Dr Ng Zhi Yang

Filler issues are more common than the aesthetic industry acknowledges. Most are managed clinically - by eye, by feel, and by protocol. Below are cases that I have assessed recently. They illustrate why point-of-care ultrasound (POCUS) changes what is possible, both in understanding what is actually present, and in planning what can be done next. Case 1 - Aquamid in the Radix: A Permanent Filler and Its Consequences A patient presented with a widened nasal radix. This is sometimes described...

A Chinese patient came to me wanting to address her double chin. She had done her research - botulinum toxin for a V-shaped jawline, energy-based skin tightening, fat-dissolving injections. Each was discussed in consultation. None of them permanently removes fat, and for a patient looking for a definitive result, the case for surgery was clear. This was her own conclusion as much as mine. But the more important conversation was not about which procedure to choose. It was about which part of...

Revision rhinoplasty is almost certainly never a simple repeat of the first operation. By the time a patient is considering a second or third procedure, the anatomy has usually been changed, sometimes by surgery, sometimes by scarring, often by both. Working out exactly what's underneath the skin, rather than assuming, is often the difference between a plan that works and one that doesn't. Point-of-care ultrasound (POCUS) has become a routine part of my practice. The cases below show how and...