Nose Revison For Better Profile And Injectable Fillers For Lines And Lips

Nose Revision gives Jamie a better profile
Dr Hodgkinson fixes a patient’s unfortunate experience from another surgeon

A Letter from Dr Hodgkinson

Secondary surgery is one of Dr H’s specialties, and ranges from improving results from other surgeons to renewing implants

The Doctor is in!
What can I do about my ‘ floppy’ arms?

Are there any creams that will really improve the wrinkles and lines on my face?
Dr John Doyle, Dermatologist, responds to your queries on skin care and treatment. Here he gives you the real story on creams and how to get rid of those wrinkles.

Update on injectable fillers for lines and lips..
Dr Margot Campion provides the latest on using these products and the options available

Did you know that..
Double Bay Day Surgery welcomes people back again and again!.

Operation Restore Hope’s 2001 Mission a great success
170 child patients healed by 29 doctors and nurses. Exhausting but rewarding was the final verdict!

Nose Revision gives Jamie a better profile

Dr Hodgkinson fixes an unfortunate experience

Jamie Kelly had previous surgery on his nose several years ago by another surgeon. He was very dissatisfied with the results and extremely self-conscious about his profile

.“People made comments like ‘What a ski-jump, no need to go to the slopes,’” he said.
It was this combination of negative comments and personal dissatisfaction that made Jamie seek the help of Dr Hodgkinson, who he was told by friends specialises in nose surgery revision. It took quite a lot of nerve for Jamie to make the first move and even think about having surgery again.

After coming for a consultation at the Cosmetic and Restorative Surgery Clinic and meeting with Dr Hodgkinson and his supportive staff, he felt more at ease about having further surgery.

Recovery “was a breeze”

The surgery took place at the Double Bay Day Surgery and Jamie was home within a few hours. Recovery “was a breeze”, to use Jamie’s words. He is exceptionally happy with his new nose and far more confident.



Jamie Kelly Before and After


A Letter from Dr Hodgkinson

Secondary Surgery
A high percentage of patients who come to our clinic have had some previous surgery elsewhere to improve their appearance.

While some of these patients come to us to have additional work, there are many who are dissatisfied with their previous surgeons’ results or are seeking further improvement or refinement of the former outcome.

The range of secondary surgery is as broad as the range of surgical possibilities itself; however, some are more prevalent than others.

Of particular interest is rhinoplastic surgery. Approximately 50% of the patients who consult me about rhinoplasty have had previous surgery elsewhere.

The patients’ results may be unsatisfactory due to a variety of reasons such as a lack of communication, healing difficulties or technical problems with the surgery.

Secondary rhinoplastic surgery is performed by me at the Double Bay Day Surgery and often requires the grafting of tissues such as cartilage or bone in order to reconstruct the nose and improve the functional aspects.

“While cosmetic surgery can ‘set back the hands of time’, it cannot stop the clock ticking”
Secondary facelifts are not uncommon because the result of a facelift cannot be expected to last much more than ten years, even with good skin care, as the ageing process marches on.

However, secondary facelifts in the first few years are rarely performed, even on unsatisfactory, technically poor facelifts. This is because the previous surgery which has resulted in the tight, abnormal appearance is usually characterised by the excessive removal of skin; a situation which is sadly irreversible.

Breast augmentation is a procedure for which eventual secondary surgery should be a consideration as it involves the use of a prosthesis which has an ill-defined ‘life’.

Failure of the prosthesis will eventually occur with time and secondary surgery allows for its replacement. In breast lifting and reduction procedures, secondary surgery is due more to the continuation of the ageing process and the patient’s desire to ‘reset the clock’. As tissues age and elasticity deteriorates, so too with time do the breasts begin to sag again even after corrective surgery.

Most patients understand the need for and place of secondary procedures. While cosmetic surgery can ‘set back the hands of time’ it can’t stop the clock ticking.

Patients once aware of the benefits are keen to maintain the edge they gain, but must realize cosmetic surgery is not a panacea for ageing, rather offering people an improvement.

We have found that our patients are happy with their results and when it is time for secondary surgery, return to us.

Sincerely yours,

Dr Darryl J. Hodgkinson
M.B. MS. (Hons) F.R.C.S.(C) F.A.C.S.


Dr Hodgkinson answers your questions

Q: What can I do about my “floppy” arms?

A: Excessive fat and/or skin in the upper arms can often be extremely embarrassing to many women, young and old.

Another name for “floppy” arms is “bat wings” or “tuckshop” arms. The skin of the upper arm becomes very thin and fragile and does not contract quite as well after weight loss or liposuction.

Sometimes the excessive skin in the arms causes such embarrassment that an arm plasty or brachioplasty can be performed.

In this young woman of 23 years of age, I reduced the “bat wings” by the procedure of an arm plasty, carried out as an outpatient procedure at the Double Bay Day Surgery. The patient is now taking pleasure in wearing sleeveless dresses for the first time in several years.


Before and After

Call us at the Clinic to learn more or learn more in our Procedures section and check out our Patients’ Before and After Gallery.


Q: Are there any creams that will really improve the wrinkles and lines that create an age altered look to my skin?

Dr John Doyle,
Resident Dermatologist at the Cosmetic and Restorative Surgery Clinic, responds to your queries

A: The pharmaceutical and cosmetic industries have invested much time, effort and money trying to develop a miracle “wrinkle removal cream”. Unfortunately all their work has produced very little result. We are still learning about the damaging effects of sunlight, smoking and age on the skin. However, certain factors that contribute to a young, fresh and healthy appearance have been identified. These include Collagen and elastic fibres and the fibroblast cells which produce these fibres.

Q: Why don’t these creams work?

A: We have learnt from our experience with procedures at Double Bay Day Surgery such as laser treatments and dermabrasion that it takes major stimuli to encourage the skin to produce new collagen and elastic tissue. Most creams are not able to produce the `right signal’ to the skin.

Q: Is there any cream that will help?

A: The greatest amount of scientific research has been carried out on Retin A cream. There is evidence both scientific and clinical that it can improve fine surface wrinkling on facial skin. Most dermatologists and plastic surgeons accept that glycolic products can also improve and freshen the appearance of the skin, but they will not help deep folds and wrinkles. The evidence for most other products is less convincing.

Q: Does this mean that I would have to undergo plastic surgery to get rid of my wrinkles and lines?

A: The staff at CRSC believe that the best approach is to combine the experience of dermatologists, plastic surgeons and aestheticians rather than relying on one single treatment for a particular patient. Quite pleasing results can be obtained with a combination of glycolic acid, chemical peels, Retin A cream, non-permanent injectibles and anti-wrinkle injections.

Q: What does the future hold?

A: At the Clinic we are critically reviewing new equipment such as “non-invasive” laser therapy which will provide optimal results with minimal down time. There are many exciting possibilities.

Dr John A. Doyle
DIP American Board Dermatology

Update on injectable fillers for lines and lips

by Dr Margot Campion, CRSC Cosmetic Physician

A very popular procedure performed at the Cosmetic and Restorative Clinic is enhancement of lips and reduction of folds and lines with non-permanent injectible fillers.

Men and women of all ages are enjoying the benefits of this quick, office-based procedure,

Non-permanent injectible has the advantage and flexibility of being a non-permanent filler since it is gradually dissolves with time allowing for the patient to decide if they require less or more filler when it is time for a touch-up.

I recently attended the annual Cosmetic Physicians Society of Australasia, of which I am a member. The meeting (held in Melbourne in February) covered many topics including updates and preservations on injectable fillers. Particularly interesting were the presentations and results which have reinforced our position at the Clinic that non-permanent injectible and collagen are both safe and effective while more experimental products are best avoided.

Non-permanent injectable fillers naturally integrate into tissue to enhance volume and shape.


Non-permanent injectibles are especially useful in
enlarging the lips and enhancing their line.

The recent press and enthusiasm for permanent injectable fillers does not show enough caution as not only are these products permanent but our faces change as we age. There is no follow-up to date on what will happen to the position of the fillers as our lines and folds change in depth and position. Patients might find themselves very unhappy with the results of permanent fillers years later if they find that the filler remains where it is placed, while the line or fold has gradually shifted, causing ridges.Fashion and concepts of beauty also change with time. Today full lips are considered fashionable but when the patient is 20 years older or as the concept of fashion changes this may not suit the patient and their needs.

Non-permanent injectable fillers naturally integrate into tissue to enhance volume and shape.They are a natural non-animal product and do not require pretesting since the incidence of allergy reaction is extremely low. These fillers can be used to enhance the shape of a lip by placing them along the lip’s edge or border. They can also reduce folds and wrinkles in the face and forehead.

Because they integrate into tissue they afford free passage of imported nutritive elements. Once placed there is a natural feel to the skin and the lips. Since the body gradually breaks down the product the process can be repeated once the effect has reduced if the patient desires.

There are 3 thicknesses of non-permanent injectibles:

  • Fine lines non-permanent injectible is less concentrated and can be used for fine wrinkles or lines, particularly around the eyes and forehead
  • Regular or medium level non-permanent injectible is used for the face, particularly lips and folds
  • The thickest form of non-permanent injectible, can be used in folds, and in lips to increase their volume.

To find out more about non-permanent injectible, call Dr Campion at the Clinic on 93627405.

To discuss the various options available to rejuvenate your skin under clinical conditions at the Cosmetic and Restorative Surgery Clinic, please contact Gail Farrugia on (02) 9362 7404 or Dr Margot Campion on (02) 9362 7405 for an assessment.

Our new Skin Care Clinic offers “gain without pain”, using only the most advanced and proven therapies and prospectively making patients much happier.


Did You Know That…

Double Bay Day Surgery welcomes people back again and again!

48% of patients admitted to the Double Bay Day Surgery are satisfied past patients returning for further cosmetic surgery procedures.


Operation Restore Hope 2001 Mission a success

170 child patients healed by 29 doctors and nurses

Dr Hodgkinson and some members of the Operation Restore Hope team outside the
nicely described “mother and baby friendly” community hospital in Paranaque, Manila.

Operation Restore Hope has successfully carried out its 2001 mission.

29 doctors and nurses from Australia, New Zealand, Singapore, the United States and Germany completed the missions in Paranaque, a district within Metro-Manila of approximately 800,000 people, and in Mactan at Lapu Lapu Hospital in Cebu City, a community of approximately 300,000 on the island of Cebu. 170 patients were operated on successfully and the majority of the procedures involved , cleft lip, cleft palate and complex burn reconstructions.

$175,000 worth of equipment

The team has raised over the years enough finances to fully equip Lapu Lapu Hospital in Cebu with over $100,000 worth of equipment so that these operations could be performed. In Paranaque approximately $75,000 worth of equipment has been donated or money has been raised to buy equipment, so that the procedures can be performed to an optimal level.

Time donated charitably

This year five plastic surgeons, three otolaryngologists, two oral surgeons, one dental surgeon, seven anaesthetists, one nurse anaesthetist, nine nurses and one hospital administrator were involved in donating time charitably without any financial reward to perform these vital procedures for these poor patients.

There are 250,000 children in the Philippines still in need of this cleft lip and palate surgery. They are suffering from social rejection and inability to speak because they were unfortunate enough to be born with a facial deformity which can be successfully repaired by skilled surgeons. And it doesn’t take much money to pay for these operations.

All funds go to performing the surgical procedures

Please review the progress of Operation Restore Hope and check out the successful results of the children’s operations on our website

Any donations are greatly appreciated and all funds go directly to performing the procedures. No funds are utilised in the administration of the Operation Restore Hope missions.