Four tips for a healthy recovery after a breast augmentation
Breast Augmentation Dubai| 5 January 2020
With an experienced plastic surgeon by your side, you can expect your breast augmentation recovery to go smoothly and quickly. In fact, many women are back to work and routine activities in three to five days. However, an easy recovery will depend on several factors, including how prepared you are to pamper yourself during those first vital days. Keep in mind these four tips for a healthy recovery following your breast augmentation.
Plan for assistance – While breast augmentation recovery is not extremely difficult, you will have just undergone major surgery. Therefore, for the first few days, you will be sore and tired. For six weeks, you should not do any heavy lifting, and this includes picking up children under 20 pounds. Plus, no driving until you are finished with all narcotic pain medications. It is recommended that you schedule assistance with household chores and with the children for the first 24 to 72 hours. Even just having a friend stop by each day to check in on you will be helpful.
Proper pain management – It is common to experience mild to moderate discomfort immediately after a breast augmentation procedure. Some women will feel pressure and tightness across their chest. Your doctor will prescribe a few days of pain medication to help you make it comfortably through the early recovery. However, many women find that after the first post-op day, they need nothing more than over-the-counter pain medications. Fill your prescriptions prior to the day of your breast augmentation, so that if you get home to find that you need pain or anti-nauseous medications, they are close at hand.
Get plenty of rest and sleep – Getting enough rest during your breast augmentation recovery sounds simple, but for some people, this is easier said than done. Make sure you have a quiet room set aside, as well as a comfortable bed to rest in, for the first few days. Have plenty of pillows, so you can prop yourself up at a comfortable angle. Some movies, books and magazines will help pass the time. You will be walking immediately after surgery, slowly regaining your strength. Just remember to listen to your body, getting plenty of sleep and relaxation, as you heal.
Have plenty of light, healthy foods and water at home – Before heading to the clinic for your breast augmentation, stock your kitchen with easy to prepare food and plenty of water. For the first post-op day, you may be nauseous from the anesthesia or not have much of an appetite, so soft, light foods are best. Make sure you have a healthy variety of foods on hand, to give your body energy and strength to heal over the following week. It is easy to become dehydrated during this time period, so drink water, water and more water.
Removing Excess Tummy Fat
Tummy Tuck Dubai | 3 January 2020
A firm, flat abdomen is a hallmark of a beautiful body contour. A tummy tuck, personalized to your needs, can help you improve your abdominal shape for years to come. A tummy tuck tightens and reshapes the abdominal area, helping to achieve a more aesthetically pleasing, slimmer overall appearance. Having a flatter, firmer midsection can dramatically improve the way clothing fits and looks, helping you feel more confident and comfortable in your body.
During the procedure, the abdominal muscles are tightened and excess, sagging skin is eliminated, correcting a protruding belly and leaving the midsection flatter and better toned. Tummy tucks are popular procedure for men and women, particularly those whose bodies have undergone dramatic changes from weight loss or pregnancy.
Who Might Benefit from a Tummy Tuck?
The decision to have any cosmetic procedure is personal, and patients choose to have tummy tucks for a variety of reasons. The best candidates are at or near their ideal body weight, are non-smokers in good health, and have realistic expectations about what surgery can achieve for them. If any of the following describe you, a tummy tuck is an option to consider:
– Diet & exercise have helped you lose weight, but your abdomen still protrudes and lacks tone.
– Your abdominal muscles and skin are stretched and sagging following pregnancy.
– After losing significant amounts of weight, you now have loose, excess skin hanging around your belly.
– You have always had a belly that “sticks out,” even though you are in very good shape.
– A tummy tuck can help patients in any of these situations address what they don’t like about their shape and achieve a firmer, flatter abdomen.
Types of Tummy Tucks
No two patients start with identical concerns, nor will any two patients share the exact same goals. I will recommend the type of tummy tuck that will achieve your desired outcome and create natural-appearing results with the least scarring possible.
Mini-Tummy Tuck: Improves the Lower Belly with Less Extensive Surgery
Are you mainly bothered by a “pooch” or loose skin and stretch marks below the belly button? A mini-tummy tuck may be a good option for you. This technique involves a single incision made just above the pubic mound, through which your cosmetic surgeon will tighten loose muscles (flattening the “pooch”) and remove excess skin to restore a smooth, flat abdominal wall.
The resulting scar from a mini-tummy tuck is a thin, horizontal line that is typically just a few inches long. Benefits of a mini-tummy tuck include a shorter, less involved procedure, a quicker recovery, and a flatter, slimmer lower abdomen that looks better in swimsuits and fitted clothing.
Classic or “Full” Tummy Tuck: Improves the Upper & Lower Abdomen
Are you bothered by roundness and/or excess skin folds above and below your belly button? A full tummy tuck, which addresses the full length of the abdominal wall, may yield the best results. Through a horizontal or U-shaped incision, made above the pubic mound, I will remove excess skin and tighten the abdominal muscles. In some cases, a second incision is made around the navel to address excess skin above the belly button and achieve the most natural looking results.
The resulting scar from a full tummy tuck looks similar to that for a mini-tummy tuck, but will typically be longer, running from hip bone to hip bone. Even so, a full tummy tuck scar can usually be hidden beneath a swimsuit bottom. Benefits of a full tummy tuck include a much flatter, smoother abdomen, reduced appearance of stretch marks, and enhanced comfort in pants and skirts. You will also find that form-fitting dresses and swimsuits have a more flattering fit.
Extended Tummy Tuck: Improves the Upper & Lower Abdomen and Flanks
Have you lost a lot of weight and now have excess, sagging skin hanging around the front half of your body? Or, have you noticed significant laxity in your abdominal muscles following multiple pregnancies? An extended tummy tuck may be the best option to address your concerns. Although it involves a longer incision, an extended tummy tuck removes excess, hanging skin from the front (upper and lower abdomen) and the flanks, as well as tightens the abdominal wall.
The resulting scar from an extended tummy tuck can often be hidden by clothing, including many swimsuits, but it may not be entirely covered for some patients. Even so, many patients consider some visible scarring a worthwhile price for a much improved body shape.
Look Younger Without Surgery
Fillers in Dubai | 2 January 2020
We’ve all been there before: You’re standing in front of the mirror, obsessing over each line and sun spot and wondering when they all appeared.
Today more people are turning to gentler new ways to get a younger look, with incredible results. Fresh, smooth, glowing skin – it’s on every woman’s wish list. And those in the know are finding clever new ways to achieve a brighter. more youthful look, without the kind of bashing and bruising so often associated with a face-lift.
Face-lifts are reportedly falling out of favour even in the U.S, and off the list of the top five requested treatments. Instead, women are increasingly seeking out gentler, non-invasive and less expensive treatments which, while perhaps not as dramatic or permanent in their results, can still help us to present a fresh, radiant new face to the world.
Dermal Fillers Treatment
Prior to any filler treatment, I always invite my clients in for a consultation to ensure we find the best treatment to achieve results suitable for you. Dermal Fillers, made from Hyaluronic Acid, are the most popular volume enhancing treatments and are often used to reduce facial lines and to restore plumpness and volume to the lips and cheeks, defining the shape of your face. Producing safe, long-lasting and natural looking results, dermal fillers are a safe and effective cosmetic treatment when administered by a qualified practitioner.
There are many dermal fillers on the market that are substandard in terms of ingredients and quality. I use only the highest quality brand of temporary fillers renowned for their superior standards.
Lip Augmentation Fillers
For those who are unhappy with the shape or size of their lips, temporary Dermal Fillers can provide an effective volume enhancing solution that keeps them feeling soft and natural. A common complaint by many of my patients is that they dislike how thin their lips look. Instead of lining the lips and creating a distorted result, we enhance your lips’ natural pattern to give them an overall pleasing and full appearance.
Tear Trough Fillers
By injecting Dermal Fillers into the tear trough – which extends from your eye to divide your cheek from your lower eyelid – the area can be made to look less hollow while subtly easing dark circles under the eyes. Tear Trough procedures treatments are very specialised and require an experienced hand to perform them, especially since the treatment may not be suitable for everyone. The area under the eyes is assessed before treatment and I will advise you on whether this is an effective treatment for your case. Those who are eligible will benefit from a fuller and brighter expression that will leave your face looking fresh and rejuvenated.
Cheek Fillers (achieve a fuller cheek bone, higher cheek done look or to lift the sagging face)
Dermal Fillers can be injected along the contour of the cheek bone to help achieve a more defined appearance to the cheek bone. Volume is often lost from the cheeks due to ageing or weight loss and can cause sagging, restoring these areas are a great way to rejuvenate your face.
Nose to Mouth Lines (Nasolabial folds)
As we talk, smile, smoke or kiss it can cause the muscles around our mouth to crease and over a long period of time these lines may become more prominent and permanent. The ageing process also causes our production of natural collagen, hyaluronic acid and elastin to reduce causing lines and wrinkles to appear. Dermal Filler can be used to plump up and fill out the lines and folds that have been created in the Nasolabial folds as well as the mouth folds, marionette lines and drooping mouth corners to achieve a more rejuvenated and fresher face look.
Non Surgical Rhinoplasty
I also offer a Non-Surgical Rhinoplasty treatment which is achieved with the use of fillers.
Dermal Fillers Results
Lines and wrinkles are smoothed out and the skin appears plumper and younger. Areas lacking in volume and shape now have more definition, with a fuller appearance.
Downtime
None. You can go back to work immediately after your treatment and you can apply make-up over the treated area.
WHAT CAN DERMAL FILLERS TREAT?
Fillers in Dubai | 31 December 2019
These days, dermal fillers have become extremely popular for facial rejuvenation without the need for surgery or recovery time.
WHAT CAN DERMAL FILLERS TREAT?
Dermal fillers are generally used for smoothing fine lines and wrinkles, and for adding volume and fullness to skin beginning to suffer from volume loss. Dermal fillers can also be used for cheek and chin augmentation.
When performed by an expert with experience using dermal fillers, these treatments can be extraordinarily natural-looking. Most men and women don’t necessarily want to look as if they have had work done, so strategic dermal filler placement is ideal for someone who just wants to soften their lines and take a few years off their face.
One of the main draws for dermal filler treatments is that they require no recovery time. The actual procedure can be done in as little as ten minutes, depending on how many areas are to be treated, and the patient is then free to resume their daily activities and go back to work immediately. The potential side effects of dermal fillers when administered professionally are very minimal, just redness or swelling around the injection site. If this happens, it usually disappears within a few hours or a day, and can be covered easily with makeup. Bruising is another potential side effect, but these can generally be avoided by following your dermatologist’s instructions before coming in for your appointment.
BENEFITS OF DERMAL FILLERS
1. Immediate Results and No Downtime
One of the biggest benefits of using dermal fillers? They provide immediate results. Once you undergo a filler injection, you will notice your appearance transform soon thereafter. On top of this, you don’t have to worry about recovery time like you would following plastic surgery. In fact, you can complete the filler treatment in just 10 minutes depending on the number of areas needing treatment. Then, you’re free to continue your daily errands or even go back to work. In fact, a filler treatment is sometimes described as a “lunchtime facelift.” Talk about a life-changing lunch break.
The side effects you may experience as a result of your filler treatment are minimal. Just a little swelling or redness near your injection site is normal. Even then, this swelling and redness should disappear within several hours or one day. In the meantime, you can simply cover it up with makeup.
You may more commonly experience bruising, but you can typically avoid this by following my instructions prior to your filler treatment appointment.
2. Long-Lasting Effects
Yet another benefit of fillers is the lasting results you’ll enjoy after getting them. In the majority of cases, you’ll stay looking more youthful and beautiful for about one year. However, you might want to go in for a quick touch-up appointment in four to six months following your initial treatment. It’s in your best interest to maintain your filler results. You can do this simply by scheduling your next treatment before your filler has had the chance to metabolize completely.
3. Beneficial for the Skin
Most fillers feature a natural skin component that help the skin – a major plus for patients interested in getting filler injections. Hyaluronic acid present in fillers are naturally occurring substances in the skin. Thus, when they are injected, they’ll feel natural beneath your skin. It’s just another reason to love the skin you’re in after you get a filler treatment.
4. Subtle Results
If you choose to receive dermal fillers, you’ll also love how subtle and natural looking the results are. That’s exactly what you want if you’re like most patients. After all, who honestly wants to look like a totally different individual after the treatment than he or she was before it? You simply want to be the best version of yourself. With dermal fillers, the majority of people won’t even know what you had done. All they’ll notice is that you look amazing.
5. Self-Confidence Builder
People who receive dermal fillers generally improve their self-confidence following their treatment. They simply love how their fillers look and feel. At the hands of an experienced aesthetic practitioner, you can achieve amazing natural looking results and love how you look like never before.
6. Plumpness
As you grow older, your skin will lose collagen and fat. In other words, you’ll lose your youthful plumpness. Replacing the young, healthy look you’ve become accustomed to will be a hollowed-out look and more blatantly obvious wrinkles – clear signs of advancing age. Fortunately, fillers help to counteract these problems by making your skin plumper. In the end, you’ll end up with fuller-looking cheeks as well as fewer facial wrinkles – You can’t beat that.
7. Botox Complements Them
Another perk of using fillers? Botox complements fillers perfectly! As you get fillers, you might notice that a few of the wrinkles on your face are particularly deep – especially those on your forehead and glabella. Or maybe you notice vertical lip lines near your mouth. In these situations, you may want to receive a Botox or Dysport treament. This product will temporarily reduce the muscle activity responsible for your deep wrinkles and frown lines. It’s perfect for tackling those lines and wrinkles that dermal fillers won’t eliminate. With the powerful combination of fillers and Botox or Dysport, you may be able to delay or even avoid surgery, such as a facelift, down the road.
8. Good for Your Lips
Of course, fillers aren’t just good for filling in wrinkles and cheeks. Fillers can work wonders for your lips. Tired of thin lips? Fillers can make your lips look plumper and sexier. At the same time, it’ll soften the appearance of annoying wrinkles around the mouth. With dermal fillers, you can finally stop feeling self-conscious when it comes to your lips. In fact, your lips just might become your favorite feature. Just be sure to get lip fillers with an experienced aesthetic practitioner to ensure yourself an experience that is safe and that yields natural looking results.
9. Say Goodbye to Scars
A major advantage of springing for fillers is that they can improve the appearance of scars. This is a big deal if you’ve spent years applying makeup to hide unsightly scars as a result of acne, for example. Your practitioner can help you to determine if dermal fillers are an option for treating certain scars.
10. Boost Your Collagen
Last but not least, biostimulatory fillers, like Radiesse and Sculptra will stimulate the body’s natural collagen. A major reason that your skin ages as you get older is that collagen production declines. This is accelerated if someone has a lot of sun damage. Collagen is one of your skin’s essential building blocks. When collagen ends up breaking down, the signs of aging is more apperant. This includes having coarse skin texture and wrinkles.
Dermal fillers, however, can help your body stimulate more of its own collagen, just as a younger individual’s skin does. This translates to the younger, healthier-looking skin you’re after – in a natural way.
PRP Therapy for Skin Rejuvenation
Aesthetic Medicine Dubai | 24 December 2019
Cosmetic PRP Therapy Treatment is an effective treatment for several conditions and has been successfully used to improve skin and hair conditions. I provide the following PRP treatments: PRP hair regeneration and PRP skin rejuvenation. PRP or Platelet Rich Plasma therapy is not for everyone. Certain medical conditions and use of certain medications may make your platelets less effective.
WHAT IS PRP?
Platelet Rich Plasma or PRP is obtained from your blood and injected into your tissue wherever tissue regeneration is needed. Over the last decade, autologous PRP has been successfully and extensively used in sports medicine to regenerate tendon injuries, muscle injuries, worn out cartilage in aging joints; in general surgery to promote faster healing of large surgical scars and in the field of cosmetic and anti-aging medicine for skin rejuvenation and hair regeneration.
Autologous PRP provides a safe and very effective regenerative treatment option but unfortunately not everyone is a candidate for PRP cosmetic regenerative treatments. Below are some of the absolute and relative contraindications to PRP treatments:
Absolute Contraindications to PRP Regenerative Therapy:
– Platelet dysfunction syndrome
– Critical thrombocytopenia – very low platelet count
– Hemodynamic instability – very low blood pressure
– Septicemia or local infection to injection site
Relative Contraindications to PRP Regenerative Therapy
– Aspirin and other NSAIDs use within one week of the PRP therapy.
– Corticosteroid injection at treatment site (1 month)
– Systemic use of corticosteroids (2 weeks)
– Cancers (hematopoetic-blood or bone)
– HGB < 10g/dl or platelet count < 105/ul
I do not want you to stop taking your aspirin or blood thinner medication if you are taking these medications for heart condition and for stroke prevention. If you are taking any of the medications for a serious medical illness, you will need to pause the medications under your physician’s care and obtain a medical clearance letter before your PRP therapy.
Cosmetic PRP Therapy Treatment harnesses the healing ability of your blood to regenerate healthy new tissue in the treatment area for natural improvement of common skin concerns and thinning hair.
CLINICAL RESEARCH ON PRP TREATMENT EFFICACY FOR SKIN AND THINNING HAIR
Platelet Rich Plasma is obtained by processing your blood in a centrifuge to get a concentrated mixture of your platelets. Platelets are small cells in your blood that are responsible for your body’s healing response to injury. Upon any injury, your platelets release a minimum of eight growth factors which initiate a cascade of events leading to regeneration of healthy tissue to repair the injured area. High-quality PRP leads to the appropriate growth factor release which results in healthy tissue regeneration for rejuvenated skin and thicker hair when injected in these sites.
PRP THERAPY FOR SKIN
Cosmetic regenerative PRP therapy provides growth factors from your own blood to optimize your wound healing and is used for several non-surgical cosmetic skin treatments to enhance the results of your cosmetic skin treatment. I love the natural results from regenerative PRP skin treatments for improvement of several common cosmetic skin problems such as; skin aging, acne and other scars, stretch marks, melasma and other hyperpigmentation disorders. I often combine your PRP with different types of skin treatments specific to your needs to help you achieve your personal best for your skin needs.
PRP SKIN SURFACE REJUVENATION AND PHOTODAMAGE REPAIR
PRP injection into the dermis (middle layer of skin) and application of PRP topically with Micropen microneedling skin treatment may improve skin surface aging, fine lines, pigmentation, texture and skin tone.
PRP SKIN TIGHTENING AND PRP DEEP WRINKLE REDUCTION
To address the signs of deeper skin aging such loss of skin elasticity, deep wrinkles and folds, which present as jowls, sagging of the eyelids, sagging of the skin below the chin, deep nasolabial folds and so forth, I recommend a deeper skin tightening and collagen building treatment. The injection of PRP into the dermis and application of PRP topically with the MFR skin treatment can improve skin tightness, build collagen to lessen the appearance of deep wrinkles, deep folds, jowls, tighten the neck skin and lift the eyelids.
PRP WITH DERMAL FILLERS FOR VOLUME ENHANCEMENT
For areas with mild to moderate volume loss below the skin such as the age-related thinning of the back of hands, deep under-eye circles and loss of facial volume, PRP injections below the dermis can be combined with a dermal filler for volume replenishment. The advantage of PRP is that the regenerative response of your body leads to an improvement in the skin texture, firmness and tightness with healthy new tissue along with the volume that is replenished with the dermal filler. I see this effect most noticeable in the under eye area.
PRP STRETCH MARK TREATMENT
Stretch marks are common in women and men of all ages. Stretch marks can present on many areas of the body such as tummy, thighs, buttocks etc due to a rapid increase in size such as rapid growth during puberty, increase in size during pregnancy and with a sizable weight gain. Stretch marks are like dermal scars in many ways and can be reduced in the same way as dermal scars. best treatment results are achieved with early intervention. For most individuals with stretch marks, I recommend a series of 3-5 treatments with PRP injection and PRP topical application with one or two of the microneedling sessions.
HOW IS THE REGENERATIVE PRP SKIN THERAPY DONE?
Treatment with PRP can be completed in less than 30 minutes. When you arrive, a small vial of blood is drawn, similar to the volume required for routine blood work. The blood is then spin in a centrifuge to separate the growth factors, and platelets from the rest of the blood. Once this unique mixture is obtained, it can be injected directly into the targeted areas or applied through micro needling.
Before your Cosmetic PRP Therapy, you will have a thorough consultation where I will evaluate your medical history for appropriateness of the cosmetic PRP treatments and discuss your goals and expectations for the treatment.
PRP HAIR LOSS THERAPY
PRP hair loss therapy is an effective treatment option for increasing hair density in individuals with certain types of hair loss disorders*
PRP hair loss therapy alone is effective in improving hair density and quality when injected into the scalp of men and women with early and mild androgenic alopecia and with telogen effluvium (after correcting the triggers of telogen effluvium). PRP hair loss therapy is effective in increasing hair density and hair quality in individuals with more advanced androgenic alopecia and androgenic alopecia lasting longer than 5 years. PRP hair loss therapy alone does not lead to hair regeneration in individuals with advanced hair loss with scarring and those with complete loss of hair follicles.
*Individual results vary with genetic, hormonal, environmental and other influences
Lif Fillers: WHAT TO EXPECT
Fillers in Dubai | 22 December 2019
Full lips have always been associated with youth and beauty. Because of this, lip enhancement is one of the most frequently requested procedures in a cosmetic practice. The objective in treating the upper lip is to artistically create a form that harmonizes with the patient’s unique facial features and takes into account the age and ethnic background of the patient. The goal in treating the lower lip is to create bulk and greater prominence and artistic projection of the vermilion. The physician must establish appropriate guidelines and patient expectations for augmentation relative to normal lip proportions in order to avoid a cartoon-like appearance.
Any physician performing lip augmentation should recognize that temporary fillers can cause permanent stimulatory effects in tissues.After 2 or 3 sessions of lip augmentation, full correction may be obtained and persist indefinitely. Patients may return for additional filler merely because a certain amount of time has elapsed since their last injection, but the physician must evaluate the proportions of the lips to truly determine if additional filler is warranted. It is helpful to have a hand mirror for the patient to observe her lip proportions as the doctor seeks to determine whether more filler is needed. It is also beneficial to show the patient her lips from the lateral view; digital photography is extremely useful in this regard.
THE PROCEDURE
It’s important to see your box of injectables opened in front of you and to be sure only your dermatologist or plastic surgeon is doing the injections. Avoid blood thinners, like aspirin and fish oil, for at least a day beforehand, which can increase bruising. If you opt for numbing cream, expect it to be placed on the lips for approximately 10 minutes. The lips absorb quickly and do not require lengthy topical anaesthesia. Then, the skin surface should be cleansed properly and then injections are performed. Your doctor should go very slowly, often pausing to show you the progress that he or she is making. There is a real balance and art to it, I find that you really need to go little by little, so you normally inject the top lip first, balance it out on the other side, then inject the bottom lip. It takes about 15 to 20 minutes. What you see is what you get, you’re not waiting for it to work, like Botox.
Some doctors will gently mould the filler with their fingers after it is injected by squeezing and patting it into place, while others aim to inject it exactly where they want it and avoid moulding, since it can increase bruising and swelling. Based on my extensive experience, there is no single stance on moulding – it’s a technique that some like, while others do it sparingly.
Your doctor should let you chime in along the way and help decide whether or not to add more or stop. I even recommend my patients go lighter than they think they may want, live with it for a week, and then decide whether or not to do more. “It’s best to start with baby steps.
After the injections, ice packs are applied. That evening, I suggest patients sleep on two pillows to decrease swelling. Use ice sparingly at home (getting the H.A. too cold or hot can prevent it from settling properly) and ask your doctor if additional anti-swelling measures are right for you, like oral antihistamines, pain relievers, or topical corticosteroids.
The entire procedure should take under 30 minutes.
NATURAL RATIO
It’s no secret that some lip augmentations look incredibly natural and some look not so incredibly natural. This is partially because of the size that you and your doctor select, but it goes deeper than that. The fact of the matter is that some doctors have a better feel for nuance and aesthetics than others.
It’s something you have to have an appreciation for, to get the proportions right for each person. There is a lot more artistry to injecting lips than just injecting a wrinkle or a line. That is another reason why the consultation is so important. I show actual before and afters of my patients, so that everyone has a realistic expectation for the type of filler I do.
Selecting where, and at what volume, to inject the lips is also an important decision to make in the consultation. The lips are supposed to be filled in a natural ratio, where the upper lip is approximately 2/3 the size of the lower lip.
That means that sometimes, only one lip needs to be filled, sometimes both, and often at different volumes, since not everyone’s pout is symmetrical. Where to inject is also a delicate matter. The lips can be injected into the skin surrounding the lips (to define the Cupid’s bow, for example), into the lips (for fullness), and into the lipline (for definition). It’s like sculpting.
Creating Philtrum Columns
Sculpted philtrum columns are in style today. As we age, these well-defined longitudinal pillars are lost, leading to a flattened, ill-defined, unattractive upper lip. If the patient still has discernible philtrum columns, the object is to further enhance them. If the philtrum columns have been completely effaced, it is imperative to re-create them. This is accomplished by superficial vertical injection of filler into each philtrum column. It is important to realize that the philtrum columns are not parallel to each other, but rather they form an inverted “V” that narrows as it approaches the nostril sills and columella of the nose.
Creating Cupid’s Bow
The pouty, Cupid’s bow appearance of the central portion of the upper lip is considered sexy, desirable, and very much in fashion today.
Creating Lower Lip “Pillows” or Tubercles on Each Side of the Midline
Here I ask the patient to evert the lower lip. I deposit approximately ~0.1 cc of filler as a depot injection into the orbicularis oris muscle at the vermilion-mucosal junction on each side of the midline. The depot injection is about one third of the distance from the midline to the oral commissure. This is gently massaged to prevent superficial lumpiness.
Supporting or Bolstering the Oral Commissures
Placing a small amount of filler in the most lateral aspect of the cutaneous lower lip so as to provide upward support to the commissures. Injectable neuromodulating agents (botulinum toxin A) placed into the depressor anguli oris muscles can be used as an adjunct to further elevate the commissures. This combines structural support with chemical neuromodulation to shape the oral commissures.
Filling the Nasolabial Creases
Placing a small amount of filler in the upper portion of the nasolabial crease helps to evert the upper lip. Augmentation lateral to the nasolabial crease only serves to deepen the appearance of the crease.
POST-INJECTION CARE
Cool compresses and ice packs can be used to minimize swelling and bruising. Patients should be advised to avoid ASA, NSAIDs, and other medications associated with an increased risk of bleeding. If anti-HSV I medication was prescribed, it should be continued according to physician recommendation. Because HAs are hydrophilic, they attract water from the surrounding tissues and further augment the soft tissue volume beyond that expected from mere implantation. The significant swelling of the vermilion in the immediate post-operative period may be camouflaged by applying flesh-toned foundation or concealer to the entire vermilion. Lipstick can then be applied to a smaller portion of the vermilion than usual so as to not exaggerate the swelling that may be present.
SELECTING THE RIGHT FILLER
There are a lot of difficult decisions you have to make when it comes to getting lip injections, but fortunately, picking the right filler isn’t one of them. Hyaluronic acid, in a few different forms, is both the industry standard for temporary lip injections and the only temporary lip filler approved by the FDA.
They’re marketed under different brand names – Restylane 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.
Breast Augmentation: After Care
Breast Augmentation Dubai | 20 December 2019
Once your surgery is completed, you must follow all the instructions given to you in order to heal properly and have a good outcome.
The following instructions are your obligation. Use this as a checklist of progress as you heal. Included are normal post-surgical experiences and key health considerations that may be a cause of concern.
TYPICAL POST-OPERATIVE SYMPTOMS
Typical symptoms of breast augmentation and signs to watch for following surgery with silicone breast implants include the following:
Tightness in the chest region and stiffness
Tingling, burning or intermittent shooting pain. These are normal experiences as the skin, muscles and tissue stretch to accommodate your breast implants, and as sensory nerves heal. Pain medication and muscle relaxants will help you cope with any discomfort. If you have drains, you may experience additional localised discomfort. Consistent sharp pain should be reported to our office immediately.
Hypersensitivity of nipples or lack of sensitivity
This is normal and will gradually resolve over time. You may also experience a small amount of fluid or milk seeping through the nipples. If this becomes painful or excessive notify my office immediately.
A feeling of heaviness
It is normal for your chest to feel heavy as you adjust to your implants. This will subside within 2-4 weeks following surgery.
Shiny skin or any itchy feeling
Swelling can cause the breast’s skin to appear shiny. As the healing process advances, you may also find a mild to severe itchy feeling of the breasts. If the skin becomes red and hot to the touch, contact our office immediately.
Asymmetry, the breasts look different, or heal differently
Breasts may look or feel quite different from one another in the days following surgery. This is normal. Although no two breasts in nature or following surgery are perfectly symmetrical, breast massage and time will produce breasts that are similar in shape, position and size.
A sloshing sound or sensation
This is not the result of your implant, but rather of air that is trapped in the implant pocket and fluid that may naturally accumulate. This is perfectly normal and will resolve within 2-4 weeks.
AFTER SURGERY CARE
Your greatest discomfort usually occurs the first 24-48 hours after surgery. During this time, take all medications prescribed by me as directed. It is helpful to take pain medication with bland food to avoid nausea, which may occur if taken on an empty stomach.
Wear garments as directed after surgery. An additional garment may be picked up at the office. Contact the office before taking any Aspirin, ibuprofen (Motrin/Advil) or Aspirin-like medications. You may take Tylenol, if you are not taking a pain medicine that already contains Tylenol (acetaminophen), such as Percocet (oxycodone) or Norco (hydrocodone).
Eat easily digestible foods. These are tolerated well the first 24 hours after surgery. If you are not experiencing nausea, you may resume a normal diet. Drink plenty of non-caffeinated beverages and eat fruit and food high in fiber to avoid constipation. Should constipation occur, discontinue pain medication (if tolerated). For relief, you may try magnesium citrate (purchased at your local pharmacy) or prune juice. It may take up to 24 hours to produce a bowel movement. These treatments may be repeated as needed.
AFTER SURGERY ACTIVITY AND HYGIENE INSTRUCTIONS
No lifting over 10-15lb. until cleared by myself. When at home, take frequent rest periods – you may walk for short distances, as walking is important to prevent clots from forming in your legs. As you increase your activity, let comfort be your guide. If it hurts, don’t do it.
Do not resume jogging, aerobics, sexual or vigorous activity until cleared by myself. No heavy household chores (laundry, vacuuming, sweeping/mopping, etc.) until cleared. You may shower 24 hours after surgery. Do not submerge incisions or drains (if present) under water such as in bath, lake, river, pool or hot tub. If present, leave steri-strips (flesh colored bandages) in place. All other dressings may be removed to shower.
Continue to wear the garment, placed on you at the time of surgery, 24/7 except to shower or to launder the garment. Two weeks after surgery, you may discontinue sleeping in the garment and only wear it during the day. While taking pain medicine, have someone assist you with daily activities, particularly personal hygiene.
Limit arm usage to routine daily functions such as brushing your teeth, eating, washing and combing your hair. Avoid vigorous arm motion that requires pushing, pulling and/or lifting heavy objects.
As you heal and soreness subsides, let pain be your guide for your activity level. If it hurts, don’t do it. Check with me before returning to work, particularly if your job requires heavy lifting or vigorous activity.
Avoid sleeping on your abdomen until all soreness has subsided. You may find sleeping propped on 2-3 pillows more comfortable. Avoid sunbathing for 4-6 weeks or until cleared by myself.
Do not wear an underwire bra for 6 weeks. At that point, you may wear a bra of your choice. However you will need to wear a good supportive bra for exercise or vigorous activity. Preferably a sports-type bra that has cups versus one that just compresses the breasts.
Do not smoke for 6 weeks as smoking delays the healing process.
WOUND CARE
You may have several layers of dressings. After 24 hours, you may remove all dressings except the flesh-colored bandages (steri-strips) or clear “tape” (Prineo). Leave either of these dressings in place until your follow up with your surgeon. If either of these dressings comes off, please contact my office for further instructions.
Do not put anything on your incisions except soap and water unless instructed.
Please notify me if:
– You have a fever greater than 101 that lasts more than 24 hours.
– You develop excessive swelling, redness or warmth of incisions.
– You experience severe pain not responding to pain medication.
– You develop thick, odorous drainage or bleeding that does not subside. – You experience shortness of breath.
– One breast appears twice the size or more than the other.
AFTERCARE: BREAST AUGMENTATION SUMMARY
Dressings
On day two from surgery remove all gauze in the bra and throw it away. Shower, and then pat the incisions (steri-strips or skin glue) with a clean cloth. Replace soft bra. You will not need gauze unless you have some slight drainage from the incision sites and want to keep this from getting on your clothes.
Bathing
You may shower two days after surgery (48 hours after surgery). Do not bathe, swim, hot tub, lake swim, or use a whirlpool until incisions are fully closed. I will determine when you are cleared for these activities based on your physical exam. You may feel lightheaded on your first or second shower, therefore a shower assistant is mandatory. Sitting on a chair in the shower is also helpful if you feel more comfortable.
Medications
Complete your course of antibiotics. Arnica may reduce bruising and you should take a complete course. Take prescribed pain medication only as directed and consider Extra Strength Tylenol in place of narcotics. Take medications with food to reduce nausea. Resume pre-operative medications unless otherwise directed by your operating physician or personal physician.
Swelling
Initially, there will be quite a bit of swelling. This swelling over the first couple of days. You will notice that your implants/breasts seem high on your chest. This is often very normal. On day 5 you will start massaging your breasts. This will assist with the implants settling and the capsule to form flexibly. Do not apply heat or ice to any treatment areas. Your ability to sense if your skin is getting too cold or hot is not normal and you may burn yourself.
Massage
Start gentle massage of the breasts at day 5. I or my office staff will demonstrate this technique for you at your post-operative visit. Lymphatic massage has also been shown to help people with fluid retention following surgery. Do not lie on your stomach.
Diet
Start with a bland soft diet and increase this slowly. Slowly resume a balanced healthy diet. This is often difficult following surgery as you are not feeling at your best and are limited in the amount of physical activity you can do. Limit the amount of salt to take in as this will affect your swelling. Drink plenty of fluids. Avoid alcohol.
Clothing
Avoid tight fitting bras that dig into your skin or incision. Wear a soft bra that gives moderate support and opens from the front. This makes it easier to take it on and off.
Smoking
It is well known that nicotine impairs healing and increases your risk of infection. Your scars and final outcome are negatively affected by smoking/nicotine as well.
Driving
Do not drive or operate any heavy machinery for 24 hours following surgery and/or until you are not taking pain pills. You will need someone with you mandatorily for 24 hours following surgery.
J PLASMA RENUVION: instantly tighten and rejuvenate anywhere on the face & body
Cosmetic Surgery Dubai | 15 December 2019
Loss of tissue elasticity and tone is a hallmark of aging skin. It is the characteristic change that makes one start to look older than one feels inside. Until recently, no surgical procedure or energy source achieved consistent significant tightening without an extensive recovery. Now, whether ultrasonic liposuction is used in conjunction with J-Plasma Renuvion for skin tightening or not, there is hardly an area of the body that cannot be treated.
WHAT IS J-PLASMA RENUVION?
J-Plasma Renuvion is a revolutionary minimally invasive procedure that uses cold plasma energy on the underside of the skin to instantly tighten and rejuvenate anywhere on the face and body. A unique alternative to traditional facelifts, tummy tucks, and body sculpting, the J-Plasma Renuvion procedure will shrink and sculpt loose and lax skin without large incisions, downtime or complications of cosmetic surgery.
J-Plasma for the face uses cold plasma energy under the skin to lift, tighten and rejuvenate the face and neck giving you natural-looking results with minimal downtime and no complications of a traditional facelift. J-Plasma Renuvion is unique because the cold plasma energy applied under the skin creates instant skin contraction resulting in improved laxity, tightening and shrinkage.
AM I A CANDIDATE FOR THIS SKIN TIGHTENING PROCEDURE?
Renuvion is a treatment option for patients who want skin tightening results, but do not want to do invasive plastic surgery. No other minimally invasive technology will tighten the skin to this degree with such a:
– tiny incision
– little or no scarring
– minimal downtime
BENEFITS OF J-PLASMA RENUVION FOR THE FACE
– Immediate skin tightening
– Improved skin elasticity
– Eliminates crepey skin
– Scar reduction
– Reduction and/or elimination of age spots, sun damaged pigment and
freckles
– Reduction of wrinkles and lines caused by ageing and weight changes
– Tightening of loose skin in known problematic areas of the face
– Improvement of skin texture and tone around the lips, eyes, cheeks,
forehead, jaw and neck
– Reduction of eye bags and crow’s feet
– Reduction of acne and pigment issues (chloasma)
J-PLASMA RENUVION COMMON TREATMENTS
Both women and men can undergo J Plasma treatment. However, it is most popular with women and the most common treatment areas are:
– Face
– Neck
– Breasts
– Stomach
– Arms
– Thighs
WHAT IS PLASMA ENERGY?
Cold plasma is created when helium gas is energized by radiofrequency energy and delivered through the J-Plasma device. Because Helium gas is very stable, it can be ionized at very low energy ensuring flexible, precise and safe delivery. Cold plasma is cooler than laser energy making J-Plasma Face a safer procedure with less risk and damage to the tissue and affording patients a quick recovery. The level of improvement and rejuvenation from cold plasma energy is unrivaled in current technologies. No laser, ultrasound or radiofrequency treatment is capable of tightening and firming skin to this level.
J-PLASMA RENUVION CONSULTATION
During your consultation, Dr. Vigo will evaluate your skin elasticity, and your underlying muscle tone. He will thoroughly explain the technique along with its risks, benefits, and recovery times.
J-PLASMA RENUVION FACE PROCEDURE
Performed in a day care facility and using local anesthesia with sedation, Dr. Vigo starts the J-Plasma (Renuvion) procedure with three tiny, hidden incisions under the chin and behind each ear. He will then use the J-Plasma device sub-dermally (under the skin) to deliver cold plasma, which instantly tightens, shrinks and rejuvenates skin from the inside out. Results are immediate and continue to improve as your body continues to heal. A compressive garment is needed post operatively in order to enhance the result of the procedure.
DOES THE PROCEDURE REQUIRE GENERAL ANESTHESIA?
J-Plasma Renuvion can be done under general anesthesia, sedation or even local anesthesia only for limited areas.
HOW MANY J-PLASMA RENUVION TREATMENTS WILL I NEED?
J-Plasma Renuvion is a single treatment. You will start seeing results soon after surgery, but the skin continues to tighten over the next several months and up to a year as the skin remodels and deposits new collagen.
RECOVERY AFTER J-PLASMA RENUVION SKIN RESURFACING
Although most patients are up and about at 2 weeks, there is still redness/erythema that lasts approximately 4 weeks. The energy penetrates deep into the skin for maximal result which does lengthen downtime. This is in contrast to J-Plasma Renuvion tightening where I have had patients go back to work within a few days. For limited areas, most patients only require a pain reliever during recovery.
RECOVERY & SIDE EFFECTS
Recovery from Renuvion procedures can take between two to three weeks depending on the extent of the procedure and the target area.
Larger body parts generally require more downtime and patients will feel more symptoms than that of smaller target areas. Patients should expect to experience symptoms for up to three weeks post treatment. These can include:
– Dry skin
– Peeling skin
– Mild pain
– Redness
– Swelling
– Itching
– Bruising
Medication can be taken to curb symptoms if at any point you feel uncomfortable. However, symptoms are very rarely severe and patients can usually return to regular light activities after two to five days.
It is common for patients to experience a ‘tight’ feeling in the area that has been treated as the sensation post treatment is different than before.
In addition, compression wraps can be worn day and night in the immediate recovery phase to help with the healing process and ensure a more comfortable resting / sleeping state.
However, every patient is different and no two are the same. So if you are feeling like you are experiencing more symptoms than you should, contact your clinician for assistance and advice.
Dermal Fillers: fuss-free beauty
Fillers in Dubai | 12 December 2019
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.
Breast Augmentation: What techniques are involved?
Breast Augmentation Dubai | 9 December 2019
Having fuller more voluptuous breasts is a very important part of feeling feminine and more confident for women. The breasts give the female body more proportion, curves and shape, which makes many women feel more sexy. There are a variety of factors that make women unhappy with their breasts. Such factors include the effects of aging, gravity which leads to sagging, post pregnancy changes and natural asymmetry. A breast augmentation helps women improve the overall appearance of the breasts and cleavage. This results in an improved self esteem, confidence and feeling sexier about your body.
Reasons why women seek breast augmentation include:
– Improved body proportion
– Correct loss of fullness or sagging due to aging, gravy, or pregnancy
– Improve cleavage appearance
– Increase breast shape and size
– Correct asymmetry of the breasts (one breast is larger than another)
WHAT TECHNIQUES ARE INVOLVED?
Breast augmentation involves the placement of an implant under the patient’s breast tissue to enhance the size and shape of the breast. The breast implants are usually inserted using an incision placed under the breast at the crease, but can also be put in via an incision in the armpit or around the nipple.
Breast augmentation surgery takes about one and a half hours, and is usually done under general anaesthetic. The operation itself involves accessing and creating the pocket into which the implant will be placed, using one of the insertion routes mentioned above: breast-crease, armpit or nipple.
Incision Options
There are three different types of incisions that can be performed when getting a breast augmentation surgery. These incisions are Inframammary (incision below the breast), Transaxillary (through the armpit), and Peri-Areolar (along the lower edge of the Areola). Dr Vigo will go over the different options available to you during your consultation, showing you the benefits of each option and explaining exactly how they are performed including the associated recovery time for each.
Inframammary
An inframammary incision is the most common incision when getting a breast augmentation. This incision is made in the fold below the breast and carries a very low risk of complications. Inframammary incisions are highly recommended for large pre-filled implants such as silicone. These incisions are usually discreet as it goes along the natural crease below the breast, however, on occasion the scar may be visible due to the size or shape of the implant. All patients heal at different rates. Your incisions will be monitored after surgery and tailor your scar managment to optimize healing and appearence. Proper care and maintenance of your incisions will be closely followed with you as you heal.
Peri-Areolar
A Peri-Areolar incision is done around the bottom edge of the areola and is typically four to five centimeters in length. This incision is very discreet after it is healed. Often times it is impossible to notice as it goes along the natural edge of the areola. The trade off risks and benefits of their incision approach will be disscused at the time of your consultation. Some women may experience difficulty with breast feeding after this incision approach. Nipple sensitivity is also jeopardized with this approach compared to other incision sites.
Transaxillary
A Transaxillary incision is the least visible of the different incision options as it is made in the armpit. This ensures there are no scars anywhere near the breasts. The breast augmentation procedure is performed using an endoscope during the surgery, which allows the surgeon to see the implant inside the pocket. Having the ability to see the implant inside the pocket allows for the best surgical decisions and precise placement of the implant. Implant type is limited by the incision, as only round smooth implants can be placed through this incision.
Once the pocket has been created, the surgeon may insert a trial implant to check that the size chosen is appropriate. The trial implant is removed, the definitive implant inserted and the incision wounds are stitched. You will be able to go home the same day. Postoperative pain in these procedures is easily controlled. Your chest will feel tight. Your breasts and ribs below your breasts will be tender. Patients will be mobile from day one and should be back to full exercise within six weeks. Patients are recommended to take around one to two weeks off work immediately after the operation in order to ensure you recuperate fully.
Implant Placement Options
There are two choices when it comes to the placement of the breast implants you select. They are subglandular (above the muscle) or submuscular (below the muscle). The benefits of each of the different placement options will be discussed with you at your consultation with a recommendation of a specific placement option depending on the natural shape of your breasts or your overall goals for getting a breast augmentation.
Subglandular
Subglandular placement is when the implant is placed above the muscle. During this placement, the implants are placed below the natural breast tissue and the surgery is usually quicker but the recovery time is about the same as below the muscle. One of the benefits of subglandular placement is that if future surgery may be required due to rupture or leakage, it allows for easier access to the implant. However, subglandular placement does also have its downsides, such as an increased risk of capsular contracture, concerns about breast views on mammography, and the implant may be able to be felt through the skin.
Submuscular
Submuscular placement is when the breast implant is put under the pectoral muscle. The benefit with submuscular placement is that the final result of the breast augmentation will look and feel more natural. Any breast imaging will be easier including mammographies, because it is easier to differentiate the implant from real breast tissue. Most patients are able to drive in a few days and you may shower the next day. Most surgeons agree that implants under the muscle are in the best position for the long term health of the patient.
Dual plane augmentation
When slender women with slightly drooping breasts seek breast augmentation surgery, surgeons often combine these two routes, placing the implants partly behind the breast and partly behind the muscle. Through this combined approach surgeons try to give patients the benefits of both techniques. This is called a dual plane augmentation.
BEFORE BREAST AUGMENTATION SURGERY
Before going into breast augmentation surgery, it is very important to get a good nights rest. You must follow the instructions given such as limitations to food or medications the day before surgery. All of this is important to get the best results and have the quickest recovery possible when getting surgery.
On the day of surgery make sure you have a friend or family member drive you to the surgical facility. You may be very sleepy from anesthesia after the surgery. Before surgery, your surgeon will review the choices you selected and answer any final questions or concerns you may have.
Your body will then be marked and you will be guided through exactly what will happen during the surgery.