Chemical Peeling - Old technique, new advances, economical and still good results.

Recently, I have been asked what would be my favourite method of maintaining skin health and youth. To their surprise, laser was perhaps last on my list. Living in a super hot tropical country with high humidity, perhaps doing laser on your face is maybe a bad idea. Especially if you are not particular enough to consistently wear sunblock (even in the house) and keep yourself protected from direct rays. Unfortunately, so many clinics, medispas and beauty salons are promoting laser as if its just a simple facial, that they forget the complications that entails when not advised properly.

Perhaps, this is why I decided to come back to work and start reeducating the public about medical aesthetic treatments and procedures. The science of beauty is real, not just some money making scheme.

Well, anyway, enough rambling. Back to the facts. Let's talk about chemical peels. This is perhaps the oldest method of beautification brining us back to the Egyptian reign where Queen Cleopatra was well known for her milk yogurt baths to exfoliate her skin and leave it smooth and flawless. Nowadays, we have more specified chemicals to give us the controlled exfoliation that we need to achieve the result we want.

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So why all this exfoliation business? Our skin consists of multiple layers of epidermis with the outer most layer being the one most exposed to the environment called the keratin layer or the stratum corneum which is mainly made out of keratocytes which are completely devoid of nucleus. This is also referred to as the outer skin or the dead skin layer. Most of the superficial peels and microdermabrasion take off this layer of the skin, thus revealing a much more fresher newer skin. However, some medium strength peels tend to peel deeper into the stratum lucidum and some into the stratum spinasum. No matter the strength of the peel, the doctor doing the procedure must be aware of the level of peel he or she is doing for the patient and how to monitor for side effects. Many times over the years, my suppliers come to me with a picture of a patient burned from chemical peels done by other doctors and asking how to resolve the problem.

So why do burns occur? The most common reason is bad technique during the procedure where either the application was too thick, the time was too long or neutralization was not done when it was warranted. The problem with chemical peel burns, sometimes it takes up to 2 weeks to heal and you may leave the patient with an unsightly scar. Whatever it is, if you have trained yourself well, you will be able to handle peelings easy since it is perhaps the simplest thing, that a lot of people take for granted.

Why do I love chemical peels? Because it is one of the simplest things you can do for the patient to remove all excess dead skin and make the patient's skin look brighter and cleaner. The procedure usually takes anywhere between 1 to 30 minutes depending on the type of peel and how it is applied and how many layers. A study published in medscape in the year 2006, caught my attention on regular chemical peelings and how it affects the skin. They wanted to see whether regular skin peeling would cause patient's skin to be thinner but on contrary, there is a few millimeters improved thickness instead. This was due to the increase skin turnover due to the feedback that the stratum corneum is thinner, thus increases cells production. However, bear in mind, the procedure has to be done correctly at the right intervals in order to have this effect. Over peeling, or complications due to peels can also cause worsening of skin texture which is what we see with certain local cosmetic products which are too aggressive and uncontrolled. 

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So recently, my clinic has been trying out new types of peels since our older ones are being phased out and I am forever in the quest of looking for super no-downtime treatments for my patients. Among all, we found some that we like. One of the newer chemical peeling treatment that we would be bringing in is called the Elsa Peel. It consists of 3 layers of peelings followed by a clay mask. The good thing about this peel is that there is no downtime after the procedure, and yet it gives you a good clean peel and helps lighten up pigmentation. So far I did once on my face and the results was satisfying. I have been peeling my face for years, and even with 1 treatment I noticed at least 2 tones lighter skin compared to before. During the peel I had an acne pop and even afterwards, the post-inflammatory pigmentation was much lighter compared to the rest. 

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The Elsa peel is suitable for most skin types. The recommended is to do a peel once every 7-14 days up to 4 times to achieve a much better skin tone with reduced pigmentation. Subsequently, you can maintain by doing it once every 1-2 months. Coupled with serum vitamin C or any other dermal replenishment creams, it would be superb for people with skin that is prone to pigmentation or for those who want a more even and brighter skin tone.

The usual price for this treatment is RM 450 / session and takes approximately 30 minutes to complete. Since we are launching this new product, we are giving a special introductory offer of RM 350 / session. Take up a package and get more discounts but this you have to ask my nurse.

For more info, or to book appointments, please email us at drmmclinic@gmail.com or drop us a message at 0129660852. Or you can like us on FB and pm us from there. 

Its All About the C's

Its the start of spring and we are entering the second quarter of the year. Busy schedules and a lot of hard work for most of us due to the current economic slow down that is happening worldwide. In the hustle and bustle of keeping up with the rat race, it is really important to keep our health intact to meet up with our expectations. So for the next couple of weeks, I will be explaining about vitamins, minerals and supplements required for the body to function better. 

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Let's start with the big C. Vitamin C is a very important nutrient for our body. Humans are the only mammals in the world that does not produce their own vitamin C. Other animals produce C's internally and it plays a major role in their immune system and survival. Because of this, we need to consume vitamin C's on a regular basis to keep our stores up.

In humans, the benefits of vitamin C has been established more and more. It is involved in the formation of certain proteins to make skin, bones, cartilage and blood vessels. It is also useful in wound healing and formation of scar tissue, repair and maintenance of bones, cartilage and teeth, and it also aids iron absorption. 

It also plays a strong role in aiding the immune system and helps alleviate colds, flus and otehr viral illnesses. Historically, it was used to avoid scurvy but nowadays, this problem is relatively rare due to reduced long sea travels. It is also used to maintain gum health, treatment of acne, treatment of bronchitis, H. pylori bacter related stomach ulcers, control of HIV, treat tuberculosis, dysentry, skin infections and help in curing infections of the bladder and prostate.

Recent studies also shown the benefits of Vitamin C in relation to brain functions. It helps reduce depression, Alzheimer's disease, reduce physical and mental stress, improve concentration, improve ADHD and reduce fatigue. It has also shown in a study recently that it reduces heart rate during exercise and reduces the perception of fatigue and exertion. 

Latest studies also show that it aids in heart disease and diabetes by improving endothelial functions and reducing inflammation thus improving the outcome. However, you will need to take more than 500mg daily in order to see the benefits. With improved endothelial functions, there is a reduced risk of artherosclerotic disease which is involved in stroke and heart disease. 

Other benefits of Vitamin include improves glaucoma, prevent cataracts, prevent gall bladder disease, relieves constipation, improves dental caries, improves Lyme disease, helps with heat stroke, hay fever, asthma, cyctic fibrosis, infertility, chronic fatigue syndrome, autism, collagen disorders, arthritis and bursitis, back pain and disc swellings and improves osteoporosis.

High doses of vitamin c has also been used in alternative cancer treatments and as adjuncts to chemotherapy to reduce chemotoxic effects and has shown to improve patient outcomes. It is also an anti-aging supplement that helps reduce signs on aging, whether applied topically, consumed or given IV.

The next popular question that I normally get is how to take the vitamin. Well, for skin problems, the best is to apply topically. If you can get a 'medical grade' vitamin C more than 20% concentration it would definitely benefit your skin by reducing wrinkles after 6 weeks of diligient bidaily application of serum. If you notice I purposely highlighted medical grade, because a lot of cosmetic skin care claim to have more than 20% vitamin C inside their products but in actual fact, when you test them most don't even hit 10%. Sometimes, they put 20% concentration prior to manufacturing and after processing, the vitamin C being a water soluble vitamin, the percentage reduces. If you want to try a good medical grade Vitamin C serum, we do carry a few brands.

The next easiest method is to consume orally. However, most people do not realize that the gut can only absorb 600mg of Vitamin C per 4-6 hours and this also depends on how good your digestive system is. Most Malaysians have really bad digestive system due to diets high in fats and carbohydrate and lack of fiber. We also have a lot of irritable bowel syndromes and leaky gut syndromes which causes poor absorption in the gut. Now with our hair profiler system, we can screen for leaky gut syndrome and improve your gut health with just a simple test. The other issue with concuming orally is the form of vitamin C that you are consuming. Some believe L-ascorbate is the best form to take, the clinical data on it is scarce. And at the end of the day, how much vitamin C can the body actually absorb in a day? Maybe 2 grams. However, really high doses of vitamin C taken orally can cause nausea, diarhoea and abdominal discomfort.

Some medical practitioners advocate intravenous vitamin C in high doses for immune curve shifting. This is to avoid gut wastage of the C's and deliver accurate high doses. The idea has been used for many years in treating people with cancer and severe immune problems and now some are advocating as an anti-aging regime. Personally, I did try 10gms of vitamin C over 30 minutes with a combination of glutathione 600mg, ALA and B Complexes. The infusion was a little bit uncomfortable despite being diluted with normal saline, and I felt stiff in the arm during the infusion process. Immediate effect for me was actually lethargy but I noticed improvements in my skin tone, pigmentation and feel. Immune wise, I guess I improved, because my sinuses improved without needing antibiotics. However, one off therapy wouldn't be sufficient and usually you will need a course to achieve a good concentration. Being water soluble, the vitamin gets excreted out by 3-7 days. However, the high dose concentration for a few hours is what gives the body that extra boost to jumpstart the immune system.

Regardless, if you are unsure or planning to start high dose vitamin C regimes, please consult a medical practitioner that is well verse in the indications, contra indications and side effects. There are some contra indications to the use of high dose vitamin C that you will need to discuss with your doctor to ensure it is safe for you.

For more information please email us at drmmclinic@gmail.com or call us at 03-21106608 or send a msg to 0123301585.

GONG Xi Fa Chai

Farewell to Starhill ....... But its not the End

It has been a gruesome month where if some of you may have noticed, our clinic has been pretty much inactive. I have to apologise to all my patients and blog readers for the hiccup. The reason for the long silence was because we were busy moving. Yes, finally Faceworks has left Starhill.

For the initial part, I thought of taking a break from seeing patients and running a clinic. Faceworks has been my blood, sweat and tears since 2008. Being a lonely captain, it can be tough sometimes especially since the rentals were exorbitant, and the economy was flip flopping year to year. Not to mention the non-stop ongoing renovations that just seems endless.

However, despite the odds, I do have many patients and followers who have supported me all this while. So my initial thought of rest, was cut short. I have an obligation to my patients. So after the move, I started negotiating venues in order to continue my service of care for my loyal patients, to allow them the benefits that they have had before. After a few discussions, finally I've decided to join up with a senior of mine in Gleneagles Medical Office block, i.e. the private clinics.

For this month, the intended suite is still under renovations, so for appointments, I'd have to use his current suite, hence the appointment only basis is a complete must. I've retained one of my nurses Mia to help keep track of all the appointments and assist during procedures. There is so many small things to do and complete like switching phone lines etc, which would take awhile. But do not fret, our clinic mobile and gmail is still functioning - Email us and we will respond as soon as possible.

The coolest thing about moving is I get to breathe better and I get to play with Thermage. Oh yes, my senior has a Thermage that have tips expiring in this year and he has given me the permission to use and promote so that the consumables do not go to waste. So for the past week I have been doing a few Thermage cases, that actually gave not just the patient satisfaction but even my team, especially when my extended protocols for neck, and breasts are applied. I will write a full entry on Thermage in the next couple of days so that you understand what the hype is all about. If you are to curious, you can check out their official page here http://www.thermage.com/ .

So basically, all our usual services are available except for some machines since I need to arrange for them to be moved over. We are thinking to fix up my Starlux, so then I can expand my services to more interesting things. We'll see how it goes. We'll be having a mother's day event to invite patients over to introduce the new place and new services. Do email or text us if you are interested to attend. I also realised that some people are having problems accessing our website. Our website is currently on www.fwclinic.com  in view of a miscommunication with our previous web hoster. Even our store has moved to a different URL but the function is still the same http://fwclinic.com/store/.

I would like to thank all my patients, friends and followers who have been with me and supported us all this way. Without patients, I am no longer a doctor - without the patience and the care, I wouldn't be where I am now. Faceworks in Starhill is much loved, and we had so much fun there with events, parties, memories. It is sad to leave but in order to succeed we need to move on. So worry not, Faceworks may no longer be in Starhill, but we are still available, still functioning to provide to you the best aesthetic treatments with that pampering touch. Hope to see you soon.

For more information or appointments please email us at faceworksclinic@gmail.com or call us at 014-2233268.

Happy New Year... 2014

Its the start of a new year. Time flies ever so fast. Reminiscing back to the earlier days of running the clinic, how much things have changed. Now, my skills are more than grown, I have started to train other doctors for most of the filler and botulinum toxin techniques. I have a good team, with a strong manager to help manage most of the clinic day to day dealings. We've established the appointment only concept that not only allows you to plan for your appointment, but for us to make the best of your time. My foreign patients love this concept, the locals are still trying to get use to it.

We've made a lot of new allies for this year, and new projects are unveiling. We may have dropped a few, but the aim is to move forward, hence we need to focus on the positives. We have good and loyal patients, we have a lot of new ones too. With the new regulations hopefully Malaysia will be able to compete with its neighbouring countries in terms of Medical Aesthetics more proactively and provide overall great service and good reputation.

Unfortunately, there are still a lot of people who fall prey to beauticians doing injections etc, providing so called professional exclusive services. An overall price comparison, their prices compared to doctor prices are pretty much similar with perhaps a few hundred difference. I have been consulting patients whom have had beautician work done on their face and overall most of them are not happy with the work, but the worst part is you can't remove it, unless of course surgically. And most surgeons would charge a bomb for having to clean up someone else's mess, plus the complications that may arise from the surgery.

So for the start of this new year, I would like to give a take home message to all my readers who may consider improving their looks for this year.

5 Reasons Why You Shouldn't Let Anyone Else But A Trained Dr Poke A Needle to Your Face

1. The Face is the first thing a person notices when they look at you. Getting fillers or BTA from an untrained hand may make you look weird / disproportionate / abnormal. Every trained medical aesthetic practitioner goes through measurement training and ratio training that allows them to make an educated assessment of your face's needs and amount required. Beauticians only inject base on what they think is pretty but not based on scientific guidelines. What may be pretty to them may not be pretty to anyone else.

2. Beauticians are not taught surgical anatomy. Yes, they may argue, they have anatomy syllabus in their courses but it is very non-specific and mostly related to massage techniques. Even doctors who are not trained in medical aesthetics have issues with face anatomy (I conduct training, I know) and most only know basic. You need a really in depth knowledge of the anatomy of the structures of your face before you can safely poke a needle in it. There are many areas which you cannot inject or even if you did required high level of care. There are reported cases of skin necrosis, granulomas, etc with filler injections even with the most trained hands, what else an untrained hand? And what more a non-medical personnel who doesn't even have the basic.

3. The collagen that beauticians keep saying they are injecting are not 100% collagen. The source is questionable, most are taken from China since its super cheap there and unlikely to be sterile. For those with religious preferences, most collagen for fillers are bovine (cow) or porcine (pig) in origin. We will never use marine sources because of very high allergy rates in humans. Sometimes, they even use human collagen (which I have no idea how they extract). Another issue is that most of the time, liquid silicone is included in the concoction to give it better volume for less usage and for the effect to stay longer (rather permanent). My simplest advice would be to be inquisitive about the product you use - see the packaging, make sure the box and the filler is the same thing, make sure it is sterile, and make sure you can actually read the label on the box.

4. Any break in the skin allows bacteria and viruses to come in and cause a local infection. Doctors are drilled with need for sterility for all procedures even before they graduate. Beauticians and other non-medical injectors are not trained towards sterility. How sure are you that the needle they use has not been used before, how sure are you that their swabs are not expired? What about communicable diseases? How healthy is your injector? You have no idea about their own medical background. Furthermore, if a doctor's procedure gets infected, the doctor can treat and prescribe antibiotics, what can your beautician do besides ask you to seek help from a doctor?

5. Beauticians charge cheaper? On contrary, you may be paying so much more for what they are worth. Most beauticians will charge 5-10 fold of their cost price, whilst most doctors would charge base on the market price for a certain product and their experience. I had one patient who went to a beautician for a nose filler and was charged RM 15K. Luckily she only paid half, but with the amount of money, I told her she could have gotten a proper rhinoplasty done. She was unhappy with the filler work which made her nose look so big that she was depressed. Then she had to spend another RM 6K to remove it from a surgeon and a few more $$ for a proper rhinoplasty. Altogether, she spent almost RM 50K for something that she could have saved if she had consulted a proper doctor to begin with.

The medical aesthetic industry is a very lucrative industry which most Malaysians are starting to realise nowadays. Hence many people will try to grab the opportunity to be in this industry. Its not a bad thing, but personally I feel that you should only sell a skill that you possess and able to handle inclusive of the consultation and complications. Although the government has imposed certain regulations on Medical Aesthetics and Beauticians, however, enforcement in Malaysia is very poor. Because of this, as a consumer, it is your own responsibility to make an informed educated decision when deciding on any procedure. Remember, all medical aesthetic procedures are elective - take your time to do your own research and sleep on it before deciding. If you are not comfortable with the injector, just walk away. Its your face anyway. Hesitation is better than regret.

Happy New Year Peeps!! Look out for more interesting blog entries for this year.

For more information or to contact us directly please call the clinic at 03-21440080 / 014-2233268 or email to us at faceworksclinic@gmail.com. 

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?

Mirror, mirror on the wall.... who's the fairest of them all....?

I have come across a lot of patients who wanted fairness and even to the point of luminant skin. Being an aesthetic physician in Asia this is not uncommon. The Asian's model for beauty is to have fair flawless skin like the Japanese, and Korean counterparts. So I've decided to give my two cents on it, based on the things that I have read and researched.

Before I start explaining on the products that claims to make a person fairer, first we need to understand the difference in skin types and tans which determines how fair or tan you will be and the factors that lead to a more exaggerated tanning. There are 6 skin types based on Fitzpatrick's Skin Colour Classifications ranging from type 1-Type 6. For Asians, Type 1 are the extremely fair Scandanavians with blue eyes and yellow hair, type 2-3 are mainly Caucasians some are the Japanese and Korean Asians and for people like us, living at the equator would likely have type 4-5 skin type. Type 6 are the African origins or dark Indians. This genetic predisposition to skin colour depends on the distribution of melanin at the basal layer of the epidermis (skin). The environment also plays a role, whereas, where there is a overstimulation of the melanin - leads to more tanner skin. The most common cause is exposure to UVA/UVB sunlight. What it means in simple tense is that, even if we were to exclude environmental factors, our genetic built up will be the limitation to the fairness that we can achieve despite any treatment. I usually tell my patients that if you want to be fair, you can only achieve fairness as much as your non sun exposed areas and not more than that unless you bleach yourself.

According to most of the clinical studies that I have come across, topical Vitamin C in high concentrations does lead to a brightening of the skin because of its anti-oxidant effects and skin healing properties which allows better new skin formations. However, a lot of the creams/serums in the market have problems in delivering the vitamin C into the skin effectively leading to reduced efficacy. (Check out blog entry What's Up with Vitamin C -  http://faceworksclinic.blogspot.com/2011_04_01_archive.html ) The better ones are more expensive and prices range from a few hundred for a bottle. Furthermore, you need to use it on a more consistent basis in order to achieve lasting results. 

Similarly, there are some bleaching agents such as hydroquinone (HQ) - which is still the gold standard for treating pigmentary problems. However, long term use of hydroquinone will lead to a condition called onochronosis which is a bluish discolouration of the skin at the area of usage. Onochronosis is really difficult to treat and require multiple laser treatments to reduce the appearance. This was the main reason why there is a lot of bad press and reports on HQ. A lot of beautician products use HQ in the creams to get fast results as fast as 1-2 weeks but in long run causes damage to the skin. The FDA approval for concentration of HQ in skin products is only 4%. I know some beautician products that use up to 8% HQ and is sold over the counter with no restriction. Therefore, if you plan to use HQ to treat your pigmentation issues, please make sure you are under a follow-up by a doctor who actually know what they are prescribing.

Then we come to the non-HQ bleaching agents such as kojic acid, arbutin, mendelic acids etc. The most common nowadays are the kojics and arbutins. In high topical concentrations, you can see an instant lightening of pigments. However, if you are using a topical cream, containing these products, you will only see results after perhaps 4-6 weeks, in contrast to HQ where you see improvement in 2-4 weeks. Because these bleaching agents are taken from natural sources, you can actually use them up to whenever you feel like it without much side effects. However, I have noticed that after 6-9 months, some patients feel that the bleaching ingredient does not give any additional effects and sometimes I shift them back on HQ. Although this may appear to be the miracle product for avoiding and brightening up pigmentation, some people are allergic to these products and develop rash and itchiness. I see this more common with kojic acid preparations.

There are some products in the market which claims oral intake can help lighten up the skin. Some offer vitamin C in high doses of 1000-2000mg daily, others claim glutathione up to 5000mg daily oral intake. Although these may appear appealing, the high concentrations may not benefit in view that the gut can only absorb as much and overconsuming of vitamin C can lead to orange discolouration of skin, gut disturbances, etc. There are some products in the market which contain melanin blockers and acts at the cellular level of melanin production. I found one product interesting called White Beaute. It is an oral supplement that acts as a melanin blocker. I have seen some of my patients who improved in skin tone when taking this product after 3-6 months. The only thing with oral supplements, it takes longer to see the results compared to other methods, and that may be the reason some people prefer not to try it out. I have also tried out oral sunblocks such as Heliocare Oral Sunblock Pynocare - I find that it does give a fair results for about 3 months but prolonged use did not appear to benefit much in terms of skin brightening. But I did notice that I got less sunburnt compared to prior being on the product and you need to take it 2 weeks prior to any sun vacations to get the best results. My consultant consumed this product only 1 week before a beach holiday and she still got burnt, so perhaps the other general precautions such as hat, umbrella,shades and topical sunblock and sunscreen should be applied despite using the product.

Now we go to the injections. The most common injections for whitening sold are the Vitamin C's and Glutathione injections. Personally, I've never tried since I'm pretty happy with my tan, but maybe for research purposes, I would subject myself to this trial in the future. However, I do have girl friends who swear that it really does work. It works fast, but you need a maintenance program to keep yourself fair and you still have to avoid direct sun exposures. Furthermore, in view that you are trying to get the anti-oxidant benefits and the glutathione overdose side effect, you need to understand that there are factors that will cause these injections to not work. Basically, oxidative stressors.

There are many different processes and substances that chronically damage cells and contribute to oxidative stress including:

• Toxic chemical compounds and pollutants in your body
• Hydrogenated fats
• All kinds of pollution , including air, water, and food
• Oils that have been heated to very high temperatures
• Cigarette smoke, directly inhaled or secondhand
• Dehydration
• Too much sugar
• Too much animal protein in your diet
• Geophysical stress like living near power lines or waste dumps
• Microbial imbalance, including bacterial, fungal and viral infections
• Preservatives in your food
• Drugs (over the counter and prescription)
• Artificial food colorings and flavorings
• Plastics
• Chemical cleaning supplies
• Chlorinated water that you drink, shower in or swim in
• Alcohol
• Pesticides in your food
• Radiation exposure
• Psychological and emotional stress

Which is why in smokers, sometimes the whole course does not work. Another issue is gaining a good IV access and being careful enough to not shoot the products too fast because it will cause damage to the vein endothelium. And the most problematic part would be the commitment to come to the clinic according to the recommended intervals. If you skip 1 even, it may not work. I have come across a few alternative studies which links the usage of Vitamin C extreme high does as a cytotoxic agent to treat cancer cells. Therefore, injections for whitening using vitamin C and glutathione although some say may not benefit the person much, I do believe would help reduce oxidative damage that causes aging and is not just an expensive urine. But whether you are willing to fork out for a treatment that you may or not become fair from, its up to the person's personal choice. I would rather the person comes to a proper doctor in a clinic who understand the benefits and complication rather than shoot it up in a beauty saloon or a hotel room by some unlicensed person. Its always better to be safe than sorry. 

So maybe one day we will find a way to lighten up skin even from darker skin subtypes. But is fairness really that important? Perhaps, since we have all been brainwashed since we were really young- remember snow white? Mirror, mirror on the wall........ who's the fairest of them all? My belief is beauty is not just skin deep, it comes from within.

For more enquiries please email to info@faceworksclinic.com or call +603-21440080 for an appointment.

The importance of consultation....

Its the last week of the year and everyone is in the jolly holiday mood until the New Year before we start striving hard. Its pretty quiet in my office too, most people are away for holidays and will only be back in the weekend.

Taking this quiet time, I manage to organize my thoughts and plans for t he next year. Its a lot of things definitely, but proper planning will ensure things get done right. Which is why I decided to talk about consultations.

Many people do not realize how important a doctor's consultation is. Many just assume going to doctors when you have a problem and immediately it will be fixed. In medical aesthetics, it is a different ball game. Aesthetic medicine is an elective procedure to the patient, and therefore a good informed consent must be given before the procedure is done.

Its like going to see a gynae because of infertility problems. You talk to the gynae, she examines you and then puts up the options. She informs you of the pros and cons and you decide based on your expectations and budget. It then allows you to plan ahead as to the suitable time for you to commence the treatment or whether any other treatment is required first before you engage the treatment that you wish to choose.

Its the same with aesthetic medicine consultations. Despite giving online replies, I would prefer to meet up with the patient, discuss expectations and also what is their main concern and explain modalities of treatment. A face to face consultation is important to allow examination of the face or body to give a more accurate treatment plan to patients. It will also allow you to discuss your budget and how you wish to proceed.

Feel free to come and talk to me in my clinic. For appointments, call 03-21440080 or emaill to info@faceworksclinic.com