Does Laser Treatment For Pigmented Skin Lesions Cause Thinning of the Skin ?

Pigmented skin lesions are defined as darker coloured spots or patches on the skin due to abnormally concentrated melanin, the skin pigment. Pigmented skin lesions could be freckles, sun spots, melasma or birthmarks. Laser treatment helps to diminish these conditions and brightens the complexion but this high-tech-skin-saver has raised some concerns and the most popular question will be “Can laser treatment thin my skin ?”

How Does Laser Treatment for Pigmented Skin Lesions Works ?

Cross section diagram of skin demonstrating absorption of laser light by skin pigments only.

Laser works by delivering an intense beam of light that is absorbed by a specified laser target, which in this case refers to skin melanin. This light is converted into heat energy, which is absorbed by the melanin. Sufficient heat is produced to damage the melanin, while leaving surrounding normal skin structures relatively unaffected. Therefore, laser treatment for pigmented skin lesions only selectively destroys the pigments and does not strip away layers of the skin.

Laser Treatment May Improve Collagen Regeneration and Skin Elasticity

Besides treating pigmented skin lesions, the laser energy also induces collagen synthesis and remodelling, leading to improvements in dermal layer thickness and collagen fiber density. This effect is well documented in many clinical studies.

Taking Care of the Skin After Laser Treatment for Pigmented Skin Lesions

 

Immediately after treatment, there will be some mild redness of the skin. Do avoid sunlight exposure for at least a month after laser treatment for pigmented skin lesions and use a sunscreen of at least SPF 25. Occasionally, the treated skin will more likely develop mild redness when exposed to the sun or feels dry - this effect is usually temporary and it is advisable to use a moisturiser to soothe any irritation and to moisturise the skin.

 

 

So, the truth is – laser treatment for pigmented skin lesions does not cause skin thinning. The treatment may sometimes induce temporary mild redness and dryness that is mistaken by some as the effects of thinned skin.

Voluma Liquid Lift - Creating The Perfect Cheekbones

There’s a reason great facial bone structure is beloved. With age, jowls and cheeks can droop, turning the face bottom-heavy and making us look older. Cheekbones can act as an achor for the skin, so it wouldn't droop as much, nor as soon. For those not blessed with high cheekbones, there is Voluma Liquid Lift to gently plump up cheeks, thus restoring youthful facial contours.

Photo : Gisele Bundchen, Wallpaper Extreme

Notice how supermodels tend to have naturally high cheekbones ? Now, the rest of us can achieve this look with Voluma Liquid Lift

How does Voluma Liquid Lift works ?

Full cheeks are the hallmark of a youthful face. Voluma Liquid Lift is a non-surgical procedure to gently fill up deflated areas of the mid cheek with injectable hyaluronic acid, which is a substance that is naturally present in our skin and connective tissues. The treatment aims to restore diminished facial fat pads and skin collagen secondary to aging. The results are natural looking and mimic natural high cheekbones. With fuller cheeks and higher cheekbones, the appearance of laugh lines and jowls will be less visible and sagging facial skin is lifted.

What are the benefits of Voluma Liquid Lift compared to conventional surgical facelift ?

Voluma Liquid Lift offers the benefit of :

- Almost no recovery time needed. Though mild swelling many linger, patients can return to their daily activities quickly, whereas facelift patients need a week or two to heal.
- Excellent safety profile as the procedure is non-invasive in nature (does not involve open surgery or general anesthesia)
- No visible surgical scar
- Natural looking results
- Offers more patient control of the outcome. Patients have the opportunity to decide on the amount of filler material to be injected as they are able to communicate with the doctor during the procedure.
- Reversible results. Patients who decide they want their old appearance back can simply have the filler material disolved with another injection procedure.

However, Voluma Liquid Lift is unable to achieve the same lifting and skin tightening effects compared to a conventional facelift.

What should I expect after Voluma Liquid Lift ?

The results of Voluma Liquid Lift are instant and last up to 18 months. Immediately after the procedure, there may be some swelling and redness which will resolve spontaneously after one or two days. Rarely, there may be minimal bruising which can be covered up with make-up. The patient can resume their daily activities immediately.

Is Voluma Liquid Lift suitable for me ?

Do consult our doctor to know if Voluma Liquid Lift is the treatment of choice for your anti-aging concerns. Generally, patients with deflated cheeks, deep laugh lines at the corners of the mouth and jowls will be good candidates for the procedure. It is also a safe and cost-effective treatment without any significant recovery time for those not keen on a surgical facelift.

How To Defy Aging Like A Celebrity - Part 2

With access to the most sought after skin and beauty experts (and endlessly deep pockets), it's no wonder that some celebrities look years younger than their real age. But we too can embrace some of their secrets to delay our own aging process.

When it comes to anti-aging, prevention is the key to younger looking skin. After identifying the causes of skin aging in the previous blog, simple lifestyle changes will be necessary to achieve anti-aging benefits.

1) Don't smoke

Smoking causes poor skin elasticity, stained teeth and smoker's lines around the mouth that can add years to our looks. It also affects fertility, increases the risk of cardiovascular diseases and certain cancers.

Image source : Bahman Guyuron, MD, Department of Plastic Surgery, University Hospitals Case Medical Center

 

Can you pick out the smoker ? Twin B smoked half a pack a day for 14 years, while her sister never smoked. Twin B also got more sun, damaging her skin from the outside, too. Eye bags, smoker's lines around the mouth and deeper wrinkles are more likely to develop in smokers.

 

2) Avoid sunlight exposure & always wear sunscreen

 

Years of getting too much sun can lead to early wrinkling and age spots, and makes us more likely to get skin cancer. For tips on how to properly apply sunscreen, do check out this previous article.

 

3) Exercise

 

More and more research shows that working out can help our brain, bones, heart, and skin look and act younger. Studies recommend moderate-intensity exercise such as brisk walking and cycling slower than 10 miles per hour three times a week for 45 minutes for anti-aging benefits. 

 

4) Good eating habits

 

Eating a well-balanced diet rich in antioxidants and low in simple sugars helps delay the aging process. Health guidelines recommend 9 servings of fruits and vegetables a day.

 

5) Adequate rest

Penelope Cruz apparently gets anything up to 14 hours a night, while Catherine Zeta Jones and Renee Zelwegger swear it keeps them beautiful. Try going to bed early each night to optimize your natural secretion of human growth hormone, which promotes cell turnover. 

Having already practiced a healthy lifestyle, if more significant results are desired, there is always the option of seeking professional help from a licensed medical practitioner for cosmetic procedures. An important reason why some celebrities seem to defy aging is because they are proactive with cosmetic treatments. These celebrities usually come in at the first sign of a wrinkle to take care of it and never wait for serious damage to show up. In the last decade, there has been an introduction many non-invasive age-reversing treatments (Botox, dermal fillers and cosmetic lasers) that, when done in moderation, look extremely natural. Celebrities, predictably, were early adopters.

 

Photo credit : Michael Todaro/ Film Magic

Vanessa Williams admits to dabbling in Botox and schedules shots every three months. "I use it very sparingly," she says. "I want to look natural. I get it so I look serene." Yes, there's nothing so serene as a injecting diluted toxin into your forehead."

How To Defy Aging Like A Celebrity - Part 1

Aging is such a fear-fraught process for many women. Many celebrities seem to have successfully stopped the hands of time when it comes to aging. It is encouraging to witness people in their 40's or 50's who look so amazing for their age as this proves that it is even possible for us to look good when we reach their age.

 A good example would be bona-fide beauty Halle Berry who looks years younger than her actual age of 46 (yes, 46 !). Halle Berry has barely aged in the past decade. Whether she's on the red carpet or at the beach, she still turns heads like a 20-year-old.

 

Another example of an ageless beauty is Datuk Michelle Yeoh, who even at the age of 49, radiates a youthful grace. The former bond girl has recently been named as an ambassador for French luxury cosmetics, Guerlain.

 

 

What Causes Skin Aging ?
 

Being able to identify our skin's enemies and keeping each one in mind as we make daily choices will make a world of difference.

 

1) Intrinsic Aging

 

Intrinsic aging of the skin, also known as the natural aging process normally begins in our mid-20s and is progressive. It is caused primarily by the genes we inherit. Intrinsic aging causes slower collagen production and decreased skin cell turnover.

 

2) Extrinsic Aging

 

Extrinsic aging of the skin is a declination process caused by external factors which include ultra-violet radiation, cigarette smoking, gravity and other environmental factors. Of all extrinsic causes, sunlight radiation has the most widespread documentation of its negative effects on the skin.

Microneedling With Dermaroller : An Effective Treatment For Acne Scarring

Scarring is a particularly distressing phenomenon and is most unwelcome when it occurs on the face. Facial scars can arise due to a number of causes, one of the commonest cause is acne.

It has always been a challenge to treat facial acne scarring. Many different treatments are available but the majority of these treatments are limited by being either marginally effective or having considerable recovery time and side effects. A safe and effective treatment option for facial acne scarring is microneedling with dermaroller. The effectiveness of dermaroller to treat scars is well documented by clinical studies.

The spikes on dermaroller are designed to pierce the skin to stimulate repair and collagen growth.


How does microneedling with dermaroller work ?

A dermaroller is a hand-held instrument consisting of a cylinder studded with fine micro-needles. Derma roller is rolled on the skin and the needles cause small pin point injuries. Skin injury instigate a process of wound healing by stimulating production of more collagen to fill up acne scars, thus leading to smoother skin.

Photo source : NCBI

Top photo : Facial scarring before treatment



Bottom photo : Significant improvement to scars after microneedling with dermaroller

 

What should I expect after microneedling with dermaroller procedure ?

There will be temporary mild swelling, redness and pin point bleeding on the skin immediately after the procedure. These effects typically last a few days. Sun avoidance is neccessary for at least a week after treatment.

What are the possible side effects from microneedling with dermaroller ?

There is very minimal risk of skin infection from dermaroller procedures that is performed in a clinical setting with proper sterilization of equipment. Application of topical anaesthetic cream to the skin prior to treatment will minimise any major discomfort or pain caused by microneedling.

How many treatment sessions are needed for dermaroller treatment ?

A series of 6 treatments performed at monthly intervals is required to achieve satisfactory results.

While microneedling with dermaroller is proven to be a simple and effective treatment for acne scarring, do note that it is a medical procedure and should only be performed by a licensed medical practitioner in a clinical environment. Self- treatment or treatment by unqualified personnel without knowledge of skin anatomy and sterility may lead to negative effects.

Laser Mole Removal

Many people refer to a mole as any dark spot or irregularity in the skin. Moles or naevi are frequently removed for a variety of reasons. If your mole is more of a blemish than a beauty spot, laser mole removal provides a safe and effective option for mole removal.

Not everyone loves their mole as much as Marilyn Monroe. Laser mole removal is a simple and quick alternative to surgery. 

How is laser mole removal performed ?

The mole will be examined by the doctor first. The skin will be cleaned and then numbed with a topical anaesthetic agent such as lidocaine cream or injection. A carbon dioxide laser is used to gently ablate the mole bit by bit until it is completely removed. The procedure takes about 5 to 10 minutes for each mole depending on mole size. Antibiotic cream will be applied to the treated area after the procedure. There will be scab formation at the treated area for a week for laser mole removal on the face and two weeks for laser mole removal on the body. It is important to wear sunscreen and avoid excessive sunlight exposure after treatment.

What happened to Sarah Jessica Parker's famous mole? Photos showed that the mole disappeared from her chin sometime during the summer of 2008 after she filmed the first 'Sex and the City' movie. She later admitted of having the mole removed for cosmetic reasons.

Can the mole be removed in a single treatment session ?

Smaller moles usually need one or two sessions of laser mole removal while larger moles will require more treatment sessions. The treatments should be performed at monthly intervals.

What are the limitations of laser mole removal ?

Laser mole removal is usually not suitable for very large moles or suspected cancerous moles. Excision and biopsy is the preferred treatment for these moles It is important to always have any odd shaped moles or other skin irregularities checked by a medical professional.

What are the possible complications from  laser mole removal ?

Immediate complications from laser mole removal include swelling, redness and pain. However, the risk of complications is low if proper care is taken.

Mole removal should always be performed by a trained medical professional. Home mole removal or mole removal by unlicensed practitioners should be avoided no matter how minor the mole seems to appear. Complications that can arise from improper mole removal include infection, bleeding, nerve damage and even permanent scarring. Mole removal performed by a an experienced medical professional significantly reduces the risk of complications.

Laser Treatment for Pigmented Birthmark (Nevus of Ota)

Pigmented birthmarks are darker colored skin spots that are either present at birth or develop shortly after birth. They come in many different colors, including brown, tan or black. Topical products is usually of no value in treatment of pigmented birthmarks while cosmetic camouflage may offer temporary cover-up.

Photo source : dermnetnz

Nevus of Ota is a birthmark where the pigment cells are found deeper underneath the skin (in the dermis layer)

A common type of pigmented birthmark in Asians is Nevus of Ota. It presents as a blue or gray patch, usually on the upper and mid part of the face. Is advisable to seek treatment early in life due to the psychological trauma and cosmetic disfigurement caused by the birthmark.

How does laser birthmark removal works ?

Q-switched Nd:YAG lasers are the mainstay of treatment for Nevus of Ota and are safe for treating darker skin types. The laser energy is selectively absorbed by pigments, resulting in pigment destruction. Pigments that are broken into smaller particles are then eliminated by the body's immune system.

How many birthmark removal treatments are required ?

On average, 6 to 10 sessions are required to clear most lesions, with an interval of 6 to 8 weeks between treatments.

Photo source : NCBI

A study published in Journal of Cutaneous and Aesthetic Surgery 2008 demonstrated the long-term safety and efficacy of laser treatment for Nevus of Ota. Left photo : before treatment, right photo :  after 6 laser treatments.

What are the complications of laser birthmark removal ?

In the hands of an experienced doctor, the risk associated with laser birthmark removal is minimal. Possible side effects include temporary darkening of the treated skin or the treated skin becoming lighter than the normal skin tone. These effects are transient and can be cleared with the use of sunscreens and topical bleaching creams.

Non-surgical Facelift – How to Turn Back the Clock Without Surgery

As we age, our skin gets thinner due to loss of collagen. In addition, there is also depletion of facial volume from bone absorption and loss of facial fat pads, leading to deflated and descended cheeks. Now, it is no longer about only treating lines or wrinkles but facial volume loss - which is a key sign of aging should also be addressed. The Non-surgical Facelift or Liquid Face Lift is a scapel-free alternative that can target multiple aging concerns.

Increasingly more people are opting for Non-surgical Facelift with injectable fillers and Botox to achieve a more subtle, natural and youthful look. Hyaluronic acid filler (which is made of a sugar occuring naturally in our skin) smoothes lines and restores volume while Botox softens lines and wrinkles. The effects typically last from 6 to 18 months.

Non-surgical Facelift offers the added benefit of :

• Instant effects
• Natural looking results
• Minimal recovery time where the patient can resume their daily activities immediately

When it comes to enhancing facial volume, a small amount of filler goes a long way. These before and after photos show significant improvement with Non-surgical Facelift. (Left photo : before Non-surgical Facelift, Right photo : after Non-surgical Facelift) Photo source : Juvederm

 

 

Get Rid of Forehead Baby Hair with Laser Hair Removal

Baby hairs on the forehead is a common complaint among women who like to wear their hair pulled back. These hairs are finer and shorter than the rest of our hair. Whether our hair style is straight or curly, removing stray hairs from the hair line is a worthwhile investment if you are intent on looking more polished and well-groomed.

Reality star Kim Kardashian has spoken out about her obsession with hair removal and even admitted that she used to wax her forehead. The brunette beauty said that up until few years ago she had baby hairs around her hairline until she tried laser hair removal. Outdated photos showing Kim Kardashian with her natural hairline. 

Kim Kardhasian pictured recently with a smooth forehead.

How does Laser Hair Removal works ?

The laser energy is selectively absorbed by dark coloured pigments within hair follicles leaving the surrounding skin intact. The hair is destroyed within the follicle. The limitation of laser hair removal is that light-coloured hairs (light blonde or white hairs) cannot be removed using this method.

How many sessions of Laser Hair Removal do I need ?

To achieve a smooth hairline, most people will need an average of 3 to 4 treatments, at approximately 4 to 8 weeks' intervals.

Are the results of Laser Hair Removal permanent ?

The effects of treatment are permanent, although a touch-up may be required occasionally from time to time for best results.

What are the possible side effects of Laser Hair Removal ?

Laser hair removal is a very safe procedure when performed by a well-trained and licensed doctor. In the wrong hands, burns and patchy hyperpigmentation (darker then normal skin colour) or hypopigmentation (lighter then normal skin colour) can occur.

What are the benefits of Laser Hair Removal over other methods of hair removal such as Intense Pulsed Light (IPL) ?

Laser hair removal can be safely performed on all skin types, including people with dark skin whereas most IPLs are only safe to treat those with fair skin types. In addition, the quality of IPL machines can vary.

How do I prepare for Laser Hair Removal ?

If you are planning to undergo laser hair removal, you should limit plucking, waxing and electrolysis for four weeks before the treatment because the doctor needs to locate the hairs' roots (which are temporarily removed by waxing or plucking). You should also avoid sun exposure for six weeks before and after treatment as sun exposure may increase the risk of complications following treatment.

   

Laser Tattoo Removal – A Safe and Effective Way to Remove Unwanted Tattoos

While tattoos are meant to be permanent, it often occurs that the same tattoo that used to excite us years back may not be appealing anymore and needs to be removed. It is estimated that as many as 50% of people with tattoos will want to have the tattoo removed later in their life.

Angelina Jolie had her " Billy Bob" tattoo removed and later replaced with

 the geographical coordinates of the birthplaces of her children. Laser tattoo removal is the preferred option when the couple split up.

Tattoo removal used to involve painful dermabrasion, salabrasion (scrubbing the skin with salt) and surgical excision of the tattoo. These older methods could leave horrendous scars but fortunately such drastic methods are no longer necessary. Laser tattoo removal was first introduced 20 years ago and has come a long way since.

How does laser tattoo removal work ?

A pigment laser (such as Q-switch Nd:YAG laser) removes tattoo by selectively breaking up the tattoo pigments with a high-intensity light beam. Pigments that are broken into smaller particles are then eliminated by the body's immune system.

Photo source : Bruce Saal, M.D, Los Gatos, CA

Clinical photos to demonstrate the efficacy of laser tattoo removal

How many sessions of laser tattoo removal treatment do I need ?

It is difficult to know exactly how many treatments will be required as the success of laser tattoo removal depends on factors such as tattoo size, colour, location and depth of ink. Black tattoo pigments absorb more laser energy, making it the easiest to treat. Generally, a small, black amateur tattoo can be removed in 1 to 2 treatments at 6 to 8 weeks apart but more treatment sessions are usually required for coloured tattoos.

Is laser tattoo removal painful ?

Topical anaesthetic agent is required for the procedure. The sensation of laser tattoo removal is similar to a hot pin repeatedly pricking the skin. Many patients feel that the procedure involves some degree of mild discomfort and is easier to tolerate than the tattooing itself.

What are the complications of laser tattoo removal ? Is it safe ?

In the hands of an experienced doctor, the risk associated with laser tattoo removal is minimal. Possible side effects include temporary darkening of the treated skin or the treated skin becomes lighter than the normal skin tone, incomplete removal of the tattoo and scarring.

As with other aesthetic procedures, the skill and expertise of the operator is crucial. Laser tattoo removal, which is otherwise a very safe option for tattoo removal, may prove to be harmful if not done by an experienced doctor.

Treating Melasma with Laser

More than 50 million women worldwide experience melasma, which is often refractory to conventional treatments such as topical lightening creams, sunscreens and chemical peels.

Recently, doctors have made significant progress using laser therapy to manage the condition and greatly improve the quality of life for patients.

What is Melasma ?

Melasma, also known as “Chloasma” or “mask of pregnancy” is a common cosmetic problem. It appears as a dark skin discoloration commonly found on the upper cheeks, nose and forehead. Melasma is often associated with female hormones and is especially common in pregnant women, women taking birth control pills or hormone replacement therapy (HRT) during menopause. Sun exposure is also a strong risk factor for melasma.

How does laser reduce pigmentation ?

Pigment lasers such as the Q-switched Nd:YAG laser effectively breaks down excessive skin pigments without damaging surrounding tissues. Laser energy is selectively absorbed by melanin. Unlike topical creams, laser energy can target deep within the dermis, so dermal (deeper) pigmentation can be effectively treated.

Photo source : ezlady.com.tw

Obvious pigmentation reduction is seen on the right photo after Q-switch Nd:YAG laser 

What are the risk and side effects associated with laser therapy ?

In the hands of a well-trained doctor, Q-switch Nd:YAG laser therapy is extremely safe. Rarely, patchy hyperpigmentation (darker then normal skin colour) or hypopigmentation (lighter then normal skin colour) can occur. This complication is usually transient. 

How many treatments are needed ?

Generally six to eight treatments are recommended to observe significant pigmentation reduction. Each treatment takes 10 to 20 minutes, with no recovery time needed.

Additional Benefits of Treating Melasma with Laser

Laser treatment also have the benefit of skin tightening and overall rejuvenation. The Q-Switched Nd:YAG laser may stimulate collagen production, minimize fine lines and reduce pore size. This is a welcome addition to clinical success in melasma treatment.

A combination of laser therapy, topical lightening cream and sunscreen is recommended for the successful treatment of melasma. However, there is currently no permanent cure for melasma and ongoing touch-up treatments are necessary to maintain successful outcomes.

Lunch Time Boob Job With Macrolane Discontinued

Macrolane for breast enhancement, also known as the 'lunch time boob job' has been taken off the market since April 2012. Q-Med, the manufacturer of Macrolane, has decided to discontinue the promotion of Macrolane for breast enhancement worldwide.

Photo source : C.P. Storm, Flickr.com

Macrolane breast enhancement does not increase the risk of breast cancer but may  increase the risk of a delayed diagnosis.

Macrolane is an injectable filler used for multiple indications including “lunchtime boob jobs”. The cosmetic treatment works by enhancing breast size without the need for implants. It was believed to be less invasive than surgical breast augmentation.

Experts warn that the injected filler material could affect breast cancer screenings but Q-Med said there was a lack of consensus amongst radiologists regarding examination of breasts treated with injectable products.

Macrolane will still remain available for non-breast related body contouring procedures such as buttock enhancement and to correct post liposuction deformities. Meanwhile, according to Q Med, women who have undergone breast enhancement by Macrolane injections do not need to take any action and are not subject to specific medical follow-up other than as prescribed by their practitioner following the procedure.

Article source : BBC

Quick Lunch Time Beauty Fixes

Office workers can now ditch the canteen in favour of the local clinic to combat signs of ageing during their lunch hour. Non-invasive aesthetic procedures are the latest quick-fix indulgence for people on the run, where they can walk-in for a treatment and be out within 30 minutes. In addition, they can return to work immediately and nobody would notice that they have had anything done !

Here are a few popular beauty fixes that you can indulge in during your lunch break :

Photo source : people.co.uk 

Would you like some Botox with your baguette? The growing accessibility of quick beauty fixes is seen as a good thing for the beauty conscious modern woman (and man).

  

1) Botox

The actual Botox injections take as little as 5 minutes and there is almost no recovery time. Most patients will have minimal needle prick marks and mild redness at the injection site which can be covered easily with make-up. It usually takes about a week to see the anti-wrinkle effects of Botox which will last about 4 to 6 months.

2) Non-ablative Laser Rejuvenation

Non-ablative laser rejuvenation has quickly become a convenient treatment option that can be accommodated in a lunch hour. Q switched Nd-YAG laser is a safe and effective rejuvenation modality that takes 15 to 30 minutes to perform. The procedure utilises laser energy to lighten skin pigmentation, minimise pores and boost collagen growth. Immediately after laser treatment, the skin is refreshed with no healing time required. However, patients with sensitive skin might experience mild redness which resolves within a day or two.

3) Permanent Laser Hair Reduction

Perhaps the days of nipping off at lunchtime for a wince-inducing wax are behind us, with permanent laser hair reduction now a quick and convenient treatment option for unwanted hair. Permanent laser hair reduction are generally done within 10 to 45 minutes, depending on the treatment areas. Usually, a series of 4 to 6 treatments are required at monthly intervals to permanently get rid of hair follicles and no recovery time is needed.

Photo source : Candela laser

Before and after photography for armpit permanent hair reduction.

4) Superficial Skin Peel

Superficial or lunch time peels commonly consist of glycolic or fruit acid peels. Glycolic peels are generally very mild and require a series of treatments. They are effective for fading brown spots and smoothing the skin. Occasionally, there may be some mild redness or flaking for a few days after the procedure. However, recovery time is minimal or negligible, which enables the majority of patients to return to work immediately following treatment.

Do note that it is advisable to spend time for a proper consultation with the doctor before the procedure. The above mentioned procedure time also does not include applying topical anaesthesia prior to treatment. If required, topical numbing cream takes about 15 to 30 minutes to achieve desired effect. However, these beauty fixes (with the exception of laser hair removal) are quite comfortable and it depends on the patient's preference to undergo treatment with or without topical anaesthesia.

The Ideal Face As Defined By The Beauty Triangle

What does the ideal face look like and how do we define it?

Japanese cosmetic company Shiseido conducted a research by interviewing 10,000 women in Japan and across Asia to find the common factors that define an ideal face. The women were given 15 mugshots and asked to pick the face they think is the most beautiful. The results revealed that an ideal face is shaped like an inverted triangle, with large, well-defined eyes and full lips.

Many theories have been proposed as a guide for cosmetic surgeons and aesthetic doctors to help restore and create an ideal face. A popular and simple theory is the concept of the "beauty triangle".

The Beauty Triangle

 Photo source : Wallpaperslot

The "beauty triangle" can be demonstrated on Scarlett Johansson, one of the most beautiful actress in Hollywood and star of recent movie, The Avengers.

A youthful face mimics the shape of an inverted triangle – the “beauty triangle”, framed by the cheekbones and chin. It consists of a narrow lower face compared to the midface (cheeks). As we age, our face gradually sags with jowls forming and the lower half of the face becoming square rather than the upside down triangle associated with a young face. This results in an inversion of the beauty triangle. The loss of facial cheek fat and bone resorption contribute to this aged look. 

Photo source : WDW

The photo on the left showed a young Val Kilmer in Top Gun. On the right, aging and weight gain caused his lower face to look wider, like an inverted "beauty triangle". Jowls and excess fat deposits in the lower face can also be seen.  

How to Achieve the "Beauty Triangle" Without Surgey

To correct the inverted triangles of aging, dermal fillers can be injected into the cheeks and upper face to restore loss volume. Skin tightening treatments such as Ultrasound and Radiofrequecy technology can also help to lift sagging skin.

Photo source : Restylane

 Cheek augmentation with dermal fillers, also known as the "liquid face lift" aims to replace volume loss in the upper and midface secondary to aging.

 Photo source : Restylane

Younger patients with naturally flat cheeks can also benefit from dermal filler injection to achieve the "beauty triangle". 

For patients with a square jawline because of bulky masseter muscles (chewing muscles), Botox can be injected to shrink the muscles to achieve a slimmer lower face.

Photo source : sohu.com   

Dramatic changes can be seen in a young patient after Botox facial reshaping.

The key is to gently restore or recreate facial contours according to the concept of the "beauty triangle" and not to alter the facial features dramatically.

New Attitude Towards Cosmetic Treatments

Acquiring cosmetic treatments is no longer the exclusive domain of the rich and famous, nor is it considered a sign of self-indulgence. Today, taking steps to improve one's appearance is considered an investment in health and well-being and is socially acceptable as it is personally gratifying. 
 

According to a recent survey released by the American Academy of Cosmetic Surgery (AACS), an overwhelming majority of Americans think that cosmetic procedures are more accepted today than it was five years ago, with almost as many stating that this shift in perception has made them more comfortable about "getting work done" themselves. The study also found that 67 percent of Americans would not be embarrassed if friends and family knew about their cosmetic surgery. It sounds like gone are the days when cosmetic treatments was a heavily guarded secret.

 Photo source : Atrisia, Emotive Potraits

Hypothetically, would it make you uncomfortable to have friends and family know that you have had cosmetic treatments?

One of the most accepted non-invasive procedure is Botox. It is undeniable that Botox has received its recognition due to usage among celebrities - as a Hollywood “open” beauty secret. According to People magazine in 2008, “This increasing openness about Botox among celebrities may have something to do with its growing popularity”. 

Photo source : David Steinberg/ AP File 

Former American Idol judge, Simon Cowell humorously remarked, “To me, Botox is no more unusual than toothpaste. It works; you do it once a year. Who cares?

 

While women account for the majority of cosmetic procedures, more men are opting for these treatments now. Men are figuring out what women have long known - that appearance really does matter. Some of them may also be motivated by competitive issues such as maintaining an edge in a youth-dominated work environment. 

 Photo source : Allergan

 Before and after photos for Botox to treat brow furrows, a procedure commonly performed in men.

Sleep Lines – Why Sleeping May Cause Wrinkles ?

If you've been subscribing to the notion that a girl needs her beauty sleep, you may want to reconsider. Apparently, visits to slumberland may cause wrinkles.

A friend of mine often complained about the lines on his lower eyelids that appeared like an eye bag despite religiously getting eight hours of sleep every night. On closer examination, there are triagular shaped creases on both his lower eye lids which are not typical of a true eye bag, tear trough or eye bulge. A photo taken when he was lying on his side suggested the root cause of his “eye bag” - they are actually sleep lines.

My friend lying on his side, with his lower eyelid skin cramped by the pillow. The opposite lower eyelid showed similar permanent creases due to his face being plastered into the pillow night after night.

Sleep lines tell the story of your restful nap. However, resting your face on the pillow in the same way every night for years on end may lead to wrinkles known as “sleep lines”. Eventually, these lines no longer disappear when the head is not resting on the pillow and becomes permanently etched on the skin surface.

In 1987, Dr. Samuel J. Stegman described “Sleep Creases”. His study noted that sleep lines are accentuated by pillow contact.

Sleep lines are sometimes single but are usually characterized by 2 to 3 parallel lines in the same area of the face, such as the temples, forehead, around the eyes and mouth. Sleeping on your side can also cause the skin to wrinkle in the laugh lines and chest.

Photo source : Intima

A crinkly clevage begins to be a problem for many women as they pass 40.

How to Treat Sleep Lines ?

Unfortunately, once sleep lines become permanent, treatment options are limited. Subcision, dermal fillers and laser skin resurfacing may help but results are variable.

A wacky way to prevent decolletage wrinkles – an adhesive silicone pad purports to smooth the clevage by just applying the pad at bedtime. But does it work ?

Prevention is the Key

Try sleeping on you back. Although getting used to a new sleeping position might needed some time and discipline, it is the cheapest and most effective way to smooth out sleep lines for both face and chest. People who sleep on their backs do not develop these wrinkles since their skin does not lie crumpled against the pillow.

If you are unable to sleep on your back, use silk pillow cases. Silk is a smoother material than cotton and allows your skin to glide through the surface smoothly.

Facts and Misconceptions About Botox - Part 2

This is the second part of the article - Facts and Misconceptions about Botox. Please click here to read the first part.

3) Will My Friends Know I Did Botox ?

Yes and No. In skilled hands, Botox will not make you look as if you’ve “had work done”. A telltale sign of Botox that has been badly done is that you can look “Spocked”, as in Mr. Spock, a fictional character from Star Trek. That is why it is important to seek treatment from an experienced doctor.

Photo source : Virgin media

Mr. Spock-like eyebrows are also known as the "Mephisto sign" - elevation of the lateral eye brows, at rest and at maximum frown. This should be avoided as it leads to either a weird or evil look.

4) Does Botox Have Any Side Effects ?

Every drug has side effects, and Botox is no exception. Luckily, they tend to be short-lived and mostly resolve spontaneously. Common side effects include droopiness of the eyelid or eyebrow, discomfort or pain at the injection site and bruising. Rarely, eye problems such as double vision, allergic reaction and facial asymmetry might occur.

5) Will I Look Worse Than What I Originally Was After the Botox Effects Wear Off ?

If you choose not to continue Botox treatment, the wrinkles or muscle bulk will gradually return to the same way they looked before treatment (and not worse than before). Botox does not affect the normal aging process.

Patients often get used to looking at the “Botox-enhanced” version of themselves. After the treatment effect wears off, they might think that they “look worse” when it really is their original wrinkles returning.

6) Botox Is Expensive

This is not necessarily true but prices vary widely. In my clinical practice, Botox is priced from a few hundred ringgit onwards, depending on the indication. Common factors that determine the cost of the Botox procedure are : brand of Botulinum Toxin (either Botox® Cosmetic, Dysport™ or others) and total units of Botulinum Toxin administered.

For Botox procedures, the quality of the results always depends on the injector. Choosing a good doctor is the key.

Facts and Misconceptions About Botox - Part 1

Botox is probably one of the most popular cosmetic treatment but often the most misunderstood. Botox inspires both confusion and admiration but is it right for you ? The information here helps to clarify some of the common misconceptions related to Botox.

What Can Botox Do ?

Botox is administered to treat dynamic wrinkles - wrinkles that occur only when we use our facial muscles to form expressions, such as crow's feet and forehead frown lines. Botox does not alter existing static wrinkles - wrinkles and folds that are present even at rest, such as laugh lines. But Botox does play a role in preventing static wrinkles (Please refer to a separate article which further elaborates on this topic). Other indications for Botox includes facial reshaping, reducing excessive sweating, neck rejuvenation and many more.

Photo source : Allergan

Unretouched photos of paid models taken at maximum frown before treatment with Botox and taken at maximum frown after treatment with Botox at indicated time points. Botox is FDA approved to treat frown lines between the eyebrows - the glabellar lines.

Limitations of Botox

Botox is not permanent. Results only last about 4 to 6 months for wrinkle elimination.

Botox Facts and Misconceptions :

Photo source : Allure

Still wondering if Botox is the right choice for you ? Read on to find out more regarding this "miracle" wrinkle eraser. 

1) Botox is a Toxin. Isn't That Dangerous ?

Yes, Botox is purified Botulinum Toxin type A produced by the bacteria Clostridium botulinum. But because the dose and volume used in aesthetics is so small, Botox is incapable of spreading to other parts of the body, and is extremely safe.

Photo source : David Cook

Botox is safe when administered at the correct dosage by a properly trained doctor.

2) Will I Look “Frozen” After Botox ?

Botox will not radically change your facial appearance. The muscle activity is temporarily reduced by Botox, so you can still frown or smile without the wrinkles. Some patients do report that their facial expressions become less intense after Botox but at the same time, they also looked more pleasant, relaxed and refreshed.

It is important to communicate your expectations to the doctor before the procedure - whether you prefer to retain some mobility of the treated muscles. An experienced doctor will have the knowledge to administer just enough Botox to relax the targeted muscles and not make the patient appear "frozen".

To be continued in the next article : Facts and Misconceptions About Botox - Part 2