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The Perfect Lips For Your Face

Fillers in Dubai | 30 June 2020

If you’d like to try lip fillers or are curious about the procedure (and it’s kind of impossible not to be, given the current state of pouty celebrities and volumising lip products), it’s important to fill up on facts before you go plumping anything.

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.

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.

FILLER SUITABILITY

When selecting a suitable filler for the lips, the following factors are taken into consideration:

Longevity: it is important to advise the patient how long a product is expected to last for, and explain that this is not guaranteed in order to successfully manage their expectations

Crosslinking technology: relates to longevity and propensity to swell

Cost: patient needs to be aware of financial commitment

Company support: specific product knowledge and training/marketing is essential

Reversibility: ensures a safety net incase of vascular accident or other filler-associated complications; you should have an emergency kit including hyaluronidase on site

Strong clinical study evidence: ensures a safe, evidence-based choice

Previous patient experience of product: if a patient has had good clinical results with a certain product and is happy with it, do not use something else as they may be unhappy with the new product

LIP AUGMENTATION TECHNIQUES

There is no single technique that fits every lip, and each practitioner will have his or her own approach to treatment. Below are the factors of which typically followed when it comes to lip augmentation:

Visually assess the lip in 3D: i.e. the lateral and frontal view. This will give an idea of projection required. For an attractive lip, the upper lip should project around 2mm further than the lower lip.

Assess the smile: if the patient has a ‘gummy’ smile and the lip disappears upon smiling then consider botulinum toxin injections to soften the action of the lip elevators. I have found that for best results, it should be a deep injection, 1cm lateral to the lateral alar of the nose. If the patient has an active depressor angulioris, contributing to a downturned mouth, also consider treating this muscle with botulinum toxin to prevent a downward pull of muscle on the corners of the mouth.

Determine the amount of filler: I always agree with the patient the amount of filler that will be used. It is important to not over or underfill the lip (amount is case dependent). For example, overfilling the upper lip can create a ‘duck lip’ appearance, which is usually not regarded as aesthetically appealing. I do not use more than 1ml per visit to prevent overcorrection and reduce the risk of vascular compression.

Enhancement or restoration: I always ask if the patient is seeking enhancement or restoration – this usually depends on the patient’s age – to ensure that you understand their expectations of treatment.

Age appropriateness: ensure that the lips are ‘age appropriate’. I advise not to try to create the lips of a 25 year old on a 60-year-old patient.

In patients showing signs of ageing: treat the perioral complex and not just the lip. To do this, use filler to turn up the corners of the mouth at the oral commissure, to treat oral rhytids and to restore volume in the cutaneous lip and chin area. Botulinum toxin in the mentalis and depressor angular oris can be used to reduce hyperkinetic activity of mouth depressors.

Consider the vermillion border: consider using low viscosity filler when treating the vermillion border. This can create a very sharp and well-defined demarcation by creating maximum light reflection without distorting the delicate lip architecture.

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 Silk, Belotero, Juvederm – 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.

Things to Know If You’re Considering Breast Reduction

Plastic Surgery Dubai | 26 June 2020

Breast reduction surgery, also known as reduction mammaplasty, is a procedure used to remove excess fat, tissue and skin from the breasts. If you have large breasts, you might choose to have breast reduction surgery to ease discomfort or to achieve a breast size proportionate to your body. Breast reduction surgery might also help improve your self-image and your ability to participate in physical activities. If you’re considering breast reduction surgery, consult an experienced plastic surgeon. It’s important to understand what breast reduction surgery entails – including possible risks and complications – as well as set realistic expectations.

BREAST REDUCTION SURGERY

Breast reduction surgery is meant for women who have large breasts and want to resolve issues such as:

– Chronic back, neck and shoulder pain that requires pain medications

– Chronic rash or skin irritation under the breasts

– Nerve pain

– Restricted activity

– Poor self-image related to large breasts

– Difficulty fitting into bras and clothing

Breast reduction surgery generally isn’t recommended if you:

– Smoke

– Have certain conditions such as diabetes or heart problems

– Are very obese

– Want to avoid scars on your breasts

You can have breast reduction surgery at any age – sometimes even as a teenager. But if your breasts aren’t yet fully developed, you might need a second surgery later in life. You might postpone breast reduction surgery if you have certain future plans, such as:

Childbirth. If you haven’t started a family or your family isn’t yet complete, you might wait until pregnancy isn’t an issue. Breast-feeding might be challenging after breast reduction surgery – although certain surgical techniques can help preserve your ability to breast-feed.

Weight loss. If you are interested in losing weight by changing your diet and starting an exercise program, you might wait to decide if reduction mammoplasty is for you. Losing weight can often result in changes to your breast size.

WHO IS A GOOD CANDIDATE?

– Patients who want smaller breasts.

– Patients with extensive breast asymmetry.

– Healthy patients without breast cancer.

– Patients who possess realistic expectations.

– Patients who will tolerate breast scars.

– Patients who complain of chronic neck, shoulder and back pain from 

  excessive breast size.

– Patients with large breasts who experience chronic skin irritation along 

  their bra straps and under the breast folds.

BREAST REDUCTION SURGERY RISKS

Breast reduction surgery has the same risks as any other type of major surgery – bleeding, infection and an adverse reaction to the anesthesia. Other possible risks include:

– Bruising, which is usually temporary

– Scarring

– Removal of or loss of sensation in the nipples and skin surrounding the 

  nipples (areolae)

– Difficulty or inability to breast-feed

– Differences in the size, shape and symmetry of the surgically altered 

  left and right breasts, which might lead to further surgery to improve 

  your appearance

HOW YOU PREPARE

Dr. Vigo will:

– Evaluate your medical history and overall health

– Discuss your expectations for breast size and appearance after the 

  surgery

– Provide a detailed description of the procedure and its risks and 

  benefits, including likely scarring and possible loss of sensation

– Examine and measure your breasts

– Take photographs of your breasts for your medical record

– Explain the type of anesthesia used during surgery

Before breast reduction surgery, you might also be asked to:

– Complete various lab tests

– Get a baseline mammogram

– Stop smoking for a certain period of time before and after surgery

– Avoid taking aspirin, anti-inflammatory drugs and herbal supplements, 

  to control bleeding during surgery

WHAT YOU CAN EXPECT

Breast reduction surgery is usually done under general anesthesia, either in a hospital or inpatient surgical facility. The specific technique used to reduce the size of your breasts can vary. The procedure might include:

– Surgery through incisions

– Liposuction to remove the excess fat in your breasts

Dr. Vigo will usually:

– Make an incision around the areola and down each breast

– Remove excess breast tissue, fat and skin to reduce the size of each 

  breast

– Reshape the breast and repositions the nipple and areola

The nipple and areola:

– Usually remain attached to the breast

– Might need to be removed and then reattached at a higher position as 

  a skin graft if your breasts are very large

Dr. Vigo will try to achieve symmetry between your breasts, but some variation in breast size and shape might occur. The size of the areola also might be reduced. Your incision scars might fade over time but will never completely disappear.

AFTER THE PROCEDURE

Your breasts will be covered with a gauze dressing or bandages. A tube might be placed under each arm to drain any excess blood or fluid. You likely will take medication for pain and antibiotics, to decrease your risk of infection.

For the first days or week after surgery:

– Your breasts will probably feel tender and sensitive

– Your breasts might be swollen and bruised

– Your surgeon might recommend an elastic compression bra to protect 

  the breasts

You’ll need to limit physical activity for two to four weeks while the breasts heal. Dr. Vigo might suggest avoiding underwire bras for a few months after surgery. Scarring usually fades over time. You will need a follow-up visit with Dr. Vigo to remove stitches and check your recovery.

COMPARING A FULL, MINI & EXTENDED TUMMY TUCK

Tummy Tuck Dubai | 24 June 2020

Depending on the patient’s aesthetic objective, plastic surgeons will recommend one of the following three types of tummy tucks available:

FULL OR CLASSIC TUMMY TUCKS 

Classic tummy tucks (which are also referred to as full tummy tucks) are utilized when individuals want to address the sections above and below their belly button, the full length of the abdominal wall. Patients who opt for a full tummy tuck often want to resolve general roundness and excess skin. With this procedure, one horizontal or u-shape incision, and possibly a second incision, are made above the pubic area and the belly button, respectively, to remove excess skin and tighten muscle. Full tummy tucks present the most natural-looking outcome, and can include a much firmer abdomen.

MINI TUMMY TUCKS

Mini tummy tucks involve less extensive incisions compared to a full tummy tuck and are intended to improve only the lower belly, below the patient’s belly button. This makes the procedure ideal for people who want to rid their bellies of a “pooch”, tiny bulge or stretch marks in the lower abdominal region only. Plastic surgeons can tighten loose muscles through a single low horizontal incision (typically without an incision around the belly button), and remove excess lower abdominal skin, resulting in a firmer, smoother lower belly.

EXTENDED TUMMY TUCK

The extended tummy tuck is considered when the goals of the procedure are to address the abdomen while simultaneously targeting the flanks and hips. To perform this procedure, the surgeon extends the horizontal incision more laterally as well as often incorporating a longer, vertical incision, which enables the surgeon to remove excess skin from the upper and lower abdominal region as well as the flanks while tightening the abdominal wall. This procedure is often ideal for those patients who have had multiple pregnancies or have lost lots of weight, either through diet and exercise or through weight loss surgery.

When it comes to a tummy tuck, I frequently explain to patients that the procedure is not a single surgical step, but rather a series of elements that can be combined to create customized results.

Whereas liposuction focuses solely on removing unwanted fat cells from the body – such as those that create a noticeable bulge at the belly – a tummy tuck is intended to create sleeker contours by addressing any number of conditions that keep the abdomen from looking toned.

Excess fat

Of course, stubborn pockets of fat are an obvious culprit when it comes to a larger waistline. While liposuction is frequently performed as a standalone procedure, it can also be used as part of a tummy tuck to help flatten the area. For this element, just about everything is handled as it would be for a solo lipo procedure: Fat is loosened and suctioned out via a cannula. The difference is that while liposuction requires small incisions that are later sutured closed, the incision made for a tummy tuck allows the surgeon access.

Excess skin

While extra fat causes bulges, extra skin creates a sagging pouch that can hide even well-defined abdominal muscles that sit beneath. The amount of excess tissue can range from a little to a lot (sometimes referred to as an “apron”). For a tummy tuck, the surgeon essentially re-drapes the abdominal skin so that it sits flat and tight, then trims away the excess. The incision and subsequent sutures for this element are typically hidden lower on the torso, where they can be covered by a swimsuit bottom or underwear.

Lax muscles

Over time, belly muscles and their covering fascia can become loose. Whereas firm fascia holds everything in place – something like interlaced fingers keeping a water balloon from bulging outward – lax fascia allow the contents behind to bulge outward. Abdominal muscles can separate, giving the entire midsection a flabby look. During a tummy tuck, a surgeon can, if necessary, stitch these muscles and fascia back together to make everything tight and toned. In some cases, as with a mini-tummy tuck, this may be the primary element of the procedure. It is often chosen by moms who have a small bulge that sits below the belly button.

Belly button placement

Depending on the tummy tuck details, the surgeon may need to “relocate” the belly button, which involves creating a hole in the newly taut abdominal skin so the navel appears where it should to remain proportional with the rest of the body. This is called “umbilical translocation.” Following this, the body can be further contoured to encourage an hourglass shape by creating an “internal corset.” I have performed measurements that show narrowing of the waist and improvement of the waistline due to work at this stage.

When all of the steps are completed, the incision will be closed with either a special glue or absorbable sutures, such that the patient can take a shower the next day and there is no need to remove the sutures. Lasers can be used post-operatively to hasten the healing of scars. Also, use of Exparel injections numb the abdomen for three days, which can minimize pain for patients.

Since every patient has a unique body shape and size, as well as personal goals for an ultimate look, each tummy tuck is its own procedure. While there are commonalities between all such surgeries, no two will be exactly alike.

The most common form of tummy tuck involves a horizontal incision near the pubic hairline, so swimwear or undergarments can hide the resulting scar. If there is excess skin above the navel, an incision around the navel may be required. Sometimes, the surgery involves liposuction to remove pockets of excess fat from specific areas of the body. To reduce scar tissue and increase the speed of healing, I may utilize a harmonic scalpel that uses ultrasonic energy to perform parts of the tummy tuck surgery. Diastasis is a term used to describe the separation of the two-paired abdominal muscles that make up the front of the abdomen, which is often caused by multiple pregnancies. Sutures are used to tighten up the abdominal wall, resulting in a flatter stomach. Stronger, tighter abdomen muscles may also help reduce lower back pain.

A tummy tuck is not a shortcut to weight loss. But, it can be a powerfully transforming surgery and complements the impact that weight loss has on the abdominal profile. Many of our patients say they feel liberated after having a tummy tuck. They can wear a bikini again, or not wear a shirt or a top to cover up their loose stomach. They feel good about being outdoors running, swimming and golfing. It does a lot to boost a person’s confidence in their bodies and for many of my patients, it’s an incentive to maintain a healthy appearance for the rest of their lives. For some patients, tighter abdomen muscles may also help reduce lower back pain.

DETERMINE WHICH PROCEDURE IS RIGHT FOR YOU

Deciding which procedure is right for you will be contingent upon several factors and is best done in consultation with an experienced Plastic Surgeon. Some of them include your desired results, overall skin quality, body type and location of excess skin on the body. The amount of excess skin will also determine which procedure is most appropriate. Finally, any scarring attained from a previous cosmetic procedure or surgery can determine which kind of tuck the patient qualifies 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.

New Neck Lift – Long lasting natural results

Aesthetic Medicine Dubai | 21 June 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.

Dermal Fillers – Look As Great As You Feel

Fillers in Dubai | 15 June 2020

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

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

WHAT ARE DERMAL FILLERS?

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

WHO ARE DERMAL FILLERS FOR?

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

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

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

HOW DO DERMAL FILLERS WORK?

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

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

WHEN SHOULD I GET DERMAL FILLERS?

A single session of an injectable has the potential to last up to five years, depending on which kind of filler is used. Less permanent options, such as those composed of hyaluronic acid are more quickly absorbed, usually within 6 months. This especially holds true if the filler is injected in a region with a lot of movement. Facial fillers do not increase sun sensitivity, making them a great year-round option. However, until the initial swelling has subsided, patients should avoid excessive heat exposure, including prolonged sun exposure. It is recommended to incorporate an at-home skincare regimen after dermal fillers; always consult with your skincare professional for individual at-home advice.

CONTOURING AND REFINING FEATURES

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

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

THINGS TO KNOW IF YOU’RE CONSIDERING DERMAL FILLERS

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

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

YOUR EXPECTATIONS

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

THE ACTUAL PRODUCT

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

HOW LONG THE RESULTS WILL LAST

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

WHAT TO DO BEFORE AND AFTER THE INJECTION

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

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

Enhancing the breast volume & shape

Breast Augmentation Dubai | 8 June 2020

The breast is the symbol of femininity. A too small or too big breast, or less toned than in the past, does not enhance the woman body figure . Through my experience I can intervene to give the breast the right shape and the whole body, the look and harmony that every woman desires.

Every woman desire is to be comfortable with her body, to feel beautiful and attractive. A beautiful and balanced body definitely depends on the breast, symbol of femininity. When the breasts are not in proportion to the other forms, a woman may feel dissatisfaction in looking in the mirror and insecurity in being with others.

How to have more pronounced, feminine and charming forms? The woman can rely on the breast enlargement surgery that allows to increase the volume and shape of the breast. In this way the breast acquires the right size and it can bring harmony to the entire body.

THE PROCEDURE

During the first visit I carefully examine the breasts in order to understand their current position, size and proportion. In this way I can find a customized solution in relation also to my patient’s wishes and achievable results. I try to give the breast a natural and well-defined shape, a breast that “fits” well and that, like a dress, is consistent with the woman’s personality.

I only use high quality implants. After engraving, I place the implant creating a pocket above or below the pectoralis muscle or following the most recent technique called Dual plane. Once the incision is closed, I might apply a drainage for few days. The surgery takes one hour and it can be done as a day case. Upon awakening, it is normal for a light swelling to appear and vanish in a few days. After about seven days, I meet my patient again in order to evaluate the healing process and to remove the small stitches excluding the ones that will vanish naturally. For the following month I recommend to wear a compression bra that supports the breasts without excessive pressure. Rest is very important, for the first fifteen days it is necessary to limit physical activity and avoid driving for the first week. 

The patient will fully return normal after about six weeks. The result? The woman can appreciate her new forms, a breast that makes her body beautiful, attractive and seductive in harmony with the rest of it.

Doubts or questions? It’s only natural to have any! Are you considering a breast augmentation? This is the big question of which is followed by plenty of brief, but equally important questions about what to expect. If you’ve never had any type of surgery or breast augmentation before you need to be advised of what to expect. Here, I share the steps towards making your final decision.

The first part of the decision making process is an honest conversation with your doctor. In this meeting you and your surgeon will review your surgical options and measurements that suit your body structure. It’s important to note that no two breast augmentations will ever be the same – the individual size and shape of your chest really does matter Your doctor can help find the most suitable look for you. Is there a type of implant that would be better for me? Why?

Keeping in mind that no two surgeries will ever be the same, it’s important to ask the right questions. These questions should be specific to your health and expectations. Ask for everything from surgeon and anaesthesiologist certifications to the type of equipment they plan to use during the procedure. Other questions you can ask include:

What are your qualifications/experience with breast augmentations?

Is there a type of implant that would be better for me? Why?

Is now a good time in life for me to get breast implants?

Am I mentally in a good place to get this surgery?

What is your typical before and after surgery? Can you walk me through a patient’s typical journey?

What are the risks or complications of a surgery?

The best way you can be prepared for this surgery is to do your own research. It is a big change, so you’ll want to spend a good amount of time preparing yourself. Come up with your own questions and try to find a look that you’d be happy with. Your doctor won’t be able to replicate it, but it will be an important part of deciding what look you ultimately want to end up with. Don’t forget, we’re here to help you feel safe and secure throughout the whole process.

PREPARING YOURSELF FOR SURGERY

For many, deciding to get a breast augmentation is exciting and the mind tends to focus on the final product – the post-surgery look. However, it is also common to feel nervous about the operation.

USING THE RIGHT MATERIALS TO AVOID REACTIONS

No surgery is without its risks. However, breast augmentation surgery is incredibly routine for a specialised surgeon, and issues are more likely to arise from the surgical materials rather than the procedure itself. Your surgeon will need to assess the materials they are using for the implant to best suit your body, as well as the drugs and tools they use throughout the process. As such, it is essential to provide a thorough medical history to your surgeon in order to avoid complications from allergic reactions. This is one of the easiest ways to avoid complications of surgery, dramatically reducing the risk of something going wrong.

ENSURING YOU ARE WELL PLACED MENTALLY

One of the biggest issues people don’t often talk about is the psychological impact of getting your breasts done. The physical changes are going to affect your lifestyle in one way or another and it’s important you go into the surgery well prepared, not just physically but also mentally. Therefore, a psychological evaluation should be conducted before your surgery to ensure you’re in a good place to accept these changes. At the end of this exam, it should be clear to you and your evaluator that you are mentally stable enough to handle a surgery.

Pre-existing conditions suggestive of psychological insecurity, for example eating disorders, can often disqualify a candidate from undergoing breast augmentation. Unfortunately, such conditions are linked to higher rates of depression post surgery. Those undergoing breast augmentation should also ensure they have realistic expectations about the surgery. No surgeon can precisely replicate the breasts of your favourite celebrity – the job will be unique to your body and its needs.

Of course, any concerns you have and how best to prepare for your surgery can be addressed in your consultation with your surgeon. Set up a meeting today, and I’ll answer any more questions you may have about breast augmentation.

Dermal Fillers — Frequently Asked Questions (FAQs)

Fillers in Dubai | 5 June 2020

Dermal Fillers: Frequently Asked Questions

How Many Sessions Will I Need, And How Far Apart Can I Have Them?

The procedure takes around 30-45 minutes and patients can expect to notice the effects for as long as 18 months after treatment. There is even precedence of results lasting up to 24 months in some cases.

Am I A Suitable Candidate?

Dermal fillers can be used on a wide range of patients, and is primarily used for skin rejuvenation and the reduction of lines and wrinkles. It can also be used to treat scarring in some cases. Other suitable candidates are those seeking to add structure and volume to the face. There is no known risk to those who are pregnant or breast feeding, but we would advise against having treatment under these circumstances.

What Areas Can Be Treated?

Crow’s Feet

These are wrinkles that form in the corner of the eyes. They can be caused by ageing, sun exposure, expressions and smoking.

Frown Lines

When we contract our forehead muscles, deep lines can materialise. Also referred to as an “11”, frown lines form in between your eyebrows. Over time, these lines start to linger and prove to be a bugbear for many.

Smoker’s Lines

The use of fillers can smooth and fill out these crepey lines, creating a much softer, younger-looking appearance.

Marionette Lines

Located just below the corners of the mouth, the marionette lines can make you look sad or angry when relaxing your face.

Lips

Thin lips are not necessarily a result of ageing; many men and women are born with thinner lips. If you would like to add volume, but avoid an exaggerated look, Dr. Matteo Vigo uses the most advanced lip fillers to enhance your natural lip shape.

Nasolabial Fold

Also referred to as “smile lines”, these lines run down the sides of the nose to the corner of the mouth. Most of us notice these when smiling, laughing or talking, but over time they can develop into static lines.

Cheeks

Ageing usually contributes to volume loss. The round, full look diminishes as the fat pads in our cheeks gravitate downward. Cheek Fillers can be used to plump up the skin.

Décolletage

Inevitably, the skin loses its elasticity and firmness over time. Sun damage in particular can contribute to this aged look on the chest area, and the thinning of the skin can amplify the neck bands, adding years to your appearance.”

What If Any, Are The Side Effects?

With any injectable treatment, there can be some slight bruising or swelling that accompanies it. This should not persist much longer than a day, and is easily cover-able with makeup.

Will My Face Be Lumpy After Treatment?

This is a possible side-effect to treatment, yes. Patients are not advised to massage the area themselves, as this may move the product. After a few weeks, your clinician will invite you back to make minor adjustments, if needed. They use a special massage technique which settles the product and what is left will be the final result.

Will My Family And Friends Notice I’ve Had Work Done?

9 times out of 10, family and friends won’t notice cosmetic treatment, instead recognising (especially with dermal fillers) a more youthful or refreshed look. I aim to leave the patient with a look that enhances natural assets, rather than distorting them, and treat all patients with this in mind.

Major Benefits Of Breast Augmentation

Breast Augmentation Dubai | 1 June 2020

Having performed many breast augmentations for women every year, I have found that patients all have different goals and benefits in mind for their breast augmentation surgeries. Here I  describe 5 of the most common benefits that breast augmentation patients are seeking.

1. Added Volume and Curves

Some women are born with breasts that are naturally small and flat and don’t provide their desired curves to their physique. Because breast implants especially add volume to the top of the breasts, a breast augmentation is a perfect way to add volume and curves to your silhouette, making you feel more voluptuous and feminine. Whether your goal is to go up to a certain cup size, fill out a bikini top, or just have curves in your everyday clothing, a breast augmentation can give you that new look you desire.

2. Even Out Naturally Asymmetrical Breasts

All women have some degree of breast asymmetry. But for some women, the differences in their breast sizes are so noticeable that it makes shopping for bras and bathing suits difficult, and the differences can be embarrassingly noticeable in clothing. A breast augmentation is a great way to balance out naturally uneven breasts for women. Because you can choose a different breast implant size, shape and profile per breast, a breast augmentation can allow you to finally have evenly matched breasts that fit well into bras, bathing suits, and clothing.

Restore Breasts After Pregnancy and Aging

We all know that pregnancy can take a toll on a mother’s body, especially her breasts. Mothers often end up with breasts that are sagging and have decreased volume, particularly if they breastfed their babies. And even women who do not have children notice similar changes in their breasts as gravity takes over as they age. A breast augmentation is a fantastic way to restore lost volume to breasts and make them appear more youthful and perkier.

3. Rebuild Breasts After a Mastectomy

Breast cancer is an extremely physically and emotionally difficult disease to deal with, and a mastectomy, though it can be life-saving, can leave a woman feeling like a shell of her former self. A post-mastectomy breast augmentation/reconstruction, which can be performed either using a woman’s own body tissue or a silicone or saline breast implant, can restore breasts and help cancer patients and survivors feel like themselves again. Dr. Vigo specializes in helping women with mastectomy reconstructions and would be honored to discuss this procedure with you.

4. Increase Self-Confidence

For women who are unhappy with the natural appearance of their breasts, their current look can make them feel inferior and lack confidence. A breast augmentation can be a confidence booster, making women feel more comfortable in their bodies and confident enough to step out in Dubai in beach attire.

If you’re curious about the additional benefits to receiving a breast augmentation, the best thing you can do is talk to Dr. Matteo Vigo about the procedure. 

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

Blepharoplasty Dubai | 19 May 2020

Blepharoplasty can be performed for any of the following reasons,

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

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

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

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

How Is Eyelid Blepharoplasty Surgery Performed?

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

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

Blepharoplasty Dubai

A Guide to Skin Problems & Treatments

Fillers in Dubai | 16 May 2020

I am passionate about skin and fuss-free beauty. I have put together this brief guide of some of the most popular skin and aesthetic concerns which I see regularly in clinic. Over time I will continue to expand and update my dataset in order to provide you with concise and accurate information. Don’t forget to visit my website for more guides, news and blogs.

FOREHEAD WRINKLES & FROWN LINES

Forehead wrinkles are horizontal lines that appear on the forehead due to contraction of the muscles that raise the eyebrows. Frown lines are verticle wrinkles that appear between the eyes when you squint or frown. Both these wrinkles initially appear when you are moving the muscles responsible but over time can become ingrained and apparent even when your face is still. Whilst natural, most people seek treatment as they feel these lines make them look grumpy, anxious or even angry.

What Causes Forehead Wrinkles & Frown Lines?

Both forehead wrinkles and frown lines are predominantly caused by ageing. As we get older we lose both collagen and elastin. These two proteins form the scaffolding of the skin. Hence, they are responsible for keeping your skin firm, elastic and plump. As thin becomes thinner and less stretchy, wrinkles develop. Initially, this is when the muscles underlying them contracts such as when you raise your eyebrows or frown. Eventually, forehead wrinkles and frown lines become deeper and visible even when you aren’t moving your face. Sun damage, or photoaging, are also a cause.

Treatment Options For Forehead Wrinkles & Frown Lines

Thankfully there are a number of treatment options for forehead wrinkles and frown lines. The first step is to ensure that you have a good skincare routine which helps hydrate, nourish and protect your skin.

Botox® For Forehead Wrinkles & Frown Lines

Botox® injections are highly effective for wrinkles and lines that are only apparent when you make an expression. The treatment is quick and pain-free with results lasting for 3-4 months.

Dermal Fillers For Forehead Wrinkles & Frown Lines

If your wrinkles and lines are deeper and appear at rest then Botox® is likely to not completely smooth them out. Dermal filler anti-wrinkle injections, however, can very effectively treat these areas and results last between 6-12 months.

Professional Skin Treatments For Frown Lines & Forehead Wrinkles

Botox® and dermal fillers offer immediate smoothing out of lines and wrinkles by reducing muscle contraction (Botox®) or by filling out and lifting the skin (dermal fillers). Professional skin treatments are really useful if you’re looking to address the underlying cause of wrinkles in the long term. A combination of a course of chemical peels and microneedling will resurface the skin and induce collagen and elastin production. This will smooth out lines and wrinkles, firm and plump up the skin as well as give a youthful glowing complexion. In the long term, these bespoke skin rejuvenating treatments could reduce the need for treatments like Botox and dermal fillers.

CROW’S FEET & SMILE LINES

Crow’s feet, also known as smile lines, are wrinkles that appear on the outer corners of the eye. They are caused by contraction of the muscles responsible for squinting, smiling, laughing or frowning. Initially, these wrinkles are only visible when you smile or laugh but over time, like all wrinkles, they become deeper. Ingrained Crow’s feet and smile lines are visible whether or not you contract the underlying muscles (ie even when you’re resting the muscles of expression). Crow’s feet can also extend upwards towards the temple and downwards to affect the cheeks when they are more advanced and as volume is lost in these areas of the face with age.

What Causes Crow’s Feet & Smile Lines?

The main reason Crow’s feet or smile lines develop is due to loss of collagen and elastin in the skin. These proteins are the skin’s natural plumpers and provide elasticity. Hence losing them causes skin to become thinner and for wrinkles to become apparrent. Loss of colllagen and elastin occurs naturally as we age. Of course, the other cause of the appearance of wrinkles is sun damage (or photageing).

Treatments For Crow’s Feet & Smile Lines

First of all its important to start with basics like understanding your skin type and following a basic skincare routine. Simple lifestyle modifications such as sun protection, keeping hydrated and stopping smoking will also help slow down the development of Crow’s feet or smile lines.

Chemical Peels & Collagen Induction Therapy

There are a number of effective treatments for existing Crow’s feet and smile lines. The simplest option for very early signs of fine lines and wrinkles would be a course of chemical peels and/or microneedling. These resurface the skin and induce collagen and elastin production. 

Botox Injections

If you have Crow’s feet that are only evident on making expression, these can be treated very easily with Botox anti-wrinkle injections. For Crow’s feet or smile lines that are deeper (ie visible without making any expressions), then using hyaluronic acid dermal fillers would provide a better option.

Dermal Fillers

For more advanced Crow’s feet or under eye wrinkles and tear trough deformities, a combination of different dermal fillers can offer a natural looking solution. If you have smile lines that extend deep onto the cheeks, then you might which to consider both cheek fillers and wrinkle smoothing with dermal filler in order to restore volume and lift the wrinkles. For co-existing under eye hollows and wrinkles, the addition of tear trough fillers would help to completely rejuvenate the under eye area.

JAWLINE CONTOURING & SQUARE JAW REDUCTION

The shape of the jaw is dependent on the bone, muscles, fat and skin the comprise it. There are many factors that affect the appearance of the jaw including genetics and lifestyle. Some people seek to enhance the shape of the jaw (usually if there is sagging of the lower face or if they are seeking a more defined appearance) by having jawline contouring. This can widen or narrow and shorten or lengthen the appearance of the jawline as required. Jawline contouring can also help lift and firm up the appearance of a sagging lower face. For those with a wide jaw, square jaw reduction can help produce a narrower V-shaped jawline. Ultimately, the results are dependent on your face shape, targets and the abilities of your aesthetic doctor.

What Causes The Appearance Of A Sagging Or Square Jaw?

The shape of the lower face is made up of several structures including your jaw bones, muscles and soft tissues like fat or skin. Whilst genetics play a huge part in terms of the shape and size of these facial structures, there are a number of other factors that come in to play. The main cause for lack of definition or sagging of the jawline is ageing and reduced face volume. One of the main reasons for developing a square jaw in both men and women can be overactivity of the chewing muscles which is usually caused by tooth grinding. Other factors that can give the appearance of loss of definition, jawline sagging or a square jaw is ageing and loss of volume in the cheeks or lack of chin prominence or neck sagging.

Non-Surgical Jawline Contouring & Square Jaw Reduction

There are a number of non-surgical options for enhancing the jawline and reducing a square jaw. Botox injections are an effective treatment for square jaw reduction which also has the benefit of stopping teeth grinding. These Botox injections can also be used to lift a sagging neck and hence sculpt the lower face and jawline.

Hyaluronic acid dermal fillers can be used alone or in combination with Botox for jawline contouring. Dermal fillers can be used to directly reshape the jawline and lift up the lower face. A combination of jawline, cheek and chin dermal fillers to contour the jawline and the whole face. 

If the aim is to reduce the appearance of a square jaw or face, then a combination of Botox and dermal fillers can be used to provide a more contoured and V-line jaw appearance.

JOWLS & MARIONETTE LINES

Jowls are loose skin and flesh that hang beneath the lower jawline. Marionette lines or “puppet lines” are lines that run from the corners of the mouth to the chin. Both are a sign of ageing and volume loss in the face. One of the most commonly cited reasons for wanting to get rid of them is because they give the appearance of being grumpy or sad.

What Causes Jowls & Marionette Lines?

The main cause of both jowls and marionette lines is ageing. As we get older our skin becomes thinner and less pliable. This is due to loss of collagen and elastin. At the same time, we also lose volume in the face (particularly in the midface area) which provides scaffolding and shape. Both these processes result in sagging of the skin and tissues which gives rise to jowls and marionette lines in the lower face. Other factors which exacerbate skin ageing are smoking, sun-damage and genetics.

Treatment Options For Jowls & Marionette Lines

There are a number of treatment options for jowls and marionette lines. First of all, it is very important to ensure that you follow a regular skincare routine tailored to your skin type. Two highly effective and non-surgical options that I offer are Botox® and hyaluronic acid dermal fillers. Which of these (if any) is suitable for you will depend on your expectations and the severity of the lines.

Botox® For Jowls & Marionette Lines

For moderate jowls, I offer jawline tightening with Botox®. This treatment can soften the appearance of early jowling and provide a more defined jawline and sculpted neck. Whilst its possible to soften the appearance of marionette lines with Botox®, I do not think that this is the most effective treatment on its own. However, in some circumstances, I combine Botox with dermal fillers for treating marionette lines.

Dermal Fillers For Jowls & Marionette Lines

Since both Jowls and Marionette lines are caused by volume loss and sagging skin in the face, dermal fillers provide the opportunity to treat the underlying problem. For moderately severe lines, I can directly inject hyaluronic acid dermal filler into and around these creases to soften and minimize their appearance. For more severe jowling and marionette lines, I recommend hyaluronic acid dermal fillers to the cheeks to lift the face in addition to adding filler to the areas themselves.

If you have both jowls and marionette lines as well as other signs of ageing such as upper face wrinkles, then you can opt for a combination of Botox® and dermal fillers as part of my liquid facelift package.

LOSS OF FACE VOLUME

The whole mark of a younger face is one with thick, plump and firm skin. Additionally, younger faces have fuller volumes due to the size and location of the facial fat pads. As we age, our faces lose their fullness because of thinning of the skin, loss of elasticity and shrinking in size of the facial fat pads. This loss of face volume results in the appearance of lines, wrinkles and sagging of the face.

What Causes Loss Of Face Volume?

The main cause of facial volume loss is ageing. Over time, our body produces less collagen, elastin and the fat pads in the face reduce in size. This results in thinner and less pliable skin as well as sagging of the face. Similarly, changes in hormonal profile, in particular, oestrogen, can help accelerate this process. Lifestyle factors such as smoking and sun damage also contribute to skin ageing as well as loss of facial volume.

How Does Losing Volume Affect The Appearance Of Your Face?

Loss of skin volume leads to thinner and less elastic skin. This gives rise to wrinkles and uneven texture. At the same time, reduction in the volume of the fat pads, as well as their descent with gravity, occurs. This gives rise to a flatter profile and sagging of the skin in the mid and lower face. Hence this can lead to a gaunt appearance. It is due to this loss of facial fat volume that gives rise to tear trough deformities, hollowing of the temples, malar flattening, nose to mouth lines, jowls and marionette lines.

How To Add And Restore Volume To Your Face Naturally

In my opinion, hyaluronic acid dermal fillers are highly effective for restoring facial volume. This is because they can replace lost volume, help firm up and lift skin, smooth down wrinkles and deliver natural looking results. How much, which type of filler and where to pace them depends on the degree of facial volume loss and your overall face shape. 

The main ways Dermal fillers can help with face volume loss are:

Cheek fillers for contouring and midface lifting

Tear trough fillers for undereye circles and shadows

Restoration of lip shape, definition and volume with lip fillers

Combat sagging, marionette lines and jowls with jawline and lower face fillers

Additionally, face fillers can be combined with Botox as part of my signature liquid facelift to refresh and smooth the face. Collagen induction therapy can also boost the effects of dermal fillers by inducing elastin and collagen formation for thicker and plumper skin.

NECK SAGGING & WRINKLES

As we age, the skin on the neck loses collagen and elastin. This leads to thin and less pliable skin on the neck which gives rise to wrinkles. Loss of fat and skin thickness also leads to the appearance of neck sagging. This is further exacerbated by the shortening and loosening of the platysma muscle around the neck hence causing sagging and banding. The main neck complaint that I see is neck sagging with visible bands as well as wrinkling of the skin.

Treatment Options For Neck Sagging & Wrinkles

Thankfully there are a number of treatment options for forehead wrinkles and frown lines. The first step is to ensure that you have a good skincare routine which helps hydrate, nourish and protect your skin.

Botox® Non-Surgical Neck Lift For Neck Sagging & Bands

Botox® anti-wrinkle injections are highly effective for smoothing out wrinkles and lines on the skin. Furthermore, Botox® can be injected to relax the platysma muscle as well as other muscles that pull on the neck or jawline. This procedure is known as the Botox® non-surgical neck lift. The effect of this is that it lifts and sculpts the neck as well as jawline. The treatment takes 3-4 weeks to work and last for 3-4 months.

Dermal Fillers For Neck Wrinkles

If the main concern is deep lines or wrinkles on the face and a sagging jawline, then dermal fillers provide an ideal non-invasive procedure. Hyaluronic acid dermal fillers smooth put wrinkles and can also be used to sculpt the jawline and lower face and upper neck.

UNDER EYE CIRCLES, BAGS & TEAR TROUGHS

These are all very common areas of concern for both men and women. Under eye circles are dark patches that are visible under the eye. Depending on cause and skin tone, these can look like shadows or discolouration that’s red, blue or green in hue. Under eye bags on the other hand, are swollen pockets or patches under the eye. Both under eye circles and bags can either occur separately or alone. They may also be caused by or exasperated by the presence of a tear trough (this is a loss of fat tissue leading to hollowness under the eye). The most common complaints people tend to have with under eye circles, bags or tear trough deformities is that they give the appearance of tiredness.

What Causes Under Eye Circles, Bags & Tear Troughs?

There are a number of genetic and environmental causes that give rise to under eye circles, bags and tear trough deformities. Some people are more predisposed to developing these and whether they affect other members of your family is a good indicator of your risk. Your skin tone may also play a role. Paler skin tones tend to show up blood vessels more readily and thus give the impression of bluish discolouration under the eyes. Darker skin tones may exhibit increased pigmentation in the under eye area which gives the appearance of shadowing. Aside from genetics, other common causes include:

Ageing: as we get older, the skin under the eyes loses its thickness and elasticity. This thinner and more fragile skin is more likely to show underlying muscles and blood vessels which also gives the appearance of dark circles under the eyes. Sun damage can also cause dark pigmentation under the eyes as well as accelerate skin ageing. Fat loss and reduced skin laxity can also cause under eye bags to appear more prominent. Loss of fat under the skin and skin ageing can also give rise to tear trough deformities.

Diet: deficiencies in Vitamins C and K as well as iron are thought to present with discolouration under the eyes. Diets high in salt can also increase fluid retention which can increase the prominence of under eye bags.

Sleeping: or rather lack of, can result in worsening of under eye circles and bags.

Dehydration: reduced water intake, excess caffeine and alcohol can all cause volume depletion in the skin and lack of laxity.

Sun damage and smoking:  this can cause increased pigmentation and skin ageing both of which give rise to dark under eye circles and bags.

Inflammation and allergies: this can cause puffiness, bags and under eye circles over time.

Treatment Options For Under Eye Circles, Bags & Tear Troughs?

Luckily, there are a wide range of treatment options if you suffer from under eye circles or bags. The first thing is to ensure that you have a good skincare routine which includes using an under eye cream that contains ingredients like Vitamin C, Vitamin K and ferulic acid which help with under eye circles. Another important skincare tip is to ensure that the under eye skin is kept moisturised so having hyaluronic acid in your under eye cream would help immensely.

If the problem is purely due to thin skin or pigmentation issues, then advanced skin treatments like chemical peels and collagen induction therapy can help brighten and firm up the under eye skin. For tear trough deformities and under eye bags, hyaluronic acid tear trough fillers can treat the hollowness under the eyes and rejuvenate the eye area. For more defined tear trough deformities, cheek fillers can help provide support for the tear trough fillers.

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