The Simply Aesthetic Sandbox

Interesting Rumour! Could It be True?

2008-08-06T20:10:00.002+08:00

The rep from J-Sports that looks after our account came to visit me today. We discussed various things, one of which was this rumour he heard from a colleague of his. Word is, Simply Aesthetic has one of the largest number of services for any aesthetic clinic in Singapore. Maybe even the largest!

Wow! That caught me by surprise! I know the one question I can no longer answer easily is "What services do you offer?". I certainly would not be surprised if we had the largest number of slimming treatments in Singapore. We undoubtedly have some unique machines with Diamond Contours and Ion Magnum. Plus we are still the only medical establishment that owns the Body Jet waterjet liposuction machine.

Our services are comprehensive, but no means complete. We could potentially add a few more items, particularly lasers, but there is no means essential. Our acute lack of storage space is more of a problem!

We are about to order a skin analysis system in preparation for the changes in regulation starting 1st Nov 2008. This is the only way we can objectively study the improvements after the treatments in question, dermaroller and actistem being the two main treatments we wish to continue with. Sclerotherapy will be taken away from us, unfortunately. Just as well we still have alternatives such as IPL to tackle spider veins. It is a shame though, as there's a certain satisfaction from watching the veins collapse in front of your eyes!

Just Remembered...

2008-07-31T15:08:00.003+08:00

We were fed so much information during the Ion Magnum & Perfector training sessions that I've forgotten a few pearls.The most important one that I was reminded of last night was about hormonal imbalances leading up to weight gain or an inability to lose weight.

Oestrogen dominance and sub-clinic hypothyroidism are common and often undiagnosed. Both result in weight gain and a resistance to weight loss by traditional means.

We were told that even patients with hormonal imbalances respond well to the Ion Magnum. But, the response rate will be slow initially. At least 5 sessions will be required before the body suddenly goes into weight loss mode.

This makes it a little more difficult to decide if one wishes to undergo a series of treatments. Under normal situations, instant reduction is visible. However, what are the alternatives? Continue the futile diet & exercise regime? Or just take a leap of faith and try the Ion Magnum?

I know my choice. What's yours?

End of Reductil iDecide Redemption Program

2008-07-31T15:01:00.002+08:00

I have just been informed that Abbott has decided to terminate the iDecide redemption program. We know this as the buy-2-boxes-get-1-free program. They will only honour the redemptions presented to them before 30th September 2008. So we will effectively be finishing our collections by mid September so as to avoid missing out from unexpected delays (ie Rep not free to come on last day!)

Please contact the clinic ASAP should you wish to take advantage of this fabulous offer before it runs out.

Abbott will be introducing a new compliance program in the next few weeks. In the meantime, the iDecide website will stay so as a weight-loss knowledge base.

SunSoul Home IPL Clothing Line

2008-07-29T22:37:00.002+08:00

Yep! You can now to do IPL in the comfort of your own home! All that is required is to wear a cap from US brand SunSoul for 2 hours a week. No pain!!!

There are two versions: Yelomod for rejuvenation and Blumod for acne.

The material is impregnated with a light filter. Sunlight is filtered to remove harmful rays and just transmit yellow light for Yelomod or blue light for Blumod. The caps are a lemon yellow & sky blue respectively. Various design shirts are also available for the treatment of the body.

I thought this was a really unique concept. Almost an oxymoron! We have been so ingrained with stay away from the sun, it's harmful, causes ageing, eek! Now suddenly we have a means of converting the dangerous into therapeutic. How wonderful!

I tried out the Yelomod cap when I was on holiday in Bangkok last week. No sunblock for 3 days in sunny Bangkok. Lots of walking in the sun. Add in a great propensity for pigmentation. Scary experiment!

And my face did not tan at all! No worsening of pigmentation. No harm done. Certainly it's far too early to judge if there's going to be much positive results from this super short exposure. It'll certainly take weeks to see much improvement with a simple system like this.

The ideal candidates for these products would be:

Post-IPL maintenance
Golfers
Active facial acne
Back acne

We have a variety of hat designs in stock & are awaiting the delivery of a couple of blue shirts.

Update on Ion Magnum: Post Liposuction Muscle Toning & Visceral Fat Reduction

2008-07-29T22:29:00.002+08:00

One of the major reasons for purchasing the Ion Magnum was for the treatment of post-liposuction patients. We often see, especially with men, that even after we all the fat out from under the skin, the tummy still bulges out. This is from a combination of poor muscle tone & visceral (internal) fat.

The Ion Magnum targets both these problems more effectively than exercise.

We finally had the opportunity to try this out over the weekend. I saw a gentleman I did abdominal liposuction on a month before. We removed almost 5L from him tummy, but it was still bulging. Measurements revealed a 10 cm loss on average at 3 points over his abdomen.

We put him on the Magnum and set it to remove visceral fat.

Thirty minutes later, repeat measurements revealed a further 10 cm loss over his upper abdomen! I've never seen him smile so widely!

I've yet to try this mode personally on the Ion Magnum. My attempts at scheduling my own treatment were thwarted yesterday & today. And that's even after I booked myself into the appointment system!

Try again tomorrow...

Revitalash for Naturally Thick, Full Eyelashes

2008-07-23T10:20:00.002+08:00

Considering I spent 3 days last weekend at a major International skin conference, I was surprisingly not enthused by much of the new products on offer. It was filler after filler after filler, all claiming to be the best. Yawn...

The first product to catch my eye was Revitalash. Having never had eye lashes of any form, and not being able to tolerate anyone coming near my eyes, falsies are out of the question. Here's a product that stimulates natural lash growth by daily application? Interesting & definitely worth trying out.

RevitaLash™ was developed by Dr. Michael Brinkenhoff as a special gift for his wife, Gayle, while she was recovering from breast cancer. Intensive chemotherapy treatments had damaged Gayle’s once-beautiful eyelashes, leaving them sparse, breakable and fragile.

After extensive research with a team of cosmetic chemists, Dr. Brinkenhoff formulated an eyelash conditioner that, after just a few weeks, gave a renewed look of vitality to Gayle’s eyelashes. Results are supposedly seen after between three to ten weeks of daily application. Then maintenance applications a couple of times a week are enough. Interesting!

I started my treatment that very night and am waiting for the day I can have visible eye lashes.

We have brought in a vials for clinic sale. Each one costs $138 and lasts for at least 6 months. At maintenance phase, each vial lasts 3 years!

Application is very straightforward. Just draw on upper and lower lash lines every night on cleansed face. Wait 5 minutes for it to dry before applying normal skin care products. Then wait with bated breath for growth.

Restylane Face Lift

2008-07-13T22:33:00.003+08:00

This was the most interesting presentation on the first day of IMCAS Singapore 2008. I had actually not planned on listening to this presentation, but found it impossible to leave once she started describing her novel technique.

The speaker was a Dermatologist from Bangkok. She realised that Restylane & Perlane were unique in having lifting properties. She has developed a technique whereby tiny amount of the filler are injected superficially into the traction lines if the face, in the direction of lift.

The technique is simple & produced immediate results. These improved over the following two weeks, following which the results remained stable for about a year. She used 2-3 1ml syringes per face, so it's a relatively costly affair. There's also a little bit of downtime: bruising, swelling, redness. This can last for up to 2 weeks.

I'm not sure if many Singaporeans would be keen on this, but it is certainly a simple procedure with good results. It may have a role in those who don't trust machines, don't want surgery and would prefer to avoid complications associated with threads. Personally, I'd give the Perfector a go first, and only resort to this if all machine and non-invasive options fail.

Update on Perfector Testing: Acne Scars & Comedones

2008-07-12T10:24:00.003+08:00

We know the power of Perfector on lifting & sculpting, so have been trying to check out its effects on other facial complaints. Two "willing" volunteers are Mery our clinic manager & Ffion my daughter.

Mery has residual acne scarring from adolescent acne. It cleared up tremendously after a couple of sessions of dermaroller treatment. So she was first up to see if Perfector would help reduce these further. She had a single 30 minute session on Thursday, and a few hours later, felt her scars were less obvious on the right side. We were too busy for her to have the treatment again yesterday. I'm hoping that with a few treatments done close together, she will get flawless skin without the discomfort of dermarolling.

My 12-year old daughter Ffion took a lot of persuading before agreeing to trying the Perfector. She'd rather live with comedones than be subjected to the treatments we had previously. To be fair to her, she has tried most things... once.

She had 10 minutes of Perfector treatment on Thursday and happily reported no discomfort. When I got home yesterday, I noticed her face was much smoother. About 50% of the comedones had disappeared! Even more had gone by this morning.

The best testament to the effectiveness and painlessness of the Perfector treatment is when a 12-year old asks to have another treatment 2 days later. :o)

Now we just have to tie her down to try the Ion Magnum!

Updates from A4M Singapore (July 2008)

2008-07-10T08:58:00.007+08:00

The American Association of Anti-Ageing Medicine (A4M) held a meeting in Singapore last weekend. I did not formally attend the meeting, but had the opportunity to participate in some of the peripheral events associated with it.

The first presentation I attended was on Thursday evening, which was the Arasys presentation. That is aso when I fell in love with the Perfector & Ion Magnum.

The second presentation was on the Friday night. This was a lecture on Nutritional Medicine in Stress, Leaky Gut and Food Intolerances. The lecturer was from Brisbane, and spoke at length about the many changes that occur during times of stress: how part of the brain shrinks, the gut becomes permeable, and how ridiculous it is to tell a stressed person to relax or do some yoga.

Instead, he used multiple formulations to re-balance the chemical deficiencies in the brain, rapidy cut stress (in 20 minutes) and heal the gut. It's a lot of supplementation to rescue the situation, but definitely more sensible than trying to cut out a load of foods and relax a the same time. That's a formula to kill, no?

Stress in the levels that we live with on a daily basis can kill. Modern nutritional medicine can help in stress management.

The main conference was held over Saturday & Sunday at the Grand Copthorne Waterfront. There were delegates from all around the world. We appeared on Saturday to listen to Dr Weiss speak on the Science behind the Arasys Perfector machines. We then stayed on to try the machines out. That is when I lost 2 inches from my tummy whilst gutsing on chocolate cake.

I did not attend any other lectures. Many of them were on Stem Cells. I heard the other focus of attention was on Starvation to prolong life. Thanks... I'd rather die!

Instead, the girls & I spent the weekend training on how to use the Perfector & Ion Magnum. Both are simple & relatively straightforward to use. But the number of possibilities and uses for each machine is so great, it just took many hours to go through the theory & practical skills. In practice, the Perfctor is much easier to use than DermaRF. Just a pair of copper glove that pull the tissues ino the desired position, hold for a few minutes & voila! Face lift!

The learning opportunities continue this weekend (Sunday to Tuesday) with the IMCAS conference, at Suntec Convention Centre. My friends from Manila (Claudine & Cathy) will be attending. Dr Chanchai will be flying in from Bangkok and we have been told about new handpieces for the Derma RF that he will be demonstrating. Arnd Kensey, CEO of Humanmed (Body Jet Waterjet Liposuction) will be attending too. Another full weekend ahead, no doubt.

First Perfector & Ion Magnum Units in Singapore!

2008-07-10T08:29:00.006+08:00

Both the Perfector & Ion Magnum were delivered late on Monday night. Unfortunately, we have had little opportunity to play with them as our schedule has been tight otherwise. I've had another little go at the Magnum, and am looking forward to getting hooked up again today. Perfector too. The stress of the last few days has resulted in a few pesky zits popping out. I'm hoping the machine lives up to its promise of zapping them so they disappear overnight.

I've also been burning the midnight oil and have put some information up on the main website. There are links from the "News" section of every page, but the URLs to explore are:

www.simply-aesthetic.com/nanomedicine.htm for the science behind the technology
www.simply-aesthetic.com/perfector.htm for information about the Perfector
www.simply-aesthetic.com/ion-magnum.htm for information about the Ion Magnum

We will continue to update as we gain more experience with these devices.

Simply Aesthetic Has Purchased Arasys Perfector & Ion Magnum Machines!

2008-07-05T21:38:00.004+08:00

As mentioned in the previous post, we were planning on adding the new technology from Arasys into our clinic's services. We just started talking to our patients today, and have had to start a "To Call" list once we knew when the machine was coming in. Considering we spent very little time in clinic today, the list is already 5 people long!

We disappeared (aka ran out!) at 12 noon to catch Dr Weiss speak on the science behind the technology. It's all very cutting edge stuff, way more complex than what we learnt in medical school all those years back. Even with my BSc in Medical Biochemistry it was not easy to fully comprehend the molecular science involved. Things have certainly moved far away from the old lock & key model of enzymatic reactions. The scientists can now see how each individual molecule behaves in vivo, how it moves as the it performs its role. Also how cells communicate with one another, plus inside each cell. The technology basically encompasses mimicking natural cellular communication to gently coerce the proteins to rejuvenate. Plus the teeny weeny (impalpable) current provides the electrons required to stabilise all the nasty free radicals that age us & cause disease.

Enough science! We are more interested in results!

Before signing the papers, I was strapped onto the Ion Magnum. I've not been eating great recently, so I was having a bad tummy day. My measurements were taken before the treatment, then I got strapped in. The sensation was an urge to contract my tummy muscles, just like doing sit ups. This went on for a good half hour. In the mean time, the trainer Christine started using the Perfector on the left side of my face.

Within a short time, the effects on my face were noticeable. My nasolabial fold was less deep, particularly obvious when I smiled. And this is the side that was always more problematic. My eyebrow was a little higher, and my skin more radiant. My dark eye circles were also improved. I felt no discomfort at all. The gloved scratched a little, but nothing else.

Once we did the left face, we decided it was feeding time! Picture this: I was strapped up in the Ion Magnum, doing crunches, eating a huge lunch, including a massive slice of chocolate cake! After the treatment was over, I had still LOST 2 INCHES around my waist!!! They tell me the results will continue to improve over the next few days. I can't wait!!!

Needless to say, we purchased the machines and called the girls in for training. So I've had the Perfector on me for hours today. Literally! Looking closely at my face after my shower was interesting. The changes are very obvious:

My brows are lifted
The early sagging in my jowls is gone on the left and minimal on the right
My nasolabial folds have never been so minimal
My skin is lighter and more radiant
My jawline is more contoured

I'm ecstatic with the outcome!

It looks like we will be getting delivery of the machines on Monday. We will be honing our skills internally initially, then call for volunteers. We plan to launch the treatment in the next week or two. Watch this space or call the clinic for more details. The number of volunteers we can treat is very limited, so please call immediately to secure your place!

I'm in Love... with Arasys Perfector & Ion Magnum

2008-07-04T11:30:00.005+08:00

I went to a product demonstration last night and fell totally, utterly in love with two machines! The technology is very unique: gentle, yet packing a great punch in terms of instant results!

The Arasys Perfector is the face machine. I saw faces being lifted & moulded into more pleasing contours in minutes. And there was no discomfort whatsoever! In fact, the sensation was NOTHING! It does what our RF does in a few sessions in a few minutes! Plus more! They have had vast experience in this machine doing the following:

Immediately reduce wrinkle depth (saw that!)
Lift faces, chins & necks (saw that!)
Reduce melasma (saw that too!)
Reduce puffiness of eye bags (yes, and we saw that!)
Reduce active acne overnight
Reduce acne scar depth
Reduce redness of rosacea
Change in skin texture (can see that in under 5 minutes!)
Reduce sun damage

The body machine stimulated muscle activity at a phase that utilised fat as fuel as opposed to glucose. One short treatment was said to be equivalent to 10 hours in the gym! The lady that tried the machine was not fat by any means, yet lost 2 inches from her lower abdomen. The effects would continue for the next few days. The stimulation of lean muscle mass and utilisation of fat for fuel has proven benefits for visceral fat reduction. They say that so much antioxidation occurs during one body treatment that even the face starts glowing the next day!

We will be attending Dr Weiss's lecture tomorrow to find out more about the science behind the technology. We also hope to finalise the deal to purchase the machines this weekend.

Save Face

2008-06-11T17:13:00.003+08:00

Finally, months after the "Big Day", the article written by Greg Vanderpyl for AUGUST MAN magazine is published.

The feature was a promise made by the ex-editor in exchange for exclusive rights (amongst men's magazines) for our beloved Chocolate (Diamond Contours Biomesosculpture) machine. That was in Spring 2007...

Their excuse? They couldn't see how to write such a "long" article about one treatment.

So they eventually decided to feature the clinic instead, and a few treatments, not just one. Then came the big problem... They could not find a male writer to brave an aesthetic clinic! Finally, they approached Greg. Big, brave, American Greg with tattoos down both arms. He was due to get married 3 weeks after the initial consultation. Our brief was to get him looking his best for the big day.

I hate deadlines like this. Big day, little time for error... Little time to get fantastic results.

Greg's almost forty and in pretty good shape. A few wrinkles and early signs of sagging, but otherwise excellent nick. He wanted some sun damage removed, lifting and reduction of double chin. Solution: IPL & RF.

The results from the first session alone were pretty good. We squeezed in 3 sessions with the RF before the big day. Unfortunately the IPL was out of order after that, so we could not give him another session.

He said the results did not last. That is to be expected since he did not complete the treatment program. He also did not complement the treatment with creams for daily maintenance treatment. I'm sure there's an element of forgetting baseline too. That's quite normal.

Anyway, he looked good on the "Big Day", and that's what matters.

For those who want to read the article, it's on page 90 of AUGUST MAN June 2008. Greg in full tattooed glory can be see on his other article on page 128-9 of the same issue.

New Promotions at Simply Aesthetic

2008-05-23T21:09:00.004+08:00

We have made some changes to our promotions, effective immediately.

Permanent Hair Reduction of Armpits with IPL

For a limited time only, we are offering this service at just $100 per session! On average, 5-6 sessions will be required, with a gap of 6 weeks between each session. The timing is critical for best results.

This offer is ONLY AVAILABLE ON WEEKDAYS and for a strictly limited time only.

On weekends, our usual rate of $250 per session applies. Please come pre-shaved, or a shaving service charge of $5 applies.

A package of 5 sessions is available at $500 to enable you to complete your treatment at the offer rate. The package must be completed within one year.

We use the Anthelia IPL machine by French company Eurofeedback. This machine is renowned for its safety and comfort. It is also patented for the removal of blond & white hairs.

Water-Jet PLUS Liposuction Consultation

I receive numerous e-mails asking how much I charge for water-jet liposuction. Although I am very open about my charging system, I strongly feel that the choice of liposuction system and doctor should not be based on price alone.

My charges are average for an aesthetic clinic despite our consumable costs being extremely high.

More importantly, the advantages of the Water-Jet Plus should be also taken into consideration, not the cost alone. And these cannot be adequately discussed via e-mail. Nor should they. So as not to place a cost barrier to consultation & patient education, we have decided to reduce our consultation cost for WATER-JET LIPOSUCTION CONSULTATIONS only to just $1.

We have plans to hold mini-workshops in the near future. This $1 offer will cease once those commence. Personal consultations will then be charged at the prevailing consultation rate of $30-50.

We're Getting Fat!

2008-05-23T13:46:00.003+08:00

We LOVE our food! After a major pig-out session in Malacca over the weekend, all of us are finding it hard to squeeze into our clothes.

So what do we do?

EAT MORE! Well, to be fair, this "little" dessert was shared by 4 of us to share the guilt. And we did work extremely hard during the liposuction!

Virtually Bloodless Liposuction with WAL Plus & Erchonia

2008-05-23T12:38:00.007+08:00

We absolutely amazed the nurses at Camden Day Surgery Centre yesterday with our liposuction surgery. The combination of Water-Jet Plus technique with Erchonia laser therapy resulted in virtually no blood in the suction bottles! The fluid came out yellowish for virtually the entire operation. We only saw some blood at the end when I was treating the back. But that area tends to be more fibrotic and vascular anyway, so it was no huge surprise.

We had one nurse after another coming in to gawp at us:

Lack of blood in suction fluid
Complete change in shape of the tummy to pancake flat with nipped in waist
All done under conscious sedation

Given that they are used to working with some of the top Plastic Surgeons in Singapore, I took the opportunity to ask them about how my technique differed from the others. These were some of their comments:

Bloodless!
No one else operates over the entire abdomen from hip to chest

Nice to know!

The yellow layer on top is pure fat. The lower layer is very cloudy pinky-yellow. The colour is actually much lighter in reality. The cloudiness is from dissolved fat, which makes up approximately 10% of the volume. It's a shame we can't get the colours to come out correctly...

New Non-Invasive Face Slimming Treatment

2008-05-16T16:53:00.003+08:00

We get many enquiries for facial slimming. With the loss of Mesotherapy, we have been using radiofrequency to melt fat. Unbeknownst to us, our far infrared mask machine can slim down very efficiently too! And we thought it was just for rejuvenation!

The FIR mask emits a gentle warmth. Using the same technology as Thermojet Morfologic, the application of the mask for 30 minutes has been effective for facial slimming. We are starting our own trials this week. Once we are happy that this works well, this will be a fantastic option for people with limited budgets and/or a low tolerance for heat. RF will still be the best option for those who need more rejuvenation (lifting, pore closure, improving skin tone, remove blackheads).

FIR facial slimming can be done 2-3x a week till the desired results are achieved. No pain, no downtime.

IPL Training

2008-05-16T16:30:00.005+08:00

We had the pleasure of welcoming Carole Baumelou from Eurofeedback to our clinic this week. She is the Trainer for IPL, and spent 2 days with us to share her experience with the Anthelia machine.

Although the Anthelia is a very simple machine to use, it was nice to find out the exact protocol used by the French doctors for best results, particularly how often the treatment was done and the maintenance schedule.

And yes, I got pinned down and had my treatment too. It was not an uncomfortable procedure. My IPL-phobia from having had extremely painful IPL treatments previously with other machines was the greatest hurdle to overcome. But I survived, and no worse for wear! Phew!

At the end of it, I was presented with my certificate! Another one to add to the growing stack! :o)

Vesak Day Closure

2008-05-16T16:24:00.002+08:00

We will be closed on Sunday 18th and Monday 19th May for a staff trip to Malacca.

We apologise for any inconvenience caused.

CERUM replaces Metabolic C

2008-05-16T16:06:00.002+08:00

The application of topical Vitamin C is an integral part of basic skin care. We had been very happy with Bellewave's Metaboli-C for the last year, but as our stocks were running low, took the opportunity to investigate other options in the market. One area of improvement was getting a product with L-Ascorbic Acid, which was the more potent form of Vitamin C.

As with all our products, we looked at various aspects of use:

No need for refrigeration
Smell
Lack of greasiness
Non-comedogenic
Concentration of Active Ingredients
Any other beneficial ingredients

For Vitamin C products, smell is a major issue. I remember an enthusiastic rep generously giving me a very large number of samples of a premium vitamin C product when we first opened in Orchard Road. He applied some on the back of my hand before he left. The smell almost caused me to faint... The product smelt of cat's pee! I couldn't imagine having that lingering scent on my face all day and all night! Ewwww!!!!

After eliminating smelly products, we next weeded out that required refrigeration (too inconvenient) and those that were too greasy. That left us with 3 options, Metaboli-C being one of them. I was finally persuaded by Ivy that CERUM was the superior product.

CERUM is made by Prollenium Medical Technologies, from Canada. It contains 17% L-Ascorbic Acid. Moreover, it has Hyaluronic Acid as a component, so it hydrates as well as protects. This means it helps to prevent as well as reverse the ageing process. Studies have shown that the use of this concentration of Vitamin C shows a 29% reduction in facial fine lines in only 15 days.

What we can see immediately, when comparing one product against another, is that CERUM produces an instant whitening effect. And that was enough for us to go ahead with this order.

Each 30ml bottle of CERUM should last for approximately 2 months. The L-Ascorbic Acid in stabilised to remain active for up to one year.

Evidence for Safety & Efficacy of Mesotherapy

2008-03-31T23:50:00.002+08:00

Mesotherapy is performed by thousands of doctors worldwide for fat destruction. The safety & efficacy of this procedure is often questioned by medical professionals not familiar with it.

These are just a few papers published in reputable medical journals that look at what happens to the fat after treatment, whether it works and whether it is safe. There is none so blind as those who won't see. Mesotherapy may be slow, but there is good evidence that it is effective and safe.

[1] Dermatol Surg. 2008 Jan;34(1):60-6; discussion 66.

Phosphatidylcholine and sodium deoxycholate in the treatment of localized fat: a double-blind, randomized study.

Salti G, Ghersetich I, Tantussi F, Bovani B, Lotti T.
Centro Chirurgico Florence, Florence, Italy. giosal@fol.it

Each patient received injections of a phosphatidylcholine/sodium deoxycholate preparation on one side and sodium deoxycholate on the contralateral side, each single patient being herself the control. Four treatments were carried out every 8 weeks in a double-blind, randomized fashion.

Both treatments have shown moderate and equivalent efficacy in treating localized fat, with sodium deoxycholate having a slower postoperative resolution, suggesting that sodium deoxycholate could be sufficient by itself to determine fat cell destruction and that phosphatidylcholine could be useful for obtaining a later emulsification of the fat.

[2] Dermatol Surg. 2004 Jul;30(7):1001-8.

Detergent effects of sodium deoxycholate are a major feature of an injectable phosphatidylcholine formulation used for localized fat dissolution.

Rotunda AM, Suzuki H, Moy RL, Kolodney MS.
Division of Dermatology, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA.

Cell viability and cell membrane lysis assays were performed on cell cultures and porcine skin after treatment with the phosphatidylcholine formula, isolated sodium deoxycholate, or common laboratory detergents Triton-X 100 and Empigen BB.

A significant and comparable loss of cell viability, cell membrane lysis, and disruption of fat and muscle architecture was seen in cell cultures and tissue specimens treated with the phosphatidylcholine formula and isolated sodium deoxycholate.

[3] Dermatol Surg. 2007 Feb;33(2):178-88; discussion 188-9.

Action of sodium deoxycholate on subcutaneous human tissue: local and systemic effects.

Yagima Odo ME, Cucé LC, Odo LM, Natrielli A.
Department of Dermatology, School of Medicine, University of Santo Amaro, São Paulo, Brazil. marina.odo@uol.com.br

Sodium deoxycholate (SD) induces an inflammatory reaction in subcutaneous human fat and dose-dependent adipocyte lysis with acute pain and fibrosis. No systemic effects were detected.

[4] Dermatol Surg. 2006 Apr;32(4):465-80

Mesotherapy and phosphatidylcholine injections: historical clarification and review.

Rotunda AM, Kolodney MS.

Department of Dermatology, University of Southern California School of Medicine, Los Angeles, California, USA. arotunda@hotmail.com

All the published studies evaluating the clinical efficacy of traditional mesotherapy currently originate from Europe. These reports focus primarily on musculoskeletal pain and vascular disease, rather than cosmetic applications. Although experimental data suggest that a number of traditional mesotherapy ingredients may theoretically reduce fat, these effects have not been supported in peer-reviewed studies. An increasing number of reports demonstrate that subcutaneous injections of a formula containing phosphatidylcholine combined with its emulsifier, deoxycholate, are effective in removing small collections of adipose tissue. Cell lysis, resulting from the detergent action of deoxycholate, may account for this clinical effect.

Mesotherapy is distinct from a method of treating adipose tissue with subcutaneous injections of deoxycholate alone or in combination with phosphatidylcholine.

[5] J Cosmet Dermatol. 2007 Dec;6(4):250-7.

Submental fat reduction by mesotherapy using phosphatidylcholine alone vs. phosphatidylcholine and organic silicium: a pilot study.

Co AC, Abad-Casintahan MF, Espinoza-Thaebtharm A.
Jose R. Reyes Memorial Medical Center, Rizal Avenue, Sta. Cruz, Manila, Philippines. genjoabby@hotmail.com

Mesotherapy using phosphatidylcholine vs. phosphatidylcholine plus organic silicium was similarly effective in reducing submental fat. There was no significant difference between them in terms of rate and degree of reduction. Optimal reduction of submental fat was achieved after three treatment sessions. Adverse reactions were few, mild, and transitory. Therefore, both regimens are safe, efficacious, cost-effective, and can be used as alternatives to invasive surgical procedures.

[6] J Drugs Dermatol. 2003 Oct;2(5):511-8

Phosphatidylcholine in the treatment of localized fat.

Hexsel D, Serra M, Mazzuco R, Dal'Forno T, Zechmeister D.
Doris Hexsel Dermatologic Clinic, Porto Alegre, Brazil. dohexsel@zaz.com.br

Clinical results reflect that phosphatidylcholine was efficacious in reducing the fatty pads in the treated areas, with few side effects. From the authors' point of view, the off-label use of phosphatidylcholine in the treatment of fatty pads and small areas of localized fat is safe, low cost, and effective.

[7] J Cosmet Laser Ther. 2005 Mar;7(1):17-9.

Histological changes associated with mesotherapy for fat dissolution.

Rose PT, Morgan M.

Punch biopsies were taken at one and two weeks after mesotherapy with PC and DC. Each of the biopsies taken at one and two weeks after treatment with PC and DC showed a normal epithelium and dermis, with a mixed septal and lobular panniculitis. The fat lobules were infiltrated by increased numbers of lymphocytes and, in particular, macrophages. The macrophages consisted of conventional forms, foam cells, and multinucleated fat-containing giant cells. The inflammation was associated with serous atrophy and microcyst formation.

[8] Aesthetic Plast Surg. 2006 Jul-Aug;30(4):474-8.

Injection of phosphatidylcholine in fat tissue: experimental study of local action in rabbits.

Rittes PG, Rittes JC, Carriel Amary MF.
Santa Casa School of Medicine, Rua Afonso Braz, 864, cj. 72, Vila Nova Conceição, São Paulo, SP, Brazil. prittes@terra.com.br

Using a randomized, blind approach, 10 rabbits were injected with an experimental assay of phosphatidylcholine (the biologic model), and another 10 rabbits were injected with physiologic saline. A histologic study was conducted, and the Mann-Whitney test was applied.

A marked difference was observed between the two groups with respect to necrosis, inflammatory exudation, and fibrosis.

[9] Aesthetic Plast Surg. 2003 Jul-Aug;27(4):315-8.

The use of phosphatidylcholine for correction of localized fat deposits.

Rittes PG.

Subjects with localized fat deposits commonly receive suction lipectomy as a cosmetic procedure. A new office procedure for correction of those superficial fat deposits was applied in 50 patients by injection of phosphatidylcholine. The method itself consists of using a 3OG1/2 insulin needle to inject about 5 ml (250 mg/5 ml) of phosphatidylcholine into the fat, distributing it evenly in an 80 cm2 area. Pre- and posttreatment photographs were taken for technical planning and analysis of the results over the long term.

A clear improvement occurred in all, with a marked reduction of the fat deposits without recurrence over a 2-year follow-up period and no weight gain. The injection of phosphatidylcholine into the fat deposits is a simple office procedure that can sometimes postpone or even replace surgery and liposuction.

[10] Dermatol Surg. 2001 Apr;27(4):391-2.

The use of phosphatidylcholine for correction of lower lid bulging due to prominent fat pads.

Rittes PG.
Clínica Patrícia Rittes, Sao Paulo, Brazil. prittes@ruralsp.com.br

Thirty patients were treated for prominent lower eyelid fat pads with phosphatidylcholine injection. Pre- and posttreatment photographs were taken for long-term analysis. A marked reduction of the lower eyelid fat pads was noted over the 2-year follow-up period. There were no recurrences.

The injection of phosphatidylcholine (250 mg/5 ml) into the fat pads is a simple office procedure that may postpone or even substitute for lower eyelid blepharoplasty.

[11] J Cosmet Dermatol. 2006 Sep;5(3):218-26.

Clinical experience and safety using phosphatidylcholine injections for the localized reduction of subcutaneous fat: a multicentre, retrospective UK study.

Palmer M, Curran J, Bowler P.
British Association of Cosmetic Doctors, 30b Wimpole St, London, UK. mark.palmer@mail.com

Thirty-nine UK doctors specifically trained and experienced in this treatment completed questionnaires, focusing on outcome and adverse effects experienced by patients. Ten thousand five hundred and eighty-one treatments had been administered over a mean duration of 13.1 months. Localized adverse effects (swelling, erythema, burning/stinging, pain, tenderness and bruising) were described by most patients as "very mild' (18.4%) or "mild" (39.2%). The total incidence of systemic side-effects was 3%: diarrhoea, nausea, dizziness/light-headedness and intermenstrual bleeding were described by most patients as "very mild" (36%) or "mild" (55%). Only 15 (0.14%) "unexpected, unusually severe or prolonged" adverse reactions (commonly pain and/or swelling) were reported. These were all self-limiting and none were judged as serious. 73.8% of patients were either "very satisfied" or "satisfied" with treatment.

This treatment appears to be associated with minimal risks when used by specifically trained and experienced doctors. The possible risks associated with this treatment should be balanced against the risks of other treatment options.

[12] J Am Acad Dermatol. 2005 Dec;53(6):973-8.

Lipomas treated with subcutaneous deoxycholate injections.

Rotunda AM, Ablon G, Kolodney MS.
Division of Dermatology, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA. arotunda@hotmail.com

All lipomas decreased in size (mean area reduction, 75%; range, 37%-100%) as determined by clinical measurement (with ultrasound confirmation in one lipoma) after an average of 2.2 treatments. Several lipomas fragmented or became softer in addition to decreasing in volume. Adverse effects, including transient burning, erythema, and local swelling, were associated with higher deoxycholate concentrations but resolved without intervention. There was no clear association between deoxycholate concentration and efficacy. Low concentration deoxycholate may be a relatively safe and effective treatment for small collections of fat.

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2008-03-28T23:15:00.002+08:00

Our unit arrives next week. WAL is already reputed for quick recovery. This addition will cut down discomfort, bruising and swelling even more!

MOH to let professionals regulate aesthetic treatments

2008-03-23T22:18:00.001+08:00

Source: Channel News Asia
By Hoe Yeen Ni, Channel NewsAsia | Posted: 23 March 2008 2134 hrs

SINGAPORE: The Health Ministry appears to have changed its stand on aesthetic treatments and what procedures can be performed.

It now says it will leave the regulation of the industry to professional bodies, while it turns its attention to the safety of patients instead.

Health Minister Khaw Boon Wan said there is a lot of "grey area" in the industry and it is "not possible" for the Ministry to stop doctors from performing aesthetic treatments if there is a demand.

Mr Khaw clarified the MOH's position following media reports surrounding last week's crackdown on doctors who perform unproven procedures.

The MOH said that regulating the beauty industry is especially challenging as in many cases, scientific evidence is missing or inconclusive.

Furthermore, it added, taking a hard, regulatory approach will mean the prohibition of many procedures. This is not practical and it is not what MOH is advocating, stressed Mr Khaw.

The MOH's remarks came just a few days after it issued what amounted to a ban on certain procedures, such as fat-zapping mesotherapy, application of stem cells to revive the skin or the use of anti-ageing hormone and skin-whitening shots.

It said these have no scientific evidence and should not be practised at all, whether or not the operator has had training.

The MOH had also issued a stern warning that any doctor found doing these "unsubstantiated" procedures will be referred to the Singapore Medical Council for disciplinary review.

But now, that stand seems to have been changed.

"Because I'm not familiar with mesotherapy, I don't even know what it is. So let's leave it to the professions to sort it out," said Mr Khaw.

"The human urge to do this kind of things are plentiful. So who are we to say, stop it? We can't do that," he added.

But what the MOH will do is that it will regulate on high-risk, highly-invasive procedures.

Mr Khaw said his Ministry is working out guidelines which will stipulate who can perform what treatments.

He declined to indicate when the guidelines will be published.

The Academy of Medicine and the College of Family Physicians are also formulating principles to govern the ethical practice of all procedures.

But the question remains -- can doctors carry on in the meantime?

"Doctors are supposed to do what they think appropriate, taking into account possible benefits, and then possible risks. So that's a decision which doctors have to make all the time. Because if they fail to do that, they could be subject to investigation," said Mr Khaw.

Mr Khaw also said that consumers should know what they are getting into before taking the beauty plunge. - CNA/ir

Quoted When No Comments Were Made!

2008-03-20T19:43:00.004+08:00

From Straits Times front page on 20th March 2008:

The ministry began cracking down on such practices from September last year, telling about 20 of the bigger operators to stop.

Prominent plastic surgeon Woffles Wu and anaesthetist Christine Cheng were among those targeted. They complied immediately.

Dr Cheng was unhappy to have been singled out, and asked why the ministry did not inform all doctors.

The ministry explained that it did not realise earlier how widespread aesthetic medicine had become.

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I have been receiving phone calls non-stop since 2 am London time. Amazing how I ended up in the newspaper when I did not make those comments!

The e-mail interviews follow. I made no comments on the situation at all, given that I was out of town with no access to the newspapers!

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Dear Dr Cheng,
The MOH has expressed concern over doctors providing what it calls "unsubstantiated practices" including mesotherapy which I believe your clinic offers.
Its concern is not that such treatments are given, but that it fears patients may think they are proper medical treatments as they are done by doctors.
Could I have your comments on this please?
Do you, perhaps, tell your patients that these are not scientifically proven methods?
Or do you disagree with the MOH's stand that there is no backing for these treatments?
Yours Sincerely,
Salma Khalik
Health Correspondent
The Straits Times
Tel: 6319 5349

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Hi Salma

We no longer offer mesotherapy after the MoH ban.

Cheers!

Dr Christine Cheng
Simply Aesthetic
Tel: 6732 5527
Fax: 6732 5517
www.simply-aesthetic.com

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Hi Dr Cheng,
Thanks for reply.
Several doctors I spoke to yesterday have received that letter, but others have not - am querying MOH on that.
Does the ban involve only mesotherapy or the other 10 listed in the Straits Times today too?
Has stopping mesotherapy affected your business much - are patients unhappy? If so, any patients I could talk to?
More importantly, do you agree with the ban, since it can still be offered by beauty saloons?
Cheers,
Salma Khalik

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Hi Salma

We have been advising our patients to undergo liposuction for the last few months, so the ban on mesotherapy has little impact on our business. I am in London at the moment, so do not know which treatments are no longer permissible in clinics. I have yet to speak to my patients regarding their feelings regarding this ban.

I do not know what goes on in beauty salons.

Cheers!

Dr Christine Cheng

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Hi Christine,
sorry to get back to you again, with you in London.
But have just found out that MOH only sent letters to 20 doctors asking them to stop treatments like mesotherapy and carboxytherapy. Many others offering these services have not been told to stop.
Do you think this is fair?
Or is there some reason why these 20 doctors, including you, have been asked to stop?
Cheers,
Salma Khalik

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Hi Salma

I have no idea why our Ministry works in this way. With the Hong Kong Medical Council, all registered doctors were notified regarding stopping the use of Phosphatidylcholine via e-mail. So it was fair to all. They did not ban the entire spectrum of mesotherapy, just the main drug used for fat melting. For your information, the injection of steroids into inflamed tendons is considered mesotherapy too. As is the injection of steroids to reduce the thickness of keloid scars.