In my practice, I get patients asking about anti-ageing treatments that can help to lift and firm the skin. Of the non-surgical and non-invasive treatments available, the most frequently enquired are Thermage and HIFU.

This is what prompted me to write this in the hopes of sharing it with the general public. So how are these treatments different and which one should you choose?

Our bodies’ ability to produce collagen drops as we age.

Essentially, Thermage and HIFU use heat to induce immediate collagen contraction and a subsequent secondary wound healing response with new collagen formation and remodelling in the deep layers of the skin that result in skin tightening.

However, the type of energy used is different. Thermage uses radiofrequency (RF) energy and HIFU uses ultrasound energy. 

Thermage

Thermage is a brand of machine that uses monopolar radiofrequency technology to deliver heat into the deep layers of the skin. It stimulates collagen production by heating a diffused area underneath to skin while protecting the epidermis.

It has been shown that repeated mild heat shock to the skin increases collagen production. The heat is generated on the surface of the skin and diffuses into the skin of up to 3mm in depth.

Therefore, it is good for tightening and rejuvenating the skin, as well as contour facial skin laxity. 

HIFU

HIFU (High Intensity Focused Ultrasound) or MFU (Micro Focused Ultrasound) uses ultrasonic energy to deliver heat to the deep facial tissues and treats it from the inside out.

There are many different brands of HIFU devices in the market including Ulthera, Ultraformer 3 and HiQueen.

They work similarly by depositing tiny bits of ultrasound energy to 1.5mm, 3mm and 4.5mm beneath the skin surface to create thermal coagulation points.

At the depth of 4.5mm, the superficial musculoaponeurotic system (SMAS) is targeted. This is the same layer that is targeted in a surgical facelift.

Therefore, collagen contraction and stimulation at this level can result in a lifted appearance, while targetting the more superficial layers can tighten the skin. 

So, which one should you choose?

Not everyone ages the same way. The way you age determines the best treatment for you.

Sagging Skin

People whose skin sag as they age often complain about loose skin and tissues. They may have more pronounced nasolabial folds and jowls, with loss of jawline definition.

If your main problem is sagging, then you are looking for a treatment that can lift better.

As mentioned, HIFU targets deep to the SMAS layer at 4.5mm, which is effectively the depth where a surgical facelift is performed. Hence, HIFU will be the best choice for you.

In addition, HIFU is able to reach the depths of subcutaneous tissue at temperatures of 60-70degrees Celsius, the thermal-coagulation effect may also induce contraction of the fat tissue.

Therefore, it can improve your issues of sagging jowls and the presence of heavy buccal cheek fat. It can also aid to firm the neck, define the jawline and reduce the appearance of double chin when done over these areas due to the contraction of soft tissues. 

Volume Loss

Conversely, the energy of Thermage is typically administered at approximately 3mm underneath the surface of the skin.

Therefore, it is better for people who are looking to tighten and firm thin skin. It is also a good choice for people who have volume loss as they age as the collagen stimulation can help to create more volume.

People who lose volume often complain of sunken cheeks and temples. However, do note that if you have volume loss, it is best to combine these skin tightening treatments with fillers to restore volumes deeper in your face.

As opposed to HIFU, Thermage can also be done over delicate areas such as the upper and lower eyelids to help tighten the skin in these regions. 

As both treatments target the skin superficially at depths of 3mm or less, they are good options if you are looking to help reduce the appearance of wrinkles, fine lines and pores. 

After Treatment 

Both Thermage and HIFU are non-invasive procedures that have minimal downtime. There may be some slight pinkishness and swelling to the face after both procedures which should go away in less than a day. 

As both procedures help to stimulate your own body to produce collagen, the effect of both treatments are best seen after 3 months.

How often the procedures should be done and the longevity of results depends on multiple factors such as how much collagen your skin is able to produce, the strength of the treatments as well as the presence of other factors that may contribute to ageing such as smoking and rapid weight loss.

Therefore, to maintain the effects of the treatment, it is still important to follow the good old rules of a healthy lifestyle: eat a healthy diet with sufficient nutrients and vitamins, adopt a regular exercise regime, wear sunscreen to protect against UV damage, get a good night’s sleep and avoid smoking and excessive stress in your life!

[27 Nov 2019] A blog post by Dr. Charlene Goh

Having obtained her medical degree in Scotland, Dr Charlene Goh returned home to Singapore, where she practised in several major hospitals and in various departments. But her education did not stop there.

From a young age, Charlene has had a strong interest in skincare and beauty trends. Urged by Dr Kelvin Chua to pursue her passion, Charlene went away to study Practical Dermatology at Cardiff University in Wales.

Not one to rest on her laurels, she returned home and picked up certifications from various aesthetic organisations.

Now armed with the proper certifications and experience, Charlene is adept at a wide range of minimally invasive aesthetic procedures such as laser treatments, dermal fillers, botulinum toxin injections, etc.

A firm believer in presenting one’s best self, Charlene hopes to help others achieve confidence through a holistic approach; a wholesome combination of a healthy lifestyle and diet, complemented by clinically proven aesthetic treatments.

Charlene is a self-confessed beauty junkie and fashionista, and will happily discuss the latest trends with friends and patients.

For more information, write to contact@slclinic.com.sg
To contact Dr Charlene Goh, write to charlene@slclinic.com.sg

With huge marketing budgets, pharmaceutical giant Allergan has made Botox a household name as a panacea for wrinkles. Surgical or non-surgical facelifts can even be found in most aesthetic clinics in Singapore, which tends to be on the more conservative side.

Exposés of high-profile personalities and features in fictional productions have associated Botox with “younger-looking” smooth skin, as well as frozen expressions and dramatic surprised looks; forever cementing the drug in the public’s mind as a “wrinkle eraser”.

But what’s unknown is how Botox works and the relationship it has with wrinkles.

Read more about Botox here.

Not All Wrinkles Are Made The Same

Our first wrinkles appear when we smile, frown, and make other facial expressions.

In fact, every single time you move a facial muscle, a microscopic groove forms under the surface of the skin. Little by little, this adds up to something more visible to the naked eye. Hence its categorisation under Dynamic Wrinkles.

Then comes ultraviolet (UV) damage, smoking, lack of hydration, genetics, gravity, other environmental factors, and even some medicines can result in wrinkle formation. Wrinkles formed as a result of these factors are typically categorised as Static Wrinkles.

And because there are so many causes of wrinkles, there exists an exponential number of supposed treatments that either claim to delay or even remove them.

Some of these such as Botox has found considerable success. While others have little to no effect at all.

Here we share a little wisdom on the types of wrinkles and how they can be treated.

First, What Exactly Are Wrinkles?

Wrinkles are creases, folds, or ridges on the skin. They are part of the natural aging process. As we get older, our skin becomes drier, thinner, and also loses its elasticity and the ability to protect itself from damage.

Dynamic Wrinkles

Crows’ Feet, Frown Lines, Smoker’s Lips, are some examples of dynamic wrinkles. At a young age, our skin is able to spring back into position easily after moving. But as we age, our skin loses its elasticity, resulting in these dynamic lines appearing. What you can do:

Getting treated with Botox once you start noticing that your skin does not bounce back into the position quickly or if these dynamic lines take longer to go away. The idea here is to reduce the action of these muscles with Botox; enough not to cause a deep crease from forming while maintaining your natural expressions.

Static Wrinkles

These can appear just about anywhere on the skin and are present when we keep a neutral expression. They are a result of the natural aging process, as the skin structures deteriorate or when we lose volume in our skin. What you can do:

Sun protection is paramount as a preventive measure. You can also speak to the doctor in any aesthetic clinic in Singapore about laser treatments or filler injections to correct any existing static lines.

Smoothen out your wrinkles with Clear + Brilliant Laser.

Lighten deep lines with face fillers that can be found in many aesthetic clinics in Singapore!

Left unchecked with Botox, lines that appear around your lips when you purse them can become deeper and even permanent.

Botox for Upper Lip – Not Just For Smokers

Many smokers have them; vertical lines that appear as you purse your lips. Especially evident in the upper lip, these lines become more apparent the more time you spend puckering your lips around a cigarette.

But you do not have to be a smoker to sport the same lines. These wrinkles can also develop as a result of the natural aging process, excessive sun exposure, and can also be hereditary.

Over time, the combination of puckering and photo-aging can leave more permanent lines around your lips.

In Singapore, where although the percentage of people who smoke is one of the lowest in the world hovering around 14%, the percentage of young adults (below 30 years old) who smoke has been on the rise.

To help reduce the appearance of such wrinkles, Botox can be used.

How Does It Work?

Botox, when injected into the affected areas, blocks nerve signals in the muscles responsible for lip movement.

This is why Botox works best for lines that are dynamic, or in other words, appear only with muscle movement.

So if wrinkles appear on your upper lip when you purse them, Botox is suitable for you as a preventive measure or treatment option.

But if you’ve reached a more advanced stage where the lines are present even without lip movement, then you will find that fillers will be the better choice of treatment. Face fillers in Singapore would definitely be a plausible skin tightening treatment for most adults in Singapore, especially if you want to keep your appearance for business purposes.

How Is It Done?

Botox for upper lip lines and smoker’s lines can be completed in a manner of 20 minutes or so, excluding consultation.

The doctor will first assess your medical history, expectations and any preexisting asymmetries on your lips. The doctor will then ask you to purse your lips as if you are blowing out a candle. This helps the doctor identify the most prominent creases on your lips for treatment.

The doctor then injects small doses of Botox, anywhere between 3 to 4 units, into your lip perioral muscles. The goal is to soften the activity of your lips, but not freeze it entirely. This is also to avoid affecting your speech or ability to close your mouth when drinking or eating.

In more severe cases, fillers are used at the same time.

What Are The Side Effects?

Side effects are typically associated with injectables such as bruising and or swelling.

Patients who cannot tolerate any weakness in their lip muscles such as singers or wind instrument players should do well to avoid this treatment.

The experience of weakness in the lip muscles is otherwise hardly noticeable with regular activities, although patients do encounter some challenges with whistling or sucking hard on a straw.

How Soon Will I See Results?

As Botox takes time to work on the muscles, you will not see immediate results. Most patients see improvements within the next 3 days, with better results after a week or two.

How Long Do The Results Last?

Botox for upper lip lines and smoker’s lines last anywhere between 3 to 4 months, depending on the individual and brand of botulinum toxin used.

You can repeat the treatment once the effects have worn off, typically on the 3rd month after treatment.

Do remember to check out your full range of options when it comes to deciding on which skin tightening and wrinkle treatment you want. Be in Botox, face fillers or even HIFU treatments in Singapore, do be sure to consult your doctor!

“Back in 2011, men made up about 5% of my total Botox clientele in Singapore. Now coming to the end of 2018, they make up about 10% of that figure, and I reckon it’ll continue to grow!” says Dr. Kelvin Chua, medical director of SL Aesthetic clinic, one of the various aesthetic clinics in Singapore.

Not Why But How

Vanity, job competitiveness, appeal to partners, social (media) pressures, etc.; the list of [reasons why] more men are getting cosmetic treatments such as Botox just keeps getting longer and varied.

“It has come to a point where men do not need convincing or persuasion; in this day and age, men know that some upkeep is required,” says Dr. Gabriel Wong, medical director of SL Aesthetic Clinic.

So the bigger question now is, what cosmetic treatments can be done, and how.

The Basics

Botox is the famous brand synonymous with botulinum toxin, the key ingredient in the drug.

It is a neurotoxic protein produced by the Clostridium Botulinum bacteria. Botox prevents the communication of nerve signals, and when injected into the muscles, relaxes it.

Cosmetically, Botox is used to relax facial muscles that cause wrinkles, reduce excessive sweating in the palms or armpits, and more.

[Learn more about Dynamix & Static Wrinkles.]

The Male Difference

While Botox works for all sexes, there are some differences in its application between the genders.

The facial muscles in men are larger and more active. Hence, more units of Botox need to be administered in men relative to women in any given area.

[Moreover, the aesthetic objectives differ between men and women.]

There are currently two perspectives in male beauty. Here, we will cover what they are and how you can achieve them. The Classic and The Progressive.

The Classic

This man is distinguished by very masculine features such as a squarish and strong jaw, low set eyebrows, a square boxy chin, a flat forehead, and a wider face.

You may spot some lines on his face. But these add character, rather than age. There is a fine line between oozing mature sex appeal and just looking plain old and haggard.

The key is in a delicate balance of cosmetic treatments. These can include:

1. Minute doses of Botox in the forehead and glabellar to soften (but not erase) the horizontal forehead lines and frown lines
2. A touch of dermal fillers on the cheekbones to create a wider, boxier look
3. Fillers to create a strong squarish chin
4. Lasers to keep your skin looking healthy and refreshed
5. HIFU to lift and tighten any sagginess in the lower face, as well as giving your jaw greater definition

The Progressive

A growing trend in East Asian countries is the softer, more feminine aesthetic in men.

This look is characterised by a sharper face, flawless and fairer complexion, fuller cheeks and lips, and little to zero wrinkles or fine lines.

This is not to say that these men look just like women. The Progressives retain the masculine appeal, just to a lesser degree.

Achieving this is more demanding than The Classic. It will be a real test of the doctor’s skills and eye for proportions. One mistake can result in the patient looking pretty rather than handsome.

What you can do to attain The Progressive look include:

1. Botox for jaw slimming. This creates a narrower jawline, hence sharpening the face
2. Botox to erase all wrinkles and character lines such as Crows’ Feet, Frown Lines, Forehead Lines, etc
3. Botox to lift the brows, giving the eyes a brighter, more refreshed look
4. Fillers to create a softer set of cheeks and to plump up the lips
5. Lasers to smoothen out the complexion as well as remove all unwanted pigmentation
6. Diligent use of sunscreen and whitening products

If you’re looking for a professional aesthetic clinic in Singapore for face tightening treatments or you just want to inquire about Botox prices in Singapore, feel free to schedule an appointment with us and we’ll do our best to answer any queries you may have!

Horizontal Forehead Lines, or “Surprise” Lines, can form over years of facial expressions, specifically the raising of the eyebrows. They can be treated with Botox. (Credit: cosmopolitan.com)

What Are Horizontal Forehead Lines?

Horizontal Forehead Lines are wrinkles that appear on your forehead; between the brows and the hairline. These lines stretch out horizontally across your forehead in rows. They appear when the brows are raised when the skin of the forehead scrunches up. After many years of scrunching up, these wrinkles can gradually stay visible even without the eyebrows raised.

What’s more, the more expressive you are (i.e. raising your eyebrows), the easier it is for you to stack up rows of the wrinkle.

How Are They Formed?

Horizontal forehead lines can appear when you raise your brows. These are called dynamic lines. The lines fade away when your brows return to a neutral position.

An example of static horizontal forehead lines. (Credit: milled.com)

Over the course of many years of frequent brow-raising, these transient lines gradually become a permanent fixture on your forehead, slowly turning into static lines.

Treatments for dynamic lines differ from static lines. More on that later.

[Wrinkle Wisdom: Dynamic Wrinkles vs Static Wrinkles]

What Cause Them To Appear?

Aging aside, the most common cause of these lines is the repetitive movement of the forehead muscles, raising the brows and upper eyelids, while wrinkling the forehead in the process.

Other factors that contribute to the formation of horizontal forehead lines include aging, weight loss, sun damage, and smoking.

As you age, you lose volume in your facial fat compartments. These pockets of fat also slide down, giving you a saggy, sad look. These factors, along with sudden weight loss, can contribute to the formation of horizontal forehead lines.

Sun damage, or photoaging, is the premature aging of the skin caused by exposure to the sun’s ultraviolet radiation (UV). Other artificial sources of UV rays also contribute to photoaging, which might be more prominent in sunny countries like Singapore, for example.

UV rays (UVB and UVA) damage the DNA in the outer layer of your skin, as well as the deeper epidermal cells, skin collagen, and elastin. This accelerates the formation of lines and wrinkles on the skin.

Cigarette smoke contains carbon monoxide that displaces vital oxygen in your skin, as well as nicotine, which reduces blood flow. This leaves skin dry, discoloured, and more likely to result in wrinkles. Smoking also cuts your skin’s access to nutrients such as vitamin C, which is crucial for skin repair and rejuvenation.

Treatment of Horizontal Forehead Lines

As dynamic wrinkles, or at the stage when they only appear during muscle movement, they are best treated with a wrinkle relaxer such as Botox.

When they have turned into static lines, a combination of fillers and Botox can help alleviate the look.

Botox helps by blocking the nerve signals in the forehead muscles, limiting their activities and hence preventing the wrinkle formation. Patients typically require 8 to 20 units of BOTOX or more, depending on the individual*. Getting Botox in Singapore can be an option because there are various reputable aesthetic clinics in Singapore with licensed doctors to help with the appropriate skin tightening treatments for your skin.

Fillers are used to fill and even out static wrinkles on your forehead.

*Unit dosage differs from brand to brand (i.e. Xeomin, BOTOX).

[Read more about the types of Botulinum Toxins in the market.]

Horizontal Forehead Lines: Men vs Women

Treatment for horizontal forehead lines is more popular with women. This is because of current beauty ideals, where women are seen to look better with a smoother forehead.

Men, on the other hand, can in some opinion look “over-Botoxed” with a completely smooth forehead. With male beauty ideals, it is considered better to soften these lines so that they are still visible but not completely erased. They are seen to add character and maturity to a man’s face.

The Story of Rebecca B. Foo

(Botox for Frown Lines – Devon Aoki in her signature RBF. Credits: allstarbio.com)

“Are you ok?”

“You should smile more.”

“Why so serious?”

Rebecca gets these kinds of remarks all the time. But what people do not understand is that Rebecca is not worried, sad, or angry. It’s her neutral face; even though it looks like a “Resting Bitch Face”.

The Resting Bitch Face (RBF) Condition

While the above story is fictional, RBF is a real condition that affects many of us. So much so that frown-induced Resting Bitch Face has become a social phenomenon. People in their teens, twenties and beyond have developed an almost subconscious reflex to frown.

Just take a look around and you’ll find plenty of examples.

Imagine yourself on the train to work.

You’ll spot people frowning in their sleep, while the others furrow their brows, hunched over mobile phones. And when you eventually get to your workplace, you face colleagues scowling all day.

Genetics and natural aging aside, the daily stresses of modern life also contribute to frown lines and RBF. Higher stress levels in big cities such as fast-paced and uber-efficient Singapore certainly do not help at all.

This constant frowning makes anyone look overly serious and worried at best, and angry and standoffish at worst. Even though you may not even mean it.

So if you do not mean to look angry all the time and want to turn that subconscious frown upside down, Botox in Singapore would be a good and effective treatment for you.

What is Botox For Frown Lines?

It is a simple solution to soften that unwanted furrow.

(Turn that frown upside down with Botox)

It works by limiting the communication of nerve signals in the muscles responsible for the frown. This stops the muscles from “flexing”, hence preventing the formation of the facial expression.

This does not mean the treatment will freeze your facial expressions. If you make a conscious effort to frown, you will still be able to, albeit more difficult than usual.

An experienced doctor, like the ones you can find in most Aesthetic Clinics in Singapore, can administer Botox for frown lines to help prevent subconscious frowns on your face. So no more RBF.

Read more about Botox here.

How Is It Done?

Botox for frown lines is a relatively quick 15-min procedure. Local anesthesia is optional.

After assessing your medical history and goals, the doctor may mark your face with an erasable marker. This serves as a visual guide of injection points.

Most patients require anywhere from 20 to 25 units of Botox for their first treatment. This varies by the individual and brand of botulinum toxin used.

Thereafter, you are free to return daily activities as per usual. However, you will be advised to abstain from alcohol for the rest of the day.

How Many Sessions Do I Need?

It only takes one session to complete one treatment. A good doctor will be conservative with the number of Botox units used for patients new to the treatment.

You may then be required to return for a follow-up session a few weeks after for touch-ups if any are required.

The treatment can be repeated once it wears out, typically on the 3rd month or so. This will vary by the individual.

How Soon Will The Results Show?

Because Botox takes time to work on your muscles, you will not see immediate improvements after treatment. Be patient and give it 2 to 3 days at least to see visible results.

How Long Will The Results Last For?

Botox for frown lines is a temporary treatment and typically lasts 3 to 4 months on average. This will vary by the individual.

If you’d like to come down to check out all the other skin tightening treatments in Singapore, schedule an appointment with us and we’ll be more than happy to go through them.

(Botox for dimpled chin is the solution if you pout, sulk and scrunch your chin up frequently. Credits: dailymail.co.uk)

Sure, it looks cute to pout when you’re in your teens until you need Botox for chin by age 40 if you keep it up.

But how exactly do you end up with a chin that looks like you can do the laundry with? Read on to find out.

What Is A Dimpled Chin?

A dimpled chin is characterised by the lines and divots formed on the chin when the mouth moves. In advanced stages, these can appear even when the mouth is stationary.

It’s also known as golf ball chin.

How A Chin Develops Into One

A dimpled chin can appear as a result of the natural aging process, where fat is lost in and around the chin area.

In younger people, it appears as a result of overactive chin muscles; specifically the mentalis muscle. When the mouth moves in certain ways, say a pout, sulk or smoke, the muscle pulls the chin up, creating a cobblestoning effect.

So what can you do to prevent or treat a dimpled chin? Let’s find out.

Treatment for Dimpled Chin

First and foremost, the overactive mentalis muscle should be addressed to minimise its effects on your chin. This will greatly prevent the signs of chin dimpling even as you age.

Botox, as a neuromodulator, can help relax the muscle. It does so by blocking the nerve signals in the muscle, softening the muscle’s “flex”, and thereby preventing the dimples from forming on the chin.

This should be done carefully by an experienced doctor so that the Botox does not interfere with your mouth functions.

Treatment of dimpled chin with Botox typically requires 5 to 10 units of the drug for the average patient. This will vary by the individual and brand of botulinum toxin used.

Sometimes, Botox alone may not be sufficient, especially in more advanced semi-permanent cases. This is when fillers can be added to the treatment mix to resolve this.

With fillers, the doctor injects the non-permanent material with a flexible cannula, laying down a smooth layer in the chin. This fills up the spaces created from fat loss, leveling and pushing out depressions and lines on the chin.

You are free to return to your daily activities as per usual immediately after the treatment. However, you will be advised to abstain from alcohol on the day of treatment.

If you’re unsure of which method you want to pursue, schedule an appointment with SL Aesthetic Clinic. We’ll do a thorough analysis and give you personalised options that could include chin fillers or other skin tightening treatments in Singapore. If you’re not ready for injectables, we also have other treatments like non-surgical facelifts in Singapore that’ll alleviate your problems.

How Soon Will I See Results?

As Botox requires time to work on the muscle, results will not be immediate. You can see better results after 10 to 14 days.

With fillers, you will see immediate improvements.

How Long Do The Results Last?

Botox and fillers are not permanent treatments; the former can last anywhere from 3 to 4 months, while the latter can last anywhere from 6 to 9 months.

Results will still vary by the individual and product used. Treatments can be repeated once the results have worn off.

As we age, our skin gets thinner, loses elasticity and fat volume. This results in wrinkles and folds on our skin. Coupled with the stress from work, it’s easy to see why some might choose to opt for skin tightening treatments in Singapore.

What Are Crows Feet?

Crows Feet are lines that appear at the corners of our eyes. These are usually one of the first signs of aging that can appear in our late 20s.

Crows Feet are dynamic wrinkles that are noticeable when muscles are contracted when we smile, squint or laugh.

Smiles, frowns and squints are some examples of expressions that lead to folds and lines on our face.

Causes of Crows Feet

Every time a muscle on our face is moved, grooves are formed under the surface of our skin.

These repetitive facial muscles movements over time will result in the permanent breaking down of the foundation under our skin. Hence, making these wrinkles permanent.

Environmental and biological factors such as sun exposure and menopause are also some of the culprits contributing to crow’s feet.

Interesting Fact:

People with more natural pigmentation, such as darker skin Asians, are protected from harmful UV rays. That probably explains why most Caucasians are more susceptible to Crows Feet as compared to Asians.

BOTOX FOR CROW’S FEET

Crows feet can be treated with 6 – 20 units of Botox. Men will typically need a higher dosage than women due to the size of their muscles. However, if it preferable for men to keep some of their lines to add character.

It is a quick 10 minutes procedure with no downtime. Depending on the brand of botulinum type A being used, results can typically be seen from 4 to 14 days with its effect lasting 3 to 4 months.

Our doctors at SL Aesthetic Clinic will assess your condition and recommend a plan that works best for you. A treatment plan will be tailored according to your needs and desired results.

Call us now for a treatment plan that is tailor-made for you.

Optimal Result

Botox can be combined with treatments such as Skinboosters and Clear+Brilliant Laser (US FDA approved) to improve overall skin texture. Having said that, maintaining a healthy lifestyle goes a long way to great looking skin, naturally.

Botox – a name synonymous with “youth in an injection” – conjures up images that horrify in one moment, incite laughter in another, and inspire people in the next.

Expressionless, cold looks are what people think of when Botox is mentioned.

Horror stories are aplenty. One notable account that comes to mind is Eric and Bonnie Kaplan‘s close brush with death; after unknowingly receiving home-made concoctions of botulinum toxin injections from a friend.

Humorous “accidents” are also common among high profile individuals. Think Rosmah Mansor, wife of ex-PM of Malaysia.

But what’s not highlighted by the media are the other millions of successful Botox injections performed per year. So rather than paint it over with a broad, negative stroke, let this article dispel your misconceptions about the treatment. Going to a reputable, if not the best aesthetic clinic in Singapore would definitely be preferred to minimise the possibilities that Botox is wrongly administered.

[What Botox can do for you – the ultimate guide]

1.   It is toxic and dangerous

The dosage of Botox used in cosmetic treatments is low and safer than compared to those used for therapeutic purposes.

As Swiss physician and chemist Paracelsus so eloquently puts it, “The Dose Makes the Poison”; a substance that contains toxic properties can cause harm only if administered in a high enough concentration.

Anything – even water and oxygen – can be toxic, if too much is ingested or absorbed into the body.

But what about the Botulinum Toxin drug in Botox?

It is one of the most toxic substances known to man and is derived from Clostridium botulinum, a very common organism found in the natural environment. However, with common hygiene practices such as cooking of food, proper sanitisation and avoidance of spoiled food, botulism poisoning is well controlled.

In Botox cosmetic, the U.S. Food and Drug Administration has strict protocols and processes that limit it to professional use.

In Singapore, only doctors are given the license to use the product. If it’s your first time, please check that the doctors in your aesthetic clinic in Singapore have that license displayed.

2.  It will give you a “frozen” or expressionless look

FACT: Comical frozen looks are often the result of the overuse of Botox. The doctor’s inexperience in handling the product can be blamed in some cases; often times the wrong dosage was used or the drug was incorrectly placed or injected. A follow-up appointment is important.

Correction of a weird look is possible in some cases such as “Spock brows” or the overarching of the eyebrows. A small dose of Botox can be administered to relax the muscles pulling the brows upwards.

However, at other times, botched treatments can also be attributed to the patient.

This may be a tough pill to swallow, but some patients have the impression that the more botulinum toxin one gets, the younger the patients look.

Hence, they often have a need for more Botox to be injected, even though this may lead to aesthetically unpleasant, or even dangerous results. This is, unfortunately, a misconception that unethical doctors may prey upon; all for extra profit.

“While a professional doctor will be able to expertly assess the number of Botox units you’ll need,” says Dr. Kelvin Chua, medical director of SL Aesthetic Clinic, “…an ethical doctor will also have to manage your expectations with what the treatment can and should realistically and optimally achieve.”

At SL Aesthetic Clinic, our doctors will not compromise on our professional code of conduct, and will not perform any procedures if the patient feels that More is Better. We aim to produce results that are naturally beautiful with unhindered facial expressions; not frozen caricatures.

3.  Botox and fillers are the same

Often, Botox and fillers are used together in treatments to achieve even greater results than when they’re used alone.

FACT: They are not. Fundamentally, Botox and fillers operate on very distinct mechanisms.

Botox is a neuromodulator; it works by blocking nerve signals and hence decrease muscle action. This reduces wrinkling and lines on the skin.

Fillers, on the other hand, are exactly what its name suggests; they fill up gaps in areas where they’re used, such as areas of volume loss, or to enhance certain areas of the face or body.

Sometimes, these two treatments can be used, whether on their own or combined synergistically by doctors to achieve the same or even greater result.

One such example is in treating horizontal forehead lines. Botox is used to prevent the lines from taking root, while fillers are used to fill up and even out any lines that are already there in the skin.

[Read more about the differences and similarities in the use of Botox and fillers.]

4.  There is only one Botox

FACT: Botox is just one of many brands of Botulinum Toxin. Other brands include Dysport and Xeomin, which are also available for use in Singapore.

The reason why people associate Botulinum Toxin treatments with the Botox brand is that the brand is the first of its kind, and is marketed and branded as such.

The products from all of these brands are made from Clostridium botulinum, but from different strains, featuring different molecular structures, and work on different parts of the nerve.

But what does this mean for the end-user like you? It means that the dosage differs between brands.

1 unit of Botox does not equate to 1 unit of Dysport, Xeomin or vice versa. Plus, patients also respond to each brand differently; the duration of effect will hence vary.

SL Aesthetic Clinic uses predominantly Botox and [Xeomin] for a variety of concerns.

[Botox VS Xeomin – Which Is Better?]

5.  It can erase all my wrinkles

No amount of Botox can remove static, or “permanent” wrinkles. Here, fillers are better at resolving them!

FACT: There are two types of wrinkles – dynamic and static. Botox treats dynamic wrinkles, which form with muscle movement such as Crows’ Feet.

It cannot help with static wrinkles; lines that form due to sun exposure and the natural aging process, such as those in the corners of the mouth.

With that said, however, dynamic wrinkles can turn into static lines after many years, which is why Botox can be used as a preventive anti-aging measure at younger ages.

Static wrinkles can be resolved using a combination of other treatments such as dermal fillers, thread lifting, lasers, or chemical peels.

[Read more about dynamic wrinkles and static wrinkles here.]

Plus, Botox can also be used for other cosmetic benefits, such as slimming the jaw muscles, lifting the brows, lowering or raising the chin, reducing your skin’s oil production, controlling sweat production and more.

6.  Stopping treatment will make me age and look older

FACT: Stopping Botox treatment means you will lose the preventive muscle relaxing effect it brings, but it will not worsen them; your wrinkles will simply slowly return to how they were before being treated.

7.  The injections are painful

FACT: Botox injections feel like little ant bites. The needles used in Botox injections are very fine and thin, which means you may only feel a little sting if any. The procedure is well-tolerated by most patients, especially with the application of numbing cream although this is usually not required. Many of our patients do not have numbing cream applied before undergoing Botox treatments.

With little to zero downtime, Botox treatments are popularly referred to as “lunchtime procedures” where patients typically return to their daily activities right after treatment.

We do, however, advise against alcohol consumption on the day of treatment itself.

8.  It is addictive

FACT: Botox does not contain any addictive properties nor cause anyone to become addicted to it. What people get used to is the cosmetic results that they see. Patients can always stop treatment at any point in time without any clinical withdrawal effects.

9.  Results are permanent

The beauty of Botox is that it’s not permanent. It’s meant to be a softer way to delay aging so that you can age gracefully, not artificially and totally prevent it.

FACT: Results last between 3 to 6 months, depending on the individual response to Botulinum toxin, lifestyle, the dosage used, and treated area.

One thing to note, however, is that with prolonged use, results typically last longer with each subsequent treatment. This is because of your muscles atrophying from lack of activity.

10. Results are immediate

FACT: Unlike other cosmetic treatments such as fillers, it takes time for Botulinum toxin to work.

Depending on the treated area, the toxin slowly blocks nerve signals on the treated muscles. This typically starts within the first 3 days, with more pronounced results in a week or even a month.

The rule of thumb is that the larger the muscle treated, the longer the result will fully realise.

11. It is only for older people with wrinkles

Botox is actually more effective for those whose wrinkles are not severe and static.

FACT: Botox is used by a wide range of demographics and as a solution to a plethora of concerns.

It is certainly popular with patients looking to reduce the appearance of wrinkles – a concern coincidentally belonging to older patients.

Many patients of varying ages also seek the treatment to temporarily [slim and sharpen their jawlines] for that coveted V-shaped face.

Younger patients also benefit from the procedure as a form of preventive aging medicine – halting the formation of lines on the skin and reducing the need for future, more aggressive treatments.

12. Botox is only for women

FACT: Women are no longer the only ones expected to look good and take care of their appearances.

Today, men have increasingly felt the need to upkeep their appearances. Botox, lasers, fillers, or even liposuction are now even considered by men; if only to sell themselves better in the dating scene or remain competitive in the job market.

13. Botox is only used for cosmetic purposes

FACT: It was first developed by ophthalmologist Alan Scott to treat strabismus, also known as crossed eye, and other misalignments of the eyes. It has since been adapted for a multitude of therapeutic treatments such as migraine headaches, chewing problems (bruxism), drooling, hair loss, excessive sweating and more.

It was only in 2002 that the USFDA approved its use for cosmetic purposes.

Botox remains to this day a “miracle” drug as scientists continue to discover novel applications in medicine and beyond.

14. You need more Botox with each treatment

FACT: Most patients do not need more units of the drug with each subsequent treatment. In fact, long-term users typically require lesser units of Botox over many years of treatment. This is due to the treated muscles atrophying from lack of activity.

For example, if you do not use your legs for decades, your leg muscles would eventually shrink and weaken. The same can be said for muscles treated with Botox over a long period.

“With regular, uninterrupted treatment of Botox over many years, eventually the muscle will atrophy from lack of use,” says Dr. Gabriel Wong.

This does not mean that your entire face will shrink and atrophy; the effects of Botox are localised at where its injected. Only the muscles treated will atrophy, leaving other muscles at their original volume.

However, a small percentage of Botox users develop resistance to the drug. Their bodies develop antibodies that break down the drug easier and faster.

In such cases, more Botox may be required with each treatment. Botulinum toxin brand Xeomin, on the other hand, claims to be able to circumvent this problem due to its “purer” form of the drug, although the verdict is still not out on this front.

15.                 It can be done cheaply

FACT: Botox is becoming increasingly available to more and more people than ever before, with prices becoming even more competitive than ever.

This is also exactly the reason why you should practice due diligence and research about the procedure, the clinic, and the doctor. Like what you are doing now.

If the price is too good to be true, it almost always is. Botox prices in Singapore vary by what concerns you have, as with all surgical or non-surgical facelifts in Singapore. The cost can range between $300 to over $1,000 SGD.

(Botox is a non-permanent way to lift and rejuvenate your skin)

Botox is a neuromodulator typically injected into the underlying muscles of your face to erase wrinkles and lines. It works by weakening the muscles responsible for skin wrinkling and folding, hence softening and preventing wrinkle and line formation on the surface of the skin.

Little do people know, Botox can also be used as a non-surgical way to lift certain areas of the face.

With a good understanding of the facial anatomy and expert placement of Botox in the appropriate amounts, the drug can create a “lifting” effect in places such as the eyebrows, eyes, neck, and even cheeks.

What is Botox? Click to find out.

How Does Botox Face Lifting Work?

Your facial muscles are made up of downward-pulling muscles and upward-pulling ones.

By injecting a small amount of Botox into the downward-pulling muscles, the doctor prevents them from working so well. This allows the upward-pulling muscles to lift easier, creating a more pronounced “lifted” effect on the skin. Facelifts in Singapore can be done by most aesthetic clinics in Singapore, just be sure to do your research before you step into the clinic!

Botox Brow & Eye Lift

This treatment works best for patients with hooded, slightly droopy eyebrows.

The drug is injected into the downward muscles located in an inverted pyramid on the forehead. This allows the upward muscles to pull the eyebrows up with greater ease, opening up the eyes beautifully.

Additional Botox can also be injected into other areas of the eyes. These include injection the drug into the muscles under the eyebrows to lift the lid, as well as at the ends of the brows to further open up the eyes.

Botox Lower Face & Neck Lift

(Botox can be used to define your jawline and lift a saggy neck)

Also known as the “Nefertiti” lift, this Botox treatment lifts sagging lower face and necks.

Botox is injected into the platysma muscles in the neck. This softens the downward-pulling action of the muscle, allow the neck and lower face to be lifted.

The result is a more lifted and tighter looking neck and jawline, with improved jowls.

What to Expect with Botox Face Lift

With an experienced doctor, you can expect to have the treatment done within half an hour or so, depending on the extent of treatment and severity of your concerns.

Using finer needles, Botox injections are relatively comfortable even compared to other forms of injectable treatments. This means that anesthetic creams are not necessary for most patients.

Should you require, an anesthetic cream can be used for greater comfort.

There is virtually no downtime with this treatment, although some minor side effects such as bruising may occur. This will dissipate over the course of a few days.

The Results?

Patients typically start seeing improvements in the first few days to a month after treatment.

Results can last up to 4 months or more, depending on the individual. Factors that influence the duration of effects include lifestyle choices such as sleep, smoking habits, stress levels, medication, and diet. Speak to the doctor at your aesthetic clinic in Singapore for a more personalised answer on other skin tightening treatments.

More than a wrinkle treatment

Discover other brilliant ways Botox can help you look beautiful.

Derived from botulinum toxin – one of the deadliest substances known to man – Botox works by blocking nerve signals in any treated area. This useful property has lent itself to a seemingly endless number of applications in the field of medicine.

Here, we’ll share 8 surprising cosmetic uses of Botox, well beyond its popularised function in treating wrinkles and fine lines on the face.

1.   Oily Skin & Acne

Botox can be used to reduce your skin’s oil production, thereby minimising acne breakout. Minute amounts of Botox are injected superficially underneath your skin, which then limit the activity of your skin’s oil glands

2.   Sagging Midface

Though still inconclusive, Botox has been shown to lift and balance the midface. This is done via an intradermal injection to weaken the downward pull of depressing muscles, resulting in a lift of the midface

3.   Thin Lips

Called the “Botox lip flip”, Botox is injected into the muscles around your mouth. This results in your lips rolling or “flipping” outward, creating an illusion of bigger lips

4.   Boxy, Squarish Jaws

Also frequently carried out by dentists to treat bruxism, Botox is injected into your masseter (chewing) muscles of the jaws. This reduces the activity of the muscles and narrows the jawline, resulting in a sharper face

5.   Sweaty Palms, Feet, and Armpits

Also known as hyperhidrosis, Botox can be injected to target overactive sweat glands, reducing the sweat produced

6.   Gummy Smile

A smile that reveals too much gum. This usually happens when your upper lip rises too far above the upper teeth when you smile. By injecting Botox into the upper lip, the muscles responsible for retracting your lips will not raise it as much, giving you a more balanced smile

7.   Cross-Eye

Also known as wall-eyed, or Strabismus, it is a condition in which your eyes do not properly align with each other when looking at an object. Botox is injected by a specialist to correct the overactivated extraocular muscles in the misaligned eye

8.   Wrinkled Neck

Called the Nefertiti Neck Lift, small amounts of Botox are injected into the upper platysma muscles, counteracting its pull and softening neck lines and wrinkles.

Because these are not common uses of Botox, the above treatments should only be performed by a very experienced medical practitioner; one who is very familiar with the facial musculature and anatomy, as well as being adept at handling Botox.

As cosmetic surgery becomes more of a norm, Botox and HIFU treatments in Singapore have become much more common, with various aesthetic clinics offering these skin tightening treatments in Singapore to the masses.

Botox is proclaimed by many as a “miracle” drug, with the ability to erase years of wrinkle and lines off a face. And it’s easy to see why. With invasive and non-invasive cosmetic surgery becoming more common, skin tightening treatments in Singapore like Botox have started popping up more often.

Since it’s FDA-approval and adoption in anti-aging medicine, Botox kicked start the rise of minimally invasive, “lunch hour” aesthetic treatments. In 2016, Allergan, the company behind Botox, made over US$2.5 billion in the drug’s sales alone.

The “miracle” of Botox lies in its ability to block nerve signals. And when applied to the right muscles, this prevents the muscles from contracting too much, thereby reducing the appearance of lines and wrinkles on the surface of the skin.

Read more about Botox here.

Here we will share 5 common facial wrinkles that we use Botox for.

1.   [Botox for Crow’s Feet]

The first sign of aging happens around the eyes and in the form of Crow’s Feet because the skin here is the thinnest.

Also known as periorbital lines or lateral canthal lines, these wrinkles appear as tiny branches from the corner of our eyes while we smile. With time, they become static and stay visible on the skin even without smiling.

The use of Botox in treating static lines is minimal. It is better as a preventive measure against Crow’s Feet rather than a corrective one.

2.   [Botox for Horizontal Forehead Lines]

Horizontal forehead lines appear on your forehead, between the brows and the hairline. The facial muscle responsible for these lines is called the frontalis muscle. As it contracts, your eyebrow is raised, creating a wrinkling effect on the forehead.

Horizontal forehead lines are more commonly seen on expressive individuals who have a higher tendency to raise their eyebrows.

Like Crow’s Feet, Botox is better used as a preventive measure in the frontalis muscle before the horizontal forehead lines turn static.

3.   [Botox for Frown Lines]

Also known as Glabellar Lines, these wrinkles appear on the glabella – the gap of skin between the eyebrows, just above the nose.

Apart from photo-aging (a combination of the natural aging process and exposure to the sun’s UV rays), a constant subconscious frowning (A.K.A. Resting Bitch Face) is also a cause of glabellar lines.

Frown lines can be prevented with early intervention of Botox treatments.

4.   [Botox for Upper Lid & Smoker’s Lines]

Often mistaken as lines that only smokers will have, these vertical wrinkles can also occur in non-smokers due to other factors such as photo-aging, genetics, and frequency of puckering.

Treatment of these perioral lines may require a combination treatment of Botox and fillers.

5.   [Botox for Dimpled Chin]

This weird looking chin has many names – dimpled chin, pebbled chin, golf ball chin are just some examples. It is identified by the lines and divots that form when your mouth moves in a way the chin scrunches up, like a pout.

Overactive mentalis muscles in the chin are the primary cause of a dimpled chin. The natural aging process and the sun’s UV rays are also contributing factors.

Treatment of a dimpled chin typically involves a small number of units of Botox which limit the activity of the mentalis muscle. Fillers are used in conjunction with more advanced stages of aging.

With millions of Botox treatments performed annually, it is one of the most sought-after cosmetic procedures in the world. With Botox prices in Singapore ranging from a few hundred to thousands of dollars for differing treatments, there’s a treatment designed for everyone.

Revered for its ability to reverse the signs of aging, many seek Botox almost instinctively to look younger. But what is it about this “miracle” treatment we should know? As it turns out, there are plenty.

Before you join millions of Botox fans around the world, here’s what you should know about Botox and its side effects.

Read more about Botox here.

Here, we will list 5 Botox side effects; from the most common such as the temporary freezing of facial expressions.

A Quick Guide to Botox

Botox is a neuromodulator. This means it blocks nerve signals. In cosmetic use, Botox is typically injected into muscles to weaken muscular activity. The drug is predominantly used to reduce and prevent skin wrinkling from muscle movement.

This is why most Botox side effects are related to this “paralysing” effect and tend to show up where the treatment was done, although a recent inconclusive study show otherwise.

Generally, although Botox in Singapore injections are relatively safe, some minor side effects can occur.

1.   Inflammation & infection

These side effects are minor and can occur in any medical treatment that is invasive in any degree, including injectables. They happen when wounds become infected by bacteria.

Board-certified medical practitioners are called as such because they meet the minimum standards as expected of them. One of which is a good standard of hygiene, which can prevent inflammation or infection from taking place.

2.   Fever, headache, and chills

Although rare, some patients react to Botox adversely. This immune response can manifest in fevers, headaches, and chills. These reactions tend to be isolated cases and vary by the individual. For example, a patient can have an allergic response to Brand A of botulinum toxin but experience none when treated with Brand B.

3.   Pain, tenderness, bleeding, swelling, and bruising

These side effects come with any medical treatment to some degree.

In Botox treatments, pain is very minimal due to its use of very short and fine needles. Of course, this will depend on the individual’s pain tolerance.

And because of its needle size, very little bleeding will occur, if any. Unless of course, the patient has a blood clotting disorder or had imbibed alcohol or painkillers before treatment.

Swelling is an immune response from the body as it recognises there’s trauma or an open wound.

Bruising with Botox treatments is very minimal as the needles are short and typically do not go deep enough into the skin to cause damage to blood vessels.

4.   Temporary Side Effects Around The Eyes

Botox can be used to lift hooded eyes, lift the brows and soften a frown.

Botox treatments of the eyes involve expert manipulation of the push and pull muscles around the eyes. In a brow lift, for example, the doctor uses Botox to create a slight imbalance between these muscles by weakening certain muscles, creating a lift or a drop of the brow.

And because the skin around the eyes is the most delicate on the face, any misplaced injection or miscalculated number of units can cause very visible side effects.

These include droopy eyelids, uneven eyebrows, dry eyes or excessive tearing, and the “classic” surprised look.

However, these side effects generally subside once the Botox wears out over a period of 3 to 4 months.

5.   Crooked Smile and Drooling

Sometimes, Botox can also be used in novel applications such as the Nefertiti Lift. In this treatment, the goal is to achieve a cleaner, less wrinkled neck by injecting the drug along the jawline.

The Nefertiti Lift is an advanced treatment with a higher risk of complications such as a crooked smile, or even drooling. It should be performed by a more experienced doctor who’s familiar with facial anatomy.

The good thing about Botox treatments is that they are usually temporary. Side effects will resolve on its own within 3 to 4 months after the drug’s effects wear off.

Afterword

A very serious allergic reaction to Botox is rare. However, always get medical help immediately should you notice any symptoms of a serious reaction such as the swelling of the face, tongue, throat, rash, dizziness, or trouble breathing.

Serious Botox side effects such as slurred speech, difficulty in swallowing, breathing, impaired vision, and loss of bladder control can occur hours to weeks after treatment. These, however, are more likely to happen in patients who have Botox treatments in higher doses for therapeutic reasons rather than cosmetic reasons.

Therapeutic treatments include correction of overactive bladder, chronic migraines, uncontrollable blinking, uncontrollable muscle contractions in the neck and shoulders, severe underarm sweating etc.

To avoid such unfortunate situations, please do your research before you visit a clinic. The best aesthetic clinics in Singapore will be happy to answer all your queries about their procedures. After all, it is your face and they want only the best for you.

1.   It is safe

Botox contains a purified protein extracted from the Clostridium botulinum bacteria. The organism produces one of the world’s most toxic substances known to mankind, the botulinum toxin.

(Botox was first approved by the FDA for cosmetic use on frown lines in 2002 and gradually expanded to include many other approved indications. It has also been approved by the Health Science Authority (HSA) in Singapore for use.)

But because Botox’s purified form only contains 1 of 8 types of botulinum toxin produced by the bacteria, it does not have the same poisonous effects as when all 8 types of botulinum toxins are delivered all at once.

That’s not to say you should concoct your own formula of botulinum toxin. The United States Food and Drug Administration regulates the production of Botox under strict protocols and processes.

Only certified doctors are allowed to administer Botox treatments in Singapore.

2.   It is more than just treatment of wrinkles

Made famous by the media for erasing lines and wrinkles, Botox is much more than that.

(Botox was first developed to treat Strabismus, a form of misalignment of the eyes.)

Cosmetically, it can help correct certain asymmetries on the face such as a crooked smile. It can also slim the jaws and sharpen the face, lift hooded brows, and even reduce the activity of your skin’s oil glands.

Botox is also widely used for therapeutic purposes. Some examples include controlling overactive sweat glands, correcting misaligned eyes, relieving migraines, and more.

3.   It does not freeze your face

Another thing the drug is famous for – the frozen, expressionless look.

Often seen on television and the silver screen as examples of plastic surgery gone wrong, these characters are unable to express their emotions on their faces.

Such caricatures are often just that; when performed by an experienced medical practitioner, especially in Singapore, Botox treatments rarely produce such “dramatic” results.

And even when treatments do go south, they usually resolve on their own as the effects wear off within months.

Moreover, patients also have a part to play in achieving natural-looking Botox results; more is not always better.

4.   It is NOT the same as fillers

Botox is a neuromodulator. It blocks certain nerve signals wherever it’s injected.

When applied to the facial muscles, this unique ability decreases the activity of the muscles responsible for skin folding and wrinkling, hence reducing the formation of wrinkles and fine lines, hence its usage as a form of wrinkle-reducing cosmetic procedure in Singapore.

Fillers, on the other hand, are exactly what their name suggests. They are substances injected underneath the skin to fill in loss volume or to enhance the look of certain areas of the face or body.

Read more about fillers here.

5.   It is NOT addictive

Botox, in and of itself, is not addictive. There are no addictive side effects with its use.

What patients get used to are the results they see with Botox treatments; the stopping of which simply means the return to how they were before treated.

You will not look worse off after stopping treatments, nor will you suffer any withdrawal effects.

Read more about Botox here.

Should Botox not be your cup of tea, or if you simply want a non-invasive treatment, you could also consider High-intensity focused ultrasound (HIFU) in Singapore, which helps to tighten loose skin around the facial area.

Melasma patch on the forehead.
Credits: American Medical Aesthetics

Do you suffer from patchy pigmentation on your cheeks or forehead? Have you tried many whitening products, lasers and even chemical peels without significant improvement? If you do, you may benefit from a treatment which has been shown to help with your pigmentation problem.

Melasma is a fairly common skin condition affecting mostly ladies in their 30s and 40s. It is also prevalent among pregnant women. Melasma appears as patchy brown pigmentation on the cheeks, forehead and nose bridge. These patches of brown pigmentation add a “dirty” look to an otherwise well-kept complexion and can affect the self-esteem of its sufferers.

What’s more, over-the-counter whitening products used to lighten pigmentation show limited results on Melasma, and even topical medications and medical laser treatments can sometimes produce marginal improvements. Melasma is also challenging to treat as it tends to recur with time and sun exposure.

Fortunately, researchers at Singapore’s National Skin Centre found that the oral medical Tranxenamic Acid, used in treating heavy menstrual periods, show significant lightening of Melasma in over 90 per cent of patients it studied. Side effects are minimal with the medication it is generally suitable for those in good health. Contraindications include those with a personal/family history of blood disorders, pregnant women, and ladies on oral contraceptive pills.

Do you suffer from patchy pigmentation and want to know if you’ll benefit from this treatment? Speak to any of our doctors at SL Aesthetic Clinic and we’ll be happy to advise on the treatments most suited you.

Source:  Journal of the American Academy of Dermatology, 2016 Aug;75(2):385-392

[13 Aug 2018] A blog post by Dr. Gabriel Wong

Having graduated from the Yong Loo Lin School of Medicine – Dr Gabriel Wong worked in several hospitals in Singapore where he honed his medical acumen.

Fate was at work when he met Dr Kelvin Chua, which sparked his interest in aesthetic medicine.

Growing from strength to strength under the tutelage of Dr Chua, Gabriel developed an eye for detail and beauty – perfectly in tune with aesthetic medicine, a confluence of art and science.

He applies this in a range of non-invasive procedures such as Botox treatments, soft tissue augmentation (Dermal Fillers with the Cannula Method), skin rejuvenation with lasers, and effective acne and acne scar treatments (e.g. Fractional CO2 Laser, subcision).

In his free time, Gabriel loves to travel in search of that perfect snapshot. His works of art have won praises by many patients.

For more information, write to contact@slclinic.com.sg.
To contact Dr Gabriel Wong, write to gabriel@slclinic.com.sg.

[6 August 2018] A blog post by Dr. Mark Lim

From facials, skincare products, to medical aesthetic procedures bearing the Skin Booster name, it’s a wild wild world of skin hydration treatments. Many of such mimic the original Restylane Skinboosters™ treatment, at varying levels of success.

Here, I give you a low-down on three medical aesthetic Skin Booster treatments, including Juvederm’s Volite.

But first. What exactly is a Skin Booster?

Not to be confused with the cosmetic product, medical grade skin boosters are meant to be injected rather than applied. Skin Boosters contain a sugar molecule called hyaluronic acid, or H.A. in short.

H.A. is a naturally occurring molecule in our skin, and one of its functions is to bind water to keep our skin hydrated. However, with the ageing process, the quality of the H.A. in our skin deteriorates. Over time, skin loses its glow and suppleness and develops fine lines.

Skin Boosters are designed to be injected intradermally either via manual injections or assisted by an injector device. Once in place, it soaks up water like a sponge and continues to hold it in place.

There are 3 Skin Booster treatments available at the point of writing. Here’s a short summary:

As individual needs, expectations, and concerns vary, there’s no one-size fits all Skin Booster treatment. Speak to your preferred healthcare professional for an individualised assessment to pick the best product for your needs!

P.S. another similar product called Rejuran Healer from South Korea has been making waves in the Skin Booster sphere. But that’s a story for another time!

He may be young, but Dr Mark Lim is definitely not a greenhorn.

As a local graduate of the National University of Singapore, Mark is also a Member of the Royal College of Surgeons, Edinburgh and is also on the Singapore Registry of Family Physicians.

But his need to push himself further saw Mark develop an interest in aesthetic medicine. And it was a fateful encounter with Dr Gabriel Wong that paved the way that grew a mere interest to into a passion to practice aesthetic medicine at SL Aesthetic Clinic.

With vigorous training under Dr Kelvin Chua while maintaining a job as a family physician, Mark honed his skills (and his needles) and proved himself an adept in injectable treatments such as Fillers and Thread Lift, as well as non-invasive facial contouring techniques and treatments such as HIFU (High Intensity Focused Ultrasound).

Further distinguishing Mark from his peers is his innate eye for aesthetics. This is evident in his taste in tailored clothes and suits, which underlines his ability to determine the best proportions for his patients.

For more information, write to contact@slclinic.com.sg.
To contact Dr Mark Lim, write to mark@slclinic.com.sg.

The Facial Ageing Process

How does one lift a droopy face? A common question I get in my practice, we first have to how our face ages.

The ageing process is not a straightforward one. Ageing takes place in the slow degeneration of multiple layers of our face:
1. Your facial bones shrink and lose volume
2. Facial muscles and ligaments that hold fat compartment in place become lax; these fat compartments shift downwards with gravity
3. Your outer skin becomes thinner and wrinkly.

Therefore, in order to reverse ageing with the aim of creating a youthful look, there is no one-size-fits-all treatment. More often, we need a combination of treatments for optimal results. Additionally, what works for one may not work for another. My role as a doctor with an interest in aesthetics is to examine your face to determine which combination of treatments works best for you.

As we age, our face shape changes from an inverse triangle to an upright triangle due facial bone shrinkage, muscle and ligament laxity, fat migration and thinning of skin.

Here are 5 treatments that can help improve ageing and sagging appearance.

1. Fillers: As you age, your bone structures change and lose volume. Imagine a table with a fitted tablecloth. This represents your face in your youth. Now picture the table frame (i.e. your facial bone structure) shrinking, while the tablecloth (i.e. your skin) stays the same. Sagging will definitely occur!

With filler injections, these empty spaces are filled to keep the skin taut. Fillers can also be introduced at parts of the face that are sunken such as the tear trough or nasolabial fold. Placing fillers in the right place can help to lift and restore volume, giving you a youthful look.

There are many different brands and types of fillers on the market with varying longevity and usage. It is important for you to find a doctor who’s familiar with handling the various fillers in the market today. This way the doctor will then be able to advise which filler is suitable for you.

2. High Intensity Focused Ultrasound (HIFU): HIFU delivers focused ultrasound energy into the deeper planes of the face, namely the deep skin (dermis), superficial fat and muscle layer (SMAS layer – Superficial Muscular Aponeurotic System). The SMAS layer is the same site that is tightened in a surgical facelift. By stimulating focal contraction points (as shown in the image below), there is immediate collagen contraction, resulting in SMAS tightness. Delayed wound healing in the next 3-6 months will stimulate new collagen production for the final results.

The advantage of HIFU when compared to conventional surgical facelift is that the deep structures of the face can be targeted without surgery, and herein without the associated downtime. HIFU is the ideal treatment for needle-phobic patients who want a firmer and lifted face!

2. Thread Lift: The loss of bone support, shift and fat compartments, ligament laxity are parts and parcel of the ageing process. Thread Lifting involves placing dissolvable surgical threads underneath the skin. These sterile threads are lined with cones/barbs, and introduced into your fat compartments to lift and reposition the sagging fat pads. This effectively reverses the signs of ageing. Immediate lifting is seen. Noticeable results can be seen after a few months as your skin’s production of collagen and fibrosis is stimulated by the threads. This keeps the skin firm and prevents the downward shift of your fats pads.

4. BOTOX (i.e. Botulinum Toxin): Oftentimes, BOTOX injections are thought of as an anti-wrinkle, muscle-relaxing treatment. However, when placed at the right places and in the right dosages, BOTOX can also produce lifting results. Depressor muscles responsible for your frowns can result in the gradual lowering of your brows and the drooping of your eyes. BOTOX injections targeting these muscles can result in what we call a “chemical eye lift”, giving you a fresher, well-rested look.

Another popular use of Botulinum Toxin is by introducing a diluted concentration into the skin layer. This is called DermaLift. This stimulates the fibroblast cells in the skin cells; tightening the collagen fibres. This gives rise to a lifted appearance in the skin.

5. Resurfacing Lasers: Now that you’ve done everything to lift your facial structures from within, you’ll need a taut, overlaying canvas (i.e. skin). This is when resurfacing lasers come into use. Contrary to popular belief, lasers do not thin your skin! Resurfacing lasers that are commonly in use are fractionated. This means that only a certain fraction of the skin will be acted upon by the lasers. This stimulates the remaining skin to produce more collagen, thereby strengthening your skin’s dermis layer. When performed at an appropriate frequency and power, your skin will feel taut and smooth after a couple of treatments.

Moreover, the common worry of long downtime is a thing of the past. I personally recommend the non-ablative Clear + Brilliant Laser, which offers minimal downtime (i.e. 2 hours to a day or two) with results.

With a plethora of anti-ageing treatments available on the market, which is suitable for you then? As your skin age in your own way and time, consult a trustworthy aesthetic professional who will be able to make recommendations suited to you.

[25 May 2018] A blog post by Dr. Charlene Goh

Having obtained her medical degree in Scotland, Dr Charlene Goh returned home to Singapore, where she practised in several major hospitals and in various departments. But her education did not stop there.

From a young age, Charlene has had a strong interest in skincare and beauty trends. Urged by Dr Kelvin Chua to pursue her passion, Charlene went away to study Practical Dermatology at Cardiff University in Wales.

Not one to rest on her laurels, she returned home and picked up certifications from various aesthetic organisations.

Now armed with the proper certifications and experience, Charlene is adept at a wide range of minimally invasive aesthetic procedures such as laser treatments, dermal fillers, botulinum toxin injections, etc.

A firm believer in presenting one’s best self, Charlene hopes to help others achieve confidence through a holistic approach; a wholesome combination of a healthy lifestyle and diet, complemented by clinically proven aesthetic treatments.

Charlene is a self-confessed beauty junkie and fashionista, and will happily discuss the latest trends with friends and patients.

For more information, write to contact@slclinic.com.sg
To contact Dr Charlene Goh, write to charlene@slclinic.com.sg

[10 January 2018] A blog post by Dr. Kelvin Chua

To some, ageing gracefully means carrying the “character lines” with pride and quiet dignity. Others seek the help of Botox and Fillers to maintain their natural youthfulness.

The operative word being natural; many aesthetic practitioners ruefully fail to master the art of minimal injections.

Choose Quality, Not Quantity.

Having practised medical aesthetics for over a decade, I’ve seen and corrected my fair share of sloppy work and botched jobs.

Frozen brows, misshapen cheeks and skewed noses were common sights. Such cases have decreased in numbers over the years. All, except for one – the overuse of Botox and fillers.

I attribute this to one common misconception among many patients who go for Botox in Singapore. The belief in getting every single drop of product to maximise the money spent. Regretfully, this is where such patients get it wrong. Quantity does not equate to results.

Allow me to explain.

It is not as straightforward as getting the largest amount of Botox at the lowest price. Patients pay for results, not the amount of product used.

In achieving natural-looking aesthetics, the doctor (hopefully) knows what’s best for the patient (in his or her own opinion anyway, which is a different story altogether). A combination of specialised techniques and a measured amount of products is key.

Less is definitely more; especially for skill-intensive procedures such as Botox and dermal fillers.

Botox

A poker-faced finish is just not what you’d want to sport unless you’re spending hours counting out those chips in a casino. You’ll want youthful skin that says “Good genes!” instead of a frozen expression that shouts “Botox!”.

Practices of giving larger Botox doses have become a thing of the past as smaller doses are used to achieve a softer look with a touch up later if necessary.

This is why it’s important to seek out ethical and experienced practitioners who understand the interaction of different muscles so as to allow some of the essential muscles to move and maintain natural facial expression.

You’d want compliments on looking younger than your age and less tired looking rather than questions on the number of Botox units you’ve received.

Volumisation and Liquid Lifting with Fillers

With present-day technology, restoring lost volume on the face is ever easier with fillers. And if done right, you can take years off the face within minutes with virtually zero downtime.

While some doctors may inject several vials of fillers into a face, a doctor can create a natural and yet youthful look without excessively plumping out the cheeks that look like you

belong to the unenviable Pillow Face Club.

Moreover, Hyaluronic Acid-based Dermal Fillers come with different degrees of fluidity and hardness. The selection of the appropriate filler for each concern is crucial in attaining the best results, rather than the quantity used.

Experienced aesthetic practitioners have a good grasp on the different layers and depth of skin to be injected.

The depth is important to create different effect instead of using vials of fillers to simply fill the entire face. The position and depth also determine the type of fillers that are best suited.

Your Face is 3D, not a 2D Painting

This is particularly important as the face is not a 2-dimensional structure but rather a 3-dimensional model. This is made more complex from muscle interactions, varying degrees of sagginess resulting from migration of fats in different layers of the skin and the loss of fats in different areas.

Ultimately, it all boils down to a doctor’s training and a natural eye for beauty and proportions. Especially when it comes to such skill-intensive procedures.

Dr Kelvin Chua started his surgical training in Australia, teaching for several years in the hospitals, and spent some time in dermatology and surgical rotations.

Kelvin was fascinated by the boom of aesthetic medicine and has since garnered over 12 years of experience in this field – with liposuction procedures and Botox and filler treatments under his belt.

With a strong passion for inspiring others through teaching, Kelvin is a trainer for aesthetic institutions as well as cosmeceutical companies. Kelvin is also a mentor to aspiring aesthetic doctors.

For more information, write to contact@slclinic.com.sg
To contact Dr Kelvin Chua, write to kelvin@slclinic.com.sg