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HOME | JAMES TROTT | THE CENTRE

 
James Trott
MBBS, FRCS(G) FRACS

The Trott Cosmetic and Plastic Surgery Centre .

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 Mr Trott
Curriculum Vitae
Papers
 
 Philosophy
Surgical
Non-Surgical

 
 Procedures
Facial Surgery (aging)
Neck & jawline, Mid face, Temple and lateral eyebrow, Browlifts, Eyelids, Lips

Facial Contour Surgery
Nose, Chin, Ears, Cheeks, Jaws

Facial Surgery (Asian)
Eyelids, Nose

Breast Surgery
Reduction, Uplift, Enlargement

Abdominal Surgery

Thigh and Upper Arm Reductions

Body Contour enhancement
Calf implants, Surgery of skin pathology

Liposuction

Non-Surgical Treatments
Skin care programmes
Anti-wrinkle programmes

Cosmetic Surgery Consultant
 

 

Procedures Performed by Dr Trott
This list is by no means comprehensive but seeks to outline the range of procedures performed. While technical excellence and attention to operative detail are critical, so too are careful patient selection and development of a tailored management plan which may include recommendations of lifestyle changes, and para-surgical treatments in addition to the surgery itself.

THE FACE

FACIAL REJUVENATION

Neck and Jawline
Procedures can correct looseness and bands in the neck and excess fat deposits as well as jowls and looseness of the jaw line.

Excess fat under the chin in younger patients can be treated by liposuction alone but aging changes require more extensive surgery.
 

Midface
This includes surgery to correct the deepening lines between cheek and upper lip but also the dropping of cheek fat away from the cheek prominence and lower eyelid.

In addition to repositioning the deeper structures fat injection may be offered where appropriate.

Physician Strength skin care and a series of chemical peels is also recommended to improve the quality and texture of the skin itself.
 

Temple and Lateral Eyebrow
These may require lifting.

It is important that, where corrective surgery of one part of the face is performed, that this blend naturally into the adjacent areas.
 

Brow Lifts
Where indicated this is usually done via scalp incisions and using a fibre optic light source to minimise scarring.

Sometimes a brow lift can be performed via lateral temple scalp incisions and upper eyelid incisions. the frowning muscles are usually rendered unusable.
 

Eyelid Surgery (Blepharoplasty)
may be upper or lower or both. Always carefully tailored to the patient's problem and the degree of correction the patient wishes (we are not all the same).

Skin and muscle redundancy will actually need correction as will fatty bags. fat distribution rather than resection is producing better long term outcomes. Occasionally fat injection of the lower lid contour may also be indicated.

Anti wrinkle injections may be recommended as an ancillary as may light laser resurfacing of lower lid skin.
 

Lips
Badly wrinkled lips will usually need treatment with laser resurfacing or dermabrasion.

Where lips have become thin, fat injection can provide significant improvement while in situations where the upper lip has lengthened with aging, this can be reduced surgically.

Permanent lip line and/or full lip tattooing is also an option to enhance the lips.
 

FACE CONTOUR SURGERY
These comments apply to male and female patients.

Nose
Where the nose alone is deformed or out of balance with the contours of the chin and cheeks the surgery can provide subtle or dramatic correction.

once again, careful planning and tailoring of the procedure to the patient's desires are imperative.
 
Chin
As with the nose, the chin may be out of balance with the general facial profile and careful analysis is essential.

Quite often chin and nose surgery will be combined to provide the optimal outcome.

The point of the chin can be moved forward or back, up or down or sideways.

Once corrected, as with the nose, the outcome is stable.
 

Ears
The commonest problem seen is the prominent or 'bat' ear. This is often corrected in childhood but there is no age limit to the surgery.
 
Cheeks
Augmentation or reduction can be carried out. Minor augmentation may be done with fat but implant materials are used where more significant changes are required. The planning of this surgery is more difficult as patients are not always able to visualise the outcome.
 
Jaws
Jawline augmentation or reduction can be carried out in selected cases. Usually implant materials will be used.
 

ASIAN FACIAL SURGERY
While all of the above apply to Asian patients, they have two unique situations which will require surgery for correction.

the double eyelid procedure will provide an aesthetically pleasing transverse groove in the upper eyelid where this is found to be absent.

Augmentation of the nose bridge line to provide more projection is a common procedure for the very flat Asian nose. this can be done using silicone rubber or using cartilage from the chest wall of the patient via a small scar under the breast.


BREAST SURGERY

Breast Reduction
While this is largely a female problem, males can also suffer an unnatural breast development.

In the female, a technique is chosen to provide the optimal outcome with minimal scarring on the breast. In the young patient there is the hope, but not the promise, that breast-feeding will be possible after reduction surgery.

In overweight patients, liposuction of the lateral chest wall may also be necessary while in patients with grossly enlarged breast who desire to be extremely small, the nipple complex may be transferred as a full graft. In such cases, breast-feeding will not be possible.

In the male breast reduction, a combination of direct tissue excision through a small incision on the nipple, with liposuction will usually produce a dramatic improvement.
 

Breast Uplift (mastopexy)
This is a female problem.

Skin tightening is always required but the use of breast implants may enhance the outcome.

Obviously the best time to perform this surgery is when no further pregnancies are planned.
 

Breast Enlargement (augmentation)
This must be carefully planned and tailored for each patient. Planning must take into account the wishes of the patient, but it is not always possible to predict the outcome with precision due to variation in tissue and skin stretchability. other difficulties may include the position of the groove under the breast in relation to the nipples and differences in the nipple heights as well as variations in the skeletal anatomy of the chest wall.

There may also be significant anomalies in the skin envelope of each breast.

Once all of these areas have been assessed a plan can be produced and limitations explained. Outcomes can be extremely pleasing.
 


ABDOMINAL SURGERY
This can apply to both males and females but is not done where the patient is obese.

Three elements of the abdomen are assessed - skin, fat and the muscular wall.

Where there is skin redundancy this will need to be excised. This is best done leaving a scar running in each groin and across the pubic area. Often a scar will need to be left around the navel (umbilicus).

Fatty deposits will often be trimmed at the same time as the skin, but, in the rare case that there is no skin redundancy, fat will be removed with liposuction.

Liposuction may also be used as an ancillary for fatty deposits in the hip and upper buttock region to re-contour the entire circumference of the lower trunk.

Initially the muscular wall of the abdomen is assessed. In most instances following pregnancy this part of the abdomen wall is badly stretched and contributes significantly to the appearance of a "pot belly". Repair of this layer will result in a flatter "tummy".


THIGH AND UPPER ARM SURGERY
This surgery is done in male or female patients. Once again it is most important that the surgical plan is tailored to the individual to take into account the extent and localisation of the fatty deposits as well as the presence or otherwise of skin laxity. It must be emphasised that this surgery is not carried out in the presence of generalised obesity.

Where there are localised fat deposits then liposuction alone provides the best solution. Where there is skin laxity and redundancy then surgical excision of this will be needed at the expense of a scar. While scars will be placed in the most cosmetically acceptable sites, they will still present a negative impact and this must be weighed up carefully before committing to such procedures.

Endermologie is recommended post liposuction to further enhance the smoothness of thew skin and help with cellulite reduction.
 


BODY CONTOUR ENHANCEMENT
Apart from the face and female breast the only area to be enhanced or augmented by Dr Trott are the lower legs or calf region.

This is done using soft silicone implants carefully measured to correct the lack of size in this area.
 


SURGERY OF SKIN PATHOLOGY
 
Skin Tumours
Benign and malignant skin tumour usually require surgical treatment. With pre-malignant and malignant (cancerous) conditions of the skin, surgical treatment will be carried out in the context of the protocol of lifestyle review and regular follow-up checks.
 
Scars
Some scars resulting from injury or surgery may be amenable to improvement by surgical revision, but not always. It must be remembered that any surgery to the skin will result in a scar. Sometimes injection with steroid will provide improvement or the use of silicone gel tapes may also be considered.
 


NON-SURGICAL TREATMENTS
 
Skin care programs
 
Anti-wrinkle programs
Injection of minute traces of chemical agents to block the transmission of nerve impulses to muscles have become a popular, non-surgical way of treating the frown lines and smile lines around the eyes.

Current injection technique including accurate placement of the material injected is mandatory to produce reliable outcomes and to minimise unwanted effects.

This technique can also be used in the treatment of neck bands and unsatisfactory position of the eyebrows.

Where this treatment is not appropriate (for example, the lips) re-surfacing methods with laser or dermabrasion are employed.
 

Fat Injection
Fat can be harvested from almost any site in the body and after preparation, reinjected back into selected problem areas.

This has been used to enhance the lips and cheeks, as well as contour depressions in the facial region. Apart from purely cosmetic cases, Mr Trott has used fat injection to enhance the upper lip in patients with cleft lip who have reached adulthood.
 

Liposuction / Liposculpture
These terms describe the removal of fatty tissue from selected areas of the body to enhance overall body form and contour.

Mr Trott uses a tumescent technique and power assisted cannulae, and has been performing liposuction on all areas of the body for twenty years.

It is important to point out that liposuction is not a treatment for obesity, but is a means of improving body contour. It will often be used in conjunction with other surgical procedures such as facial rejuvenation, breast reduction surgery and abdominoplasty (tummy tuck).

 

The Trott Cosmetic and Plastic Surgery Centre .

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282 Flinders Street, Adelaide SA 5000  
Phone: (08) 8227 1877