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. 

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.