Dr Sanja Cook is our newest injectables expert at our Takapuna clinic. Read all about her experience in medicine, what advanced treatment she loves for an instant result, and what keeps her busy in her downtime.
Where did you grow up, and what made you want to go into medicine?
I was born in Macedonia, which is a small country in Europe. I moved here with my family in 1997 and then from the age of eleven onwards grew up on the North Shore of Auckland.
Going into medicine was a bit of a random choice. I wish I had some inspirational story for you! But my parents are both doctors and they told me not to, so I did! I am very glad I did though, because I’ve had such incredible variety and personal growth through my career, with the opportunity to travel and see the world.
When and where did you decide to move into cosmetic medicine?
I’ve been so fascinated by cosmetic medicine for a long time. I finally decided to sign up for a training program in London in 2019. My husband encouraged me to give it a go, after I’d been talking about if for years. So I completed my training and opened up a clinic in Mayfair, whilst also working as an emergency doctor in the NHS.
Working in the emergency department of London’s Royal Free Hospital.
On the beach in beautiful Kefalonia, Greece.
Tell us a bit about your experiences doing injectables in the UK:
Injecting in London is a bit different than injecting in NZ, as I find that the clientele there are far less conservative with their aesthetic choices. I did find myself having to turn people down on really extreme looks! I am a natural look enthusiast when it comes to cosmetic medicine. If it looks like you’ve had something done – you’ve gone too far!
What do you enjoy about doing injectables?
I enjoy the instant gratification! I am a Millennial at heart. I enjoy the procedural aspect of it and love it when clients are happy with their results, it warms my heart.
Also after working in the Emergency Department for eight years, where every patient you see is probably having the worst day of their lives, it’s nice to have a job where people are happy to come and see you.
You gained a lot of experience using dermal filler to enhance the nose – can you tell us a bit about how this works ?
With a non-surgical rhinoplasty we can inject dermal filler at four different points in the nose to correct a hump, to raise the tip or give the nose a straighter profile. It can work really well in some, but it’s not for everyone, so I am fairly selective on who I do the procedure on. I’ve certainly had some great results in the past. Once injected the results can last 9-18 months depending on the person.
What do you like about performing this treatment?
I love how you get an instant result, and it can be quite significant in certain cases. All it takes is 15-20 minutes!
What are some of your other favourite injectable treatments to do?
I love dermal fillers for lips, tear troughs and cheeks. You can have some really nice results with these treatments and clients love them too. I’ve recently been getting to really enjoy jaw fillers too.
What led you to join The Face Place and what are you looking forward to about working here?
I was just so inspired by Dr Cat and her team. She is an amazing injector and a great person to learn from. I also love the Face Place approach to the consultation; you can really take your time with clients, which not only leads to better aesthetic results, but better relationships with your clients. To add, all the nurse injectors at the face place kept telling me how amazing it is to work there so I had to join!
Cave diving in Mexico – Sanja has an advanced scuba diving license!
Travelling around Lake Como with her husband when she was based in the UK.
What are some of your favourite things to do in your downtime?
I have a furbaby called Forest. My husband and I adopted him as a puppy from a shelter up north about a year ago. He is a mix of Greyhound, American Pit Bull, Border Collie and Jack Russell. He is the cuddliest and most loving dog and we love him so much.
In my spare time I am learning how to play tennis and improving my spoken French with an online tutor once a week.
I have an advanced scuba diving license, play the guitar and have completed the WSET course in wine tasting. (I love a good Chardonnay)
In addition I love, love, love travelling and am so happy NZ has opened up to the world, I am already planning my next trip!
Dr Sanja is available on Fridays at our Takapuna clinic. Click here to make an appointment or phone us on (09) 358 5860.
What’s the best treatment for skin pigmentation? Intense Pulsed Light aka IPL is often perceived as the ‘go-to’ best treatment for pigmentation and rosacea. It can be an incredibly effective treatment, but there are other considerations to treat these conditions effectively and with longevity. Here, I break down all the options to get the best results
1. Intense Pulsed Light & Laser
Using heat modalities such as IPL and laser can target specific tissue such as melanin and capillaries and destroys them. These therapies can be extremely effective after just one or two treatments (a course of three is recommended.) Of course, this is a highly desirable result, but it does not answer the cause of the problem.
IPL treatment yielded impressive results for this happy client.
2. Sunscreen & Antioxidants
Often these conditions are a combination of genetics and your predisposition to sun damage. The first step is to stop the predominant cause: UV. This is achieved by using effective sunscreens and antioxidants: Vitamin C, E and B are essential for thorough protection.
3. Active Skincare with Vitamin A
The next step is to influence existing damage with the use of Vitamin A or Retinoids. This is one of the most profoundly effective tools we have to do this. It will help change the way pigment is distributed into the skin; it will induce collagen and thicken the skin; it will create harmony in the skin by stimulated Glycosaminoglycans, and increase the hydration of your skin. Basically retinoids encourage an all-round healthy composition to the skin.
This client used skincare only to improve pigmentation on her décolletage.
4. & 5. Peels and/or Dermal Needling
With some types of pigment, such as dermal (deep) or melasma, the pigment has been encapsulated in the dermis and cannot be targeted with IPL or laser. In fact, the heat from the treatment can exacerbate it. The best results for this type of pigment are the use of Vitamin A peels and/or Dermal Needling. Most people will have a combination of both superficial and dermal pigment, so it may be necessary to do a combination of treatment modalities. This also applies to rosacea: using modalities such as Vitamin A peels and Dermal Needling can address the condition by improving skin health, and IPL can enhance the result by dealing with more stubborn vessels.
This client targeted her pigmentation with a series of peels.
This client used home care and had a series of peels and dermal needling.
In essence, there’s more than one way to skin a cat (pardon the expression – I love my new kitty!) but none of it should be approached without the profound benefits of topical nutrition or home care.
At the Face Place, my team and I pride ourselves on taking a holistic approach, thorough approach that gives you a lifetime of skin benefits.
Your Skin Team Leader Lauren
If pigmentation or rosacea are a concern for you, come and see one of our Skin Team for an Initial Skin Consultation today! Click here to book.
Hola from Mexico, where I’m in the last few hours of my time away. I’ve been attempting to give my body the best chance to adjust to Tamoxifen, the estrogen-blocking medication I’m supposed to take for the next five years to reduce the chance of the cancer coming back.
I’ve been visiting my mum in the beach town of Zipolite, on the Southwestern Coast, in the Oaxaca region. When I saw my mum for the first time a few weeks ago, it had been more than two years since I had seen her – a timeframe that included my breast cancer recurrence journey, fibroid surgery and breast reconstruction surgery. Despite almost daily video calls and a fabulous support team of friends looking after me, it had been really tough for Mum not being able to come visit me in NZ and support me through my surgical journey, so when I walked up the hill towards her after stepping from the taxi, we both burst into tears!
When I took Tamoxifen with my first breast cancer journey in 2020, I experienced extreme fatigue, brain fog, loss of joy, and – after taking it for just two months – rage. None of these emotions fit with my usual bubbly, positive ‘energiser bunny’ personality, and I really struggled, despite reducing my working hours.
I want to be clear that a lot of people tolerate Tamoxifen well – our CEO, Dee, took it for 10 years – and it is a well-proven medicine with a long history of being the key medication used to prevent hormone-receptor-positive breast cancer from coming back. Some people really struggle with it though, and for some reason it seems to affect me especially badly.
The sunsets in Zipolite are so stunning and relaxing.
There are amazing eateries along the beach.
Knowing how valuable it is as a preventive medication with the type of cancer I had – especially as I experienced a cancer recurrence after stopping Tamoxifen – I wanted to give myself the absolute best chance of tolerating it so I could take it for the recommended five years. I had been told that the first six months are usually the hardest, so I decided to take 6-12 months off work after my mastectomy and reconstruction on 15 November. I’m fortunate to have good health insurance to support me in the process. Recovery from the surgery is two to three months, and so I started Tamoxifen again on the 15th February, exactly three months after my surgery, to give myself the maximum chance of healing and recovery.
I popped into work for just a few hours to do some training for our injecting team, and realised the only way I would be able give myself the proper time and space to adjust was to go overseas. To really give myself the best chance of adjusting, I decided to fly to where my mum was staying in Zipolite – which is a super chill hippie-style community, and also happens to be the only public nudist beach in Mexico – and have my mum look after me.
I arrived in Zipolite in early March and was already starting to experience the effects of Tamoxifen. Mum started to get worried about me as I withdrew, unable to speak or communicate effectively, as I just felt sad and numb. For the first couple of weeks I was bursting into tears for no reason, and barely came out of my room, except for the occasional kundalini yoga class (kundalini at Golden Yogi in Takapuna was a huge part of helping me with my energy the last time I took Tamoxifen), and the nightly walk along the beach to watch the sunset with Mum and David.
When I got so down that I started having suicidal thoughts, it was a real wakeup call and I realised I needed to contact my oncologist. She immediately told me to stop taking it. I had lasted a month on Tamoxifen, despite giving myself the best possible chance of adjusting this time. Again, my mood started getting better within a week of stopping Tamoxifen – I no longer felt sad, numb and suicidal – but my energy and brain focus are still only slowly coming back. Despite doing very little, I tend to hit the wall at about 8.30-9pm most nights, and if I push myself too hard, I hit the wall earlier. I’m catching up with my oncologist soon (in New Zealand soon) to discuss the best path forward post-Tamoxifen.
As I’m reaching the end of my time here, I’m only just starting to be able to enjoy being on a beach in Mexico. I’ve been getting up to catch the sunrise and meditate on the beach, occasionally doing gentle yoga or dance when my body feels up to it. It’s a very simple life here, with friendly people and incredible food. Mum and my stepdad David are amazing cooks and passionate foodies, and the fresh Mexican food here is exceptional.
Fish tacos on the beach – it doesn’t get much better!
I love the freshness and flavours of Mexican food.
In the last week or so we have visited the Turtle Sanctuary in the neighbouring town of Mazunte, along with the crocodile eco-tourismo just a little further out in Ventanillo Lagoon. My Spanish is slowly improving, although still really limited as my brain tried to wake up again, and life feels a lot better than it did in the first few weeks here.
I was given a baby turtle to release into the water during one of the turtle releases (usually they give them to kids to release), and one night I had a wonderful time chasing giant soap bubbles down the beach with the kids, while the sun set behind them. I’ve seen sunrises and sunsets and looked up at the stars, which really helps to put life into perspective. And I’ve stopped. I’ve danced. I’ve done nothing for long periods. I’ve needed to the time to process and to heal. Just now as I write, I realise it’s been absolutely perfect.
Sea turtles are magnificent and I got to release a baby one back into the ocean.
Visiting crocodiles at an eco-tourism sanctuary.
One of my big fears going into mastectomy and reconstruction surgery was feeling like I would lose my sexiness and femininity. It has been incredibly healing to be able to walk topless down the beach, with no left nipple and big scars on my left breast and tummy, and feel fully accepted. People here don’t even look or ask about it. I’ve been comfortable sharing my experience with those who ask, and that has also been healing for me.
Sharing my journey on social media has been a big part of my healing process, especially as I’ve had a lot of people reach out to say that it really helped them (or their friend/sister/girlfriend/wife) while going through a similar journey. I recognise that every journey is different, but I hope that by sharing mine, I can show that it’s not always a death sentence, and that we can learn and grow from the experience in positive ways. I’ll continue to reflect over the next few months, but I really feel that this journey has given me a lot of gifts, alongside the challenges.
I’ve been off social media for most of the time here – firstly because it’s patchy and unreliable in this part of the world, but also because I didn’t have the energy and wanted to give myself the time and space to heal. As I get back into NZ over the next week, I’ll try to share some of my experiences and photos.
I have another surgery planned for 30 May, and as my energy and concentration are still limited, until my surgery, I’ll be using the hours that I’m allowed to work on training some of the incredible experienced doctors and nurses who have recently joined our injecting team. I’ll chat more about them in next month’s newsletter, but I’m excited about the incredible team coming together, along with Marjorie coming back from maternity leave in early May!
I’m so grateful to our wonderful team for holding the business steady while NZ went through the Omicron outbreak, crazy wild weather, some internal turbulence within the team as some people moved into new spaces in their lives, and a few of us being away on health or maternity leave. I truly appreciate your patience and understanding as we have been adjusting and accommodating all the changes in the rules and the team. We love you and appreciate your support. I’m hoping to slowly come back with some limited injecting hours once I have recovered from my next surgery (they will create a nipple for me, add an implant to the breast to make it more even, and do some fat transfer to soften the dips and hollows, giving a more even breast). I’m hopeful that stopping Tamoxifen after a month means I will recover my energy more quickly this time. I’m excited to be able to finally get back to seeing patients, so we will keep you informed with our monthly newsletter and social media.
Thank you again for all your love and support on this crazy journey. I hope that life is starting to become easier for you too as the restrictions start to lift and we all start to live again.
Wearing a face mask is essential in the age of Covid-19 – but it’s often not too kind to your skin. To help navigate our new normal, and keep your skin looking its best, we asked our skin experts Bryony and Bhavna for their top tips.
What mask-related skin conditions have you been observing in your clients?
Bryony Nixon – I’ve seen increased congestion, acne and inflammation. However for our seasoned clients, not a lot as their skin is in good condition usually so they are usually doing things to counter some of the negative side-effects of masks.
Bhavna Maharaj – There has been irritation, redness, and the odd spot on the chin or jawline. With younger clients, a lot more sebaceous activity, whiteheads and congestion.
How can masks affect oily or acne-prone skin?
BN If someone is oily/acne-prone they are more likely to be prone to ‘maskne’ as are people with a history of perioral dermatitis. The mask is likely to aggravate skin conditions already present. If someone is acne-prone and they are not wearing a fresh mask or wearing it for long period, it’s the perfect breeding ground for bacteria to spread.
Can masks also affect dry or sensitive skin?
BN A dry skin could lead to flaking but not always as people are generally lipid dry or oily – one or the other. If you are flaking, it’s likely your skin is ‘sensitised’. This is a skin condition, rather than a true ‘sensitive’ (which is a skin type that doesn’t change). It’s caused by incorrect product use, accumulation of environmental stressors, photo damage. Sensitised skin/impaired can be repaired. If you have low lipids (a true dry skin) then you are generally more reactive.
BM Dry skin doesn’t necessarily mean sensitive skin or vice versa. If you are on prescribed skincare, you should be able to manage dry skin and sensitivity a lot better. Sensitivities can occur due to barrier impairments and the skin’s microbiome being out of balance. Also look at your diet, foods you are consuming and supplements you could take to support a healthier and more balanced skin such as fish oils or other forms of essential fatty acids.
Do people need to alter their skincare routine if they’re wearing a mask?
BN They shouldn’t necessarily be changing everything, but they can add in products if appropriate to their current skin condition.
BM If you have a skin therapist you go to regularly, you should seek advice as to what changes you could make to your current routine at home and in the clinic to help combat the new skin issues that may be creeping up for you due to mask use. It could be something as simple as washing your masks daily, changing your pillow covers. Or adding in a product that may have more antibacterial and exfoliating benefits. It may be a temporary change as your skin keeps evolving.
What skincare you recommend for acne-prone skin?
BN Vitamin A, sometimes AHAs and BHAs, antioxidants, vitamin C (in some cases, a different form compared with a lipid dry skin). And always SPF.
BM A good cleanser with AHAs and BHAs. Niacinamide, retinol and lots of antioxidants. A good diet and supplements such as zinc, magnesium and fish oils can’t go amiss either. Look into treatments such as peels to help support your homecare and get more results.
What skincare you recommend for dry or sensitised skin?
BN Vitamin A, sometimes AHAs, antioxidants, vitamin C (if sensitised sometimes none, or a different form for a lipid dry skin). More emollients, humectants, plus SPF.
BM Avoid too many oils on your face and products with fragrances. Always cleanse morning and night with an appropriate cleanser to remove makeup, pollutants and bacteria from your skin. A course of LED light can work wonders for sensitive skins.
Is there anything you can do preventatively to stop mask-related skin conditions?
BN Practice good mask hygiene. If possible, choose a mask that is breathable and doesn’t rub on the skin and as much mask-free time as possible. If you are going to be working in a heavily air-conditioned place of work with a tight-fitting mask and have more lipid dry skin that is more likely to get irritated, then possibly some extra nourishment with skincare masks antioxidants to help lower any inflammation. That is also great for age-maintenance too.
It pays to have a stash of clean masks in a separate bag in your purse.
A course of Healite can help with mask-related skin conditions.
What in-clinic treatments can help with maskne?
BN Everything! Healite lowers inflammation. Vitamin A peels repair damage, speed up cell turnover, and can be paired with layered peels which can be done in specific areas if needed.
BM A course of Healites will be great for anyone. But also an option for people who aren’t on active skincare or don’t have a current skin care regime at home or in salon. It is great for sensitised and reactive skins as well since you can’t have an allergic reaction to LED lights.
For regular clients, Vitamin A peels with your appointments, layered peeling or spot treatment with salicylic peels will help combat b/outs. But keep in mind that being consistent with treatments and products is fundamental to keeping on top of skin conditions for everyone. Treatments help with Increased skin cell turnover, healing of breakouts and cystic acne, reduction in redness and irritation – and overall improvement in skin immunity and skin health.
Do you need to have a lot of treatments to stay on top of maskne?
BN Homecare and mask hygiene is most important. If they were suffering from acne, peels can be brought closer together than 4 weeks, which is what most clients do – every 2-3 weeks for some peels. If it’s more an issue of dermatitis, then often they might have course of Healite and peels every 4 weeks, but it would always depend if they are appropriate.
BM You don’t need to book everything under the sun. Take guidance from your skin professional for your specific condition. Again, as mentioned above, Consistency, Consistency, Consistency!! A peel with a Healite for example every 4-6 weeks. A one-off treatment isn’t going to give your ideal result. It’s like going to the gym. One session isn’t going to give you abs…
Do any types of masks seem better or worse for skin?
BN I personally like a KF94 mask as it’s not rubbing on your skin and it’s more breathable – literally. Also they have more layers so you aren’t losing out of protection and it’s flat at the sides, so air isn’t able to get in as easily.
BM I know that N95 masks have to be fitted for health professionals and front line workers and can be very tight thus probably the worst kind for Maskne. However, I prefer the surgical masks for myself since they are loose-fitting or the KF94 because this provides extra layers. I haven’t tried many others. Wear what is comfortable and more affordable for you and for your safety.
What do you recommend around mask hygiene?
BN Use a new mask every day at least; more if possible, ideally. When putting it away, fold it into itself so that part that is on your skin isn’t picking up more bacteria from other surfaces. And have a special mask bag so it isn’t floating around in your car or bag – ewwww! After sweating, a fresh one is ideal. Don’t go to the gym wearing a mask, then put that same mask on after you have washed your face after your workout.
BM I do wash my masks in a laundry bag. I always have extra ones in my bag – stored in a cosmetic bag to avoid it getting dirty and looking ratty at the bottom of my handbag. I definitely try and use a new disposable mask every morning and may change it in the afternoon.
Thanks to the lockdowns of the past two years, our talented Cosmedicine Nurse Camille has had some stops and starts in her training and skill-building. The great news is that now, through time and dedication, she can finally offer a more extensive, advanced range of dermal filler treatments. We asked her to share one of her latest case results and explain how skilful injecting techniques can work to give all-over ‘lift’.
Nurse Camille – in her treatment room at the Takapuna clinic.
We place quite an emphasis on education here at TFP, so I thought I’d share some not-so-common knowledge around the process of dermal filler and help break down some of the misconceptions around this popular treatment.
Unfortunately, there is a stigma around filler due to it being misused and people being over-treated. Most people have seen the overdone balloon lips or chipmunk cheeks in the media or on people they know and may think that is what filler is all about. Here at The Face Place, we work to break down that stigma and educate people on what filler can really do. We aim to enhance an individual’s natural beauty and address some of the negative signs of ageing and gravity. When filler is done correctly, it should give harmony and balance to the face and shouldn’t be obvious to the naked eye.
It is a common misconception to think that dermal filler is just for ‘filling’ – there is quite a lot more to it. We use the analogy of building a house when explaining how filler works. As we age, bone (or the foundation) of the house depletes and fat pads that provide our youthful cushioning descend. This is the cause of symptoms such as sagging of the jowls (the most common problem), under-eye bags, nasolabial folds, and lines around the mouth/chin. This analogy helps to understand the process of treatment, as we often need to address the cause (foundation) to treat the symptom (jowls, for example).
Camille has used dermal filler here to define and sculpt the jawline.
Camille has used dermal filler here to add volume and hydration to the lips while still looking natural.
A good example of this is treating cheeks with dermal filler. Treating the cheeks addresses the foundation, we can replace the depleting bone and create lift. In treating this one area we can also improve the under-eye bags, jowls and nasolabial folds. The photos below are a great example of this as I did not treat the under-eye bags or jowls directly, but they have improved significantly by treating the foundation (cheeks, jawline, chin). Keep an eye out on our Instagram for many more beautiful results from our artist injectors!
Camilletreated this client with dermal filler – specifically her cheeks, jawline, chin, lips and marionette lines.
You can see that returning volume to the cheeks has created lift and definition.
If you have been thinking of filler for a while or the results have piqued your interest, book in for a chat with me. However, you will need to get in quick! My injecting skills are not all that has been growing in lockdown 😉 as I am also expecting our first baby boy and will be going on maternity leave end of April.
Cosmedicine Nurse Camille
Please note that dermal filler appointments are currently in high demand. Wait times of 4-6 weeks can be expected.BOOK NOW to secure your preferred time/date.
From May, Advanced Senior Nurse Marjorie is coming back from maternity leave. Marjorie is experienced in all types of filler treatment, as is Senior Cosmedicine Nurse Eve.
The remainder of our nursing team is trained in our TFP methods, with ongoing training still in progress. They can offer most filler treatments and can be booked online. For advice on whom you should book for your specific area or concerns, call or email us so we can guide you and ensure we match you with the best nurse for your dermal filler requirements.
Toka Puia AT Carpark is the closest under-cover option at 15 Northcroft Street. Pay by Plate at the pay machine or via the AT Parking app ($2.50 per hour on weekdays / free weekend parking for a limited time only).
Other options…
Northcroft Street Parking (pay by meter) – One hour – $1.50 – Two hours – $3 – Hours thereafter – $3 per hour
Wilson Parking – 11 Northcorft Street (pay by plate machine or Parkmate app) – Casual – from $3 per hour – Earlybird (Mon-Fri) – from $14 valid for 12 hours – Night (Mon-Fri from 4 pm) – $4 flat rate valid until 8 am – Weekend (Sat-Sun) – $4 flat rate, valid for 12 hours from time of purchase
Anzac Street Carpark (pay by plate machine or via the AT app) – First 2 hours – $1.50 per hour – Hours thereafter – $3 per hour – Monday – Saturday (6 pm – 8 am) – No Charge – Sunday and Public Holidays – No Charge – Motorcycle and Mobility parking P180 – No Charge
Britomart Carparking
Currently, Britomart Carpark is offering 2 hours free parking* with a receipt of $50 or more from a Britomart store (such as The Face Place).
Britomart Carpark Valet Parking $20* for two hours (includes parking charges) $5 each additional half-hour to a daily maximum of $45 (to midnight). Available from 10am-8pm.
The Central Valet drop-off point is located on the corner of Gore and Tyler Streets, opposite Takutai Square. Drive in via the entrance on Gore Street, where you’ll be greeted by a friendly valet concierge. Leave your engine running, take your ticket and your car will be parked for you. Retrieve your car by taking your valet ticket to Britomart Car Park Reception on the corner of Britomart Place and Scene Lane.
Train An excellent alternative with Britomart Train Station being a short walk to us, plus, public transport is 50% off until 30th June 2023.
