Trish: Now we’re here today with Dr Marcells. Dr Marcells is an ear, nose and throat specialist and he’s also a facial plastic surgeon. He is the current President of the Australasian Academy of Facial Plastic Surgeons. He is the Medical Director of Bondi Junction Private Hospital and he also consults at About Face Clinic which is located in Bondi. Thank you so much for taking time to talk to us today Dr Marcells.
Dr Marcells: Thanks for having me Trish.
Trish: You’ve got a reputation as the guru on the deep plane facelift, can you just give is quick run down of the procedure and who can actually benefit from this procedure?
Dr Marcells: Ok, well Trish, I think the deep plane facelift is the best facial and neck rejuvenation surgery available. I think it gives the most natural results; it doesn’t give that telltale sign of a pulled look. It’s not a new surgery; it’s been around for 20 years, even since the 1990s so it’s very tried and tested. In fact, when it came into vogue, it was touted as the new facelift to give natural results. A lot of doctors started to do it and they said oh their results weren’t any better than the more superficial lifts, but in fact they actually weren’t doing it properly and there were only a few select surgeons that knew how to do it properly and they’ve been getting great results ever since.
Trish: Ok, so for someone who is sort of starting to age around the neck area, and around the jowls, that’s the perfect person for this procedure?
Dr Marcells: Yeah, I think even a young person, even say in their 40’s – normally I didn’t used to think that, you know, you’d consider a facelift at that sort of age – but if they’re getting early signs of jowling here and they’re starting to lose their neck, the skin is drooping or the muscles are drooping, they’re an ideal candidate because they can have the surgery and no-one will be able to tell that they’ve done anything because the change isn’t that dramatic, they’ll just look very very refreshed but they can’t tell they’ve had a surgery; and it should last them 10 years; 10 to 15 years.
Trish: Wow. So basically it’s a couple of weeks downtime and then people will see you again and think and “wow – they just look good”. It’s not like they look like they have anything done. They just look refreshed.
Dr Marcells: Exactly. Two weeks hiding out and you go through the whole recovery phase. It’s not very painful actually, you just feel a little bit of tightness and a little bit of discomfort. There is an intensive regime that we do to make sure everything heals well. But by 2 weeks most patients are very socially acceptable. They can put a little bit of make up on but they can get out and about and resume normal activities. And there should be some ongoing improvements with some subtle swelling decreasing over 3 to 6 months afterwards.
Trish: And I’ve seen some of the pictures, and after two weeks you can just go back to work; it looks just normal.
Dr Marcells: Yeah, I think because there’s not lot of extensive skin dissection – most of the dissections’ in the deep plane – so you haven’t disturbed all the lymphatics between the skin and the deep layers. So in fact, whilst you get a fair bit of swelling in the first week, that goes down very rapidly and in fact the patients have less swelling at two weeks than the most superficial lifts.
Trish: Great, great. Alright, and you’re obviously very involved in all things rhinoplasty and known as the master of rhinoplasty; and from being known as one of the best rhinoplasty surgeons in the country to being involved in research and training: so what is about the surgery on the nose that actually appeals to you and what is it about your work that makes other specialists refer patients to you?
Dr Marcells: Look rhinoplasty probably the hardest operation to get right. And I guess that’s a cause of great joy and great frustration for all of us. I think if you spend the time and do the surgeries well and pay a lot of attention to getting the structure of the nose right, you generally get very predictable, rewarding results. So the type of surgery I do is called open structure rhinoplasty, and in these procedures we’re reinforcing everything as we go. So the septum needs be stabilised in the mid line, the tip needs to be supported, and then the side walls need to be strengthened. So these techniques take a lot longer to do; it typically takes me 3 or 4 hours to do a case. But the success rates are much higher; we could be more predictable about getting the right shape and keeping the breathing good.
Trish: Because it is about keeping the right nose for the person as well; like you’re not going to give a little up-turned nose to someone who’s got Roman features say for example…
Dr Marcells: Correct, you’ve got to have a lot of understanding of what would suit somebody but also it’s trying to be predictable about what’s going to happen to the nose long term. So often if people doing a short case they have to remove a little bit of cartridge and it may destabilise the nose; then it starts to twist and turn down the track. It might look for the first few months; for the first year or two, but then maybe two or three years down the track, it starts to twist and turn. I think the nose jobs that you see that you think “oh they’ve have a nose job” – that’s not what we’re aiming at. You shouldn’t be able to tell that someone had a nose job – it should just suit their face. But it occurs because the nose is bent out of shape. So maybe the nostril wings were tracked upwards, or they sink in inwards and it looks a bit artificial or pinched.
Trish: I think one of the advantages is; I do talk with a lot of people who have had a nose job, and then they can’t breathe afterwards… so I think the advantage is, being a specialist – ear, nose and throat specialist as well – you’ve got the advantage that you’re going to automatically…
Dr Marcells: Well, hopefully we’re trained in those areas to keep the breathing good, and that’s one of the advantages of being a nose, if you’ve got ear, nose and throat surgical training. I guess one of the conundrums is often we’re trying to make the nose smaller in somebody, so how do we make the nose smaller that keep their breathing good, or even make the breathing better. And it can be difficult to achieve. Usually the structure techniques are the maneuvers that work with that; so even though we’re making the most smaller if we strengthen areas, they’ll collapse less.
Trish: Great. Now I just had one other question for you if you don’t mind: is there anything that you would offer as advice to someone who’s looking at having any facial plastic surgery and they start their journey searching for the right surgeon for them?
Dr Marcells: Well, obviously you want to research that person as well as you can. I guess even just looking on their website for a start, and seeing that they seem to know what they are talking about. I think seeing patients’ before and after pictures are good. So whether they’re on a website or you’ll get to see them in the room is important. And you want to see not just one or two, but try and see quite a few so you’ve got some experience that person’s aesthetic. I think in a consult, you want to make sure you’ve got a good rapport with that doctor to make sure that they’ve actually listened to you and understand what you want to achieve. And it’s probably a good idea to get several consults. I mean, I guess if you think you’ve found the person in the first go then that’s possible, but it’s good to get a second opinion and just make sure you can compare what’s going on.
Trish: So do your research; make sure they’ve got the right qualifications; have a consult; have another consult; maybe even a third one and see who you feel comfortable with.
Dr Marcells: Yeah I think you should never go ahead after just one consult as well. At least do two consults I think as a minimum.
Trish: Totally agree. Well thank you so much for taking the time to talk to us today.
Dr Marcells: Thank you for having me.
Trish: Thank you so much.
Dr Marcells: Thank you Trish.