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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.

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.

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.

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.

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.

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.

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.

Tummy Tuck Dubai | 10 July 2019

An abdominoplasty, better known as a tummy tuck, is a surgical procedure that requires careful planning and meticulous follow-up care for the best results. Knowing the steps to take before your abdominoplasty will ensure a better recovery process.

Ideally, you’ll have several months in advance to prepare for your tummy tuck surgery. I recommend most individuals give themselves a full six months to prepare, giving them time to find the right surgeon, achieve or maintain their ideal weight and get a plan for aftercare in place.

Some people may not need the full six months of prep before their surgery, and that’s okay. You’ll still want to make sure that you’ve taken sufficient time to research, plan and prepare. The better prepared you are for the big day of surgery, the better your results will be. Use the information below as your guide to planning your tummy tuck.

4-6 months before surgery

As soon as you start thinking about a tummy tuck, it’s time to get serious about your diet and exercise habits. Eating well, drinking more water and staying active should be your focal point. If you smoke, start the process of quitting and limit your alcohol intake if you drink. These two factors can affect the way your body heals and fights off infection. Stress management is also a good thing to implement as chronic stress can affect your health and immune response. In this timeframe, start doing your research and locating plastic surgeons for consultations. Look for expert plastic surgeons with experience in the tummy tuck procedure.

4 months before surgery

By this time, you should be closing in on your ideal weight and fitness level. This is going to help the surgeons you talk with to evaluate your candidacy for surgery and also puts you in a good position to recover quickly. Around 4 months before you want to have surgery, you should begin scheduling consultation and meeting with me. You will feel comfortable discussing your goals, expectations and concerns, as well as feel confident that my recommendations align with what you envision.

3 months before surgery

During your third month of preparation, after you’ve booked surgery, you should be scheduling leave from work, making arrangements for child and animal care and setting up your support system to help with transportation and care during the post-surgery recovery phase. This is something you and your surgeon should discuss and prepare for. By now, you should completely quit smoking. You are continuing with your health and wellness regimen and hopefully feeling great about life and excited for the transformation ahead.

1 month before surgery

The last few weeks before your surgery should be used to stock up on supplies needed for recovery and finalizing the details of your procedure. Staying as comfortable as possible in the initial stage of recovery is going to be your ultimate goal for home care, so now is the time to begin assembling your supplies. I will provide you with a list of supplies to buy. Some extra supplies that people have found to be useful and aid in the recovery process are:

– Extra pillows

– Gauze pads

– Comfortable clothing and underwear that is easy to remove

– Ice packs and over-the-counter medication for discomfort

– Compression clothing if prescribed

Create a meal prep plan to make and freeze food for later. Eliminating the worry of what to eat is going to reduce stress, keep you from grabbing unhealthy foods and help you maintain your new improved eating habits. 

On the day of surgery, dress comfortably and make sure you’ve followed the pre-surgery checklist I provided. You should have time to check in with your surgeon on the day of your procedure, so if you have any last-minute questions, make sure to bring those along too.

Fillers in Dubai | 9 July 2019

Dermal fillers are aesthetic gel based treatments injected into the skin. They are specifically designed to reduce the appearance of wrinkles, contour the face and create volume. Some dermal fillers are also used to hydrate and revitalise your skin.

Dermal fillers are based on a substance that occurs naturally in your body – a sugar molecule that exists naturally in almost all living organisms. Its normal function is to bind water so it acts as a lubricant and shock absorber in movable parts of the body, such as joints. It is also important for the transport of nutrients and in regulating water balance in skin. By boosting your skin with this naturally occurring substance, dermal fillers revitalise and add volume to the area instantly. This diminishes the appearance of lines and wrinkles, and giving a natural softer look. The gel we use is very tissue-friendly and closely resembles that which exists in the body.

What are the benefits of dermal filler?

A single treatment can be seen instantly and can last for around 6 to 24 months depending on the thickness of the product and a number of biological factors of an individual client. We use dermal filler injections to give a natural looking result that does not affect facial expression. As we age, our face changes over time, so dermal fillers allow you to control your looks subtly as you age.

Why are there different names of fillers?

Dermal filler products vary in thickness, anaesthetic content and longevity.  Each brand names each thickness of filler definitely so think of the name as a way to recognize the different product easily.

Do dermal filler treatments hurt?

Depending on the area, I may apply or inject a local anaesthetic to the area to be treated. Some of the fillers already contain local anaesthetic which also makes the treatment tolerable.

Are dermal fillers forever?

I believe temporary fillers are the best option. Permanently filled lips or cheeks could appear out of place as your face changes with natural ageing. The longevity of dermal fillers ranges from 6-12 months depending on the brand, thickness and area treated. Individual body factors such as how fast your body metabolises the product are also relevant to how long the filler lasts.

Are dermal filler treatments safe?

My most used dermal filler is the most scientifically documented HA based dermal filler in the world with comprehensive studies that support its safety and efficacy. It has been used in over 10 million treatments worldwide during the last twelve years and it is safe. Because the dermal filler resembles the substances that occur naturally in the body, the risk of allergic reaction is minimal.

What areas can be treated?

Dermal fillers can be used to smooth away facial lines and wrinkles, create fuller lips and shape facial contours, such as cheeks and chin, and revitalise the skin.

The most common areas treated are:

Nose to mouth lines (the nasolabial folds)

Between the eyebrows (the glabella lines)

Lips (adding volume and shape)

Cheeks

How long does a dermal filler treatment last?

One of the great advantages of dermal filler treatment is that the effects are long lasting but not permanent. Dermal filler products are biodegradable, which means they will naturally disappear in the body. To ensure an optimal and long lasting result, a top-up treatment is recommended 6-12 months after your initial treatment. My staff will guide you on the appropriate time for your follow-up appointment.

Duration also depends on many factors, such as the individual’s skin type, skin condition lifestyle and age. After the initial treatment, follow-up sessions are normally recommended around every 6 to 12 months depending on the individual and the treatment. A treatment of the lips lasts about 6 months.

Can everybody use dermal fillers?

Dermal fillers should not be used in or near areas where there is or has been skin disease, inflammation or skin related problems. Dermal fillers have not been tested in pregnant or breast-feeding women, individuals with medical conditions that lower the body’s immune response or individuals undergoing therapy that is immunosuppressive may be more prone to infection by a skin injection procedure. During your pre-treatment consultation, you should thoroughly discuss your medical history with your treating nurse or doctor.

Are there any risks with dermal fillers?

More than 10 million treatments have been performed since the launch of the original dermal filler in 1996. Product related reactions are very rare. There are however occasional injection related reactions which may occur after any injection; they typically resolve spontaneously a few days after injection to the skin, within a week after injection into the lips. These reactions include redness, swelling, pain, itching, bruising or tenderness at the injection site. After lip enhancement, lips may swell for up to a week, but this typically reduces after two to three days.

Tummy Tuck Dubai | 6 July 2019

After pregnancy or weight loss, excess skin and fat can distort the appearance of the abdomen. In particular, many women find that after their second child or after bearing twins, their muscles and skin do not return to their original appearance secondary to repeated stretch of the abdomen. The abdominoplasty, or “tummy tuck” procedure, creates a flatter, firmer abdomen by removing excess fat and skin, and tightening the abdominal muscles. You are a good candidate for a tummy tuck if you are at a stable weight and are physically healthy, you have realistic expectations, and you do not smoke.

ANATOMY OF THE ABDOMEN

The abdominal wall consists of skin, fat, and muscle. The rectus abdominis muscles, which form the “six pack” of muscles on the abdomen, are covered by a firm sheath called the rectus fascia. This fascial layer frequently weakens and stretches out with pregnancy and weight gain. As a result, once a patient loses weight or has her children, she may be left with laxity of the abdominal wall. During surgery , the fascial layer over the rectus abdominis muscles is tightened, and the excess skin and fat are removed.

SURGERY STEPS

The abdominoplasty procedure is performed with a horizontal incision in the lower abdomen within the bikini line. In patients who have undergone a prior C-section, the incision can be made in the same location and extended to the sides. The rectus abdominis muscles of the abdomen are tightened, and the excess skin and fat are trimmed and redraped. Most abdominoplasty surgeries require repositioning of the umbilicus, or navel through a second incision. In the “mini” abdominoplasty procedure, lower abdominal muscle tightening with fat and skin removal are performed through a limited horizontal bikini incision only, without repositioning of the navel. The resulting scar is usually low on the abdomen, and therefore can be concealed within most bathing suits and clothing. Small drain tubes are placed with both techniques.

ADDITIONAL PROCEDURES

Liposuction is sometimes performed in conjunction with tummy tuck surgery to contour the flanks. Some patients wish to undergo simultaneous breast surgery to lift, add volume, or both. The combination of tummy tuck surgery and breast augmentation or lift surgery is commonly referred to as a “mommy makeover” procedure.

Additional procedures incur additional operating time, anesthesia, and surgical risks.

SURGERY AND ANESTHESIA

The surgery lasts 1 1/2 –2 hours, and is performed under general anesthesia. Many patients worry about the risk of general anesthesia, but it is very safe and it assures that you will be completely comfortable during surgery. Prior to surgery you will be required to obtain medical photographs, routine bloodwork, and in some cases preoperative clearance. The evening prior to surgery, you should not eat or drink anything after midnight. This ensures that you will have an empty stomach prior to surgery, which is very important for your anesthesiologist to care for you safely. You will need to have a responsible adult available to escort you home after surgery.

RECOVERY

Following surgery, you will awaken in the recovery area. Once you are fully alert, you will be transported to the stepdown area where you will be given something to eat prior to discharge. You will have two drains and a surgical garment placed at the conclusion of the procedure. The nurses in the recovery area will demonstrate how to empty and record the output from your drains. A responsible adult will need to be available to escort you home.

Patients are seen in the office one week following surgery. At that time your drains will be removed and you will be placed into a surgical garment. Most sutures placed will dissolve on their own.

Walking is permitted the day after surgery, but strenuous activity and heavy lifting are limited until six weeks following surgery. Most patients do not complain of severe pain following this surgery, but note that the abdomen feels “tight”, as if they have performed many sit-ups. Pain medication is prescribed for any discomfort. Swelling will be present for the initial 2-3 months after surgery, and the final results are typically seen 3-6 months after surgery. The scar will continue to fade and soften for up to one year following surgery, although it will never completely disappear.

WHAT A TUMMY TUCK CANNOT DO

A tummy tuck is not a substitute for weight loss or exercise. If you have ongoing weight loss, or are planning to become pregnant, you should delay your surgery. A tummy tuck cannot correct stretch marks, but it will remove the skin beneath the umbilicus. Stretch marks above this level some- times appear lighter after surgery, but they will not disappear.