Summer is a time to enjoy the warm weather and engage in physical activities we can’t during the colder winter months. During these warm summer months, we often experience an increase in perspiration and some experience embarrassing amounts, which is called hyperhidrosis. Sweating is a natural occurrence and by doing so, our bodies do not overheat, however, some individuals experience excessive amounts of sweating and may be present regardless of the temperature or physical activity; this condition is common in the underarms and hands but can occur anywhere on the body.

Depending on the severity and concern to the patient, specific treatment options will be suggested. Antiperspirants have little to no effect for patients with severe hyperhidrosis, and surgical treatments are invasive which may deter some. Botox® which is commonly known for its cosmetic applications, is extremely effective in treating hyperhidrosis as it can reduce sweating for up to 8 months by temporarily blocking signals to the sweat glands. A medical professional will inject the Botox® to the area. The risks of bruising and localized tenderness is minimal and may last only a couple of days. There is no downtime for this procedure but patients who are having their hands treated will require a ride home, due to the local anaesthetic that will be injected, pre-treatment.

Julie Khanna MD, FRCSC, Plastic Surgeon

Abdominoplasty, or what is commonly known as a “tummy tuck”, is a surgical procedure to remove excess fat and skin from the abdomen in order to contour the body into a slimmer, more youthful shape. Patients who have had multiple pregnancies or have undergone rapid weight loss are usually the better candidates for this procedure. It is important for patients to understand that surgical body contouring procedures should never be a primary solution for overall weight loss. Patients who are deemed very overweight should be denied surgery due to the increased risk of complications. Once you are within approximately 15 % of your ideal body weight, you may be a candidate for an abdominoplasty.

The procedure itself takes approximately 2-4 hours under a general anesthetic to complete, and will require an overnight stay at the clinic. A specially fitted compression garment will be provided post surgery and is to be worn 24 hours a day (except when bathing) for the first 6 weeks.

Undergoing any surgical body contouring procedure can be life altering and it is essential for patients to make good nutritional choices both pre and post surgery for optimal results. Patients can slowly incorporate exercise regimes about 6 weeks post surgery, but any abdominal exercises should be avoided for at least 3 months post-operatively and a healthy diet will also be essential in maintaining long term results.

Patients who are lacking volume in areas on their face such as the cheeks and lips can benefit from dermal fillers like Juvéderm™. Juvéderm™ is composed of hyaluronic acid which is found naturally in the body, which makes getting the injections completely safe by a trained injector. As with any injectable based treatment there is a risk of localized bruising and swelling that should subside within a few days with the aid of ice packs.

With a technique called the Soft Lift™ a trained injector can use a combination of Botox® and Juvéderm™ in strategic places to give patients a non-surgical alternative to a facelift. The Soft Lift™ procedure is excellent for patients who may not be ready or suitable for a standard facelift, or for those who may be afraid of undergoing invasive surgery. The procedure is preferred as there is limited downtime and can give patients a more natural refreshed appearance that could last up to a year or more.

Sheetal Sapra MD, FRCPC, Dermatologist

It is essential for everyone to receive routine checkups by a family Doctor or a Dermatologist to check for any suspicious moles, though most moles are benign (non-cancerous) over time with exposure to the sun and the elements they can evolve into a cancerous lesion. Remember skin cancer is the most preventable and treatable type of cancer there is if detected early.

It is critical to practice good sun safety by applying a SPF 30 or higher on a daily basis to aid in the prevention of skin cancer, and to use the ABCDE rule when examining moles at home.

ABCDE Rule:

A – Shape of one half of area is different from the other.

B – Borders or edges are irregular or ragged.

C – Color is not uniform, variation of white, brown, black, grey and red.

D – Diameter size is bigger than 6 millimeters, about the size of a quarter.

E – Evolution of the area is present, change in size, color, and shape. Symptoms such as itching tenderness, and bleeding are present.

Skin tags are small non-cancerous growths of skin that usually appear where skin rubs. These small growths pose no threat, and most appear smooth and flat but some appear as flaps of skin.

Should you discover a suspicious mole or skin tag or wish to treat them for aesthetic reasons, they can be safely excised by a medical professional. Moles are commonly removed using the shave technique under a local anesthetic; no sutures are needed as aluminum chloride is applied to the area to prevent any bleeding. Smaller skin tags respond better to liquid nitrogen (freezing the surrounding tissue) or cauterization, (burning the surrounding tissue) with the aid of topical freezing to minimize any pain and discomfort.

Patients, who would like a more youthful appearance and are looking for a more permanent long term option then non-surgical procedures like Thermage®, and Botox ® may benefit by undergoing a rhytidectomy or what is commonly known as a facelift.

By removing excess skin on the face, a plastic surgeon can re-drape the skin leaving the patient looking years younger. Liposuction may also be performed if the area under the chin is heavy.

Depending on the suitability of the patient and how much skin laxity the face has, a standard or mini facelift will be suggested which will be determined during the consultation appointment. The downtime for this procedure is approximately 10-20 days with results appearing within 4-6 weeks, but continued improvement can be seen for up to several months later. Laser resurfacing (Erbium laser) or a blepharoplasty (eye lift), and sometimes a brow lift may also be added in conjunction with a facelift to improve overall results.

Patients who are active and engage in regular physical exercise and seek a treatment option to aid in their efforts to reduce the signs of cellulite may benefit from the VelaSmooth™ Cellulite Treatment. The unit works by using radio frequencies and infrared energy to stimulate the fat cells metabolism. There is also a vacuum like suction that smooths out and improves circulation to the treated area. A healthy diet, which includes drinking 8-10 glasses of water a day, and a regular exercise regime, can greatly improve the results of the VelaSmooth™ treatment.

The Skin Spa also offers a non-surgical procedure for patients seeking to correct areas of their bodies that may be lacking in skin tightness. By using a non-invasive Radio Frequency Energy System, Thermage® may correct areas of loose skin, not only in the face, but also the body. The use of sunscreen with SPF 60 or higher should be worn daily to prevent premature breakdown of collagen from sun exposure.

Sheetal Sapra MD, FRCPC, Dermatologist

With the popularity of laser hair removal and the emergence of new competition, potential patients will tend to seek out the most cost effective clinic that may not have the certified staff to operate the equipment properly or safely.  It is important for patients to know that it would be best to select a clinic with a physician on site to ensure safety is being observed throughout the treatment. Clinics promising to remove hair follicles permanently should also be avoided as the procedure can only deliver long term hair reduction in most patients. Also, it would be beneficial to select a clinic that has multiple machines on premises specifically for laser hair removal. With more machines on site, some patients may be better treated as certain machines are better suited to treat patients of different skin types and the areas they wish to treat.

We would like to introduce the newest technology in laser hair removal, the LightSheer® Duet™ which makes treating larger areas such as the back more efficient with its larger hand piece and vacuum assisted technology. The LightSheer® Duet™ also has a smaller hand piece for treating smaller areas such as the lips making it versatile to suit all patients’ needs.

During any type of laser treatment, it is important for patients to limit their sun exposure both before and after treatment.  Using a sunscreen with SPF 60 or higher will be suggested, if not already implemented into daily routine.

Julie Khanna MD, FRCSC, Plastic Surgeon

When electing to undergo a cosmetic procedure outside of a public hospital, it is important for prospective patients to select a qualified clinic and surgeon. The accreditation patients should be looking for when selecting a surgeon, is that the surgeon is a Member of the Royal College of Physicians and Surgeons of Canada with a specialty in Plastic Surgery. In choosing a qualified Plastic Surgeon, you can be assured that he or she has gone through extensive plastic and reconstructive surgery training and residency, and passed comprehensive written and oral examinations. Patients should be cautioned, as there are doctors in Canada that label themselves as a “Cosmetic Surgeon” and perform potentially risky surgeries that only someone who has had extensive training and specific qualifications should be performing under a safe and sterile environment.

When selecting a private clinic it is important that patients select a facility that is accredited by the Canadian Association for Accreditation of Ambulatory Surgical Facilities (CAAASF).  Members of CAAASF receive audits on a volunteer basis and seek to improve industry wide safety standards. If you have questions regarding Dr. Khanna’s credentials or experience, please do not hesitate to speak to one of her qualified staff members.

**As of May 17 2010 the College of Physicians and Surgeons of Ontario has the authority to inspect out-of-hospital facilities where cosmetic procedures are performed.

Acne affects over 80% of the population. Individuals with moderate acne may benefit from Blu-U® therapy. The Blu-U® unit emits a pain-free blue light which treats acne and its symptoms. This treatment is desirable because it has virtually no downtown. Depending on the severity of your acne, Levulan, a topical medication may be applied to the area before treatment, and can amplify the lights effect, enhancing overall results.

After undergoing Blu-U® therapy the skin is sensitive to sunlight for the first 48 hours and should be avoided. A SPF60 or higher sunscreen should be applied in-between sessions, though we advise all of our patients and their families to practice good sun safety and wear a minimum SPF30 cream when being exposed to the sun. Blu-U® can also effectively treat Actinic Keratoses (AK) which is a form of pre-cancerous skin lesions.

Julie Khanna MD, FRCSC, Plastic Surgeon

Liposuction has been an increasingly popular cosmetic procedure that can help reduce fatty deposits in problem areas. Though age is not a factor, this procedure is most successful in patients with healthy elastic skin and with patients who have isolated areas that do not respond to traditional diet and exercise. Surgery should never be considered as a substitute for a healthy diet and exercise or for an overall weight loss. If it is determined that your skin’s elasticity is lacking, an alternative treatment may be recommended. This will be determined during the consultation period.

For patients seeking to restore volume in problem areas such as the face, a fat transfer may help fill out fine lines and wrinkles, or give volume to lips and sunken cheeks. This procedure is sometimes performed in conjunction with liposuction. Since a fat transfer uses a patient’s own body fat there is no risk of an allergic reaction and the other benefit is that fat provides a long lasting result.

Both liposuction and a fat transfers can be performed at our clinic, sometimes under a local anaesthetic.  We ensure that a qualified anaesthesiologist, along with a team of registered nurses will be overseeing your operative care.