Want to know more about Microneedling?

Get that smooth, summer skin you’ve been dreaming of with our medical microneedling treatment…

There are countless treatments on the market these days which can help to improve the look and feel of our skin. The underlying conversation revolves around collagen and the natural depletion of our production of it over time. Most cosmetic procedures aim to improve collagen production in order to regenerate our skin and maintain a more smooth, even tone as well as youthful appearance. One such treatment comes in the form of microneedling. 

This procedure, involving the insertion of fine needles into the skin can absolutely help to reduce wrinkles, acne scars and stretch marks as well as blend blemishes, even out our pigmentation and give the skin its ‘smooth’ back! There are home treatments available when it comes to microneedling but with a trained, skilled practitioner you will achieve far better results due to their tools reaching deeper levels in the skin (not safe to try at home). A series of treatments may be required to achieve the desired result as well as the possibility of microneedling being used in conjunction with other treatments, all depending on the client and their needs. 

HOW DOES MICRONEEDLING FEEL? 

The sensitive zones on our skin may feel slightly more uncomfortable than others (upper lip, for example), but usually you will just feel a buzzing sensation over the skin. Generally people feel as though they have had a great facial after microneedling, though there may be some redness and slight swelling immediately afterwards which will reduce and vanish completely in a matter of hours to a maximum of three days, depending on the intensity of the treatment. Downtime is minimal and life can resume as normal right away. The use of make up and sunscreen is permitted the next day.

MICRONEEDLING AND CELL COMMUNICATION 

The aging process of our skin is generally defined by its various characteristics - wrinkles, sun spots, redness, tougher and rougher to the touch, thinning, pigmentations such as melasma, and sagging. These features occur over time for a combination of reasons; reduced ability for regeneration, oxidisation, and glycation of basic structures within the skin such as collagen, hyperfunction of some cells such as vessels and melanin, some tissues such as vasculature, as well as impaired cell defense. Our system basically slows down with age and the results are the physical characteristics of aging. As well as the slowing down, the different functions are happening simultaneously but at varying levels and speeds and so key cells and skin layers suffer a miscommunication, it is this which we can work on and provides one of the most important treatment targets. 

HOW DOES MICRONEEDLING WORK?

Microneedling is a powerful tool that permits the restoration of healthy dermal-epidermal communication, as well as cell communication. Specific growth factors and regulatory factors re-establish that communication via microstimulation and can add long term results to many procedures. Microneedling may also be used to prepare for many other aesthetic procedures in order to ensure that, post treatment, the communication between the layers is re-established and the procedure will achieve optimum results. Prior to a face and/or neck lift or facial fat grafting procedure, for example, microneedling could be carried out in order to achieve the best possible outcome of the overall treatment. 

Microneedling does work alone, or can be used within a combination of treatments and therefore compliments our 3-dimensional approach to aging skin. Microneedling can be a single or multiple procedure, (1-3 sessions). The rate of complications of microneedling is very low, patients must be selected and the treatment customized to suit.  when the right patients are selected. Some patients, for example, require preparation of the skin, especially those with darker skin or melasma. 

HOW TO ENSURE MICRONEEDLING IS EFFECTIVE…

Your chosen, skilled practitioner will…

• Utilize the correct depth of needle to reach superficial or mid dermal layer = from 1.0 - 2.5mm

• Apply the correct number of passes to ensure efficient stimulation on the area = 10 - 40 passses

• Apply the correct force and penetration to be able to cause pinpoint bleeding

MICRONEEDLING TOOLS AT OCEAN CLINIC

The 4th generation cordless microneedling - Dermapen 4th generation, gives you the chance to not only customize depth and speed of needling per area but also allows you to boost the treatment by combining dermabrasion to treat certain conditions such as scars, stretch marks, rosacea (a common skin condition that causes blushing or flushing and visible blood vessels in your face), and fine wrinkles.

To find out more about microneedling at Ocean Clinic, please contact us directly. 

 

Recovering from Plastic Surgery? Here's what you need to know...

 

Recovery After Plastic Surgery - What You Need to Know

Undergoing surgery is a big decision and you may be concerned about the length of time it will take you to get back on your feet afterwards...

To ensure you know exactly what to expect, Ocean Clinic Marbella has put together a guide covering all aspects of the recovery process. Post-surgical care will vary from procedure to procedure, but the information below applies to most surgeries.

Returning home from the clinic

It is advisable not to drive after surgery as your body is recovering from the effects of the anesthetic. You will also have reduced movement and may be experiencing some pain. Therefore, you should arrange in advance for someone to drive you. We can organise a taxi for you, if necessary.

We recommend that you have someone stay with you for a least 48 hours following surgery. It is great to have the help and support of a partner or friend at this time and they can assist you should you start to feel unwell. You may also be unable to drive for a period of time. If you do not have anyone to call on, we can recommend carers who can be privately hired.  

Painkillers and antibiotics

Everybody experiences pain differently, but in general you should expect to be taking painkillers for around three to five days. Pain is usually well managed with over the counter medication, although it may leave you feeling fatigued so make time to rest.

You may be prescribed a course of antibiotics to take to minimise the chances of post-surgical infection. The full course should be finished, even if you feel fully recovered. You will also be given a stomach protector tablet to take daily.

Bruising and swelling

Healing differs greatly from person to person - some people bruise easily, while others hardly bruise at all. You will probably have an idea of how well you heal or how prone to swelling you are, which can help inform you about how long your recovery is likely to take.

However, it is safe to assume a period of around two weeks for bruising and swelling to subside (a little longer if you are having facial bones broken). You may be offered a course of lymphatic drainage sessions to help get rid of swelling faster. If you have had fat transfer, the area will continue to decrease in size for around six weeks while fat is reabsorbed.

Dressings and stitches

You will be asked to return to the clinic at different intervals after your surgery in order to have dressings changed or removed, and for the surgeon to check you are healing well.

Some procedures use dissolvable stitches, meaning you won’t have to have them removed. If you have received regular stitches, you will be asked to come back in after 10 days for them to be taken out. If you have undergone rhinoplasty, your nose cast will also be removed after 10 days.

Taking a bath or shower

Some dressings can be worn in the shower and dried with a hairdryer afterwards. Other bandages and casts must be kept dry meaning you will be unable to bathe properly until they are removed.

You should plan to wash with a flannel and you might want to seek the assistance of a partner or friend to wash your hair. You can be well prepared by stocking up on toiletries like dry shampoo and face wipes in advance.

Compression garments

If you have had liposuction, you might be asked to wear a compression garment - or in the case of breast surgery, a surgical bra. This should stay on at all times, although it can be taken off for showering.

You may have to wear this garment for as long as a month so it is a good idea to plan outfits that will cover it. Bear in mind that it might be a little hot to wear in summer so you’ll want to keep out of the sun.

Sleeping

To aid lymphatic drainage and help swelling go down, you may be asked to sleep in a semi-upright position. If you have a facial cast on or have had breast implants, it is even more important to sleep in a way that will not impair your surgical results.

You can prepare for this by investing in a v-shaped cushion that you can use to prop yourself up in bed. Sleeping may be uncomfortable for a day or two but you will soon get used to this new position.

Scar tissue and numbness

As you heal, you may notice areas of hardness under the skin as well as lumps, bumps and unevenness. This can take months to soften up and even out so it’s important not to worry about it. To speed up the release of scar tissue, you may be offered a course of ultrasound therapy sessions.

It is important to remember that you will sustain a certain amount of nerve damage as a part of your surgery. This means that the feeling in the treated area might take a while to fully come back. You may experience numbness for a number of months while the nerves repair themselves.

The final result of your surgery

People are understandably impatient to see the results of their plastic surgery. But while you will get a good idea of what it’s going to look like after a couple of months, you won’t see the end result for around 12 months.

The healing process is very gradual and things will be changing and developing inside your body for many week post-surgery. The area that has been operated on will continue to refine and soften. Only when all hardness caused by scar tissue and swelling has gone will you really see how good it looks. To keep track of your progress, you might like to take a photo every month!

Got more questions about your surgery or recovery? Email us at info@oceanclinic.net and we’ll be happy to answer them.

Heard of the G Point lift? The latest technique in under-eye fillers...

 LIFTING THE LID ON UNDER-EYE FILLERS : The G Point lift…

Under eye fillers are a popular way to restore a youthful look to the face by replacing lost volume to the ‘hollows’ under the eyes. This deformity can be genetic or a part of the ageing process of the cheeks as well as the peri-ocular (under eye) area. When collagen production slows down, fat is lost, bone is reabsorbed, and hollows begin to form under the eyes giving the face a tired and droopy appearance. It can often appear that we have dark circles and a withdrawn look to the eyes and cheeks. Due to the constant advances in aesthetics we are gaining more and more understanding as to why this occurs, the detailed anatomical reasons behind ageing, as well as how best to counter these facial reactions using cosmetic treatments. 

A study, led by our very own Gabriela Casabona MD et al. from Ocean Clinic, Marbella, based on where to best position facial soft-tissue fillers, was carried out to look into a new injection protocol which makes use of the advances in the understanding of facial anatomy. The aim was to investigate where best to position injectable soft-tissue fillers considering the line of ligaments (an imaginary line connecting different retaining ligaments and dividing the face into lateral and medial sections) and surface of the face for most efficient volumisation. 

Better understanding of the facial anatomy and the layered arrangement of facial soft tissues has introduced a more 3-dimensional approach to minimally invasive treatments, such as soft-tissue fillers. This more extensive knowledge provides information on which layers of the face are more effective or present a greater risk for vascular events. Practitioners are now able to determine more precisely, guided by this information, how the facial fat compartments and boundaries need to be respected, achieving greater aesthetic results and safer outcomes. 

This study describes the results of a new injection algorithm respecting newly conceived anatomical concepts. Data received from 306 patients having received the same soft-tissue fillers using the same technique were used to determine the results. 

FIGURE 1: The injection scheme. The face on the far left shows how the G point is determined - a line from the nose to the ear, another from the corner of the mouth to the corner of the eye, and a third from an intersection of the two. The middle face shows where the injection points are allocated and the third depicts the contours.

All patients were treated with the same injection technique, the product was applied using markings made on the skin using the protocol in Figure 1 - the G Point - a combination of this starting point alongside the G-prime effect shown in Figure 2. 

The technique was carried out as follows:

A dermal access puncture was performed with a 21G needle 1 cm supero-lateral to the midportion of the nasolabial sulcus. A 22G 50 mm blunt-tip cannula (Dermasculpt) was introduced into the superficial nasolabial fat compartment and advanced in the direction of the G-point. After the level of the infraorbital foramen was passed, the cannula was introduced deeper into the supraperiosteal plane. This “first-superficial-then-deep” cannula advancement technique assured that the infraorbital neurovascular structures and the angular vein were crossed superficially. The correct positioning of the tip of the cannula was digitally controlled and assured that it corresponds to the lateral aspect of the sub-orbicularis oculi fat (SOOF)12 and that it is located lateral to the line of ligaments.7,9,10

In the next step contouring, the cannula was retracted (with- out exiting the facial soft tissues) and re-advanced cranially in the mid-pupillary line. Again, a “first-superficial-then-deep” cannula advancement was performed to assure that the infraorbital neurovascular structures were crossed superficially. Three serial bolus injections were applied in the supraperiosteal plane targeting the upper/middle/lower aspects of the medial SOOF.

Next, the cannula was retracted and re-advanced cranially following the “first-superficial-then-deep” approach positioning another supraperiosteal bolus in the palpebromalar groove, inferior to the orbicularis retaining ligament at the level of the lateral canthus and another bolus in the supraperiosteal plane in the tear trough.

Thus, a total of 6 boluses of soft tissue filler of high visco-elastic characteristics were positioned in the supraperiosteal plane utilizing one single dermal access puncture (Figures 1,3). 

Then the contour between the cheek and the lower eyelid was addressed. Dermal access was made by a 23G needle (TSK Laboratory) in the dermal location of the G-point. A 25G 38 mm blunt-tip cannula (Dermasculpt) was introduced into the SOOF without establishing bone contact. The cannula was advanced medially, deep to orbicularis oculi muscle and superior to the orbicularis retaining ligament. During retrograde movement, small amounts of soft tissue filler (low visco-elastic characteristics) were injected (Figures 1,4).

So, each patient received the same amount of soft-tissue filler at the same injection sites using the same algorithm and techniques to determine whether this is an improved and more effective method to administer soft-tissue fillers under the eye.

The statistical analysis results (Descriptive and comparative analyses were performed using SPSS Statistics 23 (IBM), and results were considered significant at a probability level of ≤.05.) showed the following:

 

FIGURE 2 Figure showing the volume changes (middle face) and vectorial skin changes (right face) after injection in the G-point. An increase in volume is represented by dark blue, as a decrease is represented by dark red. Note the laterally oriented skin vectors, indicating a lifting effect after injection into the G-point.

 

FIGURE 3 Figure showing the volume changes (middle face) and vectorial skin changes (right face) after injection in the G-point and giving off six infraorbital boluses. An increase in volume is represented by dark blue, as a decrease is represented by dark red.

FIGURE 4 Figure showing the volume changes (middle face) and vectorial skin changes (right face) after injection in the G-point and giving off six infraorbital boluses and infraorbital contouring. An increase in volume is represented by dark blue, as a decrease is represented by dark red. 

CONCLUSION

This clinical study retrospectively analysed a total of 306 patients treated for infraorbital and medial mid-face volume loss according to a standardised injection algorithm. This cannula injection-based algorithm utilises novel anatomic concepts (line of ligaments and surface volume coefficient) and positions the product in the supra-periosteal plane following a “first-superficial-then-deep” cannula advancement technique. The results revealed that utilising these novel anatomic concepts, a mean amount of 0.32 cc high G-prime soft tissue filler injected in the lateral SOOF (G-point) can change mid-facial distances by an average of 0.19 mm. This repositioning of medial mid-facial soft tissues resulted additionally in a reposition of the lower eyelid-cheek junction by an average amount of 0.49 mm.

Put into general terms this means that the result of this study and analysis of this particular style of injection is highly efficient, achieves outstanding results and has an excellent safety outcome. Therefore it seems that the recent anatomical findings and consistent advances in our understanding of every layer and angle of the face has a great impact on the outcome of minimally invasive treatments such as soft-tissue fillers. 

WHICH SURGERIES ARE TRENDING AT OCEAN CLINIC, MARBELLA IN 2022?

 WHICH SURGERIES ARE TRENDING AT OCEAN CLINIC, MARBELLA IN 2022? 

The start of the new year always brings about an element of change in people. It represents emergence, a time for metamorphosis, rebirth, and growth. Quite often this feeling inspires people to make personal changes; some big, some small, some physical.  

So far this year, the Ocean Clinic, Marbella has been thriving and booked solidly for various surgical procedures. Looking at the client log and following up on patient progress, we can see which of the many surgeries offered at Ocean Clinic have been trending this quarter. The information below is a summary of the most popular surgeries performed at the Ocean Clinic since January 2022. 

RHINOPLASTY

Top of the list for the first quarter of 2022 is a solid favourite that seems to trend year after year. Rhinoplasty is a procedure which can make radical or subtle changes to a person’s facial appearance. Whether it is a bump on the bone, a misshapen nostril, a deviated septum, repair from breakage, or a reconstruction, there are countless reasons, aesthetic or physical, that can prompt a ‘nose job’. One of our recent clients underwent a nose reconstruction after the removal of a tumor, another was to simply straighten and refine the shape, it is a very diverse procedure considering the small surface area the nose covers.  At Ocean Clinic, Marbella so far this year we have completed many rhinoplasty surgeries making it the most popular procedure of 2022 to date. 

Nose Correction Before & after photos Closed Rhinoplasty (Nose Job). Reshaping of the Nasal Tip, Bridge and Dorsum and Nasal Bone (Hump Removal)

BREAST AUGMENTATION

Surgery on the breasts is another firm favourite at Ocean Clinic.  Breast augmentation includes a range of surgical procedures - it is not limited to implants - there are also uplifts, implant changes, breast reductions, fat grafting, as well as reconstruction or removal of implants. Often a combination of procedures is used to create the optimal shape and outcome. For example, someone changing their implants for a different size may also opt for a simultaneous uplift as the heavier weight has caused the skin to drop over time. This is absolutely one of the most popular types of surgery at Ocean Clinic, Marbella this quarter and every quarter! 

Breast Augmentation Before & after photos with 210cc Anatomic Epipectoral Silicone Breast Implants

LIPOSUCTION ABDOMINOPLASTY

You may know this procedure more affectionately as the ‘tummy tuck’. The removal of excess, unwanted fat around the abdominal area using liposuction. The remaining loose skin is then removed and secured by a discrete line of stitches just above the pubic area (under the knicker line). Common in both men and women, abdominoplasty is rising in popularity; a strong choice for those who have been through pregnancy, or undergone extreme weight gain and then loss. The physical changes our bodies go through in these extreme circumstances are often very difficult to recover from and so a surgical procedure is elected to achieve the desired body shape. The liposuction also works to shape the waist and hips, not simply to remove fat, leaving a more sculpted and defined look. 

Tummy Tuck Before & after photos Mini Abdominoplasty with Liposculpture

FACELIFT AND NECK LIFT 

Facelifts and neck lifts have always been popular surgical procedures, especially with our slightly older clients. However, lately clients have been opting for this at a slightly younger age than usual which has caused the numbers to rise. The facelift and neck lift can also include a fat transfer to the face which refills lost volume under the skin and adds to the more youthful appearance. 

Face and Neck Lift Before & after photos Rhytidectomy MACS lift face and neck

BROW LIFT

The surgery that seems to be increasing in popularity the most is the ‘brow lift’ or forehead lift. This procedure rejuvenates the face from the eyes upwards giving a more refreshed look. Excess skin is removed, helping to correct a furrowed brow, and sagging eyelids, restoring a more youthful look to the whole face. 

PATIENT TESTIMONY 

"For many years, I thought that I needed eyelid surgery but during my first consultation at the OC I understood that my concerns were to be addressed with a brow lift. My eyes appear more open now, my face more youthful and less tired."

Helen, (48)