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丁达尔现象 Tyndall effect
不过在医学美容里的注射美容领域，丁达尔现象的出现并不是好现象。
通常发生这一个现象的原因就是注射过浅，当光线打在皮肤上，产生散射而形成。蓝色光线波长为400NM，相比红光它更容易散射。如果将玻尿酸透明物质注射过浅或注射量过大，容易造成蓝光被散射而形成发蓝现象。
如何避免呢？
只要注射的层次正确，这现象就可以避免。
若已经发生了，怎办？
如果注射产品是玻尿酸，那么很幸运的可以注射玻尿酸的溶解剂来消除或稀释使其溶解或减量。也可以尝试镭射或RF让玻尿酸加快溶解或消失。
如果是其他产品，或许就必须动刀把其取出了。
为何好的镭射机器那么贵
http://www.fotona.com/de/products/?id=677
不同国家不同产方的镭射机器，科技都不一样。
以前觉得应该会大同小异，不过当使用多了有了经验就会发现它们的不同。
就如同去除色斑的镭射，有的机器效果很好很快见效，有的就比较慢；有的进行特定次数的镭射疗程后会出现白点斑（色素细胞受损）的后遗症，有些就不会。有些可以用来治疗比较多种的色斑问题，有些就差强人意；有些可以耐久机能仍然能量强度保持，有些呢就能量强度很快走下跛。
当然，除了镭射机器的科技，制造的材料，使用的方式，和使用者的习惯，都会对镭射机器的寿命造成影响，也会对效果造成差别。
所以，可以理解为什么有些欧州镭射机器的价格那么的昂贵，而一些亚洲的机器可以差别那么大。对于这些医疗机器，真的是一分钱一分货。当然，若我们选择，一定是要安全性能高的机器，毕竟，我们所要的，是治疗问题，而不是治疗出现问题。
这是看了不同产方的机器后有所感。
Nurse reveals the top 5 regrets people make on their deathbed
Good article to share.
Article origin from here
REGRETS OF THE DYING
For many years I worked in palliative care. My patients were those who had gone home to die. Some incredibly special times were shared. I was with them for the last three to twelve weeks of their lives.
People grow a lot when they are faced with their own mortality. I learnt never to underestimate someone's capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them.
When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again. Here are the most common five:
1. I wish I'd had the courage to live a life true to myself, not the life others expected of me.
This was the most common regret of all. When people realise that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honoured even a half of their dreams and had to die knowing that it was due to choices they had made, or not made.
It is very important to try and honour at least some of your dreams along the way. From the moment that you lose your health, it is too late. Health brings a freedom very few realise, until they no longer have it.
2. I wish I didn't work so hard.
This came from every male patient that I nursed. They missed their children's youth and their partner's companionship. Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.
By simplifying your lifestyle and making conscious choices along the way, it is possible to not need the income that you think you do. And by creating more space in your life, you become happier and more open to new opportunities, ones more suited to your new lifestyle.
3. I wish I'd had the courage to express my feelings.
Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result.
We cannot control the reactions of others. However, although people may initially react when you change the way you are by speaking honestly, in the end it raises the relationship to a whole new and healthier level. Either that or it releases the unhealthy relationship from your life. Either way, you win.
4. I wish I had stayed in touch with my friends.
Often they would not truly realise the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying.
It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away. People do want to get their financial affairs in order if possible. But it is not money or status that holds the true importance for them. They want to get things in order more for the benefit of those they love. Usually though, they are too ill and weary to ever manage this task. It is all comes down to love and relationships in the end. That is all that remains in the final weeks, love and relationships.
5. I wish that I had let myself be happier.
This is a surprisingly common one. Many did not realise until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called 'comfort' of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. When deep within, they longed to laugh properly and have silliness in their life again.
When you are on your deathbed, what others think of you is a long way from your mind. How wonderful to be able to let go and smile again, long before you are dying.
Life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness.
WH
Article origin from here
REGRETS OF THE DYING
For many years I worked in palliative care. My patients were those who had gone home to die. Some incredibly special times were shared. I was with them for the last three to twelve weeks of their lives.
People grow a lot when they are faced with their own mortality. I learnt never to underestimate someone's capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them.
When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again. Here are the most common five:
1. I wish I'd had the courage to live a life true to myself, not the life others expected of me.
This was the most common regret of all. When people realise that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honoured even a half of their dreams and had to die knowing that it was due to choices they had made, or not made.
It is very important to try and honour at least some of your dreams along the way. From the moment that you lose your health, it is too late. Health brings a freedom very few realise, until they no longer have it.
2. I wish I didn't work so hard.
This came from every male patient that I nursed. They missed their children's youth and their partner's companionship. Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.
By simplifying your lifestyle and making conscious choices along the way, it is possible to not need the income that you think you do. And by creating more space in your life, you become happier and more open to new opportunities, ones more suited to your new lifestyle.
3. I wish I'd had the courage to express my feelings.
Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result.
We cannot control the reactions of others. However, although people may initially react when you change the way you are by speaking honestly, in the end it raises the relationship to a whole new and healthier level. Either that or it releases the unhealthy relationship from your life. Either way, you win.
4. I wish I had stayed in touch with my friends.
Often they would not truly realise the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying.
It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away. People do want to get their financial affairs in order if possible. But it is not money or status that holds the true importance for them. They want to get things in order more for the benefit of those they love. Usually though, they are too ill and weary to ever manage this task. It is all comes down to love and relationships in the end. That is all that remains in the final weeks, love and relationships.
5. I wish that I had let myself be happier.
This is a surprisingly common one. Many did not realise until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called 'comfort' of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. When deep within, they longed to laugh properly and have silliness in their life again.
When you are on your deathbed, what others think of you is a long way from your mind. How wonderful to be able to let go and smile again, long before you are dying.
Life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness.
WH
Aesthetic medicine (Scope of Practice)
Aesthetic medicine is branch of medicine, distinct from plastic surgery, focused on satisfying the aesthetic desires and goals of patients. Aesthetic medicine comprises all medical procedures in the field of Aesthetics excluding all surgical procedures which require an operating table and general anesthesia (such as breast implants, liposuction, surgery of obesity, facelifts, rhinoplasty, etc.).[1]
This specialty is primarily focused on the pathophysiology of aging skin, and adheres to scientific based procedures. Physicians practicing Aesthetic Medicine are trained in both invasive and non-invasive treatment modalities, and typically utilize a combination to meet the needs of the patient.[2]
Indications:
It can intervene
- in the treatment of the wrinkles and the scars
- in the ageing of the face, the hands, the low neckline and the glance
- in the treatment of the pigmentary spots, of the disgracious blood-vessels
- in the prevention of body ageing
- in laser tattoo removal
The fields of competence are mesotherapy, the general medicine, biology, the dermatology, the endocrinology, gynecology, psychology.[3]
Most current non-surgical aesthetic procedures:
- Injections Botulinum toxin
- Injections of Hyaluronic Acid and other fillers.
- Chemical Peels
- Medical Cosmetology
- Aesthetic Mesotherapy
- Shapes and Cellulite Control
- Nutrition
- Hair transplantation
- Hair removal
- Skin Laser Therapy
- Aesthetic Venous Treatment
- Aptos/Contour Threads
- Curl Lifting
- Non-surgical liposuction
- Lipotomy
- Carboxytherapy
The real benefit of practicing Aesthetic Medicine is the type of care that physicians are offering to their patients. These procedures are elective and are performed on patients who do not suffer from illness. They are usually happy and in excellent health. They simply want a quick fix or a preventative procedure to help manage the normal effects of aging.
When performed by a trained physician, non-surgical procedures are safer than plastic surgery as they do not require general anesthesia. They are usually quicker (can be done during lunch breaks) and are preferred by patients as they do not involve a scalpel and an operating table.
Information from Wikipedia
International references:
- ^ American Institute of Aesthetic Medicine, AIAM.
- ^ International Association for Physicians in Aesthetic Medicine, IAPAM.
- ^ fr:Médecine esthétique "Médecine ésthetique", French Wikipedia.
From Guideline on Aesthetic Medical Practice (Malaysia)
2.0 SCOPE OF PRACTICE
2.1 The basic consideration for the scope of practice in aesthetic medical practice
by general practitioners is the minimum level of competence required (refer Table
1).
2.2 General practitioners are only allowed to perform non-invasive and minimally invasive procedures. The non-invasive and minimally invasive aesthetic medical procedures are as listed below:
(a) Non-invasive:
(b) Minimally invasive:
2.3 As medical science advances, any other aesthetic medical procedures in the future that fulfil the criteria of non-invasive and minimally invasive may be added to the list upon approval by the Main Credentialing and Privileging Committee of Aesthetic Medical Practice.
2.2 General practitioners are only allowed to perform non-invasive and minimally invasive procedures. The non-invasive and minimally invasive aesthetic medical procedures are as listed below:
(a) Non-invasive:
- Superficial chemical peels Microdermabrasion Intense pulsed light
(b) Minimally invasive:
- Chemical peel (Medium depth)
- Botulinum toxin injection
- Filler injection - excluding silicone and fat
- Skin tightening procedures-up to upper dermis (radiofrequency, infrared,ultrasound and other devices)
- Superficial sclerotherapy
- Lasers for treating skin pigmentation
- Lasers for treating benign skin lesions
- Lasers for skin rejuvenation (including non ablative)
- Lasers for hair removal
2.3 As medical science advances, any other aesthetic medical procedures in the future that fulfil the criteria of non-invasive and minimally invasive may be added to the list upon approval by the Main Credentialing and Privileging Committee of Aesthetic Medical Practice.
About Aesthetic Medical Practice
a) There is no internationally accepted definition for “aesthetic medical practice”.
For the purpose of these guidelines it is defined as:
An area of medical practice which embraces multidisciplinary modalities dedicated to create a harmonious physical and psychological balance through non-invasive, minimally invasive and invasive treatment modalities which are evidence-based. These modalities focus on the anatomy, physiology of the skin and its underlying structures, to modify the otherwise „normal‟ (non- pathological) appearance in order to satisfy the goals of the patient and are carried out by registered medical practitioners.
(b) “registered medical practitioner” is defined as a medical practitioner who is registered and holds a valid practising certificate under the Medical Act 1971 [Act 50]
Extract from the Guideline: Malaysia Guideline of Aesthetic Medicine
New Committee Members of 2013/2014 The Malaysian Society of Aesthetic Medicine
MSAM 2013/2014 Executive Committee:
President : Dr Chin Shih Choon
Vice President : Dr Hew Hin Keat
Hon Secretary : Dr Masilamoney Asirvatham
Asst Secretary : Dr Jeyanthi Veluppillay
Treasurer : Dr Wong Chee Hin
President : Dr Chin Shih Choon
Vice President : Dr Hew Hin Keat
Hon Secretary : Dr Masilamoney Asirvatham
Asst Secretary : Dr Jeyanthi Veluppillay
Treasurer : Dr Wong Chee Hin
Committee members:
1. Dr Louis Leh Swee Koch
2. Dr Liow Tiong Sin
3. Dr Michael Ng Leong Toong
4. Dr Nicholas Lim
5. Dr William Hoo Khee Liam
1. Dr Louis Leh Swee Koch
2. Dr Liow Tiong Sin
3. Dr Michael Ng Leong Toong
4. Dr Nicholas Lim
5. Dr William Hoo Khee Liam
吸烟让你更快老
照片来自http://tobaccobody.fi/
吸烟是慢性自杀。
一路来我们都这样的知道，不过很多人还是依然故我的沉醉在烟雾的世界里，从吸烟里继续获得自以为的安慰，与解脱。
我一直告诉病人说，如果您吸烟，那么您的健康，您的生命，都会受影响。
不过那些致命的影响通常都不会立刻到来，可是却有迹可寻。
这一个网站是很有意思的网站，他把健康的一个人，和吸烟后的改变放在一起，立刻可以看到差别。
皮肤会变差，皱纹，干枯
荷尔蒙会有变化，色斑的到来，体毛不寻常的增长
青春痘肆虐，难以控制，毛孔粗大
口臭
肺活量减低
更别说对怀孕胎儿的不良影响
肠胃病
等等等等
以及最严重的癌症
可以到达那一个网站，再把照片放大，看看肉眼清晰可见的变化
很可怕
如果您还在吸烟，想想您的健康，想想您身边人的健康
是不是，应该戒烟了？
祝福您。
By,
Dr William
耐久的玻尿酸填充液
填充液 dermal Filler 有很多种类。
其中最广泛使用的一个是玻尿酸。
而市场上有很多品牌，其中值得信赖的品牌如： Juvederm, Restylane, Teosyal eg...
不过玻尿酸填充液的耐久和产品里头的玻尿酸浓度有关。
不同的脸部部位需要不同的浓度，不同的浓度才能给予最自然的效果。
不同的玻尿酸浓度，在人体内的耐久时限也不一样。
玻尿酸浓度低的，“柔软性”比较好，适合部位如泪沟，眼部底下，或改善皮肤水分肤质，耐久大约4－6个月
浓度中等的，适合部位如嘴唇，法令纹，木偶纹等，耐久 6－9 个月
浓度高的，适合雕塑面型，鼻梁等，耐久9－12个月。
不同的品牌，玻尿酸在填充液里的排列方式也不一样，现在越来越先进的技术，让玻尿酸在体内可以逗留更久。
这一个品牌的玻尿酸，最新的技术，让这个产品可以在体内逗留得更长久。
最新的报告
Clinical, Cosmetic And Investigational Dermatology: Efficacy and safety of a hyaluronic acid filler in subjects treated for correction of midface deficiency: a 24 month study
24个月后，依然有很多使用者对这产品的效果感到满意
意思是说，在注射后24个月，依然有令人满意的效果存在。
这个颠覆了以前我们的认为：玻尿酸在一年后就会消失殆尽
如何要让玻尿酸的效果持久呢？
玻尿酸在我们体内的逗留时间和我们的体内新陈代谢有很大的关系。
抽烟者，熬夜者，或运动健将，体内的新陈代谢快速，或很多自由因子free radical的产生，都会让玻尿酸的寿命减少，不耐久。
另外就是注射的层面和技巧。
表情动作越少的部分，就更耐久。
注射在骨骼上的部位和相比肌肉群上的玻尿酸，比较耐久。
下次我们再讨论更多关于填充液。
整形变脸到底是为了什么
变脸到底是为了什么呢？
我们常常说，比较重要的其实是个性，内在，可是在这一个“以貌取人”的大环境里，无可否认的是外貌比较出色的人得到的机会比较多比较好，而有一些先天条件没有那么好运的，则在生活圈子里活得不是很开心。
如果改变可以改善自己的信心，带来更好的人生，那么，有何错呢？
我们必须尊重所有人的选择。
看看这一群整形后的人们，有些人真的获得了生活里的改善，以及与朋友们的圈子关系。
不过，这也让我想起了香港某诊所的照片广告
你唯一担心的是该如何和孩子解释
该如何解释呢？
或者告诉孩子，等你长大了，就也去变脸吧！
By
William Hoo
注射美容的安全时代
 |
| Dr Anna (左三) Restylane Workshop at Le Meridien Hotel Sept 2013 |
经过一段时间后，常使用的医生们也开始累积经验，对于产品的认识和认知更深入。在累积经验的过程中，也免不了有些错误，或意外的发生，而如何补救甚至急救，则是保证病人们的安全的最大保障。
今年开始，产方所邀请的讲师或特约医生，在讲解的过程中，会概括了如何面对，如何补救，以及如何避免副作用，或后遗症。
每一种疗程都会有其危险性，副作用，或后遗症。
把这些重要的知识实践在日常工作上，其实是对病人的祝福，而且应该是每一个医生的责任。在专业的领域里，不知者无畏可不是一个勇敢的表现。不知者无罪更不应该是一个推卸责任的借口。如果自己不懂，就不要进行任何自己不确定的疗程，而进行疗程后，就应该为自己的行动而负责。
一些专业的讲师坦诚他们也是花了一段不短的时间，面对了不少出现问题意外的病人，而成就了现在经验更丰富的他们。初期的开发者面对的问题总是特别的多，后来者就必须学习他们的经验，而造福日后的病人。
注射美容，尤其是填充液有其危险性，不过危险性是可以靠注射者的经验，良好的产品，适当的技巧，和选择适合的病人而减少的。
还记得这一个新闻吗？
其实选择对的注射者（一定要是经验医生），在对的环境（拥有急救措施），发生问题后及时补救（溶解注射物），伤后复原疗程等，可以避免出现大伤害，就算伤害发生了，也可以及时把伤害减至最低最小。
医生们要努力学习经验技巧，而病人们也要努力寻找对的医生啊！
现在的市场上的产品零零种种，太多产方的出现，如何选择适当，安全，有品质的产品也开始成为一个话题。而未来，可以预想的是，会有更多的新产品出现，会有更多的医生加入这一个行列，希望不会有更多的不幸事故发生。
大家都应该做好各自的功课。
而我在想，要不要在这里分享更多已经发生的后遗症案例？
会不会吓坏人呢？
by Dr William Hoo
FDA approves Botox Cosmetic to improve the appearance of crow’s feet lines
FDA NEWS RELEASE
For Immediate Release: Sept. 11, 2013
Media Inquiries: Andrea Fischer, 301-796-0393, andrea.fischer@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA
FDA approves Botox Cosmetic to improve the appearance of crow’s feet lines
The U.S. Food and Drug Administration today approved a new use for Botox Cosmetic (onabotulinumtoxinA) for the temporary improvement in the appearance of moderate to severe lateral canthal lines, known as crow’s feet, in adults. Botox Cosmetic is the only FDA approved drug treatment option for lateral canthal lines.
The FDA approved Botox Cosmetic in 2002 for the temporary improvement of glabellar lines (wrinkles between the eyebrows, known as frown lines), in adults. Botox Cosmetic works by keeping muscles from tightening so wrinkles are less prominent.
“This additional indication will provide people with a new FDA approved treatment option for those seeking a smoother appearance by temporarily minimizing the appearance of crow’s feet at the sides of the eyes,” said Susan Walker, M.D., director of the Division of Dermatology and Dental Products in the FDA’s Center for Drug Evaluation and Research.
Botox Cosmetic is administered via intramuscular injections. Treatment for both frown lines and crow’s feet can be given at the same time.
Botox Cosmetic’s safety and effectiveness for treating lateral canthal lines were established in two clinical efficacy and safety studies. The studies enrolled 833 adult participants with moderate to severe lateral canthal lines who were randomly assigned to receive Botox or placebo. Results showed that those treated with Botox had greater improvement compared to placebo in the appearance of lateral canthal lines.
The most common adverse reaction associated with the use of Botox Cosmetic for treatment of lateral canthal lines is eyelid edema, a condition in which the eyelids are swollen and contain excessive fluid.
OnabotulinumtoxinA is marketed as Botox and Botox Cosmetic. The FDA approved Botox for the treatment of chronic migraine, severe underarm sweating, blepharospasm (eyelid spasm) and strabismus (misalignment of the eyes when one or both eyes turn inward or outward). Botox and Botox Cosmetic have a boxed warning that says the effects of the botulinum toxin may spread from the area of injection to other areas of the body, causing symptoms similar to those of botulism. Those symptoms include swallowing and breathing difficulties that can be life-threatening. There has not been a confirmed serious case of toxin spread when Botox or Botox Cosmetic has been used at the recommended dose for the approved indications.
Consumers and health care professionals are encouraged to report adverse reactions from the use of Botox Cosmetic to the FDA’s MedWatch Adverse Event Reporting program at www.fda.gov/MedWatch or by calling 800-FDA-1088.
Botox Cosmetic is manufactured by Allergan Inc. based in Irvine, Calif.
For more information:
FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
整形的意义
每一个人听到整形都会想起爱美。
其实当我们在医学院当医学生的时候，所理解的整形其实都是一些帮助一些不幸人士的手术，它有一个很好听的名字：颜面重整。
有人先天不足，有人后天不幸，而整形最大的帮助就是让他们重新拾回自我的信心，可以生活得更有自信，而不是单单的追求美貌而改头换面。
也许，这个才是真正整形的意义：重拾生活的自信。
其实当我们在医学院当医学生的时候，所理解的整形其实都是一些帮助一些不幸人士的手术，它有一个很好听的名字：颜面重整。
有人先天不足，有人后天不幸，而整形最大的帮助就是让他们重新拾回自我的信心，可以生活得更有自信，而不是单单的追求美貌而改头换面。
也许，这个才是真正整形的意义：重拾生活的自信。
很多人都会把焦点放在变成美女这一个话题上
其实，不再被人恶意歧视，改善咬嚼食物的能力，才是她最大的收获。
整形，有其正面的意义。
而我们，也该尊重所有人的选择。
美白针不合法
很多人对于美白这一回事真的如热恋中的情感，爱此不疲。
也许是大家所说的一白遮三丑而让众多人士不停的寻找美白秘方。
很多美容院，甚至有一些医美诊所都有替人注射美白针的服务，不过这些服务其实都没有经过医学验证，而是很多人的人云亦云，甚至盲目相信名人的背书效应而铤而走险。
注射美白针可是一件危险的事情。
大家所看到的都只是被放大后的漂亮效果和夸大的美白结果，可是有谁知道其实其潜在的危险性甚至可以危害生命。
Anaphylatic shock，过敏性休克，是其中的潜在危险之一。若不幸发生而没有适当的医疗救护，可严重至失去性命。
为了暂时性的美白效果而让自己的生命处于危险之中，值得吗？
有人就说，所以应该去诊所叫医生帮忙打针，甚至亲自带了产品上门，要求医生注射。
其实这是不对的。
现今这市场上没有任何一种美白的注射产品，是卫生部注册，可以合法和安全使用。
医生如果被抓到不合法的替病人注射美白产品如Vit C，可以罚款最高25千零吉，或三年监牢，或两者兼施。
为什么在国外那么的流行呢？难道不危险吗？
法律和国情不一样。
其实在国外注射，也是AT Own Risk，意思是万一发生不幸事故，自己得承担所有责任而不能问责。
好，那么如果不能注射美白针，要如何美白呢？
1. 防晒，全年全身防晒
2. 适当的美白护肤产品
3. 镭射美白疗程
4. 果酸换肤
5. 维生素的摄取，尤其是口服Vit C
6. 适当的食物摄取，减少感光食物的摄取
7. 饮取足够的水分
美丽是从内而外的。
身体健康的美，是所有其他东西都比不过的。
Selamat Hari Merdeka
Greeting from us:
Selamat Hari Merdeka.
"Dare to love yourself
as if you were a rainbow
with gold at both ends."
— Aberjhani (The River of Winged Dreams)
as if you were a rainbow
with gold at both ends."
— Aberjhani (The River of Winged Dreams)
The 8 Point Lift
The 8 Point approach was pioneered by Dr Mauricio de Maio and is a revolutionary new approach to achieving a non-surgical face lift.
The 8 points
1,2. Cheek structure Over time, we start to lose this youthful volume and definition in the cheeks.
3. Tear troughs As we age, volume loss in this area can create a hollow depression, giving us a tired appearance.
4. Nasolabial folds - the lines that run from the corner of our nose to our mouth gradually deepen as the soft tissue volume in our face decreases.
5. Mouth frown A mouth frown is where the corners of our lips begin to turn down. With time, these become more pronounced.
6. Pre-jowl area Jowls slowly appear when soft tissue volume moves down the face, giving the face a heavy look.
7. Jawline In our youth, the jawline is a smooth line extending from our jaw to our chin. As we age our jawline loses definition.
8. Cheek volume Over time, volume loss in the mid section of the face can make our cheeks look hollow.
Facial contours will be improved and facial volume subtly enhanced.
A little redness may be experienced for a brief period following the treatment and bruising is possible.
Result will last up to 24 months depend on type of the filler use.
Aiming for NATURAL, REFRESHING LOOK, for a better you.
If you would like more information, please see your doctor for further explanation.
by William Hoo
“永恒的微笑”
嘴角往下弯，或者比较熟悉的形容是嘴角往下掉，带给人的印象是不好的。
你有心事吗？
你在伤心吗？
你有烦恼？
你在不高兴或生气吗？
你是不是情绪低潮不舒服？
其实都是负面的印象。
当我们笑的时候，嘴角会往上弯，不自觉间带给旁人开心心情灿烂晴朗的舒服感觉。
别人和你说话的时候，也会被你不自觉地欢乐气氛给感染，觉得你真诚，自信且让人舒服。
http://abcnews.go.com/ABC_Univision/joker-lips-surgery-south-korea-creates-perma-smile/story?id=20023365
如果不想要挨刀动手术，有没有方法可以让自己嘴角往上翘呢？
有的。
医学美容的疗程：
肉毒杆菌素，可以让往下拉的面部肌肉放松
而波尿酸填充液，则可以在嘴角下摆适当的部分填补，让嘴角可以往上提。
不过也许效果是暂时性，在长时间后需要再次进行疗程
整容手术：
一劳永逸的方法就是进行嘴角再造手术
可以带来一个令人惊艳的效果
“永恒的微笑”
呵呵，你说呢？
你有心事吗？
你在伤心吗？
你有烦恼？
你在不高兴或生气吗？
你是不是情绪低潮不舒服？
其实都是负面的印象。
当我们笑的时候，嘴角会往上弯，不自觉间带给旁人开心心情灿烂晴朗的舒服感觉。
别人和你说话的时候，也会被你不自觉地欢乐气氛给感染，觉得你真诚，自信且让人舒服。
美国外科医生称这为小丑唇。而很多人西方人认为这是不正常的，是面部提升手术所带来的并发症，是美国外科医生想要设法避免的。
可是这一个嘴角微微往上翘的造型，最近在韩国风行起来。
在韩国，实施该手术的美容诊所接待的求美者以年轻人比较多，而且有些人追求的手术效果更夸张。
天生嘴角向下、两侧嘴角不对称，以及自感笑容不自信都可以考虑进行手术改善，手术费用在2000美元左右。韩国目前极其注重外表的极端社会压力下，很多人不断寻求各种方式以增加自己的外观竞争力。
天生嘴角向下、两侧嘴角不对称，以及自感笑容不自信都可以考虑进行手术改善，手术费用在2000美元左右。韩国目前极其注重外表的极端社会压力下，很多人不断寻求各种方式以增加自己的外观竞争力。
GIRL_STONE_13_8_22_4x3t_384.jpg)
http://abcnews.go.com/ABC_Univision/joker-lips-surgery-south-korea-creates-perma-smile/story?id=20023365
如果不想要挨刀动手术，有没有方法可以让自己嘴角往上翘呢？
有的。
医学美容的疗程：
肉毒杆菌素，可以让往下拉的面部肌肉放松
而波尿酸填充液，则可以在嘴角下摆适当的部分填补，让嘴角可以往上提。
不过也许效果是暂时性，在长时间后需要再次进行疗程
整容手术：
一劳永逸的方法就是进行嘴角再造手术
可以带来一个令人惊艳的效果
“永恒的微笑”
呵呵，你说呢？
Biofiber Hair Implant
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The synthetic hair are almost like natural hair. They are soft and flexible, have variety of shapes, lengths and color which suit different needs. The biofiber hair can be washed and dried as usual however it is not advisable to be blenched or dyed. The raw materials used for biofiber hair production that are all FDA approved and CE for medical use. Hence the procedure should be carried by a trained medical doctor.
It is an option for those who do not have a sufficient donor area for hair transplant. It also can improve the aesthetic appearance of various type of hair loss baldness.
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定期保养比急救性疗程好
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“有什么办法可以去除我脸上这一些痘疤？”
这是青春期年级比较轻的朋友们比较常面对的东西。
“我的毛孔粗大。”
“工作压力大，皮肤容易看起来暗沉。”
“我开始有黑眼圈，看起来样子很累。”
进入工作生涯，生活与工作的压力开始让皮肤失去青春期的亮丽。
“你看，我笑得时候，眼角开始出现皱纹了。”
“我很讨厌我眼睛周围的小细纹。”
“我的样子看起来很不开心。”
“我的抬头纹线路好深哦！”
“我的脸型好像变四方了。”
30岁后，脸型慢慢走样，皱纹渐渐蔓延，初期老化的迹象肉眼也开始看出来。
“我的脸部开始下垂。”
“我脸上这些是什么斑点？”
“上眼皮开始下垂，眼袋开始明显了。”
“脸颊凹陷的地方开始明显了。”
“法令纹，木偶纹，鱼尾纹让我看起来好伤感和苍老。”
40岁后，想要改善的地方需要比较大动作的疗程了。
经过了一段日子，对于医学美容，观察中会发现不同年龄层的男生女生都会有不同的需求。
不过大概大家在某年龄层的时候，所面对的问题都会大同小异。
所以呢！不同年龄层的需求就需要对症下药。
青春期的青春痘问题，是很多青少年的痛，而在青春痘肆虐期间，若照顾不当，所留下来的痘痘伤疤可以是一辈子的疤痕。这伤疤建议进行的疗程是镭射磨皮，可以是二氧化碳镭射(CO2 laser)磨皮，可以是飞梭镭射 （fraxel/ erbium yag laser），大概都需要进行至少三次的疗程，效果才会明显，间隔则是2-3个月左右。另外一个比较新颖的疗程是INTRAcel(Micro Needling Radio Frequency) 微针电波换肤，效果很好，不过也是建议进行至少３次的疗程以达到好效果。
肤色暗淡，脸部暗沉，毛孔粗大，雀斑晒斑等等，则可以以偏皮肤保养和去除色素的镭射疗程对付，也就是所谓的Q Switch Nd Yag镭射，市场上品牌不少：Fotona QxMax, Tribeam Premium, Medlite, Revlite, C6, Spectra 等等都可以提供类似效果，差别的是操作的医生的经验与对问题的了解度。
关于皱纹，又分为动态皱纹和静态皱纹。肉毒杆菌素对于减少抚平动态皱纹的效果显着，也可以注射在咬肌部位以修饰脸型。
皮下组织填充液如波尿酸可以填补凹陷的部位，改善皮肤水分的问题，除此之外还可以垫高鼻子山根部位，填补凹陷的夫妻宫，甚至重新焕发苹果肌。填充液其实有很多种类，波尿酸只是其中之一，另外还有微晶瓷Radiesse，Sculptra，Collagen，等等暂时性的填充液，和永久性的填充液如Aquamid。会推荐波尿酸，因为其安全性较高，可逆转性若发生问题也比较容易化解。
脸部提升也要视乎脸部的老化情况，脂肪遍布的状态，和皮肤的品质。医美微整可以是肉毒杆菌素面部拉提(BOTOX liquid face lift)，波尿酸填充液拉提(Filler Face Lift)，埋线拉提(PDO thread lift)，镭射拉提 (Laser Facelift: AccuLift, Long pulse Nd Yag Facelift)等等。不同的技巧拥有不同凡响的响亮名字，不过大致上是大同小异。选择哪一个疗程就视乎医生对于现实状态的诊断和提议，当然，费用也是消费者的考量之一。
每一种的疗程效果都是暂时性的。人会慢慢变老，皮肤也是。没有任何人可以什么也不做就可以自动抗老永远活在不老的青春期，有什么我们应该做的呢？
答案是保养。
就算是动手术进行脸部拉提，效果最多也是数年而已，而不是一次性就断根性的解决问题。脸部的皮肤依然会逐渐下垂，如果没有照顾和保养得体。
可以和您的医生讨论参考，针对性的为自己的皮肤状况设定保养的疗程。如同之前所说的，不同的年龄层会出现不同的问题，而不同的问题需要不同的器材疗程以针对性的解决问题。医美疗程的效果相比美容院的保养疗程会比较显著和见效，看似急救性的疗程，其实换一个角度看，也可以把它当作例行性的保养疗程，可以三个月一次，或半年一次，如果没有任何大问题也可以当作是预防性的保养疗程，花费会比急救性的疗程少，效果也更可以耐久。
就算是汽车，也需要定期维修修整和保养，不是吗？
by
William Hoo
医美烟霾
近几日烟霾问题越来越严重，开车的时候不仅能视度减低了，空气中更是充斥着令人不舒服的烧焦的味道。这可是危害人体健康的空气污染，遗憾的是，这灾害完完全全是人为的。
尽管空气情况不理想，苏菲亚依然离开家门到诊所来做镭射除上唇细毛。诊所里今天人不多，做了镭射之后，就聊开了。
“医生，最近附近有人因抽脂手术而丧命。原来抽脂手术是那么危险的啊？”
不久前报章报道八打灵再也某美容院的顾客在进行抽脂手术半途中陷入昏迷，虽然紧急送往医院，但仍不幸不治身亡。
“这件事我知道的并不详细。传闻有很多版本：有人说是麻醉药过量、有人说动刀的是外国过来的无牌医生、有人说是早有前科的医生，更有人说根本就不是医药人员。”
“怎么这些人那么的大胆啊！”
“对啊！虽然不知道真相如何，但总结来说动刀的大胆，接受动刀的更大胆。也许很多人并不知道注射药物、开刀等等的美容疗程其实属于医疗行为，只有经过训练、有经验的医务人员才有资格进行的。本地美容的趋势和其他亚洲国家并不一样。在韩国、台湾或香港，整形整容风气再强，大家都知道动手术要去医院或医疗中心。在马来西亚，大家的医美知识和安全意识不高，也许还要再过几年，情况才会慢慢改善吧！”
“我真不明白，那么多报章报导，发生了那么多事故之后，依然还有人傻乎乎的成为下一个受害者。再说，这些美容院的收费不菲，往往比诊所还昂贵，说那些受害者是贪小便宜，也说不过去。”
“无知所以无畏，很多时候在还不知道实情的时候就听朋友介绍，盲目的跟风，后果却只有自己承担。”
目前卫生部正在进行着执业医美疗程的医生注册，经过考核后注册的名单将会公布在网上让民众查询。以后有兴趣于医美疗程的民众可以上网寻找合格的医生，以此减少日后的欺诈案件。
为了更新执业执照，医生都会依法向官方申请注册。然而，在医院、医疗中心和诊所之外为所欲为的非医务人员又如何呢？没有本地执业执照的外国的 所谓"客卿"或"过客"医生又如何呢？他们倒是不受法律约束。
这些问题还没有解决方案，一如每年令人难受的烟霾，危害民众的健康和安全。
阿瑞发的雀斑
阿瑞发是被老同学兼多年好友的米娜拖进诊所的。阿瑞发有双大眼睛、皮肤白皙，是个天生丽质的美女，但近看之下发现她的额头，鼻子和双颊上却是长满褐色斑点。
“这一些褐色小斑点都是雀斑呀！"
欧美国家常把雀斑看成女性美。然而，在亚洲国家，雀斑被认为是脸上的瑕疵，大家都千方百计的要去除它。
"雀斑是怎么形成的呢？我自少女时代就有这一些斑点了，近年来越来越明显，花了很多钱买了美白产品，有时候明明看似淡化了，不到几个月又重新长出来。"
"雀斑是因为色素代谢问题而形成的，也和遗传、阳光曝晒、皮肤pH值增高、内分泌失调等因素有关。在马来西亚这样热带气候的国家，大部分人长雀斑都是因为没有好好防晒而使皮肤受损所致。”
“这斑点能够去除吗？”
“能。最直接的方法就是做镭射疗程了。”
“镭射？听起来很可怕。我可是从来没有考虑过用镭射去除雀斑。没有其它的治疗方法吗？我用过了某品牌的淡化色斑护肤品大约半年，之后觉得功效不够理想又换了另外一种名牌护肤品。果酸换肤和脉冲光我做了不下十次了。去年年尾我也在某一家美容院尝试针挑雀斑疗程。”
“有的。从美白护肤品，果酸换肤，脉冲光，到镭射疗程，都是雀斑的治疗方法。针挑雀斑？这是什么疗程，是以尖针把那雀斑挑出来吗？”
“是啊！还弄到我脸上血淋淋的。“
“那不是很痛吗？你连针挑都不怕，怎么害怕镭射呢？”
“镭射？那不会有辐射吗？”
“谁说镭射有辐射了？我们生活中多的是各种各样的镭射：镭射打印机、镭射唱碟等等。所以镭射并不可怕。话说回来，雀斑的治疗有这么多种，选择哪一个疗程应该根据色斑在皮肤的位置而定。比方说雀斑如果处在皮肤表层顶层，那么用护肤品或做果酸换肤就会有效了。如果色斑处在比较深层，那么就需要做脉冲光或镭射。你的雀斑长在靠近眼部周围，也相对比较深，我建议做镭射，比较安全。”
“只要做了镭射，我的雀斑就能消除了？”
“镭射的效果视乎个人皮肤对镭射的反应，你可能需要3次到5次的疗程才能达到比较理想的效果。更重要的是一定要做好防晒功夫。多吃蔬果，戒掉抽烟、喝酒、熬夜等不良习惯，充足的睡眠和休息都是很重要的。除此之外，你也必须避免刺激性的食物，如咖啡、可乐、浓茶、香烟、酒等。"
雀斑不是大问题。如果你觉得雀斑很可爱，你尽可以保留它。如果想要去除它，最好的方式还是让合格的医生检查，这样才能对症下药，避免不必要的花费，甚至是莫须有的皮肉之痛。比镭射更重要的是饮食和生活习惯的改变。唯有这样，才能确保脸上的斑点一去不回头。
by
William Hoo
Star News: Ugly truth awaits beauticians
The star news: 30062013
KUALA LUMPUR: Beauty centre operators and non-doctors found to be practising aesthetic medicine could be fined up to RM50,000 or jailed for up to two years once the amendments to the Medical (Amendment) Act 2012 and its regulations come into operation before year-end.
Health Ministry officials said Section 33 of the Medical (Amendment) Act 2012 stated that first-time offenders could be fined not more than RM50,000 and jailed not more than two years while the fine could increase to not more than RM100,000 and jail term to not more than three years for second-time offenders.
Deputy health director-general Datuk Dr S. Jeyaindran said the ministry was in its final stages of drafting the regulations following the amendments passed in Parliament in June last year.
“Beauticians can be hauled up by the Malaysian Medical Council (MMC) if they portray themselves as doctors or they carry out procedures that only doctors can do under the guidelines on aesthetic medical practice,” he said during a press conference at the 2nd Malaysia-Singapore Conference of Aesthetic Medicine yesterday.
Dr Jeyaindran was asked if the ministry was taking any action to address loopholes in the law that did not penalise beauty centre owners who conducted invasive cosmetic procedures.
The Star recently reported that consumer bodies urged that they and untrained doctors be criminalised for carrying out the procedures.
Recently, guidelines on aesthetic medical practice was introduced and doctors who carried out the procedures and did not have the credentials to do so would be hauled up by the MMC for breach of professional code of practice.
Dr Jeyaindran said the first batch of 22 doctors had been registered with the National Registry of Registered Medical Practitioners Practising Aesthetic Medicine.
罗素的眉
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| 网络照片：万人迷也有过这样的眉 |
蓝色星期一的早上，罗素顶着一对高挑的眉毛推开大门走进诊所，着实引人注目。我看了看档案，他在两个月前咨询，没做任何疗程就走了。
“上一次和你聊了之后，我对肉毒杆菌素注射很有兴趣，但觉得费用不菲，就暂时打消主意。两个星期前，朋友介绍之下的某某医生，新开张的诊所有打折扣，我想试一试无妨，就在那儿打了肉毒杆菌素和填充液。”他说说：“花了钱，打了针，皱纹是没有了，但大家都说看起来很奇怪。”
罗素的眉毛尾不自然的提高，这是一些西方男士喜欢的造型，看上去有性格、威严，仿佛任何时候都神采奕奕。然而，这样一对眉毛长在亚洲人脸上就很不自然，往往有凶神恶煞的感觉。许多人觉得外国的月亮特别圆，爱找曾留学海外的医生、甚至不惜买飞机票到欧美做手术，最后却觉得很不满意就是这一个原因。相较于欧美医生，韩国和台湾医生对亚洲人脸的特征比较熟悉，本地人若要出国去做医学美容甚至整形手术，亚洲国家往往是更合适的选择。
我常常觉得医学美容其实是不只是个技术活儿。除了知识、技术和经验，每个医生的审美观都稍有差异。同样的医学美容疗程为什么在不同的医生手里出现不同的效果吗？其中的关键不只在于使用的产品，还在于使用的分量、角度和地方。薄薄的皮肤之下注射的深浅、方向都会让最后的成果看起来很不一样。
“上一次的会谈中，你不是说过若有不自然的注射效果，事后还可以改正吗？”
这才是罗素今天过来就诊的主要目的。
“先让我看一看吧！你的法令纹上注射的填充液是什么材料制成的？”罗素的眉毛可以稍微改变，让轮廓不那么刚硬，但他的法令纹呈现不自然的肿胀，这才是让我担忧的地方。
“这里吗？我也觉得肿肿的，但不太记得他说打的是什么了。”
“那，我们不妨问一问那位替你注射的医生吧！”虽然说有溶解剂，但并不是任何填充液都能轻易溶解的。要修正，还得拿到一个肯定的答复，我才能安心动手。
正如生了病吃药的病人应该知道自己吃的到底是什么药，没生病的人做医学美容也应该主动了解自己做的是什么疗程。知道自己要的是什么，知道自己做的是什么，知道你的医生的审美标准和角度，我想，这才是最精明的医学美容消费者。
William Hoo @ 符气廉
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