Home 2016 issue 2 Why Plastic Surgeons Should Be Artists

Why Plastic Surgeons Should Be Artists

  • Why Plastic Surgeons Should Be Artists

    Having just attended the opening of “The Nude” from the Tate at the Art Gallery of New South Wales, I marveled at the artistic talents of sculptors and painters rendering the male and the female body on canvas or in stone.

  • Facelifting

    "Volumising" the face

  • Rhinoplasty

    Follow-up is essential

  • Breast Augmentation

    Is this type the right one for me?

  • Eyelid Surgery & Non-surgical Procedures

    Analysis is the key

  • Operation Restore Hope Collaborations Going from Strength to Strength

    Operation Restore Hope has always been especially proud of its Deductible Gift Recipient (DGR) status granted by both AusAID and the tax office.

  • A Letter from Dr Hodgkinson

    Rejuvenating the Neck

  • Why Plastic Surgeons Should Be Artists

    Having just attended the opening of “The Nude” from the Tate at the Art Gallery of New South Wales, I marveled at the artistic talents of sculptors and painters rendering the male and the female body on canvas or in stone.

    why-plastsurg-artists-img1

    Having just attended the opening of “The Nude” from the Tate at the Art Gallery of New South Wales, I marveled at the artistic talents of sculptors and painters rendering the male and the female body on canvas or in stone. It made me think about the difficulties a plastic surgeon has in their attempts to improve the female and male form.

    It is so helpful to be exposed to art. It is essential to have an appreciation of art to be able to adapt surgical

    “Each plastic surgeon must take a long journey himself or herself to develop artistic skills…”

    maneuvers to give patients the best possible results when they want changes to their body.

    Unfortunately, there is no artistic training for plastic surgeons and each plastic surgeon must take a long journey himself or herself to devel- op artistic skills. Sadly, most fail to do so. Most are not artistic and are not committed to this endeavour.

    Harnessing the Imagination

    Artists require imagination to produce a work of art which when combined with their hard-earned technical skills allows them to harness this imagination. Technical skill and virtuosity thus combine to produce a product that is harmonious and aesthetically pleasing.

    The Unfortunate Reality

    Sadly, many plastic surgeons sell themselves predominantly for personal and financial gain. They dance to the tune of mass media and subjugate themselves to consumerism.

    They post self-aggrandising claims on social media and bow to fashion and fads in lieu of science to get the public to come through their front doors.

    The public is being bombarded by a tsunami of unvetted information from the internet, print media, TV and radio of everyman claiming to be an expert and the best, regardless of experience or qualifications.

    “You cannot judge a book by its cover”

    When considering plastic surgery beware of “artists”, as true artists do not make commercial gain their ultimate ambition. ‘’You cannot judge a book by its cover’’ and in this era of self-glorification and deceptive advertising, it is a period of ‘’buyer beware.’’ The harder the sell, the less the artistic and/or genuine the “endeavour!”

    Facelifting

    "Volumising" the face

    Before and After Facial Rejuvenation Surgery by Dr Hodgkinson
    Before and After Facial Rejuvenation Surgery by Dr Hodgkinson

    Natural results are the holy grail of facial rejuvenation surgery. To create such a result requires an armamentarium of refined technical skills which blend together to achieve rejuvenation and enhancement without an obvious look.

    Recently, at the International Society of Aesthetic Plastic Surgeons Meeting (Kyoto 2016), there was an emphasis on volumising the face, being careful not to over-volumise it.

    Fat injections can be a problem

    Fat injections can be problematic as the patient is often over-volumised and has a ‘’pillow’’ face look. Patients who are over-tightened have an ‘’apple on a stick’’ look or their face is horizontally wrinkled giving a mask-like appearance. Since most patients present with distress over the ageing of their neck and jowls, this needs to be an area of focus.

    I was honoured at this latest meeting to speak to over 2000 plastic surgeons on my technique of neck rejuvenation which I have published in the international Plastic Surgery journals and textbooks.

    This technique is recognised as giving a significant improvement to the whole of the neck from the decolletage to the jawline by elevating the muscles of the neck or the platysma and re-establishing three ligament supports to the sagging muscle.

    You can always tell a woman’s age from her neck. A tall, well- defined, non-sagging smooth neck is only achieved when attention to these sagging muscles under the skin is addressed.

    Rhinoplasty

    Follow-up is essential

    Before and After Rhinoplasty by Dr Hodgkinson
    Before and After Rhinoplasty by Dr Hodgkinson

    There were many papers at the re- cent ISAPS Kyoto meeting on aug- mentation or enhancement of the nose as Asians tend to have atter noses than Caucasians. In Australia, 11% of our patients are Asians, many of whom request an improve- ment in the shape of their nose.

    Use the patient’s own tissue

    I do not use a silicone implant for the nose as these have a high rate of complication over time, but prefer to use the patient’s own tissues, most often bone and cartilage to give a nice elevation and a perma- nent result. I’ve published several articles on rhinoplasty and the Eurasian nose in surgical journals.

    A multitude of techniques

    Rhinoplasty is often regarded as the most di cult plastic surgical operation. Years of commitment and e ort are needed to be able to employ a multitude of techniques in this very delicate area in the middle of the face where millimeters make a lot of difference.

    Follow up is essential

    Follow up is essential to rhinoplasty as the nose is subject to so much movement and unpredictability in healing and up to 7-10% of cases may require a minor touchup or revision.

    Avoid “Tourist surgery”

    “Tourist surgery” in Asia (unless you are an Asian) is a poor choice as Asian plastic surgeons rarely have experience in treating Caucasian patients. And experience is important. I perform a large percentage of my rhinoplasties on Middle Eastern patients who require aesthetic sensitivity in order to maintain the ethnicity of the nose by bringing it into balance with the other features.

    Digital imaging useful

    We find digital imaging particularly useful to communicate to the patient what their ideal nose might look like after the operation. Remember, no one nose suits everybody.

    Breast Augmentation

    Is this type the right one for me?

    Before and After Saline Implants by Dr Hodgkinson
    Before and After Saline Implants by Dr Hodgkinson

    From the recent international meeting in Japan, there was very little new on breast augmentation other than the fact that silicone implants have improved. There is, however, a warning that textured silicone implants have a low risk of malignancy occurring around them and patients must be warned if they have a textured silicone implant that this rare complication could occur. I only use smooth walled implants and 50% of my patients choose saline implants which have never been withdrawn from the market, are very safe and are very e ective in patients who do not want to be too large. The trend these days is for implants to be smaller than they were 10 to 20 years ago.

    Eyelid Surgery & Non-surgical Procedures

    Analysis is the key

    why-plastsurg-artists-img6
    Before and After Upper Lid Blepharoplasty by Dr Hodgkinson

    Dr Oscar Ramirez, one of my colleagues with whom I have practiced in the US, has rede ned an extra area of fat in the upper eyelid which comes down from underneath the brow. This is something I also see regularly and this fat needs to be contoured in addition to the other measures carried out in eyelid surgery.

    Avoid over-removal of fat

    Careful analysis and experience are the keys to avoiding over resection or over removal of fat, which gives a hollowed out and in turn an older look to a patient. Eyelid surgery is often the first facial rejuvenation procedure that patients have in their mid to late 40s.

    Reviewing old photographs can help

    Many surgeons miss the fact that a sagging brow can contribute
    to heavy upper eyelids. I always review old photographs of patients to see what the shape of the eyelid was before the patient’s bulging and sagging occurred.

    Non-surgical Procedures

    We have lasers, radiofrequency machines, anti-wrinkle injections, injectible llers, chemical peeling and resurfacing of the skin.

    Newer machines are coming on the market continuously. If one machine proves to be better than another and there is good scienti c evidence (rather than just a sales pitch), I am prepared to endorse and invest in the new technology, as when we made the move from Thermage to Infini.

    I have been very careful with “new” technology as these machines may enhance my practice but are never a substitute for an e ective surgical procedure when needed.

    Operation Restore Hope Collaborations Going from Strength to Strength

    Operation Restore Hope has always been especially proud of its Deductible Gift Recipient (DGR) status granted by both AusAID and the tax office.

    Dr Hodgkinson with ORH plastic surgeon Anton Fries and Director Grant Brown visiting Dr Taps Gurango and Restore Hope children at PCMC
    Dr Hodgkinson with ORH plastic surgeon Anton Fries and Director Grant Brown visiting Dr Taps Gurango and Restore Hope children at PCMC

    Operation Restore Hope has always been especially proud of its Deductible Gift Recipient (DGR) status granted by both AusAID and the tax office.

    Amongst the extremely stringent requirements for charities operating overseas is that we not only provide aid but that we partner and collaborate with other organisations in our recipient countries, providing training and assistance where necessary to develop and maintain infrastructure to help our partners work more e ectively in serving their own communities.

    Operation Restore Hope has taken this to heart and has collaborated with Filipino medical professionals, local hospitals, NGO’s and medical training programs to ensure that the work we begin is ongoing and sustainable.

    One of our longest standing collaborations has been with the Mijares Gurango Craniofacial Foundation operating out of the Philippine Children’s Medical Centre (PCMC). We are very excited to announce the launching of a new mission in 2017 at Las Pinas City Medical Center.

    There are many ways to help from volunteering to donating. Every dollar counts and every cent goes directly to our programs. For more information please visit us at www.operationrestorehope.org

    A Letter from Dr Hodgkinson

    Rejuvenating the Neck

    thumbnail_kyoto-isaps

    In October I was invited to make a presentation on my technique for rejuvenation of the neck, combining neck lift- ing with face lifting, at the 23rd Congress Of The International Society Of Aesthetic Plastic Surgeons (ISAPS) held in Kyoto, Japan, as an invited member of the faculty and as one of five surgeons on the Scientific Committee.

    Recently I also attended a symposium in Sydney on face and neck lift surgery. Four visiting speakers from the United States gave lectures and demonstrations to a group Australian surgeons.

    They all reinforced the concept of Platysma Muscle Elevation as the key to neck rejuvenation. This platysma muscle elevation was previously referred to as the deep plane or SMAS facelift.

    I practiced this deep plane facelift technique in the early nineties, even when I was back in the United States at the Mayo Clinic and in private practice prior to repatriating to Australia. Over the years, having followed advancements in the scienti c literature, I modified this technique, emphasizing more dramatic neck results after reviewing initiatives by Dr Alain Fogli from France.

    Since modifying the Fogli technique, which I published, I have performed about six hundred facelifts over the last eight years alone utilizing “vertical platysma elevation”. My techniques have allowed me to obtain a superior neck rejuvenation. Before and after surgery we can also utilize anti-wrinkle injections, injectible fillers, radio-frequency, laser and skin resurfacing to further enhance the results.