Guest: Dr. Michael Rich
Guest Bio: Dr. Michael Rich is the principal doctor at EnRich Dermatology and Cosmetic Centre in Melbourne. There, theyspecialise in cosmetic dermatology, cosmetic surgery and laser therapy. He is a true pioneer of cosmetic lasers. Dr. Michael Rich is a key founding member of the Melbourne Laser Clinic.
Health Professional Radio
Katherine: Thank you for joining us today on Health Professional Radio. Today, we have with us Dr. Michael Rich. He is the principal doctor at EnRich Dermatology and Cosmetic Centre in Melbourne. There, they specialise in cosmetic dermatology, cosmetic surgery and laser therapy. He is a true pioneer of cosmetic lasers. Dr. Michael Rich is a key founding member of the Melbourne Laser Clinic. Welcome.
Dr. Michael Rich: Yes, hello. Nice to speak to you today.
Katherine: Now, for those of us who don’t know what laser therapy is, can you explain to us what it is and what it can be used for?
Dr. Rich: Well, a laser basically is what is called a monochromatic light source. That’s complicated, but they are single wavelengths of light that’s utilised to treat many, many conditions. A lot of people get confused by lasers. There’s not one laser. You wouldn’t say all fruits are the same. Apple and grapes are not the same. Lasers vary by the fact that their wavelength varies, their energy varies and the pulse duration … how long each shot of light varies for. Those are three things that delineate the differences.
Katherine: Right. In your clinic, what would you say you use laser therapy for?
Dr. Rich: We’ve got more than 20 lasers. There’s lots and lots of choices. Our lasers are quite expensive because you can get, for example, a cheap IPL from China, for $30,000 that tries to do everything but doesn’t do anything as well as a laser. We have lasers specifically that treat hair problems, but not one laser. We’ve got three different lasers, with different wavelengths depending on skin types.
We have lasers that treat tattoos – two different lasers, in fact, three lasers for tattoos, because of the different colours need a different approach. We have lasers that just rejuvenate the skin without any pain or discomfort, lasers that treat the vessels that are noticeable on the face, what I call the plumbing that’s obvious. We have lasers that treat the pigmentation, I call it a dirty wall, you want to wash it, and lasers which tighten the skin and lasers which remove wrinkles. There’s really no limit to what lasers do.
Katherine: Right, and, with the results, are they permanent?
Dr. Rich: Well, nothing’s absolutely permanent because aging is relentless, and, with time, things happen.
Dr. Rich: Nothing’s forever. You won’t want it forever because you crave a look that’s definitive. The look just right today may not be right in 20 years’ time. You’ve got to be a little bit careful. But, the benefit is ongoing. If you’ve got less wrinkles today, you would still have less wrinkles in 20 years’ time. You still will get more wrinkles. But by having had the lasers today, you won’t have as many wrinkles in 20 years’ time because you had administered it 20 years ago.
In a way, there is a semi-permanence to it. The same applies, let’s say, to open blood vessels. We treat the open vessels. There’s less of them. As more open up with time and with more sun damage, it becomes noticeable again, but far less than if you wouldn’t have treated them years before.
Katherine: I see. You mentioned before about laser treatment and some people are doing, say, cheaper imports. Is there any regulation in Australia for those who can administer laser therapy treatment?
Dr. Rich: All right. There are some controls in some of the states. I think Western Australia and Queensland, where I don’t work. But, in Victoria, there’s nothing stopping you, Katherine, from opening Katherine’s Laser Treatment tomorrow with a cheap Chinese IPL, absolutely nothing. To be honest with you, there isn’t a week that I don’t see in my practice two or three patients damaged and burned by inexperienced operators. It’s interesting that you could start your own laser clinic with [inaudible 00:04] company and you got no legal responsibility.
If I treat someone, they can go to the Medical Board, they can complain about me, they can go to the Health Services Commissioner and lodge a complaint, and I’m liable. But you would have no risks. It’s such an anomaly.
Katherine: Yeah, because people are, say, maybe they’re searching online for a laser clinic, how would they tell which one, like you said, is certified or has the licenses to do the treatments properly? How would they differentiate from legitimate clinics, and, maybe one that they should avoid?
Dr. Rich: First of all, a few things. I think the principle should be a doctor, that’s the first thing. Then, you’ve got to see how long they’ve carried out their treatments for. It’s not an easy thing because really… I once wrote an article on Australian doctor there, “Non-surgical rejuvenation of the face”, and to the editor asked me, “How do you differentiate a good clinic from a bad one?” I thought about it. I really thought that the major thing is the clinic that offers one machine or two machines … they’re trying to sell what they have and pigeon hole everyone into one treatment.
But a good clinic will have lots of options. When you say, how can I treat different things, do you have specific equipment for this problem, or are you just trying to sell me the one machine you have bought. I think that’s a good way to tell.
Dr. Rich: But, really, you need an experienced doctor, preferably a dermatologist or a doctor who’s had a lot of cosmetic experience.
Katherine: Yeah, that’s really good advice. What about … have you seen some of these home use devices that people can buy for microderm abrasion or UV light therapy? I think you can get them at certain department stores, or, even from Home Shopping channels. What do you think about these at-home-devices?
Dr. Rich: I’m very much against them. It’s interesting you ask me that question, but, my last patient, just before I spoke to you now, was a television presenter, who bought herself not a laser but a home freezing unit in a supermarket to treat what she thought was a wart on her face. She has inflicted second degree burns on her chin, all right? I told her … my statement to her was, “We have a saying in medicine, the doctor who treats himself has a fool for a doctor and a patient.’” Here she is, a non-qualified person, treating herself.
Dr. Rich: You can cause damage. Lasers are not without risks. This wasn’t a laser but still a home device. She is a television reporter, she’s got to be having a big problem. She might have a permanent scar on her chin. I think there are dangers involved, that’s the first thing. The second thing, they’re not going to be as sophisticated… most of my lasers cost me well over $100,000, $150,000, the good lasers. They’re not going to get the same precise treatment, the same variation in wavelength and energy that we can use and with our experience, cater for different skin types.
A fair person needs a different type of energy from someone, let’s say, with an Indian background where their skin is dark and much prone to colour variations. They’re prone to colour variations.
Dr. Rich: You’ve got to be careful.
Katherine: Sure. I noticed in the news recently that there have been reports that parents are actually rewarding high school students that get good grades with the option to have cosmetic surgery as a reward. Some segments of the general public is really appalled by this because they think we’re living in a superficial society and that teenagers – some of them have not even come through or finished their puberty yet, why they are thinking about things such as cosmetic surgery.
My question to you is: “How young is too young?“ In Australia, are there any laws against minors getting cosmetic surgery? When I say, ‘cosmetic surgery’, I mean, like, breast augmentation and things like that, not maybe, getting a wart removed, or, maybe getting a freckle removed. Something a little bit invasive.
Dr. Rich: Right. I don’t think there’s any laws against it. There’s the moral issue, and the fact that you should really never do anythingon a young person unless there’s a good reason to do it. Having said, I’ve told many parents over the years that no parents should decide to have a cosmetic procedure for their child on their own. I’ve always used the analogy if Barbra Streisand’s parents decided that she needed a nose job at an early age, they would have changed her looks.
She might have looked better, but, to my understanding, she’d done very well with her nose, and her voice would have changed and she’d never would have a successful career. There’s really no need. But there are exceptions to the rule, there really are. I’ll give you an example: Many years ago, I had a 16-year-old boy, and he’s now quite a well-established solicitor. He had [indecipherable 09:08] man boobs and that boy was so affected psychologically by this, he wouldn’t play sports. He wouldn’t partake in activity, he never ever took his T-shirt off, never went to the beach.
Really, sucking out that little bit of tissue from his chest under local, changed his life. He’s comfortable and he’s a successful lawyer today. I really think it’s when it’s affecting someone psychologically … when a person is being ostracised, then there are grounds for carrying out the procedure. But it should be thought out and possibly even a psychiatric opinion given as to its validity. But it’s a difficult problem, it is a difficult problem. The other thing I want to say is that… I mean, some things, it’s like … why do people [indecipherable 0:09:55] nice clothes? They want to look more beautiful.
If someone doesn’t look beautiful and is psychologically affected, then in effect, they’re not functioning within their peer group in a very important time in their life, then that should be considered, but very carefully and not rushed into.
Katherine: Yes, very good advice, doctor. Well, thank you so much for giving us some information about laser therapy treatment, and thank you for your time today.
Dr. Rich: It’s a pleasure.