Happy Needles An Interview With Masquerade Magazine

Interview by: Sofia Guellaty

With procedures popping up every month, MSQRD takes you directly to the Doctor herself to get the answers to our readers’ most pressing cosmetic surgery questions.

MSQRD: I don't want to go under the scalpel as I am only 30. I hate looking like I did something BUT I want to loose weight in my legs, have a firm stomach, I smile so much I have thin lines around my mouth. Can I resolve all those issues with needles?

Dr. Shazia: Before we go into details of: “How to take care of aging skin and look younger?” we need to know “Why do we age?” “Why do wrinkles appear?”
Answer is simple as, we age our skin’s capacity of making new collagen goes down. Post 20 years of age skin stops making new collagen. Studies have shown that every year past the age of 20 we loose 2-3 mg of collagen in the skin of face and neck area. Hence, skin starts to look thinner and wrinkles more readily. Collagen is not the only element deteriorating in our body as we age, we are also loosing fat in the center of face, muscle mass is depleting and bones are also thinning.  To top it all gravity is pulling every thing south. If you want to beat time and look young, fresh and lifted naturally you need to work on all these factors and work in 3D approach.
If you are in your 30’s its too early to go under the knife. Start working on preserving and restoring the damage done past 20. You still got time as little damage has happened.

Basic rules of skincare 20’s, 30’s and Past: Always use Sun protection. Second most important message is Moisturize, Moisturize, and Moisturize. Dry and dehydrated skin is prone to wrinkling and aging faster than well balanced and hydrated skin.
Early and diligent use of skin appropriate products helps conserve collagen loss and helps make new collagen. Tried and tested ingredients include Vitamin C and A based products.
 If you want star quality skin and body, start with radiofrequency assisted skin rejuvenation procedures. There are devices available in your dermatologist’s office, which give amazing results and take you 5-10 years back in time. Thermage, Accent XL and Mabel Pro are some of the commercial names using radiofrequency for skin tightening and body contouring. They work on the principal that if skin is exposed to a temperature of 42 degrees for few minutes the fibroblasts (factories that make collagen) start producing new collagen. Hence, restoring and compacting skin’s collagen content. Deeper focused treatments help to zap fat and strengthen sub cutaneous fibrous septae helping in erasing double chin, hanging jowls cellulite reduction and body sculpting.

Smile lines, nasolabial folds (folds running from nose to lips), marionette lines (sad expression lines going south from lips), and lacrimal grooves (hollow groove under eye) can easily be smoothed out with hyaluronic acid based fillers. My latest indulgence is Anteis Liquid Face Lift with Anteis family of hyaluronic acids. You can take care of each part of face and neck with specific concentrations of area appropriate injections.
 Lets talk body sculpturing: Diet and exercise are the two strong pillars on which your physique depends. Always drink 10-15 glasses of water (2 glasses before each meal), eat small portion meals multiple times a day (4-5). Talking food selection focus on vegetables, fruits & proteins. Eat carbs, starches, sugars and fats sparingly. Avoid junk food, sodas and fatty snacks altogether. Indulge in green tea with ginger and lemon.

Unsightly areas like lower belly, thighs and lower back can be contoured easily with non-surgical methods.
There are several devices available in your dermatologist’s office that help to trim fat, zap cellulite and tighten and lift skin. Reliable technologies available in the market to sculpt body non surgically include:
  • ·       Radiofrequency (RF) based devices: Thermage, Mabel Pro, Accent XL (RF heats up skin and fat resulting in skin tightening, cellulite reduction, and zapping superficial fat under the skin. You loose 1-2 cm in each session. Can be repeated every 15 days)
  • ·       Ultrasound based devices: Liposonix, Luvitra Twin (Focused sound waves blast the fat cells mechanically. You loose 1-6 cm with each session. Can be repeated every 15 days)
  • ·       Cryo lipolysis: Zeltiq cool sculpturing (Freezes your fat and causes fat necrosis you see 20% bulge loss in 2-3 months. Can be repeated every 2-3 months)

Mesothrapy: Injections of caffeine and phosphatidyl choline have proven to zap fat. Most cosmetic practitioners in Europe have been using them over the past decade with good safety record though, no studies are available to prove or disapprove. New studies are under way currently in US to get FDA clearance.

Laser Assisted Liposuction: If you’re a little brave at heart Laser assisted liposuction is another option, which has changed the way we do liposculpting. It is much gentler and less traumatic than the original procedure. A numbing solution is injected through very tiny incision points. You hardly feel anything and get sculpted in a matter of few hours. Your skin looks tighter and angles look sleeker in a matter of few weeks.
MSQRD:Tell us about this non-chirurgical nose lift procedure?

Dr. Shazia:  Non-surgical nose job entails injecting a filler product at the tip of the nose and at the base of the columella to elevate the tip. Some strategic injections on the bridge of the nose also help to straighten the nose and give it a more pleasing curvature. The procedure takes 10-15 minutes. The results last 1-2 years depending on the material chosen (hyaluronic acid or calcium hydroxyapatite). Few units of well-placed botox coupled with the filler makes end results even more interesting and refined. 

MSQRD: What about my lips?

Dr. Shazia:  Lips can be rejuvenated gorgeously with hyaluronic acid injections. Simple trick is “less is more”. Some people go over board and inject multiple syringes and end up with the frowned upon “trout pout”. All aesthetic doctors need to respect boundaries of beauty and should work on enhancing subtly instead of producing overdone looks.

MSQRD: What is the difference between a good and a bad procedure, why some girls end up looking like Demi Moore and Megan Fox after doing tons of work and others look like a balloon?

Dr. Shazia: Doctors working in aesthetics need to have an artistic sense and an earnest eye for beauty. Just being a doctor does not mean you can create or restore beauty. You can inject yes but can’t create a masterpiece. Aesthetic sense is something you’re born with or you work really hard to attain.
A good aesthetic doctor is first and foremost familiar with the golden proportions of an attractive face. While working she/he aims at restoring the harmony of a beautiful face and not creating unsightly balloons and balls. Botox or fillers for face should be strategically placed not stuffed in mindlessly like filaments in a pillow.
MSQRD: Do you believe in miracle procedures? Which one is your favorite?

Dr. Shazia: I believe in beauty, I believe in proportions, I believe in harmony (BPH). If you understand BPH you can create miracles.
Today we have quiet a number of useful tools in our armament to restore and create beauty. Botox and fillers are undoubtedly a dermatologist’s no. one best friends. I love radiofrequency facials and body treatments because they produce fast and qualitative results. Fat and stem cell injections have given me a lot of flexibility to restore and enhance face, breast, & buttocks, etc. (areas previously dealt with surgical approaches only).
We talked about 3D rejuvenation earlier, I believe if you want to restore properly and naturally the only way to think and plan is 3D. 3D transformation requires a combination therapeutic approach. Every face and body is unique. I like to analyze and define weak points first and foremost and only then I make my strategy to fix and restore.

MSQRD: It would appear that a new procedure comes onto the market every month. How can we spot the gimmicks between the tested and true procedures?

Dr. Shazia: Aesthetics is a multi billion dollar industry and every one wants a bigger chunk of this pie. Literally, “the race is on”. You are right every month a new procedure or product is being introduced which is mind-boggling. The only way to know what’s true and what is a gimmick is to keep up with the industry and study in depth “what’s going on?” or acquire the help of a trustworthy expert to keep you updated. Looking for regulatory body approvals also helps you to choose the right procedures and products.
MSQRD: What are the best natural preventative aging tricks you can suggest?

Dr. Shazia: When we talk prevention first thing to avoid is: sun or UV tanning.
Other major factors that break down collagen and damage skin are: smoking, and gobbling sweets & carbohydrates. Scientists believe that inflammation is at the basis of aging in all organ systems, including the skin. One of the reasons inflammation occurs is from a rapid rise in blood sugar, which causes biochemical changes in the cell that result in accelerated aging. You can have deterioration of the brain or the heart muscle, and likewise of the skin. Numerous studies have shown us that one of the big internal causes of inflammation is diet. In addition to biochemical changes, sugar causes damage to the skin in another way: When blood sugar goes up rapidly, sugar can attach itself to collagen in a process called "glycation," making the skin stiff and inflexible. Losing this elastic resilience of young skin will give you deep wrinkles and make you look old.
Basics: Good diet (plenty of organic vegetables and fruits), regular exercise (at least 4 times a week), and plenty of water (10-15 glasses) everyday to be practiced as a lifestyle.
Sun protection: A skin appropriate sun block SPF 50+ used on sunny as well as cloudy days. UV rays are really harmful, a study recently showed 10 minutes of daily UV exposure is enough to cause skin cancer, premature aging and pigmentation alterations in the exposed skin.
Daily Skincare: A good skin specific cleanser, toner and a moisturizer are a must to have a clean radiant and youthful complexion. Moisturize as many times as you wash your face.
Collagen Boosters: Vitamin C and A based products. Peptides are all the new rage these days they are less irritant than vitamin A based products yet, delivering similar results.

MSQRD: I understand that the neck is a tricky area to operate, what can we do regain a youthful neck?

Dr. Shazia: Radiofrequency devices help with double chin, hanging jowls as well as skin tightening and lifting.
Botox can help with softening the Platysma bands that make the neck look older and pull the face down. Procedure is called Nefertiti Neck Lift.
Hyaluronic acid in very low concentration “Mesolis” can help erase the lines and wrinkles very niftily and help plump up the thinning skin. 
These days I am using a lot of plasma cell injections to rejuvenate the neck, décolleté, delicate area around eyes and hands. The procedure is called Vampire face-lift. We use your own blood to heal the damaged tissue of your face, neck or hands. Blood is packed with natural growth and healing factors. We separate them from other cells and inject them back to rejuvenate damaged tissue. Works like magic!


Adult Acne: Myth Or Reality? (Part III)

We have been talking adult acne for the last two weeks now. The causative factors have been established and we have figured out a plan how to avoid them. We have discussed topical and oral medical plans to keep acne under control. Next step is to working on getting rid of any unsightly pigmented or scarred areas (the aftermath of acne!)
Lets commence on our last mission ..........unclog your pores once and for all and let your beautiful skin glow.


Gone but not forgotten—zits often leave a lasting mark
Although post-inflammatory pigmentation—red spots that linger for months or even years after your pimples go away—is genetic, squeezing and picking can exacerbate the problem. The earlier you treat the spots, the better the odds they'll disappear. Apply a product containing the plant extract willowbark (a derivative of salicylic acid) and antioxidants (like vitamin C) twice a day to fade marks and boost cell turnover.
Try Babe Depigmenting cream or BDF Fade gel-4. If your spots haven't budged after six months, consider getting chemical or laser peels at your derm's office (they'll run you about 400 to 2000SR a pop); you might need two or three to get the job done.


When the body has a vigorous response, almost inappropriately strong, to acne bacteria, this can lead to inflammation. Intense inflammation over time cause scarring. Some people are more prone to scarring than others. Some patients with intense inflammation can end up with significant disfiguring scars.


There are different kinds of acne scars: ice pick, atrophic, and hypertrophic. Ice pick scars are deep pitted scars with steep edges. Atrophic scars are pitted but have smooth borders and are not as deep. Hypertrophic scars, more common on the back and chest, are thick, lumpy scars that sit above the surface of the skin.


The most safe and effective treatment for the majority of patients with acne scars is the Fractional CO2 Laser. “Fractional” laser means that the laser works by resurfacing only a “fraction” of the skin at a time, leaving the surrounding area intact for faster healing. This vastly reduces the incidence of side effects and has given us the ability to treat all skin types.


The CO2 fractional laser pokes tiny microscopic holes in the skin down past the epidermis and into the dermis. These holes cause new collagen generation which fills in the acne scars and creates rejuvenated smoother skin.

Most patients start to notice improvements in their skin as early as 1 week after the treatment. Continued improvements occur for the next 6 months and peak at around month 6. Most patients notice between 50-70% improvement of the condition treated. However, results vary individually.


The vast majority of patients require 1-4 treatments to achieve the desired results. Since the treated area continues to improve for the 6 months following the laser treatment, we re-evaluate the need for any additional treatments at that time.

Fractional CO2 Laser treats acne scars in patients with all skin types including Asian, Indian, and African-American skin. Though an experienced laser surgeon is needed to treat darker skin types safely.


The fractional CO2 laser causes a wound in the skin, which means you will have three to four days of downtime when the skin is healing. During that time you have to apply an ointment frequently to your face keep the skin greasy, which makes healing faster.


The main risks are temporary or long-lasting light or dark spots from treatment. Very rarely scarring can still result. For these reasons it is important to be treated by an experienced laser surgeon.

I have personally tried Fractional CO2 laser and am very happy with the results.

I hope our journey exploring the myth of adult acne and its after math has been fruitful and with final treatment plans for scars and pigmentation clear and beautiful will be unveiled. Wish you all clear skin and radiant complexions!


Adult Acne: Myth Or Reality? (Part II)

Lets continue from where we left off last week..........Mission unclog your pores once and for all and let your beautiful skin glow.

Now that we know what causes are behind the unsightly acne affliction. Next order of business is planning how to get rid of them and keep your skin clear.



First things first: Don't freak out if bumps show up; it'll only make things worse. Get eight hours of sleep each night—it's how much you need to reduce excess cortisol and let your skin regenerate—and making time for stress-relieving activities like a 30-minute daily workout or even (yes!) sex to stay Zen. These reduce excess cortisol and produce endorphins, which have a calming effect. Bonus? Exercise delivers oxygen to your skin cells, making it hard for CV hating acne bacteria to thrive.


Though the same ingredients that clear up teen acne also work for the adult kind, grown-up skin is thinner and more prone to irritation—so you need a gentler, more moisturizing approach. Using an acne wash, an acne lotion, and an anti-aging cream simultaneously may dry out the skin.

Start slowly: Wash your face twice a day with a salicylic acid cleanser to help dissolve dirt and oil and gently exfoliate the skin (if skin is on the dry side, cut back to once a day). Try Babe Atop AKN Cleanising gel. If zits persist, cover them in a thin layer of a lotion with 0.5 to 2 percent salicylic acid at night (La Roche-Posay Effaclar K Daily Renovating Acne Treatment). After two weeks—the amount of time it takes for your skin to get used to a new product—bump it up to twice a day. Got wrinkles too? Try a retinoid cream instead. It smooths lines and speeds up the shedding of dead skin cells so they don't block pores. Try RoC Multi Correxion Night Treatment or Pharmagel Bio A Lotion.
Either way, slather on oil free SPF every morning, as zit fighters can make skin sun-sensitive. Olay Professional Pro-X Clear UV Moisturizer SPF 15.


High-glycemic-index (GI) carbohydrates like white bread and sugar-laden foods aren't just waistline saboteurs: They raise blood sugar and insulin levels, another male-hormone-boosting process that may lead to breakouts. Balance your hormones with low-GI eats-think whole grains and veggies—that won't aggravate acne. As for chocolate, despite past research that put the sweet stuff in the clear, a more recent study by the University of Miami Miller School of Medicine found that men who consumed six ounces of 100 percent pure cocoa daily got breakouts in a week. It's likely that chocolate affects a woman's skin the same way.


If your pimples come out to play about a week before your period, your doctor may prescribe an oral contraceptive to help stabilize hormone levels throughout the month. Birth control pills like Diane, Yaz, and Yasmin contain analog hormones that may help clear the skin. (Or you can try spironolactone, a drug that may help nix breakouts and is available by prescription.) Birth control pills can also help women who overproduce male hormones, as in the case of PCOS (ask your doctor for a blood test if you have other hormone-related issues, such as an irregular cycle).


If you're plagued with deep, painful red bumps that just won't go away, schedule a doctor's appointment ASAP. Cystic acne heals slowly and can leave permanent marks. Your dermatologist will prescribe a topical retinoid (like Retin-A), antibiotic (to kill bacteria and reduce inflammation), or Aczone—an anti-acne, anti inflammatory gel that's great for those with sensitive or aging skin. 
Curious about Accutane? It works as a last resort for severe teen acne, but it won't combat the underlying hormonal issues of adult acne. It may come with unpleasant side effects  like depression, headaches, and thinning hair. Plus, you can't take it while pregnant—it can cause birth defects—or breastfeeding.


Adult Acne: Myth Or Reality? (Part I)

Summer is approaching stress levels are flying high, weather is getting hot & humid. With this background more and more ladies are visiting my clinic complaining about break outs, open pores, black heads and white heads. When we start our discussion on acne; mostly I get a response, "I am not a teenager why am I getting acne at this age?" To clear up the concept of adult acne and put it out there that it's not a myth its a very real problem I am dedicating today's blog and the next two blogs to Adult/Teen acne going into details of causes, prevention/treatment and scar management.

Let's begin....... Mission unclog your pores once and for all and let your beautiful skin glow.

Grown-up women are not only fending off wrinkles: Studies show they're battling acne too. But you don't have to feel as if you're 30 going on 13! A savvy skin-care regimen—and a few simple lifestyle tricks—will smooth the way.

Research has shown that low-grade, persistent acne is common among women in their twenties, thirties, and forties (yep, that magical time when wrinkles start to appear). While acne may be nonexistent or dormant for years, certain factors—like stress, hormones, and diet—can eventually cause it to surface, with frustrating emotional side effects. I've seen patients shy away from certain situations—they've canceled dates and rescheduled meetings at work—because they're ashamed of their breakouts. Because no woman should have to endure extra bumps in the road (or on her face), here's a simple zit-erasing plan.


When dirt, excess oil, and dead skin cells mingle, they plug the openings of your pores. This allows an army of Propionibacteria living in your sebaceous glands to set up camp, multiply, and create trouble for your skin. Although this pore clogging process is the same whether you're 13 or 35, adult acne pops up in different places than the teen kind. It typically appears on the jawline, chin, and neck, as opposed to the forehead, cheeks, and nose.

Studies have traced the cause of acne to one thing: hormonal fluctuations. Whether brought on by lifestyle (stress, diet), PMS, pregnancy, or polycystic ovary syndrome (PCOS), the result is the same—an increase in cortisol (also known as the stress hormone), which gets broken down into testosterone, a male hormone that pumps excess oil through your pores. When your hormones are out of whack, your skin's oil production may go into overdrive, causing an acne flare-up.

It doesn't take a midlife crisis for it to happen. Even a moderate amount of daily stress—like balancing a career and a social life, or coming home from work and having to cook dinner for your family—is enough to trigger a breakout. Smoking can also spark a breakout: A study in the Journal of the American Academy of Dermatology showed an association between lighting up and adult acne (specifically, whiteheads and blackheads) in women.

Given that the origin of acne goes deeper than your dermis, experts say that to nix blemishes, keeping your hormones in check is just as important as following the right skin-care regimen. Read on for ways to do it.

We will talk more on the subject next week.............