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What are anti-wrinkle injections?

Botulinum toxin Type A is a purified protein produced by the Clostridium botulinum bacterium. “Botox” is the most well known brand on the market. It works by temporarily weakening the muscles that cause frown lines and wrinkles, resulting in a dramatically smoother, younger-looking appearance. The effects are outstanding which is why this is the most popular cosmetic treatment in the world.

Which areas can be treated?

Most clients request treatment on one or more of these facial areas:
• Frown lines between the eyebrows
• Crow’s feet or smile lines around the eyes
• Horizontal forehead lines
Other areas that can be treated with botulinum toxin include the lower face and neck. It is also a very
successful treatment for excessive sweating.

How does the treatment work?

Using a tiny needle, small quantities of the protein are injected into the muscle under the skin where wrinkles are most troublesome. The protein temporarily blocks the nerve signal to the muscle, which in turn relaxes the muscle and reduces its movement. The nerve that supplies the nerve signal shrivels away due to lack of stimulation. With time (usually 3-4 months), new nerve grows in its place and muscle movement returns.

How soon will I see the effects and how long do the effects last?

The initial effects of the treatment usually appear within the first 48-72 hours, but it can take up to 14 days to see the full effect. It is generally required to attend a follow-up appointment after 2-3 weeks in order for the effect to be reviewed and an additional top-up to be administered (at no extra cost) if required.
The effects of the treatment usually last between 3 and 5 months, this will vary from person to person. Deep lines will be softened and may take several treatments until the optimum result is seen. Fine lines can almost disappear. Too frequent or excessive dosing of Botulinum toxin may increase the risk of antibodies which may lead to failure of treatment. With this in mind, and the recommended license guidelines, botulinum toxin treatments are carried out after 12 weeks. You should have further treatment when the muscle activity returns, but before the lines and wrinkles have had a chance to re-establish.

Is it safe and does it hurt?

Millions of people worldwide have had these injections and the safety of the product is well established and beyond doubt. There are a few rare medical conditions such as myasthenia gravis which affect muscles, and people with these conditions cannot have treatment. Treatment is also not recommended in pregnant or breast-feeding women. 
The injections are virtually painless and may cause a minor stinging discomfort. Also as the needles are very small, the risk of bleeding or bruising is minimal. Once the effect of the toxin has worn off, there is no lasting effect and the muscle returns to normal activity.

Are there any side effects?

Side effects are rare and temporary – you may experience bruising or tenderness at the injection site, a mild headache and very occasionally the treatment may not work as some people are immune to the effects of Botox. When injecting close to the eye there is a very small chance (significantly less than 1%) of developing a temporary drooping of the eyelid. If this occurs, drops can be used to lessen the effect until it wears off naturally. Many people worry about having a ‘frozen’ face after Botox; this is almost always due to poor injection technique and can be avoided. Very rare side-effects are also listed in the product literature and a full list will be provided, along with the opportunity to ask questions during and after the initial consultation.

What can I expect after the treatment?

For six hours after treatment you should avoid exercise, hot baths or alcohol as these can increase blood flow and dilute the effect. It is important to avoid touching the area injected, including applying makeup, as this may actually push the product beyond the intended area. It is recommended to actively use the treated muscles (e.g. frown or squint) frequently during the first hour after treatment, as this may enhance the effect. Wrinkles normally begin to disappear after two or three days, and full results are usually seen within ten days. On average the effects last three to four months, but with repeated treatments the results may last longer. A follow up appointment is offered 2 – 3 weeks after the treatment to ensure that the best results are achieved. Any additional toxin needed at this appointment is included in the original cost.

What are dermal fillers?

Dermal fillers are hyaluronic acid based soft tissue fillers which are used to fill facial lines and restore volume. The most common brand of dermal fillers is Juvederm by market leaders Allergan.

Which areas can be treated?

Dermal fillers can be used in various areas in order to restore lost volume, as well as contour and refine the face. Commonly treated areas are the temples, cheeks, tear troughs, chin, jaw, nasolabial folds (lines between the nose and mouth) and the marionette lines (between the mouth and chin).

How does the treatment work?

Using a needle or cannula, small quantities of the filler are injected into different layers of the skin. The product temporarily fills wrinkles, restores volume loss and enhances features by lifting and supporting the skin in the area being treated.

How soon will I see the effects and how long do the effects last?

The initial effects of the treatment are seen straight away but it can take up to 14 days to see the full effect. You may be advised to book a follow up appointment 2-3 weeks after if you would like your treatment reviewed, or if additional product is needed. This can help to optimise the results and maximise the duration.

The effects of the treatment usually last between 6 and 18 months but this varies from person to person and depends on area treated, product used and lifestyle factors, such as smoking and sun exposure.

Is it safe and does it hurt?

Millions of people worldwide have had these injections and the safety of the product is well established. Most dermal filler products contain a local anaesthetic which makes the treatment more comfortable.

Are there any side effects?

The injections are fairly painless and may cause minor stinging, redness, itching or discomfort. This reaction wears off after a few days. Indurations (hardening of the skin), bruising or nodules may develop at the injection site. These usually resolve within 1 –2 weeks.

Infection is possible at the injection site, although rare, and can be treated with antibiotics. The injection of dermal fillers in patients who are prone to herpes simplex (cold sores) may trigger an outbreak, particularly when injecting into the lip area. Prophylactic treatment with anti-virals can be used before treatment in order to prevent an outbreak. Other rare complication are also listed in the product literature and will be discussed during the consultation.

What can I expect after the treatment?

For 12 hours after treatment you should avoid extreme facial expressions, alcohol consumption and applying make up. You should also avoid extreme sun exposure, UV light, freezing temperatures and saunas for 2 weeks after treatment. It is important to avoid touching the area injected.
A follow up appointment is offered 2 – 3 weeks after treatment to ensure the best result possible has been achieved. Any additional product needed at this appointment may incur an additional cost.

What are chemical peels?

Chemical peels are cosmetic treatments that can be applied to the face, hands, and neck. A chemical solution is applied to the area being treated, which causes the skin to exfoliate and eventually peel off. This allows newer and healthier-looking skin to establish. Chemical peels are ideal for multiple skin rejuvenation concerns such as rough texture, fine lines, wrinkles, discolouration, blemishes, keratosis pillaris, pseudofolliculitis barbae, and mild keratoses.

What types of chemical peels are there?

There are three different types of chemical peels:

  • Superficial peels, which use mild acids like alpha-hydroxy acid to gently exfoliate. They only penetrate the outermost layer of skin.

  • Medium peels, which use trichloroacetic or glycolic acid to reach the middle and outer layer of skills. These are more effective for removing damaged skin cells.

  • Deep peels, which fully penetrate the middle layer of the skin to remove damaged skin cells; these peels often use phenol or tricholoracetic acid. 

How is a chemical peel done?

During a light or medium peel a cotton ball, gauze, or brush will be used to apply a chemical solution to the area being treated. The skin will start to whiten, and may have a slight stinging sensation. Once complete, the chemical solution will be removed or a neutralizing solution will be added. Recovery time is between 4 and 7 days. The skin may initially swell a little bit and form crusts and brown blotches before revealing new skin. Redness after a medium peel can persist for a few months.

Very deep chemical peels require sedation or general anaesthesia and therefore they are not suitable for office-based treatment and are usually carried out in a hospital setting. 

What are the risks and possible side effects of a chemical peel?

Common side effects of superficial and medium peels are mild and temporary. They include redness, dryness, stinging or burning, and slight swelling. Deeper chemical peels can have more serious side effects, such as skin discolouration, scarring and skin infections.

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