7 Facts You Need To Know About Adult Acne

As an aesthetic doctor, I meet many patients with adult acne, and they are often very perplexed and troubled by it.

"I'm 35!" One woman tells me. "I haven't had acne for 15 years!"

One gentleman has lived with acne that has covered his cheeks and chin since he was 13.

Another woman wants to know how she can prevent the recurring acne that appears on her face every month just before her period. As a person who has many social engagements, having pimples greatly affects her self-confidence.

Which Facial Treatments Really Work? Part 2 - The Best From The Rest

This post is part two of my two-part post on facial treatments that really work. Read part one here, to read more about the supposed and actual benefits of treatments such as gold, diamond, snail mucus, bee venom and caviar.


This post at beautyeditor.ca discusses why spa facial treatments are not really good for your skin. This New York Times article also explains why dermatologists don't recommend facials for optimal skin health and beauty. This article quotes Professor of Dermatology, Doris Day, MD about spa facials: "I call it 'spa science' because there isn't a lot of science behind many of the claims." She further adds,"Think of a facial as a treat rather than a medical treatment." Good at-home daily facial care can preclude the need for costly facial treatments. 

Which Kind Of Under-Eye Circles Do You Have?

Dark circles are a common beauty problem, but not all under-eye circles are created equal. The color of your dark circles can help you decide what kind of treatment is most effective for your condition.

Is Skincare Enough? The Truth About Skin Care and Aging

The amount of skin care products available on the market is staggering, with existing brands releasing new ranges all the time, and new brands coming on to the market everyday. They are marketed for acne-prone, mature age, pigmented, oily, sensitive, combination skin, in too many varieties to count, each marketing a special ingredient or function. I know that when my wife visits the cosmetics and skin care counters, I'd better get a comfortable place to sit because it will be a long wait as she goes through her many options!

As an aesthetic practitioner, skin care is my expertise, so it is not unusual that I am asked this question: If I take care of my skin and have a good skin care regimen, am I doing enough for my skin to help it age well?

Laser Facials - The Future Of Skincare

Jennifer Aniston keeps her skin youthful
 with laser facial treatments

Laser facials have been getting a lot of attention in the press of late, after Jennifer Aniston publicly announced that they are the reason she looks closer to 25 than her real age of 43. Other celebrities like Kim Kardashian and Courteney Cox have also been quoted in the media talking about procedures such as Fraxel as part of their beauty maintenance regimes.  

Much as the regular visit to beauty salons for a facial rejuvenating mask and steam session was the norm in previous years, the trend today is for doctors to offer lower-powered, no-downtime laser sessions that can deliver on all of those spa treatments' promises of anti-aging, skin beautifying and rejuvenation. These laser facials are designed to fill the gap in your skincare regime, when you don't necessarily need or want a full laser resurfacing, but would like improvement on the limited results you get from skincare, spa and salon treatments.

What You Need To Know About Cosmetic Lasers

What You Need To Know About Cosmetic Lasers -

10 Common Myths  About Laser Treatments

Many of my patients are new to the concept of cosmetic lasers, and are understandably concerned about their use. They have heard so much about the potential of lasers to damage and permanently scar the skin, and often are swayed by claims made in the media and advertising about the ability of various creams or beauty treatments to replace the effects of laser treatments. Here I have listed some of the common misconceptions about cosmetic laser treatments, and I hope to help dispel some of these common myths.

The Eyes Have It - Younger Eyes Nonsurgically

When you look at a person's face, the eyes are always the focal point. Sadness, joy, delight, disgust, anger, fear, outrage or indifference, the eyes show us emotions, expressions and are a pivotal clue to our body language.

The eyes are not just a window to your soul, but  also  an indicator of your health, stress level and physical well-being

The eye area is also very easily affected by stress, whether from illness, fatigue, emotions or environmental factors. This stress, combined with the constant movements of the muscles surrounding the eyes contributes to wrinkles, crepe-like skin, crow's feet, eye bags and under-eye circles.

Effects of aging and stress on the eye area - 

Addressing the problem - The Madonna Eyelift

The Madonna Eyelift is named after the famous pop star, who had the procedure done to improve her eye area. The results are very dramatic, giving you years off your age, and refreshing and brightening your looks.

Can you believe Madonna is 54 years of age?
Her eyes don't give her age away.

The technique involves a fractional laser procedure in the upper and lower eyelid areas, which leaves skin tightened, lifted and smoothened. The procedure takes only 10 minutes to do both eyes, and about 3 -5 sessions may be necessary for optimal results.

Just as fractional lasers help to restore collagen, smoothen skin surfaces, and erase fine lines on the facial area, it works in the same way on the eye area. It is important to note that the technique has only been proven on certain fractional lasers, and specialized training is required for any doctor who is doing the procedure.





Watch Dr. Bruce Katz, the pioneer of the Madonna Eyelift, do this procedure -

The Madonna Eyelift is a minimally-invasive, low downtime procedure that gives you a refreshed, brightened eye area, with results that are very rarely seen with topical creams and serums, for example.  Botox, fillers, thread lifts and surgery can be used in conjunction with the Madonna Eyelift in severe cases.

Cosmetic Medicine, MD

Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and  conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or email. 

Collagen Supplements - Do They Really Work? What Does?



Old or young? The difference is collagen

I've had many patients come to me and say they take excellent care of their skin,with a regimen that includes regular beautician visits, expensive skincare and that latest must-have - collagen supplements. Usually available in a drink, and costing up to USD100 per bottle, these supplements are not cheap, but come with a lot of promises for prolonged beauty and general health.

 

Collagen - is it really so important?

Collagen is a natural protein component of the skin that acts like a scaffold and the main building block for cells, tissues and organs. About a third of the protein content in your body is made up of collagen, which is found in the bones, muscles, and tissues of the organs. Collagen, keratin and elastin give the skin its strength, elasticity and structure.

The body naturally produces the collagen that it needs, but this production is gradually disrupted as part of the natural aging process. Women produce less collagen than men, and this collagen is lost at a rate of about 1% per year. This means that a woman has naturally lost almost half of the collagen from her skin by the age of 50.

Collagen is also greatly affected by environmental stresses such as sun exposure, nutrition, skin damage, and exposure to toxins such as pollutants, cigarette smoke and recreational drugs. With decreased collagen, the skin loses its natural elasticity and firmness, and fine lines, wrinkles and sagging appear.

 Poor collagen levels also affect the bones, and this picture (right) shows how collagen loss affects facial shape in extreme age degeneration.

Here's to your youth - anti-aging drinks claim to deliver beauty in a bottle, but do they really work?

 

Collagen supplements claim to offer a range of benefits, including

• reducing wrinkles
• reversing age of skin
• tighter skin
• plumps up skin
• improves skin elasticity

The truth is, however, that there is little to no evidence that beauty supplements, pills and drinks can do what they claim. Collagen is a type of protein which when ingested, is broken down by the digestive system into individual amino acids to be recombined by cells according to their needs.  

So many companies have jumped on the collagen bandwagon that it is very hard for consumers to realise that there is actually no scientific proof that collagen supplements have any effects on skin health and appearance at all. There is no guarantee that drinking collagen drinks would be any more effective than any source of protein such as meat, cheese, eggs or beans at restoring the collagen in your skin.

So if you can't get collagen through a drink, what about collagen in skin care products? Most collagen molecules applied to the skin in lotion, cream or gel forms are far too large to be absorbed into the dermis - they merely lie on the surface and get washed or rubbed off. There are some companies that are selling micronized collagen which are meant to be small enough to be absorbed into the skin, but it is unlikely these micro molecules would be in any form useable by skin cells. It is also highly likely that any collagen that actually manages to penetrate the skin would be challenged by the body's immune system as a foreign body. They would either cause an allergic reaction or simply be destroyed by the white blood cells before they manage to be of any benefit to the skin whatsoever.

What really works?

The abundance of collagen supplements on the market tells us that many people are genuinely concerned about their skin health. So, based on the best dermatological and anti-aging expert advice, what can be done to ensure we show up at our 20-year school reunions with our best faces forward?

Reduce collagen degradation
To ensure sufficient collagen in the skin, first prevent loss of the collagen that you already have. If you are not already on a proper sun care regimen, that should be your first priority. Studies have shown that sun protection is one of the most important ways in which you can combat aging. Cigarette smoke, like sun exposure, has also been shown to greatly degenerate collagen, and there is also evidence that improper and insufficient sleep has a negative effect on skin health. Read more about tips for choosing a good sunscreen in this previous post.

A nutritious diet
Eating the right foods and getting good sources of antioxidants from fruits and vegetables is very important for collagen production. Brightly coloured produce such as tomatoes, grapefruit and watermelon contain the powerful antioxidant lycopene, which helps prevent collagen degeneration. Fruits such as oranges, strawberries and red peppers also contain Vitamin C, something that is key for the optimum condition of the skin. Vegetables such as broccoli, leafy greens and cauliflower provide our skin with glucosinolates, which fight the free radicals that attack our collagen. Also key to skin health is the omega-3 fatty acid known as eicosapentanoic acid or EPA, which has anti-oxidative and anti-inflammatory effects to help protect and heal the skin. Omega-3 is readily available from food sources such as oily fish and spirulina. Avoid starchy foods and sugary substances; this helps
reduce inflammation which interferes with the body's natural collagen production processes.

Proper skin care
The right skin care helps regulate the optimum skin condition so that it is protected from extreme stresses. What works? Regular exfoliation with a gentle exfoliator scrub, or with alphahydroxy acids (AHAs) can help to 'exercise' the skin, and ensure healthy cell renewal. Skin care products that have been proven to help combat aging include products that have antioxidant properties, examples of which include green tea extracts, coffeeberry and DHEA. Try products with retinol, a Vitamin A derivative, sometimes known as Retin-A, which works to both stop collagen degradation from the effects of UV exposure while boosting collagen production.


Collagen Stimulating Dermal Fillers
Hyaluronic acid, a natural water-binding component of the skin, helps to stimulate collagen production by surrounding fibroblasts - the skin cells that produce collagen  - with plenty of water. As the skin ages, this important component of the skin also suffers a decline. 
 
Researchers at the University of Michigan medical school found that Restylane injections (Restylane's key component is hyaluronic acid) not only stimulated the fibroblasts around them to increase collagen output, but also seemed to be protective of the existing collagen in the area as well. The two top hyaluronic acid dermal filler brands are Restylane and Juvederm, and they work by immediately filling the area to plump out lines and wrinkles. The effects of the filler are enhanced by the collagen stimulation, so patients tend to need repeat sessions less frequently. 

Just like hyaluronic acid, poly-L-lactic acid or PLLA, has been shown to stimulate collagen growth. PLLA is a major component in Sculptra dermal fillers, which are injected deep into the dermal layer in a three-session treatment program which lasts up to two years. Sculptra has been proven to correct both collagen loss and fat atrophy, and is also FDA approved for AIDS patients who have severe cheek lipoatrophy (fat loss).

Radiesse, which has calcium hydroxylapatite as its collagen stimulating active ingredient, is another dermal filler that works very effectively in restoring volume in patients with deep lines or sagging skin. The effects of the collagen stimulation allows the volumising effect of Radiesse to last for about 12 months or more. 

Laser and RF collagen stimulation
Collagen production slows with the aging process, but where the skin is injured, collagen production is increased as part of the skin healing process. Aesthetic equipment such as carbon dioxide and Fraxel lasers, and radiofrequency modalities such as Thermage and Ultherapy all work by subjecting the skin to controlled damage, so that collagen renewal can be stimulated. All of these methods work very well to tighten the skin and improve its appearance, although lasers are designed to stimulate regrowth on the surface and epidermal (top layer) areas, and radiofrequency skin tightening works in the deeper dermal areas for greater wrinkle and line rejuvenation.



- Cosmetic Medicine, MD


Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and  conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or drop him an email at cosmedmd@gmail.com  

Botched Laser Treatments - Stay safe!

This article in today's The Star reports yet another case of laser treatments gone wrong at beauty salons in Malaysia. There have been many such cases, sometimes involving laser or IPL machines, but there have also been cases where botox, filler or 'nutritional' injections of questionable source or content have also gone horribly wrong, not just here in Malaysia, but in the region and throughout the world.

I would like to remind consumers to be wary when seeking any kind of treatment that involves a high degree of risk, or relies heavily on the skill of your service provider. Any time you are seeking to do a treatment such as lasers - a procedure that essentially damages the skin in a controlled way, in order to achieve a specific effect such as skin cell renewal or destruction of skin structures such as hair follicles - it is also vital that you have a certain amount of trust in the service provider.  You need to know that the person handling the machine has been well trained to understand what the effect of each turn of the dial or push of a button, on your skin will be. It is unfortunately much harder to be certain that the equipment they are using is reputable, reliable and has been thoroughly tested and calibrated to give the desired effects.

Scars, blisters and burns are some of the dangers of bad laser treatments

Even medically approved laser machines have vastly different modalities, and the protocol involved has to be carefully planned through tests and actual user feedback for maximum efficacy. Though there are protocols given by laser equipment companies, and sometimes expert users who have had personal experience with real-life hands on treatment, each service provider - which may be your aesthetic doctor, or an assistant under the supervision of the doctor - still needs to have the skill and knowledge to adjust the equipment to each patient's personal needs.

I spoke before of the risks involved when choosing laser or other beauty treatments by price sensitivity, but it is very important to realise that laser equipment in particular, can vary greatly in cost. A machine from a reputable laser company can cost upwards of USD100,000, whereas a cheap salon set can be had for merely USD1000. When you factor in the cost of disposables, manpower, and upkeep of premises, the fact that a treatment can be had for the cost of a cup of coffee and a slice of cake should alert you to be wary of the results to be expected.  

CosMed, MD

How To Age Like A Celebrity And Look 30 Forever

There are some lucky people who never seem to face the ravages of time. Celebrities like Madonna, Tina Turner and Demi Moore are some examples, and despite being over 50, they manage look better than people 20 years their junior.

Christy Brinkley will celebrate her 58th birthday this year, but  her looks remain forever 30.

Aging is a process that is greatly affected by genes, environment, sleep habits and diet to name just a few factors, but since this is a cosmetic medicine blog, and my patients come to me to reverse the effects of time rather than prevent them, let's examine exactly how a face ages.

As the face ages, it undergoes significant and visibly identifiable changes

As the face ages, it undergoes significant and visibly identifiable changes. It begins with weathering of the skin, and changes to the texture, transluscence and variance in skin colour in the mid twenties. By the mid thirties, furrows and lines are visible in forehead and near the eyes. Loss of fat from the temples and upper cheeks may show by the age of forty, and the undereye area is one tell-tale sign of aging as the skin begins to sag and pouch. The neckline is also an age giveaway as it becomes loose and baggy during the fifties. By the sixties, the skin is noticeably lined and very loose and saggy as the cheek fat atrophies.

How to Turn Back The Clock

1. Loss of volume
Lipoatrophy, the loss of fat in the underlying facial structures means the facial skin begins to sag, the cheeks become sunken and gaunt, facial shadows become more pronounced and lips become flatter and thinner, jowls appear on the sides of the face, and the neckline is visibly looser.

The Fix: Thread lifting, fillers, Thermage

Thread lifting for jowls and sunken cheeks




Fillers for deep lines and for plumping cheeks, lips and sunken areas

Thermage for overall facial rejuvenation and collagen remodelling

2. Skin texture and pigmentation
Environmental effects such as sun exposure and air pollution, as well as hormonal changes and effects of diet all play a part in the appearance of the skin as we age. The skin also gets thinner and fine lines appear, while melanin deposits and surface damage all contribute to obscure the glow of healthy, young skin.

The Fix: Skin resurfacing

3. Wrinkles and lines
Wrinkles appear in forehead, eye, cheek and around the mouth, as a result of the loss of fat and also due to constant muscle movements.

The fix: Botulinum-A injections


There are many exciting techniques for holding back the ravages of time, and ensuring you look your best, even into your 50s and 60s. These treatments are best used in combination, for a natural look that is purely you, but just younger, brighter and refreshed, so you too, can look and feel like a star, no matter your age.

Cosmetic Medicine, MD

Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and  conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or email. 

Body Contouring - Newest Technologies for Getting The Body You Want

Body contouring is of huge concern to many people, old or young, fit or unfit, and the growing trend is for less invasive, low risk treatments with proven efficacy. Even as economies around the world tighten their belts, our physical waistlines are getting bigger. In Asia, there has been a steady growth in the body shaping and tightening market. While not a replacement for diet and exercise, body contouring treatments are an effective way to spot treat problem areas such as abdomen, back, hips, thighs and upper arms. Some equipment are also approved for double chin areas.

Non-invasive body contouring treatments generally work by the application of some sort of energy, such as radiofrequency (RF) or ultrasound, to disrupt or destroy fat cells that are then flushed out through the body's waste drainage system. Results are rarely immediate as the body's elimination process can take up to six weeks. Best results are also seen with repeated treatments, as each session is designed to target only a certain percentage of the fatty layer to prevent accidental damage to other areas of the body. Most treatments are quick, relatively painless and require no downtime, which are all factors contributing to their popularity. 

Here is a list of some of the latest treatments and modalities available, as well as a general picture of how the treatment is conducted. Bear in mind that best results are seen when used in combination with proper diet and exercise, and that results are generally modest compared to liposuction. Fat loss from these treatments are generally permanent with dietary moderation. The best canididates for non-invasive body contouring treatments are those who have a BMI less than 30, are generally fit, but with unwanted pockets of fat.


MedContour / Vaser Shape
MedContour (Vaser Shape MC1 is the name used in the US) uses external ultrasound to target cellulite and localized fatty deposits, and combines it with a massage therapy for lipo drainage and boosting the metabolism.
The machine uses two angled transducer heads to shoot two beams of modulated energy through the skin. Each beam is harmless, but when they meet, the combined energy heats up the targeted area, causing fat cells to vibrate and be destroyed. The treatment is akin to warm massage. The lymphatic massage is delivery using a separate suction applicator, and is a quick and painless adjunct to the treatment.
Typical treatment time is 60 to 90 minutes, and the treatment can be repeated every week. A minimum of four treatments are recommended to see lasting results, with up to three centimetres lost after every procedure.

Before                                                               After
MEDCONTOUR /VASER SHAPE

Coolsculpting by Zeltiq
Zeltiq is a US FDA-approved cryolypolisis treatment. Based on research done in the USA on the effect of cooling on fat, Coolsculpting essentially freezes the fat cells, causing them to die and be eliminated from the body.
Every session typically eliminates 20-22% of the fatty deposit and takes one hour per area. During the session a suction cup is placed over the fatty deposit, the fleshy area is vacuum suctioned into the cup and a sustained cooling procedure is applied. The actual treatment process is very comfortable, with most patients experiencing some minor discomfort when the machine is removed. Most people compare this discomfort to the feeling of pins and needles that occur when you remove your hand from a bowl of ice-cold water.
The treated area can feel numb for several days after the procedure, and a repeat treatment can be done two months later. Results are generally seen by the first month after the first treatment, with up to three treatments recommended depending on the amount of fat. 

Before                                                                                       After -
COOLSCULPTING

Zerona Laser
Zerona Laser is a cold laser is that US FDA-approved for loss of inches from the waist, hips and thighs. This technology was proven to create a pore in fat cells to drain away the fatty contents while doing no harm to the surrounding capillaries and organs. The body then removes the drained fat by the natural detoxification process. The process does not employ any heat, so discomfort levels are very minimal, and clinical studies have shown an average of 3 - 9 inches lost per six treatment cycle.
Each treatment involves a cold laser being projected onto the abdomen, hip and thigh areas for 20 minutes on the front, and 20 minutes on the back. The treatment must be repeated every 48 hours for maximum results, and a minimum of six sessions are given within a two week time frame.
A dietary supplement known as Curva is given in conjunction with the Zerona treatment to enhance the lymphatic drainage effects of the procedure.

Before                                                                                    After
ZERONA

UltraShape 
UltraShape uses pulsed focus ultrasound and vacuum-assisted radio frequency technologies to target and shrink localised fat deposits for a reduced body circumference and improved body shape.
The one hour treatment involves an extensive preparation in which the target area is measured, marked and surrounding areas covered with protective sheets. During the treatment, focused pulses of ultrasound are directed all over the targeted area, and energy levels are adjusted to maximize comfort of the patient. The ultrasound pulses destroy fat cells, while selectively prevents harm to surrounding vessels, tissues and cells. After the ultrasound treatment, the vacuum radio frequency head is applied briefly to assist in the drainage of the destroyed fat.
A minimum of three treatments given two weeks apart are recommended for proper results, and an average of a 4cm circumference reduction has been demonstrated after three treatments.

Before                                                     After
ULTRASHAPE

LipoSonix
LipoSonix is the newest player in the body contouring market, and employs a high-intensity focused ultrasound methodology to disrupt subcutaneous fat. This US FDA-approved treatment delivers precise and consistent thermal energy to the targeted areas, and energy levels are adjusted to suit patient needs. The advantage of this treatment is that even areas with smaller or harder fat deposits that are hard to treat with other procedures are treatable with LipoSonix.
The one hour treatment session involves positioning of the energy transducer head on marked treatment areas and a mild warmth or tingling sensation can be felt as the ultrasound waves are delivered, heating fat cells to 56 degrees celcius to ensure their destruction.
Each single procedure promises an average of a one-inch circumference loss, and full results can be seen in eight to twelve weeks after the body has had time to process and eliminate the destroyed fat.

Before                                                             After
LIPOSONIX

Looking Younger without Surgery

Nobody enjoys the process of growing old, and it is especially distressful when external factors such as sun, pollution, stress, poor sleep habits and so forth cause premature aging of our skin. Fortunately science can lend a helping hand and erase or minimize the damage. From wrinkles, to lax skin, pigmentation and deepening lines, the signs of aging are thankfully very easily dealt with, even if you are hesitant to undergo surgery. If you're looking to improve the ravages of time on your complexion, here is a short list of some of the most popular non-surgical options available out there.

1. Botox
Botox is the most popular anti-aging treatment available, and for good reason. Just one session with your doctor will give you 6 - 9 months free of wrinkles and lines, and at about the same price as a set of branded anti-aging skin care products. It is quick, about as painful as a paper cut, and can make you look 5-10 years younger in a matter of days.
Botox has always suffered from a poor reputation as some people have had bad experiences, but in the hands of a trained professional, the results you get will amaze you. Some people are concerned about getting 'addicted' to Botox, but I find it comparable to a maintenance regime not unlike having a regular facial or haircut. Botox is also useful in the treatment of headaches, neck and back pain, muscle spasms and bladder disorders, which is always helpful when age starts to create more physical concerns in areas other than the face.


2. Fillers
Fillers and botox are almost like husband and wife; they complement each other and work together to create a harmonious effect. Botox works to relax muscles and smooth out wrinkles while fillers work by volumizing deep facial furrows such as the naso-labial folds and deep glabellar lines (frown lines). Fillers are also effective in increasing the fat pads on the cheeks and the sides of the forehead, to reverse the effects of gravity. Fillers can also be used to reduce lines around the lips, volumize the lips, plump up sunken under-eye areas, and have been used to replace lost fatty deposits in areas such as the breast and buttocks. There are too many filler brands to count, such as Radiesse, Juvederm, Restylane, Esthelis, Macrolane and many more. Different fillers are indicated for different uses, but in general are all very successful at volumizing lines, wrinkles and sunken areas. Sculptra is one that is especially designed for long-term re-volumizing, and helps to boost collagen production as well as fill in sunken areas.


3. Skin Tightening & Lifting Therapies
Skin tightening and lifting is important as gravity and collagen loss create the sunken areas and deep lines that are seen on aging faces. While a face-lift will always provide the most dramatic results, a range of non-surgical therapies such as Thermage, Ultherapy and Exilis are available.
Thermage burst onto the scene about 6 years ago with its promise of non-surgical, non-invasive skin tightening, with a single treatment, no less. Since then, Thermage has become a brand icon, and it has expanded its range from lifting skin on the face, neck and eyes to upper-arms, hands, abdomens, buttocks and thighs.
Thermage works by using radiofrequency waves to heat up the collagen in the skin and produce a rejuvenating, tightening effect. Results are not immediate, but the treatment gives a progressive uplifting effect as the collagen remodels over the next few months. Some patients report an improvement in their facial wrinkling and overall condition of the complexion as a pleasant side effect of the treatment.
Exilis is another therapy that utilizes radiofrequency (RF) to target collagen deposits and boost their production. Commonly used in the facial, neck, decolletage, abdomen, thighs and buttock areas, Exilis is also effective in spot fat reduction. A typical course is 4-6 sessions, and is a quick and painless way to more youthful, tighter skin.
Ultherapy uses ultrasound waves to similarly heat up and remodel collagen, helping to tighten brow lines, smoothen skin on the cheeks, lift sagging eyelids and refresh the overall look of the face, results which are visible from the second or third treatment.
While these skin tightening therapies are not indicated for the elderly where collagen is very minimal, or for those who are severely saggy due to extreme age or weight loss, they can restore youthful tone and give a refreshing uplift for those who are just starting to notice the ill-effects of aging and poor skin care.

4. Fractional Laser Resurfacing
Laser resurfacing modules work by damaging the top most layers of the skin to remove fine wrinkles, pigmentation and scars. Fractional laser resurfacing means that instead of treating all of the skin surface at once, only a fraction of the surface is treated, so pain is manageable and healing is faster. Examples of these treatments are Fraxel, Pixel, ProFractional and Mosaic, which all work in the same way to remove the top-most problematic layer, and allows the growth of younger, healthier skin in its place. A further benefit of this treatment is that skin texture and tone will also improve.

Fraxel - Before and After

5. Platelet Rich Plasma
Plaetelet Rich Plasma therapy involves the use of a patient's own blood, from which platelets are extracted and re-injected into facial areas to boost collagen production. Generally, treated areas include the cheeks, peri-ocular (around the eyes), neck, decolletage, jaw line and back of hands. Results include improved skin texture, tone and overall appearance. Platelet-rich plasma is an established medical procedure which has been used in long-term pain management, joint healing and a proven record in facilitating healing.

5. Stem Cell Therapy
As stem cells are the body's own healing components, stem cell therapy has been hailed for its ability to improve the body's overall condition. Promised results include a better complexion, thicker hair, brighter eyes, improved memory and libido, greater energy and stamina and a better general well-being. There are various methods used in stem cell therapies, from stem cells extracted from a patient's own fat or bone marrow, or in some procedures, using stem cells collected from human or even animal embryos.
While scientific evidence is still contentious as to the true value of such treatments, many are convinced of their anti-aging and medicinal value. This article on USAToday.com highlights just one such satisfied customer, a baseball player who amazed his fans with his brilliant sporting performance after undergoing stem cell therapy.

- CosMed, MD

Four Reasons Why Cheap Aesthetic Treatments Are A Bad Idea

Groupon is one place where you find an
abundance of cheap laser treatments
- but is this in the patient's best interests?

As a practicing aesthetic physician (or cosmetic doctor, which is the preferred term in the US), I am often approached by patients who are unhappy about the cost of aesthetic treatments we offer. Laser hair removal is an especially contentious market - there are so many players out there, offering a whole range of different modalities for hair removal, and it is especially hard for patients to understand what makes the price so varied in what is essentially the same service.


Laser treatments adhere especially well to the old adage "good things don't come cheap, and cheap things are no good." Here's why:

 
1. Standards of Service

When you go to a high end restaurant, you expect a certain level of service. There is a maitre'd or manager who is there to coordinate everything just as an orchestral conductor does. The wait staff are courteous, well-informed and helpful. The chef is often famous, well-trained and well-respected by his peers in his field. Of course, these standards of service are seen usually only at the most expensive and exclusive eateries.

Like the restaurant business, aesthetic treatments belong to the service industry. Similarly, aesthetic treatments come at a high price when the standard of service is set high. Professional medical qualification, aesthetic medical specialisation and equipment-specific training are just some of the costs a doctor will incur, and that doesn't include properly trained staff, which are one of the key components of a professional medical facility.

"Don't expect to pay economy class rates if you want first class service."

 If you don't care if the person who is operating the laser is qualified, well-trained and experienced; if it doesn't matter if the rooms in which you are to be treated will be sanitary and comfortable; and if you aren't concerned with the efficacy, safety and reliability of the equipment you are being treated with, then you will be happy with cheap laser treatments. I wonder if any of the patients who demand discounts would ever do the same at a fancy restaurant.


2. Professional Service

A professional, as the term implies, is someone who has put in a lot of time, money and effort into mastering his skill at his chosen profession, with the view to marketing his unique ability for the benefit of others.

 Any doctor who offers any service, be it a botox injection or a chemical peel or a laser rejuvenation treatment, will do so with his reputation and professional licence on the line. He risks his good name with every patient who leaves his office. As everyone knows, good news travels fast, but bad news surfs the internet!

That's why someone who is in it for the long-haul will renovate his premises to accommodate his aesthetic practice, and invest a lot of time in research, seminars and training, as well as take the time to hone and perfect his skills.
Comparitively, establishments that offer bargain basement aesthetic treatments with wildly exorbitant claims rely not on professional reputation and experience, but depend on these cheap treatments to attract their clientele. I don't know which is worse: the salons that offer cheap and often unethical - and sometimes unlawful - treatments. or the unwise, gullible people who answer their ads.


3. Cost of Equipment
 
You wouldn't think it, but the cost of laser equipment can vary vastly from one to another, from top end machinery that sell for the price of a Mercedes, to those that cost about the same as a scooter.

A doctor who is serious about growing his aesthetic business will invest in professional, clinically tested and health-ministry approved equipment. The best machines, from the US, Europe and some from Korea, must be from companies with proven track records, backup service and who have done the R&D to ensure their products are safe, reliable and with properly designed guidelines of usage. All these add up to make the costs of machinery very expensive indeed.

The prohibitive cost of lasers means that doctors often turn to hire purchase companies to afford them, and this also adds to the cost of end user treatments. Add to this the costs of consumables and extra equipment that some machines require for their operation, and you can begin to understand the costs of treatments at aesthetic clinics.

The beauty salons who offer hair removal at supermarket prices can afford to do so because they buy China-made machines, which cost as low as USD1000 - USD5000 each on Alibaba.com. Like a hundred dollar replica of an actual LV bag, you can never expect to get the same results and satisfaction from these machines compared to true professional equipment.

Patients will have to decide if the risk of complications are
worth the discounts with cheap aesthetic treatments. 

4. Quality Over Quantity

Some aesthetic clinics choose to offer cheap services and heavily discounted packages as a way of attracting patients, but they sacrifice the attention to detail, individualised service and commitment levels of a doctor who is truly dedicated to his craft. If a doctor charges USD100 per patient, he may only need to see 10 patients a day, and be able to spend more time with each. Someone charging USD20 per patient will need to see 50 patients so that he can recoup his expenses. The level of service patients at either spectrum receive of course differ, due to the time constraints and patient demands on the doctor.

When a patient is focused on minimising cost, a doctor cannot spend the time and effort necessary to give a truly optimised treatment. And unlike a cheap pair of shoes that can be discarded when they pinch your feet, a poor aesthetic treatment can cost you much more if a repair job needs to be done.



Just as doctors must maintain a certain fee for treatment due to the high costs involved in setting up and maintenance of an proper aesthetic establishment, so too must they adhere to market rules and adjust their prices so patients will still feel happy to come to them. So, most doctors are happy to offer reasonable prices, commensurate with the treatment offered. Just don't expect to pay economy class rates if you want first class service!


CosMed, MD