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REJUVENATE AND TIGHTEN SKIN IN THE FACE, NECK & BODY WITH J PLASMA RENUVION

Aesthetic Medicine Dubai | 18 June 2020

Loss of tissue elasticity and tone is a hallmark of aging skin. It is the characteristic change that makes one start to look older than one feels inside. Until recently, no surgical procedure or energy source achieved consistent significant tightening without an extensive recovery. Now, whether ultrasonic liposuction is used in conjunction with J-Plasma Renuvion for skin tightening or not, there is hardly an area of the body that cannot be treated.

WHAT IS J-PLASMA RENUVION?

J-Plasma Renuvion is a revolutionary minimally invasive procedure that uses cold plasma energy on the underside of the skin to instantly tighten and rejuvenate anywhere on the face and body. A unique alternative to traditional facelifts, tummy tucks, and body sculpting, the J-Plasma Renuvion procedure will shrink and sculpt loose and lax skin without large incisions, downtime or complications of cosmetic surgery.

J-Plasma for the face uses cold plasma energy under the skin to lift, tighten and rejuvenate the face and neck giving you natural-looking results with minimal downtime and no complications of a traditional facelift. J-Plasma Renuvion is unique because the cold plasma energy applied under the skin creates instant skin contraction resulting in improved laxity, tightening and shrinkage.

AM I A CANDIDATE FOR THIS SKIN TIGHTENING PROCEDURE?

Renuvion is a treatment option for patients who want skin tightening results, but do not want to do invasive plastic surgery. No other minimally invasive technology will tighten the skin to this degree with such a:

– tiny incision

– little or no scarring

– minimal downtime

BENEFITS OF J-PLASMA RENUVION FOR THE FACE

– Immediate skin tightening

– Improved skin elasticity

– Eliminates crepey skin

– Scar reduction

– Reduction and/or elimination of age spots, sun damaged pigment and 

   freckles

– Reduction of wrinkles and lines caused by ageing and weight changes

– Tightening of loose skin in known problematic areas of the face

– Improvement of skin texture and tone around the lips, eyes, cheeks, 

   forehead, jaw and neck

– Reduction of eye bags and crow’s feet

– Reduction of acne and pigment issues (chloasma)

J-PLASMA RENUVION COMMON TREATMENTS

Both women and men can undergo J Plasma treatment. However, it is most popular with women and the most common treatment areas are:

– Face

– Neck

– Breasts

– Stomach

– Arms

– Thighs

WHAT IS PLASMA ENERGY?

Cold plasma is created when helium gas is energized by radiofrequency energy and delivered through the J-Plasma device. Because Helium gas is very stable, it can be ionized at very low energy ensuring flexible, precise and safe delivery. Cold plasma is cooler than laser energy making J-Plasma Face a safer procedure with less risk and damage to the tissue and affording patients a quick recovery. The level of improvement and rejuvenation from cold plasma energy is unrivaled in current technologies. No laser, ultrasound or radiofrequency treatment is capable of tightening and firming skin to this level.

J-PLASMA RENUVION CONSULTATION

During your consultation, Dr. Vigo will evaluate your skin elasticity, and your underlying muscle tone. He will thoroughly explain the technique along with its risks, benefits, and recovery times.

J-PLASMA RENUVION FACE PROCEDURE

Performed in a day care facility  and using local anesthesia with sedation, Dr. Vigo starts the J-Plasma (Renuvion) procedure with three tiny, hidden incisions under the chin and behind each ear. He will then use the J-Plasma device sub-dermally (under the skin) to deliver cold plasma, which instantly tightens, shrinks and rejuvenates skin from the inside out. Results are immediate and continue to improve as your body continues to heal. A compressive garment is needed post operatively in order to enhance the result of the procedure.

DOES THE PROCEDURE REQUIRE GENERAL ANESTHESIA?

J-Plasma Renuvion can be done under general anesthesia, sedation or even local anesthesia only for limited areas.  

HOW MANY J-PLASMA RENUVION TREATMENTS WILL I NEED?

J-Plasma Renuvion is a single treatment. You will start seeing results soon after surgery, but the skin continues to tighten over the next several months and up to a year as the skin remodels and deposits new collagen.

RECOVERY AFTER J-PLASMA RENUVION SKIN RESURFACING

Although most patients are up and about at 2 weeks, there is still redness/erythema that lasts approximately 4 weeks. The energy penetrates deep into the skin for maximal result which does lengthen downtime. This is in contrast to J-Plasma Renuvion tightening where I have had patients go back to work within a few days. For limited areas, most patients only require a pain reliever during recovery. 

RECOVERY & SIDE EFFECTS

Recovery from Renuvion procedures can take between two to three weeks depending on the extent of the procedure and the target area.

Larger body parts generally require more downtime and patients will feel more symptoms than that of smaller target areas. Patients should expect to experience symptoms for up to three weeks post treatment. These can include:

– Dry skin

– Peeling skin

– Mild pain

– Redness

– Swelling

– Itching

– Bruising

Medication can be taken to curb symptoms if at any point you feel uncomfortable. However, symptoms are very rarely severe and patients can usually return to regular light activities after two to five days.

It is common for patients to experience a ‘tight’ feeling in the area that has been treated as the sensation post treatment is different than before.

In addition, compression wraps can be worn day and night in the immediate recovery phase to help with the healing process and ensure a more comfortable resting / sleeping state.

However, every patient is different and no two are the same. So if you are feeling like you are experiencing more symptoms than you should, contact your clinician for assistance and advice.

FULL LIPS = YOUTH + BEAUTY

Fillers in Dubai | 16 June 2020

Full lips have always been associated with youth and beauty. Because of this, lip enhancement is one of the most frequently requested procedures in a cosmetic practice. 

The objective in treating the upper lip is to artistically create a form that harmonizes with the patient’s unique facial features and takes into account the age and ethnic background of the patient. The goal in treating the lower lip is to create bulk and greater prominence and artistic projection of the vermilion. The physician must establish appropriate guidelines and patient expectations for augmentation relative to normal lip proportions in order to avoid a cartoon-like appearance.

Any physician performing lip augmentation should recognize that temporary fillers can cause permanent stimulatory effects in tissues.After 2 or 3 sessions of lip augmentation, full correction may be obtained and persist indefinitely. Patients may return for additional filler merely because a certain amount of time has elapsed since their last injection, but the physician must evaluate the proportions of the lips to truly determine if additional filler is warranted. It is helpful to have a hand mirror for the patient to observe her lip proportions as the doctor seeks to determine whether more filler is needed. It is also beneficial to show the patient her lips from the lateral view; digital photography is extremely useful in this regard.

THE PROCEDURE

It’s important to see your box of injectables opened in front of you and to be sure only your dermatologist or plastic surgeon is doing the injections. Avoid blood thinners, like aspirin and fish oil, for at least a day beforehand, which can increase bruising. If you opt for numbing cream, expect it to be placed on the lips for approximately 10 minutes. The lips absorb quickly and do not require lengthy topical anaesthesia. Then, the skin surface should be cleansed properly and then injections are performed. Your doctor should go very slowly, often pausing to show you the progress that he or she is making. There is a real balance and art to it, I find that you really need to go little by little, so you normally inject the top lip first, balance it out on the other side, then inject the bottom lip. It takes about 15 to 20 minutes. What you see is what you get, you’re not waiting for it to work, like Botox.

Some doctors will gently mould the filler with their fingers after it is injected by squeezing and patting it into place, while others aim to inject it exactly where they want it and avoid moulding, since it can increase bruising and swelling. Based on my extensive experience, there is no single stance on moulding – it’s a technique that some like, while others do it sparingly.

Your doctor should let you chime in along the way and help decide whether or not to add more or stop. I even recommend my patients go lighter than they think they may want, live with it for a week, and then decide whether or not to do more. “It’s best to start with baby steps.

After the injections, ice packs are applied. That evening, I suggest patients sleep on two pillows to decrease swelling. Use ice sparingly at home (getting the H.A. too cold or hot can prevent it from settling properly) and ask your doctor if additional anti-swelling measures are right for you, like oral antihistamines, pain relievers, or topical corticosteroids.

The entire procedure should take under 30 minutes.

NATURAL RATIO

It’s no secret that some lip augmentations look incredibly natural and some look not so incredibly natural. This is partially because of the size that you and your doctor select, but it goes deeper than that. The fact of the matter is that some doctors have a better feel for nuance and aesthetics than others.

It’s something you have to have an appreciation for, to get the proportions right for each person. There is a lot more artistry to injecting lips than just injecting a wrinkle or a line. That is another reason why the consultation is so important. I show actual before and afters of my patients, so that everyone has a realistic expectation for the type of filler I do.

Selecting where, and at what volume, to inject the lips is also an important decision to make in the consultation. The lips are supposed to be filled in a natural ratio, where the upper lip is approximately 2/3 the size of the lower lip.

That means that sometimes, only one lip needs to be filled, sometimes both, and often at different volumes, since not everyone’s pout is symmetrical. Where to inject is also a delicate matter. The lips can be injected into the skin surrounding the lips (to define the Cupid’s bow, for example), into the lips (for fullness), and into the lipline (for definition). It’s like sculpting.

Creating Philtrum Columns

Sculpted philtrum columns are in style today. As we age, these well-defined longitudinal pillars are lost, leading to a flattened, ill-defined, unattractive upper lip. If the patient still has discernible philtrum columns, the object is to further enhance them. If the philtrum columns have been completely effaced, it is imperative to re-create them. This is accomplished by superficial vertical injection of filler into each philtrum column. It is important to realize that the philtrum columns are not parallel to each other, but rather they form an inverted “V” that narrows as it approaches the nostril sills and columella of the nose.

Creating Cupid’s Bow

The pouty, Cupid’s bow appearance of the central portion of the upper lip is considered sexy, desirable, and very much in fashion today. 

Creating Lower Lip “Pillows” or Tubercles on Each Side of the Midline

Here I ask the patient to evert the lower lip. I deposit approximately ~0.1 cc of filler as a depot injection into the orbicularis oris muscle at the vermilion-mucosal junction on each side of the midline. The depot injection is about one third of the distance from the midline to the oral commissure. This is gently massaged to prevent superficial lumpiness. 

Supporting or Bolstering the Oral Commissures

Placing a small amount of filler in the most lateral aspect of the cutaneous lower lip so as to provide upward support to the commissures. Injectable neuromodulating agents (botulinum toxin A) placed into the depressor anguli oris muscles can be used as an adjunct to further elevate the commissures. This combines structural support with chemical neuromodulation to shape the oral commissures. 

Filling the Nasolabial Creases

Placing a small amount of filler in the upper portion of the nasolabial crease helps to evert the upper lip. Augmentation lateral to the nasolabial crease only serves to deepen the appearance of the crease.

POST-INJECTION CARE

Cool compresses and ice packs can be used to minimize swelling and bruising. Patients should be advised to avoid ASA, NSAIDs, and other medications associated with an increased risk of bleeding. If anti-HSV I medication was prescribed, it should be continued according to physician recommendation. Because HAs are hydrophilic, they attract water from the surrounding tissues and further augment the soft tissue volume beyond that expected from mere implantation. The significant swelling of the vermilion in the immediate post-operative period may be camouflaged by applying flesh-toned foundation or concealer to the entire vermilion. Lipstick can then be applied to a smaller portion of the vermilion than usual so as to not exaggerate the swelling that may be present.

 

SELECTING THE RIGHT FILLER

There are a lot of difficult decisions you have to make when it comes to getting lip injections, but fortunately, picking the right filler isn’t one of them. Hyaluronic acid, in a few different forms, is both the industry standard for temporary lip injections and the only temporary lip filler approved by the FDA. 

They’re marketed under different brand names – Restylane Kisse, Neauvia Lips, Juvederm Volbella – but they’re all made from the same molecule, which is hyaluronic acid, as you may already know, naturally occurs in skin and is a top ingredient in hydrating skin-care products, since it plumps skin by capturing and holding onto water. Picking which of the formulas is best for you is really up to your doctor. Hyaluronic acid is not only the best option, but the only option for those new to the world of injections, since it will dissolve on its own and is well-tolerated, since it’s already in your body. There are irreversible fillers and implants, but those are not for beginners. 

PAIN MANAGEMENT

Lips are one of the more uncomfortable places to inject filler. We have a lot of nerves in our lips, so I can do a combination of topical numbing cream and, sometimes, injectable numbing medications, so patients are comfortable. However, many of the H.A. injectables come with lidocaine (a numbing pain reliever) built right in, so some doctors opt out of additional measures.

One, or a combination of the above pain-reducing options, will normally temper the pain of the actual procedure, but you’re likely to experience pain later, since the skin is being stretched. The pain as mild to moderate and notes that it can last for a few days.

SIDE EFFECTS

Any time there is a needle crossing the skin, there is a risk. Bruising, swelling, and pain – all of which can last up to days and in rare cases, even weeks – may occur. There is also the risk of infection. Naturally, this makes it very important to check in with your doctor post-treatment, especially if you’re feeling nervous about side effects.

While hyaluronic acid is a naturally occurring substance in your body, you can still have an allergic reaction to H.A. injectables, since there are often inactive ingredients (like carrying agents) and pain-reducing ingredients (like lidocaine) in the formula. Those prone to allergies or are just plain nervous can do a patch test on their forearm a few days before the procedure to be sure they won’t have an adverse reaction.

Injecting the lips can prompt cold sores for those who are prone to them, so he normally pretreats those patients with a round of anti-viral medication, like Valtrex.

There are also less common side effects that are important to consider. More rare side effects include nodules or palpable material within the lips – basically bumps of H.A. that don’t settle or feel natural. Extremely rarely, lip filler can be introduced into a blood vessel in the lip, which can have more significant consequences if not dealt with immediately and appropriately.

WHAT TO EXPECT

One of the great things about lip injections is that the results are instantaneous, so you’ll leave the office with fairly accurate (albeit swollen) results. For the first 24 to 48 hours, the filler is malleable and your skin is prone to swelling, which means be gentle! This is noted as the time that your injections need to “settle.” No facials, yoga, or exercise is recommended, which can alter the placement of the filler and increase swelling and bruising.

Lips often swell for one to three days after treatment, but this is highly variable and some patients will experience no swelling and some will have more dramatic swelling that will take longer to subside. Bruising can last approximately one week, but can be covered with makeup or lipstick, as needed. Some doctors will offer to treat more significant bruising with a laser treatment if necessary.

While the average length of time H.A. fillers will last is about six months, it varies for everyone, from around three months to a year.  H.A. lasts different lengths, depending on where you put it and how active that body part is. I find that if the labelling says six to 12 months, patients normally come back every three to six months.

 

PLATELET-RICH PLASMA THERAPY FOR HAIR LOSS

Aesthetic Medicine Dubai | 11 June 2020

Are you looking for a hair loss solution? A therapy that promotes healing in injured joints may help restore your lost hair.  

Millions of men and women have male- or female-pattern baldness. It can begin early in life, but is much more common after the age of 50, when more than 50 percent of men will experience some kind of hair loss.   However, an emerging treatment — platelet-rich plasma (PRP) therapy — appears to help regrow lost hair. And, there are virtually no side effects from PRP, except for a mild feeling of pressure at the injection site.

HOW DOES PRP THERAPY WORK? 

Physicians began using PRP therapy about a decade ago to speed up the healing process in damaged joints after injury or surgery. During the treatment, a technician draws your blood and spins it in a centrifuge to separate out the platelets and plasma. Doctors then inject the plasma, which helps repair blood vessels, promote cell growth and wound healing, and stimulate collagen production.

Doctors began using PRP in dermatology after researchers found that high concentrations of platelets in plasma cells help promote hair growth by prolonging the growing phase of the hair cycle. Doctors inject plasma into the scalp where hair loss has occurred. They typically administer injections monthly for three months, then spread them out over about three or four months for up to two years. The injection schedule will depend on your genetics, pattern and amount of hair loss, age and hormones.  

HOW DOES PRP THERAPY COMPARE WITH OTHER OPTIONS? 

Other treatments for hair loss currently on the market are often more problematic for many patients.  There are two medications for treating hair loss: finasteride and minoxidil. But you must take these drugs consistently over time and results are inconsistent. Each drug also sometimes has side effects: 

• Minoxidil may cause dryness and itching on the scalp.

• Finasteride may cause sexual dysfunction in men.

RESEARCHERS SEE PROMISING RESULTS 

Recent research bears out the potential of PRP therapy.  In a 2014 study, researchers looked at men with male-pattern baldness who used both approved medications, but saw little change in their hair growth.   After four PRP treatments, they had about 30 percent more growth in thinning areas.  A 2017 study out of Italy also found male patients had increased hair and density in areas where doctors used PRP therapy.

It takes about three months to see an improvement. After that time, most  patients – both male and female – have regrown 30 to 40 percent of the hair they’ve lost.  

WHAT MAKES YOU A GOOD CANDIDATE FOR PRP THERAPY? 

Part of the success of PRP comes from selecting the right patients for therapy, PRP is safe and effective for many people. However, you should not have PRP therapy if you fall into either of these groups: 

• If you have an underlying disorder such as thyroid disease or lupus, you aren’t likely to have good results because these conditions will continue to cause hair loss over time.

• If you are on blood thinners, your platelets won’t work as effectively and the procedure is not as effective.

PRP therapy works better if your hair loss is recent. It is more challenging to “wake up” hair follicles that have been dormant for a long time.

FILLERS IN DUBAI: WHICH FILLERS ARE RIGHT FOR YOU?

Fillers in Dubai | 8 June 2020

Which filler is the best for you, and which filler should you choose for a specific treatment: nasolabial wrinkles, lips, nose, cheeks, quality of skin tone, or undereye bags? The internet and media are full of contradictory information.  

Although there are dermal fillers such as Radiesse (calcium hydroxylapatite crystals), Sculptra (poly L-lactic acid), and permanent fillers like Aquamid, in this guide, I cover dermal fillers based on hyaluronic acid – as these are the only dermal fillers I personally recommend. The reason for this is that hyaluronic fillers are not permanent, they have no lasting effects, they yield the most natural results, and if necessary, can be removed and dissolved using a special enzyme.

If a doctor prefers the use of renowned brands such as Restylane, Juvéderm, or some other (i.e. Teosyal and Belotero hyaluronic fillers), then the patient is definitely in very good hands, because these brands offer a whole range of different fillers, with various densities, hyaluronic concentration, and molecule size, let alone years of medical testing and research. My medical experience in aesthetic medicine has shown me that no specific brand is ideal, which is why it is in every patient’s interest that their doctor has a selection of at least 2 of these brands of fillers. 

Hyaluronic dermal fillers, along with Botox are the main tool of modern aesthetic medicine. Hyaluronic acid is a natural component of our skin, and its main task is skin hydration, as well as collagen reinforcement, and the restoration of elasticity. Our skin thus acquires a glow, stays firm, we have a healthier skin tone, and lost volume is restored in the face.

The history of hyaluronic dermal fillers is a relatively brief one. Bengt Agerup, a Swedish scientist and genius, was the first to stabilise hyaluronic acid in 1996. Up to then we only had inferior collagen and dangerous silicone fillers, but when the first dermal filler, Restylane, was produced in Uppsala, the world of aesthetic medicine changed forever. Over 25 million treatments using Restylane fillers have been performed all over the world to date. Most hyaluronic fillers are produced by fermenting bacteria in a laboratory, meaning they are produced in a natural and organic way (rare brands of hyaluronic fillers such as Dermavisca stem from animal sources – the fleshy comb of a rooster). This hyaluronic acid (the largest production plants of natural hyaluronic acid are in France and China) is used not only in dermal fillers, but in cosmetics and many creams, as well as in mesotherapy. Each brand of filler uses a different method and technology to stabilise and bind the hyaluronic acid, so that it can last in the skin for an average of 6-36 months. There can be a great difference between various dermal fillers. The stabilisation process and binding of hyaluronic acid varies with each brand, and the consistency of each filler is also different, as well as the concentration of hyaluronic acid, size of the molecules, and density. Furthermore, only some dermal fillers such as Restylane, Juvéderm and Teosyal contain lidocaine, a local anaesthetic. This, for me, is essential, because the treatments are less painful, and are a mark of a serious dermal filler brand.

WHICH FILLER IS THE BEST FOR WHICH TREATMENT?

LIPS

I will begin with the lips because in my many years of experience I have come across the greatest controversies especially when it comes to this treatment. Although it appears to be simple, it is one of the most difficult procedures in aesthetic medicine, and one which requires years of experience.

Today I am proud to say that I perform countless lip augmentations and contouring on a monthly basis.  Restylane Classic is a dermal filler I have used for years for lip augmentation. The results are excellent and yield very natural and soft lips. It is still one of my favourite lip fillers because it contains the optimum concentration of hyaluronic acid. Drawbacks? The results only last 6 months, and the lips are very swollen right after the procedure; however, the swelling dies off in just 24 hours.

Restylane Lyps is a newer version of Restylane Classic filler, with everything the same, except that results last over 9 months, because of the larger molecules and higher concentration of hyaluronic acid. The latest lip filler from the house of Galderma has a very fitting name – Restylane Kysse, which uses the new Emervel technology. There is no significant swelling following the procedure, the lips look exceptionally natural and very sensual, and results last over 9 months.

Juvéderm Ultra 3 is a very good lip filler from the house of Allergan, but offers subtle results that last for only 6 months. Allergan has recently launched its new Vycross technology, under which is its selected lip filler, Juvéderm Volift, although Juvéderm Volbella can also be used.

Juvéderm Volift lasts for 12 months, there is no significant swelling following the procedure, but I have noticed minor swelling in some patients, which can be manifest as small balls and thickening of the upper lip after a couple of weeks. However, this problem quickly dissipates on its own, or after a massage.

Teosyal Kiss is also a very good dermal lip filler. As its name suggests, it is specially formulated for lip treatment. It yields great results, with minimal side effects. Although it is difficult for me to determine the best filler for this treatment, I would give the title to a specially designed lip filler – Restylane Kysse. Right behind are definitely Juvéderm Volift and Restylane Lyps. In most cases, only 1ml of filler is enough per treatment, and it is not recommended to do more than that. It is wiser to come back after a month’s time and add another 1ml if your doctor finds it appropriate. What is most important is that the results are natural, and the face proportional.

UNDEREYE BAGS

Many doctors believe that there is no dermal filler suitable for this procedure, but from my own personal experience and following many successful treatments, I can confirm that this is not true. With my experience of undereye treatments, this is a remarkable treatment that yields outstanding results, and the best fillers for it are Restylane Classic and Restylane Lyft (Perlane). Here it is possible, with great expertise, to use both thinner and thicker dermal fillers. Knowledge is what counts most. Over the years, I have tried using other dermal fillers in this facial zone such as Teosyal Redensity, Juvéderm Volbella, Belotero, and although they yielded adequate results, too much oedema was reported, and the effects were not as good as the above-mentioned fillers. Restylane is the absolute king for undereye bags. In 80% of cases, 2ml of dermal filler is enough to erase bags under the eyes – even extra-large ones. 10% of patients require only 1ml, while 10% need to come back for their third ml.

NON-SURGICAL FACE-LIFTING / CHEEK AUGMENTATION

This increasingly popular treatment offers a natural facelift for skin that has lost volume and appears relaxed. With the expert administration of hyaluronic dermal fillers, there is no more need for a scalpel and surgery, because this can yield very effective and natural results with non-surgical face-lifting, and requires the use of 2ml – 5ml of dermal filler. What’s more, the effects can last for even 18 – 36 months (because this treatment uses denser fillers with larger molecules). The first such filler on the market was Restylane Sub Q, but it has proven to be too hard a filler, and so over the last 5 years my favourite filler for lifting the face, cheeks and saggy skin around the chin is definitely Juvéderm Voluma. It is a wonderful filler with large molecules that provides an adequate lift, which can easily be injected. 

For these procedures, I can also pay compliments to Restylane Volyme, which has recently emerged on the market. It is a new technology from Galderma which is now keeping stride with Juvéderm. These two brands are unique in that they come in 1ml doses and can be injected with a syringe. Other brands either do not have these fillers with larger molecules (vital for an adequate facelift), or only offer 2ml ampules that can solely be applied through a cannula, which may be unsuitable for many patients. It is my opinion that in the majority of cases, fillers must be administered with a syringe and not a cannula, as this yields better and more accurate results, which is logical. From patient to patient, if we take into account their age, skin type and condition, at least 2ml of filler is needed for a non-surgical facelift, but the dosage can rise up to 8 – 10ml of filler, which is obviously administered in 2 to 3 separate treatments.

NOSE

When it comes to the nose, dermal fillers should not be too dense due to the sensitive anatomy of the nose, yet must also have enough strength to lift and contour, fill in imperfections and align the nose. Restylane Classic can achieve perfect results with no side effects, I only use this and have done for years. Juvéderm, Teosyal, Belotero and other fillers, are also suitable for this treatment. As always, the most important factor is the expertise and experience of the doctor. If we select a proper brand of hyaluronic acid, along with a good quality doctor, in most cases 1ml is enough to yield results that last over 18 months.

NASOLABIAL WRINKLES

The correction of nasolabial wrinkles is still the most sought-after dermal filler treatment. It is a procedure that is most easily performed with the longest lasting effects. But, just a word of warning – I must emphasise that extensive knowledge, skill and expertise is also required here, not only to achieve the best results, but also because this zone demands detailed cognisance of its anatomy, in order to avoid side-effects such as vascular compromise, which cannot occur when administered by an expert, but becomes highly probable when one is in “unprofessional” hands. Here, many dermal fillers are very suitable, and so one can choose from a wide pallet. The dermal filler should be thinner, with less molecules, such as is the case with Juvéderm Volbella or Volift filler, Restylane Classic, Teosyal Global Action or Belotero Soft filler. When dealing with shallow wrinkles, 1ml is enough for both wrinkles, but in many cases 2ml are required.

REJUVENATING THE SKIN OF THE FACE, NECK, DÉCOLLETÉ AND HANDS WITH STABILISED HYALURONIC ACID (“SKINBOOSTERS”)

Modern aesthetic medicine is turning more and more to treatments of the skin itself and its rejuvenation. Laser treatments, plasma treatments, and dermal rollers are increasingly popular, but hyaluronic preparations achieve the best results. The skin of the face, neck, décolleté and hands gain a new glow, while wrinkles, pores and scars disappear. Elasticity is restored, and the skin is firmer. In a treatment which I call medical mesotherapy, the best product is Restylane Vital Skinbooster. It’s greatest advantage is the technology of the syringe itself that has a special “clicker” to provide a precise dose with each prick of the needle. The latest product of this type on the market is Juvéderm Volite, which yields excellent results, but we must also mention Profhilo, a recent market launch by Ibsa. It is an innovative dermal filler that is something between a dermal filler and a skinbooster.  

ABDOMINOPLASTY DUBAI: PREPARING FOR A TUMMY TUCK

Tummy Tuck Dubai | 5 June 2020

If you’re considering having a tummy tuck or have one planned, it’s important to consider what the recovery will involve. Your recuperation will depend on several factors, including your age, health, and body weight. It will also depend on the type of tummy tuck you have.

It’s natural to want to bounce back to normal after your surgery, but it’s important that you give your body time to heal. You may only need to stay in the hospital for a few hours after the surgery, or I may have you stay for one night or longer. And once you leave the clinic, the real recovery begins. Here’s what you need to know.

TIMELINE FOR RECOVERY

You’ll want to figure out a time frame for your recovery so you have ample time to heal and can take a break from certain aspects of your life. Make sure you make the proper arrangements and are fully prepared for your recovery period.

Your drains will be left in for a few days after the surgery. You’ll be shown how to take care of and empty the drains. You’ll likely need to take an antibiotic and an anticoagulant while your drains are in place.

You’ll wear an abdominal binder for about six weeks. This helps to avoid fluid buildup and helps to support your abdomen.

While the recovery period is usually shorter for a mini-tummy tuck, you’ll still need to avoid strenuous activity for at least six weeks. This includes any vigorous exercise or heavy lifting.

WHAT TO EXPECT AFTER YOUR SURGERY

I will properly brief you about how to recover at home.

You will be guided:

how to care for incisions and drain tubes

what to be aware of in terms of infection or overall health

what to avoid in terms of physical activity that affects your incision line for six weeks

when you need to see me again

how long to wear the abdominal pressure garment

how much to rest

what you can eat

You’ll need to have someone who can drive you home from the hospital and help take care of you for at least the first few days after your surgery. You can shower few hours after you remove your drainage tubes. You may want to take a sponge bath until you can shower. You may be advised to use a chair when showering for some time.

You’ll be prescribed an antibiotic and possibly an anticoagulant. You may be given some type of medication to apply to the skin. Take any pain medication as directed. You shouldn’t take any medicine containing aspirin unless directed by your doctor.

You should also avoid alcohol if you’re taking pain medication, and avoid any form of nicotine for at least six weeks. Smoking can hinder the healing process and may cause complications.

GUIDELINES FOR AT-HOME RECOVERY

You may need to sleep on an incline for the first few days after surgery. Keeping your upper body raised slightly with your knees bent at an angle can help reduce swelling. Putting pillows underneath your knees can also reduce pressure on your abdomen. Your doctor will advise you on this.

Keep moving after your surgery, even if it’s only a bit of walking. This will help to keep your blood flowing, which helps with the healing process and decreases the chances of a blood clot in your legs.

I will also tell you how to find an optimal resting position that will be most comfortable. Rest as much as possible since you may feel tired for weeks or even months.

It’ll be several weeks before you are fully back to normal. You won’t be able to drive for a few weeks. You’ll also have to limit strenuous exercise and demanding physical activity for four to six weeks. I can help you decide what activities you can perform and how long you’ll need to take off work.

POSSIBLE PHYSICAL SIDE EFFECTS

Most of the intense pain will be in the first few days following surgery. You can take pain medication to control the pain you are likely to experience. You may experience swelling for up to three months after the surgery.

Your tummy may feel like it’s being pulled when you try to stand up straight. You may feel numbness in your tummy for months or even years. It’s normal to have bruises in your abdominal area. You may have fluid-filled swelling above the scar, but this will go away. Your scar may be red and raised, but it will eventually fade.

TIPS FOR RECOVERY

Taking steps to ensure a healthy recovery is important. You’ll want to be as healthy as possible during this time.

Set up a comfortable space where you can relax and have your needs met. Allow yourself to rest fully for at least two weeks and make sure not to push yourself to do anything physically before you’re ready.

You’ll want to drink plenty of water to flush your body of toxins and reduce swelling. Keep your diet as healthy as possible. Include as many fresh fruits and vegetables as possible.

TUMMY TUCK RECOVERY

There’s a lot to consider as far as tummy tuck recovery goes, but all of it is attainable and manageable. It just requires that you consider and plan for all aspects of this healing process, including the time frame.

It’s a slow process, so focus on getting better each day as you move toward your intended goal of full recovery. Be sure to check in with me if you have any questions or concerns.

UNDERSTANDING COSMETIC REGENERATIVE PRP TREATMENT

Aesthetic Medicine Dubai | 1 June 2020

Cosmetic PRP Therapy Treatment is an effective treatment for several conditions and has been successfully used to improve skin and hair conditions. I provide the following PRP treatments:  PRP hair regeneration and  PRP skin rejuvenation. PRP or Platelet Rich Plasma therapy is not for everyone. Certain medical conditions and use of certain medications may make your platelets less effective.

WHAT IS PRP?

Platelet Rich Plasma or PRP is obtained from your blood and injected into your tissue wherever tissue regeneration is needed. Over the last decade, autologous PRP has been successfully and extensively used in sports medicine to regenerate tendon injuries, muscle injuries, worn out cartilage in aging joints; in general surgery to promote faster healing of  large surgical scars and in the field of cosmetic and anti-aging medicine for skin rejuvenation and hair regeneration.

Autologous PRP provides a safe and very effective regenerative treatment option but unfortunately not everyone is a candidate for PRP cosmetic regenerative treatments. Below are some of the absolute and relative contraindications to PRP treatments:

Absolute Contraindications to PRP Regenerative Therapy:

Platelet dysfunction syndrome

Critical thrombocytopenia – very low platelet count

Hemodynamic instability – very low blood pressure

Septicemia or local infection to injection site

Relative Contraindications to PRP Regenerative Therapy

Aspirin and other NSAIDs use within one week of the PRP therapy.

Corticosteroid injection at treatment site (1 month)

Systemic use of corticosteroids (2 weeks)

Cancers (hematopoetic-blood or bone)

HGB < 10g/dl or platelet count < 105/ul

I do not want you to stop taking your aspirin or blood thinner medication if you are taking these medications for heart condition and for stroke prevention. If you are taking any of the medications for a serious medical illness, you will need to pause the medications under your physician’s care and obtain a medical clearance letter before your PRP therapy.

Cosmetic PRP Therapy Treatment harnesses the healing ability of your blood to regenerate healthy new tissue in the treatment area for natural improvement of common skin concerns and thinning hair.

CLINICAL RESEARCH ON PRP TREATMENT EFFICACY FOR SKIN AND THINNING HAIR

Platelet Rich Plasma is obtained by processing your blood in a centrifuge to get a concentrated mixture of your platelets. Platelets are small cells in your blood that are responsible for your body’s healing response to injury. Upon any injury, your platelets release a minimum of eight growth factors which initiate a cascade of events leading to regeneration of healthy tissue to repair the injured area. High-quality PRP leads to the appropriate growth factor release which results in healthy tissue regeneration for rejuvenated skin and thicker hair when injected in these sites.

PRP THERAPY FOR SKIN

Cosmetic regenerative PRP therapy provides growth factors from your own blood to optimize your wound healing and is used for several non-surgical cosmetic skin treatments to enhance the results of your cosmetic skin treatment. I love the natural results from regenerative PRP skin treatments for improvement of several common cosmetic skin problems such as; skin aging,  acne and other scars, stretch marks, melasma and other hyperpigmentation disorders. I often combine your PRP with different types of skin treatments specific to your needs to help you achieve your personal best for your skin needs. 

PRP SKIN SURFACE REJUVENATION AND PHOTODAMAGE REPAIR

PRP injection into the dermis (middle layer of skin) and application of PRP topically with Micropen microneedling skin treatment may improve skin surface aging, fine lines, pigmentation, texture and skin tone.  

PRP SKIN TIGHTENING AND PRP DEEP WRINKLE REDUCTION

To address the signs of deeper skin aging such loss of skin elasticity, deep wrinkles and folds, which present as jowls, sagging of the eyelids, sagging of the skin below the chin, deep nasolabial folds and so forth, I recommend a deeper skin tightening and collagen building treatment. The injection of PRP into the dermis and application of PRP topically with the MFR skin treatment can improve skin tightness, build collagen to lessen the appearance of deep wrinkles, deep folds, jowls, tighten the neck skin and lift the eyelids.

PRP WITH DERMAL FILLERS FOR VOLUME ENHANCEMENT

For areas with mild to moderate volume loss below the skin such as the age-related thinning of the back of hands, deep under-eye circles and loss of facial volume, PRP injections below the dermis can be combined with a dermal filler for volume replenishment. The advantage of PRP is that the regenerative response of your body leads to an improvement in the skin texture, firmness and tightness with healthy new tissue along with the volume that is replenished with the dermal filler. I see this effect most noticeable in the under eye area.

PRP STRETCH MARK TREATMENT

Stretch marks are common in women and men of all ages. Stretch marks can present on many areas of the body such as tummy, thighs, buttocks etc due to a rapid increase in size such as rapid growth during puberty, increase in size during pregnancy and with a sizable weight gain. Stretch marks are like dermal scars in many ways and can be reduced in the same way as dermal scars. best treatment results are achieved with early intervention. For most individuals with stretch marks, I recommend a series of 3-5 treatments with PRP injection and PRP topical application with one or two of the microneedling sessions. 

HOW IS THE REGENERATIVE PRP SKIN THERAPY DONE?

Treatment with PRP can be completed in less than 30 minutes. When you arrive, a small vial of blood is drawn, similar to the volume required for routine blood work. The blood is then spin in a centrifuge to separate the growth factors, and platelets from the rest of the blood. Once this unique mixture is obtained, it can be injected directly into the targeted areas or applied through micro needling.

Before your Cosmetic PRP Therapy,  you will have a thorough consultation where I will evaluate your medical history for appropriateness of the cosmetic PRP treatments and discuss your goals and expectations for the treatment.

PRP HAIR LOSS THERAPY 

PRP hair loss therapy is an effective treatment option for increasing hair density in individuals with certain types of hair loss disorders*

PRP hair loss therapy alone is effective in improving hair density and quality when injected into the scalp of men and women with early and mild androgenic alopecia and with telogen effluvium (after correcting the triggers of telogen effluvium). PRP hair loss therapy is effective in increasing hair density and hair quality in individuals with more advanced androgenic alopecia and androgenic alopecia lasting longer than 5 years. PRP hair loss therapy alone does not lead to hair regeneration in individuals with advanced hair loss with scarring and those with complete loss of hair follicles.

*Individual results vary with genetic, hormonal, environmental and other influences

Eyelid Surgery (Blepharoplasty or Eye Lift) for a Youthful Look

Blepharoplasty Dubai | 19 May 2020

Blepharoplasty can be performed for any of the following reasons,

– The ‘tired’ look is the most common reason that patients opt for blepharoplasty surgery. The heaviness of the eyelids and bags under the eyes give the appearance of a constantly exhausted and tired appearance.

– The appearance of the eyelids may be asymmetrical and blepharoplasty may be performed to improve symmetry.

– Saggy upper eyelid skin can obstruct the visual field (you may not be able to see the full extent of your lateral vision) so blepharoplasty is performed to remove this obstruction and improve vision.

– There are several disfiguring conditions such as Thyroid Eye Disease which require blepharoplasty surgery to restore the natural appearance of the eyes. This type of surgery is highly specialised.

How Is Eyelid Blepharoplasty Surgery Performed?

Experience and expertise are required to execute all forms of blepharoplasty surgery. Upper eyelid blepharoplasty is a procedure offering rapid recovery. The blepharoplasty incision is measured and marked. Variable amounts of skin, underlying muscle and fat are removed, or if there is pre-existing upper eyelid hollowness, these tissues can be repositioned to fill the hollows in order to achieve a pleasing and youthful appearance of the eyelid and to improve the visual field. After the desired amount of excision is accomplished, buried dissolvable stitches are used and the skin surface is closed. Lower eyelid blepharoplasty is a more involved procedure requiring an incision under the eyelash line, running beyond the corner of the eye. Excess skin, muscle and fat can then be removed or repositioned through this incision. Sometimes, particularly for younger patients, the main aesthetic issue is the underlying fat bulge. In these cases, a transconjunctival ‘scarless’ approach through the inside of the eyelid is preferred. 

The skin closure is made using either removable sutures or with glue, meaning that sometimes no suture removal is required. Upper eyelid blepharoplasty surgery is most often performed under local anesthesia either with or without sedation. Lower eyelid blepharoplasty is usually performed under local anaesthesia with sedation, or general anaesthesia if the patient prefers. When having both upper and lower eyelid surgery together.

Blepharoplasty Dubai

A Guide to Skin Problems & Treatments

Fillers in Dubai | 16 May 2020

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.

Fillers in Dubai

Is a Tummy Tuck the right procedure for me?

Tummy Tuck Dubai | 14 May 2020

If you have spent endless hours in the gym and followed a healthy and well-balanced diet but still struggle to achieve a flat tummy, you may be thinking about a tummy tuck. There may be times that excess fat and skin simply don’t respond to diet and exercise, especially in the abdominal area. The reason for that lingering fat and skin may be weight loss, pregnancy, or the simple result of aging. Some new moms even get tummy tucks as part of a “Mommy Makeover” that allows for a whole body overhaul. A new mom can get a breast lift, a tummy tuck, and a breast augmentation to become virtually a whole new woman. No matter what the reason that you are thinking about a tummy tuck, I can help. A tummy tuck can help restore your self-confidence and allow you to feel good about yourself again.

To decide whether tummy tuck surgery is right for you, you should first consider the reasons that you want to have the surgery.

The best reason to get a tummy tuck: You want one! This is something that you should do for yourself, not because someone else tells you that you need it or should have it. Although you can always consider the thoughts of your partner, your own thoughts on the tummy tuck are the most important thing by far. In short, tummy tucks are only right for people who truly want them or truly feel they need them.

While every person may have different reasons for wanting a tummy tuck, here are some of the most common.

• Have you struggled to get your flat tummy back following the birth of your children? Do the stretch marks in your abdominal area make you feel miserable when you look at them?

• Have you found that the older you get, the harder it is to keep the stomach area toned?

• Have you experienced a significant weight loss after weight loss surgery and now find that you’ve got excess skin that makes your abdominal area look awful?

• Do you exercise and put considerable effort into toning your tummy, but never get the results you’re looking for?

• Do you diet and eat right, but find that your abdominal area just doesn’t respond like the rest of your body does?

Any of these reasons can be excellent reasons for choosing a tummy tuck. However, it is important to know that a tummy tuck can’t replace weight loss. It is not a magic bullet that will instantly take a person from being very overweight to being super svelte. However, people who are of healthy weight – or who are as close as possible to their ideal weight range – can often benefit enormously from a tummy tuck.

End| Tummy Tuck Dubai

Dermal Fillers Aftercare Advice From Dr Matteo Vigo

Fillers in Dubai | 12 May 2020

How long does it take for dermal fillers to work?

You can expect the results of the procedure to be visible immediately after having the treatment. If there is any swelling then this should take a couple of weeks to settle down.

Is it possible to have an allergic reaction to dermal fillers?

Hyaluronic acid is a substance naturally found inside the human body so a reaction to this substance is extremely rare. Collagen stimulating fillers, such as Radiesse, are made from calcium, a substance also found naturally in the body so, again, reactions are very rare. Immediately after the treatment, there may be a slight redness, swelling, tenderness, a faint bubble like appearance and an itching sensation in the treated area. These side-effects are a normal result of the injection and will generally disappears gradually over a period of 7-14 days.

Should I expect to feel any pain after having dermal fillers injected?

Most patients won’t experience any pain after having dermal fillers. But some people may find they have a little bit of soreness and/or mild bruising at the injection sites. If you do experience any pain, bruising or swelling then you can treat this with an ice pack to reduce swelling and redness. I will apply local anaesthetic cream to the area before the injections to help keep any pain during the procedure to a minimum. The filler also has some local anaesthetic which makes the procedure very comfortable.

Can I take painkillers before having dermal filler injections?

It’s recommended to avoid anti-inflammatory painkillers before and after the procedure as these can thin the blood and increase the risk of bruising, swelling and bleeding. Ibuprofen and aspirin are the most well-known anti-inflammatory drugs; however, during your consultation it’s important that you let us know what medication you are taking so we can advise on possible contraindications.

Can I exercise after having dermal filler injections?

I recommend waiting at least a week after dermal fillers before doing any strenuous exercise to avoid the risk of infection. All strenuous exercise should be avoided, but it’s also recommended to avoid yoga as inverted positions, such as headstands, could also increase the risk of bruising and swelling.

How soon after having dermal fillers can I fly?

Although there is some concern that flying after having fillers can cause issues due to changing air pressure in the cabin, there is no evidence that this is the case. There should be no issue with flying after having dermal fillers.

How long is the recovery time after having dermal fillers?

Some people experience mild bruising and swelling after the procedure. If this occurs you can expect the bruising and swelling to wear off in a week or two. After the procedure you can expect to have slight redness around the treated area, which will last a few hours.

How soon after having dermal fillers can I sunbathe?

Sunbathing, sunbeds and intense heat (such as saunas and Turkish baths) should be avoided for 1 week after treatment. If you do go out in the sun, wear sunscreen at all times. You should also avoid exposing your skin to extreme cold for 1 week after treatment.

How soon after having dermal fillers can I touch my face?

Avoid touching the treated area for at least 6 hours after treatment. After that, the area can be gently cleansed and clean light make-up can be applied.

If I suffer from cold sores can I still have dermal fillers?

If you have a history of cold sores, there is a risk, due to the insertion of the needle into the skin, that the virus may be activated. This may cause a first outbreak of a cold sore or another eruption of a previous cold sore. Before your treatment, we advise you to take anti-viral medication. In the case of an outbreak of cold sores, please contact the clinic or seek medical advice.

What are some of the possible side-effects I should be aware of?

Rare but possible side-effects include redness, swelling, bleeding, bruising, pain, itching, infection, abscess formation. You can also experience lumpiness, prolonged firmness, nodule formation, granuloma formation, local necrosis, discolouration, allergic reaction and acne.

Rarely a scab can form at the treatment site, which can result in a scar. Treatment around the eyes and upper face can also result in swelling, bruising, lumpiness, discolouration, infection, abscess formation, scar formation, haemorrhage of the eyes, double vision and loss of vision.

Dermal fillers are one of the most widely used treatments for restoring smoothness and facial volume. Injected by an expert healthcare professional, they fill in space and absorb water to create a smoother, fuller appearance or enhance the contours of the face.

A common complaint of ageing skin is the general loss of volume in the face and less ‘bouncy’ skin. As we age, our supplies of collagen and elastin decline, and the fibres themselves become weaker and less springy. The surrounding fluids that cushion and support these fibres also begin to ‘dry up’ resulting in wrinkles, ridges, and a general loss of volume in the skin. While injecting neurotoxins, such as botulinum toxin, will help smooth out wrinkles caused by muscle movement, only a dermal injectable can address the depressions and loss of volume associated with ageing. This is why dermal fillers are most commonly used to fill nasolabial folds, marionette lines (from the edge of the mouth to the chin), the jawline, cheeks, lips and the under eye area.

What are dermal fillers?

Dermal fillers come in various formulations, each of which works differently in softening the lines, folds, creases and loss of volume associated with age and/or exposure to environmental aggressors. Fillers are also effective for augmenting contours of the face; to create fuller lips, a more defined jawline or plumper cheeks for example. The most popular fillers are derived from hyaluronic acid, a water-binding sugar that is already produced in the skin. Hyaluronic acid fillers are usually well tolerated and the effects, if undesirable, can often be reversed by injecting an enzyme called hyaluronidase, which helps to dissolve hyaluronic acid fillers. Other fillers are composed of synthetically derived substances, such as calcium-based microspheres. However, these synthetic options cannot be reversed and the effects last longer, which could be problematic if the results are unfavourable. More recently, fillers have been created using the patient’s own cells with results lasting up to two years.

 

Who are dermal fillers for?

Fillers are appropriate for any skin type and address a multitude of age-related concerns, but only adults should have fillers, as they can inhibit bone structure if not fully developed at the time of injection. They can fill in hollows under the eyes and eliminate the depressions caused by deep creases, wrinkles, or scars, as well as plump up larger areas such as the cheeks and temples.

Recently, researchers have also discovered that injectables stimulate fibroblasts to synthesise additional collagen, so doctors are now increasingly seeing younger patients who use fillers as a preventative treatment to slow ageing¹. They are also popular for augmentation and contouring (fuller lips, a wider jawline, etc).

Fillers are not recommended to be used by pregnant or nursing women.

 

How do dermal fillers work?

A syringe needle injects a gel-like substance into the skin at various depths. A series of injections evenly disperses the filler. This filler substance fills up the area, resulting in improvements such as smoother nasolabial lines or fuller cheekbones. Although the discomfort associated with receiving dermal fillers is minimal, it is not entirely pain free. A treatment generally begins with the application of a numbing cream. After approximately 30 minutes, the numbing cream is removed and a series of injections are administered into the target areas. Certain areas may be more sensitive during injection. For example, under eye fillers may cause more discomfort to the patient than cheek fillers.

Some soreness, bruising, and swelling may occur in the days, or even weeks, following the procedure. Many factors affect the severity of these side effects, such as the speed of the injections and the site of injection. Another factor is the material used for the filler. Fillers that provide semi-permanent results, as often seen in cheekbone fillers, are associated with more swelling and discomfort. Due to the potential side effects associated with dermal fillers, it is important that they are performed by an experienced medical professional, such as a cosmetic dermatologist or cosmetic doctor. 

When should I get dermal fillers?

A single session of an injectable has the potential to last up to five years, depending on which kind of filler is used. Less permanent options, such as those composed of hyaluronic acid are more quickly absorbed, usually within 6 months. This especially holds true if the filler is injected in a region with a lot of movement.

Facial fillers do not increase sun sensitivity, making them a great year-round option. However, until the initial swelling has subsided, patients should avoid excessive heat exposure, including prolonged sun exposure.

It is recommended to incorporate an at-home skincare regimen after dermal fillers; always consult with your skincare professional for individual at-home advice.

CONTOURING AND REFINING FEATURES

When injected by an experienced professional, fillers also have the ability to contour and refine features. Lips can be augmented to reduce the lines that appear with aging, and small noses can be enlarged so that they balance nicely with other facial features. A flat chin can be injected with filler to provide a symmetrical profile. Fillers can provide a straighter nose for people who have a hump in the middle. Cheek bones can be injected to provide a natural-looking lift to the face. Although amazing results can be achieved with injectable fillers, it is the artist in control of the needle who determines the final outcome. It takes artistry, not just a licence, to sculpt the face in perfect harmony and proportions.

Not only can fillers be injected in a short period of time, but there is also little discomfort for the patient. Local anaesthetic is administered prior to the injections, and some brands even have the anaesthetic combined with the filler. Slight swelling or redness at the injection site may be experienced, but this is minimal, eliminating the need to take a few days off of work to heal. Another major benefit of injectable fillers is that they are affordable. Great results can be accomplished without breaking your pocket book.

THINGS TO KNOW IF YOU’RE CONSIDERING DERMAL FILLERS

Whether you are considering getting dermal fillers to smooth out wrinkles or enhance facial contours, a quick look at some criteria and facts will help you know you have come to the right place for your treatment.

Dermal fillers should be injected only by an experienced and qualified medical doctor. This procedure requires qualifications, experience, and an artistic edge, because 90% of the success of cosmetic procedures depends on who is doing them. For example, a bad haircut would indicate the level of experience of the stylist, not the scissors that were used. This is why it is extremely important to inquire about the credentials of your practitioner and ask to see before and after pictures. Getting a consultation first is advisable, as you would get a chance to see my facility and raise your questions or concerns with me.

YOUR EXPECTATIONS

Bringing a picture of your younger self to your appointment is helpful. However, bringing a picture of your favorite celebrity is not conducive. While you may see one aspect or feature of your face, it is important to know that a face has to be analysed in whole and not in part. The aim of the injectable procedure is to look naturally enhanced. It is also important to understand that each face has its own asymmetry. A good doctor can help bring more symmetry while keeping the overall aesthetics of the face visually pleasing. So make the most of your consultation by being open to recommendations. Your doctor sees in three dimensions, and you would benefit from exploring all your options.

THE ACTUAL PRODUCT

There are many types of dermal fillers on the market. But the most common of them are hyaluronic acid (HA) products. They have proven to produce natural and lasting results while maintaining fluidity to move with facial expressions. This line of dermal fillers also incorporates antioxidants, minerals, and vitamins to deliver further treatment benefits while filling and contouring the face.

HOW LONG THE RESULTS WILL LAST

Hyaluronic acid in dermal fillers also naturally occurs in the body and therefore gets metabolized eventually. Depending on the dermal filler chosen and whether or not this is the first time you are having a filler injected, you can expect results to last anywhere from 3 to 6 months. If for some reason you are not satisfied with the results, which is very rare, HA fillers are also dissolvable at your request by injecting an enzyme called hyaluronidase.

WHAT TO DO BEFORE AND AFTER THE INJECTION

It is always best to schedule your injectable appointments a couple of days to a week prior to any major event. With dermal filler injections, you will also need to take bruising and swelling into account. You can reduce this likelihood by stopping any supplements that can act like blood thinners such as fish oil and also some pain killers such as Aspirin, Aleve, Advil, etc., 2 weeks prior to your appointment.

After your dermal fillers treatment, follow the post-care instructions given, which include applying cold compresses, avoiding extremely cold or hot drinks, sun exposure, extreme temperatures, excess facial mimicry, and vigorous exercises. Being gentle is key.

Fillers in Dubai

 

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