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Tummy Tuck Dubai | 6 July 2019

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

ANATOMY OF THE ABDOMEN

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

SURGERY STEPS

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

ADDITIONAL PROCEDURES

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

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

SURGERY AND ANESTHESIA

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

RECOVERY

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

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

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

WHAT A TUMMY TUCK CANNOT DO

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

Fillers in Dubai | 4 July 2019

Botox and dermal fillers are cosmetic treatments given through injections, usually in a clinic. They are minimally invasive, meaning they do not involve surgery. That is where their similarities end, however. Botox and dermal filler treatments are popular, accounting for more than 9 million procedures in 2015, according to the American Society of Plastic Surgeons (ASPS).

Botox contains purified bacteria that freeze muscles. In doing so, Botox can help minimize the appearance of lines and wrinkles caused by facial expressions. Dermal fillers contain ingredients that add fullness to areas that have thinned due to aging. This thinning is common in the cheeks, lips, and around the mouth. People should be aware of the costs and risks of treatments and have realistic expectations of what they can do.

What is Botox?

Botox is a purified form of the botulinum toxin that is obtained from bacteria. Though it is deadly in larger amounts, the tiny, regulated amount of Botox given to correct wrinkles has been used safely for decades.

Botox works by blocking nerve signals in the muscles where it is injected. When those nerve signals are interrupted, the affected muscle is temporarily paralyzed or frozen. Without movement of these selected muscles in the face, certain wrinkles may be softened, reduced, or even removed.

Botox and other treatments made with botulinum toxin are sometimes called neuromodulators or neurotoxins.

Treatments made with botulinum toxin are sold under the brand names Botox Cosmetic, Dysport, and Xeomin.

What can Botox correct?

Botox only works on wrinkles that are caused by muscle movement. These are known as dynamic wrinkles, and are often called “expression lines.” The most common dynamic wrinkles that Botox can treat are lines on the upper face, such as the “11” between the brows, horizontal lines on the forehead, and crow’s feet around the eyes. These lines are caused by smiling, frowning, squinting, and other facial expressions. Botox will not work on fine lines and wrinkles caused by sagging or loss of plumpness in the face. These are known as static wrinkles. Static wrinkles include lines in the cheeks, neck, and jowl areas. Botox is not a permanent treatment. Repeated treatments are necessary for continued wrinkle-reducing effects. Most people find that the muscle-relaxing effect of Botox lasts for 3 to 4 months.

What are dermal fillers?

Dermal fillers, sometimes called soft tissue fillers, are substances designed to be injected beneath the surface of the skin to add volume and fullness.

Substances used in dermal fillers include:

Calcium hydroxylapatite, which is a mineral-like compound found in bones.

Hyaluronic acid, which is found in some fluids and tissues in the body that add plumpness to the skin.

Polyalkylimide, a transparent gel that is compatible with the body.

Polylactic acid, which stimulates the skin to make more collagen.

Each one of these is designed to treat different signs of aging or other cosmetic issues. The time they take to work, as well as how long they last, also vary. Some fillers last 6 months, while others last up to 2 years or longer. People should discuss their individual needs and expectations with their doctor to determine what filler would be the best choice for them.

What can dermal fillers correct?

Different types of dermal fillers are designed to treat varying signs of aging. Depending on the filler selected, they may:

plump up thinning lips

enhance or fill in shallow areas on the face

decrease or remove the shadow or wrinkle under the eyes caused by the lower eyelid

fill in or soften the look of recessed scars

fill in or soften static wrinkles, especially on the lower face

Static wrinkles include those around the mouth and along the cheeks. These wrinkles are usually a result of a loss of collagen and elasticity in the skin.

Tummy Tuck Dubai | 2 July 2019 

Tummy Tucks’ Types of Scars

Your scar size and its location depend on the type of abdominoplasty you undergo. In a traditional tummy tuck, the scar goes from hip to hip, I will do my best to ensure that the scar is hidden under the bikini line. A scar around the belly button is also necessary as belly button is actually relocated during the procedure. Clients who need just a small amount of skin to be removed and little muscles tightening, a mini tummy tuck is an option. A very little amount of excess skin is removed and the incision leaves a scar as little as a C-section scar.

Tummy Tuck Aftercare

You will be discharged from the clinic on the second day after your tummy tuck. Therefore you will need certain level of assistance at doing everyday routine activities. Such assistance may take up to seven days. General physical ease is recommended and no heavy weight lifts are allowed.

Muscles tightening, excess skin removal, and remaining skin pulled and stretched are the reasons that are significantly responsible for limited movement and cause a kind of bent over position of the client after the tummy tuck.  Various pain levels and back spasms are inevitable and present during the first couple of days after your tummy tuck. Cleaning the incision with anti-bacterial solution and medication are necessity and help prevent getting the wound infected. Clients are given a compression garment which must be worn for next six weeks. Such garment helps the healing process and keeps your belly at the right position. Proper diet and food rich in nutrition is a key factor too and makes healing smoother, ensures the best results and keeps you fit. Smoking is not allowed as these activities are healing stoppers.

Tummy Tuck Benefits Beyond The Cosmetic

Benefits of your tummy tuck procedure bring not only the physical approach toward yourself and the public but you will feel a lot more confident in your mind and your “new skin” than ever before.  The procedure can also offer medical benefits as some studies show that tummy tucks may help with urinary incontinence, strength and support your body’s core. The abdominal muscles are tightened and this fact results in supporting your body as a whole. Generally speaking, the first 2 weeks may be physical and emotional demanding, but after a few weeks you will enjoy the results and expectations of your tummy tuck procedure, feel more confident, and look forward to your New look lifestyle.

Blepharoplasty Dubai | 30 June 2019

Blepharoplasty can be performed on upper eyelids, lower eyelids — or both at the same time. During surgery, incisions are made in the natural folds of the eyelid, in the crease of the upper eyelid and just beneath the lashes or behind the lower eyelid. This way, incisions are virtually unnoticeable after they have healed. While you are lying down during blepharoplasty, your surgeon will make precise markings to designate where excess skin and fat pads need to be removed. Some underlying muscle also may be removed. These tissues are removed with surgical instruments such as scalpels, surgical scissors, radio-frequency cutting devices and sometimes cutting lasers. Sutures or tissue adhesives (glue) then are carefully applied to smooth and reconfigure areas around the eyebrows and eyelids. During the procedure, your surgeon will make judgments about how much skin, muscle and/or fat to remove, based on a preoperative evaluation of factors such as your underlying facial muscle structure, bone structure and the symmetry of your eyebrows.

Dry eye patients frequently require that less tissue be removed to avoid exposing more of the eye to the air, which can cause symptoms to worsen. In cases where the eyebrows also are droopy, a procedure to elevate the eyebrows also may be appropriate. This procedure, called a brow lift, involves making incisions into the scalp and tightening the skin to lift the eyebrows.

Recovery From Blepharoplasty

Following an eye lift procedure, topical antibiotic ointment will be applied. Eye patches rarely are necessary. On the first day, you should apply cold packs each hour you are awake, for about 10 to 15 minutes at a time. The ice should reduce the swelling and keep bruising to a minimum. On the second day, apply cold packs every few hours for about 10 to 15 minutes at a time. After 48 hours, warm compresses should be applied to promote faster healing. I will instruct you about what pain medication to take, if needed. Most people need only non-prescription pain relievers. Narcotics rarely are necessary.

Expect mild discomfort during the immediate recovery period. But if pain is severe or vision changes occur, call your surgeon’s office immediately. While you recover, your eye area will be bruised and red with swollen eyes, particularly during the first few days. The whites of your eyes (sclera) also may become red and bloodshot. It may take a few weeks for healing to be complete, during which time you should not wear eye makeup. You can resume wearing contact lenses when the eyelid swelling subsides enough to allow the lenses to be comfortable. If you wear eyeglasses, you can put them on carefully at any time after surgery.

Often the sutures used for your procedure will dissolve on their own in four to seven days, and you will not need to have them removed. If non-dissolving sutures are used, then your surgeon will remove them about a week after the procedure. Most people who undergo eyelid surgery report satisfaction and improved self image. Those whose vision was hampered by excess folds of skin often have improvements in the visual field they are able to see.

Tummy Tuck Dubai | 25 June 2019 

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

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

TIMELINE FOR RECOVERY

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

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

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

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

WHAT TO EXPECT AFTER YOUR SURGERY

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

You will be guided:

– how to care for incisions and drain tubes

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

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

– when you need to see me again

– how long to wear the abdominal pressure garment

– how much to rest

– what you can eat

You’ll need to have someone who can drive you home from the hospital and help take care of you for at least the first few days after your surgery. You can shower 48 hours after you remove your drainage tubes. You may want to take a sponge bath until you can shower. You may be advised to use a chair when showering for some time.

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

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

GUIDELINES FOR AT-HOME RECOVERY

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

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

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

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

POSSIBLE PHYSICAL SIDE EFFECTS

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

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

TIPS FOR RECOVERY

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

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

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

I recommend the following:

– Take vitamin A and vitamin C supplements.

– Drink green tea to boost immunity and antioxidant levels.

– Take a probiotic supplement.

– Eat pineapple and papaya to reduce bloating and inflammation.

– Use arnica to reduce swelling, bruising, and pain.

– Take a staphysagria supplement to heal your incision.

– Take a phosphorus supplement or drink ginger tea to relieve nausea.

TUMMY TUCK RECOVERY

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

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

Tummy Tuck Dubai | 20 June 2019

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

ANATOMY OF THE ABDOMEN

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

SURGERY STEPS

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

ADDITIONAL PROCEDURES

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

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

SURGERY AND ANESTHESIA

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

RECOVERY

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

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

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

WHAT A TUMMY TUCK CANNOT DO

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

Blepharoplasty Dubai | 15 June 2019

Ptosis is the medical term for drooping of the upper eyelid — a condition that may affect one or both eyes. Ptosis that is present since birth is called congenital ptosis. Droopy eyelids in general occur when the edge of the upper eyelid (eyelid margin) falls from its normal position. When the edge of the eyelid falls too low and covers part of the pupil, it can block the upper part of your vision. In most cases, a drooping upper eyelid results from aging of previously normal structures. Typically, the tendon of the muscle responsible for lifting the eyelid stretches and the eyelid falls. Surgical correction of a drooping upper eyelid involves repairing the stretched tendon.

It is not uncommon for a person to develop a droopy upper eyelid following cataract surgery or other eye surgeries because manipulation of the eyelid during a procedure can cause weakening of the muscle that holds the eye open. Stroke and trauma also can cause ptosis. Ptosis surgery most often is performed by ophthalmologists and oculoplastic surgeons.

Who Are the Best Candidates for Eyelid Surgery?

If you aren’t sure that you are a candidate for blepharoplasty, schedule an appointment with me to evaluate you for any medical problems related to your eyelids. If you don’t have a medical reason for a blepharoplasty procedure, you can discuss with me any concerns or interest you might have regarding cosmetic eyelid surgery. You might consider blepharoplasty if you have excessive drooping and sagging of skin around eyes, which often is due to normal aging. Sagging skin also can be exaggerated when you have other conditions such as puffy eyes caused by eye allergies or edema.

Fillers in Dubai | 12 June 2019

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

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

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

THE PROCEDURE

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

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

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

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

The entire procedure should take under 30 minutes.

NATURAL RATIO

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

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

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

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

Creating Philtrum Columns

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

Creating Cupid’s Bow

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

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

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

Supporting or Bolstering the Oral Commissures

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

Filling the Nasolabial Creases

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

POST-INJECTION CARE

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

SELECTING THE RIGHT FILLER

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

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

PAIN MANAGEMENT

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

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

SIDE EFFECTS

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

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

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

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

WHAT TO EXPECT

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

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

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

Fillers in Dubai | 10 June 2019

Wrinkles can be expected during the aging process, there are several other factors that may contribute to their formation. Lack of proper skin care, genetics, too much sun exposure, and smoking all have the potential to increase perioral wrinkles. Each time the mouth is puckered around a cigarette, the muscles form these tiny lines. Although unnoticeable at first, they become deeper and very noticeable with age. Smoke from a cigarette also contributes to the dryness of the skin, thereby making the skin more prone to wrinkles. Unfortunately, perioral wrinkles often make both women and men look older than they actually are.

Dermal fillers provide an excellent solution, because there is no need for surgery and no need to take time off work.

The wrinkle treatment process takes approximately 20 minutes, with immediate and very satisfying results. The injectable fillers normally injected around the mouth contain hyaluronic acid (HA), which is a naturally-occurring protein already found in the soft connective tissue of the skin. The gel-like substance is a synthetic form of HA and varies in thickness, depending on the manufacturer. Topical anesthetic can be administered to the area being injected, but several products such as Restylane, Juvéderm, and Teosyal combine an anesthetic called Lidocaine with the HA, so this step is not necessary. The dermal filler is injected with tiny needles in and around the area being augmented. Usually clients experience only mild irritation and slight swelling for the first few hours after being injected. They are delighted with the immediate transformation and can expect the fillers to last 6 to 18 months before being absorbed into the body and completely metabolized. You may require touch up treatments to maintain the smooth, youthful skin you desire, but regular maintenance will prolong the time between further injections. Although dermal fillers are a temporary solution to perioral wrinkles, they are very cost-effective.

Cosmetic Surgery Dubai | 8 June 2019

Breast lift surgery (also known as Mastopexy, or breast reconstruction) helps to restore the elasticity of female breast tissue which can be stretched, most often through factors such as; weight loss, pregnancy and childbirth, breastfeeding or ageing. The improvement in self-esteem and confidence can be remarkable, making a breast lift one of the highest ranking cosmetic procedure in satisfaction. The procedure is designed to lift breasts that hang abnormally low over the chest, with the majority of their volume sitting at their base. It can be an effective way to enhance the breasts, without drastically changing their size. During the procedure, I will lift and reshape your breasts, giving them a firmer and more youthful appearance.

Additionally, I can re-position the nipples higher on the breast so the changes are proportionate and natural To ensure the best possible results, your surgeon may also recommend a breast enlargement or reduction to be performed alongside your breast lift if appropriate. This will be discussed at your initial consultation.