Tapan Patel, MBBS

I always hated the bump on my nose, always wanted a nose job, but I decided to go down the route of non-surgical before I went for surgery. I went to PHI Clinic and saw Dr Tapan after seeing loads of reviews online and some of his past results. He was really lovely and reassuring, we had a great consultation where he gave me loads of information about the procedure and made me feel really at ease, but he gave me time to go away and think about it before I booked in for treatment. I decided to go for it, and my treatment went really well, he has such a wonderful bedside manner and the treatment was over in a flash with basically no pain or discomfort. I love my results and I would recommend PHI Clinic (www.phiclinic.com) and Dr Tapan in a heartbeat to anyone looking for similar results. (I also had a few other things done but I couldn't select multiple treatments for this review)

I have suffered from acne like many of us here since i was 8 year old. I thought that the scar will fade with time, unfortunately, my acne was pretty severe so the scarring remains. I did some research and decided to tried on CO2 laser. In the past, i have tried chemical peels, salicylic peels (which i believed is 50% and above), derma-roller, but the scar remains. I did more intensive research and came across CO2 laser. I had 3 session of Fractional CO2 but the scarring is still obvious. My doctor decided to try Ultrapulse co2 laser (125mj) this time on my skin. I took some pain killers as i my pain threshold is fairly low. I arrived an hour earlier as usual to have the anesthetic cream applied to the entire face. It was fairly painful and after the treatment (0-2 hours), it actually did not look too bad compared to the previous fractional co2 treatment that i have had . After several hours, my skin started looking raw red and was oozing and cluster of blisters developed. Yellow liquid was oozing from treated areas to form crusts. I tried not to scratch or pick at crusts as it can cause scarring.. I cleaned my face with tap water for several times throughout the day to keep it clean and prevent secondary infection. I am on antibiotic course for five days (ciprofloxacin 250mg twice daily). On second day, my skin started going dark red/brownish, looking like i had suffered from a severe sunburn. Skin feels tighter and still oozing and cover with blisters. I am now in my third day post-treatment, i was experiencing itching and stinging. I am drinking plenty of water, orange juice, consuming lots of greens (kale, spinach, goji) at the meantime, to help with the skin renewal process.

Updated on 3 May 2015:
The itch intensity has increased and getting tighter so I am assuming that new skin is forming underneath. Not sure why I am feeling more tired than usual but I am consuming lots of warm lemon water and lots of fruits and green vegetables as they contain vitamins and minerals that are required for new cells formation. I have also applied a generous layer of MEbo ( a scarring ointment that contains sesame oil) on my top skin layer as advised by the consultant to keep the skin surface hydrated.

Updated on 4 May 2015:
My face is still itching and feeling tighter. Each time when i try to smile ( i went to work today) , i can feel the burnt skin underneath the ointment "cracks/peels off". I can see some new pink skin resurfacing so i am getting excited over it. I cleaned my face with simple skin wash and ate lots of fruits, nuts, and spinach and had fish and veg for dinner to ensure that my system is getting all the nutrients that is required, again for cell renewal. I also soaked a face towel in cold water and use it to clean my face three times a day to reduce the chances of bacteria accumulation on the skin surface that can lead to more blisters and secondary infection.

Updated on 5 May 2015:
My top layer of the skin has peeled off and the treated area (cheeks) appear pink and I have couple of blisters forming. I am doing some research on healthy diet that can promote healthy skin and cell growth. As the skin is very likely to stay pink for few weeks, I will start updating my post-treatment on weekly basis instead of daily.

Updated on 10 May 2015:
Redness is still visible but definitely improving compare to few days ago. I have a few new spots and am using benzoyl peroxide for those spots so hopefully it will dry up soon. My skin is constantly peeling although i have been using serum and thick moisturiser. I am relating this to cell renewals which can take up to 12 weeks.

Updated on 8 Jun 2015:
The redness has subsided and it is not obvious unless you are standing within one arm's length from me that you could see a define line across my cheeks where i had the laser done. I have developed some sort of allergic reaction so my face is covered with tiny pimples; i thought it was the laser that caused my skin to be more sensitive and had triggered the outbreak. However i did not have the laser carried out on my forehead and it is also covered with spots. I guess it is due to hormone or allergic reaction. As it was fairly itchy, i am currently taking antihistamine, cetirizine twice daily. I cannot tell if my pores are less visible but i can see my complexion has become clearer ( area not covered with pimply spots). It is also fairly sensitive to the water temperature so i try not to use hot water ( uk is not the warmest country on eaeth) but cold water to clean my face.

Updated on 6 Jul 2015:
As requested, these are the pictures before my treatment that Dr Tapan and his team had taken.

Updated on 29 Jul 2015:
My scar is still visible and the unknown caused of allergic reaction that i have developed after the treatment has improved slightly-not itching as much and red lumpy pimples have calm down a bit. I came across some individual peer review that this could be a side effect of laser, where the high heat could have triggered the outbreak. I am currently using avene produtcs ( as it is for sensitive skin and does ease the itching off) and hoping that it is the right product for my current skin condition.

I have reviews uploaded that detail the nose surgery I've previously had.. But in a nutshell:

2 .5 years after an unsuccessful rhino and revision rhino, I was unhappy with the shape of my nose. It just didn't fit my face and wasn't me. I had requested a smaller version of my natural nose and came out with somebody else's nose! I regret the rhinoplasty and miss my natural nose.. I was in a bad place mentally when I impulsively booked my nose job in June 2012. My nose was fine, it was elegant and narrow and strong but feminine.. the surgeon shouldn't have touched it.

Mr Tapan Patel was professional, friendly informative and realistic for my expectations. We had an initial consultation and then I had the treatment two weeks later, and a follow up another 2 weeks after this. Upon meeting he said my nose was fine as it was - and I agreed. However I explained to him what's happened, how it just wasn't my nose and I wanted to try to emulate the convex shape of my natural nose pre rhinoplasty.

During the first treatment he was very cautious and he said it was the most technically challenging nose enhancement he's done due to the mass of internal scar tissue created from both of my surgeries. He flat out wouldn't go near the tip which was fine by me - the tip has been enlarged from the surgeries anyway.

After the first treatment he filled out the scoop a little and my nose was straighter. He had booked me in for an early appointment, the clinic gave me his mobile number and told me to keep an eye on my nose for the rest of the day and to call him directly if there were any concerns. Very thorough and very comforting.

Worth mentioning here - it wasn't painful and I experienced VERY little swelling.

I was happy with his considerate approach and the improvement, but booked in for some additional filler. When I arrived we again discussed the overall shape I'm after, and agreed the profile could still be improved. He "over-corrected" my shape and I love it. By over-correcting I think this means he not only straightened out the shape to correct it, but surpassed this with more filler to give me a slightly convex curve to my shape - exactly what I wanted. He actually listened to me - something I WISH my previous surgeon had done.

The picture I've posted shows before Juvederm (i.e my result from the rhinoplasties), and the reault after the second treatment (the day after). I've tried to take the picture from the same angle! Some swelling may be present but I doubt it.. I will keep Mr Patel posted but so far I'm thrilled to have my family shnoz back!

Updated on 26 Nov 2014:

BACKGROUND

I am a 27 year old male from England and have suffered with Axillary Hyperhidrosis since 14 years of age. Similar to the other reviewers, I have tried to keep this embarrassing condition a secret. I won’t go into detail, but like most here, my wardrobe is full of black and white clothing (dark jumpers and jackets have been a blessing!) I am generally a ‘sweaty person’; for example, if I workout or am in a particularly hot environment, I sweat far more than the average person (not just armpits, but all over my body). However, my armpits sweating are disproportionate to the rest of my body. On a daily basis I go through the following cycle like clockwork: Armpits sweat > paranoia of anybody noticing > armpits sweat more. Repeat.

Following on from non-surgical treatments not working (prescription deodorants, iontophoresis), I had come to accept that this was how it was always going to be. However recently (around 6 months ago), I started to smell of sweat (not BO) and have been getting white patches on my clothes. Although a nuisance, I could hide sweat patches, but smelling and white patches, too!? I needed a solution! As a result, I [re]considered surgery and botox. I wasn’t prepared to accept the risks associated with surgery (compensatory sweating), nor the long-term costs of botox. Enter, miraDry.

I have been aware of miraDry for a while now and have been impatiently (!) waiting for it to arrive in the UK. That moment finally came in January 2014 to Doctor Tapan Patel’s PHI clinic in London. I was the first person to book for the treatment, which, to my surprise, meant I was eligible for a promotional offer – first 6 bookings get around 50% off. This meant the treatment (2 sessions) would cost £1,500. On a less positive note, I never received a reply from my emails enquiring about miraDry and 7 days before my appointment, the clinic called me to say it had to be rescheduled. But, the benefit of 50% off outweighed all of these slight hiccups.

DAY OF PROCEDURE

I had a consultation with Doctor Patel’s assistant, Jodie. We ran through the procedure, level (decided level 4), potential side effects, what to do post procedure etc. Following this, Jodie cleaned my armpits in preparation for the Doctor to inject the anaesthetic. It was a busy day in the clinic; this was evident by the fact that the only time I spoke with Doctor Patel was when he was to preparing, and injecting, the anaesthetic. In addition to this, when he had around 5 injections left to inject, another member of staff entered the room requesting Doctor Patel’s assistance. That said, Doctor Patel was great; he showed genuine compassion. He asked me questions such as ‘how has hyperhidrosis impacted my everyday life?’ and ‘How would my life change if the procedure was a success?’. I opened up to him and he seemed as excited as me for the results! He thanked me for being so open about my condition. He said it’d help him improve his services to others as he now has a better understanding of what sufferers are going through. We decided to carry out the procedure on level 4.

Doctor Patel gave me 32 injections in both armpits. Whilst uncomfortable, it wasn’t too bad – and this is coming from somebody who has a phobia of injections! Bizarrely, the injections were considerably more uncomfortable on my left armpit (the armpit that sweats the most); this did not surprise the doctor at all. The injections had the desired effect – both armpits completely numb. At this point, Doctor Patel left and handed it over to Jodie, who proceeded to carry out the procedure. Not much to say regarding this, I felt absolutely nothing. A painless procedure. Once done, Jodie gave me 2 ice packs and had them on for about 10 minutes before departing. All in all, the procedure took about 2 hours.

POST PROCEDURE

Swelling peaked 4 -24 hours post procedure. Felt like I had golf balls under my armpits. Wasn’t really in pain, just uncomfortable.

It’s now been 6 days since the procedure, and my armpits are still swollen, lumpy and bruised – but have dramatically improved. I have lost about 50% sensation in my armpits and surrounding skin. Haven’t got any concerns, they appear to be healing nicely. It feels like there is a plate of dead tissue under each armpit.

So far the results have been fantastic! In normal situations I haven’t sweated at all, and in stressful situations I would say there has been a 98% reduction (slightly moist, not enough for a wet patch on shirt). It often feels like I am sweating, and, upon checking, I am not. In stressful situations, it appears my hands are sweating considerably more than before; however this does not bother me in the slightest.

I’m not building my hopes up at this point because initial elimination of sweating appears to be common amongst many of the other reviews – even of those where the sweating returned. However, if these results last I will be the world’s happiest man! I've rated the treatment as 'Not sure' simply because it is too early to tell; I will update the rating and the review as time goes on.

Excuse me while I put a yellow t-shirt on!

Updated on 17 Mar 2014:
Firstly, I sweated! However only to the point of small sweat patches. Still a HUGE decrease compared to pre-miraDry. However it looks like I will need that 2nd treatment. It’s worth noting that I am only sweating in stressful situations. In all other situations I am dry. Haven’t experienced any odour yet.

More surprisingly though, the amount of pain I am in has increased. Visible bruising has completely gone, however lumps remain. My armpits, bicep and tricep muscles are very tender. Also, the skin around my armpits, extending to the corners of my back, is also very sore. And finally, if I put my arms in the air, reach behind me, or apply pressure to an upper-central lump, it feels like a nerve is being ‘plucked’. Said nerve runs from my armpit to the upper corners of my back. Despite this, I am not concerned; I think all will heal in due course.

No regrets thus far!

Updated on 30 Mar 2014:
A brief update that I'll split into 2 sections: results and recovery.

RESULTS

Unfortunately sweating has returned to about 50% of what is was pre-treatment. However, I have not had any no odour.

RECOVERY

Lumps have reduced in size, but, as expected, still tender. Muscles and skin surrounding the armpit are sore - both on the surface and 'deeper', if that makes sense. Not so much on the armpit itself, but above and to the side of it (when I say to the side, I don't mean chest side, I mean towards my back)

I've also developed a small blue area on my armpit which I suspect to be a [newly] visible vein. Other veins have appeared around the blue area, and have also on the other armpit, too (albeit not as visible). Unfortunately the pictures do not capture it very well, but it's quite prominent.

Updated on 13 May 2014:
Results:
Unfortunately sweating is slowly creeping back; I would say it is about 60% of what it was pre-op.

Recovery:
Lumps still present, however they're very small now (pics don't pick them up); they are tender if pressed. Nerve twitching and blue area now healed. Hair growth is starting to return. Upper armpit (where arm meets pit) is still painful if I press it.

Looking forward to having the 2nd procedure carried out at level 5.

Updated on 22 May 2014:
Something odd happened a few days after my last update: my sweating completely returned. As said by somebody else who has had the procedure, it was as if my body suddenly turned on a switch for the sweating to come back. I've been doing some physical gardening work this week which started to hurt the 'arm meets pit' joint that I previously mentioned.

I'm a bit disheartened, because, as it stands, I am still sweating, however have gained new aches and pains, and am £1500 out of pocket.

Looking forward to having the 2nd procedure carried out, even more so now!

Updated on 12 Sep 2014:
I've received an overwhelming number of private messages regarding this treatment, from people all over the world. I am glad people have found this review helpful.

All pain has subsided, but, as stated before, sweating has returned.

I have my 2nd MiraDry treatment scheduled on 3rd October. I will update this review just as I did the first time, then follow up with less-frequent-long-term updates (6 month+ post procedure).

Updated on 7 Oct 2014:
Hi all,

I had my 2nd procedure done Friday 3rd October 2014 at PHI Clinic in London.

PHI Clinic were great; they were courteous, friendly and professional. It was the same set-up as last time: Dr Patel did the local anaesthetic injections and Jodie performed the MiraDry treatment.

The injections were much worse this time round. On a pain scale of 1 to 10 (10 being really painful) it was about a 7 / 10, whereas the first time round it was about 4 / 10. The Miradry treatment itself was a doddle; I felt the heat of the 'gun' once, but no pain. It took about 1.5 hours to complete the injections and Miradry treatment, followed by a 10 minute cooling period with ice packs.

Whilst the injections were worse first time round, my recovery has certainly not been. I had bruising and swelling for the first two days, but could still fully function (extending arms etc.). From day 3, besides the usual numbness and swelling under my armpits, I am pretty much pain-free. I am hoovering and dusting, I mean ummm, drinking beer and boxing, as I usually would be.

One final thing that's worth noting: whilst I believe my sweating has returned 100%, Dr Patel noted that last time when he was carrying out the injections the stencil ink was running due to my armpits perspiring, however this time they were dry(ish). Now I am not sure whether that it was because I wasn't as anxious this time (as I wasn't entering the 'unknown') or whether Miradry has had an effect. Hopefully the latter!

Nothing else to report. I will keep this updated like I did last time.

Updated on 7 Oct 2014:
.. I am not sweating at all. Got the 'phantom sweats' back though! (where you think you're sweating, but upon panic-checking, you are not)

Updated on 7 Oct 2014:


Updated on 27 Jan 2015:
It seems my previous review update did post or has been removed. Anyway, here is a brief update:

- Side effects: nearly fully healed. Still tender if pressed. Hair growth returned. No issues or concerns here.

- Results: the important bit! I would say my sweating has reduced about 60-70%. As stated previously, I now only sweat when nervous/anxious; it's still more than the average person, but less than I did before! If these results last I will be fairly happy. I would love to be closer to the 90-95% reduction mark, but, as they say, progress not perfection!

I'll put a reminder in my diary to update this at the 6 month mark.

Updated on 1 Jul 2015:
It's now been 1 year and 3 months since my 1st procedure, and 9 months since my 2nd procedure. Unfortunately I am one of the unlucky patients - my sweating has returned 100%. As such, I have adjusted my rating accordingly to "Not worth it". My armpits are still lumpy, but pain free. As it stands, I cannot justify going for a 3rd treatment just in case it didn't work.

I had two CO2 laser treatments with Dr Tapan Patel at Viva Clinic in London on my old facial burns scars (23 years old scars). I have really bad scars on my face and hands after gas explosion in childhood. After two treatments on my face the scars have become visibly flatter. Of course, the scars will not go away as a miracle the next day, thats why Dr Patel said that at least 4-5 treatments are necessary.


The benefits of the CO2 is that it is done under local anesthetic, and you recover quite fast -about 1-3 weeks. Last time it took 3 weeks, and this time its 1.5 week to recover for me.


What you should prepare for, is a bit of pain, which is tolerable. I was really afraid before the first treatment, because I didnt know what to expect. But now I know what to expect, and beauty requires sacrifice after all. After the treatment my face was all swollen, and looking not best of course. I was prescribed antibiotics, and antiviral medicine. The next day I washed my face already with antibacterial mild soap, and was putting lots of vaseline. As soon as my face was feeling hot, I was washing it as I was afraid of infection.
I am now very happy that my scars are getting flatter, and cant wait till the next treatment! i have a hope now.