Author: Dr Ash Dutta

Facelifts naturally suggest a surgical procedure but the liquid facelift is a completely non-surgical procedure. It is done with Sculptra which is poly-L-lactic acid and sometimes we may add filler. The liquid facelift has been done with diluting the poly-lactic acid with saline and local anaesthetic and injecting into small amounts into the surrounding areas of the cheeks chin to give a full volumizing effect. It takes about 2-3 sessions delivered every 4-6 weeks apart to give the desired effect which usually lasts between 18 & 24 months. And for some structural improvement of the face for example a very defined cheek or the jaw line we can add Radiesse. The treatments are called bio-stimulators meaning they don’t just give the volumizing effects but also excite the surrounding cells to produce collagen to help the effect last longer. Each of these treatments has various benefits and side effects and the patient needs to be counselled about them. We also need to take good before and after pictures to help the patient see the change that is happening in their face over the next 3-6 months. It is very slow but it does give the patient much fresher looks over the next few months.

Endovenous Laser Ablation (ELA) is a technique which has been developed for the treatment of unsightly Varicose Veins from within, and without resorting to surgery to remove any unsightly veins. The veins are heated locally by laser, with the heat killing the cell walls and allowing the body to absorb the dead tissue naturally. The laser treatment has several brand names such as EVLT, Veinseal and ELVes, but they all do the same job; with the good news being that almost all patients with Varicose Veins are suitable candidates for EVLA treatment with a very small percentage who have experienced recurrent veins after surgery being managed by ´Foam Sclerotherapy Treatment.´

The Procedure

Using Ultrasound equipment, a scan is performed on the area and the veins suitable for treatment are very accurately targeted and marked with a pen. In a horizontal position with the patient laying either front or back, the leg is cleaned and covered while a local anaesthetic is injected into the skin above the vein; then using a Catheter, a laser-fibre is inserted into the vein – usually up to the groin area, while more local anaesthetic is injected to minimise any discomfort.

All parties present are required to wear laser safety spectacles as a precaution while the treatment commences. The laser treatment into each vein takes around 5 minutes, with an average treatment time of 20 minutes per leg. During this time, it´s quite normal for the patient to experience some burning sensations; but the treatment will be painless thanks to the infusion of the local anaesthetic. The laser and catheter are then removed and the tiny needle puncture wound is covered with a sterile dressing. The leg is then fitted with a compression stocking to fully protect it.

Post-Operative Awareness

After a short period of recovery to check all is well, the patient will be allowed home. Like any other surgery, it is preferable that you have a friend or relative to escort you home and you are advised not to drive and keep undue pressure off the area. The compression stocking will be necessary for around two weeks and you must follow advice on how to bathe and you must not swim or get the legs wet during this recovery period. It is normal for the patient to feel a tightening sensation along the line of the treated vein and possibly some associated pain – but this can be treated with anti-inflammatory drugs as prescribed.

The treatment is not designed as a ‘catch all´ solution for Varicose Veins, but purely to reduce the severity of their appearance. Further treatments in the form of Foam Sclerotherapy or avulsions to remove the dead vein tissue may well be required at a later date. Avulsions are done after a local anaesthetic is

injected around the vein with small incisions being made over the veins, before removing them surgically. These small incisions do heal with minimal scarring and with any post-operative problems being rare. However, it’s wise to discuss at length your pre or post-operative concerns with your aesthetic professional who will be happy to alleviate any fears that you may have.

Whether you’re for or against invasive aesthetic transformations, it’s a booming industry with new technologies which are advancing treatments all the time. 2019 looks set to see the demand for cosmetic surgery procedures further increase, with a trend for truly ´natural-looking´ results. According to the some of the leading cosmetic surgery groups and influential cosmetic surgeons, these are some of the trends that you should expect to see in the national trade press, this year.

1. ‘Impact Treatment’

Whereas before, to change a face significantly – you’d have to perform plastic surgery. But now, with a needle, a cannula and 3D imaging, you can do it all in the space of the doctor’s clinic.

Using 3D imaging and augmented reality, clients now get a chance to see what their face will look like post-treatment, before they’ve even gone near a needle. Defined as ´impact treatment ‘by Dr Esho ¨the new treatment works on the entire face and can transform round faces into defined, sharp silhouettes.¨ The big game changer is that instead of using surgery to make the changes (circa 2018), the results are all achieved via bespoke fillers.

2. Better Botox

The still the number one requested non-invasive treatment, but in 2019 the Botox market is going to be ´blown apart´ thanks to a new B-type 2 toxin. With this, you’ll need less of the toxin and the results last longer, which is good for practitioners as it means you save more in terms of dosage, and for the good of their patients as the longevity means less treatments. Due for release imminently, so watch this space.

3. The ‘Secret Facelift’

Davood Fallahdar, a consultant plastic and reconstructive surgeon at The Private Clinic of Harley Street explains that the ‘temporal facelift’, also known as the ‘mini’ or ‘secret facelift’, “will become one of the most popular cosmetic surgery procedures in 2019”. Apparently this demand has been increasing in recent years, with many patients opting for it over a full facelift due to the natural and fresher look it offers.

“Unlike a full facelift, the treatment is carried out under local Anaesthetic. This means that patients can return to work the next day and don’t have to suffer the abundance of unsightly bruising, swelling and bandages as seen with full facelifts, as the scar is hidden on the scalp, within the hair and not on the face.”

4. Non-Surgical ‘Jobs’

Dr Hao Hanson Yu, aesthetic doctor at The Private Clinic of Harley Street confirms that the era of dramatic cosmetic surgery procedures has truly passed, “with patients looking for not just a subtler look and an alternative to invasive forms of cosmetic surgery”. Cue fewer over-filled lips and a further rise in ‘tweakments’.

“Perhaps one of the most popular of these treatments will be the non-surgical nose job. This is a form of nose reshaping that uses dermal filler as an effective alternative to surgical Rhinoplasty. The fillers are used to subtly enhance the contours of the patient’s nose and at the same time reshaping to provide more definition. Most patients experience little swelling and can go back to work immediately.”

5. Minimally-Invasive Bunion Treatment

We can thank the ´Meghan-effect´ for this one; given the speculation around the Duchess of Sussex’s bunion treatment this year – but luckily, it’s also driven by major advancements in the treatment for the condition. Mr Andrea Bianchi, orthopaedic surgeon explains that, “a pioneering, minimally-invasive keyhole surgery is now available that requires only a local anaesthetic and removes a bunion quickly without the use of screws or plates. Unlike any other bunion surgery available in the UK, patients can walk without crutches immediately after the procedure and are able to return to everyday activities almost straight away.” He’s therefore expecting to see “a huge surge in the number of women seeking treatment for their bunions”.

6. Same-Day Varicose Vein Removal

A survey of 1000 UK men and women (conducted via OnePoll) found that over two thirds of Brits admit to feeling self-conscious wearing certain clothes because of their varicose veins and spider veins. Dr Dynesh Rittoo, vascular surgeon hypothesised; “I think this is down to the ever-increasing role of social media with everyone wanting to look as good as their favourite celebrity or influencer.”

The response? “I now treat varicose veins with a minimally-invasive method called Endovenous Laser Ablation (EVLA) which can be delivered under local Anaesthetic which enables the patient to leave the clinic on the same day as their treatment.”

Dr Ashish Dutta – The Top Autumn Trends For Male Cosmetic Surgery Part II

Continuing on from our first part of our special feature, esteemed Harley Street Cosmetic Surgeon Dr Ashish Dutta continues to take a candid look at the developing world of male cosmetic surgery alongside the trends and treatments that we should expect to see in the coming Autumnal months.

Hair Transplant

It´s not just celebrities who consider having a hair transplant with 40% of under 35’s starting to suffer from hair loss.

¨ Both men and women are having hair transplant and often for different reasons. Male pattern baldness is the traditional or standard presentation and 80-90% of my patients are from that category. Now that beard, eyebrows, pubic hair and even eyelashes can be restored, we are seeing a completely different set of patients. The techniques are much more refined than what we did 5 years ago and the improved success rate is attracting celebrities like Sir Elton John, Callum Best, Matthew McConaughey and of course, Wayne Rooney.¨ – Dr Ashish Dutta.

Some men are psychologically adept at handling the onset of baldness but for those that need the reassurance of fuller locks a hair transplant can achieve a new level of confidence. Footballer Wayne Rooney underwent the Follicular Unit Extraction or FUE; it’s a much less invasive technique and involves removing individual hairs from the back or side of the head or chest and implanting them into the scalp where hair once grew.

The procedure is carried out under local anaesthetic, takes around 8 hours and costs about £10,000 leaving no scars or stitches. Its results can vary however and more than one FUE procedure may be required every few years or so to keep your head ‘topped up’ and may not fully correct the problem especially if you are prone to thinning hair.

Liposuction is no longer in the realm of the Hollywood ‘A’ listers and has been a reliable form of removing excess fat from the body for several decades now. It can increase confidence and self-esteem and is a safe way to improve definition and tone to your body.

¨ Liposuction or Body contouring can be achieved with various technologies e.g., Vaser (ultra-sound assisted liposuction), BodyTite (radio-frequency assisted liposuction), Smartlipo or Laser lipolysis (laser assisted liposuction), Euromi or Vibrolipo (vibration assisted liposuction), etc. Most of the procedures can be conducted under local anaesthesia as a day case procedure. With the vaser, we can also deliver high definition (Hi-Def) liposuction where the muscular definition is highlighted to create an athletic look.¨ – Dr Ashish Dutta.

In spite of our best efforts sometimes diet and exercise are not enough to break down the excess fat. Liposuction and Cool sculpting can break down those deposits with excess fat being sucked out of the body via a tube. Liposelection uses ultrasound to break up pockets of fat from neck, abdomen and chin and uses a much smaller tube under local anaesthetic to remove fat leaving the other tissue intact. The skin is far more even and reacts smoothly to the procedure with reduced pain and bruising.

Depending on the level of treatment involved typical less invasive procedures start at around £1500 for cool sculpting and healing is quicker at days rather than the weeks involving more invasive liposuction work.

Otoplasty

The technical name for ‘ear pinning’ with one in twenty Britons convinced they’re ears stick out too much. It´s a relatively simple operation re-sculpturing cartilage at the base of the ear to reposition it closer to the head. The reasons for the operation can be many but an incision is made at the back of the ear in a fold that exposes cartilage and then its partially removed or reshaped leaving scars difficult to see.

It takes around one or two hours under local anaesthetic at a cost of £3000 upwards .The results are generally good but the cartilage can change over the years and following the operation you’ll need to wear a head bandage for about a week to give the procedure time to heal. Time for catch-ups then get the box sets out.

Rhinoplasty 

Known more commonly as the ‘nose job’ the procedure is one of the most popular performed in the UK with over a thousand procedures performed every year. As with other types of procedure the reasons for undergoing it can vary and the procedure is relatively straightforward with the incision made inside the nostrils to access the bone and cartilage underneath. Both are then re-shaped before folding the skin back over the newly re-contoured framework. 

The operation takes around two hours under local anaesthetic but usually leaves bruising for about ten days but again that can vary depending on the individual with some lucky folks only experiencing redness around the area. It can take up to a year for the area to fully recover and the benefits of the procedure be fully enjoyed. The price can vary between around £3000 – £5000 depending on the level of alteration and re-sculpture involved. 

Scrotoplasty 

Quite literally an area men don’t usually discuss in a medical fashion is the nether region. It’s designed to tighten up and lift sagging skin on the testicular area. 

Scrotoplasty is on the rise in the UK with the procedure originally developed to help restore the scrotum after injury or illness. The work involves slicing away excess skin and re-joining the muscle at the seam of the scrotum area to reduce evidence of scarring tissue. Again it’s a procedure completed under local anaesthetic taking around 90 minutes and the patient being able to leave the clinic the same day at a cost of around £2,800. The number of gentlemen undergoing this procedure isn’t totally known but enquires increased in 2016 by 169 %. 

Cosmetic surgery is not to be considered lightly and although many opt to chase down overseas treatments in developing nations such as India and Turkey because of cost, but you must really take into consideration the aftercare needed in any procedure and how it will pan out while abroad in terms of economy and if would you be more comfortable undergoing the procedure more safely in your home nation. 

You can discover more about Dr Ashish Dutta by visiting his website or finding out more about male cosmetic surgery options by visiting the main website of the Aesthetic Beauty Centre.

Dr Ashish Dutta – The Top Autumn Trends For Male Cosmetic Surgery Part I

While you’re in the vehicle service bay waiting area watching mechanics scurrying like ants all over your pride and joy, have you ever wished you could be in the next bay getting a tune up yourself? Well heaven forbid that you find non-health professionals tinkering with you is the stuff of nightmares, but in reality it’s possible to get a tune up of sorts to make you feel good not just on the inside but the outside as well.

More men than ever before are coming around to the idea of cosmetic surgery with 10 per cent of them accounting for procedures in the U.K. alone according to the British Association of Aesthetic Plastic Surgeons (BAAPS). Just like a car engine by having regular minor ´Tune Ups´ cosmetically, our natural performance or appearance can be maintained or even enhanced.

There are a great deal of minor tweaks available to the male form from the well-known Botox brow smoothing treatments and the equally well known procedures of Rhinoplasty (Nose) enhancement, Blepharoplasty (The eyelid lift) through to male breast reduction (Gynaecomastia) Liposuction and even beard and hair transplants. Such procedures need not be as expensive as they once had been and are no longer only for the rich and famous as the need to look good in both personal and physical grooming can be vital for our self-esteem.

As Doctor Ashish Dutta, Chief Surgeon and CEO of the London and North East England Aesthetic Beauty Centre explains the trend;

¨ The recent trend of an overall decline in the number of Cosmetic Surgical procedures being performed in the private sector is not reflected in the male cosmetic surgery market. Overall, the number of face-lift and Gynaecomastia reduction among the male population saw a 5-6% growth. Men want a discreet or subtle improvement in their overall appearance and the other areas of growth are chin augmentation, hair transplant and penile enlargement.¨ – Dr Ashish Dutta.

It’s certainly no crime to want to look your best especially in the work environment. Industry studies state that that taking advantage of eyelid work is common among middle aged men, but the go-getting professionals prefer toned stomachs without fat in their place. If you’re thinking of such procedures then it’s worth perusing this series of articles for a guide to what’s available, what the procedures involve and above all cost for the enhancement.

Beard Transplant

The growth of interest in facial hair among men and the disappointing ability of some to grow a satisfactory face full of fuzz lead naturally to the ability to develop a satisfactory beard transplant technique. Whatclinic.com saw a 72 percent rise in male enquiries about such procedures in 2015 and also a 21 percent interest in transplants to the male genital area as another form of enhancement.

Having a beard transplant is a solution to thin and patchy beard growth. This involves taking individual hairs from the back of the neck and individually replanting them one by one. A full beard can involve painstakingly replanting up to 4000 hairs while a goatee needs only 1500. The cost can be reflected in the amount of time the procedure can take (up to £6000 and taking between 3-9 hours) also remember that Rome wasn’t built in a day, with the skin and growth requiring several months to recover before the growth is satisfactory.

Blepharoplasty

This is the eye rejuvenation so beloved of celebrities and is designed to eliminate droopy eyelids that can affect men of middle age.

¨ The eyes are the windows of our soul and with Blepharoplasty, the skin and fat is removed from the upper or lower eyelids to obtain a fresher, rejuvenated appearance. The aim is to improve the hooded or droopy eyelids and reduce the eye bags. In certain situations, fat is added to the eyelids to give a natural and less sunken look.¨ – Dr Ashish Dutta.

If tired eyes can prompt comment then visually perfect pupils can be a real confidence booster in the appearance stakes. It’s not that the individual is tired, it’s the presence of excess skin and fatty tissue that cause the problem and cosmetic enhancement can easily remedy the situation. The procedure involves small incisions to the eyelid folds to remove the offending tissue is relatively straightforward and costs around £3000. It can involve a week’s recovery time (note that further treatments for overall facial enhancement may be needed as a supplement to the Blepharoplasty).

Botox: The Smooth Facts

We won’t pull any punches here, if your face has more cracks on it than the moon of Europa or the lines on your face are a highway to hell, then this perceived wonder drug could be the answer to some of your prayers. It’s a drug that was first approved in America in 2002 as a ‘catch all´ method to improve furrows on the forehead and is suitable for both men and women. Botox is fast approaching its second decade in use after being pioneered as physical aide memoire for celebrities worried they had passed their cinematic shelf life.

¨ It is recognised as the most common non-surgical treatment worldwide. It has gradually gained popularity and now used as a quick-fix solution to look fresher. There is a common misconception that Botox is sought after by women alone. It is far from the truth, there has been a year on year increase of Botox use in the male population and is now a part and parcel of the average male grooming agenda.¨ – Dr Ashish Dutta.

It can be a great ice-breaker during a boring interlude at the cinema speculating on the host of A and B list celebrities who may have had the treatment. Although seemingly strange to have what is in essence a deadly poison injected into the system, the brand name of Botox genuinely helps to reduce these seemingly age defining wrinkles and lines by blocking the nerve receptors to muscles that respond to the outer layers of the skins epidermal tissue and thus block them making the skin more smooth in the process. The British Association of Aesthetic Plastic Surgeons reflect on the fact that such facial procedures through approved practitioners are up by around 15% and on the increase, with men of all ages who want to improve their initial appearance having it done.

The psychological and physical boost of looking younger can be amazing, but the downside providing you are willing to cancel your dairy for a few days can be initial bruising (just like any other injection) and headaches or discomfort for up to two days. The treatment only takes a few minutes and no aesthetic is required but let’s not also forget that the jaw dropping treatment costs of up to £350, but like anything it pays to shop around and remember this treatment will need to be topped up perhaps several times a year to maintain its maximum effectiveness on your pride and joy.

Botox Injection – No Sweat

Another less glamorous effect of the Botulinum Toxin , Botox being just a brand name; is its ability to block sweat glands and the unspeakable truth is that excessive sweating (Hyperhidrosis) is something that 3% of the population in these islands suffer from.

¨ Botox is licensed for the treatment of Hyperhidrosis of the underarms, palms and face. It is extremely effective and can change a patient’s self-confidence. Botox is also used in minute amounts to reduce the sebum production of the face and improve the shiny appearance of the oily skin; the technique is called micro-Botox. For excessive sweating of the underarms, I also use the 1064nm (Nd: YAG) laser to destroy the sweat glands under the skin to achieve a significant reduction of sweat production, often permanently.¨ – Dr Ashish Dutta.

We all like to look good and every day we do our level best to cheat. It could be wearing breathable materials for socks and shirts, more comfortable quality footwear or deodorant that contains a sweat fighting ingredient If none of those everyday suggestions doesn’t work and leaves you taking the elevator to the 17th floor alone, a health specialist may possibly suggest Botulinum injections to stop the sweat flow dead. This drug blocks overactive glands that produce sweat in forehead, feet, hands and dare we speak it armpits of the body. Generally the effect can help in the more unpalatable areas too.

A course can involve up to 20 injections to the areas of suffering and although typically costing from £150 to £450 for forehead and armpits it is available by doctor’s referral on the NHS.

Gynaecomastia / Male Breast Reduction

This is one of the other more popular growing trends we are keeping abreast of (you knew that pun was too good to waste!) The reality is there can be many factors that cause a flabby chest and not necessarily diet and lack of physical exercise -excessive male hormone production can also be a factor as well as disease.

¨ Gynaecomastia (sometimes referred to as ´man boobs´) is a relatively common condition that causes adolescent boys’ and adult men’s breasts to become larger than normal. It can cause psychological and social issues for the modern, image-conscious male. Sizes vary from a small amount of extra tissue around the nipples to more prominent breasts with a fair amount of glandular tissue (it can affect one or both breasts.) Gynaecomastia can have several causes but the commonest one is a result of an imbalance between the sex hormones testosterone and Oestrogen. The fatty tissue can be removed with Vaser liposuction, but the gland tissue may need to be excised through an incision.¨ – Dr Ashish Dutta.

If you are continually attending gyms like a Russian shot putter but are still how shall we say, more sunken than the Titanic, the removal of excess breast fat will help firm up the assets helping them to resurface again. The procedure involves an incision around the nipple, removing the offending tissue using Liposuction if large amounts are present and then adjusting or re-positioning the nipples as required. It’s not normally available on the NHS unless there is a clear medical need. Costs privately begin at £3500 and you’ll need a week off work to catch up on all those World Cup highlights.

You can discover more about Dr Ashish Dutta by visiting his website or finding out more about male cosmetic surgery options by visiting the main website of the Aesthetic Beauty Centre.