Dermal Grafting for Acne Scars

I came across this fascinating post in an Acne forum where this girl basically describes how her dermatologist has filled out her rolling acne scars with collagen harvested from the back of her ears and has transformed her face to nearly flawless. He combined it with needling of the scar first, then filling a few depressions each time.

Pierre Fournier describes a very simple collagen extraction technique from unwanted fat pockets, so the donor site does not require stitching. Large quantities can be harvested and stored in deep freeze for future use or topical application (mix with night cream for autologous stem cells).

Wonder if we can combine these two technique and add in dermarolling for maximum benefits? Hmmmm.........

The Food Pyramid

This is an excerpt from "Your Hidden Food Allergies Are Making You Fat" by Rudy Rivera MD and Roger Deutsch.

It is interesting that the official USDA food pyramid recommends a large sampling of grains and fruit each day. This pyramid may represent a way to ensure adequate nutrient intake in the form of vitamins and minerals, but it certainly is no way to lose weight. Whereas the USDA food pyramid was not intended as a with loss plan, normal healthy eating should promote normal weight.

As noted by Dr Barry Sears in his book The Zone, the food pyramid closely resembles the proportions of fat, protein, and carbohydrates fed to cattle in feedlots to fatten them for slaughter. I suggest you rethink the food pyramid. If it fattens cattle so well, why would it make us thinner? Observe that "food pyramid" Americans aren't getting thinner; they are getting fatter. And that's not just a coincidence.

The 2001 Annual Meeting of the North American Association for the Study of Obesity revealed preliminary results from a three-centre study comparing the Atkins high-protein diet to a conventional low-fat, high-carbohydrate plan. The researchers concluded that the Atkins diet produced favourable results on weight, HDL (High-Density Lipoproteins, a combination of fat and proteins which carry cholesterol from the cells to the liver for breakdown and elimination from the body), triglycerides (the main type of stored fat in animals), and retention of study subjects.

The low fat plan showed favourable effects on total cholesterol and LDL (Low Density Lipoprotein cholesterol is commonly referred to as "bad cholesterol") and is thought to be a major risk factor for heart disease cholesterol.

Lose the pyramid, folks, it's a bust. And to make your diet work even better, determine your food sensitivities and lock out the processed grains and sweets.

Highlights of 2007

As the year draws to a close, it is apt to remember all that has happened to make 2007 a most memorable one.

Move & Re-Brand

Top of the list has to be our move from Faber House in Orchard Road to our current location in UE Square Shopping Mall. It was a difficult decision as we valued our proximity to Somerset MRT Station. However, the lack of visibility was a killer, and the great UOL unhelpful (understatement of the year!).

So in July, we packed our belongings and in a record three days, moved everything over to UE Square.

We decided to shorten the clinic name from "Simply Aesthetic Rejuvenation & Contouring Clinic" to "Simply Aesthetic". We hired a graphic designer to create a new logo. A brochure soon followed, and our new bags are now in production.

New Team

We've had a few changes in staff earlier in the year, but are delighted with our current team. Mery, who has been with us from day one, is the Clinic Manager, and effectively ensures smooth running of our services.

Ivy joined us mid-year, and has become our champion in machine therapy. Her favourite is undoubtedly the Radiofrequency machine. She takes great pleasure in re-moulding a sagging face and melting away unwanted fat.

Dyna is our latest addition. A Staff Nurse from the Philippines, she has been crucial in getting our liposuction service off the ground. She has had to learn all about Medical Aesthetics, and is currently undergoing in-house training to become a Therapist like Mery & Ivy.

New Machines

We started off 2007 with six machines. We end with about twenty! It all started slowly enough in January, with the acquisition of our "Chocolate" (Diamond Contours Biomesosculpture) machine. Then suddenly, from August onwards, we've been picking up over one new machine every single month! We can barely move for machines now! But that's pretty cool, since we really can provide a very comprehensive range of treatment options for weight loss in particular.

Intensive Training

The rate at which Medical Aesthetics is advancing is tremendous. Comparing this field to say Anaesthesia, there really has been nothing added to routine Anaesthetic practice for the last 10 years! Although we do not provide every aesthetic treatment in our clinic, it was only when we were training Dyna that we realised how much has been added since Ivy joined us!

Training received this year included:

• Curl Lift & Lipofilling Course with Dr Pierre Fournier (Singapore, Aug 2007)
• 3rd Asia Pacific Aesthetic Medicine Conference (Singapore, Aug 2007)
• Arcadia Laser Course (Singapore, May 2007)
• Radiofrequency in Aesthetic Medicine (Bangkok, Nov 2007)
• Minimally Invasive Facial Aesthetic Surgery (Manila, Nov 2007)
• Water-Jet Assisted Liposuction Training (Singapore, Nov 2007)

Looking Forward to 2008

We look forward to offering new and exciting treatments to complement our current services. With strategic alliances locally, as well as in Hong Kong and Manila, we are confident of being at the cutting edge of aesthetic medicine in Singapore.

As we near the peak in our time of rapid growth, we continue to seek a suitable Therapist to join our team. We have also been waiting for additional space to become available at UE Square.

2007 brought many surprises which we did not anticipate. We have embraced many of the opportunities presented and taken the clinic to new heights. We look forward to new opportunities in the coming year, and can only guess at the possibilities ahead.

Doctors turn fat into stem cells to repair breasts deformed by cancer

Source: The Electric New Paper

For the first time, doctors have used stem cells from liposuctioned fat to fix breast defects in women who have had cancerous lumps removed.

The procedure, still in an experimental stage, will be welcome news to those who go through lumpectomies, where a portion of the breast is removed.

For such women, left with 'cratered' areas and breasts that look very different from each other, the options have so far been limited.

Implants? Those are generally for reconstructing breasts after mastectomies, in which the whole breast is removed, but they aren't designed to fix odd-shaped deformities from lumpectomies or radiation.

Explained Dr Karol Gutowski of the University of Wisconsin-Madison: 'Each (problem) is so different, there's no little thing you can just pop in there.'

Mini-implants of fat tissue?

That has been tried, too, but the fat tissue is often re-absorbed by the body or it dies, turning turn hard and lumpy.

Other treatments: Making the other breast smaller to match, transplanting a back muscle to boost the flawed breast, or rearranging tissue to more evenly distribute what's left.

But these involve surgery and leaves scars.

And the deformities left by a lumpectomy can be significant because as much as a third of a woman's breast may be removed.

That is why the recent study - done in Japan and reported on Saturday at the San Antonio Breast Cancer Symposium - has generated such interest.

CELLS THAT SURVIVE

The key is the presence of the stem cells - master cells that can replenish themselves and form other tissues in the body.

Fat cells are rich in stem cells and doctors think the stem cells will keep the tissue from dying and will form lasting mini-implants.

In the study, half the liposuctioned fat was processed for stem cells then combined with the unprocessed fat and injected into the breast.

The company sees potential for cosmetic breast augmentation of healthy breasts, but for now 'our plan is to focus on an unmet medical need' in cancer patients, he said.

The American Society of Plastic Surgeons says doctors must be cautious about using fat cells for cosmetic purposes until more is known.

Internet Brand Hijacking

I started receiving e-mail from a chap named Leo a couple of days back. He claims to be the "Principle of Checking Department" of Shanghai Ou Pu Information Technology Inc. He said someone was trying to register the .cn and internet brand of simply-aesthetic and we were offered first rights to our brand.

Cost of protecting our brand? 30 EUR a year for the .cn domain and 100 EUR a year for the internet brand. Minimum registration period: 10 years!

Ridiculous price!

Then I found this website discussing Chinese con artists pulling the same trick on various people around the world! They use many company names, but the message is the same: pay to keep your brand. And these guys call and call and call! The poor folks in the US get it real bad... The calls happen in the middle of the night!

They are persistant. And yes, they have called the clinic too. I wonder how many people have actually fallen for their trick and paid up. Interesting that they choose to con people in EUR instead of US$ now...

Repeating ALCAT

It's a year since I first checked my blood for food intolerances. At that time, we were still relatively inexperienced with the food intolerance test. My results were most depressing. I had to give up chilli, tapioca, wheat, duck, lamb, chicken, eggs, basil, coffee..... The list did go on, and on, and on....

I've been getting rashes again recently, and sniffing more than usual. I don't stick to the list very well, but it seemed like my body was changing again. Anyway, we repeated the test on Wednesday, and the results came back today! Yep! It's that fast nowadays!

But before I tell you about my new results, suffice it to say that I have not been well this week. My tummy has been playing up really badly: cramps, nausea, diarrhoea, bloating. You name it, I've suffered it! I just assumed food poisoning, but couldn't understand why it lasted so many days.

Anyway, lo and behold, my trigger foods have changed! Quite dramatically! A lot of the things I do really like eating I can now safely eat again! Yay!!!! 

BUT...

Peanuts are now a problem. And tomatoes! And MSG! And coconut and sweet potatoes (so yam is out...). And milk!

Grapefruit, tapioca, safflower and buckwheat are constant between the 2 tests. So those are obviously genetic intolerances. 

We've had tingkat dinners delivered to the clinic for the last 2 months. That would explain the MSG overload. Tomatoes will be tough: spaghetti, pizza, and the sweet & sour fish I have every other Tuesday at NCC!

But peanuts! Darn it! Peanuts were behind this week's suffering! I bought a crispy peanut cake thing from an old Chinese bakery on Sunday. I had that for breakfast on Monday morning. And Wednesday morning. The symptoms started on Monday afternoon and lasted till Thursday! No wonder it seemed to get worse on Wednesday instead of better! And today? I'm fine! Wow!

An Interesting Meeting...

I have been purchasing Propofol for clinic sedation from B.Braun for years. As an Anaesthetist with Day Surgery as my subspecialty, this is undoubtedly my drug of choice for clinic cases requiring deeper levels of sedation. I've used it twice in Simply Aesthetic. Once a year ago for an APTOS demonstration and earlier this week, just to tide my patient through liposuction of the sensitive inner thigh area.

Used properly, this drug is sweet. Fast acting, short duration, rapid recovery. Misused, this turns into a beast that stops breathing, crashes the blood pressure, and can be very frightening.

I was in two minds to even bring my residual stock to the clinic, but I'm glad I did. The patient I had to use it on is even more relieved! And my hesitancy? Knowing how quickly it works and how dangerous it is when used without specific monitoring and airway support, I did not want to add risk to a procedure when I was scrubbed and unable to manage the airway if needed. We manage just fine with simpler forms of sedation during WAL. But if it is needed, I have the facility to provide oxygen if required, and I will scrub out to control the situation as necessary. I'm sure that won't be likely, as knowing the beast allows me to control the beast and tame it.

So I happen to meet Loo, the chap I've been buying the stuff from for years. He mentions that some Aesthetic doctors doing Vasers in Singapore have been buying pumps and Propofol from him. Well, it was only a matter of time. Most have had as much experience with liposuctions as with Anaesthesia (read: none), but that won't stop them. Anyway, Loo recounted stories of flow rates being moved up so slowly no effect was seen. That's just funny. Then he said one patient's BP crashed. Not so funny anymore. He's decided to stop selling pumps and Propofol to Aesthetic doctors. He wisely does not want to be around if disaster strikes.

Is sedation with Propofol such a big deal? Well, I think it is. Many Anaesthetic trainees (even senior ones) would stress at giving sedation with this drug in a clinic setting. There is a very fine line between deep sedation and general anaesthesia. Propofol is used for both. It is my drug of choice for induction of general anaesthesia. It is used alone in a technique called total intravenous anaesthesia (TIVA). Difference between TIVA and deep sedation? Not much. Patients deeply sedated are effectively anaesthetised.

When I use Propofol for WAL, I stop the drug or slow it right down once I achieve my desired end point. The patient remains responsive and is able to turn from side to side as instructed.

And the really cool thing is, the sales rep for Body Jet says that other than one case under sedation, all the other water lipo cases she has attended have been done under general anaesthesia. And we have shown that that is so unnecessary. Hardly any sedation is required!

Your Hidden Food Allergies Are Making You Fat (Paperback)

Authors: Roger Deutsch (Founder of the ALCAT Food Intolerance Test) and Rudy Rivera MD.

This is a book that helps you understand the process by which the body processes foods. Each person is individual. This book will help explain why you fail to lose weight despite eating healthy foods. This book is not just about dieting, but contains a wealth of information about how food sensitivities can negatively affect your whole body and your life. It explains, in easy to understand terms, the science of allergic reactions to foods, how to deal with symptoms, and best of all, it thoroughly describes a simple blood test, the ALCAT test. This test identifies your food intolerances, so that you can develop an individualized eating plan to help lose weight or feel better/get well from illnesses.

Anyone who's taken the ALCAT test will inevitably have many questions which may not be easy to explain. This book helps the average person without a medical background to understand.

We have a few copies of this book available for sale at our clinic. A browsing copy is available from our staff for clinic reference. Each book costs $38. A 20% discount is available for clients who take the ALCAT test with us.

ALCAT Food Intolerance Price Increasing 1st Jan 2008!

We've just had notification that the lab cost of ALCAT Food Intolerance Test will be increased from 1st January 2008 by at least $110! Unfortunately, this inevitably means an increase in price on our side too... Current prices will remain till end of December 2007, after which they will go up by $100. That's right, we'll be absorbing $10 of the price hike.

There's still no signs of the testing being done in Singapore any time in the near future. So the timing for collection is still very restrictive.

Please book your appointment early to have this invaluable test at current prices!

Food Allergy or Food Intolerance? What's the Difference?

My friend Kevin, the General Manager of ALCAT, just sent this nice summary detailing the difference between the two oft confused entities:

Food allergy is mediated by an immune response that requires prior exposure and occurs immediately after subsequent ingestion of the food. It has a very specific trigger (antigen) and antibody response (serum IgE). The RAST technology measures the amount of antibody the body makes against the offending food.

Food Intolerance, Food Additive and Coloring Sensitivities are very different. When the body doesn't digest foods well, they tend to "leak" into the bloodstream in large macromolecules. This can trigger a Cellular Inflammatory Response by the body. White blood cells (WBCs) produce chemicals that break down foreign matter to eliminate from our body. However, a by-product of the process is inflammation. Over a long period of time, inflammation can create a lot of degenerative
diseases.

Chronic inflammation has been linked to digestive disorders, obesity, migraine headaches, Attention-deficit disorders, rheumatoid arthritis and many others. The ALCAT test measures how your body's WBCs respond to the foods. If the WBCs release the chemicals when exposed to foods, then eliminating the food from your diet can reduce the inflammation in your body and thereby reduce or eliminate the symptoms of chronic inflammation and disease.

We believe that because ALCAT measures the cellular response which encompasses both the antibody (requiring prior exposure) and general inflammatory response (no prior exposure necessary), it is the best methodology for food intolerance and chemical sensitivity testing.

Early Experience with Water-Jet Assisted Liposuction

After an exhausting few days of training with Dr Ueberreiter, we are now seeing the fruits of our efforts. The patients have returned for review today, and the post-operative experience has been very encouraging. The bruising is truly minimal, and swelling variable. The larger the treated area, the more swelling seen. Our gentleman patient did not have any obvious swelling or bruising to be seen, and his abdominal musculature was very nicely visible 24 hours after op!

Pain was also mild to moderate, with pain relief only needed for larger ops. In fact, for tummy work, little sedation was needed to tolerate the procedure. We were about to communicate very well with the patients at all times! This meant turning from side to side, lifting legs, etc, were done very easily such that we can check for fat thickness and contour irregularities at any time.

More importantly, we learnt that patient selection is far more critical than with mesotherapy. fibrosis from any cause can make the operation very tough. And fat trapped under fibrosis is very stubborn indeed!

Anyway, it's back to work for us. Lots of clinical work to catch up with. And stock to replace before our next few cases booked for next weekend!

German Plastic Surgeon Launches Water-Jet Assisted Liposuction at Singapore Clinic Simply Aesthetic

(PRLEAP.COM) SINGAPORE - German Plastic Surgeon Dr Ueberreiter, an expert in Water-Jet Assisted Liposuction (WAL), introduces the new Liposoft technique with the Body Jet machine to the doctors at Singapore clinic Simply Aesthetic. This new form of liposuction has the advantage of low tissue trauma and high operative precision, this improving the safety and results of liposuction surgery.

Dr Ueberreiter will be training Dr Christine Cheng of Simply Aesthetic on the technique. Six operations are booked during this period. Some of the procedures are corrective for irregularities developed after other forms of liposuction.

WAL dislodges fat cells with a powerful jet of water, then simultaneously sucks up the water and released fat cells, thereby minimising the swelling normally associated with liposuction. The water jet is too gentle to cause trauma to the blood vessels and nerves, hence there is little bruising or changes in sensation from the treatment. Recovery is fast with little post-operative pain, swelling and bruising.

WAL is the only liposuction technique that allows precise intra-operative contouring as large volume tumescent infiltration is not required as with other liposuction techniques. Minimal sedation is required, so the patients are able to re-position themselves during the operation, thereby allowing any contour irregularities to be detected and corrected.

The technique also allows large volumes of fat to be removed. In Germany, up to two litres of fat can be safely extracted from up to six operative regions.

WAL will be the definitive treatment for body contouring at Simply Aesthetic. This procedure is complemented by non-invasive treatments for skin firming and cellulite reduction.

Dr Ueberreiter will be in Singapore from 22nd to 25th November 2007.

Source: PR Leap (Nov 22, 2007)

RSS Feeds for Updates

RSS (Really Simply Syndication) Feeds have just been added to the Simply Aesthetic Blog. It's my first attempt at playing with this technology, so please do contact me if I've not done it quite right! I've checked the feed to My Yahoo! and it seems to work nicely. Yay!

Why this foray into deeper tech-land?

Well, I figured I'm not the most disciplined Blogger in the world. With "littering" all over the WWW, contributions to this blog are sporadic & mood dependent. The addition of RSS Feeding allows our readers to keep in touch with our entries when available. No need to waste time checking if I happen to ignore the blog for weeks or months. But if there's news, subscribers will always be the first to know.

Pretty cool, right?

Bangkok Training (November 2007)

Workshop on Radiofrequency Application

In Aesthetic Medicine
9th & 10th November 2007

Waiting To Start Training


Lifting Demonstration by Prof Niwat

Ivy concentrating hard on Prof Niwat's demo


Surgical Applications with Dr Chanchai

Presentation of Certificate of Competency

Prof Niwat with Jay in the background

New Face Scrub Treatment

I promised myself I'd not buy anymore machines. But I could not resist this one. My last peel was all the way back in February. My skin has been crying out for some quick fix. It's had a little attention recently with the RF lift & rejuvenation, but still lacked the post-peel glow that I love.

When I was poking about at an exhibition recently, I spied a cute little machine that looked interesting. Within 5 minutes, I was flat on my back in public again (at least my butt and cellulite was not bared for all to see & feel this time!). After a quick facial cleanse, this device was unleashed on me. The ultrasonic scrubber quickly and gently lifted off the dead cells that caused my loss of radiance. Then vitamin C was infused in for a more whitening. My skin was instantly revitalised and looked cleaner & clearer.

Yep, the little cutie is now sitting in Simply Aesthetic. And I'm hoping to get my skin scrubbed once a week.

Back to Work!

After a week away, we are just settling back into work again. The time away has been incredibly fruitful as we have learnt from experts in the field. Some of the treatments can only be described as miraculous! The most mind blowing is my encounter with a 62-year old lady (most senior Anaesthetist in the hospital, no less!) with skin better than many 20 year olds! Well, her cheeks anyway, as that was the area treated last year. In a few months time, she will have a forehead and neck to match. Want to know what this miracle treatment is? Watch this space! We will be bringing this into Simply Aesthetic soon. Discussions have begun with the local distributor. In the meantime, photos of the contrast between treated & untreated areas will be posted in the next few days.

During the Bangkok sector, we spent 2 days watching the leading experts re-shape faces with the DermaRF radiofrequency machine, blitz off unwanted skin lesions & pigmentations, as well as trim down a lady's tummy so much her trousers were loose!

Of course, we shopped and ate too!

Manila was the best! Julie was my travel companion for this sector. It was lovely to meet up with my old friends, especially Cathy (who sponsored my lecture tour last year), Dr Claudine Roura (Derm Surgeon) and Dr Lam from Hong Kong. Claudine & Lam were both at the workshop too, which made it a lot more fun! Both had some operative experience, so I could hear their perspective on what we were seeing that day.

Things I will be keen to implement from that workshop include (guess what the 62-year old had!!!):

• Gold Thread implantation
• Stitch Blepharoplasty (No-Cut Double Eyelid Surgery)
• Transconjunctival Lower Blepharoplasty (No Scar Eye Bag Surgery)
• Fat Transfer (Cheek Augmentation)
• Brow Lift

The surgeons were working non-stop till 7pm when they pretty much gave up from exhaustion. There were many more cases yet to do, including rhinoplasties. Such a shame!

They've invited me to return next year. They're after my nose. Yep! It's a BIG job apparently, the whole works! I don't know. Nice to have a free nose job by one of the top plastic surgeons in Japan, but I kinda like my nose as it is... And I have no pain threshold whatsoever!

Congratulations to the Lucky 10!

When we ordered our Body Jet WAL a month ago, we were confident that its numerous advantages would make it a popular choice for fat reduction. We decided to offer the first 10 people who agreed to have this treatment with us the opportunity to undergo this treatment at a very low introductory price. Without any form of marketing other than placing some information on our website, our phones have been ringing off the hook!

For those who have come for consultation and gone away to think about it, we're terribly sorry, but we can no longer offer the treatment at the price we quoted. All ten slots have been taken.

Six will have the operation when Dr Ueberreiter is in Singapore on 23rd & 24th November. The rest from 30th November onwards. The break is so I can recover from my own WAL experience on the 25th! I'm going by the reported experience of over 90% of people undergoing being completely pain free by the 4th post-operative day.

For anyone who's interested in undergoing WAL, we are still offering a good discount for the next 10 confiirmed bookings. The cost has increased by 10%, so it's still a really good deal. We're still being very liberal about the definition of an area, but I know that this will change after Dr Ueberreiter's visit.

ALCAT Updates

It has been little over a week since we started running the ALCAT Food Intolerance Test again. We have now sent off 4 tests, and 3 sets of results have come back. The turnaround time seems to be in the region of a week to ten days.

Our initial concerns were regarding the limited collection times (Monday to Thursday mornings before 10.30 am) so as to get the blood processed within the vital 30 hour window. Mediquest has been excellent at providing local support during the times when we could only collect the blood at noon. They have come specially to collect the samples for delivery straight to the airport!

One other perk of the new system is we can get a soft copy of the results before the hard copy is couriered over from Australia!

What I do miss is direct communication with the test lab to find out why there are delays. All I get from Mediquest is "The result is not ready yet"... Not very helpful to someone who's been waiting a week to find out if their favourite food is causing their health probems.

Hopefully, these issues will be resolved once ALCAT testing is done in Singapore again. In the meantime, the the testing in Australia is proving to be a very decent alternative.

November is Training Month

We finished October at a high and welcome Dyna to our team. Dyna is a Staff Nurse in the Philippines, and joins us just in time for the next phase of growth.

Just as Dyna is learning the ropes in our clinic, the rest of us will be putting our thinking caps on in November too!

Ivy & Mery will be accompanying me to Bangkok on 7th November for training with Dr Chanchai, the inventor of our DermaRF radiofrequency machine. We will be learning from the expert himself, how successive treatments allow us to mould a person's face into a more desirable contour. We currently take over an hour to do each treatment. He gets the results in twenty minutes!

This will also be the first time he teaches the course attendees how to use his new body hand piece. From body lifting, butt lifting, breast lifting and fat melting, this new addition can also be used for vaginal tightening! Wonder if anyone will volunteer for that demonstration!

The machine also comes with a variety of surgical attachments. Dr Chanchai will demonstrate how these can be used for minor surgical procedures, particularly for skin lesions. This allows us to increase the number of minor operations we can perform at Simply Aesthetic.

The learning continues the following week with eyelid and eyebag surgery, and nose augmentation with silicon implants. The double eyelid procedure is with the stitch technique which does not require the skin to be cut. As this technique is less invasive, the recovery will be faster.

Then it's just a week to rest (!?!!) before Dr Ueberreiter flies in from Germany to train us on the Water-Jet Assisted Liposuction technique. He will be with us from 23rd to 25th November 2007. We have lined up 5 operations so far, and are extremely excited about this new addition to our services.

We're almost ready with the preparations for these new services. We've had to order new drugs, equipment, reorganize our storage and procedures completely so things will run smoothly on the day.

The training sessions do mean periods of reduced services in November. Please call the clinic for more information and book your appointment early! And yes, we are offering very low introductory prices for the new medical procedures. Numbers are extremely limited, particularly for liposuction (only 3 left before the price goes up!)

Body Jet Presentation by Dr Meyer

Lunchtime liposuction: The new ninety minute surgery

Source: Daily Mail 5th October 2006

Liposuction, sold as a short-cut to re-shaping your body, usually involves a general anaesthetic and an overnight stay in hospital. Now, however, a new technique uses a local anaesthetic which allows the patient to be home just a couple of hours after surgery. So does it work? Helen Conyers, 29, a PR who lives in Manchester, is one of the first women in the UK to undergo Liposoft — the new surgical alternative. Here, she tells her story to FEMAIL.

"I’m naturally slim but I’ve had a major hang-up about my thighs since my mid-20s when cellulite started to appear in abundance, largely, I think, due to my sedentary office job.

"Today, I’m having a consultation with a surgeon at the Transform Clinic in London to see if I’m suitable for Liposoft — a new treatment in the UK that promises to be a revolutionary alternative to traditional liposuction, thanks to its short operative and recovery times.

"Some of my friends think I’m mad because I’m a size ten, but I still have lumpy thighs. I am not comfortable wearing a bikini and, like millions of women, am frustrated that the fat on my thighs won’t budge despite regular exercise and a healthy, low-fat diet.

"Transform’s surgeon Mr Singh is lovely and says it would be the ideal treatment for me as it’s been designed for women who are slim but have stubborn areas of fat they can’t shift. "Even better, Liposoft can be performed under local anaesthetic so I can go home shortly after surgery.

"I decide to go ahead with the operation and, amazingly, there’s a slot for me in a week’s time. It’s going to cost £3,400, but I’ve got savings and you can’t put a price on self-confidence.

Thursday September 7

"I’ve arrived in London for my operation in the morning and will spend tonight at my aunt’s house in Bromley. I have to be at the clinic in Golders Green, North London, at 10.30am.

"The butterflies in my stomach tell me the chances of my sleeping tonight are slim. Although I’m excited about finally waving goodbye to my saddlebags, I feel nervous, too.

"I’ll be awake during the 90-minute procedure and wonder whether I really won’t be able to feel a thing.

Friday September 8: 10.30am

"It’s a beautiful late summer’s morning as I report to reception, which is a hive of activity. A lady stands on the doorstep with her overnight bag, waiting for a taxi.

"I think she must have had a boob job the day before since she has a voluptuous chest but a slender frame.

10.45am

"I’m looking forward to my operation now and a nurse comes to take me up to my private bedroom. We walk past a waiting room where a mix of men and women all nervously pretend to read magazines.

"I wonder who’s here for surgery and who’s here to give moral support. My bedroom has an en-suite bathroom, a large single bed, a TV and quaint leaded windows.

"With the consent forms completed, Mr Singh comes into the room and asks me to strip to my underwear. I jokingly tell him that I’m getting used to showing him my bottom.

"He draws on my thighs with a purple pen to outline the areas of fat I want removed — my outer thighs, saddlebags, and around my knees. Strangely, the right leg is apparently more fatty than the left.

"A nurse gives me a bright turquoise gown and hat and a pair of fetching paper knickers to put on.

11.25am

"This is it. I’m led into the theatre — a big room with bright white walls, lots of lights, technical-looking equipment and an operating table in the middle.

"At the end of the table is the Body Jet — the machine responsible for draining away my fat. It’s a neat unit with a clear, three-litre plastic container on each side. That’s where all my fat will collect.

"A clear tube protrudes from the machine onto which Mr Singh will attach a large, foot-long canula — a tube the size of a knitting needle that’s hollow inside.

"He’ll insert it repeatedly into my thighs to spray in a liquid — a mixture of saline and adrenaline — that will help break down the fat cells before using the same tube to suck them out.

"I’m introduced to the anaesthetist who inserts a small canula into the crook of my left arm and injects a sedative into it. A pulse monitor is clipped to my thumb.

"Within minutes the sedative kicks in and I feel as if I’ve had a few glasses of wine. Theatre nurses busy themselves wrapping my feet, lower legs and torso in protective sheets, then paint my legs with iodine to prevent infection.

11.40am

"Mr Singh begins surgery on my right leg and first injects a local anaesthetic into the deep tissue of the saddlebag. ‘It might sting a little,’ he warns, and he’s right.

"I wince as I feel a scratchy, burning sensation but he reassures me this will be the only discomfort.
"He makes a one-centimetre incision in my saddlebag with a scalpel and inserts the large canula, attached to the Body Jet machine, into the cut.

"He explains that a solution containing adrenaline is now being sprayed under my skin to help loosen the fat cells.

"Unlike conventional lipo, I’m not being pumped with a large quantity of fluid, which is used to attack a bigger area of fat.

"Instead, Liposoft allows him to have more control over the procedure and for the fat cells to be removed with precision — leading to significantly improved symmetry and reduced swelling.

"I feel a pulling sensation but no pain. There’s a lot of suction and spraying noises as the fluid goes in and the fat is sucked out.

"The anaesthetist reports that the first plastic container attached to the Body Jet is already filling up with fat.

11.50am

"Amazingly, there is already almost a litre of fat and body fluids in the plastic container. It’s a mixture of one third fat which sits on the top, with the rest being fluids and the adrenaline solution.

"Mr Singh manipulates my thigh with the flat of his hand to ensure an even finish. Then he announces that my saddlebag is gone and that he is now injecting anaesthetic lower down my outer thigh, ready to make a second incision. It stings again, but lasts only a few seconds.

12.10pm

"We’re on the home straight with my right leg. Mr Singh numbs the inside of my right knee and it hurts because there’s not much flesh in that area.

"Again, he inserts the canula and begins to work on breaking down the fat and sucking it out. I feel much more awake now as the sedative I was given earlier wears off.

12.20pm

"Just 40 minutes after surgery began, my right leg is apparently a shadow of its former self, with the treatment completed and an astonishing 2,700 millilitres of fat and fluid expelled.

"I can’t wait to see the results once the procedure’s finished.

12.25pm

"Mr Singh begins to anaesthetise my left leg and makes an incision into the saddlebag. It stings. The anaesthetist, Dr Moustafa, tells me to relax.

"I joke that I loved the blissed-out feeling the sedative gave me at the start and ask if I can please have some more. He agrees because I’m feeling a bit of discomfort on my left side because I’m more awake now.

"It’s injected through the canula in the crook of my arm and, almost immediately, I’ve got that warm, fuzzy feeling again.

12.45pm

"I’m so sleepy that I’m struggling to keep my eyes open as Mr Singh continues to extract fat from my left thigh through a second incision.

"He tells me about a young woman who had Liposoft on her stomach at another London clinic the week before and an hour later she was out buying shoes on Oxford Street.

12.55pm

"There’s 1,700 millilitres of fat and fluid now in the second plastic container and Mr Singh makes the final incision on my inner knee. It’s sensitive again but I’m so woozy I barely notice.

"I’m vaguely aware that Dr Moustafa is entertaining Mr Singh and the nurses with tales of his grandmother, who died recently — at the age of 110.

1.10pm

"I must have dropped off because all of a sudden I’m opening my eyes to hear Dr Moustafa saying: ‘That’s it Helen, it’s all over now.’

"I’ve only been asleep for about 15 minutes. Mr Singh is putting an internal stitch into each of the incisions and a plaster on top.

"The nurses remove the protective sheets and lift me carefully onto a trolley then wheel me into the recovery room next door.

"A total of 2.2 litres was taken from my left leg and Mr Singh tells me about two litres of the total fluid sucked out of my thighs will be pure fat. I feel fresh and totally awake. It’s difficult to believe I’ve just had surgery.

1.30pm

"Back in my private room, I sit up and peel back the bedcovers to admire my new thighs. It’s like looking at someone else’s legs.

"Gone are the saddlebags and I’ve got a lovely smooth, flat shape like an athlete’s at the top of each thigh. My knees look much slimmer, too.

"But my legs are still covered in iodine and I can see what looks like the first signs of bruising and swelling.

1.45pm

"I stand up and lift my gown to inspect my legs in the mirror. I’m given a three-day course of antibiotics to prevent infection, painkillers in case I need them and a pair of tight, white leggings to wear for two weeks while my legs heal.

"A nurse says she will call me this evening to check I’m feeling well.

3pm

"I can’t believe it, but I’m already waving goodbye to the medical team and jumping into a taxi to meet Mum in central London before she drives me down to stay with her and Dad in Kent for the weekend.

"It’s all very surreal but if I’d had a general anaesthetic and traditional liposuction I’d have needed an overnight stay at the clinic and probably wouldn’t have been able to sit down for a week due to the bruising.

September 9

"I wake up, and it takes me a second to remember that 24 hours ago I was in an operating theatre.
"My thighs look quite puffy and swollen this morning but there’s barely any bruising and no pain, which means I’m ready for a shopping trip with Mum.

September 11

"I’m back at work today in Manchester and my thighs are swollen. But that’s normal — the body’s natural defence when it’s been through a trauma is to retain water to protect itself.

"In two weeks’ time I’ll be totally recovered and I can’t wait to see my new thighs.

September 27

"It’s almost three weeks since my operation, and I’m happy with the results. My thighs are so smooth that it’s like looking at someone else’s legs.

"The lumps, bumps and saddlebags are gone, the sides of my thighs are toned and my knees look slender. I can see the difference when I wear skinny jeans because my silhouette is lithe.

"I can’t wait to get a little pair of shorts on next summer.

For more information or to arrange a consultation with Transform Cosmetic Surgery Group, call 0500 595959 or visit www.transforminglives.co.uk

Doctors See Increasing Demand for Cosmetic Procedures

Source: Channel News Asia 16th October 2007

SINGAPORE: Doctors in Singapore are seeing a rise in patients seeking both non-invasive cosmetic procedures as well as major cosmetic surgeries.

Spider veins are caused by hormonal changes such as pregnancy, and people who are on their feet all day or have a family history are prone to the problem.

The condition does not usually cause pain or health problems, but laser treatment is available for those who want to maintain their youthful legs.

Dr Sanjay Nalachandran, Consultant, General and Vascular Surgery at Tan Tock Seng Hospital, said: "Laser heats up the blood within the blood vessels and this causes a certain amount of damage to the vessels and over a period of time, these vessels disappear as they are reabsorbed by the body."

Serene Teo has had three sessions to erase the miniature veins.

She said: "You don't feel a thing at all. Just take a little rubber band and snap it on your skin and that's what it feels like – it's like tiny ant bites."

Such non-invasive cosmetic treatments have grown in popularity over the past ten years.

But cosmetic surgeons are now seeing an increasing demand for major procedures, with liposuction among the most popular.

The latest technique uses ultrasound to break down the fat, making it easier to remove.

Dr Martin Huang, Consultant Plastic Surgeon, said: "When you liquify the fat beforehand, it's a lot easier to remove, so we can accomplish this much more gently with less trauma to the tissues, and it is more thorough and effective."

Doctors said it also allows for a high definition technique that creates the illusion of six-pack abs.

"The most I have ever removed safely, meaning everything went smoothly and there were no problems at all, is about 10 litres (of fat) and I've only done that once. Most times it would be anything from 2 litres to 5 litres," said Dr Huang.

A 36-year-old patient, who does not want to be identified, said she used to weigh 100kg and suffered from knee pain.

So two years ago, she started dieting and exercising regularly.

She lost 33kg, but could not tone up her arms and trunk, so she thought she would "cheat a little bit" with liposuction.

The eight-hour surgery plus two-night hospital stay cost about S$30,000.

But she thinks the money is well spent.

She said: "I want to go for more exercise because now that I have lost the weight, I want to maintain my figure. Hopefully, I will be more confident going out at night, meeting people and friends."

The first few days of recovery from liposuction are often painful and it can be a couple of weeks before the patient is ready to go back to work.

There are also the risks of infection and blood loss, and at the end of the day, the patient still has to adopt a healthy lifestyle because too much food and too little exercise will bring back those unwanted pounds.

Return of ALCAT Food Intolerance Test to Singapore

After a 3-month absence from Singapore, the ALCAT Food Intolerance Test is finally available once again. The test lab is still in foreign lands (Australia currently), which does complicate matters somewhat, but the blood can still get processed within the 30-hour window as long as collections are made fresh before 11am on Mondays to Fridays.

We have certainly missed having this as a weight loss option. I see so many people who claim to eat no more than the next person, exercise religiously, yet are classed overweight or obese. Some do look for a quick fix, but many are truly desperate to find out why they absolutely cannot lose the weight.

Having done a good number of tests in the past year, I can certainly testify that those who manage to stay away from their "banned" food types seem to have no problems losing weight.

And who knows? You may not be intolerant to chocolate (I'm not!), so indulge in this decadent treat without fearing weight gain. Your chances of being intolerant to lettuce and black pepper are much higher. And there's really no way of knowing until you get tested.

Where It All Began...

Many have wondered about the time and effort taken in creating the Simply Aesthetic website. The current one is I believe version 4. Just creating version one resulted in many nights without sleep, changing from one program to another in a desperate attempt to find one simple enough for me to handle. The first launch also resulted in the first major argument with Dr Ivan, a petulant deletion of the entire site by myself, followed by disaster as my computer crashed with the entire "masterpiece" in it!

The current version was launched in March 2007 and has proven satisfactory. Re-doing it would we a nightmare now, as the number of pages exceed 50, and grow in number almost every week.

But my attempts at web design did not start with www.simply-aesthetic.com. I only dared try this task because of a previous website many years ago. Long forgotten, I was only reminded of it by my old friend, web host & SEO guru Shi Heng Cheong last night. It turns out he bought the domain I abandoned & took over my entire content! He re-did the site a year back, and the traffic now is in the thousands every month. Worldwide! WOW! He's graciously offered to share the site with me again.

Take a look. It's much prettier now than when I designed the template 5 years ago. www.healthychineserecipes.com.

I'm tickled pink!

DermaRF Radiofrequency Non-Surgical Face Lifting at Singapore clinic Simply Aesthetic

(PRLEAP.COM) Singapore - October 15, 2007 - Simply Aesthetic, a Singapore-based medical aesthetic clinic, has acquired the DermaRF Radiofrequency device for non-ablative skin tightening and fat melting. This adds a new dimension to the clinic's rejuvenation and body contouring services.

Using Superpulse RF technology, immediate collagen shrinkage occurs, resulting in an instant lifting effect. Deep dermal stimulation results in new collagen formation and long-lasting results. Used in combination with the other treatments available at the clinic, clients can achieve an improvement in skin texture, lifting, reduction in wrinkle depth and number, and lightening of pigmentary changes caused by sun damage and ageing. The new treatment can help in jaw line definition, lift cheeks and reduce the fine lines around eyes.

The rejuvenation mode improves skin tone and texture, reduces the size of open pores and helps to evacuate blackheads and comedones. Large pores are a particularly difficult problem to eradicate in the local Asian population, greatly exacerbated by sun damage and tropical conditions.

The DermaRF was chosen for its unique advantages over other radiofrequency devices. The radio waves are delivered through special glass tipped wands. The Superpulse technology allows a high energy delivery with minimal discomfort. The epidermis is protected as the heat is rapidly transmitted deep into the dermis, producing its effects on collagen shrinkage and activating new collagen production.

The treatment protocol is simple, with each session lasting about an hour (depending on area and degree of sagging). The lifting effect is immediately visible. The results are maintained with an average of six treatments spaced a fortnight apart. The frequency of treatment allows gradual moulding of the face into a more youthful contour.

Subsequent maintenance is one session every six to twelve months.

The treatment involves the rapid movement of the treatment wand over the areas of concern. A special ionizing gel is used for gliding. Heat is generated very rapidly to a target temperature of 40 degrees Celcius, and maintained for two to three minutes for maximum effect. Minimal discomfort is experienced during the treatment.

Different hand pieces are available for face lifting, rejuvenation, and body lifting. Clients have the option of purchasing personal body probes for non-surgical vaginal lifting. Small area targeted fat melting, breast lifting and buttock lifting is also possible with this device.

Simply Aesthetic is a medical aesthetic clinic located at Singapore’s UE Square Shopping Mall. Led by Dr Christine Cheng, the clinic offers a range of services to reverse the signs of ageing, weight loss and body contouring.

Source: PR Leap

"Hello Doctor" Episode 3 Features Simply Aesthetic

We were approached by Singapore's Mediacorp TV12 earlier this week regarding our willingness to provide information for a new Tamil health education TV series called "Hello Doctor". Episode 3 is about Obesity in Singaporeans and how to safely lose weight. The producers chose Simply Aesthetic as the clinic to seek advice for weight loss. Naturally, we were delighted to have the opportunity to showcase our entire weight management program.

Not knowing exactly what was expected of us, our preparations included requesting Humedical to lend us one of their demo Water-Assisted Liposuction units, which looked great, lined up next to our other machines.

Body Jet Water-Assisted Liposuction

Finally, the TV crew arrived, and briefed us on their requirements. It would be a straightforward interview plus demonstration of a few of our treatments.

Ffion Superstar-Wannabe peers out from the pantry
(Fortunately for her, no school today!)

Lights, Camera, Action!

Filming the introduction at Reception. Mery gets to be on TV too!

It was a unique experience to be part of TV production. Fun! We can't wait to see the final product. Roll on Jan 2008!

Battle of the TIGHTENs!

Radiofrequency technology is very popular for skin firming and fat melting. Thermage is the best known non-surgical skin tightening treatment, but is painful and results are delayed for 3-6 months.

We have had the unique opportunity of testing out two alternative radiofrequency devices, one from Bangkok and the other from Korea. Both units were on trial at Simply Aesthetic this week. My plan was to bravely volunteer for a half face test!

Part one: Korean machine from Skin MD. This came with three components: skin scraper, iontophoresis and radiofrequency. The right side of my face was treated with this machine. The treatment took 15 minutes. A warm probe was moved over my face with a special creams the gliding base. The process was pretty comfortable (just a little hot around the eye area).

Result: some lift of my cheek with slightly better definition of my jawline. My patient could see a difference, but she did not know which side I'd had done! Twelve hours later, after a night's sleep, the effect was gone. Both sides were identical once again.

Yes, I know I wanted the other side done with the other machine, but clinic was busy. It had to wait. And wait. Finally, a whole three days later, it was finally my turn!

Result: My jawline was more defined. My open pores were reduced in number and size. We'd seen great results for listing and reduction in depth and length of wrinkles too:

Before

After

The decision was quite simple really. The machine we chose offered more practical features:

• Instant lift (results lasting after 6 sessions)
• Painless treatment
• Rejuvenation mode to improve skin texture and colour
• Reduction of pore size
• Expulsion of comedones & blackheads (no extraction!)
• Fat melting
• Facial contouring (literally mould the face over the 6 sessions)
• Abdominal skin firming
• Tighten "bye-bye" upper arms
• Vaginal tightening (yes, really!!!)
• Surgical applications

And so we finally acquire the DermaRF Vision 7 Radiofrequency machine. It was delivered this afternoon.

We head off to Bangkok for training in November (from 7th evening to 10th). Mery & Ivy included. The inventor of the machine, Plastic Surgeon Dr Chanchai will instruct us on how to get the best out of the device, by changing the settings and handpiece to that most appropriate to the clinical situation.

Water-Assisted Liposuction at Simply Aesthetic

We will be adding the latest liposuction technology to our services shortly. The Body-Jet Water Assisted Liposuction (WAL) from German company Humanmed will be included in our services.

Developed to avoid the problems associated with tumescent anaesthesia required by other liposuction techniques, this new technique is believed to be the safest form of liposuction with the least downtime.

Traditional liposuction requires the infiltration of large volumes of fluid containing the vasoconstrictor adrenaline (to reduce bleeding) and large amounts of local anaesthetic. Many anaesthetists balk at the large amounts of the latter, as we are usually very cautious about calculating a maximum dose to avoid heart arrhythmias and seizures. It is believed that the slow absorption of local anaesthesia from the tumescent fluid renders it safe. However, the peak absorption into the circulation occurs 14 hours after surgery, when patients have gone home. This may be the cause of the fatalities associated with liposuction.

The infiltration of large volumes of tumescent fluid also makes the surgical field too bloated for the assessment of results at the time of operation. This can produce uneven results or skin rippling.

Ultrasound-assisted liposuction techniques such as Vaser are extremely popular in view of the protection of vessels and nerves. Laser lipolysis is also popular as it is associated with low downtime. Both these techniques risk damaging the skin by either ultrasonic or laser burns.

WAL uses the force of water to blast the fragile fat cells, protecting the other vessels and nerves during the process. The water is immediately sucked back with the fat, so less swelling is observed. Minimal infiltration with tumescent fluid is required, purely for vasoconstriction, to minimse bleeding. Intra-operative pain is minimal, and sedation is often not required! The patient can move on the table or even stand up for contour assessment. In the absence of excess fluid, it is very easy to assess if any areas need additional liposuction before the end of surgery. This produces superior results in a safer procedure.

British studies have shown less post-operative pain and a faster recovery. Fewer pain relief tablets are required by patients undergoing WAL compared to traditional liposuction, and most are pain-free by the third post-op day.

WAL can also be used for six-pack definition and the destruction of sweat glands in situations of excessive sweating.

We are awaiting confirmation of date of installation of the machine and are delighted to be the first clinic in Singapore to commit to the purchase of this latest liposuction technology.