Sweat Sweat here... sweat sweat there........

It has been a super hectic month. With Fashion Week started end of September in New York, so a lot of the boutiques were having their fall/winter collection show. Fashion is a personal interest even though I am not really a shopper. I love seeing the designs and colour themes that come out which are distinct from years before. 

The fall and winter collections are very interesting although perhaps not the best suited for Malaysia's climate. Malaysia so hot and humid, so it's almost impossible to wear tweed or fur or long coats. Besides, we do not have snow here. Its sunny year round. Because of this sort of hot humid weather..... the major problem everyone have is sweat. A quick stroll between shopping malls and you will start sweating. If the sun shines a little bit more, everyone will start sweating.

But some people sweat more than others due to hyperactive sweat glands. The term for this is hyperhidrosis. According to PubMed, "Hyperhidrosis is a medical condition in which a person sweats excessively and unpredictably. People with hyperhidrosis may sweat even when the temperature is cool or when they are at rest."

The causes can be primary or secondary to other medical illnesses. For primary hyperhidrosis, it is usually limited to a few areas of the body commonly arm pits, hands, face and back. It affects 2-4% of the world population and seem to run in families. It is a simple problem, but it can be pretty annoying to those who have it. Especially in social functions in a hot country like this, you'll be needing to bring a hanky and wear sleeveless. 

There is no permanent cure for this problem. Yes, some surgeons say you can do ETS (Endoscopic thoracic sympathectomy) but its like a double edge sword. Despite solving 85-90% of primary hyperhidrosis in palms, there is a compensatory sweating risk that occurs in 20-80% (Notice the wide range means that it is different for each individual). Not to mention the other risks which can be minimized in very careful hands but still, it is hard to say since you will be tampering with your sympathetic nerves. Plus, the procedure costs a bomb between RM 10-15K depending on center.

The over the counter aluminium chloride preparations to help inhibit sweating does work to a certain extent and is much more affordable. However, this is only for mild cases and the concentration of this compound has to be more to have a more visible effect. The common side effects would be skin irritation and later leads to darkening of the skin (note how using certain deodorants the armpit area becomes darkened?)

So the next modality of treatment that comes into my field of interest is the use of botulinum toxins (Botox/Dysport/BonTa) to help control symptoms. In the past, we learn about the use of botulinum toxins to relax muscles causing dynamic wrinkles. Then it extended to skin tightening, pore closure (yes, it can do these too if you are willing to fork out the cost) and now sweat glands. How did this came about? Well, it was observed during the early usage of BonTa on the forehead and the patient would complain of less acne or sweating. So, they studied it more and found that it does help to stop overproduction of sweat by sweat glands by making them inactive for a certain period of time. Usually, we will dilute the toxin more compared to what we use on the face as our aim is more for the sweat glands and so lower doses at a more distributed area is ideal. In fact, recently FDA of America has approved the usage for underarm sweating.

The procedure involves multiple superficial injections aiming at the subcutaneous of diluted botulinum toxin. The pain is tolerable although now with advancement of more potent pain relief, it can be minimized. It takes about an hour to complete since it involves a few things. There would be some local swelling, but usually subsides in a couple of hours. Results can be observed between 1-2 weeks after injection and lasts 4-9 months on average depending on how severe the hyperhidrosis was to begin with. Complications? Less sweating at the area of injection and dilution but for palms, there may be some muscle weakness of the palms. Cost wise - depending on the area and the technique used can be between RM 2-5K per session. Regardless, comfort is valuable and not being shy due to wet armpits and sweaty palms is makes a huge difference to your life.

For more inquires or appointments, please email to info@faceworksclinic.com or call the clinic at 03-21440080

Miss Universe 2012 is Miss China....

I think my blog roll have collected some cobwebs since I have been super busy with a million and one things to do on a day to day basis. From patients to management issues, to children and bffs jumping off the plan for an unplanned holidays and the so many events after fasting month, oh yes, I have my plate pretty full. 

Anyways, last couple of months Miss Universe World pageant came to an end with Miss China crowned as the Miss Universe World for 2012. She also won the Miss talent award and she is actually the 2nd person from China to win such a title in the whole 61 events in the past. Congratulations to Miss China.

Personally I love watching Miss Universe pageants. I caught the last bit of it recently as they were crowning Miss China. Its a show full of glitz and glamour and not to forget the pretty girls. Looking at each of the girls features, you can see similar traits that signifies beauty - flawless skin and symmetry. Although for these beauty queens it is actually loads of make-up to get the flawless effect. But proper skincare and supplements can also help you achieve that effect. When dealing in the aesthetics world, we need to have a good eye for beauty, and what better way to train yourself than watching and appreciating beauties.

Coming back to Miss China, she is definitely beautiful and talented. But perhaps the more attention is that she is Asian, and yes the Asian look is becoming more appealing to a lot of people. (think K-Pop). Semi slanted big eyes, with dark hair and eye brows, yellow tinged skin, full lips and a high nose. Despite Asians typically having a flatter nose bridge, the advancement of fillers have made it possible for Asian's to have a higher nose bridge thus enhances the look. Skin fairness is often sought by most Asians - seriously I am wondering why Asians are so obsessed in being fair? Hence so many supplements claiming to help improve skin tones and fairness are being sold like hot cakes. My personally opinion on it - I'm cool about it as long as it does not cause any harm. Some skin bleaching products were taken off market due to risk of cancer and other more harmful conditions. Some of the beauty supplements have unknown ingredients so a proper evaluation of their safety is impossible.

Skin fairness depends on a few factors. The first is of course genetics. You cannot expect to be Korean fair if your family comes from a line of dark tanned people. Nor would you get Caucasian pink skin if you were a pure Asian. Some may argue about this, but unless you are an albino, you would be as tan as your parents were. The second factor is of course sun exposure. You cannot expect to be fairer is you are exposed to the sun most of the time. The sun in the equator tend to be most consistent and thus people near the equator tend to be tanner than those living in the Arctic. Vitamin C supplements, glutathione etc are just temporary measures. As long as you take the supplement you can maintain the skin tone. Pretty expensive investment for something unnatural perhaps. But everyone's perception of beauty is different, hence why we hear the proverb beauty lies in the eye of the beholder. So what do you think is beautiful?

September October Promotion....

I remember a senior colleague of mine who whenever he conducts training... he will always tell us, " You know, for every Asian who walks into the clinic, definitely will look better with a nose filler in," Initially I laughed at his remark, but after a few years, I realized he did make sense. Traditionally Asians tend to have a more flatter nose bridge, hence makes the distance between the two eyes more far apart and appear smaller and less attractive. But by inserting a filler at the nose bridge, and even elongating the tip slightly, it helps reduce the distance and automatically makes the face more appealing. The eyes become more obvious and bigger (relatively). Nowadays with advancement of injection techniques, you can even do it as a lunch time procedure without much bruising or even being noticed by your colleagues. But there is a certain accepted norm for Asian nose, thus you need to go to a well trained practitioner in order to get a natural looking  nose. The most common comment you will get from your friends is that, you look different - but most wouldn't realize that you had your nose done unless pointed out or if you really had no bridge at all. The immediate improvement is superb and it really helps with self confidence without feeling fake. Besides, it is only 1 injection away.

Interested to try out our promotion? Do call us at 03-21440080 or email to info@faceworksclinic.com for appointment. See you there.

Oppan Gangnam style?

Taken from Wikipedia

     I have always been amazed by the K-pop culture as it has a lot to do with medical aesthetics. From being a reserve country now over a couple of years K-pop culture has actually disseminated to almost every part of Asia if not the world. The most recent craze of K-pop culture is the Oppan Gangnam style. At first I was like... What? Initially hearing the name Gangnam I was thinking of some Hindustani movie or song, but I heard it air on Hitz Fm the other day and realized it was K-Pop. I asked my suppliers and my friends about it, and everyone was familiar with the Gangnam style except perhaps me. I guess I must have been too caught up with work to realize the viral hit sensation and I thought aging was getting to me, but apparently, the Gangnam Style was only aired on July 15th of this year. Pheewww.... and I thought I was losing my touch to the world.

So I decided to take a look at the infamous Gangnam Style on YouTube. The original video has 87 million views since July (not bad). And it even has its own entry on Wikipedia. Definitely super viral. And I would say that the you tube is pretty interesting and entertaining. His funny dance actually looks cool when it is done by so many others at the same time and it is a different view of K-Pop culture where the singer is usually super 'lencai'.

But despite the singer's common look - I did notice he had his nose done which is really common in Korea. My colleagues in Korea tell me that every single Korean will get a nose filler done by the time they are 18. It is so popular that on 1 small street there are 30 different aesthetic clinics and they can still make a good living. (And I thought 30+ clinics on Orchard street in Singapore was overboard). In fact medical aesthetics in Korea is so common that they have actually developed machines and techniques which initially I was pretty resistant to the idea because we had a private joke that Korean machines only lasted 2 years but nowadays with their advancement and technology, it is almost at par with the American or UK produced machines. They have also come up with mini thread techniques which looks promising and less invasive compared to traditional threads. On this 16th I will be attending a training introductory course and hopefully from there if it is really safe with minimal complications then perhaps I will introduce the technique to my clinic to tackle sagging issues of face, breasts and buttocks.

More solutions for my patients.

Going back to Gangnam style, Mr PSY rapper is pretty good and he does have a pretty contagious song. The Gangnam moves are simply hilarious but with the tune it looks cool and I wouldn't be surprised if it becomes an aerobic routine soon (or perhaps already is). How safe it is to your joints in view of the twisting movements of the knee? I'd have to get an orthopedic opinion on that. In the mean time, let's enjoy the shuffle movements while we can. (Reminds me a bit like poco poco craze). But I do recommend some child monitoring for the video, some of the scenes are not so proper.

Oh, for those wondering what is Gangnam....

According to Wikipedia :

"Gangnam Style" is a Korean language colloquialism that refers to a luxurious lifestyle associated with the Gangnam district,^[4] an affluent and trendy area of Seoul.^[5] The music video depicts Psy dancing at various locations in Gangnam.^[6] The song's theme is about "the perfect girlfriend who knows when to be refined and when to get wild."^[7]

In Korean colloquialism, "오빤 강남 스타일 (Oppan Gangnam style)" may be translated as "I love the Gangnam style" or literally translated as "Your big brother is Gangnam Style". The Korean word 오빠 (oppa) means "a female's elder brother" but can be also used as a first-, second- or third-person masculine pronoun to designate a male who is elder or older than a female. Based on more recent cultural norms, the term has typically been used to refer to a boyfriend or male spouse. It is used as a first-person pronoun in this phrase. 오빤 (oppan) is an abbreviation of 오빠는 (oppaneun). 는 is a topic marker, which in this case means the implied subject of the sentence is the singer (오빠). The verb "to be" is omitted, as is often the case in such short Korean sentences. Thus the literal translation of "Oppan Gangnam style" is "Your big brother [is] Gangnam Style".

The lyrics are by Psy, music by Psy and Yoo Gun-hyung, and it was arranged by Yoo Gun-hyung, who is a well-known producer in South Korea and also collaborated with Psy in the past.

Cheers.

Dermaqueen - a solution for hydration.....

Finally, a quiet Sunday I can sit and write my blog. I know I owe my readers a lot of entries, hopefully before month end, I will be able to write up all of them. Today, I'm going to write on Dermaqueen. It took me awhile to write this entry because I was trying to decide how I felt about this treatment. 

Nowadays, a lot of people are looking for more solutions for their skin besides lasers and IPLs although there are some die hard fans of these procedures. The reason is because now we realize that there are a lot of complications with energy based procedures especially for Asian skin type IV or V i.e. burns, scarring, post-inflammatory pigmentation and also the fast recurrence of pigmentation post procedure. The other issue that most doctors worry about is trying to get the patient to abstain from sunlight for 3 months to avoid complications which in a country of 12 hours hot blazing sun is pretty difficult. Yes, we do advise sunblock but most people only use sunblock when they plan to leave the house only, and apply it once in the morning. (Seriously, you need to reapply every 2-4 hours for sunblock and 6-8 hours for sunscreen). Another issue post-laser/IPL is dryness of the skin and loss of hydration due to high heat procedure which can be tackled with religious application of a good lipophilic moisturizer but there is always a group with severe dryness that requires more intervention.There are also a group of patients on retinoid acid creams or Obagi which have persistent dryness until you can see cracking and fine wrinkles appearing. And not to forget the peri and postmenopausal women who have generalized dryness due to hormonal issues, despite using vitamin E oils and taking evening primrose still have problems.

That is why they came up with the Dermaqueen system. So what is Dermaqueen? Dermaqueen is a procedure that you can do to improve hydration of your skin as it delivers hydrating solutions/brightening solution and even non-cross link HA intradermally and this helps to give you instant hydration. It uses fine needles and a vacuum assisted device and plants the desired solution into the mid dermis. The good thing about this system is that it is preprogrammed to deliver an accurate dose at the accurate site. The only thing that makes people worry is the needles part. But nowadays with better lignocaine creams to numb the the face, the procedure is almost painless. Added with the vacuum suction allows doses to be delivered accurately into the skin with just a slight pricking sensation.

Its a pretty short procedure and takes about 20-30 minutes to do. In terms of downtime, although it claims to have no downtime, I would still say that it will depend on your skin and what solution you are using, so normally I'd advise patients to have 1 day off for the first time and see how long it takes to recover. As for myself, There was only  minimal needle prick marks on my face, and not much pain. It disappeared after 1-2 days. For those who have tendency for bruising or rosacea issues, yes, you may bruise but it can be covered with concealer and it will depend on your own system how long you would bruise.

So what is is good for? Mainly hydration and brightening. We use peptides solution from Dermaheal which is an established product from Korea and has been in the market for the past 3 years. I love Dermaheal as the results are fascinating and almost instant. The only thing about this system is that you will need more than 1 session. They recommend 3-6 sessions done weekly for best results and then maintenance every 3-6 months afterwards.The major complaint will be the cost of the treatment. At the moment 1 session is between RM 900-RM 2000 depending on solutions used. Some even argue say, why not I do laser instead. But the function of this treatment is different i.e. it is more for hydration of the skin and overall rejuvenation.

Other functions of Dermaqueen are as follows:

Other functions not included in the table is also Breast rejuvenation which helps sagging breasts that has loss the upper volume and also hand rejuvenation to make your hands look as young as your face. So what can you expect from this treatment?

Reduction in melasma - I think this was after 6 sessions

This one used non-cross-link HA mixed with peptides after 8 sessions

Rejuvenation of hands - 1 session with non-cross link HA

Pore reduction and skin tone improvement - this was after 1 session.

 I've met this guy. This was after 6 sessions of using Dermaqueen with hair restoration peptides. Although still a bit bald, but there is improvement in hair texture and volume.

So my take on Dermaqueen? I think this is a good alternative to doing Laser treatment for texture issues and for pigmentation improvement. It also helps those who have very dry skin to improve the hydration. The only setback is the cost as 6 treatments can set you back to around 10K but it does solve certain issues with more comfort and less complications.

Interested? Please contact the clinic at 03-21440080 or email us at info@faceworksclinic.com for appointment.

Fasting month......

Its the fasting month and after a week of fasting, most of us have probably gotten into the cycle. The hectic afternoon jams and the sleepy mornings, make a lot of us try our best to stay indoors and not come out.

Despite so, fasting month is also a good time to get treatment done, as there are less social gatherings, and working hours are shortened. Furthermore, input from Muslim scholars have clarified on things that are not allowed to do during fasting and medical treatment has a lot of leeway. So to answer a lot of questions regarding getting things done in the fasting month, I can safely say that most everything is allowed except infusions of drips containing nutrients as that will hydrate the body. Yes, that means your fillers and botulinum toxin (bta) injections do not break your fast because most are injected either in the skin or intramuscular.

So when is the best time to get things done? For fillers and bta, I always tell my patients, at least 2 weeks before your function. Although filler results appear instantly, but the molding after 2 weeks makes it look more natural. Similarly for bta, it takes up to 3 days to start working, and at 1 week you will have the full effect and usually after 2 weeks it will soften a bit. For chemical peeling, the mild ones you can do a few days before, the deeper ones at least a week before. For Fraxel, although redness lasts about 3 days, I'd always say, reserve a week for swelling since some people react differently.

For those who are fasting, I'd recommend to drink more water at night since the skin does not heal well when dehydrated. Water as in plain water, not those sugary substances or teh tariks that will just dehydrate you more.If you tend to get dryness and skin peeling, use an extra moisturizer at night. For a healthier glow, invest in a good vitamin C serum or cream that allows good absorption. And last but not least, sunblock, sunblock, sunblock. The worst thing you can do is be out in the sun, in a dehydrated state with no sunblock - its a recipe for bad skin definitely.

For appointments do call us at 03-21440080 or email to info@faceworksclinic.com. We are open from 10am-10pm daily but for consultations, appointment required.

Medical Aesthetics for age groups......

I went to Penang two weeks ago and enjoyed beautiful sun rises and sunsets on the beach, despite some haze but the ambiance was wonderful. The only thing was the lack of internet access in my room which made it less convenient to update my blog. Still, I did get nice writing ideas which I would like to share.

Today's entry is about medical aesthetic procedures for age based groups. It is just a simple suggestion of things you can get done based on your age to improve how you look. As I always tell my patients, it is always better to do something than nothing because by doing something, there will be some change in your end result. I would also include a rough budget of how much the procedures will pinch you just as a guide.

Early 20s (18-25)

Usually at this age group, you will not have much aging issues. However, acne control and skin tone problems are very common because in this age group, you will still have some hormonal imbalance and is more active outside. Acne treatments would include chemical peeling, extractions, hormone pills or even retinoid A to clean up the skin and control sebum production. The usual skincare would range from acidic wash to exfoliators and gel based products to cope with the active sebum productions. You need to treat acne, because if you don't, you may end up with scars. Medically, we do have oral medications to help control sebum and a change of habits is usually advised. Smoking, late nights, low personal hygiene, stress and food selection does influence worsening of acne. Treatment for acne will depend on severity. Usually doctors would charge between RM 200-RM 1000 per treatment depending on what is involved in the treatment. Skin care can range between RM 300-RM 1000 for a full range depending on brand. Some doctors will use IPL or long pulse lasers to reduce sebum production and reduce P. agnes bacteria that is abundant in acne prone skin. To even out skin tone, I normally would recommend regular skin peeling and religious use of sunblock. Laser peels are also an option but if you have acne issues, there is a high chance of acne breakouts post procedure due to heat stress.

Besides acne and skin tone, this would be a good age to fix asymmetry of the face or to augment. The skin is young, hence fillers will sit in better. But because of the young age, I normally would only recommend doing hyaluronic acid fillers (Juvederm, Teosyal, Restylane) which are non permanent because it is easier to change the look when you've decided and because as you age, a lot of your face fat pads disappear so putting a permanent structure there may look awkward after a couple of years. For face shaping, you can slim down your face with a simple injection of botulinum toxin A (Botox/Dysport). You can read more about this in my previous entry on face shaping. (http://faceworksclinic.blogspot.com/2012/03/face-shaping-it-only-takes-5-minutes.html) Filler prices would range between RM 1400 - RM 2000 per syringe depending on type and how long the filler lasts. 

Late 20s- 30s (26-35)

This is usually when a person is most prime in their life. Biologically for most people, the hormones have settled and you start losing the baby face and your face becomes more defined. The early signs of aging start appearing such as wrinkles on your forehead, frown lines, crows feet and some loss of volume especially at the malar area. (cheeks) Pigmentation problems start occurring and the skin texture becomes drier. Botulinum toxin A can help with dynamic wrinkles. Fillers can help with the slight loss of volume and also to define the face to make it more attractive. Regular peeling can help with the skin texture but a definite skin care range change need to be considered. For pigmentation, using hydroquinone will help to reduce the pigmentation substantially but requires constant use. Lasers can help to reduce pigmentation and improve the skin texture but if proper sunblock used religiously is not applied, there is a high recurrence rate and may even worsen the pigmentation. This is also the point where I would normally suggest to add serum vitamin C into the skin regime as a maintenance and preventive program to help with texture and pigments. Supplements and vitamins are also important at this point to keep the skin glowing healthy. 

Another issue would be the body contour change, where most people find that certain areas are not as attractive as before. For this, I would recommend body contouring programs using medical grade radiofrequency machines (http://faceworksclinic.blogspot.com/2012/02/radiofrequency-tightening-rf.html) , or other medical grade body contouring machines to help. For some people, they prefer mesotherapy injections to reduce fats n certain parts but this requires recurrent treatment of specific area and so may add up to be costly. Regular exercise helps, and target specific exercises are more warranted.

Late 30s to 40s (36- 45 years old)

Most people are more stable at this age but due to the aging process, coupled with stress of work and family and other responsibilities can cause you to look older than you really are. For the face, At this age, most people would start complaining of more pronounced wrinkles on the forehead, frown lines and crows feet. There would be a more marked loss of volume in the malar and lower face, especially around the mouth and the folds by the side of the nose looks more prominent. The skin texture is still good, but pigmentation is more seen if nothing has been done before. Sagging of the cheeks is felt, although not extremely obvious and causes a lot of concerns in some people. Fillers and botulinum toxin A are a good investment for non-invasive treatment to treat lines, wrinkles and volume loss. Some would consider lip fillers because the upper lip has started to thin out more and you lose that youthful look. (Check out http://faceworksclinic.blogspot.com/2012/05/sexy-lips-in-15-minutes.html) Regular chemical peeling and face tightening with radiofrequency devices or lasers would help improve overall skin texture and turgor. At this point, you should also consider having a retin-A or derivatives cream supplement to the face to help with fine wrinkles. 

For the body, you can still opt for body contouring and tightening programs but the expectations should be more realistic. There will be improvement although subtle, and you may need to consider options of skin lifts and fat grafts to get a more marked improvement. Weight control can be achieved by modifying the diet and exercise and I do suggest most everybody above 36 with BMI more than 25 to go on HCG diet (http://faceworksclinic.blogspot.com/2012/03/hcg-diet-my-experience.html) to not only lose the excess weight and reduce body fat percentage but also to retrain yourself to a much more healthy diet and lifestyle. If done properly, you will be able to maintain your weight and enjoy a better life. It also helps increase personal health consciousness as only organic and non-processed meats are allowed during the diet.

After 46 (46 to 65 or more)

At this age, the skin texture is more wrinkled and you will need more moisturizers to help maintain suppleness. Laser resurfacing treatments are a good investment as it helps to improve your skin texture and tightens it as well. Radiofrequency device tightening of the face is another method to help improve sagginess. At this point, fillers are used for volumnization, and a lot of fillers would be needed to have a good effect. (At least 3 syringes per sitting usually). Semi permanent fillers (Aquamid) can be considered for structures like lips and cheek. Mesotherapy treatment with PRPs (http://faceworksclinic.blogspot.com/2011_02_01_archive.html) or non-cross link hyaluronic acid fillers (Dermaqueen, Restylane Vital, Juverderm Hydrate, Teosyal Redensity) is also an option to increase hydration of the dermis layer. Skin peeling is still a good way to maintain the skin. Surgical options would be fat graft to the face and face lifts. Vitamin E  and hyaluronic acid topical creams can help maintain hydration as dryness is always a problem. 

After 46, a lot of our natural hormones start to decline. Because of this, we will have vague tired symptoms that we cannot explain. Another thing that you should consider is to undergo anti-aging consultation and the use of bioidentical hormones to help supplement the decline of hormones. The blood test are expensive (a complete test would cost around +/- RM 1000). The hormone supplements are in cream form. Please be sure to go to a proper anti-aging doctor (trained) because not all doctors are trained properly.

This is just a rough guide of procedures you can do at the certain age. However, the current environment pollution, poor diet and nutrition, work stress and health problems can always make you look aged more than you really are. A proper consultation can help give you a good idea of the possible intervention to help make you maintain a healthy and youthful you. But one thing for sure, you need to start taking care of yourself early, to stay younger longer.

Any enquiries please email to info@faceworksclinic.com or call 03-21440080 and book an appointment to see me.

July-August Puasa Promotion....

Its the start of July and soon we will be having the fasting month and Hari Raya Celebration.
Faceworks Clinic is giving away wonderful promotions to make yourself look good for the coming festive season.

Interested? Call us today for your appointment at 03-21440080 or email us at info@faceworksclinic.com (if from abroad). Don't miss this great opportunity.

Tried & Tested Part 2

I have been trying out so many products lately, and now I think I need to rest my face for a bit. But before that let me share my experience with these products.

1. Infracyte Wrinkle Resist Complex Serum.

Infracyte is a brand from USA which is pretty new. I like the bottle a lot because it reminds me of a posh perfume. The wrinkle resist serum has 99% hyaluronic acid for better hydration. It also contains alpha-oligohexylpeptide that is an ingredient that acts on the neuromuscular end plate to give an action similar to botox but temporary. It takes around 2 minutes to completely absorb the product on your skin. It is moisturizing and not oily hence making it suitable for oily and combination skins as well. For very dry skin, you would still need to put on extra moisturizer at night but for day wear it's pretty cool. Post treatments, I find it very effective and gives the skin a cool feel. Each bottle costs around RM 328++ and can last you up to a month if used daily.

2. KISS Dermablend Vitamin C Milky Cleanser

I have been selling KISS in my clinic for the past 1 and a half years, and one of the questions I get is about the make-up remover. Although KISS is purely mineral and you can just wash with water ( a lot of water that is) some prefer to have a make-up remover for a cleaner face. So finally KISS came out with their own Mineral Make Up cleanser called the KISS Dermablend Vitamin C Milky Cleanser, which not only cleans mineral but also other dirt on the face as well. It has a very unique apple smell and you just need a little bit to lather on your whole face and it feels so clean afterwards. It is gentle on most skins and few of my friends have tried it without having any complications. With its active ingredient being Magnesium Ascorbyl Phosphate, it allows better penetration of Vitamin C into the skin which also helps to hydrate and is a potent anti-oxidant to the skin giving it a clearer and more luminous glow. It is sold at RM 190 per bottle of 200ml which can last up to 3 months or more. So if you like wearing make-up and thinking of getting a good cleanser, this is one you should have.

3. KISS Dermablend Swiss Apple Extract

Having a good cleanser is incomplete if you do not have the moisturizer to go with it. So KISS came up with their own Dermablend Swiss Apple Extract. This is a specially formulated moisturizer containing extracts from swiss apple stem cells that helps to keep skin supple and moist by the direct effect of the extracts to the skin. So not only you will have clean skin, now you can preserve its youthfulness with this moisturizer, before applying on your Mineral Make-UP. It is a very interesting moisturizer that absorbs quickly and has a nice peach scent to it. Because of its liposomal properties, you may feel that it is slightly oily but after absorption, it makes the skin feels so soft and moist. I would recommend this for people with more mature skin without much problems for maintenance purposes. Each 50ml tub cost only RM 380 and can last over a month with twice daily usage.

4. Phiderma vitamin C and retinoid A capsules.

 

These are pretty cool treatment options for those who like serums. Phiderma is a well-known clinical skincare producer from America. These serums are a great investment for busy people who travel a lot since they are placed in single used capsules and come in 50's in one tub. There are 2 main capsules. One is retinol complex that gives the same benefit as retin A creams but with reduced side effects. They created the serums with microsponge technology which allows better absorption of the serums into the skin. The Cerum vitamin C is a favourite of mine, since it comes in separate capsules leads to better hygiene and no risk of oxidization of the vitamin C which occurs in serums in bottles over time. This in turn guarantees better efficacy of the serum to work compared to other serums in bottles due to this non-oxidation factor. Applying the Cerum on your face will give an instant softness of the skin. For those who use both, normally the Cerum is used in the morning after cleaning the face and before moisturizer or sunblock and the retinol complex is used at night. With 50 capsules in each bottle allows almost 2 months supply of serum at affordable prices of RM 300 for the Cerum, and RM 320 for the Retinol Complex.

Exercise is a must - Even if you don't have time.

Recently, my good friend gave me a 3 month free pass to use a gym. Despite not being a gym person, I thought I'd give it a try. The gym was near my office, but getting there was already a 15 minute aerobic cardio exercise from walking. This was good, since I needed to warm up before getting started. The first machine they normally put you on is a thread mill, and yes, it was the same for me too. Then after that they got a PT to guide me (or rather try to close PT training sessions sales). It kinda pissed me off a bit, since the PT was suppose to show you how to use machines but he was busy making me do 3 laps of butterfly jumps and then tell me I have bad stamina when the chick next to me can't even complete 1 lap. So in a way, I was pretty discouraged to go to the gym, since I know that they are just trying to make you buy more and more packages to sign up. Whatever, I still have my 3 months pass, so I don't really give a hoot to what they want to think or say.

Regardless, exercise is a crucial must in our daily lives. Yes you got me right, it has to be daily. But it doesn't mean you have to jog every single day. There are many types of exercises you need to understand and plan them according to target.

1. Cardiorespiratory work out

This is the most common work out everybody does because it is perceived as the most important. It can be anything from running to jogging, or brisk walking to dancing, aerobics, swimming. Regardless, most professionals agree that 30-45 minutes a day is enough and can help reduce a lot of heart related problems such as reduce risk for coronary artery disease, hypertension, diabetes, lipid levels etc. I would normally recommend doing some cardio workout before targeted exercises as it helps to improve your blood circulation, muscles are more prepared and warmed up so it reduces injury. But if you have existing problems like back pain, obesity, joint pains - you should start with low level exercises like walking first before jogging or running. When is the best time to exercise? When you can slot a time of 30 minutes of no disturbance of the routine. An exercise is only effective if you do it continuously for at least 10 minutes at a time. 

2. Body strength and composition exercises.

One of the most interesting things I learnt during my previous anti-aging conferences was that in order to maintain weight you need to lift weights. So I decided to follow this technique and bought myself some dumbbells. And sure enough, I did notice my weight maintaining better despite my lack of running around. So I decided to read more and understand why. The main reason is that if you have a lot of muscle bulk, you burn more energy in your sleep maintaining them compared to if you didn't. The problem when you are obese or overweight, most of the muscles are mixed with too much fat, and fat is a storage organ, so you don't really burn that much calories with them. Now, when we go on a starving diet, our protein stores in our muscles are the first to go hence leading to smaller muscle mass thus why the weight doesn't go down. That is why a lot of diets nowadays preach on a higher protein consumption, more fiber and no refined carbs for a better weight loss result. Another new thing I learnt was that sudden usage of energy for example short sprinting exercises burns more energy and brown fat compared to a 60 minute cardio. So for people like me, who persistently have a V/Q mismatch or poor respiratory endurance, 5-10 minutes sprinting in between my regular jog benefits more in terms of fat loss, compared to trying to sustain 45 minutes of running that would exhaust me more. As for heart rate, although most people believe that you cannot exceed 80% or your max heart rate as it can cause problems, this is not entirely true. High velocity sprinting causes your heart rate to jump even higher than the so-called maximum heart rate level, and studies have shown that it is safe in short outbursts.

3. Flexibility exercises

When I was younger, we use to have this game where we would try to flex our body backward all the way and walk. It was so much fun then. Flexibility exercises are important to maintain the elasticity of the joints and avoid injuries especially in sudden movements. How to stretch? Basically it needs to involve the muscles in each group i.e. extensors or flexors. Still gibberish? Try Yoga or Pilates - these involve a lot of stretching exercise in the routine that is done in stages. Other simple stretch methods are the stretch exercises we use to learn in school during PE (If we did). Or when you learn martial arts or dancing half of the routine are flexible exercises. I normally do stretching exercises after all the cardio and sprinting as the joints are already warmed from the 2 other work outs. Otherwise, I do it on my bed before getting up :).

Basically you need to have a mixture of all three types for a complete work out. There are many forms of exercise to choose from besides the typical treadmill so choose one you are most comfortable and happy with. Other benefits of exercise also includes:

1. Reduce risk of cardiovascular diseases. Even if you already have cardiovascular disease it helps to improve it.

2. Reduces risk for diabetes by increasing insulin sensitivity and improving glucose metabolism. So even if you already have diabetes, it helps. This is also true for resistance exercises, not just the normal aerobic.

3. Reduces hypertension - this is true for aerobic exercises. High intense exercises have not shown much effect.

4. Reduces blood TG, Cholesterol and LDL. This is true when you burn 1000-2000 calories a week usually from constant aerobic or sprint exercises.

5. Reduces risk of stroke due to all above.

6. Reduces risk of colon, breast, lung and multiple myeloma cancers with 30-60 minutes of moderate to high impact exercise daily.

7. Reduces osteoporosis. Lunge exercises and medium impact exercises stimulate bone growth.

8. Improves muscle health and reduces sarcopenia. Sarcopenia is the age-related muscle wasting that we see in elderly people. In some it occurs faster than others. Regular exercise helps maintain muscle masses thus reduces sarcopenia.

9. Maintains body composition and reduces obesity.

10. Reduces Arthritis.

11. Reduces stress. This is only true when you make the exercise fun. Like I said, there are many forms of exercise you can choose from.

12. Improves mood.

13. Reduces Depression and anxiety due to the improvement of mood and reduction of stress.

14. Improves self-esteem. When you exercise and feel good about it, reduces stress and elevates your mood, your self-esteem improves. Plus the multiple health benefits and the figure benefits would definitely boost the inner you.

For busy people like me, there are studies on people who do exercises only on weekends or once or twice a week and it does shows improvement and benefits. So even if you are strung out during most the week, at least take a day off to do some exercise. The recommended is to burn at least 1000 calories a week and this would give you a reduced risk of 20% of dying prematurely. 

Like I always tell my patients during aesthetic consultations, Doing something is always better than doing nothing. So even if you do not get an optimum exercise routine, at least doing some exercise would benefit.

Mother's Day Promotion....

     Last week we had a nice event in Faceworks Clinic for Mother's Day. Although it was a week earlier, but the thought that counts and we had a good turn up of guests. You can see pictures on our Facebook Faceworks Clinic Page - http://www.facebook.com/FaceworksClinic (Do like our page if you could :) ). It was a wonderful event. I gave a talk on medical aesthetics and what we can do with the current technology and medical advancement that we have. Mr Terry from Dermaqueen gave an interesting overview about our latest service called Dermaqueen, and Mrs Nazli gave a nice talk and short demo on Nutrilite organic nutrition as an important supplement to keep healthy. Then we had the nice delicious home cooked variety buffet. I personally made the marinara and buffalo wings. Whilst we had Kak Nora prepare some traditional lontong. Kak Nora is excellent with traditional menus and she even had some of the AFC chefs come down to learn her recipes. (Yes, if you want to try her cooking or learn you can ask me how to contact her). Bite Size kitchen prepared the colourful and beautiful muffins. (Thank you Ayu) and Mrs Haze prepared the delightful Tiramisu. (Yes, she also takes orders for her cakes). Dessert was delightful with Mr Belo's puddings that was delivered by Mr Belo himself - Neatly placed puddings for any occasion. As usual, Faceworks Clinic Events have the most wonderful palatable tastes, so it is definitely an event worth going to.

     After most of the guest indulged the food, we had a lip filler demo with Juvederm Ultra XC - the new range of hyaluronic acid filler with lidocaine to reduce pain, bruising and swelling. Our model was very brave, as she did not request for any nerve block, just some numbing cream, but with the new XC, you do not really need any nerve blocks since pain is reduced up to 70% compared to the previous fillers without lidocaine. And the best part is that it is already infused in the gel so that the filler does not get diluted and hence the efficacy of the filler remains the same. So say bye bye to painful lip fillers, because that is the thing of the past.

     I also demonstrated Obagi Blue Radiance Peel which gives instant radiance and evening of skin tone even after 1 application. We applied a complete 4 layers on the Model (a different one) and he was able to tolerate the pain (scored around 6 and improving to 0 over 5 minutes). We then left it on for 15 minutes, and applied a soothing mask afterwards for another 15 minutes to reduce any redness. Instantly after the procedure he looked more refreshed (well, who wouldn't after a nice 15 mins of lying with a mask and lavender pillows on the eyes in a dim room). I called him a few days later and he said he was okay, with minimal skin peeling but looking a lot more refreshed, with even skin tone and less oily compared to before. Yes, the Obagi blue peel radiance although is very good, does have a social down time of around 3-5 days, so I would normally tell my patient to do it on a social clear calender. It only takes 20 minutes to do anyway, so you can run in during lunch time. You only start peeling during day 2 onwards.

     The last demo was the highlight of the day, i.e. the Dermaqueen Demo. I had one of my friends as Demo i.e. Mr Ed (The Nutrilite guy). We numbed his face for 30 minutes and did the treatment on his face. There was a slight tingling sensation, with a pain score of maximum 2 - merely negligible. You can see pictures of him on our Faceworks Clinic Facebook Page. Immediately after the procedure, he felt his skin feel so hydrated and lifted. I met him yesterday and today and he looked fairer with better skin tone and he still feels the hydrating effect. He also noticed that his pores appeared smaller and because his skin is tighter, he looks better. Not bad for a guy who just went through a swimming marathon. (Which was why he got so tanned in the first place). For those interested to try this treatment out, we are giving a 1st trial special price of RM 1080/=. (Normal price RM 1800/++ session). 

Overall, the event was a definite success. A lot of my guests were impressed by the instant results from the demos, and of course the wonderful food. We had fun, and I hope my guests had fun too. Thank you so much to all my suppliers who helped sponsor goodies for my guests, and thank you to all my guests who came till the final hour. Thank you also to all my food providers for the wonderful food. Can't wait for the next event.

Well, for those who missed it, these are the promotions that we launched that day.

For more information please call us at 03-21440080 or email us at info@faceworksclinic.com

   

Sexy Lips......... In 15 minutes...

Lips... Lips... Lips..... Everyone is so obsessed with lips. Which is why cosmetic companies make so much creating lipstick and lip conditioners from various types to various colours. When a person looks into your face, the 1st thing that catches their attention would be eyes than lips, hence it is normal for us to want to have perfect lips. But lipsticks can only play with colours and some enhancement which is gone by the end of the day. And as we age, our lips start losing its shape, colour and more wrinkles are seen, especially if we smoke. So what can we do? Fillers of course. But which one?

Lip filling with fillers is not really something new. It has been around from years and was especially rampant in the United States. But in the past, most people used silicone or collagen lip fillers and the idea of enhancement was to have bigger lips. But bigger did not always meant better.

(Borrowed From Top 10 Worst Celebrity Jobs)

Looking at the celebrity botch jobs makes people feel scared to even think to try, but we all know that when it comes to tabloid, everything is blown big out of proportions. The other issue when dealing with lips is pain as the lip receives multiple nerve supplies in the face hence explain why the lips is a very sensitive organ. The saying before Beauty is pain. I personally do not believe that.

Which is why when Juvederm came out with their XC brand, I was excited. So what is Juvederm? Juvederm is a brand of hyaluronic acid filler which claims to be the number 1 brand in the world. Now they have preparations with lignocaine premixed in the syringe to reduce pain and inflammation. I have been using Juvederm for years, and it is my filler of choice when it comes to dealing with lips because of less problems when it comes to lumpiness. (Yes, fillers can get lumpy at times). Plus it softens within 2 weeks and now with lignocaine in it makes it less painful. Prior to this, I would need to give a complete nerve block around the lips which would involve additional 7 injections to get a good block - but with this, I have an option to reduce the block injections or not use blocks at all. (For first timers, I'd rather use blocks)

Furthermore, since it is a very soft and smooth product we can inject with a small 30G needle to allow better control and shaping. It is FDA approved to last 12 months, so for a non-permanent filler, this is ideal. Yay, great - now we have no pain and temporary. What else to consider?

Before you want to get your lips done, you need to have a clear idea what you want or at least discuss it with your doctor. From my observation, most young ladies prefer to increase the size, and more matured ladies prefer to return their original shape. Having a non-permanent filler the first time round is good, as you will have a look and feel of how it will be in case you do not like the change. I would normally advise, less is more. Its never good to look done, the more natural it appears makes a lot of diference. How many syringes? Usually for lip defining and contouring takes only 1, but if you are thinking of adding up volume then maybe 2 or more. How much is it? Well in US roughly around $600++. In Malaysia, the price starts RM 1500 onwards for the XC range. In proper hands, you can get marvelous results.

 

2 syringes of JUVÉDERM^® Ultra 1 week after treatment

Interested? Please call 03-21440080 for consultation and appointments. Especially for our Mother's Day Open House on this coming 5th of May, we will be having a Juvederm XC lips demonstration and will be selling RM 1200 coupons for Juvederm lips only on that day. This coupon can be used any other time till 1st Jan next year. See you there.

Tried and tested........... (Part 1)

I have been super busy with so many things that sometimes I wonder what is it that is making me so busy to begin with. Well, one of the things I was up to was actually testing out supplements and products to see how good they are. So here are a list of things I have been trying and the outcome.

1. Tiox-C Glutathione and Vitamin Capsule tablets.

At first when I saw this product I was skeptical. Oral glutathione and vitamin C? But since it was provided in gelatin capsules, it would survive the acidic PH of the stomach. I took some for the clinic and some of my patients tried it out. I gave a box to my sister, and she took 10 capsules a day at different intervals. (The recommended was 2 capsules daily). In one week she was fairer than me by at least 2 shades. Anotehr patient took 4 tablets a day, and she was fairer after 2 weeks, despite spending some time in the sun over that weekend. Besides the fairness, my patients also commented on the brightness of the skin and healthier glow. So I decided to try it out, so I am currently on my 2 week and I think I am a tan lighter compared to usual. This product is from Japan but packed in Malaysia. The bovine gelatin capsules are from Pakistan, and has a Halal certification. Other benefits of this product is that it is a good anti-oxidant and was actually promoted as a supplement for detox. One box comes with 90 tablets with 150mg of vitamin C and 150mg of glutathione in each one. The price for a box is around RM 328/= which is pretty good since you have 90 tablets to take. So instead of going for vitamin C injections, you can take orally for cheaper with results. You can get this product in my clinic.

2. Linurase Serum from Phiderma

This is a new product in town called Linurase. As the name entails it is designed to erase wrinkles and lines. Fine ones that is. I have tried this product for about more than 2 weeks everyday twice daily application without fail and this is what I think about it. First of all, the product is in a serum form. It absorbs quickly within 2 minutes. Initially I had a little bit of a tingling from using this product but after a few days it felt better. After a few minutes, I do notice my wrinkles improving, even the dynamic ones. They claim to be better than botox or BTA, but after 2 weeks, I'd say that they are competitive, but you need to apply daily to get the best effect. Once you stop, the muscle action will return and expressive wrinkles will come back again. Nevertheless, it is a good alternative for people who have needle phobia or not keen to get BTA/botox done yet. Daily usage of this serum actually stalled some of the wrinkles on my forehead, until I stopped a few days ago to try out another product. The lines came back after a few days. After reading more about the active ingredient, you need to use it consistently for more than 30 days to have a lasting effect. It contains Acetyl Hexapeptide-8 which acts on the same acetyle choline receptors as bta/botox thus blocking muscle actions. Other ingredients are Hyaluronic acid, anti-oxidants and seaweed biopeptide extracts. If you are interested with this serum, you can contact my clinic and we will order for you. It is selling at RM 300/bottle which may well last up to 3 months.

3. Double X from Nutrilite

Previously being on stem cell supplements and later HCG diet has actually turned me into a pretty health freak where I am seriously into organics and reducing artificial colourings, flavours and sugar based foods. But stem cell supplements are expensive, and it would be not so ideal for people of the working class to take on a monthly basis. So I scoured the internet for solutions and I came across this particular brand of multivitamins. Nutrilite actually has the largest organic farm in the states, and has passed accreditation for few years already. (4 or more) My major turn off was the fact that it was sold under Amway which is a multi-level company. However, being a curious and caring doctor, I decided to search for it anyway and give my opinion on it. I have been taking this vitamin for almost a month now and for what it is, it is super affordable. (RM 150 per box of 62 X 3 tablets for non Amway members). What I felt after taking these vitamins is that my energy level came up again, despite my super busy schedule. I looked less tired and these changes started perhaps after a few days after taking them twice daily and after a week I felt healthier. What I really like about it is the fact that they divide 2 separate doses in a day which is actually what is recommended by all Nutritionists and dieticians since 3 years ago. The reason for this is that the gut has a saturation level for all nutrients so if you were to take too high a dose at a time, you will only absorb as much as the saturated level allows thus wasting the vitamin. Another good thing is that they separate vitamins from minerals which allows accurate concentrations to be achieved since in processing a lot of the minerals get binded by the vitamins - e.g. sodium to vitamin c - ascorbate and others. They even added a third component which is more of a traditional preparation but known to have good benefits like cranberry extracts, apple extracts, etc as anti-oxidants to complete the multivitamin. The only thing is, you cannot take this on a completely empty stomach since when I tried, there was some reflux felt, so I'd recommend some food before taking them, but definitely not on a full stomach. Another downside would be having to swallow 3 hard tablets which I know there are some people who do not like popping pills. But otherwise, this is certainly a keeper to maintain on a daily basis for good health. Personally I do not sell this, but if you are interested to get some you can contact my clinic and we will get you in touch with my friend Ed.

These are but a few of the other things I've been testing. I welcome any feedback or comments.

For more information or if you would like to try out these products you can contact my clinic at 03-21440080 or email to info@faceworksclinic.com.