Watch Dr James Southwell-Keely (Dr JSK) & Registered Nurse in Aesthetic Medicine Lisa Rush – The popular Body Beautiful series continues with The “Look Natural Look” Facelifts.

James S.:          Hi, there. James Southwell-Keely, here.

Lisa Rush:         Lisa Rush.

James S.:          We are from Woollahra Health and Beauty. We’re the big blue building on the road, Edgecliff Road, just down the hill from Bondi Junction. What are we talking about tonight, Lisa?

Lisa Rush:         Tonight is all about our look natural look series and we wanted to touch a little bit on consultation process and all about the face, so patients that have got past that point of doing the non-surgical stuff and want to have a bit of a chat with James about possible facelifts. Yeah.

James S.:          And, likewise, patients that have not yet come to that point and want to talk about what they can do to optimize their look, their natural look, before it comes to the surgical angle.

Lisa Rush:         Yeah.

James S.:          So, where does it all begin? I say, look, bring in some old photos of yourself, because that is a great starting point. Actually, bringing celebrity photos in is not so helpful.

Lisa Rush:         I find that it creates a bit of an unrealistic expectation of what we can potentially achieve with a client, so, yeah, at the end of the day it’s all about you and your face, your facial anatomy. How can we improve on what you’ve already got? We can’t create a whole new face, so, yeah, photos of celebrities just don’t work.

James S.:          Don’t work. Bring in old photos of yourself, though, it’s fantastic. And to get a little bit of a glimpse in the time machine, of what you’re going to look like in time, look at Mum and Dad, because that’s essentially … you’re carrying the same genetic material that Mum and Dad have, a mixture thereof, and so you’re going to look something like an old version of Mum and Dad mixed together.

Lisa Rush:         Yeah.

James S.:          So, a combination of that, plus old photos of yourself when you were younger, we can work out where we are now, what we have to expect moving forwards, but also what we can aim to achieve moving backwards.

Lisa Rush:         Yeah. So, James, with your consultation process, how does it normally start off with your patients? What’s the run through? How do patients get to know you a bit better and confident with you, as a practitioner, a surgeon, and what things do you highlight in the consultation process? Yeah.

James S.:          Absolutely. Great question, Lisa. I’ll hazard a bet that our consultations are very similar.

Lisa Rush:         Yeah, yes.

James S.:          It starts with, straight back to the patient. What is it that you’d like to achieve? What is it that you see when you look in the mirror, that you don’t like anymore? What’s that face telling you, that you’d like to erase or wind back the clock on? And then, once they’ve told us, I usually say, “Well, look, I can see that, too. That’s great, but there’s also X, Y, and Z that you may want to put into the mix, because just fixing this and that is going maybe look a little bit disharmonious. Whereas, if we fix it all up, or every little area is attended to, then it just creates that more natural look.” That’s what we’re after, the look natural …

Lisa Rush:         Look natural look.

James S.:          Yeah.

Lisa Rush:         I agree. And, you know, when patients come in, they often are used to looking at their face two dimensionally, as well, in the mirror, whereas us, as a practitioner, we get the opportunity to look at the face in a three dimensional way, and also to educate the patient about the structural changes and how we can best optimize that with the treatments and the procedures that we can potentially perform.

James S.:          100%.

Lisa Rush:         Yeah.

James S.:          I then sort of delve into the aging changes and, really, you’ve got to be specific to the patient, because we don’t all age the same, and we all age differently and at different stages of our lives. But the aging process is happening at every layer of the face. I know we’ve touched upon this previously. Here’s a little diagram that illustrates the different layers of the face. It’s slightly gory. It’s like a book of your face has been opened up, and this is peeled back, but it just shows you the multiple layers there. Each of these layers, from the skin, through the fatty layers and the muscle layers, all the way deep down to the skeleton, which we’re not quite seeing in this image, but they all change with age.

So you, as a clinician, and myself, as a surgeon, we say, right, so, where is the main problem that is affecting this patient, and then how do we address that to achieve what it is that they’re hoping to achieve?

Lisa Rush:         Yeah, and I know your next series, you’re actually going to go into a little bit more detail, as well, about the different type of facelifts that are available and actually what that involves, and what you do in that procedure.

James S.:          Yeah, sure.

Lisa Rush:         So, if we’ve got the expectation from a client of what they want to achieve and what do we see, what’s the next step in the consultation process? We’ve gone through, you know, okay, my concerns are X, Y, Z, you’ve talked about what you can see in the face, so what’s the next step for the consult?

James S.:          The next step is a detailed history, which we find out about your general health conditions and everything else that then will affect the subsequent decisions that we make in terms of treatments, and then a detailed examination. That detailed examination looks at those different layers of the face, and really tries to nail down on where it is that the aging problem lies for you. Is it the recession of the bone? Has the bone receded as you’ve gotten older? Or is it a squaring off of the face, with the descent of the soft tissues, or is the aging problem mainly at the skin level? Is it a combination of the deep wrinkles between nose and mouth, or mouth and chin, or is it the really fine wrinkles around the mouth, around the eyes, et cetera. So really trying to pin down where it is that we can target our treatments towards.

Lisa Rush:         Yeah, and obviously it’s not just about facelifts. There are potential other treatments that somebody may be more suitable for.

James S.:          Absolutely.

Lisa Rush:         Or in combination with the facelift, yeah.

James S.:          Yeah, absolutely. So, in combination, it may be eyelids, or neck as well, or maybe it’s just the eyelids, at this point in time. Maybe you don’t want to jump straight into surgery. Maybe you’re better off being treated initially with the non-invasive sort of treatments.

Lisa Rush:         So, with the first consultation process, do you tend to go through a lot about the procedure? The risks associated with it?

James S.:          Yeah, 100%

Lisa Rush:         Yeah.

James S.:          Look, to be fair, most patients who come to me have already been through a series of practitioners, clinicians, and they’ve reached a point where the injectable treatments are no longer working, or the skin rejuvenation, soft tissue rejuvenation techniques are no longer giving them the return for investment that they were hoping for, or at least were achieving in their earlier years.

It’s kind of come down to the surgery now, and so then we go into a great deal of detail about that surgical procedure, but we also go into great detail about what it means to you intraoperatively, what it means to you postoperatively. How long will you be in hospital for? What sort of downtime will you expect? When can you go back to work? When can you go back to the gym? When will I be able to reintegrate into society? When will I be able to show myself down at the shopping centre and people won’t be saying, “Oh, my God. She’s had [inaudible 00:06:05]”?

Lisa Rush:         Yeah.

James S.:          So, flying under the radar.

Lisa Rush:         Do you tend to find that most patients go ahead with the procedure after one consultation, or do you tend to find this is a bit of … you know, they tend to come for a few consultations before they feel comfortable to go ahead with the procedure?

James S.:          For me, the minimum norm is two.

Lisa Rush:         Yeah.

James S.:          So, even people who are jumping at the bit to get in there after the one consultation, I think you need time to reflect. You need time to absorb all of that information, and then we’ve got to touch base again, because we’re about to do something that’s very invasive, life changing, and almost universally for the better, but it’s a big decision and it’s a big step.

So let yourself think it through, talk through with your loved one, family, whoever you need to, friends, et cetera, and then come back. That almost always involves a series of new questions that have popped up. Then, once you’re comfortable, and I’m comfortable, and we both feel like we’re on the same page, that’s the time to move forward.

Lisa Rush:         Fantastic.

James S.:          Yeah.

Lisa Rush:         Now, this is meant to be as interactive as possible. Does anyone have any questions, that’s watching?

James S.:          If so, fire them away. Fire them away.

Lisa Rush:         Yeah, and look, if there’s no questions now, then obviously after this is finished tonight and you’re watching this video at any point, just shoot us a Facebook message. Also, you could email us, or just go onto our website, Woollahra Health and Beauty, and there’s opportunities on the website for you to actually put your details in, and fire away questions and we can hopefully answer them for you.

James S.:          It’s almost like being in consultation.

Lisa Rush:         Yeah.

James S.:          The best questions don’t come at the time. It’s like, “Oh, my gosh. Why didn’t I ask that?” Well, you have that opportunity, so just send them through, in whatever format you’d like.

Lisa Rush:         Fantastic.

James S.:          So for you, and the patients who are not quite ready for surgery, do you have the same sort of process that you go through?

Lisa Rush:         Yeah, absolutely. I think it’s so important, when a patient comes in, is for them to feel comfortable and to be able to express to me, first of all, what their concerns are, what their potential expectations are. We do a thorough facial assessment, or if they’re having any body treatments a body assessment. We go through what we can see and then, yeah, recommend potential treatments for the clients.

But I think you and I have got the same goal, in that we want to achieve natural looks with our clients, so the look natural look is what we’re all about, here at Woollahra Health and Beauty. It’s about making you a better version of you.

James S.:          Yeah.

Lisa Rush:         Yeah, I think that’s really important.

James S.:          I think that’s a good point to end.

Lisa Rush:         Yeah, I think so, too.

James S.:          So if we don’t have any questions, we’ll say a fond farewell and look forward to our next instalment.

Lisa Rush:         Yeah. See you all soon. Have a good evening.

James S.:          Bye, bye.

Lisa Rush:         Bye, bye.


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