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FAQs

Anti-wrinkle injections

What are anti-wrinkle injections?

Anti-wrinkle injections are based on the botulinum toxin type A which is a purified protein produced by the Clostridium botulinum bacterium. It is a safe and effective treatment that works by temporarily weakening the muscles that cause lines and wrinkles resulting in a smoother and 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 people require treatment on the frown lines between the eyebrows, the smile lines around the eyes and the horizontal forehead lines. Other areas that can be treated with anti-wrinkle injections include the lower face, the neck and areas of excessive sweating such as the armpits and the palms of the hands. More information on areas treated can be found here.

How does the treatment work?

Using a tiny needle, small quantities of the anti-wrinkle agent are injected into the muscle just under the skin where wrinkles are most troublesome. The anti-wrinkle temporarily blocks the nerve signal to the muscle, which in turn relaxes the muscle and reduces its movement. This means that the muscle is no longer able to wrinkle the skin. The nerve that supplies the nerve signal shrivels away due to lack of stimulation. After approximately 3 to 4 months, new nerve grows in its place and muscle movement returns and at this time the injections need to be repeated.

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 recommended 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 4 months but 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 treatment with anti-wrinkle injections may increase the risk of the body creating antibodies against the agent. This can lead to failure of treatment in the future. 

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 which affect muscles (such as myasthenia gravis) that preclude treatment.
The injections are painless and may cause a minor stinging discomfort. As the needles used for the injections 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 the anti-wrinkle. 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 treatment; 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 before consenting.

What can I expect after the treatment?

For six hours after treatment you should stay upright and avoid touching or rubbing the area. You should avoid vigorous exercise, hot baths and alcohol for 24 hours post treatment. You should not apply make up on the day of the treatment. 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. 

What are dermal fillers?

Hyaluronic acid dermal fillers are substances that are used in order to volumise and contour the face. Hyaluronic acid is a naturally occurring substance that is already found in the skin. It helps keep the skin plump and hydrated. HA fillers are typically soft and gel-like. Crosslinking is a process by which the molecule is manipulated by the manufacturer in order to produce fillers that differ slightly in their consistency and mechanical properties. These properties dictate their indication for treating an array of aesthetic concerns and areas of the face. Most fillers contain local anaesthetic which makes the treatment more comfortable.

Dermal fillers
 

Which areas can be treated?

Dermal fillers can be used in various areas of the face, neck and hands in order to restore volume, contour the face and refine the skin. Commonly treated areas are the lips, 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 in order to replace volume, soften wrinkles, lift and contour the face. Hyaluronic acid is very hydrophilic and draws water in, which helps hydrate and improve the quality of the skin. In-vitro studies have shown that fillers may stimulate the synthesis of collagen by exerting a mechanical stimulus (stretching) on fibroblasts (collagen producing skin cells).

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

The results are seen straight away but it can take up to 2-4 weeks to see the full effect as the filler draws water in and enhances the volumising effect. Results last between 6 and 18 months, or even longer, depending on the type of filler, the area being injected and lifestyle factors such as smoking and sun exposure. The body gradually and naturally breaks down the filler. 

Is it safe and does it hurt?

Millions of people worldwide have had these injections and the safety of the product is well established. The treatment is usually well-tolerated, and although minimal discomfort is expected, it should not be painful. Most dermal fillers also contain a local anaesthetic which makes the treatment more comfortable. A bit of soreness may develop after the local anaesthetic wears off and it can easily be treated with simple painkillers such as paracetamol. If pain develops at any point during or after treatment, the practitioner must be notified straight away as this is not expected and needs to be investigated.

Are there any side effects?

The injections are fairly painless and may cause minor stinging, redness, itching or discomfort. Bruising, swelling and soreness may appear after treatment and they are usually minor and self-limiting. 

Persistent lumps and infection at the injection site are rare complications and should be reported for assessment and treatment. The injection of dermal fillers in patients who are prone to herpes simplex (cold sores) may trigger an outbreak, particularly when injecting into the lips. A short course of antivirals can be started before treatment in order to prevent this. Other rare complications have been reported with dermal fillers and these will be discussed before consent is obtained.

What is the pre and post-treatment advice ?

Avoid taking anti-inflammatories (such as ibuprofen and naproxen), alcohol, fish oils, St. John’s Wort, Gingko Biloba and Vitamin E, for 3 days before treatment in order to minimise the risk of bruising. If you are particularly prone to bruising, you may start taking Arnica tablets a few days before treatment. These are thought to reduce bruising and can be bought over-the-counter from the local chemist. 

You must avoid alcohol and vigorous exercise for 24 hours post treatment. Do not apply pressure on the area. Avoid sunbathing, sunbeds and extremes of temperature for 2 weeks post treatment as these can increase the risk of swelling and bruising. Do not undergo any dental work or any facial treatment such as chemical peels and lasers for at least 4 weeks before and after treatment. 
Please reschedule your appointment if you feel at all unwell.

What are chemical peels?

Chemical peels are solutions that can be applied to the face, hands, and neck in order to exfoliate the skin and allow new skin to establish. They are ideal for a number of concerns such as rough texture, fine lines, wrinkles, discolouration, blemishes and scars.

Chemical peels
 

What types of chemical peels are there?

There are three different types of chemical peels based on depth of penetration into the skin:

 

  • Superficial peels, which use mild acids like alpha-hydroxy acid to gently exfoliate. They only penetrate the outermost layers of the skin and are good for treating fine lines and refining rough and dull looking skin.

  • Medium peels reach the middle layers of the skin. These are more effective for removing deeper imperfections such as wrinkles, discolourations and scars.

  • Deep peels fully penetrate the skin. They are commonly made of phenol and TCA. Although they are more effective at treating deep seated imperfections such as deep scars and wrinkles, as well as inducing collagen and improving skin laxity, their depth of penetration is associated with higher risk of complications. 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. 

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.

 

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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