Sunday, 6 February 2011

Treatment of facial blood vessels

Facial redness and spider veins are a common cosmetic and medical complaint. These are particularly common in rosacea suffers. Common associations are seen with sun damage, a fair complexion, stress, spicy foods and fluctuations in temperature which exacerbate rosacea symptoms. As with many conditions, genetics plays a role too.
Numerous treatments are available but laser and light based treatments are the gold-standard treatment options. Commonly used lasers are ktp and pulse dye lasers for red veins and nd-yag lasers for blue veins. The smaller wavelength lasers work well on superficial spider veins whereas, the longer wavelength lasers are effective for the ablation of slightly deeper and larger veins. Pulse duration must also be matched to vessel size; the larger the vessel diameter, the longer is the pulse duration required to treat the vessel.
Recently intense pulsed light devices have gained popularity. Unlike lasers, IPL devices produce a broadband light and effectively target a number of cosmetic concerns such as brown/ black pigmentation and red and blue vessels simultaneously. IPLs also tend to have larger spot sizes and purpura [bruising] is not a required endpoint as is the case with certain lasers. Patients see gradual but very noticeable improvements with complexion blending and brightening achieving photo rejuvenation of the skin.

Often we see larger blood vessels especially around the nose and these may require treatments with nd-yag lasers. Caution is required with these lasers as high energy or pulse stacking can cause scars. Some doctors use sclerotherapy for facial veins and very precise small volume injections are made. I do not use sclerotherapy on the face as a rule. Area around the mouth and nose is a danger area as veins here communicate directly with venous sinuses inside the skull. Similarly veins around the eyes are another risky area as there is a possibility of flow of scleroscent in the retinal vessels. Sclerotherapy is very valuable for treatment of leg veins but laser and IPL treatment is safer and better for facial veins. We will look at leg vein treatments in my next blog.

Wednesday, 8 December 2010

So, aspirin is the re-discovered wonder drug!

Recent media headlines are dominated by rediscovery of aspirin as a wonder drug. Doctors are well aware of benefits of low dose aspirin. It thins theblood so naturally reduces chances of stroke or heart attack which are predominantly caused by blockage of blood supply to these organs. It has also been shown to have anti-cancer properties.
So, do we all rush out and start taking aspirin!
Well, let’s put this in perspective. I am not against aspirin and use it very often in my practice. Some patients can have side-effects or problemswith intestinal tract bleeding with aspirin and its risks in certain
circumstances can outweigh the benefits. So, is there an alternative without the risks?
The good news is, yes. Omega 3 fish oils can provide many similar benefits.Populations that consume a diet naturally rich in omega 3 fish oils have a low incidence of cardiac and cerebro-vascular disease, cancer and all causemortality [a low death rate from all causes.] These populations also have other factors that contribute to their longevity but fish oils do play a role.
A natural approach to longevity and reducing diseases such as heart disease,stroke and cancer would include a number of things such as stress reduction, regular exercise, adequate sleep & hydration, positive relationships, positivemental attitude, balanced diet, avoiding sugar & tobacco, hormone balancing in certain circumstances and nutritional supplements suchas fish oils. It is synergy of these which is much more powerful than one thing in isolation.
So, what omega-3 oils do we consume? Vegetable oils such as flax seed oil provide some of these but not enough. The best source is fish oils. 1 gm of oily fish three times a week shouldbe adequate for most of us. Another option would be fish oil capsules, ideally these should be in enteric coated formulations and provide EPA and DHA as mainingredients.
Are there any risks? 
Due to contamination of our oceans, concern has been raised about mercury content of the large predatory fish such as tuna, grouper, snapper & bass etc. Theoretically smaller fish would be low in mercury content and better in this regard. Also, too much of fish oils can thin the blood so I would not recommend more than 1-2 gm a day for most healthy people. And, do remember to tell your doctor if you are having any aesthetic procedure or surgery. It is possible to run a fatty acid profile as part of a nutritional assessment. This would indicate omega-3,6 and 9 oil levels in the blood. Testing can also reveal mercury levels in the body. This testing however is not widely recognised by mainstream medicine at the moment.
Most important thing to remember is that there is no one answer or magicdrug to solve all our problems. It has to be a combined approach.

Monday, 8 November 2010

Non-surgical face lift in your lunch hour. Liquid facelift at the Coltishall Cosmetic Clinic.

If you have thought about having a facelift but worry about aneathesia,
bruising, pain or recovery then read on. You can now have a pain less face lift in your lunch hour. It provides great results at lower cost than surgery.
How is this possible?
A face lift only tightens loose skin; it does not replace lost volume from the face which is probably the most important component of facial ageing. It will not improve skin texture or tone either. We are increasingly using volumisation of the face in addition to skin tightening which if performed without volume restoration gives a tight but not a natural look. I prefer a natural look for my clients.
Most of us do not have time to recover from a surgical  procedure and with recent advances in non-surgical treatments we can achieve very impressive results. We have an impressive array of lasers and other devices to address all aspects of ageing skin.
Restylane Sub Q lifts your face in an instant and the results are great. It is being hailed as something of a breakthrough. My clients who have received this treatment are very pleased with it. It is performed under local anaesthesia and takes about 30 minutes. You can then walk away with a rejuvenated natural look and years taken off your face. As it is a deeper filler, there is usually no bruising or redness.
The best part is that I don’t use a needle anymore. I use a special cannula which has a blunt tip. So, now there is no pain or bruising which sometimes occurred when we used to use the needle. It is an alternative to permanent cheek implants which can be problematic as they sometimes cause infection or move, creating asymmetry in the face. Although fat can be used to transfer into the face and add volume, deep filler is the only method available to achieve a similar result without the need for surgery.
Restylane Sub Q is the brand name for an injectable form of hyaluronic acid
specially formulated for facial contouring. Hyaluronic acid is a sugar that is
found in the connective tissue of our skin and along with collagen forms the
building blocks of healthy tissues. As it is totally natural component of our
skin, no allergy test is required. Restylane is the most popular facial filler
in the world today and has been used in over 11 million treatments. It has a
proven safety record. The result from the treatment is immediate and can last more than a year.
Another exciting development is the use of botox to achieve a defined outline of the jaw. The so called “Nefertiti lift”. We also use botox for
eyebrow lift to correct drooping eyebrows. A combination of these procedures and other non surgical tools is now capable of producing remarkable results without going under the knife. Everyone is not suitable for these procedures and as we each have our unique features and requirements we tailor our treatments and pick and choose best options from our increasing number of non-surgical treatments.
For more information, phone 0800 0430737 or log on the

Friday, 8 October 2010

Do your hands give your age away?

Most of us look after our faces very well, but our hands take a lot of abuse and most of us pay little attention to their care and protection. They are subjected to cumulative sun exposure and wear and tear just like the skin on our face, neck, and décolleté. The skin on the hands also tends to be thin and sun damage causes brown spots, slackening, and wrinkling. These textural changes cause visible signs of ageing. Wearing a hand cream with SPF 25 and occasional exfoliation helps prevent some of this damage, but there are many effective treatments to help correct it. You can have a combination of treatments to reverse visible imperfections or pick and choose a treatment to best address the concerns that you have.

For discoloration, tone, and texture, a course of intense pulsed light treatments can help significantly over time. IPL treatments from Lumenis, for example, used to treat the hands address the effects of photoaging and sun damage without downtime. Brown discoloration will be lightened with each session. If deeper pigmented spots are your main concern, lasers such as the Q-switched Nd: YAG or alexandrite laser can lighten them more effectively. If you have sun damage generally, then we recommend a fractional CO2 laser peel for global improvement with a little downtime which can be customised to your needs.
Restylane vital is also commonly used for hand rejuvenation. Three sessions at monthly intervals can provide dramatic results as shown here.
If you are after a maintenance treatment and next step up from hand creams then a course of gentle chemical peels and or diamond microdermabrasion is all you need.

Monday, 20 September 2010

Fractional eyelift - a non-surgical alternative to blepharoplasty!

I am convinced- Surgery is taking great strides, we now have a full-face transplant surgery.
The future in facial and body aesthetics is non-surgical. Most people today prefer a quick, no downtime procedure rather than risk anesthesia and downtime associated with surgery.
Certainly our CO2 lasers are capable of providing great results for skin tightening. I have achieved a great degree of skin tightening in neck and eyelid areas. You can read more about fractional eyelift here

Sunday, 15 August 2010

BRIC dominate cosmetic surgery and non surgical procedures

I am sure you have heard about BRIC. Whilst we were all worried about the recession in the west, BRIC [that is Brazil, Russia, India & China] economies were roaring ahead.
Now it seems they have overtaken most western economies except the USA when it comes to cosmetic surgery and non surgical treatments.

Recent figures released by The International Society of Aesthetic Plastic Surgery (ISAPS) revealed a new hierarchy of countries with the most surgical and non surgical cosmetic procedures. 1st is USA , 2nd China, 3rd Brazil and  4th India.  Russia is at no 12 and UK is at 17.

The popularity of surgical procedures varied by country with Brazil, the United States, China, Mexico, India and Japan the dominant countries for the top five procedures.

The countries where non surgical procedures were performed were dominated by the United States, Brazil, Mexico and China and to a lesser extent by Japan, Hungary, South Korea, India and Germany.

The top five non surgical procedures are: toxins or neuromodulators injections (Botox, Dysport) (32.7%), hyaluronic acid injections (20.1%), laser hair removal (13.1%), autologous fat injections (5.9%) and IPL Laser treatment (4.4%).

Most popular surgical procedures were  liposuction representing 18.8% of all, followed by breast augmentation at 17%, and blepharoplasty (upper or lower eyelid lift) at 13.5%, rhinoplasty (nose reshaping) at 9.4% and abdominoplasty ("Tummy Tuck") at 7.3%.

What stands out is that more Non surgical than Surgical procedures were performed. This data relates to plastic surgeons. Recent figures also show us that vast majority of Non surgical procedures are performed by non plastic surgeons. So we can reasonably conclude that Non surgical procedures are rising at a much faster rate than cosmetic surgical procedures.
See how this compares to our experience.

Wednesday, 11 August 2010

Don't hide those legs because of Spider Veins, Varicose veins or Thread Veins


Spider and thread veins are a common problem worldwide. These are not only of cosmetic concern but can be medically important as they can cause achy and tired legs specially in the evenings after a days work.

Abnormal leg veins are more common in women who often suffer in silence. But it does not have to be this way. Often the first step is to be aware that there are excellent non-surgical treatments available for treatment of this condition.

US FDA approved Asclera [Polidocanol]

Varicose veins can be an embarrassing condition that causes patients to avoid shorts and outdoor activities. Recently, the US FDA approved Asclera (polidocanol) injections for the treatment of varicose veins.

The FDA has approved Asclera to close spider veins (tiny leg veins less than 1 millimeter in diameter) and reticular veins (those that are 1 to 3 millimeters in diameter). Asclera acts by damaging the cell lining of blood vessels. This causes the blood vessel to close, and it is eventually replaced by fibrous tissue.

Dr Gheyi has been using this medicine for last 4.5 years with excellent results. Another medicine that he uses is fibrovein which is approved in the UK. This is a further testimonial that we use safe and effective treatments in our clinic.

So what other cutting edge treatments can we offer for treatment of Leg veins, thread veins and spider veins?

For those of us who prefer not to have injections of mdicines or for those patients where we think laser is likely to offer a better solution we can offer three different state-of-the-art laser treatments.

find out more about laser treatments here

read a patients experience of leg vein treatments here

read patient testimonials here