October is Pink Month

I think most of us would agree that this year is indeed a very fast year for most of us. Its already October. OMG, when did that happen? With the current political and economical issues surrounding our country, it has been a pretty tough year for a lot of us, including myself.

After closing down the Starhill Clinic (Faceworks Clinic) in March 2014, I decided to take a break from my crazy hectic practice that demanded 12 hours daily 7 days a week with only 1 day holiday for important days like New Year or Eid. Yes, having a clinic in a mall is challenging and needed a lot of patience and perseverance. So in a way, I was welcoming the 2 year break I decided to take to rediscover myself.

It was a well worth time taken off. Despite the obstacles and the hurdles, it taught me a lot about how my life use to be and how the now choices I make have totally changed it. I felt that I have morphed from my cocoon of that shy girl who had an idea of what she wanted, to a full bloom woman who commands what she wants. Although I lost a few friends along the way, but I made new better ones, whom I admire and adore so much that when I grow up I want to be just like them. These are women who drive their own industries, whilst giving back to the society and inspiring others to become better people without any insecurities of jealousy or negative competition. I feel so blessed that I am surrounded by these titans (Yes, I am taking notes on their steps towards success). One of the tips of being successful yourself, is to surround yourself with people who have the success that you desire, and it will motivate you to work harder.

And my patients, whom I feel so blessed to manage and care for, kept me going, even when I felt like my life was so bleak. The trust and loyalty they have for me is so heart felt that although at one point I felt like having a complete career change (I have many talents than being a good doctor), I could never abandon their needs. My patients need me, and more patients would benefit from my skill and talents in not just medical aesthetics but also consulting on lifestyle modifications, and other anti-ageing therapies that are the in thing nowadays. 

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After pondering for months, I've decided to announce my return from semi-retirement. Yes, people, I'm back and I am working on my new project that will benefit my patients and my readers. I'm working on my new site, which will have multiple blog topics, not just on medical aesthetics but also focusing on lifestyle and nutrition, with some stories for motivation related to some of my past experiences and others whom I've met along the way. The whole idea is to inspire others, the way others have inspired me. How fast will it come on live...? Depends on how good I am at handling wordpress (Or if I get the intern i requested asap). I would just like to request to all my patients and friends, to help Like my clinic page on Facebook ( https://www.facebook.com/drmmclinic), follow me on Instagram ( @dr.marr), and if you are happy with my service and my care to tell 5 friends about me and get them to Like my social medias. If you are not happy, please let me know so that I can improve myself and the clinic. 

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October is Pink month. It is breast cancer awareness month. Despite all the awareness campaigns, it is still the leading cause of deaths due to cancer for a woman. Latest studies have shown Vitamin D can help reduce risk for cancer. So perhaps its time to spend more time in the sun to gain this benefit, or you can just supplement daily. If you are out in the sun, don't forget to wear good sunblock with UVA and UVB protection. Unsure of a good one? Buzz us, and we can recommend the ones we carry which are clinical sunblock products.

Have a good week ahead peeps, the October parties are just starting.

Ciao.

For more information and appointments, do contact us at drmmclinic@gmail.com or contact us at 0129660852.

Testosterone Therapy - Men Need Help Too .....

When I first started my private practice, my focus was mainly on medical aesthetics and external beauty, skincare and products to enhance beauty.  After 8 years, now it have evolved more into lifestyle, where I also delve into optimizing my patient's systems so that the body functions the best. Because what is the point of looking beautiful, if you feel like crap and you gain weight excessively for no reason? I myself face similar dilemma trying to keep my weight checked, to the point that I start studying more on hormones and internal body processes and metabolic pathways. And after awhile, everything seems to make sense.

A very interesting problem nowadays is how a lot of men in their prime are not in optimum health that you find young men having testosterone deficiency symptoms. The factors contributing to this dilemma is mainly stress levels, diet and lack of physical exercise that causes the testosterone levels to decline and slowly leads to weight gain, low mood, low energy and depression. Another issue that a lot of men have is the aromatization of testosterone into oestrogen by an enzyme called Aromatase. This then leads to the formation of gynaecomastia or also dubbed man-boobs and the collection of fats around the stomach pot belly area. This conversion leads to a reduced amount of available testosterone in the body leading to symptoms of deficiency. So basically that growing tummy is not a good thing boys, you better start thinking of losing it. Recent studies have also shown that men with reduced testosterone levels have higher mortality risk. So its not just about getting that 6 packs, but it is also to ensure then men live longer.

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Last July I attended a conference on men focusing on hypogonadism or low testosterone and erectile dysfunction. It was a real eye opener. Thank you Bayer for the kind invitation. Our speakers were well experienced andrologist from Malaysia and Singapore who were very informative and entertaining. Andrologist are doctors who specialize in male sexual and urinary problems. I learnt so much on testosterone in that two days that a lot of the things I was studying made more sense.

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Most doctors believe that as long as the testosterone levels are within range, it is normal. However, more and more studies have shown that there is an age relation to the level, where it peaks highest in the adolescent stage up to 1200ng/dl at 18 years old and slowly declines over the years with an average of 1.6% decline per year. The range given by the labs is so huge i.e. from 270ng/dl - 1070ng/dl. A few community studies have shown the averages based on age groups which can also be used as a rough guide. The best way is to look at the symptoms and signs and correlate clinically. 

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Possible symptoms of Testosterone deficiency:

1. Psychological symptoms

     - Irritability

     - Nervousness

     - Anxiety

     - Depressive Disorders

     - Memory Disturbances

     - Lack of Concentration

     - Mood changes

2. Somatic Symptoms

     - Muscle Pain

     - Joint Pain

     - Excessive sweating

     - Sleep disturbance

     - Muscle strength and muscle mass decline

     - Hot flushes

     - Cardiovascular disease

     - Increase body weight

     - Increased visceral body fat

     - Testicular atrophy

     - Osteopenia

     - Chronic fatigue

     - Anaemia

3. Sexual Symptoms

     - Low libido or sexual interest

     - Reduced number of morning erections

     - Delayed ejaculations

     - Impotency

These symptoms can be reduced by increasing testosterone levels in men to what they require. You see, not everyone function well on the same level. It really depends on the individual. Just like how our body built are not the same. In the past, the testosterone range was determined by subjects between the ages of 20-80 years old. Nowadays, there is a more age specific range based on the general well being of the man, whether or not they have metabolic issues like diabetes or cardiovascular problems.

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But it is not as easy as just supplementing testosterone as what most men believe. There are many factors to consider such as age, and cause of low testosterone and whether future offsprings are considered. Long-term testosterone therapy causes the Leydig cells to stop producing sperm in 91% of cases. Hence, we should weigh the pros and cons of treatment. The best is always to consult your anti-ageing or lifestyle practitioner properly to give you the best options based on your age, and future expectations. Furthermore, too much testosterone has been proven to increase aggression in men, with a higher tendency for them to drink, smoke and engage in high risk sexual behaviours. Therefore, careful planning  and monitoring is required to ensure optimized treatment. I'll explain more about treatment options in another blog entry.

For more information or for appointments feel free to contact us at drmmclinic@gmail.com or +60129660852.

Stem Cells Treatment - Are they for real?

I was over at my girlfriend's chic boutique trying out some new close for the KL Fashion Weekend happening next week with a few other girls that happen to be there at the same time when this interesting topic of Stem Cells suddenly popped up. One of the ladies was considering to do stem cells but was not so convinced as the price is exorbitant and the person explaining the product doesn't even have any medical background.

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This is a common scenario in Malaysia where more and more people are selling so called stem cell treatments that seem to be the cure for every single disease in the body ranging from consumables to injection form, promising eternal youth. Apparently it is more of an Asian trend compared to other parts of the world where they are more skeptic on whether the product is real.

Why is this obsession in stem cells? Well basically, being in a society where outlook is very important, many believe that stem cells can help improve your appearance and make you live longer. There are many research done in stem cells and a lot of the testing done shows really good outcomes, with the reproduction of cells such as neural cells, NK killer cells, skin, cartilage and also heart muscle. Yes, the technology is out there definitely and more and more people had benefit in these novelty treatments.

However, these are really high grade, laboratories of the most stringent manners in terms of harvesting, culturing, magnifying, enhancing and storing which definitely will not come cheap.The lab itself requires thousands to be maintained monthly to adhere to the stringent quality control standards and the hiring of specialized, well trained and experienced scientists is also a bomb to cost.

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Which actually makes me wonder, how can people believe in over the counter so called 'stem cells' products promising anything from flawless skin to longevity. If the quality is what it claims, the price shown would be incredibly cheap and ridiculous. And yet, many fall for these stem cell products and they are mushrooming everywhere. The best part is some products sell stem cells, stating that the product is from the stem of a plant (yeah, how low can your marketing gimmick go?) but at least they are honest enough to mention it on their package.

Then you have the MLM companies parading stem cell promises to their members and buyers and you get tablets from sheep, deer and whatever animal they can get their hands on. These sign ups are not cheap and on top of having to recruit more people in, you still need to maintain a monthly of few hundreds to few thousands.

The worst part is the source. Many claim to be from either Germany or Switzerland but sometimes it is hard to be positively sure. Many of the over the counter supplements are written as Swiss formula, which means the recipe is swiss, but it could be manufactured elsewhere.

My personal take on it? As far as stem cell research and technologies, yes, the advancement is pretty much fascinating. But the high cost laboratories and technical expertise means that it is not a cheap technology to begin with. Supplements that come in the box are mainly extracts of the real thing combined with other supplements to make it more efficient. Depending on the quality, the extract percentage can range from below 1% to perhaps 30-50% of the capsule. I have tried a few on the market and my personal favourite is Celebre placenta capsules because of how fast it makes my skin glow and become soft, and that I do not get any break out nearing my menstrual cycle. Others I have tried takes more than 2 weeks to work and usually affects my menstruation. As for over the counter products, I really err on the side of caution because twice I tested placental products from different brands and it caused excessive weight gain.

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In terms of IV or IM injections, there are a few different types of cell preparations. The cheapest form are the extracts, whether from placenta, fetus or specific organs . These are not live cells, just extracts usually taken from the whole soup after the live cells and lipoproteins are taken out. Then you have the lyophilized form of stem cells, which are air dried cells which has more DNA content as compared to the extracts. And the most expensive are the cryocells, which are live cells in the millions based on which organ specified. However, all these lines are mainly from animals such as sheep, rabbits, deer etc. 

In terms of human cells, we have started on mesenchymal human cell cultures. Many claim it to be better than animal cells but with one major limitation. It only divides into mesenchymal type cells i.e. muscle, cartilage, bone, blood and some connective tissue. Re-enhancement is required for differentiation into other cells such as neuronal cells or NK (natural killer) Cells.

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So, who to take and which one to take? If you are looking for soft glowing skin or have a few deranged parameters on your regular blood test, the extracts would do wonders in transforming your skin and optimizing your organs. You can choose to consume the supplements or do the injections. You will need to consume regularly for pills at least for 3 months for the effects to last. I sometimes recommend my patients to take daily for 3 months, then alternate every other day to save on the cost. For those who do not fancy swallowing a big capsule in the morning, you can go for the weekly injections usually between a 6-8 weeks course. The effects are faster than consuming daily, and you can have a lasting effect between 6-12 months. (Some even more, but it really depends on lifestyle). For those who have damaged organs or severe diseases like ischaemic heart disease, diabetes, hypertension, etc. Then you have no choice but to go with cryocell types specifically to the organ in question. There are specific protocols based on the patient's problems and different organ cell cultures are made and sent in cryo. Even for cancer patients, depending on the stage, there is a possibility of NK cells culturing to aid the immune system to fight the cancer but all of this require proper consultation, evaluation of the patient's condition and investigations, or treatments done. The stem cells do not offer 100% cure but there have been cases where there is a marked improvement especially in the quality of life that allows the patient to sort out their last requests. There are also some success stories on autistic children, where improvement of the child's focus and behaviour is seen as early as 1 month post treatment. Cryocells innoculation whether animal or human source usually requires a repeat treatment after 1-2 years depending on the condition.

If money is not an issue, and you just wish to try out an alternative method of treatment, stem cells may provide some solutions to the patient. A proper clinical assessment and counselling needs to be done to manage expectations because despite the high price tag, it is not a all-in-one cure.

For more information or appointment feel free to contact us at drmmclinic@gmail.com or send a text to +60129660852 and we will get back to you.

Lipo-V - New Mesotherapy on the block.

Mesotherapy is back on the block as a way to remove stubborn localized fats. Yes peeps, localized not generalized. During the last IMCAS in France in January, there was much hype about the reemergence of mesotherapy as a modality for treatment.

Fat areas and weight loss has always been an area of interest for me since I was previous really overweight and I have bulge issues. So when a friend of mine introduced this new mesotherapy line from Korea, I was skeptic but curious.

The older generation mesotherapy usually requires multiple treatments done at weekly intervals to get a good result and sustain the effect. Usually you require between 2-10 vials per area (depending on area size) and the treatments are done weekly 5-10x. The usual problems with the previous mesotherapy is bruising that can be unsightly and for double chins, it can be very tricky.

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Skeptic but curious, I was fortunate that they were having a mini launch and workshop to introduce this mesotherapy. The training was done in KO skin center in Klang and as many as 50 doctors attended the talk and training conducted by Dr Seo from Korea together with his colleague Mr Joseph (Korean too). 

This mesotherapy line is called Lipo-V and it comes in 2 sets. One is Lipo-V for face specially designed for double chin and to remove face fatty areas (yes, you can also sculpt those chubby cheeks). The second line is Lipo-V body which comes with an additional drainage  vial and is used for body parts.

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Attendees during the workshop 

The brochures and before after testimonials were pretty impressive. Dr Seo showed some of his Korean patients pictures and how he has used Lipo-V to create a more 3D less chubby look. It is not ethical to snap photos of other doctor's patients and post it on online, hence why I don't, but even for an experienced aesthetic practitioner like me, I was pretty impressed. I was also thinking of how many Malaysians can actually benefit from such treatment. What impressed me the most was the immediate effect which gets better over 3 days and the lack of bruising. Bruising is always a challenge when it comes to doing mesotherapy around the face, since patients will feel uncomfortable if they get bruises and need to hide them.

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With Dr Ko and the Korean team, Dr Seo, Mr Joseph and sorry but I really didn't get his name lol. 

There was a live demo session which was impressive because of the skill and speed of Dr Seo in doing the patients. There was also a demonstration of using PLLA threads in contrast to PDOs but I'll talk about them in much detail in another entry.

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 Of course, we definitely need to take a wefie.....

So, being the curious cat I am, I volunteered myself as a demo subject. The area of my concern is of course, the tummy. After 2 natural childbirths and gaining like 30 kilos per pregnancy, it is a big issue to tackle. The method of administration was via cannula technique, hence reduces injection points and pain. This also contributes to less bruising. They used a total of 8 vials on my whole tummy with 2 vials on the top, 2 vials on the sides and the 4 for my lower tummy area. 

Did it hurt? Well, I did feel a sharp sensation, and a little bit of acidic feel which was not entirely painful but not so comfortable either. However, since Dr Seo was very fast, it was acceptable. The problem afterwards was more related to the lidocaine content in the syringes because they actually pumped me up with 2mls X 8 syringes of 2% lidocaine which gave a total of 16 mls of 2% in one shot. I had tongue numbness and lightheadness which also made me feel a bit giddy and unsteady on my stilettoes. I drank 3 bottles of mineral to wash out the effects, and after 4 hours only my tastebuds were better. It was pretty funny because I had spicy banana leaf in Nirwana Bangsar, and I felt that it was not spicy and lacked sweetness when my kids where complaining that it was a tad too spicy. 

So I guess, my advice to the doctors is to be a bit careful with the lidocaine content. I guess anything more than 5 vials, we should cut back on the lidocaine to 1 ml instead of 2. Result wise, I think it is pretty impressive. They advised me to do RF or any high frequency device on the same area after 2-3 days. I took the liberty of taking daily photos to observe the changes. The quality is not super super excellent but you can make out the difference. The lower abdomen improved so much after 1 session, but the best would be after 3 sessions.

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My tummy from day 0 to day 3

I asked Mr Joseph about the longevity of the results. The results are good even up to a couple of months pertaining that you do not over eat and do regular exercise. Personally, I was happy with the results because from experience, usually I would require 2-3 sessions of mesotherapy to achieve what I achieved in 1 treatment. The combination with RF makes the results even better and I think it should be done together. The best part is the lack of bruising and soreness that you usually feel after a conventional mesotherapy treatment.

Ingredient-wise, this product is plant base thus adheres to certain sensitivities related to animal products. The best results is after 3 treatments, which is good since most mesotherapy courses take up to 10 sessions. The safety of the product? Well, because it is plant base and hypoallergenic, there is no restriction to the use of vials per session. The only thing doctors need to watch is the amount of lidocaine mixed into the solution.

Perhaps, the only setback is the cost of the treatment. 1 vial is charged at roughly RM 600 and you may need between 2-10 vials per sitting. However, you only require 3 sessions as compared to 5-10 of the normal mesotherapy. When you add it up, it is just about the same but with the results you want, and almost no downtime. Plus the mesotherapy is so safe, you can use it almost anywhere you want. As for face, you need perhaps 2-4 vials just for double chin, and to reduce cheek volume perhaps another 2-4 vials per session (because you have left and right obviously). Another interesting usage is to reduce gland swelling which is common in Asians due to high consumption of spicy foods. Depending on the doctor and technique for the face a vial will cost between RM 600-RM1000 because of the technical difficulty and clinical experience. Yes people, different doctors have different skill levels. The more experienced and well trained a doctor, the fee is usually slightly higher. (Actually we have a standard range for our professional service).

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I am pretty much excited about this new product especially after testing the product on myself. So, how much is it? For an introductory offer prices are as follows:

      

            Face : 6 vials at RM 3000 ( 5+1 offer)

                       12 vials at RM 5500 

                       20 vials at RM 8500

            Body : 1 set consists of 2 vials i.e. fat lipolysis and drainage which will be injected

                        together

                        10 sets at RM 5000 (NP RM 6000)

                        20 sets at RM 8000 (NP RM 12000)

                        30 sets at RM 9000 (1 box at 50% discount, NP RM 18000)

Hurry quick.... Offer ends soon. For more information or to book treatments contact us at drmmclinic@gmail.com or send a whatsapp or text to +60129660852 and we will respond soon. Not to be missed.

Post Raya Blues...... Its not all that bad.

It is the week after the Raya holidays and the kids are back to school. The adults have to get back to work despite Raya being a whole month of celebration. Yes, even though Eid arrived on the 7th of July, in Malaysia, Raya is celebrated till the end of Syawal with open houses, festivities and of course food and more food.

Today being the first day after the long Raya weekend, the streets of Kuala Lumpur still appear pretty much tranquil as most people would have taken an extra day off in case of the massive traffic entering back into the metropolitan city that may incur hours of jam. And of course, the finals of the Eurocup 2016 was airing at 3 am this morning with a miraculous win of Portugal over France with a score of 1-0 during extra time unexpected since their star player Ronaldo was taken off field for injury earlier on. For most Malaysian men, football is as loved as food, regardless of which continent it plays in, hence probably a quarter of the nation is at work bleary eyed from watching the game. C'est la vie.... Sorry France, you'll have to tie Spain some other year.

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Courtesy of Star.com.my 

With a long week of holiday after a whole month of fasting, the most common complaint you would always hear about is how a person loses a few pounds during fasting and then regains back what is lost (or more) during the raya spree. Ah, yes, but how can you say no the the most delicious wondrous food that come out usually only once a year of celebrations. It is rare to see a Malaysian turn down rendang, ketupat, sate and all the different types of food every state has to offer, not to mention the multiple open houses that invites people to dine from morning till late night. Yes, we love our food, we love festivities, and we really love Raya.

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But we are also the fattest nation in south-east Asia which was recently shown on recent statistics with a high prevalence of non-communicable diseases (NCD) like diabetes, hypertension, heart problems, spine issues etc. Hence, the post raya blues.

There are many studies linked to obesity and weight loss which gives us a good picture of how to reduce weight and what works and what doesn't. There are also so many products and fads in the market that promises weight loss and slimmer body. Whether they really work or not? Well, its hard to say since there is not much evidence collected on them. And when I say evidence, it does not mean testimonials. It means controlled comparison studies between product A and a placebo (placebos are usually just water or sugar tablets mimicking the original product but have zero effect on the person) blindly randomized and given to an x amount of people and observed over time. Testimonials are flawed because some people are paid to write positive testimonials on a product. We have so many websites offering ghost testimonials mimicking real life people that anyone can create testimonials and put them on their site.

On the lighter side, eating is culture in Malaysia. It would rude not too. But we can still keep off the extra pounds if we are mindful of what we eat. Here are a few tips to stave off the extra calories despite having to be guest to the many open houses.

1. Stay off the carbs as much as you can. 

Omitting rice, bread and other carbohydrates would definitely help to reduce the pounds gained. But still, the delicious food can be so enticing. Instead of completely omitting the carbs, try to portion the carbs to be smaller than usual. For example, maybe just a small portion of rice compared to the dishes or limit your ketupat lemang intake to just a fistful.

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2. Watch out for additional sugars in the drinks.

Stay off the sodas and cordials if you can. Usually when I go to open houses, I would opt for plain water, sparkling water or coffee without sugar. All forms of canned drinks, soda, gas and fizzies are a complete no - no on my list. Cordials are minimally welcomed because usually they have been diluted in a lot of water. Fresh juices are acceptable but you barely get those in open houses. Teh tarik and nescafe tarik contains a lot of sugar from the evaporated milk used (approximately 182 kcal calories per cup). 

3. Kuih Raya are sugar culprits.

What is raya without kuih raya? We have a tendency to stock on these cookies during festivities. The problem is, eating these biscuits can be quite addictive and we tend to lose track of how many we take. Most of these cookies are sugar laden, margerine or butter laden, well you get the picture. They may look innocently small but 1 hari raya cookie can easily give you between 53-110 kcals of calories. Imagine taking 10?

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4. Drink More Plain Fluids

Malaysia is a hot and humid country and Raya usually falls in the middle of the year where it is super hot. Eating all the salty and sweet foods also leads to more dehydration and thus we need to rehydrate constantly with water. This also helps with our digestive system and bowels to avoid constipation. The more you eat, the more you need to drink to get it out of your system as fast as possible,

5. Local fruit are sugar menaces. Take in moderation.

We are always encouraged to take fruits in our diets and told to increase servings. However, our local fruits tend to have a higher sugar content due to the tropical nature of the fruits. Durian is a common favourite among Malaysians. It is tasty but 1 seed is roughly 50 kcal calories. Imagine eating a whole fruit? It can come close to 1200 kcals for a fruit. For those durian lovers, limiting to 2-3 seeds per day is actually the best way to go. Besides, you have other things to eat which are equally heavy in calories. Moderation is always the key.

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 Courtesy of www.huffingtonpost.com

Well, of course if all else fails, you can always come in for a proper consultation on weight loss management and regimes to help get back that shape you wanted. For a limited time only we are offering 30% off our HCG diet programs and Mesotherapy spot treatment courses. Offer valid for the whole month of July only so book your treatments now.

Contact us at drmmclinic@gmail.com or send us a txt to +60129660852 for more information or to grab this deal.