Desperately Seeking Female Plastic Surgeon in Singapore!

I stayed back late last night for a young lady who could not make it for her liposuction consultation till after 8 pm. She came to know of me after I booked her sister in for waterjet liposuction. 

It seemed that the pair of them had been desperately looking for a female doctor to help them get rid of their unwanted fat for years! They had both searched online over many months, but only found male Plastic Surgeons in Singapore. They even contemplated going to Indonesia to have the surgery as they found a clinic with female doctors there!

Somehow, her sister located me about a month ago, has booked for surgery, and she was not far behind.

I had been told many times that female aesthetic doctors were more sought after in Singapore. Interesting to see that this is true for a segment of the population. Especially since the general consensus is that the ladies here usually prefer male gynaecologist!

Dangers of Internal Fat

I attended a lecture last week entitled "Drugs To Treat Hungry Genes". What an eye-catching title! The lecturer was from Brisbane & an expert in Obesity & Metabolic Disease. I was fascinated to ear what he had to say, whether there were any revolutionary new medicines out in the pipeline.

Naturally, he started with an introduction of the risks of obesity. How the waist circumference was a predictor of chronic disease. How liposuction did not alter that risk whatsoever, so it was really up to lifestyle habits (diet & exercise) to make the difference. He felt that the addition of Duramine to the treatment regime was beneficial, as the majority of weight loss occurred during the first 6 months. Surgically, only omentectomy could remove internal fat. The omentum is the fatty apron that lies inside the abdomen. Certainly a drastic step to take, and I have only seen this done for cancer operations, not weight reduction.

I was really disappointed that he didn't have anything new to add to our treatment regimes. He used meal replacements as part of his treatment protocol, and I am really not in favour of such a calorie restrictive diet plan. Surely he should take the loss of muscle mass into consideration? Seems like he has forgotten that the body is built for survival, and accumulation of fat at the expense of muscle is the body's main defence against starvation.

But then I guess we are one of the lucky few clinics who own machines that can reduce internal fat and build muscle. So I can afford to be critical of doctors who are in a less fortunate position equipment-wise. The combination of Thermojet with Ion Magnum is pretty potent. Both speed up the metabolism and burn fat for fuel. Ion Magnum in addition builds muscle and has major anti-aging benefits. Plus has clinical studies to show its efficacy in slowly burning off the dangerous internal fat. No operation or major lifestyle changes needed.

Back to Manila to Lecture

I was in Manila this time 2 years ago, running around the conference circuit, lecturing about Mesotherapy. That was when I fell in love with that city, and have always looked for opportunities to return.

Last week, I was invited to lecture again. Same group of doctors as 2 years ago. Hundreds of them! This time, I only had a week to prepare. In fact, less than a week... The trip was confirmed last Thursday afternoon & here I am at the airport on a Wednesday morning. I didn't even know the lecture title till the weekend!

Thankfully, the lecture commitments aren't as heavy this time. Just a single half hour talk on a new needle-free mesotherapy device. Yeah. Ironic, isn't it? Speaking as an expert on a subject I'm no longer supposed to practice except as a trial?

We borrowed that machine & tried it out over the weekend. Dyna's mother got volunteered. It was a seriously tedious process, but painless (except on my pocket as the solutions were oh so expensive). She saw her pores close up very quickly. And by the next day, her nasolabial folds had completely disappeared.

She was impressed! She wanted more! Thankfully the machine went back yesterday afternoon. ;o)

The rest of my time in Manila will be spent doing demonstrations at the booth. Mixture of demos including the Botox Dermalift which I learnt from Dr Lam in Hong Kong 2.5 years ago and love. I guess there'll be demos on the new Aesthetic Dermal products too, including Meso-K/Arnica for dark eye circles, Reparastim for rejuvenation & BONTA Botox replacement.

And shopping at Greenhills of course, before I get back on the plane on Friday night. Perfect timing for Christmas shopping!

Preparing for F1 Parties

I have the great privilege to have been invited to 2 premiere events this weekend. Tonight's party is at the Mercedes centre and is my first red carpet party. The second is on Sunday night. A major hush hush top-secret party at an even more secret waterfront location, hosting VVIPs including some of the F1 drivers.

So how does one prepare for such spectacular events with celebrities and media (local & foreign)?

I only received the invitations a week ago, so crash slimming is out of the question. Especially when I had to dash around Orchard Road to search for appropriate dresses that fit! Can't risk doing anything that could jeopardise my new clothes!

So intensive face work was called for. I've been quite lazy about doing treatments generally. Something about being surrounded by all these machines... Mery last did a facial for me in mid 2007, when we were still at Faber House! I don't think we'd even decided to move to UE Square at that stage! Since then, I've had one round of Easy TCA peeling (end 2007), 2 lots of Actistem (January & June this year) and the odd Perfector session. Fortunately, having just had to prepare for a photo shoot last week, I had done a little bit of lifting with the Perfector recently.

On examining my face earlier this week, I decided I had a few clogged pores I wanted cleared out. I still needed just a little more lifting for ideal jawline definition, and my complexion looked a tad dull.

With these in mind, I decided some treatment with the RF in rejuvenation mode was the first step. RF rejuvenation acts as an electric peel, so skims off some of the dead skin cells and ejects blackheads and comedones. Half an hour later, the skin looked more radiant, most of the pores were cleaner, but there were a few deep comedones that still refused to come out. So the face steamer came out and Joey extracted the stubborn comedones.

Since I was in the self indulgent mood, I decided I should have a mask treatment to follow. We decided on the Caviar mask with Caviar ampoule for hydration. I had always used the Whitening mask before, so this was a nice first for me. Half an hour later, I emerged radiant and most surprisingly, the lift I wanted was there! The collagen from the mask had impregnated through and hydrated my skin, providing the lift I so desperately wanted! Since closing our Spa, we had pretty much neglected these Biomatrix masks and I had forgotten how amazing they were.

The rest of today will be spent getting my nails, hair and makeup done. Then F1 party, here I come!

Preparing for 1st November

Recent communications with Jessica from Straits Times has reminded me that time is flying by. We are fast approaching 1st November, the day Singapore aesthetic medicine is set to change, supposedly for the better.

In a nutshell, there must be no further use of the terms aesthetic physician or aesthetic doctor. Some of the treatments which have been well accepted in the aesthetic community have been categorised as "List B" or having low scientific evidence of efficacy.

Two of the treatments in question are dermaroller and deep tissue massage (endermologie) for the treatment of cellulite. Rather than a blanket ban on these procedures, doctors can opt to continue offering these services under study conditions. The two options are full clinical trial or detailed observational study. The protocols have to be lodged with SMC, and the treatments must be stopped if there is no evidence of efficacy, or evidence of harm.

Thank goodness I spent my SGH days doing different types of research. Lots of cobwebs have had to be swept away, but the various components of such studies is still second nature. I have currently prepared protocols for both dermaroller therapy for acne scar reduction, and endermologie as part of a multi-modal treatment protocol.

Although the aim is to start on 1st November, my intention is to start implementing the new consent and data collection protocol before that. I believe I should be ready in the next few days. Although the consent is for "experimental" treatment, we have had vast experience with both treatments and are confident of their efficacy and safety. And as solid clinical evidence is collected, this has to be beneficial for all concerned.

Waterjet Liposuction at Mount Alvernia Hospital

We did our first liposuction at Mount Alvernia yesterday. Things went smoothly once we got going. The nurses were fantastic, and were very pro-active in learning from Dyna how to prepare the fluids and work the machine. In fact, things flowed so smoothly once we started that I was able to complete the entire abdomen in just 2 hours (my average is 3 hours). Such bliss to work with an electric operating table!

I have had word from MoH too. They are now only interested in accrediting clinics for liposuction (under 1 litre fat). Doctors looking to operate at ambulatory surgery centres or hospital operating theatres are to be accredited by the individual institution. Sister Ee has helped me with accreditation for liposuction in Mount Alvernia, so everything is set for us to continue there.

Keeping the Memory of Ivy Alive

I have just updated the photographs in the "About Us" page of the Simply Aesthetic website. We have had a few staff changes in the last few months, so the original picture above is long outdated. I felt it was a shame to just delete it completely though, as it holds fond memories of Ivy (bottom right) as well as the reception area of our original clinic in Faber House.

Ivy left us in June this year so as to further her studies. She is now knee deep in CIDESCO training, and hopes to continue with Brazilian waxing after that! We had initially hoped to have her working part-time with us on Sundays, but that was not to be.

We waited some weeks for Mery's CIDESCO classmate Joey to join the team. She's been with us since 9th September and is working very hard to learn her way around our services.

Our team now comprises:

Cha, Dyna, Joey and Mery

From Blog of Xanya Sofra Weiss

Stirring excitement in a Trade Show is not always easy. First you need a great product. Then you need instant visible results. Third you need to know your product. And most importantly you need to represent your product, especially if you are in the field of anti-aging. We visited a number of booths in anti-aging shows around the world. We met doctors with gray hair and aged skin confidently promoting their skin line. Young blondes smiling gracefully while overweight salesmen enumerated the advantages of their Cellulite Reduction device. But only one booth captured our attention. Occupying nearly twice the space of all the other booths, Arasys Perfector was in turquoise motif with beautiful look-alike brunettes in matching aqua dresses. On a plexi- glass illuminated stage, older women sat on massage chairs, while the sirens instantly lifted one side of their faces their faces with silver gloves. Exclamation remarks or “wow” “oh my God” “this is amazing” fed the enthusiasm of audience surrounding the stage. On the other side of the stage, overweight men sat on treatment chairs wrapped up in belts and seemed to contract as if they were lifting weights. A youthful looking woman in red spoke on the microphone in a mature serious voice about science and nanotechnology.

“Dr Moheinan wants to try to Ion Magnum, the British device manufactured by Innovations Science, a research center funded by the European Union. The device burns fat and builds muscle. Results are instant. You will lose between 2 to 3 inches. My name is Dr. Weiss and I am the director of Research for Arasys Perfector / Ion Magnum, LLC”

Dr. Moheinan climbed on the stage smiling in disbelief. “How long do results last?” she asked.

“As long as if you went to the gym for a week working out about two hours a day,” replied Dr. Weiss while Femme fatale looking technician measured and wrapped her a neoprene belt with pads around her waist.

“Twenty minutes on the Ion Magnum is like a condensed strenuous workout that takes several hours in the gym,” Dr. Weiss announced on the microphone. “Ion Magnum burns fat and builds muscle. Simple it sounds, yet it took its inventor thirty years of research to compose the electronic waveform that can do just that, safely and effectively.”

“Ah! No, it doesn’t hurt, it’s just a strange sensation,” cried Dr. Moheinan giggling and laughing as the technician turned on the machine. Just then, waiters appeared with trays of appetizers. Fresh Sushi, cheeses and a decadent dark chocolate mouse cake.

A muscular male model brought a plate with delights for Dr. Moheinan. Dr. Weiss passed the microphone to a tall gorgeous brunette and grabbed an entire tray with chocolate mouse cakes for the booth. “I’ll have half of this by myself,” she told us confidentially. “I love chocolate.”

“How do you stay so slim?” I asked. “How many hours do you work out?

Dr. Weiss chuckled. “How many hours? None. Here punch my stomach!” She took my hand and brought it against her hard rock body. “That’s the Ion Magnum. Nothing like it, there’s absolutely no other machine that can do that. And after you lost a few inches during the treatment, you continue loosing inches overnight plus it speeds up your metabolism so you keep on losing...”

“You can have eat while you are the Ion Magnum,” The femme fatale technician informed Dr Moheinan who was reluctant to touch her plate with appetizers.

“That.s right. I always munch on chocolate cookies or something when I am on the Ion Magnum. Have you ever worked out while having chocolate cake?” Dr. Weiss said swiftly preparing serving Dr. Moheinan with three pieces of the chocolate mouse.”
“What a feast! I am not going to lose any inches on this treatment,” Dr Moheinan quipped, with her mouth full.
“You will, you will,” Dr. Weiss exclaimed in a matter of fact tone.

The moment of truth came as Dr. Moheinan had just finished her enormous meal that included the chocolate cake and the femme fatale technician took out the measuring tape.

“Two inches off!”

“Oh my Lord!” Dr Moheinan’s eyes are shinning. “After all this food I lost two inches? “When we were in Singapore Dr. Cheng lost two and a half inches on the Ion Magnum while having lunch, “Dr Weiss said. “You can read the story on her blog website, http://simply-aesthetic.blogspot.com

“I lost an inch and a half yesterday, but when I measured myself today I had lost another inch,” says a tall blonde doctor introducing himself to me as Dr. Long. He lifts up his shirt revealing a round hairy stomach. “How many treatments do I need to get a six pack?”

“It might not reduce the hair on your belly but you will lose more inches today and by tomorrow, you will lose more,” the femme fatal technician chuckles as she measures him.”

“Is it going to give me a six pack?”

“You’ll probably have to buy the machine for that,” Dr. Moheinan patronizes him.

Meanwhile Dr. Weiss explains to me that the Ion Magnum acts as a pacemaker to the skeletal muscle. It targets the neurons and resonates the signal of strenuous regular exercise to build muscle burning fat for energy. The face machine has a far more compex explanation. “Nanocurrent acts like a massive anti-oxidant,” Dr. Weiss explains. “Nanocurrent infuses a large amount of electrons into the body to stabilize the free radicals, which are molecules missing an electron. Given their missing electron which is replaced by the nanocurrent electrons, the free radicals are transformed into stable molecules and the whole system starts functioning optimally.”

“Dr. Long, you’ve lost 4 inches,” The femme fatal says in a matter of fact tone.

”Four inches? No, I didn’t. How did I lose four inches?”

“You’ve lost an additional 4 inches from your waist. Two and a half yesterday and four today makes six and a half inches off your waist.” She hands him the measuring tape. “Go ahead measure yourself.”

“I don’t want to see how big I am...” Reluctantly Dr. Long puts the measuring tape around his waist. “I lost 4 inches,” he cries.

“Maybe because you did not eat the gigantic piece of cake that Dr. Moheinan had,” Dr Weiss quips. Taking his hand, the femme fatale tech directs him to the large mirror adjacent to the booth. “You’ve even lost your love handles, see?”
“I still don’t have my six pack. But I did lose my love handles. That much is true...”

“You only had two treatments. You’ll need a lot more before you get a six pack.”

“But I can get a six pack?”

That’s what most of us want. We want to look twenty years younger with a six pack. The technology in the Arasys Perfector booth promised to do just that. The dramatic results, the overall energy of the beautiful girls, the educated presenters, the impressed attendees, was what grabbed our attention and convinced us to do an editorial about Arasys Perfector and Ion Magnum. For more information please visit their website at www.arasysperfector.com

Source: www.xanyasofraweiss.com

On The Move Again?

We have been happily performing our liposuctions at Paragon Day Surgery International. Truly I love it there. However, it has been one shock after another for the last few invoices. They have implemented one surcharge after another without informing us first. From a 3% nursing surcharge, to linen fee, to recovery surcharge on Saturdays, use of Bair Hugger, plus a load of hidden items classed as consumables and disposables. Each surcharge works out to be in the $50 range. Add these together and the bill is inflated by 10-20% easily. Have we passed on the increment to our patients? No... We don't find out till after all payments have been settled that these new charges have come in. And our sales consultant is more often than not unaware that these changes have taken place.

Novena Surgery has been very aggressive in trying to lure us over to them. However, their prices remain higher than Paragon DSI, so there's absolutely no reason to move.

A surprise alternative surfaced last week. I anaesthetised a lady for caesarean section at Mt Alvernia. This was my first visit to Mt A OT in over a year! I got to talking to the nurses and particularly Sister Ee who is in charge of the OT. She welcomes us with open arms, and came back with a very reasonable quote.

Mt Alvernia OT is very nice, having been totally refurbished fairly recently. It's a little further from UE Square, but I'm sure our patients wouldn't mind hospital-grade operating theatre facilities at a more affordable price. Certainly our prices would have to be revised upwards if we stayed on at Paragon. I can absorb $50, but not multiples of $50 with no end in sight!

So the arrangements are being made as we speak. The machine will be moved to Mount Alvernia on Thursday and we will try our new locale for a while. Hopefully it will be home sweet home.

Please submit your votes in the new poll in the right hand column. I'd be interested to see where the majority wish to have their liposuction at.

Blumod Back Acne Treatment

Stocks of the Blumod shirt (female design as shown above) have finally come in over a month after I originally placed the order. We decided to bring these in as I occasionally see people with back acne. This is not an easy area to treat, being hard to access for cream application. The pimples in this area are often the huge pustular variety, so scarring is very common.

The Blumod shirts offer a unique painless treatment that is painless and incorporates state of the art light technology. Light in the blue wavelength has been proven to be useful in the treatment of acne. Hence IPL is one option of acne management.

Blumod from Sunsoul is made from a material that specifically filters out all other wavelengths of light, allowing only blue light to penetrate through to the skin. Used for just 2 hours a week, it is an affordable, comfortable, effective way of controlling acne in an otherwise awkward area.

We also have Blumod caps for facial acne.

Yelomod filters out all but yellow light which stimulates collagen production, hence is good for rejuvenation. We have various hat designs in stock. With Yelomod, sunlight is no longer enemy number one, but becomes a partner in skin rejuvenation. Golfers rejoice!

Interesting Rumour! Could It be True?

The rep from J-Sports that looks after our account came to visit me today. We discussed various things, one of which was this rumour he heard from a colleague of his. Word is, Simply Aesthetic has one of the largest number of services for any aesthetic clinic in Singapore. Maybe even the largest!

Wow! That caught me by surprise! I know the one question I can no longer answer easily is "What services do you offer?". I certainly would not be surprised if we had the largest number of slimming treatments in Singapore. We undoubtedly have some unique machines with Diamond Contours and Ion Magnum. Plus we are still the only medical establishment that owns the Body Jet waterjet liposuction machine.

Our services are comprehensive, but no means complete. We could potentially add a few more items, particularly lasers, but there is no means essential. Our acute lack of storage space is more of a problem!

We are about to order a skin analysis system in preparation for the changes in regulation starting 1st Nov 2008. This is the only way we can objectively study the improvements after the treatments in question, dermaroller and actistem being the two main treatments we wish to continue with. Sclerotherapy will be taken away from us, unfortunately. Just as well we still have alternatives such as IPL to tackle spider veins. It is a shame though, as there's a certain satisfaction from watching the veins collapse in front of your eyes!

Just Remembered...

We were fed so much information during the Ion Magnum & Perfector training sessions that I've forgotten a few pearls.The most important one that I was reminded of last night was about hormonal imbalances leading up to weight gain or an inability to lose weight.

Oestrogen dominance and sub-clinic hypothyroidism are common and often undiagnosed. Both result in weight gain and a resistance to weight loss by traditional means.

We were told that even patients with hormonal imbalances respond well to the Ion Magnum. But, the response rate will be slow initially. At least 5 sessions will be required before the body suddenly goes into weight loss mode.

This makes it a little more difficult to decide if one wishes to undergo a series of treatments. Under normal situations, instant reduction is visible. However, what are the alternatives? Continue the futile diet & exercise regime? Or just take a leap of faith and try the Ion Magnum?

I know my choice. What's yours?

SunSoul Home IPL Clothing Line

Yep! You can now to do IPL in the comfort of your own home! All that is required is to wear a cap from US brand SunSoul for 2 hours a week. No pain!!!

There are two versions: Yelomod for rejuvenation and Blumod for acne. 

The material is impregnated with a light filter. Sunlight is filtered to remove harmful rays and just transmit yellow light for Yelomod or blue light for Blumod. The caps are a lemon yellow & sky blue respectively. Various design shirts are also available for the treatment of the body.

I thought this was a really unique concept. Almost an oxymoron! We have been so ingrained with stay away from the sun, it's harmful, causes ageing, eek! Now suddenly we have a means of converting the dangerous into therapeutic. How wonderful!

I tried out the Yelomod cap when I was on holiday in Bangkok last week. No sunblock for 3 days in sunny Bangkok. Lots of walking in the sun. Add in a great propensity for pigmentation. Scary experiment!

And my face did not tan at all! No worsening of pigmentation. No harm done. Certainly it's far too early to judge if there's going to be much positive results from this super short exposure. It'll certainly take weeks to see much improvement with a simple system like this.

The ideal candidates for these products would be:

1. Post-IPL maintenance
2. Golfers
3. Active facial acne
4. Back acne

We have a variety of hat designs in stock & are awaiting the delivery of a couple of blue shirts. 

Update on Ion Magnum: Post Liposuction Muscle Toning & Visceral Fat Reduction

One of the major reasons for purchasing the Ion Magnum was for the treatment of post-liposuction patients. We often see, especially with men, that even after we all the fat out from under the skin, the tummy still bulges out. This is from a combination of poor muscle tone & visceral (internal) fat.

The Ion Magnum targets both these problems more effectively than exercise. 

We finally had the opportunity to try this out over the weekend. I saw a gentleman I did abdominal liposuction on a month before. We removed almost 5L from him tummy, but it was still bulging. Measurements revealed a 10 cm loss on average at 3 points over his abdomen.

We put him on the Magnum and set it to remove visceral fat.

Thirty minutes later, repeat measurements revealed a further 10 cm loss over his upper abdomen! I've never seen him smile so widely!

I've yet to try this mode personally on the Ion Magnum. My attempts at scheduling my own treatment were thwarted yesterday & today. And that's even after I booked myself into the appointment system!

Try again tomorrow...

Revitalash for Naturally Thick, Full Eyelashes

Considering I spent 3 days last weekend at a major International skin conference, I was surprisingly not enthused by much of the new products on offer. It was filler after filler after filler, all claiming to be the best. Yawn...

The first product to catch my eye was Revitalash. Having never had eye lashes of any form, and not being able to tolerate anyone coming near my eyes, falsies are out of the question. Here's a product that stimulates natural lash growth by daily application? Interesting & definitely worth trying out.

RevitaLash™ was developed by Dr. Michael Brinkenhoff as a special gift for his wife, Gayle, while she was recovering from breast cancer. Intensive chemotherapy treatments had damaged Gayle’s once-beautiful eyelashes, leaving them sparse, breakable and fragile.

After extensive research with a team of cosmetic chemists, Dr. Brinkenhoff formulated an eyelash conditioner that, after just a few weeks, gave a renewed look of vitality to Gayle’s eyelashes. Results are supposedly seen after between three to ten weeks of daily application. Then maintenance applications a couple of times a week are enough. Interesting!

I started my treatment that very night and am waiting for the day I can have visible eye lashes.

We have brought in a vials for clinic sale. Each one costs $238 and lasts for at least 6 months. At maintenance phase, each vial lasts 3 years!

Application is very straightforward. Just draw on upper and lower lash lines every night on cleansed face. Wait 5 minutes for it to dry before applying normal skin care products. Then wait with bated breath for growth.

Restylane Face Lift

This was the most interesting presentation on the first day of IMCAS Singapore 2008. I had actually not planned on listening to this presentation, but found it impossible to leave once she started describing her novel technique.

The speaker was a Dermatologist from Bangkok. She realised that Restylane & Perlane were unique in having lifting properties. She has developed a technique whereby tiny amount of the filler are injected superficially into the traction lines if the face, in the direction of lift.

The technique is simple & produced immediate results. These improved over the following two weeks, following which the results remained stable for about a year. She used 2-3 1ml syringes per face, so it's a relatively costly affair. There's also a little bit of downtime: bruising, swelling, redness. This can last for up to 2 weeks.

I'm not sure if many Singaporeans would be keen on this, but it is certainly a simple procedure with good results. It may have a role in those who don't trust machines, don't want surgery and would prefer to avoid complications associated with threads. Personally, I'd give the Perfector a go first, and only resort to this if all machine and non-invasive options fail.

Update on Perfector Testing: Acne Scars & Comedones

We know the power of Perfector on lifting & sculpting, so have been trying to check out its effects on other facial complaints. Two "willing" volunteers are Mery our clinic manager & Ffion my daughter.

Mery has residual acne scarring from adolescent acne. It cleared up tremendously after a couple of sessions of dermaroller treatment. So she was first up to see if Perfector would help reduce these further. She had a single 30 minute session on Thursday, and a few hours later, felt her scars were less obvious on the right side. We were too busy for her to have the treatment again yesterday. I'm hoping that with a few treatments done close together, she will get flawless skin without the discomfort of dermarolling.

My 12-year old daughter Ffion took a lot of persuading before agreeing to trying the Perfector. She'd rather live with comedones than be subjected to the treatments we had previously. To be fair to her, she has tried most things... once.

She had 10 minutes of Perfector treatment on Thursday and happily reported no discomfort. When I got home yesterday, I noticed her face was much smoother. About 50% of the comedones had disappeared! Even more had gone by this morning.

The best testament to the effectiveness and painlessness of the Perfector treatment is when a 12-year old asks to have another treatment 2 days later. :o)

Now we just have to tie her down to try the Ion Magnum!

Updates from A4M Singapore (July 2008)

The American Association of Anti-Ageing Medicine (A4M) held a meeting in Singapore last weekend. I did not formally attend the meeting, but had the opportunity to participate in some of the peripheral events associated with it.

The first presentation I attended was on Thursday evening, which was the Arasys presentation. That is aso when I fell in love with the Perfector & Ion Magnum.

The second presentation was on the Friday night. This was a lecture on Nutritional Medicine in Stress, Leaky Gut and Food Intolerances. The lecturer was from Brisbane, and spoke at length about the many changes that occur during times of stress: how part of the brain shrinks, the gut becomes permeable, and how ridiculous it is to tell a stressed person to relax or do some yoga.

Instead, he used multiple formulations to re-balance the chemical deficiencies in the brain, rapidy cut stress (in 20 minutes) and heal the gut. It's a lot of supplementation to rescue the situation, but definitely more sensible than trying to cut out a load of foods and relax a the same time. That's a formula to kill, no?

Stress in the levels that we live with on a daily basis can kill. Modern nutritional medicine can help in stress management.

The main conference was held over Saturday & Sunday at the Grand Copthorne Waterfront. There were delegates from all around the world. We appeared on Saturday to listen to Dr Weiss speak on the Science behind the Arasys Perfector machines. We then stayed on to try the machines out. That is when I lost 2 inches from my tummy whilst gutsing on chocolate cake.

I did not attend any other lectures. Many of them were on Stem Cells. I heard the other focus of attention was on Starvation to prolong life. Thanks... I'd rather die!

Instead, the girls & I spent the weekend training on how to use the Perfector & Ion Magnum. Both are simple & relatively straightforward to use. But the number of possibilities and uses for each machine is so great, it just took many hours to go through the theory & practical skills. In practice, the Perfctor is much easier to use than DermaRF. Just a pair of copper glove that pull the tissues ino the desired position, hold for a few minutes & voila! Face lift!

The learning opportunities continue this weekend (Sunday to Tuesday) with the IMCAS conference, at Suntec Convention Centre. My friends from Manila (Claudine & Cathy) will be attending. Dr Chanchai will be flying in from Bangkok and we have been told about new handpieces for the Derma RF that he will be demonstrating. Arnd Kensey, CEO of Humanmed (Body Jet Waterjet Liposuction) will be attending too. Another full weekend ahead, no doubt.

First Perfector & Ion Magnum Units in Singapore!

Both the Perfector & Ion Magnum were delivered late on Monday night. Unfortunately, we have had little opportunity to play with them as our schedule has been tight otherwise. I've had another little go at the Magnum, and am looking forward to getting hooked up again today. Perfector too. The stress of the last few days has resulted in a few pesky zits popping out. I'm hoping the machine lives up to its promise of zapping them so they disappear overnight.

I've also been burning the midnight oil and have put some information up on the main website. There are links from the "News" section of every page, but the URLs to explore are:

• www.simply-aesthetic.com/nanomedicine.htm for the science behind the technology
• www.simply-aesthetic.com/perfector.htm for information about the Perfector
• www.simply-aesthetic.com/ion-magnum.htm for information about the Ion Magnum

We will continue to update as we gain more experience with these devices.

Simply Aesthetic Has Purchased Arasys Perfector & Ion Magnum Machines!

As mentioned in the previous post, we were planning on adding the new technology from Arasys into our clinic's services. We just started talking to our patients today, and have had to start a "To Call" list once we knew when the machine was coming in. Considering we spent very little time in clinic today, the list is already 5 people long!

We disappeared (aka ran out!) at 12 noon to catch Dr Weiss speak on the science behind the technology. It's all very cutting edge stuff, way more complex than what we learnt in medical school all those years back. Even with my BSc in Medical Biochemistry it was not easy to fully comprehend the molecular science involved. Things have certainly moved far away from the old lock & key model of enzymatic reactions. The scientists can now see how each individual molecule behaves in vivo, how it moves as the it performs its role. Also how cells communicate with one another, plus inside each cell. The technology basically encompasses mimicking natural cellular communication to gently coerce the proteins to rejuvenate. Plus the teeny weeny (impalpable) current provides the electrons required to stabilise all the nasty free radicals that age us & cause disease.

Enough science! We are more interested in results!

Before signing the papers, I was strapped onto the Ion Magnum. I've not been eating great recently, so I was having a bad tummy day. My measurements were taken before the treatment, then I got strapped in. The sensation was an urge to contract my tummy muscles, just like doing sit ups. This went on for a good half hour. In the mean time, the trainer Christine started using the Perfector on the left side of my face.

Within a short time, the effects on my face were noticeable. My nasolabial fold was less deep, particularly obvious when I smiled. And this is the side that was always more problematic. My eyebrow was a little higher, and my skin more radiant. My dark eye circles were also improved. I felt no discomfort at all. The gloved scratched a little, but nothing else.

Once we did the left face, we decided it was feeding time! Picture this: I was strapped up in the Ion Magnum, doing crunches, eating a huge lunch, including a massive slice of chocolate cake! After the treatment was over, I had still LOST 2 INCHES around my waist!!! They tell me the results will continue to improve over the next few days. I can't wait!!!

Needless to say, we purchased the machines and called the girls in for training. So I've had the Perfector on me for hours today. Literally! Looking closely at my face after my shower was interesting. The changes are very obvious:

• My brows are lifted
• The early sagging in my jowls is gone on the left and minimal on the right
• My nasolabial folds have never been so minimal
• My skin is lighter and more radiant
• My jawline is more contoured

I'm ecstatic with the outcome!

It looks like we will be getting delivery of the machines on Monday. We will be honing our skills internally initially, then call for volunteers. We plan to launch the treatment in the next week or two. Watch this space or call the clinic for more details. The number of volunteers we can treat is very limited, so please call immediately to secure your place!

I'm in Love... with Arasys Perfector & Ion Magnum

I went to a product demonstration last night and fell totally, utterly in love with two machines! The technology is very unique: gentle, yet packing a great punch in terms of instant results!

The Arasys Perfector is the face machine. I saw faces being lifted & moulded into more pleasing contours in minutes. And there was no discomfort whatsoever! In fact, the sensation was NOTHING! It does what our RF does in a few sessions in a few minutes! Plus more! They have had vast experience in this machine doing the following:

• Immediately reduce wrinkle depth (saw that!)
• Lift faces, chins & necks (saw that!)
• Reduce melasma (saw that too!)
• Reduce puffiness of eye bags (yes, and we saw that!)
• Reduce active acne overnight
• Reduce acne scar depth
• Reduce redness of rosacea
  
• Change in skin texture (can see that in under 5 minutes!)
• Reduce sun damage

The body machine stimulated muscle activity at a phase that utilised fat as fuel as opposed to glucose. One short treatment was said to be equivalent to 10 hours in the gym! The lady that tried the machine was not fat by any means, yet lost 2 inches from her lower abdomen. The effects would continue for the next few days. The stimulation of lean muscle mass and utilisation of fat for fuel has proven benefits for visceral fat reduction. They say that so much antioxidation occurs during one body treatment that even the face starts glowing the next day!

We will be attending Dr Weiss's lecture tomorrow to find out more about the science behind the technology. We also hope to finalise the deal to purchase the machines this weekend.

Save Face

Finally, months after the "Big Day", the article written by Greg Vanderpyl for AUGUST MAN magazine is published.

The feature was a promise made by the ex-editor in exchange for exclusive rights (amongst men's magazines) for our beloved Chocolate (Diamond Contours Biomesosculpture) machine. That was in Spring 2007...

Their excuse? They couldn't see how to write such a "long" article about one treatment.

So they eventually decided to feature the clinic instead, and a few treatments, not just one. Then came the big problem... They could not find a male writer to brave an aesthetic clinic! Finally, they approached Greg. Big, brave, American Greg with tattoos down both arms. He was due to get married 3 weeks after the initial consultation. Our brief was to get him looking his best for the big day.

I hate deadlines like this. Big day, little time for error... Little time to get fantastic results.

Greg's almost forty and in pretty good shape. A few wrinkles and early signs of sagging, but otherwise excellent nick. He wanted some sun damage removed, lifting and reduction of double chin. Solution: IPL & RF.

The results from the first session alone were pretty good. We squeezed in 3 sessions with the RF before the big day. Unfortunately the IPL was out of order after that, so we could not give him another session.

He said the results did not last. That is to be expected since he did not complete the treatment program. He also did not complement the treatment with creams for daily maintenance treatment. I'm sure there's an element of forgetting baseline too. That's quite normal.

Anyway, he looked good on the "Big Day", and that's what matters.

For those who want to read the article, it's on page 90 of AUGUST MAN June 2008. Greg in full tattooed glory can be see on his other article on page 128-9 of the same issue.

We're Getting Fat!

We LOVE our food! After a major pig-out session in Malacca over the weekend, all of us are finding it hard to squeeze into our clothes.

So what do we do?

EAT MORE! Well, to be fair, this "little" dessert was shared by 4 of us to share the guilt. And we did work extremely hard during the liposuction!

IPL Training

We had the pleasure of welcoming Carole Baumelou from Eurofeedback to our clinic this week. She is the Trainer for IPL, and spent 2 days with us to share her experience with the Anthelia machine.

Although the Anthelia is a very simple machine to use, it was nice to find out the exact protocol used by the French doctors for best results, particularly how often the treatment was done and the maintenance schedule.

And yes, I got pinned down and had my treatment too. It was not an uncomfortable procedure. My IPL-phobia from having had extremely painful IPL treatments previously with other machines was the greatest hurdle to overcome. But I survived, and no worse for wear! Phew!

At the end of it, I was presented with my certificate! Another one to add to the growing stack! :o)

CERUM replaces Metabolic C

The application of topical Vitamin C is an integral part of basic skin care. We had been very happy with Bellewave's Metaboli-C for the last year, but as our stocks were running low, took the opportunity to investigate other options in the market. One area of improvement was getting a product with L-Ascorbic Acid, which was the more potent form of Vitamin C.

As with all our products, we looked at various aspects of use:

• No need for refrigeration
• Smell
• Lack of greasiness
• Non-comedogenic
• Concentration of Active Ingredients
• Any other beneficial ingredients

For Vitamin C products, smell is a major issue. I remember an enthusiastic rep generously giving me a very large number of samples of a premium vitamin C product when we first opened in Orchard Road. He applied some on the back of my hand before he left. The smell almost caused me to faint... The product smelt of cat's pee! I couldn't imagine having that lingering scent on my face all day and all night! Ewwww!!!!

After eliminating smelly products, we next weeded out that required refrigeration (too inconvenient) and those that were too greasy. That left us with 3 options, Metaboli-C being one of them. I was finally persuaded by Ivy that CERUM was the superior product.

CERUM is made by Prollenium Medical Technologies, from Canada. It contains 17% L-Ascorbic Acid. Moreover, it has Hyaluronic Acid as a component, so it hydrates as well as protects. This means it helps to prevent as well as reverse the ageing process. Studies have shown that the use of this concentration of Vitamin C shows a 29% reduction in facial fine lines in only 15 days.

What we can see immediately, when comparing one product against another, is that CERUM produces an instant whitening effect. And that was enough for us to go ahead with this order.

Each 30ml bottle of CERUM should last for approximately 2 months. The L-Ascorbic Acid in stabilised to remain active for up to one year.

Evidence for Safety & Efficacy of Mesotherapy

Mesotherapy is performed by thousands of doctors worldwide for fat destruction. The safety & efficacy of this procedure is often questioned by medical professionals not familiar with it.

These are just a few papers published in reputable medical journals that look at what happens to the fat after treatment, whether it works and whether it is safe. There is none so blind as those who won't see. Mesotherapy may be slow, but there is good evidence that it is effective and safe.

[1] Dermatol Surg. 2008 Jan;34(1):60-6; discussion 66.

Phosphatidylcholine and sodium deoxycholate in the treatment of localized fat: a double-blind, randomized study.

Salti G, Ghersetich I, Tantussi F, Bovani B, Lotti T.
Centro Chirurgico Florence, Florence, Italy. giosal@fol.it

Each patient received injections of a phosphatidylcholine/sodium deoxycholate preparation on one side and sodium deoxycholate on the contralateral side, each single patient being herself the control. Four treatments were carried out every 8 weeks in a double-blind, randomized fashion.

Both treatments have shown moderate and equivalent efficacy in treating localized fat, with sodium deoxycholate having a slower postoperative resolution, suggesting that sodium deoxycholate could be sufficient by itself to determine fat cell destruction and that phosphatidylcholine could be useful for obtaining a later emulsification of the fat.

[2] Dermatol Surg. 2004 Jul;30(7):1001-8.

Detergent effects of sodium deoxycholate are a major feature of an injectable phosphatidylcholine formulation used for localized fat dissolution.

Rotunda AM, Suzuki H, Moy RL, Kolodney MS.
Division of Dermatology, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA.

Cell viability and cell membrane lysis assays were performed on cell cultures and porcine skin after treatment with the phosphatidylcholine formula, isolated sodium deoxycholate, or common laboratory detergents Triton-X 100 and Empigen BB.

A significant and comparable loss of cell viability, cell membrane lysis, and disruption of fat and muscle architecture was seen in cell cultures and tissue specimens treated with the phosphatidylcholine formula and isolated sodium deoxycholate.

[3] Dermatol Surg. 2007 Feb;33(2):178-88; discussion 188-9.

Action of sodium deoxycholate on subcutaneous human tissue: local and systemic effects.

Yagima Odo ME, Cucé LC, Odo LM, Natrielli A.
Department of Dermatology, School of Medicine, University of Santo Amaro, São Paulo, Brazil. marina.odo@uol.com.br

Sodium deoxycholate (SD) induces an inflammatory reaction in subcutaneous human fat and dose-dependent adipocyte lysis with acute pain and fibrosis. No systemic effects were detected.

[4] Dermatol Surg. 2006 Apr;32(4):465-80

Mesotherapy and phosphatidylcholine injections: historical clarification and review.

Rotunda AM, Kolodney MS.

Department of Dermatology, University of Southern California School of Medicine, Los Angeles, California, USA. arotunda@hotmail.com

All the published studies evaluating the clinical efficacy of traditional mesotherapy currently originate from Europe. These reports focus primarily on musculoskeletal pain and vascular disease, rather than cosmetic applications. Although experimental data suggest that a number of traditional mesotherapy ingredients may theoretically reduce fat, these effects have not been supported in peer-reviewed studies. An increasing number of reports demonstrate that subcutaneous injections of a formula containing phosphatidylcholine combined with its emulsifier, deoxycholate, are effective in removing small collections of adipose tissue. Cell lysis, resulting from the detergent action of deoxycholate, may account for this clinical effect.

Mesotherapy is distinct from a method of treating adipose tissue with subcutaneous injections of deoxycholate alone or in combination with phosphatidylcholine.

[5] J Cosmet Dermatol. 2007 Dec;6(4):250-7.

Submental fat reduction by mesotherapy using phosphatidylcholine alone vs. phosphatidylcholine and organic silicium: a pilot study.

Co AC, Abad-Casintahan MF, Espinoza-Thaebtharm A.
Jose R. Reyes Memorial Medical Center, Rizal Avenue, Sta. Cruz, Manila, Philippines. genjoabby@hotmail.com

Mesotherapy using phosphatidylcholine vs. phosphatidylcholine plus organic silicium was similarly effective in reducing submental fat. There was no significant difference between them in terms of rate and degree of reduction. Optimal reduction of submental fat was achieved after three treatment sessions. Adverse reactions were few, mild, and transitory. Therefore, both regimens are safe, efficacious, cost-effective, and can be used as alternatives to invasive surgical procedures.

[6] J Drugs Dermatol. 2003 Oct;2(5):511-8

Phosphatidylcholine in the treatment of localized fat.

Hexsel D, Serra M, Mazzuco R, Dal'Forno T, Zechmeister D.
Doris Hexsel Dermatologic Clinic, Porto Alegre, Brazil. dohexsel@zaz.com.br

Clinical results reflect that phosphatidylcholine was efficacious in reducing the fatty pads in the treated areas, with few side effects. From the authors' point of view, the off-label use of phosphatidylcholine in the treatment of fatty pads and small areas of localized fat is safe, low cost, and effective.

[7] J Cosmet Laser Ther. 2005 Mar;7(1):17-9.

Histological changes associated with mesotherapy for fat dissolution.

Rose PT, Morgan M.

Punch biopsies were taken at one and two weeks after mesotherapy with PC and DC. Each of the biopsies taken at one and two weeks after treatment with PC and DC showed a normal epithelium and dermis, with a mixed septal and lobular panniculitis. The fat lobules were infiltrated by increased numbers of lymphocytes and, in particular, macrophages. The macrophages consisted of conventional forms, foam cells, and multinucleated fat-containing giant cells. The inflammation was associated with serous atrophy and microcyst formation.

[8] Aesthetic Plast Surg. 2006 Jul-Aug;30(4):474-8.

Injection of phosphatidylcholine in fat tissue: experimental study of local action in rabbits.

Rittes PG, Rittes JC, Carriel Amary MF.
Santa Casa School of Medicine, Rua Afonso Braz, 864, cj. 72, Vila Nova Conceição, São Paulo, SP, Brazil. prittes@terra.com.br

Using a randomized, blind approach, 10 rabbits were injected with an experimental assay of phosphatidylcholine (the biologic model), and another 10 rabbits were injected with physiologic saline. A histologic study was conducted, and the Mann-Whitney test was applied.

A marked difference was observed between the two groups with respect to necrosis, inflammatory exudation, and fibrosis.

[9] Aesthetic Plast Surg. 2003 Jul-Aug;27(4):315-8.

The use of phosphatidylcholine for correction of localized fat deposits.

Rittes PG.

Subjects with localized fat deposits commonly receive suction lipectomy as a cosmetic procedure. A new office procedure for correction of those superficial fat deposits was applied in 50 patients by injection of phosphatidylcholine. The method itself consists of using a 3OG1/2 insulin needle to inject about 5 ml (250 mg/5 ml) of phosphatidylcholine into the fat, distributing it evenly in an 80 cm2 area. Pre- and posttreatment photographs were taken for technical planning and analysis of the results over the long term.

A clear improvement occurred in all, with a marked reduction of the fat deposits without recurrence over a 2-year follow-up period and no weight gain. The injection of phosphatidylcholine into the fat deposits is a simple office procedure that can sometimes postpone or even replace surgery and liposuction.

[10] Dermatol Surg. 2001 Apr;27(4):391-2.

The use of phosphatidylcholine for correction of lower lid bulging due to prominent fat pads.

Rittes PG.
Clínica Patrícia Rittes, Sao Paulo, Brazil. prittes@ruralsp.com.br

Thirty patients were treated for prominent lower eyelid fat pads with phosphatidylcholine injection. Pre- and posttreatment photographs were taken for long-term analysis. A marked reduction of the lower eyelid fat pads was noted over the 2-year follow-up period. There were no recurrences.

The injection of phosphatidylcholine (250 mg/5 ml) into the fat pads is a simple office procedure that may postpone or even substitute for lower eyelid blepharoplasty.

[11] J Cosmet Dermatol. 2006 Sep;5(3):218-26.

Clinical experience and safety using phosphatidylcholine injections for the localized reduction of subcutaneous fat: a multicentre, retrospective UK study.

Palmer M, Curran J, Bowler P.
British Association of Cosmetic Doctors, 30b Wimpole St, London, UK. mark.palmer@mail.com

Thirty-nine UK doctors specifically trained and experienced in this treatment completed questionnaires, focusing on outcome and adverse effects experienced by patients. Ten thousand five hundred and eighty-one treatments had been administered over a mean duration of 13.1 months. Localized adverse effects (swelling, erythema, burning/stinging, pain, tenderness and bruising) were described by most patients as "very mild' (18.4%) or "mild" (39.2%). The total incidence of systemic side-effects was 3%: diarrhoea, nausea, dizziness/light-headedness and intermenstrual bleeding were described by most patients as "very mild" (36%) or "mild" (55%). Only 15 (0.14%) "unexpected, unusually severe or prolonged" adverse reactions (commonly pain and/or swelling) were reported. These were all self-limiting and none were judged as serious. 73.8% of patients were either "very satisfied" or "satisfied" with treatment.

This treatment appears to be associated with minimal risks when used by specifically trained and experienced doctors. The possible risks associated with this treatment should be balanced against the risks of other treatment options.

[12] J Am Acad Dermatol. 2005 Dec;53(6):973-8.

Lipomas treated with subcutaneous deoxycholate injections.

Rotunda AM, Ablon G, Kolodney MS.
Division of Dermatology, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA. arotunda@hotmail.com

All lipomas decreased in size (mean area reduction, 75%; range, 37%-100%) as determined by clinical measurement (with ultrasound confirmation in one lipoma) after an average of 2.2 treatments. Several lipomas fragmented or became softer in addition to decreasing in volume. Adverse effects, including transient burning, erythema, and local swelling, were associated with higher deoxycholate concentrations but resolved without intervention. There was no clear association between deoxycholate concentration and efficacy. Low concentration deoxycholate may be a relatively safe and effective treatment for small collections of fat.

Lipo Laser Enhances Liposuction Recovery

Our unit arrives next week. WAL is already reputed for quick recovery. This addition will cut down discomfort, bruising and swelling even more!

MOH to let professionals regulate aesthetic treatments

Source: Channel News Asia
By Hoe Yeen Ni, Channel NewsAsia | Posted: 23 March 2008 2134 hrs

SINGAPORE: The Health Ministry appears to have changed its stand on aesthetic treatments and what procedures can be performed.

It now says it will leave the regulation of the industry to professional bodies, while it turns its attention to the safety of patients instead.

Health Minister Khaw Boon Wan said there is a lot of "grey area" in the industry and it is "not possible" for the Ministry to stop doctors from performing aesthetic treatments if there is a demand.

Mr Khaw clarified the MOH's position following media reports surrounding last week's crackdown on doctors who perform unproven procedures.

The MOH said that regulating the beauty industry is especially challenging as in many cases, scientific evidence is missing or inconclusive.

Furthermore, it added, taking a hard, regulatory approach will mean the prohibition of many procedures. This is not practical and it is not what MOH is advocating, stressed Mr Khaw.

The MOH's remarks came just a few days after it issued what amounted to a ban on certain procedures, such as fat-zapping mesotherapy, application of stem cells to revive the skin or the use of anti-ageing hormone and skin-whitening shots.

It said these have no scientific evidence and should not be practised at all, whether or not the operator has had training.

The MOH had also issued a stern warning that any doctor found doing these "unsubstantiated" procedures will be referred to the Singapore Medical Council for disciplinary review.

But now, that stand seems to have been changed.

"Because I'm not familiar with mesotherapy, I don't even know what it is. So let's leave it to the professions to sort it out," said Mr Khaw.

"The human urge to do this kind of things are plentiful. So who are we to say, stop it? We can't do that," he added.

But what the MOH will do is that it will regulate on high-risk, highly-invasive procedures.

Mr Khaw said his Ministry is working out guidelines which will stipulate who can perform what treatments.

He declined to indicate when the guidelines will be published.

The Academy of Medicine and the College of Family Physicians are also formulating principles to govern the ethical practice of all procedures.

But the question remains -- can doctors carry on in the meantime?

"Doctors are supposed to do what they think appropriate, taking into account possible benefits, and then possible risks. So that's a decision which doctors have to make all the time. Because if they fail to do that, they could be subject to investigation," said Mr Khaw.

Mr Khaw also said that consumers should know what they are getting into before taking the beauty plunge. - CNA/ir