Thursday, 30 April 2020

Let food be thy medicine and medicine be thy food

You are what you eat.

This is very true and at a time like this, when the world is in the midst of a pandemic let's take an opportunity to revisit our diet and the principles of optimum nutrition.

When I was in medical school there was very little formal education on nutrition. Yes, we did learn about principal food groups, vitamins and minerals and diseases caused by deficiency or even excess of these items but that was it! No education on optimal nutrition for prevention of diseases or indeed optimum nutrition in the post-operative period to hasten recovery. I believe this was important knowledge for a surgical resident but the emphasis was on surgical anatomy and how to do the operations well.
I don't believe this situation has changed much today.
Most of the nutritional education for me has been self directed learning and and a huge amount of knowledge working with my membership of learned societies such as the American Academy of Anti-aging medicine and World Academy of Anti-aging medicine. I also took and passed the board certification examination in anti-aging medicine all those years ago. I do not practice all aspects of anti-aging medicine especially bio identical hormones at present. I like to call it as optimal aging or age management rather than anti-aging!

Nutrition and optimum nutrition can be a very confusing subject. Hardly a day goes by when you do not read conflicting headlines about benefits and harms of substances like chocolate or alcohol!
So what is the truth ?
One has to critically appraise the literature out there. There are a couple of books that I highly recommend and and these are -

1)Thomas M. Campbell II
The China Study Solution: The Simple Way to Lose Weight and Reverse Illness, Using a Whole-Food, Plant-Based Diet

2)David Servan-Schreiber
Anticancer: A New Way of Life

Both by highly regarded authors. There are others but let's not overload you!

So here is a summary of what I believe to not attract much controversy. 

Modern diet is rich in calories but deficient in nutrients.

Obesity is a ticking time bomb.

Portion size distortion has occurred. Our stomach is the size of our fist so this has to be remembered when we talk about an optimal portion size.

Natural whole foods are good and processed food is not that great.

High fructose corn syrup, trans fats and sugars are what I call daily poisons.

Meat and dairy are not good for us.

"Well most government guidelines say that a balanced diet should have meat and dairy in it' I hear you ask. The problem is that there are so many lobby groups that by the time the government guidelines come out they have been watered down to keep different pressure groups happy, so you have to consider conflict of interest when you read any of these.

In summary I believe that predominantly plant-based, unprocessed and locally sourced food is best. You get fruits and vegetables that are in season, that have been produced locally and haven't been plucked before they've had chance to ripen and secrete all the good flavanoids and polyphenols. These are the real immune boosters.

I do believe that vitamin and mineral supplementation is important as modern diet is deficient in these items.

So what's in it for me?
I have no financial interest in any of this. I believe in preventative medicine and that prevention is better than cure. Of course it goes without saying that you get the best results from our treatments if you have good nutritional status. Poor nutritional status will not provide optimal results from any medical or cosmetic intervention..

I hope you found this article of some benefit. You're welcome to leave your comments below.

Dr Sanjay Gheyi MBBS MS FRCS BCAAM Medical Director Coltishall Clinic 
#optimumnutrition  #gooddiet   #antiageing  
#norwich   #norfolk

Tuesday, 24 March 2020


Cessation of all routine activities. Coltishall Clinic is now closed for all routine activities for a period of at least two weeks. We will keep you updated and see you once this Covid-19 is sent packing away or government advice is updated. We apologise for the inconvenience. 

23 March 2020

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.