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davidlohsurgery

Everything you need to know about Dermal Fillers in Singapore – With David Loh

DR DAVID LOH

dr_david_loh
Dr David Loh is the immediate past president of the Society of Aesthetic Medicine in Singapore, having published on his filler injection techniques. His publications on the management of filler complications is often cited in scientific journals.

 

Growing old gracefully has taken on a new meaning in the last few years.

In the past, it referred to growing old “without any work” done. These days, with plastic surgery so pervasive, growing old gracefully means growing old with “only minimal work” done. And B*tox and Fillers are as minimal as it gets in aesthetics. Let’s talk about dermal fillers in this blog, shall we?

facial_filler_faqs

 

Frequently Asked Question on Dermal Fillers

What areas are best treated with dermal fillers?

All areas on the face, from the forehead down to the chin can be safely and effectively treated with dermal fillers. Here are the more common areas that are treated.

  • Forehead augmentation and projection can contour the forehead;
  • Nose, lips and chin augmentation bring out the beauty in the central facial features;
  • Cheek and under-eye augmentation support the skin over the cheeks. This decreases the appearance of the under-eye hollows, the nasolabial folds and the jowls;
  • The temples and lateral cheek augmentation creates a natural lifting of the face.

At David Loh Surgery, we excel in the art of dermal filler injections having published our special injection technique (The DL Lift) as an instructional guide for doctors in PRIME, International Journal of Aesthetic and Anti-Ageing Medicine in 2018.

 

What are the prices for dermal fillers like?

The price for dermal fillers costs $800 per syringe of 1ml. Check out our price list

  • Treatments like the nose and lips often require only 1ml.
  • Treatments like forehead, cheek and chin augmentation require 2-3mls per area, but they do not need to be done all in one go on the same day.
  • Then there are treatments like The DL Lift (our treatment named after Dr David Loh) may require 4-5mls of fillers each time. The DL Lift is also sometimes called a Liquid Facelift
  • Skin hydration boosters also cost $1000 per syringe of 1ml. To hydrate the under-eye skin, the skin over the cheeks including the nasolabial folds, and around the lips, patients will need 2-3mls of skin hydration boosters.

WhatsApp +65 8878 8045 , call us +65 6733 5300, or send us an email here.

Are filler injections painful?

All of the reputable brands of modern fillers contain an anaesthetic called lidocaine which takes away the discomfort of filler injections. You shouldn’t settle for less.

The only sensation you will feel is the tiny needle entering the skin, and the sensation of movement (not pain) when the cannula is moved under the skin.

Are fillers injection results immediate?

Yes, the results are immediate and “what-you-see-is-what-you-get”. Plus minus 10%-20% perhaps because of slight initial swelling. In fact most of the time, the results are natural enough and the patients are presentable enough to go out and meet friends immediately after a treatment. This actually gave rise to the term “lunchtime facelifts”.

Is there any recovery time (downtime) when getting filler injections?

The chances of getting a tiny bruise with filler injections is about 10%-30% depending on which areas are being treated. Also with multiple areas of treatment, there is also a higher chance of getting at least one bruise.

No doctor can guarantee bruise-free injections; after all needles and cannulas are involved in the process of filler injections. If a bruise occurs, it will need to run its natural course taking a 7-10 days to slowly disappear. Most of the time bruises are tiny and can be easily covered with a bit of makeup.

Besides bruising, which of course causes some swelling, there is often some swelling which unrelated to the bruises. This is a natural process in filler injections. This post injection swelling usually takes 3-7 days to subside.

WhatsApp +65 8878 8045 , call us +65 6733 5300, or send us an email here.

 

How safe are filler injections?

preperation_facial_filler

Filler injections are only as safe your doctor’s knowledge of the anatomy of the face. So don’t settle for non-medically trained injectors like beauticians. In fact, best to approach doctors that do filler injections frequently than those who do not.

With proper training and experience, filler injections are generally very safe.

Our doctors are trainers for other doctors. Dr David Loh has published in medical literature on the prevention and management of filler complications. One of the papers have been awarded a Best Paper (Gold) Award by the Plastic and Reconstructive Journal (PRS Global Open) in 2019.

The other aspect about safety with regard to dermal fillers is the filler material itself. As a filler material, hyaluronic acid fillers have been safely used on millions of patients since the 1990s. Without mentioning brands here, we are of the opinion that only biodegradable non-permanent fillers are safe. This is because they do not hang around long enough to cause granulomas or infections. And as the face changes, as it inevitably will over the years, fillers can be topped up to suit the changes associated with aging.

WhatsApp +65 8878 8045 , call us +65 6733 5300, or send us an email here.

 

About David Loh Aesthetics

Dr David Loh is one of the first trainers and mentors in aesthetic medicine in Singapore. He developed and published in medical literature his filler injection techniques as instructional pieces for other doctors. He also published in medical literature his works on the prevention and management of filler complications.

WhatsApp +65 8878 8045 , call us +65 6733 5300, or send us an email here.

 

What is the “overfilled syndrome”?

The “overfilled syndrome” is an unfortunate term coined by some doctors with the intention to disparage the work of other doctors. These doctors bring up isolated incidents of overfilled media celebrities to discourage patients from have filler injections. Perhaps these doctors are themselves not skilful enough nor experienced in filler injection, hence they try to divert clientele to the non-injection treatments. As a patient-consumer, you should be able to discern this kind of marketing tactics.

What you need to know is that you would need an incredible amount of filler material (maybe >20 syringes) to reach the kind of caricatured appearance of some of these celebrities. The so called “overfilled syndromes.” These celebrities can afford it but most patients would not be able to, and most conscientious doctors would hold back the patients before they even reach that kind of look.

The fact of the matter is that most patients with early signs of aging actually would benefit a great deal from filler injections into the fat compartments that have begun to shrink. This not only reverses the early signs of aging, but it can even prevent sagging.

Overfilled syndrome can easily be avoided as long as there is clear communication between doctor and patient. Clear goals and expectations are aligned prior to the procedure, and the  doctor has restraint in his or her approach, with  the  aim of creating a natural result while resolving the  concerns of facial aging such as sagging and volume loss.

WhatsApp +65 8878 8045 , call us +65 6733 5300, or send us an email here.

 

The Only Way is Up

Improving Appearance is what we do everyday. Not making our patients look like someone else, but making them more confident through the art of the DL Lift and other techniques of filler injections. Bring out their best features and still being themselves. This is the essence of Enhancing Confidence.

 

 

WhatsApp +65 8878 8045 , call us +65 6733 5300, or send us an email here.

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davidlohsurgery

在新加坡做皮肤填充术必须了解的知识

DR DAVID LOH

dr_david_loh

在过去几年里，优雅地变老有了新的含义。

过去，它指的是对于变老“毫不作为”。如今，随着整容术的普及，优雅地变老意味着“花极少的精力”变老。肉毒杆菌素及填充术在医美学上是最基本的整形术。在这篇博客中，我们来讨论一下皮肤填充术，好吗？

filler_faqs

关于皮肤填充术的常见问题

哪些部位最适合接受皮肤填充术？

从前额到下巴的所有面部区域都可以安全有效地进行皮肤填充术。以下是较常见的填充部位。

  • 额头丰盈和突出可以勾勒前额的轮廓；
  • 隆鼻、隆唇和隆下巴使面部的中央区域更加美丽；
  • 隆脸颊和眼部下方可支撑脸颊上方的皮肤。这会减少眼下凹陷、鼻唇沟和下颌垂肉的出现；
  • 隆太阳穴和侧面颊可自然提升面部轮廓。

皮肤填充术是新加坡罗大卫医美诊所（David Loh Surgery）的专长，并于2018年在国际美容与抗衰老医学杂志PRIME上公开发表了我们的特殊注射技术（DL-Lift) ，作为美容医生的指导文献。

皮肤填充术的价格是多少？

皮肤填充术每针（1毫升装）的价格是800新币。详情请浏览我们的价目表

  • 丰鼻丰唇等部位通常只需要1毫升。
  • 丰额头、丰脸颊和丰下巴等部位，每个部位需要2-3毫升，但不需要在同一天一次性注射完所有部位。
  • 还有一些治疗方法，比如DL-Lift（我们以罗大卫医生的名字命名的标志性治疗方法），每次可能需要4-5毫升的填充剂。DL Lift有时也被称为液态拉皮
  • 皮肤保湿水光针每针（1毫升装）的价格也是1000新币。为了给眼睛下方的皮肤、脸颊（包括鼻唇沟）和嘴唇周围的皮肤保湿，患者需要注射2-3毫升的Volite皮肤保湿水光针

注射填充剂会痛吗？

所有知名品牌的现代填充剂都含有一种叫做利多卡因的麻醉剂，可以消除填充剂注射带来的不适感。

您能感觉到的唯一不适是小针刺入皮肤，以及顿针管在皮肤下移动时的操作感（而不是疼痛感）。

注射效果是否立竿见影？

是的，效果是立竿见影的，“所见即所得”。可能有10%-20%的差距，那是因为起初会有轻微肿胀。事实上，大多数情况下，治疗效果都很自然，患者在接受治疗后可以立即出去见朋友。“午餐时间整容”这个词就是这么来的。

进行皮肤填充术是否需要恢复期（请假停工）？

皮肤填充术造成轻微瘀伤的几率约为10%-30%，具体取决于填充部位。此外，对多个部位进行填充时，很可能至少会有一处瘀伤。

没有哪个医生能保证注射过程不会产生瘀伤；毕竟填充剂注射过程会用到针头和套管。如果出现瘀伤，则需要7-10天的自然过程才能慢慢消失。大多数时候瘀伤很小，用化妆品很容易掩盖。

除了瘀伤，当然也会有一些肿胀，还有一些与瘀伤无关的肿胀。这是填充剂注射的自然过程。注射后肿胀通常需要3-7天才能消退。

皮肤填充术有多安全？

facial_filler

只有当医生了解面部解剖结构时，皮肤填充术才有安全保障。所以不要随便信任那些没有受过医学训练的注射师。其实，最好找那些填充经验丰富的医生，而不是那些缺乏经验的医生。

如果接受了适当的培训并有足够的经验，皮肤填充术通常来说很安全。

我们的医生是其他医生的培训导师。罗大卫医生在医学文献中发表了关于预防和处理填充并发症的文章。其中一篇论文于2019年被《整形外科医学期刊》（PRS Global Open）授予最佳论文（黄金）奖。

关于皮肤填充术安全性的另一个方面涉及填充材料本身。自20世纪90年代以来，透明质酸填充剂作为一种填充材料已安全用于数百万患者。这里我们不谈品牌，我们认为只有可生物降解的非永久性填充材料是安全的。因为它们停留的时间不足以引起肉芽肿或感染。至于面部的变化，随着时间的推移，变化是不可避免的，我们可以补充填充剂以延缓与衰老相关的变化。

关于新加坡罗大卫医美诊所（David Loh Surgery）

皮肤填充术是罗大卫医美诊所的专长。请阅读关于这位填充专家（填充剂注射）的媒体报导。

罗大卫医生是新加坡首批美容医学培训师及导师之一。他开发并在医学期刊中发表了他的填充剂注射技术，作为其他医生的指导文献。他还在医学期刊中发表了他关于预防和处理填充剂并发症的著作。

David Loh 医生是新加坡最早的美容医学培训师和导师之一。他开发并在医学文献中发表了他的填充注射技术，作为其他医生的指导文章。他还在医学文献中发表了有关预防和治疗填充并发症的著作。

什么是“过度填充综合征”？

“过度填充综合征”是一些医生为了贬低其他医生的技术而臆造出来的一个诋毁术语。这些医生指出某些媒体名人过量填充导致面部僵硬扭曲的孤立事件，以打消患者进行皮肤填充术的念头。也许这些医生本身在皮肤填充术方面不熟练，也没有经验，因此他们试图诱导客户接受非注射治疗。作为一个有辨别力的医美消费者，您必须分辨这种营销策略。

要知道，您需要大量注射填充剂（可能超过20针）才会达到这些名人那种不自然的样子。所谓的“过度填充综合征”也只有这些名人负担得起，大多数普通患者根本无法承受，而大多数尽职尽责的医生都会在患者变成那种样子之前阻止他们。

事实是，往已经开始塌陷的脂肪区注射填充剂对大多数有早期衰老迹象的患者都大有好处。这不仅可以逆转衰老的早期迹象，甚至可以防止下垂。

自2006年以来，罗大卫医生一直在不断开发填充剂注射技术。他指导了几代年轻医生，是一名倡导者，并发表了关于填充术抗老化的著作。除非患者强行要求医生给他们过度注射，否则不存在所谓的过度填充综合症。任何有良知的医生都会阻止患者过度使用皮肤填充剂。

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davidlohsurgery

5 ways to spot and solve under-eye ageing

Updated to include Dusederm Collagen Fillers

Treat signs of aging using under eye dermal fillers

A couple of things happen as we age. The fat compartments under the eyes above the cheeks shrink (atrophy is the scientific term). Thus reducing support for the skin and muscles around the eyes. The bones around the eye sockets also remodel (change shape) which causes even greater loss of support for the overlying soft tissues. This sagging in the under eye area gives rise to the signs of aging. And dermal fillers are a great way to reduce the signs of under eye aging.

peri_orbital_aging
Under-eye area showing signs of aging

5 signs of under-eye-aging:

  1. Hollowness or sunken under-eye area is the direct effect of the fat atrophy.
  2. The lengthening of the lid cheek junction (above red line)  which is due to the lack of support.
  3. The tear-trough deformity, which is a groove under the eyebags. This is also due to the lack of support.
  4. The Eyebags. These may be psuedo-eyebags caused by skin laxity rather than actual eyebags, which are caused by fat pad herniation.
  5. Dark eye circles. Thin skin draping over muscle gives rise to the darker color. Only very rarely are dark eye circles the result of actual pigmentation on the skin.

The Treatment For Under-eye Aging

The treatment however is relatively simple. Dermal fillers when skillfully injected into the fat compartments in the under-eye area provides support and resolves most of the above problem features. The dermal filler is carefully placed using a cannula (a needle with a rounded tip) to minimize trauma. The dermal filler spreads evenly over the areas treated. Lumpiness is rare with the cannula technique of injection. Bruising can sometime occur even with a cannula but are usually quite minimal.

As far as safety is concern, opinion differs. But cannulas a generally accepted as the gentle method in this area while blood vessels are a plenty. Here is a paper by Dr David Loh on safety in filler injections

As for the crepey skin in the under eye area, the dermal fillers can help somewhat, but usually a bit of laser to tighten up the skin, and reduce the fine lines, and that’s all it takes to brighten up the look. The fractional CO2 laser is good, but has a bit of downtime. Otherwise, Sylfirm or Thermage eyes are not too bad too.

Watch Dr Davin Lim from Australia being treated by Dr David Loh while he was in Singapore. Under eye dermal filler injections.

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davidlohsurgery

David Loh Surgery Awards and Accolades

September 2019

PRESS RELEASE

A medical case report by David Loh Surgery has been awarded the PRS Global Open 2019 ‘Best Case Report’ (Gold) by international medical journal Plastic & Reconstructive Surgery.

With facial fillers being a widely available aesthetic procedure to temporarily reduce the appearance of wrinkles, or contour faces, there have been some cases where patients have developed features of “impending skin necrosis”: discolouration of the skin due to the premature death of skin cells, in reaction to soft tissue augmentation resulting from the injection. While rare, this complication may occur even under the care of experienced injectors.

David Loh Surgery’s founder Dr David Loh and partner Dr Phoon Yi Shan, who is in charge of the branch clinic at Novena Medical Centre, together with two other doctors jointly authored a case report on such an incident which was successfully managed with prompt diagnosis and treatment.

Entitled Successfully Managing Impending Skin Necrosis following Hyaluronic Acid Filler Injection, using High-Dose Pulsed Hyaluronidase, the paper was first published by PRS Global Open in its February 2018 issue. Using data collected on the article’s view count and sharing activity, among others, David Loh Surgery’s case report was then scored and selected by the journal’s editorial and publishing staff for the award.

“We are very honoured to represent Singapore in contributing to the global body of medical knowledge with our recent case report on successfully managing hyaluronic acid filler-induced impending filler necrosis,” says Dr David Loh, founder and medical director of David Loh Surgery.

“This accolade from PRS Global Open, as an open-access and peer-reviewed international journal, bears testament to our commitment to furthering safety and standards in aesthetic medicine. The culture of knowledge sharing and continuous learning is very much in line with our philosophy at David Loh Surgery,” he adds.

Plastic and Reconstructive Surgery is the official publication of the American Society of Plastic Surgeons. The title launched Plastic and Reconstructive Surgery – Global Open, in April 2013 as a companion journal with an intention to globalise plastic surgery research, collaboration, and best practice sharing through its open access platform.

PRS Global Open holds its annual Best Paper Awards event with the aim of recognising the best new papers by both US and international authors across multiple categories including that of Best Case Report under which Gold, Silver and Bronze Awards are presented.

David Loh

David Loh Surgery’s award-winning case report can viewed in full here:

https://journals.lww.com/prsgo/pages/collectiondetails.aspx?TopicalCollectionId=56

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Fractional Laser Treatment
davidlohsurgery

5 Popular Aesthetic Treatments among Men in Singapore

The kinds of aesthetic treatments that men have done on themselves are not very different from the ladies.

The main difference being that men prefer those treatments with almost no recovery time.  Treatments like Skin Tightening Treatments, B*tox and Dermal fillers. What gave rise to the era of male aesthetics was really the invention of aesthetic treatments that involved so called “no downtime”.

ultherapy_machine


What really broke down the barrier to men fully embracing aesthetic treatments were the skin tightening treatments that started becoming popular around 2009-2010. Treatments like Ultherapy and Thermage mean “no-downtime”, and totally non-invasive skin tightening treatments. This went down very well with men.

In the past, cosmetic surgery used to be associated with bruises and bandages; extended healing time and exaggerated features post-surgery. Men absolutely hate having such procedures done. For one they cannot apply makeup to conceal any bruises, and secondly men hate taking time off work for such vanity-associated reasons.

With the newer methods and technologies, doctors are now getting reasonably good results with no recovery time at all. Hence more men are keener to do such procedures. Not only are they keener to do such procedures, they are also more keen to talk about their experiences with they spouses or their male buddies. This really re-defines aesthetic treatments for men, aka males aesthetics.

In fact, we have found that the “power of control” over one’s appearance that aesthetic treatments offer, goes down very well with the highly-driven male-corporate climbers’ psyche. Looking sharp is as much a prized commodity as being sharp-witted and sharp-minded.

You have to to admit it. Not only do they embrace aesthetic treatments, they will often travel the world looking for the latest technologies and the most skillful doctors.

And these highly driven, very successful individuals, usually have no qualms talking about “having work done” so long as the aesthetic treatments do not leave them with any recovery time. And as long as they do not have to put on makeup to conceal bruises, they would be most happy to share their experience about how they keep young and competitive.

That is in essence what male aesthetics has become – the “power of control” in our ever changing and highly competitive world.

Read more on the top 5 most popular aesthetic treatments among men. Ultherapy, Thermage, B*tox, Fillers, Skin Tightening Treatments,

Read more about Ultherapy vs Thermage vs Threadlifts

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Aesthetic Doctor
davidlohsurgery

Dr David Loh teaching in various Asian countries

[nz_dropcap type=”empty full” color=””]I[/nz_dropcap]f he is not busy treating patients an his Wheelock Place clinic along Orchard Road, Dr David Loh travels to teach doctors throughout the region. In fact, Dr David Loh has trained a generation of doctors on the art of administering B*tox and facial fillers since 2006. Some of his trainees are now experts in the field themselves.

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Back in 2006, he was appointed as one of the original trainers for the Restylane range of HA fillers. This was when Q-Med still owned the Restylane brand. And there was only Restylane and Perlane. Q-Med was the only serious filler manufacturer at that time. Of course in the years since, Q-Med was acquired by several parties and it is now owned by Galderma. And Allergan has since risen to also be a global player in the aesthetic field. It too was a target of mergers and acquisitions. Despite all the upheavals in the industry, Dr David Loh remained steadfast in honing his skills and techniques with some of the best in the industry from Australia, Brazil to France (You know who you are!).

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Dr David Loh has worked closely with Allergan since 2009, and is now a faculty member of the Allergan Academy. The Allergan Academy formalises B*tox and facial fillers training for doctors progressing from basic to advanced levels.

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filler expert
Allergan Academy Training

 

Beyond the Allergan Academy, Dr David Loh also works closely with Galderma in China to impart his facial fillers injection techniques and artistry. He has lectured at the 1st People’s’ Army General Hospital’s plastic surgery conference in May 2014, and at a major national plastic surgery (3rd MIAPSD) conference in Shanghai in September 2014.

He works closely with hospitals in Changsha, Guangzhou, Shenzhen and Dongguan to elevate their standards of practice, at least where filler injections are concerned.

Registered to practice Medicine in The People’s Republic of China, Dr David Loh held regular visiting-expert sessions at a hospital in Shenzhen in 2013-2104. “Full face makeover with just Fillers” was his area of special interest, often drawing large crowds.

Besides China, Dr David Loh has also trained doctors in Jakarta and Bali in Indonesia on B*tox and Fillers. Dr David Loh lectured on micro-focused ultrasound at the SWAM conference in Jakarta in 2015.

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Visiting Fillers Expert to Hospital in China
Expert Meeting in Shenzhen China
Facial Fillers Teaching at Hospital in Changsha China
Teaching at Hospital in Changsha China
Facial Fillers Lecture and Workshop at the 1st Army General Hospital in GuangZhou, China
Lecture and Workshop at the 1st Army General Hospital in Guangzhou, China
Lecture at 3rd MIAPSD in Shanghai
Lecture at 3rd MIAPSD in Shanghai
MIAPSD
3rd MIAPSD in Shanghai, China
Facial Fillers Workshop at BIMC Bali
Workshop at BIMC Bali
Facial Fillers Workshop at Rejuvie Clinic in Bali
Workshop at Rejuvie Clinic in Bali
Facial Fillers Workshop at ARC Bali
Workshop at ARC Bali
Workshop in Dongguan China
Facial Fillers Workshop in Dongguan China
Facial Fillers Workshop in Guangzhou, China
Workshop in Guangzhou, China
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Facial Sculptor
davidlohsurgery

Sculptor without Scalpel – Dr David Loh using Facial Fillers

facial fillers singapore
The article was written circa June 2013. And reported in Herworld.
Since then, Dr David Loh has gained multiple international awards for his work on safety and innovative techniques. 

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Doctors welding syringes of facial fillers instead of scalpels have changed the entire landscape of aesthetic treatments. Firstly, they are not just wrinkle chasers anymore. With highly evolved perspectives of what constitutes beauty, they are injecting fillers into areas hitherto unimaginable and sculpting and contouring faces in ways previously unheard of. And secondly, using only facial fillers, they are transforming faces into spectacular works of art! These are the sculptors without scalpels.

If you thought during your visit to the aesthetic doctor, he will simply inject some fillers into your nasolabial folds (the folds beside your nose), then you are quite mistaken. That’s almost an extinct method. Facial fillers are now used to prop up skin in surrounding areas to stretch out the naso-labial folds – all without ever injecting into the fold itself.

With facial fillers, you can expect to come out of the doctor’s office not only looking younger and fresher, but a more beautiful and more stunning version of yourself.  There’s nowhere that fillers cannot be injected. The forehead, around the eyes, the nose, the cheeks, the chin and even lips can be made to look more prominent or de-emphasized, as may be needed – all just with fillers.

“Evolved into art form, facial filler techniques are used to sculpt and contour faces to enhance beauty in already beautiful faces. Beyond just chasing wrinkles, facial fillers more importantly restore proportions, balance and symmetry.”

Faces that are flat can be made to appear shapelier; faces that are broad appear slimmer; or faces that are angular to appear softer. Small chins can be made more prominent; and flat noses more projected. And the list goes on.

And where fillers were once a dull and boring cousin of B*tox, it now takes center-stage as the most impressive and the most instantly gratifying aspect of any encounter with aesthetic doctors.  Not surprisingly, it has had a major revival in popularity in the last 5 years.

Previously taboo subjects about cosmetic surgeries suddenly became cool, hip, and something to talk about over dinners and at parties. While “no-recovery time” is de rigueur, facial sculpting and contouring with fillers is now the cutting-edged frontier.

“The way for aesthetic doctors to stand out from the crowd is to have a good foundation in injection techniques and to hone one’s skills into an art form. Today, aesthetic doctors are sculpting faces and shaping skin in such a way that lines stretch out even without a single drop of filler material injected into the line itself. In the future” Dr David Loh, who is the trainer for B*tox and fillers, added, “we will probably be looking at how to predict the effects of aging and using fillers to prevent it altogether. Already, studies have shown that fillers alone can stimulate the production of collagen just by their stretching the skin.”

Dr David Loh is the Allergan appointed trainer for B*tox and Fillers since 2006. He has trained more than 150 doctors in the region and was recently in Jakarta and Bali to train the future trainers for Indonesia. He also trains and consult for doctors in Guangzhou, Shenzhen and Shanghai, China. In China, he works with the Restylane range of Facial Fillers.

He owns a chain of aesthetic clinics along Orchard Road in Singapore. And he is the President of The Society of Aesthetic Medicine in Singapore.

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Expert's opinion on Filler Techniques
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How Hyalase changed the practice of Filler Injections

Tear Trough Correction with Fillers
Tear Trough Filler Injections.

In the age before Hyalase (or more accurately Hyaluronidase) became easily available, over injection of fillers was a nightmare most aesthetic doctors had to deal with pretty regularly. Luckily the fillers of that age didn’t last so long and most doctors weren’t so adventurous, sticking mostly to the nasolabial folds.

In that era (circa 2002-2005), some of us had to resort to using lasers and IPLs to dissolve the fillers, which of course didn’t work. We now know better and have stopped advocating lasers to “dissolve” fillers”. But the lesson learnt allows us to confidently use skin tightening devices like Ulthera together with fillers without the fear of destroying the fillers.

Now with hyaluronidase available, however, we can infinitely adjust fillers as long as they are made of hyaluronic acid. Too much and we will dissolve some of it away. Too little, we can inject some more. This gives us us accuracy and precision to venture into more hallowed areas like the tear trough and the marionette lines.

The hyaluronidase instantly dissolves the fillers in situ. It breaks Hyaluronic acid down into simple sugars that can easily be absorbed into the bloodstream or the lymphatic system. After several days when the hyaluronidase has been reabsorbed and any swelling has subsided, we can do the corrective adjustments for the areas as some of the surrounding will also be inevitably be affected.

Hyalase gave us the ability to infinitely adjust any filler treatments, gave us rise to the art of facial sculpting with fillers which we have termed the Liquid Facelift.

 

Photo Credit: Galderma Restylane

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Upper Face Fillers

We all know about fillers into lines like the nasolabial folds. And we all know about fillers in the cheeks, the chin and the nose. Fillers were seldom employed in the upper third of the face in the forehead, eyebrow and temple area. At the 1st Malaysian-Singapore Conference of Aesthetic Medicine held in KL on 15 July 2012, Dr David Loh demonstrated the advanced techniques of upper face fillers and brow injections produce a stronger forehead. This is particularly useful for those with eyes that protrude producing a groove in the upper eyelids. It is also useful for Asians men with very flat foreheads to get stronger (hooded brow) features. Or even Asian girls who want to make their features a little more Caucasian-like (less flat). Upper Face Fillers is an advanced technique which should only be attempted by experienced injectors.

NB: Dr David Loh is not a fan of using fillers to fill lines. He feels that injecting fillers in the skin (in the dermis) can sometimes leave lumpiness obvious under certain lighting. No matter how refined the fillers are and how experienced the injector is. Besides a lot of these lines like the crow’s feet and the glabellar frown lines are better off treated with B*tox. Dr David Loh advocates using fillers to sculpt the face and to soften features by altering volume and providing supports for the skin so that it does not sag.

 

Dr David Loh started his aesthetic clinic in 2002 when the field Aesthetic Medicine was still in its infancy. He is now a well known international trainer for advanced B*tox and Filler techniques. He is on the faculty of the Allergan Academy and is the President of The Society of Aesthetic Medicine.

 

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preventive antiaging
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Preventive Anti-aging

1. What is preventive anti-aging?

This is a whole new concept where we approach the problem of aging way before aging sets in. Look at your mum and you will know how you will age. Why wait till then to seek treatment? It is easier to do treatments to maintain your skin now then treat the problems later.

2. At what age does skin start to age?

Your skin actually starts to age immediately after puberty. However, even though your collagen is lessened, it is still able to heal itself quickly. This starts to slow down in the late 30s and 40s where actual signs of aging like sagging and wrinkles appear.

Your lifestyle also plays a big part in your aging process, so if you smoke and sun tan a lot, your skin’s aging will be accelerated.

3. Do genes play a big part in how we will age?

It does. Genetics determine your skin’s healing process. Certain races age better like Asians and African-Americans compared to Caucasians. Your face structure is also important when it comes to aging well. For example, certain features like thick lips can make a person look youthful.

4. I’m only in my 20s, do I need to do any anti aging treatments? Why?

You need to be aware of what environmental damage can do to your skin and start using skin care that protects. Maintanence is better than cure so you can start doing gentle laser and IPL treatments to regenerate collagen and keep your skin in good condition.

5. Will doing these treatments early make my skin more resistant to them as I get older?

No, in fact, it’s been scientifically proven that fillers actually stimulate collagen and improve skin tone. If you test skin before and six months after it’s had filler injections, you will see that the new skin has more collagen.

These treatments actually improve your skin’s baseline and takes it to a higher level so that you age slower.

6. What are some treatments to do for skin maintenance?

You can start with fillers to improve collagen and IPL to take away freckles, reduce acne and acne marks.

7. How do these treatments compare to anti aging creams?

Unlike the treatments above, creams can only go so far. Our skin is an excellent barrier against dust, oils, etc. That’s why sonophoresis machines have been used to drive the molecules of creams into our skin in some beauty treatments. Creams have to be designed very well to be able to deliver nutrients on its own.

Creams have their own place of course – it is comforting to use them when your skin feels dry. It just has to be formulated very well to be able to deliver its benefits.

8. In your experience, what is the best anti aging treatment available and why?

So far, Ulthera has been the most revolutionary as it is able to look into the many layers of skin and deliver the precise dosage without harming the epidermis. Patients are able to get a firmer and tighter face just from one treatment!

9. What other benefits does Ulthera have?

It stimulates collagen, reduces lines and gives you an overall radiant look.

10. Can we delay our skin from aging and how?

Realistically, we can’t delay our skin from aging but we can hold back the signs of aging that chronological age will show. In the last 20 years, there have been a lot of advances in technology like non-ablative lasers, Thermage, Titan and Ulthera – many affordable treatments that have been scientifically proven to deliver results. So, you can delay the signs of aging even though you can’t delay aging itself!

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