Botox me

Women in their 20s now clamour for Botox

By Lee Yen Mun
yenmun@thestar.com.my

KUALA LUMPUR: Every week, an average of five women will knock on the doors of a plastic surgeon here to give their faces a more ‘feminine’ shape.

But, while it was the middle-aged who used to ask for botulinum toxin type-A (BTA) injections to smooth out the wrinkles on their faces, these days it is women in their 20’s.

These women, unhappy with a square-shaped face, want the injections to reduce the size of their jaw muscles, so that their faces will appear smaller.

Each injection administered may cost the customer from hundreds of ringgit to RM1,500, depending on the amount of BTA, popularly known by the brand name Botox, used.

Plastic surgeon Dr Victor Cheong said it is now very common for younger Malaysian women to seek BTA injections, a trend he had observed among his clients.

“Although I have also performed the injection on some men, 97% of the clients who seek BTA are women,” he told The Star at his clinic here yesterday.

Malaysian Association of Plastic, Aesthetic & Craniomaxillofacial Surgeons (Mapacs) president Dr Peter TL Wong said that BTA injections was also an acceptable treatment for teenagers who had prominent jaw muscles.

“This helps to reduce the square jaw look and sharpen the jaw line, and is an alternative to jaw reduction surgery,” Dr Wong said of the non-surgical treatment.

He, however, added that plastic surgeons here were not giving BTA injections to teenagers to prevent the onset of wrinkles or delay aging.

“These claims are dubious and the procedure is not justified.”

Dr Wong was responding to media reports of 18-year-old Charice Pempengco, who created a worldwide furore over her decision to resort to BTA injections so that she could maintain a fresher look on television.

The talented singer from the Philippines was due to appear on season two of award-winning musical comedy Glee, which will debut on US television next month.

“I cannot understand why teenagers would want to do it unless it is for clinical reasons,” said Dr Eileen Fong, a plastic surgeon based at a private hospital here.

She said the oval-shaped face is the preferred look among most BTA injection recipients, as a square face is considered a more masculine feature.

StarOnline

Look good instinct

A natural instinct to look good

IS society becoming more superficial and obsessed with looks and money?

Clinical psychologist Sylvester Lim says “superficial-ness” has always been present in society to some degree.

“Would it be incorrect to say that in our grandparents’ day, or even in the time of Caesar, that men were not driven by looks? Isn’t it as old as humanity that we are first drawn by the outward rather than the ‘inner beauty’?”

He believes there are as many people in the world seeking material wealth as there are seeking spiritual enlightenment.

“Beneath everything else – I believe at the root of it all – in all times during the history of mankind – people seek love, acceptance and peace,” he says.

So he sees nothing wrong in people wanting to go under the knife or having other cosmetic procedures to look good.

On one hand, it appears to be a move towards being superficial or “plastic” but, on the other, it could also suggest that people are beginning to come to a greater appreciation of their physical health (which includes good grooming) and their emotional well-being, he says.

The “instinct” to look good to attract the attention people want is natural, he says.

“Just as animals instinctively prime themselves for their mate, I would wager that, similarly, humans are also driven by this same instinct (though we may deny it) to seek to make ourselves more attractive to enable us to find the most suitable mate in order to ensure the continuation of our species.”

For Lim, the trend of people becoming more concerned about their looks is “not unhealthy” – as long as they are not obsessive about it and don’t go overboard to reach that state of “perfection”.

“Such obsession may be indicative of a lack of liking for oneself,” he says.

He is also not against cosmetic surgery for teenagers, provided it is not an obsession, not born out of self-dissatisfaction or coercion of some sort by the child’s parent.

He says parents who push their kids into having cosmetic surgery or procedures so that they would get the job or a good mate could damage the child’s self-esteem.

“It may imply to the child that he or she is ‘not good enough’ in the eyes of the parents or not up to par with the rest of the world and needs fixing. I feel parents should always be accepting of their children and provide them with unconditional love.”

But if it is teenager who is pushing for the cosmetic procedure, there are questions that have to be asked, Lim says.

Parents should find out why their child wants it.

Could it be due to peer pressure or social pressure? Is it a norm or a trend or is it because the child is feeling inadequate?

Lim draws a distinction between the child seeking cosmetic surgery “because I hate the way I look” and “because I want to look even better”.

If the child is okay with himself and the way he looks but has the means (or the parents have the means) to make himself look better, then “why not”, he reasons.

Developmental psychologist Elaine Yong, however, takes a different view.

She says the teenage years are the age of development and children go through a period of soul searching and self-discovery during this time.

“They are trying to form their identities. Their self-image changes very quickly. Therefore, it will be very damaging for them to think that cosmetic surgery is the way to fix their imperfections.

“It would be better for parents to teach their teenagers about self-acceptance and self-love. Every individual is unique,” she says.

But she agrees that some parents might choose cosmetic surgery or procedures “out of love and the need to protect their child’s developing self-esteem”, such as in cases where the child is born with a cleft palate, has severe acne scarring on the face, and facial or other physical deformities.

But where it is purely to enhance one’s looks, she feels it is better to wait.

If parents hear their otherwise normal-looking girl or boy being made fun of by their peers, what they should do is to teach their child to stand up for himself in a non-aggressive manner.

“In life, a person can’t avoid being talked about by others. What matters is how we deal with the problem,” she says.

As to whether good looks could mean securing that job, Lim says many studies seem to support this. The good-looking ones are more often “forgiven for their transgressions” and appear to have greater influence over others, he says.

But Yong feels that “the good looker getting the job” adage is true only for males!

“Recent research has shown that beauty reduces the chances for females to be hired for masculine jobs. Beauty is only an advantage for females in their applications for feminine jobs!”

On promotions and salary increases, she says that skills rather than looks are more important.

In the world of children, good looks also come into play, says Lim, citing a 20-year study done in the UK called Child Of Our Time. It showed that kids picked friends whom they considered “better looking” and the ones deemed “better looking” had more friends and were described in much nicer terms by their peers!

StarOnline

Look good

Hello, good looks

Stories by SHAHANAAZ HABIB
shaz@thestar.com.my

The quest to look good through plastic and cosmetic surgery, which used to be the domain of women, has now caught on with men and even teenagers.

LET’S face it. Good-looking people seem to have an easier time in life.

There is research that says the attractive ones find it easier to get jobs (compared with someone less attractive with the same qualification and experience), to get promotions and even close deals.

And, of course, the “lookers” are heavily sought after by the opposite sex.

Is it any wonder then that people are trying all sorts of ways, including plastic and cosmetic surgery as well as the countless other aesthetic procedures, in their quest to look good?

This craze, which used to be the domain of women, has now caught on with men – and even teenagers.

“Like it or not, people judge a book by its cover. Looking good has become a necessity all over the world. It has become a part of life,” says aesthetic physician Dr Alice Prethima.

She says that in the old days, when a person was out of shape and looked bad, people accepted it and merely said “she has aged, she has put on weight”. For a male, they would comment that “he’s prosperous, he ate too much good food”.

But things have changed.

“These days, people think the person is lazy and won’t do anything for himself.”

She believes that just like exercise and supplements, cosmetic surgery and procedures are becoming a way of life as the country becomes more prosperous and people have the means to strive for good health and to look better.

“It’s in the subconscious. It is common in any living species that they will be attracted to a better-looking person. The reason is that a better-looking person is supposed to be more fertile and healthier and that will go towards progeny.

“If a person looks good, is fit and takes care of himself, then people would think they can take care of the family, the office or the community. The brain thinks that way. It’s natural,” says Dr Prethima, who has been running an aesthetic clinic for 11 years.

Concurring, consultant plastic and cosmetic surgeon Dr Heng Kien Seng believes it is human nature to want to look at beautiful things and people.

“There is research that shows that even at kindergarten, children actually pay more attention to a better-looking teacher than an unattractive one,” he points out.

Between 1% and 2% of Dr Heng’s clients these days are teenagers.

Kids below 18 need parental consent for cosmetic procedures and some parents are giving the go-ahead.

Sometimes the teenagers are the ones who want the surgery; at other times it is the parents who want it for their kids.

“Parents are more aware of the competition out there. They actually bring their children in for enhancements, like doing a double eyelid and a nose job, to put them in the same or higher category as their peers,” he says.

“When the kids feel their features are not as beautiful as they want, they will persuade their parents to bring them in. A lot of parents have gone through this themselves; that’s why they are willing to bring their children in.”

Men want it too

Teenage girls and boys are even coming in for botox treatment although the number is still very small, he says.

And there are girls under 18 coming in for a breast job.

Dr Prethima says mothers are concerned when their daughters have undeveloped breasts or have one breast smaller than the other, so they bring their girls in for treatment.

“They want to do it before the girl becomes an adult and starts dating,” she adds.

About 5% of her clients are under 18, she reveals.

Over the years, men too have become more conscious of their looks and have undergone cosmetic and other aesthetic procedures.

They are game for botox, fillers, liposuction, buttocks implants, laser treatments, acne scarring treatment, eye-bag removal, and even penis enlargement.

“Guys like minimally invasive trends. They do not want to be seen as looking too ‘plastic’ or as having had things done on themselves,” says Dr Prethima.

She finds that men also hate pain and having to come in every week, so they prefer to get the procedure done in one go.

Even so, there is a marked increase in the numbers going under the knife for specialised surgeries like getting a six-pack abdomen and the V-shape male body. This is done through a body sculpting technique called Vaser Assisted High Definition Liposelection, which uses fat as building blocks to create the illusion of a six-pack.

Dr Heng, one of the few cosmetic surgeons trained in this area of expertise, claims that the sculptured six-pack abdomen lasts even longer than the muscled torso that you get from gym workouts! He says he performs about 30 to 40 of the procedures a year.

While some are fine with the surgical way to enhance themselves because the results are more or less permanent or long lasting, the growing trend these days is for minimally invasive or non-invasive cosmetic procedures where the results are temporary, lasting a few months or even a year or two.

Among the minimally and non-invasive procedures are botox, fillers, lasers, thermage, freezing the fat, fat-melting, permanent hair removal, body shaping, hymen repair, vagina tightening, and penis enlargement.

“People are looking for minimal downtime and safe techniques with minimum pain,” says aesthetic physician Dr Inder Kaur.

“People want to walk into the clinic, do the procedure and be able to walk out immediately after it, with no need for general anaesthesia or a hospital stay.”

One non-surgical cosmetic procedure people are raving about these days is PRP (Platelet Rich Plasma), which Dr Inder says are “aesthetic stem cells”.

However, Malaysian Association of Plastic, Aesthetic and Craniomaxillofacial (Mapacs) president Dr Peter Wong advises caution, pointing out that the procedure is still largely experimental.

“It still requires a lot of further trials and clinical studies before its effectiveness and safety can be established and accepted for facial rejuvenation treatments in general,” he says.

Currently, there are 60 plastic surgeons (20 in full-time private practice) and about 100 aesthetic doctors in the country.

Dr Wong says non-surgical or minimally invasive cosmetic procedures are more popular and accounts for about 90% of all cosmetic procedures these days.

“Even so, conventional surgical procedures such as facelifts, liposculpture, mammoplasty, eyelid surgery and rhinoplasties are here to stay,” he says.

But aesthetic doctors like Datuk Dr Joginder Singh believe temporary solutions are the way to go.

“If you do a non-invasive procedure, it is temporary. Fashion changes with time, and you are ready and looking forward to the changes every six to 12 months – just like the fashion industry,” he says.

Risky business

Other than aesthetic doctors and cosmetic and plastic surgeons, there are thousands of beauty salons that are also in the cosmetic industry business. Some even perform cosmetic surgeries like liposuction, breast augmentation, and the double eyelid and nose jobs!

These carry a greater risk. Each body reacts differently and people have died after a liposuction, especially those carried out in beauty saloons.

What happens if there is an infection? Would the beauty salons know what to do? What if there are complications when administering the local anaesthesia?

Dr Prethima says a person can have an allergic reaction to an injectable procedure at any time.

At hospitals and registered clinics, they have a doctor at hand and emergency resuscitation facilities for such eventualities. But beauty salons have nothing of that sort.

“It’s scary that people would do injectable procedures in the back room of a beauty salon or a hair salon. If anything goes wrong, it can be dangerous,” warns Dr Prethima.

“And they can’t even claim for damages because it is not the forte of beauty salons to carry out those injectable procedures in the first place.”

She also points out that a lot of beauty centres use the names of overseas “doctors” (whose qualifications are dubious) to give them a touch of legitimacy.

The long-awaited Cosmetology Bill would provide clear guidelines on procedures a beauty salon can and cannot do.

Plastic and reconstructive surgeon Dr V. Surendranathan says it is shocking that less than 10 % of the people going for cosmetic procedures do research before undergoing cosmetic surgery.

The person should look up the Malaysian Medical Council website to see if the doctor is registered there, check the doctor’s qualifications, talk to the nurses and find if there are botched cases, and visit the facilities including the operating theatre, he advises.

“The onus is on you. When you buy a car, you ask around for people’s opinions. How come you don’t do that when going for a breast job or liposuction?”

StarOnline

Yea, blame it on food

Bizarre effects on teens

KUALA LUMPUR: Is hormonal imbalance creating more male teenagers with breasts, while female teenagers are getting more hairy?

Cosmetic and aesthetic physician Dr Alice Prethima said she is seeing many cases of gynecomastia (enlargement of breasts in males) in her clinic.

But, she is also seeing teenage girls coming in because they have too much hair all over their body.

“Compared to the past, there are many girls with terrible hair problems. They are losing the hair on their heads and growing hair on other areas of their body where there shouldn’t be. And, the hair is so long and thick,” she said.

Dr Prethima attributed the abnormalities in male and female teenagers to the food chain and diet.

“Children are eating too much animal-based food, and those animals are fed with a lot of growth hormones.

“Our society has become more affluent. We may eat meat for breakfast, lunch and dinner,” she added.

She said bad oestrogens was also entering the body from plastic materials such as fizzy bottled drinks which “bleed” bad oestrogen.

“Those plastic containers that we use to warm our food, the polystyrene boxes in which we pack our food, the plastic bags that we pour the curry into, the roti canai we wrap in plastic – all of those bleed bad oestrogen substances. There is also a lot of pesticides, insecticides and bad oestrogenic substances in the environment, and this will manifest in different ways for those of different ages,” she added.

Dr Prethima said due to “xeno ostrogen”, instead of producing testosterone, the bodies of teenage boys are converting it to (harmful) 16 hydroxyoestrone, which results in the loss of hair and the development of acne, abdominal fat and abnormally-sized breasts.

Plastic and reconstructive surgeon Dr V. Surendranathan said gynecomastia was now becoming very common among teenage boys, mainly due to the children’s eating habits and sedentary lifestyle.

“They are eating too much chicken and getting very little exercise. They are stuck in front of the television and computers all day.

“It’s very embarrassing for the boys to have breasts. They can’t even take off their T-shirt in school.”

Dr Surendranathan said he has even had to perform breast-reducing procedures on 13 and 14 years old boys. The former president of the Malaysian Association of Plastic, Aesthetic & Craniomaxillofacial Surgeons (Mapacs) said there has been a noticeable increase in such cases over the last few years.

Consultant plastic and cosmetic surgeon Dr Heng Kien Seng said he too has been seeing a lot of cases of teenage boys with gynecomastia, and he has had to perform breast reduction procedures on these boys so that they can regain the physical look of normal male chests.

Among the treatments available include liposuction, gland excision, and reduction mammoplasty.

StarOnline

Nip and tuck in men too

Experts: More men into nip and tuck jobs too

By SHAHANAAZ HABIB
newsdesk@thestar.com.my

KUALA LUMPUR: More men are turning to cosmetic surgery to look good in order to “hold on” to their partners, while some teenagers are opting for double eyelids and ear pin procedures, said doctors.

Some teenage boys are also choosing to go under the knife to reduce their “breasts”.

Consultant plastic and cosmetic surgeon Dr Heng Kien Seng said he had seen a 15% increase in male patients in his clinic over the last one and half years while aesthethic physician Dr Inder Kaur said men made up 35% of her clients.

“It’s a competitive world out there. Women are doing it and unlike before, they are not submissive. They can change partners.

“So the men also have to enhance themselves and look better for their partners,” said Dr Heng.

“The men come for botox, filler, lasers, buttock implants, liposuction, to remove eye bags and even to sculpt a six-pack abdomen and the perfect male body,” he said.

He said about 5% of his male clients are gay.

“They have a lot of money to spend. A number of them are talented, being fashion designers and make-up artistes.

“They have no family or children so what is there to save for? They use whatever they have to make their partners happy,” he said.

Teenagers below 18 are now also going for cosmetic surgery and procedures like botox, nose jobs, double eye lids, ear pins, liposuction and even breast augmentation.

Somehow, parents are willingly bringing their children for these procedures.

“Parents are more aware of the competition out there. They bring their children for enhancements to put them in same or higher category than their peers,” said Dr Heng.

Teenagers make up one to two per cent of his clients and that figure, when seen against population ratio, is really “quite reasonable”.

“The trend has changed in a certain way. Cosmetic surgery has become accepted and the younger age group has been coming in.

He said he will not do breast implants for those under 18.

“I have to tell them you are too young,” he said.

But if the teenager has “really huge” breasts which cause discomfort and problems, Dr Heng would do a breast reduction operation even if she is not yet 18, provided she comes with her parents.

“They must understand the consequences, including scarring, less breast milk production and less nipple sensation,” he said.

Aesthetic physician Dr Alice Prethima has had girls under 18 coming in for breast augmentation.

She said mothers are concerned when their daughters have undeveloped or asymmetrical breasts.

StarOnline

Psoriasis association

Psoriasis is more serious as it also affects muscle joints, says expert

By AUSTIN CAMOENS
newdesk@thestar.com.my

JOHOR BARU: Psoriasis also affects the joints, and the public misconception that it is just a skin disease needs to be corrected, according to a medical expert.

Sultanah Aminah Hospital (HSA) dermatologist Dr Choon Siew Eng said many Malaysians were still unaware of the severity of the disease.

“Psoriasis is believed to affect between 2% and 3% of the country’s population, but many do not know they have the disease because they believe it is a skin disease or fungal infection,” she said.

She added that since the set-up of a psoriasis registry here in 1992, there were 2,829 patients suffering from the disease.

Dr Choon said the first sign that an individual was having psoriasis was a troublesome scalp resembling bad dandruff.

“Although there is no cure for the disease, it can be controlled with proper treatment,” she said in her presentation during a talk at the hospital yesterday.

Dr Choon added that conventional treatment for the disease would cost about RM100 a month, but there were designer drugs that could help contain the disease faster costing between RM4,000 and RM5,000 a month.

A psoriasis patient, who only wanted to be known as Morgan, 43, said individuals suffering from the disease must be mentally strong.

“I was diagnosed with psoriasis about 22 years ago, and it has been a depressing time for me,” he said, adding that he believed stress played a major role in triggering the disease.

Morgan said the only way to keep the disease at bay was to keep one’s spirits high and to diligently take the medication prescribed.

Another patient, Guna, in his 50s, said he has had the disease for 26 years, and he kept away from society initially because he was embarassed with his condition.

“It was difficult for my family and close friends to accept the disease because they did not understand how it could happen to me,” he said.

Psoriasis Association of Malaysia (PAM) president Eugene Clifford Cross said the association was established to update patients on the latest treatment and information about the disease.

“The association is a support group for people afflicted by the disease to get professional advice, as well as to share their experiences with fellow patients,” he said.

To learn more about PAM or other information, visit its website at www.psoriasismalaysia.org or call 03-8948 4335.

Staronline, 25th August 2010