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„This is a synergistic trinity: 3 effects happening in a fraction of a second“

Interview with Dr. Isaac Wong, Singapore

Dr. Isaac Wong is an aesthetic physician with expertise in EBD, filler and thread lift combination therapy for full face rejuvena- tion and non-surgical facelifting, based in Singapore. He is the founder of “The Artisan” anti-aging and aesthetic clinic, located in the prestigious Paragon Medical Centre right in heart of Orchard Road, Singapore. Dr. Wong is proud to be a pioneer for
the latest medical aesthetic technology and machines that he mentioned “revolutionize the whole industry.“ Working with Cynosure Systems such as Potenza, Tempsure and Picosure, he is dedicated to give us some insights into current patient desires and his relevant experiences with the latest technology of the radiofrequency Microneedling device Potenza by Cynosure.

DISKURS Dermatologie:

Dr. Wong, working as an Aesthetic Practitioner in a multi-national country like Singapore with its variety of skin tones, facial features and body types, could you explain which are the most common requests in your clinic?

Dr. Wong:

Looking beautiful and natural is an Asian woman‘s aim. My local and regional patients (from East Asian countries of China, Singapore, Vietnam, Indonesia and Malaysia) orientate towards South Korea and Japan for aesthetic treatments and trends. They are very influenced by the K-pop, K-drama singers and actresses, who have fair, dewy, “glassskin” complexion with no visible pores. They also yearn for the “heart- shaped” facial silhouette and defined, V-shaped jawline.

Due to our warm and humid weather conditions, acne, acne scars, blackheads, whiteheads and open pores remain a top concern amongst younger women. On the other hand, women above 35 are more concerned about dull, uneven skin tones, lines and wrinkles, dark eye circles and facial sagginess. Therefore, the most common requests are always how to improve their facial skin texture, skin tone, radiance, shine, pimples, pigmentation, and pores. Next most common, would be to get the heartshaped facial silhouette with defined V-jawline.

Fig. 1: 44 years old Patient’s right side is lifted with the Potenza Lift protocol developed by Dr Isaac Wong. Utilising Potenza’s unique monopolar RF to target the retaining ligaments of the face, we can see a reduction of the lateral upper eyelid hooding, an uplift of the lateral canthus and jowls and oral commissure, and an immediate reduction of the nasolabial fold. The silhouette of the lifted side is more “V-shaped”, hence giving the asian ideal of a “heart-shaped” face or “V-shaped” jawline.

Fig. 2: 66 years old Patient’s left side is lifted with the Potenza Lift protocol developed by Dr Isaac Wong.
Utilising Potenza’s bipolar RF first to target the dermis and epidermis for textural and skin tightening improvement, he then switches to monopolar RF mode to target the retaining ligaments of the face and deeper tissues of the face for collagen remodelling. We can see a reduction of the lateral upper eyelid hooding, an uplift of the lateral canthus, cheek, jowls and oral commissure, and an immediate reduction of the nasolabial fold and marionette fold. The silhouette of the lifted side is more “V-shaped”, hence giving the Asian ideal of a “heart-shaped” face or “V-shaped” jawline.

DISKURS Dermatologie:

Do you think these trends will also spread to other regions such as Europe?

Dr. Wong:

Yes, definitely. Trends coming from South Korea and Asia such as “Dewy Glass Skin” and “Heart-Shape Face” do permeate to other countries including Europe due to the influence of social media to a certain extent. It is the same vice versa as well. For example, “Foxy-Eye” Lifting and “Lip Filler Enhancements” (which are big trends in the Caucasian and western patients) do appeal to a certain percentage of our Asian patient population as well. I am always very active on social media because that is our patient’s platform to look for the latest aesthetic and beauty trends, and it would be almost a sin for a top aesthetic doctor and clinic not to be on it, researching and posting.

DISKURS Dermatologie:

What exactly does “Dewy Glass Skin” mean, and how would you treat a Patient who is looking for this type of skin perfection?

Dr. Wong:

Just turn on Netflix or YouTube and watch the latest Korean pop group or Korean drama! “Dewy Glass Skin” refers to the picture-perfect skin these Korean celebrities have, very even, uniform, bright, radiant skin tone with zero pigmentation. Their skin also looks smooth and “bouncy”, like a newborn’s skin. To achieve such an effect, I would use “Potenza” in combination with “PicoSure”.

DISKURS Dermatologie:

And with which combination treatment do you achieve these outstanding results when it comes to e.g. Lifting, V-Shaping, and Jawline Contouring?

Dr. Wong:

In my experience, when it comes to lifting and creating a V-shape jawline, I like to combine Potenza, with high G’prime fillers. Sometimes, botulinum toxin may be needed to reduce hypertrophic masseters. In certain cases, I may even add on thread lifts for an enhanced lifting effect.

DISKURS Dermatologie:

What makes Potenza different from other RF Devices? Why is it so good for Lifting?

Dr. Wong:

Ah, people ask me this question very often. You better grab a drink and some popcorn, there are tons of improvements built into Potenza, I will need some time to explain. Most traditional MicroNeedle RF devices only have Bipolar RF modes built in – as they were designed for skin texture rejuvenation only, the mild skin tightening effect that occurs is an after-thought. Monopolar RF (e.g Thermage, TempSure) is important for deep tissue heating and lifting and collagen stimulation, as can be seen by the success of Thermage and TempSure. Potenza has both Bipolar RF and Monopolar RF!

The lifting effect that accompanies the skin texture improvement is due to the built-in Monopolar RF – I always tell my patients “when you get a Potenza treatment, you’re not only getting smoother, firmer, radiant skin, you’re getting a free facelift as well”.

Potenza has a new patented technology called the “Tiger-Tip” (consisting of microneedles which are insulated except for 2 points where RF energy radiates from), which, in essence, is the ability of Potenza to treat 2 depths with Bipolar RF during 1 treatment. It gives a second depth of treatment, so that the patient can enjoy a double effect for one treatment and price.

Potenza also has the new patented “Fusion Tip”, which allows a vacuumpush of topical products into the dermis (skin) cells in evenly distributed streaks, which sort of “turbo- charges” the microneedle RF effect. From Cynosure research we see an improvement of 67%.* Potenza also has a variety of needletips that allow for highly customizable treatments, with 21, 25, 49 needle-tips available for the doctor to choose from. Therefore, the doctor can select a more microneedle and lesser RF effect (49 needle-tip) or a stronger RF effect and lesser microneedle effect (21 or 25 needle-tip). It also has a single-needle tip for spottreatments of active acne as well.

Fig. 3: 66 years old patient, 4 weeks after Potenza.
Her jowls, nasolabial folds, marionette folds are lessened, her upper eyelids and cheeks are lifted and her face looks “lifted” and “fresher”, on top of the textural improvements. This is a testament to the power of Potenza’s unique bipolar and monopolar RF combination.

DISKURS Dermatologie:

You said that you are a “heavy user” of the “Fusion Tips”. What makes it such a game changer for you?

Fig. 4:
36 years old patient – after photos taken 1 month after 2nd Potenza treatment (6 weeks apart between 1st and 2nd treatment). Most of her boxcar and rolling atrophic acne scars have resolved and the visible pores are also lessened. The pre-auricular patch of dermal atrophy (seen on second photo) has also resurfaced. The skin texture is also more smooth and radiant. The patient, who was suffering from low self-confidence for 20 years, now feels much more confident and cheerful after the marked improvement in her acne scars and overall skin texture quality.

Dr. Wong:

The Fusion Tips firstly are USA FDA-approved, which means quality, effectiveness, and safety. Secondly, they are the only technology of its kind which can deliver topicals in thin strands into the dermis (skin) cells consistently and effectively, during a Microneedle Radiofrequency treat- ment. No other MNRF device can do this currently. Mesotherapy guns can inject the topicals into the dermis as well, it is also popular in Asia, but they do not have the radiofrequency effect. Mesotherapy injections also deposit the topicals in big balls which are not evenly distributed and absor- bed as compared to Potenza. This is Potenza‘s synergistic trinity: Microneedle + Radiofrequency + Effective Topical Delivery – 3 effects happening in a fraction of a second, occurring in synergistic trinity.

DISKURS Dermatologie:

Which topicals do you use most? What is your recommendation?

Dr. Wong:

I use a variety of topicals, from collagen-stimulators (Poly-L-Lactic Acid, Polycaprolactone, Calcium Hydroxyapatite), to brightening concoctions (tranexamic acid, glutathione), to growth factors. I am still investigating the effects of different concoctions and ingredients but currently I would highly recommend the collagenstimulators.

DISKURS Dermatologie:

From your point of view, why are South Korean topicals more effective?

Dr. Wong:

I find that the Korean scientists and doctors are very innovative in terms of advancing the research and growth of the medical aesthetics industry. For instance, Poly-L-Lactic Acid, in its first available version, is known to have a chance of nodule formation, and thus the Koreans researched and discovered Poly-L-Lactic Acid versions with smaller particle sizes and more uniform heterogeneity when diluted with saline. This mar- kedly reduced the chance of nodule formation and gives great results when combined with Potenza. They are also able to combine multiple skin-boosting ingredients in one concoction (e.g. for depigmenting, the concoction combines PDRN, glutathione, tranexamic acid), which makes things much easier for us as day-to-day clinicians.

DISKURS Dermatologie:

Dear Dr. Wong, thank you very much for taking the time to speak to us! We are very much looking forward to your BTS Congress Webinar to gain more precious insights in your work.

Dr. Wong:

Thank you and I look forward to sharing my knowledge and insights at this BTS Congress after last attending it in person in 2016.

The interview was conducted by S. Höppner.

Further informations about the BTS Congress: www.btsstockholm.com