removed. In lower eyelid surgery the incision is normally made along the lash line or smile creases of the lower lid (external subcilliary incision) so that excess skin and fat (bags) can then be removed. Occasionally the incision can be made inside the lower eyelid. This is called a (transconjunctival blepharoplasty).

People from East Asian background commonly have no or limited upper lid creases. Double eyelids are a normal variant and is considered to be aesthetically pleasing. People who would like to double eyelid surgery do not want Westernisation (high eyelid crease) but enhancement of their ethnic feature. Options are suture technique or surgical incision in the upper lid. While suture technique is less invasive the result is more variable and has higher recurrence in the long term. Surgery to form a permanent crease is more involve but provide the best long term result. It is performed as a day procedure under local anaesthetic with sedation.

Patients from East Asian background commonly request double eyelid surgery blepharoplasty and Nasal Augmentation / Augmentation Rhinoplasty together.

INCISION FOR DOUBLE EYELID SURGERY

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GALLERY – DOUBLE EYELID SURGERY

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Tiny sterile dressings are applied in the corners of the eyelids, which should be left on for 4-5 days. An antibiotic ointment (Chloromycetin) will be prescribed to prevent infection and dryness of the eyes. There will be a small amount of swelling and bruising, and head elevation and cold or iced compresses (30 minutes every hour for 48 hours) will help to reduce this. It is important to continue applying the eye ointment and a moisturising ointment directly on the incisions regularly (4 times per day) in order to keep it clean. These incisions can get wet after 36-48 hours as water, soap and shampoo trickle over them. The incisions should not be directly scrubbed or irritated. The sutures are removed 4-5 days after surgery.

Always protect your face from the sun by wearing a hat and sunglasses. Following surgery, our staff will tell you when it is okay to apply sunscreen, cosmetics and facial creams.

You should rest for the entire day after surgery. You should do nothing that involves excessive bending, lifting or straining. Do not drive for one week following surgery. One to two weeks off work is recommended.

Following blepharoplasty, it takes time for the swelling to subside and for the skin to heal. Most patients return to work between one to two weeks after surgery. Swelling, bruising and disrupted sleep are very normal postoperative symptoms and will decrease as the healing process occurs. Assistance with daily activities during the first two to three days after surgery is strongly recommended. Almost all of the swelling will be resolved by 4-6 weeks.

Final results following a blepharoplasty are not fully apparent for up to 6 months following surgery.

Modern surgery is safe but does have risks. Complications can occur despite the highest standards and the world’s best practice principles utilised by Dr Pham. The potential risks are:-

GENERAL RISK OF SURGERY

  • Wound infection – may require antibiotics
  • Bleeding, blood clots or seroma
  • Chest infection
  • Sore throat from the breathing tube
  • Scars that become raised (hypertrophic or keloid)
  • Major psychiatric conditions

SPECIFIC RISKS

  • Pain and discomfort
  • Bruising for usually 2 – 3 weeks
  • Temporary swelling causing tightness around the eyes
  • Too much skin removal – may cause inability to close the eyes and corneal injury
  • Rounding of the eyelid margin or retraction of the lower lid
  • Asymmetry of the eyelids
  • Scars at the incision site
  • Temporary change in vision – usually short term, rarely permanent
  • Itchiness, dry or watery eyes – may require artificial tears. Rarely permanent.
  • Very rarely loss of vision – risk is 1 in 40,000. People with pre-existing eye conditions, or smoking, heavy lifting or coughing have higher risks.

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 wound
  • Severe pain or tenderness
  • Visual loss
  • Significant redness, or discharge around the incision
  • Significant swelling

A double chin can be due to fatty deposit. Liposuction is a relatively safe and simple method to remove unwanted fat cells. A metal cannula is placed through a small skin incision and attached to a suction machine. Fat is commonly removed from the neck through small incisions beneath the chin and/or in a crease around the ear. The other cause of double chin is neck laxity and is treated by neck lift or face lift. A small chin can cause an illusion of a double chin and is corrected with chin augmentation or chin implant.

Liposuction can be performed as an individual procedure or in conjunction with another procedure such as a facelift, neck lift, chin augmentation or chin implant. Once the excess fat is removed, the overlying skin will reform to its new contour. Younger skin has more elasticity and will contract more rapidly and smoothly than older skin. An elastic bandage will usually be worn for a few days after surgery and then at night for several weeks. Any bruising or discoloration will usually disappear in approximately two weeks, but the swelling can last considerably longer.

A brow lift / forehead lift is used to correct a drooping brow, smooth out the deep forehead wrinkles and lessen frown lines between the nose and eyes, that often make a person appear tired, sad or angry. The procedure results in a refreshed, youthful appearance to the forehead area above the eyes. It also improves the droopy eyelid appearance and is commonly performed with a blepharoplasty. Combined with a browlift either before or after the procedure, wrinkle relaxers can significantly improve the outcome. It is also combined with endoscopic subperiosteal mid facelift and facelift.

 

Dr Pham usually performs endoscopic brow lift where the incisions are hidden in the hair or along the hairline. Occasionally mid foreheads lift or direct brow lift is performed and the incision is in the forehead or above the brow along the skin crease.

After surgery Dr Pham will apply sterile dressings. There will be a moderate degree of discomfort and some swelling and bruising. Ice packs on the area may help reduce any puffiness or swelling. You may have some drains in situ and these will normally be removed one day after surgery. Staples and sutures will be removed within 5-10 days. There will also be some numbness in the skin in front of the ears and this may take up to 6 months to get back to normal.

Hair can be washed on the second day but sutures and staples must be dried thoroughly. Applying Vaseline four times a day to the sutures is an essential part of the healing process. Sutures that have been kept lubricated with ointment are less painful to remove.

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

GENERAL RISK OF SURGERY

  • Wound infection – may require antibiotics
  • Bleeding, blood clots, bruising
  • Pain and discomfort
  • Chest infection
  • Sore throat from the breathing tube
  • Scars that become raised (hypertrophic or keloid)

SPECIFIC RISKS

  • Altered or loss of sensation of the forehead or scalp, which may last for a few months. Rarely permanent.
  • Itchiness in area of numbness.
  • Loss or reduced movement of forehead muscles. Usually temporary, but permanent paralysis may occur, causing eyebrow asymmetry.
  • Severe oedema of the eyelids.
  • Raise in hairline
  • Loss of hair – temporary or very rarely permanent at sites of incision.

Full and voluptuous lips have always been recognized as aesthetically desirable features. Thin lips can be a result of aging, trauma or congenital abnormality. A number of procedures and injectable products can be used to enhance the lips. Long lips can be reduced and lips can be lifted.

COMMON LIP FILLERS ARE:

  • Injectable Synthetic Fillers
  • Fat or fascia

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You can view the range of cosmetic surgery and non-surgical cosmetic procedures available, or see the Gallery / Before & After Photos /. If you wish to learn more about cosmetic surgery and facial plastic surgery please contact us to schedule a consultation with our Facial Plastic and Cosmetic Plastic Surgeon or Nurse Coordinator.

Yes. There are two types of wrinkles: dynamic and static. The dynamic wrinkles are due to contractions of specific facial expression muscles giving rise to forehead lines, frown lines, crow feet, lip lines and bunny lines. The treatment for these types of wrinkles is injectable muscle relaxants. When lines and folds occur at rest they are static wrinkles such as nasolabial folds, tear troughs, mouth frown, marionette lines, vertical lip lines and neck banding. The treatment options are injectable fillers, skin resurfacing and surgical lifting (e.g. Facelift). With loss of skin elasticity there is atrophy or thinning of structures such as the lips. The dermal fillers can also be utilised to increase volume and definition of the lips (lip enhancement).

Wrinkles can now be safely and successfully treated to produce a more youthful, rejuvenated appearance. Treatments for facial wrinkles are usually performed by Dr Pham and his staff in the office, which is convenient and private for you.

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These treatments can provide additional and complimentary aesthetic benefits when combined with other facial rejuvenation procedures such as facelift, browlift, blepharoplasty or skin resurfacing.

Methods used to Manage Wrinkles are

  • Wrinkle relaxers
  • Wrinkle fillers
  • Platelet – Rich Plasma
  • Skin resurfacing – laser, chemical peel
  • Surgery – facelift

Dr Pham uses a well-known wrinkle relaxer which is a sterile, purified protein produced in the laboratory. The wrinkle relaxer is injected in small amounts into facial muscles binding to the nerve endings supplying the muscle and preventing nerve impulses from travelling to the muscles. When injected into muscles, it weakens or paralyses the muscles around the area injected for a period of several months. The resultant weakening or paralysing effect on the facial muscles temporarily reduces or eliminates previous skin creasing. New skin creasing is also avoided. Wrinkle relaxers may take several days to take effect, and these effects typically last 3-4 months, in most individuals, before full muscle movement returns. Repeated treatments may increase the duration of effect and over time you may require fewer injections.

Yes. Dr Pham uses a common wrinkle relaxer, which has been extensively used for over 10 years for the treatment of cosmetic wrinkles and other medical conditions. It is now the most widely used cosmetic treatment.

Wrinkle Relaxer injection is a simple and safe procedure. Using a tiny micro-needle, a very small amount of the wrinkle relaxer is injected, very precisely, into specific locations on the face. There may be some discomfort with each injection and slight temporary bruising may occur. Usually no local anaesthetic or sedation is required but cold ice packs can help in some patients. It only takes a few minutes to perform and you can resume normal activities immediately and drive back to work or home.

Minor local irritation, redness, bruising, or swelling at the injection sites are the most commonly observed side effects, all of which typically abate within a few hours. They are easily covered with make-up. On very rare occasions the wrinkle relaxer can migrate and cause a temporary weakness of nearby muscles, droopy eyelids or asymmetry of facial expressions. These are all temporary and last for a few weeks and in some cases may be improved by medication.

HOW CAN I FIND OUT IF I AM A CANDIDATE FOR WRINKLE RELAXERS?

If you would like to learn more about your cosmetic options, or find out if wrinkle relaxer treatment is for you, please call our office and schedule an appointment with Dr Pham or our Nurse Coordinator.

Here are a few:

  • Do not take any Aspirin or any anti-inflammatory medications for seven days before
  • Wrinkle relaxer injections, as these may contribute to a greater risk of bleeding problems.
  • The effect of wrinkle relaxer may be exaggerated by aminoglycoside antibiotics or other drugs known to interfere with neuromuscular transmission.
  • Remain upright for 4 hours after injections.
  • Do not touch injection area for 4 hours.
  • Use the injected muscle as often as you can for the first hour after injection.
  • Take no naps in a reclining position the remainder of that day.

Wrinkles and certain folds and depressions can be treated with fillers. They can be

1. NATURAL

Autologous fat and fascia (from your own body) – this has a high absorption rate and may leave unevenness. Only 30-50% is retained long term. Newer techniques of micro fat injections allow for higher retaining rates.

2. SYNTHETIC

a. Lasting for 6 months
b. Lasting for 6-9 months
c. Lasting for 12-18 months
d. Lasting up to 3 years or more.

Dr Pham uses many different types of filler. One type of filler, HA(HA) is natural complex sugar found in skin and body tissues that have a role in tissue hydration, skin structure and elasticity. Dr Pham also uses synthetic forms which are manufactured into an injectable gel that is easily used and does not require a pre-test for allergy. This is the most commonly used filler at Perth Facial Plastic & Cosmetic Surgery and other cosmetic practices.

Fat grafting / fat injections create a natural augmentation for the face, especially for the lips and mouth regions. Fat is usually harvested from the abdomen and about one third of the volume remains after the treatment. Fat grafting can be repeated for additional fullness.

In comparison to typical cosmetic surgical procedures, the office time for these wrinkle erasing procedure and the subsequent recovery period until one returns to normal function are minimal. Wrinkle filler treatment takes 15-20 minutes to perform (longer for fat transfer or implants), and most patients may return immediately to home or work. Minor local irritation, redness, bruising, or swelling at the injection sites are the most commonly observed side effects, all of which typically abate within a few hours. Some mild irritation at the injection sites is unavoidable but can easily be camouflaged with standard make-up, if necessary. In most cases swelling will subside over the next few days.

Please contact us for your consultation on wrinkle management / wrinkle relaxer / wrinkle fillers or other cosmetic surgery and non – surgical cosmetic procedures.

Yes. 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.

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

This is a new method of wrinkle and skin rejuvenation utilising your own plasma concentrated with platelet. These platelets contain growth factors and protein that stimulate tissue regeneration and rejuvenation, increase collagen production and initiate vascular growth. This is a natural method using your own cells to generate new tissue, thus there is no risk of disease transmission or allergy. PRP is safe and effective.

Indications: In aesthetic or cosmetic practices Plasma-Rich Platelet can improve skin health, volume, lines and wrinkles in areas around the eyes, cheeks, mid and lower face (jaw line), neck, décolletage and hands

Understanding the Procedure: This is a day procedure and usually takes 45 minutes. A small amount of blood is drawn from your arm and placed in a centrifuge for less than 10 minutes. A concentrated layer of platelet rich plasma is isolated and re-injected into your skin to help healing, stimulate collagen growth and tissue regeneration. Small amount of local anaesthetic is used and minor side effects include mild swelling, redness and bruising lasting 1-2 days. The procedure may be requested in 1-2 months if further rejuvenation is required.

Results are expected in 4 weeks and continue to improve over the next 3-6 months. The effects are improvement on skin colour, hydration, tone and texture and usually last for 1 year.

Platelet-Rich Plasma can be combined with other skin rejuvenation / wrinkle management and facial rejuvenation surgery such as Facelift, Neck Lift and Eyelid Blepharoplasty.

Please contact us for your consultation on Platelet-Rich Plasma / Wrinkle Management or other cosmetic surgery and non-surgical cosmetic procedures.

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