New Acne Zapper Device

When I went to Cosmoprof in Hong Kong last November, the only item that really caught my attention was a handheld acne management device. It's not much thicker than a standard lipstick and promised to clear up acne spots within 24 hours.

The device is called Clean and is made in Korea. I spoke briefly to the guy in charge, but they were clearly not after individual clinics or spas. The minimum order volume was way more than I could ever hope to sell.

As I was visiting the fair with Andy from Ocean Health, I dragged him along to see it. It would be a great addition to their TDF acne skincare range. As with all skincare, however good it is, breakthrough spots will occasionally appear. This was ideal to clear it up quickly.

So how does it work?

The device emits heat and blue light. Both act to neutralise the acne causing bacteria. In fact, Zeno, which retails at about $400 works on heat alone.

This device is reusable, rechargeable and has no consumables. It should last for 2 years, and is charged through a USB cable.

The burning question in everyone's mind was "does it work"?

So Andy persuaded the Korean guy to sell him a few pieces for trial. Over the past few months, the tests that have gone on have shown great results. Spots have been clearing up in just 1-2 days, without any scars.

I sold one to a Bangladeshi patient, who brought it home & shared it with her relatives. She reports good response.

So we've started selling this device in the clinic. It's just $250+GST for now. Ocean Health is still trying to figure out the best price point for this, and this price is likely to increase in the near future. In the meantime, if you'd like your personal acne zapper, please call Simply Aesthetic to reserve one. We hold limited stocks, so may not have enough supply between deliveries.

Hair Loss Treatment to Reduce Hair Fall

Many years ago, when we first started with mesotherapy, one of the cocktails was for stimulating hair growth. We tried it on one of Ivan's friends, and were amazed when we saw baby hairs growing after just 3 treatments. This is a young man who'd been thinning since his teens, and his hairline was receding pretty significantly.

By the end of the first course of treatments, there was a lot more hair than what he began with.

But mesotherapy was expensive. The products were costly, and it was a pretty time consuming process too. I really don't know how uncomfortable it was. I used a meso gun to inject the cocktail into the scalp. It felt like I was running a sewing machine over his head. There was a little bleeding too. He was very brave though, and endured it all very well.

Fast forward to 2010. Mesotherapy's been banned for years now. Hair lasers and hair transplantation are very much in. Hair loss, particularly in the young, is getting way too common. Blame it all on stress and junk food!

I was given a few samples of XL Hair to try out a few months ago. Our test case was a young man, still in NS. His hair was thinning out really badly. He'd been quoted thousands by a hair speciality centre, which was way out of his budget. For some reason, his girlfriend called us.

We started the protocol on him, not knowing what results we'd see. To our amazement, his hair started to grow back about a month after we started treatment. And it was a simply jetting of a hair tonic with 47 active ingredients into his scalp, followed by a massage. He did have to use a home serum 3 times a week too. But after 8 weeks, he was done!

This time, there was none of the discomfort or bleeding associated with mesotherapy. No drugs involved, just primarily vitamins, amino acids and minerals. Pure nourishing of the hair follicles. Good for male hair loss as well as female hair loss.

After waiting a few more months, stocks of the product are finally in. This may be the cheapest hair loss treatment in Singapore. I could charge much more, but I really don't see the point. I believe in fair prices, after all, this is likely to require maintenance treatments over time. And $150 per treatment is certainly worthwhile to maintain a healthy head of hair.

End of Liposuction at Simply Aesthetic

It is with great sadness that I announce the end of Waterjet Liposuction at Simply Aesthetic. Our final operation will be on Monday, 9th February.

This decision was a tough one to make. There were many factors, including the lack of demand for a relatively more expensive liposuction technique. Few seemed to appreciate the safety and recovery benefits associated with WAL. The recent liposuction death has reduced demand even further.

Most importantly, however, is that my personal health has not been optimal recently. I have had spasms in my left trapezius muscle behind my shoulder on and off for the past few months. There is some discomfort almost every day, which is usually tolerable. However, at times, the pain moves to my left arm and elbow. When this happens, the entire arm can go numb and weak. I can still just about cope with small liposuction procedures, but certainly not big ones.

With the unpredictability of this dysfunction, plus the negative market sentiments, we finally made the very difficult decision to discontinue liposuction services, at least for the time being.

Although liposuction is great for contouring, our recent results with Ion Magnum has shown that tremendous results can be obtained withoit surgical risk and downtime. The current machine is uncomfortable, but we have ordered the upgraded Magnum 2 which promises to be very comfortable. That should be arriving in the next few weeks.

Personally, I too have lost 4kg in the past month, with simple dietary changes (no starvation), oral supplementation and Thermojet sessions 2-3 times most weeks. You can read more about it in my personal blog. I'll be happy to share more during consultation.

Inevitable Price Increases

Despite our costly move to Robertson Walk, we've always tried to maintain our fair prices, particularly for popular treatments such as IPL and chemical peels.

Unfortunately, we're not only in the position of having higher overheads (rental, utilities and staff), but our suppliers have also increased the cost of our consumables and skincare products quite significantly over the last few months. For some items, the increase has been over 100%!

We therefore have had to increase the price of some of our popular treatments in line with the increase in our costs to deliver the treatments. It's unfortunately inevitable. We're keeping the costs as low as physically possible, and creating packages in order to create more value.

As such, we apologise that any quotations given previously may now be out of date. Please do check with the clinic staff (call 6732 5527) to confirm current pricing.

On the bright side, Simply Aesthetic now as a new manager who will oversee operations. Julie Lee comes from a spa background, and has many ideas on how to truly pamper each of our patients whenever the opportunity arises. So watch this space to find out the details as they unfold! And no worries, these little touches come with our compliments!

Upgrading Ion Magnum

The Ion Magnum has become the most valuable asset that we own. The results we have had for some of the more persistent patients have been quite amazing. However, the number of patients who are unable to have adequate treatments because of treatment discomfort is also significant.

I had always thought of it as a "no pain, no gain" situation, plus "you reap what you sow". Afterall, even normal exercising can be uncomfortable and results are proportional to effort put in. However, I recently received an e-mail from Ion Genius, the distributors of Ion Magnum. It was primarily to inform us that the cost of the machine had increased yet again, but there was a small one-liner mention about thev latest version being very comfortable. Intrigued, I decided to find out more, and most importantly, if it was possible to upgrade mine.

After a lot of e-mailing back & forth to the Ion Genius team, we have finally come to a compromise. The upgraded machine will be ready sometime in February. They are including all the latest modifications, so we move from the earliest version to the latest. Treatments should be more comfortable. Resistance reduced, so results should be better. Personally, I'd love to get up high on the intensity scale & not feel too much.

As the upgrading comes with a hefty price tag (of double my budget, but hey, I'll do whatever is best for my patients), so once the new machine arrives, the price will have to go up. Sadly, my credit card bill will be here before the machine arrives. We are already offering the treatments at about half the price of another Singapore aesthetic clinic, but the new prices will still not be that high. I believe in fair prices and affordability long term. Clients who have expired packages will have to renew at prevailing rates once the new machine arrives. Those on existing packages will continue on the lower current prices as long as they maintain a balance, ie renew before expiry.

Sculptra Liquid Face Lifting

I'd heard of Sculptra many years ago, but other than it being a type of filler for large volume facial filling, never thought much more about it. However, when I saw a video presentation about it at a recent aesthetic conference, my interest was piqued. As an added bonus, as part of the launch of the product in Singapore, they were offering to train interested doctors for free. Their trainer was scheduled to fly in from Australia to give personal tuition to each interested doctor.

It was our turn today!

We had three excited (albeit a little nervous) volunteers lined up for the treatment. One had a full liquid face lift, going from temples to upper cheeks to naso-labial folds to jowls. The second had filling of her hollow tear troughs and below her acne scars. The last, sadly, was breastfeeding, so was postponed till January.

The technique is pretty straightforward. Each treatment could be done in 10 minutes once perfected. We didn't really take much longer, just wasted a lot of time joking around with each other. The volume increase is seen straight away, so the response from both volunteers was "wow!". Pin point bruising is possible, but this resolves quickly. The "swelling" lasts a couple of days, then the body slowly builds new natural collagen over the next ten months. A top-up (if required) is done a month later. The final results last 2 years.

So why do I want to learn Sculptra? We've used machines for face lifting for years now. It works well for some, not so well for others. The less adequate results are usually with people with low cheek volumes. Even surgical face lifting would not give great results with such folks, as the skin might be tight, but the features not youthful.

So what does Sculptra do? By stimulating new collagen production, it adds volume to the face. Three vials are required on average, but very thin faces may need 10! The skin quality also improves. And by injecting in specific traction lines, a lifting effect can be created.

I was quite concerned about the safety of the product. There are some scary stories online, afterall! So I quizzed them in detail. As a company, Sanofi looks at all the problems seriously, and concluded that the problems occurred with wrong technique and/or bad practice. Early on, they diluted the product with very little water, so the product set into hard rocks. Now, it is injected extremely dilute, and carefully massaged into the face to ensure even spread. Tear trough reconstruction can be safely approached by injecting upwards from the mid cheek. The lumps seen are from depot injections directly through the eye muscles into very thin skin. The product also had to be diluted the day before to ensure complete dissolution. That is a relief, as hollow tear troughs & flat cheeks are extremely common and result in premature ageing.

So I'm very happy to finally have a volumizing treatment available. Well, once we order the product anyway... But that won't be too far in the future.

Urticaria!

Urticaria is a skin condition that can afflict people for many months (to years) at a time. Itchy lumps appear out of nowhere & move from one area to another, causing havoc with work, sleep and social activities. It's not a condition aesthetic doctors deal with, but a topic dear to my heart as I have suffered on & off with this for decades! So when the opportunity arose this week for me to attend a lecture by a world expert from Germany, I jumped at the chance!

Turns out, there can be many causes of chronic urticaria, from infections (teeth, tonsils, gut), to environmental factors (hot, cold, exercise, etc), food intolerances and an inherent tendency towards the condition. And to complicate matters, an affected individual may have 2 causes, or require 2 sets of conditions to co-exist before developing urticaria!

I know I had food intolerance issues: the ALCAT test proved my excessive ingestion of tomatoes caused my incessant itching two years ago. The latest bout seems to have settled down, and I have yet to find a trigger other than "stress".

Which really brings me to treatment. Stopping the cause is ideal, but locating the cause may not be easy. The aim ultimately is for cure and/or stopping all symptoms. Without the cause, we are left with a series of pharmacological interventions. Starting with a non-sedating antihistamine at standard dose, then quadrupling it to maximum dose for another month. If this is insufficient, then other fancy drugs get added.

Anyway, the anti-histamines have been ordered. I'm desperately awaiting their arrival. Not so much for the skin now as for my allergic rhinitis. The joys of being atopic (tendency to allergic rhinitis, urticaria, eczema & asthma)...

How this is related to standard aesthetic practice? By controlling urticaria, we stop skin trauma from excessive scratching. And scratches can cause severe post-inflammatory hyperpigmentation (PIH). PIH is relatively easy to treat on the face (eg after acne), but seems much more stubborn on the body, particularly legs.

Melasma Treatment Options

I've been told that Melasma is very common amongst the Asian population. But in my 3 years of Aesthetic practice, I've hardly seen a single case! So although I was always intrigued by how to treat this very common condition, I've never had much opportunity to try it out.

Melasma, also known as Chloasma and "mask of pregnancy" is a hereditary condition that causes the deposition of pigmentation in the face. The brown discolouration has indistinct edges and predominantly affects both cheeks, athough the forehead ad chin can be affected too. It is predominantly seen in women, worsened by hormonal stimulation (pregnancy, oral contraceptive pill) and sun exposure. The pigmentation can be at various leves, from superficial to relatively deep.

The treatment options have been relatively limited, with creams containing Hydroquinone (such as Triluma) being first line. Although it is known that lasers do not improve the condition, it seems people continue to persist trying!

When we obtained the Nano Perfector last year, the treatment of Measma was one of the draws. Apparently, relatively recent onset Melasma could be reversed quite quickly with this device. We have yet to try this. Upon discussion with Dr Xanya Weiss recently, she now says that it can cause a lightening, but it didn't sound hugely dramatic. Perhaps it's as well we've not had any patients to treat in this way?

I'd also been hearing about the success our Thai friends have been havng with soft plasma peeling for Melasma. So when the opportunity came about for me to tag along with our local distributor for training, I jumped on it!

The treatment protocol for plasma peeling Melasma came about because the doctors were treating Melasma with lasers. What started off as superficial Melasma was recurring as deep Melasma. So from a light brown, it was turning very dark. Naturally patients and doctors were distressed, so they started to look for alternative options.

The protocol now involves rather aggressive plasma peeling with iontophoresis and the occasional glycolic peel. The skincare regime has also been documented, including exact quantities for best results. Downtime is minimal.

I met one lady who has been treated for the past year. She started off wth significant melasma over both cheeks. Now it is barely visible and her skin glows. There is still a light hit of the underlying condition, but she is happily continuing treatments in hope that it will one day be gone.

We are also bringing in Estelan, a program that is modified from Cosmelan. This starts off wth the application of a cream in clinic. This is left on for 4 hours, so washed off at home. Then twice daily application of Estelan 2 continues the treatment for the next few months. There is some peeing and redness after the initial peel, but by all accounts the results are pretty decent and provides rejuvenation & lifting as well as de-pigmentation. This is perfect for the person who is able to tolerate a few days of downtime and doesn't want the inconvenience of regular trips to the clinic for pasma peeling.

With the introduction of these two services, it's interesting that I am starting to see some patients with Melasma now. So I'm really looking forward to assessing for mysef which of these is more superior in the long term.

Surprisingly Effective Puffy Eyes Treatment

I saw my friend Ivan for the first time in ages yesterday. I was horrified to find huge eyebags under his eyes! I don't remember him ever having any problems in that area before. The skin also looked a little dark and water-logged. I was just about to convince him into a little bit of Botox when I remembered that I had a new eyebag treatment.

The new eye mask, in conjunction with Aesthetic Dermal's Meso-K Arnica Solution is primarily used for reducing dark eye circles. The Vitamin K helps to strengthen the blood vessels in the eye area. Leakage in weak blood vessels causes the deposition of pigmentation in the delicate under-eye area, hence dark eye circles.

The treatment is pretty straightforward: 3 drops of Meso-K Arnica solution is massaged under each eye. The mask is applied and moistened with toner. It is left on for 15 minutes before the mask is massaged into the under-eye area.

One hiccup: when the 15 minutes was up, I was the only one free! And I can't massage to save my life, let alone do any fancy lymphatic drainage movements. So poor old Ivan had me rubbing this stuff into his face, until Cha took over. Now Cha's a nurse by training, so although more gentle with facial massage, equally clueless about lymphatic drainage.

After about 10 minutes, the sheet mask turned sticky goop was pretty much all absorbed. We had to wipe off some of the residue so Ivan could open his eyes and see, but otherwise it went pretty smoothly for our little play.

Ivan's eyes looked brighter straightaway. Less puffy. This was even more obvious half an hour later. I have no idea how long the results will last. He didn't get a bottle of Meso-K Arnica to continue the treatment at home. So his results won't be maximised by any means. I guess if he likes it, he could purchase a full kit for home use. These are available by pre-order only as we don't hold any stock at the moment.

I'd say that this was a successful trial of a new product. The dark circles were certainly less apparent, and the puffiness totally gone. Bye bye eyebags! This service will be available at both Simply Aesthetic & Divine MedSpa once we finalise the price.

Last Few Weeks of Nano Perfector

The Nano Perfector has been a fantastic addition to my huge family of machines. It has been my favourite for face lifting and general rejuvenation. The response has mostly been positive. Instant results, painless, relatively long lasting... What's not to love?

But sadly, we'll be giving up this machine in just over a month's time. It'll be an upgrade to an even more powerful machine, that is currently still in the production phase. We've been waiting for this machine for the last 6 months. But they have delayed the production till they were absolutely 100% satisfied with the new machine.

And new machine it is! It started off as a new card within the Perfector casing. Now the engine is housed within a transparent casing, with snazzy LED display. There are 300 programs to choose from, and by all accounts the results are reven more remarkable than the Perfector. How could I refuse???

If everything goes to plan, the new machine will be delivered in early September. The price will increase, to cover the cost of the upgrade. However existing clients will continue to enjoy the current price as long as their packages have not lapsed. The increase will be at least 20% above current prices. We have a number of patients who have pre-purchased their treatments at the current super-low Perfector prices and are waiting (very impatiently) for the new model to come in. Us too!