Dr Sin Yong Blog - DR SIN YONG

Chin Sculpting Ideals

7/26/2020

Sculpting the chin can be done with minimally invasive aesthetics employing the use of dermal fillers. The ideal chin must always take into consideration the overall facial shape and adjacent areas such as the nose, neck and lips before sculpting can commence.

Proportions of projection, elongation, retraction must be evaluated by your doctor before proceeding. Dermal fillers allow for sculpting down to every detail and also carry with it the chance for reversibility should you choose to.

Let's take a look at some photos of beautiful chins and we can see why they match and complement the facial shape of the respective person. A well projected and sculpted chin can achieve a V shaped youthful lower face!

What is your ideal chin?
Beauty is in the eye of the beholder.
Each of these beautiful faces have a chin that complements their facial shape.

Bae Suzy

Adriana Lima

Jade Rasif

Whenever we look to improve the chin, we would always consider the lower face as an entity, to give better definition to the lower face.

Find out more from your treating doctor about whether the chin you envisioned matches your facial shape!

Hair Loss In Women

7/25/2020

A woman's hair allows her to create her beauty and sexuality. Yet, hair loss in women is common and ranges from a variety of causes. The most common is that of female pattern hair loss which starts with a gradual hair thinning/ shedding where family history can play a role. It is normal to lose between 50-100 strands of hair per day and can increase with age. However, increasing number of hair shed during showering or hair dressing should prompt you to seek treatment. The frontal hair line may or may not be affected.

A consideration of other causes that could result in hair loss is pertinent such that treatment can be targeted. Basic blood tests that aim to replace iron, zinc and rule out concurrent thyroid or autoimmune disease can be considered.

Needless to say, the psychological impact can be severe and hence needs to be treated promptly.

What can we do to arrest the ongoing hair loss?

Steps To Arresting Loss of Hair

(1) Diagnosis
A diagnosis should be achieved using a combination of presenting history, physical examination and relevant blood tests. Other diagnoses such as telogen effluvium, alopecia arreata should also be entertained.

(2) Topical Therapy
Topical Minoxidil 2-5% is encouraged as a scalp shampoo to prolong the the growth phase of the scalp hair.

(3) Low Level Laser Therapy
Low level laser therapy in the form of a comb or helmet can seek to improve overall hair density, commonly seen after usage for at least 6 months.

(4) Nutrient & Growth Factors Injection To Scalp
This aims to provide the scalp with sufficient nutrients and an ideal environment for hair to grow and recover.

(5) Hair Transplantation
Should the area of defect be large, a hair transplant can be considered to target severely affected areas.

For women, the hair is an attribute that expresses individuality and attractiveness. Any defect should be addressed as soon as possible. Find out more about your condition from your doctor today!

Hair Loss In Men

7/21/2020

Androgenetic alopecia is the most common form of hair loss. Excessive androgenic hormone - dihydrotestosterone, and genetics, are implicated in progressive miniaturisation of hair follicles.

This ultimately results in conversion of thicker terminal hair into thinner vellus hair. Insufficient flow of blood to the scalp and dysregulation of inflammatory cytokines which promotes microinflammation also contributes to its pathophysiology.

If you are suffering from loss of hair, you are not alone. This condition can affects close to 60% of Asians and up to 80% of Caucasians.

Our hair contributes to our self image and identity, and society perceives dense and strong hair as youthful, healthiness, beauty and success.

Loss of hair results in altered appearance which causes psychosocial distress with decreased self confidence, self esteem, heightened self consciousness and negatively affects the quality of life of patients.

It is hence, important for this to be addressed!

How do we address Hair Loss in Men - Androgenetic Alopecia?
The key lies in a combination of treatments, aimed to arrest the progression of hair loss and also to reverse the miniaturisation of the hair follicles.

Steps to Addressing Hair Loss In Men

(1) Anti Hair Loss Medications
Commonly, these include finasteride and minoxidil. The main consideration here is that it is a ongoing therapy, which means it will be a semi life long decision. If the decision here is to start and stop every now and then, this therapy will result in rebound hair losses rather than arresting the loss of hair.

(2) Stem Cell Hair Regeneration / Growth Factors
By utilising fats and hair grafts with technology to give a solution that is then reinjected back into the areas of poorer density. The improvement varies between 10 - 30% increase in density for patients.

(3) Low Level Laser Therapy
Employing the use of either a specialised helmet or comb that you can use a few days every week, the laser utilises red light to decrease inflammation, thereby allowing increased hair growth.

(4) Definitive Hair Restoration Using A Hair Transplant
A Hair Transplant still remains the definitive restoration by taking hair from the occipital region and grafting them to areas that are bald or have poor density. Results are definite and survival rate of the grafts ultimately depends on the team involved in the hair transplantation and also post treatment care.

**The diagnosis of how the hair loss happens remains the cornerstone before treatment can be instituted.
Though Androgenetic Alopecia remains the most common cause of hair loss, other causes must also be considered before moving on with therapy. Remember to ask your attending doctor for the diagnosis before proceeding with any treatment!

Photoacoustic Tattoo Removal

7/18/2020

Tattoos are used to allow one to redefine themselves, to create a unique statement on their selected part of their body. It gives a sense of control and identity to the individual.

Apart from that, it is also used as a form of permanent make up such as for eyebrows, coverage of scars, micropigmentation to camouflage hair loss.

Yet, in certain circumstances, one may desire for them to be removed.
How do we achieve it?
The answer is using photoacoustic laser tattoo removal!

Steps to Photoacoustic Tattoo Removal

(1) Evaluation of Tattoo
This is crucial and will determine how many sessions it may take to clear up the tattoo.
Factors that influence the resultant number of sessions include
(A) Your Skin Color
(B) Location of The Tattoo
(C) Color Pigments of The Tattoo
(D) Amount of Ink In The Tattoo
(E) Any Scarring or Layering Involved

(2) Photoacoustic Laser Removal Treatment
This involves the practitioner using an optimal power to treat the tattoos. An optimal power will result in fewer sessions rather than always treating at a suboptimal power.

(3) Post Treatment Care
Blisters, bleeding, redness, swelling, scabbing are common from treatment and the key is to manage them properly. Usually, these can take between 5 - 14 days to recover depending on your skin.
I recommend using an antibiotic ointment from your doctor, twice a day across the areas affected.
As with any laser, treatment at optimal power requires optimal recovery. Usage of RAI Post Laser Intensive Recovery Serum is recommended to achieve the optimal recovery with minimisation of side effects.

(4) Repeat Sessions
These will be conducted at one month intervals as the skin takes time to clear off the fragmented pigments.

*With any treatment, a careful evaluation and diagnosis allows us to outlay a proper treatment plan to target your concern effectively. Always ask your doctor for a diagnosis and clear treatment plan.

Resolving Rosacea

7/14/2020

Rosacea is a long standing condition where inflammation and blood vessel dilation forms a significant part of the disease. It is postulated to involve our immune systems as well as neural systems. Commonly, this results in a flushed appearance across affected areas over our face with small areas of red blood vessel dilation.

Triggers include that of

UV radiation
Temperature change
Skin irritation
Alcohol
Spicy foods

Is there a way for us to resolve Rosacea?
We are looking at a combination of steps to treat this effectively!

Steps To Resolving Rosacea

(1) Avoidance of Trigger Factors
This includes all of the above and also encompasses the regular use of sun protection.

(2) R2 Glow Laser Resolution Treatment
A cornerstone of treatment which allows us to reach a definitive resolution against rosacea.

(3) Importance of Skin Care
Usage of quality skin care products that deliver a calming anti inflammatory effect helps to keep rosacea at bay.
I recommend RAI Post Laser Intensive Recovery Serum which uses natural herbs to create a calm soothing environment for skin afflicted by rosacea.

**Diagnosis is critical whenever we are treating skin diseases.
With regards to rosacea, always remember to tell your treating doctor if you have any blurring of vision which can affect a number of patients.

Resolving PIH

7/12/2020

Post inflammatory hyperpigmentation (PIH) is an acquired form of hyperpigmentation that results from either injury or cutaneous inflamation, distributed over the region of causative inflammation.

Common causes include that of acne, accidental injury and burns.

Post inflammatory hyperpigmentation worsens with sun exposure or recurrence of inflammation. These pigments can be both superficial or deep within the skin.

Is there a way to treat PIH effectively?
The answer to it is to use a combination of treatments.

Steps To Resolving PIH

(1) Removal of triggers to inflammation
This can be as simple as putting a stop to scratching the affected area. Minimising inflammation to the area prevents the area from progression to more areas which can develop PIH.

(2) Sun protection and sun avoidance
Avoidance of excessive UV lights helps in preventing the production of more pigments. Regular use of susn block in recommended.

(3) Laser Therapy
A combination of both the Pigment Removal Laser and the R2 Glow Laser is crucial to target both pigments and underlying inflammation, reaching a optimum speed of improvement for the areas of PIH affected.

(4) Post laser care
Usage of skin lightening agents can be employed. The best choice will be the use of one that calms the inflammed areas down and decrease the production of pigments at the same time.
I recommend RAI Post Laser Intensive Recovery Serum.

** The diagnosis is always critical when evaluating any form of pigmentation in the skin, before subjecting it to any treatment. Make certain to arrive at a diagnosis with your doctor before commencing any form of treatment!

Stopping Acne Flares

7/8/2020

Acne Vulgaris is a chronic inflammatory skin disease of the pilosebaceous unit that affects about 85% of adolescents. It is characterised by comedones, papules, pustules, nodules and cysts which give it a spectrum of severity.

Yet, only about 40% of people affected seek medical help. The cycle of increase in sebaceuous gland activity, coupled with abnormal follicular differentiation with an increase in keratinisation which in turn predisposes to microbial colonisation leading to increased inflammation propagates the spread of acne.

Other contributing factors include:

Hormonal disturbances from medications
Family history
Comedogenic products
Dietary intake of high glycemic or dairy food which elevates IGF-1 levels and in turn cause an increased sebum production and follicular keratinisation

What can we do to stop Acne Vulgaris?
The answer lies in breaking the cycle of acne.

I would recommend the following steps to break the cycle effectively.
Other additional steps maybe added for specific skin types.

(1) Thorough Evaluation of Skin Care Regime
These are the products that we use on our face daily and forms the foundation in our battle against acne. Any comedogenic products should be removed and the texture and consistency of products should be evaluated.

(2) Adjuvant Laser Therapy
A combination of R2 Glow Laser and Pigmentation Removal Laser aims to achieve the following results.
(A) Decreased Inflammation (B) Decreased Bacteria Counts (C) Lightening of Pigmentation & Redness

(3) Chemical Peel / Hydrafacial Microdermabrasion
Chemical peels help to remove excessive dead skin cells which can predispose to clogging of sebaceous ducts which in turn results in comedone formation.

** You should always have your condition evaluated by a trained doctor to ascertain the diagnosis before commencing any form of treatment.

How do I know how severe is my acne?

Grading To Acne

(1) Clear
No lesions to barely noticeable ones; very few scattered comedones and papules

(2) Almost clear
Hardly visible from 2.5 meters away; a few scattered comedones and a few small papules; and very few pustules, comedones, and papules

(3) Mild
Easily recognizable; less than half of the affected area is involved; many comedones, papules, and pustules

(4) Moderate
More than half of the affected area is involved; numerous comedones, papules, and pustules

(5) Severe
Entire area is involved; covered with comedones, numerous pustules and papules, a few nodules and cysts

(6) Very severe
Highly inflammatory acne covering the affected area, nodules and cysts present

Do I need to be treated?
Or should I let time pass by and hopefully it gets better?

Like any disease, it is always better to treat it early before it spreads.
Acne destroys our self confidence, takes away our self esteem and burdens our psychological health, creating a depressed self.

Dr Sin Yong is a firm advocate against the acne and stands to utilise the best equipment at optimal treatment protocols to help you manage acne together. A common treatment regime will see good clearance of between 50-90% after 3 months.

Controlling Melasma

7/5/2020

Melasma is an acquired pigmentary condition that tends to be long term, with patients commonly falling into relapse. It tends to affect women in their 30s and 40s and can occur more frequently in child bearing women. Men can also be affected as well. Contributing factors are abound such as long term ultraviolet exposure, genetics contribution, oral contraceptive use, hormonal fluctuations, thyroid disorders and use of irritant cosmetics.

What can we do to control it?
The answer lies in understanding Melasma, arresting the aggravating factors, then rebalancing the skin profile!

Arresting The Aggravating Factors
Avoid UV radiation
Use of broad spectrum sunscreen can achieve up to 26% improvement as early as 3 months. Regular application of broad spectrum sun block can reduce melasma incidence by up to 90% and decrease its intensity by 50%.

Hormones
Increase in pregnancy hormones or use of oral contraceptives can trigger melasma.

Avoid over-exposure to heat
Professions such as bakers who are exposed to oven can have aggravation.

Avoid exposure to high light intensities
Professions such as dentists are more resistant to treatment of melasma. Visible light can induce hyperpigmentation via opsin 3 which is a specific sensor in melasma. Sunscreens containing iron oxide confer protection against these visible light of shorter wavelengths.

Avoid use of photosensitizing cosmetics
Found in a range of cosmetics where they can aggravate melasma.

**Reproduced with permission from RAI Aesthetics.

Rebalancing The Skin Profile
The key here is to select treatments that are sustainable in the long term with minimal side effects.

Use of Skin Lightening Agents
I recommend RAI Post Laser Intensive Recovery Serum for a few reasons:
(1) Herbal extract with skin lightening components.
(2) Calms down inflammation in skin which is associated with Melasma.
(3) Zero risk of exogenous ochronosis
*a permanent darkening that occurs with prolonged use of certain skin lightening agents such as hydroquinone.
(4) Improvement in overall skin profile, texture and quality.

Use of R2 Laser
(1) Targets underlying inflammation implicated in melasma.
(2) Helps to balance and normalise the production of pigments rapidly.
(3) Disperses areas of concentrated pigmentation.

Other Modalities Involving chemical peels, growth factors can be considered on a case by case basis.
On a personal note, I do not advocate oral medications for long term management of melasma.

Enquire with your doctor today to find out what is the best way to control your melasma and restore clear even skin tone!

*This website blog is purely for educational purposes for the general public and other doctors.
The opinions expressed are not representative of any clinic or company.
Email: dr.sinyong@gmail.com
Phone: +65 9675 4838