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chickenpox scar treatment

Chicken pox scar treatment

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Chickenpox scar treatment

Chickenpox scarring is extremely common, affecting 90% of individuals.   The earlier you  have chickenpox, the milder the scarring.   Chickenpox that occurs in adult life will often result in moderate-to-severe scarring.   This is one of the most difficult types of scarring to remove; however, Dr Davin Lim has his own unique way of subcision together with dermal buffering to treat this condition.   In most cases, two treatment sessions will yield at least a 60% improvement in chickenpox scarring. Two other treatments include subcision combined with energy based microneedling and subcision with PRP.

 

What causes chickenpox scarring?

The chickenpox lesion itself is due to a virus, which is related to cold sores.   When we have chickenpox in our younger years, our body’s immune system is strong and hence, skin repair usually occurs without significant scarring.   In some situations, when we have chickenpox in our older years, scarring can be significant.   This is due to marked inflammation in the skin, which ruptures the organisation of collagen  in the organised dermal layers.   This results in a depressed and often anchored scar, much like an acne scar; however, unlike acne scarring, chickenpox scars are  often geographical or round.

 

What treatments are  available for chickenpox scars?

Until recently, most treatments were unsuccessful.   Certainly microneedling, fractionated lasers and PRP have all been described.   However, treatment rates are often dismal, multiple treatments are needed and improvement is minimal.   This is due to the fact that the scars are often anchored into the deepest layers of your skin.

 

 

How do I treat chickenpox scars?

I use a special method of subcision using a 25-gauge needle that is horizontally introduced for chickenpox scar treatment.   Once I breakdown the scar, using a method of subcision, namely with three to four passes, I then introduce a buffer.   This buffer is made out of HA or hyaluronic acid.   This is a sugar molecule, which is formed naturally in your body but synthetically  manufactured.   This  buffer acts to give a spacer between the upper layer of skin and the lower dermal scar.   Once the scar is treated, the bonds do not form and hence, the scars raise.   Realistically, two treatments will yield at least a 50% improvement. The second method of chicken pox scar treatment is with subcision and PRP. This can give good results, but I personally prefer the buffer method. Finally if dermal scarring is extensive, I use both subcision and an energy based microneedling RF system called INFINI RF. This form of chickenpox scar treatment is reserved for bound down scars that are resistant to buffer subcision methods.

 

Can chickenpox scars be totally removed?

Realistically, the answer is no.   At most, I can give a 90% to 95% improvement.   This is after multiple treatments using this procedure.   I also do introduce the use of RF microneedling together with PRP or fractional CO2 laser to stimulate collagen and buffer the edges.

 

How much is chickenpox scar treatment? 

This will vary depending on the number of chickenpox scars you have and the complexity.   Treatments start from $990 ranging to $1400.   In some situations, it is covered under Medicare under the scar revision rule.   If I were to use microneedling and fractional laser treatments, no Medicare rebate is applicable.   I will discuss with you in detail what is appropriate and legal to claim through Medicare and what is not. The most reliable method of chickenpox scar treatment, in my hands, is the subcision and buffer filler method. Note- Medicare rebates only apply for scar revision on the face if this procedure is performed by a Dermatologist or Plastic surgeon – namely Specialists. Scar revision performed by cosmetic GPs do not carry a Medicare rebate. For more information on the differences between Specialist and Cosmetic Physicians, ask your GP for advice.

 

Can chicken pox scar treatment be done on the same day?

Yes.   Typically, in a given week, I will see at least five to seven cases, usually from all around Australia.   My procedure of chickenpox scar removal is successful and to date, I have seen longevity all the way up to three years and beyond.   No formal studies have been completed; however, I am planning to publish a paper in the next few years when all my data has been collected.

 

How do I book in for chickenpox scar treatment? 

Call reception on  (07) 3871 3437  to book an appointment with Dr Davin Lim.   It is essential that you have a referral from a GP as Dr Davin Lim is a Board Certified Dermatologist. This will enable you to claim part of the consultation cost. In most situations Dr Lim can perform scar treatments on the same day. Chickenpox scar treatments can take as little as 2 minutes to revise a few scars, all the way to 30 minutes for extremely severe chickenpox scars- acne scars.

 

Dr Davin Lim and his opinion on chickenpox scar revision.

This is a common condition, which can be devastating in adults.   Chickenpox scarring can even be worse than acne scarring, as the scars are often deeper and geographical in distribution.   Until now, lasers and microneedling were unsuccessful; however, my technique of horizontal dermal subcision together with buffer filler has proved to be extremely successful.   Expect to improve by up to 60% with just two treatments.   To date, my data collection only  expands to three years; however, I do expect that this will be a long-lasting procedure due to the fact that subcision  breaks down the bonds which hold down the chickenpox scar, as well as stimulate collagen production.   The tiniest use of a filler acts as a buffer so that the scars do not rejoin.   This coupled with CO2 laser resurfacing can also stimulate further collagen production over time.   The advantage of this treatment is that it has virtually no downtime and side effects are exceedingly rare.   Extreme caution must be taken to fill chickenpox scars in the forehead area, as this area is rich in blood vessels. Two other techniques I use include PRP (this is done if patients are allergic to fillers). PRP is not as good a filler as it is more fluid, this means  that your chicken pox scars can rejoin back up. The other method I use for very severe bound down chickenpox scars is with microneedling RF or laser based devices like the CO2 laser.

 

For more on this procedure, my various YouTube videos show the before and after results with angle lighting.

best cosmetic doctor brisbane

Dr Davin Lim- Top 1% of Cosmetic Doctors Internationally

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Best cosmetic doctor Brisbane

Dr Davin Lim Receives RealSelf 100 Award For Enduring Commitment to Consumer Education and outcomes. 

For two years in a row, Dr Davin Lim has received the Top 100- the only Australian to have won this award

 

Brisbane, Australia – April 17th , 2017 – Dr Davin Lim  is one of 100 doctors worldwide to receive the RealSelf 100 Award, a prestigious award honoring the top influencers on RealSelf—the most trusted online destination to get informed about elective cosmetic procedures and to find and connect with doctors and clinics. We honour the Top 1% of aesthetic specialists Internationally by acknowledging their achievements in Times Square New York.

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In 2016, more than 82 million people visited RealSelf to research cosmetic treatments and connect with local medical professionals. The RealSelf 100 Award, now in its seventh year, honors the top rated and most engaged board-certified aesthetic doctors who consistently demonstrated a commitment to patient education and positive patient outcomes throughout 2016. This elite group of 100 doctors have excelled at sharing their expertise, with tens of millions of RealSelf community members actively searching for information and the right provider. The award is based upon contribution to the community, but most importantly patient votes and feedback for their outcomes.

 

 Dr. Davin Lim works at Westside Dermatology and The Fiori Institute. His specialties include acne scar revision procedures that has helped thousands of patients in Australia and Worldwide. He also performs birthmark treatments, fillers, laser resurfacing, face-lifts and high level facial aesthetics. He is a noted lecturer and teacher Nationally and Worldwide, and enjoys teaching. His YouTube Channel ‘Lasers and Lifts by Dr Davin Lim’ was voted as the top 3 medical content channel in YouTube for 2016 with over 21 million views. 

‘ I’m surprised to have won this award for the second year in a row- totally unexpected. I don’t believe in advertising, but patient education, and that is what RealSelf is about. Giving guidance to patients seeking treatments is my way of giving back to the community. In today’s age of Google Ad words and promotions, I think patients should be best informed by options and experiences they have had from other patients and make their own opinion based upon the feedback and answers in a portal only for high level specialists. RealSelf provides unparalleled patient education, and hence this is the site that I chose to educate patients on. Dr Davin Lim’

 

“The RealSelf 100 represents an exclusive group of doctors who embody both excellent patient service and an ongoing commitment to educating consumers shopping in the aesthetics market,” said Tom Seery, Founder and CEO of RealSelf. “Our research shows that more than 95 percent of patients expect a practice to engage with them online. These doctors are leading the way in terms of their online engagement and focus on empowering patients with good information.”

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Dr Davin Lim  is an expert contributor to RealSelf, and to date has posted over 4000 answers to questions on RealSelf. Davin also maintains a patient star rating of  4.8 out of five stars in RealSelf reviews. For more information on Dr Davin Lim , please visit this website, and for the full list of RealSelf 100 Award winners, visit http://www.realself.com/RS100

About RealSelf

RealSelf is the largest online destination to get informed about elective cosmetic procedures and to find the right doctor or clinic. More than 9 million people visit RealSelf each month to find out which treatments and providers live up to their promise of being “Worth It.” RealSelf is powered by unbiased experiences shared by consumers for hundreds of treatments, ranging from simple skincare to highly considered cosmetic surgery. Offering millions of photos and medical expert answers, RealSelf has become the essential resource and service for those seeking to find the right doctor or clinic. Dr Davin Lim has won the best cosmetic doctor brisbane award for two years in a row. 

belkyra-treatment-brisbane

Belkyra or Coolsculpting for double chins

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Injection treatments or Coolsculpting mini for double chins- which is better?

The debate continues in regard to what is the best nonsurgical method for double chin reduction.  Fat melting injections are a novel method to  in Australia with major media release due in May 2017.  This treatment has been an established treatment in the United States for the past 2.5 years.  Essentially, this is a form of the deoxycholic acid which is a naturally found substance in the body.  This acid essentially breakdown fatty foods and has been synthetically manufactured by Allergan which is the maker of well known cosmetic injectables.

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In 2017, we have two nonsurgical methods to remove unwanted submental fat and reduce the double chin.  The CoolSculpting Mini applicator was first introduced in 2015, to date it has provided an excellent result in patients who fit into the applicator.  This was followed by a device called Cooltech Mini that has a very similar applicator; however, the difference with the Cooltech device is that the applicator is slightly deeper, meaning more fat can be vacuumed into the applicator.  Additionally with the Cooltech device dual treatments are standard; however, with CoolSculpting Mini, dual sculpting is an optional extra.

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Double chin injections can markedly improve unwanted fat below the chin, but the down side is swelling and bruising for 4-7 days. The cost of  injection treatment  is 3 times that of Coolsculpting Mini. 

 

Both CoolSculpting Mini and Cooltech provide what is known as cryolipolysis.  This means both technologies cool down fat to -7 to -11° for a period of just over 35 minutes.  Over time the body’s immune system breaks down the fat cells and the broken down fat is carried away by the lymphatic system.  Some patients need one treatment; however, factor in two treatments for demonstrable results.  Downtime following this procedure is only 48 hours.

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Now with under chin fat reducing injectable treatments patients undertake a series of injections.  The downside about this treatment and there is more pain involved; however, the treatment time is quicker- half an hour versus 45 minutes.  Downtime following this procedure means that almost universally patients will experience bruising for four to five days and swelling for up to one week.  This is somewhat significant compared to CoolSculpting/Cooltech.  When it comes to cost, most patients will require two treatments with two vials of fat reducing injectables.  This equates to around $2500 for a treatment session. Fat reducing injection treatment works much like CoolSculpting Mini/Cooltech, namley fat is broken down by this chemical and is also carried away by your immune system through the process of inflammation.

When are the best results seen following fat injection treatment? 

Best results following this treatment is seen three to four months after the initial injections.  Realistically for patients with large amount of fat in this area often three sessions treatment sessions are needed, spaced 6-8 weeks apart.

When it comes to cost one can see that $800 for a CoolSculpting Mini treatment is much better value than $2500 for each treatment session of fat reducing injections.  The results are somewhat equal with an equal distribution of patient satisfaction rate (around 85%).

 

So, what is the right answer, is CoolSculpting Mini/Cooltech better than fat melting injections?

Certainly if you can fit into the applicator, I do believe that this is more cost effective treatment for the patient; however, if the applicator size does not fit the area of excess under the chin fat/double chin area, then certainly injection treatment is the only solution for the nonsurgical removal of unwanted fat.

Combination – fat injection treatments and Coolsculpting Mini

I often utilize two treatment to keep the cost down- CoolSculpting/Cooltech to debulk the area.If needed I often use one or sometimes two vials of injectables to further resculpt the area for a tighter, firmer neckline.  I do believe that these treatments are indeed complementary and finding a practitioner who can perform both of these procedures is in the patients best interest. If you can fit into the Coolsculpting Mini or Cooltech applicator, do it! It’s less painful, with less downtime, and cost far less than one fat injectable treatment. If the applicator size is not for you, sure, injection treatment can reduce unwanted fat.

For a free Coolsculpt Specialist assessment, call the Fiori Institute of Skin and Body on 07 3849 2759.

Face lifts brisbane

Face lift trends- update for Brisbane Specialists

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Face lift – new procedures available in Brisbane 2017

 

In today’s day and age, looking natural never goes out of style.  Gone are the days of high tension face lifts with maximal downtime and unnatural looks.  Additionally, the costs have been markedly decreased over the years with a newer technology to tighten loose skin around facial areas.

In the past few years, there are different energy devices such as Ultherapy and Themarge to help tighten loose skin.  Both of these technologies are noninvasive, namely they use a high intensity focus ultrasound and radiofrequency respectively to help heat collagen and tighten skin.  Universally the use of high intensity focus ultrasound (Ultherapy) gives better results than Thermage.  The exception is with the Asian ethnic population whereby the dermal layers of the skin is thicker and collagen contraction is better in this race.  Themarge seems to work better in Asian population patients compared to Caucasian patients due to this physiological reason.

 

So what is new for 2017, in regard to nonsurgical face lifting?

The answer is Silhouette soft thread lifting. This treatment has a very long safety record that produces great results – with a natural look!

 

What is the Silhouette soft thread lift?

This formal noninvasive face lifting involves the use of minimally invasive solution for mild-to-moderate skin laxity.  In fact, it can also be used for heavy jowl lines and also neck lifting.Thread lifting has evolved since its first inventions nearly two decades ago.  The very latest and safest in thread lifting is known as Silhouette.  Threads are placed under the skin and with skilled hands and good eyes the specialists can mould the threads to lift facial sagging and skin laxity as a result of the aging process.  Essentially thread lifting improve skin tone.

The Silhouette soft thread lift does not replace the facelift, however, it is intended to produce a natural lift of up to 10 mm in strategic areas.

 

What areas can be treated with nonsurgical threat lifting?

The most common areas are the lower face including the jowl lines, however, the cheeks and also eyebrows can be treated with this procedure.  It is also best for strong nasolabial lines. These lines run from the nose to the corners of the mouth.

 

What is the recovery following thread lifting with silhouette soft? Face lift Brisbane with Silhouette soft threads. 

This can be considered as a minimally invasive procedure.  Downtime is typically 48 hours.  Most patients will experience bruising for up to 72 to 96 hours.  There will be some mild but noticeable puckering of the skin for up to one week, however, this will settle down within two weeks.

 

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How long does this Silhouette thread lifting procedure last? 

Because threads are made from polylactic acid, they breakdown over a period of 18 months.  In some cases this procedure may last for up to two years.

 

How long does it takes to perform this procedure?

The procedure itself only takes 30 minutes to perform.  However, I spend most of my time planning for this procedure.  The planning takes 40 minutes.  However, the procedure itself only half an hour.  I believe in meticulous planning prior to the placement of threads.  This will give the best, but also most natural results. Unlike traditional face lifts, this procedure is non- invasive, and provides minimal down time for the patient.

 

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How do I book in for an assessment in regard to nonsurgical face lifting?

I am trained but in surgical together with nonsurgical techniques including the use of Ultherapy, Thermage and thread lifting.  The best treatment will depend on your expectations and the condition of your skin.  Please book in for consultation and I will spend at least 20 to 40 minutes with you in assessing the skin type and also various treatment options.  I will take into consideration your downtime, costs, together with ethnic origin and skin type, in order to give you the best possible results with the most natural look. Call 07 3871 34 37 to book in for a consultation with Dr Davin Lim to see if surgical or non – surgical options are best for your skin type and requirements. Th

 

Thread  lifting is not a substitute for face lift brisbane. 

double chin treatment

Double chin treatments- injections vs Coolsculpting Mini

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Double chin treatment

The dreaded double chin can now be treated without the need for liposuction. As of March 2017, a new treatment has entered the Australian Market.  This treatment is also known as Kybella in the United States, however due to TGA regulation we are not allowed to name the Australian counterpart. Needless to say, this is exactly the same formulation apart from a name change.

 

How can double chins be treated?

Until now the only treatment for double chins have been with liposuction or with a device known as Cool Sculpting mini.  Both of these are reliable treatments, however, Kybella is another non-surgical method for reducing unwanted under chin fat. Read carefully as there are advantages and disadvantages to these forms of double chin treatment.

 

Which is better Coolsculpting Mini or injections for double chins?

If your submental or double chin fits in the Coolsculpting applicator, this is the better treatment ! Why? Firstly treatments are more predictable. Secondly total down time is much less- 48 hours of swelling compared to 10 total days (2 sessions of under chin injections). Thirdly the procedure is less painful. Fourthly the mini Coolsculpting procedure is 1/3 the price of injections. So, when do I advocate injections over Coolsculpting Mini? Only if the applicator is not a good fit for your under chin fat. IMO double chin injections have a role to play, however it is not the answer for everyone with excess sub mental fat.

double chin-coolsculpting mini

 

Double chin treatment – One treatment of Coolsculpting Mini- many advantages over injections however your chin must have a secure fit in the applicator. Minimal downtime and cost compared to injections. Swelling is 48-72 hours in total compared to injections – 10 days in total (2 sessions). Dr Davin Lim.

 

Can all forms of double chin be treated?

Kybella injections is only suitable for stubborn supplemental fat.  This excess of submental fat causes double chins.  It is not suitable for skin laxity. The same applies for Coolsculpting MINI.

 

How does injections for double chins work?

Belkyra or Kybella is a synthetic preparation of deoxycholic acid. This is a substance that breaks down and absorbs dietary fat.  This is a naturally occurring substance that has sympathetically be seen purified by a strict process.  When Belkyra is injected into the fat cells under your chin, it promotes the destruction of fat cells.  These fat cells then get absorbed by your body and over a period of 6-8 weeks, completely disappear.

How do I perform this procedure?

Kybella  is performed by a series of injections into the fat cells under the chin/double chin area.  Each treatment takes approximately 15 minutes to perform. Dr Davin Lim is only one of a few injectors in Brisbane that performs this procedure.

How many injection sessions for double chin treatment are necessary to produce the best results?

It depends on the extent of fat.  Most patients will require at least two treatments although some patients with excess fat in the area may require additional treatments. This is why I prefer Coolsculpting Mini IF your submittal fat fits in the applicator.

How soon will I see results from treatment?

 Following injections to your double chin, the results will start to appear within six to eight weeks of treatment. This timeframe is very similar to Coolsculpting Mini, however with this procedure, patients only undertake one session on average.

What to expect from double chin treatment with injections?

Almost all patients will experience swelling after the procedure that varies from individual to individual.  Expect small areas of bruising due to the injection procedure.  Though the product guideline says that there is minimal downtime, in my experience most patients can expect swelling for up to four to five days.  The use of compression, together with ice packs can help reduce the swelling.

Is Belkyra a treatment for loose neck skin?

No.  Belkyra is a procedure which is effective in reducing double chin fat, however, it is not designed for tightening skin, specifically.  If you suffer excessive laxity on your neck area you may require a surgical treatment or nonsurgical therapy such as Ultherapy.  Belkyra, however, has been known to tighten skin in some individuals, however, this is a by product of the reaction rather than the aim of treatment. The same applies for Coolsculpting MINI.

Dr Davin Lim’s viewpoint on non-invasive therapy for under chin fat – double chins.

This treatment is the second noninvasive treatment for double chins in Australia.  The first being mini Cool Sculpting applicator.  Both treatments have been shown to be an effective and is associated with a very high patient satisfaction rate.  Go to www.realself.com and type in Kybella to see the before and after’s together with the patient testimonials, also check out Coolsculpting.  I do believe that patient selection is critical to obtaining the best result possible.  Without conflict of interest, I do perform both these procedures, but advice patients on Coolsculpting Mini as the first treatment of choice? Why? Because it works, it is less painful, less costly, and has less swelling and over all downtime. Certainly I will and do perform injections- only in patient’s that do not fit the Coolsculpting applicator. Given both have the same patient confidence rate, choosing one the best one will come down to the shape of your double chin.

For a Free Assessment on what works best for you book in with my Specialist Therapist at Fiori Institute of Skin and Body at Garden City. Contact 07 3849 27 59

NOTE- this Free Assessment is only valid at Fiori Institute Garden City, as we have access to over 30 different applicators -finding the one that suits you will give you the best possible results.

Kybella or Belkyara after two treatments. Which treatment is best depends on your anatomy, and everyone is different, hence why I can not emphasise a bespoke approach.

double chin-treatments

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Fillers and facial harmony

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Facial Harmony – balance of skin texture, tone and volume

For the most pleasing aesthetic results once the balance texture, tone and volume.  This equates to facial harmony.  With beautification and aesthetics, not one aspect of skin balances standout, however, all three should be equally balanced for the most natural results.  Lets explore each of these factors and see what can be done to improve skin ageing.

What is skin texture?
Skin texture basically is the pallet of the skin.  This refers to the colour.  People residing in Brisbane in Gold Coast will have copious amounts of UV exposure.  This can lead to brown pigmentation.  Brown pigmentation can be classified as hormonal (melasma), age spots, liver spots and also freckling.  These can be treated with various lasers and BBL.

Sun can also lead to certain skin conditions including broken blood vessels, broken capillaries, redness, flushing, a red blotchy skin and of course rosacea.  Rosacea is extremely common and presents as redness as well as pimples and papules on the face.  One of the flareup factors is Brisbane’s changing climate, namely the cooler winters but humid summers.  Rosacea can be treated with anti-inflammatory tablets, avoidance of flare factors and also V-beam vascular laser.

Texture also refers to the fine wrinkling on the skin.  Once again with the high UV index of both Brisbane and Gold Coast, I have seen many patients with premature skin wrinkling.  In most cases I like to use the 1927 Fraxel laser for mild wrinkling, however, for more severe wrinkling I use what is known as hybrid laser resurfacing namely erbium and CO2 or the new YouLaser with a nonablative wavelength together with fractional CO2 laser resurfacing.

 

What is meant by skin tone?
Tone equates to collagen.  In youth one has excellent skin tone which deteriorates after the age of 28.  Skin tone refers to how tight one’s skin is.  This is in direct measure with the amount of collagen and the tensile strength of both collagen and elastin.  It also refers to the deeper layers of the skin, known as the SMAS.  As one ages there is a relaxation of the ligaments holding the skin and hence skin tone is decreased.  Skin tone can be addressed using fillers.  However, nonsurgically it can also be addressed using high intensity focus ultrasound (Ultherapy) or Thermage.  I also use suspension thread lifts for decreased skin tone.  If skin tone is markedly diminished a mini-S facelift will help markedly improve laxity.

What is referred to as skin volume? Juvederm Brisbane
I do believe out of all these factors, namely skin texture, tone and volume that volume replacement gives the biggest improvement.  The reason being is that the skin texture can be covered with makeup, however, volume replacement cannot.  For patients who lack a tiny bit of volume, replacement volume will also tighten skin, hence improving both skin volume and also tone.  Volume refers to the amount of fat, collagen and elastin in the skin. Juvederm Brisbane is the term I use to optimise dermal fillers – I also use Restylane and Volift as well as Radiesse in my practice. 

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Juvederm Brisbane gives natural results, much like Restylane, and Radiesse. 

Notice as one ages shadows appear?
We first start losing volume around the temple areas followed by the under eye areas, cheek and also the jawline area.  The volume replacement can also help with dark circles around the eyes and also reduce eye bags.  For volume replacement and I do prefer HA fillers.  HA fillers are essentially dermal fillers with sugar molecules.  Depending on the type of HA filler I use, they typically last between 12 to 24 months.  My favoured HA filler is the Juvederm range including Juvederm Volbella, Juvederm Voluma and also Juvederm Volift.  Each type of filler has a particular property which if used correctly will give a natural result.  The amount of filler one requires is directly proportional to the age of the patient but also genetics play a role.

For more on skin texture, tone and volume, please explore the website.  All my treatments are individualised and hence no two patients will receive the same treatment.  I do believe that this gives us the best outcomes for patients. Dr Davin Lim.

 

Juvederm Brisbane

double chin treatment

Double chin treatments

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Double chin treatments – Belkyra or Kybella is finally in Australia

Belkyra treatment for double chins.  As of February 2017, Belkyra has entered the Australian Market.  This treatment is also known as Kybella in the United States.
How can double chins be treated?
Until now, double chins treatment have been with liposuction or with a device known as cool sculpting mini.  Both of these are reliable treatments, however, Belkyra/Kybella are noninvasive treatments.

Can all forms of double chin be treated?
Belkyra is only suitable for stubborn supplemental fat.  This excess of submental fat causes double chins.  It is not suitable for skin laxity.

How does Belkyra work?
Belkyra or Kybella is a sympathetic preparation of deoxycholic acid which is a substance that breaks down and absorbs dietary fat.  This is a naturally occurring substance which has sympathetically be seen purified by a strict process.  When Belkyra is injected into the fat cells under your chin, it promotes the destruction of fat cells.  These fat cells then get absorbed by your body and clear way.

How is Belkyra performed?
Belkyra is performed by a series of injections into the fat cells under the chin/double chin area.  Each treatment takes approximately 15 minutes to perform.

How many treatments of Belkyra are necessary to reduce the double chin?
It depends on the extent of fat.  Most patients will require at least two treatments although some patients with excess fat in the area may require additional treatments.

How soon will I see results from Belkyra treatment?
Following injections to your double chin, the results will start to appear within six to eight weeks of treatment. Double chin treatment with Belkyra is maximal after 14 weeks, namely 2 sessions spaced 4- 6 weeks apart.
double chin treatment
What to expect from your Belkyra treatment/recovery.
Almost all patients will experience swelling after the procedure which varies from individual to individual.  Expect small areas of bruising due to the injection procedure.  Though the product guideline says that there is minimal downtime, in my experience most patients can expect swelling for up to four to five days.  The use of compression, together with ice packs can help reduce the swelling.

Is Belkyra a treatment for loose neck skin?
No.  Belkyra is a procedure which is effective in reducing double chin fat, however, it is not designed for tightening skin, specifically.  If you suffer excessive laxity on your neck area you may require a surgical treatment or nonsurgical therapy such as Ultherapy.  Belkyra, however, has been known to tighten skin in some individuals, however, this is a by product of the reaction rather than the aim of treatment.

Specialist viewpoint on Belkyra/Kybella for double chins
This treatment, the second noninvasive treatment for double chins in Australia.  The first being cool sculpting with the mini applicator.  Belkyra has shown to be an effective treatment with a very high patient satisfaction rate.  Go to www.realself.com and type in Kybella to see the before and afters together with the patient testimonials.  I do believe that patient selection is critical to obtaining the best result possible.  This can only be done on close examination together with palpation, namely touch of the area.   To see if you a suitable for Belkyra book in for a consultation.

double chin treatment brisbane

Double chin treatment can be achieved with liposuction, or Belkyra. 

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Fraxel laser resurfacing

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Fraxel Brisbane

Fraxel Laser Resurfacing – Fraxel Brisbane

Fraxel is the best known brand for fractional laser resurfacing.  Fraxel resurfacing has been used in Brisbane for the past decade.  Historically for those patients who have had the initial Fraxel laser, it was known as the blue Fraxel.

What is fractional laser resurfacing?

Fractional laser resurfacing involves treating portions of skin.  This is known as the density.  The density can be controlled from 1% all the way up to 80% depending on the type of laser used.  The logic behind fractional laser resurfacing is that untreated skin provides an avenue for laser treated skin to heal quicker.  There are many different wavelengths and laser companies which now produce fractionated lasers.

What condition can Fraxel treat?
Fraxel comes in three different wavelengths.  The 1927 Fraxel wavelength is an excellent treatment for skin pigmentation (freckles, age spots, general dullness), however, it is also an excellent method to treat sunspots and actinic keratoses.  Ane scars can be treated with the 1550 or Fraxel CO2.  Note, however, that this is old technology and since the intention of Fraxel dual and Fraxel CO2, newer CO2 lasers and microneedling energy devices have been invented. Fraxel Brisbane by Dr Davin Lim who is one of Australia’s leading dermatologists.

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What is the difference between Fraxel machines?

Essentially a Fraxel can be divided into ablative and nonablative.  The ablative Fraxel laser is known as the Fraxel repair.  This laser is over eight years old.  It is still a good laser to treat the neck, chest and décolletage area especially to blend in sun damaged skin.  I do not like to use of Fraxel CO2 on the face as I do believe that there are other more powerful lasers that I have that can do a better job than CO2 Fraxel.  Nonablative Fraxel laser resurfacing include Fraxel 1927 and Fraxel 1550.  Collectively this is known as the Fraxel dual system.  Once again then 1927 is great for skin rejuvenation while the 1550 wavelength I do believe is obsolete. Fraxel Brisbane at Westside was the first clinic in QLD

What is the recovery rate following Fraxel laser treatment?
The recovery will depend on the factors including the wavelengths used, the skin condition treated, the number of passes, the power levels and your immune system and healing up time.  On average Fraxel 1927 has the quickest healing time of approximately five days whilst Fraxel CO2 repair has a healing time of up to 10 days.  With the older Fraxel CO2 systems, because we overlap on the skin, redness may pursue for up to three months.  This is the reason why I do not use Fraxel CO2 on the face very often.

Apart from Fraxel fractionated lasers are there any other newer fractionated devices? Fraxerisbane by dr davin lim
Yes there is.  The Fraxel systems are extremely old, however, they are still in use.  Even though the Fraxel 1927 dual is over seven years old, it is still an excellent method to treat the skin pigmentation.  Another gentle 1927 wavelength is known as the Clear and Brilliant.  I do use this laser to treat certain forms of pigmentation such as melasma.  Newer fractionated laser resurfacing devices has emerged for 2017 including the You laser.  This laser will arrived within the next month.  The parameters seem to be promising as this is twice as powerful as the Fraxel CO2 with very little overlap.   Additionally the density can be controlled to a greater degree.  The advantage of the You laser, in theory is that it combines two laser wavelengths both an ablative and nonablative in the one treatment.  This means that the recovery time will be quicker and with less overlaps, post laser redness will be markedly reduced.

I am excited to take delivery of this new laser as it will be the first You laser in Brisbane.  I will keep you posted in regard to outcomes of this laser and how well it performs compared to our older Fraxel laser systems.

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Asian skin rejuvenation

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Asian skin rejuvenation

Asian skin rejuvenation is one of the more complex cosmetic and aesthetic procedures I perform. Why? Because Ethnic skin types are more prone to PIH or post inflammatory hyperpigmention or skin darkening. This applies to cosmetic treatments such as age spot spot removal, sun spots, liver spots, freckles, as well as fine wrinkles and pores as well as medical laser procedures including acne scar treatments and birth mark removals. Conditions that require Asian skin rejuvenation include melasma, spots and dots or dermatosis papulosis nigra – as seen in this video, as well as enlarged pores- much more common in ethnic skin rejuvenation.

Asian skin rejuvenation- basic principles

The first step in treating ethnic skin types, and Asian skin rejuvenation is sunscreen. This forms the foundation of all treatments. Secondly, I often pre-treat the skin with Vitamin A and also a cream that decreases pigment production. Thirdly, lasers used in Ethnic- Asian skin rejuvenation need to be gentle, and treatments must be conservative. This means low power with more treatments. Following these rules will reduce unwanted side effects such as skin darkening following treatment of age spots, melasama, pigmentation, sun damage and even acne scars.

Asian skin rejuvenation and ethnic skin lasers

I prefer 3 devices for  skin rejuvenation in Ethnic clients.  Firstly, the Picosure Focus with a defocus 6 mm spot. This is one of my favourite fractional laser devices for darker skin types. Secondly, Fraxel 1927 for overall improvement of skin texture, and thirdly, microneedling RF using the insulated INFINI system combined with PRP or platelet rich plasma.

Ethnic and Asian skin rejuvenation – in summary

If you are considering getting any form of laser, filler, or energy devices, see someone (does not necessarily need to be Dr Davin Lim!) who works on Asian skin rejuvenation on a daily basis. Experience, training and the correct equipment can give you realistic results with minimal side effects.

Dr Davin Lim also does Botox injections for facial and jawline slimming – this procedure is common with Asian patients as they often have enlarged masseter muscles associated with a broad face and headaches, as well as teeth grinding. Botox is not subsidised by Medicare for facial slimming. 

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Acne scars before and after- by Dr Davin Lim

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Acne scars before and after

The field of acne scar revision has undergone numerous advances over the past 2 years with newer devices, techniques and products to improve scars with minimal downtime.
In the past the only solution was laser resurfacing with either a CO2 or erbium laser. In 2007, fractional laser resurfacing emerged as ‘the best acne scar treatment procedure’, but fast forward a decade later, we all know this is marketing hype. The highest success rate is  treating the scar type with a procedure, device or product, and not the other way around. This article will concentrate on the use of filers and a procedure called subscision for the treatment of atrophic and tethered or bound down- anchored scars.
The advantage of filler and subscision is that this procedure can INSTANTLY improve most forms of acne scarring, with the exception of box car scars and ice pick scars.
In Australia we have dermal fillers that consist of cross linked sugar molecules called HAs. Each type of dermal filler will have a certain ‘g prime’ property- some are more fluid than others, some provide more support and lift. More fluid HA fillers can give finesse – namely in the treatment of fine tethered scars on the temples and forehead, as well as treating chicken pox scars. Thicker fillers are used for support – especially if atrophic scars are present in the mid cheek area. So, how do you assess if you are a good candidate for fillers? Atrophic scars are best assessed with angled lighting and animation, however another way to ‘test if your scars will respond to  filler- subcision is to use my 3 point touch technique. Use your thumb, index and pointer finger, then stretch the skin surrounding the acne scar areas, if they improve, chances are you will respond to filler-subcision.

Why do I combine filler and subcision in the majority of acne scar revision cases ?

The combination of filler and subcision will treat both atrophic scars as well as tethered or anchored scars. In the vast majority of cases, tethered scarring will have some element of atrophy, and hence filler acts as a ‘spacer’ to lift the acne scars use. See the acne scars before and after pictures for an idea of how fillers can be used to improve scarring.
acne-scars-before-and-afters 1
IN SUMMARY there are advantages and disadvantage for Filler- Subcision acne scar revision. The acne scars before and after picture depicts what can be achieved using fillers and subcision, without the use of lasers. Note- not all scars can be treated this way- atrophic and tethered scars respond best.

Advantages of filler- subcision for acne scars

  1. Instant results- however most patients will need 2-6 sessions for best outcomes
  2. No downtime- low downtime. Unlike lasers, filler subcision procedures do not damage the upper layer of the skin, but address the primary deficit- loss of collagen and tethered bonds that lie below the surface.
  3. Medicare rebate applies- this only applies to the subcision procedure (provided by Plastic Surgeons or Dermatologist and not cosmetic GPs). Medicare does not cover any filler for scarring.
  4. HA fillers are reversible- namely there is a robust safety record, and should lumps occur (highly unlikely), HA fillers can be dissolved.

Disadvantages of filler- subcision for acne scars

  1. Results will vary from patient to patient. Some types of acne scars respond very well with a correct of over 90% with one session, whilst other patients with high density dermal hypertrophic scars with atrophic scars are much hard to treat- in this case one treatment will only improve things by 20%. In some cases I would only know the amount of tethering and collagen density when I subcise the scar during the procedure.
  2. Multiple treatment are often needed. Unlike box car scars, where one fully ablative laser treatment can address 90% of scars, most patients will require a series of 2-6 sessions, depending on the severity of acne scars, location of scaring and patient expectations. See the acne scars before and after pictures to get an idea of how much improvement you can expect.
  3. Brusing and swelling! This can be minimised by ‘gentle subcision’, however in some cases acne scars are tethered or anchored to the underlying muscles with thick strands of altered collagen. In this situation, I may use a special instrument called a Nokor blade- this will definitely break down even the toughest of scars, however the downside is that with more force, bruising and swelling may occur. This settles down over 3-7 days. This can be predicted, and I will always warn you of this BEFORE Nokor subcision is performed.

Acne scars before and after

See more revision of acne scars before and after results by Dr Davin Lim on this website. Note- acne scarring is as individual as you are. Most patients will have a variety of acne scars, and targeting the scar type will give the best result.
For more information on this procedure explore the website under acne scarring.