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  Recently, I was browsing through some of my favorite Facebook groups for aesthetic providers a nd I noticed something alarming. There was a glut of posts from inexperienced injectors, asking for advice on how to get best results with dermal   fillers. They weren’t sure whether common situations were normal  and were even asking for advice on complications. For example, one injector was concerned that her patient was experiencing swelling in her lip immediately after her appointment:   She didn’t have enough experience to know whether or not something had gone wrong. Or take this injector, who wasn’t sure whether the redness in her patient was normal:   The answer is “probably yes”, but a more experienced provider could have achieved much gentler results with a cannula and know if there's something more serious like a blood vessel compression has occured.  A lso looks like she missed the right injection point a few times, which is not great.   Meanwhile, this
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  “What’s happened to Charlotte’s face!?” If you’ve been on Twitter or Reddit recently, you’ve probably come across lots of comments like that... It’s a reference to the character Charlotte in Sex and the City . The series, which became a cultural icon 20 years ago, recently rebooted as “ And Just Like That...” And while all the characters have aged, Charlotte looked more different than the others... Her face was much broader, her lips were strangely flat and her cheeks are unusually full. The actress, Kristin Davis, didn’t look quite like herself any more. Initially, commentators wondered whether she’d had plastic surgery. But it seems much more likely that she’s had dermal fillers - done badly.   I know that this kind of “unnatural” result is a great concern for many including my clients too. Fillers are there to help ‘plump up’ areas of the face which have lost volume with age,  ‘fill in’ fine lines and wrinkle a nd give more definition to some of the facial featur

Male Hormones: Out of Balance?

  When male hormones are out-of-whack A few nights ago, my neighbor Justin showed my husband and I his latest purchase: a beautiful sporty Lexus . We “oohed” and “aahed” in equal measures as we circled the car. “You’ll certainly turn heads in this,” I  told him. “Yeah,” he sighed. “It’s just that everyone thinks I’m having a midlife crisis...” Although we all laughed, I could tell that Justin was a little upset at this. And I can totally understand that. After all, when we think about the female ‘mid-life’, it conjures up images of menopause, hot flushes, night sweats and often a very difficult time. Mention the male mid-life stage and you’re more likely to get funny comments about mid-life crises, leaving your family, Harley Davidsons and ponytails. So let’s correct a few myths. Many people don’t believe that the ‘male menopause’ really exists, but it’s a fact of life that in their 40s, most men will have a drop in their testosterone and DHEA hormone levels. The result can be periods

I Don't Want to Change My Face

  The other day, I was at my nephew's wedding, and ended up talking to a very nice lady who asked me what I did for a living.  I told her I was an aesthetic doctor  and a aesthetic clinic owner... Her attitude immediately changed. “Oh, you do Botox injections?” She replied, shaking her head. “I’m not into that. I don’t want to change my face.” It’s a concern I hear a lot, both from strangers and from patients who come in for skin treatments, but are wary of injectables. So in case you feel the same way, I want to share with you what I told this lady. The truth is, your face is changing the whole time. After the age of 18, you lose 1% of the collagen in your skin every year. That’s the key protein that keeps your skin firm and taut - so you can imagine what happens to your skin when you’ve lost 15% or 20% of it... Meanwhile, once you hit your 40s, the ligaments which support your skin start to loosen,  and the fad pads which keep your skin nice and plump start to shrivel and move ar

Linda Evangelista’s Fat Freezing Disaster

Former supermodel Linda Evangelista hit the headlines in September after suing Zeltiq for a bad experience with CoolSculpting.  There was widespread press coverage and I had patients mentioning her story in clinic. So I am writing this piece to explain what happened, and to reassure patients that the risk of PAH is extremely low.  I also want to discuss complications / risk in aesthetic procedures in general. The bottom line is I want to be open and honest with patients, so I can build up their trust in me.  So let's delve into Linda Evangelista's fat-Freezing disaster.  By now, you’ve probably seen the news reports about supermodel Linda Evangelista’s unfortunate experience with fat-freezing. Since I’ve had patients asking me about it in clinic, let’s talk about it... First, here’s what we know.  Around 5 years ago, Linda underwent a fat-freezing procedure, which is commonly used to get rid of stubborn fat. We’re not sure exactly which area she had treated, but it seems likel