Our Entry for the Award:
Best Non Surgical Makeover
Please provide us with a professional biography listing details of where and when you trained, qualifications, accreditations and experience.
Dr. Andrew Clark is both an internationally published scientific author and experienced medical doctor practicing cosmetic medicine since 2010. Dr Clark graduated from the University of Tasmania with a medical degree (MBBS) with Honours in 1999. He has worked in the public hospital system as a surgical registrar, and emergency department registrar. While working as a surgical registrar, and as a private practice surgical assistant to severl Plastic Surgeons, Dr Clark first trained in the use of medical relaxers and dermal fillers over fourteen years ago. During his career in medical research and medicine Dr Clark has worked along side many leading plastic surgeons, cosmetic physicians and professors in Australia, the United States and the Netherlands.
In 2005 Dr Clark gained his PhD in the fields of skin and muscle biochemistry and physiology (also from the University of Tasmania). Dr Clark has been invited to lecture on, and teach cosmetic medicine injection techniques at numerous conferences and venues throughout Asia. He is an International Key Opinion Leader for the dermal filler Ellansé as well as a certified trainer for the administration of Galderma, Anteis, and Sinclair aesthetic medicine products. He is also an active member of several Cosmetic Medicine groups including Membership of the Australasian College of Aesthetic Medicine.
From mid 2013 until mid 2016 Dr Clark was a partner in a busy Perth comsetic medicine practice and helped the practice grow into a second location and more than double the number of injecting staff. Dr Clark was responsible for devoloping and implementing treatment protocols and training, mentoring and supervising the 10 injecting staff of these clinics.
In November 2016, Dr Clark opened the Medical Institute for Rejuvenation and Aesthetics in West Perth - MIRA Clinic. Dr Clark and the staff at MIRA Clinic have become well known for being honest and realistic during consultations that use "before and after" images of actual clients treated by the staff to help prospective patients to better understand the likely outcomes of proposed treatments.
Please provide a full treatment plan/Case report detailing the patient?s initial concerns, details of your diagnosis and the reasoning for the recommended treatments, including alternative options presented to the patient.
I first met Carole Bramston in 2014. Carole had come to see me at the recommendation of a friend. Carole had just finished filming "House Rules" and was wanting to refresh her appearance so that she might feel more confident dealing with the media interest that followed the airing of the top rating TV show. She was extremely worried about looking unnatural or of being "found out" for having any cosmetic medical treatments. We actually had to schedule Carole's appointments when no other clients were around and she would wait until the coast was clear before entering via a rear entry to the clinic.
The first cosmetic medical treatment that Carole had was wrinkle relaxers (Botox) for her frown and crows-feet. There was no way Carole was going to let me take any pre-treatment photos (which is why all of the 'Before" photos in this application are in fact “after" botulinum toxin treatment).
Carole was surprised by how easy the treatment was and how profound were the results. She seemed to enjoy the results so much that she announced publicly that she was getting “Botox treatments. Carole returned some time later to discuss options for further treatments that could restore her appearance but keep her looking “normal”.
Carole came to me explaining that she had some important media appearances in just one month’s time. Carole asked me to help her achieve the most significant results I could non-surgically, so she could look her best for these appearances. Carole had a few other requests that also helped to determine the treatment options:
- Carole wanted minimal down time as she had to travel and spend time with family in just over a week
- Carole wanted the results to last as long as possible
- Because Carole was going to be travelling, all of the treatments had to be done on just one day
Carole told me that she was frustrated that she was frequently being asked why she was looking so tired or sad. She had specific concerns with her jowl area and wanted help to look more “refreshed”. Carole showed me several photos of some celebrities whom she felt looked unnatural from too much “plastic surgery or fillers” and she “definitely [didn’t] want to look like that”.
Carole’s most recent botulinum toxin therapy was still working well and at that time further Botulinum toxin treatment was unnecessary.
Carole had never before had dermal fillers.
Carole’s “tired” and “sad" look was contributed to by sub-orbital hollowing, volume loss through the cheeks, down turned mouth corners, sagging of the jowls, small (volume depleted) lips. An upward folding of the chin, causes a deepening of the mental crease, together with a relatively short lower third of the face, the long and tired look of the mid face was exaggerated.
The small window of opportunity for treatment meant many treatment modalities (that I might otherwise use in my clinic) relied upon repeated treatments and / or delayed manifestation of results (such as Poly-L-Lactic Acid, Platelet Rich Plasma, Dermal Needling, Laser resurfacing) all had to be excluded.
I felt that the most important physical signs of the tiredness and sadness were best addressed with the following treatments that were all undertaken on the one day soon after the consultation:
- Malar volumisation (1.5mL total)
- Pre-auricular volumisation (2.5mL total)
- Temple volumisation (1mL total)
- Lip augmentation (1mL)
- Sub-Dermal filling of the Mental crease and slight augmentation of the pre-jowl sulcus (1mL)
- Tear trough deformity correction with dermal filler (1mL total)
- Silhouette Soft thread lifting with two threads on each cheek (2 threads per side)
- Cannulas were selected for administration of lip augmentation, Malar, pre-auricular, tear trough filler, mental crease filler, and Pre-Jowl-Sulcus augmentation. This was done for improved safety and for decreased risk of bruising and reduced down time.
- Due to Carole’s request for immediate results and for long lasting results I opted for the “E” (i.e. longest lasting) version of the dermal filler / collagen stimulator “Ellansé” for use in the Malar and Pre-auricular areas and mental crease/ Pre-Jowl Sulcus.
- It is my practice to only use Ellanse in the deeper tissue planes and to avoid its use in the lips and immediately below the eyes. For this reason I used Hyaluronic Acid filller for the tear troughs and for the lips.
- I have found that my results from the Silhouette Soft thread lifting treatments are improved by requiring my patients to wear some tape after the procedure. I believe the tape takes some of the weight of the tissue that has been lifted and in the 48 to 72 hours during which the tape assists by taking weight from the thread cones, the inflammatory cells of the body have time to respond to the Poly-L-Lactic Acid of the thread and form adhesive connections to the thread (which in all liklihood exceeds the physical lifting capable only through the resistance of the cone).
After the Dermal Filler and thread lift procedure
Carole was extremely satisfied, her results were obvious to her and her loved ones. She felt that her results looked natural and she told me that I had avoided the “overdone” look that she didn't want. Carole also reported that she became more satisfied with her results over time. Perhaps due to the collagen stimulating effect of the Ellanse product. Since this makeover, Carole has had her lips retreated as well as her tear troughs, but she has not had further malar or pre-auricular volumisation.
Soon after the Belkyra treatment became available in Australia, I undertook training in the procedure and contacted Carole to see if this was something that she would be interested in having done. Assesment of her sub-mental fat area (and medical history), and the reasonably good tissue quality and absence of loose skin led me to believe that she would be a suitable candidate for this treatment.
Following the injection area marking procedure and dosing protocols recommend by the manufacturer. Due to the significant immediate post treatment swelling that we expected, Caroles work commitments dictated that here subsquent treatments occurred at a various intervals approximately 6 to 8 weeks apart.
Carole showed some improvements in her neck contour prior to her third treatment. Some quite significant results were evident 6 weeks after her 3rd treatment. These results can be seen in the images attached to this award application.
On Tuesday 19th September 2017 Channel 7's "Today Tonight" broadcast their segment on Carole's Belkyra treatment. Within 24 hours there were more than 50,000 views of the video on Facebook:
Please provide testimonial from the patient ? the patient's story, how has the treatment impacted on their life.
What is your experience like at Mira Clinic and with Dr. Clark?
I find Andrew incredibly thoughtful, warm and understanding throughout every process. Andrew and his team really seem to genuinely care about you and tailor appropriate treatment plans specific to your individual needs. His professionalism is unparalleled. My impression is that he doesn’t work from a business perspective - its clear that he simply loves his job. In my experience it’s really the furthest from a “one size fits all approach” and I honestly believe he understands the unique beauty of each individual patient and how best to enhance their attributes without going overboard.
From my perspective, self-confidence varies amongst women, as does the aging process. Some women don’t feel the the need to undergo any procedures, whilst others go overboard. It really is a spectrum and I’ve sat in consults (with friends of mine) where Dr. Clark has advised against specific treatments that the patient has requested - as he doesn’t believe it is necessary. He takes pride in his work and genuinely only recommends treatments he thinks patients will benefit from. He understands balance and exercises restraint, so I have a lot of trust in him.
In addition, Dr. Clark makes you feel valued in the sense that he is considerate. He’s exceptionally knowledgeable and takes the time to explain every aspect of the treatment, ensuring he addresses any questions or concerns that you have, even taking the time to explain what the treatment will feel like.
Why did you decide to pursue these treatments/this process?
Whilst my experience on House Rules was amazing, it really wears you out doing that kind of work, the work itself is a lot of manual labour and the competition side of it can be very stressful, and after a while you really notice the strain on yourself both physically and emotionally. So naturally, you feel as if this reflected in your overall appearance. On top of this, being thrust into the limelight after House Rules and exposing yourself to all this extra publicity, I felt overtly conscious of my looks and some of the things tabloid’s can say about you means your self-confidence can really take a blow.
How do you feel these treatments have made a difference to your overall level of confidence?
I feel like it has really changed my life significantly. I used to be so reluctant to attend public events as I just didn’t feel good about myself. Now it’s completely different. I can confidently say that now when I go out, I never come home without receiving at least one or two compliments about the condition of my skin or my face.
The Belkyra treatment in particular has had the most dramatic impact on my self-confidence. I did not realise my side profile was as bad as it was until I saw it in photos of me taken at publicity events, I was really more conscious of other features on my face. But it was through my insightful consult with Dr. Clark that I came to understand how much of a neglected area this was amongst women my age, and that this treatment would be more valuable to me than addressing what I considered to be more pertinent issues.
In addition the results I've got has also given me the confidence to further pursue my career in television, in particular commencing work as part of a new television program called New Homes Guide on Channel 9. I used to find going on camera to be incredibly daunting. But at the end of the day, the work that I do on television is really my passion and it’s truly rewarding being able to share my work with a broader audience on a platform like that. It also allows me to set an example for other women my age, encouraging them to pursue similar pathways in the media. You shouldn’t be made to feel intimidated by your age, and that is what is special about MIRA Clinic and Dr. Clark; he allows me to feel comfortable in my skin. I’ve never felt more encouraged or more authentic in my life and every time I visit, it genuinely feels like I’m coming home!
Please supply any evidence where your case study created a story and attracted media attention for the outstanding results creating awareness for future patients of your practice.
When "Womans Day" magazine heard that Carole was going to be undertaking the dermal filler and thread lift procedure, they were very keen to send along one of their journalists to document Carole's journey. Details of the procedure and "before and after" images were featured in a double page spread in the magazine.
Subsequently many other internet news sites picked up the story.
As a result of the story, we had an influx of enquiries from ladies requesting to have "the same thing Carole had". It seems that there were a large number of woman, particularly in their forties, fifties and sixties who wanted to learn more about acheiving a significant reduction in the physical signs of aging, but particularly because they felt from seeing Carole's results and from reading her comments that the results could still look natural and that there was relatively little down time.
Woman's Day magazine is published nationally and many clients travelled to Perth or to Brisbane (where Dr Clark also practices) to have similar dermal filler and thread lift procedures as a result of reading the articles.
March 2017 to July 2017
A couple of years after Carole's Womans Day appearance, Carole was still very happy with her results and they were still evident in her clinical photographs, particularly the reduction in the extent of the jowls. However, I felt that below her jawline had not been significantly improved by the original midface and lower face treatments. After I first trained in the use of Belkyra, I immediately thought that Belkyra would be the perfect treatment for Carole. I discussed this with Carole, and once again Carole was kind enough to allow me to feature her results and experiences publicly.
We approached Producers from Channel Seven's "Today Tonight" and asked if they wished to document Carole's expereince with the new Belkyra treatment. Because there had already been some recent coverage of the treatment, their proposal was that they would need the story to bring something much more than just a description of the treatment. They wanted to see real results. They proposed to film footage of the initial treatment, then wait for Carole to complete a course of treatments, and then based upon the producer's assessment of Carole's result, they would determine if they were going to bother to return to film the "after treatement footage" and produce a story.
In July 2017, after Carole had completed three sequential treatments with Belkyra, we sent the clinical photographs of Carole's jawline profile views to the TV producers. They were extremely impressed with the results so the rest of the segement was filmed. At the time of writing (Early September 2017) a segment for Today Tonight has now been produced and is about to go to air.
We plan to link footage from the Today Tonight article to our YouTube channel as soon as the segment is aired. We are very excited to shortly become one of the first clinics to show on television real results of Australian clients treated in Australia with the Belkyra treatment. Once the segment airs, we will be promoting our appearance, and the results that we acheived for our patient with extensive, Facebook, Instagram and local radio advertising.
In no more than 500 words, please tell us why you feel you should win the title of Best Non Surgical Makeover.
I think Carole's "before and after" images speak for themselves. In our clinic we show Carole's "after" pictures first. Everyone agrees that she looks great, and doesn't look like she's had "too much work done". Almost everyone is amazed when we show Carole's "Before" images side by side. They can't believe that the difference was acheived without surgery.
A huge percentage of our clients are in the 50 to 60 year old age group, they are looking for natural looking results and they wish to avoid the costs, risks and downtime of surgey. Seeing Carole's results and reading about Carole's experiences with the treatments has been a huge inspiration for many of our clients.
We have experienced an enourmously positive response from our clients by demonstrating the realistic results on our well known clients like Carole. We strive to be completely honest and comprehensive when describing the treatments that our "before and after" models received. Along with a thorough account of the costs of these treatments, as well as an account of the possible side-effects and likely down time, clients are then in the best position to make decisions about the treatments they would like to receive. This approach has meant that satisfaction rates have skyrocketed and complaints about insufficient outcomes or downtime has plummeted.
If Carole's makeover were to win this prize, I hope it would inspire our industry colleagues to use more of their own before and after images in the marketing of their practices, and to use those images in a more factual and educational manner.
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