Cheap fillers for sale? You might get more than what you bargained for!


 















The end of the year is approaching, and some of the things everyone looks forward to, are year-end sales. Every retailer is offering jaw dropping discounts to clear off their stock and encourage shoppers to spend. You scroll through Instagram to get inspiration on what to wear for the holiday season and you find yourself somewhat drawn to a before-and-after picture of someone who’s had their face enhanced with fillers. You click on the picture and you see the hashtags, “#nosefillers, #lipfillers and #chinfillers.” Excited, you click on the user profile to see where this person had their fillers done, but strangely, the user profile does not look like the official account of a legitimate clinic. So you send a direct message to enquire, and you are told that there is a special year-end offer on fillers, at only RM400 for the nose, lips and chin! A fraction of the price that licensed aesthetic clinics would charge! WHAT COULD POSSIBLE GO WRONG, you think. “It’s just fillers”! “Just” a few tiny injections, and you’ll look ravishing at your year-end dinner with friends, you tell yourself.

Stop right there.

Fillers are expensive for a reason. The WORST thing that could possibly happen to you, if you decide to have your fillers done by an unlicensed and untrained person without any medical background - is permanent blindness. You read that right. Irreversible and permanent loss of vision in your eyes.

How can blindness possibly happen? How can you go blind when it is not the eyes that are being injected with fillers?

Up to February 2019, there has been a total count of 146 cases of total vision loss related to filler injection throughout the world. It is rare, but is without a doubt, a major catastrophic and life changing complication.

Impairment or loss of vision (be it temporary or permanent) takes place when the central retinal artery is occluded, or blocked by filler particles. This happens when the tip of the needle accidentally punctures the vessel, causing the filler to injected into the vessel (instead of the intended location), and when too much pressure is applied to the plunger of the syringe while injecting, the arterial pressure can be overwhelmed, causing retrograde movement of the filler into the proximal arterial network. Eventual embolization of the central retinal artery will deprive the retina of oxygen, leading to blindness. The sites that are of the highest risk are the nasal region, glabella, forehead and nasolabial fold, but the fact is that any region of the face is at risk for this complication!

Visual loss following embolization usually occurs within SECONDS of filler injection, but it has also been reported to occur up to 7 hours post injection. Once the retinal artery has been occluded, there is a window of 60-90 minutes before blindness is completely IRREVERSIBLE.

What are the signs and symptoms of this devastating complication? 

Pain(ocular, facial or headache)

Nausea

Vision loss

Paralysis or weakness of ocular muscle

Ptosis

Posterior displacement of the eye

Misalignment the eyes when looking at an object

Corneal edema

Pupillary abnormality

Iris atrophy

Anterior chamber inflammation

Mottled, reticulated vascular pattern of the skin

Cerebral infarct – STROKE!

What can be done within that precious time frame of 60-90 minutes?

Reduction of intraocular pressure (administration of a medication called Timolol into the affected eye, and rebreathing into a paper bag to increase carbon dioxide concentrations in the blood, causing retinal arteries to dilate and possibly help dislodge the clot). 

Administering Aspirin to prevent blood clotting.

Massaging the eyes to dislodge the embolus.

Administering hyaluronidase, an enzyme to degrade the filler, into the area behind the globe of the eye.

Save yourself the unnecessary worries of encountering this devastating complication by only seeking filler treatments from licensed and experienced doctors. It is not worth risking your eyesight for a cheap bargain.


Dr.Arzhealza R.
Anna Hoo Clinic



Diapers are for babies- let’s keep it that way!

When you hear the word ‘diaper’, the first thought that crosses your mind is most likely babies. Babies need diapers just as much as they need milk, that’s just how it is meant to be. But did you know that there is a condition called Urinary Incontinence that causes adults to depend on diapers to avoid the discomfort and embarrassment felt when bladder leakage happens in regular clothing while carrying out daily activities?

What exactly is urinary incontinence? It is also known as urinary leakage, urine loss or hyperactive bladder, and it is defined as the involuntary loss of urine affecting mainly the female population. It does not just affect half the population of menopausal women, but up to 30-40% of post partum women who are still in the prime of their age! Urinary incontinence happens when the pelvic floor muscles which support the pelvic organs weaken and do not provide sufficient support for pelvic organs and continence control due to body aging, childbirth or hormonal changes.

There are 3 types of urinary incontinence:

1) Stress urinary incontinence – this occurs during increased intra-abdominal pressure to the bladder. Imagine wetting yourself when coughing, sneezing, laughing or lifting. This can be a great source of anxiety in social settings for many women!

2) Urge urinary incontinence – the intense desire to urinate, typically a symptom of an underlying disease like diabetes

3) Mixed urinary incontinence- a combination of stress & urge UI.

Many women are reluctant to discuss this with their doctors or even other people around them because of embarrassment or even fear associated with treatment options – it is, after all, involving their most intimate body parts. Some might not even know there is a solution to their worries, and assume that it is something inevitable that comes with age or childbirth.

Are men spared from incontinence? No. In male patients with prostate cancer requiring surgical removal of the prostate, up to 60% complain of incontinence, which is a common side effect of the procedure.

Fret not – with the advancement of science and technology – there is a solution to this problem! 

You can remain fully clothed and all you have to do is sit and relax on a life changing chair for less than half an hour, or only 28 minutes to be precise. The BTL Emsella is an FDA-approved breakthrough treatment for urinary incontinence using High-Intensity Focused Electromagnetic (HIFEM) technology to effectively stimulate pelvic floor muscles, leading to regained control over the pelvic floor muscles and bladder. You are recommended to complete 6 sessions, twice a week for best results. You may observe improvement after a single session, but results will typically improve over the next few weeks.The best part of all? Besides addressing your urinary incontinence issues, up to 85% of patients actually report an improvement in overall intimate sexual satisfaction with their partners.

What are you waiting for? Don’t be shy to talk to us about this, because urinary incontinence is more common than you think it is. Contact us at Anna Hoo Clinic to know more about our amazing offer price on this life changing treatment now!


Dr. Arzhealza R.
Anna Hoo Clinic

Tranexamic Acid : A New Skin Care Ingredient for Pigmentation

 

Tranexamic Acid

The desire for fair skin is pretty universal especially among young Asian women who equate being fair as being more attractive. There is even a Chinese saying that can be roughly translated to “one part of fairness hides a hundred parts of ugliness”. This belief often led to irrational use of skin lightening or whitening agents, which may result in untoward effects.

Often, I would come across patients who are excited about certain medications or products, the effects of which are strongly vouched for by their 'friends'. They make claims like “Trust me, it really works!” or “My friend’s been using it and swears by it!” or “Don’t be such a worrywart, try it!” Hence, it is no wonder even the most hesitant ones would be tempted to give it a try. The more cautious ones who are concerned about the side effects would maybe show me the products and ask for my opinion. In many instances, these so-called miracle products more often than not contains Tranexamic Acid, one of the skin lightening or whitening agents available in the market.

Tranexamic acid or its mouthful scientific name, trans-4-aminomethyl cyclohexane carboxylic acid is essentially a plasmin inhibitor, commonly used to stop bleeding (haemostatic agent) during major surgeries or heavy menses. In the field of dermatology, cosmetics and aesthetics, it has been used either as an oral agent, topical agent or intradermal injection to treat melasma and some other pigmentation disorders for its whitening effect.

How exactly does tranexamic acid works?

  • Control melanin pigment formation
  • Prevent melanin pigment accumulation
  • Reduce skin pigmentation
  • Anti-inflammation

Treatment of melasma with tranexamic acid produces gradual improvement that could be observed in the majority of the patients and usually detected after one month.

Tranexamic acid is well tolerated under normal circumstances. However, commonly reported side effects are gastrointestinal disorder such as abdominal discomfort, nausea, vomiting and diarrhea. Tranexamic acid may also reduce menstrual blood loss.

Oral and topical uses of tranexamic acid have shown to be effective in localized lesions such as in the treatment of melasma. There is no scientific data available to demonstrate the role of tranexemic acid as an overall skin whitening or lightening agent. In other words, you should not expect a whole body skin whitening effect à la Michael Jackson even if you are taking tranexamic acid orally! It is always important to know what you are using or consuming. There are plenty of products out there in the market with outrageous claims. This is not to say all of them are fakes. You can never be too careful. Just be mindful and if you have any doubts, please seek advice from your doctor.


Dr. Ian Tan 
Anna Hoo Clinic

There’s always a silver lining in every cloud !


What a year this has been. Doesn’t it feel like we just rang in the New Year yesterday? 2020 was the year that everyone who grew up in the 90’s looked forward to. Most of us have memories of ourselves drawing posters of how we envisioned the year 2020 was going to be, and humming along to the patriotic song “Wawasan 2020”(Vision 2020) each time it was played on TV and radio. Some of us might also have read books written back then which predicted that people in the future would be able to access almost everything imaginable at their fingertips. While many of those technological advancements have indeed become a reality-you can buy anything your heart desires online, keep in touch with loved ones living thousands of kilometres away at any given time of the day, and even consult a doctor online regarding your symptoms-no one ever saw this pandemic headed our way. 

Almost everyone thought it would just come and go, without much effect on our lives. But life must go on, despite this inevitable adversity. What can we do for ourselves, to make the rest of this year more bearable? In about 2 months, some of us will be celebrating Christmas, which simply put, is a celebration of love. So make the most of the remainder of this year, to practice self-love, and always look at silver lining in the cloud.

If travelling has always been your means of escape, and you are unable to do so because of travel restrictions, you can take this time to do in depth research of the places that you intend to visit once the pandemic has passed. How many times have you wished that you’d done your research properly before flying off to an unfamiliar place, only to regret when you come home and realise that you’d missed out on something really interesting?

If you’d always fretted about not looking your best in your holiday pictures, why don’t you take this time to embark on a fitness journey? You don’t necessarily need a gym membership to be fit and strong--your own bodyweight, determination and discipline will suffice. Start a food journal and you’ll be amazed at how healthy eating will boost your overall health.

If you’d been delaying that long due appointment with your aesthetic doctor because you were worried about that long but unavoidable downtime-now is the best time to call them up! Masks are compulsory, so you can avoid intrusive questions about your downtime from strangers. 

Just remember, if you intend to have minimally invasive treatments done on your face—double check if your doctor is fully qualified and certified to carry them out. There are many more things which you can do to make yourself feel better—just practise precautionary steps to keep yourself protected if any of these activities involve some form of contact with others.

Remember, nothing lasts forever, not even the bad times.


Dr. Arzhealza R.
Anna Hoo Clinic


Have you ever experienced any of the following symptoms, which you are not able to get rid of:

  • Mood swings
  • Irritability
  • Decreased sex drive
  • Worsening PMS symptoms (breast tenderness, acne flare up, headaches, etc)
  • Irregular menstrual periods
  • Heavy periods
  • Uterine fibroids
  • Bloating
  • Weight gain particularly in the hips, midsection and thighs
  • Anxiety
  • Hair loss
  • Poor sleep
  • Fatigue
  • Fertility issues
  • Memory problems
  • Brain fog
  • Hot flashes & night sweats 

You might be having estrogen dominance.

You might be wondering, what exactly is estrogen dominance? Isn’t estrogen supposed to be good for women? 

Estrogen dominance is simply a type of hormonal imbalance when the body contains too much estrogen compared to progesterone, which occurs as a result of the body producing too much estrogen than what is needed, or when it is exposed to excess estrogen in the environment, or when it is unable to properly break down estrogen.

And yes, we need estrogen because it is crucial for our day-to-day functioning. Estrogen regulates menstruation in women, hunger and satiety, insulin sensitivity, maintains bone density and metabolizes cholesterol. Without estrogen, you will experience symptoms of menopause.

What can be the possible causes of estrogen dominance?

Certain birth control pills add on more estrogen on top of pre-existing excess estrogen, and release synthetic progesterone, which suppresses the body’s natural progesterone production. Progesterone is responsible for balancing the effects of estrogen.

Certain skincare and cosmetics may contain chemicals which mimic estrogen and disrupt your hormonal balance.

Estrogen can also come from poultry, meat and dairy products which have been exposed to hormones for faster growth.

Estrogen can leak from plastic bottles into our drinking water.

Microbial imbalance in the gut reduces the body’s ability to eliminate excess estrogen effectively.

Heavy metal toxicity.

Uncontrolled stress - as the body uses up more pregnenolone to produce the stress hormone cortisol instead of progesterone.

Why is estrogen dominance dangerous?

An excess of estrogen can increase a woman’s risk of developing endometrial (uterine) cancer, ovarian cancer, and breast cancer!

Ways to reduce estrogen dominance include being at an ideal body weight, managing stress, increasing your intake of fiber and taking adequate healthy fats, avoiding plastic bottles, avoiding skincare products which may contain estrogen mimicking chemicals, getting adequate sleep, and considering taking certain supplements that may help the body break down excess estrogen.

Schedule your appointment with us today to get your hormone levels tested, and we will assist you in balancing your hormones, to allow to you live the life you deserve today!


Dr. Arzhealza R.
Anna Hoo Clinic


 

再见脂肪:瘦身减脂,从此不再复胖


减少身上多余的脂肪,是大部分人的梦想吧!(梦想这条路,是要不停不休不断的勇往前进)很多方法可以减脂,差别是效果快或慢,对身体的健康好或不好而已。当然,大家都会锁定“快速”的方法,而不小心忽略了所谓的“快速”,减掉的是不是脂肪,或者是其它如:宝贵的肌肉;水分等。

来,我们来讨论一下减脂的一些原理与方法。

首先,心态!
减脂最重要的是:你同意不同意减脂。
只有你愿意,你想要,你希望,你需要,减脂才比较会成功。
你同意了,那么,你的动力/原因/理由,是什么?找出来,写出来。
你想要的结果/成果/过程又是怎样的呢?

减脂的原理与方法:
减脂原理:卡路里:总热量的吸取与使用。
身体一天躺着不动消耗的热量叫基础代谢,如果你有运动,就有额外的热量消耗。如果一天你所吃下的总热量,比你所使用的总热量高,那么多余的热量,身体就会很开心帮你储存起来,变成一个你不喜欢听到的名字:脂肪。
所以,逻辑思维方法在于:减少总热量的吸取(Input),或提高总热量的使用(Output)。
是不是少吃多动?
不要吃太少而动太多,热量吃不够,身体会燃烧肌肉当热量的,肌肉量减少,基础代谢就会减少,很容易会陷入“遥遥球效应”,更严重的腹胖;
算一算你的总热量消耗TDEE,目标是减少TDEE,大概300-500卡路里之间吧!

减少总热量吸取:
方法:改变饮食成分/分量
  1. 减少碳水化物。大部分人的餐盘上50-80%都是淀粉+油脂。
  2. 参考健康饮食餐盘:大概类似:50%蔬果,30%蛋白质,20%碳水化物
  3. 多吃原型食物,少吃加工食品
  4. 吃足够的营养素
  5. 喝足够的水,戒喝糖饮料/果汁
  6. 每餐吃8分饱;多吃蔬菜,无上限;多吃蛋白质,耐饱又保肌
  7. 没有任何不可以吃的食物,除了毒药;重要是成分和分量

另外:
个人觉得刚开始自我监控(自我不行就寻求他人帮助)很重要,尤其当开始要养成健康饮食方式的食物。每天量体重蛮好的,可以看到进步,会更有动力与信心。
好好的睡眠,可加多生长激素的分泌而让减脂效果更好。

方法:改变饮食习惯/关系
  1. 探视自己与饮食的关系:你吃是为了什么?庆祝?宣泄压力?发泄情绪?
  2. 早餐也要营养均衡;外食得聪明选择;自己备餐最简单
  3. 好好的安排饮食的成分,选择健康的成分
  4. 减掉不必要的餐次:上午茶,下午茶,夜宵。我国有些人习惯了一日6餐。
  5. 慢吃,不要狼吞虎咽;专注,不要玩手机看电视
  6. 间歇性断食法:16/8


提高热量使用:
方法:无氧运动增肌:提高基础代谢;有氧运动燃脂,增强心肺功能
  1. 规律,足量的运动,每周三次,每次三十分钟,心跳率大约每分钟130次
  2. 无氧运动增肌,可以提高基础代谢;有氧运动可以加强心肺功能
  3. 从微量,轻度运动开始,当身体适应后,逐渐提升运动强度和增加不同的项目
  4. 无氧运动优于有氧运动,如果你不喜欢运动,没有时间运动,就纯做无氧运动吧!
  5. 能走就不要站;能站就不要坐;能爬楼梯就不要坐电梯;每天至少10000步

方法:改善环境影响
  1. 家里多储存健康食物,不要有零食;要吃零食的话,就准备健康谷类作物或水果。
  2. 减少呆在厨房,面对冰箱,或餐厅的活动时间
  3. 减少不必要的应酬/夜宵/酒类活动
  4. 可以尝试自己备餐-均衡健康饮食,对抗外食饮食不均衡
  5. 餐盘里的分量装少一些,不要太迟吃晚餐,安排三餐的固定时间
  6. 打造方便适合的运动环境:参加健身课程,找健身教练,找运动伙伴,使用一些运动/饮食app或tools来让过程更有趣。
  7. 多看些运动/健康饮食的视频或书籍,多学习,会提高动力

方法:提高持续减脂的动力
  1. 设定小目标,达到就有些健康的小庆祝,如穿合身好看的衣物
  2. 社交/朋友家人的支持很重哟
  3. 多看些提高动力/士气的视频,书籍

总结:
减脂: 
  • 心态很重要
  • 原理: 减少总热量吸取,提高热量使用。

每个月最好减1-2公斤的脂肪就好。也不要一味的追求最少脂肪,最大量的减重。男生大约10-15%身体脂肪率是理想的目标,女生大约15-23%。
记得饮食习惯需要慢慢改变,刚开始改善一日中的一餐,进而两餐;改善一星期中的一天,慢慢几天,慢慢每天;若觉得需要欺骗餐/欺骗日,都没有问题不必吃了愧疚,吃了后心情满意平复后就重回减脂的轨道吧!
如果不喜欢运动,没时间运动,那么就选择需要花费最短时间,最快见效的重训吧!一星期一两次,每次30-45分钟就好,都可以好好维持了。
这是一个马拉松,不是短跑。如果成功养成良好的饮食习惯与运动习惯,就这样保持着健康的体重,与理想的身体状态,一直到永远吧!


PS: 如果觉得刚想开始瘦身没有头绪,欢迎询问哦!

Dr William Hoo

Tattoo removal – how many treatment sessions do I need?







Case scenario:

Mrs. X, a 40 year old Chinese housewife had black eyebrows tattoo/embroidery done a year ago by an amateur eyebrow tattoo artist which she is very unsatisfied with the design. Now she would like to have her eyebrows tattoo removed so that she can get a new one. She  wanted to know how many treatment sessions she requires. Well, let’s start the calculation.

Skin type                              : 3                 = 3 points
Location                               : face            = 1 point
Amount of ink                      : amateur      = 1 points
Layering                               : no               = 0 point
Scarring & tissue change      : no               = 0 point
Color                                     : black         = 1 point
                                                                                     
Total points                           : 6

Estimated number of treatments required by Mrs. X is 6. 

To determine the number of treatments needed for successful removal of tattoos, the Kirby-Desai Scale is used. It is a quantitative system that assigns numerical points to six different factors that, when summed together, reveal a score that determines the number of treatments a patient will need for successful tattoo removal. The six factors are as follows:

1. Patient Skin Type
2. Location of Tattoo
3. Amount of Ink
4. Layering/Cover-Up
5. Scarring/Tissue Change
6. Color(s) of Ink


Skin Type

Skin type or tone can be categorized using the Fitzpatrick Scale, a tool that classifies skin types from a 1 – 6 scale, with type 1 being the lightest skin tone and type 6 being the darkest. Patients with darker skin tones are more susceptible to certain risk of complications, including scarring and hypo or hyperpigmentation. Therefore, patients with darker skin tones need to be treated more conservatively and carefully with safer treatment protocols such as lower energy laser settings and longer waiting periods between treatment sessions, to minimize the risks of unwanted side effects. In general, people with darker skin tones require more visits for best tattoo removal results.




Location

Location is rated on a scale of 1 to 5 depending on how vascularize that area is. Tattoos on the head, face and neck will fade faster, as these have the largest amount of regional lymph nodes and a larger vascular supply, so removing a tattoo from these areas takes less time. Meanwhile, tattoos on distal extremities such as on the feet and hands in particular will take longer to remove. In short, tattoos placed closer to the heart and major blood vessels and lymphatic system fade at a faster rate.




Ink Amount

This is rated on a scale of 1 to 4 depending on the tattoo ink density. Amateur tattoos or homemade tattoos typically contain less ink and is unevenly placed closer to the skin surface which usually require much lesser treatment session. Professional tattoos on the other hand use more ink and the ink is place deeper under the skin.




Layering/Cover-ups

A layering/cover-up is defined as a tattoo on top of another one in order to conceal the previous piece or design. These often lead to a very heavily dense and saturated tattoo ink in that area. Therefore, more treatments will be needed to successfully remove the ink from the combination of cover-up tattoo and old tattoo.





Scar Tissue

Scar tissue is on a scale of 0 to 5. Scoring is based on the severity of scarring or tissues change, with 0 meaning there is no scarring present and 5 with significant scarring or tissue changes. Tattoos with scarring and tissue change are much more difficult to remove and usually require more treatment sessions.





Ink Color

Ink color is rated on a scale of 1 to 4. Darker colors respond the best to laser tattoo removal and the easiest color to remove, while the hardest are green, yellow, and light blue. Thus, the more colors you have on the tattoos, the more treatment sessions are required.




By using the Kirby-Desai scale, we are able to provide a more precise estimation(80% accuracy) of how many treatments are required for a successful tattoo removal. However the number produced by this scale should not serve as a conclusive answer. It's important to emphasize that this is only an estimate, each person is different and each tattoo removal is unique. Drop in for a consult with any of us at Anna Hoo Clinic regarding tattoo removal. We are more than happy to address whatever doubts and concerns you may have.


Dr. Ian Tan
Anna Hoo Clinic