Welcome Year 2016

 

It is a hot and fiery new year as we leave 2015 behind and enter 2016. Dr MM Clinic is my latest project and as of today has just reached the 3rd month of operation. After almost a year of planning and a few hiccups along the way, finally I've decided to take a leap of faith in changing the whole concept of the clinic to a more functional one.

Besides the usual aesthetic stuffs to keep you young on the outside, Dr MM Clinic also intends to focus on overall health and wellness of you as a patient. We have a few new investigative panels and also our new epigenetics hair profiler that can help detect problems and deficiency with just 3 strands of hair, within 15 minutes of sampling. With this new device, we are able to have a general overview of yourself, to guide you towards a more healthier and youthful you. We also have new stemcell products and supplements to give you the extra boost based on your needs and requirements. 

We have also perfected our aesthetic treatments to give you more solutions to your needs and come up with a comprehensive detox program to lose weight and change your perception towards dieting and healthy eating.

As for the blogs, follow us today and you will discover a lot more about the medical technology related to aesthetics and anti-aging. I will also be posting a few Vlogs that will play a good role of explaining the things I write about.

We also have a few alliance partners i.e. other clinics or parties who offer services that we do not offer and thus you can be assured of the similar hospitality. As for this new setup, Visit us today and take a nice selfie from our beautiful view. The clinic is inside an office building with valet facilities for working days from 9am to 9pm at only RM 5/hour. There is also a basement carpark or if you prefer by foot, it is walking distance from Monorail stations and very close to Pavillion KL and Changkat Bukit Bintang. We have equipped the clinic with toilet and shower facilities for the ease of our patients. There is a comfortable waiting room, and high speed wifi for your convenience. And, as our usual policy, appointment times are flexible to not just working hours, Saturdays, Sundays, Public Holidays, early or late based on the patient's preference but only with prior booking. Otherwise, most likely I am elsewhere sipping a latte and writing the blog.

I'm really excited with this new year and hope the clinic can give its best service to you. Happy New Year Peeps. May this year bring prosperity and good health to me and you.

For more information and details feel free to email us at drmmclinic@gmail.com or visit our website at http://drmarrfaceworks.wix.com/drmmclinic

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.

Know Your Injector........

Fillers and BTA (botox/dysport) are still perhaps the bread and butter of medical aesthetics despite the emergence of new technologies and machines. It is a simple technique requiring injection of products into the skin layers/muscle to create a more appealing youthful look almost instantly. It is a very lucrative business too. Because of this, a lot of people try to learn to inject. Even if they have no medical background. Hence you will see that in certain places, beauticians or aestheticians as they call themselves injecting fillers and products into customers and so-called 'cheaper' price than doctors. (Really?)

What most people do not realize is that hypodermic needles and syringes are only licensed to be used by doctors in this country (and also most other countries as well). Even nurses or MAs are not licensed to use needles unless under the supervision of a doctor or in Emergency cases. I remembered this so well because during my practice in the government sectors, the nurses at that particular hospital refused to do any blood taking and kept quoting this rule in the nurse/MA handbook. Funnily, when you move to the private sector the nurses are all so willing to do injections, especially fillers and BTA.

The thing a lot of people do not get about doing injections to your face, although you can get really good results with minimal downtime, you can also have very bad results that would last you quite a bit and for some cases of those using semi permanent or permanent fillers it can be life long and would require surgery. A lot of people know this, but why do they still risk going to beauticians or other unqualified injectors to do their face? The most common reason is peer pressure, second would be cost and third would be some bad experience with an untrained doctor somewhere that made them lose confidence with professionals. Between fillers and BTA, fillers are worst because usually the beauticians use illegal products that lasts too long and has no reversal.

So for those who wish to indulge in injection rejuvenation, I will give you a few tips:

1. Know your injector - Are they a qualified injector i.e. a real doctor? (A lot of fake ones parading in my country). Are they really trained to do the injections? Not all doctors are trained to do aesthetic injections so they maybe a licensed doctor but may not have the skill. Going for 1 workshop does not quite cut it as being trained. Are you comfortable with the doctor? Has he/she answered all your queries and doubts? Will he/she be following you up? Will he/she be responsible for the work done if any problem arises? 

2. Know your product. What is it that the person is injecting into your face. Is it hyaluronic acid filler? Is it Radiesse or Aquamid? Is it collagen - if it is collagen - purely collagen/bovine/marine or porcine? A lot of the collagen fillers from beauticians are mixed with liquid silicons hence why it just does not disappear. Is the product safe? Just because the person says so, doesn't mean its safe. Ask for safety profile. Are you sure its the product claimed by the injector or did they take out another product from a different box for the injection. Google information about the brand.

3. Are the products sterile? The last thing you want is getting an infection under the skin from using products already contaminated. In my clinic, I open a new syringe in front of the patient to show its sterile. Infections due to contaminated fillers are a nightmare and may take weeks to heal. It would require high end antibiotics, dilution of filler or even excision. In some cases, we would be giving steroids to stop inflammation from the infection. It can cause you to have a mark or a scar from a so-called suppose to be very safe procedure.

4. Is the premise you are receiving an injection a proper medical facility with license? Beauty salons are not licensed to do injections, nor are hotel rooms, cars nor boutiques nor spas. So if it is not a clinic, better think twice because likely the hygiene of the place is not up to par and you cannot sue the person if anything went wrong since it is not in the right premise. You'll just be bombarded by the defense lawyer, stating that you agreed to be injected in the premise when you know its illegal.

5. Check the current market price for services before deciding on having it done to give you a rough idea of what is the normal range. Usually for promotions, the price of the service would not be discounted more than 30% in view the cost to acquire original products is expensive. If the clinic or center is giving too cheap a promotion, you should bear in mind a few things. Its either the product is expiring (already expired) or they've reduced the amount of filler/bta given but charged at a cheaper price. The end result would be unsatisfactory results or treatment not lasting what it should. And this would not only cause disappointment but also reduce confidence towards the treatment altogether.

Courtesy of http://www.plasticcelebritysurgery.com/2011/09/worst-celebrity-plastic-surgery-before.html

For more info you can email us at info@faceworks-clinic.com / faceworksclinic@gmail.com. For appointments, please call us at 03-21440080 or text 014-2233268.

Interesting gifts to help your loved ones.......

Today I've decided to write on something less serious and more entertaining. Having a lot of friends, family and meeting a lot of people, you tend to come across many personalities that sometimes does not appeal to your own positive self. There are just some people who are forever negative, and regardless of how you try to lighten things up, they seem to be able to dampen your spirits. 

Funnily, medical aesthetics does have a lot to do with psychology and maybe a bit of psychiatry. Apparently 60% of the world population are concerned on how they look and what other people perceive onto them. Especially since nowadays, looks play a very importance role in career and confidence. Which is why the cosmetic and beauty industry is one of the most fast growing industries in the world with a 16% increase revenue per annum despite recession. 

So, what can you suggest to your loved ones to make your life happier:

1. Glabella BTA 

In simpler tense, botox / dysport into your muscles that makes the nice 11 on your forehead (frown lines). This is extremely good for those depressing, whining, or stressed out relatives and friends who makes your sunny days go cloudy with their negativity. Apparently, studies have shown that people who are depressed / upset feel less upset when we freeze their glabellar muscles due to lack of frowning feedback from the forehead to the brain - hence the brain registers it as less stressed/depressed/upset thus equates to being happier. Its a simple 5 minute procedure which will cost roughly RM 600 / session (some cheaper services uses BTA from China/Korea) and will last the person between 3-6 months. It may be temporary but at least they stop complaining much for this period of time. How about that for price of peace?

2. Marrionette lines

Have you ever seen a puppet or a marrionette? Puppet shows were made popular in the UK before the invention of television. They would cut out a stage and create puppets or marrionettes on strings and move them around telling a story. One of the most popular puppet shows till today is the comedy Punch and Judy. Marrionette lines refer to lines extending from the edge of the lip to the border of the jaw, just like a puppet. Some people have these lines even when they are not frowning and it makes them look sad all the time. Depending on the severity of the line, it can be fixed with just using BTA to the Depressor Anguli Oris muscles to reduce the pull (only 2 injections at each side ~ RM 200/procedure) or in combination with hyaluronic acid (HA) fillers for a more complete fix. The good thing with fillers is that it lasts between 9-12 months or even longer, so your frowning buddy would look happier for at least a year. Although it may wrack up your wallet a bit (filler prices start as low as RM 1K - 2K for HA). This procedure only takes 15 minutes or less, so you can even drag your friend in during lunch time.

3. Lethargic looking and no luster skin.

Its one of those people who look tired all the time, no matter how much caffeine you pump into their body. Not to worry, perhaps all they need is a chemical peel to get rid of all the dead skin accumulated on their face. A lot of us do not realize but if you look tired most of the time and your skin lacks luster or shine, it could be because of the dead skin accumulation. When the horny layer of the epidermis has too much dead skin and is not exfoliated, it causes the surface to be bumpy, thus when light hits the skin, it does not reflect well and hence looks dull. A simple solution is to try out our Clear & Bright Facial which not only peels off all the dead skin but we also infuse vitamins to your skin to give it a nice radiant glow. The facial takes approximately 20 minutes with no downtime, so you would need not worry about hiding your face for a day. Sunblock is advised due to the peeling process that happens in clinic. Usually this facial would set you back by RM 500/session, but do call our clinic for any special promotions going on.

4. Panda Eyes

Some people look so tired and lethargic because of their panda eye look. Some panda eyes look so bad, you start wondering whether they are on drugs or why they are not sleeping. There are many causes of panda eyes, some being hereditary pigmentation, some being vein congestion. A quick and simple fix that we can do for you is doing a chemical peel and then infusing some bleaching agents at the area, to reduce the pigmented look. Subsequently, we would recommend eye creams/ ampules to help strengthen the skin to reduce the appearance more. As us today about this new treatment.

5. Sagging Sad Face

Some people have sagging skin that makes them look worn out and sad most of the time. A simple Relax-F facial will be tightening up skin in no time. Even after the first session, there is a mark improvement and after a few more, the skin will appear tighter than ever. The best part about this facial is that it is painless, takes approximately 30 minutes and no downtime, and results can last up to a month even with 1 session. For a more lasting and faster effect, you can combine this with our liposome face-neck-low neck ampules. With DMAE as a powerful skin tightener, the sagging face will be no more in no time. Hence, gone is the need for facelift or threads which are more invasive.

Here are but a few gift ideas for your loved ones. Email us for more solutions to day to day problems.

For more info please call 03-21440080 / 014-2233268 or email to info@faceworks-clinic.com

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

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

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

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

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

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

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

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

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

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

Medical Aesthetics for age groups......

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

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

Early 20s (18-25)

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

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

Late 20s- 30s (26-35)

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

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

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

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

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

After 46 (46 to 65 or more)

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

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

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

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

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

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

1. Tiox-C Glutathione and Vitamin Capsule tablets.

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

2. Linurase Serum from Phiderma

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

3. Double X from Nutrilite

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

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

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

Face shaping..... it only takes 5 minutes.

I have been busy with multitudes of tasks - events, training sessions, functions, patients, kids - you name it, at some point, I feel like I need to either clone myself or grow extra 4 arms but then I'd be too weird. During one of my training sessions, one of the doctors I was training asked me to teach them masseter hypertrophy botulinum toxin A injection technique.

Before I go to detail, masseter hypertrophy is a term to use when your lower cheek muscles are enlarged. What is so important about this? This is one of the reasons that makes a person's face more rounded and they feel that they lose the sharpness of the jaw angle. As Asians, most of us tend to have a square face due to a few reasons i.e. the anatomical structure of our skull which is rounder compared to caucasians, and our diet and habits which includes chewing of nuts and pacifiers when small, and also teeth grinding problems (bruxism). It also helps to reduce bruxism so this is also another indication besides beauty. Other causes of the face appearing to be more square would also be excessive fat around face area and enlarged parotid glands hence eliminating the angle of the jaw. 

So how to know whether its due to muscle or other tissues? Just do a simple test. Clench your teeth and touch your cheek in front of a mirror. If you feel a stronger bulge when you clench I can assure you that it will most likely improve with botulinum toxin injections. 

A lot of people will ask me, is it safe? Yes, if the doctor knows what he/she is doing. The common side effect from the injections is feeling of heaviness of your lower jaw which usually makes you feel lazy to chew or eat. Occasionally you may have some temple muscle spasm if the injections were too high, and the other thing is your jaw may feel loose or weaken. This feeling usually lasts between 1-3 months, and subsequently you will regain normal feeling. But what is more exciting is that you will start seeing a more slimmer face as fast as 2 weeks and it will stay up to 1-2 years depending on a few factors:

1. How strong your muscles were to begin with.

2. Your eating and chewing habits.

3. Dose given during the 1st visit.

Personally, I prefer to give high dose of 200-260 units of dysport (Cost between RM 2500-RM 3000)  - or botox (different units) during the first sitting and review my patient at 1 month, then 3 months and then decide whether more is needed. Usually after 1 session would be suffice, unless the patient has habitual chewing or bruxism then they would need to repeat every 6 months. Some doctors prefer low doses but multiple visits.

The best results are seen in the younger age group, because of better skin turgor. In more advanced aged patients, sometimes they will complain of loose skin, as the muscle bulk disappears. However, this can be fixed by skin tightening procedures like RF or laser tightening. Another issue that usually pops up is that when the jaw is reduced, some patients will notice their chin appear to be smaller. This can also be fixed by putting in fillers for chin. 

How many injection points? There are many techniques but for ladies, I prefer 3 points, men usually 3-5 points depending on muscles size. This procedure also helps to fix facial asymmetry due to uneven muscle size and another benefit is the compensation of your upper cheek muscles make your cheeks look fuller after 3 months. So, because of this, I'd normally tell my patients who want to augment their cheeks to wait 3 months after this procedure to avoid the cheeks to look over done. In most cases, I don't even need to inject the cheeks anymore.

It is painless, simple and takes 5 minutes and results can be seen as early as 2 weeks. Oh, I forgot to mention, I just had mine injected less than 2 weeks ago and I am already noticing the difference. Also loving the fact that I don't feel like eating much so its easier to maintain my weight after the HCG diet I just completed. Will definitely post up my own photos for you to see the difference.

Interested to know more or to do the procedure? Please contact the clinic for an appointment today at 03-21440080 or email info@faceworksclinic.com for more questions.

Botox and Fillers Q & A

Botox and fillers are the bread and butter for any aesthetic physician. It is what differentiates us from normal general practitioners. However, in my consultations, I have noticed that a lot of my patients have the initial belief that everything injected to the face is Botox. So instead of writing up long entries, I decided to write this as a Q&A session for better understanding of injectibles (injectibles : things that you can inject) .

1. What is Botox or BTA?
Botox or BTA is a protein derived from botulinum A toxin which is a type of bacteria that causes tetanus.

2. What is Botox used for?
It is used to relax muscles and therefore can be used to reduce spasticity in celebral palsy children, correct ticks and strabismus problems, and in medicqal aesthetics we use botox and BTA to relax muscles that forms wrinkles i.e. get rid of dynamic wrinkles. We can also use botox for face reshaping, calf reshaping and to reduce excessive sweating.

3. Is Botox safe?
Depending on the indication of use, you will need at least 5 vials of botox or 10 vials of BTA to cause paralysis of the whole body. The usual clinic use is half a bottle for one patient.

4. How long does it last?
Botox usually lasts 3-6 months but it will depend on the body's self metabolism because we do observe that active young people have a shorter duration of botox span compared to a more elderly less active person. Also, we do notice that repeated botox injections would prolong the duration that the effect lasts. However, there are some people who develop resistance to botox i.e. if too frequent injections were given. Therefore, we normally recommend the first follow-up to be around 3 months, and subsequently only twice a year or less.


5. What are fillers?
Fillers are substances used to fill up areas of the face and body which needs to be filled. Usually fillers are used on the face to enhance features or to return volume loss due to aging.

6. What are the types of fillers and duration it lasts?
There are many types of fillers as follows:

• Hyaluronic acid fillers (lasts 6-24 months depending on type, area and molecule size)
• Calcium hydroxypatite filler - Radiesse (lasts 15-18 months)
• PRP fillers derived from own blood (Lasts up to 15 months)
• Bioalcamid - lasts up to 3 years.
• Fat harvested from other parts of body (lasts 3 months-3 years depending on skill of surgeon).
• Collagen fillers (last 1-3 years depending on skill of surgeon)
• Silicon liquid filler - permanent but banned due to complications related to cancer.

7. Are fillers safe?

Technically they are except silicone, but it really depends on the skill of the injector.








8. Can you do botox and fillers in one sitting?

Yes.



9. Are the procedures painful?

Botox is usually tolerable with ice numbing prior to procedure. For fillers, it will depend on type and area injected. Hyaluronic acid fillers are the least painful. Nose tip and lip injections are painful but the doctor can make you comfortable by giving proper local anesthesia or nerve blocks.



10. If I had botox or fillers does it mean forever I have to use the products?

Contrary to belief, no you don't. However, vanity is addictive and the reason most people repeat the usage of these products because they are cheaper than permanent procedures, safe and has a short downtime. It will depend on your individual assessment of yourself.

For more personalized info, please email us at info@faceworksclinic.com .