As part of the ageing process, our skin progressively loses its elasticity and our facial muscles tend to slacken.
The effects of gravity, smoking and exposure to sun along with the stresses of daily life can all be seen in our faces. As skin loses its elasticity, fine wrinkles develop around the lips, at the outer corners of the eyes and lines of expression.
Facial rejuvenation may help the way help the way we feel about ourselves as well as making us look younger. There are many procedures available to rejuvenate the face. Some, such as facelifts, browlifts and blepharoplasties involve surgery. Others involve non-surgical techniques such as Botox injections, skin peels and dermal filler injections. It is important to choose treatments that will maintain facial harmonies as well as making us look younger. An important part of your consultation will involve discussing the way in which your face has aged and the ways in which this can be treated to produce a harmonious a pleasing result.
Many facial lines are caused by the repeated use of the underlying facial muscles, which over time results in a permanent crease or wrinkle. Botulinum Toxin (Botox) offers an alternative to surgery for many people with relatively mild wrinkles. Botulinum toxin reduces these lines by temporarily reducing the action of the underlying muscle. This gives a smoother, more rested appearance to the face. Botox also has a preventative effect when used repeatedly to reduce the onset of wrinkles forming in the long-term. To achieve the best results, Botox is injected to a level, which does not cause complete freezing of the muscles, but weakens them so that some movement is still possible.
Botox is most commonly used in the upper face. The most common areas requested are the horizontal forehead lines, vertical frown lines between the eyebrows, and crow’s feet (or laughter lines) radiating away from the eyes. It can also be used for some types of lines around the mouth. Several tiny injections are usually required. The smallest needles are used and the medicine itself does not tend to sting as much as injections of local anaesthetic. It is advised not to use aspirin as this can increase the risk of bruising.
Injectable fillers can be used to treat facial wrinkles caused by ageing and can also be used to add fullness to the lips and cheeks. The technique involves injecting a substance into the skin to correct a wrinkle or deep fold such as the nose to mouth lines. When injected beneath the skin, these fillers plump up creased wrinkles and folds of the face. Injectable fillers may be used alone or in combination with other procedures such as Botox or surgery. Deeper folds and creases in the face and brow can be more effectively treated using surgery.
There are many different types of dermal fillers on the market, but only a few dermal fillers have demonstrated predictable long-term results with minimal swelling and reliable safety.
Restylane is the brand name for an injectable form of hyaluronic acid specially formulated for facial contouring. Hyaluronic Acid is found naturally in the connective tissue of our skin and along with collagen forms the building blocks of healthy tissues. Restylane is the most popular facial filler in the world today and it has a proven safety record. The result from the treatment is immediate and will last approximately 6 months.
Most injectable fillers are injected into the skin with a very fine needle. Either using a local anaesthetic injection or a topical anaesthetic cream applied to the skin before treatment can reduce the discomfort from the injection. Some patients may experience a little redness and swelling which can be minimised with makeup.
As ageing progresses, these wrinkles deepen. Smile lines become more noticeable, the corners of the mouth droop, the jaw line sags and the skin of the neck becomes slack. Around the eyes, the brow droops, the skin of the eyelids gathers in loose folds and eyelid bags may form. As people age they often look tired. The rate at which the face ages, varies greatly. Ageing of the face may not reflect how we feel about ourselves and many people feel frustrated or depressed about the ageing face they see in the mirror.
Frequently Asked Questions
Following the treatment, do not massage the area of the injection and do not lie down for about 3-4 hours. Frowning and closing the eyes tightly intentionally after treatment may help to localise the Botox to the selected muscles. Do not take any aspirin for two or three days either side of the injections as this may help to reduce the chance of bruising. It is also advised not to perform any vigorous exercise for 24hours after the treatment.
Successful therapy is signaled by muscle weakness that begins 3 and 5 days after injection with the main effect visible at about 7 days. The effect after the initial injection lasts between 3 and 5 months for most patients.
Repeat treatment is suggested every 4-5 months to keep the muscles sufficiently frozen to allow the furrows to smooth out. In practice, this means coming three times in the first year. After using botox for one year, the intervals between injections may be a little longer so that you need it only twice a year.
As with any sort of injection, there can be some bruising and minor swelling although this is not severe and usually settles within a few days. Very rarely if the botox reaches the upper eyelid muscle, there may be transient drooping. This is the most significant risk and occurs in about 1 in 1000 injections. It occurs from a local spread of the botox from the injection site and can be minimised by accurate dosage, proper placement, as well as keeping in an upright position for three to four hours after the injection. If drooping eyelids occur, it usually resolves over a few weeks. Special eye drops may temporarily reduce eyelid droop if it occurs.
The following people should not have Botox:
- Pregnant women
- Breastfeeding mothers. There is no evidence that Botox is expressed in breast milk but it is best avoided if breastfeeding
- Patients with a history of neuromuscular disease (multiple sclerosis and myasthenia gravis) or other types of diseases involving neurotransmission should avoid Botox
- Patients taking the following medicines should not receive Botox: aminoglycoside antibiotics, penicillamine, and calcium channel blockers (Calan, Cardizem, Dilactor, Norvasc, Procardia, Verelan)
- Known allergy to human albumin (egg white) or Botox; currently there are no documented cases of allergy to Botox