Botox is a non-surgical cosmetic treatment for anti-ageing that results in a wrinkle-free face. It uses botulinum toxin to temporarily relax muscle activity. It reduces the appearance of wrinkles and takes about 72 hours to take effect. The maximal effect of these injections comes up by about two weeks, but usually has to be repeated every 3-6 months. The areas characteristically treated are frown lines, worry lines and crow’s feet. A very nice effect with Botox is to elevate the lateral end of the eyebrow. Other off label uses for Botox are for facial asymmetry, masseteric hypertrophy and hyperhidrosis of axilla and hands.

The procedure takes roughly 15 to 30 minutes and the pain is minimal. Pain is minimised under influence of a numbing cream. It is completely trouble-free and the patient can easily resume normal activities right after the treatment.

As we age, the face starts losing elasticity and youthful volume, which results in the formation of folds and wrinkles. However, with the introduction of new generation of cosmetic treatments in recent years, it has now become possible to delay these signs of aging. Dermal fillers or soft tissue fillers are proven to be effective in the restoration of facial volume and diminishing the fine lines, wrinkles as well as the age spots.

Unlike Botox, which relaxes the muscle under a wrinkle, injectable fillers fill the line, crease, or general area with different kinds of substances. Fillers can also be used as “volumizers”, plumping and lifting the cheeks, jawline, and temple. Injections into the lip margin and lip tissue can make lips more attractive, provide definition and shape and improve lip proportions. Injections at the corner of the mouth can reverse the appearance of a permanent resting angry look that may occur as we age. The most popular among fillers is hyaluronic acid, which stimulates the body’s own natural production of collagen. The effects usually last for 12-18 months. Another interesting use of dermal fillers is Hand rejuvenation.

Candidates who do not want to undergo surgical treatments for problems like sunken cheeks and dark circles under the eye, can do well with dermal fillers. It is a lunchtime procedure. The procedure usually takes a very short duration and the exact time taken depends on the areas to be treated. There are no serious side-effects associated with dermal fillers except for minor bruising or swelling, which settles down within a few hours after the procedure. In experienced hands, major & scary complications do not occur.

The causes for hair fall and hair loss are many. These are family history (heredity), hormonal changes, stress, smoking, certain hairstyles and dyeing treatment, prolonged illness and some deficiency states such as protein deprivation (during strict dieting), thyroid disease, iron deficiency anaemia and secondary syphilis, to name a few. Correction and treatment of these causes can improve hair fall and loss. A popular treatment modality for hair loss is injecting growth factors and essential proteins into the scalp, the commonest being platelet rich plasma (PRP).

Platelet-rich plasma (PRP) is an autologous serum containing high concentrations of platelets and growth factors. PRP continues to evolve as an important treatment modality with many applications in cosmetic surgery, particularly in the areas of hair restoration, skin rejuvenation, acne scars, dermal augmentation, and stretch marks. It utilises plasma derived from the patient’s own blood (approximately 30-40ml). This is injected into the scalp using a very fine needle into areas of hair fall or baldness. It takes about 30-45 minutes for the entire process. There is minimal discomfort or pain, which is quite bearable and often disappears in the next 10-15 min. For sensitive patients, nerve blocks can also be administered to further reduce pain.

Patient can take a full bath including a head bath the next day and is back to routine work immediately. It is an office procedure with minimal downtime. Usually, 3-6 sessions at the gap of  approximately a month are recommended. Sometimes, patients may do better with upto 9-10 sessions. Since PRP is prepared using one’s own blood, chances of adverse reactions are rare. Some mild swelling or heaviness can be experienced which usually disappears by next morning. The effects of PRP are thickening of hair shaft, rejuvenation of dormant hair follicles and reduction of hair fall. Many nutritional supplements are available in the market but should preferably be combined with either PRP or hair transplant surgery, which is the gold standard, or ideally both, for a satisfying long-term result.

It seems like lasers can do anything these days! Laser skin resurfacing works to give the patient a clearer, younger-looking facial skin by removing skin, layer by layer, with precision. This means one can get rid of facial blotches, scars, wrinkles, or acne scars. A full-face treatment with carbon dioxide laser takes up to 2 hours. After about 5-7 days, the skin will begin to dry and peel, and it will take another 5-10 days for the skin to fully heal. Carbon Facial, also called “party” laser by some, is a non-invasive procedure that involves applying a layer of carbon gel on the face and using a laser to blast away the carbon. Light from a Q-switched laser is highly attracted to carbon particles and peels away the impurities and the contaminants that the carbon attracts, leaving behind a markedly clean and glowing look.

Light-emitting diode (LED) therapy, commonly called "Party laser", uses a variety of different coloured lights to target various parts of the face, treating acne, fine lines and wrinkles, pigmentation, acne scarring, and rosacea. It also targets redness and inflammation. But it must be repeated several times before significant results are seen. However, immediate glow is visible within hours or less than a day after this treatment. Intense Pulsed Light (IPL) therapy is a similar facial treatment that works well for brown pigmentation, red vessels, and sun damage. The treatment involves a broadband light device that delivers a spectrum of wavelengths. Its effects are seen more readily than that of LED therapy.

Thermage is a radiofrequency cosmetic procedure that helps to smooth and improve skin by tightening existing collagen and stimulating the production of new collagen. It is used to treat fine line and wrinkles as well as dimpled skin and cellulite. It also lifts the brows, cheeks, and jawline. It needs to be repeated every 2 to 3 years to maintain results.

High Intensity Focused Ultrasound (HIFU) or Ultherapy uses ultrasound to heat targeted tissue under the surface of the skin, which triggers the natural production of collagen. Ultimately, ultherapy counteracts the effects of time and gravity on the skin. Ultherapy can be repeated every 6 to 12 months, as collagen typically takes this long to develop. Patients typically require three to four treatments.

Threadlifts are the new “it” non-surgical facelift option. The facelift procedure can be performed under 2 hours and involves a cosmetic surgeon inserting thin threads into the face through tiny incisions made in the targeted area. The threads attach to the skin tissue and then are pulled back to lift and smoothen the face. The ends of the threads are hidden and the results of the lift are seen immediately. The effects last about 15-18 months, at which point the threads biodegrade and are absorbed by the body.

As we age, our skin appears dull with lack of lustre as the dead skin cells do not slough off as easily as when we are young. Light, medium and deep chemical peels are nonsurgical cosmetic procedures used to peel away the skin’s top layer to improve sun-damaged, unevenly pigmented and wrinkled skin. Improving the evenness of colour and texture in the skin creates a youthful look and restores a healthy and radiant appearance. Chemical peel results into an even skin tone, smoother skin and helps get away with age spots, sun spots, fines lines and wrinkles to a great extent.

Chemical peels work on the deeper layers of the skin in comparison to regular salon peel facials. Therefore, patient can expect a refreshed and naturally glowing skin after the treatment. This is an office procedure, done without anaesthesia with minimal downtime. Patients may feel burning sensation when the solution of chemical peel is applied on to the skin for which we use fan-aided evaporation. Deeper peels may require some anaesthesia unlike superficial and mild peels. The chemical peeling process starts with the application of defatting solvent which is applied and then removed uniformly over the skin to be treated. Then the peeling solution will be applied for a specific time period followed by a neutralizing solution. The patients can go home the same day. The complete results will be visible after a few days or weeks in some cases. Initially treated skin will be red and swollen but with time these side effects will settle down. Lotions and creams should be applied as per the doctor’s recommendations. And sunscreen shall be used to protect the skin from UV rays. Make up shall be avoided as the cosmetic products may cause irritation on your sensitive skin. The patient is advised to continue with follow-up appointments so that the doctor can monitor patient’s skin regularly.

Most important post peeling instruction is sun protection. Sunscreens, as advised have to be applied every 3-4 hours from sunrise to sunset even if the patient is indoors. Along with that we recommend a mild cleansing and moisturising agent and night creams. Whenever one has to go out for work, one must not forget a black or dark umbrella and black goggles preferably covering almost half of the face. Usually post peeling we recommend not to travel out more often unless one has some urgent engagements. Usually, superficial peels are preferred over deeper ones. Post Peel, skin lightening creams, vitamin C serum & sunscreen lotion with SPF 30-50 twice or thrice a day from dawn to dusk are advised.

A Vampire Facelift or Vampire Facial is a procedure for facial rejuvenation which uses the patient’s own blood PRP). This revolutionary treatment is followed by incredible anti-aging results such as skin tightening, lifting, volumizing, collagen remodelling and overall brightening of the face and neck. It is a painless and minimally invasive procedure which combines the science behind injecting the concentrate of growth factors to the face. Benefits of Vampire Face lift includes Improved tone, texture, and colour of the skin. It helps to smoothen the wrinkles and fine lines. It Activates the growth of collagen.

Vampire face lift treatment targets the supporting tissues present beneath the skin instead of treating the upper skin layers. It helps to treat acne scars and other scars. The procedure is done under local anaesthesia or under the influence of numbing cream. A small quantity of patient’s blood will be drawn and centrifuged to isolate a concentrate of growth factors & essential proteins. This concentrate helps in healing injured tissues. Then, a fine needle is used to inject these growth factors back into the patient’s skin resulting into new collagen production and blood vessels under the skin. One can expect a natural looking youthful skin after a vampire facelift. No admission is required as this is a lunchtime procedure. At least 3-6 sittings at monthly intervals are recommended for optimal results. There is some redness that may persist for upto 2-3 days after the procedure which is self-limiting.

The hair on face and body of female patients are mostly due to hormonal imbalance. In the Laser Hair Removal process hairs are damaged by coagulation (not burn) caused by selective photosynthesis of melanin in the funicular epithelium and hair matrix. Men too now-a-days like to be groomed and with treatments like beard reshaping, laser hair reduction has reached out to them as well. Therefore, Laser Hair removal is ideal for both women and men who don’t want to spend time on shaving or spend hours at the salon. The traditional methods of hair removal have many disadvantages as compared to the laser technique. The other techniques such as waxing, threading and epilating available for hair removal can be painful, ineffective and time-consuming. Laser Hair removal technology on the other hand is a revolutionary treatment for hair reduction. While laser hair removal doesn't get rid of hair forever (only electrolysis is FDA approved for permanent hair removal), it does drastically reduce hair growth, to the point one can stop shaving altogether. One can get it done anywhere on the body, and the machine can cover large areas rapidly. The biggest advantage is that it helps to get rid of unwanted hair growth and remove them without damaging the surrounding skin. It is a quick procedure to remove unwanted hair. It is less painful as compared to waxing and threading. It is also considered as a safe technique for sensitive areas near mouth and eyes. Before the procedure, exposure to the sun should be avoided & the skin protected from sun tanning ideally for at least a few weeks prior to the treatment. Bleaching, plucking, and waxing should also be avoided.

To begin the procedure, patient’s hair will be trimmed to a few millimetres from the skin surface. The laser equipment for hair removal procedure will be adjusted according to the skin colour and thickness of hair being treated. After this, a pulse of light will be focused on a small treatment area and then that specific area is monitored for a few minutes to ensure that the procedure can be carried out without any harm to the skin. The laser emits heat energy which penetrates deep down the root of each targeted area and damages the follicle and gives a smooth hair-free skin. A firm pressure is exerted to cause a blanching during the shots. The treatment is painless & safe due to the inbuilt deep cooling of the skin. Post treatment, ice packs can be used to reduce pain and swelling, and to promote healing. Cosmetic products and creams over the treated areas should not be used as the skin will be sensitive and can cause a rash. Scratching and rubbing the treated area should be avoided. The treated area should be washed gently as the skin will be sensitive. A medical treatment for correction of underlying hormonal imbalance, if any, is important for long lasting results. Sunscreen lotion before going out in the sun during the treatment is a must to prevent hyperpigmentation. These sittings are repeated as per need, generally varying from 2 – 6 weeks. Bleaching, waxing and threading should be avoided during the treatment. Five to seven sittings, sometimes 10, are generally required. Each sitting takes roughly 20 – 30 minutes.

Microdermabrasion is a non-chemical, non-invasive procedure that uses a dermaroller with various size microneedles or a spray of microcrystals to remove the outermost layer of dry, dead skin cells and reveal younger, healthier-looking skin. Microdermabrasion also encourages the production of a new underlying layer of skin cells with higher levels of collagen and elastin, which further improves the skin’s appearance. It is very cost effective and can be done with previous application of a numbing cream to make it almost painless. The skin usually heals quickly in couple of days with good texture and radiance.

Microdermabrasion is a lunchtime peel and is an effective, non- surgical way to decrease acne scars, fine wrinkles and sunspots by removing the top layers of the skin. No chemicals or laser beams are used. Aluminium oxide micro crystals are used that gently sandblast the skin, leaving it smooth and fresh. This procedure also helps in stimulating collagen production and thereby rejuvenating the skin. Firstly, the skin is degreased and cleaned properly. The process is started with a special hand held device through which the aluminium oxide micro crystals are sandblasted through a small tube pressed against the skin. The device is gently moved around the entire face. After microdermabrasion, a sun blocking cream is applied so that patient can be back at home or work immediately after the treatment.

Surgery is a better option when the patient desires a more dramatic body sculpting, he or she has significant loose or sagging skin, prefers to undergo a procedure only once to achieve a good result, or if he/she would like to enhance, rather than reduce, the size of an area.

However, non-surgical fat reduction is a new approach for removing excess, unwanted fat without an invasive surgery. It is a safe and effective technique that can help patients in getting rid of love handles, bulging tummy and other places where stubborn fat is located. Non-invasive fat reduction has gained popularity amongst patients who want to reduce fat but do not wish to go under the knife. It destroys fat cells within a targeted area of the body using various techniques. Without making an incision, the surgeon can permanently remove a pocket of unwanted fat. Non-surgical fat removal can be used on any part of the body. A number of treatments are available, each achieving gradual, modest fat loss without surgery or downtime. Some of these are minimally invasive while some are completely non-invasive.

Globally, cryolipolysis, laser fat reduction, ultrasound, radio frequency-based treatments and injectables based treatments are seen as effective options for non-surgical fat reduction methods.

Non-invasive fat reduction has numerous advantages such as:

• No downtime. Patients can resume their normal routine immediately after the sessions.
• No need for general or local anaesthesia to carry out the procedure.
• Long-lasting results if patient maintains a healthy lifestyle.
• Effective method for fat reduction.
• No incision and no stitches.

a. Cryolipolysis (CoolSculpting®)

Cryolipolysis is a noninvasive technology that uses extreme cold to dismantle fat cells and help reduce a fat pocket. A panelled or cupped device is placed on top of the skin in the treatment area, where it transmits temperatures that are just low enough to freeze fat cells, essentially destroying them. Because skin, muscle and nerve tissue freeze at a lower temperature than fat, these tissues remain unharmed. CoolSculpting is the brand name of cryolipolysis.

Sites recommended are abdomen, hips, inner or outer thighs, back (“bra rolls”), upper arms, under the buttock, and under the chin. It is best for patients who wish to reduce the size of a fat bulge with a little reshaping. Up to 25% fat reduction per treatment is typical. Treatments take 35 to 60 minutes to perform; any discomfort is typically mild and includes an intense cold feeling. Typical patient is satisfied after 1 to 2 treatments. Results are noticeable within 1 month and final after 2-3 months. Results last long barring significant weight gain.

b. Laser Treatment (SculpSure®)

Laser fat reduction works by dismantling subcutaneous fat using controlled heat. A specific laser wavelength is delivered through the skin, heating fatty tissues to the point where fat cells begin to break down. A constant cooling mechanism ensures that skin is not damaged in the process. SculpSure is the brand name of this non-invasive laser technology.

c. Injectable Deoxycholic Acid (Kybella®)

Deoxycholic acid is a naturally occurring substance in the body that helps break down fat for digestion. In injectable form, deoxycholic acid can break down fat cells on contact for isolated reduction of a fat pocket. Currently, Kybella is an approved form of injectable deoxycholic acid, and can be used to effectively reduce a double chin. Injections take about 20 minutes to perform; local anaesthetic may be used to enhance comfort. Little to no downtime is required; most patients return to full activity within 2 days. The typical patient requires 2 to 4 treatments, spaced 1 month apart, for optimal results. Fat cells destroyed with Kybella do not return, and results should last barring significant weight gain.

d. Ultrasound Fat Reduction

Ultrasound fat reduction uses highly focused sonic waves to break down fat cell walls in the treatment area, thereby releasing the fat inside to be metabolized by the body and reducing the size of a fat deposit. The ultrasound energy transmits through the skin, creating rapid pressure changes that cause the fat cells to break down while leaving surrounding tissues unharmed. Ultrasound is non-invasive and no downtime is needed. Typical patient requires 1 to 3 treatments spaced 2 weeks apart, depending on treatment. Results appear gradually and are typically final within 6 to 12 weeks. Destroyed fat cells do not grow back; results can last with weight maintenance.

e. Red Light Therapy (UltraSlim)

One of the newest technologies to be FDA approved for non-surgical fat reduction uses red light therapy to reduce the volume of subcutaneous fat cells. Instead of removing or destroying fat cells, photonic lypolysis, or “red light therapy,” delivers specific wavelengths of light through the skin using a specialized lamp. This light triggers selected fat cells to create small openings and release some of their contents, thus helping them shrink in size.