Wednesday, October 23, 2013

Asiatic Aesthetic Series 240: Lasers and hi tech gadgets in private practice

 Many doctors want to know how they can have a reasonably successful practice ,using gadgets that do not cost too much but  give reasonably good results.

These days, lower cost products are available, with good patient satisfaction. The combined IPL and RF (2 in 1 device) successfully treats many skin conditions and causes less side effects in patients of colour . Radio frequency has no target chromophore and  is safe in all skin types.The combination of radio frequency with intense pulse light significantly reduces the problems of post procedure hyper pigmentation in darker Fitzpatrick types. IPL used in isolation can cause unwanted side effects in darker skin types, which include burns and hyperpigmentation.

The Nd YaG 1064nm laser is also a useful addition to the initial collection because of it's versatility and safety in darker skin types.
The investment can be recovered within a few years ,enabling the practitioner to add more items in the future.
These two models ,along with a microdermabrasion machine is adequate for an initial practice and ensures a reasonably good start to the business.

The above gadgets should not be used by those who have not been certified in the use of lasers and IPL machines. Unless one has taken the necessary trainings and has adequate experience in the practice of aesthetic procedures with good patient numbers,the complication rates will be unacceptably high. 

Many of the complications one reads about in unregulated med spas and aesthetic practice are caused by inexperienced ,or even poorly trained /untrained professionals.Patients undergoing aesthetic procedures need to understand the benefits and side effects of the procedures and not shop for cheaper options.

Sunday, October 20, 2013

Asiatic Aesthetic Series 239: great expectations?

Aesthetic medical practice has many enquirers .Doctors involved in this speciality often use means to convince patients to buy their stuff. An honest plastic surgeon who has many years of experience in the field knows that not all aesthetic treatments work.Unsuspecting patients are often made to believe that the procedure that is being being marketed is the best,if not the "one and only".
This sort of practice is quite rampant in today's medical world where doctors try to get as many clients as they possibly can and promote their methods as unique and exclusive. The present fad will last for a few months. By then, most would have realised the truth behind aesthetic procedures.

It is not fair on the part of a plastic surgeon to use  simple methods like micro polishing on a Glogau Type one patient who has healthy Grade O skin which has no wrinkles,very few pigmentary changes,well hydrated skin and no keratosis, to tell other patients that they could look like this if only they use this method of treatment and look like this young model.In fact, all the patient needs are mild exfoliants ,moisturizers and antioxidants. The same is not true for more advanced intrinsic and extrinsic aging,or for darker skin types.

Great expectations often lead to great disappointment in the aesthetic medical world. 
It would be more honest and better for one's own conscience if a clearer picture of aging and treatment options is presented to all our clients.

Thursday, October 17, 2013

Asiatic Aesthetic Series 238: Decreasing sebum production in acne with SA

(pic: body language UK 2007 p.55)

Apart from scarring,one of the troubling effects of acne in young patients is the excessive production of sebum leading to whiteheads,blackheads and pus formation.The bacterial infection by anaerobic propionibacterium acnes is effectively treated with antibiotics like  tetracylines,doxycyline, or septran,along with combinations of clindamycin cream and benzyl peroxide gel .

In this section, the focus is on the efficacy of 30% salicylic acid for the above complaints.Salicylic Acid is the best acid for treating this type of acne . Because it is a beta hydroxyl acid with large molecules, it stays on the surface of the skin and exerts its effects superficially,acting within the pores and exfoliating the skin and removing excess sebum. 

The skin in darker individuals is usually treated with 4-5 weeks of  4% hydroquinone in order to lessen the chances of hyperpigmentation later. Some patients will experience flaking of the skin for 2-5 days post peel;moisturizers are needed following treatment for about a week to ten days.
Sunblock should be used for the next six months.

The post peel results are good and there will be a significant reduction in sebum production,and elimination of comedones as well.


Wednesday, October 16, 2013

Asiatic Aesthetic Series 237: 2600 plastic surgery patients

 The true story of this blogger who operated over 2600 plastic surgery patients in medical projects from 2003 -2013 across Arabia Felix.The book is presently being written, and it will be published in the near future.
Thanks to so many who stood in the gap along the way, and made this miracle mission happen for poor plastic surgery patients across a troubled nation.

Tuesday, October 15, 2013

Asiatic Aesthetic Series 236 :Staying Safe in Aesthetic Medical Practice

One of the ways to stay safe in the practice of aesthetic medicine is to follow some  useful rules in the business:

1. A good overall knowledge of the speciality and the latest advances in the field,along with work experience and hands on knowledge of safe procedures,downtime, expected results and side effects
2.A good understanding of skin colour types and what treatments best suit different skin types.The role of skin conditioning cannot be overemphasized.A proper conditioning programme avoids many of the dreaded complications of hyperpigmentstion and hypopigmentation.
3.A thorough knowledge of facial anatomy;this is one of the most important aspects of a good and successful practice of the speciality for all physicians. Non physician injectors and non medical practitioners can cause a lot of problems because of their limited understanding of facial anatomy.
4.Using only those products which have a well researched safety profile.Botox and fillers are common in the practice and one does well to research the products before using them.Many spurious brands of botox are found in the market these days and it is best to stay safe and  deal mainly in three well known international products- Botox(Allergan,Merz etc),Dysport(US), and Xeomin(Germany). Better to avoid and research  Spaintox,and botox from China,Russia and Iran which generally do not contain accurate amounts, or no botox at all.
5.Facial assessment before any procedure includes skin types,soft tissue problems and craniofacial skeletal support of the structures.Each entity can be addressed during the treatment process,thereby giving an overall desired outcome after  rejuvenation procedures.
A cookie cutter template will not work for all patients and one has to play by ear, improvising according to the different presentations of each patient. The art takes time to master and one learns many useful lessons along the way.
If the above rules are strictly followed,one can expect minimal complications and successful outcomes for most procedures.

Friday, October 4, 2013

Asiatic Aesthetic Series 235: 960 families with cleft children benefit from free smiles

Nine hundred and sixty familes with cleft children have benefited from free cleft lip and palate surgeries from Feb 2010 till October 2013.
Some of the children are referred to child specialists for further care,till they gain weight and are fit for the surgeries.
The numbers continue to grow at the charity camps and many are being helped across the region.
Some operations were postponed because the children were sick with respiratory infections,anemia,heart problems, poor oxygen saturation and low weight.
The palate operations are usually more difficult and require more precise planning. We usually do about 4-5 palate surgeries at each camp.

Thursday, October 3, 2013

Asiatic Aesthetic Series 234:Lip advancement in cleft lip surgery

Case: The patient had a previous cleft lip operation with the following post op problems:
1.lip notch
2.distorted Cupid bow due to  marking errors surgery thin lip

The lip was redesigned using: markings for the Cupid bow
2.Mucosal advancement for the new lip, to make it fuller
3.correction of the lip notch