Faceworks Clinic

International Conference of Aesthetic Dermatology (ICAD) 2012, Bangkok.

2012-01-27T07:55:00.002+08:00

Oh yes…. It was certainly a busy week and flying off toBangkok in between was seriously physically challenging with only few hours ofsleep at night and the day spent concentrating on scientific lectures. Butdefinitely it was a fun and fruitful escapade although I was only in Bangkokfor less than 36 hours.

It was the first time for me attending ICAD and like theother conferences I go, a lot of new things and updates were given and newfriendships made. A lot of new knowledge learnt and we get to compare thedifferences of our own practice compared to our colleagues elsewhere.

The highlight of this conference was a specialistdemonstration of catheter technique on fillers which I will be starting soonand the introduction of Redensity as anew adjunct for skin rejuvenation. I will write more about this treatment lateronce I have all my q&a’s answered to my satisfactory. We also learnt a loton anti-aging, tackling complications and updates on things like acne treatmentand melasma. We learnt more about hormones and their affect on aging and our body, treatment modalities. One funny slide that I couldn't help bursting out laughing was when they showed the comparison of a man and woman when dealing with anti-aging and hormone replacement therapy in a machine form. The man's machine had only 1 dial, them woman had so many dials and buttons. Yes, women are complicated, even to the biological level.

The short visit to Bangkok was definitely rewarding in terms of knowledge, experience and I have set my mind on a few more resolutions to do this year in order to better myself. One of it would involve taking a series of exams and perhaps having to take a holiday from aesthetics for awhile. Others would include studies of new treatments that I will start to introduce to my patients. Aesthetics and Anti-Aging is a very broad field, hence it still requires continuos studies as other branches of medicine or even more.

Secret - Microneedling RF

2012-01-13T08:24:00.002+08:00

Last Monday I was visited by two nice gentleman from GTG Wellness to explain to me about Secret - a new microneedling radiofrequency designed for skin tightening, pore size reduction, improvement of wrinkles and give an overall lifting of the face. Sunds like fun? Well, the idea is pretty amazing as well of the results, but the process may not be everyone's cup of tea.

What is microneedling radiofrequency? The concept behind this technology is pretty simple. Using microneedles poked directly into the skin at a certain depth, and radiofrequency energy is then released inside of the skin. This gives a more uniformed deep tissue warming that will then stimulate the collagen cascade to break and uniform thus new collagen fibers are produced. The needle tip contains 25 very small gold needles acting as an internal conductor. Too technical? Well the pictures will help explain better.

First question that will pop into your mind would be - OUCH!. Luckily before the procedure is done, the face is numbed for 40 minutes before starting. The whole face would take approximately 20-30 minutes to do depending on the area and pain threshold. Despite some needle pricking sensation, I only shed a tear towards the end of the procedure that they needed to stack some areas. Immediately after the procedure, my face felt warm and it was red and swollen. They applied some Pep-Bu to help with the healing. Usually, the swelling will subside within 1 day. In terms of my swelling, by bedtime the swelling was down by 50%. Although the secret is said to have minimal to know downtime, it will also depend on your skin type and the intensity of treatment. In my case, I had sensitive skin but we wanted to know how good the intense therapy level was (and since I was pretty cooperative) so we went to the most desirable setting with multiple stacking at problem areas. The next day I woke up, there were thousands of micro-needle marks on my face which I wasn't really expecting. Luckily, it fades off (or probably falls off) in the subsequent days but even on Day 4 it was pretty visible to my eyes. With the swelling gone by Day 1, it is still possible to cover up the needle scab marks with a light concealer. Yes, I said light - because of the uniformed small dots, it'll look like you are slightly tanner from a far and only if you come up close then you notice the needle marks. (Something like having a pixel laser done).

But was it worth it? Well after a long discussion with Jeffery and Kevin - I do admit that despite the needle marks on my face, even after the 1st day I have noticed a reduction in my pore size, and some lightening of PIH (post-inflammatory hyperpigmentation) after acne on my face. Now its 4 days, the needle marks are slowly dispersing, my neck and face does feel tighter and more lifted although many would argue I wouldn't need any form of lifting, but there is a difference. Probably in my case, the most significant difference seen in this early stage is pore size reduction around my nose and mid cheek areas. The best thing is that it will last me at least 8 months even with 1 treatment and with 2, more than a year. How's that for all the torture?

So to sum up, the Secret RF microneedling can provide:

1. Non-surgical face lifting lasting 8 months with a single treatment.

2. Wrinkle reduction

3. Skin tightening and rejuvenation.

4. Minimizes pore size.

5. Reduce the appearance of acne scars or other form of scars.

6. Brightening of pigmented scars.

7. Reduces neck wrinkles.

8. Reduces stretch marks.

9. Safe for dark skinned people

Some of the clinical trial pictures done on this machine:

Want to improve your look for this year? The good news is that Faceworks Clinic is hosting this machine for a limited time only i.e. 13/1/2012 (Friday) till 18/1/2012 at RM 800/session (Normal Price: RM 1800/session) for this Chinese New Year Festival. Interested?? Call Us today for appointment at 03-21440080.

Chinese New Year Promotion...

2012-01-10T12:16:00.000+08:00

Don't Miss our Chinese New Year 2012 promotions.

Book your appointment today.

For more information call us at 03-21440080 or email to info@faceworksclinic.com

The perfect nose........

2011-12-22T12:39:00.002+08:00

The nose has always been one of the most concerned aesthetic areas of the face. Depending on your ethnicity, the problem with the nose would differ from a Caucasian wanting to perfect a defect, or an Asian whom are more likely to have a flatter nose bridge. The nose, being the center of your face would be among the first thing a person would notice when they look at you. Therefore, most people would want a perfect nose.

There are many techniques of improving the nose from rhinoplasty to implant insertion, reduction of the ala nasi and fillers. Filler injections have shown to be the easiest non-invasive method of nose augmentation and reshaping. When we mention fillers, most people will relate to hyaluronic acid fillers such as Juvederm, Teosyal, Perlane or the calcium hydroxypatite based i.e. Radiesse. Although these fillers give wonderful results in the hands of a skilled injector, many patients would start thinking about the hassle of having to come back and reinject every few months. If the fillers were in the cheeks or folds, it will be less noticeable when it becomes smaller, but the nose? It would be kind of funny to have the perfect nose in the beginning of the year, and by christmas it is reduced again.

Hence, the appearance of semi-permanent fillers into the market such as collagen fillers, Bioalcamid and Aquamid. Collagen fillers although shows promising results has increased the worry of practitioners as to allergic reactions towards the animal component. In a few religions like Muslims and some Hindus, the use of bovine or porcine collagen is not preferred. Furthermore, results last up to 3 years only or even less. Hence we have non-animal products such as Bioalcamid and Aquamid. Bioalcamid is more like an implant in gel form. When placed under the skin in the right manner will encapsulate and stay for 3-5 years with minimal change. It is removable by expressing out the capsule. However, it does require a good injecting skill and knowledge of the doctor to understand the gel implant and identify any risks early. For the nose, it can be placed at the bridge and will likely stay there, but there has been reported cases of migration (which I believe is due to the injector's technique). The only downside is that it needs bolus injections of the substance, hence fine sculpting of the nose may not be achievable.

Which comes to the next filler which is Aquamid. Aquamid is also a semi-permanent filler which has a lasting profile of 3-5 years but recently cross-section studies have shown that even after 10 years it is still there. It is 97% water based and does not form capsules. Usually after the 2nd month, the patient could not even feel the filler anymore because it integrates with the skin. It requires multiple injection techniques and a lot of local is given during each sitting. Because of this, usually 2-3 visits is required to achieve the best results. As far as anyone is concerned, Aquamid is the most preferred non-surgical nose augmentation technique for plastic surgeons and advanced filler injectors. In fact, the rate of surgical rhinoplasty has declined with the advancement of this product because it allows the surgeon to tailor the nose according to the patient's face, less aggressive and invasive, minimal downtime, and the best part, no sutures. It allows the doctor to fix defects in the nose in the clinic, and the patient can resume work the very first day with minimal redness or bruising compared to doing a rhinoplasty.

How I usually consult a patient who wants to get their nose done will depend on how much the patient knows about fillers and what it does. For virgin noses, if the patient is unsure, I'd ask them to choose between HA or Radiesse first, then later plan for Aquamid. For Aquamid, I would normally only inject 1 syringe at a time with a 2 weekly follow-up for the 1st 3 months to ensure no signs of infection. Remember, it is almost irreversible, so doing 1 syringe at a time would be the best approach. As for pain, usually the first few injections to numb the nose will be felt. Some people do complain of a slight pain sensation after doing the filler for a few days and gradually improves. Most patients are happy with the filler and the results. Even a review after 1 year showed that there was not much change in the filler shape.

So what is the perfect nose? It depends on the individual patient's perception. At this moment a lot of people are interested in getting a Korean nose as how the Korean drama series actors and actresses look. Is it achievable? To a certain extent, yes, and the best part it does not involves surgery.

For more information or further inquiries, kindly contact the clinic for a proper consultation at 03-21440080 or email to info@faceworksclinic.com

Year End Promotions mot to be missed.......

2011-12-22T11:31:00.001+08:00

Once a year opportunity not to be missed. For booking and enquiries please contact the clinic at 03-21440080.

Year End Promotions.....

2011-11-28T13:08:00.001+08:00

I almost forgot to post this one up... My bad :).

You can also look up our Facebook Page at : http://www.facebook.com/FaceworksClinic?ref=ts

Don't miss these exciting deals :).

Caviarlieri - Supplements for vitality.

2011-11-04T11:40:00.000+08:00

A lot of people ask me about stem cells and placenta supplements and whether it is worth taking. I think that the word 'stem cells' has been overly used that it confuses a lot of people including doctors. According to wikipedia:

'Stem cells are biological cells found in all multicellular organisms, that can divide (through mitosis) and differentiate into diverse specialized cell types and can self-renew to produce more stem cells. In mammals, there are two broad types of stem cells: embryonic stem cells, which are isolated from the inner cell mass of blastocysts, and adult stem cells, which are found in various tissues. In adult organisms, stem cells and progenitor cells act as a repair system for the body, replenishing adult tissues. In a developing embryo, stem cells can differentiate into all the specialized cells, but also maintain the normal turnover of regenerative organs, such as blood, skin, or intestinal tissues.'

Oral supplements which claim to be stem cells are not stem cells but are rather supplements. But depending on the bioavailability of the supplements to the body and the concentrations, thus will give varying effects despite the component being the same. Which is why I am very skeptical about the efficacy of supplements claiming to be stem cells.

I was approached by Caviarlierli's people 3 months ago during the start of the fasting month. Caviarlieri is a new type of supplement which contains DNA from marine source i.e. expensive caviar from sturgeon fish and collagen from salmon and the sturgeon. Produced from perhaps the only lab with the recognized technology for extraction of DNA and creation of high quality stem cells in Switzerland, it comes in an interesting box sealed neatly. The accreditations were printed on the box, with a Halal certification from Singapore. Still being skeptical, I asked for the internal clinical studies done on the product and the results from the studies were promising. Prior to this, most stem cells were derived from either human or animal source, mainly from the placenta or the yolk cells. Despite its benefit, a lot of questions arise on the products as whether they contain any hormones since there are some results suggesting it does although there were no statements from the producing companies. Another issue was for Muslims and people who do not take red meat, some feel that it is not okay to consume or take placenta supplements due to beliefs.

The only downside of this product is that because it is made out of fish collagen, people allergic to fish is an absolute contraindication. In US, 2.4% of the whole population is allergic to seafood in general. In Malaysia, there is no statistics on allergies published but I believe it would be somewhere around 1% at least.

I'm already at my 3rd box and I would say that it would be a really good supplement if you can afford it. (Yes, the price is pretty expensive approximately USD$400/box). Certain changes I noticed after starting on the supplements:

Initial 1st week I was so sleepy and slept more but after the 5th day, the sleepiness disappeared and I found that I was pretty hyper.
I had more energy in the morning and I was able to sleep late and wake up the next day fresh.
I slept better at night with less waking up.
My appetite improved, and I found that the 1st month I think I gained a few pounds, but subsequently the weight reduced.
After the 1st box, people started to notice my skin appears to glow, and it feels softer. My girls were the first to tell me.
I also noticed my hair growing more and faster. I use to have thinning hair on my head, but after 2 weeks my hair felt heavier. Even my eyebrows grew faster. Initially I thought I was just imagining things but after a visit to my hairdresser, he reconfirmed that I had better volume.
I noticed after 1 month, my nasolabial lines have improved without using fillers, Radiofrequency or BTA.
The appearance of my cellulite has also improved dramatically without any procedures done at the area.
I have less sinus problems. I recover from illness pretty fast compared to when I wasn't on it.
I have less PMS symptoms and although initially my menses was delayed for a week. Subsequently it remained the same.
It elevates your mood so that you feel less stressed and happier.
What it doesn't do is avoid you from getting illnesses, so you can still fall sick. If you have PIH or post-inflammatory pigmentation like me, it still remains but maybe lightens faster. You may have a lighter skin tone, but don't expect to be extremely fair.

The listed benefits of Caviarlieri are as follows:

Reversing the degeneration of aging and age-related conditions like arthritis, chronic fatigue, asthma, degenerative brain disease and osteoporosis.
Strengthening the body's immune system.
Substantially increases energy and stamina.
Increases sexual desire and performance.
Increases sexual satisfaction and elevates mood.
Delaying premenopausal symptoms and delays menopause.
Improvement of mental concentration and alertness.
Substantial reduction in joint pains.
Lowers glycemic index and thus leading to weight loss.
Visible increase in radiance and glow of skin.
Reduces appearance of lines and wrinkles significantly.
Prevents macular degeneration.

For more info about this product you can visit http://www.swisscaviarlieri.com

I would recommend this supplement to anyone who can afford it, ideally those with chronic diseases like diabetes and hypertension to help control the disease better. The ideal is to take continuously but for those who wants to try, at least 3 months for best results.

For more information please contact Faceworks Clinic at 03-21440080 or email to info@faceworksclinic.com

Keep it Simple and Safe - K.I.S.S

2011-09-06T22:25:00.000+08:00

Every women in their life time would require to wear some form of make-up. In a lot of formal cultures, it is an essential tool for all women and for some, it would be rude not to wear any. However, choosing the right make-up to suit your skin can be a difficult task. The most common problem that arise with make-up is not getting the right colours, but rather making sure you don't get any reactions to the chemicals they use to create the make-up in the first place. The most common problem would be break-outs after wearing foundations, development of itchiness or rash with lipsticks, gloss, blushers etc. Red eyes with eyeliners and mascaras.

After treating my face with Obagi for post-inflammatory hyperpigmentation from acne, I felt a little bit worried to use make-up in case I clog up my pores again and start having break outs again. Then I was approached by KISS. What is KISS? It is a range of mineral make-up mainly produced in Australia and has 100% concentration of minerals in all powders and maximum mineral in sticks.

I was skeptical at first, but gave it a try. Initially it looked like so much work having to put layers and layers of loose powder but amazingly, after it sets in - it looked very natural. And since it is pure mineral, it only stays on my skin, so I don't have to remove it when ablution prior to prayers, and if I'm lazy, I can sleep on it till morning and not get any break outs. It has nice coloured lipsticks which help to moisturize the lip and the lip gloss has a nice minty taste to it. The eye brow pencil was soft and easy to apply. My only problem was the eye-pencil which was a nice soft black but it runs if you don't set it properly. The blusher comes in one colour, which didn't seem to last too long and I preferred orange hues rather than pink. Amongst all the products I liked the foundation the most because it acts like a concealer and a foundation 2 in one and that it lasts long on the skin with a natural look. Another cool thing is that it also has a good brush from goat's hair which absorbs all the powder thus leading to zero wastage. You just need a small amount for each application to get a good coverage.

Why should you choose mineral make-up over the commercialized cosmetic counter brands? Well, personally, if you have no skin problems, you can use whatever you like. But if you have acne or sensitive skin, using KISS would be one of the best investments because of these reasons:

KISS mineral make-up is 100% from minerals.
It is chemical-free, preservative-free, fragrance-free and free of synthetic colouring that may cause irritation to skin.
It does not contain any talc thus does not clog pores. Talc is also considered harmful since long term exposure may lead to lung cancer or silicosis.
It does not contain bismuth oxychloride which is commonly found in other mineral make-up preparations to help make the product stay longer on the face. However, this compound is not safe to be used on skin and may cause itchiness, rashes and it worst cases mild to severe cystic acne.
It gives natural broad spectrum UVA & UVB protection as it contains zinc oxide and titanium dioxide for an SPF 24 cover.
It is very water resistant (true for foundation and setting powder) thus rarely a need for reapplication. Even though it is water resistant, it does not stop water from reaching the skin surface (hence no need to remove during ablution).
Provides complete coverage for acne, rosacea and redness following clinic procedures such as chemical peels, microdermabrasion and laser resurfacing without irritating the skin.
It is dry and inorganic which makes it impossible for bacteria to survive - thus making it have no expiry date.
Each application of the make-up is minimal, thus one foundation will last approximately 6-9 months on daily usage and wear.

So when putting all this in consideration, perhaps it is a good investment after all for busy people like me who need to look good all the time. It does however take a lot of practice in the beginning, especially when you are use to conventional make-up methods which some are not applicable to mineral make-up use. At the end of the day, it all depends on the person's own opinion whether they would opt for this or not. If you are curious to try it out, you can try out in Faceworks Clinic where we do have a set for patients to try out the product on themselves and if you want, our nurse can do a make-over for a minimal sum.

For more information or to purchase this product please visit us at Faceworks Clinic or call 03-21440080 / Email to info@faceworksclinic.com .

Mirror, mirror on the wall.... who's the fairest of them all....?

2011-09-01T11:24:00.000+08:00

I have come across a lot of patients who wanted fairness and even to the point of luminant skin. Being an aesthetic physician in Asia this is not uncommon. The Asian's model for beauty is to have fair flawless skin like the Japanese, and Korean counterparts. So I've decided to give my two cents on it, based on the things that I have read and researched.

Before I start explaining on the products that claims to make a person fairer, first we need to understand the difference in skin types and tans which determines how fair or tan you will be and the factors that lead to a more exaggerated tanning. There are 6 skin types based on Fitzpatrick's Skin Colour Classifications ranging from type 1-Type 6. For Asians, Type 1 are the extremely fair Scandanavians with blue eyes and yellow hair, type 2-3 are mainly Caucasians some are the Japanese and Korean Asians and for people like us, living at the equator would likely have type 4-5 skin type. Type 6 are the African origins or dark Indians. This genetic predisposition to skin colour depends on the distribution of melanin at the basal layer of the epidermis (skin). The environment also plays a role, whereas, where there is a overstimulation of the melanin - leads to more tanner skin. The most common cause is exposure to UVA/UVB sunlight. What it means in simple tense is that, even if we were to exclude environmental factors, our genetic built up will be the limitation to the fairness that we can achieve despite any treatment. I usually tell my patients that if you want to be fair, you can only achieve fairness as much as your non sun exposed areas and not more than that unless you bleach yourself.

According to most of the clinical studies that I have come across, topical Vitamin C in high concentrations does lead to a brightening of the skin because of its anti-oxidant effects and skin healing properties which allows better new skin formations. However, a lot of the creams/serums in the market have problems in delivering the vitamin C into the skin effectively leading to reduced efficacy. (Check out blog entry What's Up with Vitamin C - http://faceworksclinic.blogspot.com/2011_04_01_archive.html ) The better ones are more expensive and prices range from a few hundred for a bottle. Furthermore, you need to use it on a more consistent basis in order to achieve lasting results.

Similarly, there are some bleaching agents such as hydroquinone (HQ) - which is still the gold standard for treating pigmentary problems. However, long term use of hydroquinone will lead to a condition called onochronosis which is a bluish discolouration of the skin at the area of usage. Onochronosis is really difficult to treat and require multiple laser treatments to reduce the appearance. This was the main reason why there is a lot of bad press and reports on HQ. A lot of beautician products use HQ in the creams to get fast results as fast as 1-2 weeks but in long run causes damage to the skin. The FDA approval for concentration of HQ in skin products is only 4%. I know some beautician products that use up to 8% HQ and is sold over the counter with no restriction. Therefore, if you plan to use HQ to treat your pigmentation issues, please make sure you are under a follow-up by a doctor who actually know what they are prescribing.

Then we come to the non-HQ bleaching agents such as kojic acid, arbutin, mendelic acids etc. The most common nowadays are the kojics and arbutins. In high topical concentrations, you can see an instant lightening of pigments. However, if you are using a topical cream, containing these products, you will only see results after perhaps 4-6 weeks, in contrast to HQ where you see improvement in 2-4 weeks. Because these bleaching agents are taken from natural sources, you can actually use them up to whenever you feel like it without much side effects. However, I have noticed that after 6-9 months, some patients feel that the bleaching ingredient does not give any additional effects and sometimes I shift them back on HQ. Although this may appear to be the miracle product for avoiding and brightening up pigmentation, some people are allergic to these products and develop rash and itchiness. I see this more common with kojic acid preparations.

There are some products in the market which claims oral intake can help lighten up the skin. Some offer vitamin C in high doses of 1000-2000mg daily, others claim glutathione up to 5000mg daily oral intake. Although these may appear appealing, the high concentrations may not benefit in view that the gut can only absorb as much and overconsuming of vitamin C can lead to orange discolouration of skin, gut disturbances, etc. There are some products in the market which contain melanin blockers and acts at the cellular level of melanin production. I found one product interesting called White Beaute. It is an oral supplement that acts as a melanin blocker. I have seen some of my patients who improved in skin tone when taking this product after 3-6 months. The only thing with oral supplements, it takes longer to see the results compared to other methods, and that may be the reason some people prefer not to try it out. I have also tried out oral sunblocks such as Heliocare Oral Sunblock Pynocare - I find that it does give a fair results for about 3 months but prolonged use did not appear to benefit much in terms of skin brightening. But I did notice that I got less sunburnt compared to prior being on the product and you need to take it 2 weeks prior to any sun vacations to get the best results. My consultant consumed this product only 1 week before a beach holiday and she still got burnt, so perhaps the other general precautions such as hat, umbrella,shades and topical sunblock and sunscreen should be applied despite using the product.

Now we go to the injections. The most common injections for whitening sold are the Vitamin C's and Glutathione injections. Personally, I've never tried since I'm pretty happy with my tan, but maybe for research purposes, I would subject myself to this trial in the future. However, I do have girl friends who swear that it really does work. It works fast, but you need a maintenance program to keep yourself fair and you still have to avoid direct sun exposures. Furthermore, in view that you are trying to get the anti-oxidant benefits and the glutathione overdose side effect, you need to understand that there are factors that will cause these injections to not work. Basically, oxidative stressors.

There are many different processes and substances that chronically damage cells and contribute to oxidative stress including:

Toxic chemical compounds and pollutants in your body
Hydrogenated fats
All kinds of pollution , including air, water, and food
Oils that have been heated to very high temperatures
Cigarette smoke, directly inhaled or secondhand
Dehydration
Too much sugar
Too much animal protein in your diet
Geophysical stress like living near power lines or waste dumps
Microbial imbalance, including bacterial, fungal and viral infections
Preservatives in your food
Drugs (over the counter and prescription)
Artificial food colorings and flavorings
Plastics
Chemical cleaning supplies
Chlorinated water that you drink, shower in or swim in
Alcohol
Pesticides in your food
Radiation exposure
Psychological and emotional stress

Which is why in smokers, sometimes the whole course does not work. Another issue is gaining a good IV access and being careful enough to not shoot the products too fast because it will cause damage to the vein endothelium. And the most problematic part would be the commitment to come to the clinic according to the recommended intervals. If you skip 1 even, it may not work. I have come across a few alternative studies which links the usage of Vitamin C extreme high does as a cytotoxic agent to treat cancer cells. Therefore, injections for whitening using vitamin C and glutathione although some say may not benefit the person much, I do believe would help reduce oxidative damage that causes aging and is not just an expensive urine. But whether you are willing to fork out for a treatment that you may or not become fair from, its up to the person's personal choice. I would rather the person comes to a proper doctor in a clinic who understand the benefits and complication rather than shoot it up in a beauty saloon or a hotel room by some unlicensed person. Its always better to be safe than sorry.

So maybe one day we will find a way to lighten up skin even from darker skin subtypes. But is fairness really that important? Perhaps, since we have all been brainwashed since we were really young- remember snow white? Mirror, mirror on the wall........ who's the fairest of them all? My belief is beauty is not just skin deep, it comes from within.

For more enquiries please email to info@faceworksclinic.com or call +603-21440080 for an appointment.

IMCAS 2011

2011-08-13T10:21:00.002+08:00

Wow.... its been so long since I had time to write on this blog. Yes, I have been very busy since returning from IMCAS in Singapore last July. What is IMCAS - it stands for International Master Course for Aging Skin. Its a conference that connects all doctors like me to the rest of the world.
We get to meet the real pioneers of the industry, from USA, UK, Middle East, Japan, Thailand, Korea, and Israel even.

It is a 3 day conference with every session around one hour and in one session there are around 5-7 topics given at 8-15 minutes interval each. Yes, sounds crazy - by the end of the day, the only thing I can think of is food, because its so brain draining. But in a good way. It is meant as an update to what you already know and if you really pay attention, you will be able to grasp a lot of things in the conference that is useful for practice.

There are also demo sessions showing injection techniques and machines, and I was so happy to be able to see Dr Woffles Woo inject Radiesse. If you don't know who Woffles is, well, I regard him as the father of medical aesthetics in this region. I would love to meet him one day, as he is a true inspiration to my practice. He developed so many techniques in facial aesthetics that is excellent and gives great results. He practices in Singapore.

I learnt a lot on the latest laser technologies available and most important they stressed on treating complications. You also get an overview of what other parts of the world does, for example in middle east - a lot pf phenol peels are used. You learn botox and filler injection techniques that differ and gives more excellent results. These people are credible due to their many years of experience in medical aesthetics, 10-20 years. When I look at myself, with a mere 4 years under my belt, it feels like nothing, but still I do work hard to keep the standard of my practice to be good at all times.

I was honoured to meet up with Dr Michael Goldberg, whom I met earlier in the practice and his books were my guidelines to keeping the practice safe, I met Dr Diane Duncan, who shared a lot of tips on chin, lower face and neck tightening, I met Dr Bob Khannan, who shared his lower face botox tips. Dr Sebina Zenker, again, who also shared some of her injection techniques and laser tips. I met other new doctors from Korea, Japan, Indonesia, India, Pakistan, its a whole list.

Meeting up with your so-called super seniors in the field gives me a great sense of security and confidence to practice what I do. I remembered when I was an undergraduate, and my professor, Prof Christina use to say, its not about the degree, its about after that. Do you just want to be a doctor, or do you want to be a good doctor? I chose to be a good doctor and hopefully by broadening my knowledge in this feel I can safeguard my patients from harm. Who knows, a few years from now, I'd be addressing people from all around the world to share my experiences. :)

Silkpeel training.....

2011-06-13T11:12:00.007+08:00

Last Thursday, we had a training session for Silkpeel conducted by Mr David from Redo Marketing. It was a short and sweet session, where my staff were taught about the machine, and we discussed about the benefits of using Silkpeel.

Besides the usual facial regime, we were also shown the technique for eye area and lips. Lips was really interesting because prior to this, I never thought we could use the silkpeel on the lips. This to me is a very exciting new thing, since there are very limited procedures you can use on your lip. I was the model for the training and when it came to the lip part, it was pretty cool. The lines of my lips smoothen, and my lips was rehydrated again, and the colour became a lot redder than previously. It looked really healthy and it didn't hurt one bit. It is a good way to return the softness of lips, and actually you can puck out the lip more. Combined with a lip conditioner, my lips have remained soft till today and I'm just checking to see how long does the softness effect lasts.

For the eye area, David suggest 4-6 treatments for people with dark eye circles or fine wrinkles around the eyes to get the best results. Interval between treatment is approximately 2-4 weeks.

Another interesting part was learning about the off-face usage for Silkpeel. Apparently, it is good for the next to rehydrate, the decolletage area for people who love to use low necks, to whiten underams, to smoothen dry elbows and knees, and you can even use it for the bikini and brazilian areas post waxing to lighten up darker areas and give the area a more smoother feel.
I think I will be starting this bikini and Brazilian lightening treatments soon once I get an additional tip for those areas.

Information about Silkpeel:

SILKPEEL DERMALINFUSION : a breakthrough treatment that combines non-invasive exfoliation with deep delivery of skin-specific solutions to improve and revitalize your skin.

Why SilkPeel DermalInfusion?

Goes beyond microdermabrasion by providing simultaneous exfoliation and DermalInfusion topical delivery treatment
Painless,soothing treatment
Noticeable, immediate outcomes and lasting skin improvement
Return to normal activities at once
Patient-specific topical formulations to address your unique skin care needs
Eliminates the risk and health concerns of aluminium-based crystals

And the best part is that it takes around 30-45 minutes per session with no downtime. You can go back to work immediately after the procedure.

For more information or appointments, please call 03-21440080 or email to info@faceworksclinic.com

My personal experience with Obagi......

2011-05-10T12:57:00.007+08:00

Recently I had a visit from a good friend Richie who also supplies the Obagi products for my clinic. He was preparing to go for the World Congress for skin which will be held in Korea. I was suppose to come along but due to the hectic clinic schedule, well suffice to say, my patients have to come first. Probably next year I'll be able to go.

He was asking me for some of the photos of my patients who were on Obagi. However, I had to politely decline his request since I haven't asked the patients whether I am allowed to disclose their pictures to anyone else. So in the end, I decided to give my picture instead.

Going through my files I came across one particular picture that was taken before I used Obagi products that was in September last year. Now its been close to 9 months on Obagi and I am pretty shocked at the difference it made.

I have tried many products and procedures but seriously, the Obagi gave a marked difference.
During this period between September to May, I have had 1 fraxel dual 1920 nm done in October, 2 glycolic 20% chemical peel(Dec, Feb), 1 2-coat Obagi blue peel(Apr) and 1 session of rev-light done in April. I used 2 sets - 1 Nuderm travel set, and 1 C-Rx set.

For more inquiries, you can email me at drmarr@faceworksclinic.com or call 03-21440080 for an appointment to see me.

It's May.....

2011-05-03T16:57:00.004+08:00

It's May, and its Mother's Day month.
Show your appreciation to your mum by treating her to a nice wonderful pampering treatment at Faceworks Clinic. Check out our:

Mother's Day Promo on Facebook

Valid till 2oth May 2011.
Don't Miss it.

What's up with Vitamin C?

2011-04-12T18:15:00.010+08:00

I have been asked about this question a couple of times, so I've decided to write about it in my blog. A lot of people wanted to know whether Vitamin C actually works.

After going through a few papers and a few professional opinions, this is what I have managed to gather:

Benefits of Vitamin C

1. Reduces fine wrinkles around eyes and mouth.
2. Improve skin hydration.
3. Improve pigmentation appearance and age spots.
4. Improves wound healing through fibroblast stimulation nad migration.
5. Increases capacity of fibroblasts to repair potentially mutagenic DNA lesions.
6. Prevents scurvy.
7. Potent anti-oxidant that protects skin from UVA oxygen radicals.

However bear in mind that:

1. Ascorbic acid or vitamin C is pretty unstable and oxidizes easier when exposed to air.

Because of this, most vitamin C preparations have a pretty short shelf life and usually will change colour after a few months if stabilizing agents are not added in. An oxidized form of vitamin C is sometimes more harmful to skin and may cause sensitivity. An easy tip to keep it stabilize is to keep the bottle sealed tight, away from sunlight and chilled in the fridge.

2. Vitamin C is a water soluble vitamin whereas the skin is protected by water by our keratinized layer.

Because of this, you need to be very careful when selecting vitamin C creams or gels to ensure that absorption can occur. Look for products which are lipophilic as it will absorb better into the deeper layers of the skin.

3. Topical Vitamin C has shown to have more benefits towards skin health compared to other methods, although oral vitamin C of 1000 mg daily is sufficient to maintain good health and good skin. Never exceed 2000mg daily as this will lead to vitamin C toxicity which gives you an orange discolouration of the skin, and some have reported renal side effects.

So what would I recommend for a good topical vitamin C?

Obagi has just launched its new range of Vitamin C + Hydroquinone 4% for whitening effect. So far I have been using this serum for the past 1 month and have noticed a significant increase in radiance. Recently, they launched another product which replaces the hydroquinone with Arbutin instead, thus making long term usage possible. Although I do admit these serum are not exactly cheap, but one bottle would last you a good 3 months with the benefits of vitamin C and enhanced whitening. There are also topical vitamin C ranges from 5%-20% for those who are looking for only vitamin C.

For more information, contact us at info@faceworksclinic.com or call 03-21440080.

PRP Facial Rejuvenation.....

2011-02-11T10:55:00.007+08:00

How about using your own blood to rejuvenate your face? I get a lot of reaction when I ask this question. "Blood - ewww... scary" Some would say. "Is it safe?", and most would ask me "Why blood?"

Its really a simple procedure you can do in my clinic. Using a special kit from Regen-Lab (biotechnology Swiss company) called Regen-ACR, I can provide a facial rejuvenation using your own blood (the plasma platelet component that is) to improve texture, and act as a collagen stimulator.

Platelets have been known to have many functions and is now being considered as a regenerative treatment due to its functions and properties such as:

Tissue regeneration and rejuvenation
Increase collagen production
Recruitment of other cells to the site of injury
Initiation of vascular in – growth
Induction of cell differentiation
Allo-allergenic since it comes from your own body thus eliminating risk of donor transmissible infections.
Acts as a biological Glue: for tissue adhesion especially in skin flaps, bone grafts and trauma.

How is it done?

It is a very quick and easy procedure. 1st of all, I would withdraw some blood - approximately 8-10cc and put it into a sterile Regen-Lab PRP tube. The blood is then centrifuged for 8-10 minutes. Once the process is complete, there will be a good definition between red blood cells and the plasma component of the blood. The plasma component is then withdrawn carefully into a syringe and the PRP (Platelet Rich Plasma) is then used on the face using either Nappage technique, dermaroller or as a filler at nasolabial area and other wrinkle sites.

PRP has been used in many otehr medical fields such as orthopedics, stomatology and reconstructive surgery for the opast 10 years. In medical aesthetics, it was first introduced in Europe since 2003 and has been used for improvement of:

Cheeks
Nasolabial folds
Eye areas - crow feet, eyelids
Lips, chin and forehead
Neck and nape of neck folds
Cleavage
Hands
Improving acne scars
Male type alopecia

It has shown to give the skin youth and vitality, improve density and tension of skin, nourishes and regenerates the skin and improves the structure and colour of the skin.

How long does it last?
Based on the literature surrounding the usage of PRP, it recommends for patients 30-45 a one time treatment and for >45 years old 2X treatments in a year. This is for facial rejuvenation. Immediately after you normally feel a tightness which is due to the techniques used which lasts a week or 2, but the rejuvenation process of diminishing fine lines and collagen stimulation would take 3 weeks or more to occur. Most patients would agree that there is immediate tightening and hydration of the face, with a healthy glow which lasts up to 2 weeks or more. However, if you are treating alopecia (balding) or acne scars, you may need monthly treatments and results will only be obvious after a few months.

Contraindications:

Despite this cool new technology, not anyone can have this procedure done. It is contraindicated for patients with:

Skin disease (SLE, porphyria, allergies),
Cancer,
Chemotherapy,
Severe metabolic and systemic disorders,
Abnormal platelet function (i.e. blood disorders).
Anti-coagulation therapy
Underlying sepsis

Also, smoking, alcohol or drug abuse and unhealthy lifestyles would contribute to minimal outcome of treatment. Otherwise, you should normally get a satisfiable result immediately and months to come.

Interested to try? Call or email us now for an appointment : 03-21440080 / info@faceworksclinic.com

The importance of consultation....

2010-12-28T14:42:00.004+08:00

Its the last week of the year and everyone is in the jolly holiday mood until the New Year before we start striving hard. Its pretty quiet in my office too, most people are away for holidays and will only be back in the weekend.

Taking this quiet time, I manage to organize my thoughts and plans for t he next year. Its a lot of things definitely, but proper planning will ensure things get done right. Which is why I decided to talk about consultations.

Many people do not realize how important a doctor's consultation is. Many just assume going to doctors when you have a problem and immediately it will be fixed. In medical aesthetics, it is a different ball game. Aesthetic medicine is an elective procedure to the patient, and therefore a good informed consent must be given before the procedure is done.

Its like going to see a gynae because of infertility problems. You talk to the gynae, she examines you and then puts up the options. She informs you of the pros and cons and you decide based on your expectations and budget. It then allows you to plan ahead as to the suitable time for you to commence the treatment or whether any other treatment is required first before you engage the treatment that you wish to choose.

Its the same with aesthetic medicine consultations. Despite giving online replies, I would prefer to meet up with the patient, discuss expectations and also what is their main concern and explain modalities of treatment. A face to face consultation is important to allow examination of the face or body to give a more accurate treatment plan to patients. It will also allow you to discuss your budget and how you wish to proceed.

Feel free to come and talk to me in my clinic. For appointments, call 03-21440080 or emaill to info@faceworksclinic.com

Botox and Fillers Q & A

2010-12-07T15:58:00.008+08:00

Botox and fillers are the bread and butter for any aesthetic physician. It is what differentiates us from normal general practitioners. However, in my consultations, I have noticed that a lot of my patients have the initial belief that everything injected to the face is Botox. So instead of writing up long entries, I decided to write this as a Q&A session for better understanding of injectibles (injectibles : things that you can inject) .

1. What is Botox or BTA?
Botox or BTA is a protein derived from botulinum A toxin which is a type of bacteria that causes tetanus.

2. What is Botox used for?
It is used to relax muscles and therefore can be used to reduce spasticity in celebral palsy children, correct ticks and strabismus problems, and in medicqal aesthetics we use botox and BTA to relax muscles that forms wrinkles i.e. get rid of dynamic wrinkles. We can also use botox for face reshaping, calf reshaping and to reduce excessive sweating.

3. Is Botox safe?
Depending on the indication of use, you will need at least 5 vials of botox or 10 vials of BTA to cause paralysis of the whole body. The usual clinic use is half a bottle for one patient.

4. How long does it last?
Botox usually lasts 3-6 months but it will depend on the body's self metabolism because we do observe that active young people have a shorter duration of botox span compared to a more elderly less active person. Also, we do notice that repeated botox injections would prolong the duration that the effect lasts. However, there are some people who develop resistance to botox i.e. if too frequent injections were given. Therefore, we normally recommend the first follow-up to be around 3 months, and subsequently only twice a year or less.

5. What are fillers?
Fillers are substances used to fill up areas of the face and body which needs to be filled. Usually fillers are used on the face to enhance features or to return volume loss due to aging.

6. What are the types of fillers and duration it lasts?
There are many types of fillers as follows:

Hyaluronic acid fillers (lasts 6-24 months depending on type, area and molecule size)
Calcium hydroxypatite filler - Radiesse (lasts 15-18 months)
PRP fillers derived from own blood (Lasts up to 15 months)
Bioalcamid - lasts up to 3 years.
Fat harvested from other parts of body (lasts 3 months-3 years depending on skill of surgeon).
Collagen fillers (last 1-3 years depending on skill of surgeon)
Silicon liquid filler - permanent but banned due to complications related to cancer.

7. Are fillers safe?

Technically they are except silicone, but it really depends on the skill of the injector.

8. Can you do botox and fillers in one sitting?

Yes.

9. Are the procedures painful?

Botox is usually tolerable with ice numbing prior to procedure. For fillers, it will depend on type and area injected. Hyaluronic acid fillers are the least painful. Nose tip and lip injections are painful but the doctor can make you comfortable by giving proper local anesthesia or nerve blocks.

10. If I had botox or fillers does it mean forever I have to use the products?

Contrary to belief, no you don't. However, vanity is addictive and the reason most people repeat the usage of these products because they are cheaper than permanent procedures, safe and has a short downtime. It will depend on your individual assessment of yourself.

For more personalized info, please email us at info@faceworksclinic.com .

Radiesse Workshop......

2010-11-30T13:50:00.005+08:00

Last Sunday, I was at Pantai Hospital, Bangsar for the Radiesse Workshop organized by Servicom. The guest speaker was Dr Peter Huang, a well-known aesthetic plastic surgeon from Taiwan. It was my second encounter with Mr Huang, and both times I have been very impressed with his technique and work. Previously, it was a workshop on hyaluronic acid fillers, this time its Radiesse.

What is Radiesse? Radiesse is also a type of filler that you can inject into the face to fill up spaces or add volume to areas you need adding. It is made out of calcium hydroxypatite, which is almost equivalent to your bone. Compared to hyaluronic acid (HA) fillers (such as Restylane, Juvederm, or Teosyal) Radiesse is much harder and last approximately 15-18 months.

It is really good for nose bridges, because it does not expand as much as HA fillers do and it lasts longer. It can also be used for chin, nasolabial folds, marionette lines and for midface areas and enhancing cheek bones.

The injections are similar to HA technique where ideally you are given nerve blocks or analgesia to reduce pain initially. The process takes around 15 minutes to 1/2 an hour depending on how many areas you are doing. In terms of pain, some say that it is more painful than HA fillers, but nothing unbearable, and its only for a few hours after the blocks run out. Swelling is more than HA and usually it goes off after 2-3 days. Bruising is a complication and you may consider having the procedure done during the less busy days just in case, or use concealer if needed. The filler is soft and moldable within the first week - but I would usually ask my patients to wait until the swelling is gone before they try to remould the filler. Top-ups usually 2-4 weeks later, depending on suitability.

The only down side of it, is that you can't remove it once its in - so I would suggest that unless your mind is already set on having the filler done, you should keep to HA fillers which lasts shorter and can be dissolved with hyaluronidase. Another more important aspect is to be confident with your doctors injecting skills, which would make a difference to the outcome.

Interested to know more? You can email me at info@faceworksclinic.com or book an appointment for a chat at Faceworks Clinic - Tel : 03-21440080.

Faceworks Clinic Products

2010-11-25T14:35:00.014+08:00

Its about time I posted the newer products available in myclinic. After trying out a number of them, I finally rested my convictions on these products, which I find does give results at an affordable price.

1. Obagi Nuderm System.

This is one of the most impressive sets I've ever come across. The Nuderm System is a 6 step care which is targeted at changing the skin environment to reduce acne break-outs, reduce pigmentation and also tackle fine wrinkles. Its active ingredients contains Hydroquinone 4% (which is the recommended % to treat pigmentation problems) and in combination with retin-A is the complete solution for acne with post-inflammatory hyperpigmentation and melasma which are the 2 major concerns in facial skin health. It is a prescribed skincare and would require physician monitoring but the results can be seen as early as 2 weeks after initiating the product. The product is used in small quantities and a travel set can last up to 3 months.

2. Obagi C treatment System.

This is a skincare range for people who have mild pigmentation or have flawless skin that they wish to maintain and add more luminance to the skin. Vitamin C being a potent anti-oxidant has shown benefits in skin brightening and evens out of skin tone. It comes in 2 forms of preparations, i.e. with Hydroquinone 4% or just Arbutin. The product is light and non-greasy, absorbs into the skin almost immediately.

3. Obagi Vitamin C serum 15% and 20%

The Vitamin C serum from Obagi is one of the most stable vitamin C compounds in the world. Multiple studies done has shown that over time, the Obagi Vitamin C does not get oxidized as fast as other brands. In terms of its solution, it is highly absorbable and has that nice orange scent. it comes in concentrations as high as 20% and for those vitamin C serum lovers would love this as an adjunct to your current skincare regimes.

4. Obagi Clenziderm for Acne.

Clenziderm is a range produced to treat acne in younger people and those who are not keen to be using hydroquinone or retin-A preparations. The active ingredient is salicylic acid and liquid benzyl peroxide for elimination of P. acnes bacteria which is the cause of pustular acne breakouts. Some may say why liquified benzyl peroxide and not your normal Oxy - well, in view of its form you get evenly distributed lotion with better penetration into the pores. Results can be seen as soon as 2 weeks of usage. The pack lasts up to 4 months.

5. Obagi Elastiderm Eye treatment.

Elastiderm eye treatment from Obagi comes in two forms, the eye gel and the eye cream. Both are made for different types of skin and the main function is to treat under eye fine wrinkles and increase elasticity around the eyes. It has been proven to increase elasticity by 46% in 9 weeks and visibly reduce fine wrinkles around the eyes in 9 weeks. As aging occurs, the elasticity around the eyes are compromised thus giving rise to fine wrinkles and thining of the skin around the eyes.

6. Obagi Elastiderm Decolletage.

Now we have a system to maintain that sexy neck and decolletage area. Obagi Elastiderm Decolletage offers a system to help keep the decolletage area supple and even out the skin tone in the neck area to give you a more youthful bust to flaunt. It is good for sun damaged bust areas as it contains hydroquinone 4% or arbutin to help reduce pigmentation. It also tackles fine lines and wrinkles around the bust area and returns some of the elasticity. Results can be seen as early as 4 weeks.

7. Under EyeBryten for severe dark eye circles and puffiness.

Under EyeBryten could be the solution to your dark eye circles and puffiness. The active compound is called Haloxyl and is recognized as the accepted treatment for undereye discolouration. It works better when combined with regular chemical peels which can also be done in the clinic. One package of 30 mls lasts up to 2 months based on twice daily usage.

8. Skintech Vitamin E cream.

Most people would agree that when you peel your face with laser, IPLs or chemicals, the most common side effect is dryness of the skin. Skintech Vitamin E cream is a wonderful adjunct for people with flaking skin due to treatment. Its a definite keeper for your late night mousterizer after retin-A creams or other treatments and it helps reduce flaking post chemical peel and dryness post laser. Its a moisturizer that can suit most skin types, and most would agree that the texture of your skin in the morning after an overnight application feels wonderful.

9. PK24 Natural 24 hours Feminine Tightening Creme.

This is a weird addition to my range of products but since I do consult cases for vaginoplasty and hymenoplasty, why not. PK 24 is only sold in USA and Malaysia. It is made out of natural ingredients and acts as a feminine tightener. The viscous gel-like substance acts within 5 minutes of application and lasts up to 24 hours. It is recommended for sexually active women after childbirth or those who just want to enhance what they already have.

10. Heliocare SPF 50 Gel sunblock.

Personally I love this sunblock. Its gel based and its tinted so it does not clog up my pores and I don't get that chalk like appearance with other sunblocks. It has a nice scent of oranges and it absorbs swiftly into the skin. I would recommend this for daily use, although for sporting activities, it may not last long enough on the face when you sweat.

11. Foltene Hair treatment system for men and women.

Foltene is a hair care range from Europe. Its a system that consists of a shampoo, a conditioner and treatment ampules. Its good for people who are having problems with hair fall or some scattered baldness patterns, and early balding. The whole set is for a months use and it is recommended to be used for 6 months at least, although there are some reports of results as fast as 2 weeks. It is made out of plant base products and has separate systems for men and women.
For more info check out http://www.foltene.eu .

For enquiries about these products, feel free to email us at info@faceworksclinic.com or call 03-21440080.

Obagi...........

2010-11-19T19:42:00.002+08:00

It has been a really hectic month and one of the things that I have seem to neglect is this blog which I started to share my journeys in anti-aging and aesthetic medicine. With a lot going around, it was quite hard to actually find time to sit and write but I guess I have to since my BOD has started asking me about the blog. So probably today, I'm just gonna give a sneak peak on the few new items I have in my clinic.

I have recently started to use Obagi Medical skincare in my clinic, and me being the skeptic I usually am, was given a full set sample to try on my own face. The verdict - I absolutely love it! Not only it helped even out my skin tone, but also reduce the appearance of my laser burn which has been stuck to my face for the past 2 years. Yups, 2 years....... despite laser, IPLs, kojic acid, regular peels. All thanks to the hydroquinone content in the product - the post-inflammatory hyperpigmentation is not as obvious.

The good thing, it comes in a cute travel set pack and the price is reasonable. However, it is a prescribed skincare since it contains hydroquinone and therefore requires monitored use. But you can get them in my clinic after a quick consult and proper analysis.

There is a wide range of Obagi products so in my subsequent entries I'll fill in with the details. As for now, I'm pretty happy with the results and can confidently go out without any foundation or make-up and still look good.

Quick slim medication.....

2009-10-31T11:18:00.002+08:00

Slimming pills use to be a fad in the past decades but since a few years back, the news of problems arising from the use of certain chemicals to reduce weight has caused it to be such a taboo. A few medications were taken off the market, although some still remained.

There are many types of drugs used for slimming. It will depend on how it acts to reduce weight. Reductyl is one of the commonest drugs used for appetite suppression. Perhaps it is the only slimming drug still allowed in the market due to the fact that the other drugs have found to cause some severe side effects to patients. I always believe that medication taken without the proper advice and the wrong way will cause side effects. So, if you intend to use this drug, perhaps you should know a few things about it first and consult your professional medical advisor.

Reductyl is an appetite suppressing drug. It acts in the higher centers of the brain making the person feel full. The drug is taken everyday in the morning and over a week, there will be noticeable weight loss due to reduce food intake. In fact, the manufacturers guarantee a 4 kilo loss a month if used well. Most people taking reductyl would feel less depressed, perhaps it has something to do with the satiety feeling. However, this drug is not for everyone. People with uncontrolled hypertension is a major contraindication because it can elevate BP. People with bipolar mood disorders or manic episodes are not advised because it has been found to increase manicity. Other side effects would include mood swings, palpitations and insomnia. Which is why it is crucial to be under a physicians care while using this drug rather just buy it over the pharmacy counter.

I do have patients on reductyl and I have found the results promising. Coupled with proper diet and physical activity advice, the weight loss is sustained better. It has been discovered that you can safely use this drug continuously for up to 2 years although normally I would prescribe for 3 months.

Another group of slimming drugs would be the fat inhibitors. These are drugs that inhibit fat absorption from the gut into the system. The medical drug is called Orlistat, whilst over the counter you can find a lot of pharmacies selling chitosan which gives a similar effect. Orlistat is perhaps the most safest slimming drug available as it does not absorb into the gut. This is also the drug of choice when dealing with teenage obesity. However, there are a few drawbacks. First for most is the flatulence and bloatiness problem because it accumulates all the fat in the gut for excretion. Secondly, there is a problem of liquid fat leaking from the backside, and this can be socially limiting to the person. We do recommend the use of cotton pads whilst on the medication, however men find this a bit awkward. Other side effects would be floating stools and foul smelling stools. If used well, it may bring a reduction of up to 5 kiloes a month, depending on diet. Most people on Orlistat would abstain from fatty foods because it makes the leaking worst.

There are other drugs in the market but most taken off the counter already, so there's no point to mention them. Slimming medications used the correct way does harbour good results, but you need to be under a physician's care who understands well the usage of these medications and the side effects that follow.

Chemical Peels

2009-01-26T11:59:00.007+08:00

I remembered a few months back a friend was asking about chemical peels. She was concerned that by doing chemical peels, the skin would become thinner and thinner. Rather, it was quite the opposite. Chemical peeling is a method used to remove certain layers of the skin, depending on type of peel used. By taking of the skins top layers, it actually stimulates faster migration of epithelial cells to the surface, and induce formation of new epithelial cells at the bases. Thus you will get skin that is new and appear healthier.

Chemical peeling is not new age technology. It actually dated back to ancient times, the most famous being Cleopatra and her yogurt bath. Yogurt (sour milk) contains lactic acid which acts as a mild chemical peel for skin leaving it soft and supple. Some even use grapes and other fruit acids to get the similar peeling effect. Nowadays we group the mild fruit acids into alpha hydroxy and beta hydroxy acids and are commercially produced for the purpose of peeling.

Who would benefit from a chemical peel? Well perhaps everybody. Depending on what you want, a mild peel such as a glycolic acid peel, or salicylic acid peel can help remove dead skin and give your skin a nice glow for that function tomorrow. Multiple sessions of peels can also help with oil sebum control and removal of comedomes and other things.

Much stronger peels would be a TCA peel which acts at the epidermal-dermal junction, but it has a longer downtime of 5 to 7 days and you will experience peeling of skin, at times in sheets. Most people nowadays use a modified TCA peel such as Blue peel, Easy peel, Krystal peel. In my clinic we use Easy TCA peel by Skin Tech. Recently I did one of my girl's face in the clinic and it gave beautiful results with finer texture of skin and reduced hyperpigmentation scars after one week, although during the first 2 days, her mum said she looked like an alien offspring.

The strongest peel in the market would be the phenol peel. It is a very deep peel which can even remove wrinkles. However, it should only be done in a plastic surgeon's office. The downtime is long up to months and the care is tedious, but the results, fantastic. I have yet to see one, let alone do one. In Malaysia, the use of phenol for peels is restricted.

Chemical peels are an easy and effective way of getting that radiant skin look. For first timers I would recommend a quick chat with the physician first to get a better idea of the procedure and to tackle unsettled worries.

Welcome to the world of aesthetic medicine....

2009-01-15T19:03:00.003+08:00

Some may say that it was the ancient Greeks who first supplied the world with the theory of aesthetics, running back to the great thinker Socrates and his views of relative beauty. Personally, I believe the concept of aesthetics has been there since Adam and Eve. Aesthetics is defined as anything concerning good taste and beauty. When we combine it with medicine, it becomes the art and science of making things beautiful. Some physicians may call it the study of vanity, but regardless, it is now an important aspect of medicine, because everyone deserves to be beautiful, and people are aware of it.

Aesthetic medicine was first introduced as a science by a Parisian endocrinologist called JJ Lengrand in France in 1973. It originated from the belief that the well-being of an individual is about being satisfied with one's health, occupation and environment. The goal was to create a harmonious physical and psychological balance as desired by the individual, by administering medical treatment which acts both as a corrective and preventive measure. It is also regarded as an extension of dermatology by some physicians as it involves the skin and repair of the skin, but now it is more of a multidisciplinary approach as it dwells with other issues such as obesity, surgery and psychology.

Why aesthetic medicine? Despite having a lot of aesthetic techniques brought down by our forefathers and traditional healers such as scrubs, jamus (herbal remedies), susuk (traditional way of inserting needle under skin to keep the skin tighter), spas, and facials, most of these techniques have never been properly tested for side effects. Thus, there was a need for scientifically proven techniques that produces results which are relevant. However, these techniques would require a person of good knowledge of the body, in order to understand the actions and to avoid possible side effects. Thus trained physicians were sought, as they possess the knowledge of anatomy and disease, and the skills for injectibles and pharmacology.

There was also an era where everyone was thrilled by the idea of plastic surgery as it gave quick results and depending on the skill of the surgeon, exactly what the individual want. However, not everyone is willing to go under the knife. It takes a lot of mental and physical preparation, plus the recovery period is longer and may take up to weeks. There is also a higher risk of wound infection, and other complications from the surgery. Hence, even the plastic surgeons are looking at aesthetic techniques as an alternative option to their patients. With less invasive techniques and faster recovery periods, it is no wonder why aesthetic medicine is on the rise.

Aesthetic medicine is a broad branch which involves many procedures from injectibles such as fillers and Botox, to chemical peels, intense pulse light, laser treatment, radiofrequency and ultracavitation, mesotherapy and many many more new techniques and technology which is rapidly expanding. The most important thing is that the patient be well informed of the procedure and the effects of treatment. This blog acts as a tool to spread information concerning aesthetic procedures and techniques that some may have heard of, but unsure of the details. With the access to more knowledge that is comprehensible, we aim to gain more confidence in the benefits of aesthetic medicine techniques.