A. Hi Gemma Sounds as though you have melasma here. This can be difficult to treat especially with sensitive skin There are no instant answers but improvements can be made over time Please do contact the girls to arrnage a consult: 0845 2600 261 or email help@paulebanwell.com www.skininstituteuk.com www.paulebanwell.com

		Mr. Paul Banwell McIndoe Surgical Centre Holtye Road East Grinstead West Sussex RH19 3DZ Tel: 0845 2600 261 Web: www.paulebanwell.com

A. Thank you very much for your enquiry about the outstanding damage following your restylane sub q.   We have used sub q and none of our patients had noticed any significant problems with it.   Generally, it seems to work very well with good results. The advantage that we have found with sub q is that it had hyaluronic acid filler that can be dissolved with hyalase if you are unhappy with the appearance.   Overall, I think the effects are very likely to be stable and very safe in the long term.   If you feel you would like to schedule a free consultation to discuss the best way forward for you please do so by ringing us on 01844-214362.   Best wishes yours sincerely,   Adrian Richards Plastic and Cosmetic Surgeon Surgical Director of Aurora Clinics

		Mr. Adrian Richards The Gatehouse 82 Billing Road Northampton NN1 5DF Phone: 0800 328 5743 Web: www.aurora-clinics.co.uk

A. Thank you very much for your enquiry, there are essentially two methods of lip enhancement, the first is with hyaluronic acid fillers which typically lasts, also injections which typically lasts 6 months and the other is with permalip lip implants. Permalip lip implants are permanent solutions which involve inserting implants into your lips.   There are various different sizes and shapes of the implants and we would be more than happy to see you to discuss the best options for you.   For more information about what’s involved in the procedure please have a look at our websitehttp://www.aurora-clinics.co.uk and if you feel you would like to schedule a free consultation to discuss the best way forward for you please do so by ringing us on 01844-214362.   Best wishes yours sincerely,   Adrian Richards Plastic and Cosmetic Surgeon Surgical Director of Aurora Clinics

		Mr. Adrian Richards The Gatehouse 82 Billing Road Northampton NN1 5DF Phone: 0800 328 5743 Web: www.aurora-clinics.co.uk

A. Thank you very much for your enquiry, we’ll be happy to look at the pictures of your chest following your macrolane injection and we could do this if you send them to info@aurora-clinics.co.uk.   Unfortunately, macrolane can have lumps for some years but it is also possible to remove the macrolane and replace the form of better breast augmentation procedure we performed this a number of times at Aurora Clinics and if you would like to see more information about the procedure please visit our website http://www.aurora-clinics.co.uk.   Many thanks for your enquiry, we do look forward to meeting you in the near future should you decide to schedule a consultation.   Best wishes yours sincerely,   Adrian Richards Plastic and Cosmetic Surgeon Surgical Director of Aurora Clinics

		Mr. Adrian Richards The Gatehouse 82 Billing Road Northampton NN1 5DF Phone: 0800 328 5743 Web: www.aurora-clinics.co.uk

A. Thank you very much for your enquiry about possible non-surgical breast enlargement.   This is not a procedure we specialize in here at Aurora Clinics but there are a number of clinics which do concentrate on this operation. If you feel you would like to schedule a consultation with one of these in our clinics I think it would be sensible to do a further search on the web to find a clinic who do specialize in this type of treatment.   Best wishes yours sincerely,   Adrian Richards Plastic and Cosmetic Surgeon Surgical Director of Aurora Clinics

		Mr. Adrian Richards The Gatehouse 82 Billing Road Northampton NN1 5DF Phone: 0800 328 5743 Web: www.aurora-clinics.co.uk

A. Hi there. I perform macrolane for non surgical breast enlargement. I can usually see you for an appointment within a few weeks and perform the treatment a couple of weeks after that too. If you want to know about prices and appointment availability, please could you call 01415520828 or email enquiries@labelleforme.co.uk and my staff should be able to help

		Mr. Taimur Shoaib La Belle Forme Clinic 24-26 Wilson Street Glasgow G1 1SS Tel: 0141-552 0828 Web: www.labelleforme.co.uk

A. Thank you very much for your email, unfortunately we do find that juvederm treatments to the tear trough can cause quite a lot of puffiness by withdrawing water in towards to the juvederm. This does tend to vary depending on activities and how tight you are.   I think hyalase would certainly be an option and this is generally very safe and only absorbs the hyaluronic acid and will leave your normal tissues completely intact.   If you are seeing the same practitioner I think it’s worthwhile asking them how many times they have performed hyalase injections and their experience with this.   I do wish you the best of luck with this if you do decide to go along with hyalase injections.    Best wishes yours sincerely,   Adrian Richards Plastic and Cosmetic Surgeon Surgical Director of Aurora Clinics

		Mr. Adrian Richards The Gatehouse 82 Billing Road Northampton NN1 5DF Phone: 0800 328 5743 Web: www.aurora-clinics.co.uk

A. Thank you for your email. I think that my office staff has already dealt with your inquiry. With best wishes,

		Mr. Shailesh Vadodaria 10 Harley Street London W1G 9PF Tel: 0208 997 3976 Web: www.vadodariaplasticsurgery.com

A. Hi and thankyou so much for your question. Lip reduction is a less common request than augmentation these days but Lip enhancement occasionally requires the ability to be able to undertake both types of procedures.  As always, one will be better guided after a thorough consultation and assessment from an experienced eye taking into account your aims and expectations; this is really an operative site that requires tailoring any treatment specifically for each patient.  I think one of the more important aspects of assessement in this regard is to appreciate facial proportions and to balance the lips to each other and to the facial profile for the best outcome and to produce really beautiful lips.  I undertake surgery for cleft lip and palate which often involves both lip augmentation with muscle surgery, grafts or filler, but also reduction to achieve the best balance and attractive smile. Lip reduction is certainly possible; please feel free to contact our office for further information.

Mr. Tariq Ahmad Spire Cambridge Lea 30 New Road, Impington, Cambridge, CB24 9EL Tel: 01223 864 678 Web: www.cosmeticsurgeoncambridge.co.uk

A. Lip enhancement is possible in a number of ways, depending on teh patient’s aims and expectations.It is important to maintain upper and lower lip balance, and I think to avoid the ‘overdone cosmetic surgery’ look. With lips I often feel that the adage ‘less is more’ is good to bear in mind – the patient should look better but natural and undetectable; so friends might wonder where you have been on holiday but not necessarily be aware that you are physically enhanced!The options for enhancement include fillers, grafts and implants. Sometimes a filler is a good starter so that you can assess whether you like the look as if you don’t then with a temporary filler the appearance will eventually go back to that which it was before.  Unfortunatley, with a temporary filler if you do like the look then the same is still true: the appearance will eventually go back to that which it was before. Temporary fillers include variations of hyaluronic acid which is a natural ‘cement’ substance that holds the body cells together.  Restylane, (or its related productsare (Perlane and Restylane Lipp) and Juvederm are the most well known. These products may also be utilised to soften fine wrinkles (‘smoker’s lines).  For most patients I feel that temporary filler are safer in that a permanent filler may produce a permanent problem, a permanent enhancement with an implant may be appropriate for some patients and usually a slim silicone implant is best as it is a simple outpatient procedure and silicone is one of the least reactive substances available for implantation so causing least upset to the body’s tissues as long as the procedure is undertaken by an experienced clinician.  There are plenty of other fillers and implantable materials out there and can be considered after consultation.Finally there is also the option of lip enhancement with your own tissue – either with fat injection or a skin-fat graft. The advantage is that this is your own tissue so no ‘rejection’ but it is not an outpatient procedure and the fat or skin graft comes from somewhere else in the body.  I undertake these so called Dermis-Fat grafts regularly for my patients with cleft lip and palate who often have upper – lower lip imbalance, very successfully.If there are a lot of wrinkles around the lip then these can be significantly improved with chemical peel, skin laser or manual ‘dermasanding’; I have found the latter procedure particularly effective in rejuvenation around the mouth; I am in fact presenting the results at the national aesthetic surgeons meeting just now. Dermasanding can be undertaken as an outpatient under local anaesthesia.I hope this information is helpful, please contact the office for price ranges for these.

Mr. Tariq Ahmad Spire Cambridge Lea 30 New Road, Impington, Cambridge, CB24 9EL Tel: 01223 864 678 Web: www.cosmeticsurgeoncambridge.co.uk