This is a mild viral illness that mostly affects children. The symptoms are: sudden development of a high temperature; a sore throat and small blisters on the mouth, palms of hands and soles of feet. It occurs more commonly in summer and early autumn and is spread by direct contact in the early infectious stage of the illness. Symptoms will appear 3-5 days after exposure to the virus. Treatment No treatment is required as the sores heal on their own. Spread of the disease can be limited by keeping infectious children away from other children, careful hand washing, regular washing of toys that come in contact with saliva or nasal discharge and encouraging children to use their own towels.

Acne is a skin disorder that is characterised by pimples, blackheads, whiteheads, and, in bad cases, cysts (deeper lumps). Acne usually starts at puberty and is in response to our body’s production of hormones, called androgens. These hormones cause the sebaceous glands (oil-producing glands in the skin) to get bigger and produce more oil. The extra oil (sebum) mixes with dead skin cells and naturally occurring bacteria on the surface of the skin and blocks pores. Once a pore is blocked the bacteria multiply and cause inflammation, which produces the characteristic signs of acne. Acne commonly occurs on the face, neck, back and chest. Acne can lead to permanent scarring. Other causes of acne may include: genetics heavy makeup harsh and repetitive cleansing picking and squeezing certain medications diet. Acne Vulgaris is the most common form of acne. Adult Acne occurs in about 30% of people at some stage in their adult life. It is thought that adult acne also has some hormonal influences. Acne Roseaca is similar to acne vulgaris, with oily skin and spots, but also has flushing or redness of the skin in the affected area. The flush may be set off by certain spicy food or alcohol. Treatment Usually acne can be treated successfully, but results do not happen overnight and what can work for one person may not work for another. It may take several months to see initial results, and once it significantly clears treatment is still required to keep it from coming back. Some medications for acne can only be prescribed by a dermatologist. When acne is treated early the results are very good and it also helps to reduce scarring. Over-the-counter products are available to treat mild-to-moderate acne, but check with a pharmacist which product is the best for your type of acne. In moderate-to-severe acne, treatment usually requires the help of a dermatologist and often more than one type of treatment. Treatments may include: antibiotic creams topical (apply to your skin) retinoids oral (take by mouth) antibiotics: these reduce the number of bacteria present on the skin which leads to a decrease in inflammation oral contraceptives: these reduce the amount of oil produced by the sebaceous glands. However, possible side effects must be taken into consideration before starting treatment over-the-counter acne products. Severe acne, with deep cysts, inflammation and scarring, should be treated by a dermatologist and in most cases can be successfully treated. Treatment may include: surgery: the deep cysts are removed and drained corticosteroid injection: used to treat the inflammation, promote healing of an acne cyst and help prevent scarring isotretinoin: an oral medication prescribed by a dermatologist that effectively works on all factors that cause acne. It can also have some side effects so you will need to be continually monitored whilst on this medication oral antibiotics oral contraceptives. Scarring can be treated with laser

Bacteria and a number of types of fungi live on the surface of the skin. Fungi generally live in moist areas of the body, thus these are the areas where fungus tends to overgrow and create a fungal infection. A type of fungi that occur naturally in the gastrointestinal tract (mouth, oesophagus, stomach, intestines) and moist skin areas are yeasts. Fungal infections are named according to the type of fungi and area of infection. Common fungal infections: Athletes Foot (Tinea pedis) – a tinea fungal infection of the foot and between the toes that is more common in males. Ringworm (Tinea corporis) – the same type of infection as athletes foot. Ringworm of the Scalp (Tinea capitis) – a tinea fungal infection characterised by raised bumps that form in a circular pattern on the scalp. This may result in bald patches. Jock Itch (Tinea cruris) – a tinea infection that affects the inner thighs, bottom and genital area. Pityriasis Vesicular – a yeast infection of the skin resulting in lighter patches in areas of skin. Candida Infection – a yeast infection that occurs on the skin’s surface or within mucous membranes especially when they are damaged. Yeast infections require a humid, moist environment and grow rapidly when your immune system is not working properly. Antibiotics can also cause yeast infections by killing off the normal flora (bacteria) and allowing growth of the yeast. Yeast infections occur in: skin folds tummy button vagina (thrush) penis (thrush) mouth (inside and outer) skin surrounding and under nails. Symptoms of Candida infections depend upon the area involved and can include: itchiness/burning redness general irritation and tenderness skin splits dry scaly skin discharge (thrush). Treatments Generally over-the-counter products are enough to treat mild-to-moderate fungal skin infections. If symptoms persist, it is important to see a doctor.

There are several different types of eczema but all have a number of common symptoms, the main feature being red, inflamed, itchy skin. The skin can be covered with small, fluid-filled blisters that might ooze and form a scale or crust. Constant scratching can eventually lead to thickening and hardening of the skin. The several types of eczema are caused by a number of different things, such as irritant contact and allergies, or from unknown causes. Determining the cause can be very difficult. Atopic eczema This is the most common form of eczema. It often occurs in the first few months after birth and is a chronic condition (may last for many years). Atopic eczema is often associated with hay fever and asthma, and has a tendency to run in families. It is also known to disappear with age. Emotional stress, changes in climate or diet or certain fibers in clothing (especially wool) can be triggers for atopic eczema or can worsen the existing condition. Generally the eczema occurs in areas where the skin folds in upon itself, such as behind the knees, inside the elbows, the neck and eyelids. It is more likely to occur in winter. With uncontrolled itching the skin can become grazed and weepy and is a potential area for a secondary bacterial infection. As this is more common in young children, it is important to control scratching. There are no specific tests to diagnose atopic eczema, but a visit to the doctor is an important step. The diagnosis can be made once the rash has been viewed, based on its typical pattern and also whether an atopic tendency (i.e. eczema, hay fever or asthma) runs in the family. Symptoms are: redness and inflammation of the skin small fluid-filled blisters intense itching, especially at night dry scaly/cracked skin thickened skin as a result of continuous scratching. Treatment There is no cure, but the following actions can help control the symptoms: moisturising creams help soothe and heal dry skin soap substitutes prevent drying of the skin when washing corticosteroid cream/ointment relieves inflammation and controls itching. These should be used as directed by your doctor, nurse or pharmacist. non-steroidal creams that alter your body’s immune system response antibiotic creams can be used if a secondary infection is present avoidance of any known irritants oral antihistamines can also be prescribed for itchiness keep fingernails short to prevent damage to the skin from scratching. Seborrhoeic dermatitis This is an inflammation of the upper layers of the skin, which gradually results in dry or greasy scaling of the affected area. This type of dermatitis tends to be chronic and recurrent. It occurs in both infants and adults and tends to run in families. In infants, this condition is known as ‘cradle cap’ when it occurs on the scalp, but can also affect the nappy area to cause ‘nappy eczema’. In adults, the rash tends to occur around the nose, eyebrows and scalp. Treatment Infants: wash the scalp with mild shampoo. Oil can be applied to help comb scale out. Adults: regular use of an anti-dandruff shampoo is often all that is needed. Corticosteriods can also be applied, only 1% strength to the face. Ketoconazole 1% shampoo and cream are very effective. Contact dermatitis Contact dermatitis is inflammation of the skin caused by contact with a specific substance. This happens because of irritation or by an allergic reaction. Substances that can trigger this inflammation can include cosmetics, soaps, detergents, rubber, nickel (in jewellery) or specific chemicals used in skin creams or from plants. With an allergic reaction, it is not the first exposure that causes a reaction but may be the next exposure or, in some cases, it is possible to have contact with a substance for a number of years without any skin inflammation occurring. But once the skin has become sensitive, even a tiny amount of that substance can cause a reaction. Usually contact dermatitis affects only the area that has been in contact with the trigger or irritant (item that has caused the reaction). Symptoms can vary from a mild rash to a severe rash and blisters, with subsequent scaling and itching. The severity depends on the concentration of the irritant and how long the skin was exposed to it. Once the irritant is taken away, the redness and rash usually disappear over a few days. Treatment A dermatologist can perform patch testing to find out which substances are causing the allergic reaction. This is done by placing small discs (with possible allergen-causing substance on them) on the skin and removing them after 48 hours for examination. The patches are then examined again 2 days later, to check for delayed reactions. Once the trigger has been identified, it is important to avoid it as continued exposure may cause a persistent rash, which will be difficult to treat. Treatment involves the use of steroid creams to decrease the symptoms of the reaction. With severe contact dermatitis, oral steroids or a steroid injection may be given. Nummular Eczema This is also known as discoid eczema. This form of eczema is more common in older males, is associated with existing dry skin and is most common in the winter season. The cause is unknown. It is characterised by an itchy rash that forms in coin-shaped spots, sometimes with associated small blisters, scabs, scales and thickened skin on the forearms and elbows, the backs of hands, tops of legs and the feet. Nummular eczema can be confused with a fungal infection but diagnosis can be made from a skin biopsy (removing a small piece of skin for examination under a microscope). Treatment is usually with moisturisers, steroid creams and sometimes antihistamines, if required. Asteatotic eczema This is generally common in the elderly and is mainly caused by the dryness of the skin that accompanies older age. It is characterised by a scaly itching rash that can often be cracked and have a pattern to it. Dyshidrotic eczema This type of eczema is characterised by thickening of the skin accompanied by large numbers of blisters that tend to ooze. It usually affects the fingers, palms and soles of the feet. The cause is unknown.

Our skin is our body’s first defence mechanism and even though many types of bacteria live on its surface, we still need a healthy, intact skin surface to maintain its defense. Any break in this defense, whether it is from a cut or a pimple, is a possible risk for a bacterial infection. Some diseases such as diabetes and HIV increase the risk of major infection when this barrier is broken, as these patients already have a faulty immune system. Impetigo This is a bacterial infection of the outer layers of the skin. It is infectious and is spread to others by direct contact, but can also spread to other areas on the body. It shows up as a crusty, weepy area and most often begins on the face or exposed areas of the arms and legs. The bacteria that causes it is commonly found around children and schools. Thus, impetigo is more common among children than adults and often occurs in spring and autumn. Impetigo is easily treated with oral or topical antibiotics. In some cases a child may require time off from school to prevent spread to others. Cellulitis This is a bacterial infection of the skin and underlying tissues that can happen in normal skin but often occurs in an area of skin damaged by a wound, insect bite, eczema, chicken pox etc. It usually involves the skin of the face, arms and legs. Bacteria spread and cause the following symptoms: swelling, pain and inflammation of tissue warmth and redness of skin fever aches and general unwellness red streaks from original cellulitis site. In someone with diabetes or someone who is taking medications to suppress the immune system, cellulitis can start in areas of intact skin. The bacteria that cause cellulitis are usually Streptococcus or Staphylococcus. Cellulitis responds rapidly to antibiotic treatment, either orally or through injections. Boil This is a tender, red, inflamed raised lump that has a pus-filled centre. A boil develops when a hair follicle becomes infected with bacteria. The usual bacteria that causes a boil is Staphylococcus. Common areas of infection are the neck and face, breast and buttocks. Boils are more prevalent in people who have a low immunity. Carbuncles This is the term for a cluster of boils. Folliculitis This is inflammation of the hair follicle, caused by the Staphylococcus bacteria. The inflammation produces pus-filled pimples around the follicle. It can occur on any area of the body but is more common in areas that are shaved or plucked. Treatment Often boils, carbuncles and folliculitis clear without any specific treatment. They may burst and release the pus. Keeping the skin clean with antibacterial wash can prevent infections and prevent the spread. Do not squeeze as this can spread and worsen the infection. Application of warm heat can help to relieve symptoms. Antibiotics can be prescribed in some cases.

Psoriasis is a common, recurring (keeps coming back) skin condition that is hard to treat. It is characterised by raised patches of skin (known as plaques) that are red, thickened and scaly that commonly occur on the elbows, knees and scalp, but can affect any parts of the body. Psoriasis usually starts out as a small spot that is excessively flaky and that gradually enlarges, then other plaques start to appear. Sometimes the flaking can be mistaken for dandruff. These areas are not always itchy. It is unusual in children and more common in adults. Psoriasis happens when new skin cells are produced at a faster rate than the dead skin cells are removed, thus excess skin cells form in thick scaly patches on top of the skin. The reason this happens is unknown, but it is known that: it may run in families; it may be triggered by infection, injury or stress; it is associated with the use of certain medications; and it is associated with psoriatic arthritis. There are different types of psoriasis and a person can have more than one type at a time. Plaque psoriasis – the most common type, which keeps recurring, or coming back, over a lifetime. It can develop at any age. Symptoms are: plaques on the elbows, knees, nails, scalp, and behind the ears. This condition can be itchy at times. When it occurs on the nails, it is associated with discolouration and pitting of the nail. Guttate psoriasis – this type is more common in children and young adults and often follows a bacterial throat infection. It appears as many coin-shaped pink scaly plaques usually covering the back and chest. It can be itchy. Guttate psoriasis usually disappears over time and does not recur, although if someone has guttate psoriasis they are more likely to go on to get other types of psoriasis at a later stage. Pustular psoriasis – a rare and potentially fatal condition that generally affects adults. Symptoms are: small pus-filled blisters on palms of hands and soles of feet, with areas of skin that are painful, red and inflamed. Some scaling and thickening may be seen. Inverse psoriasis – this commonly affects the elderly. It is characterised by large moist reddened areas of skin occurring in skin folds such as the groin area, armpits and under the breasts. This type of psoriasis is easily treated, but is also recurring. Psoriasis can be hard to diagnose as other conditions have similar symptoms. To confirm a diagnosis a skin biopsy (small sample of skin is removed for examination) can be taken. Treatment Treatment can begin once a diagnosis is made and usually involves both topical (applied to the skin) and generalised treatments. There is no cure for psoriasis but treatment can control symptoms. Topical treatments: skin creams and ointments to lubricate and soften the skin corticosteroids vitamin D cream coal tar preparations salicylic acid preparations. Oral medications such as etretinate, retinoids, methotrexate or cyclosporin can be prescribed, under the guidance of a dermatologist. A generalised treatment such as ultraviolet light therapy may be effective and can be combined with an oral medication, which makes the skin more sensitive to the effects of light. This treatment is called PUVA or UVB and is given under the direction of a dermatologist.

Shingles is caused by a virus called herpes zoster, this is the same virus that causes chickenpox. After the virus has caused chicken pox it remains dormant (inactive) in the nerve cells, but can then be reactivated in later life to cause shingles. It is not known why the virus is reactivated, but it often occurs in times of stress and illness. Shingles is more common in the older age group or among people with decreased immunity. Shingles is characterised by clusters of small fluid-filled blisters that erupt along a nerve path in a belt-like line, often on the stomach, chest or face. This is a very painful condition and tender to touch. The rash dries out and slowly disappears over several weeks, occasionally leaving scars. The pain from the area is slower to disappear and can last for months. The symptoms are: fever, chills, nausea, diarrhoea, and the appearance of tiny red spots that form into blisters then dry out over 3-5 days to form scabs. Shingles itself cannot be caught from someone with shingles but chickenpox can be caught from someone with active shingles (active meaning before the rash has formed scabs). As shingles can often be hard to diagnose it is important to visit your doctor early. A description of a band of pain will help the doctor to diagnose the condition. Once the rash appears, it is much easier to diagnose. Treatment Starting treatment early is important as this can reduce the severity of the illness and how long it lasts. Anti-viral drugs will be prescribed if the shingles is in its early stages but these are not useful if the rash has been present for a number of days. At this stage treating the symptoms is all that can be done e.g. medication for pain and applying cooling antiseptic gels/lotions. Avoid secondary bacterial infections by keeping the rash clean and dry and get lots of rest. Avoid children/adults who have not had chickenpox.

There are three main types of wart infections that occur on our body: common warts, plantar warts and venereal warts (genital warts). Common warts These are caused by a slow-growing virus. Warts are more common in children and are caught from direct contact with someone else who has warts. Most people have had warts at some stage in their lives. To look at they have a rough, irregular surface and are usually round in shape. They often appear on the hands, feet or knees. Plantar warts Also known as verrucas, these occur most often on the soles of the feet. They can be very tender, as they take the pressure of movement. They are skin-coloured and have a slightly irregular surface. They can grow larger than a common wart. As these are painful, they usually need to be removed or treated. They are generally harder and more painful to treat than the common wart. Treatment There are many over-the-counter treatments available, but most warts will disappear over time (around 18-24 months) with or without treatment, especially in children. If the wart has become painful or unsightly, it can be treated. Types of treatment are as follows: liquid nitrogen (a freezing process) diathermy (burning away of the wart) laser chemical acid surgical removal. After most of these treatments, the area will need to have a dressing and to be kept clean and dry. If the wart is surgically removed a hole is left that will need to heal on its own. Once a wart has been removed or treated there is no guarantee that it will not return and in a number of cases they do recur. Remember to get your doctor to look over your warts next time you are visiting, as some skin cancers are very much like warts. Venereal Warts (genital warts) Venereal warts are caused by a virus called human papillomavirus (HPV). This condition is known as a sexually transmitted disease (STD). It is a common disease and has a higher occurrence in males. Genital warts can be passed on during a sexual encounter, even if no symptoms or warts are present. Warts appear from 1-6 months after initial infection. Genital warts look like small flat irregular shaped growths, often occurring in clusters that enlarge quickly. They usually grow on the shaft of the penis and on the vulva in women (the external female parts), but they can also grow around the anus and rectum. Treatment Genital warts can be difficult to get rid of. Treatment options include: freezing, chemical methods, laser or, if the warts are large, surgical removal. The warts tend to recur and new ones grow, so treatment can sometimes take a long time. Sometimes the treatment will require a local anaesthetic (the area with the wart is numbed) or in some cases a general anaesthetic (you are put to sleep during the operation). HPV in women is linked to cervical cancer, thus it is very important for woman with genital warts to go to the doctor and to have regular smear tests. Prevention is the key in reducing the spread of genital warts. Practicing safe sex is the only real way to prevent a sexually active person from getting this. In some cases condoms will not prevent the spread, as they will not cover the whole area that is infected.

New Zealand has a very high rate of skin cancer, when compared to other countries. The most common forms of skin cancer usually appear on areas of skin that have been over-exposed to the sun. Risk factors for developing skin cancer are: prolonged exposure to the sun; people with fair skin; and possibly over-exposure to UV light from sun beds. There are three main types of skin cancers: basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Basal Cell Carcinoma (BCC) This is the most common type and is found on skin surfaces that are exposed to sun. A BCC remains localised and does not usually spread to other areas of the body. Sometimes BCC’s can ulcerate and scab so it is important not to mistake it for a sore. BCCs occur more commonly on the face, back of hands and back. They appear usually as small, red lumps that don’t heal and sometimes bleed or become itchy. They have the tendency to change in size and sometimes in colour. Treatment Often a BCC can be diagnosed just by its appearance. In other cases it will be removed totally and sent for examination and diagnosis, or a biopsy may be taken and just a sample sent for diagnosis. Removal of a BCC will require an appointment with a doctor or surgeon. It will be termed minor surgery and will require a local anaesthetic (numbing of the area) and possibly some stitches. A very small number of BCCs will require a general anaesthetic (you will sleep through the operation) for removal. Squamous Cell Carcinoma (SCC) This type of skin cancer also affects areas of the skin that have exposure to the sun. The most common area is the face, but an SCC can also affect other parts of the body and can spread to other parts of the body. The spreading (metastasising) can potentially be fatal if not successfully treated. A SCC usually begins as a keratosis that looks like an area of thickened scaly skin, it may then develop into a raised, hard lump which enlarges. SCCs can sometimes be painful. Often the edges are irregular and it can appear wart like, the colour can be reddish brown. Sometimes it can appear like a recurring ulcer that does not heal. All SCCs will need to be removed, because of their potential for spread. The removal and diagnosis is the same as for a BCC. Malignant Melanoma This is the most serious form of skin cancer. It can spread to other parts of the body and people can die from this disease. A melanoma usually starts as a pigmented growth on normal skin. They often, but not always, occur on areas that have high sun exposure. In some cases, a melanoma may develop from existing pigmented moles. What to look for: an existing mole that changes colour (it may be black, dark blue or even red and white) the colour pigment may be uneven the edges of the mole/freckle may be irregular and have a spreading edge the surface of the mole/freckle may be flaky/crusted and raised sudden growth of an existing or new mole/freckle inflammation and or itchiness surrounding an existing or new mole/freckle. Treatment It is important that any suspect moles or freckles are checked by a GP or a dermatologist. The sooner a melanoma is treated, there is less chance of it spreading. A biopsy or removal will be carried out depending on the size of the cancer. Tissue samples will be sent for examination, as this will aid in diagnosis and help determine the type of treatment required. If the melanoma has spread more surgery may be required to take more of the affected skin. Samples from lymph nodes that are near to the cancer may be tested for spread, then chemotherapy or radiotherapy may be required to treat this spread. Once a melanoma has been diagnosed, a patient may be referred to an oncologist (a doctor who specialises in cancer). A melanoma that is in the early stages can be treated more successfully and cure rates are much higher than one that has spread.

Full skin checks are performed by a dermatologist and photography of lesions/moles is carried out, if required.

Full skin surgery for removal of: skin cancers skin lesions moles cysts scar revision We specialise in complex repairs, flap advancement/rotation, full thickness skin grafts, wide excisions and composite repair (flap and graft). We also offer mohs surgery onsite with our lab technician.

Mohs micrographic surgery is a specialised procedure for the microscopically controlled excision of skin cancer. Mohs surgery gives the highest cure rate for skin cancer (approximately 99%) and is the most advanced and effective treatment procedure for skin cancer available today. Mohs surgery is performed by specially trained dermatologic surgeons. Dr Middelburg performs Mohs surgery on a Tuesday morning.

Tumescent liposuction is a liposuction technique which has been specially developed by cosmetic dermatologists. Tumescent liposuction is performed entirely under local anaesthetic and is recognised as the safest form of liposuction. The objective is to improve body contours by removing unwanted fat in a very careful manner. The small cannulas used also give the best results. Liposuction procedures are carried out by Dr Ken Macdonald in a purpose built liposuction surgery suite at his practice at 202 Bealey Avenue, Christchurch, New Zealand. The word tumescent means swollen and firm. Tumescent liposuction relies on large volumes of saline solution, local anaesthetic, and adrenaline being infiltrated into the fatty areas. These areas then become swollen and firm. This state enables the surgeon to insert a small instrument called a cannula through tiny incisions in order to remove unwanted fatty deposits so as to create an attractive body contour. What areas can be treated by liposuction? Lateral thighs (saddle bags) and buttocks Medial thighs (friction sites) and knees Upper and lower abdomen (tummy) Thickened calves and ankles Male flanks and waist (love handles) Back and upper back (buffalo hump) Enlarged male breasts Female hips and waist Upper arms Chin, cheeks and neck You will go home after the procedure and rest for a few hours, after which you may gradually increase your activity as tolerated. After 2 to 5 days you may resume normal activities. You will need to wear an elastic garment and binder over the treated areas for the first week to aid healing initially and to help create the best contour. Minimal blood loss Quick recovery Comfort No general anaesthetic

VASER LipoSelection® uses an ultrasonic technology that is tissue-selective. The ultrasound energy targets unwanted fat, but preserves other surrounding tissues, such as nerves, blood vessels and connective tissue, to promote smooth contours and rapid healing. Maximum results and minimum downtime are what you can expect with VASER LipoSelection®. A special saline solution is injected that helps numb the site and shrink the blood vessels (to minimise blood loss and reduce bruising). A thin probe is inserted that emits ultrasonic waves. The energy delivered to the area breaks down the fat into a liquid form. The liquefied fat and saline solution is removed with gentle suction and massage. A small number of stitches may be used to close the tiny incision.

Excess skin and/or fat can be surgically removed from your upper and/or lower eyelids to give your skin a less wrinkled and puffy appearance. The procedure typically involves making a small cut (incision) in the fold of the eyelid (for the upper lid) or just below the eyelashes (for the lower lid) and removing any excess skin and/or fat. The surgery will take 1-3 hours and is performed under local anaesthetic (the area being treated is numb) together with a sedative to make you feel drowsy. You will be able to go home the same day. It is recommended that you have complete rest and keep eye pads on for a couple of days after surgery. You should be able to return to work within one week.

As we age the skin undergoes visible changes such as irregular pigmentation, increased pore size, damage from the sun's rays and loss of volume and elasticity. Other factors such as cigarette smoke can lead to premature ageing of the skin. The pursuit of a suntan through sun exposure or sun bedding is now known to be a major cause of damage to the skin. Also known as photoageing, this is believed to be responsible for almost 80% of the skin changes attributed to the ageing process. Why wrinkles form Many wrinkles occur when we use our facial muscles to create expressions and these are known as dynamic wrinkles. When we smile our eye wrinkles become more prominent and when we frown the vertical lines between our eyebrows become more noticeable. Dermal Fillers Dermal fillers are becoming an increasingly popular treatment option. With minimal down time patients can resume normal activities after the treatment and have the benefit of an immediately obvious improvement. Dermal Fillers can be used to: Increase lip volume Enhance lip borders Remodel or enhance cheeks Correct volume loss Fill tear troughs and pre-jowl sulci Smooth nasolabial folds Soften marionette lines and mental crease Lift mouth frown and eyebrow droop Soften forehead lines and crow's feet Combination treatments with Botox® are often preferred.

Botox® is a natural, purified protein that relaxes wrinkle-causing muscles, creating a smoothed and rejuvenated and more youthful appearance. It is a simple non-surgical procedure that smoothes the deep, persistent facial lines that develop over time. Botox® is also used medically for treating muscle spasm and some headaches; it is also very effective for treating excessive sweating (hyperhydrosis). Many facial wrinkles occur when we make repeated facial expressions. Botox® relaxes the tiny facial muscles that cause expression lines, leaving the overlying skin smooth and unwrinkled. Once the muscle is relaxed, you cannot contract it and continue to make the undesirable facial expression. Then the lines gradually smooth out from disuse, and new creases are prevented from forming. This is excellent for frown lines and squint lines, also known as crow's feet. At KM Surgical we treat the following: Crow's feet Frown lines Reduce neck bands and jowls (sculpts skin around jawline & chin for a more defined jawline) Reduce bunny scrunch lines Smooth a popply chin Slim down a wide jawline Excessive sweating (underarms and hands) Botox® is the only botulinum toxin in the world registered for the treatment of frown lines and approved by the US FDA. It has been widely tested, with 12 years of safe and effective use in hundreds of thousands of patients worldwide for various medical uses. Side effects are usually minimal. The tiny injections are quick and relatively painless. A small bruise can sometimes develop and occasionally muscles beside the targeted muscle can be temporarily affected. It can take several days for Botox® to have its full relaxing effect on the muscle but then this lasts for up to four months before further treatment is required. Studies show that severe underarm sweating can often be improved for up to a year; with repeat Botox® treatment this effect can last longer. When Botox® is administrated by trained medical professionals you will get natural results with a fresher look. It will not ‘freeze’ your facial expressions and does not travel throughout your body. KM Surgical also use Dysport ® (Clostidium botulinum Toxin Type A) Dysport® has been available in New Zealand for over 19 years to treat neuro-muscular disorders and was the first botulinum toxin Type A to be approved in this country for medical use. Botox® is a prescription medicine containing 100 units of clostridium botulinum Type A toxin complex for injection. It is used for the treatment of frown lines. It should be administered only by trained medical professionals. Cautions: people with neuromuscular transmission disorders, infection at site of injection, pregnancy and lactation. Some people have reported temporary side effects; the most common being headache, eyelid droop and injection site pain. Talk to your specialist about the benefits/risks of this procedure. A charge applies.

Lumenis M22 IPL™. KM Surgical specialises in non-ablative photorejuvenation using Intense Pulsed Light with Optimal Pulsed Technology™. Optimum Pulse Technology™ is a new breakthrough in Intense Pulsed Light (IPL™) technology unique to the M22™. The M22 IPL™ is a powerful and effective treatment for blemishes resulting from premature ageing of the skin. IPL™ can recondition sun damaged skin of the face, neck and hands. M22™ offers a safe, non invasive solution that can be tailored to your individual condition and skin type, providing superior cosmetic results and outstanding satisfaction, through photorejuvenation. Proper training and staff experience is essential to achieve results without risking side effects and misdiagnosis; KM Surgical offers this expertise and best standards of care using the most effective IPL™ equipment and other treatments. KM Surgical is the only dermatology clinic in Christchurch which has the Lumenis M22 IPL™. The Lumenis M22™ is a physical grade IPL machine which gives superior results. Photorejuvenation can treat the following conditions: Age spots and other blemishes such as freckles Broken blood vessels and redness Uneven skin tone and texture Coarse sebaceous glands and reddened hair follicles General sun damage (face, chest, neck and hands) Certain birthmarks and disorders of pigmentation Reddened scars and some leg veins Rosacea (erythemato–telangiectatic type)

Excel V KTP™ 532nm laser works when the yellow/green laser light is absorbed by blood vessels which become heated and precisely destroyed (selective photothermolysis). Because of this, damage to the skin is minimal and therefore scarring is very uncommon. The 532 nm wavelength is ideal for superficial vascular targets including small telangiectasias, cherry angiomas, diffuse redness and port wine stains. Excel V KTP™ laser includes variable contact cooling through a sapphire window that allows the physician to adjust the contact temperature from 5 degrees C to 20 degrees C. The contact cooling allows for aggressive bulk cooling when treating larger vessels, or reduced cooling when treating superficial targets or pigmentation. The CoolView™ design of the Excel V KTP™ laser handpiece combines continuous parallel cooling for protection with excellent visibility of the vessel during treatment. The Excel V KTP™ laser can also treat other skin abnormalities e.g. some birth marks and pigmented lesions. Excel V KTP™ vascular treatment enhances Intense Pulsed Light (IPL) and is preferred for more obvious individual red veins particularly around the nose, cheeks and chin.

Diffuse redness and rosacea are challenging conditions to treat. The very small, fine network of vessels that creates diffuse redness requires a very short pulse width to treat effectively. Cutera's Excel V™ laser includes the parameters for a patented procedure known as Laser Genesis. This microsecond 1064 nm treatment is an excellent choice for diffuse redness, rosacea, and scars, as well as being an excellent skin rejuvenation treatment. This unique procedure targets the micro-vascularity with microsecond high-peak-power pulses, reducing erythema while stimulating collagen production. Recent research has shown improvement in a range of scars, from fresh surgical scars to keloid and hypertrophic scars, following treatments with Laser Genesis™. Because this procedure has no downtime, minimal discomfort and no disposables, Laser Genesis™ has become a staple of skin care for many offices. This one procedure offers a multi-purpose, all-season, all skin type solution for overall skin health.

Why Long Pulse Nd:YAG for Leg Veins? While lasers with wavelengths in the range from 520 to 600nm are excellent at treating superficial vascular conditions, these wavelengths scatter in the skin and do not penetrate sufficiently deep to treat deeper vascular conditions. This makes conditions such as leg veins, venous lakes and port wine stains a challenge for these visible lasers. Cutera's Excel V™ includes a long pulse 1064nm mode that is ideal for treating these deeper vascular conditions. The 1064nm wavelength provides deeper penetration than 532nm or pulsed dye lasers, and the Excel V™ laser delivers sufficient energy to allow independent control without compromise of fluence, pulse duration, spot size, or repetition rate. The Excel V™ laser includes the Nd:YAG capabilities originally introduced with the Cutera CoolGlide™, the first clinically effective long pulsed Nd:YAG laser for lower extremity vascular lesions and an award winner as the best laser for leg veins. Excel V's™ laser power is delivered through a new handpiece that includes continuous contact cooling and a wider range of spot size for improved ease of use and control. The Excel V™ laser 1064nm can be used for blue facial veins as well.

GenesisPlus™ is a Nd:YAG 1064nm laser that has been cleared by the FDA to be both a safe and effective solution for the treatment of nail infection (onychomycosis), more commonly known as a toenail fungus. Onychomycosis is a common condition estimated to affect up to 10% of the population worldwide. It can cause nails to become yellow or discoloured. As the infection advances the nail can become thick, brittle and separate from the nail bed. Current treatments options for nail infection include oral & topical drugs and laser. Oral drugs can be effective in removing the nail infection but it can cause side effects. How does Laser GenesisPlus™ work? The light from the laser GenesisPlus™ passes through the nail and the surrounding tissue. The laser light is absorbed by the pigment in the fungi which then causes the pigment to heat and the heat then kills or damages the fungal organism. The treatment takes around 20 minutes approximately. Most patients see an improvement after one treatment but you may require several treatments depending on how severe each nail is infected.

For tattoo and pigmentation removal Picosecond Technology A picosecond is one trillionth of a second! A picosecond laser emits optical pulses with extremely short duration of between 1 picosecond and some tens of picoseconds. The nature of picosecond lasers allows for absorption of wave pulses that generate a brief and precise photo-thermal effect within the targeted area – alongside ultra-structural and intrinsic chemical modifications in association with rapid changes in volume. This is also called photo-acoustic effect, for the popping sound it creates. By passing these waves through the skin in the area of the tattoo or pigmentation, the laser breaks the ink particles – leading to chemical and structural changes in the skin, thus allowing the particles to fracture, and be disposed of by our own body’s lymphatic system. High Energy The high energy levels of PiQo4 allow pigment/tattoo removal with fewer treatments compared with other competing laser systems. They can be set as either Nano or Pico, for dual pulse treatments. 4 Wavelengths Each pigment colour absorbs a specific wavelength – PiQo4 offers 4 wavelengths in order to treat the broadest range of pigment/tattoo colours, on the widest range of skin types. Its four wavelengths – 1064nm, 532nm, 650nm and 585nm – target the most frequently used tattoo colours ranging from light orange to dark black.

Lipostructure is a term which refers to augmentation and contouring using the patient's own fat. This technique involves the transfer of fat from a region in the body such as the abdomen or thigh and transplanting it into areas, such as the face, backs of hands, breasts or buttocks area, to augment or recontour and add natural volume. The technique is quite labour intensive and time consuming. It is carried out under light oral sedation. How is it done? Fat transfer involves removing fat from an area such as the abdomen or thighs where there is a reservoir of fat. This fat is then refined and reinserted through tiny punctures and then laced into the structures of the face in layers to gradually build up contour. It can be used to augment folds and to conceal hollows. Small stitches may be placed which will be removed in a few days. The puncture sites heal without a visible mark in most instances. Sometimes several treatments may be necessary and bruising and swelling can be noticeable for several weeks. We do not offer fat transfer to the breasts or brazillian butt lifts at KM Surgical

Photo-chemo-surgery is an effective treatment for some non-melanoma skin cancers as well as certain types of pre-cancerous lesions. These are known medically as actinic keratoses (or solar keratoses), superficial or nodular basal cell carcinomas and squamous cell carcinoma in situ. How does it work? It is simple, non-invasive treatment that consists of the application of a Metvix® cream to the lesion(s) followed by its exposure to light from the specially designed lamp. The cells in the lesion absorb the active ingredient from the Metvix® cream. When exposed to the red light from the lamp, a chemical reaction occurs which destroys the lesion, minimising side effects and potential for scarring. Treatment of skin lesions using Metvix® consists of the following steps. You may have more than one lesion treated at one time. 1. Lesion preparation Before the Metvix® cream is applied, the lesion(s) will be prepared by removing scales and crusts and roughening the skin surface. This preparation helps the cream be absorbed by the abnormal cells that cause the lesions. 2. Application of Metvix® cream Metvix® cream will be applied to the lesion and around the surrounding area. The area will then be covered with a dressing, which must remain in place for 3 hours. You must not remove this dressing. During this time you are free to leave the surgery, however you should ensure that the lesion is not exposed to very cold air or direct sunlight. 3. Exposure to the lamp After 3 hours, the dressing will be removed, the treated area cleansed with normal saline, and then immediately exposed to light from the lamp for a short period - approximately 10 minutes. This process is called illumination. Due to the selective nature of Metvix® cream, healthy skin surrounding the lesion does not need to be protected during illumination. As a safety precaution, you will be given goggles to wear during the illumination to protect your eyes from the intense light. The number of treatments you will need depends on the type of lesion you have. You will be asked to return for a further check-up after 3 months. Is it painful? Not everyone experiences pain, however you may experience a stinging or burning sensation during the illumination. If the treatment becomes too uncomfortable, we can pause the light for a short while to relieve your discomfort. Metvix® cream selectively targets abnormal cells. This level of accuracy means that while the lesion is destroyed, the potential for scarring and disfigurement often associated with other treatments is significantly minimised with Metvix® PDT. What should I expect after treatment? After your treatment, you are advised to keep the treated area clean. It is also recommended that you protect the treated skin from direct sunlight for a couple of days. Local discomfort around the lesion site immediately after the treatment is the most common side effect with Metvix® PDT. Mild to moderate redness, swelling and inflammation are normal after-treatment responses, which usually resolve rapidly.

Leg vein treatments with Intense Pulsed Light, Nd:YAG laser and sclerotherapy Leg veins, spider veins and other benign vascular lesions are one of the most frequent and challenging aesthetic complaints. This problem affects a wide range of age groups, skin types and lifestyles. KM Surgical offers the Lumenis One IPL™ and the Nd:YAG 1064 laser which integrates two highly effective technologies to provide an effective clinical solution for treating superficial leg veins in combination with sclerotherapy. The versatility of the Lumenis One™ is its range of 515 to 1200nm wavelengths for the treatment of benign cutaneous vascular lesions, including leg telangiectasias, and superficial veins. The 1064nm wavelength produced by the Nd:YAG laser is used for coagulation and haemostasis of vascular lesions including venulectasias and reticular veins of the leg which are larger in calibre and more blue in colour. Is the treatment painful? A pulse of laser or Intense Pulsed Light energy may feel like a pinch similar to a snapped rubber band. Chilled gel is applied to the skin and we can also apply a topical anaesthetic if you still find the treatment uncomfortable. How many treatments are needed? Many leg veins need multiple treatments, often over a few months before the effect is complete. Even small vessels often require time to resolve. It is often best to combine laser treatments with sclerotherapy. Can I get my varicose veins treated? Varicose veins are enlarged vessels that have widened as a result of weakness in the vein wall, which stretches and bulges. We do not treat large bulging varicose veins at KM Surgical and will advise a referral to a vascular surgical clinic.

Laser Resurfacing - Bridge Therapy with Active FX™ ,Deep FX™ & Scaar™ Bridge Therapy is the family of fractional treatments. Each procedure involves treating only a fraction of the skin's surface, leaving "bridges" of untouched skin to aid in the regeneration process. Bridge therapy utilises UltraPulse™, the gold standard of CO2 lasers, to deliver a variety of low downtime treatments that can be customised for each patient. Patients want the low downtime and safety of non-ablative treatment with results that are closer to traditional resurfacing using bridge therapy. Active FX™,Deep FX™ and Scaar FX™: reduced downtime - remarkable results The latest advance in the treatment of aging skin, Active FX™, Deep FX™ & Scaar FX™ are fractional laser procedures performed in a single treatment with minimal patient downtime. During fractional treatment, only a portion of the skin's surface is treated by the laser, this makes the healing process much quicker than with a full resurfacing procedure and enables patients to get back to their normal lifestyle sooner. Active FX™ Reduces wrinkles and fine lines Causes immediate skin tightening Improves skin tone and texture - shrinks pore size, textural unevenness Collagen formation - restores skin to healthy state and achieves long term effect. Deep FX™ Heavy lines and damaged skin Extreme photoageing Acne scarring Immediate collagen contraction and long-term collagen remodelling. Scars are created when the healing process is overwhelmed and the collagen is created in a disorganized manner, causing thick scar tissue to form. Scaar FX can help smooth the surface of the scar and improve the discoloration. It permanently removed micro-columns of scar tissue and stimulates new organized collagen. Scaar FX™ Keloid scars Hypertrophic Atrophic Burns Deeper Wrinkles and scars have a dermal component and are most effectively treated by penetrating deep into the problem areas. Higher percentage of untreated skin enables quicker healing. The Active FX™,Deep FX™ & Scaar FX™ procedures work by applying CO2 laser energy in a very narrow, high energy beam which smoothes out lines, wrinkles and scars and removes dark spots and other irregularities, while leaving untreated skin to ensure rapid healing. The CO2 laser energy is ideal because it penetrates deep into the dermis, eliminating damaged cells and stimulating the growth of new collagen. The new collagen lifts and supports the skin's surface and produces satisfying results. Deep FX™ & Scaar™ fractional laser resurfacing is for the treatment of heavier lines, wrinkles, scars and deeper dyschromias and significantly tightens skin. Deep FX™ & Scaar FX™ has a smaller spot size than the Active FX™ and penetrates deeper into the skin. Deeper wrinkles and scars have a dermal component and are most effectively treated by penetrating deep into the problem areas. A higher percentage of untreated skin enables quicker healing. ALMA HYBRID™ LASER Experienced Dermatologist & laser specialist Dr Ken Macdonald and his team at KM Surgical will work with you to determine the best course of treatment for your specific skin concerns and goals. The Alma Hybrid™ Laser is a state-of-the-art laser wavelengths that uses a combination of ablative and non-ablative to resurface the skin and reduce the appearance of lines, wrinkles and sun damage. The Alma Hybrid™ Laser is a safe and effective laser which is minimally invasive and produces natural-looking results that can last for several years. Your first line of defence for preventing lines, wrinkles and sun damage is of course cosmeceutical grade skincare and sunscreen! You should be applying a minimum of 30 + SPF and reapplying throughout the day if you are doing physical, outdoor activities. The Alma Hybrid™ Laser is a cutting-edge laser system that combines the power of two different laser wavelengths to achieve optimal results for a range of skin concerns. This advanced technology allows for precise and safe treatment of various skin types and concerns with minimal discomfort and downtime. Here are some of the skin problems that can be effectively treated with the Alma Hybrid™ Laser: Skin photoageing: The Alma Hybrid™ Laser can improve skin texture, reduce fine lines, and even out skin tone by removing damaged skin cells and promoting collagen production. Acne scars: The laser's dual-wavelength technology can target deep scars and stimulate the production of new collagen, resulting in scar reduction and smoother skin. Surgical and traumatic scars: will improve with a series of treatments. Pigmentation: The Alma Hybrid™ Laser can treat various types of pigmentation, including solar lentigines, and freckles. (not suitable for Melasma) How does the Alma Hybrid™ work? Ablative laser technology: The ablative laser component of the Alma Hybrid™ Laser works by removing the outermost layers of skin to reveal fresh, new skin beneath. This recues the appearance of fine lines and wrinkles by stimulating the production of collagen and elastin in the deeper layers of the skin. Non-ablative laser technology: The non-ablative laser component of the Alma Hybrid™ Laser works by heating the deeper layers of the skin without damaging the outer layers. This triggers the body's natural healing response, leading to the production of new collagen and elastin. This helps to tighten and firm the skin. Combination therapy: The combination of ablative and non-ablative laser technologies in the Alma Hybrid™ Laser allows for targeted and customized treatments. How does the Alma Hybrid™ laser compare with other laser resurfacing devices? The Alma Hybrid™ Laser combines two different laser technologies, ablative and non-ablative, to offer a more comprehensive and effective skin resurfacing treatment. Here's why it is considered better than other laser devices on the market: Versatility: The Alma Hybrid™ Laser is highly versatile and can be used to treat a wide range of skin concerns, including fine lines and wrinkles, age spots, acne scars, and sun damage. It can also be used on different skin types and tones, making it a versatile treatment option for many patients. Customization: The Alma Hybrid™ Laser allows for customized treatment to meet the unique needs and goals of each patient. The device can be adjusted to deliver different wavelengths and energy levels, enabling practitioners to tailor the treatment to the individual's specific concerns and skin type. Safety: The Alma Hybrid™ Laser is a safe and minimally invasive treatment option that produces natural-looking results with less downtime. The device uses advanced cooling technology to protect the skin and minimize discomfort during treatment. Efficacy: The combination of ablative and non-ablative laser technologies in the Alma Hybrid™ Laser provides a more comprehensive and effective treatment compared to other laser devices on the market. The ablative laser component removes the outermost layers of skin to stimulate collagen production, while the non-ablative laser component heats the deeper layers of skin to tighten and firm the skin. FDA-approved: The Alma Hybrid™ Laser is FDA-approved for the treatment of fine lines and wrinkles, age spots, and acne scars, providing patients with added confidence in its safety and efficacy. In summary, the Alma Hybrid™ Laser is a highly versatile, customizable, safe, and effective skin resurfacing treatment that is considered superior to other laser devices on the market due to its advanced technology and ability to produce natural-looking results with minimal downtime. How much is the Alma Hybrid Laser Treatment? We have two options available, we have the Softlift with our Medi Dermal Therapist and our Alma Hybrid Lift with our Registered Nurses. KM Surgical offer a complimentary consultation to discuss laser resurfacing. Call now to make your appointment on (03) 377 1010 to find out how this procedure can benefit you.

Laser Hair Removal Lumenis Splendor X Hair removal can be painful, messy and ineffective. But SPLENDOR X laser hair removal with BLEND X™ technology is different. It combines Alexandrite and Nd:YAG wavelengths for a perfectly tailored treatment that is fast, effective and comfortable. The Lumenis Splendor X is an FDA-cleared device that’s most often used for laser hair removal. It’s designed to safely remove hair anywhere on the body, across all skin types and tones. What sets Splendor X apart is its BLEND X™ technology, which targets hair follicles with two different laser wavelengths: alexandrite (755nm) and Nd:YAG (1064 nm) These wavelengths can be synchronized and their level adjusted, based on the individual patient’s skin tone, hair colour, and hair thickness. Instead of firing a single wavelength at a time the Splendor X allows you to fire both wavelengths simultaneous in adjustable amounts to suit the skin type and hair types. This means you are target multiple chromophores at any given time given enhanced results across the board. Splendor X laser has two wavelengths to target the hair follicle: The Alexandrite wavelength at 755 nm, which is ideal for treating skin tones 1, 2 and 3 (fair and light skin tones). It is highly absorbed in melanin and is therefore not safe for use on darker skin tones. The Nd:YAG wavelength at 1064 nm, which is ideal for treating skin tones 4, 5 and 6 (4 being tanned skin and 5 and 6 darker skin tones) as the absorption by melanin is much lower than with the Alexandrite wavelength. This wavelength is highly absorbed in oxyhemoglobin, which affects the blood supply to the hair follicle. INTEGRATED SMOKE EVACUATOR The handpiece of the Lumenis Splendor X integrates a smoke evacuator and cooled air to remove unwanted plumes and smell during treatment and offer additional cooling for patient comfort. What to do before my laser hair removal appointment? Within 24 hours before your appointment, shave the treatment area. Your body or facial hair will need to be in an active growth phase for the laser to effectively target the melanin in the hair follicle. Your sessions will be scheduled at intervals that align to this phase of growth. Can I keep waxing or tweezing? No. You must stop waxing or tweezing the hair you want to remove for three to six weeks before your treatments, though it’s fine to shave. How many Splendor X sessions will you need to see results? Typically, people need six to eight hair removal sessions, every one to two months, to see optimal results. You’ll see some reduction in hair after your first session, but because not all hair in the treatment area will be at the same growth stage at the same time, you’ll need multiple treatments in order to remove all unwanted hair. The number of treatments and their cadence can vary by body part, since hair grows more quickly on the face than on the body. Does Splendor X permanently remove hair? Like all laser hair removal treatments, Splendor X treatments will permanently and significantly reduce hair growth, but it may not permanently remove all of it. What are the risks and side effects of Splendor X? Splendor X carries fewer risks than some laser hair removal systems, due to the precision of its square spot (which reduces the risk of overlap and burns) and its dual cooling system (DCS). However, it is possible for the treatment to trigger changes to skin pigmentation and texture, especially for patients with Fitzpatrick skin types IV through VI. Avoid any laser treatment if you have active infections or skin inflammation; viral, fungal, or bacterial disease; active cold sores; or open wounds in the area you want to address.

Axillary Hyperhydrosis Excessive underarm sweating (axillary hyperhydrosis) can be a distressing and debilitating medical condition which usually occurs in otherwise healthy people who do not normally have significant sweating problems elsewhere. Traditional underarm treatments often give poor results and can irritate the underarm skin causing dermatitis. Electrical modification of the sweat glands with iontophoresis can help some people but units need to be purchased and continuing treatment is required. Recently botulinum toxin (Type A, prescription medicine) has been very effective but only lasts for 7-9 months approx and can be uncomfortable and expensive. There is no very good traditional surgical procedure because removal (block dissection) of underarm tissues can cause severe scarring and contraction and can limit arm movement, and sympathectomies do not work well for this area even with the endoscopic transthoracic (ETS) technique. Latest technique available at KM Surgical The most recent advance in hyperhydrosis treatment is suction curettage of the axillary sweat glands. The procedure uses a variation of the tumescent liposuction technique where the sweat glands can be removed by special curettes on the end of the small liposuction cannulas. The underarm area is first prepared with lots of local anaesthetic (tumescent technique) after the sweat glands have been mapped out. The procedure is performed under light sedation and is not unpleasant. You will have dressings applied and followed up the next day. You can expect immediate reduction in sweating and a high percentage possibly of achieving a long term and fully satisfactory reduction of sweating.

The MACS-Lift (minimal access cranial suspension) is an effective face lift operation that is designed to lift the lower two thirds of the face in a relatively straightforward manner with minimal inconvenience. Only a limited amount of excess skin is removed, resulting in an inconspicuous scar in the crease in front of the ear. In contrast to most other face lift techniques, the MACS-Lift can be performed under local anaesthetic and light sedation. Liposuction under the chin may also be carried out at the same time for an improved result in the neck. Many individuals between 35 and 70 years of age may be suitable for this type of superficial plane face lift. It is best for people whose neck and facial skin has begun to sag, but who still have some elasticity and muscular tone. The following features can be improved: - Deep grooves that run from the corner of the mouth to the nose - Wrinkles and sagging skin near the cheek bones - The jaw line where there is early 'squaring off' and 'jowling' - Loose skin of the neck and under the chin A MACS-Lift is also an excellent procedure for patients who have previously undergone a face lift and require a touch up procedure. In the MACS-Lift the surgical incision is confined to front of the ear and there is less undermining of skin and therefore less swelling and bruising than in other types of face lift. Permanent sutures are used to suspend the facial tissues and the skin is re-draped once everything is secure. Special tissue glue is used to give smooth results and to speed recovery and an Aqua Cool device is applied post procedure to reduce swelling and bruising and for increased comfort. How is a MACS-Lift performed? The procedure is 'day stay' at KM Surgical and performed under light sedation and tumescent anaesthesia. Once anaesthetised, the procedure will take approximately 180 minutes. An incision is made on pre-marked skin in front of the ears, where dissection (separation of the skin and underlying tissue) is performed after administration of an anaesthetic fluid (hydro dissection). The underlying tissue is then elevated and the skin repositioned and moulded with a fibrin tissue glue. The excess skin in front of the ear is removed and the skin flap is re-draped and meticulously repaired. Is MACS-Lift suitable for me? You will first need to have a consultation with Dr Macdonald to assess your suitability for the procedure, and to discuss possible undesired effects and any contraindications. Blood tests will be required prior to this procedure and you must not smoke any cigarettes if you are considering this procedure. Sometimes when patients need a MACS-Lift they might also benefit from other procedures such as eyelid surgery and neck skin tightening may also be undertaken. Generally a period of several weeks is advised between your consultation and your final decision to proceed with the MACS-Lift so that you can research things properly and make plans to fit with your schedule. Allow at least 10 days for recovery after the procedure.

Tattoo Removal PiQo4 PiQo4 laser provides maximum tattoo removal while leaving the surrounding skin unharmed. PiQo4 laser can remove professional and amateur tattoos. A picosecond laser emits optical pulses with extremely short duration of between 1 picosecond and some tens of picoseconds. The nature of picosecond lasers allows for absorption of wave pulses that generate a brief and precise photo-thermal effect within the targeted area – alongside ultra-structural and intrinsic chemical modifications in association with rapid changes in volume. This is also called photo-acoustic effect, for the popping sound it creates. By passing these waves through the skin in the area of the tattoo or pigmentation, the laser breaks the ink particles – leading to chemical and structural changes in the skin, thus allowing the particles to fracture, and be disposed of by our own body’s lymphatic system.

Introducing a Revolutionary Skin Treatment! The use of Platelet Rich Plasma (PRP) is not new; it has long been recognised for its accelerated wound healing properties in such applications as surgery and sports injuries. This technology is now being used for cosmetic enhancement with outstanding results. What is PRP? The latest technology in skin rejuvenation, uses your own cells derived from your blood, these are then reinjected into the skin to stimulate collagen and new skin cells. Where does the PRP come from? Your blood is rich in these red blood cells, white blood cells, and plasma. We only use the plasma portion of your blood. Then a special process is used to obtain the PRP. You only receive treatment with your own cells. What can I expect? A vibrant, fresh youthful skin and a reduction in fine lines and wrinkles; due to the new collagen formation. At KM Surgical our Registered Nurses will give you a complimentary consultation and give you details on how effective this treatment will be, and how many treatments you may require. Results take around 2-3 weeks to see and a series of three treatments is recommended. Your skin should still continue to improve with time following your treatment programme. Is PRP safe? PRP is 100% your own cells (autologous) and therefore there is no risk of allergy, or rejection. PRP is inherently safe. How long does PRP last? After 2-3 initial treatments, a repeat treatment should be done within two years. How long does the treatment take? Approximately 45 minutes per 2-4 tubes. Who are not suitable candidates for PRP? People with chronic disease, cancer and poor platelet count. PRP treatment is ideal for: - Crepey neck - Eye area - Fine lines and wrinkles - Textural improvement - Dull dry skin - Backs of hands - Full face rejuvenation - Decolletage - Other body areas - Hair loss

Vbeam® Perfecta Pulsed Dye laser (PDL) is a safe and effective laser to treat vascular and pigmentation abnormalities such as port wine stains and rosacea. PDL treatments have been used since the 1980s for the treatment of port wine stains in infants and young children. Are the treatments painful? Most patients feel a sensation similar to a mild sunburn after the treatment. During the treatment the skin receives additional protection through the patented Dynamic Cooling Device™ (DCD™), which delivers a cooling burst of cryogen before the laser pulse is delivered. The DCD™ increases comfort during the treatment and minimises side effects such as redness. The DCD™ goes a long way toward ensuring both the patient's comfort and the protection of the treated skin. Some patients experience redness immediately after treatment, occasionally a laser bruise called purpura may occur; this usually disappears in three to five days. Vbeam® Perfecta treatments are done by Dr Ken Macdonald, dermatologist. Vbeam® Perfecta Pulsed Dye laser (PDL) is a safe & effective laser to treat vascular and pigmentation abnormaities such as port wine stains & rosacea. PDL treatments have been used since the 1980s for the treatment of port wine stains in infants and young children. Are the treatments painful? Most patients feel a sensation similar too a mild sunburn after the treatment. During the treatment the skin receives additional protection through the patented Dynamic Cooling Device™ (DCD™), which delivers a cooling burst of cryogen before the laser pulse is delivered. The DCD ™increases comfort during the treatment and minimizes side effects such as redness. The DCD™ goes a long way toward ensuring both the patient's comfort and the protection of the treated skin. Some patients experience redness immediately after treatment, occasionally a laser bruise called purpura may occur; this usually disappears in three to five days. Vbeam ®Perfecta treatments are done by Dr Ken Macdonald, dermatologis Request more information from KM Surgical about Vbeam™ Perfecta Pulsed Dye Laser . Fill in the form below to send us an enquiry and we'll be in touch. Name: E-mail: Telephone: Where did you hear about us?: Radio Yellow Pages Doctor's referral Metropol Word of mouth Google Search Google Ad Finda.co.nz Gopher Facebook Other Enquiry: I'd like to book an appointment.: Captcha: Enter security code:

Lipoedema is a condition that leads to extra fat and fluid being retained in the lower section of the body. That includes the calves, thighs, and buttocks. In some cases, patients can develop this adipose tissue disorder in the upper arms, but lipoedema rarely affects the feet or hands. Lipoedema presents in different stages, also known as levels of progression. Those with an advanced stage of lipoedema, have the classic “column leg” look & cuffing. Lipoedema is associated with pain, easy bruising, and a mass of nodular fat. Lipoedema treatment with liposuction Liposuction surgery is the only available technique to correct and remove the abnormal adipose tissue of lipoedema. Tumescent liposuction is a surgical treatment that involves the application of local (tumescent) anaesthesia, and subsequent removal of adipose tissue through small cannulae and enables liposuction to be undertaken without general anaesthesia. One end of the cannula is connected to a vacuum device, and the other end is inserted through a small incision of the skin and removes fat via aspiration. Multiple treatments with liposuction may be needed to help relieve symptoms and improve the condition long term.

SkinPen® by Bellus Medical is a medical grade micro needling device and is the only micro needling device that is FDA cleared. SkinPen micro-needling treatment is clinically proven to treat the skin, increasing the skin’s natural ability to produce collagen, by stimulating the skin’s ability to repair itself. The treatment rejuvenates your skin, and leads to the reduction in appearance of fine lines, wrinkles, stretch marks and scars. SkinPen precision by Bellus Medical offers the next advancement in skin regeneration. SkinPen creates controlled micro-injuries to stimulate the body’s natural wound-healing process, while minimising cellular damage. The result: effective remodelling of scar tissue, while keeping the overall structure of the skin intact. SkinPen uses adjustable length, disposable straight needles to penetrate at a 90-degree angle. This adjustability allows for differences in skin thickness and skin types. The vertical technology allows for extra precision. All scarring is treated by Dr Ken Macdonald, Dermatologist. All treatments come with a take home aftercare skincare pack by SkinPen.

Corrective in-clinic treatments are 30-45 minutes and include a deep cleanse, exfoliation, custom peel and mask. Each peel provides the skin with different ingredients and a decision on which peel to use will be made on the day of treatment, once the therapist has assessed your skin needs and goals.

The Alma Hybrid™ Laser is a cutting-edge laser system that combines the power of two different laser wavelengths to achieve optimal results for a range of skin concerns. This advanced technology allows for precise and safe treatment of various skin types and concerns with minimal discomfort and downtime. Here are some of the skin problems that can be effectively treated with the Alma Hybrid™ Laser: Skin photoageing: The Alma Hybrid™ Laser can improve skin texture, reduce fine lines, and even out skin tone by removing damaged skin cells and promoting collagen production. Acne scars: The laser's dual-wavelength technology can target deep scars and stimulate the production of new collagen, resulting in scar reduction and smoother skin. Surgical and traumatic scars: will improve with a series of treatments. Pigmentation: The Alma Hybrid™ Laser can treat various types of pigmentation, including solar lentigines, and freckles. (not suitable for Melasma) How does the Alma Hybrid™ work? Ablative laser technology: The ablative laser component of the Alma Hybrid™ Laser works by removing the outermost layers of skin to reveal fresh, new skin beneath. This recues the appearance of fine lines and wrinkles by stimulating the production of collagen and elastin in the deeper layers of the skin. Non-ablative laser technology: The non-ablative laser component of the Alma Hybrid™ Laser works by heating the deeper layers of the skin without damaging the outer layers. This triggers the body's natural healing response, leading to the production of new collagen and elastin. This helps to tighten and firm the skin. Combination therapy: The combination of ablative and non-ablative laser technologies in the Alma Hybrid™ Laser allows for targeted and customized treatments. How does the Alma Hybrid™ laser compare with other laser resurfacing devices? The Alma Hybrid™ Laser combines two different laser technologies, ablative and non-ablative, to offer a more comprehensive and effective skin resurfacing treatment. Here's why it is considered better than other laser devices on the market: Versatility: The Alma Hybrid™ Laser is highly versatile and can be used to treat a wide range of skin concerns, including fine lines and wrinkles, age spots, acne scars, and sun damage. It can also be used on different skin types and tones, making it a versatile treatment option for many patients. Customization: The Alma Hybrid™ Laser allows for customized treatment to meet the unique needs and goals of each patient. The device can be adjusted to deliver different wavelengths and energy levels, enabling practitioners to tailor the treatment to the individual's specific concerns and skin type. Safety: The Alma Hybrid™ Laser is a safe and minimally invasive treatment option that produces natural-looking results with less downtime. The device uses advanced cooling technology to protect the skin and minimize discomfort during treatment. Efficacy: The combination of ablative and non-ablative laser technologies in the Alma Hybrid™ Laser provides a more comprehensive and effective treatment compared to other laser devices on the market. The ablative laser component removes the outermost layers of skin to stimulate collagen production, while the non-ablative laser component heats the deeper layers of skin to tighten and firm the skin. FDA-approved: The Alma Hybrid™ Laser is FDA-approved for the treatment of fine lines and wrinkles, age spots, and acne scars, providing patients with added confidence in its safety and efficacy. In summary, the Alma Hybrid™ Laser is a highly versatile, customizable, safe, and effective skin resurfacing treatment that is considered superior to other laser devices on the market due to its advanced technology and ability to produce natural-looking results with minimal downtime.