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Course Overview Join plastic surgeon, Dr. Damir Matic, MD, MSC, FRCS(C), together with nurse injectors Mariam Zabian, RN, and Jessika Flanagan, RN, for an expert introductory injection course. Interested in a career in aesthetics? LPS Advanced Aesthetics is offering another highly demanded course for practicing surgeons, physicians, and nursing professionals in all stages of their careers, who are interested in furthering their knowledge and skills in neuromodulator and hyaluronic acid injectables. This 2-day educational event consists of lectures, small group discussions, and hands-on injection training. Participants will have the opportunity to practise on models with a 2:1 trainee to trainer ration. Goal of the course: To teach principles and current standards in treatment of wrinkles, reversing the signs of early aging, and maintaining facial function and proportions by using neuromodulators and hyaluronic acid injectable fillers. This course addresses patient concerns such as deep and fine lines, early facial fat descent and facial skin laxity. Topics include: Facial anatomy and proportions, botulinum toxin use from reconstitution to injection to follow up, HA filler classification and guidelines and use in lips and cheeks. Tips on patient documentation, avoidance and treatment of complications, and combined injectable treatments are covered as well. Contact us at opportunities@londonplasticsurgery.ca or (519)850-5435 ext 2 Date: November 18-19, 2023 Duration: 2 days (16 hours) Location: LPS Advanced Aesthetics, 123 Dundas st. London Prerequisite: Licensed Medical Professional Cost: $4300 *Early Registration: $3500

By London Plastic Surgery People in their late 30s to early 40s and older will often come in for a consult wondering about what they can do to improve the aging that they see in their face. Sometimes they start by saying things like,” I’m starting to look like my Mother (or Father) and I hate it!!!” Part of what they are seeing and concerned about is due to age and gravity, part is how they may have taken care of their skin when they were young like sun and cold exposure (….like I worked as a lifeguard for 5 years….and used baby oil for my skin and lemon juice in my hair!), and part is unfortunately genetic from which you cannot escape! The first few things to “go” tend to be the eyes and brow with some minor brow drooping which can give you the appearance of having more skin on your upper eyelids. Sometimes the fat around our eyes can also start bulging particularly in the lower lids giving us a tired look and “bags” under the eyes. The other things in the face noticed around this time might be worsening of wrinkles in the forehead and eyes, as well as loosening of the muscles and skin in the neck with mild jowls appearing. So what can be done about these things? Personally, I think it will depend on all the stuff the person brings to the discussion, how good is their skin quality and elasticity? Did they have a lot of sun exposure and do they smoke? All of which hurts the skin. How much fat do they have in their face? A slightly fuller/rounder face looks younger. What are they prepared to do? Some patients want to avoid surgery like the plague and others want to do only one thing which will last as long as possible. From my perspective, Botox is truly an amazing product, it is the only thing (other than sun screen and medical grade skin care) that is a preventative. It improves fine lines that patients already have and prevents new ones from forming. It is effective if done on a regular basis, perhaps 3-4 times per year, it is relatively affordable and safe across ages. Of course, only doing it once in a while for special occasions can work but in general I feel that this is a waste of money since those patients are really not preventing the lines from coming back! So, I would start most people concerned about seeing the effects of aging on their face with some Botox. The next topic is filler. Fillers that we use at LPS are all resordable and a form of hyaluronic acid which is a naturally occurring substance in our skin. It attracts water and can be used to plump up and even sculpt portions of our face. It really fills depressions rather than eliminating wrinkles. In patients worried about aging it can be used to fill the dark circles around the eyes and fill cheeks to give a bit of a lift to the face. It can define the jawline and reduce the appearance of mild jowls. In patients with heavier jowls and laugh lines it can be used to soften their appearance. Being made of hyaluronic acid however means that the effect will not be permanent but can last up to 12-18months. This is great for patients who have mild aging issues, do not want to consider surgery yet, and even in patients that have had surgery like a face or neck lift allowing them to maintain their result and even augment or improve it! So, to summarize, there is a place for Botox in most peoples’ skin and face regimes as it smooths existing wrinkles, prevents new ones, and can be used to raise eye brows and the corners of the mouth. Meanwhile, fillers are useful in improving the early effects of gravity, filling depressions, treating mild sagging skin in the cheeks and jowls giving people a rested and rejuvenated look. It goes without saying however, that any technique done poorly can have disastrous effects, things like the “deer in the headlights” look where the face doesn’t move at all, or the over inflated face that changes a person’s original appearance (Kenny Rogers and Meg Ryan….I’m talking about you!) must be avoided at all costs so people should spend time researching who to go to. Ask a friend, look at web sites and social media, ask the right questions, and perhaps go to places where there are physicians working who are experts at providing this type of treatment and care. There are a lot of places people can now go to have these procedures from basement apartments, to hair salons, and dental offices. After all, this is a buyer beware type of industry, be safe out there and choose wisely!

by Mariam Zabian As the signs of time slowly appear on your face, you may consider reversing the trend with a soft lift treatment. A “soft lift” is non-invasive which means no surgery is required. This is appealing to many people as the recovery time is much less. Rather than treating individual problem areas, we treat your face as a whole – restoring lost volume and enhancing the facial contour to give a more rejuvenated and refreshed look. This is achieved by using a combination of dermal filler and Botox to restore facial balance and combat the signs of aging. Botox is used to treat fine lines created by repeated muscle movements and contractions, like frowning or squinting. These wrinkles are most likely around the eyes, forehead and frown lines. Botox is injected into specific muscles and goes to work blocking the signals from the nerves to the muscles. This leaves the injected muscle unable to contract and softens wrinkles. Dermal filler will replenish the lost volume and fullness in your face, so the shadows and hollows are improved and light will reflect off your smoother skin, rejuvenating and refreshing your appearance. Dermal filler injections can include the cheeks, marionettes, chin, jaw, and tear trough. A soft lift will give you the refreshed, younger look you are seeking without the recovery time of surgery. However, depending on your skin type, you may experience some temporary bruising or slight redness at the injection site.

By London Plastic Surgery When considering if Botox is right for you, you should discuss your questions, concerns and desired outcome with a qualified professional. I have experience and training specifically for Botox and would be happy to answer your questions during a consultation. You’ve likely heard a lot about Botox – it is the most popular non-surgical cosmetic treatment with more than 6 million treatments each year – but you might not be entirely sure about what it is or how it works. Over time, repeated muscle movements and contractions like frowning or squinting create fine wrinkles. By having Botox Cosmetics (botulinum toxin type A) treatments, the muscles relax, decreasing the signs of wrinkles. When injected, the Botox blocks the signals from the nerves to the muscles, leaving the injected muscle unable to contract. This relaxes and softens the wrinkles. I should note that wrinkles caused by sun damage or gravity will not respond well to Botox. On the day of the procedure, a fine needle is used to inject the Botox into specific muscles. It only takes a few minutes and no anaesthesia is required. You should see the full effects in 7 – 10 days and the results will last between three to four months. For more information about Botox Cosmetics, visit www.botoxcosmetic.ca. To discover if Botox is right for you, book your consultation with Mariam Zabian today by calling our office at 519-850-5435