Saturday, October 27, 2012

Skin Rejuvenation

How to tell aging skin?

As one ages, there are tell tale signs of skin aging on the face. The following are those signs:
  1. Fine lines, thin skin and wrinkles
  2. Pigmentary changes e.g. solar lentigo, white marks
  3. Vascular changes e.g. telangiectasia, cherry angioma
  4. Skin cancers e.g. basal cell carcinoma, squamous cell carcinoma
What is skin rejunvenation?

Skin rejuvenation basically is to improve the skin condition to minimise the aging signs of the skin. Of course, if there are any of the above, the problems should be treated accordingly. We will assess the skin and give appropriate advice. However, if there is no major problem like nos 2 to 4 (tell tale signs of skin aging), then skin rejuvenation programme can be advised. The considerations are:
  1. Good skin care regime and products
  2. Facial spa therapy
  3. Chemical Peels – Medical Grade
  4. Machine based treatment e.g. our signature 2 or 3 D rejuvenation, skin resurfacing, Radiofrequency
  5. Botox
  6. Fillers to give facial volume
  7. Thread lift
  8. Cosmetic surgery
Is there a need to change my lifestyle?

Yes, if you have bad ones. It would be best to have a balanced diet, to reduce stress, reduce alcohol consumption and stop smoking. It is imperative to use sunblocks.

Body Contouring

ICE-SHOCK-LIPOLYSIS

Fat cells are known to be uniquely sensitive to extreme cold. Exposing fat cells to extreme cooling for a stipulated time period can reduce the thickness of fat under the skin. Proshockice is a non-invasive device that gets rid of localized fat and fibrous cells. It employs patented, safe technologies known as “ice-shock-lipolysis” and “shock therapy”, in which excess cellulite and adipose cells are eliminated without causing harm to surrounding tissues through a controlled cooling process and acoustic shockwaves. The dead fat cells are then expelled by the body’s natural metabolic processes.

Why Proshockice?

Being a painless and non-invasive procedure, Proshockice allows patients to undergo fat reduction procedures with minimal discomfort and resume daily activities immediately after treatment. Proshockice is also certified as a safe procedure: the cooling system is scientifically proven to only affect fat cells, leaving surrounding tissues unaffected and intact. Many patients have seen excellent results with this innovative procedure, experiencing drastic fat reduction in 2 weeks and visible reduction of cellulite.

What To Expect

Each treatment is carried out according to a prescribed protocol and the duration of the treatment is set depending on the size of the area to treat, varied from a minimum of 20 minutes to a maximum of 60 minutes. Treatment protocol varies slightly for the treatment of fatty tissue and the treatment of cellulite, but in general, a transducer with cooling plates is placed on the targeted area for a stipulated period of time to freeze and kill fat cells. Following that, a shock probe along with conductive gel is applied to the targeted are to disperse the dead cells, aiding the body’s natural expulsion process of the dead fat cells.

How Long Before Results Are Seen?

A reduction in centimeters of the area can be achieved in the first session. An improvement of the cutaneous texture and “orange-peel-like skin” is immediately visible. Over the course of treatments, one can see further reductions in centimeters of the targeted area.

Number Of Treatments Required

This depends from patient to patient, but Dr Kok will access and advise patients on the number of treatments required to suit their needs. There are generally weekly intervals between each treatment.

Suitable For

Proshockice is generally suitable for those who are seeking spot reduction in specific fatty areas, but are not willing to undergo surgical procedures.

UltraSound Weight Loss Treatment

UltraSound Weight Loss Treatments make use of UltraSound technology to disturb the fat cells under the skin layer, and to break these problem cells up. This is a targeted method that allows pinpoint accuracy fat reduction. This allows for the targeting of problem areas, whilst ensuring the patient’s desired proportions.

This technology makes use of HIFU – High Intensity Focused UltraSound . This can be effectively used because it can pass through the skin without damaging it, just as used in UltraSound scans during pregnancy. These concentrated blasts of UltraSound destroy small areas of fat in the shapes of spindles.

UltraSound Weight Loss methods are painless and have no recovery time. When the fat cells have been disturbed and broken down, the body will be able to remove them as waste - as per normal Lymphatic Drainage. The body carries this out as if the excess fat is a toxin that will be processed by the kidneys, and disposed.

Radiowave Body Contouring Treatment

Accompanying and following Weight Loss treatments, we also provide Body Contouring services to help achieve a tauter skin tone, and sleeker silhouette. Weight loss often shrinks the layers of fat that plumpen your skin. This can result in a flaccid and saggy physical appearance. In order to minimize this problem, we also provide Radiowave Body Contouring , and recommend a series of deep moisturizing and collagen-building after-care products to be used in conjunction.

The Radiowave Treatment uses radio frequency to encourage skin cell renewal, and increased collagen production. Collagen is a building block of skin that gives skin its healthy and tight appearance. Radiowaves are applied to the skin to stimulate the cells to produce higher amounts of collagen such as to ensure a smoother and tauter texture of skin. This treatment, when applied together with deep moisturizing and collagen-building creams, encourages softer and suppler skin. This gives skin more flexibility and allows it to bounce back from changes in body shape.

Facial Spa Therapy

We have various programmes for the following:

Acne - We have customized packages to clear comedones, acne that include combination of products, facial treatments and machines including ultrasonic cleaning, Iclear blue light or lasers.

Pigmentation – We have various programmes including the popular AFA peel or the Claypeel version. Of course we also have the Cosmelan and Dermalelan Peel (for deeper and darker pigment problems). All the programmes can include ultrasonic cleansers or Parisan peel, ionotophoresis or lasers or limelight.

Rejunvenation – There are many programmes range from Signature Red Light Rejunvenation programme to 3D Rejunvenation. All the rejunvenation programmes come with various machines depending on the recommendation of the doctor.

Doctor’s Signature Chemical Peels (Generally 3 peels at the interval of 3 weeks are recommended to see best result) – We have 3 main programmes under this category:

  • Acne – Quick Fix : This consists of a customized chemical peeling by the doctor. You should see immediate result in terms of resolution of the acne lesions and significant reduction of oil and drying up of the comedones. Of course, one needs the relevant products at home to sustain the improvement.
  • Glow – Fast Glow: The doctor will apply different chemical peels to enhance the “whitening’ effect on the face. There is usually a slight stinging sensation immediately after the peel. This follows up with our signature whitening mask. It would be better to use the LS formula products to continue the whitening effect of the peel.
  • Rejunvenate – Anti-Aging: This would help to reduce fine lines, age spots and improve the texture of the skin. You would expect reduction of pores too. This is followed by our signature Collagen mask. Of course, it would be best if you continue to use our anti-wrinkle creams/products to enhance the effect.
If interested to find out more, you are most welcome to enquire by just calling us for an appointment.

Chemical Peels

What is Chemical Peel?

The use of chemical peels, termed chemoexfoliation, to rejuvenate skin is one of the most powerful tools available to facial plastic surgeons. The concept of using a chemical agent to resurface the skin for purposes of improved appearance dates as far back as ancient times. In fact, it has been reported that Cleopatra routinely bathed in sour goat's milk to help beautify her skin. Unbeknownst to her, the lactic acid contained in the milk was the active ingredient providing her with a rejuvenating peel.

The modern era of chemical peeling began at the turn of the century when George Miller MacKee, a dermatologist, began using phenol to treat facial scars.

Currently, a number of categories of chemical peeling agents available for rejuvenating the skin can be found. These range from superficial formulations available over-the-counter to deep chemical agents that should only be applied by a physician in a controlled setting. When used in the proper setting with appropriate technique, nearly all of these products have proven successful in improving quality and appearance of facial skin. The skin is composed of 2 mutually dependent layers, the epidermis and dermis, which rest on a fatty subcutaneous soft tissue.

Chemical peeling is the process of applying chemicals to the skin to destroy the outer damaged layers. The epidermis regenerates from the epidermal appendages located in the remaining dermis. This process begins within 24 hours of wounding and is usually complete in 5-10 days. The new epidermis shows greater organization and vertical polarity, with the disappearance of actinic keratoses and lentigines. Dermal regeneration is a slower process but is usually complete within several months. The overall result is soft supple skin that appears more youthful with fewer rhytides and dyschromias.

What are the indications?

Superficial peels are used to improve the appearance of pigment changes in the skin, acne scars, mild sun damage, or fine wrinkles in all skin types. They can be done on the face and on other parts of the body. A superficial peel may also be used to prepare the skin for a deeper peel.

Medium peels are used to treat mild to moderate wrinkles, long-term sun damage, pigment changes, and precancerous lesions of the skin (usually caused by sun exposure). Medium peels are used most often on the face.

Deep peels are used to treat severe wrinkles, long-term sun damage pronounced pigment changes, and lesions and growths on the skin. They are done only on the face. Deep peels are not done on darker skin types because they bleach the skin.

Who is the “right” candidate?

Anyone who has acne, photodamaged skin or want to have a rejunvenated face (including removing fine wrinkles) can do the peel. However, a proper medical history is advised e.g. past medical history like cardiac or liver problem or diabetic condition or herpes infection as this will affect the choice of chemical agent to be used. It is best to use some exofoliative agent e.g. tretinoin cream, to facilitate uniform penetration of the peeling agent and promote more rapid re-epithelialization. This pre-conditioning of the skin helps to improve overall result.

What is the classification of Chemical Peel?

The general classification can be as follows:

Superficial Peels - Superficial chemical peels are typically accomplished with use of alpha hydroxy acids (AHA). This group of chemicals is largely comprised of naturally occurring fruit acids, including glycolic, lactic, citric, tartaric, and malic acid. Other type is Jessner or Modified Jessner. This is a combination peel consisting of salicylic, lactic and resorcinol. As this category is superficial, number of sessions is required to see optimal result.

Medium Peels – Trichloroacetic acid (up to 35%) is used in this category. Trichloroacetic acid works as a keratocoagulant that produces a frost or whitening of the skin, which is dependent on the concentration used. Frosting of the skin can be seen very often and peeling of the skin after the procedure is common.

Deep Peels – Phenol peel is commonly regarded as one and this is usually combined with various formulations e.g. croton oil, liquid soap (Classic Baker Gordon formula).

What is the procedure?

The skin is cleansed and acetone is applied to ‘degrease’ the skin. Appropriate chemical or pumpkin treatment peel can be applied and left for a short period of time. The skin is then washed with cold water or neutralized to stop the chemical action.

How to take care afterwards?

Use a mild cleanser with liberal applications of moisturiser and sunscreens. Avoid exposure of sun. Instruct patients to refrain from trans-retinoic acid, sunscreen, or makeup until the face is healed to the satisfaction of the treating physician

What do you expect to see after the peel?

The skin may ‘sting’ a bit and peeling may occur after a few days later. Dryness, peeling and redness will subside after a few days later. Avoid the sun and if not possible, use sunscreen with at least SPF 30 and above. When the skin settles down in about a week, normal skin routine can continue. Review by the doctor is usually one month after the peel is done.

Why choose us?

In LS, we look at each individual face and will advise the appropriate combination of peels. However, we do not do deep peel as we find that complications outweigh benefits. There are other safer and better treatment alternatives to replace this.

Botox & Fillers

What is Botox?

Botox is the brand name of one type of Botulinium toxin A (other serotypes are B, C, D, E, F and G) produced by bacteria Clostridium botulinum. Dr Alan Scott was the first to develop botulinum toxin type A and conducted trials in monkeys for strabismus. He later sold the toxin to Allergan. In 1970s and 1980s, the first clinical applications were for treating blepharospasm & strabismus. It all started in 1990 when Dr Jean Carruthers discovered the disappearance of fine lines around the eyes when Botox was used for therapy of muscle spasm around the eyes. Over the years, it has spread to other clinical aesthetic applications.

How does it work?

Basically, the toxins block the nerve endings in the muscles, thus causing paralysis. However, over time, the effect wears off and the muscles work again. This usually takes about 3 to 4 months. However, repeated injections of botox in the same area may prolong the ‘effect’ because of the so called “paralysis” of the muscles by the botox effect.

Who are the ‘right’ aesthetic candidates?

Anyone with no medical history of muscle weakness like myasthenia gravis, certain motor neuron conditions and those who are allergic to Botulinum Toxins . Pregnant women are not advised to be given botox.

What to ask before injections?

To ask Medical history and to avoid aspirins, NSAIDs, gingko biloba, Vitamin E 7 days prior to injection.

What to expect?

It is a relatively painless and quick procedures. The doctor will assess the region and give the number of injections accordingly. The experience will surface as it is the art of giving the injections besides knowing the science behind it. The botox injections can be combined with various aesthetic procedures to enhance the result. E.g. fillers and botox, titan and botox..

What can be improved with Botox?

Dynamic Lines – Horizontal Forehead lines, glabella, crows feet, Brow lift/shaping, Bunny lines, Nasal Flares, perioral lines, marionette lines (sad lines), mental crease, Dimpled chin.
Face contouring
Lifting e.g. Nefertiti Contour Lift
Intradermal/Micro Botox – to improve skin texture, tightening effect, pore size reduction and control oil.
Excessive Sweat control of hands
Calf Contouring
Others - Migraine

What precautions after injections?

Generally no special precautions except common sense approach. Wash area gently and not to massage or scrub for 3 days. It is good to move the muscles in the area for the first 3 hours to ‘distribute’ the botulinium toxin. If possible, avoid facials, sauna and any pressure around the area injected for the first week.

Is it safe?

This has been debated for a long time. Although it was reported that there were some deaths related to botox injections. All the cases are related to medical conditions like dystonia that requires very high dose of botox. In aesthetic practice, the amount given is very much smaller. Besides occasional headaches, bruises and swellings at the injection sites, there are no serious side effects reported.

It is not good to inject because once you start injecting and if you stop, you will look worse than before, is it true?

This is definitely NOT TRUE that once you stop injecting, the lines will ‘deterioriate’ and you will look worse than before. If you stop, the area will go back like before and the dynamic lines will appear. Tthe common observation is that after a few botox injections, the effect appear to last longer.

How do I start?

You are welcome to call us or email us for further information. All you need to do is at least call us and find out more.

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