Redensity II - Solution for tear trough

      Dark under eye rings can be such a nuisance to many of us. It makes you look tired, sick or just unhealthy. But some people are genetically prone to have rings under the eyes. Being Asian, we are predisposed to have a more prominent under eye problem due to the structure bone which is flatter than others. In Indians, we would see a hollower eye socket and thus appearance of the eye ring is more prominent especially with age and we start losing some of our malar fat. Look in the mirror and you will notice that the area next to your nose tend to appear flatter, and in some people there is a line. This is what you call a tear trough line.

Over the years, doctors have been using soft fillers to treat this problem. The light weight fillers give a satisfactory effect but only lasts approximately 3-6 months and the cost is high. Much sturdier fillers may cause lumps and bumps and not to mention the Tyndall Effect. 

What is Tyndall Effect?

The Tyndall effect, also known as Tyndall scattering, is light scattering by particles in a colloid or particles in a fine suspension. It is named after the 19th century physicist John Tyndall. It is similar to Rayleigh scattering, in that the intensity of the scattered light depends on the fourth power of the frequency, so blue light is scattered much more strongly than red light. An example in everyday life is the blue colour sometimes seen in the smoke emitted by motorcycles, particularly two stroke machines where the burnt engine oil provides the particles.

In relation to the tear trough, when fillers are placed beneath the thin skin, there is a chance of this effect occurring especially if the fillers are placed too superficially. The only way to remove it is by dissolving the filler with Hyaluronidase. However, even this does not guarantee 100% reduction of the Tyndall effect. Despite the fillers lasting less than a year, I have come across people with Tyndall effects lasting up to 2 years. Thus, in this case, cosmetic concealer would be prescribed. 

Hence my reservation in treating tear troughs in the past. I usually treat the malar area wmith fillers by replacing the lost of fat pads and volume. It gives satisfaction to most patients but there are those who require a little bit more. Thankfully since last year Teosyal came up with a filler designed especially just for tear trough - Redensity II.

Redensity II is a new age filler which allows thin area injection without causing Tyndall effect. It is a hyaluronic acid filler that is combined with a restructured complex of vitamins to tackle tear troughs, dark circles and fine lines around the eyes. It exerts minimal pressure on surrounding tissue giving the eye a homogenous, long-lasting and natural fill. A clinical study done on test subjects find that 100% of candidates would recommend this procedure to be done as it is quick, with minimal downtime (some none at all) lunch time procedure that gives satisfactory results.

But no matter how good the filler, the injector must be well-trained and have steady hands to give you the best result. It is a pretty forgiving filler which allows some room for error and will recorrect itself. Done by trained hands you will have minimal to no bruising. This service starts from RM 1500 / session and the effects lasts up to 12 months. I'm completely in love with this filler and now using blunt needles, this service is comfortable and gives wonderful results. The best look is after 2 weeks but immediately after you can see the difference.

For more information or appointments do contact us at 03-21440080 / 014-2233268 or email to faceworksclinic@gmail.com. You can also LIKE us on Facebook and send your enquiry through there.

Beautiful Breasts...... How to fix my sagging breasts.....

When we think about women, breasts are one of the things that pops in mind. Despite the gender differences in aspects of discussion, it will always still be a topic. Men would normally talk about cleavage and size (one of the first thing a man notices in a woman they bump in the street), whilst women would be talking about size, sag, lag, etc.... In this modern world, looking our best is now a requirement not just an option. The way you look really plays a major role in the confidence you portray. Despite what some people may say about looks does not matter, reality is, it does. We all know that. 

Breasts are part of every women. It is a differentiating anatomy between male and female and serves as feeding organ for babies. One thing that a lot of women worry about is size. Most women prefer big breasts but it needs to be proportionate to the body. Too big breasts can lead to health problems and it estimated that too large a bust can reduce a woman's lifespan by 5 years. The main problem that most women with a huge bust will have is additional pressure to the spine which causes pain in the long run. Its either they extend their back more to compensate for the weight or slouch due to gravity hence leads to long term abnormal posture thus causes spine problems and even muscle pains. Sometimes when the size is too big, women have difficulty in breathing and are unable to sleep on their backs because the breasts add pressure to the chest. It can also cause headaches and migraine due to constant strain to the surrounding structures. Too huge breasts also can have skin implications as fungal infections occur easier due to bigger folds and bigger bra straps can cause abrasions and affect skin health. There is also a more significant risk of weight gain for women with bigger breasts as the big bust limits a lot of physical activities due to strain onto the muscles, ligaments and spine from the weight. Thus there is a reduction in exercise that leads to weight gain. Big breasts also causes stress for a lot of women, especially with their own self-confidence. A study done shows that women with excessive breast size have reduced confidence due to the breast size, especially if it becomes an object of banter or joke in their society. If you have any of these symptoms, the solution to it is breast reduction surgery which should always be done by a trained plastic surgeon.

In Asia, the more problem is small breast size and breast sag especially after breastfeeding. Luckily for us, medical technology has come a long way to helping solve these woes. For breast size, despite multiple methods promised by the media I would still say if you are really decided go for surgical breast implants by a well-trained plastic surgeon. The high-grade silicone implants would be good for at least 10 years without any other complications. Low grade implants may burst and cause massive tissue scarring and would require surgical removal. Normal saline implants are still encased in silicone and may leak and reduce in size over time. Silicone injections are banned for use in many parts of the word due to the complications that arises from it. There was a hype for fillers but the effects were only a maximum 1/2 cup increase and lasts longest 1 year in terms of aesthetic effect but may cause scarring and calcifications. Not to mention the cost than is not cheap and usually I would advise my patients for permanent implants instead. Fat grafts are also used but it depends on the skill of the doctor. You may need to top up after 3-6 months and the effect can last up to 2 years. There is still risk for tissue scarring and failed fat graft, not to mention the cost.

Now, we come to sagging breasts. Why do breast sag? 

1. Age 

The most common factor is age. As we grow older, there is more gravity pull and our ligaments start to become more lax. There is no muscles in the breast, only mainly breast tissue, fat and other connective tissues. The connective tissue is also called the "Cooper Ligaments" starts loosing its elasticity as we age.

2. Running without proper support.

Over-bouncing of the breasts can make the breasts sag faster. Hence why we are recommended to wear proper sports bra to support our breasts. When a person runs or does strenuous exercises, the breasts move everywhere in an 8-like motion. Without proper support, the breasts move too freely that can lead too over-stretching of the Cooper's ligaments leading to sagging.

3. Changes in weight and/or hormones.

Extreme diets and extreme weight loss/weight gain can lead to sagging. Pregnancy causes sagging in women and is proportionate to the number of pregnancies she has. The key here is gradual changes to the body, will not affect the breasts too drastically. Breastfeeding DOES NOT contribute to breast sagging, so give your babies all the milk that he/she needs.

4. Smoking

If you love your breasts then you should quit smoking. Smoking not only causes other harmful effects to the body, it also breaks down elastin which is a protein that gives the skin elasticity. Reduce elasticity causes sagging.

So how to improve sagging?

The definitive treatment is to do a breast lift but even this surgical procedure is not permanent due to the factors which cause sagging and after awhile the ligaments are just going to lose its elasticity and sag again. Not to mention the cost, the downtime and risk for scarring. Other methods in medical aesthetics includes use of Laser to tighten the skin around and above the breast to lift it up but this also is temporary. My favourite would be to use Gentle-YAG or any long pulse ND-YAG 1064nm at a tightening setting to give that additional lift. It can be a little bit painful during the procedure as it requires a longer interval that the normal rejuvenation protocol. Cost for each treatment varies on type of laser ranging from RM 1000-RM 2500 per session. In my clinic, we have Fraxel that can also help to a certain extent for breast tightening but it would be more of skin rejuvenation over the décolletage area avoiding the breast tissue. Some places do RF tightening for breasts, but it requires multiple sessions at close intervals and results can sustain up to 6-9 months after completing the course. However, we do not recommend RF on the breast tissue areas since it may lead to reduction in volume. This method also requires good knowledge of anatomy on the person handling the RF, but at least it is a cheaper alternative. 

Threads for breast lifting.

The Korean influence has increased the usage of threads in medical aesthetic practice. Now more doctors are promoting threads for breast lifting as an alternative to surgical breast lifting. The results are quite interesting although the is still risks of bruising and pain, and some downtime. If placed correctly, you will not be able to feel the threads. Depending on what you wish to achieve, the doctor would advise you on type of threads and how many you need. The two common ones used are suspension threads and PDO threads. Other threads would require surgical anchoring to allow the threads to stay in place. Suspension threads would give you a good lift for 18-24 months almost instantly and usually you will need 2-3 per side. Cost for the procedure is anywhere between RM6-10K at the moment. PDO threads on the other hand takes up to 3-6 weeks to start showing results as its mechanism of lift is more of collagen stimulation. You may require anything from 50-100 threads per side and probably a combination with suspensory threads. PDO threads is common in Korea, China and Japan. In Malaysia, be aware of beauticians and unregistered 'doctors' also doing this procedure since it is so easy to buy it off Alibaba.com. Price ranges anything from RM 2000-RM 6000 per session but you will need multiple sessions (3-5X)  in short intervals before the end result. The complications also includes pain, swelling, bruising and possible failure or infections if not done properly. For the record, I have not started this service but if you wish to try it out, I can direct you to my colleagues who do.

PRP for breast lift and rejuvenation.

Now this is a method that I am pretty interested about. This year, I have been studying a lot on this particular technique and had the chance to tutor under a very knowledgeable senior on this matter. Dr Rahmat has been practicing for over 20 years and at one point was teaching anatomy to students. Anatomy plays a very important role in achieving good results and avoiding complications. Using his technique which involves using PRP as a natural glue to strengthen the Cooper's ligament and keeps it perked. The growth factors concentrated in the PRP also helps to rejuvenate the ligament via encouraging new cell growth and improving collagen and elastin. The real mechanism is still uncertain. More superficial injections are also done to improve the overall breast appearance and lighten the areola to for a more rejuvenated and youthful look. I have done a couple of treatments for patients and overall were happy with the treatment. I injected myself with my own PRP to observe the changes and I noticed there was initial swelling and fullness that lasted approximately a week. There was a size change, and I had an extra 1/2 cup that lasted me at least 6 weeks before shrinking again. There was definitely a lift and my nipples points a more symmetrical fashion nowadays. There was not much areola lightening since I didn't inject much at the areola (Its painful when you are doing it on yourself). I did one on my manager and she had a better lift and 1/4 size improvement and results lasted about the same. I believe that there is a cumulative effect, hence you will need repeated 3-5 treatments to get a more lasting effect. So I am getting another round today :). We charge RM 1800 per treatment and there are packages available. The procedure takes approximately 1 hour with numbing. The good thing is that its autologous, meaning that it comes from yourself, so there is less chance of allergic reactions or risk of excessive scarring. The best thing about doing this is the superficial effect on the skin. My bosom feels softer and look more refine compared to before and the skin tone is fairer. I have found very fascinating results with PRP, and am really considering to conduct a proper controlled study on this topic.

Preventing Breasts From Sagging

Recent studies have shown that wearing a bra causes more sagging to the breast. Prof Roullin from France did a 15 year comprehensive study on hundreds of women and recently published his findings. Rouillon found that women who never wore bras had nipples on average seven millimeters higher in relation to their shoulders each year than regular bra users. Apparently, the slight bounce that you get when you walk is important for the ligament's development and using tight bras from a very young age for long term impedes this process. So it looks like we have to reduce our bra wearing activities... O...o.

Cutting down and quitting smoking is another way to prevent early sagging. Nutrition has shown to play a role too. A healthy diet that consists of good proteins help to keep the breasts in shape. Vitamin C and E plays a role for skin health and helps to keep the skin around the breast firm to reduce sagging. Some people believe in phytoestrogens to perk up breast size and keep it firm. Although it may be beneficial, be careful with hormones as some preparations may increase risk for breast cancer and other problems.

Exercise is another important factor. Push ups, arm lifts, free weight lifting, resistance exercises or any form of exercise that strengthens your chest muscles (pectoralis, trapezius etc) will help to keep your breasts firm and looking good. Postural fixing, and back exercises helps with excessive weight of the chest.

For more info on the treatments mentioned here or for appointments please call Faceworks Clinic 03-21440080 or 014-2233268 or email us at faceworksclinic@gmail.com. Like us on Facebook https://www.facebook.com/FaceworksClinic to get the latest news and blogs.

Love your breasts.... October is Breast Cancer Awareness Month :)

It's October again, my favourite month. This year I have just turned 33 and I am loving every moment of my life. This is also the pink month. That's right, Breast Cancer Awareness Month. Wear the pink ribbon to support breast cancer awareness. The published statistics shows that every 1 in 19 women in Malaysia is at risk of getting breast cancer. However, we believe this number to be higher i.e. perhaps 1 in 11 as there were many late detections compared to earlier ones.

Breast Cancer may be fatal but you will be able to survive if detected early enough! So for this blog entry, I am also going to include steps for breast self examination. This simple 5 step test in the shower or on your bed could well save your life, so I hope all my readers can make this a weekly routine, especially if you are above the age of 35 or have a family history of breast cancer.

What are the risk factors for breast cancer?

Risks you cannot change:

1. Gender - Women are 100x more likely to develop breast cancer than men.

2. Age - The older you get your risk increases more.

3. Genetic risk factors - 5-10% of breast cancer cases are thought to be hereditary.

• BRCA1 and BRCA 2 are the most common cause of hereditary breast CA. Lifetime risk for families with BRCA1 is on average 55-65% with as high as 80% and more common in Caucasians. For BRCA 2 mutations, the risk is lower around 45% and more commonly found in Asians and Hispanics. Usually the disease with these mutations occur in much younger women and more often affects both breasts. Women with these mutations also have a higher risk of developing ovarian cancer.
• Changes in other genes - These gene mutations are much rarer and often do not increase the risk for breast cancer as much as the BRCA genes.
• ATM gene which helps repair damage DNA. Inheriting 2 abnormal copies of this gene causes ataxia-telangiectasia. Inheriting 1 mutated copy of the gene is linked to a high rate of breast cancer in families.
• TP53 gene gives instructions for making a protein called p53 that helps stop the growth of abnormal cells. Inherited mutations of this gene cause Li-Fraumeni syndrome which has an increased risk of developing breast cancer, leukemia, brain tumours and sarcomas.
• CHEK2 gene : Can also cause Li-Fraumeni syndrome and even if it does not, increases breast cancer risk 2-fold if mutated.
• PTEN gene normally helps regulate cell growth. Inherited mutation of this gene can cause Cowden syndrome, which people are at increased risk of both benign and malignant breast tumours.
• CDH1 inherited mutations causes hereditary diffuse gastric cancer and women with mutations in this gene also has an increased risk of invasive lobular cancer.
• STK11. Defects in this gene can cause Peutz-Jeghers syndrome which has an increased risk of many types of cancer including breast cancer.

4. Family history of breast cancer - Risk is higher among women with close blood realtives who have the disease.

5. Personal history of breast cancer - If you have had one before, the chance for a new breast cancer is 3-4x more.

6. Race and ethnicity. African American have a higher risk - Asians, Hispanic and Native-American have a lower risk.

7. Dense breast tissue.

8. Certain benign breast conditions.

• Non-proliferative lesions - no increase risk. Includes fibrosis, simple cysts, mild hyperplasia, adenosis, ductal ectasia, Phyllodes tumour, a single papilloma, squamous and apocrine metaplasia, epithelial-related calcifications, other benign tumours & Mastitis.
• Proliferative lesion without atypia (no overgrowth of cells). Increase risk slightly by 1.5-2X normal. Includes usual ductal hyperplasia, fibroadenoma, sclerosing adenosis, papillomatosis and radial scar.
• Proliferative lesions with atypia (with overgrowth of cells). Increase risk 3.5-5X higher than normal. These type of lesions include atypical ductal hyperplasia (ADH) and atypical lobular hyperplasia (ALH).

9. Lobular carcinoma in situ (LCIS) - the cells that look like cancer cells are growing in the lobules of the milk producing glands of the breast but they do not grow through the wall of the lobules. Women with this condition have 7-11X increased risk of developing invasive cancer in either breast.

10. Menstrual period - early menarche (before 12 years old) or late menopause is also a risk factor.

11. Previous chest irradiation for other cancer treatments - i.e. higher risk when exposure given earlier in life compared to later.

Lifestyle-related factors and breast cancer risk

1. Women with no children or late childbirth has higher risk for breast cancer.

2. Oral contraceptive pills - but reduces once stopped.

3. Depo-Provera contraception injections increases breast cancer risk.

4. Hormone therapy after menopause increases risk for breast cancer. Combined hormone therapy increases risk to getting and dying of breast cancer. Bioidentical hormones although safer in handling menopausal symptoms have not shown any evidence that they are safer and more effective in breast cancer.

5. Estrogen therapy does not increase risk for breast cancer, but increases risk for ovarian cancer and formation of blood clots and strokes.

6. Breast feeding slightly reduces risk for breast cancer especially if continued to 1.5-2 years.

7. Alcohol consumption is linked with an increased risk for developing breast cancer. The more you drink in a day, the higher the risk.

8. Being overweight or obese after menopause increases breast cancer risk. The risk appears for those who gained weight as an adult, rather than overweight since childhood. Excess fat in the waist area contributes more to the risk.

9. Higher levels of insulin in the body increases breast cancer risk.

10. Physical activity i.e. exercise reduces breast cancer risk. Walking 1.25-2.5 hours a week reduces risk by 18%.

11. There is no strong evidence that taking supplements reduces risk for breast cancer.

12. Chemical compounds in the environment is thought to increase risk for cancer but studies are still inconclusive.

13. Long term heavy smoking is linked to higher risk of breast cancer.

14. Several studies suggest that women who work at night (night shifts) may have an increased risk of developing breast cancer.

     Breast cancer is a major issue due to the many deaths and disability caused by it. In Malaysia it is the number one cancer for women and the mortality is high if not detected earlier. The best way to get early detection is via breast self examination. Its a simple 5 step home examination that allows you to detect any abnormalities in your breasts. If you detect anything weird about your breasts as per mentioned in the diagrams, do not hesitate to see a doctor. Funnily, a lot of people I meet are so scared to see a doctor and get a diagnosis. I think we should encourage people to seek proper treatment as early as possible. It is frustrating to get patients at stage 3-4 whom have noticed changes earlier but ended up going to a bomoh or sinseh because they were to scared to see a doctor. And when they deteriorate and die in the hospital, it is the doctors fault. Doctors are healers based on science and evidence, we can only do so much or know as much as what the patients is willing to tell you and based on the clinical findings and examination.

So what are the 5 steps:

Your breast self-exam should be done the same time every month, 7-10 days after

the start of your period if menstruating. If not, use a fixed day each month.

Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.

Here's what you should look for:

• Breasts that are their usual size, shape, and color
• Breasts that are evenly shaped without visible distortion or swelling

If you see any of the following changes, bring them to your doctor's attention:

• Dimpling, puckering, or bulging of the skin
• A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
• Redness, soreness, rash, or swelling

Step 2: Now, raise your arms and look for the same changes.

Step 3: While you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).

Step 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.

Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.

Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage.

Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.

5 simple steps to be done every week. Early detection saves lives. I hope all my readers would make this a habit. For my next entry, I will explain about medical aesthetic methods to maintain and beautify your breasts :).

Natural Supplements for Vitality - Somaplus

Nowadays, there are many different food supplements promising everything from vitality, health beauty etc, etc. Some are mustered via MLM companies charging exorbitant fees for the membership or supplements, whilst others are over the counter so-called miracles (which ain't that cheap either). However, the mainstay of popularity for these supplements are the natural ingredients which is suppose to be better than your normal diet.

Although it may sound a bit like a commercial, I do agree to some certain extent we would require supplementation for our vitamins, trace minerals and other required nutrients for an optimal bodily function. Food nowadays are processed excessively with too many chemicals and other additives which have not been researched fully as to their long term side effects. Furthermore, with the emergence of news of fraud with the regulatory bodies where a lot of the companies pay off the people inside to get their products approved without proper clearance or studies conducted makes you a bit paranoid to take processed food items or drugs altogether. Certain chemicals and colourings in food items have proven to cause hyperactiveness in children, attention disorders, mood swings and increased risk for obesity leading to the whole myriad of diseases.

Hence why more and more health conscious people are going to a more natural diet which involves organic food substances and reduced intake of prepared preserved food items from the shelves. We have all sorts of diets that encourage natural foods and discourage any form of junkfood or fastfood or canned food thus eliminating chance of consuming these additives in food that make them last longer. It may appear querky to some most people but for the health conscious it is a necessity. Besides, the diet does influence the body in terms of its shape and performance.

I count myself as a naturalist to a certain extent. Living in Malaysia it is almost impossible to go all organic especially since most of the food cooked outside uses some form of unnatural seasoning. Hence my naturalist endeavours would be more on my own time, from my own kitchen or friends who share similar concepts. But as much as I could, I would avoid processed or overcooked food. Which was why recently I was given the opportunity to try out a very interesting product called Somaplus.

Somaplus

This product is supplied by a medical supplier thus can only be found in clinics or medical centers. It has a very interesting history surrounding its creation. The product concept originates from an island in Japan called Okinawa. The product is made in USA. Well, back to my story, the island of Okinawa is also known as the "Village of Long Life" and is situated between Kyusu and Taiwan. There are 34 centenarians (a person who lives past 100 years old) per 100,000 people, which is 3X more than the rate in Japan. They believe that this longevity is due to the lifestyle and unique diet which involves fermented soy products, fermented rice, seaweed, sweet potato and potato roots. Hence the basis of this supplement drink.

Somaplus comes in sachets which you need to dilute in water. The drink is somewhat sweet and the taste is palatable. However, don't sniff the powder directly because it is pretty sharp in powder form (yes, I sniffed it that's why I know). You can feel the powder straight to the throat if you do. I started taking the product since 2 weeks ago when I got my first box. There are 22 sachets per box meant for 11 days i.e. morning and before dinner with 2 rest days a week (altogether 15 days). The recommended is 1 hour before meal and they recommend a high protein low carb meal. So how did I fair?

I run a very busy schedule, so I was pretty discipline with the early morning dose of the drink. Initially there was nothing much to tell about it but after a week I felt less sleepy in the morning and I had an improved energy level. I forgot to rest initially, so I only rested after the 10th day, but the 2 day rest was okay, I did not feel a withdrawal of energy. I sometimes took the afternoon sachet if I happen to remember. Perhaps being pretty young, the 1 a day sachet was enough to boost my energy level. However, I did notice a few other things besides the energy. My staff noticed my skin complexion improved despite no treatment being done on my face - I attributed it to the new products that I was testing on my face, but even my body skin seem to glow a bit more. I was more alert and I felt happier and motivated for exercise. Despite being of my calcium pills, I did not experience much cramps as I normally would, and the more astonishing part - I was able to go on without coffee for more than a day. Even if I drank coffee, it would not be the number 1 thing in the morning as it use to be and I cut back drastically from 8 shots to a mere 2-3 shots a day. I also notice that I sleep better and I tend to wake up at the same time every morning even without alarm clock. I wake up feeling fresher and less lethargic compared to before. Seems to be doing a lot for me, but bear in mind, I am quite a health freak and consumed supplements would have similar effects but not exactly the same for everyone.

So what is it actually? Soamplus is made out of natural ingredients which help boost the production of hormones in the body mainly Growth Hormones, DHEA and Melatonin. It is also a potent antioxidant which helps with the elimination of free radicals in the body. The main ingrediets are NAtto (Japanese fermented soy), Miso (Japanese fermented soy paste), Satsumaimo (Japanese sweet potato) and Mochi (Sweet sticky rice). So don't think this sachet has no sugar, it has natural sugars and each sachet has approximately 0.62gms of Sugar. Besides the powder getting to my throat, I think my appetite increased a bit on this supplement. It could be also due to my more relaxed mood.

A few comparative studies have been on the Okinawa diet comparing the benefits between the diet and other countries without the diet and it has shown positive response towards cancer, dementia and improvement of sex hormones. However, I have yet to come across a controlled RCT study between this product and a placebo. Still, it does seem to be giving some benefits and the price for this product is not exorbitant. 1 month supply is approximately RM 500 +/- and has 2 boxes taken 5 days a week and rested 2 days. Since it is a supplement, you may only see the results after long term consumption after the initial boost. They recommend at least 6 months of consumption for the most optimal effect.

I would recommend taking this supplement prior to starting out any bio-identical hormones to see whether there is symptoms improvement. For me, it seems to work to a certain extent. It is not a one all cure for everything, so don't think you can just skip your medications etc, by taking this product.

For more information, do call us at 03-21440080 / 014-2233268 or email enquiries to faceworksclinic@gmail.com. You can also LIKE our FB page and PM us the comment there.

Happy Malaysia Day....... 2013

Its 16th of September, Malaysia Day. The Day in history where the whole Malaysia was united i.e. the peninsular, Sarawak & Sabah approximately 50 years ago. It is only recently the country announced the celebration for this day, hence adding an extra public holiday for Malaysia. This country has the most numbers of public holidays in the world. Sometimes I do wonder whether it is beneficial to the country in the long run.

Of late, I have been super busy with so many things and traveling. Towards the year end, usually there will be a lot of conferences and training and other things. This year, my heart is left in Langkawi. The beach, the sun, the sea air - living in KL for most of the part, the change in scenery is welcoming and exhilarating.  Despite the hectic schedule, I did manage to test out a few products which can be ordered through the clinic.


1. Dermaceutic Foamer 15 - Face Wash

I have been trying out the Dermaceutic range on and off and recently, they have changed their formula a bit to suit Asian climates and skin. The in-house peels are marvellous but some of the skincare initially was too rich for our hot and humid weather. Now, they have come up with a new packaging and formulation and I was given the opportunity to try out some of them. This is one of my favourites, the Foamer 15. Foamer 15 is a foaming cleanser with glycolic 15% as an active ingredient. For my skin, it would be ideal since I do have on off oily skin due to my hectic and active lifestyle. It not only helps to strip off excessive oils but it gives you a mild exfoliation to keep your skin looking vibrant and fresh on a daily basis. It has a very clinical smell i.e. no perfumes as the UK standard usually clinical skincare are without any fragrance. It is good for people with oily skin and also those who are slightly more mature. Some people may experience dryness with this foamer, but it is always a must to use moisturisers after washing your face with any type of soap. Personally, I did not experience any dryness. In combination with this foamer, you can opt for other lines of Dermaceutic products such as Hyalceutic or Light Ceutic for mild pigmentation. This range is affordable with each product costing less than RM 200 per bottle. Some products are available in the clinic, but most require pre-order. Ask us today.

2. Aknicare Range

This is a new acne range brought in by Neostrata. It was launched last year, but I only had the opportunity to try it out this year. What attracts me to this product is the different specific range of items it has at very affordable price. The usual face regime would include a cleanser, a lotion and a treatment cream that cost only RM 350 for all three products. The usage on a daily basis is minimal hence would last you 2-3 months. They have conducted few studies on this product and in Singapore, it is recommended as a first line for acne treatment before giving Ro-accutane or doing other more invasive procedures to treat acne. It is hypoallergenic and is suitable even for teenage skin.

My manager has hormonal acne due to change in contraception pills and I guess our set came in just in time. After a week of using the product, most of the redness have disappeared and the formation of new comedomes were significantly less. However, when she skipped 2 sessions, acne started to form again so perhaps it is really like a treatment which requires twice daily application. Otherwise, the skin is less oily and looks clearer. Personally I tried out the spot treatment. I sometimes get spots like these popping up especially if I am highly stressed up.

Its a small bottle which is convenient since you need to apply 6X a day to reduce the acne within 1-2 days. As you can see, it is just the size of your lippy, so it makes carrying it around in your purse minimal hassle. I used it 3X only and the red flaring pimple dried up nicely and went off in 2 days. Definitely keeping this in my purse for emergencies. Initially when you apply the roller onto the acne it does feel a lil bit tingling especially if there is a break in the skin. This range also comes with a back and chest acne care for those who has body acne breakouts. It comes in a spray bottle to ease application, but I still find it difficult to apply onto the back without help. So I've been applying more in the front and I did notice a reduction in acne around the chest area. So now even my chest looks a lot nicer with less congestion. For those curious as to how the system works, here's a hand summary of the mechanism of action. 

For more information about these products, email us at faceworksclinic@gmail.com or call us at 03-21440080 / 014-2233268 or just Like our FB page and send us a PM there.

Tried And Tested....... Part 4 ........

Its been a quiet Ramadhan month. Personally, I have found the idea iftar at home is more inviting. Probably all the caloric restriction diets I've been on throughout the pass year has reduced my crave for food as much as I did before. The only thing driving me nuts now is the lack of caffeine.

Recently, I was visited by a new patient who turned out to be a follower of my blog. I felt really honoured that she enjoyed the contents and was really looking forward to my posts. So Killah, this one is for you.

I was quiet for a bit due to a very hectic schedule. However, in the huff buzz, I managed to try out a few products for this review.

1. Neostrata Skin Active Line Lift

     This is the newest product from Neostrata Skin Active range. As the name suggests, it helps to reduce appearance of deep lines and wrinkles. After 5 years of research, Neostrata labs discovered a technology they patented as Aminophil that acts by stimulating the skin's own hyaluronic acid and collagen creating volume to replace the loss areas. It is a regarded as a topical filler and results can be seen after a few minutes of application. However, you need to be religious in applying the product, since it relies on your own cells for the lasting effect. There are 2 products in this range - Step 1 Aminophil Activator is applied first. This compound has the ability to pump up skin 4 times more than inactive substance. It penetrates deep into the skin to stimulate collagen and hyaluronic acid production thus improving the appearance of deep lines instantly. It is also a potent antioxidant that helps to reduce free radicals responsible for premature aging skin. The Step 1 is applied with a roller ball to allow light massage and precision thus making it convenient for areas like under the eyes. Step 2 is the Finishing Complex that complements the action of Step 1. It contains NeoCitritate and NeoGlucosamine ingredients which enhances the production of collagen and hyaluronic acid. It also contains optic blurring agents that improves the appearance of deep lines. I find this product a tad too oily for me but Step 1 was nice.

         I tried out this product via the samples they gave me and managed to apply religiously for a week (and then I got busy so sort of gave up). There is an instant line reduction of at least 30% after 5 minutes of application. After a week, I notice that there was up to 75% improvement after application. However, later during the day, I did notice a return of the lines, and when compared to baseline, It looked almost similar. According to the research papers and recommendations, they ask you to use for at least 4-6 weeks for lasting effect. I guess this is a good solution for people scared of needles or not keen for filler injections. However, you need to apply constantly twice a day in order to keep the desired effect. Practically, for busy people like me, I think fillers would be a better solution so that I do not have to worry about it if I forget to apply. It would also be cool to use prior to functions, for that pumped up look since it does last for a couple of hours in a day. You will need to have both Step 1 and Step 2 in order to have the desired results. Each tube is sold at RM 135/= retail.

2. Strath tablets - Herbal Yeast Food Supplements

During the haze period, I developed very bad sinusitis until I lost my voice for 3 days and had sinus headaches up to 2 weeks with altered voice for a month. It was during this time, my medical colleagues suggested that I try out this particular supplement. He mailed it to me and insisted that I try it out to help reduce my sinus symptoms. 

     So what is Strath? This is a natural herbal and yeast preparation that is available in both liquid and tablet form. The one I was given was tablet form - 100 tablets per box. It naturally contains 11 vitamins, 19 minerals, 20 amino acids, 2 nucleic acids and other stuff such as s lecithin, choline, L-carnitine

and co-enzyme Q10, as well as glucan and mannan. There were not much research papers on this product and I have yet to find any literature that explains scientifically how it works. How they actually prepared this supplement is by introducing herbs and supplements to the yeast over a 2 month period and subsequently plasmolyising (getting rid of the yeast membrane) the yeast and the solution inside is used as the supplement. In a way, the nutrients are incubated inside the yeast and perhaps with some component of the yeast helps with the body's immune system and metabolism thus gives the beneficial outcome. There was a paper on mice that showed a significant increase in lifespan of mice that took the plasmolyzed yeast supplement after injected with Staph. Aureus bacteria in comparison to the placebo group.

I have to admit, I was pretty skeptic when I received the supplements but I decided to give it a go. I initially took 2 tablets 3 times a day as recommended by my friend. After a few days, I noticed an improvement in my sinus flu-like symptoms. However, I felt pretty lethargic the first week with some giddiness. I didn't think much of it as I was also on antibiotics short course, but looking in retrospec, I recovered much faster that I normally did. I continued taking the tablets twice daily due to hectic schedule, occasionally only once daily. After finishing the whole box in a month (Supposedly 17 days) - I did noticed relief of my allergy symptoms. I usually have a stuffed nose in the morning but for the past 2 months, my nose hasn't dripped as much. Despite my office manager having a really bad flu, I stayed fine although we were always in close contact. Generally, I felt healthier and less lethargic. The beauty of this product is that it is not that expensive to try. The retail price is RM 162 for 100 tablets or the liquid form. There is also a preparation with alcohol that costs RM 180. Another cool thing is that there is an animal preparation for your pets called Animastrath that helps improve your pets well-being and possibly help reduce harm from animal flu.

Bio-Strath is 100% natural and free from preservatives, colourings and any artificially produced substances.

• For fatigue (school fatigue, spring fatigue).
• For nervous tension, stress.
• To strengthen immune defence.
• To increase physical and mental efficiency.
• To promote vitality.
• To help during convalescence (recovery phase after illness).
• During pregnancy and lactation period.
• To help concentration, development and calmness in children
• To help recovery in sports

This is a pre-order item, so it is not readily available in the clinic.

3. Lash Booster - Eye Lash Conditioner

This is a cool product that I love especially since there are times I need to wear mascara and excessive eye make-up and sometimes I notice I am losing some of my lashes (especially after wearing fake ones). It is not really a new item in the market, however, due to certain FDA regulations, the formulation has been changed a couple of time. The latest formulation has FDA approval and works just as good as the previous one or perhaps a little better? I tried this product continuously for a week and the significant change was the volume of my lashes and brows (yes, I even applied on my brows) appeared more and even friends noticed that my brows and lashes look thicker. In terms of length, I didn't see much difference but perhaps, it would take 3 weeks to actually see length difference. It comes in a small mascara like tube, and you apply the solution at the roots of your lashes and your brows. This product comes from USA, and is a sister product of Revitalash. Perhaps the only downside is that you need to consistently apply the product in order to achieve the desired results although its once daily application at night. Another problem that may arise is sensitivity to the chemicals used in this formulation that may cause some eye irritation or redness despite the company claiming that it is even suitable for the most sensitive eyes. The key is to avoid as much as applying the solution into the eyes. Regardless, it is still a cool product for lash growth and conditioning. This is not really the first time I am trying out this product - I started prior when it first launched and I feel that the formulation has definitely improved. Time to start applying daily for beautiful lashes for Hari Raya. If you are concern about irritation, you can come over to the clinic and try out our sample. This Product is sold at RM 280 per tube and it can last approximately 1 1/2 - 2 months if applied daily. For a limited time only, we are selling this product at an intro price of RM 250 (Save RM 30 till 15th August). Get yours today.

For more information concerning the products kindly call us at 03-21440080 / 0142233268 or email to faceworksclinic@gmail.com .

PRP Updates - The Vampire Facial?

Recently, there is a lot of hype about Platelet Rich Plasma (PRP) facial since our beloved Kim Kardashian decided to get hers done and post the video on Youtube. There were multitude of responses from complete horror to complete awe. And whilst the whole population was amazed to see the procedure, it is not really a new thing.

(Sourced from www.tagroom.com)

However, the in the medical world - more and more doctors are realising the potential benefits of PRP to treat their patients. As for myself,  PRP is like a lifeline to medical aesthetics alternatives of treatment to patients. We have multiple studies conducted on rejuvenation of the skin and most seem promising. My own patients have also shown great improvements in terms of texture, hydration, pigmentation and scars. The most rewarding was one patient with recalcitrant melasma who improved so much after a few treatments - despite previously tried with IPL, peels and Fraxel. We also had patients doing breast rejuvenation where most are satisfied with the tightening effect and skin rejuvenation effect of using PRP. In terms of volume, only time could tell, since the cases are pretty new. Most PRP facial patients are satisfied with the results and are looking forward for the next one.

So what is new to our Vampire Facial regime?

(sourced from ieeet.com)

After attending so many lectures, hands-on, friendly exchange of ideas with colleagues and literature study, nowadays I do my PRP facials differently than before. Prior to this, I only take 10cc of blood per session, but now I prefer to take between 60-120 mls of blood depending on area needed and indication. For face, usually 60cc of blood is suffice. The centrifuge process is also different where I start with a soft spin, extraction then a second faster spin. From the 6 bottles, I would usually obtain 12 cc of concentrated PRP - and roughly 12 cc of PPP. So what's the difference again?

The Platelet Rich Plasma is the layer between the red blood cells and the upper clearer serum part. The serum part is also called PPP (Platelet Poor Plasma). The platelet rich plasma is where all the growth factors and cytokines are available. The upper portion although has some platelets have minimal benefits, thus sometimes we just give it to the patient as a home mask. Some studies say the white cell are detrimental to healing but others say they have no role or helps with healing. The red cells play no significant role nor does it causes any reduction in effect. And thus, we have an autologous (coming from oneself) cells stimulator.

Luckily with Dermaqueen technique, PRP can be delivered evenly throughout the face without much downtime. Last weekend, I asked my nurse to help inject using the Dermaqueen vacuum assisted needle device onto my face with minimal anaesthesia. (I am still a baby when it comes to pain). There were only minimal needle marks at the thinner skin areas but there was still a remarkable difference. My face was brighter, and some of the pigmentation disappeared. Its been 2 days only and my skin still glows. The tear trough injected manually appear to still keep the volume injected which is good, thus making me look less tired. For a PRP facial, the best results would only be seen after 3-4 weeks although immediately after you would have a refreshed look and brightening of the skin. The best part is that we do observe continuous healing even up to 3 months after the initial procedure. Average results lasting period for a single treatment is between 6-9 months. However, most literature suggest a minimum of 3 sessions per year.

From my observation of doing my patients, I do have a few recommendations for patients planning to try this out. As PRP is from the patient, the patient him/herself has to be optimum to achieve the best results. You should keep yourself well-hydrated and well-nourished before going for a procedure. Smoking and drinking alcohol excessively seems to reduce the effectiveness of the treatment. You should be fit with no underlying infection going on as it will affect the outcome too. Patients with underlying blood or metabolic disease should consult the doctor thoroughly as some conditions are contraindicated for PRP. Use of health supplements that promote healing and cell growth may have some beneficial effects, although a proper study to compare the results is warranted to conclude. Vitamin C and other antioxidant supplementation may also benefit but is still subjected to further proper research.

Personally, I love this treatment as it offers a less aggressive treatment modality for skin rejuvenation as compared to energy devices. At the moment, we are studying the effects of PRP on stretch marks. Can't wait to report the finding.

For more information or to book an appointment with us contact the clinic at 03-21440080 / 014-2233268 or email to faceworksclinic@gmail.com