Thursday, 16 August 2018

Commoditisation of Botox and Dermal fillers. Norwich is wild west of facial aesthetics.

Botox is a prescription only medicine. By definition it has to be administered by someone who can prescribe. Also prescription drugs cannot be advertised. Walking through Norwich High Street I saw beauty salons advertising Botox openly with posters outside their doors. If you do an online search for Botox in Norwich you will see high-ranking pages from non-medical people who put their lives on social media. Search engines of course love them because they are churning out content non-stop and putting every treatment they do online despite the fact that often they are making people look like aliens!
As someone who has run a successful Norwich based aesthetic practice administering botox and dermal fillers for more than a decade this is somewhat disconcerting to see. United Kingdom is unique in this regard as anyone can inject Botox and Fillers. There are people who are abusing their position to be able to prescribe Botox and fillers and then supplying them to non-medics to administer ( for a fee ). Of course every year there are more and more complications from these treatment carried out non professionally. Did you know that filler complications can be catastrophic! No I am not saying that complications do not occur in hands of doctors. No medical treatment is risk free but by seeing a properly trained qualified and experienced medical professional you are making it less likely for this to occur and should complications occur, you are in best hands with somebody who can take care of these. Why would you see a non doctor for a medical procedure?

Dr Sanjay Gheyi MBBS MS FRCS is medical director at the coltishall cosmetic clinic in Norfolk. He administers thousands of injectable treatments every year along with a full range of cosmetic surgery, laser and non surgical treatments with outstanding patient satisfaction.

Monday, 9 October 2017

Treatment of leg veins. A case study.

Leg veins are a common complaint.  They can be symptomatic and untreated can cause complications such as eczema and leg ulcers.

Unfortunately Varicose Vein treatments are often not available on the NHS. Successful treatments usually require a combination of modalities.

A patient journey starts with a thorough assessment that usually includes a duplex ultrasound scan that we perform in the clinic. It is best to have this scan performed by the treating surgeon. If the scan reveals underlying hidden varicose veins these have to be addressed before treatment of surface veins.

We are grateful for our patient for allowing us to use her photos. She has had endovenous laser therapy, microphlebectomy and sclerotherapy treatments. She is very pleased with her results which will further improve over next few months. She was able to go on a sunny holiday and wear shorts after 20 years. What is remarkable is that modern technology now allows us to treat leg veins without general anaesthesia or hospitalization. This also allows treatments as a day case without prolonged recovery period.
It is a mistake to treat thread veins without making sure there are no hidden veins lurking beneath the surface. Make sure you see a practitioner who can at least use a screening ultrasound to make sure you are treated the right way.

You can find out more information here 

Call us on 0800 0430737 or fill our appointment form to arrange your consultation.

Sunday, 18 June 2017

Facial Rejuvenation Experts- Coltishall Cosmetic Clinic

There is no shortage of practitioners from a variety of backgrounds offering Dermal fillers and Botox injections. The trouble is that a majority of these practitioners do not understand how the face ages and/ or have a limited number of treatments to offer. Any specialist mechanic needs a properly resourced toolbox not just one or two tools. Same thing with facial rejuvenation. If your practitioner only has one or two tools, that is all they can offer you, whether or not it is best for you. 
Someone with 30 years experience in general practice or nursing maybe an expert in asthma management or vaccination but it does not make them an expert in facial rejuvenation- although they may make such claims. So do check that your practitioner has experience in procedures they are offering you.
Concepts of beauty also change over time. So we need a balanced approach rather than too much of the wrong thing!
Let me give you some examples. In the 1970's when we did not have the modern treatments and technology all we had was facelift surgeries. Surgeons devised extensive invasive techniques in order to produce the tightest and longest lasting results that they could. We all know the consequences, the results were too tight 'Wind Tunnel' look faces but they were not necessarily young or pleasing to look at.
Now such surgeries have fallen out of favour and we are in an era of over filling. What I call 'pillow faces'. Sadly it is not only the patients, but I see practitioners with such appearances. Looking filled has almost become the norm!
When Botox first came out it was the norm to see frozen expressionless faces. Patient themselves are now moving away from too much Botox and requesting less of the stuff so they still have moment but look softer and well rested.

So what is our approach of facial rejuvenation at the coltishall clinic?
Our approach is to produce natural looking, pleasing and harmonious results. We recommend that you bring your old photo that you like to your consultation. We can see how your face has changed and try and reverse these changes.

What happens with facial ageing and how we can help?
1. Loss of skin quality, sun exposure and smoking related changes.
Solution- skincare and skin rejuvenation treatments. You need a machine or laser that is suitable for your unique concerns. We are one of the very few clinics in the country who have invested in the full range of specialised dermatological lasers. Some practitioners claim their laser can do everything but that simply is not true. Often a combinations of machines are required to produce best results. Dedicated Medical Lasers are advanced tools and much better than cheap devices that have become widely available to non-medical personnel since deregulation!

2. Hyper dynamic wrinkles or in simpler terms wrinkles caused by over use or overactivity of facial expression muscles.
Solution-judicious use of botulinum toxin injections.

3. Loss of volume- we lose bone, fat and muscle resulting in facial deflation and sagging of tissues.
Solution-facial fillers to restore lost volume and surgery to reposition sagging tissues and remove excess skin. 
Fillers have come a long way and today's fillers are natural, highly purified products which are extremely unlikely to produce allergic reactions or other problems. One caveat is to stay away from permanent fillers. The only permanent filler I use is your own fat to restore the facial volume.

4. Sagging skin- gravity and reduction in skin quality can cause skin to stretch and sag. If you have not had the benefit of preventative treatments or there is significant skin excess surgery is required. However, you do not need extensive surgery under general anaesthesia. By improving your skin quality and replacing lost volume you are less likely to need extensive surgery.  Extensive surgery has fallen out of favour and less invasive surgery under local anaesthesia is in. This is what we like to offer. Extent of surgery is also tailored to your specific requirements.
© Coltishall Clinic 2017

Sunday, 29 January 2017

Safe and effective Laser Hair Removal for all skin types. Why it is a great idea to see us.

When it comes to laser hair and tattoo removal it is the wild west in this country. There is no shortage of new places opening up at every corner. We are seeing increasing number of patients who are either dissatisfied or have been harmed because of poorly trained and unregulated providers and cheap copycat or downright dangerous and unapproved machines.

Nd-Yag Laser
As we all know one size does not fit all. There is simply no machine which is suitable for every person's needs. With this in mind we have invested heavily in modern high-end medical machines that have undergone rigorous testing and evaluation. All our therapists also undergo rigorous initial and on going training in laser safety.

We have helped thousands of patients remove unwanted hair, ingrowing hair and rashes, pseudofolliculitis barbae (razor bumps) and even helped patients with poly-cystic ovaries.

Thanks to our proven gold-standard lasers and extensive experience we are able to treat every skin type- from very fair to dark skin patients.

Nd-Yag laser is great for treating Asian and Afro-Caribbean patients.

Caucasian patients are generally treated with Alexandrite laser or  IPL machine made by worlds leading medical laser company- Lumenis corporation.
Alexandrite laser

Lumenis IPL
Sometimes additional lasers are required so we also have a selection of diode lasers. In general though we prefer our three "big-boys" as pictured here.

So if you have wanted safe and effective Laser Hair Removal at an affordable price-come and see us. It simply is not worth taking chances and trying anything other than a reputable clinic with lot's of experience and FDA approved medical lasers.

Thursday, 29 December 2016

Tackling difficult areas with fillers. Why you need to see an experienced doctor.

The temples, chin, jawline, tear trough and forehead are difficult to inject so you need and experienced doctor to do these and not someone who injects fillers ‘on the side’. Ask your practitioner how many filler injections they do and can they show some before and after photos. When injecting fillers it is important to stay away from the important structures such as nerves and blood vessels. So a deep understanding of anatomy is essential.

When the jaw angle gets blurred, It makes a huge difference in how the person is perceived. We can inject fillers to contour the jawline, angle of the jaw and chin. Botulinum toxin injections remain popular for this area as in Nefertiti lift. As we age, we start to lose a little chin projection. This can be restored using fillers.

Age-related changes in the temple area include not only loss of fat but also loss of other soft tissues and bone. Additionally, patients can develop sun damage, skinlaxity and muscle atrophy, We are trying to replace a three-dimensional, multi-structural loss with one injection.
When filling the temples I am on the bone, as deep as possible. I can usually get most of the temporal areas filled effectively with one or two injections. That minimizes the risk of danger.

We routinely inject fillers in frown lines and forehead lines but this is a tricky area to inject-even for very experienced practitioners. A more comprehensive approach to the forehead involves three-dimensional forehead reflation. This approach differs drastically from simply filling lines because it requires placing fairly substantial amounts of filler on underlying bone while avoiding the blood vessels. This is a challenging technique that can produce beautiful results.

Monday, 2 November 2015

Lasers for skin health. Our treatments make your skin healthy and delay age related changes.

We live in an age of technological revolutions and breakthroughs. Medicine has also benefited from an explosion in technology. Lasers have completely changed the field of cosmetic dermatology.

A couple of ground breaking studies from California have shown that light-based treatments do not only make the skin appear younger, they are actually making skin healthier and delaying skin ageing. Lasers work not only at a visible level but also at a microscopic, cellular and genetic level.
Researchers analysed characteristics of treated skin by taking skin biopsies and found that of the 2265 genes whose expression was altered in aged skin, 1,293 were fully restored to the expression seen in younger skin. After three successive Broadband Light treatments, the re-expressed genes included those associated with longevity and increased life.

A second blinded study showed that patients in the treated group on average had nine years younger looking skin.

Lasers can also be used very successfully to treat acne scarring, facial wrinkles and to achieve skin tightening. These procedures however may require a small amount of recovery time. These can be performed purely under local anaesthesia

For Vein care, we are now routinely able to treat conditions and achieving results which just 10 years ago would have been considered far fetched. In general there is a move away from major surgery and minimally invasive procedures and lasers are capable of achieving similar or better results with less risk of complications.

So can we see anyone with a laser?
We see major advances in technology which has resulted in better and better machines becoming available, at the same time there has been proliferation of less than desirable, and sometimes dangerous technology at the lower end of the market. Not all lasers are good and there are a lot of unqualified people using these so do your research before choosing a clinic and/ or a practitioner. In worst case scenario the outcomes can be less than desirable with complications sometimes difficult or impossible to rectify. So don’t take chances and visit a well established and reputable clinic. Preferably a clinic registered with Care Quality Commission, the only regulator of health care in England.

What conditions can your lasers treat?
Lasers can very successfully address a number of skin concerns either together or one at a time. This could be visible broken veins and capillaries, birth marks, acne,acne scarring, pigmentation, rosacea or facial blemishes. age spots offace, neck, chest and hands etc. Skintags, moles and benign lumps and bumps can be vaporised in an instant, in a bloodless procedure and with minimal risk of scarring.
Unwanted hair can be removed and tattoos can be faded or removed completely and leg veins can be sealed from inside in a nonsurgical way rather than having to undergo painful stripping operations.

We also use lasers to tighten the tissues under the skin as can be achieved with laser liposuction and laser assisted face and neck lift surgery.

Where can we find more information about these treatments?
Log on to for more information, treatment prices and downloadable information sheets.

How can we book an appointment?
Call us free on 0800 0430737 or fill our appointment request form on the website and we will contact you.

Monday, 29 June 2015

Gentle Laser Skin Rejuvenation - Also known as Polaris laser, Laser Skin Tightening or Laser Genesis.
 The perfect lunch-time procedure.

Gentle Laser Skin Rejuvenation - Also known as polaris laser, laser skin tightening, clear lift or laser genesis
The perfect lunch-time procedure.

What does it do?
It is an innovated, technologically advanced way to promote vibrant and healthy looking skin in men and women. The non-invasive laser procedure safely, discretely and effectively treats fine lines, wrinkles, large pores, uneven skin texture and diffuse redness. You can expect to see subtle results after just one treatment without unwanted side effects.
 For optimal results most people need 6-10 treatments.

What does the treatment feel like?
Patients describe the treatment as relaxing and therapeutic. You will experience a gentle warming of your skin’s surface as the laser headpiece is moved back and forth above you skin. Laser procedure is very comfortable; it’s sometimes called the warm laser facial. It is a gentle, relaxing and virtually painless procedure with zero downtime.

How does it work?
The effect that Laser treatment has on your skin is a gradual one. Most of our patients begin to see an improvement in their skin after about 3 or 4 treatments. 
We use a medical grade laser to gently heat the skin below the surface.  This “healthy heat” stimulates the body’s own natural healing response which stimulates new skin cell growth and collagen production. The texture of your skin literally becomes smoother. Depending on what you are having treated, pores get smaller, lines are decreased as your underlying collagen is refreshed, and color of your skin will even out while redness is diffused.

What is diffuse redness?
Diffuse redness is the appearance of facial redness, such as rosy cheeks. This condition is caused by dilated capillaries.  The most common areas are the nose, forehead and cheeks. Diffuse redness is often associated with a condition called rosacea. Laser treatment will help your appearance by gently generating heat in the dilated capillaries resulting in reduced redness.

How many treatments will you need?
People and conditions will vary in the way they respond, based on their skin biology.  Typically we recommend a series of 4 to 6 treatments to optimize the results.

How long does the treatment take?
Each treatment session takes about 30 minutes.

What are the side effects? 
Most patients report few if any side effects and return to their normal activities immediately following the treatment. You may be flushed from the heat but that will disappear within a few hours of the treatment.
 The most common side effect of Laser treatment is beautiful skin !

What can you expect?
Laser treatment can help restore the skin’s youthful glow and appearance by smoothing out uneven textures caused by aging, sun damage or scars.  You will see a creamier, healthy complexion as large pores reduce in size, and minor imperfections are diminished.  The individual treatment results are subtle, but the overall effect of multiple treatments can be quite dramatic.

Can anyone have it done?
Yes. Adults of all ages and all skin types can benefit from Laser treatment and can have it done year round. 

How does it differ from other laser treatments you offer ?
If you have obvious issues or medical conditions such as rosacea, acne, acne scarring or pigmentation issues then you need a customised treatment plan which may include any one or more of our sixteen lasers. We first suggest a consultation with our doctor for such problems.