Friday 7 February 2014

What do we really think of the lunch time procedure?

Isn’t it just so fashionable to be super busy lately?? It’s the naughtiers and “Apologies, I’m afraid my diary is overflowing.” Back to back engagements, meetings, personal trainer at 6am, out of the office and “Ooh it appears I have completely missed daylight! “ Odd isn’t it though, that it really is a must today to let absolutely everyone know just how bogged down we are with occupational and social commitments only to then be embroiled in an amicable comparative banter of who should win the battle of the busiest. Stress is the buzz word. If this last word happens not to be in your vocabulary, in today’s day and age it is assumed that you are either of inferior mental capacity, debilitatingly slothful or a member of the fine but dying breed of the species better known as ‘the kept woman’

The common mortal today is absolutely bogged down with endless tasks and duties while trying to maintain an illusory harmonious work-family-life balance. We live in an era where ruthless redundancies are rife, and unemployment is not an acceptable option. The requisite reply to the question ‘how are you?’ is now (with the obligatory mop of the brow, of course) “Oh, I’m stressed, just waaaaay too busy”. But, at a cursory glance, how many of us actually display the evidence of the strain and walk about looking frazzled? While we happily extol the hard workers, we don’t exactly laud the unkempt, slovenly worker. However, is it really all that feasible an option to take a morning off work to make our way to the hair dresser, the manicurist and most importantly to he who wields the needle of youth-restoring venom? It is certainly not amenable my schedule, or to the city business whizzes. The recent loom and boom in so called lunch-time procedures hardly comes as a surprise. Businesses cater to meet the needs of their clients. This industry is no different, and hence a new breed of clinics has spawned and are now commonplace. Hours of operation have been extended till late into the evening and the lunch-time procedure moniker is now a valuable marketing tool.

This however has brought with it some ominous implications. A lunch-time or 15 minute intervention, is often perceived to be a no frills, no extras included, in-out quick fix with little weight given to the quality of the service or the standard of the ensuing result. We can hurl mud back at those who rather ungraciously slung mud first in our direction. I speak of none other of course, than sensationalism-hungry journalists who tweak and embellish horror stories thus throwing the practice into disrepute. However, reason tells me that we, the practitioners aren’t entirely blameless. While most of us remain true to the Hippocratic oath, there are a few vultures among us who, ever-ready to turn a quick buck, take advantage of the ever-growing desire to remain more of a grape than a shriveled raisin. This trend is gaining momentum. Would we be raving lunatics to ignore and continue status quo? Or should we cash in?

We are relentlessly inundated with marketing advice. However this counsel does not emanate from governing authorities ie the likes of the General Medical and Dental Councils. If a patient feels that she was “done” in a flurry, in front of the judge, she will wax lyrical on how she was done in a hurry and felt shortchanged.

Another misconception lies in the perception of the associated downtime. It is often accepted as true that quick and simple equates to negligible pain thereafter or compromise on daily activities. A prime example is the lip augmentation procedure, which rarely takes up more than twenty minutes of our precious time. However, returning to work straight after would beg an interrogation and concern of recent assault. And no, the boss would not approve of the swollen and bruised pout in the next meeting, especially if orally incontinent and lisping post nerve block! I am still to see a microneedling victim jumping into a cab heading straight back to the City after I’m done with her! Herein lies the worth of the consultation, which very often, especially if it is the initial doctor patient chat can effectively last longer than lunch time! So, it is certainly not a ‘ooh, just spotted this on the high street, perhaps I’ll just nip in for a quick fix jab, fill and tox, and lo behold, my summer freeze!’ It might be somewhat acceptable that a patient is in and out of the clinic in 30 minutes should the procedure in question takes little time, the patient is not a novice to the treatment and the doctor is content that he is comfortable carrying out the intervention given the patient’s condition and knowledge on the subject matter.

Whereas straightforward brief procedures, such as a repeat toxin treatment or steroid injections for scar treatment might be well suited and indeed comfortably squeezed into the tea break, the blatant unashamed marketing of more complex and lengthy procedures such as minimally invasive breast augmentation or minimal access liposuction as lunch time contender, is a hoodwink. Truthfully, the interventions are far less invasive and painful than their classical surgical counterparts. However, there is no way a patient should or could return to the office following such surgery. So, in essence the beauty brigade shouldn’t take this marketing moniker too far by applying it universally to the wide array of procedures offered. Misleading a patient often means disappointing a patient, and an unhappy patient tells twenty people. Happy patients on the other hand will only sing our praises to five souls. Breeding a progeny of discontented and disgruntled patients is injurious to the doctor’s reputation, and that of the profession in its entirety.

We have all heard of prolific surgeons in the pinnacle of their career, who had previously been lauded for their contributions to the specialty, suddenly taking a high vortex downward spiral. ‘The flying doctor’ notoriously made the headlines for completing a surgical facelift in half an hour. Individual patients left unhappy with the results of his knife-wielding trends came together, coalesced and formed an army. Their effort finally culminated in having him struck off the medical register.

These trends tend to go hand in hand with BOGOF and ’recommend a friend’ offers, all of which I think seem to trivialize the weight and potential risks of the treatment involved. While it might be very feasible from a time management point of view to trip off the street into the clinic on your way to lunch with the ladies, have you never noticed that we disapprove on alcohol consumption following the administration of our favourite poison? Or the avoidance of hot drinks after we’ve imparted our lidocaine packed hyaluronic acid to our lips?

It is hardly a riveting revelation that this lunch time trend has caught on and its popularity is gaining momentum by the day. If in the space of a latte and a newspaper, faces could be symmetrized and beautified, sweaty underarms rendered dry and faces peeled to glowing youth, thank you, where do I join the queue? In a day and age where judgment starts and lingers long on outwardly appearance, and the pretty young people rule, it is too effortless for us to feed off the insecurities this notion brings with it. Thus while we might indulge in self-exaltation at our contribution towards making the people prettier and thus more confident and successful, might we be responsible for fuelling the social acceptability of such psychology and cultivating a ne breed of addicts?

Thursday 7 November 2013

NON-Surgical Lip Enhancement

It's been known for a long time, we find fuller lips sexier.  Studies into human behavior have revealed that this is because thicker lips tend to be associated with a warmer, more approachable and more nurturing personality, which the male of the species is naturally drawn to.

Lip enhancement procedures may be carried out to enhance or define the lips, or to correct any asymmetry or unevenness.  Lips which have been enhanced using dermal fillers should never give the secret away.  Hence, natural-looking results are the best ones.

Artificially large lips are often too evident due to excessive pouting, eversion or size.  Those lips certainly cannot be considered attractive.  When it comes to enhancing lips, less is often more.  The use of small amounts of dermal fillers placed very judiciously, just to define the red border or the Cupid's bow, or to evert the lip slightly can yield beautiful results, while avoiding the "done" look.

The most important part of the lip enhancement treatment is the consultation and discussion with your doctor beforehand.  This is the opportunity to understand each other, discuss your expectations, address any concerns understand the risks versus the benefits and to know way the treatment entails.

Normally, a lip enhancement procedure is a rather quick intervention lasting about 10-15 minutes.  Your lips will be number with numbing cream beforehand to make the procedure more comfortable.  If you are extremely sensitive to pain, a numbing injection (like the density's) can be given beforehand, although this is not usually necessary.

At Aesthetic Virtue, we take pride in delivering excellence in aesthetic medicine at every level.  We believe natural-looking results are the superior results.  In fact, we don't like people noticing you've been to one of our clinics! 

Remember that any treatment involving dermal fillers, especially in the lip area is usually followed by some swelling and bruising, so always allow at least a couple of days between the treatment and a cosmetically sensitive event, such as the Christmas office party!!

Should you consider a lip enhancement procedure, please do speak to us.

Friday 1 November 2013

An insight to Obagi Nu-Derm treatments

If you'd like beautiful looking skin it is time to start the Obagi Nu-Derm treatments.

The Obagi Nu-derm system is one of the only medically proven facial cream skin treatments which affects the way the skin works by penetrating the middle layer.  It is the only effective treatment for hyperpigmentation and improves the appearance of fine lines and wrinkles, while getting rid of the other typical signs of ageing, such as open pores.  It also works very well on active acne and scarring.

Achieving good skin takes time.  Obagi Nu-Derm regenerates your skin from deep below the surface. As the Obagi Nu-Derm system is so effective, for the first couple of weeks, the skin will feel slightly irritated and some redness and peeling will occur, especially around the mouth.  This will give way to a smoother, clearer and brighter skin.  Results can be seen within 4 weeks, and the skin is generally glowing by 6 weeks.

To boost this treatment or to kick start the effects, the Obagi Radiance peel, is the answer.  This is a very light peel that requires no preparation.  It leaves the skin glowing and refreshed and has no associated down-time.  There is little or no peeling, although the skin may feel tight for a while after.
Also for those who aren't fans of face cream regimens, the Obagi Radiance peel is your answer!  A peel every 3-4 weeks, will leave the skin glowing.

Check our website for more information about Obagi treatments in our clinic at Harley Street

Thursday 31 October 2013

Split Earlobe Repair

Chandelier earrings are back in! They certainly are very pretty, but is it really all that wise to subject our poor earlobes to such pressure?  This little square centimetre of skin has been the bearer of heavy loads or adornment  through the centuries.  Earlobes tend to enlarge and sag with age naturally, and unfortunately, Dynasty-style earrings don't help much.

At Aesthetic Virtue, we are seeing more and more people coming to us for repair of torn or split earlobes. Most of the time the split earlobe occurs sue to the prolonged use of very heavy earrings.  What happens is the weight of the earring slowly cheese wires itself through the earlobe flesh, finally causing a rent.  As this is a very gradual process, most of the time , this is not painful and there is very little associated bleeding if at all.  It can also occur sure to traumatic tearing, such as if a child forcefully grabs onto an earring.

Simple split earlobes are very easily repaired at Aesthetic Virtue. After a thorough consultation, our surgeon, Dr Raina Zarb Adami, numbs the area with local anaesthetic and makes a small incision to be able to sew the split surfaces back together with stitches. The procedure takes around 20 minutes, and is done on an out-patient basis. We advise leaving at least 6 weeks before re-peircing the ear.  A 3 month wait is ideal. The surgeon will then re-pierce the ear herself, to minimise the chance  of the earlobe re-splitting.

There has recently been a trend in enlarging earring holes. The earlobe's capability of stretching is impressive. However, on many an occasion, these individuals seek to reduce this earlobe enlargement and restore it to its original size and appearance. This surgical procedure is a little more complex and may take slightly longer, but it can also be done as an out-patient.

The Daily Mail , as usual, has plenty to say about enlarging and split earlobes, and their repair.


Rise of earlobe repair procedures


Split earlobe repair is one of the commonest procedures carried out at Aesthetic Virtue in London's Harley Street. Split earlobe repair procedures start at £350.  As we pride ourselves in excellent patient care at every level, we make it a point to ensure the patient journey is as smooth, comprehensive and as enjoyable as possible. The follow-up appointment and ear re-piercing is therefore complimentary following the procedure.

Should you be concerned at all about you enlarged or split earlobes, please do give us a call on 0207 436 0460

Monday 21 October 2013

Ageing Hands

So we’ve lavished meticulous anti-ageing and beautifying attention to our faces, and have conquered the effects of ageing on most parts of the body. Our now fresh youthful looks keep even the most discerning guessing.  Those in pursuit of the perfect body can either work at it themselves, or be on the receiving end of the knife or needle.  However, while our stomachs are tucked, our breasts lifted, face and neck too, and saddlebags sucked out, we might unknowingly be giving away our age at the first glimpse of withered shrivelled hands.
Our skin-care routine is religiously adhered to and we have endless supplies of make-up to cover blemishes and enhance our features.  While we can achieve success in holding back the years on our faces, our hands often bare the truth of our age.  In fact all it takes to gauge a person’s true age is a cursory glance at the backs of someone’s hand (think Madonna – her hands are a dead give-away).
Daily wear and tear takes its toll on our hands as we expose them to environmental factors.  Our hands are constantly being used (if not abused) as we move through our daily lives. Thankfully with a little basic care and some expert help, we can avoid letting our hands give the game away!!
Ageing signs on the hands, typically include the formation of wrinkles, sun spots (very similar to those on the face), thinning skin, loss of volume and guttering (the appearance of longitudinal hollow  “gutter” running down the back of the hand starting in between the knuckles), enlarged veins and a bony appearance.
At least 80% of the ageing signs on hands can be attributed to UV exposure.  So, whip out the sun cream, and remember your hands need it as well as your face does.  Cumulative exposure to UVA and UVB accelerate the the breakdown in collagen and elastin – the essential proteins which render the skin elastic and young.  We stop producing elastin and collagen when we about 25 years old.  This starts to become apparent at the age of 28.  As the body’s stores become depleted, signs of ageing in the form of wrinkles and thinner papery skin begin to appear.  This process is accelerated by exposure to the sun’s harmful rays and other factors such as smoking and chronic dehydration.   As the skin loses volume, the hands can appear thinner and more boney with hollowing out between the londitudinal long bones.
Chronic sun exposure also predisposes to sunspots, blemishes of pigmentation, ageing spots and possibly to more sinister lesions such as skin cancers. While most pigmented spots are benign, any sudden change or suspicious features (irregular borders or pigmentation) should be promptly investigated.
Even with seemingly innocent activities such as washing our hands, wringing clothes or doing the dishes, the skin on our hands is exposed to a whole plethora of insults.  Constant hand washing and the use of various astringents in soaps and detergents leads to a leaching out of intrinsic moisturisers, normally present in the epidermis.  This is the skin’s outer ‘dead’ layer, which provides barrier protection against irritants and infection.  Dry and chapped hands never look good, so have a moisturizing hand cream (preferably with a decent sun protection factor too) at the ready, and when cleaning, a pair of rubber gloves can go a long way in preventing this premature ageing.
So what if the damage is done ie you’re looking at a pair of crinkly, furrowed and spotty hands? Despair not, help is at hand (pardon the pun!).
The skin on the hand is amenableto the same treatments used on the face.  Chemical peels (such as TCA, AHA, or the Obagi Radiance Peel) are instrumental in reducing uneven pigment and reducing fine lines and wrinkles.  Before undertaking any chemical peel, the skin must be primed with products to reduce the potential of adverse reactions and to ensure uniform results.  Many of these treatments involve prescription only medications in the form of ointments including hydroquinone and/or tretinoin as a preparation for the peel.  Chemical peels are very safe treatments, yielding beautiful results, both on face as well on the hands.
The thickness of skin can berestored by injecting hyaluronic acid directly into the dermis (the middle layer responsible for all the activity).  Hyaluronic acid is a naturally occurring substance found naturally in the skin which maintains moisture and volume.  Alas, as with collagen and elastin the skin’s sources of hylauronic acid become depleted as we grow older. The injected hyaluronic acid absorbs moisture and rehydrates the skin restoring volume.   Hyaluronic acid is capable of absorbing up to 1000 times its weight in water.  This treatment would need to be repeated every 6 to 9 months, as it is gradually re-absorbed by the body.  This procedure is a relatively painless one, and some bruising may occur.  This is temporary. 
Another dermal filler which canbe used similarly for longer lasting effects (up to 18 months) and is alsouseful in filling out the guttering appearance is calcium hydroxyl appatite.  Guttering occurs due to loss of fat in the subcutaneous tissues.  A recent trend pioneered by American plastic surgeons is the replacement of the patient’s own fat harvested from elsewhere in the body.
Veins tend to become more apparent with the loss of volume and the thinning of the skin.  Some centres offer ligation of the veins on the back of the hand to reduce this appearance.  Dermal fillers could reduce the appearance of these veins by restoring volume.
The above medical treatments should only be carried out by qualified and experienced medical professionals for optimal results.  While these treatments are extremely safe, there might be some contra-indications such as pregnancy, breast-feeding, blood-thinning medications and infection at the site to be treated.  As with any other medical or surgical intervention, no procedure is without its risks (however minimal) and it is imperative to be aware of the potential adverse effects, hence the importance of taking an educated decision and having the opportunity to ask questions when choosing to undergo any treatment
As always prevention is better than cure.  So slather on the hand cream, carry your SPF with you everywhere, handbag sized versions are very convenient, drink your daily 2 litres of fluid – no, alcohol does not count – stop smoking (nicotine stains are so unsightly), and use rubber gloves when going about your chores!

Visit our page if you want more information about treatments at

Tuesday 17 September 2013

FDA approval for Botox Cosmetic to improve the appearance of crows’ feet lines around the eyes

Botulinum toxin is used applied to many of the muscles of the face, either to improve the appearance of wrinkles or to reverse the effects aging has on the face.  While the general Medical Council and Professional Indemnity bodies fully approve of this use, for a long time, the only cosmetic application formally approved by the FDA (the American Food and Drug Administraiton) was limited to the area between the eyes, often referred to as frown lines, or the number 11, or the glabella in medical terms.

This approval has now been extended to the treatment of crows’ feet (or lateral canthal lines).  These are the lines seen radiating from the corners of the eye on smiling.  This is the second commonest area to be treated with Botulinum toxin A after the frown lines.  Other areas treated (but now approved by the FDA as yet) include horizontal brow lines, neck lines, smokers’ lines around the mouth, gummy smile, dimply “cobblestone chin” and drooping corners of the mouth.
In expert hands, Botulinum toxin A is an extremely safe drug which can be used discerningly to yield beautiful natural-looking results when treating the aging face.

If you would like to know more about Botulinum toxin A treatments, please visit our website.

Tuesday 13 August 2013

Skin Care

We don't normally associate the smell of sunscreen with London, but isn't it lovely to sniff the smell of summer right over here. And many of us didn't even need to seek out a beach to lap up some sunshine. Clearly, the Brits heed the sunscreen advice. However, many of us aspire to be bronzed beauties. There is no such thing as a healthy tan. It is a myth, and the predecessor to skin cancer. And we do get a sufficient dose of Vitamin D without having to revert to sun worshiping. Never be frugal with your sunscreen. A good rule of thumb is a teaspoon on the face, and a shot glass to the body. Recent studies show that the SPF factor plays a smaller part than originally thought. It is important to apply the protection in a relatively thick layer without rubbing it in too much, and replacing it every couple of hours or so. An SPF of 20 should suffice.

We all know about the sun and its deadly link to skin cancers. How many of us know that sun exposure is the lead cause of facial and skin ageing? Excessive exposure leads to patchy hyperpigmentation, ageing spots, and the acceleration of the development of lines and wrinkles. This is due to increased DNA and cellular damage.

But what if you already suffer from hyperpigmentation and fine lines and wrinkles? The good news is something can be done about it. At Aesthetic Virtue, a thorough consultation with the doctor will highlight the cause of the problem and a management plan will be decided together to treat the problem and prevent its return. Generally such treatments consist of a series of face creams and chemical peels. At aesthetic Virtue, we employ the use of the current gold standard, the Obagi Nu-Derm system. This treatment regime provides long lasting results while improving hyper pigmentation, age spots and replenishing the skin's healthy glow, appearance and condition. As the skin is a very dynamic organ responding to both internal (hormonal and other) stimuli as well as its external environment, treatment needs to be maintained over a few months. Improvement general starts within about 2 weeks, and at 6 weeks results are already apparent.

For those wanting quicker results, or an instant glow, the Obagi Radiance peel is a brilliant alternative. It can also be used as an event peel, to give your skin that beautiful glowing appearance. It is best done one or two days before the event.