The US Food and Drug Administration has given the green light to two devices designed for the noninvasive tightening of the skin, One utilises radiofrequency technology while the other relies on ultrasound technology. Both devices produce heat, although by different methods. The heat produced by the devices elicits a micro-inflammatory stimulation of fibroblasts, which stimulates the production of new collagen in the deep layers of the skin, thus causing a compensatory tightening that can last a year or more.

The devices, which are known as Thermage and Ulthera, are used to tighten mild to moderate skin looseness.

And thanks to ongoing refinements with radiofrequency and ultrasound-based contouring modalities, these devices have become more versatile and patient-friendly since they were first introduced.

In the ultrasound category, Ulthera is the only device that can deliver energy below the surface of the skin to a depth of 4.5 millimeters, targeting the foundational superficial musculoaponeurotic system (SMAS) layer, which is what plastic surgeons tighten in a traditional facelift.

At that depth, some patients reported feeling discomfort. To ensure the most comfortable patient experience, a recent updated software system now affords a more comfortable procedure.

Treatment with high density demonstrates a safe and effective result with a high rate of patient comfort and satisfaction.

The radiofrequency skin tightening procedure Thermage is monopolar.

The advantage of monopolar radiofrequency is that it provides bulk heating so it penetrates deeper than bipolar radiofrequency, and is able to reach the deep skin layer and impact a larger area.

The latest advances in the monopolar radiofrequency device include the addition of comfort pulse technology to the facial-treatment tip, which is designed to send energy deeper and also makes it more effective.

Both radiofrequency and ultrasound devices have been used successfully in properly trained and skilled practitioners’ hands.

Those who are thinking about a skin-tightening procedure should absorb the above information and choose a skilled physician who is able to put his or her experience to use in truly improving the contour of the patient’s face, with long-lasting results.

THANISORN THAMLIKITKUL MD| is a member of the American Society of Cosmetic Dermatology and Aesthetic Surgery and |certified in dermatological laser surgery. Send your questions |for her to info@romrawin.com

Necks don’t lie. If there’s anything that shows the creeping effects of age, it’s the saggy skin on your neck. This delicate area develops wrinkles quite fast, yet has been one of the most neglected spot on the body.

But there are steps you can take to minimise the damage.

When it comes to neck lines and mild skin laxity, Botulinum Toxin can make an ageing neck look more youthful. The procedure that diminishes the neck lines and tightens the jowls is called “the Nefertiti Lift”, aptly named after the Egyptian queen famous for her very defined jawline and long neck.

The Nefertiti Lift technique involves multiple tiny injections of Botulinum Toxin into the neck and jaw to relax the platysmamuscles enveloping the area, and relieve that downward pull. This results in softening the horizontal wrinkle lines and lifting the jawline, allowing for a younger-looking neck and chin.

If your problem is loose skin and there is not much fat in that area, Ultherapy, an ultrasound-based technology will probably be the answer. It’s the only technology with US Food and Drug Administration- approval for neck and under-chin lifting.

The technology uses micro-focused ultrasound energy to stimulate collagen production both in the dermal and SMAS layers without injuring the outer skin. The SMAS is a fibrous network connecting the facial muscles with the dermis. It also consists of collagen and elastic fibres. Prior to the introduction of the micro-focused ultrasound technology, only plastic surgeons could reach such a depth. With this non-invasive treatment, a dermatologist can deliver energy to a precise depth and layer of the skin resulting in the building of new collagen and the firming up of a supporting structure of the neck skin.

Lastly, if there is a collection of fat under the chin, then you may be a candidate for a cryolipolysistechnology. The procedure involves selective fat freezing, causing fat cells to die. With the new applicator design, the technology offers the dermatologist a new treatment for a difficult-to-treat area like the under chin. The device pulls the fat bulge into the applicator where cold plates reduce the temperature of the fat to its freezing point. Fat cells die and are eliminated by the body’s natural mechanism. During the clinical trial, patients saw results at three weeks but the best result were observed after one to three months.

THANISORN THAMLIKITKUL MD is a member of the American Society of Cosmetic Dermatology and Aesthetic Surgery and certified in dermatological laser surgery. Send your questions for her to info@romrawin.com.

Next to the face, the hands are the most continuously exposed areas of the body. They also show signs of ageing through wrinkles, dorsal volume loss, clearly visible veins and bones. So why not give your hands more attention and keep everyone guessing how old you really are?

Autologous fat transfer, a technique in which fat is harvested – by liposuction – from the abdomen, buttocks or thighs and then reinjected elsewhere in the body, was first used for hand rejuvenation more than a decade ago. However the fat is very bulky and lumpy and the procedure can cause bruising and swelling.

Fortunately, women now have a new option for younger-looking hands.

Dermatologists have turned to biodegradable fillers to restore ageing hands. Hyaluronic acid or calcium hydroxylapatite fillers are the most common materials used for this relatively easy procedure with basically no downtime.

Intradermal injection of native hyaluronic acid (HA) increases dermal thickness and elasticity while cross-linked Hyaluronic acid, which does not degrade as quickly as native hyaluronic acid, has been shown to enhance the production of collagen in vivo and can be injected as a volume replacement. The duration of the effect has been reported to last six to 12 months.

The calcium hydroxylapatite (CaHA)-based filler, which is characterised by its high viscosity and elasticity, can provide immediate volume replenishment and will last for a year or two. Various studies of the calcium hydroxylapatite with an observation period of up to one year for augmentation of the hands have confirmed the high efficiency and safety of the material. The efficacy and tolerability of this filler has been investigated in clinical studies in more than 3,000 patients.

The newest filler on the market is even packed with lidocaine. The benefit to this is that it makes the procedure less painful and it doesn’t even require multiple injections – one to numb the area and the other to apply the filler.

Overall, volume replacement with dermal fillers is sufficient for masking boniness, patent tendons and blood vessels as well.

Dark spots, which are believed to result from a genetic predisposition and chronic sun exposure, can be improved with laser technology. When the skin is exposed to the laser, the melanin absorbs the energy, causing the melanocytes to disintegrate. It may take a number of sessions to fully remove the dark spots.

Happily, you no longer have to stare at your hands and feel depressed. The variety of non-surgical techniques now available can go a long way to rejuvenating your hands in just a matter of minutes.

THANISORN THAMLIKITKUL MD is a member of the American Society of Cosmetic Dermatology and Aesthetic Surgery and certified in dermatological laser surgery. Send your questions for her to info@romrawin.com.

BLAME it on the idea of transformation or simply witness the success of the Korean reality show “Let Me In” and other programmes of that ilk. Today, more and more Asian women aspire to a lean and curvy body shape. It is said a slender waist and slim body convey a sense of femininity and sexiness.

But can you really get a smaller waist, tighter tummy, thinner thighs and sculpted arms especially in middle age? It is no secret that as you age your body changes and excess fat seems to park itself all over your body. Besides eating the right foods and exercising regularly, many women are opting for medical procedures to sculpt a sexy shape.

The gold standard for fixing bothersome excess fat is liposuction, which is an invasive procedure. The post-procedure pain, bruising, numbness and swelling can last up to several weeks. However, surgical liposuction isn’t the only way to get slender arms and abs. And there are more high-tech fat fixers without surgery on the horizon. According to the 2015 American Society for Dermatologic Surgery’s annual meeting, the most promising procedure is fat-freezing. Also known as cryolipolysis, this procedure was first approved by the US FDA in 2010, and has now evolved with multiple adaptors and multiple indications for non-invasive fat reduction.

Dermatologists now can treat the flanks, the abdomen, the thighs, the upper arms, bra fat and most recently, the fat under the chin.

Unlike ultrasound and heat-based fat reducing procedures, which explode or melt the fat cells, the cryolipolysis procedure works by freezing them, causing them to die. As fat cells die, they collapse and a natural inflammatory process removes the dead cells through the lymphatic system. This has fewer side effects, less bruising and soreness, and it seems very effective. It can reduce fatty tissue by about 25 per cent after a series of treatments and there’s also retraction of the skin. Results are visible within three weeks though in more drastic cases can take two months.

In the never-ending quest for flatter tummies and thinner thighs, a non-invasive procedure like cryolipolysis with little discomfort, and requiring no post-treatment downtime has definitely revolutionised the idea of body transformation.

Today dermatologists can treat significant areas of fat in a non-invasive fashion and that has to be good news for figure-conscious ladies.

THANISORN THAMLIKITKUL MD is a |member of the American Society of Cosmetic Dermatology and Aesthetic Surgery and certified in dermatological laser surgery. Send your |questions for her to info@romrawin.com

Like a peacock’s brilliant feathers, the hair on the head is so much more than just protection for the scalp. The discovery of thinning hair is thus a stressful experience for both sexes and all ages. There are a few treatment options available when hair loss first starts, and both medication and laser treatment can be quite successful in the early stages. However, many people wait too long before realising or admitting their hair loss is getting worse. And while relocating healthy follicles to barren patches can solve the problem, hair transplant procedures are invasive, expensive and new hair takes time to become visible.

Continuing research into improved hair restoration techniques has helped considerably in the long-fought battle against hair loss or hair thinning and today the implant of biocompatible fibres is a plausible alternative or complementary treatment for patients.

Artificial hair implants first began in the 1970s as a quick solution for the coverage of the baldness but slowed as a result of scepticism among physicians due to the lack of clinical trial at that time. That has now changed. A study published in the Journal of Biological Regulators & Homeostatic Agents in 2015 reported the efficacy and safety of hair fibre implants through the three-year follow up of 133 patients. The study concluded that the biocompatible fibre hair implant procedure had been demonstrated to be safe and well tolerated by patients. The procedure involves using a special device to hook the reversible knots at the end of the biofibre hair and insert the strands manually one by one into the scalp, which has been numbed with a local anaesthetic, under aseptic technique until the desired hair density is obtained. The procedure doesn’t require downtime; patients can walk out of the clinic with a much fuller head of hair.

The procedure is considered safe for patients because it uses a synthetic material that’s completely biocompatible, which means it is highly unlikely to be rejected by the body. This biocompatible material has received CE certification in Europe and is also approved for medical use.

The biocompatible fibre hair implant is suitable for patients with a healthy scalp but a poor donor area. It is also ideal for patients who need an immediate result. It can be used to increase volume of a patient’s hair following a hair transplant procedure as well. A consultation with a dermatologist will help identify if the procedure suits you or not.

THANISORN THAMLIKITKUL MD| is a member of the American Society of Cosmetic Dermatology and Aesthetic Surgery and |certified in dermatological laser surgery. Send your questions |for her to info@romrawin.com

Some elements of beauty appear to be universal. Large eyes with double eyelids, for instance, are considered a mark of youthfulness and femininity. Unfortunately, women lose skin elasticity as they grow older and excess skin develops leading to droopy eyelids. These droopy eyelids make the eyes appear smaller and the natural crease of the lid becomes less defined.

And that little crease makes a huge difference! Most Asian women believe that the double eyelid gives the eye a more beautiful appearance and use a thin strip of tape or sticker to enhance their double eyelids and give the eyes an open look.

However, there will come a time when the trick looks unnatural or no longer works at all.

What do you then?

The drooping eyelid can be fixed with surgery known as blepharoplasty. For some women, the surgery is extreme. They want a procedure with less downtime and less of a dramatic result.

In response to this demand, Professor Giorgio Fippi, president of the Italian Society for Aesthetic Medicine, has developed an innovative device that uses plasma. This plasma treatment is the latest technology in blepharoplasty and non-invasive double eyelid surgery.

The device, which has received CE approval, works through the non-ablative process of sublimation. Plasma is formed through the ionisation of atmospheric gas, which works to coagulate the surface of the skin causing tightening of skin fibre and new collagen production. This results in the reduction of the excess skin on the upper eyelid and the improvement in the eye appearance. |The procedure usually takes approximately 30 minutes, depending on the area being treated and the severity of each case. Once treated, the skin will develop a crust-like protective layer, which will fall off within five to seven days post procedure. The new skin will be smooth, firm, pinkish and develop to match the natural skin colour within a month.

For double eyelid correction, three to four sessions may be required, and these are performed at intervals of six to eight weeks. Studies into the efficacy of plasma technology for enhancing double eyelid have been conducted with positive results.

Surgical blepharoplasty is still the “gold standard” for people seeking dramatic and impressive results but plasma technology is a good non-surgical option for |others who want a gradual, |scar-less correction without the risks of surgery.

THANISORN THAMLIKITKUL MD| is a member of the American Society of Cosmetic Dermatology and Aesthetic Surgery and |certified in dermatological laser surgery. Send your questions |for her to info@romrawin.com

Another long weekend is looming for the Coronation Day holiday, which runs from May 5 through Monday, May 9, Ploughing Day, though the latter is not an official bank holiday. For those of us who can also take May 6 as leave, it’s worth heading out of town for the sea, sand and sun. Spending a day of fun in the sun with friends or family is a perfect getaway for a long weekend. But unless you opt for adequate protection, your skin is at great risk of discoloration and premature ageing. Here are four easy tips to help prevent sun damage and also get your skin back on track.

l Choose the right protection

Wearing sunscreen is essential for your skin care and sun protection. You should use one with SPF 15 or greater. Make sure your sunscreen is water-resistant, preferably very water-resistant. Apply it generously and evenly to protect your face and body. I suggest putting a layer of sunscreen on your skin, waiting for five minutes, then applying a second layer all over again to get maximum protection. This should be done about 20 minutes before sun exposure in order to allow the sunscreen to absorb into the skin. And don’t forget to reapply it every two to four hours or after swimming.

l Add extra protection

Besides wearing sunscreen, sunglasses and a hat with at least a three-inch brim can also help cover your face and prevent sun damage.

l Be wise about time

Many of you already know that the hours between 10am and 4pm are the most hazardous for UV exposure. So choose to swim or take part in outdoor activity in the early morning or late in the afternoon and limit the time you spend in the midday sun when the UV rays are strongest and most capable of causing burns and damage.

l Search for shade

Sun damage is cumulative, so every minute spent out of dangerous rays will help your skin stay young looking and healthy. Try to enjoy the outdoors from underneath a tree or umbrella if possible.

Summer is as usual flying by. So let’s make the most of it while staying safe in the sun.

THANISORN THAMLIKITKUL MD| is a member of the American Society of Cosmetic Dermatology and Aesthetic Surgery and |certified in dermatological laser surgery. Send your questions |for her to info@romrawin.com

With summer approaching, most of us will be reaching for a chilled soft drink and a scoop of ice cream to cool us down. But before you reach for that cold bottle or ice cream, you might want to consider how these treats are affecting your face. And that’s not a sweet story: recent research has shown that a sugar-rich diet is to blame for early signs of ageing.

When you eat a high-sugar diet, the food rapidly converts to sugar in the bloodstream. The sugar molecules attach to proteins to form harmful new molecules called advanced glycation end products or AGEs for short.

This process creates inflammation, which can activate your immune system and lead to accelerated ageing of the body.

Accumulation of AGEs damages the proteins in a domino effect. The proteins most vulnerable to damage are the same ones responsible for a youthful complexion – namely collagen.

Sugar breaks down collagen and creates crosslinks that turn collagen from an elastic, soft and supple substance into a rigid and brittle one, leading to wrinkles and sagging. These ageing effects start at about age 35 and increase rapidly after that, according to a study published in the British Journal of Dermatology.

Another study by Leiden University Medical Centre in the Netherlands in collaboration with Unilever in the UK confirms that consuming a diet high in sugar over a period of time wreaks havoc on skin and is terrible for your face. The scientists measured blood sugar levels of 600 men and women aged between 50 and 70. Photographs of these people were presented to a board of 60 independent evaluators. What these evaluators perceived in this study was that those with higher blood sugar levels looked older than those with lower levels.

Experts now believe that a lifetime of eating too much sugar can age you faster than you might be genetically programmed to age.

So is it time for everyone to accept a life of sugar abstinence?

Not yet, because sugar is an essential fuel for cells and energy metabolism, critical to survival. However sugar is in virtually every meal we consume, so cutting out additional sugar entirely such as in cakes, soft drinks, ice cream and dessert would be wise. Or try to limit your total sugar consumption to 25 grams or less (4-6 teaspoons) per day.

The bottom line is if you truly want to maintain a youthful appearance, it is essential to reduce your sugar intake. Beauty and health come from the inside out. You are what you eat and drink, it really is that simple!

THANISORN THAMLIKITKUL MD |is a member of the American Society of Cosmetic Dermatology and |Aesthetic Surgery and certified in dermatological laser surgery. |Send your questions |for her to info@romrawin.com

When it comes to looking youthful, skin that is |even-toned, radiant and free of spots, blemishes and discoloration is more important than battling |lines and wrinkles, the experts say. A brighter and glowing complexion, they |tell us, is perceived as more youthful and attractive.

Their findings are based on a 2010 study in which images of middle-aged women were photoshopped into two sets: one set showing women with extremely uneven skin tones or hyperpigmentation and the other with women boasting an abundance of deep wrinkles. Both sets were shown to a group of people who were asked to rate the attractiveness and youthfulness of the women’s faces. The result was unanimous: the women with uneven skintone were less attractive and much older than their wrinkled compatriots.

What we can take away from this is that our brown spots age us more than wrinkles. These spots are signs of sun damage. Though usually harmless, they can make us look older than we really are.

However, thanks to advances in technology, getting rid of brown spots and obtaining brighter, fresher, spot-free skin is easier than ever before. Today, a treatment programme combining gentle exfoliation, non-invasive laser technology and the delivery of nutrients produces significant improvement in getting rid of brown spots and discoloration with minimal risk and no downtime.

The combination procedure appears to work because the gentle exfoliation removes dead skin cells, speeds epidermal cell turnover and reveals the new, lighter skin beneath.

The non-invasive laser light is absorbed by melanin causing the pigment to break up into particles which are small enough for the body’s own immune system to remove, helping to reduce pigmentation without collateral damage.

The procedure is finished with nutrient cocktails made of vitamins, antioxidant, amino acid, nucleic acid and hyaluronic acid delivered into the facial skin. Nutrients such as Vitamin C, E and antioxidants penetrate the skin to battle free radicals caused by sun damage while the hyaluronic acid rehydrates the skin for a brighter and fresher complexion, and can help protect skin cells against UV rays.

This triple combination procedure has proved to be promising. After the treatment, patients commonly described their skin as radiant and glowing.

Skin lightening treatment is one of the most sought- after procedures today. And the emergence of this new alternative creates more |options for women desperate |to have a brighter skin and a younger-looking face.

THANISORN THAMLIKITKUL MD is a member of the American Society of Cosmetic Dermatology and Aesthetic Surgery and certified in dermatological laser surgery. Send your questions |for her to info@romrawin.com

A universal sign of youth is a tight jawline and upper neck. Fair or not, our subconscious mind sees both men and women with a tight , defined jawline and upper neck as younger, thinner, healthier and more attractive.

Unfortunately, as we age, jowls appear and the jawline tends to merge with the neck. These often show up on profile pictures and cause us to cringe. According to a recent newspaper report , the five worst signs of ageing that worry Hong Kong women the most are a sagging jawline , double chin , turkey neck , cheek wrinkles and volume loss in cheeks. I would wager than Thai ladies are not very different in their concerns.

So is it possible to firm up the jawline and make it the way it used to be and, if so, can this be done without surgery?

Fortunately , today’s bag of tricks can mitigate this ageing sign more effectively than ever before.

Non-ablative skin tightening programmes such as Thermage , Ulthera and Duo Lift are used to correct the “triangle of youth”, a term used to describe the widest part of the face. In our younger years , the triangle of youth places its lengthiest points at the cheek bones and temples but eventually inverts to the ” pyramid of age ” as gravity causes sagging and widening of the jawline and jowls.

The primary goal of these revolutionary skin-tightening technologies is to cause contraction and regeneration of collagen to decrease some of the skin laxity and enhance the neck and jawline, without surgery.

We all know that collagen is an essential connective protein that gives skin the youthful qualities of structure and elasticity. Thermage, Ulthera and Duo Lift programmes work by emitting and delivering energy into the underlying tissue, creating collagen contraction and stimulating collagen production as well. |The procedures require little to no downtime. For three to six months following treatment, collagen formation will tighten and lift the skin for a more youthful contour. The results from these skin-tightening programmes tend to look natural and last about a year.

So while we may fear and shun all the indicators of ageing, it is never too late to regain our youth. And with the promise of further developments in cosmetic care technology ahead, we may one day be able to banish the ravaging signs of age forever.

THANISORN THAMLIKITKUL MD| is a member of the American Society of Cosmetic Dermatology and Aesthetic Surgery and |certified in dermatological laser surgery. Send your questions |for her to info@romrawin.com