Dr. Harlow Hollis, FRCS (C)
Plastic and Cosmetic Surgery

Who is a candidate?
If you have fine or course wrinkles of the skin – usually on the face.
If you have uneven skin surface as a result of acne scarring or small skin growths.
If you have areas of hyperpigmentation (age spots).

Intended Results
Smoother, youthful appearing skin or more uniform color.

Procedure Description
The procedure is usually done on an outpatient basis under local sedation and local or general anesthesia.
The superficial layers of the skin are removed by the pulsed laser. The advantage of the laser is that the depth of treatment is extremely controlled and predictable.
The laser treatment also tightens the skin.

Recuperation and Healing
You will be sent home with specific written instructions. Depending on location, the treated areas are covered with a tape-like covering or with ointment.
The treatment postoperatively will prevent formation of a crust or scab. Healing will be complete in 7 to 10 days.
Redness (pink colour) will usually last from 1 to 6 months.
Makeup can be worn once healing is complete (7 to 10 days).

Other Options
Other facial procedures such as blepharoplasty (eyelid lift), face lift, rhinoplasty, cheek implants, etc… can be performed at the same time.

Insurance Guidelines
This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment.

Note
The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.

Skin Peel
Who is a candidate?
If you have superficial wrinkles of the face, neck, upper chest, arms, etc…
Deep facial wrinkling.
Uneven pigmentation problems caused by sun exposure, prescription drugs, or disease.
Enlarged facial pores.
Superficial acne scars of the face.
‘Age spots’

Intended Results
Smoother, youthful appearing skin of more uniform color.

Procedure Description
These procedures are done on an outpatient basis under sedation and local or general anesthesia. Light peels may be done without any anesthesia. Light and medium depth peels do not require any anesthesia.
After preparing the skin, a series of solutions may be applied.
Light, moderate, or deep peels are available. A consultation is required to determine which type of peel (if any) will be most suitable for you.

Recuperation and Healing
You will be sent home with specific written instructions. The treated areas are washed, and medicated lotions are usually applied several times daily.
After light peels, the treated skin turns red or pink and heals without crusting.
After medium or deep peels, a superficial crust or membrane usually forms and peels off 3 to 7 days later like a sunburn blister -- revealing a new skin surface that is smoother.
The skin redness after deeper peels fades in a month or two.

Other Options
Please consult the staff at the office for optional procedures.

Insurance Guidelines
This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment.

Note
The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.

Botox
What is Botox?
Botox is a new concept in treating facial wrinkles in the forehead, between the eyes and in the ‘crows feet’ areas (upper third of the face). Botulinum toxin, or Botox, works by weakening the muscles of facial expression. Once the resting tone of the treated muscles is weakened, the pull of the muscles relaxes and the overlying skin flattens. This approach is different that the other local treatments for the aging face. Silicone, collagen, autologous fat transfer, Alloderm, Softform, etc. all work by filling in wrinkles or depressions. These fillers are frequently not as effective as Botox in treating wrinkles in the upper third of the face. By physiologically weakening the muscles, wrinkles are lessened naturally.

How Long Does it Last?
Injection of this material into the small muscles between the brows, in the forehead, and at the corners of the eyes causes those specific muscles to halt their function (to be paralyzed), thereby improving the appearance of the wrinkles. This paralysis is temporary, and re-injection is necessary within three to ten months. Options for alternative treatment include injection of either collagen or free fat, or the surgical excision of the muscles, usually through a brow-lift incision.

How is it Used?
Botox is freshly prepared on the day of injection. Once prepared, the medication needs to be used within 12 hours as the potency diminishes within time. Because of the short shelf life and the cost, Botox is not available every day in our office. In order for the treatment to be cost effective, more than one patient must be treated on the same day. Very small amounts of Botox are injected into the muscles to be paralyzed using a very time needle. Depending on the areas being treated, 5 to 15 needle pricks (or more) may be required. Discomfort is minimal and lasts only a few seconds.

Side Effects
Occasionally, the tiny needle may puncture a small blood vessel during the injection and a small black and blue area may develop. Such an area can last 5 to 10 days and requires makeup to cover.
If any of the Botulism toxin reaches a facial muscle not being treated, partial weakness of that muscle may last for several months. (it is for this reason that you are requested not to massage the injected areas for 12 hours following injection.) In the event of an area of unwanted muscle weakness, the only ‘treatment’ is to wait for the effect of the toxin to wear off in several months.
There are no known permanent side effects to Botox. Complications are rare, but may include paralysis of a nearby muscle resulting in its temporary loss of function (i.e. a drooping eyelid). Botox has been used safely in the treatment of muscular facial spasms for approximately 15 years.

Other Options
Botox injected in conjunction with nearby facial surgery has caused spread of the toxin and unwanted facial weakness in at least one patient. For this reason, we will inject Botox only as an isolated facial procedure or treatment.

Insurance Guidelines
This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment.

Note
The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.

Removal of Skin Lesions
Who is a candidate?
If you have a concern about possible skin cancer.
If you have a desire to remove unsightly or uncomfortable moles or cysts.

Intended Results
Removal of lesions with a satisfactory cosmetic result.

Procedure Description
Skin tumors or cysts are usually removed under local anesthesia on an outpatient basis.
Each lesion is excised in the best possible orientation (direction) and sutured using plastic surgery techniques.
Some lesions do not receive any sutures.

Recuperation and Healing
Pain is usually very minimal and requires no more than Tylenol for control.
Sutures are usually removed in 4 to 6 days on the face and 7 to 10 days on other parts of the body.
Where sutures are used, healing usually occurs in 7 to 14 days.

Other Options
Additional procedures that would enhance the result is the cautery of small vascular spots or surface irregularities, and the treatment of spider veins.

Insurance Guidelines
Lesions removed because of suspicion or proof of skin cancer are usually covered by insurance. Cyst removal is also usually covered. Lesions removed for cosmetic reasons are usually not covered by insurance and the patient is responsible for payment.

Note
The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.

Scar Repair using Z-Plasty Technique
Who is a candidate?
If you have contracted or tight scars.

Intended Results
To reduce the tightness or contracture of a scar and thereby make it more comfortable and less conspicuous.

Procedure Description
Z-Plasty is performed by raising two adjacent skin flaps and transposing the flaps (putting each flap where the other one was).
While this creates a Z-shaped scar that is three times as long as the original scar, the two ends of the original scar are now further apart and the tightness or contraction is reduced.

Recuperation and Healing
Initial healing takes place in a week and all swelling is gone in 4 to 6 months.
Z-Plasty is usually not a painful procedure.

Other Options
Additional procedures that would enhance the result are Dermabrasion or scar revision of other scars.

Insurance Guidelines
Z-Plasty is frequently covered by insurance if the scar results from an injury or surgery that was covered.

Note
The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.

 
Dr. Harlow Hollis


Canadian Society for Aesthetic Surgery
The Canadian Society for Aesthetic (Cosmetic) Plastic Surgery was
established in 1972 with a membership of certified (FRCS(C)) Plastic
Surgeons specializing in cosmetic surgery...

 Dr. Harlow Hollis MD FRCS (C)
100 1830 Oak Bay Avenue
Victoria, BC  V8R 6R2
Tel: (250) 592-7368
Fax: (250) 592-8998
email: hollismd@shawcable.com

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