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Picture perfect
Getting some work done on your face, or
your tummy, isn't all that unusual these days. TAN SU YEN
reports on the
growing acceptance of cosmetic surgery and the latest
non-invasive procedures that have fuelled these trends.
'WHAT people want is to look good as fast
as possible, as easily as possible and with as little down
time as possible,'
says consultant plastic surgeon Dr Martin Huang, succinctly
describing the nature of demand in the cosmetic surgery
industry.
 Dr Huang is a director of The
Cosmetic Surgery Clinic and Pacific Healthcare Holdings. In the early
part of his
career, Dr Huang's work was mainly in reconstructive
surgery; his
particular interest being in a sub-specialty of plastic
surgery known as craniomaxillofacial surgery. In the
last eight years,
he has worked mainly in the field of cosmetic surgery,
a branch of plastic surgery that he readily acknowledges
has
become consumer-led to a significant degree.
'Consumers are often the driving force
behind new developments in cosmetic surgery, especially in
the field of non-invasive
treatments. We can use the term 'consumer' here because
cosmetic surgery is a good example of consumer medicine.'
By
definition, cosmetic surgery is altogether different from
conventional medicine and with good reason.
To begin with,
it is purely elective; added to this the fact that
people pay for it with their disposable income.
Most importantly,
the nature of the problem and the desired changes
are very much customer driven.
Says Dr Huang: 'If
a person is sick with a disease, it is up to the doctor
to make a diagnosis and
the patient
generally
accepts whatever treatment is recommended. In
cosmetic surgery, a patient will say 'I don't like the way
my nose looks and
I want it to look this way instead'. Recognising
and lending weight to the patient's views is
very
important
because even
if the doctor finds the nose inoffensive, there
may be physical features about it that disturb
the patient
and
that is why
they want it to look different. In that sense
the patient has a lot of say.'
Another issue that makes cosmetic
surgery or medicine unique is that it is more price sensitive
compared
with other fields
of medicine. Dr Huang explains: 'If you have
breast cancer and you need surgery, you are
not going
to quibble very
much about the fee that is going to be charged;
at any rate it
is probably covered by insurance. But if you
want some Botox treatment, you will shop around
until
you find
a doctor whom
you think you feel comfortable with and whose
price you are happy with as well.'
These realities
present unique challenges to those working in the field
of cosmetic surgery
and medicine.
'Although
we are all trained as medical professionals,
practising in this field requires us to be
very cognisant
of the fact that
this type of patient is a bit different from
a regular medical patient because they behave
very
much like
consumers.'
But who are these consumers of
cosmetic medical and surgical procedures? And how did cosmetic
surgery come to fall
within the realm of mainstream, albeit
elective, medicine?
The explanation lies in the changing nature
of contemporary society. Says Dr Huang:
'We live
in a very visual
society where we constantly seek visual
gratification in all
aspects of our life - from our home,
work or leisure environments
to our very appearance. 'Everyone wants
to look good and everyone wants to be surrounded by good-looking
people so
there is
great pressure
on people
to look attractive.'
Shifting values
and perceptions have also made cosmetic surgery more socially
acceptable.
Says Dr Huang:
'In the old days,
cosmetic surgery was seen as a silly
pursuit in vanity by ageing actresses
and eccentric
celebrities. Today
people
from all walks of life, from students
to grandmothers,
regard improving your looks as a
valid means of
self-improvement. Because of that
cosmetic surgery has effectively
come out
of the closet.'
Procedures for that desired look
BOTOX,
Thermage, Laser Peel - the language of cosmetic medicine
is starting to creep into mainstream vocabulary. Most of
the jargon refers to non-invasive procedures, and this
is hardly surprising. In recent years, growth in non-surgical
cosmetic procedures has been nothing short of exponential.
Says
consultant plastic surgeon Dr Martin Huang: 'The trend
in cosmetic surgery and medicine is that we are
moving more
and more towards less and less invasive surgery and even
completely non-invasive procedures. This trend is fuelled
by an increasing demand for these types of procedures
and the need to minimise down time, or even to eliminate
it
altogether.'
At Dr Huang's practice, The
Cosmetic Surgery Clinic, demand for non-invasive procedures
far surpasses that
of surgical
procedures. Nonetheless, the surgical side of the business
continues to grow steadily, given the clinic's reputation
for performing complex and technically challenging
cosmetic surgery operations.
Surgical procedures
Most cosmetic surgery operations are day surgery procedures
with no hospitalisation required. Some of the more
frequently performed surgical procedures at The
Cosmetic Surgery
Clinic are:
Lower Blepharoplasty or lower eyelid
surgery
Dr Huang takes an unconventional approach
to the fairly common procedure of rejuvenating the lower
eyelid.
People with eye
bags typically also have a groove below the eye
bag. The conventional approach to lower eyelid
surgery
is to surgically
remove the eye bag, then inject filler into the
groove later.
Dr Huang has refined a surgical technique
in which fat from the eye bag is not removed
but is instead
redistributed
to
the groove as part of the same procedure.
Says
Dr Huang: 'Instead of wasting the fat, we fill the groove
with the patient's own fat, thus
correcting
the
bulge of
the eyebag and addressing the second problem
of the groove beneath the eye bag, all in one
operation.
The technique
is laborious and exacting but after years of
practice my results have been consistently
good.'
Upper Blepharoplasty or upper eyelid surgery
The
two most popular upper eyelid surgeries are the creation
of double eyelids and ptosis
repair
or the
correction
of droopy eyelids.
Departing from the norm for most plastic
surgery practices, Dr Huang creates a double
eyelid
by using a stitching
technique that requires no incision and
leaves no scars. Says Dr
Huang: 'The procedure only involves sewing,
there is no cutting
at all, but the technique is advanced and
can fail if not done well.'
Droopy upper
eyelids, which are characterised by sleepy looking eyes
and absent or multiple
creases
on the
eyelid, are corrected
by a procedure known as ptosis repair.
People with droopy eyelids often look
tired or downcast.
At
its most severe,
ptosis can cause obstruction of the visual
field. The challenge in ptosis repair
is to get perfect
symmetry,
says Dr Huang.
'With the eyes, even a half mm discrepancy
is noticeable.' The other challenge is
to identify mild forms of
ptosis and to address it early, rather
than to
treat it as
just another
case of double eyelid surgery.
Rhinoplasty
or cosmetic surgery of the nose
The bread and butter
of an Asian nose job is to place an implant in the nose
but
more can
be done,
says
Dr Huang.
'If you listen to your patients closely
and what they really want to achieve
for their
noses,
it becomes apparent that
an implant alone is often an inadequate
solution. The
Asian nose is characterised by a round,
bulbous tip covered by
a thick layer of oily skin that obscures
its internal architecture. There is
a lot we can
do in terms
of modifying the size
and shape of the cartilage of the nasal
tip in order to refine
it, make it narrower and sharper and
to give it more definition.'
One peculiarity
of Dr Huang's practice is that most of the nose jobs
he performs
are
complex
and long,
reflecting
his
belief that the more refined the
desired end result, the more work needs to
be done.
LipoSelection by Vaser
An
advanced alternative to traditional liposuction, LipoSelection
precisely
and efficiently removes
unwanted fat using
ultrasound technology. A small
probe that transmits sound energy is
used to first liquefy the fat before
it is removed from the body by
gentle suction.
LipoSelection may be used
to treat
various areas like the abdomen,
buttocks, hips, love handles and arms. It is
particularly helpful
for
areas where the
fat is known to be tough, fibrous
and difficult to remove using conventional
liposuction,
such as the
back. As
this technique selectively targets
fatty tissue while minimising
damage to other tissues, patients
experience
minimal pain, swelling and bruising,
shorter down time,
and enjoy smoother
contours compared with conventional
liposuction.
Non-surgical procedures
Non-invasive
procedures are typically outpatient treatments that are
performed with topical
or no anaesthesia.
These are some of latest and
most sought after treatments:
Thermage
Thermage is a non-invasive
procedure that tightens loose or saggy
skin to produce
a 'lift' without
incisions. Using Radio Frequency
(RF) energy, the Thermage process
works
from within to tighten collagen
fibres and jumpstart new collagen
production in a single treatment.
It
can rejuvenate the
upper face, by lifting the
brows, for example, and in the lower
face it can reduce the appearance
of aging by improving nasolabial
grooves
and jowls. A new
Thermage treatment
to rejuvenate
the upper eyelid while ensuring
the
safety of the eyes was launched
recently.
Refirme Skin Tightening
Using
a combination of RF and infrared energy, this treatment
also tightens
the skin to
produce a non-surgical
lift.
However, unlike Thermage,
this is achieved via a series of
six treatments
performed every two to three
weeks. It is particularly
helpful for
tightening the skin
of the lower
eyelid and reducing
the appearance of eyebags,
thus giving patients a non-surgical
option for
lower
eyelid rejuvenation.
Micro
laser peel
The micro laser peel is a
high-tech laser peel of
the skin that
improves skin texture
by reducing
wrinkles,
refining
pores and acne scars, and
tightening the skin. It
also improves skin colour by removing
sun damage and creating
a uniform
skin tone. It is ultra
precise in its
workings. The down time
after a peel, when the patient
needs to
protect her skin from the
sun, can range from two
to 12 days,
depending
on the depth of peeling.
This has given rise to
the term
'weekend peel' to describe
mild peels performed at
the weekend
so as to
allow clients to
go back to
work as
usual on Monday
but with dewy, baby-smooth
skin. Source:
Business Times, 28 July 2006
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