Trish Hammond: Well I’m here today with Dr. Joanne Samer, who’s a general practitioner who does cosmetic treatments, if you like. She’s based in Watermans Bay, in Perth. Welcome, Dr. Samer.

Dr Joanne Samer: Hi, Trish.

Trish Hammond: Now, I met you online, and I was really, really interested in the fact that you do something a little bit different. Your website is called healinggracefully.com.au.

Dr Joanne Samer: Yes.

Trish Hammond: I went to your website and it really appeals to me, because I’m very much into the more natural side of things. Tell us a little bit about what makes you so different.

Dr Joanne Samer: Okay, so I guess there’s a few things that differentiate me from other practitioners doing this kind of work. One of the things that most of my clients like is the fact that I actually have a home based practise. I have a purpose-built clinic that is separate from my home, but on the same block as my home, with lots of parking. We’re right near the ocean, so most ladies love coming here just because it’s so beautiful. That’s the first thing that’s different. The second thing that’s different is that it’s me, myself, and I. I don’t actually have any staff.

When people call, we’ll always speak directly with me, I answer all my phone calls. If I can’t pick up in the moment, because I physically can’t because I’m doing a procedure, then I will usually return the calls within a very brief period of time. Most people get a bit of a surprise when they speak to me, they go, “Oh, I didn’t expect to speak to the doctor.” They like that, because it’s more personal and straight up. They can ask big questions of me, and I can respond, so that they’re not having to have an appointment and then come and then get all their questions answered. They can have the vast majority answered up front. Which they like.

Trish Hammond: Yep, oh go on, sorry.

Dr Joanne Samer: No, go on.

Trish Hammond: I was going to say, one thing that really appealed to me about … I’m all about, I think we’re the same demographic, so you’d be right up my alley. One thing that really appealed to me, which I think a lot of ladies would be interested in as well, is the fact that you like to … You like your work not to be noticed, but to make the person feel and look better.

Dr Joanne Samer: Correct. I have this saying or phrase that I use, if you have a look at the person who’s doing the injecting for you, and if they don’t look natural, then there’s a high probability that that’s the look that they like, and they like creating. I always get the comment, “Wow, you look so natural, Joanne” and that’s because I am, I do use Botox, and I do use fillers myself, but only to the extent that I need them. I’m very keen to create the most natural looks that I can. The last thing I want is for people to walk out the door and someone [inaudible 00:02:50] and say, “Oh, you’ve been to see Dr. Samer, haven’t you?” That’s not how my ladies like to be. They like to leave knowing that they’re going to … No one’s going to particularly know how to [inaudible 00:02:59] themselves.

Trish Hammond: Exactly.

Dr Joanne Samer: Yes, I do like natural, and I do like to think of it as bringing out the beauty that’s in the face there waiting to be shown.

Trish Hammond: Okay, so do you have a certain age of client that comes you, or it’s varied?

Dr Joanne Samer: Look, I see women in their late 20s right through to, today I had a lady who’s 74. I do see the full spectrum, but certainly the vast majority would be between the ages of 35 and 65. There are some procedures that I [inaudible 00:03:37] to not to do after the age of 65, simply because the skin won’t respond. If we’re looking at skin rejuvenation procedures like skin needling, or platelet rich plasma treatments or thread lifts, then over the age of 65 are less likely to get a tissue response, and certainly who are smokers, then I don’t do thread lifts for smokers ever.

Trish Hammond: Why’s that?

Dr Joanne Samer: The tissue is less responsive and cigarettes are such a toxin, that we just … The surgeon who developed the strength that I use, which are called Promoitalia threads, he has a blanket policy, smokers forget it, and what he’s found is, that if women are really motivated they will quit smoking to have the procedure. That’s great. Interesting, Trish, yesterday I had a lady who wants to have a thread lift, and I said, “Sorry, you’re a smoker.” She said, “Oh, I’m quitting, I’m quitting” and I said, “Do you know anything about essential oils?”

This is bit that definitely differentiates me, because I do integrate a lot of complementary medicine into what I do. She said, “No, I don’t know anything,” and I said, “Well, if you use black pepper oil, and I use pure essential oils, on the tip of your tongue one drop, it’ll stop cravings.” I gave her a little sample bottle, and I said, “Take it away.” I put the label, black pepper, on the bottle, and she texted me back today. She said, “I want two bottles of this stuff, I can’t believe it. I put one drop on the tip of tongue, and I stopped, my cravings have completely disappeared.”

Trish Hammond: Oh, wow.

Dr Joanne Samer: I’ve got tips and strategies for ladies to get what they need to get with their health overall, and that comes on a strong general practise background. Then last 15 plus years, since 2003, maybe longer, I’ve been working in that complementary realm as well, so looking at nutrition and lifestyle, diet, exercise, supplements, and more recently, using essential oils, because they’re plant medicine, that they do amazing things.

Trish Hammond: Okay, so basically you’re like a … I could come to you as a GP, as my cosmetic physician, help me with diet if I wanted, like a one stop shop.

Dr Joanne Samer: Sort of. I mean, I don’t run it as a general practise, Trish, it is ostensibly a cosmetic practise, however, a lot of people, they’re getting advice from their general practitioners or their specialist, which they feel a little uncomfortable with. Sometimes the advice is perfect, sometimes it fails to see the whole person. I like to take a full history from my patients, I like to really see them as whole person with all their health concerns. Then I can just value add to what they’re getting from their general practitioner and show them other solutions that might complement what they’re doing or may in fact support them such that they can perhaps wean off other things. I’m working as a general practitioner. I used to, but these days, it’s cosmetic with a twist.

Trish Hammond: Okay, okay. It’s like a holistic cosmetic approach almost.

Dr Joanne Samer: Correct.

Trish Hammond: Okay, so tell me about some of the treatments, I know you do the thread lift. You also do the anti wrinkle injections.

Dr Joanne Samer: Correct, so I won’t for the purposes of, what’s the word? The law will use the drug names, because if I do that, I might get myself into trouble, but you ladies can read between, your listeners can read between the lines. Anti wrinkle treatments I do, which are used for movement related lines, so lines around, typically, the eyes. I do the eyes, between the eyebrows, across the forehead. Sometimes we can use a little bit on the chin for ladies who’ve got that heavy crease on their chin. There’s several different products on the market, but there’s one that I preferentially use, because of its longevity and its predictability. Some products are little more predictable in their results.

I use dermal fillers, so dermal fillers are very different to Botox. They are used to restore lost volume. As we age, we lose volume in the face. We can lose it, if we work from the top down, we can lose it from the temples, we can lose it from the lid face around the cheeks, we can lose it on the jawline and the chin. Anywhere on the face and lips, which most people know about, but often people don’t know about the other areas that can be supported with dermal fillers. I’d people to think of it as clay or putty, we’re putting a product into the tissue, which is sugar-based, which draws water to it and creates volume, so then we can bring everything north and stop it going south, so to speak.

Then I also do, as I talked about earlier, skin needling and platelet rich plasma. This is a bit like, for those of your listeners who are gardeners, a bit like aerating the lawn and putting fertiliser and [inaudible 00:08:26] and so on into it. The needling device is run by an electric current, and it goes up and down super fast like a sewing machine. You can needle the skin and then drop into those micro holes, any sort of product you choose. Sometimes we’ll just use hyaluronic acid, which is what’s in dermal fillers, but I also like to use people’s own platelets.

Many people who have heard of the vampire treatment with Kim Kardashian. Well, Kim Kardashian’s photos are far, far worse than the reality of this particular procedure. I’m not actually convinced she had that procedure done with those photos, but that’s another story. We use platelets, platelets are the cells that are involved in tissue repair. When we fall over and graze our knees, the platelets are the first cells that go to those areas to restore the skin back. When we needle the platelets in, we actually get an increased tissue repair outcome, and it’s fantastic for skin rejuvenation, fantastic for pigmentation, great for fine lines, will restore a bit of volume. A few different things that can benefit.

Trish Hammond: Okay, I’m really, really … I think PRP’s great. I haven’t had it done myself yet, but I’m really looking forward to having some done next year, because I’ve seen some incredible before and afters, it’s just like, “Whoa.”

Dr Joanne Samer: Yeah, and you can inject it, it doesn’t have to be needled in, you can literally inject it through a needle and syringe. It just depends. It’s fantastic under the eyes for those little hollow areas, what we call the tear troughs. I like it for pigmentation, I think it’s fantastic for pigmentation. It’s great for necks, when necks get that crinkly look about them as we age. It’s interesting, often we treat our face and use lots of product on our face, but we forget our neck. Then the neck looks more aged than the face. Tip number one is always put product on your face and neck, and back of hands. Then, when that neck gets that wrinkled look, the PRP and needling is really restorative for that area. It’s quite amazing. I like PRP and needling, and it’s done … I get my ladies to come with numbing cream on their face so that they’re prepped, and then it’s quick and easy. Then they go, they leave like they’ve had nothing done, because I put product on afterwards to get the skin back to a nice comfortable look and feel.

Trish Hammond: Okay, and how often would you have a treatment like that done?

Dr Joanne Samer: I like to suggest three times, initially, so once a month, and thereafter once or twice a year, just to keep the skin fresh and alive. The first three treatments, because we’re stimulating the tissue to grow, you don’t see the results immediately. The results come bit by bit. Same with thread lift. The results can take six months to be fully done. It’s really important that ladies with those sorts of rejuvenating and restorative procedures have realistic expectations about how long it would take for the results to be visible.

Trish Hammond: With the needling, I think you can feel it straight away, anyway. When I’ve had it done, I just loved the way it feels, that smoothness. It just feels great to me, the needling. I usually do notice a difference straight away with the needling on myself.

Dr Joanne Samer: Fantastic.

Trish Hammond: I’ve noticed that you also do double chin reduction.

Dr Joanne Samer: Yes.

Trish Hammond: Can you tell us about that, because I get asked about this all the time, so a non-surgical reduction for the chin. What is that?

Dr Joanne Samer: It’s great. The general term is lipo dissolve or fat dissolving. The product that’s used is a soy-based extract. Provided you don’t have soy allergy, it’s very safe to use. What happens, is when it’s injected into the double chin area, and it needs to be injected … The results are the best when it’s injected into what we call lose, wobbly fat. Some men will have quite a firm, hard double chin, less effective in that. Women usually have that soft, wobbly fat. When it’s injected into that fat, what the product does, is it draws water to it, it causes the fat cells to swell and burst, and then the product emulsifies that fat down so that the body can remove it as if it had a fatty meal. That whole process of fat disruption and emulsification takes about four weeks, and then the removal is the next four weeks.

I follow up up on those procedures after eight weeks. Depending on the volume of fat in the chin area, it may take one or two, or very occasionally three treatments. The main thing I like to explain to people is that it will be uncomfortable post procedure, because the swelling is uncomfortable, but if you go about your business, and you’re busy, and I hate chewing gum, but I do suggest chewing gum to keep the area moving, then most ladies are fine. At worst, a Panadol or perhaps a little bit of ice over the area. Exercise is great, the more you do the better. The results are permanent provided you don’t regain weight. That’s a fantastic treatment for those who are carrying a bit of extra fat under their chin. It will give them a much cleaner, neater jawline, to make them look like they’ve got a jaw again.

Trish Hammond: Is that a new thing that’s out, or has that been out for a while?

Dr Joanne Samer: No, I’ve been doing that procedure since 2003, so it’s nothing new. The product was developed by German doctors. It’s kind of interesting history, the phosphatidylcholine, which is injected, has been used for, well now, probably 70, 80 years in cardiology. It’s used to melt what we call fat emboli. Most people know about the deep vein thrombosis and clot that forms in the veins, and how that can break away and go up into the heart. You can also have fat clots, and so it’s been used in high doses intravenously for a long, long time in cardiology to dissolve fat emboli. The cosmetic physician started experimenting with it to see, “If it dissolves fat in the bloodstream, I wonder if it can just dissolve fat tissue.” Sure enough, it did.

It’s been around for quite a long time and I used to inject it in many other parts on the body, but the results are, it’s good for small areas of fat. An embolus is usually a tiny little bit of fat. When you’ve got large amounts of fat that’s not the solution, it’s not a weight reduction treatment. It’s purely a cosmetic treatment for small areas of fat, and that’s why the double chin’s perfect. The other area where I don’t typically do it, but I can, is when women have what I call a baby belly. Just that little bit of fat on their abdomen, looks like they’ve just had a baby and it’s full, so contracting back. Other than that, I tend to not to use it for … People have unrealistic expectations with the results, and that’s not going to work.

Trish Hammond: Yeah, we want a quick injection, and then all the fat’s just melted, that would be perfect.

Dr Joanne Samer: Oh, then I would a trillionaire, Trish.

Trish Hammond: You also have a solution for excessive sweating.

Dr Joanne Samer: Yes, so the drug that’s used for wrinkle relaxers can also be used for excessive sweating. This is an interesting one, because a lot of people will know that it can be used under the armpits for people who sweat profusely under the armpits. It is what we call an off-label procedure, so the TGA hadn’t approved its use, but it can benefit facial sweating. A lot of women will get lips that sweat or foreheads that sweat, and that can be quite disabling, because they’ll be going about their business, and the sweat’s just dripping off their face. That procedure involves using the wrinkle relaxer drug but in much, much tinier doses. For example one unit might do a whole top lip, I might put two units to do a whole or whatever. It’s just done with a lot of very small injections that’s diluted up, and we do lots of little injections to shut down the sweat glands, because the sweat glands, the reason we sweat is the muscles around the sweat gland contract. If we relax that muscle, then we don’t sweat.

Trish Hammond: Okay, I get it. Yeah, I have heard of a lot of success with it, but you have to have it done quite regularly, don’t you? Once a year, or how often?

Dr Joanne Samer: Initially, it might be three to six months, but the more regularly you have it, the less frequently you’ll need it, so that you might just want to have it at the beginning of summer, and away you go. In Western Australia, we have a lot of people who fly in and out of the northwest up here, and it’s very hot up there, so if they’re flying in and out all the time, they might go get more regularly to manage their work environment. People who do, for example, a lot of public speaking maybe, and get a bit anxious and sweat. Great when they’re doing a lot of public work. Just some women at menopause can start getting a lot of facial sweating, so that’s a good time to work with those ladies. Just depends.

Trish Hammond: Can you put it in the top lip at all?

Dr Joanne Samer: Yes, it can be used as a wrinkle relaxer for the top lip, this is what I would call an advanced technique. You wouldn’t want to be having this kind of procedure done by anyone who’s injecting, because if they haven’t the experience and the training, same with the chin and anywhere along the jaw and neck line, you need experienced injectors. If not, if they haven’t got many years of injecting under their belt, I would be saying you’re tempting fate, because if you inject the top lip in the wrong place or too much, you may lose the function of the top lip, and then you won’t be able to speak properly or whistle or hold a straw, or whatever. It’s really important that you have an experienced injector doing what we call the advanced or specialised areas with the wrinkle relaxers.

Trish Hammond: I was thinking for me, I am, I think I’m going through menopause now, and I crack a sweat on my upper lip, and thought, maybe that would be good for that.

Dr Joanne Samer: Yes, so you can use it there, that’s what I was discussing, Trish. Again, though, the vast majority of injectors would not know about that. It’s something that’s an advanced technique and you’d want to see a practitioner who really knows what they’re doing.

Trish Hammond: I did actually have, I’m not sure where, this is really early on the pace that I had my first injection at 46, and it was the second injection I had. I got back home and I couldn’t drink. I was drinking out of a straw, and it was just dripping out, so I was like, “Oh my God, what have I done?”

Dr Joanne Samer: Well, it’s not what you’ve done, it’s what the injection has done, because it’s been either too big a dose or misplaced.

Trish Hammond: Yeah, all right. Well, good, thanks for that. I was going to ask you one more thing. I know you do a bit of skin pigmentation stuff, can you just give us a quick rundown on what you do with regards to the lumps and bumps, I think you call them?

Dr Joanne Samer: Oh, lumps and bumps. That’s not skin pigmentation, that’s things like spider veins, milia, moles. You can treat pigmentation with it. I use a machine called Clinical Skin Clear machine, which runs a radio high-frequency, so it’s a very fine, light electrical current, and what it does is it zaps all these little lumps and bumps on the face or anywhere, really. Neck, decolletage, armpits, where people have skin tags and things like that. It’s a very quick, simple procedure to get rid of those sorts of things. It’s uncomfortable, but it’s quick. Most people find, if I’m doing a lot of work for someone, I might suggest they come with numbing cream on their face to make it more comfortable. Especially spider veins on the nose and on the cheeks, if there’s a lot of them it’s more comfortable to have anaesthetics so I can do my work more quickly.

Trish Hammond: Yeah, of course.

Dr Joanne Samer: It was quite a fiddly procedure, I actually wear magnifying glasses for that sort of work, because it’s such fine detail work.

Trish Hammond: Yeah, of course, and I know that you’re really passionate about aromatherapy, which I’m also very passionate about aromatherapy.

Dr Joanne Samer: I am.

Trish Hammond: How do you … I love this, but how do you incorporate that into your practise? I mean, I’ve trained myself about 15 years ago, and I’m absolutely obsessed with aromatherapy. I know how powerful it is. How can we tell … How would you use that in your practise?

Dr Joanne Samer: There are many ways that I use it, Trish. I run a diffuser in my office at all times. In that, I diffuse frankincense blend called On Guard, and peppermint. On Guard is an immune protection blend, it’s good for reducing the risk of infection within the room. It means the risk of me creating an infection in someone with a procedure that I do is reduced, the risk of me contracting coughs and colds, and flus and bugs because someone comes into the room and is unwell, is reduced. I can also use it, and some of the ingredients of the oils that are that blend I put on the skin post procedure. That’s the On Guard blend.

Frankincense is what we call the father of all oils. It’s an oil that has its history dating back to the time of Jesus. It is a very good oil, it’s very anti-inflammatory. It reduces immune problems, it is a very good healing oil. It’s the oil for everything, if you will. I like to diffuse that in the room. Partly for myself, partly for my patients. Peppermint is a really good oil that stimulates cognition. I’m working in an environment where I need to be absolutely accurate with what I’m doing, and I find the peppermint just really keeps my brain sharp. I diffuse oils in the room in a very purposeful way.

I’ve been, if patients have skin conditions, then I like to use the oils or recommend that oils for those, and it depends on the condition as to what oils I might suggest they try to support themselves and get some relief from those skin conditions. I also use an essential oil ointment post procedure, especially post fillers. I massage the filler with the ointment, and a lot of the ladies take a tube home with them because it reduces the risk of bruising and bleeding and infection. It also has an oil in it called helichrysum, which I have to confess is one of my favourites. It’s fantastic for pain.

Trish Hammond: How do you spell that?

Dr Joanne Samer: Helichrysum. H-E-L-I-C-H-R-Y-S-U-M. Helichrysum comes from a yellow flower, a bit like status for those listeners who are gardeners. It’s like a paper flower, and it’s bright little yellow flower. Helichrysum is an oil for pain. By way of example, last night I had a muscle in my jaw that was in massive spasm, I could barely eat my dinner, and I put some helichrysum and frankincense on my jaw, and hello. Within half an hour, my jaw was better. It’s an amazing oil to be used topically, fantastic for skin conditions. I like to use that essential oil blend with post procedural stuff.

It just depends, like I had this lady I mentioned, I think, with cigarettes, I recommended black pepper. Migraines, there’s a fantastic blend for headaches, they have a blend for skin, they have a whole skin care range. A lot of people are very sensitive to skin care ranges, or feel like they were spending their money and wasting it. Whereas, pretty much universally, when people start using the essential oil range, their skin just starts to freshen up and come alive. Their compliments start flying. It’s really interesting. It’s all plant based, it’s all natural, it’s pure, there’s no man made anything. No chemicals, no preservatives, no fillers. They’re great, so I like them because for me … You asked the question right at the beginning, and maybe this is a good place to finish. Trish, you said, what makes me different? What makes me different is my own health story. In 1991 I was diagnosed with Multiple Sclerosis, and in 1996, with thyroid cancer.

Medicine had nothing, and still has nothing particularly to offer me to keep me well. Back in the late 90s I started this journey of looking into what else is out there to help me stay well. Of course, when find out what works for you, you start then taking it further, and sharing that around. My practise became extremely busy with anti ageing medicine, complementary medicine, and nutritional medicine, until the stress was too great for me, and I had to shrink it back down to just the cosmetic. It’s that passion for the complementary stuff that makes my work interesting. It keeps me interested. I love what I do with the injecting, because I make a difference for people. I like ladies to go away feeling like they look the way they feel, and that their confidence and self esteem are restored a little bit, especially those who are, maybe relationships have ended, or they’re looking for a new job, and competing with a younger demographic for employment. All those sorts of things can really make a difference. I just like making a difference in people’s lives.

Trish Hammond: That’s great. Yeah, I just love the fusion, because it’s almost like the allopathic and naturopathic kind of combines to create just wellness in a different kind of … Almost a different realm.

Dr Joanne Samer: Wellness and beauty. I like to think I bring out the beauty in whoever I’m looking after, because we’re all beautiful inside, and sometimes our place doesn’t quite tell the story the way we want it to. It’s a nice thing to be able to offer to people.

Trish Hammond: That’s so true, I’ve got a girlfriend who quite often looks like she’s angry, but she’s not angry, she’s just … That’s just what’s happened to her face over time, and she’s like, “No, no, I’m not angry.” I’m used to it now, so I don’t even ask her anymore. I’ll say, “Are you upset?” and she’d be like, “No, I’m not upset at all.” All right, well that’s been so good talking to you. Can you just tell us, because I know that you’re, or do you have a … I notice that you do a bit of travelling, so do you have other locations that you go to?

Dr Joanne Samer: Yes, I do. Within Western Australia, I travel way down south to Esperance, and then within Perth, I go to a clinic in a suburb called Aveley, and another suburb called Stoneville up in the hills. Then periodically down to Albany as the demand requires. I am travelling extensively into state, particularly in 2017, and I’ll be going to Sydney and Kalgoorlie, which is again, Western Australia. More in terms of the complementary stuff that I do, and will be doing talks and seminars and training, and all sorts of different things.

If people are interested in any of that, that will be on the Healing Gracefully website. My business is actually called Graceful Healing, but [inaudible 00:28:05] Google didn’t let me keep my website going for various reasons which I won’t bore you with. The website is actually healinggracefully.com.au, but I also have another website called wellnessalchemy.com.au, and I have a Facebook page called Dr. Samer and Wellness Alchemy. A lot of my travel will be on that Facebook page, and where I am and what I’m doing. Similarly, the Graceful Healing page, the Facebook page called Graceful Healing, has where I’m going to do all the clinical work. People can tap into my travels and where I am through both those Facebook pages.

Trish Hammond: Great, and I’m happy to catch up with you when you’re actually in Brisbane doing it.

Dr Joanne Samer: I look forward to it.

Trish Hammond: Yes. Well, thank you so much for your time today.

Dr Joanne Samer: My pleasure.

Trish Hammond: This is if you’re out there, and you’re thinking, “Oh, yeah, I’d really like to see Dr. Samer,” and you can’t remember any of the stuff that she’s just said, just drop us an email at info@plasticsurgeryhub.com.au. Thank you so much for taking the time today.

Dr Joanne Samer: My pleasure, Trish.

Trish Hammond: Okay, bye.

Dr Joanne Samer: Bye.

Trish

Trish is a plastic surgery blogger. She is passionate about wellbeing, health and beauty, and doesn't mind a little bit of 'help' from the amazing cosmetic and beauty procedures that are available today. Trish spends her days talking to women and men who are looking for suggestions and advice on procedures that are available to them. Cutting through the sales pitch and hype, a down-to-earth response on general information is what you will get.

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