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Cosmetic Clinic Dubai | 14 September 2019

As skin ages, it loses elasticity and becomes less supple resulting in lips losing their fullness, lines appearing particularly around the mouth and nose area, and cheeks looking sunken and hollow. Others find themselves unhappy with the general volume in certain areas of the face, but don’t necessarily like the idea of a surgical procedure. Dermal Fillers are popular non-invasive treatments that make it possible to restore volume to hollowed areas, to contour your face and to tackle fine lines and wrinkles. Dermal Fillers can add definition to your face and are particularly effective in creating more prominent cheeks, fuller lips and a fresher smoother appearance.

Dermal Filers Areas treated:

Under the eyes (Tear Trough)

Cheeks (create a fuller cheek or a high cheek bone look)

Lips (Vermillion border and lip augmentation)

Lip Lines (Smoker’s Lines) plumper and fuller lips

Nose to mouth lines (Naso-labial folds)

Mouth to Chin lines (Marionette lines)

Chin (defined chin with fillers)

Nose (Non-Surgical Rhinoplasty / non surgical nose job)

Hands

If you’re considering using Dermal Fillers to regain fullness or volume in the cheeks, lips, or around your face, your most important consideration should always be safety, the expertise of your practitioner and the products being used. All of which will be discussed fully in your consultation, my priority is YOU.

Fillers in Dubai | 13 September 2019

Latest figures show that lip fillers are becoming one of the most sought-after aesthetic treatments, so here is a summary of information about lip fillers or lip augmentation. Here’s your questions answered!

Q: How long does the procedure take?

Less than an hour. First, your injector will cleanse the area and apply a topical numbing cream which takes about 20 minutes to kick in have an effect. Then, the injections themselves take 15 to 20 minutes.

Q: Does it hurt?

When asked to describe the sensation, most people say it can be best described as an immediate pricking sensation, then uncomfortable pressure as the filler moves throughout the lips.

Q: Will they look good straight after?

You do see immediate volume, but you may see a few days of bruising and swelling.

Q: What about the side effects?

There can be some small bumps under your lips, though this is rare. They usually smooth out on their own within a week or two, but if not, your injector can remove them. While rare, more serious complications (like a blood clot) can occur.

Q: How do I take care of them after?

Gentle treatment without harsh products and no touching your lips for 48 hours after the injections. And hold off on exercise for a few days, as it speeds up your blood flow, which can break down the filler.

Q: How do I maintain them?

Touch-ups every three months to a year. Certain factors like filler consistency and lifestyle can affect longevity.

Q: What if I hate them?

Your doctor can dissolve the filler by injecting lips with the enzyme hyaluronidase. This can only be done two weeks after the filler was injected. If you are not sure about the level of volume less is more its far easier to add more filler than take it away.

Fillers in Dubai | 9 September 2019

What are Wrinkle Relaxing (Botox®) Injections?

Wrinkle relaxing injections are more commonly referred to as Botox®, short for Botulinum Toxin. Botox® itself is a registered trademark and brand name by the market leader, but other Botulinum Toxin products are available. 

Whatever you call it and regardless of brand, Botox® when injected acts as a nerve block.  So what really happens is your brain sends the message to the muscle to move, however the nerve can no longer respond as the Botox® has blocked the message being sent, resulting in a reduction in the movement of the muscle. This helps to reduce the appearance of lines and wrinkles, as these are caused by repetitive contractions of the muscle. It’s also used to relax tight muscles, which is more common in the lower face.

The thing to remember here is that this is only a temporary effect, eventually the Botox® wears off and the muscle starts moving as it did previously.

Is Botox® safe?

Botox® has been used in cosmetic procedures for at least the past 50 years – yes that’s right, it’s been around that long!  Once reserved for the rich and famous due to its cost, it is now used widely mainly due to the reduction in the cost of treatments over the past 20 years.  It is extremely rare for individuals to be allergic to Botox® or have anaphylactic reactions to it post injection. 

What is Botox® used for?

More and more studies are carried out on Botox® every year and the list of the conditions it can treat almost seem endless, it is now known to significantly reduce facial scarring after trauma and also reduce psoriasis skin plaques; it really is a wonder drug. I use Botox® on both men and women to smooth out lines and wrinkles around the eyes, on the forehead and the glabella (between the eyebrows). I also use it to relax muscles around the lower jaw and smooth out the neck, this procedure is called the Nefertiti Lift.

You can also use Botox® to treat Hyperhidrosis,also known as excessive sweating. Although you can have the palms of your hands and the soles of your feet treated, the most common area tends to be the armpits.  It’s a highly successful treatment that can significantly reduce the amount of sweat produced under the arm and for real sufferers of excessive sweating, this treatment can be a real lifesaver, especially during the summer months.

People also use Botox® to help alleviate the symptoms of migraines, unlike other headaches migraines are transmitted across the nerve endings of the forehead, by having Botox® in this area and blocking the nerve endings the migraine isn’t able to travel and for many people it will stop it altogether.

Are there any side effects to Botox®?

The most common side effects are slight swelling at the injection site, this is normal and shows that the Botox® has got into the muscle; these little bumps will go down within approximately 40 minutes.  You may also have some redness around the injection site and you may get some bruising.  If you do get bruising it is likely to be small pin prick marks which will may take up to 7 days to completely disappear.  Some people do suffer with headaches post treatment, if you do just take Paracetamol or Ibuprofen as you would do normally.

One side-effect of Botox® that concerns people is something called a ptosis, these are related to injections of Botox® in the forehead when post treatment the brow drops and feels very heavy.  Full ptosis is extremely rare, however what is more common is something called a partial ptosis, if you get a partial ptosis it is unlikely that anyone else will notice and it will resolve within about 4-6 weeks. 

How quickly will I see results from a Botox® treatment?

You will start to see results about 4 days post treatment, however it could take 10-14 days for the full results to be seen.  We expect to see a significant reduction in the size and the depth of the lines and wrinkles 14 days post treatment.

How long do the results last?

Typically results can last between 3-6 months, generally you start to see some muscle movement around 3 months post treatment, however it takes about 5-6 months for full muscle movement to return.  Most people tend to have Botox® treatment every 4 months, the more you have it done, the longer the results tend to last.

Will Botox® make me feel numb?

No, everything will feel just as it did before, you will not have any reduced sensation in the area you’ve had treated.  Some people have reported that their forehead feels “tight” and occasionally the brow may feel a little heavy, but these feelings are likely to reduce over the first 4-6 weeks following treatment.

How should I prepare for a Botox® treatment?

If you are concerned about bruising, or you tend to bruise easily avoid taking Aspirin, Ibuprofen and Vitamins for 3 days before treatment. 

Fillers in Dubai | 4 September 2019

What are dermal fillers?

Dermal Fillers is the name given to products which can be injected into the skin to rejuvenate areas which have over time lost volume, however they can also be used to add volume to areas that we want to accentuate, typically the lips and cheeks. Commonly Dermal Fillers are composed of a substance called Hyaluronic Cross-Linked Acid (HA), which is something the skin naturally produces.  (There are also other Dermal Filler products that use other products such as polylactic acid and calcium hydroxylapatite, but this post concentrates on HA)

How do they work?

Over time, our body reduces the amount of Hyaluronic acid it produces, which is associated with skin ageing. Hyaluronic Acid comes pre-packed syringes in a gel form, which is injected into the skin. This gives an instant plumping effect, however the Hyaluronic Acid also attracts approximately 500 times its own weight in water, which gives a secondary plumping effect and also gives the skin a really lovely rejuvenated and rehydrated appearance.

What areas can they be used to treat?

Dermal Fillers can be used to treat almost any problem area on the face, hands, neck and décolletage.  Typically though they tend to be used for: nose to mouth lines, marionette lines (from the corner of the mouth to the chin), cheek enhancement, lip enhancement, smoker’s lines on the top lip or any fine line or wrinkles.

What are the benefits?

Dermal Fillers really do have anti-ageing properties, anecdotally people have said that even when the product has worn off the area that was treated never truly goes back to the way it was.  This is because of the positive effect hyaluronic acid has on collagen and fibroblast production.

What is the difference between Dermal Fillers and Wrinkle Relaxing Injections?

I get asked this question a lot and I think it’s really important for the client to understand.  Wrinkle Relaxing Injections consist of a neurotoxin Botulinum Toxin being injected into the muscle, which causes temporary paralysis of the muscle.  Whilst the muscle isn’t moving, the skin is able to iron out and lines and wrinkles appear less obvious.  The important thing is that word temporary; after 3-4 months the muscle will start moving again, with full movement returning around 6 months later.   Hyaluronic Acid-based Dermal Fillers involve a completely natural product being injected into the skin to plump up areas which have lost volume or to areas that you want to accentuate.

Is it safe?

The Hyaluronic Acid used in Dermal Fillers is almost identical to what is created naturally by the body, so you would be extremely unlikely to have an allergic reaction to them.   The most common side-effects include bruising, swelling and redness which typically clear up within 7-10 days. Less common side-effects can include migration of the product from the area it was injected, which can be easily fixed by dissolving the product with an enzyme called hyalauronidaise. Very rare side-effects can include granulomas, which are little lumps created by the body as a form of reaction to the Dermal Filler, and necrosis caused by the Dermal Filler being injected into a vein.   

Fillers in Dubai | 1 September 2019

What are lip fillers?

Lip fillers – also known as ‘lip enhancement’ or ‘lip augmentation’ – is a popular cosmetic procedure that results in fuller and plumper lips. Lip fillers used to involve the injection of collagen, but these days dermal fillers are the most common method of lip enhancement as they last longer and are much more stable than collagen. There are a lot of different types of dermal filler that can be used for lip filler treatments. The most common of these are fillers that contain substances similar to hyaluronic acid – a natural substance found in the body that increases the volume of your lips. Once they are injected, hyaluronic acid fillers add support and shape to the lip tissue. The benefits of using this kind of lip filler include:

Lip volume control

The amount of substance injected can be easily controlled, so the practitioner has a high degree of control over how much more volume is created.

Gradual treatment

These injections can be administered gradually over time, so the patient can have several different appointments until they achieve the desired results.

Lumps dissolve quickly

Any lumps and bumps that are created by movement of the lips dissolve quickly and easily.

Less bruising

Compared to other dermal fillers, there is usually a lot less bruising when using hyaluronic acid fillers.

Long lasting results

Although they are not permanent, the results are very long lasting.

How long do lip fillers last?

The effects of lip fillers typically last approximately six months. After that, more injections will be needed to maintain the desired volume of your lips.

What to expect when getting a lip filler treatment

Lip filler treatments are usually very quick and simple procedures that can be carried out quickly. Before receiving the injections, either a topical or local numbing agent will be applied to the treated area to ease any potential discomfort. It is also not uncommon for nerve blocking injections to be used – which are similar to the type of anaesthetic injections applied by a dentist to numb your mouth. Following this your practitioner will carefully mark the areas of your lips that are to be injected, and then very fine needles are used to inject the dermal filler substance into your lips. After the injections ice might be provided to help ease any discomfort and reduce any swelling. This should only be applied lightly though, as no firm pressure should be put on the treated area immediately after the injections. Lipstick and any other lip products should also be avoided following the lip filler procedure.

Cosmetic Clinic Dubai | 30 August 2019

Platelet Rich Plasma (PRP) therapy, also known as the ‘Vampire Facelift’ or ‘Dracula Therapy’, works on the basis that the body’s own natural healing powers may slow and even reverse the ageing process. It is a revolutionary repair system that places growth factors in the exact location where we want the skin to repair and rejuvenate itself.

Platelets contain a high content of “growth factors” – proteins that help to heal injured tissue or damaged skin. Upon re-injection the platelets release their growth factors which trigger surrounding cells to proliferate, in turn stimulating repair, increasing volume and rejuvenating the skin.

A state-of-the-art Concentrated Platelet Rich Plasma System enables me to process large amounts of whole blood which means that more areas are able to be treated during the session and that patients aren’t required to have as many sessions throughout the year. The blood is taken from the patient during the treatment, then treated (in a centrifuge) to harvest the platelet rich plasma which will be activated and re-injected into the desired area. The therapy plumps the skin, fills out fine lines and wrinkles, and gives an overall more radiant appearance. The procedure also has fantastic healing benefits for injuries.

Blepharoplasty Dubai | 28 August 2019

You may feel that your eyes look tired and puffy. Lower eyelid surgery could reduce the bags and puffiness beneath your eyes. Helping you to achieve a more youthful appearance. The skin under the eye is very thin and as we age the muscles around the eye weaken and the fat deposits shift. In addition, the collagen in skin starts to breakdown and in time the skin loses it elasticity. There are two different types of lower eye lid surgery to remove the fat deposits from beneath the eyes.

Outside – An incision is made outside the lower eyelid. It removes excess skin, fat deposits and sometimes muscle tissue from beneath the eye.

Inside – A single incision is made inside the lower eyelid. It is for those who have fatty deposits which need removing but do not have any excess skin.

Seven to ten days after surgery you should see an improvement and you will have brighter eyes with the youthful look you desire.

Blepharoplasty Dubai | 26 August 2019

What to expect after the operation

Eyelid reductions for the lower lid, or the lower and upper lids, are usually carried out under a general anaesthetic (so you would be asleep), or a local anaesthetic and sedation (where the whole area is numbed with injections and you are awake but sedated to keep you calm). Eyelid reductions for the upper lid only are usually carried out under local anaesthetic. The operation usually takes one or two hours.

You might be given antibiotics to keep the wound clean. You might go home the same day, or stay in hospital overnight. If you do go home on the same day, a responsible adult should stay with you for the night. Simple painkillers should be enough to keep you comfortable. After the surgery you should not drive or use machinery for at least 24 hours, until you have recovered feeling, movement and co-ordination.

It is common to have watery eyes after an eyelid reduction, partly because of swelling under the conjunctiva (the membrane that covers the front of the eye and lines the inside of the eye socket) and partly because the tear ducts are swollen and do not drain properly. This will last a few weeks. I may give you eyedrops to help to ease the feeling of grittiness. After surgery, the eyelids might look and feel tight when closed because of the swelling and because skin has been removed. If you cannot completely close your eyes at night you should apply some eye ointment before going to sleep. This tightness will ease as the swelling goes down.

Dressings

I may apply some suture strips to support the eyelids. If these become crusted they can be replaced. Cleaning the eyes with water is useful, and the surgeon may advise you to use eye drops or ointment. Sleeping propped up will help reduce swelling and will help you stay on your back. Using cold compresses on your eyelids for one or two days can also help to reduce bruising and swelling. Do not put ice directly onto your skin.

Stitches

The stitches are usually removed after three to five days, and you will be able to use make-up soon after. You may be advised to use the suture strips to support the lower eyelids for a week or so.

Recovery

You will be out of bed on the same day as your surgery. You may have a little bleeding from your eyelids for the first day or two after your operation. Dab this away gently with gauze squares or a clean handkerchief. Activities that increase the blood flow in your face (for example, bending over, straining, lifting or taking a hot bath) may increase the chance of bleeding, so avoid these for the first week. Sleep with extra pillows to keep your head raised and be gentle with your eyelids for at least another month. You can gently clean your eyes with wet gauze.

You will be able to do light activities after one or two weeks. Most patients take at least two weeks off work after the operation, depending on their job. With all activities, start gently. Do not drive until you feel safe and are comfortable wearing a seatbelt. Check your insurance documents if you are not sure.

Seeing the results

At first your eye skin may seem too tight and swollen, and you will have some bruising, which can be disguised with make-up and dark glasses. It can take a few weeks for the swelling to settle, and many months for the final result to appear. The scars will be pink for a few months, but eventually they become almost invisible. The scars may also become tight after a few weeks, but this normally settles after four to six months. Most patients are pleased with the final result, but some find their new shape difficult to get used to. This may happen to you.

Your aftercare

To protect your body, and get the best result, look after yourself. Avoid vigorous activities after your operation. Protect your wounds as you are told to. Putting on weight will affect the results. Maintain a healthy weight and level of exercise.

Cosmetic Clinic Dubai | 24 August 2019

Perioral lines, loss of volume to the lips, nasolabial folds and marionette lines are all common lower facial concerns that patients present with when seeking aesthetic treatment. In addition, a sagging jawline is a key indicator of facial ageing and often has a significant impact on a patient’s appearance. The combined effects of gravity, progressive bone resorption, decreased tissue elasticity, and redistribution of subcutaneous fullness all contribute to the manifestations of facial ageing;1 however, there are a number of non-surgical options available to help lift and contour the lower face.

Consultation

Every patient benefits from a full face consultation where I look at the structure, the soft tissues and the proportions of their face. It’s interesting for patients to learn how each part of the face relates to the bit beside it, and never is this more true than for the lower face, which shows the effects of everything that happens above it. In my consultations, I will talk through each part of the patient’s face and point out the cause and effect of each aesthetic concern. Doing so, allows patients to understand that lower face ageing is generally a result of ageing of the mid-face and helps patients to recognise that only addressing one concern is not necessarily going to have an overall positive effect. Performing a full face clinical analysis helps to understand where I can get an uptake of extra skin and still keep results looking natural. I use specific measurements tailored to each patient to know where to treat to ensure that the patient looks natural, but also better.

Dermal fillers

Administering dermal filler treatment can offer significant improvement to the contour of the jawline. While hyaluronic acid (HA) can be used successfully, A treatment of choice is RADIESSE (+), a dermal filler composed of small calcium hydroxylapatite (CaHA) microspheres that is suspended in a soft gel matrix. Once injected, it aims to provide immediate volume and correction, as well as stimulate the skin to produce its own natural collagen.

Patients get dynamic results as it can really sharpen the jawline. As it contains CaHA, resorption of the gel occurs over three to six months so you will get increased dermal depth, more collagen and more/better quality elastin. Regardless of the type of filler used, the use of a cannula when treating the jawline to avoid the risk of injecting an artery. The facial artery in that region is protected by the superficial muscular aponeurotic system (SMAS), so it’s not easy to accidently go underneath that fascia with a cannula. By using a cannula I can stay in the plain where there are no major arteries and I would feel it if I moved out of this area. Successful results are achieved by injecting subdermally with lots of little passes. I examine the jawline in three dimensions, aiming to straighten it – particularly with the formation of jowls – sharpen and then contour it. In my experience, treatment results usually last for a year, however, in some cases it can last up to 18 months.  

Blepharoplasty Dubai | 22 August 2019

The skin loses its elasticity and our muscles slacken with age. For the eyelids this results in an accumulation of loose skin which collects as folds in the upper lids and forms deepening creases in the lower lids. At the same time there is slackening of the muscle beneath the skin allowing the fat, which cushions the eyes in their sockets, to protrude forward to give the appearance of bagginess. In some families there is an inherited tendency for bags to develop during early adulthood before any skin changes.

What is blepharoplasty surgery?

Blepharoplasty surgery, commonly known as an eyelid reduction, is an operation to reshape the eyelids. An upper-eyelid reduction can improve your vision and make you look younger. A lower-eyelid reduction can help to reduce wrinkles and puffiness.

Why have an eyelid reduction?

With age, our muscles slacken and the skin loses its elasticity. For the eyelids, this results in folds in the upper lids and deepening creases in the lower lids. Also, the slackening of muscle beneath the skin allows the fat which cushions the eyes in their sockets to bulge forwards to give the appearance of bagginess. In some families there is an inherited tendency for bags to develop during early adulthood.

Folds, creases and bagginess often seem worse in the morning, particularly after periods of stress and lack of sleep. This is because fluid that is normally distributed throughout the body when it is upright tends to settle in areas where the skin is loose, such as the eyelids, when a person is lying down. The ageing process can also cause drooping of the eyelids, and folds of skin to gather in the upper eyelids. Sometimes there is so much skin that the upper lids hang over the eyelashes.

What will happen before my operation?

We will meet to talk about why you want surgery and what you want. I will make a note of any illnesses you have or have had in the past. In particular, you should tell me if you have ever had any thyroid disease, high blood pressure, diabetes or eye disorder (such as a detached retina or glaucoma). I will also make a record of any medication you are on, including herbal remedies and medicines that are not prescribed by your doctor. I will examine your eyes, face and skin, and may take some photographs for your medical records. I will ask you to sign a consent form for taking, storing and using the photographs.

I will measure your height and weight to make sure that it is safe to do an operation. If you are overweight, pregnant or planning to become pregnant, I may suggest delaying your operation. If you would be having the surgery under a local anaesthetic, I will make sure that you can lie flat and still. I may want you to be checked out by an ophthalmologist.

How is the surgery performed?

Eyelid reductions can be carried out under local anaesthetic or general anaesthetic. In a typical procedure, I make cuts that follow the natural lines of your eyelids – in the creases of the upper lids and just below the lashes in the lower lids (see the eye on the left of the diagram opposite). These cuts are extended a little way into the crow’s feet (also known as laughter lines) at the corner of the eyes.

What is the alternative treatment?

Sometimes, a sagging forehead and eyebrow can make the eyelid look like it is sagging. I may recommend an eyebrow lift instead of, or at the same time as, an eyelid reduction.

Only wrinkles in the skin which is cut away by the surgery will be improved. Folds of skin extending on to the cheek will not normally be improved. If you have wrinkles and saggy skin elsewhere on your face and neck, it may be useful to have a facelift or necklift (or both) at the same time as the eyelid reduction. A facelift can be used to not only lift the eyebrow and the upper eyelid, but also to lift and open the outer corner of the eye.

Although an eyelid reduction is the best way to reduce sagging of the eyelid, a laser can sometimes be used to burn the surface of your skin in a controlled way. This is called laser resurfacing and it can be carried out at the same time as the eyelid reduction to improve any remaining wrinkles. After laser resurfacing, the skin heals to be softer and less wrinkled. This improvement is not permanent, and the procedure does not work well on dark skin. It has no effect at all on dark circles under the eye.

Botox (injections of the botulinum toxin) can also be used to smooth out fine wrinkles.