EMOTIONS THAT CAN MAKE YOU SICK & EVEN IMPEDE HEALING POST SURGERY by Dr Khoo Lee Seng

You eat right, you do regular exercise, you take the correct supplements, heck you don't even smoke or drink but yet you became severely ill! Why? You did everything right but your emotions ran wild....

“The seven emotions give rise to chaos, which leads to the formation of mucus.”

 “Shock, fear, worry, and pensiveness are the roots that produce mucus.”

The Yellow Emperor's Classic of Medicine 黃帝內經

These observations are grounded in the ancient wisdom that recognizes the subtle interplay between emotions and the body’s internal balance. Emotions—particularly those that are intense and unresolved—are the source of qi stagnation. 

This stagnation manifests in the body’s most vital systems, especially the lungs and liver, disrupting their natural functions. 

The lungs, which are responsible for the downward movement of qi, and the liver, which governs the upward flow of energy, become obstructed. 

The result is a cascading imbalance that impedes the spleen’s ability to regulate water, giving rise to dampness, which accumulates as mucus in the lungs. This dampness blocks the body’s ability to metabolize water properly, further exacerbating heat and contributing to a cycle of anxiety.

“Strange and difficult diseases come from mucus,” Huang Di Nei Jing (Yellow Emperor's Classic of Medicine).

Allow me to translate this understanding into the language of Western medicine. 

YOUR EMOTIONS CAN MAKE YOU ILL 

Strong emotions—such as anger, fear, grief, and stress—create a dysregulation in the body's delicate balance. 

For example when the liver is overworked for example processing too much alcohol or toxins such as nicotine or drugs - the person manifests this as easily angered. 

Overthinking and overworking taxes the spleen and disrupts the digestive system leading to constipation or diarrhea. In traditional Chinese medicine, a weak spleen may lead to blood leaving its vessels, which can manifest as easy bruising, and it can also be associated with a low iron count (anemia).

Specifically, they interfere with the production and function of gasotransmitters (such as nitric oxide and hydrogen sulfide) and elevate cortisol levels. 

QI (CHI) STAGNATION

This is the manifestation of qi stagnation. This disturbance leads to an imbalance in the gut and respiratory microbiomes—what the West refers to as dysbiosis—which further impedes the body’s natural water metabolism.

As the body attempts to deal with the dysregulated water, it accumulates in inappropriate areas, creating what we call dampness. 

This dampness becomes a fertile ground for pathogens—molds, vaginal yeasts, bacteria (bacterial vaginosis), and viruses (HPV, Hepatitis, Herpes Simplex 1 & 2)—which trigger a low-grade systemic inflammation and create biofilms to shield themselves from the immune system. 

This is the mucus, the thickened, protective barrier that obstructs the flow of energy, impeding circulation and contributing to further stagnation. This results in tender and blocked meridians that need to be treated with medical Acupuncture and emotional regulation.

A vicious cycle emerges, a loop that strengthens itself over time, leading to the slow decline of health, vitality, and a gradual process of aging.

Sadness & Lung Health

When a person is sorrowful, their lungs often become weak. In Chinese medicine, sorrow is linked to the lungs, both of which belong to the metal element. So, how does one treat a patient with weak lungs caused by sorrow?

A mediocre physician might prescribe herbs to strengthen the lungs directly. A more knowledgeable physician might strengthen the stomach to improve digestion and nourish the lungs, following the inter-creativity principle (earth creates metal). While this is a more thoughtful approach, it still addresses only the symptom.

A master physician, however, understands the deeper issue: the real problem is emotional. Strengthening the lungs directly with herbs will only aggravate the imbalance. If the lungs are weak (yin deficiency), increasing their function (yang) will create a disharmony—too much yang will overwhelm the already frail yin. Strengthening the stomach is a better choice, but it still doesn’t address the root cause: sorrow itself.

USING EMOTIONS TO "TREAT" EMOTIONS

To treat sorrow, the physician must work on the emotion. The Chinese saying “emotional illness is best overcome by using emotions” holds the key. Sorrow corresponds to metal, and metal can be countered by fire—joy. By cultivating joy in the patient, the sorrow is diminished, and the weakness in the lungs gradually resolves.

This is the inter-destructivity principle: joy (fire) destroys sorrow (metal). But the real skill lies in the physician’s ability to bring joy into the patient’s life. The practitioner must invoke the emotion of joy to restore balance, not just focus on physical symptoms.

GOING BEYOND TREATING JUST THE SYMPTOMS

In true healing, the master physician treats the cause, not the symptoms. By addressing the root emotional imbalance, the body’s natural harmony is restored.

Here is a STORY that illustrates how a deep understanding of emotional theory in Chinese medicine can lead to powerful healing—though not in the way most would expect.

An emperor fell ill. Despite the best efforts of his imperial physicians and the finest delicacies prepared by palace chefs, he could not recover his appetite. No treatments worked. (In hindsight, one might wonder whether the physicians could not cure him—or dared not.)

One day, a renowned physician who had long declined palace service in favor of helping the common people offered to treat the emperor.

“I’m glad you’ve finally come to serve the court,” the emperor said.

“This will be my final act of loyalty,” the physician replied. “But I ask only one thing: allow me to roam freely within the palace grounds.”

“Of course,” said the emperor. “Wander as you please.”

Days later, the emperor entered his beloved concubine’s chambers and, to his shock and fury, found the physician appearing to assault her.

“Seize him! Behead him immediately!” the emperor roared in outrage.

And not long after—the emperor was cured. His appetite returned.

Why did this work?

In Chinese medicine, worry corresponds to the earth element. Excessive worry weakens digestion and appetite. To counteract worry, one must engage the wood element—its controlling counterpart. And the emotion of wood is anger.

By provoking intense anger, the physician used the emotional force of wood to destroy the stagnating influence of earth, thereby restoring the emperor’s appetite and internal balance. This was not madness or disrespect—it was a calculated act, rooted in deep medical theory and an understanding of how emotions govern the organs.

This is the power of treating the root cause, not just the symptom. True healing often lies in the unseen, in the emotional landscape that shapes the flow of qi.

An ingenious doctor may invoke certain emotions to cure certain disorders!

Dr Khoo Lee Seng

Leaking Qi & Depleted Jing- The Cause of All Medical Maladies & Premature Aging by Dr Lee Seng Khoo

 

“This leak happens little by little, silently. It doesn’t cause a major illness all at once. But gradually, you grow older, get sick, fall behind — without even realizing it.”

And that’s what’s truly frightening.

It’s not a sharp pain.

It’s not a sudden diagnosis.

It’s like a tiny crack in the pipes hidden behind your walls — dripping bit by bit, day after day, silently wearing you down.

Until one day, you suddenly realize: your energy is gone, your mind scattered, your thoughts cloudy and you are emotional and easily agitated or overreact to everything. It’s like someone has quietly stolen the vitality from your life.

These “leaks” come in three forms:

Qi Leak: Your vital energy drains away. You feel exhausted and sluggish all the time, like a deflated tire that can’t hold air no matter how much you pump it.

Essence (Jing) Leak: Your muscles and bones deteriorate prematurely. You have back pain, stiff joints, and feel like an elderly person despite your age — your body no longer feels like your own.

Spirit (Shen) Leak: Your memory fades, attention scatters, and your mind becomes foggy and slow. It’s harder and harder to focus. Your thoughts drift like you’re walking through a mist. This is the most common and most overlooked leak in modern life.

You may not even realize these symptoms are caused by leaking. Sometimes you may still look pretty good exteriorly from the naked eye but damage to the engine is taking place often irreversibly.

For example, leakage of Qi as it relates to the Middle Jiao, or middle burner, involves how the Spleen is managing blood. In Chinese Medicine, the Spleen’s Qi is responsible for containing the blood in the vessels. A person who bruises or hemorrhages easily likely has a weakness of the Spleen Qi. 

You just assume it’s “stress from work,” “lack of sleep,” or “weather changes”…

You Think You’re Just Tired — But It’s Your Spirit Leaking

In the modern world, spirit (shen) is the most vulnerable to leakage.

Brain fog, forgetfulness, mood swings, lack of focus… these aren’t just issues for the elderly. They’re symptoms of sitting too long, overusing your brain, and having poor posture — all of which prevent qi from rising to your brain.

Many people overwork their mind closing business deals with more and more deadlines, making more connections while struggling to optimise the ones that matter most, seeking money to maintain their image or lifestyle while simultaneously draining their body of the most important lifeforce “qi” thereby draining their “jing”. With high stress levels and cortisol overload coupled with lack of sleep and late nights working or substance abuse to cope with stress; it is little wonder how some seemingly vibrant people suddenly age rapidly in their late 30s and early 40s. Diseases that was supposed to only surface at old age manifest prematurely. 

It’s like charging your phone every day, but only up to 80% — while constantly using energy-intensive apps. Over time, the battery wears out early. Yes, even doctors who chase money or work without rest meet the Grim Reaper early or get ill. "Superman" doctor loses battle with leukaemia in Malaysia: 'He was our pillar of support' | STOMP

Renowned liver transplant surgeon Dr Yoong Boon Koon passes away at 54 - News

It is most important to know where, how, when, and why our Jing leaks. Only then can we begin to prevent it.

To protect our Jing, we must first recognize that the main causes of its loss are not external, but internal. The way we live, the habits we cultivate, and the thoughts we entertain (overthinking) all contribute to the depletion of our essence. Therefore, the responsibility is on us to make the necessary changes.

The mind is one of the most powerful tools for preserving Jing. When the mind is scattered, it creates disturbances in our Qi and depletes our essence. Meditation (Neigong & Qigong) and solitude helps to calm the mind, replenish the spirit, and prevent the excessive use of Jing through overthinking and mental agitation.

Neigong (internal work) focuses on refining the body’s energy channels and improving the circulation of Qi, while Qigong (external work) helps to build strength, flexibility, and stamina. Both play vital roles in reinforcing the body’s ability to retain and store Jing. Such exercises include Hua Tuo's Five-Animal Play Wǔ Qín Xì(五禽戲), Eight Pieces of Brocade- Ba Duan Jin (八段錦), 18 Lohan Hands Shiba Luohan Shou (十八羅漢手) and ultimately the Small Universe - Xiao Zhou Tian (小周天), Muscle Tendon Change Classic -Yi Jin Jing (易筋經) and the Big Universe Da Zhou Tian (大周天) to end dualism by expanding into the cosmos.

In modern life, many people deplete their Jing through overwork, poor sleep, stress, and overindulgence (or severe calories restriction) in food, heavy alcohol intake and smoking or drugs. This creates a vicious cycle where the body and mind become weakened, and Jing leaks out faster than it can be restored. It is essential to adjust your lifestyle so that you can support your Jing. This may involve eliminating unnecessary stress, setting boundaries, and prioritizing rest and recovery.

Jing Loss and the Dangers of Stress: A Taoist Perspective

In the Lingshu section of the Yellow Emperor's Classic, it is written:

"Xue and Mai, Ying and Qi, Jing and Shen are stored by the Five Zang. If a situation becomes such that by a succession of overflowings (leaking) and invasion they leave the Zang, then Jing is lost, and Hun and Po are carried away in an uncontrollable agitation."

This ancient wisdom reveals the profound relationship between the Five Zang, the vital substances — Jing, Qi, Ying, Xue, and Shen — and the importance of maintaining their balance. When these vital substances overflow, leak, or are invaded, they leave their proper storage in the Zang organs, and Jing is especially vulnerable. Without Jing, the Hun (the ethereal soul) and Po (the corporeal soul) become unsettled, leading to chaos in both the body and mind.

Conclusion

Leaking Qi and depleted Jing is common and can negatively impact health, but it is typically resolved with proper diagnosis & treatment as well as lifestyle (mental) & dietary changes. Preventing Qi leakage and depletion of Jing  is crucial for maintaining energy levels and preserving Essence (Jing), which helps slow aging and promotes long-term health and longevity.

When Chi and Jing is restored, one becomes luckier in life and the Shen is seen in the eyes. In Traditional Chinese Medicine (TCM), "shen" (or "shen qi") is the spirit, consciousness, and vitality of a person that is said to manifest in the eyes. When a person's shen is bright and lively, it is seen in sparkling, clear eyes, indicating good mental, emotional, and spiritual health.

PS- Acupuncture is one of the methods used to unblocked blocked meridians to restore qi flow and to rebalance qi in the body. However, without adequate mental rest and without plugging the leaking qi and restoring the depleted jing- good health and vitality remains at large.

THE “F” WORD IN FACIAL COSMETIC SURGERY BY DR KHOO LEE SENG

Today I want to address an important subject in facial rejuvenation: the F-word.

Now, no, I’m not talking about the controversial F-word you might be thinking of! I'm talking about facelifts.

It’s common for patients to come in and say something like, “Doc, I don’t want a facelift. I’ve got this turkey waddle and some sagging skin here, but I really don’t want surgery.” And I completely understand where they’re coming from. It’s natural to want to look youthful, but the thought of surgery can be intimidating for many. But let’s talk about what truly works when it comes to addressing significant facial aging.

Facelift surgery is often the most effective way to achieve natural, long-lasting rejuvenation. When someone has lax skin around their neck, jawline, or lower face, there’s simply no substitute for a facelift if they want a beautiful, lasting result.

Do you really want the Truth on the so called "Liquid Facelift"? 

Now, this doesn’t mean that I’m here to bash non-surgical treatments. We live in a time where there are amazing devices— HIFU ,Ulthera, Thermage, Radiofrequency Microneedling treatment like Potenza, injectables (skin boosters, fillers, PDRN), and thread lifts—that can offer some benefit. And for certain patients, these options can definitely help tighten and refresh the skin.

However, the truth is that these treatments are limited. They can provide a temporary tightening effect, but they don’t offer the same level of transformative results that a facelift & necklift can provide, particularly for those with more advanced signs of aging. Many patients spend more money on non-surgical treatments—Thermage, threads, fillers, you name it—only to find themselves back at square one, financially burdened and still dissatisfied with their appearance.

I’ve seen this play out time and again. A patient comes in for a consultation, and I recommend a facelift & necklift because it’s the most effective solution. (Although I do perform the entire gamut of non-inasive treatment including fillers, energy based devices and threadlifts)

They’re hesitant, and often say, “I’m not ready for surgery.” I respect that, of course. But months or even years later, they’ve tried multiple minimally invasive treatments and spent way way more than they would have on a real facelift & necklift. And they’re right back where they started, only now they’re facing a bigger financial gap.

I’m not here to criticize those who perform these non-invasive procedures—they definitely have their place. Many of my colleagues specialize in them, and I respect their expertise. But when it comes to significant sagging, you have to do your homework. Ask the right questions, and make sure you know what you're getting into.

Patients can see the gallery of before-and-after photos from my practice when they come for a consultation—patients who’ve had facelifts, eyelid surgery, breast surgery etc and more. You can see for yourself the kind of results you can expect from my work. 

Now, let's circle back to the F-word—facelift surgery. There used to be a stigma around facelifts, and many people still fear the idea of looking “windblown” or “unnatural.” But in reality, facelifts have become routine, and when done properly, the results are subtle, natural, and incredibly rejuvenating. I’ve performed over hundreds of facelifts and it remains my absolute favorite procedure. I have also published my findings and techniques in facial rejuvenation surgery here for those are interested.

‪Dr Lee Seng Khoo‬ - ‪Google Scholar‬

Why? Because nothing else can achieve the same results. Facelifts are an incredibly precise and methodical surgery, performed with intricate techniques to ensure every detail is just right. The results last, typically providing over 10+ years of rejuvenation with a single treatment.

If there were a device that could do the same thing, I’d be the first one to get it. But as of now, nothing compares to the long-term benefits a facelift can provide. It’s like the difference between a horse and a car—the automobile revolutionized travel, and once it was invented, nobody wanted to go back to the horse-drawn carriage. Similarly, if a better solution than the facelift existed, the entire field of facial surgery would shift. But that’s just not the case.

Again, I’m not here to discredit non-surgical treatments. Many of them can be effective for minor signs of aging, but if you’re dealing with significant sagging, you have to understand the limitations. Do your research, and don’t let anyone (including yourself who cling on to a belief that isn’t true) push you into a treatment that won’t deliver the results you’re hoping for.

When it comes to facelifts, the key is to choose a surgeon with experience and a portfolio of real, patient-driven before-and-after results. You should always feel comfortable asking for those, and any reputable surgeon will be more than happy to share them.

I hope this clarifies the importance of facelifts in facial rejuvenation. The “F-word” no longer needs to be a scary term. It’s about informed choices and understanding what will give you the best, most natural results.

Thank you for taking the time to read this. I truly appreciate your interest, and I look forward to helping you achieve your aesthetic goals.

Yours Sincerely,

Dr Lee Seng Khoo

‪Dr Lee Seng Khoo‬ - ‪Google Scholar‬

The Relationship of Fascia, Diseases and Medical Acupuncture - An Introduction by Dr Lee Seng Khoo

Try answering this question: What helps keep the human body upright?

If you're like most people—about 95 percent—you probably thought of things like "bones," "the skeleton," or "muscles."

All of these elements—bones, muscles, and the skeleton—are interconnected by a flexible, supportive tissue known as fascia. This remarkable structure weaves throughout the body, creating connection and continuity.

Now you may be wondering this structure we call fascia?

A quick but important note about the word "fascia"—because it tends to confuse people.

We’re not talking about the glossy dashboard of a freshly waxed red sports car, and it has absolutely nothing to do with any dark chapters of history. The word fascia comes from Latin, meaning "bands" or "to bind together"—which is exactly what it does. It binds tissues throughout the body into a unified, connected whole.

To help visualize it, think of vacuum-packed vegetables, appliances, or even cuts of meat. Vacuum packing keeps everything tightly sealed, preserving what’s inside. In the body, fascia does something very similar. Every organ, every muscle, every structure is wrapped and held in place by fascia—not plastic—but a living, responsive tissue that supports and connects everything.

STEAK!

Have you ever noticed those thin white lines running through a piece of steak? That’s fascia—a connective tissue that runs throughout your entire body.

Fascia being peeled off the steak

Fascia is more than just a structural layer. It plays a vital role in stabilizing the body, shaping our form, and supporting fluid and nutrient exchange. It wraps around your muscles, bones, and organs, helping to facilitate neurological communication and keeping everything in place.

Describing fascia precisely is tricky—it’s incredibly complex. Think of it like the thin membrane that separates sections of an orange. It acts as a protective and organizing layer, surrounding and connecting all the structures in your body.

Superficial Fascia of human body

Deep Fascia of human body

What makes fascia truly remarkable is its continuity. It forms a single, uninterrupted web that stretches from head to toe. Because of this deep interconnection, pain or tightness in one part of the body can actually be caused by tension or restriction in the fascia somewhere else. Everything is connected.

The Four Main Functions of Fascia

1. Shapes the Body

Fascia provides the body with its structure and form. Acting like a protective barrier, it surrounds, cushions, and shields muscles, bones, and organs—helping to guard against external threats and maintain internal stability.

Superficial Fascia portrait: ~ "Venus-Mary" ~ The entire superficial fascia (subcutaneous adipose layer) of a female form dissected as an autonomous organ and demonstrated alongside the form from which it came. I share this to transform our vision of the fatty fleece beneath our skin so we might consider it with greater appreciation, curiosity and respect.

2. Facilitates Movement

Fascia plays a vital role in movement and mobility. It helps regulate the tension levels in muscles, ensuring the right balance of flexibility and support needed for efficient, pain-free motion.

3. Nourishes the Body

Fascia is essential for the exchange of nutrients and waste within the body. It supports the delivery of vital nutrients to tissues and also aids in the removal of toxins through the lymphatic system, contributing to overall cellular health.

4. Supports Neurologic Communication

Surprisingly, over 80% of all nerve endings are located in the fascia. Between its superficial and deeper layers are sensory and mechanical receptors that allow the body to detect pain, control muscle contractions, and maintain proprioception—our sense of body awareness. This intricate web of communication makes fascia a critical player in how we experience and respond to the world around us.

Fascia is incredibly strong. In fact, during the era of tennis legends like Björn Borg and John McEnroe, professional tennis rackets were strung with fascia derived from cow gut—that’s how durable it is! Even today, surgeons use fascia sourced from sheep intestines—known (somewhat confusingly) as catgut—to tie surgical knots because of its unmatched resilience and compatibility with the human body.

Catgut Sutures

What makes fascia truly remarkable is its impenetrability. It resists almost all biological substances—water, air, blood, pus, and even electrical current tend to slide across it rather than pass through. This property allows fascia to create compartments within the body, forming distinct spaces that serve specialized purposes and allow different systems to function efficiently side by side.

But that’s not all—fascia is also electrically active. It doesn’t just conduct and resist electrical impulses; it actually generates electricity through a property called piezoelectricity. When fascia is compressed or stretched, it produces small electrical charges, which may play a role in cell communication and healing.

Scientific Perspectives on Fascia and Chi

Modern research into fascia has uncovered its vital role in transmitting electrical signals and facilitating communication between cells and tissues throughout the body. These discoveries offer a compelling parallel to traditional concepts of chi (or qi)—the life energy said to flow through meridians in many Eastern healing systems.

The transmission of electrical impulses through fascia-rich networks may provide a biological framework for understanding how energy is perceived to move through the body. Additionally, fascia’s unique ability to contract and relax in response to mechanical tension and movement mirrors the dynamic, flowing nature of chi along the meridians. This growing intersection between ancient wisdom and contemporary science suggests that fascia may be a key anatomical and physiological basis for interpreting the concept of                                            energetic flow in the body.

Fascia is made up of 70–80% water and is incredibly flexible and resilient. In fact, it can withstand significant force while remaining adaptable. When we're young, our fascia is typically more fluid and elastic, allowing for better movement and quicker recovery.

However, when fascia becomes unhealthy or damaged, it changes. It becomes thicker, drier, and less responsive to the body's needs. In this state, the tissue transforms, developing more fibrous cells known as myofibroblasts. These cells are larger and stiffer, contributing to inflammation, reduced mobility, and chronic pain.

Because these myofibroblasts restrict the flow of water and nutrients, movement becomes limited and the fascia loses its ability to support the body effectively. Damaged fascia often becomes dehydrated, leading to adhesions, chronic tension, and even the development of scar-like tissue.

Importantly, this kind of tension doesn’t show up on standard X-rays or MRI scans, which is why fascia-related pain and dysfunction have often gone unrecognized. Yet growing research suggests that fascial tension may play a major role in many modern illnesses—including conditions that were previously misunderstood or lacked a clear medical explanation.

If this tension is ignored or merely masked with painkillers, it can worsen over time, potentially leading to joint degeneration, chronic inflammation, and even degenerative diseases like arthritis.

Issues such as pain, stiffness, instability, joint problems, headaches, and more are increasingly being linked to fascia health. Even how the body retains and distributes water is influenced by fascia. It’s not just about how much water you drink—it’s about how much actually reaches your cells. And that depends heavily on the state of your fascia.

In other words, if your fascia is compromised, your cells may dry out, even if you’re drinking plenty of water. Over time, this internal dehydration can accelerate aging and reduce your body’s ability to function at its best.

Examples of diseased fascia pathologies I routinely see in medical practice includes :

Plantar fasciitis is the inflammation of the plantar fascia, tissue in the foot used during walking and foot movement. Plantar fasciitis can be caused by a number of factors, including type of shoes, foot structure, overuse and types of walking surfaces.

Dupuytren's Contracture:

Dupuytren contracture is an abnormal thickening of the skin in the palm of the hand. The skin may develop into a hard lump. Over time, it can cause one or more fingers to curl (contract) or pull in toward the palm. You may not be able to use your hand for certain things.

Peyronie's disease of the penis causing abnormal curvature

The Elusive Channels—Hidden in Plain Sight

Acupuncture meridians have long puzzled Western medicine. While they often trace the paths of muscles and tendons with surprising accuracy, they also seem to veer off unexpectedly, following their own internal logic. Some alignment exists with the body’s known fascial compartments, but that relationship becomes inconsistent once those compartments end.

Despite centuries of anatomical study—bodies dissected, stained, scanned, frozen, and irradiated—anatomists have yet to find any definitive physical structure labeled “meridians.” This absence of direct, observable evidence has been a key argument used to dismiss acupuncture’s validity in scientific circles.

And yet… the answer may have been in their hands all along.

Surgeons and anatomists rely on a tissue system that is omnipresent, almost invisible, yet absolutely essential: fascia. It lies beneath their scalpels, under their gloves, guiding their movements through the human body like a roadmap. Fascia is everywhere—wrapping, dividing, connecting. But because it’s so thin, so translucent, so often overlooked, its significance has gone largely unrecognized in this context.

In seeking proof of meridians, Western science may have missed the very thing under their fingertips—the fascial network. Ignoring fascia while searching for acupuncture channels is like a man looking for his glasses while they’re sitting on his face.

There is a straight connection between a body structure and its function. Think of a car. If it has a flat tire, say on the left side, the whole car will be tilted - i.e. be lower - on the left side. It follows that the function of the car is restricted. You may still be able to drive with it, but it is uneconomical as more fuel will be needed and in the long run, it will be completely wrecked.

As an example, we may look at a forward-head posture. This is a commonly seen structural feature. When your head is in front of your body, your neck muscles and especially the trapezius have to work in order to keep your head from falling off your shoulders. The fascia of these structures around this area will become hard and stiff over time and the normal function will be decreased. More often than not this also leads to neck pain and headaches. 

If I was to work solely on the neck part I could possibly alleviate pain for a while. But after a few weeks (or sooner) it would return. Simply, because the structure has not been changed. The head belongs above the shoulders, not in front of it. So working solely on the neck does not solve the problem. We have to work on the body as a whole and e.g. open and straighten the front line and release the fascial adhesions, maybe work on the position of the pelvis and also work on the feet and legs. As soon as the head is above the shoulders again and the fascia is free gliding, pain will be gone for good and function returns. That's how important body structure and restoring healthy fascia is.

Fascia: A Modern Lens for Ancient Wisdom

Fascia provides a compelling scientific framework for understanding the channels described in acupuncture. Not only does it align with the major meridians, but it also helps explain the intricate network of smaller pathways known in traditional Chinese medicine as the Jing and Luo—the primary and secondary channels. Since fascia is present everywhere in the body, it naturally accommodates the idea of a nearly limitless number of acupuncture points. These points often align with fascial junctions, planes, and lines of tension, making the once-mystical map of meridians anatomically predictable.

Stored Emotions and Unresolved Emotional Trauma Can Affect Fascia Causing Illness

Fascia can harden and become dehydrated also as a result of emotional trauma and the body’s response to extreme stress. This dehydration, tightening, and hardening decreases the space between the fibers and increases friction and irritation inside the fascia. As a result, fibers shorten, thicken, and constrict, putting pressure on the adjoining areas. 

This resulting pressure then compresses nerves and capillaries. Which in turn leads to discomfort, pain, and reduced blood flow in the area, affecting the immune system and reducing your resilience even further causing the onset of arthritis, impaired function and even the catalyst for frequent infections and malignancy (cancer) due to the faulty lymphatic drainage as a result of diseased fascia.

Acupuncture and fascia are interconnected through the concept of the myofascial system. Acupuncture, particularly when targeting trigger points, can influence the fascia, potentially releasing tension and improving musculoskeletal function. The fascia, a network of connective tissue, plays a vital role in overall health and well-being, and its interaction with acupuncture is becoming increasingly recognized. 

How Acupuncture Affects Fascia:

Releasing Tension:

Acupuncture needles inserted into trigger points can cause tense muscle fibers, and the surrounding fascia, to relax. 

Improved Circulation:

Acupuncture stimulates blood flow to the treated area, enhancing circulation within the fascial network and promoting healing. 

Pain Reduction:

By addressing fascial restrictions, acupuncture can alleviate pain associated with myofascial pain syndrome and other musculoskeletal conditions. 

Holistic Approach:

Acupuncture, along with other Traditional Chinese Medicine (TCM) techniques like cupping and Gua Sha, can work synergistically to release fascial tension and improve overall musculoskeletal health. 

One of the most exciting developments in this area is the connection between fascia and morphogens—biochemical signals that direct how cells develop, migrate, and form tissues. These substances play a vital role in stem cell behavior, tissue regeneration, and even cancer development. In this light, Qi is no longer a metaphor, but a living, biochemical process shaped by fascia and its interactions with the body’s signaling systems that can be altered and treated with Medical Acupuncture.

Sincerely yours,

Dr Lee Seng Khoo

Director, Skin Check Malaysia

TRENDS IN FILLERS - ARE WE DOING THE RIGHT THING? by Dr Lee Seng Khoo

 Over the past half a decade, I’ve seen a sharp rise in the trend of using multiple syringes of dermal fillers for full-face rejuvenation. Where once the focus was on targeting specific areas, like the laugh lines or under-eye hollows, now we’re seeing younger patients wanting to sculpt their faces, add volume, and sharpen their features. A significant amount of fillers are injected to enhance jawlines and to build nose bridges or to volumize the columella. Some doctors pump syringes after syringes into the temples in an attempt to volumize the area.

While I understand the desire for these enhancements, I’m also cautious about the long-term effects of using so many fillers. Yes, dermal fillers are a great way to restore volume and enhance features, but they’re not without risks.

• Risk of delayed reactions: Though hyaluronic acid is naturally found in the body, the stabilizing agents used in dermal fillers can cause delayed hypersensitivity reactions, leading to inflammation or swelling that could require medical intervention. As a surgeon who performs plenty of facelifts, I can tell you that these fillers never fully resorbed and I remove plenty of residual fillers during facelifts.

Filler granuloma identified and removed during facelift surgery.

MRI Scan shows fillers present after one injection 5 years later.

• Lymphatic drainage issues: Too many fillers can block lymphatic drainage, leading to puffiness, dullness, or even skin issues like breakouts. Think frequent filler injection to delay eye-bag surgery and what you have over time is the inevitable lymphatic blockade. 
  
  
  

 

           

• Migration and unnatural aging: Dermal fillers break down at different rates, which could cause them to shift or migrate over time, potentially leading to unnatural aging patterns. Many are also injected within the muscle and accumulate over time preventing animation which unlike Botox never fully resorb giving an unnatural appearance to animation of the face.
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I believe the accessibility of dermal fillers is a good thing — they provide a non-surgical option for many who want to enhance their features. However, moderation and proper consultation are key. It’s essential to balance enhancing beauty with maintaining the natural structure of the face. When it is time to stop fillers, as ethical practitioners we have to stop advocating fillers to our patients, period!

"Oh don't worry - we can always dissolve it with hyalase!"

When it comes to dissolving hyaluronic acid — whether it’s from your body’s natural cells or from filler injections — there’s an important factor at play: the enzyme hyaluronidase. Hyaluronidase is a class of enzymes that plays a crucial role in breaking down hyaluronic acid within the body.

Now, for your filler to break down naturally, your body would need to produce a steady amount of hyaluronidase at the injection site over an extended period. The problem? Your body doesn’t want to do this.

You see, hyaluronidase is responsible for breaking down hyaluronic acid, but if your body regularly produces it, it can begin to break down not just the filler, but also your skin and other tissues. Essentially, if your body made hyaluronidase constantly, it could result in unwanted breakdown of healthy tissues, which is something your body is designed to avoid. So, while we can use hyaluronidase in a controlled setting to dissolve filler, it’s not something your body wants to continuously produce — and for good reason. As fillers are injected in multiple planes and get embedded in muscles, subcutaneous tissues, fat and periosteum, it is not possible to dissolve every single bit of filler with hyalase injections. Also note that certain types of  fillers such as Sculptra, Radiesse and Ellanse do not respond to Hyalase. They accumulate in facial tissues over time and there comes a time when organic surgery is the only answer for the clinical scenario.

It’s a balancing act that’s critical to understand when considering any injectable procedure.

My 20 cents.

Dr Lee Seng Khoo