Knowing When To Stop

At one facial aesthetics course I attended, the instructor said something interesting: “Patients won’t notice/remember what you’ve done. They only notice what you have not done.”

It didn’t seem very believable to me back then, but it turned out to be so true. The good thing about fixing teeth is that when one tooth is fixed, anything that is not fixed would be another tooth. For the face, it can be trickier. After you thought you have evened out patient’s wrinkle, she comes to you a week later and complains that the effect is gone. Of course it isn’t. What happened is that the patient forgets about what she looked like before the treatment and when she keeps looking at her face after the treatment and getting used to the new normal, she only sees what else needs to be done. The wrinkle is still visible. Can inject a bit more? What about my eyes? What about my cheek? A bit more for the cheek. I never knew I had such a small chin …

This mentality is not unique to women. While self-injecting on my own face, I was struck by the same thoughts and that’s when I began to understand these patients better. The treatment is “addictive”. For me, there is no “labour cost” when I self-inject fillers. I only need to pay for the filler and I can inject as much into my face as I wish. I can imagine that if I had no training or self control, I would almost definitely have ended up overdoing it.

It’s impossible for 1cc of filler to cause this. I believe it’s a case of DIY lip filler injection. While it’s easy to cringe and say WTF, the person who is doing it on herself really had no idea that she had gone from augmentation to deformation. I believe that fillers are readily available OTC in some countries. No wonder there are so many disasters out there.


Dental & Facial Aesthetics By Dr Chan Joon Yee @ Kent Ridge

What Happened To That Lump?

Tear Trough Injection

Depending on the depth of the filler injection, the deposit is usually palpable. It tells you the filler is there and it feels like a firm lump. Then, a few days later, the lump gradually softens until it disappears. Has the filler disintegrated? Well, before treatment pictures do not always tell you the answers. If the part that was filled is under the eyes, you can do a spectacle test. For instance, if you have a hollow under your eyes before treatment, you may feel that your cheeks can touch the lower rim of your glasses after the injection. You’ll feel that the cheeks will still touch the lower rim of your glasses after the “lump” is “gone”.

Well, it’s actually not gone. Hyaluronic acid (HA) fillers are actually hygroscopic. This means that they absorb water from your tissues. Like sponges, HA filler deposits will absorb water from your body. Like sponges, they will not swell much, but they will soften and give you the impression that it’s not there anymore.


Dental & Facial Aesthetics By Dr Chan Joon Yee @ Kent Ridge

Lotus Buds

The lotus bud is used as an offering, a representation of purity.


Dental & Facial Aesthetics By Dr Chan Joon Yee @ Kent Ridge

Ice Packs For Post Operative Care

icepack

Ice packs are very good for reducing swelling after surgery. You don’t need to go to a pharmacy to for that. Just visit your local supermarket.


Dental & Facial Aesthetics By Dr Chan Joon Yee @ Kent Ridge

Oldies & Goodies

shutterstock_67945105

Alamak Patient: “我以前的假牙很好的。戴了什么都能吃。你现在做的就没那么好了。”

Alamal dentist: “Auntie, 你以前拍的照片也比现在拍的好看呀。是不是因为新相机没旧相机好?”

bookcover


Dental & Facial Aesthetics By Dr Chan Joon Yee @ Kent Ridge

Stepping On Mines

bookcover

One of my filler suppliers A kept asking me to come out of retirement and set up my own practice so that I can market myself and do as many facial aesthetic cases as I can. However, I’m well aware that the potential for problems in facial aesthetics cannot be underestimated. As a semi-retired dentist, I think I should treat facial aesthetics as a “special interest” and not as a primary focus. An interesting encounter this afternoon convinced me of that.

Technically, I’m still on holiday. I’m not bored, but when my supplier P called me up and said that he had a couple of aesthetic cases to refer to me, I decided that I could do with a bit of “exercise”. So I popped down to Ang Mo Kio and thought I could use up some of my stock of cross-linked filler and make somebody very happy.

Two aunties and a little boy were waiting for me in the waiting area. The boy was obviously not a patient and one of the aunties backed out when the word “bruising” was mentioned. The other auntie appeared keen. In fact, she was so keen that she started doubting my credentials. Of course, showing her my annual practising certificate was not too unreasonable a demand, but she went on to ask about the courses I attended, where I practised and even wanted to see my “syringes” and equipment. This made me wonder what sort of objections she would raise after seeing my consent form.

Anyway, she probed further to ask me where I was practising, why I didn’t have my own clinic and even doubted I was telling the truth as I looked too young to be semi-retired. Well, I have to say that I’m not averse to discussing my personal life and choices, but it’s important that it comes out as part of a friendly chat and not an interrogation. But what’s most disturbing, was the fact that she wanted the bridge of her nose raised. On observing her nose, I concluded that it did not need any fillers. Too much will make it too unnatural. I suggested that she should instead, do her tear troughs. As you may be able to infer from what I told you about her so far, she curtly rejected my advice and insisted that she needed a nose job.

Stock photo

Stock photo

I could have just told the auntie off and/or walked off, but I didn’t want to embarrass P. So I shook my head to indicate to him that this was a confirmed FON case. I was keen on doing something exciting and satisfying on my day off, but I wasn’t prepared to accept any Alamak patients. I would rather waste the afternoon than to waste Buddha knows how much time managing auntie’s complaints.

Fortunately, the two aunties said they wanted to be given 10 minutes and decide. They went outside and just as I expected (and thankfully) they didn’t come back in. I’m quite cool about it. I just hope they don’t think that we’re desperate and disappointed. Maybe I’, a bit annoyed with all that “interrogation”, but I’m actually quite relieved that I didn’t end up stepping on a mine.


Dental & Facial Aesthetics By Dr Chan Joon Yee @ Kent Ridge

How Much Chin?

Beauty is not necessarily subjective, but the there are really no fixed measurements that will fit anybody’s definition of beauty. Take a look at this young lady. Her name is Aries and she’s from Hongkong.

Overall, she has a very pleasing look, but do you find her chin a bit too long? Maybe, but so what? As long as she looks good with it, there ought to be no issue at all.

If the overall look is quite pleasing, then don’t go for any major changes.


Dental & Facial Aesthetics By Dr Chan Joon Yee @ Kent Ridge

Skin Deep, Impermanent, So What?

People who go for plastic surgery and other aesthetic procedures are often judged or criticised as “vain” and “superficial”. But then, who doesn’t want to look good? Why bother to dress well and decorate your home if appearances are not important at all? More interestingly, what is permanent? So what if the things you pursue are impermanent? We are not permanent. What’s wrong with being happy and pretty before we depart?


Dental & Facial Aesthetics By Dr Chan Joon Yee @ Kent Ridge

Li Ying Zhi

Frankly, I had no idea who she is until pictures of an apparent botched “plastic surgery” made the news. What happened to Li Ying Zhi’s face? DIY filler injections?


Dental & Facial Aesthetics By Dr Chan Joon Yee @ Kent Ridge

No Pain No Gain

Some people have thin lips and fillers can be injected into the lip to give it a fuller appearance. The lip is probably the most painful part of the face to inject fillers. But then, lips can be numbed without injecting directly into the lips. Dentists know how to do it.


Dental & Facial Aesthetics By Dr Chan Joon Yee @ Kent Ridge

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