For more information, visit www.wlbeauty.com. Private consultations may be arranged by phone/email or in person at wlbeauty@aol.com.

Disclaimer: the following responses are delivered without any form or warranty expressed or implied, and are not to be considered medical advice by any means, and are not intended to be a substitute for a consultation with a licensed medical professional. Wendy Lewis & Co Ltd assumes no liability for the information provided below.

Thank you for writing a guide for all of us new to the plastic surgery world. You have inspired me to get a facelift after many years of being a fraidy cat. What do you suggest I do to prepare for the surgery and after - change eating habits, exercise, take medicines, topical regimens, etc? I'm worried about the healing process. Name and address withheld

You want to be in good health before surgery, stop all medicines that may contribute to bleeding or bruising (under your doctor's supervision only), and discontinue Vitamin E. Pre surgery is an ideal time to quit smoking entirely if you do, and limit your alcohol intake. Some doctors will recommend Arnica Montana, Bromelain and Vitamin C pre and post surgery to encourage speedy healing. If your skin is sun damaged, dry or dehydrated, treat yourself to a good skin care regime for at least 3 weeks before surgery including exfoliation via peels and microdermabrasion, intense hydration and anti-ageing ingredients such as vitamin C, E, A and antioxidants.

I have recently realised that my lips are not as "full" as they used to be. I was advised that this could be improved by using a dermal filler. Following a web search, with all the new products on the market, I am somewhat perplexed, and have a problem choosing. And how do I find a reputable practitioner? Sue, London

The most widely used dermal filler worldwide is Restylane. www.restylane.com. It works great in the lips and is made of hyaluronic acid gel and is fully biodegradable so it resorbs in about 6 months naturally. If your lips are particularly thin, you may also consider Restylane Perlane, a thicker more viscous version of the same molecule. There are many other hyaluronic acid fillers on the market as well. Be wary of long lasting or permanent fillers in the lips with synthetic particles that can cause lumps, bumps and infections. ONLY a fully licensed medical practitioner (doctor or registered nurse) may administer injectable fillers in the UK. Choose someone who has a lot of experience and comes recommended by a friend or another doctor, or whose reputation is well documented.

I had silicone breast augmentation six years ago, but I have wanted it reversed almost from the beginning, as I should never have done it. The problem is there is no information out there on the effects of removal. The surgeon told me it would be a big mistake to remove and not replace. I am terrified. I feel I am living with a time bomb. Any advice appreciated. Name and address withheld

Your situation is intensely personal. Removing breast implants after 6 years may be devastating for many women. Once you are used to having full breasts, the loss of volume can be a shock. If you are fearful of silicone gel, you may have your implants exchanged for saline filled implants. You may also consider one of the newer, thicker forms of cohesive gel, if that is not what you have already. Your concerns about the longterm effects of silicone gel should be addressed to your surgeon. Perhaps further research will lessen your worries. The Institute of Medicine issued a report in 1998 that would be helpful to read. Visit www.breastimplantsafety.org.

As I have a skin condition that does not let scar tissue heal very well, and am left with nasty scars, would I be able to have breast enlargements done through the armpit? If this is possible, where in the UK would they do such an operation? Kerri Baker, Norwich

Inserting an implant through the armpit, called a "transaxillary approach", has several limitations, including the fact that this method makes it trickier for surgeons to place the implant properly in some cases. For starters, silicone gel implants are not typically done this way, so you would have to choose only saline filled implants. Secondly, there will still be a scar, although it would not be directly on the breast which may offer some advantages to you. Another method involves placing an implant through the tummy button, called a "transumbilical approach." Visit www.baaps.org.uk to find a qualified surgeon for breast augmentation in the UK.

I am thirty this weekend and have lines directly beneath my eyes, but have very fragile thin fair skin. Can I use Botox directly beneath the eye? Are there any treatments that can help thicken the skin? My fair, thin skin seems so fragile. B. Jones, London

Happy birthday! Botox is sometimes used directly beneath the eye, but more typically for muscle bulges. It is very effective for crows feet. It will not relieve every line. Restylane or Sculptra may be injected underneath the eye on the bone, however, depending on how thin your skin is, this may leave lumps so it must be very conservatively done, if at all. Laser resurfacing and peels such a trichloracetic acid peels, may be helpful in that delicate area, but if you have fair, thin skin, you can expect to be pink for a long while. I would suggest you start with a good anti-ageing cream, such as Retinova, which is only available by prescription in the UK, wear an SPF15 or higher daily, and consider some mild glycolic peelings as a first step. If you do not see enough improvement after several months of this regimen, you can consider more invasive options as needed.

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