In the News

Are You Losing Volume in Your Face?

Aesthetic Medicine Dubai | 21 November 2018

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.

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Square Jaw Reduction: No Surgery Slim Your Face

Aesthetic Medicine Dubai | 17 November 2018

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.

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How to Get Rid of Forehead Wrinkles

Aesthetic Medicine Dubai | 15 November 2018

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.

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WHAT ARE CROW’S FEET & SMILE LINES?

Aesthetic Medicine Dubai | 12 November 2018

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 collagen and elastin occurs naturally as we age. Of course, the other cause of the appearance of wrinkles is sun damage.

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. Hence, over time these smooth out wrinkles and prevent them from developing further.

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.

WHAT ARE JOWLS & MARIONETTE LINES?

Aesthetic Medicine Dubai | 9 November 2018

What are 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 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® as part of our non-surgical neck lift. 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.

How Can Dermal Fillers Help?

Aesthetic Medicine Dubai | 4 November 2018

Tired of looking and feeling older than you’d like? Flatter, sagging skin with deepening groves and wrinkles combined with thinning lips lead to a hollow, aged look.

How Can Dermal Fillers Help?

As you get older collagen breaks down in your face and it can become flat and saggy. Fillers simply replace the collagen you lose through ageing, raising flatter areas and restoring your youthful look. They can also be used to enhance your existing facial features. Once the treatment is gently injected into the target area it will pull in water to hydrate your skin. It also has antioxidant qualities providing instantly smoother skin with better results than any top brand moisturising creams. Results last between 6-12+ months. No none will guess you have had a filler treatment but you will feel more refreshed, confident and glamorous.

The use of injectable facial fillers

Aesthetic Medicine Dubai | 2 November 2018

The use of injectable facial fillers is one of the fastest growing areas in the field of cosmetic surgery. Many advances in have been made in the last 5 years that have led to safer, more predictable and longer lasting fillers.

As one ages, the face loses volume. This creates more prominent wrinkles and skin folds while features become less distinct. Dynamic wrinkles caused by facial movement such as smiling and frowning appear. Injectables were designed to subtly reduce these signs of aging.

Most fillers work by restoring the volume of a part of the face or filling the lip or wrinkle and are gradually digested by the body. Hyaluronic Acid Fillers: These were the first of the new fillers to be FDA approved. Hyaluronic acid is a naturally occurring carbohydrate which occurs in skin. It is a clear gel with a thick consistency. Since skin testing is not required, injections may be done on the same day as the initial consultation. Manufacturers have manipulated particle size (thickness) and crosslinked molecules to offer both normal and longer duration products.

Juviderm and Teosyal are examples of normal duration products that are injected in more superficial lines and have easier flow characteristics. Juvederm Voluma and Teosyal Redensity II are examples of longer duration products are usually injected into deeper lines and folds.

The newest advance has been the addition of local anesthetic, Lidocaine, to the filler to reduce discomfort upon injection.

Tummy Tuck – treatment, procedures and outcomes

Tummy Tuck Dubai | 30 October 2018

Tummy tucks are best performed when a patient is fit and healthy. No special diet or exercise programme is required prior to an abdominoplasty, but you should be close to your ideal weight. You will be admitted on the day of surgery, and your length of stay depends on which procedure is done. With a full abdominoplasty you will have some dressings on your tummy and usually some drains (plastic tubes attached to suction bottles). The drains will usually be removed before you go home. You will be given instructions about your dressings and stitches when you go home. I will use dissolving stitches. Post-operative pain in these procedures is easily controlled. Patients will be mobile from day one and should be back to full exercise within six weeks. Patients are recommended to take at least four weeks off work immediately after the operation in order to ensure they recuperate fully. These timings are approximate and depend on what exactly is done; also some people recover quicker than others.

All abdominoplasties result in some scarring although the nature of the scars will depend on the technique that has been used. Scars tend to be quite red and raised in the first six weeks, changing over next six months or so and then fading to white. Most patients will form good quality scars over time, but occasionally and unpredictably some patients will get red lumpy scars that do not improve.

What happens in a tummy tuck procedure?

Tummy Tuck Dubai | 22 October 2018

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. 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.

Tummy Tuck – Other options

Tummy Tuck Dubai | 19 October 2018

Abdominoplasty surgery, commonly known as a tummy tuck, is an operation to remove extra skin, scars, stretch marks and fat from the tummy, and sometimes to tighten the tummy muscles. However you could also consider the following. Having liposuction (where fat is sucked out through a tube inserted into small cuts) before or after the tummy tuck, to thin the abdominal wall. This is helpful but the results can be unpredictable. Liposuction alone will have less effect than a tummy tuck. Having an extended tummy tuck, where extra skin and fat are removed from the lower back and above the hips. With this surgery, the scar goes around onto the lower back. An endoscopic tummy tuck, where the tummy muscles are tightened through a short sideways cut above the pubic hair. Skin is not removed, but liposuction can be carried out. An apronectomy, which is a modified mini tummy tuck for if you have a lot of skin and fat hanging down over the pubic area. Here, only the extra skin and fat are removed. This leaves a long, sideways scar. If you have scars from previous operations, the usual tummy tuck may be modified to suit the scars.

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