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Botox Dubai | 18 August 2020

Wrinkles are part of the ageing process. They can be attributed to sun damage, effects of gravity and muscle contraction resulting from facial expressions such as frowning and laughing. Wrinkles due to the effects of gravity represent natural sagging of tissue with age and are generally only improved by surgical tightening procedures. Wrinkles caused by muscle contraction such as frown lines, forehead lines and crows’ feet, can be improved by Botox treatment.

Botulinum toxin anti-wrinkle injections work by relaxing the facial muscles responsible for wrinkles. When used appropriately, botulinum toxin is a great solution for reducing the appearance of wrinkles around the face. In particular, it is highly effective in the lip, forehead and eye areas. I always undertake a detailed medical consultation to assess your general health and requirements. After which, if it is deemed safe and appropriate then I can offer botulinum toxin anti-wrinkle injections as a treatment.

Botulinum toxin injections are most commonly used for:

– Frown Lines  

– Lines around the eyes (crow’s feet)

– Horizontal forehead lines

– Nasal scrunch or squint lines

– Lines on neck

Botulinum toxin is also used in small amounts in a number of other areas on the face depending on the way your muscles of facial expression work. It can raise the outer part of the eyebrow if it is sagging, lift the corners of the mouth, and help to smooth out dimpled or cobblestoned chins. Generally it is not used in the lines around the mouth, usually because it might be difficult to speak and eat. 

WHAT IS BOTULINUM TOXIN?

Botulinum toxin is an injected liquid used to treat frown lines, squint and smile lines, nasal crunch lines, and horizontal forehead wrinkles. By relaxing the underlying muscles, these lines become less deep.

Botulinum toxin has been used to treat thousands of patients medically and cosmetically over 20 years. Botulinum toxin is produced in a lab by a bacterium called “Clostridium botulinum”. It has been purified under very strict controlled conditions. The Botox brand of botulinum toxin is made by Allergan, a company with a twenty-year history of making this product safely.

When injected into a small facial muscle, it doesn’t travel anywhere else in the body. It gradually wears off naturally over a 3-6 month period.  There are other forms of botulinum toxin now being produced by other companies. 

PROCEDURE 

In preparation for botulinum toxin treatment, or any injectable procedure, bruising can be minimized by discontinuing aspirin and any medication or dietary supplement that has anticoagulant effects two weeks before treatment.

Patients are advised to avoid lying supine following treatment for four hours. They are also advised to avoid massaging or applying heat to the treatment area, and to avoid activities that cause flushing (such as exercising heavily, consuming alcohol, and hot tub use) on the day of treatment. 

Partial reduction in function of the targeted glabellar complex muscles is seen by the third day after botulinum toxin injection, with maximal reduction visible two weeks after injection. Return of muscle function is gradual, typically three to four months after treatment. Subsequent treatment is advised when muscle contraction is visible in the treatment area before facial lines return to their pretreatment appearance. After multiple treatments, botulinum toxin effects may be prolonged and, for some patients, treatment intervals can be extended beyond three to four months.

HOW LONG DO THE EFFECTS OF BOTULINUM TOXIN LAST?

Most patients find that the effects of botulinum toxin injections last approximately 3-6 month . Most of my patients come 3-4 times the first year and then 2-3 times a year after that. After the muscles have been relaxed for a while, it takes less to maintain that relaxation. But every patient is an individual, and there is no knowing exactly how you will respond.

HOW LONG DOES BOTULINUM TOXIN TAKE TO WORK?

The effects are may be first noticed in 72 hours but it may take up to 7 days to maximize the effect. You may be asked to return after the first treatment so that I can assess your response. The first set of botulinum toxin injections may only give a partial response. This is common and complete relaxation may be noticed after the second or third treatment.

DO BOTULINUM TOXIN INJECTIONS HURT?

Botulinum toxin is injected with a very small needle (like an acupuncture needle), so it causes very little pain upon injection. Botulinum toxin does not cause irritation or inflammation. Occasionally, patients have noticed that there is a mild stinging sensation.

ARE THERE ANY PEOPLE WHO SHOULD NOT RECEIVE BOTULINUM TOXIN?

Botulinum toxin injections should not be given to pregnant women, nursing mothers, or patients with neuromuscular diseases like myasthenia gravis, Lambert-Eaton syndrome, ALS (Lou Gehrig’s), or motor neuropathy should not use botulinum toxin. Patients who are allergic to human albumin (different than an egg allergy) should not use botulinum toxin. It is not recommended in pregnancy or nursing because it has not been tested.

Are there any medical side effects?

Side effects include bruising, eyebrow or eyelid droops, and a temporary headache, and rare flu-like symptoms have been reported. Many of the side effects that are listed for botulinum toxin are seen when large amounts are injected for medical purposes as opposed to the small amounts used for cosmetic purposes. Very rare allergic reactions have been reported.

COSMETIC SIDE EFFECTS OF BOTULINUM TOXIN?

We’ve all seen these – and with celebrities too frequently. Basically, these problems are due to either a inexpert injector or a patient who insists on this look despite all evidence that it looks bad! With an expert, experienced doctor or nurse injecting, these potential problems should be rare or nonexistent.

Fillers in Dubai | 16 August 2020

These days, dermal fillers have become extremely popular for facial rejuvenation without the need for surgery or recovery time. 

WHAT CAN DERMAL FILLERS TREAT?

Dermal fillers are generally used for smoothing fine lines and wrinkles, and for adding volume and fullness to skin beginning to suffer from volume loss. Dermal fillers  can also be used for cheek and chin augmentation. 

When performed by an expert with experience using dermal fillers, these treatments can be extraordinarily natural-looking. Most men and women don’t necessarily want to look as if they have had work done, so strategic dermal filler placement is ideal for someone who just wants to soften their lines and take a few years off their face.

One of the main draws for dermal filler treatments is that they require no recovery time. The actual procedure can be done in as little as ten minutes, depending on how many areas are to be treated, and the patient is then free to resume their daily activities and go back to work immediately.  The potential side effects of dermal fillers when administered professionally are very minimal, just redness or swelling around the injection site. If this happens, it usually disappears within a few hours or a day, and can be covered easily with makeup. Bruising is another potential side effect, but these can generally be avoided by following your dermatologist’s instructions before coming in for your appointment.

BENEFITS OF DERMAL FILLERS

1. Immediate Results and No Downtime

One of the biggest benefits of using dermal fillers? They provide immediate results. Once you undergo a filler injection, you will notice your appearance transform soon thereafter. On top of this, you don’t have to worry about recovery time like you would following plastic surgery. In fact, you can complete the filler treatment in just 10 minutes depending on the number of areas needing treatment. Then, you’re free to continue your daily errands or even go back to work. In fact, a filler treatment is sometimes described as a “lunchtime facelift.” Talk about a life-changing lunch break.

The side effects you may experience as a result of your filler treatment are minimal. Just a little swelling or redness near your injection site is normal. Even then, this swelling and redness should disappear within several hours or one day. In the meantime, you can simply cover it up with makeup.

You may more commonly experience bruising, but you can typically avoid this by following my instructions prior to your filler treatment appointment.

2. Long-Lasting Effects

Yet another benefit of fillers is the lasting results you’ll enjoy after getting them. In the majority of cases, you’ll stay looking more youthful and beautiful for about one year. However, you might want to go in for a quick touch-up appointment in four to six months following your initial treatment. It’s in your best interest to maintain your filler results. You can do this simply by scheduling your next treatment before your filler has had the chance to metabolize completely.

3. Beneficial for the Skin

Most fillers feature a natural skin component that help the skin – a major plus for patients interested in getting filler injections. Hyaluronic acid present in fillers are naturally occurring substances in the skin. Thus, when they are injected, they’ll feel natural beneath your skin. It’s just another reason to love the skin you’re in after you get a filler treatment.

4. Subtle Results

If you choose to receive dermal fillers, you’ll also love how subtle and natural looking the results are. That’s exactly what you want if you’re like most patients. After all, who honestly wants to look like a totally different individual after the treatment than he or she was before it? You simply want to be the best version of yourself. With dermal fillers, the majority of people won’t even know what you had done. All they’ll notice is that you look amazing.

5. Self-Confidence Builder

People who receive dermal fillers generally improve their self-confidence following their treatment. They simply love how their fillers look and feel. At the hands of an experienced aesthetic practitioner, you can achieve amazing natural looking results and love how you look like never before.

6. Plumpness

As you grow older, your skin will lose collagen and fat. In other words, you’ll lose your youthful plumpness. Replacing the young, healthy look you’ve become accustomed to will be a hollowed-out look and more blatantly obvious wrinkles – clear signs of advancing age. Fortunately, fillers help to counteract these problems by making your skin plumper. In the end, you’ll end up with fuller-looking cheeks as well as fewer facial wrinkles – You can’t beat that.

7. Botox Complements Them

Another perk of using fillers? Botox complements fillers perfectly! As you get fillers, you might notice that a few of the wrinkles on your face are particularly deep – especially those on your forehead and glabella. Or maybe you notice vertical lip lines near your mouth. In these situations, you may want to receive a Botox or Dysport treament. This product will temporarily reduce the muscle activity responsible for your deep wrinkles and frown lines. It’s perfect for tackling those lines and wrinkles that dermal fillers won’t eliminate. With the powerful combination of fillers and Botox or Dysport, you may be able to delay or even avoid surgery, such as a facelift, down the road.

8. Good for Your Lips

Of course, fillers aren’t just good for filling in wrinkles and cheeks. Fillers can work wonders for your lips. Tired of thin lips? Fillers can make your lips look plumper and sexier. At the same time, it’ll soften the appearance of annoying wrinkles around the mouth. With dermal fillers, you can finally stop feeling self-conscious when it comes to your lips. In fact, your lips just might become your favorite feature. Just be sure to get lip fillers with an experienced aesthetic practitioner to ensure yourself an experience that is safe and that yields natural looking results.

9. Say Goodbye to Scars

A major advantage of springing for fillers is that they can improve the appearance of scars. This is a big deal if you’ve spent years applying makeup to hide unsightly scars as a result of acne, for example. Your practitioner can help you to determine if dermal fillers are an option for treating certain scars.

10. Boost Your Collagen

Last but not least, biostimulatory fillers, like Radiesse and Sculptra will stimulate the body’s natural collagen. A major reason that your skin ages as you get older is that collagen production declines. This is accelerated if someone has a lot of sun damage. Collagen is one of your skin’s essential building blocks. When collagen ends up breaking down, the signs of aging is more apperant. This includes having coarse skin texture and wrinkles.

Dermal fillers, however, can help your body stimulate more of its own collagen, just as a younger individual’s skin does. This translates to the younger, healthier-looking skin you’re after – in a natural way.

Breast Augmentation Dubai | 11 August 2020

Breast augmentation, or augmentation mammoplasty, or is a surgical procedure that aims to increase the size, shape, or fullness of the breast.

Breast augmentation is done to:

– Enlarge breasts that are naturally small

– Restore breast size and shape after pregnancy, weight loss or 

  breastfeeding

– Restore symmetry when the breasts are asymmetrical

– Restore the breast or breasts after surgery

LIFE AFTER BREAST AUGMENTATION

Breast augmentation is a daycase procedure, typically performed using general anesthesia. You can expect to walk around on your own a few hours after surgery, and most patients feel up to leaving the house within the next day or two.

You may feel sore the first week or so, and you will need to limit strenuous exercise for about 2-4 weeks. Your cosmetic surgeon will also ask you to wear a supportive surgical bra or sports bra for a certain period of time after breast augmentation—it is crucial to follow your cosmetic surgeon’s instructions to ensure you heal optimally.

If your breast implants are placed partially beneath the pectoral muscle—the preferred method in most cases—your breasts may seem to sit high on the chest at first. This is normal, and your implants will settle into their optimal position over the next several weeks, with final results after a couple of months.

BREAST AUGMENTATION

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

WHAT BREAST AUGMENTATION SURGERY CAN DO

– Increase fullness and projection of your breasts

– Improve balance of breast and hip contours

– Enhance your self-image and self-confidence

WHAT BREAST AUGMENTATION SURGERY CAN’T DO

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

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

WHO IS A GOOD CANDIDATE FOR BREAST AUGMENTATION?

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

You may be a candidate for breast augmentation if:

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

– You have realistic expectations

– Your breasts are fully developed

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

– You are dissatisfied with your breasts losing shape and volume after 

  pregnancy, weight loss or with aging

– You are unhappy with the upper part of your breast 

   appearing “empty”

– Your breasts are asymmetrical

– One or both breasts failed to develop normally or have an 

   elongated shape

WHAT TYPES OF BREAST IMPLANTS ARE AVAILABLE?

Saline breast implants

Saline breast implants are filled with sterile salt water. Should the implant shell leak, a saline implant will collapse and the saline will be absorbed and naturally expelled by the body. Saline breast implants provide a uniform shape, firmness and feel. I usually do not recommend the use of these implant

Silicone breast implants

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

Gummy bear breast implants

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

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

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

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

Round breast implants

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

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

Anatomical or tear drop shaped breast implants

These kind of implants are built with a particular shape in order to give a more natural effect filling more the lower pole and keeping the upper one very lightly filled. Different shapes and sizes are available to fullfill the desire of the patients. 

Smooth breast implants

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

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

Textured breast implants

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

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

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

HOW SHOULD I PREPARE FOR BREAST AUGMENTATION?

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

– Get a blood test

– Get a breast ultrasound or mammogram (if above 40y old) to exclude any lump in the breast

– Take certain medications or adjust your current medications

– Stop smoking

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

  increase bleeding

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

  you for at least the first night following surgery.

WHAT SHOULD I EXPECT DURING MY BREAST AUGMENTATION RECOVERY?

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

Immediately after surgery, you will be taken into a recovery area for close monitoring. You may be permitted to go home when you are stable for discharge, typically after 6 hours or so.

WHAT RESULTS SHOULD I EXPECT AFTER BREAST AUGMENTATION SURGERY?

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

Plastic Surgery Dubai | 8 August 2020

When it comes to Botox and other non-invasive cosmetic procedures, experts in the field believe that less is more. Every procedure has an undesirable consequence, so people need to understand the necessity of less is more, and only have treatments where the positive outweighs that consequence.

If you can tell someone has had work done, it’s been done wrong. The results of a ‘less is more’ approach rest on knowing exactly where to put these minuscule measures of Botox to deliver the desired results.

Many people think that the aim of Botox is to get rid of lines, but it’s not – It’s far more important to look at the face as a whole, aiming to subtly lift key points using small amounts of Botox to create a fresher appearance.

BOTOX DUBAI 

Botulinum toxin anti-wrinkle injections work by relaxing the facial muscles responsible for wrinkles. When used appropriately, botulinum toxin is a great solution for reducing the appearance of wrinkles around the face. In particular, it is highly effective in the lip, forehead and eye areas. I always undertake a detailed medical consultation to assess your general health and requirements. After which, if it is deemed safe and appropriate then I can offer botulinum toxin anti-wrinkle injections as a treatment.

Procedure Preparation

In preparation for botulinum toxin treatment, or any injectable procedure, bruising can be minimized by discontinuing aspirin and any medication or dietary supplement that has anticoagulant effects two weeks before treatment.

Aftercare

Patients are advised to avoid lying supine following treatment for four hours. They are also advised to avoid massaging or applying heat to the treatment area, and to avoid activities that cause flushing (such as exercising heavily, consuming alcohol, and hot tub use) on the day of treatment. 

Results and Follow-Up

Partial reduction in function of the targeted glabellar complex muscles is seen by the third day after botulinum toxin injection, with maximal reduction visible two weeks after injection. Return of muscle function is gradual, typically three to four months after treatment. Subsequent treatment is advised when muscle contraction is visible in the treatment area before facial lines return to their pretreatment appearance. After multiple treatments, botulinum toxin effects may be prolonged and, for some patients, treatment intervals can be extended beyond three to four months.

What are botulinum toxin injections used for?

Botulinum toxin injections are most commonly used for:

– Frown Lines  

– Lines around the eyes (crow’s feet)

– Horizontal forehead lines

– Nasal scrunch or squint lines

– Lines on neck

Botulinum toxin is also used in small amounts in a number of other areas on the face depending on the way your muscles of facial expression work. It can raise the outer part of the eyebrow if it is sagging, lift the corners of the mouth, and help to smooth out dimpled or cobblestoned chins. Generally it is not used in the lines around the mouth, usually because it might be difficult to speak and eat. 

What is botulinum toxin?

Botulinum toxin is an injected liquid used to treat frown lines, squint and smile lines, nasal crunch lines, and horizontal forehead wrinkles. By relaxing the underlying muscles, these lines become less deep.

Botulinum toxin has been used to treat thousands of patients medically and cosmetically over 20 years. Botulinum toxin is produced in a lab by a bacterium called “Clostridium botulinum”. It has been purified under very strict controlled conditions. The Botox brand of botulinum toxin is made by Allergan, a company with a twenty-year history of making this product safely.

When injected into a small facial muscle, it doesn’t travel anywhere else in the body. It gradually wears off naturally over a 3-6 month period.  There are other forms of botulinum toxin now being produced by other companies. 

How long do the effects of botulinum toxin last?

Most patients find that the effects of botulinum toxin injections last approximately 3-6 month . Most of my patients come 3-4 times the first year and then 2-3 times a year after that. After the muscles have been relaxed for a while, it takes less to maintain that relaxation. But every patient is an individual, and there is no knowing exactly how you will respond.

How long does botulinum toxin take to work?

The effects are may be first noticed in 72 hours but it may take up to 7 days to maximize the effect. You may be asked to return after the first treatment so that I can assess your response. The first set of botulinum toxin injections may only give a partial response. This is common and complete relaxation may be noticed after the second or third treatment.

Do botulinum toxin injections hurt?

Botulinum toxin is injected with a very small needle (like an acupuncture needle), so it causes very little pain upon injection. Botulinum toxin does not cause irritation or inflammation. Occasionally, patients have noticed that there is a mild stinging sensation.

Are there any people who should not receive botulinum toxin?

Botulinum toxin injections should not be given to pregnant women, nursing mothers, or patients with neuromuscular diseases like myasthenia gravis, Lambert-Eaton syndrome, ALS (Lou Gehrig’s), or motor neuropathy should not use botulinum toxin. Patients who are allergic to human albumin (different than an egg allergy) should not use botulinum toxin. It is not recommended in pregnancy or nursing because it has not been tested.

Are there any medical side effects?

Side effects include bruising, eyebrow or eyelid droops, and a temporary headache, and rare flu-like symptoms have been reported. Many of the side effects that are listed for botulinum toxin are seen when large amounts are injected for medical purposes as opposed to the small amounts used for cosmetic purposes. Very rare allergic reactions have been reported.

Cosmetic side effects of botulinum toxin?

We’ve all seen these – and with celebrities too frequently. Basically, these problems are due to either a inexpert injector or a patient who insists on this look despite all evidence that it looks bad! With an expert, experienced doctor or nurse injecting, these potential problems should be rare or nonexistent.

Does Botox interact with other drugs?

Very rarely. It is always important to let me know if you are taking other drugs.

Plastic Surgery Dubai | 5 August 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.

Plastic Surgery Dubai | 1 August 2020

As part of the aging process which happens to all of us sooner or later, our skin progressively loses its elasticity and our muscles tend to slacken. The stresses of daily life, effects of gravity and exposure to sun can be seen on our faces. The folds and smile lines deepen, the corners of the mouth droop, the jaw line sags and the skin of the neck becomes slack. 

Around the eyes, the eyebrows droop and the skin of the eyelids gathers in loose folds. In the skin the first sign is fine wrinkles developing around the lips, at the outer corners of the eye and lines of expression. The rate at which this happens varies from one person to another and is probably determined by our genes. Aging of the skin of the face does not necessarily reflect the rate that the rest of our body and mind is ageing and many people feel frustrated that the face they see in the mirror is not the one they feel should be there. Substantial weight loss can produce similar changes in facial appearance to those of the aging process.

WHAT IS FACELIFT AND NECKLIFT SURGERY?

A facelift is an operation to tighten and lift the loose skin of your face below the eyes. (Anything above the eyes is a browlift.) A necklift tightens and lifts the skin of the neck.

WHY HAVE A FACELIFT OR NECKLIFT?

As you age, your skin gets less elastic and droops, and your facial muscles slacken. The natural fat under the skin also sags, making you look older. The rate this happens at varies from person to person, and is probably determined by your genes. The stresses of daily life, the effect of gravity and exposure to the sun also affect your face. Drastic weight loss can also age the face. The rate your face ages does not necessarily reflect the rate that the rest of your body and mind is ageing, and you may feel that the face you see in the mirror is not the one you should have.

A facelift gives the best results if your face and neck have started to sag but your skin still has some elasticity and your bone structure is strong and well defined. Most people who have facelifts are in their 40s to 60s, but facelifts can be done successfully on people in their 70s or 80s.

It should not be obvious that you have had a facelift, but you should look younger, healthier, lively and cheerful.

WHAT WILL HAPPEN BEFORE MY OPERATION?

You will meet your surgeon to talk about why you want surgery and what you want. The surgeon will make a note of any illnesses you have or have had in the past. They will also make a record of any medication you are on, including herbal remedies and medicines that are not prescribed by your doctor. Your surgeon will examine your face and neck, and may take some photographs for your medical records. They will ask you to sign a consent form for taking, storing and using the photographs.

The surgeon will measure your height and weight to make sure that it is safe to do an operation. If you are overweight, or planning to become pregnant, your surgeon may suggest delaying your operation.

A facelift improves the lower half of the face, particularly the jawline. If you have sagging eyebrows and wrinkles on your forehead, your surgeon may suggest a browlift. Loose skin with fine wrinkles, freckles and rough areas will benefit more from a chemical peel or laser resurfacing, which can be performed with a facelift, browlift or necklift.

HOW IS THE SURGERY PERFORMED?

A facelift involves raising and repositioning the skin and soft tissue of the face. During the operation, cuts are made on both sides of the face in front of the ear, extending up along the hairline, just in front of or behind the cartilage, and around behind the earlobe, into the crease behind the ear and then into the lower scalp. Occasionally, the surgeon may need to make a small cut under the chin for the necklift part of the surgery.

Sometimes only the skin above the neck is lifted (a facelift only).

Sometimes the neck muscle and the skin over it is just tightened by stitching them together (a necklift only).

Sometimes the neck muscle and the skin over and above it are tightened and then lifted and stitched tightly to the solid structures in front of and behind the ear (a facelift and necklift).

Excess skin is then removed, and the remaining skin is sewn into position.

Fat and tissue is redistributed, and is sometimes added to the face.

HOW CAN I HELP MY OPERATION BE A SUCCESS?

Be as healthy as possible. It is important to keep your weight steady with a good diet and regular exercise. If you intend to lose weight, you should do so before the operation. This allows the surgeon to remove more skin and so achieve a better result. You should avoid taking tablets containing aspirin, as well as non-steroidal anti-inflammatory drugs, such as Voltarol and Indocid, for at least two weeks before the operation as they increase the risk of bleeding.

If you are planning to have your hair permed, bleached or coloured, do this before your operation as fresh scars are sensitive to these chemicals for a few weeks.

If you smoke, stopping at least six weeks before the operation will help to reduce the risk of complications, particularly the risk of the flaps of skin behind the ear losing their blood supply. Do not worry about removing hair near where we will be making cuts, but do have a bath or shower during the 24 hours before your operation to make sure that the area is as clean as possible.

WHAT IS THE ALTERNATIVE TREATMENT?

Facelifts and necklifts are the most effective ways of tightening the skin of your face and neck. They do not get rid of wrinkles around your eyes, forehead and mouth. Other treatments such as Botox injections can help with this.

Facelifts and necklifts do not change the texture and look of your skin, though treatments such as laser resurfacing (where a laser is used to burn the surface of your skin in a controlled way) or chemical peels (where a chemical is applied to peel off the surface of the skin) may help with this. Sometimes, fat grafting or lipofilling (where fat removed by liposuction from another part of the body, such as the hips or thighs, is injected into the face) can be performed instead of or as well as facelift, to make your face and skin look younger. Sometimes sagging eyebrows can be the main problem. In this case, a browlift, either on its own or with a facelift or necklift, may help to tighten the skin on your face.

WHAT ARE THE MAIN RISKS AND COMPLICATIONS OF FACELIFTS AND NECKLIFTS?

As with all operations, there are risks involved in having a facelift or necklift. Although the risks are unlikely, it is important to weigh them up against the potential benefit of the surgery. Discuss each of them with your plastic surgeon to make sure you understand the potential complications and consequences.

WHAT TO EXPECT AFTER THE OPERATION

Facelifts and necklifts are usually carried under a general anaesthetic (so you would be asleep) or a local anaesthetic (where the whole area is numbed with injections and you might be sedated). The operation takes between two and five hours. You might be given antibiotics to keep the wound clean. You may have drainage tubes in your face or neck to drain away any fluid or blood. These tubes will be taken out when the fluid or blood has stopped draining, usually before you go home.

You might go home the same day, but most likely you will stay in hospital overnight. If you do go home on the same day, a responsible adult should stay with you for the night. Your face and neck will feel tight and sore. Simple painkillers should be enough to keep you comfortable.

DRESSINGS

You will have some dressings on your face and neck. Most surgeons will bandage your face to reduce bruising and swelling. These bandages will stay on for one or two days, and the stitches will be removed after seven or eight days.

RECOVERY

It is normal for there to be some numbness of the skin of the cheeks and ears. This will usually improve in a few weeks or months, although there may be long-term loss of sensitivity of the skin in front of your ears. It is better to keep your head up to reduce swelling. In particular, sleep with extra pillows to keep your head raised for the first few days after surgery. You will be out of bed on the same day as your surgery, and doing light activities after two weeks. Avoid strenuous activity, saunas and massage for at least two weeks. At first your face will look a little puffy and may feel rather strange and stiff. The scars can be very well hidden with your hair so that you can return to work and socialising within a couple of weeks. Men find it more difficult than women to disguise the scars, and their beard will grow closer to their ears as a result of the skin being lifted. 

Botox Dubai | 29 July 2020

Botulinum toxin anti-wrinkle injections work by relaxing the facial muscles responsible for wrinkles. When used appropriately, botulinum toxin is a great solution for reducing the appearance of wrinkles around the face. In particular, it is highly effective in the lip, forehead and eye areas. I always undertake a detailed medical consultation to assess your general health and requirements. After which, if it is deemed safe and appropriate then I can offer botulinum toxin anti-wrinkle injections as a treatment.

Procedure Preparation

In preparation for botulinum toxin treatment, or any injectable procedure, bruising can be minimized by discontinuing aspirin and any medication or dietary supplement that has anticoagulant effects two weeks before treatment.

Aftercare

Patients are advised to avoid lying supine following treatment for four hours. They are also advised to avoid massaging or applying heat to the treatment area, and to avoid activities that cause flushing (such as exercising heavily, consuming alcohol, and hot tub use) on the day of treatment. 

Results and Follow-Up

Partial reduction in function of the targeted glabellar complex muscles is seen by the third day after botulinum toxin injection, with maximal reduction visible two weeks after injection. Return of muscle function is gradual, typically three to four months after treatment. Subsequent treatment is advised when muscle contraction is visible in the treatment area before facial lines return to their pretreatment appearance. After multiple treatments, botulinum toxin effects may be prolonged and, for some patients, treatment intervals can be extended beyond three to four months.

What are botulinum toxin injections used for?

Botulinum toxin injections are most commonly used for:

– Frown Lines  

– Lines around the eyes (crow’s feet)

– Horizontal forehead lines

– Nasal scrunch or squint lines

– Lines on neck

Botulinum toxin is also used in small amounts in a number of other areas on the face depending on the way your muscles of facial expression work. It can raise the outer part of the eyebrow if it is sagging, lift the corners of the mouth, and help to smooth out dimpled or cobblestoned chins. Generally it is not used in the lines around the mouth, usually because it might be difficult to speak and eat. 

What is botulinum toxin?

Botulinum toxin is an injected liquid used to treat frown lines, squint and smile lines, nasal crunch lines, and horizontal forehead wrinkles. By relaxing the underlying muscles, these lines become less deep.

Botulinum toxin has been used to treat thousands of patients medically and cosmetically over 20 years. Botulinum toxin is produced in a lab by a bacterium called “Clostridium botulinum”. It has been purified under very strict controlled conditions. The Botox brand of botulinum toxin is made by Allergan, a company with a twenty-year history of making this product safely.

When injected into a small facial muscle, it doesn’t travel anywhere else in the body. It gradually wears off naturally over a 3-6 month period.  There are other forms of botulinum toxin now being produced by other companies. 

How long do the effects of botulinum toxin last?

Most patients find that the effects of botulinum toxin injections last approximately 3-6 month . Most of my patients come 3-4 times the first year and then 2-3 times a year after that. After the muscles have been relaxed for a while, it takes less to maintain that relaxation. But every patient is an individual, and there is no knowing exactly how you will respond.

How long does botulinum toxin take to work?

The effects are may be first noticed in 72 hours but it may take up to 7 days to maximize the effect. You may be asked to return after the first treatment so that I can assess your response. The first set of botulinum toxin injections may only give a partial response. This is common and complete relaxation may be noticed after the second or third treatment.

Do botulinum toxin injections hurt?

Botulinum toxin is injected with a very small needle (like an acupuncture needle), so it causes very little pain upon injection. Botulinum toxin does not cause irritation or inflammation. Occasionally, patients have noticed that there is a mild stinging sensation.

Are there any people who should not receive botulinum toxin?

Botulinum toxin injections should not be given to pregnant women, nursing mothers, or patients with neuromuscular diseases like myasthenia gravis, Lambert-Eaton syndrome, ALS (Lou Gehrig’s), or motor neuropathy should not use botulinum toxin. Patients who are allergic to human albumin (different than an egg allergy) should not use botulinum toxin. It is not recommended in pregnancy or nursing because it has not been tested.

Are there any medical side effects?

Side effects include bruising, eyebrow or eyelid droops, and a temporary headache, and rare flu-like symptoms have been reported. Many of the side effects that are listed for botulinum toxin are seen when large amounts are injected for medical purposes as opposed to the small amounts used for cosmetic purposes. Very rare allergic reactions have been reported.

Cosmetic side effects of botulinum toxin?

We’ve all seen these – and with celebrities too frequently. Basically, these problems are due to either a inexpert injector or a patient who insists on this look despite all evidence that it looks bad! With an expert, experienced doctor or nurse injecting, these potential problems should be rare or nonexistent.

Does Botox interact with other drugs?

Very rarely. It is always important to let me know if you are taking other drugs.

Plastic Surgery Dubai | 22 July 2020

Some men find that one or both breasts may be abnormally large. Known as gynaecomastia, this condition can result from a hormone imbalance or from being very overweight, which can increase levels of oestrogen and cause breast tissue to grow. Breast reduction surgery is an option for men with this condition. It may also be used to tighten the breast area after dramatic weight loss that has caused the skin to sag.

However, it is not suitable for men whose large breasts are simply excess fat from being overweight.

WHAT IS GYNAECOMASTIA?

Gynaecomastia is the benign (non-cancerous) growth of male breast tissue and can be due to a number of causes. It may be due to hormone imbalance or as a consequence of medication you are taking. It can also be due to alcohol excess or recreational drug abuse. I will discuss the cause of your gynaecomastia with you. Along with causing swelling of the breast and nipple, gynaecomastia can be uncomfortable and the nipple can become sensitive.

HOW CAN GYNAECOMASTIA BE TREATED?

Some cases of gynaecomastia will get better without any form of treatment. If one of your medications is thought to be causing the gynaecomastia, it may improve with changing or stopping a particular tablet. Whilst gynaecomastia itself can be uncomfortable and unsightly, it is not dangerous and no harm will come from having it. When cancer has been ruled out, many men are happy to have no treatment. Another form of treatment is to have medication. These medications are often good at reducing discomfort and sensitivity but may not reduce the size of the breast. The third form of treatment involves surgery to your breast.

SURGICAL TREATMENT OF GYNAECOMASTIA

There are three main surgical procedures which can be undertaken:

Liposuction

Liposuction is used to remove the fatty tissue under a general anaesthetic. Small incisions (cuts) are made on the chest wall. A small metal tube (cannula) is used to suck out the fatty tissue. The incisions are then sutured to give a flatter, firmer and better-contoured chest. Any stitches will be of the dissolving type and so do not need to be removed.

Excision of gynaecomastia

In excisional surgery, I will make a cut around the nipple to remove the breast tissue. This may be combined with liposuction of the breast tissue at the same time.

Male breast reduction

If the breast is very large more tissue and skin may have to be removed. This will give more scars. The degree of scarring will depend on how much skin needs to be removed. I will advise you about this.

AFTER SURGERY

After surgery for gynaecomastia your breasts will look discoloured and feel firm and swollen. Bruises can occur. You may need to have a drain (a fine plastic tube) inserted into the breast during the operation. This will be removed by the breast care nurses seven days after your operation. You should be able to go home the same day. You may be advised to wear a corset for up to four weeks after the operation to help with the swelling. You will not be able to drive home after your operation and it may be two to three days before you can drive.

The dressings can be removed after 7-10 days and you should be able to return to work after one weeks. For the first three weeks after the operation, don’t lift anything heavy or do heavy manual work. Most men resume normal activities within two to three weeks. 

FOLLOW UP

You will be given an appointment to return to the clinic in 7-10 days where the dressings and drain(s) will be removed and the wounds inspected. You will also be reviewed after your surgery once the bruising and swelling has completely settled.

LONG TERM OUTLOOK

If liposuction is performed and only fat is removed, weight gain can make the gynaecomastia return. If the breast tissue itself is removed, as in the excision surgery or male breast reduction there is a chance the breast tissue can regrow. You will have medical photography before and after surgery of your chest. There will be nothing which will identify you to anyone else on these and they are used as a record of your treatment.

Abdominoplasty Dubai | 20 July 2020

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

ANATOMY OF THE ABDOMEN

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

SURGERY STEPS

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

ADDITIONAL PROCEDURES

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

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

SURGERY AND ANESTHESIA

The surgery lasts 2 – 2.5 hours, and is performed under general anesthesia. Many patients worry about the risk of general anesthesia, but it is very safe and it assures that you will be completely comfortable during surgery. Prior to surgery you will be required to obtain medical photographs, routine bloodwork, and in some cases preoperative clearance. The evening prior to surgery, you should not eat or drink anything after midnight. This ensures that you will have an empty stomach prior to surgery, which is very important for your anesthesiologist to care for you safely. You will need to have a responsible adult available to escort you home after surgery.

RECOVERY

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

Patients are seen in the office 3 or 4 days following surgery. At that time your drains will be removed and you will be replaced into your surgical garment. Most sutures placed will dissolve on their own. The surgical garment should be worn for the following  4 weeks

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

WHAT A TUMMY TUCK CANNOT DO

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

Fillers in Dubai | 18 July 2020

Injectable dermal fillers can give you a more youthful look for a fraction of what a traditional facelift costs. Most will fill hollows, lines, and wrinkles in less than 30 minutes with results that can last from 6 months to more than a year.

Injectable dermal fillers, unlike Botox injections that relax the muscle under a wrinkle, fill the line, crease, or area with one of several different substances. As a result, trouble spots nearly disappear.

Dermal fillers can also be used as “volumizers,” plumping and lifting cheeks, chins, jawlines, and temples; filling out thin lips, and plumping sagging hands.

The treatment is fast and easy. But all wrinkle fillers have a downside, including the risk of allergic reaction and the formation of tiny bumps under the skin. In some cases, those bumps may be permanent. And sometimes, a bluish skin discoloration known as the Tyndall effect happens. The color change can last for several months, but there are treatments available. In very rare cases, skin cells may die if the wrinkle fillers are not used properly. There have also been a few reported cases of blindness and nerve paralysis. Typically, the wrinkle fillers that last longer are the ones more likely to cause side effects.

Not every dermal filler is right for every type of correction. The least risks and best results come from using the right one correctly. That’s why you should only have fillers injected by a board-certified dermatologist or plastic surgeon with ongoing, special training.

Here is a breakdown of available dermal fillers. It includes their basic ingredients, how they work, their pros and cons, and the best areas for treatment. I can help you choose the right one for you.

HYALURONIC ACID 

The most popular category of dermal fillers is hyaluronic acid. Each type works in a slightly different way with varying results.

Side effects are rare but can include redness, swelling, and bruising at the injection site. The filler may also show up under the skin as tiny bumps. This is a problem that often improves over time.

How long the results last varies from several months to over a year or two. Some research shows that repeated injections may help stimulate the body’s own natural production of collagen. That will help reduce the number of lines and wrinkles. There is also some evidence that less filler is needed over time to achieve the same look.

Hyaluronic acid fillers include:

– Juvederm Voluma 

– Juvederm Volift

– Juvederm Volbella 

– Neauvia intense

– Neauvia stimulate

– Neauvia rheology

– Restylane kiss

– Restylane-Lift

– Restylane Defyne

– Teosyal redensity 1 and 2

– Teosyal RHA 3

SYNTHETIC FILLERS

This smaller category of wrinkle fillers includes lab-made substances that are not related to anything found naturally in the skin.

All the fillers in this group have similar side effects, such as redness, swelling, or bruising at the site of the injection. Other side effects include nodules or bumps under the skin that can be seen and felt and that, in rare instances, may require surgery to remove.

The benefits include a longer-lasting effect. And at least one filler offers semi-permanent filling of lines and creases. Remember, products with longer-lasting effects are more likely to cause side effects. And when not used correctly, synthetic fillers may cause disfigurement.

Synthetic wrinkle fillers include:

– Ellanse

– Radiesse

– Sculptra

It is important to underline that permanent fillers such as liquid silicone are dangerous and may cause severe disfigurement on the patient. Such fillers are responsible for a beautiful result in the immediate period, followed by migration, infection, displacement and other severe problems over the months/years. It is so recommended not to use them at all to avoid all this kind of problems.

COLLAGEN FILLERS

Scientists made the first fillers from a purified form of collagen extracted mostly from cows. Although it worked well and offered a natural-looking fill, the results didn’t last long. Most collagen injections began to break down as early as 1 month after treatment. Because these wrinkle fillers were made from an animal source, they also had a higher rate of allergic reaction and required allergy testing beforehand.

New ways of processing the collagen have helped lower the risks. Plus, new forms of synthetic collagens are making these injections safer and more useful to a wider range of people. Although the results don’t last as long as other fillers, many believe the results are more natural looking.

Side effects of collagen injections include some risk of allergic reaction (mostly for those still using cow sources), as well as bruising and redness at the site of the injection.

Collagen injections include:

– Cosmoderm

– Evolence

– Fibrel

– Zyderm

– Zyplast

AUTOLOGOUS FILLERS

Fat is the most commonly used substance in this category. Your own fat is surgically removed from your thighs, buttocks, or stomach, treated, then injected. You will need to have two procedures (one to remove the fat and one to inject it). Both procedures can be done in one visit. Additional fat purification steps done in the lab can be costly and time-consuming. Results can be semi-permanent, although you may need a series of injections done over time.

Risks are similar to other wrinkle fillers, including bruising, redness, and swelling at the site of the injection. Because the fillers come from your body, these injections do not require FDA approval.

MINIMIZING RISKS AND INCREASING GOOD OUTCOMES FOR ALL FILLERS

Dermal fillers are among the safest cosmetic procedures in use today. But there are things you can do to help ensure your treatment is safe:

Don’t let price be your guide. If you are offered a filler treatment that costs far less than the standard treatment, it’s likely some compromises are being made, either in the skill of the provider or the quality of the product. Never risk making a bargain with your face.

All fillers should be done in a medical setting with sterile instruments. Treatments done in homes, hotels, spas, or resorts are not being done in medical environments, regardless of who is doing them.

Do not get injectable fillers from sources outside a doctor’s office. Know what you are being injected with, and ask your doctor if an FDA-approved filler is being used and if it was purchased directly from the maker. There have been reports of everything from industrial-grade silicone to baby oil being used. If a provider won’t give you this information, don’t let them do the procedure.

Use sunscreen daily to help preserve the filler and help protect against post-inflammatory pigment changes due to the needle sticks from injections.