Metamorphosis - Alaxis (in Greek)

Tokyo

2011-10-29T09:00:00.000-07:00

I like to visit Japan.

Other the food, techie stuff, kawai girls - the thing I love most is the high quality of cosmetic work I see there. These surgeons - whether its plastics or cosmetic surgeons - all possess very high skill sets. In addition they have a great desire to improve themselves. They are always asking me things / tips eventhough I am way junior to them. It doesnt matter to them, as long as they see a real sincere doctor also seeking the truth like them, they will interact with you and seek any new ideas or experience. It is the pursuit for perfection combined with a great humility for their trade that sets them apart. In no other country have I seem plastic surgeons and cosmetic surgeons so close and friendly. It seems it doesnt matter what is your lineage of training that excludes one but rather a communion of passion for excellence that binds them together. That is most inspiring to me.

Read the words in the Tokyo Declaration 2000. Maybe it sums it all up.

Taipei

2011-10-29T08:42:00.000-07:00

I was in taipei recently - invited as a speaker in the Taiwan Academy of Facial Plastic and Reconstructive Surgery Conference. Oct 7-9 2011. I spoke on lower face contouring - mainly facial sliming techniques.

It was a meeting that was attended by most of the ENTs in the region and I was invited by one of my mentors - Dr Kao from Triservice Hospital Taipei.

It was a well organized conference but for me many of the topics were beyond me as they focused on reconstructive work rather than cosmetic work. So other then preparing for my talk and trying to attend some talks I had lots of time on my hands. It was a strange saturday and sunday wandering around 101 district. Back in SG I am always busy with work or with family, but when suddenly you have too much time on you - wandering around can seem very surreal. Nonetheless, I was very grateful to be given the chance to share my experience to a large group of facial plastics or ENTs seniors.

Sapporo

2011-09-23T20:23:00.001-07:00

I was just in Sapporo on mon-wed this week. Went to visit my mentor - Prof Nohira for training. I didnt realise that was his 25th wedding aniversary and he invited me to have dinner with his family is a special french restrauant. Its a specialty chef, he runs a one man show - does only 1 table a night. He looks for the best possible ingredient available and amazes his guests every night. It was the second time I have been brought there. The most memoriable dish I had the last time was uni spaghetti (sea urchin). This time round it was the tuna shashimi salad and the hokkaido beef steak.

This is the hokkaido beef - look at the amazement in all of them - even for a local, its a rare dish. Hokkaido beef to me is by far the best of beef. I have tried all the japanese branded beef and find hokkaido beef very fresh, tender without the fat, taste the blood with a great aroma. Suffice to say, we had a great time together. I asked my mentor to promise to come to SG on my invitation to attend my 25th wedding anniversary party.

I enjoy Sapporo alot because of the friends and mentors that I have there and the way they treat me - like family, I also enjoy it because it has the best sashimi - the freshest ingredients, the taste is not over powering but genuine and very aromatic.

A regular in Bangkok

2011-09-16T22:39:00.000-07:00

I have been appointed by my laser mentor Prof Niwat to be a medical advisor in Cosmetic Surgery in his hospital, Kasemrad Aesthetic Center. I have been going to perform liposuction for their patients and teaching doctors (dermatologists) there liposuction. It is by far one of the greatest honor a young doctor like me can get and to be able to give something in return is really wonderful.

So I would be going to Bangkok at least once a month until they are much better, safe and consistent with the procedure. I am really beginning to like it very much as I also notice that when one is giving instructions and tips to doctors totally new in liposuction, I also become much more aware of my steps and technique when I perform lipo for my own patients back in SG. Its an unexpected reward.

This also comes at a time when mishaps have happened in Singapore after liposuction. It just goes to show that in any procedure, experience and care when performing the procedure is really most important. Care is exercised when one keeps safety tips in mind while performing the procedure. These are the same tips that I tell the doctors who are new to liposuction. Having said that, complications can still happen and its really sad when all your esteemed collegues start throwing blames on you when it happens. There is no substitute for proper training but really no one is totally exempt from making complications. It takes a lot of care and respect for the body to be safe every time.

A wedding

2011-09-05T00:57:00.000-07:00

Yesterday was one of my best friend's wedding. He was a friend of about 20 yrs and someone whom I respected and cared a lot for. Mainly because he was a kind soul. Very poor EQ, madly hardworking, almost bordering on being genius but a very kind man at heart. Its hard to make friends and even harder to find a genuine one. These are people you know will be a part of your life no matter what happens and for as long as one will live.

It was a busy wedding for me - being on the team of brothers in the morning,in the afternoon and night - last minute MC, church singer and then elvis impersonater for the dinner reception. It was fun to say the least. The best part was seeing so many happy people, parents from both sides, relatives, friends - all very happy for this kind soul. And the wife, I only met her on the wedding day, but seems like a really nice and down to earth lady.

Weddings is a time to rejoice and remind ourselves of the happiness relationships can bring one and the visible support of close and extended family in one's life.

After the Trip

2011-09-02T19:09:00.000-07:00

If you were reading, I was in Bangkok. It was a good trip but tiring. Did 2 large cases on a sat afternoon. A large man - lipo tummy / love handles / underchin n jowls. A lady - lipo arms / tummy. It was busy but fun - doing lipo n trying to give instructions and allowing doctors to have a feel performing the procedure. It was really nice to be able to give back to someone who has been a great mentor to me. I cant say I am some great famous surgeon nor do I ever intend to but being in a opposite end giving instructions and tips really makes one realise the importance of clear communication and a genuine heart to share / teach. The desire to share and teach is now a rare commodity. You can go to conferences one after another and the only thing you take out of it is a great commercial desire to sell you something. Not to teach. It is really hard to get an pearls of wisedom nowadays. So when one finds such a teacher, you go back, you do what is needed to go back - beg even. Such is the only way one can learn a higher skill or make new revelation. In large conferences, whether its Korean or American or European, its just famous people showing nice before and afters and then nothing really revealing about their technique - so these are people trying to ride on the conference to make themselves more famous. And then, a whole lot of companies trying to make a buck, oftentimes sponsoring doctors to sell their ware. Such is the state of cosmetic medicine/ surgery. But Prof Niwat - he is one such gem that once found any self respecting doctor will treasure.

Just before the trip

2011-08-25T15:27:00.000-07:00

I would be on my way to Bangkok tonight. Well this is something worthy to report - I would be going to Kasemrad Hospital Aesthetic Center and starting the new service for my prof Niwat. Its such an honor to go and start the liposuction service in his center. I have been performing liposuction for the last 5-6 yrs and have tried my hands on several machines - laser / vaser / vibro / RF / syringe and performed liposuction for countless patients. He has invited me as the trainer / consultant to his center and to teach his doctors how to do liposuction. It would be 2 large cases on Sat 27 Sept which is also the Presidential Election Day in Singapore - I really would like to vote having been in a walk over area all my life but I promised Prof Niwat several weeks before the election date was set. This is important to him so I must make the commitment. I am not making any money - its all pro bono work but for someone who has been and still am a great inspiration and teacher to me, I cant say no. As a matter of fact, it is a real honor, if I must say it again. He has one of the most intriguing minds. A thought leader in laser work as well as a good teacher in all things about life. It is very hard, I must add, to find such a person, such a doctor and I can only count myself blessed. Being a young chap - especially so in the medical world one does not achieve any status of maturity until mid 40s - finding a gem of a doctor is one of the most precious finds in life. An often times, these mentorships turn in friendship that last for life as people driven by the same passion come together. Its been so long since I wrote anything, still unsure how to work a blog but i guess it should be kept an open diary where one selectively shares good and positive things.

Top 6 Antiaging Breakthroughs

2010-11-24T22:38:00.000-08:00

This article is from the WebMD Feature Archive

Dozens of beauty products have hit the market, but do any of them truly deliver? WebMD asks the experts to separate the science from the hype.
By Colette Bouchez
WebMD the Magazine - Feature Reviewed by Michael W. Smith, MD
Wanting to look young is not exactly a new idea -- the search for the fountain of youth has been going on for centuries. And while this past year didn’t deliver the perfect elixir, the year did introduce some scientifically solid, significant advances in anti-aging skin care. To home in on what can truly make a difference in your skin, WebMD asked medical experts to evaluate the cream of the crop.

Antiaging Breakthrough No. 1: Fractional CO2 Laser Skin Resurfacing

The antiaging breakthrough of the decade, according to many doctors, is a skin-resurfacing treatment known as CO2 fractional laser therapy. Combining the effectiveness of traditional carbon dioxide lasers -- long thought to be the gold standard in wrinkle removal -- with a new application technique, it delivers powerful results without the traditionally harsh side effects.

"Essentially, you are getting all the benefits of laser resurfacing, still the best way to remove wrinkles, but you’re getting it without the downtime and without the horrendous complication rate," says David Goldberg, MD, director of Skin Laser and Surgery Specialists of New York and New Jersey and clinical professor of dermatology at the Mt. Sinai School of Medicine in New York City.

How does it work? The natural aging process, combined with exposure to sun and pollution, destroys collagen -- the main protein of connective tissue that keeps skin plump and line-free. Laser resurfacing uses beamlets of energy light to bore tiny holes in the skin, which works to put the body’s natural collagen production on fast-forward. Here’s what’s new: Fractional CO2 laser resurfacing does this in a way that prevents damage to the top layer of skin, offering maximum results with minimal recovery time.

While laser resurfacing doesn’t come cheap -- the procedure will cost you about $5,000 -- it is quick, accomplished in one or two sessions, with about four days downtime. Goldberg says effects are thought to last eight to 10 years.

According to the American Society for Dermatologic Surgery, patients with darker complexions may be at risk for pigmentation loss with any laser surgery. Common minor side effects for fractional laser resurfacing include redness and swelling that lasts about two days.

Antiaging Breakthrough No. 2: The New Wrinkle Injections

Wrinkle injection technology soared to new heights last year when the FDA approved four fillers: Perlane, Juvéderm, Artifill, and Radiesse. Along with Restylane, approved in 2003, each uses a slightly different substance to fill wrinkles.

But according to Rhoda Narins, MD, professor of dermatology at NYU Medical Center in New York City, that’s just the beginning. "What’s really significant is that we can now use these fillers to volumize skin anywhere on the face, so you can really sculpt a lifted, youthful look without surgery," she says.

Antiaging Breakthrough No. 2: The New Wrinkle Injections continued...

Dermatologist Bruce Katz, MD, the director of Juva Skin and Laser Center in New York City, agrees. "Unlike a face-lift, which pulls the skin taut and tight, volumizing plumps up the skin so the look is youthful but more natural," he says.

In even more good news about wrinkle injections, studies conducted by Frank Wang, MD, at the University of Michigan Medical School found that those containing hyaluronic acid (such as Restylane and Juvéderm) led to "robust collagen production" while also interfering with collagen breakdown. So not only do you get a filling effect, says Narins, but you also have an actual increase in natural collagen production.

Currently, most fillers last up to one year, or longer. Only one -- Artifill -- offers permanent results, but not without concern. According to a published report by the FDA, it increases the risk of granulomas, bumps that form under the skin and may be permanent, as well as an increased risk of allergic reaction.

Still, Narins says all currently approved wrinkle injections have been used in Europe for several years, and the track record on safety is generally good. Most often, side effects are mild, usually limited to redness or swelling at the site of injection, she adds.

The cost of wrinkle-filling volumizers is between $600 and $1,000 per syringe.

Antiaging Breakthrough No. 3: Antioxidants

Topping the list of over-the-counter antiaging ingredients making the most noise these days are antioxidants. These skin-care nutrients fight aging by destroying free radicals, the unstable molecules that occur from sun exposure or pollution and that can literally gobble up the skin’s collagen supply.

"Antioxidants are nutrients that, when topically applied, disarm and neutralize free radicals before they harm skin -- so they can play an important role in antiaging skin care," says Sumayah Jamal, MD, an assistant professor of dermatology and microbiology at NYU Medical Center in New York City.

Scores of studies demonstrate the power of topical antioxidants (particularly CoQ10 and vitamins C and E) to rejuvenate and protect skin. However, the ingredient generating the loudest buzz in 2007 was clearly coffee berry, which some experts now believe is the single most powerful antioxidant discovered to date.

Two independent studies found that the same plant that gives you your java jolt in the morning is ready to provide a powerful antiaging boost to your face. The research conducted by David McDaniels, MD, at the Institute of Anti-Aging Research in Virginia, and Zoe Draelos, MD, at Dermatology Consulting Service in North Carolina, reported that coffee berry extract significantly improved the appearance of fine lines and wrinkles without allergic reactions or skin irritations.

Although Goldberg says it will be a few years before the full extent of coffee berry’s rejuvenating properties is known, he adds that it is "so powerful in its antioxidant rating that even if 1/1,000th of what’s applied gets into the skin it’s probably going to have an effect."

Dermatologist Ken Beer, MD, director of Palm Beach Esthetic in Palm Beach, Fla., says he’s seen the science and he’s impressed: "I think this is going to be a major cosmeceutical ingredient."

Other cosmeceuticals with new and powerful antioxidants include:

Prescriptives Super Line Preventor Xtreme with seven antioxidants (1 ounce, $48)
Neutrogena Antioxidant Age Reverse Day Lotion and Night Cream (1.7 ounces, $17.99 each)
Lumene Vitamin + Energy Cocktail (1 ounce, $17.99)
Clinique Continuous Rescue Antioxidant Moisturizer with eight time-release antioxidants (1.7 ounces, $39.50)

Antiaging Breakthrough No. 4: Peptides

Small proteins that stimulate the production of collagen, peptides have been on the cusp of antiaging skin care for a while. The excitement began several years ago with NIH-backed research on the ingredient Matrixyl (palmitoyl pentapeptide-3), showing its ability to stimulate collagen production in skin. Today, further studies on additional peptides continue to generate research news.

According to Jamal, studies on formulations such as Argireline (acetyl hexapeptide-3) show they can produce a mild, Botox-like effect, inhibiting the release of neurotransmitters that keep facial muscles from forming wrinkles. Even newer peptide formulations act like growth factors, stimulating skin cells to make a quicker turnover, much like young skin.

What’s new for peptides? Formulations that seem to yield overall improved results. "They are really getting the science down now, learning how to stabilize the peptides and at the same time inhibit collagenase [the breakdown of collagen] so we have better, more tailored peptide products," says Beer.

Products containing the newest versions of that peptide technology include:

Olay Regenerist Micro-Sculpting Cream with amino peptide complex (1.7 ounces, $29.99)
Lumene Premium Beauty Rejuvenating Instant Serum (1 ounce, $29.99)
Avon Anew Clinical Eye Lift (0.5 ounce, $28)
Osmotics Blue Copper 5 Face Lifting Serum (1 ounce, $75)
Emerge Bio-Peptide Night Repair Cream with 10% peptides (1.12 ounces, $43)

Antiaging Breakthrough No. 5: Vitamin A

Among the most medically studied topical antiaging treatments are the retinoids -- derivatives of vitamin A. They are offered as prescription treatments such as Retin A or Renova, but also available in weaker strengths in over-the-counter products, listed as the ingredient retinol.

Retinoids are "thought to work on aging skin by increasing collagen production and decreasing collagen breakdown," says Jamal -- and a ream of studies backs her up.

But while many doctors believed only the prescription-strength retinoids were powerful enough to cause significant change in the skin, 2007 was the year that idea changed. In a study published in the Archives of Dermatology in May, researchers from the University of Michigan found that 0.4% retinol lotion applied three times a week for 24 weeks yielded significant difference in skin wrinkling when compared with a similar lotion without retinol used on a separate group of people in the study.

Even more surprising: The average age of study participants was 87, meaning it’s truly never too late to look younger.

"For those who can’t or don’t want to have an office procedure for wrinkles, I suggest starting with retinol products, and if there are no problems, such as redness or irritation, you can work up to a prescription-strength Retin A product. But we now know that both have the power to produce measurable antiaging results," says Goldberg.

Products containing retinol include:

Vichy Reti-C Intensive Corrective Care (30 milliliters, $31)
Neutrogena Healthy Skin Anti-Wrinkle Intensives with retinol and antioxidants (Serum, 1 ounce, $16.99; Eye Cream, 0.5 ounce, $16.99)
Clinique Zero Gravity Repairwear Lift with retinol, antioxidants, and peptides (1.7 ounces, $52)
L’Oreal Advanced RevitaLift Double Lifting Gel (1 ounce, $16.99)
RoC Retinol Correxion Deep Wrinkle Serum (1 ounce, $19.99)

Among the most exciting new ways to fight skin aging are two dramatic breakthroughs in sun protection: Helioplex, a new technology that makes current sunscreen ingredients more effective, and Mexoryl SX (ecamsule), a new protective agent. Representing the first innovation in skin sun protection in more than 20 years, each is specifically designed to defend against the aging effects of short UVA rays.

"They are truly the best we have, and they are a major, major advance in terms of antiaging protection," says Katz.

Most of us know about the dangers of burning UVB rays, but you might be less aware of the damaging and aging effects of UVA. "These are the ones that go deep -- UVA rays cause the deep collagen and elastin damage that contributes to aging skin," says Katz.

While most sunscreens effectively protect against UVB rays, protection from UVA was mostly limited to the "long" waves, with ingredients that were unstable and frequently degraded in the sun.

But Mexoryl SX (ecamsule), a UVA-blocking sunscreen developed by L’Oreal, and Helioplex, a technology created by Neutrogena to stabilize traditional sunscreen ingredients avobenzone and oxybenzone, are proving not only to protect against the damaging short UVA rays, but to offer long-lasting protection without the need to constantly reapply.

"They have been available in Europe for some time now, and there is no question they work -- and from an antiaging standpoint, they can be your best friend," says Goldberg.

Even more exciting: In 2007 these sunscreen advances were combined with antioxidants and other antiaging ingredients in moisturizers and day creams that offer Fort Knox-level protection against the aging effects of the sun.

Products containing the latest Helioplex technology include:

Neutrogena Healthy Defense SPF 45 Daily Moisturizer (1.7 ounces, $11.99)
Neutrogena Ultra Sheer Dry-Touch SunBlock SPF 70 (3 ounces, $9.99)
Products containing Mexoryl SX include:

Vichy Capital Soleil SPF 15 Sunscreen Cream (3.4 ounces, $29.99)
L’Oreal Revitalift UV Moisturizer and Sunscreen (1.7 ounces, $22)
LaRoche-Posay Anthelios SX (3.4 ounces, $29)
Lancome UV Expert 20 (3.4 ounces, $35)

Originally published in the November/December 2007 issue of WebMD the Magazine.

Sharing of experience

2010-07-26T09:02:00.000-07:00

I had a kind experience with a fellow medical collegue today.

Singapore is a small place and oftentimes we think too much about competition and not about a collaboration to achieve greater medical excellence for our patients and our nation. It is also the same in Hongkong. In Korea, my experience is slight different. Eventhough, they are also highly competitive, they share and collaborate on many issues. They believe that eventhough they are competing for korean patients, they are also setting their eyes on the wider world and all the asian patients out there. So maybe thats why they are so famous now.

Back to my little world, one of the most important thing to share experience about is our individual bad complications and side-effects. In many cases, in a competitive environment, doctors do not share, because they are afraid that it may be used against them. I tend to believe that Doctors are professionals who have taken an oath and who are kind towards patients and each other. In many cases, it is always true, lest someone writes to the council and states that I am writing unprofessionally and slaming my esteemed collegues.

This afternoon, I was discussing a situation I have with another collegue ( or my competitor) and was very much surprised to be not only not alone in this situation but also been given good timely advice. Nothing bad had happened to my patients dont worry, but he probably saved me from more headaches and sleepless nights. We need more generous sharing of experiences and more kind advices. If not for our own peace of mind, but also for the good of all our patients that we endear ourselves to and want so much to manage as best as we can. Indeed the saying is true, a kind word can save one from walking down the wrong path. My plea to whoever is reading, more love more peace and more kindness haha

Shouchu Effect

2010-07-18T15:59:00.000-07:00

Since I realized that people do look at my blog, I like to talk more now haha.

I just had a great time in Seoul, good meeting, although short, just over the weekend, but there was some honest discussion on the topic at hand. A couple more tips to my hat.

What I like to share about was something else that I learnt. There is a phenomen called the shouchu effect. Another name for it is Markori effect. It means the same – when friends meet together over some Korean BBQ and kimchi, when there is a generous watering of shouchu or markori, what happens is just short of amazing. In just short of an hour, usually half an hour, reserved honorable medical folks suddenly become rowdy and very friendly. We talk and laugh, like little boys on a school outing. The amount of fun is correlated to the color of our faces, the redder the more. In a very short time, they call me their brother. I become Korean for a brief period that night. A Korean that speaks no Korean but we share the common language of brothers – laughter in slight drunkedness. Don’t misunderstand, there is no band, no music, no babes around, just grown men talking, drinking, eating, laughing and of course serving each other shouchu or markori. This is my new discovery, the shouchu or markori effect. I must have had many many dinners before in Seoul and had become Korean several times before but I guess this is the 1st time I am evaluating and stating my discovery. If I am the 1st to state it, I must claim it as the biggest discovery of the life thus far. Haha.

This effect stays on till the next morning, when we meet again for the 2nd day of meeting, we are still brothers, I am still Korean, although a very much subdued one. Nonetheless, the bond built in slight drunkedness is still strong. The brotherhood is still with us. I love Korea and this shouchu effect. And of course, I love the brothers I have made in Seoul. We stand together and share experiences and trade tips. They inspire me, thanks.

HK medical conference

2010-07-10T06:04:00.000-07:00

I am in Hongkong for the famous conference. Today is the 1st day and the program starts at noon. So in the morning, I accepted a close friend's invitation to watch some recorded lectures in the conference held last year in the US. I usually cant stand going to the US due to the long long flight and the jet lag. And I am too stingy to go there by business class.

It was a most enlightening lecture by a famous doctor - Sydney Coleman. I picked up quite a lot of pointers that will transform how i think and work wit fat fillers. Wow - The day was looking really hopeful and exciting. Rushed to the convention slight late and crashed with lots of people - searched for the lecture rooms and eye and ears open like a little boy getting a new toy.

A good student I am, I listened and watched, hoping to gleam some pearls from 12noon - 7pm. I took out my iphone and filled up the notes with points. I asked questions hoping to get some sincere reply. But end of the day, my mood went from bad to worst - so what did i learn ? Nothing much. Its so sad that no one gives presentation to teach anymore, its showing, its impressing but to no avail to the listeners. Did I benefit anything that can impact my practice ? No not really, some introduction of new concepts, but its not like you can start work on it. There is someone really happy though,it seems its the organizer. When an educational events becomes a money making event, it loses its value and will only be survived by fools.

I was really disapppointed by the very last lecture - from 6 - 7pm, its a teaching session and you need to pay extra to attend. But the lecturers speak like they only want to impress not to share, some with v little experience, some with much experience but no pearls, no sincere treatment of the topics at hand. Not teaching in any way.

Lets see if tomorrow is another good or bad day.

a close shave

2010-07-07T05:06:00.000-07:00

I drive a BMW black car - damaged but still not so bad

The offending car that smashed into my car - a good japanese make - the side totally smashed.

I was involved in an accident this morning, my car was parked by the side of a small road and I was about to come out of the car when a speeding car smashed into the driver's door. It was such a loud bang, I was totally shocked. If I came out seconds eariler, it wouldnt have just been the car door but maybe my hand or part of me. The lady driving the car was very apologetic, said sorry and I softened , we exchanged details and I had to run for a lipo case in the morning.

Went to Idac during lunch time, the car had to be towed, and had the reporting done as required. Rushed back to work, thinking that it should be a simple clear cut case. But it was not to be so simple, the nice lady called me in the afternoon and now she directed all the blame to me and even wanted me to pay for the damages on her car. I suppose I half expected it but was still kind of disappointed. The driver happened to be someone that recognised me from college days and now is a church worker in one of the larger churches in singapore. I expected some level of integrity and honestly but I guess when it comes to money, even if its just a couple of thousands, it can be hard to come by.

Still unhappy, I couldnt decide if its pure bad luck or that i am so blessed - I didnt get hurt. I am almost certain now on hindsight that there is a very high chance that if i was a matter of seconds faster, it would have been my door and me smashed. So i suppose, we just have to take what is thrown at us and manage it at our very best. Its common to get all kinds of stuff thrown at us on the road, but i guess i m bothered enough to pen these down. Hopefully, insurance will be fair.

2010-07-06T04:15:00.000-07:00

Alaxis Talk - 31 July Sat 4-5 pm on Nose Fillers and Implants

Sayings of a wise man

2010-07-06T02:50:00.001-07:00

Had the fortune to have dinner with a senior hair transplant surgeon from India just a few days ago. Started out like any normal dinner, he was asking me about my experience and my hair transplant technique. Cant really say we were exchanging notes, as he is much more senior to me, but he doesnt do FUE and has been doing strip technique for 12 yrs while i do the converse. He has a large team of nurses and hair technicians ( over 20) and is fully booked with a 3 months waiting time. So he doesnt need to do any marketing, his old patients refer their friends to him. He says, sometimes they come and do all the consulting for him so he doesnt need to talk too much. Patients come asking when is the next available date, pay the deposit and leave. India is a large country so the number of men looking for balding solution is huge. It would be nice if its also the practice here in Singapore.

Well, its not my intention to talk about the hair transplant business in this insert. I would like to share the words of wisedom that came from this man. As we talked and shared about life and work, I felt very much impressed by some of statements he made. As a doctor, we are actually just well paid technicians, we only get paid when we work, if we dont work, we draw a blank. Its ok, when you are young and working everyday, but one of my greatest fears is if I was ill or injuried and cannot work, what would I do, I would right away be in some form of debt - the monthly rental / overheads, machine loans, etc. I sought to get some form of insurance to cover situations when I cant work, but the cover is so limited that it really doesnt make sense to start. This has been a concern for me for sometime now, then this surgeon tells me this. All the money he makes, a fixed percentage goes to the overheads and family use and etc, for him its 20% to business overheads and family expenses, 20% to savings, 20% to upgrade oneself, 20% to tax, 20% to unexpected but necessary expenses.He says that when you set aside a fixed amount every month to unexpected expenses, like car breakdown or household items - when you suddenly have such expenses incurred you will not be stressed as it has already been catered for. It acts like some form of insurance. and with time, this amount will accumulate and then you can get some interest from it to pay for the other overheads. I suppose, the percentages in India is very different from that in Singapore as our cost of living is much higher, but nonetheless its a new and worthy concept to me. Then to further elaborate on the issue of money, he says at we all need to plan and time about how we get our money. According to him, there are 3 types of M. M1 - is money you make when you work - most of us belong to this catergory. M2 - is money you make when you dont work, someone works for you. M3 - this is the highest level to be attained. Its money you get when you dont work and nobody else works. We all need to start planning and working towards M3. I recounted with him about my dad, he used to run a successful company for 20 yrs and had recently closed it and retired. He however does not have M2 and M3 so he has suddenly become very stingy with himself. Eventhough he does have some money stored for retirement, but because now there is no more influx, he doesnt want to use his money. This is a sad reality of life when we dont plan for M3.

These 2 concepts of money impacted me quite a bit and it took several days for me to digest. I hope someday, I would practice it.

2010-06-25T09:14:00.000-07:00

Today I would like to talk about my 1st real mentor - Prof Niwat (Clinical Professor in Dermatology from Bangkok).

Recently, he was invited to chair a local conference and I had the opportunity to meet him and spend a whole day with him on Sunday. I have known him for about 5 yrs now and had been to his hospital several times over these years. Initially as a student and recently as a speaker in one of his conferences. All these years, he has always been near, teaching and sharing knowledge with me - not just about how to use lasers and skin but also about how I should manage my clinic, treat my patients and lead my life. In short, I am greatly indebted to him in every way in every sense of the word. You know, sometimes, just 1-2 phrases can steer your decisions, mindset and outcome so much its hard to believe. So why am i talking about him here ? I guess its just to make a record and remind myself and others about some golden invaluable truths in life and work. I suppose there is a full story behind each of these antedotes that I can share but m too tired to do it now.

"Success is not a destination but a journey"

"Never treat your patients like business, they are your friends and people that you will grow old with"

"Aesthetic business is not just about perfection or beauty, but rather its about making people happy, you are giving happiness, its a wonderful field to practice"

"Never chase after money and try to charge high - or you may select rich but difficult to please, unloyal, dissatified patients - and you will end up with a miserable practice and a miserable doctor."

"Knowledge is open for everyone, its silly to try to keep knowledge secret, but skill is yours and no one can take it away from you once you acquire them"

I would add more tomorrow - tired now :)

I hope to remember these phrases all my life.

2010-06-24T07:34:00.000-07:00

It was another busy day and my neck was aching badly by the end of it. But tonight's last patient really brought a smile to everyone. She has been a long time patient but due to work has not come for several months. Skin got loose and she really wanted to start the rejuvenating regime. We did a treatment for her and she was commenting during the treatment in chinese - " so silly to come and pay money to suffer" we hear this comment quite often. Then she said that its a love - hate relationship ! Explain pls, we asked her. This is her experience: she really likes to come and make herself look better and so she loves the doctor who helps her but also hates the discomfort very much and hate seeing my face cause it means she will have to suffer. Haha. We started laughing.

Just an afterthought, isn't life also like that most of the time. We treasure and love some people very much but usually these are also the people that have the ability to hurt us the most. The more we give, the more we would feel hurt by the person if somehow we are betrayed or let down. Even if we give without any expectations. Its the same with my staff - I run a small clinic with 4-5 staff. I try very hard to make my staff happy because of my strong conviction that only if my staff are truly happy would they be able to provide good and welcoming service to my patients. To this endeavor, we would go for company dinners very often to build rapport. But recently, I have learnt that being nice to people isnt always the right thing to do sometimes and for some people. Its sad some would climb over and try to abuse this kindness and make life miserable for everyone.

I guess I never kept a diary before in my life, maybe its time to start with this blog regardless if there is anyone reading. haha. Silly man - I think :)

Korean Academy of Cosmetic Surgery

2010-06-23T09:11:00.000-07:00

In Seoul again

2010-06-23T08:54:00.000-07:00

I was just in Seoul last weekend for another 2 day course. It was quite tiring flying into Seoul on Sat 6am, then taking the 1 hour journey from Incheon to Soeul and to the meeting place. This has been my second time attending the course and it was v nice meeting old faces. The lectures are always interesting as you always can pick up something new, a new tip and new variation, even if you think you have heard the topic a thousand times and even performed the procedure many many time over.

I suppose this is it with life and anything we do in life. Its always the small things, the little things that make this fried rice a better fried rice then the one down the corridor. And there is just no way, anyone would be able to know all the things about 1 topic - its the accumulation and the sharing of experiences that will accerlerate the knowledge and skill. It takes humbility and passion to seek of all these tips. It takes passion to want to better yourself and to beat the competition.

At the end of the day, totally tired and now nursing a headache, I struggled to go back to the hotel. But had to meet some of these doctors for dinner and drinks. I love the koreans for this really - they are about the most loyal and hearty people I know. Once you develop a relationship with them and remain loyal to their trust, the friendship is no longer about what i can gain and what you can give, but about coming together to share tips and secrets, about BBQ beef, shoucho, bean paste soup, spicy fish soup and of course - whisky.

And thats how they do things and build strong lasting relationships in this part of the world. I guess I can only thank my lucky stars for having met good doctors and mentors in this land of kimchi and also mecca of cosmetic surgery.

Starting Issues

2010-06-06T02:05:00.001-07:00

I suppose I am still not sure how to and what to do with a blog. Its interesting though to be able to write something on a more casual note or to make comments about things happening around us.

For the past year, I have been travelling much more often then ever before. Although I have limited my travels to regions around asia mostly, I have seen and heard much. It makes one realise that Singapore is a small place and we are part of a larger region not just S.E Asia but rather Asia as a whole. I have been to Korea, Japan, Thailand, Vietnam, Indonesia, Shanghai, Hong Kong, Macau, Taiwan. That's where I have been disappearing to if you have been wondering - patients do get frustrated by my disappearing acts every month - for that I apologize deeply.

I have so much to share and tell, but do not know what the boundaries are and where to start. Suffice to say, it has been an excellent year for me. Made many friends that will be life long partners in the pursuit of making people beautiful.

Dont worry, regardless of whatever, I will slowly and surely learn to share. One of my mentor told me this : knowledge cannot be contained, it is to be shared to all, it cannot be owned by anyone for long. Skill on the contrary, is one's possession forever. Skill comes only when one with knowledge puts it into practice. It comes only with experience. It is my dream that cosmetic medicine and surgery is no longer a mystery but an open book for all who seeks it to understand and learn - for doctor and patients alike.

Donald

Alaxis Talk

2010-06-04T10:36:00.000-07:00

We will present a talk on double eyelids and eye bags on 26 June 3-5pm.