Top 5 tips to enhance your immunity | Korean Aesthetic Clinic

Medical experts have warned that Covid 19 may well be around for the long haul. In the coming months, we may start to see a second wave from other countries. Experts noted that one the most challenging transmission modalities is a spread within the family. Hence, in my humble opinion, it is most important to learn what steps we can do, to protect ourselves and our families from this infection.

Inspired by my thoughtful buddy from Jebhealth, Jimmy Boey, this month, we will kickoff a series dedicated to #healthmatters #protectyourfamilies. We will start with discussing the TOP 5 tips to enhance your immunity. To make it easier to remember, we have coined a mnemonic WUHAN.

Dr Daniel Chang | Asia Aesthetic Dermatology
Dr Daniel Chang

TOP 5 TIPS TO ENHANCE YOUR IMMUNITY | And protect your families 🙏

  1. Workout regularly ||Fact: Studies show 30 min of exercise daily, be it brisk walking, swimming, jogging, aerobics, dancing, can help one to maintain a healthy weight and blood pressure. I strive to exercise daily, be it running, Tabata workouts or hitting the gym. The key is to keep standing, keep moving, and avoid a sedentary desk bound routine. For more exercise tips, feelfree to PM me.||Myth: The more exercise the better. Exercise is all good, but too much exercise can weaken your immune system, so always pace yourself. Last thing we want is an injury that lands us in bed and inactive for a month.
  2. Unwind and rest when your body tells you to || Fact: We need rest. We need good sleep. The duration of sleep varies from person to person, but the bottom-line is, sleep is necessary for restorative rest, to destress, reduce cortisol levels. Sleep experts advocate an average of 7 hours of sleep, and quality sleep, where one wakes up feeling refreshed and energised is the best. If you have difficulty sleeping, try a glass of warm milk and pistachios before bed =) Another mind restorative activity is mindful meditation. The mindfulness movement is the rage these days, and sitting still, taking some time to slow down, and be conscious of your breathing, emptying your mind and the numerous thoughts you have, is a practice most beneficial to your mind and body.
  3. Healthy connections || Fact: Staying in touch with family and friends boosts our immunity. Take for example Japan. Okinawans, long famed for their longevity, are a close knitted community. They stress the importance of regular laughter, sunshine and engaging in social activities. Neighbours know one another, and smiling, greeting and helping with day to day affairs is a common sight. A typical day starts with waving at your neighbours, a friendly smile and a simple catchup. Many participate in community activities like karaoke, dancing and gardening. Man was not made to live in isolation. Having strong social connections reduces risk of anxiety and depression, increases gene expression for immunity ( as per study by Steve Cole, UCLA), increases self esteem and creates a positive feedback loop of social, emotional and physical well being. Loneliness is on the rise. In 2004, over 25% of Americans saying that they have no one to confide in. Between April 2007 and 2012, a large and representative German adult population was sampled to investigate loneliness. It revealed a total of 10.5% of participants reported some degree of loneliness (4.9% slight, 3.9% moderate and 1.7% severely distressed by loneliness). All these data points to an increasingly isolated world. I am sure if we did a survey in Singapore right now, the figures would be not much better. How many close friends do you have? When was the last time you connected with a long lost friend or family member? It is never too late to do so. =)
  4. Avoid smoking and alcohol || Fact: Smoking and excessive alcohol causes the production of free radicals and in the long run, is detrimental to your health.
  5. Nutrition || Fact: A healthy diet, rich in fruits and vegetables, provides your body with the right vitamins and antioxidants to maintain optimum levels of health. Touching on the Okinawan diet, it stresses the healing properties of food together with calorie restriction. Okinawans eat less rice and less calories than the rest of Japan. Their meals consist a variety of fruits and vegetables (in the colours of the rainbow!) in small portions, and eating only until one is 80% full. I agree, eating less is not easy. I for one love my carbs haha. || Myth: The more vitamins and immune boosting supplements we take, the healthier we become. More is not necessarily better. Scientists agree that when our body has a deficit in a mineral or vitamin, taking supplement help. But it is not medically proven that taking excessive amounts of supplements, tumeric, garlic can protect ourselves against an infection. So moderation is key and dont be fooled by advertisers touting their immune boosting products.

So I hope these time tested methods are helpful to you and your family. Remember… 😉

  1. Workout regularly
  2. Unwind and rest
  3. Healthy connections
  4. Avoid alcohol and smoking
  5. Nutrition

This video is a brief summary of the above ☝️😊

Lets stay safe, stay healthy and together, we can protect our families. #sgunite #sgunited

– Dr Daniel Chang
💪💪
Dr Daniel Chang | Asia Aesthetic Dermatology
Dr Daniel Chang 🥼 – Fulltime Daddy (I wish!)| Part-time Kickass Writer 🤓| Key Opinion Leader for Medical Aesthetic Treatments 💉

References:

  1. Akerele O. WHO guideline for assessment of herbal medicines. Fitoterapia. 1992;63:99–104. 
  2. Bishop, NC, Walsh, NP, Haines, DL, Richards, EE and Gleeson, M. 2001b. Pre-exercise carbohydrate status and immune responses to prolonged cycling: II. Effect on plasma cytokine concentration. International Journal of Sport Nutrition and Exercise Metabolism, 11: 503–512.  
  3. Calder, PC. 1996. Fatty acids, dietary lipids and lymphocyte functions. Biochemical Society Transactions, 23: 302–309.  
  4. Calder, PC and Jackson, AA. 2000. Undernutrition, infection and immune function. Nutrition Research Reviews, 13: 3–29.  
  5. Buettner, Dan (2015). The Blue Zones Solution: Eating and Living Like the World’s Healthiest People. National Geographic.
  6. Emma Seppälä, Ph.D, is Science Director of Stanford University’s Center for Compassion and Altruism Research and Education and the author of The Happiness Track (HarperOne, 2016).

ACNE treatment Singapore guide |

ACNE free Skin|青春豆.痤疮治疗

acne singapore
acne maskne singapore

With year end coming, and heaps of feasting and merry making, the last thing we want are pesky zits appearing on our faces and spoiling our selfie taking habits. I hear you so sharing some tips to bring your best face forward this Christmas! =P

What are the 3 causes of acne?

Acne is caused by clogging of your pores by…

  1. Sebum
  2. Dirt and impurities
  3. Bacteria P acne

How can I clear up my acne?

  1. Good skincare and lifestyle measures – Which will be discussed later in this chapter
  2. Topical skincare – Your retinoids, keratolytics and antibiotics
  3. Special – Laser, Medical Peels, etc

Why acne is caused?

When your hair follicles are blocked, acne develops. It starts with non inflammatory comedones, your whiteheads and blackheads. Whiteheads are closed comedones, blackheads are open ones. When inflammation with P acne bacteria sets in, you get angry red pimples.

How common is acne in Singapore?

Acne vulgaris is the most common skin conditions in young adults in Singapore. It affects up to 80% of teens and young adults in Singapore. Stress, lifestyle and diet are the main triggers.

 Should I see a GP, or dermatologist for acne?

Mild cases can be dealt with by your friendly GP.

Severe cases are referred to see a dermatologist.

Severity is determined by extent of acne, number of inflammatory papules, and presence of scarring, cysts and deep seated nodules.

 

 

open_and_closed_comedones
how-acne-develops
how-acne-develops

Acne is the blockage of our pores. And if we dont manage it carefully, it can lead to acne scarring. Most acne medications BOUGHT OVER THE COUNTER are drying to your skin. They work by reducing sebum. Benzoyl peroxide works by killing the P Acne bacteria.

The flipside of course is the triggering of skin irritation and inflammationNever attempt to wage this battle alone. Acne is not rocket science. If over the counter medications do not work after 2 weeks, it is time to enlist the help of your friendly Dermatologist to guide you with a personalised treatment.

Post acne laser
Post acne laser

So the question is, how do we treat acne?

In the latest 2022 guidelines released, the American Academy of Dermatology recommends combination treatment for acne. The aim of treatment is to reduce acne outbreaks and minimise the dreaded acne scarring.I believe in the combination of good basic cleansing and toning, topicals+/- medication, chemical peels and laser treatment, to obtain optimum results. Acne should be actively managed to reduce the risk of permanent scarring.

Acne can be divided into non inflammatory, inflammatory and acne scars.

Non inflammatory acne:  consists of comedones, blackheads, whiteheads

1) Blackheads – extraction BY A PROFESSIONAL

2) Whiteheads – retinoids ( retacnyl, differin), AHA peels and scrubs to remove the gunk and unclog the pore. Retin A based creams work well on long term acne control, and have anti ageing benefits too.

Inflammatory acne: Consists of angry, red, bumpy  pimples

1) Benzoyl peroxide based topical treatment, plus minus oral antibiotics. | This is my secret and you can do this without seeing a doctor. Depending on skin sensitivity, I like to use clindamycin, clindoxyl and epiduo. I will explain more in my video.

2) Laser and AHA based medical peels | control your skin sebum, and increase exfoliation.

3) Blue light and antibiotics | to kill p.acne bacteria. Only when active acne is controlled, can we proceed to acne scar treatment.


Dr Daniel Chang’s 3 STEP ACNE Treatment SECRET Formula: 

1- Laser/ Light/ Peel

2- Topical medication +/- oral antibiotics

3- Lifestyle changes |


Combination Treatment |

Medical peels + Laser  Light + Blue light therapy ( unclog pores, control oil, kill p. acne bacteria)

  1. Cleanse gently, splashing with warm water and pat dry
  2. Apply moisturiser gently. No rubbing.
  3. *Top Homecare Tip*  Dab anti-acne cream, gently, no rubbing, with a cotton bud. Key to effective treatment here are ingredients containing retinoid + benzoyl peroxide. But balancing the side effects require time and careful use. |Epiduo, Differin cream, clindoxyl and clindamycin are my top choices | (Retin A based creams like retacnyl, differin work best with benzoyl peroxide based antibiotic creams for example clindoxyl and epiduo, but these products are harsher and do cause more skin irritation, so its important to learn how best to apply them onto your face for optimum efficacy and minimal side effects. Watch my video to learn more. 

    Daniel Chang

What topicals work best for acne?

adapalene | Vitamin Atopical retinoid + keratolytic
alpha hydroxy acid | glycolic acidkeratolytic


BPantiseptic + keratolytic
clindamycinantibiotic

Here’s my TOP TIP: A skincare regime using glycolic acid wash and toner + retin A at night and topical clindoxyl in the day time is my recommended for best results. Not all patients can jump to this regime so its best to start low and go slow.

Dr Daniel Chang


What can trigger
acne?

Lifestyle GUIDE for acne free skin


  1. Diet | Studies have shown that dairy products, food rich in GI, and fried oily food are a no no. They tend to provoke a hormonal surge, which is the trigger for acne. Thats probably why acne tends to affect people in developed countries, where the diet is so rich.
  2. Lifestyle | Stress is no good. Thats why breakouts tend to occur after frequent OTs, after a flight (as the cabin air is super-drying to your skin), before an important photo-event etc. Keeping a regular exercise regime and sleeping sufficiently helps!
  3. Contact | In this day and age, its our dreaded mask. Minimise contact with your fingers. Dap, and not wipe, your face with a towel. Apply cosmetics sparingly. Use oil-free, non comedogenic products. And when applying acne treatment like benzoyl peroxide, retinoids, adopt a hands-free approach. All these serve to reduce inflammation. As for how to select the right products for your skin, and how to use them appropriately, please speak to your Aesthetic physician for further information.

Now, let me share with you my TOP skincare tips for acne control.

  1.  Cleanse, exfoliate and go easy | Gently clean your face 2x a day, using a minimal touch technique. Dont overclean your face. (This is to remove all the old and dead skin that is clogging the pores, but not over irritating your skin.)
  2. Use oil free or ‘non comedogenic’ makeup products | Remember, you use makeup to look more beautiful, not to look worsen your acne.
  3. Never ever squeeze a pimple and minimise touching your face | I know its easier said than done. You risk scarring, darkening and spreading the pimple to other parts of your precious face
  4. Wash your pillowcase, and your pillow on a regular basis | *Question: How many of you still let your parents do this for you, own up now lol* Your pillows otherwise collect all the sebum, makeup and dirt that contribute to pore clogging.

Common pitfalls: Lifestyle mistakes

  1. No moisturiser used OR Mistaking aloe vera gel as a moisturiser | A well moisturised skin will help with sebum control and reduce clogging of pores, which leads to acne. And keep yourself well hydrated. Healthy skin starts from within. Oftentimes, the patients I see having breakouts do not use mositurisers. They may use aloe vera gel (which is NOT a moisturiser). Moisturising helps. The skin takes a month to get used to a new product. 2 months to stabilise. 3 months to gain good control.
  2. Too much makeup | When you cover your skin with heavy makeup, this becomes a vicious cycle as makeup clogs pores. If u run your fingers over your skin, you may feel mini bumps, common over the cheeks, jawline and forehead.
  3.  Habit of picking your pimples, squeezing them | *raises hand* I confess i have itchy fingers too lol! This is a major NO no! Scar and pigmentation risk is high. Some people go to beauticians for their extractions. I dont recommend this, but if you must, find a professional to do it for you.
neck acne
neck acne
forehead acne
forehead acne
male acne
male acne
teenage acne
teenage acne
Adult onset acne
Adult onset acne – Distribution is commonly U shaped
As a general rule of thumb I find that a nano-second laser, which serves to kill the P acne bacteria, shrink pores, and reduce oil production, is a good treatment to undergo. In addition, I would recommend the following coupled with a good skincare regime to get on top of your acne.Now acne can be classified into mild, moderate and severe. Below is a summary and their corresponding treatment.
  1. Mild (comedonal acne or mild inflammatory acne): topicals retinoids +/- AHA, BHAs
  2. Moderate: oral and topical antibiotics for inflamed acne, + benzoyl peroxide, +/- OCPs
  3. Severe (nodular): please speak to your dermatologist    

Now lets move on to common queries about acne. 

Why do some people get breakouts after a chemical peel or laser? 

There are 3 main reasons.

  1. Skin is too dry. Hence not suitable for treatment.
  2. Your skin is unstable, having active breakouts. This can be due to a multitude of reasons. Any treatment during this period acts to purge pimples.
  3. Skin is reacting to the skincare that was used after the treatment. Remember, it takes time to get used to a new product.

Why do many people get breakouts after a holiday?

1- Stress. This can be in the form of unhealthy sleep habits, unhealthy lifestyle, unhealthy diet, which often happens when we want to ‘live life to the fullest’ during our vacation. =)

2 – Change in humidity. This stresses your skin and oil water balance.

3 – They had too much yummi-licious food during the holiday!


Dermal filler review 2022 Ellanse vs Sculptra filler | 少女针.童颜针.玻尿酸

sculptra cost
cost of Ellanse in Singapore
Table of Contents

What is sculptra. What is Ellanse? | 少女针.童颜针是什么?

Sculptra is a unique PLLA based collagen boosting filler (poly-L-lactic acid = PLLA).

Sculptra works to restore your facial volume by activating fibroblasts in your skin to produce new collagen in a process known as neocollagenesis. Type 1 and Type 3 collagen are the key products.

Ellanse is a PCL based collagen stimulator, officially approved by MHRA in the UK and the FDA in the USA and for restoration and/or correction of the signs of facial fat loss (lipoatrophy) and is used for treating facial lines and wrinkles

What are patient reviews for sculptra filler?

On realself, a leading unbiased, objective patient review website based in the US, sculptra scores a whooping 82% from 1,041 reviews. Dont take my word for it. Read the 1041 reviews on their site. =) In my clinic experience, aesthetic treatments tend to yield subjective results. It is not often we get such high patient satisfaction rates. So for >1000 reviews and 82% ratings, its certainly SPEAKS volumes of the treatment.

Sculptra has been FDA approved for more than a decade, so it is backed by science and time tested evidence. The long term side effects have been well investigated.

What are patient reviews of facial fillers | dermal fillers in Singapore so far?

From realself, Dermal fillers have a >90% satisfaction rate for facial volume restoration and enhancement based on 3134 reviews. The reason being, Hyaluronic acid fillers have been FDA approved for use for more than a decade, so its safety and efficacy is without question.

What are patient reviews of Ellanse? | 为何要选择打少女针?

Because it’s a longer-lasting filler, you may have delayed side effects for as long as it stays in your body. It can’t be dissolved, if you don’t like the result or have a complication. RealSelf reviews who said it’s Not Worth It reported lumps and other visible side effects. Overall, a satisfaction rate of > 75% if used correctly in the right candidates.

However, do note that as of now… ELLANSE IS still NOT an FDA approved filler. The long term side effects have not been as extensively investigated as the fillers above, and persistent nodules and granulomas tend to occur in patient’s with altered immune reactions.

What is the cost of ellanse, vs sculptra vs facial fillers | dermal fillers in Singapore in 2020?

在新加坡打少女针价钱? 在新加坡打玻尿酸.乔雅登.绿珠兰.瑞蓝价钱?

This varies across the board. Cost depends on experience of injector. In experienced hands, prices of dermal fillers starts from $650…. Here is a breakdown.

Sculptra starts from $1500 per vial / session. Depending on your skin quality vial is 3-5 cc of product.

Ellanse starts from $1200 per syringe. Each syringe is 1cc of product.

Juvederm starts from $850 per syringe.

Teosyal starts from $650 per syringe.

Restylane starts fromm $700 per syringe.

There are basically 2 main types of dermal fillers.

Hyaluronic acid dermal fillers lnclude Restylane, Juvederm, Boletero, Teosyal range

Semi permanent, collagen boosting dermal fillers include Radiesse, Ellanse, Sculptra

What are the pros and cons of Sculptra vs Ellanse | 少女针.童颜针

Pros of Sculptra:

  1. Unlike hyaluronic acid fillers, that volumise sunken faces and fill wrinkles. Sculptra has the additional ability to promote collagen production over time.

2. With neocollagenesis, effects of sculptra last up to 36 months.

3. Collagenesis leads to skin tightening, whitening and brightening, a unique feature of sculptra.

4. Sculptra is a well regarded skin and facial volumiser. It can improve your dermis, subcutaneous and deep layers of your skin. It is particularly effective in patients with large facial volume deficits.

5. Sculptra is more cost effective when several syringes of dermal filler are required over extensive facial areas. Average cost of a sculptra programme ranges from $3600 – $5000, depending on the number of vials required. This works out to roughly the price of 4-5 syringes of Juvederm Voluma. In experienced hands, Ellanse starts from $1500 per syringe. The beauty of Sculptra is, you are getting more than 5cc of product =)

Cons of sculptra:

  1. Sculptra requires a minimum of 3 sessions unlike dermal fillers treatment which can be completed in 1 sitting. So more trips to your doctor is needed.

2. The results are not noticeble after a session. One would need at least 3 months for neocollagenesis to take place. So this takes time.

3. In some patients, who have reduced collagen producing properties, the effects of sculptra are reduced in terms of volume restored and duration or result.

4. Sculptra is not dissolveble unlike traditional Hyaluronic acid fillers. Hence for first timers who just want to augment a small area, I would recommend Hyaluronic acid fillers.

5. Compared to other dermal fillers like Ellanse, after Sculptra injection treatments, facial massage is NECESSARY AND A REQUIREMENT.


Sculptra vs Perlane | Restylane Lyft, which is better?

Price wise, Restylane Lyft starts from $799 in experienced hands.

Longevity is between 6 – 12 months.

Only a single session is needed, but depending on volume required, several syringes may be used.

Sculptra vs Juvederm Voluma, which is better?

Price wise, Juvederm voluma starts from $899 in experienced hands.

Longevity for midcheeks is touted to last up to 24 months.

Only a single session is needed, but depending on volume required, several syringes may be used.

Sculptra vs Ellanse, which is better?

This would be dependent on the clinician. In my clinical experience, I have had very nice results with sculptra. Several of my patients have fedback preferring the long term results of sculptra for skin volumizing, brightening and tightening.

What are the risks and side-effects of Sculptra?

In experienced hands, sculptra is safe and effective, as evidenced by realself.com.

Common risks of Sculptra include transient tenderness, swelling and bruising at the injection sites. 

There is a risk of lumpiness under your skin so be sure to massage firmly and attentively the first 5 days to optimise collagen growth.

Are there any post-treatment instructions after Sculptra?

After Sculptra injections, you are advised not to have any alcohol or exercise for the first 3 days to reduce the chances of bruising and swelling. 

I encourage my patients to follow the magic rule of 5s for facial massaging. 5x a day, 5 min each day for 5 days.

Is sculptra suitable for everyone?

I would avoid sculptra in patients with thin skin.

And in patients with poor neocollagenesis properties.

Pregnancy and breastfeeding are also contraindications.

How about Ellanse, Asthefill, PCL based fillers?

Background: Aging signs can be corrected through volume restoration in multiple soft tissue layers and in the supraperiosteal plane using hyaluronic acid (HA) or non hyaluronic acid (non-HA) fillers. The non-HA bioresorbable polycaprolactone (PCL)- based filler with collagen-stimulating properties has a proven safety profile, but rare potential complications such as nodules and granuloma can occur. Furthermore, PCL based fillers cannot be immediately removed by injection of an enzyme.

What is Ellanse used for? What is Ellanse?

It is a unique filler which has collagenesis properties.

Is Ellanse a permanent filler?

Ellanse is a unique dermal filler that works by correcting the wrinkles and folds in the skin, but also by stimulating the body’s own natural collagen to have a long lasting, natural result. It is a semi-permanent filler.

What studies support the safety and efficacy of Ellanse?

Polycaprolactone-based dermal filler complications:
A retrospective study of 1111 treatments
Shang-Li Lin MD

The author performed 1111 treatments between 2015 and 2018. This study
aims to review and analyze these treatments to ascertain the complication rates of the PCL-based filler.
Results: Among the 1111 treatments, there were 50 cases (4.5%) of edema that lasted longer than 2 weeks, 30 cases (2.7%) of bruising, 8 cases (0.72%) of malar edema, 5 cases (0.45%) of temporarily palpable lumps and 2 cases (0.18%) of discoloration.
There were no cases of intravascular injection, nodules/granulomas, or infection.
Conclusion: The complication rate of the PCL-based filler was found to be low, and there were no cases of intravascular injection, nodules, and/or granulomas during the 3-year observation. Longer-lasting edema was associated with a higher injection volume and malar edema was related to lymphatic compression


1. Are dermal facial fillers safe and effective?

Dermal fillers have been FDA approved for the FACIAL Volume restoration for more than 20 years. Numerous level 1 evidence papers can be found, demonstrating its efficacy in the face. Worldwide, there have been more than 50 million dermal filler treatments performed. Hence it’s efficacy is without doubt. Regarding safety, it is safe in experienced hands. Do scroll down to the end of this page to learn about the risks.

2. Will I look worse than before once I stop facial fillers |botox | threadlift treatments? Will my face age faster, sag faster etc?

This is a myth. Your face will return to its original state. Fillers and botox will not accelerate ageing. Ageing is a dynamic process that remains unchanged.

3. Why are there so many different dermal fillers in the market? 

Sculpting your face with dermal fillers is a work of art. Just as Picasso uses different colour paint to work his magic, I use different types of fillers to bring out your features in different parts of your face.

Ultra light dermal fillers are excellent for hydration and achieving a dewy skin appearance – Examples include restylane vital light, redensity 1

Soft dermal fillers are excellent for undereye and lips. Examples include Restylane Kiss, Juvederm Volift.

Firm dermal fillers work best for chin and nose. Example would be Perlane, Ultradeep.

A mid density dermal filler would be perfect for the cheeks. – Example would be voluma, RD4.

4. Will I look better the more dermal fillers I put into my face?

Does more sleep more you more refreshed? Or optimum amount of sleep? So its the same with fillers, you want the right doctor to inject in the right area, with the right amount of filler. Not too much, not too little.

So remember, it is important to know when to stop. Aesthetic treatments can be rather addictive.

One interesting fact:

  1. Traditionally, botox lasts 3 months.
  2. Fillers last 6- 12 months depending on the brand and model.
  3. Over the years, I have had patients telling me they only need to do botox every 6 months, and fillers every 18 months, all because they have been maintaining their treatments regularly.
  4. Of course for those who did sculptra, I see them nearly once in 3 years lol.

As mentioned in the earlier part of this article, dermal fillers need to be performed in experienced hands. Otherwise, accidents can and may happen.

sculptra injection singapore
dermal fillers | facial fillers Singapore

FILLERS Q + A

How long do dermal fillers last?

The short answer is, typically 6 months and above, depending on your skin type, lifestyle and choice of filler.

One of the great advantages of dermal fillers is that the effects are fairly lasting but not permanent. The length of the treatment depends on a number of factors including

  1. The area you have had treated
  2. Quantity of dermal filler injected
  3. Quality of skin
  4. Age+ Lifestyle + Health
  5. However, the range of dermal fillers in the market, are proven to last up to one year in (laugh lines) nasolabial lines and six months in the lips.
  6. After the initial treatment, follow-up sessions are normally recommended around every six to twelve months depending on the individual and the treatment.

Is dermal filler good for your skin?

Yes, it replaces your lost Hyaluronic acid, which is a natural sugar molecule in your skin.

Are dermal fillers Better than Botox?

They work differently and serve different functions in your skin. In essence, they work best in combination. Botox soften dynamic wrinkle lines. Dermal fillers are for restoring volume loss and enhancing facial structure and shape.

Do dermal fillers actually work?

Yes, this is a medically proven treatment, HSA approved with more than 100 million dermal fillers done worldwide at last count. The results are instant and can last 6 months or more.

Who can have Dermal Filler Injections?

Any adult who is clinically indicated and deemed fit to make an informed decision about the treatment and its associated risks.

Who can’t have Dermal Filler Injections?

Anyone with the following

  1. Previous allergic reaction to a Dermal Filler or someone with a allergy to Lidocaine
  2. Pregnant or breast feeding mothers
  3. Post plastic surgery patients, and those who havepermanent implants or fillers are also contraindicated for filler treatment.

What are the side effects of dermal fillers?

  1. Short term side effects can include redness, swelling, pain, itching, bruising or tenderness at the injection site,
  2. These can be relieved with a cold compress, paracetamol and arnica if you have no allergies.
  3. There is no evidence to date of any long-term safety concerns associated with hyaluronic acid filler treatment, as the body naturally metabolises the product over time.

Are Dermal Fillers Safe?

  1. There are many Dermal Fillers in the market.
  2. It is vital to use trusted and reputable Hyaluronic acid Dermal Fillers.
  3. These are the most scientifically documented HA based dermal fillers in the world with comprehensive studies that support their safety and efficacy.

What is the evidence for fillers?

Fillers have level 1 evidence for safety and efficacy from randomised studies conducted since more than a decade ago. This is especially so for hyaluronic acid filers.

Of course fat grafting can also be done, but thats a surgical option.

Can I improve facial balance and symmetry with Fillers ( Restylane, Juvederm, Teosyal)?

Yes facial balance and symmetry can be improved with fillers. The key is finding an injector with a good eye for beauty in order to achieve a natural look, to bring out your best features. I recommend having a consultation with an expert injector.

I am Asian and have thin skin. Will I get lumpiness with fillers?

Asians have a unique facial anatomy, so filler treatment is more focused on the central T zone.

Lumpiness occurs when the area of injected lacks soft tissue volume. A combination of good placement technique in the right injection plane, appropriate filler type and amount would help you achieve good results.

Undereye is a delicate area, so a small volume of extra soft filler would help. Good choices include restylane vital light and redensity 2.

Marionette lines and nasolabial folds require more dynamic fillers. Good choices include Juvederm voluma and Perlane.

I must stress, it is not so much the brand of fillers, but more the injector’s technique, and amount injected, that would help PREVENT lumpiness.

What are the benefits of dermal fillers?

  1. A treatment with dermal fillers provides an easy way to enhance your looks.
  2. The result of a single treatment can be seen instantly and lasts around one year for facial treatments and around six months for the lips.
  3. With dermal fillers you will achieve a natural looking result that does not affect facial expression. Remember, your face changes over time, and treatments with dermal fillers allow you to control you looks naturally as you age.

What are dermal fillers?

  1. Dermal fillers are an injectable substance made from natural and synthetic material and have been developed for injection into the skin to restore its youthful appearance.
  2. Over 30 million people across the world have been successfully treated. The main type of dermal fillers in the market, are a soft gel consisting of stabilized, non-animal hyaluronic acid.
  3. The gel is tissue-friendly and closely resembles the hyaluronic acid that exists naturally in the body. It is long-lasting but not permanent.

Are longer lasting fillers any good?

Many people comment that hyaluronic acid fillers dont last, and they seek a more permanent soluntion. It is common to notice volumisation reduces as swelling subsides a few days after filler injection.

Historically, permament fillers have had a string of complications, from infection to nodules, granulomas etc

There is no antidote for these except surgical excision, leaving behind a permament scar.

It is best to stick to hyaluronic acid fillers as these can be reversed if needed.

What causes static fine lines, and  how can we treat static fine lines?

Static fine lines occur from collagen breakdown due to repeated muscle movement. They often exist around the mouth This is akin to bending a credit card, causing a crease to form from repeated movement.

Your options include filler injection and laser resurfacing.

Soft fillers will help to hydrate and plump up the lines and are your best choice. You can expect up to 75% correction.

What are granulomas and can they occur post fillers?

Granuloma is a delayed foreign body inflammatory condition, suggesting that your body had an adverse reaction to your fillers. It cannot be dissolved. It is not in your best interest to have further filler injections.

If you wish to remove the granulomas, surgical excision is an option, but that in itself is not without risks. Hence it may be better to just monitor it if it doesnt cause you any problems.

Concerned about filler result 3 days post treatment?

3 days is still too early to tell what your final result will be like. Tissue swelling is still present and can persist, depending on the volume and choice of filler. It is best to wait 14 days before doing anything to address your concern.

How to treat superior sulcus hollowing?

Superior sulcus hollowing occurs due to volume loss.

You are right to suggest that your options include filler and fat grafting.

Filler is a non surgical option and is effective with results lasting up to a year. There is a risk of blindness, so it is best to find an expert filler injector who is well versed with the microcannula technique to reduce your risk.

Fat grafting is operator dependent and carries other risks. Results will be more lasting.

Is there a filler that can fill my cheeks, lips and nasolabial fold together?

Fillers vary in density and propensity to attract water. Hence, there is no one size fits all filler that can be used throughout the face.

Cheeks and nasolabial folds respond well to denser fillers.

Lips are a delicate area, so a softer more dynamic filler is advisable to avoid an overdone look.

IMHO, I would suggest going slow and focusing on your top area of concern first to give yourself the best result there, rather than using one type of filler in 3 areas.

Bumps > 3 weeks after filler injection?

Based on the time course, this is not common. Your filler must have been placed superficially.  It is best to seek a formal review with your injector. A small measured amount of carefully placed hyluronidase can clear the bumps quickly.

How to achieve a heart shaped face?

A heart shaped face is a common request here in Asia.

The key is having a beautiful chin, slim jawline and apple cheeks.

What are my treatment options for facial sagginess, flat midface, sunken cheeks?

Midface can be sunken from bone and soft tissue depletion, and that accounts for your sagginess.

Your options include hyaluronic acid filler, collagen stimulators and fat grafting.

Hyaluronic acid fillers have the strongest evidence for safety and efficacy, with several level 1 evidence studies conducted. Of which, Voluma is FDA approved for the midface, with longevity of 18 months on average.

Collagen stimulators, for example radiesse, sculptra take time to achieve peak results and possess mainly level 2 evidence to support its use.

Fat grating is a surgical measure, but is operator dependent.

For a straightforward treatment, I would suggest hyaluronic acid fillers.

2 weeks after volumisation, if you still notice saggy skin, then you may opt for midface thread lift to give your face the extra bit of lift.

How to correct indentation from hyaluronidase?

It is best to wait 2 weeks to see your final result. Then, you may opt for fillers to fill up your indentation, which is essentially an area of volume loss.

I hope this helps.

I am stressed. How can I correct my facial asymmetry?

Most of us have a certain degree of facial asymmetry, and that is what makes us unique.

Your options include seeing a craniofacial surgeon vs an Aesthetic Physician. In addition, it is good to focus on ways to handle stress and build on your positivity.

After mastering the above, you can then consider simple measures, for example lip fillers to lift your left mouth corner and botox to your left masseter to improve the fullness over your left jaw.

Why is chin filler some common in Asians?

​​In Asia, chin fillers is a commonly performed treatment as Asians tend to have a small chin.

Commonly, our chin is small and would benefit from enhancement to increase both the vertical and anterior projection to give us a more defined, 3D look.

Options include a chin implant and chin fillers.

I would start with fillers, then if you like the result, you can move on to a more permanent solution ( implant).

Chin fillers and botox for v shaping?

​In Asia, chin fillers is a commonly performed treatment for V face shaping.

I often combine it with botox to the mentalis to relax the muscle for 3 main reasons.

1. To smoothen the chin

2. To reduce appearance of the mental crease

3. To increase longevity and shape of the chin filler by reducing uneven muscle pull

It is difficult to comment on your case without pictures, so I hope the above helps!

Can I go under the sun after filler injection?

Generally excess sun will not have a major effect on your fillers. However, for good wound healing and recovery, it is best to wait until your swelling subsides, which can range from 48 to 72 hours depending on the amount and choice of filler.

What is hyaluronic acid?

  1. Hyaluronic acid is a naturally occurring substance found in the body that helps to hydrate and add volume to our skin.
  2. Natural hyaluronic acid is broken down by the body in one or two days so is constantly replaced.
  3. As we age this replacement mechanism diminishes so the moisturising and plumping effects of hyaluronic acid decrease. Hyaluronic acid is used for aesthetic treatments, and has also been used for injection into arthritic joints to aid movement as well as eye surgery.

How long is the treatment?

  1. The injection process takes 15-30 minutes.

What areas can be treated with dermal fillers?

Dermal fillers can be used to smooth away facial lines and wrinkles, create fuller lips, shape facial contours and revitalise the skin. The most common areas treated are:

  1. The nose to mouth lines (Nasolabial fold).
  2. Lines around the mouth (Perioral lines and mouth corners).
  3. Natural lip enhancement and definition of the border.
  4. Natural cheek augmentation.
  5. Nose and chin enhancement.
  6. Also can be used for replacing soft tissue volume loss and scar corrections.

Does dermal fillers treatment need pain relief? Will the procedure hurt?

  1. Generally, pain relief is not necessary when injecting into the skin to correct lines and wrinkles. Some people may experience the treatment as a mild discomfort.
  2. A local anaesthetic spray can be applied to the area for a more comfortable treatment experience.
  3. Dermal fillers are also available with the local anaesthetic 0.3% lidocaine included for a more comfortable experience.
  4. Our practitioner will be able to advise you on suitable anaesthesia for your treatment.

Will I notice the difference right away?

  1. Yes, the aesthetic results are immediate. You’ll see the results as soon as your appointment is over—and no one else needs to know!

Will I need to take time off work?

Nope! You can have an appointment in your lunch hour then get right back to your normal routine.

Are there any risks or side effects with dermal filler treatments?

  1. Millions of treatments have been performed with dermal fillers in the past.
  2. Product related reactions are rare.
  3. These reactions include redness, swelling, pain, itching, bruising or tenderness at the injection site. All skin injection procedures carry a small risk of infection.

How long will the effects of dermal fillers treatment last?

One of the great advantages of dermal fillers is that the effects are long lasting but not permanent. The length of the treatment depends on a number of factors including

  1. The area you have had treated
  2. Quantity of dermal filler injected
  3. Quality of skin
  4. Age+ Lifestyle + Health
  5. However, the range of dermal fillers in the market, are proven to last up to one year in (laugh lines) nasolabial lines and six months in the lips.
  6. After the initial treatment, follow-up sessions are normally recommended around every six to twelve months depending on the individual and the treatment.

Is there anything I need to know before I have the treatment?

  1. We advise you to avoid using aspirin or other non-steroidal anti-inflammatory drugs, omega fish oil a couple of days before your treatment (unless they are taken for chronic medical conditions).
  2. Avoiding these medications will reduce the risk of bruising and bleeding at the point of injection.
  3. Ask our practitioner if you have any concerns.

What do dermal filler treatments involve?

  1. Before treatment
    1. Start by making an appointment with our practitioner. During consultation be prepared to discuss your treatment expectations. After discussion, our practitioner will recommend which treatment is most suitable for you.
    2. After the consultation, and if you are happy to proceed, your practitioner will help you complete a medical assessment and you will need to sign a consent form before treatment can progress.
  2. During treatment
    1. The dermal filler is injected into the skin in small amounts using a very fine needle.
    2. The gel provides natural volume to smooth away the appearance of lines and wrinkles, enhance facial shape, or create fuller lips. Dermal fillers improve the elasticity and texture of skin, restoring and maintaining the skins hydro balance.
    3. The treatment is quick, typically taking about 15-30 minutes. Treatments with dermal fillers do not affect facial expression and the benefits can normally be seen instantly.
  3. After treatment
    1. Dermal fillers are biodegradable, which means they will naturally disappear in the body.
    2. To ensure an optimal and long lasting result, a top-up treatment is recommended six to twelve months after your initial dermal filler treatment. This will discuss during the consultation with our practitioner. And a follow-up appointment can be arranged.
    3. After a treatment some reactions might occur, these include; are slight redness, swelling, itching, bruising, pain and tenderness. The reactions are generally mild to moderate and usually disappear shortly after injection. They typically resolve spontaneously within one or two days, but for some treatments they may last longer.

Can everyone undergo dermal fillers?

  1. DO: Most people can benefit from dermal fillers treatment. If you wish to reduce lines and wrinkles, create more defined or fuller lips, define the contours of your face, or boost your skin’s vitality, for a healthier more hydrated skin tone.
  2. AVOID: Dermal fillers have not been tested in pregnant or breast-feeding women, Individuals with medical conditions that lower the body’s immune response or individuals undergoing therapy that is immunosuppressive may be more prone to infection by a skin injection procedure.
  3. During your consultation, our practitioner will carry out a full medical assessment and discuss your needs for treatment.

Are there different dermal fillers products?

  1. There is a range of different dermal fillers designed to be used at different levels in the skin to meet your treatment needs and maximise your treatment results.
  2. Discuss with our practitioner during your consultation what type of products suits your needs best.

Do I need to take a skin test?

  1. No skin test is required as hyaluronic acid dermal fillers do not contain any animal-derived ingredients.

Can dermal fillers be used if I have had laser treatment or a chemical peel?

  1. If you have recently had a light laser or chemical peel treatment, so long as there is no skin wound, you are good to go.

When will I need another injection?

  1. Many patients like to book touch-up injections as well as repeat injections to maintain the effects of treatment.

– Dr Daniel Chang

References: 

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  2. Vartanian AJ, Dayan SH. Complications of botulinum toxin A use in facial rejuvenation. Facial plastic surgery clinics of North America. 2005;13:1.
  3. Almeida et al. –Diffusion characteristics of botulinum toxin products and their clinical significance in cosmetic applications Journal of Cosmetic and Laser Therapy 2007 , 9 (supp1) 17-22
  4. 4 Cliff et al. – Different formulations of botulinum toxin Type A have different migration characteristics: A double blind, randomised study, Journal of Cosmetic Dermatology 2008, 7: 50-54
  5. Niamtu 3, Joseph. Complications in fillers and Botox. Oral and maxillofacial surgery clinics of NIsaac CR, Chalita MRC, Pinto LD.
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  13. Bailey SH, Cohen JL, Kenkel JM. Etiology, prevention, and treatment of dermal filler complications. Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery. 2011;31:110-121.
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  15. Funt D, Pavicic T. Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clinical, cosmetic and investigational dermatology. 2013;6:295.
  16. Carruthers JDA, Fagien S, Rohrich RJ, Weinkle S, Carruthers A. Blindness Caused by Cosmetic Filler Injection: A Review of Cause and Therapy. Plastic and Reconstructive Surgery. 2014;134:1197-1201.
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How to get rid of my neck lines | Treatment review 2022

Necklines A NOVEL Compound Filler treatment Contents •                 Causes of neck lines •                 Scale to grade neck lines •                 Studies of neck line treatment •                 Technique •                 Video Causes of necklines? Why do I have neck lines? •          Genetic inheritance •          Exercise : Vertical head movements – yoga •          Posture: This situation could be due

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