October 2021

Patricia Oliver: Outline treatment plan

Dear Patricia,

Thank you for seeing me recently. It was an absolute pleasure to meet you. I
have spent some time considering your treatment options, please find below a
copy of your recommended treatment plan, based on what you have told me.

This is a recommendation based on my expert opinion for treatment that will give
you the best, most natural-looking and long-lasting result, you may decide you
want all, none or only part of the treatment.

Your concerns about your skin and face

• You have noticed your lips have disappeared and would like to have
treatment for yourself. They used to be full.
• Any treatment must look natural
• You would like to look fresher, more lifted and better

Examination findings
• Loss of volume in the upper and lower lips, as a result of ageing. The lips
are thin and tight.
• Deep nose-to-mouth lines, marionette lines and loss of contour in the
lower face as a result of skin laxity and jowling of the tissues

Below is a recommendation and explanation of the treatment I feel would be

appropriate in rebalancing your features.
Treatment

Step 1: Filler to gently lift a volumise the lips, bringing back the fullness – 2
sessions
Hyaluronic acid dermal filler will be used to plump, hydrate and gently volumise
the lip. This will need to be carried out over two separate sessions for the most
natural and optimal result.

Far from the exaggerated look you see plastered over the tabloids, Dr Sheila can
provide a subtle, natural-looking dermal lip filler for lip enhancement that will
augment your features and introduce volume to the lip area.
Dr Sheila uses the most advanced range of hyaluronic acid dermal fillers,
specifically designed for lip augmentation. Unlike traditional fillers, Maili Precise
is silky and soft, meaning results are much more discrete and realistic.
Maili Precise also contains lidocaine, meaning the treated area is numbed
simultaneously during treatment, improving your comfort. You will see an
immediate result after your treatment however, it will not be your final result.
Optimum results will be seen after a few weeks as the product retains water to
rejuvenate and add volume. A natural and subtle result, rather than exaggerated
or fake looks is Dr Sheila’s ethos, and as such she always prefers to undertreat
any concern, but if you feel that you would benefit from more product, this can be
discussed before treatment and at the follow-up consultation if needed.

I would expect the results of this treatment to last up to 12 months, but this can
vary depending on individual response and lifestyle.

Step 2: Non-surgical thread lift and volumising the lower face with dermal
filler

The goal here is to lift the tissues and smooth the lines by using a combination of
threads and dermal fillers, resulting in a more lifted, smooth and rejuvenated
appearance. The jawline will also appear smoother.

Silhouette Soft is a unique facial rejuvenation procedure that lifts sagging face
and neck skin without the need for surgery, scars, or general anaesthesia. It is a
simple, in-clinic procedure to recontour your face by elevating the deeper layers
of your skin.

Silhouette Soft uses dissolving sutures to lift sagging tissue in areas of the face
including the brow, cheek, jawline, and neck. The sutures have moulded cones
that stimulate the body to produce collagen.
Silhouette Soft restores “the triangle of youth” without surgery by repositioning
the sagging tissue of the face and neck and stimulating a gradual regeneration of
collagen. The repositioning effect is immediate and discreet, allowing the
contours of the face to be re-shaped and become visibly smoother. I would
recommend 10 threads in total (5 on either side of the face and jawline) and 3mls
of dermal filler for refinements (see below).

I would expect the results of this treatment to last up to 18 months, but this can
vary depending on individual response and lifestyle. Treatment with dermal fillers
can further enhance the result and may. Mean less of a need to use as many
threads to repeat the result.

Step 3: Refinement stages: Nasolabial folds (nose-to-mouth lines) and

marionette lines with dermal filler
The nasolabial folds start from the nose and can extend to (and beyond) the
mouth, and the marionette lines start from the corner of the mouth and extend to
the jawline. These are the two most common reasons patients will come in to see
me.

The cause of these lines are a result of volume loss in the cheek area, causing
fat and skin to essentially drop down and forwards. Gravity further exacerbates
the appearance of these lines.

With age, we often see the nasolabial folds and marionettes deepening, and the
lower face becoming heavier. I always avoid trying to treat these lines in
isolation, as adding volume to “fill” these lines, adds to the overall heaviness of
the face, which is more ageing. The result is more natural if we treat the cause of
these lines (which is the midface volume loss or skin displacement) by lifting the
skin in your thread lift. Once we have done this, we can then go in a refine this
area with a little more dermal filler, and would now require much less dermal filler
to further treat and soften these lines, overall achieving a more natural and
attractive result. We will require up to 3mls to improve the volume and soften
these lines.

I would expect the results of this treatment to last up to 18 months, but this can
vary depending on individual response and lifestyle.

The cost for treatment would be:

1. Lip filler, 2 sessions £380/session
2. Silhouette soft lift: 10 threads £3000 (
3. Up to 3mls dermal filler £1050 (reduced from £1500 if treated following
threads)
which includes follow up and reviews.

Appointment schedule
This will be confirmed when you tell us how you wish to proceed

Recommended When/Time Cost Notes

Treatment
TBC

Please also note the following:

Change in treatment plan:

This is intended to be the definitive treatment plan based on the information
available at the time of preparation. If more information comes to light that
requires a change to the treatment plan, we will discuss the clinical and financial
implications with you in advance of carrying out substantially different treatment.
Namely, if we need more dermal filler to get you to your desired result, this will be
discussed with you before carrying out any additional treatment.

Aftercare and maintenance

We will provide you with comprehensive aftercare instructions which we insist
you must read and adhere to, to reduce the risk of potential complications or side
effects.
A good skin regime using high-quality products correct for your skin condition
and age is advised to prolong your results.

Appointment cancellation policy

Each of Dr Sheila’s clinics has its own cancellation policy. You will be informed of
the policy before booking. For threads treatment a £500 deposit is taken, a
refund for any appointments cancelled within 5 days of the appointment will not
be given, irrespective of the reason (e.g. illness, Covid etc)

Appointment availability
Facial aesthetics clinics are available across London and Essex.
Terms & Conditions
Courses of treatments purchased will expire 12 months from the date of
purchase if unused, this includes courses of treatments to include skin peels,
Profhilo and advanced facial courses. You will be responsible for ensuring that
paid treatments are redeemed before this expiry date after which, we will retain
the funds if the treatments are not redeemed before this date.

Results may vary from person to person, and they cannot be guaranteed by our
doctors.

We require 48 hours notice to change or cancel your appointment, or your

deposit will be forfeited, 5 days for threads appointments.

Due to the nature of our procedures, and because results vary from person to
person, we have a strict no refunds policy.

As part of your injectable treatments, reviews must be carried out within 2-3
weeks of your appointment at no additional fee (unless advised otherwise by our
doctors). For Botulinum Toxin treatments, if additional doses are required this will
be part of the initial fee.

It is your responsibility to ensure a review appointment is attended within 2-3

weeks of your initial treatment. Appointments outside of this period will be
chargeable.

Any questions?
I hope that all this is clear, but please feel free to ask any questions either by
email if you wish, though if you prefer to come in and discuss things again face to
face, I will be happy to see you for another consultation at no charge.

Dr Sheila Nguyen BDS (Lond), BSc (Hons)

Dental Surgeon and Advanced Facial Aesthetics Practitioner