Are you ready for an injectable treatment?

My heart sinks when I get a potential patient inquiring about a cosmetic injectable treatment and the first question is "how much is the treatment?"  Whilst I try to keep my prices reasonable so I can reward my loyal patients and help them manage the upkeep of continued treatments, please be aware it would be foolish for price to be the deciding factor when choosing to undergo a cosmetic procedure.

A good proportion of patients who contact me do not seem ready for a treatment. Firstly, you must be over 18 years old and I would prefer you to be over 21 years old.  You need to have emotional maturity and resilience to undergo a cosmetic procedure.  There are certain common complications that you can expect following a treatment and you must have the resources to handle them. It can take 2-4 weeks for the body to heal post-procedure and you must be able to manage your emotions and expectations should that occur. 

It is also best to wait and schedule your appointment well before any holiday or big event - at least 4-6 weeks beforehand. It is ill-advised to have a treatment prior to travel (how could you be reviewed in the event of a complication or undesired outcome?) or big event (what if you encounter severe swelling and/or an undesired outcome?) In many respects, you will benefit from scheduling your appointment with plenty of notice - especially if before a holiday or big event and taking time off work, if required.

Lastly, there are lots of good resources out there for you to read up about before you come to your consultation. Do check out the Consulting Room and Save Face and Real Self.

Be wary of social media photos and videos from lay-people demonstrating procedures because you are best seeking a comprehensive consultation from a medical professional that takes time to cover all that is needed to give you a safe and effective treatment.

Getting Ready for your Lip Filler & Possible Complications

It has been lovely to recently have some new clients express an interest in lip filler injections.  At our consultation, I will take a medical history and advise you of the risks and benefits of the procedure before making a recommendation of the most appropriate lip filler product for your requirements.  However, I cannot predict how your body will react to the product and the procedure.  You will have a safer, more informed and stress-free recovery if you are aware of the commonly occurring and rare complications.  With this in mind, I ask you to consider...

Preparation for Lip Filler Injections

• Do not take aspirin/ibuprofen the week before a treatment.

• Consider using arnica in the week before your treatment.

• Do not exercise beforehand.

• To prevent blood pressure from being high - try to stay calm.

• Have the lip area clean and make up free - avoid using make up for at least 4 hours after your treatment.

Complications

Injections are a form of trauma which cause bruising, bleeding and swelling (including asymmetric swelling). You should expect a degree of swelling and bruising after your lip filler procedure. Also the hyaluronic acid filler is designed to attract water to the area is is placed giving a puffy appearance at first.

Examples of swelling are:

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Examples of bruising are:

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Help is at Hand!

In the first two days after your lip filler treatment:

• Do not rub or massage your lips.

• Do not take aspirin/ ibuprofen and avoid alcohol.

• Use a cold compress on your lips for 15 minutes in every hour.

• Sleep with your head raised.

Swelling is most noticeable in the first two days after your treatment but if there is some swelling after 48 hours, an over the counter anti-histamine like Benadryl might help.  Bruising might take longer to improve, depending on its severity.  In approximately 1 in 10 procedures, there is the complication of an internal bruise - also called a haematoma/blood blister.  It is an enlargement of tissue due to the accumulation of blood cells and fluid.  Blood fills the area, creating a bulge.  Over the next 1-2 weeks, the body will reabsorb the blood cells and fluid from the region.

Another potential complication for you to consider is if the filler does not settle evenly with the formation of a lump.  They can be evened by massage but if that is not effective then you need to come back to the clinic for me to smooth them.

Very Rare Complications

Every reputable aesthetics professional is mindful of the risk of filler affecting the blood supply to the area treated and other regions of the face.  The risk of this occurring is estimated to be 1 in 30,000.  This is caused when the dermal filler is either injected into an artery or around an artery to the point that the blood flow is reduced or completely stopped.  The area of skin or other tissues that are supplied by the affected vessel will start to die without the necessary blood supply.  

Almost always, if this complication occurs, there will be an immediate blanching (paleness, tissue turns white) when the blood flow is interrupted, often in areas far away from the actual injection (see the photo of the blanched cheek). There is usually immediate pain but there have been cases reported that occurred 12-24 hours after being injected.

If no treatment is initiated to improve the vascular flow, the skin will start to appear dusky, a bluish tint, with fine reticulations (lace like) to areas beyond the site of injection (see the mottled appearance of the cheek in the top right photo).  This occurs within 24 hours.  If still no therapy is done, the skin will start to die, turning black, and sometimes there is an associated infection. 

Is it important that you tell your aesthetics professional:

During the treatment:

• If you are experiencing any unexpected pain or tenderness that feels different to the usual lip injections.

In the first 24 hours after the treatment:

• Any paleness or dusky appearance to the skin and surrounding area.

• Any mottled/lace like appearance to the skin and the surrounding area.

• Any goosebumps/blisters to the skin and the surrounding area.

• Severe pain and tenderness.

Though it is rare in the extreme, this is an urgent complication that requires immediate attention so you must call and send a photo should you suspect this event.

How do Fillers Work?

Gone are the days of pillow face and expressionless face, we are a modern aesthetics service that prides itself on being able to deliver a treatment to any age group with its specialist and advanced aesthetics techniques.  Meticulous care is crucial to injecting into the deep dermal plane or intradermal plane. This expertise makes the difference between a great result and an average result.

How does it work?

Modern injectable fillers are made from hyaluronic acid, a naturally occurring substance that the body breaks down gradually. Depending on the purpose and the viscosity of the filler, it can last for different time frames but that is a good thing. Although you might feel inconvenienced by returning for further treatments, your face will change as it ages which is why refreshing a treatment is advised.  As the company's Lead in filler treatments I am trained in the advanced treatments and only use products that are the market leaders in effectiveness and safety.  Anaesthetic cream is used topically to minimise the pain of injecting but the filler also contains an aesthetic chemical so if you are one of the minority who experience some discomfort, the pain should not worsen. 

How long do fillers last for?

For lips: Lip filler commonly lasts 6-9 months though we hear reports from our customers that they are still pleased with their results 12 months later. For other customers who are looking to work towards longer-term pouty lips, they stagger 3-6 months between treatments in order to reach a stable end result 18 months later.

Cheeks: Juvederm Voluma restores lost volume to regain a youthful curve in the cheek. The product is elastic, viscous and supports structures to enhance the cheeks, it lasts 18 months and is seen as a great investment as an alternative to a face lift and is known as a liquid face lift. A commonly occurring issue is that it may highlight deficits in the tear trough and so dependent on your consultation, it might be worth considering a simultaneous tear trough enhancement.

Laughter lines: Juvederm Ultra 3 is used to fill the nasolabial lines that are a deeper wrinkle.  The product plumps up the skin and stays in place for a result that will last about 9 months, though we have reports of 12 months from our customers.

Tear Troughs: I call this treatment the "cherry on the cake" because all the other filler treatments aim to take the viewer's aim to the mid face.  The eyes really are the windows to the soul which is why a beautifully proportioned face keeps a person's attention in that area.  Depending on whether or not other treatments are required, the tear troughs are "airbrushed" with a light filler because it sits next to the service of the skin, only the best product is used and it is meticulously applied. Unlike other fillers that encourage water being drawn to the area for a plumping effect, Juvederm Volbella aims to restore lost volume in the orbital rim without causing swelling to the area, it lasts about 12 months.

How quickly can you see the results?

Unlike toxin treatments (like Botox) the result is instant and your clinician is guided by what they see as they deliver it in order to complete the entire procedure. However you can expect swelling and bruising after a filler treatment so don't feel alarm if there is more volume initially than you expected.  In exceptional circumstances filler can be reversed with an enzyme (because it is a naturally occurring substance).

How does Botox Work?

How do wrinkle reducing treatments work?

Wrinkles are mainly caused by muscle contraction. For example, when you are angry or confused, you draw your eyebrows together and downwards. This causes pleating of the skin which results in frown lines. Similarly, elevation of the eyebrows causes horizontal lines on the forehead and smiling/squinting causes crows feet around the eyes.

Toxins are injected into the target muscle directly below the wrinkled area and blocks the transmission of signals from the nerve ending to the muscle. This causes temporary paralysis of the treated muscle the causes the wrinkles, which results in the reduction or loss of wrinkles.

How long do results last?

Results will start to show after 3-10 days and will last 3-5 months. The result is not permanent because the nerve ending re-establishes it’s signalling by forming new nerve sprouts. This sprouting takes approximately 3-4 months, at which point the muscle regains it’s activity and the wrinkles begin to reappear. Clients who have treatments 2 or 3 times per year tend to find the results may last longer after the first 2 years of treatments. When combined with other skincare treatments, it is an essential component of anti-aging.

What is Microneedling?

Microneedling stimulates collagen production in your skin to give you better-looking skin on every level. The skin has a natural ability to repair itself whenever it encounters physical damage such as cuts, burns and other abrasions. Immediately after an injury occurs to the skin our body reuses the damaged collagen and elastin fibres as well as other damaged skin components to produce new ones. Skin needling allows for controlled induction of the skin’s self repair mechanism by creating micro “injuries” in the skin which triggers new collagen synthesis, yet does not pose the risk of permanent scarring. The result is smoother, firmer and younger looking skin.

After the procedure the clients skin will be red and flushed in appearance in a similar way to moderate sunburn. Skin will feel tighter with mild sensitivity to touch on the area being treated. This will diminish greatly after a few hours following treatments and within the next 24 hours the skin will be completely healed. After 3 days there is barely any evidence that the procedure has taken place.

Myth: Microneedling hurts.
Fact: For the most part, microneedling may be uncomfortable but it’s not totally unbearable. At Juno Aesthetics microneedling procedures done in a clinic setting and are performed with topical anesthesia depending on the depth of the procedure being performed.

Myth: Microneedling leaves holes in the skin.
Fact: While microneedling does create a controlled injury in the skin to incite collagen production and does it by creating microscopic holes, the holes it creates are so tiny that they can’t be seen by the naked eye. You may notice more of a red or pink flush to the skin, which will dissipate soon afterwards, and potentially some bleeding. No need to worry, it’s totally normal. Plus, makeup can easily cover up anything that you don’t want exposed.

Myth: The treatment can’t be done around the eyes or lips.
Fact: Thanks to advancements in both science and skin care, microneedling can safely be done in these areas as long as the right device is used. Companies like Aesthetic Dermal, which manufacture microneedling tools, have specially designed rollers that can be used on the upper eyelid, close to the eyelashes of the lower lid, the areas on the side of the nose and the upper lip.

Myth: The only benefit you’ll get from microneedling is an anti-aging one.
Fact: The treatment works to create smoother skin but it has been shown to be effective in correcting acne marks, too. The microneedles stimulate collagen production to help with scarring—when retinoids and other collagen stimulating topicals are applied to the skin after a treatment they are able to penetrate better for more improvement.

10 Bot Toxin Myths Busted!

There are A LOT of inaccuracies and untruths out there about B-Tox. Here are 10 myths that we are going to bust!

MYTH 1: B-Tox can be used anywhere on the face
There’s a filler and injectable to treat just about every line and wrinkle on the face, but Botulinum Toxin cannot be used for everything.  While it may seem like B-Tox can be used all over the face, there are only certain areas where it works; other injectables are an option for problems that B-tox cannot correct.

MYTH 2: It works immediately
Because B-tox acts on the nerves that control muscle movement, its can take anywhere from three to five days for it to set in before you notice results.

MYTH 3: You can never develop an allergy to Botox
Anyone can be allergic to anything, B-tox included. Although rare, there have been cases of allergies following Botox injections though it can be hard to distinguish between a true allergy to B-tox or an allergy to the dilutent used to dilute the B-tox.

MYTH 4: If you workout a lot you’ll need more B-tox than the average person
Whether you’re a workout fiend or you haven’t seen the inside of a gym in years, it’s not your workout choices that dictate how much B-tox you need, but rather the degree of your lines and wrinkles.

MYTH 5: B-tox alters your emotions
In actuality, if done correctly and in proper moderation, B-tox will look natural and emotions will still be expressed on your face. But angry appearances emotion that occurs when you furrow your brow will be diminished. But in the right amount, B-tox will not affect any other movement in the face like lifting your brows or smiling so you remain expressive.

MYTH 6: You can never become immune to B-tox
It is extremely rare but it is possible to develop resistance to B-tox due to the formation of antibodies to it following repeat injections.  Techniques to deal with these cases include using a different brand of toxin to inject, using the minimum dose required to achieve the desired effect at the longest interval between treatments.

MYTH 7: B-tox is the same exact thing as botulinum found in food
Some people believe that B-tox injected is the same as the bacteria that causes botulism.  Actually the B-tox manufacturers produce an isolated toxin that is not the entire bacteria.

MYTH 8: B-tox gives a fake looking result
The majority of my patients tell me no one knows they have had anything done. That's what I want.  In Aesthetics anything done correctly and in moderation can look natural. My goal is to under-treat so you look renewed and refreshed.  Celebrities that look over injected and fake or plastic have been over treated and good aesthetics practitioners should have conversations with their clients about keeping treatments looking natural.

MYTH 9: B-tox won’t do anything for super-heavy lines on the forehead
B-tox can work wonders on deeply etched lines in the forehead. It can sometimes take multiple rounds of treatment and time before the muscles become weak enough to really soften the lines.

MYTH 10: It’s safe to have anyone inject B-tox as long as they are some sort of doctor
Aesthetics practitioners should be MEDICAL professionals with advanced training and clinical experience in aesthetics. Each person will have differences in their anatomy and expectations of treatment and so the skill of an appropriately trained aesthetics practitioner is pivotal in planning injection sites, dosages and considering vector movement changes to deliver a beautiful aesthetic result.