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Blepharoplasty – FAQs

Blepharoplasty Dubai | 6 August 2019

Infection: This is very uncommon. If you feel unwell, hot, or the treated area appears red, with sensations of burning or there is any discharge we would urge you to contact the clinic for advice and/or urgent treatment.

Pain: You will experience discomfort over the first few days following surgery however the degree of pain does vary from person to person. Painkillers can be prescribed and taken home with you and manages any discomfort well.

Work / Sport / Leisure Activities: It is recommended that you take one week off from work, however if you have a sedentary job a few days is acceptable but you must stand up and walk around every hour or so as movement will accelerate healing. If you have an active hobby or leisure interest, please seek advice from your surgeon as to when you will be able to return to it following surgery.

Children: If you have young children or babies, please ensure that the area(s) treated are not touched or disturbed for at least 1 week. Your tissues have been agitated and require a period of time to heal without disturbance. It is recommended that you organise help with caring for young children during the first few days of recovery.

Bathing: Wounds must be kept completely dry for the first week. ‘’Baby wiping’’ the face for the first week to clean yourself is recommended. After your first post-operative check with the nurse at the end of week one, you will be advised that you can shower and wash as usual – you will also be provided guidance appropriate products to use.

Sun Bathing: Do not sit out in strong sun for the first two weeks after surgery. Once you have fully recovered and your scars are matured you may allow your eye area to be completely exposed in the sun but shielding them as much as you can in the weeks following your treatment will only improve your final scarring results

Diet: Ensure that you maintain a healthy nutritious diet with plenty of fruit and vegetables, as this is important for wound healing and bowels. As you are inactive and have most likely been taking painkillers constipation may become an issue, to help prevent this or to ease symptoms you may use a product such as Senokot® or whatever has suited you in the past

Flying: If possible avoid flying for the first six weeks – usual medical guidelines dictate 2 weeks for short haul flights and a full 6 weeks for long haul. Following surgery, you must ideally wear flight socks and take low dose aspirin before flying.

Top Things to Consider Before Having Cosmetic Surgery

Cosmetic Clinic Dubai | 3 August 2019

If you’re thinking about cosmetic surgery, there are a few things that you should consider beforehand. These include: making sure you fully understand your motives, having time to explore all of your options, becoming familiar and informed about the realistic results that cosmetic surgery can achieve, ensuring you know the costs and how you will fund your procedure, listening to pre and post operation advice and, knowing the risks and recovery time of your cosmetic surgical procedure. An appreciation of all these things will help you make a decision about having cosmetic surgery. Often reputable clinics have a cooling off period after a consultation to allow you to digest and reflect on all the information you have gathered, so that if and when you go ahead with cosmetic surgery you are fully informed and certain you would like to proceed.

1. Do it for the right reasons

Cosmetic surgery is elective and can be major surgery so you shouldn’t make a rash decision or do it for the wrong reasons. Your choice to have cosmetic surgery should be considered and be because you want to improve an area of your body that you’re not happy with and feel more confident with the way you look. Cosmetic surgery may improve your self-esteem and confidence but it should not be considered if you’re pinning your hopes on it changing and improving other elements of your life or, if you’re doing it for someone else.

2. Do your research

It’s important to research your cosmetic surgeon and the clinic or hospital setting where they operate. Don’t just accept their claims for excellence of care. 

3. Have realistic expectations

Cosmetic surgery aims to improve a body part that you’re not content with and potentially improve your self-esteem. Your consultant will discuss with you the realistic improvements that your chosen cosmetic surgery can achieve for you. Every procedure is tailored to an individual and their specific requirements. 

4. Don’t go overboard

Your cosmetic surgeon will aim to enhance or refine a body part to improve your overall look whilst retaining your natural physical characteristics so that you still look like you.

5. The costs

You’ll need to be aware of the total cost of your cosmetic surgery including any follow-up care.  Some clinics offer the reassurance of all-inclusive package prices with no hidden extras to pay or competitive finance options to fund your treatment.

6. Be prepared to follow pre and post-operative advice

If you’re a smoker your cosmetic surgeon will strongly advise you to stop smoking altogether or at least for two to four weeks before and after your surgery. Smoking significantly compromises your body’s ability to heal and recover after surgery as well as increasing your risk of infection and other complications.

Your consultant may also offer recommendations regarding your alcohol consumption, prescription medications and, diet and exercise. You should listen to this guidance as it will support your welfare and the success of your operation. For example, following your cosmetic surgery you’ll need to be active enough to prevent the unlikely but possible occurrence of blood clots, chest infection, or constipation.

7. The risks of your procedure

Many cosmetic surgery procedures are major surgery and as such they carry the possibility of complications occurring such as excessive bleeding or infection at the surgical site. Your cosmetic surgeon should discuss in detail the risks of the specific surgery you’re considering. You need to understand these risks.

8. Recovery time

Your cosmetic surgeon will be able to give an estimate of how long in general patients take to recover from specific cosmetic surgeries. You can organise your best recovery plan based on this information and put in place any personal or professional measures to make your recovery easier and more amenable. 

What is Eyelid surgery?

Blepharoplasty Dubai | 1 August 2019

Eyelid surgery, sometimes known as an eyelid lift or blepharoplasty, is a common surgical procedure that is used to alter the shape and appearance of the upper eyelid, lower eyelid, or both eyelids. Blepharoplasty is typically performed by removing any excess skin and tissue from the eyelid area.  Additionally, the underlying eyelid muscles are adjusted and smoothened and support is created for the surrounding eyelid tissue in order to improve the ‘droopiness’ of eyelids and to eliminate the ‘puffiness’ of eyebags.

What causes eyelid problems?

As we get older, we start to lose elasticity in our skin as a natural part of the aging process. Because the face and the facial skin are often more exposed to environmental factors (such as sun, wind, pollution, etc.) than other parts of the body, it is often the first part of the body to show visible signs of aging and a loss of this elasticity. The skin around the eye is very thin and delicate, and it is one of the places where aging skin will be most visible on the human body. As the skin around the eye loses elasticity, it will begin to stretch, and gravity will cause the stretched skin to pool above and below the eyes. On the top eyelid, this creates the appearance of ‘hooded’ or droopy eyelids. If the top eyelid sags too much, it can start to impede a person’s field of vision. On the bottom eyelid, the effect is slightly different. There are small fat deposits located under each of our eyes that helps to cushion the eye socket. When the lower eyelid skin begins to lose elasticity, this area will become more exposed and a bulge can appear under the eye. This is commonly referred to as ‘undereye bags’.

Who is a good candidate for eyelid surgery?

Eyelid surgery is a relatively uncomplicated outpatient surgery procedure. It is suitable for someone who is generally considered to be in good health. Both men and women can have the surgery, and it is suitable for people from any ethnic background. Blepharoplasty is usually recommended for people over the age of 35, as this is when the appearance of the eyelid will start to show signs of aging. In certain cases where a person may have a family history of droopy eyelids and severe bags, the surgery may be performed on someone younger.

Before you undertake the procedure, your surgeon will physically examine the structure of your eyes and face and provide recommendations so that you will have a good understanding of what to expect from the surgery. You should carefully consider any advice you receive from the surgeon to ensure the surgery is the right choice for you. If you have certain medical conditions, particularly eye conditions, you may not be a good candidate for eyelid surgery. Dry eyes, glaucoma, and other eye conditions may have an impact on the outcome of your eyelid surgery. You should inform your surgeon of any eye or general health conditions that you have. The surgeon will discuss these issues with you and ensure that the procedure is safe for you.

What can I expect from the surgery?

Eyelid surgery is a relatively short, uncomplicated procedure that is normally performed as a outpatient surgery. In a typical eyelid surgery procedure, local anaesthetic will be applied to the eyelid and the surgeon will make several small, discreet incisions along the eyelids. Special care will be taken by your surgeon to ensure there will be minimal bleeding or scarring. The incisions will normally be hidden in the natural eyelid folds. In an upper eyelid procedure (upper blepharoplasty), incisions will be made in the upper eyelid crease. In a lower eyelid surgery, the incision will be made just underneath the lash line of the lower eyelid. In some instances where no skin needs to be removed, the surgeon may be able to perform a transconjunctival blepharoplasty. In this procedure, an incision is made from the inner side of the lower eyelid directly, and as a result there is no visible scarring. Once the incisions are made, any excess of tissue (skin and/or fat) will be removed and the incision will be sealed with small sutures. The whole procedure will typically take between one to three hours. The specifics of your eyelid surgery procedure will vary depending on the nature and severity of the eyelid issue that is being addressed and whether the surgery will be on your upper, lower, or both eyelids. Your surgeon will outline and explain all of the details of your particular procedure before the operation to make sure that you are prepared.

What can I expect after surgery?

Following surgery, you should arrange for someone to rive you home. As with any procedure that affects your vision, it is important that you allow sufficient time for recovery before you drive or undertake any activity that requires uncompromised vision. As part of your recovery, you will need to ensure that you rest, elevate your head, and apply ice to the eye area to keep swelling and bruising to a minimum. Individual patients will experience pain differently, but the procedure should only cause mild pain. Regular, over-the-counter pain medications, such as Tylenol, should be taken as needed. The recovery time from an upper eyelift can vary for individual patients, but the skin of the upper eyelid tends to heal quickly.  Most patients find that they are able to return to normal activities within three to four days. Some patients may develop dry eyes for one to two weeks.  If the dry eye symptoms persist for a longer period of time, you should discuss this with your surgeon.

WHAT BREAST AUGMENTATION SURGERY CAN DO

Breast Augmentation Dubai | 31 July 2019

Breast augmentation, sometimes referred to as a “boob job” by patients, involves using breast implants or fat transfer to increase the size of your breasts. This procedure can also restore breast volume lost after weight reduction or pregnancy, achieve a more rounded breast shape or improve natural breast size asymmetry.

WHAT BREAST AUGMENTATION SURGERY CAN DO

Increase fullness and projection of your breasts

Improve balance of breast and hip contours

Enhance your self-image and self-confidence

WHAT BREAST AUGMENTATION SURGERY CAN’T DO

Breast augmentation does not correct severely drooping breasts. A breast lift may be required along with a breast augmentation for sagging breasts to look fuller and lifted.

Breast lifting can often be done at the same time as your augmentation or may require a separate operation. I will assist you in making this decision.

WHO IS A GOOD CANDIDATE FOR BREAST AUGMENTATION?

Breast augmentation is a deeply personal procedure, and it’s important that you’re doing it for yourself and not for someone else, even if that person has offered to pay for it. Patient satisfaction is high, specifically when they want the procedure themselves.

You may be a candidate for breast augmentation if:

You are physically healthy and you aren’t pregnant or breastfeeding

You have realistic expectations

Your breasts are fully developed

You are bothered by the feeling that your breasts are too small

You are dissatisfied with your breasts losing shape and volume after 

  pregnancy, weight loss or with aging

You are unhappy with the upper part of your breast 

   appearing “empty”

Your breasts are asymmetrical

One or both breasts failed to develop normally or have an 

   elongated shape

WHAT TYPES OF BREAST IMPLANTS ARE AVAILABLE?

Saline breast implants

Saline breast implants are filled with sterile salt water. Should the implant shell leak, a saline implant will collapse and the saline will be absorbed and naturally expelled by the body.

Saline breast implants provide a uniform shape, firmness and feel.

Structured saline breast implants

Structured implants are filled with sterile salt water, and contain an inner structure which aims to make the implant feel more natural.

Silicone breast implants

Silicone breast implants are filled with silicone gel. The gel feels a bit more like natural breast tissue. If the implant leaks, the gel may remain within the implant shell, or may escape into the breast implant pocket.  

Gummy bear breast implants

Form-stable implants are sometimes referred to as gummy bear breast implants because they maintain their shape even when the implant shell is broken.

The consistency of the silicone gel inside the implant is thicker than traditional silicone gel implants. These implants are also firmer than traditional implants.

Shaped gummy bear breast implants have more projection at the bottom and are tapered towards the top. If a shaped implant rotates, it may lead to an unusual appearance of the breast that requires a separate procedure to correct.

Placement of gummy bear implants requires a slightly longer incision in the skin.

Round breast implants

Round breast implants have a tendency to make breasts appear fuller than form-stable implants. Higher profile options can achieve even more projection.

Because round implants are the same shape all over, there is less concern about them rotating out of place.

Smooth breast implants

Smooth breast implants are the softest feeling. They can move with the breast implant pocket, which may give more natural movement.

Smooth implants may have some palpable or visible rippling under the skin.

Textured breast implants

Textured breast implants develop scar tissue to stick to the implant, making them less likely to move around inside of the breast and become repositioned.

Texturing offers some advantage in diminishing the risk of a tight scar capsule. Implant manufacturers occasionally introduce new styles and types of breast implants, so there may be additional options available.

Whether you choose saline or silicone implants, it is important for you to monitor your breast implants and follow-up with appropriate checkups.

HOW SHOULD I PREPARE FOR BREAST AUGMENTATION?

In preparing for breast augmentation, you may be asked to:

Get a blood test

Take certain medications or adjust your current medications

Stop smoking

Avoid taking aspirin and certain anti-inflammatory drugs as they can 

  increase bleeding

arrange for someone to drive you to and from surgery and to stay with 

  you for at least the first night following surgery.

WHAT SHOULD I EXPECT DURING MY BREAST AUGMENTATION RECOVERY?

During your breast augmentation recovery, your breasts will be wrapped in gauze dressings and an elastic bandage or support bra will minimize swelling and support the breasts as they heal.

Immediately after surgery, you will be taken into a recovery area for close monitoring. You may be permitted to go home when you are stable for discharge, typically after an hour or so.

WHAT RESULTS SHOULD I EXPECT AFTER BREAST AUGMENTATION SURGERY?

While a breast augmentation yields larger breasts right away, the final results may take a few weeks as the swelling subsides and the skin stretches. Some patients may need to wear a bandeau to help shape their breasts, especially if they have underlying asymmetry or very small breasts to start with. Incision lines may take several months to fade.

Dermal Fillers – What to Expect During Treatment

Fillers in Dubai | 28 July 2019

Dermal filler injections are non-surgical and typically completed during an office visit. Your initial treatment will begin with a consultation, during which you will meet me to discuss your concerns and goals.

Pre-treatment consultation

During your consultation, I will evaluate your area of concern and review your medical history. While the risks associated with dermal fillers are minimal, you need to fully disclose your medical history prior to treatment, as certain allergies, skin and neurological conditions, or medications can jeopardize your safety or results. For instance, you need to tell me if you have been taking NSAIDs (e.g., aspirin, ibuprofen, naproxen) or blood thinners, as these increase the likelihood of bruising.

Your injectable filler treatment

Just before the actual treatment, the area will be cleaned, and you may be given a topical anesthetic to numb the area prior to injection. Many filler products also contain lidocaine, a mild anesthetic, which is intended to help minimize discomfort during and after your treatment. I will then inject a precise amount of filler strategically beneath the skin.

Depending on the product and the areas treated, you should be able to notice results immediately after receiving filler injections. Some patients experience mild bruising and swelling, but these are temporary and should subside over the days following treatment. You will be able to go back to your normal activities right after treatment, but I may ask you to take the day off from exercise or other strenuous activity.

If you are having fat injections…

Facial fat grafting is a surgical procedure and follows a different treatment protocol. Typically, fat grafting is performed as an outpatient procedure, using general anesthesia or local anesthesia with sedation. Up to 2 weeks of downtime may be required, depending on the extent of liposuction performed. I will go over what to expect with surgery and recovery during your consultation.

What to Expect During Your Tummy Tuck Recovery

Tummy Tuck Dubai | 25 July 2019

Whether you’re undergoing a reconstructive, cosmetic or functional surgery, downtime will be required. If you have been considering a tummy tuck for some time now and have finally scheduled one, this is what you can expect during your recovery period.

Tummy Tuck Recovery – A Timeline

Every patient heals differently, which means their recovery will be different too. Your age, your health and the type of tummy tuck that you receive will all play a role in your recovery. Here is a basic idea of what you can expect week by week.

Week One

Your abdominal area will be wrapped with dressings and supported by a compression bandage directly after your surgery. Draining tubes will be inserted in order to get rid of excess bodily fluids, but they will be removed several days after your surgery. Most patients are free to go home directly after their surgery but if I am concerned about fluctuations and abnormalities, you may be asked to spend a night in the hospital. I will provide you with pain medication and antibiotics to use during your recovery.

Week Three

By the start of week three, I will have removed your draining tubes and you will have completed your course of antibiotics. Even though showering will now be possible, it’s still important to wear your compression bandages to avoid fluid build-up and swelling. I will also tell you what you can do to start strengthening your body again. Simple movements such as walking, bending and raising your arms should be allowed. Strenuous activity should still be avoided.

Week Five

If you’ve chosen to receive a mini tummy tuck, you will be back at work a month after your surgery. Traditional tummy tucks tend to require a slightly longer recovery but you should be almost completely back to normal after a month. Most patients are back at work in week five regardless of the type of tummy tuck they received. Your compression bandages may still need to be worn for support purposes. You may want to clear any planned activities with me before you go ahead with them. During week five, you should also be able to see the final results of your surgery and your abdominal muscles will feel tighter. Your scarring will be quite visible at this time but they will fade as your body continues to heal.

This is just a brief guide on what you can expect during your tummy tuck recovery. It’s still important to carefully follow my specific aftercare instructions to ensure the best results.

The healing process is not one that should be rushed. Everyone heals at a different pace so it’s important to approach your recovery period with realistic expectations and above all, patience. I will ensure that you are fully prepared for your recovery and know what to expect in terms of your results. Don’t forget to ask your friends and family for help during this time.

What are Fillers Made With?

Fillers in Dubai | 22 July 2019

There are a variety of dermal filler products that cosmetic surgeons use. In general, fillers are categorized by the substance they are made from. A note for your safety: always make sure that you are receiving approved, brand name fillers, which are only available through a licensed physician, such as a qualified cosmetic surgeon.

Hyaluronic Acid (HA)

Hyaluronic acid is a naturally occurring substance that is already found in your skin. It helps keep skin plump and hydrated. HA fillers are typically soft and gel-like. The results are temporary, lasting 6 to 12 months or longer before the body gradually and naturally absorbs the particles. Most HA fillers are infused with lidocaine to help minimize discomfort during and after treatment. FDA approved HA fillers include:

Juvéderm products: Juvéderm XC, VOLUMA, VOLBELLA, VOLLURE

Restylane products: Restylane, Restylane Silk, Restylane Lyft, Restylane Refyne, and Restylane Defyne

Belotero Balance

Calcium Hydroxylapatite (CaHA)

Calcium hydroxylapatite is also a naturally occurring substance, found primarily in our bones. When used in a filler, the calcium particles are nearly microscopic and suspended in a smooth gel. The consistency of a CaHA filler is typically thicker than that of a hyaluronic acid filler and typically last longer as well, about 12 months for most patients. Calcium hydroxylapatite is also reported to help stimulate natural collagen production, and it is typically used for deeper lines and wrinkles. FDA approved CaHA fillers include Radiesse®.

Poly-L-lactic Acid

Poly-L-lactic acid is a biocompatible (meaning it is safe to use in the body), biodegradable synthetic substance. It has been used for many years in medical devices, such as dissolvable stitches. Poly-L-lactic acid products are technically classified as “collagen stimulators,” as their main mechanism to smooth fine lines is by helping your skin rebuild natural collagen—the filler gel itself dissipates a few days after treatment. Poly-L-lactic acid is typically used to treat deeper facial wrinkles, and results can last more than 2 years. FDA approved Poly-L-lactic acid fillers include Sculptra® Aesthetic.

Polymethylmethacrylate (PMMA)

Polymethylmethacrylate (PMMA) is a synthetic, biocompatible substance that has been used in medicine for much of the last century. In dermal fillers, PMMA takes the form of a “microsphere” or tiny ball, that remains beneath the skin indefinitely to provide continued support. PMMA fillers will also contain collagen, a naturally occurring substance in the skin that provides structure and firmness. FDA approved PMMA fillers include Bellafill® (formerly known as Artefill).

Autologous fat injections (facial fat grafting)

Autologous fat injections are the only injectable filler treatment that requires surgery, but results can last for many years. Your own fat is harvested from another area (autologous means “from the same person”), typically using liposuction. The fat is then purified and injected into the face to help restore volume to the cheeks, temples, lower eyelids, or other areas. Fat injections require specialized training to perform safely and achieve great results, and should only be performed by an experienced, board certified cosmetic surgeon.

Guide to Breast Uplift (Mastopexy)

Breast Augmentation Dubai | 19 July 2019

Breast lift surgery (also known as Mastopexy, or breast reconstruction) helps to restore the elasticity of female breast tissue which can be stretched, most often through factors such as; weight loss, pregnancy and childbirth, breastfeeding or ageing. The improvement in self-esteem and confidence can be remarkable, making a breast lift one of the highest ranking cosmetic procedure in satisfaction.  

The procedure is designed to lift breasts that hang abnormally low over the chest, with the majority of their volume sitting at their base. It can be an effective way to enhance the breasts, without drastically changing their size. During the procedure, one of our highly-qualified surgeons will lift and reshape your breasts, giving them a firmer and more youthful appearance. Additionally, we can re-position the nipples higher on the breast so the changes are proportionate and natural To ensure the best possible results, I may also recommend a breast enlargement or reduction to be performed alongside your breast lift if appropriate. This will be discussed at your initial consultation. 

MASTOPEXY: AT A GLANCE

– Surgery time 2 hours

– Hospital stay day case

– Sleeping position sleeping on back recommended for 1-2 weeks.

– Reasonably mobile 1 day

– Washing shower after drain removal (if any) or 2 days post op

– Driving 1 week

– Exercise including gym 4 weeks

– Sexual activity restricted activity after 4 weeks

– Full recovery 6-8 weeks

– Time off work 1-2 weeks

– Bras & garments sports bra worn for 4 weeks

HOW THE OPERATION IS PERFORMED 

A Mastopexy or breast uplift is usually required if the position of the nipple is pointing downwards or if it lies below the natural crease of your breast (the inframammary fold.)  It is performed under general anaesthetic as a day case procedure, meaning advanced sedation techniques are employed to enable patients to recover more quickly after surgery and return home on the same day.

THE INCISION SITE

Generally this procedure is performed to rejuvenate and reshape the look of the breasts – due to the scarring associated with this particular breast procedure, the incision sites will be considered in great detail.  There are various places where the incisions can be placed as detailed below:

Periareolar mastopexy or ‘donut’

This method of uplift addresses the loose/sagging skin or envelope of tissue.  The incision in this instance is limited to the circumference of the areolar only and is often combined with an augmentation to help restore lost volume. This method proves satisfying for most patients although there is a potential risk of the extra weight of the settling implant distorting the areolar, although the benefit is that scars are kept to a minimum.

Vertical or ‘’lollipop’’ mastopexy 

This method helps to reshape the breast very well indeed, however there will still be a visible scar down the centre and underside of the breast. The scar does eventually fade with time – this method is best suited primarily for breast lifts and breast reductions of any size without augmenting and adding further weight to the breast whilst it heals.

Traditional ‘T-Scar’ or ‘Anchor’ technique

This is by far the most common and preferred technique of uplift – typically, your scar will start around the areolar, travel vertically down the underside of the breasts and then horizontally across the natural breast crease or inframammary fold.  There is of course a consideration around  scarring, however, with our expert aftercare team your wounds should heal beautifully and with time fade almost completely. This method usually incorporates an augmentation very well as the new weight of your breasts is distributed evenly across all incision sites. 

Often as part of a mastopexy procedure your nipple will be realigned – the aim of this surgery is to rejuvenate the look of low, pendulous breasts, therefore, the nipple will be repositioned so that after your surgery, when you stand in front of the mirror naked your nipple is adjacent to the midline of the upper arm.

THE TYPES OF STITCHES/SUTURES

All sutures are placed below the skin and are dissolved by the body over the course of a few weeks. Nothing needs to be pulled out/removed by a nurse following your procedure. Often surgeons will seal the wound with tissue glue, to limit the risk of superficial wound infection – this glue peels off over 1-2weeks. 

ASYMMETRY

Most women have some form of minor breast asymmetry. One side may differ from the other in volume, position of the nipple or shape of the chest wall – this is completely normal and your surgeon will be able to assess how best to correct these variances during your procedure.

AFTER CARE

How you behave in the immediate weeks after your operation can significantly impact the results you are able to achieve, for example, wearing the correct supportive post-operative bra will support the breast position and protect the settling scars during the crucial initial healing stage. You must also ensure that you lie resting in a slightly elevated position to help reduce swelling, you must also try to not move yourself up the bed using your arms as this action moves the muscle on your chest and could potentially move the implants or cause bleeding. You should use your stomach muscles and bottom to move up the bed. Do not allow anyone to assist you up the bed by lifting you up from under the armpits.

An appointment will be made for 1 week after your surgery where your incision sites will be checked, cleaned and redressed and you will be given instructions on how to care for these areas for the remainder of your healing. A follow up appointment will also be arranged at 2 weeks, 1 month and then 3-6months time.

I advise patients should be able to return to their normal day-to-day activities after about two weeks – we would recommend one week off work with the option of two if you require, as swelling is greatest during this time and it is advisable to give wounds an appropriate time to heal.  During this period, it is advisable to keep all physical activity to a minimum including visits to the gym, practicing aerobics, yoga or any other sports that involve using your arms.

Skin Problems & Treatments Guide

Fillers in Dubai | 13 July 2019

I am passionate about skin and fuss-free beauty. I have put together this brief guide of some of the most popular skin and aesthetic concerns which I see regularly in clinic. Over time I will continue to expand and update my dataset in order to provide you with concise and accurate information. Don’t forget to visit my website for more guides, news and blogs.

FOREHEAD WRINKLES & FROWN LINES

Forehead wrinkles are horizontal lines that appear on the forehead due to contraction of the muscles that raise the eyebrows. Frown lines are verticle wrinkles that appear between the eyes when you squint or frown. Both these wrinkles initially appear when you are moving the muscles responsible but over time can become ingrained and apparent even when your face is still. Whilst natural, most people seek treatment as they feel these lines make them look grumpy, anxious or even angry.

What Causes Forehead Wrinkles & Frown Lines?

Both forehead wrinkles and frown lines are predominantly caused by ageing. As we get older we lose both collagen and elastin. These two proteins form the scaffolding of the skin. Hence, they are responsible for keeping your skin firm, elastic and plump. As thin becomes thinner and less stretchy, wrinkles develop. Initially, this is when the muscles underlying them contracts such as when you raise your eyebrows or frown. Eventually, forehead wrinkles and frown lines become deeper and visible even when you aren’t moving your face. Sun damage, or photoaging, are also a cause.

Treatment Options For Forehead Wrinkles & Frown Lines

Thankfully there are a number of treatment options for forehead wrinkles and frown lines. The first step is to ensure that you have a good skincare routine which helps hydrate, nourish and protect your skin.

Botox® For Forehead Wrinkles & Frown Lines

Botox® injections are highly effective for wrinkles and lines that are only apparent when you make an expression. The treatment is quick and pain-free with results lasting for 3-4 months.

Dermal Fillers For Forehead Wrinkles & Frown Lines

If your wrinkles and lines are deeper and appear at rest then Botox® is likely to not completely smooth them out. Dermal filler anti-wrinkle injections, however, can very effectively treat these areas and results last between 6-12 months.

Professional Skin Treatments For Frown Lines & Forehead Wrinkles

Botox® and dermal fillers offer immediate smoothing out of lines and wrinkles by reducing muscle contraction (Botox®) or by filling out and lifting the skin (dermal fillers). Professional skin treatments are really useful if you’re looking to address the underlying cause of wrinkles in the long term. A combination of a course of chemical peels and microneedling will resurface the skin and induce collagen and elastin production. This will smooth out lines and wrinkles, firm and plump up the skin as well as give a youthful glowing complexion. In the long term, these bespoke skin rejuvenating treatments could reduce the need for treatments like Botox and dermal fillers.

CROW’S FEET & SMILE LINES

Crow’s feet, also known as smile lines, are wrinkles that appear on the outer corners of the eye. They are caused by contraction of the muscles responsible for squinting, smiling, laughing or frowning. Initially, these wrinkles are only visible when you smile or laugh but over time, like all wrinkles, they become deeper. Ingrained Crow’s feet and smile lines are visible whether or not you contract the underlying muscles (ie even when you’re resting the muscles of expression). Crow’s feet can also extend upwards towards the temple and downwards to affect the cheeks when they are more advanced and as volume is lost in these areas of the face with age.

What Causes Crow’s Feet & Smile Lines?

The main reason Crow’s feet or smile lines develop is due to loss of collagen and elastin in the skin. These proteins are the skin’s natural plumpers and provide elasticity. Hence losing them causes skin to become thinner and for wrinkles to become apparrent. Loss of colllagen and elastin occurs naturally as we age. Of course, the other cause of the appearance of wrinkles is sun damage (or photageing).

Treatments For Crow’s Feet & Smile Lines

First of all its important to start with basics like understanding your skin type and following a basic skincare routine. Simple lifestyle modifications such as sun protection, keeping hydrated and stopping smoking will also help slow down the development of Crow’s feet or smile lines.

Chemical Peels & Collagen Induction Therapy

There are a number of effective treatments for existing Crow’s feet and smile lines. The simplest option for very early signs of fine lines and wrinkles would be a course of chemical peels and/or microneedling. These resurface the skin and induce collagen and elastin production. 

Botox Injections

If you have Crow’s feet that are only evident on making expression, these can be treated very easily with Botox anti-wrinkle injections. For Crow’s feet or smile lines that are deeper (ie visible without making any expressions), then using hyaluronic acid dermal fillers would provide a better option.

Dermal Fillers

For more advanced Crow’s feet or under eye wrinkles and tear trough deformities, a combination of different dermal fillers can offer a natural looking solution. If you have smile lines that extend deep onto the cheeks, then you might which to consider both cheek fillers and wrinkle smoothing with dermal filler in order to restore volume and lift the wrinkles. For co-existing under eye hollows and wrinkles, the addition of tear trough fillers would help to completely rejuvenate the under eye area.

JAWLINE CONTOURING & SQUARE JAW REDUCTION

The shape of the jaw is dependent on the bone, muscles, fat and skin the comprise it. There are many factors that affect the appearance of the jaw including genetics and lifestyle. Some people seek to enhance the shape of the jaw (usually if there is sagging of the lower face or if they are seeking a more defined appearance) by having jawline contouring. This can widen or narrow and shorten or lengthen the appearance of the jawline as required. Jawline contouring can also help lift and firm up the appearance of a sagging lower face. For those with a wide jaw, square jaw reduction can help produce a narrower V-shaped jawline. Ultimately, the results are dependent on your face shape, targets and the abilities of your aesthetic doctor.

What Causes The Appearance Of A Sagging Or Square Jaw?

The shape of the lower face is made up of several structures including your jaw bones, muscles and soft tissues like fat or skin. Whilst genetics play a huge part in terms of the shape and size of these facial structures, there are a number of other factors that come in to play. The main cause for lack of definition or sagging of the jawline is ageing and reduced face volume. One of the main reasons for developing a square jaw in both men and women can be overactivity of the chewing muscles which is usually caused by tooth grinding. Other factors that can give the appearance of loss of definition, jawline sagging or a square jaw is ageing and loss of volume in the cheeks or lack of chin prominence or neck sagging.

Non-Surgical Jawline Contouring & Square Jaw Reduction

There are a number of non-surgical options for enhancing the jawline and reducing a square jaw. Botox injections are an effective treatment for square jaw reduction which also has the benefit of stopping teeth grinding. These Botox injections can also be used to lift a sagging neck and hence sculpt the lower face and jawline.

Hyaluronic acid dermal fillers can be used alone or in combination with Botox for jawline contouring. Dermal fillers can be used to directly reshape the jawline and lift up the lower face. A combination of jawline, cheek and chin dermal fillers to contour the jawline and the whole face. 

If the aim is to reduce the appearance of a square jaw or face, then a combination of Botox and dermal fillers can be used to provide a more contoured and V-line jaw appearance.

JOWLS & MARIONETTE LINES

Jowls are loose skin and flesh that hang beneath the lower jawline. Marionette lines or “puppet lines” are lines that run from the corners of the mouth to the chin. Both are a sign of ageing and volume loss in the face. One of the most commonly cited reasons for wanting to get rid of them is because they give the appearance of being grumpy or sad.

What Causes Jowls & Marionette Lines?

The main cause of both jowls and marionette lines is ageing. As we get older our skin becomes thinner and less pliable. This is due to loss of collagen and elastin. At the same time, we also lose volume in the face (particularly in the midface area) which provides scaffolding and shape. Both these processes result in sagging of the skin and tissues which gives rise to jowls and marionette lines in the lower face. Other factors which exacerbate skin ageing are smoking, sun-damage and genetics.

Treatment Options For Jowls & Marionette Lines

There are a number of treatment options for jowls and marionette lines. First of all, it is very important to ensure that you follow a regular skincare routine tailored to your skin type. Two highly effective and non-surgical options that I offer are Botox® and hyaluronic acid dermal fillers. Which of these (if any) is suitable for you will depend on your expectations and the severity of the lines.

Botox® For Jowls & Marionette Lines

For moderate jowls, I offer jawline tightening with Botox®. This treatment can soften the appearance of early jowling and provide a more defined jawline and sculpted neck. Whilst its possible to soften the appearance of marionette lines with Botox®, I do not think that this is the most effective treatment on its own. However, in some circumstances, I combine Botox with dermal fillers for treating marionette lines.

Dermal Fillers For Jowls & Marionette Lines

Since both Jowls and Marionette lines are caused by volume loss and sagging skin in the face, dermal fillers provide the opportunity to treat the underlying problem. For moderately severe lines, I can directly inject hyaluronic acid dermal filler into and around these creases to soften and minimize their appearance. For more severe jowling and marionette lines, I recommend hyaluronic acid dermal fillers to the cheeks to lift the face in addition to adding filler to the areas themselves.

If you have both jowls and marionette lines as well as other signs of ageing such as upper face wrinkles, then you can opt for a combination of Botox® and dermal fillers as part of my liquid facelift package.

LOSS OF FACE VOLUME

The whole mark of a younger face is one with thick, plump and firm skin. Additionally, younger faces have fuller volumes due to the size and location of the facial fat pads. As we age, our faces lose their fullness because of thinning of the skin, loss of elasticity and shrinking in size of the facial fat pads. This loss of face volume results in the appearance of lines, wrinkles and sagging of the face.

What Causes Loss Of Face Volume?

The main cause of facial volume loss is ageing. Over time, our body produces less collagen, elastin and the fat pads in the face reduce in size. This results in thinner and less pliable skin as well as sagging of the face. Similarly, changes in hormonal profile, in particular, oestrogen, can help accelerate this process. Lifestyle factors such as smoking and sun damage also contribute to skin ageing as well as loss of facial volume.

How Does Losing Volume Affect The Appearance Of Your Face?

Loss of skin volume leads to thinner and less elastic skin. This gives rise to wrinkles and uneven texture. At the same time, reduction in the volume of the fat pads, as well as their descent with gravity, occurs. This gives rise to a flatter profile and sagging of the skin in the mid and lower face. Hence this can lead to a gaunt appearance. It is due to this loss of facial fat volume that gives rise to tear trough deformities, hollowing of the temples, malar flattening, nose to mouth lines, jowls and marionette lines.

How To Add And Restore Volume To Your Face Naturally

In my opinion, hyaluronic acid dermal fillers are highly effective for restoring facial volume. This is because they can replace lost volume, help firm up and lift skin, smooth down wrinkles and deliver natural looking results. How much, which type of filler and where to pace them depends on the degree of facial volume loss and your overall face shape. 

The main ways Dermal fillers can help with face volume loss are:

Cheek fillers for contouring and midface lifting

Tear trough fillers for undereye circles and shadows

Restoration of lip shape, definition and volume with lip fillers

Combat sagging, marionette lines and jowls with jawline and lower face fillers

Additionally, face fillers can be combined with Botox as part of my signature liquid facelift to refresh and smooth the face. Collagen induction therapy can also boost the effects of dermal fillers by inducing elastin and collagen formation for thicker and plumper skin.

NECK SAGGING & WRINKLES

As we age, the skin on the neck loses collagen and elastin. This leads to thin and less pliable skin on the neck which gives rise to wrinkles. Loss of fat and skin thickness also leads to the appearance of neck sagging. This is further exacerbated by the shortening and loosening of the platysma muscle around the neck hence causing sagging and banding. The main neck complaint that I see is neck sagging with visible bands as well as wrinkling of the skin.

Treatment Options For Neck Sagging & Wrinkles

Thankfully there are a number of treatment options for forehead wrinkles and frown lines. The first step is to ensure that you have a good skincare routine which helps hydrate, nourish and protect your skin.

Botox® Non-Surgical Neck Lift For Neck Sagging & Bands

Botox® anti-wrinkle injections are highly effective for smoothing out wrinkles and lines on the skin. Furthermore, Botox® can be injected to relax the platysma muscle as well as other muscles that pull on the neck or jawline. This procedure is known as the Botox® non-surgical neck lift. The effect of this is that it lifts and sculpts the neck as well as jawline. The treatment takes 3-4 weeks to work and last for 3-4 months.

Dermal Fillers For Neck Wrinkles

If the main concern is deep lines or wrinkles on the face and a sagging jawline, then dermal fillers provide an ideal non-invasive procedure. Hyaluronic acid dermal fillers smooth put wrinkles and can also be used to sculpt the jawline and lower face and upper neck.

UNDER EYE CIRCLES, BAGS & TEAR TROUGHS

These are all very common areas of concern for both men and women. Under eye circles are dark patches that are visible under the eye. Depending on cause and skin tone, these can look like shadows or discolouration that’s red, blue or green in hue. Under eye bags on the other hand, are swollen pockets or patches under the eye. Both under eye circles and bags can either occur separately or alone. They may also be caused by or exasperated by the presence of a tear trough (this is a loss of fat tissue leading to hollowness under the eye). The most common complaints people tend to have with under eye circles, bags or tear trough deformities is that they give the appearance of tiredness.

What Causes Under Eye Circles, Bags & Tear Troughs?

There are a number of genetic and environmental causes that give rise to under eye circles, bags and tear trough deformities. Some people are more predisposed to developing these and whether they affect other members of your family is a good indicator of your risk. Your skin tone may also play a role. Paler skin tones tend to show up blood vessels more readily and thus give the impression of bluish discolouration under the eyes. Darker skin tones may exhibit increased pigmentation in the under eye area which gives the appearance of shadowing. Aside from genetics, other common causes include:

Ageing: as we get older, the skin under the eyes loses its thickness and elasticity. This thinner and more fragile skin is more likely to show underlying muscles and blood vessels which also gives the appearance of dark circles under the eyes. Sun damage can also cause dark pigmentation under the eyes as well as accelerate skin ageing. Fat loss and reduced skin laxity can also cause under eye bags to appear more prominent. Loss of fat under the skin and skin ageing can also give rise to tear trough deformities.

Diet: deficiencies in Vitamins C and K as well as iron are thought to present with discolouration under the eyes. Diets high in salt can also increase fluid retention which can increase the prominence of under eye bags.

Sleeping: or rather lack of, can result in worsening of under eye circles and bags.

Dehydration: reduced water intake, excess caffeine and alcohol can all cause volume depletion in the skin and lack of laxity.

Sun damage and smoking:  this can cause increased pigmentation and skin ageing both of which give rise to dark under eye circles and bags.

Inflammation and allergies: this can cause puffiness, bags and under eye circles over time.

Treatment Options For Under Eye Circles, Bags & Tear Troughs?

Luckily, there are a wide range of treatment options if you suffer from under eye circles or bags. The first thing is to ensure that you have a good skincare routine which includes using an under eye cream that contains ingredients like Vitamin C, Vitamin K and ferulic acid which help with under eye circles. Another important skincare tip is to ensure that the under eye skin is kept moisturised so having hyaluronic acid in your under eye cream would help immensely.

If the problem is purely due to thin skin or pigmentation issues, then advanced skin treatments like chemical peels and collagen induction therapy can help brighten and firm up the under eye skin. For tear trough deformities and under eye bags, hyaluronic acid tear trough fillers can treat the hollowness under the eyes and rejuvenate the eye area. For more defined tear trough deformities, cheek fillers can help provide support for the tear trough fillers.

Difference between a Tummy Tuck and Liposuction

Tummy Tuck Dubai | 16 July 2019

Tummy Tuck

Also known as abdominoplasty, a tummy tuck is frequently used to remove excess skin from the abdomen. Excess skin often becomes a problem after weight loss or pregnancy and cannot be fixed with diet and exercise. There are two main types of tummy tuck, partial and full, both of which are performed under a general anaesthetic. Sagging skin together with excess fat is removed and the abdominal muscles may be tightened. Stretch marks and areas of older scarring may be removed with the excess skin.

The operation can take several hours, and you will likely have to stay in hospital for a few days afterwards. It can take several weeks of healing before you can return to your full daily activities and several months for bruising and swelling to subside so that you can enjoy the full benefits of your tummy tuck procedure.

Liposuction

Liposuction also aims to improve the appearance of your abdomen. As its name suggests, liposuction removes small areas of body fat that cannot be shifted through diet and exercise. During the liposuction procedure, the surgeon makes small incisions in the skin, breaks up fat cells and removes them with a suction tube. Unlike the tummy tuck, liposuction is not used to remove excess skin and will not eliminate stretch marks or tighten abdominal muscles. It works best on people who already have tight abdominal muscles and supple skin and who are a normal body weight.

Liposuction is usually performed under general anaesthetic, although epidural anaesthesia may also be an option. If only a small area is being worked on, local anaesthesia may be appropriate. The procedure is usually completed in under an hour. You may have to stay in hospital for a night after the liposuction operation. Total recovery time can be as little as two to six weeks. Bear in mind that liposuction is not just confined to the abdomen but can be performed on other parts of the body, such as hips, arms and thighs.

Liposuction and Tummy Tuck together?

It may be the case that you would benefit from having both liposuction and a tummy tuck: it is entirely possible to have both procedures done at the same time. I can advise you what options are right for you.

Weight management following surgery

It is important to note that neither a tummy tuck nor liposuctions are ways of managing your weight. Furthermore, following either procedure it is important to maintain a healthy weight with regular exercise and eating a balanced diet, otherwise the benefits of the surgery could be lost.