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Interview with Dr. Al Jaafar by Health Care magazine. Published in March and April, 2009 issue.

 

Trends in cosmetic surgery
By Excel Dyquiango and Jyasmin Calub

A few decades ago, surgical enhancement was considered as a “confidential” procedure, a tightly-guarded secret of movie stars and wealthy socialites. Not only were the procedures prohibitively expensive; most of them were also very invasive and required several weeks or months of downtime. More worrisome was the risk of side effects, which could range from the unattractive to the downright fatal. At that time, cosmetic surgery or surgical enhancement was an option taken only by the very rich or the very vain.

With the continuous development of new techniques, procedures and materials, however, cosmetic surgery has become much safer and less invasive, with more natural-looking results, and less downtime. These improvements have also led to a more open and accepting attitude toward cosmetic enhancement, as movie and TV personalities, government officials, business people, and even average people on the street have candidly admitted undergoing rhinoplasty, breast enhancement, or laser skin treatments. Today, it seems that there is a solution for almost every conceivable skin or figure flaw.

Aesthetic/cosmetic surgeon Dr. Al Farabi L. Jaafar of The Asian Tropics Cosmetic Surgery Center tells us more about the latest trends in cosmetic surgery.

 

Breast augmentation
Dr. Jaafar explains that the basic procedures and objectives of cosmetic surgery remain essentially the same – what has changed are the preparations, implants and tools used in the procedures.

For instance, the basic procedure of breast augmentation still involves inserting an implant in each breast in order to increase breast size. In the past, surgeons used either saline implants (normal saline solution inside a soft, smooth silicone sac) or silicone implants (silicone sacs containing silicone gel). Because of the implants’ smooth surfaces, however, these types of implants were prone to contractures. This happens when the body recognizes the implant as a foreign object and covers it with scar tissue, resulting in hardening of the breast. Today, aesthetic or cosmetic surgeons like Dr. Jaafar prefer using implants with a textured surface, which helps to reduce the risk of contracture. Newer implants are also designed to withstand pressure, and may be compressed to a very small size without rupturing. This allows surgeons to make smaller incisions when inserting the implants, and also helps the implant to resist “bursting or leaking” in case trauma or when contracture occurs. Newer type of gels inside the implant is also designed to have memory and thus remain within the sac and prevent going into the surrounding tissues  even if the sac is torn.

 

Rhinoplasty
Colloquially known as a “nose job”, rhinoplasty involves inserting an implant on the nose bridge to reshape and improve its appearance. Until recently, most nasal implants were made of silicone, or less commonly, cartilage taken from the patient’s own body. Today, some doctors are also using PTFE or polytetrafluoroethylene (Goretex), a soft, porous substance that is also used by cardiovascular surgeons to repair ruptured or damaged blood vessels. Some doctors who have tried it on their patients report that PTFE gives  good results, but Dr. Jaafar prefers to be more cautious. For instance, he points out that PTFE has only been used in rhinoplasty recently, while silicone has been used for several decades and has a low (<1%) rejection rate. That’s why medical grade silicone is still the gold-standard for augmentation rhinoplasty. Dr. Jaafar explains that with any new medical devices, it is better to wait until extensive clinical experience has demonstrated safety. “Maybe in 5-10 years and after all the results have come in, that’s the only time that we can really say Goretex is worry-free and safe for rhinoplasty. Further, some surgeons don’t even tell their patients that tissues get integrated to it and therefore it is permanent and difficult to remove. So that if you develop complications or didn’t like the outcome of your nosejob, be ready for a challenging and possibly a damaging revision.”
It may not also be able to give a good lift since it is too soft as an implant (unlike silicone which has the same flexibility as that of your nose cartilage and can likewise be sculptured to your desired shape). To compensate, surgeons using Goretex would have to harvest a  portion of your ear cartilage resulting to an additional unnecessary wound.

 

Liposuction
Liposuction today has come a long way from the old days when a suction tube or cannula was simply inserted under the skin and the fat was suctioned out. This method was quite dangerous, since it could result in massive blood loss due to heavy bleeding. Nowadays, liposuction is done using the tumescent or “super-wet method”. A fluid containing anesthetic (to reduce pain) and a vasoconstrictor (to reduce bleeding) is first injected into the target area. This makes it easier and safer to vacuum out the unwanted fats. Recently, cosmetic surgeons are doing Ultrasound-Assisted Lipoplasty (UAL).  This technique requires the use of a special cannula that produces ultrasonic energy. As it passes through the areas of fat, the energy explodes the walls of the fat cells, liquefying the fat. The fat is then removed with the traditional liposuction technique. However, the heat produced from the ultrasound device may cause injury to the skin or deeper tissues. Dr. Jaafar adds that “even though UAL has been performed successfully on several thousand people worldwide, the long-term effects of ultrasound energy on the body are not yet known”. Use of lasers have also been introduced. This has resulted to shorter downtime but has added more cost to the procedure. In the hands of a good and safe surgeon, tumescent liposuction is still a time tested procedure. Bottomline is, surgeons should know the selection criteria for candidates of liposuction and importantly must know when to stop the procedure when they encounter problems in the operating room.

Sclerotherapy
In the past, varicose veins were treated through a procedure called vein stripping. This involves literally stripping or removing the affected veins through a small incision in the skin. Because it is an invasive surgical procedure, vein stripping can result in complications such as post-operative bleeding, nerve injury, or even infection. The patient will also need to avoid physical activity for days or weeks after the procedure.

Today, varicose veins (although to a limited extent – for cases with lower grades) can be treated either by injecting a sclerosing agent into the affected vein, or by “burning” it with laser. This effectively closes off the vein, removing the varicosity. Unlike vein stripping, scelotherapy and laser only need a few hours of downtime and cause less pain to the patient.

 

Skin needling
Chemical peels, dermabrasion, and microdermabrasion are popular methods for treating skin conditions such as fine lines, scars, and discolorations. These methods work by removing the top layer of the skin (a controlled amount of skin damage) and thus encouraging the skin to produce new, healthy epithelial cells. These methods can produce very good results, but at times, they can be painful, can cause oversensitivity to the sun, and can take days, weeks or months to heal completely. In some cases, too much of the epidermis is removed, causing deeper damage to the skin.

Recently, a new technique has been gaining popularity among dermatologists and cosmetic surgeons. Known as skin needling or “derma roller”, the new method not only stimulates the outer layer of the skin (epidermis) but also the dermis which is responsible for our skin elasticity with less pain and less potential for damage than chemical peels or dermabrasion. The derma roller is a small, handheld roller with hundreds of tiny pins (similar to those used in acupuncture) on its surface. When rolled onto the patient’s skin, it creates a series of small, shallow punctures on the skin surface. The skin recognizes these punctures as injuries, and thus produces new epithelial cells, collagen and elastin to “heal” them. By creating a repeated process of controlled damage and healing, a series of derma roller treatments gradually “builds” enough new collagen to treat scars, lines, and discolorations. Since the treatment does not remove the entire epidermis, healing is faster than in conventional peels.

 

Radiofrequency
Celebrities have been singing the praises of radiofrequency (RF), a treatment that has been touted as a safer, faster for lifting sagging skin, sculpting flabby areas, and removing unwanted cellulites. This uses electromagnetic wave energy (yes, the same energy that heats up food in your microwave oven but at a different and safe spectrum of radio waves) applied on either the face or any part of the body.  A probe transmits radiofrequency energy into the dermis (the second layer of the skin) or the subcutaneous layer (where fats are deposited), while sparing the top layer or epidermis. The probe itself does not heat up, but the radio waves heat up the dermis to stimulate collagen production and the fat layer to soften and dissolve it. Since collagen can take some time to build up and fats also time to be excreted by the body, the results will be visible weeks after several treatments are made which can be done 2-3x a week for 8-16 sessions.

 

Galvanic spa
Galvanic treatments use the basic principles that like charges repel each other and opposites attract – similar to magnetic poles. Products are formulated to contain key ingredients which carry a positive or negative charge. The instrument is also set to have the same charge as the product. The repelling of like charges “pushes” the product into the skin facilitating the delivery of key ingredients. With the careful application of positive and negative galvanic currents to the skin, an esthetician is able to perform a variety of beneficial skin treatments.

With all these new procedures, there is no reason for people not to look and feel their best. However, Dr. Jaafar encourages patients to still exercise caution when deciding to undergo aesthetic surgery. In particular, he stresses the importance of looking for the right doctor to perform the operation. “Check on the background of your doctor and don’t just rely on one source. Look for (a doctor who belongs to) a legitimate organization (Philippine Society for Cosmetic Surgery) of cosmetic surgeons recognized by the Philippine Medical Association. Talk to your doctor and know the process step by step.”
***
Sources:
http://showbizandstyle.inquirer.net/lifestyle/lifestyle/view/20081205-176145/Radiofrequency-for-skin-tightening
http://www.massage-tools.com/galvanic-facial-machine-current.html
http://www.prweb.com/releases/2006/04/prweb375982.htm
http://www.derma-rollers.com/24/derma-roller-faqs/
http://www.clearskincare.com.au/skin_needling.html
http://en.wikipedia.org/wiki/Chemical_peel
http://en.wikipedia.org/wiki/Teflon
http://en.wikipedia.org/wiki/Sclerotherapy

 

 

 

 

Cebu Pacific in-flight magazine feature of The Asian Tropics May and June 2009 issue.

 

 

HAPPY NEW YOU!

 

WANT A BRIGHTER SMILE, BETTER EYESIGHT OR A NEW NOSE? THE PHILIPPINES OFFERS HEAD-TO-TOE OPTIONS FOR YOUR MEDICAL AND AESTHETIC NEEDS, REPORTS CHARMAINE BAYLON
With the country’s developing medical tourism industry, you don’t have to go far to have quality procedures and consultations. You needn’t have to fork out a fortune, either — the packages in the Philippines are about 35 to 75% less expensive than those in the US, according to the government-accredited Philippine Medical Tourism, Inc (PMTI). But why else would people from the US, Japan, Europe, South Korea and Australia opt to come here? Our hospitals are internationally accredited, and our doctors are trained by as well as affiliated with renowned hospitals. Finally, we speak English and have a wide range of facilities as well as vacation destinations to make a stay here as comfortable as possible. Here’s a look at some of the treatments and services you can choose from.

FOR YOUR CROWNING GLORY
J Go for… a hair transplant L What it is “This surgical hair restoration plan involves the removal of a strip of hair-bearing skin from the back of the head. Surgical assistants will separate and divide the follicular units, and the doctor employs a lateral slit technique to mimic the natural alignment and distribution of hair. They then place the grafts onto the sites, which results in 70 to 90 hairs per cm2,” says Janice Macapagal, operations manager of Philippine Medical Tourism, Inc ë Downtime This outpatient procedure includes a five-day/four-night stay at a reputable hotel $ Price PHP115,000 ( Contact Philippine Medical Tourism, Inc, Penthouse, Goodwill Building, 393 Sen Gil Puyat Avenue, Makati City, tel: +63 (2) 897 5813, www.philmedtourism.com

 

FOR BETTER VISION
J Go for… LASIK (Laser-Assisted In Situ Keratomileusis) surgery L What it is LASIK involves the reshaping of the cornea for better eyesight. It helps correct myopia, hyperopia and astigmatism, especially for those advanced grades ë Downtime This outpatient procedure includes a four-day, three-night hotel stay $ Price PHP66,000 for both eyes ( Contact Philippine Medical Tourism, Inc, tel: +63 (2) 897 5813, www.philmedtourism.com

 

FOR IMPROVED HEARING
J Go for… some Oticon dual and streamer hearing aids L What it is The new Oticon Dual system helps eliminate that “plugged” feeling in your ear so you enjoy clearer and more natural sounds. “It also feels comfortable, as it is a small device,” explains Liza Abano-Robles, chief clinical audiologist of Manila Hearing Aid. “The Oticon Streamer enables you to talk on the phone and hear the TV with the same ease that everyone else can.” $ Price PHP160,000 Contact www.manilahearingaid.com.ph

 

FOR “REFRESHING” YOUR FACE
J Go for… a minor aesthetic surgery retreat L What it is “You can have: augmentation rhinoplasty (silicone noselift), upper blepharoplasty (eyelid creation/ reconstruction), lower blepharoplasty (eyebag removal), chin augmentation, or liposuction in one area (arms, neck, upper or lower tummy, or small flanks),” says Dr Al Jaafar, head surgeon of The Asian Tropics Advanced Aesthetic and Wellness Center. The package includes a nine-night stay at The Oracle Residences, post-operative medications, a treatment at the Tropics Spa and one diamond peel session, among many others ë Downtime Two to three days $ Price US$1,200/PHP57,279 ( Contact The Asian Tropics Advanced Aesthetic and Wellness Center, Unit 1 Anonas Commercial Complex, Project 3, Quezon City, tel: +63 (2) 994 3081 or 434 1800, www.asiantropics.com, dr.aljaafar@ asiantropics.com.ph

 

FOR AN EXTREME MAKEOVER
J Go for… a major aesthetic surgery retreat L What it is “You can choose any one of the following procedures: breast augmentation, whole tummy liposuction, tummy tuck or full face lift,” says Dr Al Jaafar of The Asian Tropics Advanced Aesthetic and Wellness Center. There is a range of choices and options, depending on what you need. With this package, you get a 15-night stay at The Oracle Residences, special nurse services, pre-operative blood work-up as well as trips to the Tropics Spa for body treatments and one diamond peel session, just to name a few. ë Downtime Seven days $ Price US$3,800/PHP181,384 ( Contact The Asian Tropics Advanced Aesthetic and Wellness Center, Unit 1 Anonas Commercial Complex, Project 3, Quezon City, tel: +63 (2) 994 3081 or 434 1800, www.asiantropics.com, dr.aljaafar@asiantropics.com.ph

 

FOR AN IMPROVED SMILE
J Go for… cosmetic teeth bonding L What it is A procedure to improve the appearance of teeth. “Composites made of acrylic resins and inorganic fillers are sculpted to a proper shape,” says Dr Joseph Jagoring, cosmetic, restorative and aesthetic dental specialist who heads the team at Estetico Manila. “Pigments will match your tooth color.” ë Downtime This outpatient procedure can last from one to several hours depending on the case. Procedures of PHP250,000 come with a complimentary five-day hotel stay and free breakfast $ Price PHP5,000 per tooth ( Contact Medical Tourism Philippines, tel: +63 (2) 523 9731/400 6305, www.. philippinedentaltourism.com and www.. philippinewellnesstravel.com, mtp.rxpinoy. com, help@rxpinoy.com

 

FOR A HEALTHY HEART
J Go for… a coronary artery bypass grafting L What it is “The three- to five-hour surgery involves taking an artery or vein on your body and using it as a graft for the bypass,” says Janice Macapagal of Philippine Medical Tourism, Inc ë Downtime Seven days at the hospital, with a 14-day/13-night stay at a hotel $ Price PHP895,000 ( Contact Philippine Medical Tourism, Inc, tel: +63 (2) 897 5813, www.philmedtourism.com  
 

 

FOR BETTER BODY DEFINITION
J Go for a… liposculpture L What it is “VASER Hi Def (VHD) is an advanced body sculpting technique for fit men and women who want more. It entails the precise removal of superficial and deep fat to enhance musculature visibility,” says Dr Claudine Roura, medical director of Contours Advanced Face and Body Sculpting Institute ë Downtime Three days $ Price Available upon request ( Contact Contours Advanced Face and Body Sculpting Institute, 2/F, South Park Plaza, Paseo de Magallanes, Makati City, tel: +63 (2) 556 4878 / 489 8526, www.rouradermsurgery.com

 

FOR OVERALL WELLNESS
J Go for… a stress buster program L What it is A three-hour spa package to unkink your tight nerves and muscles. “The program alleviates your anxiety and stress with herbal steam, a chromotherapy hot bath, luxury chocolate and 120 minutes of Devarana Massage and yogic therapy. Your body is re-balanced and energized and your mind is rejuvenated,” says Sudaporn Prasertsang, the spa manager at Devarana Spa in the Dusit Thani Hotel $ Price PHP6,500++ ( Contact Devarana Spa, Ayala Center, Makati City, tel: +63 (2) 867 3333, spamanila@devaranaspa.com

 

THE PERKS OF HIRING A HEALTH TRAVEL PLANNER

According to the Philippine Medical Tourism, Inc (PMTI), getting a health travel planner or medical tourism provider is similar to getting a travel agent — only instead of handling your vacation, the provider will help you find the right doctor, hospital, flight and amenities to suit your health needs, budget and lifestyle. The PMTI even has a medical concierge in case of emergencies or changes in arrangements. The best thing about these services is that they are free — the costs are borne by the airlines, hotels, hospitals, doctors and resorts.

 

ONE MAN’S TESTIMONY

“Aside from changing the look of my nose, the procedure changed my features. I now see a bridge and my eyes appear different. I am more confident now.” – Hektor Baluyot, who had augmentation rhinoplasty with Dr Al Jaafar of The Asian Tropics

Other Photos