Facial lines result from repetitive facial movement in skin that has been damaged and has lost collagen and elastic tissue. Important predisposing factors are skin thickness which is genetically determined, sun damage and smoking.
Dermal fillers (Restylane, Perlane, Juvederm) are clear gels consisting of stabilized hyaluronic acid that bear and bind water, thus smoothing wrinkles and folds, imparting lift and new firmness to your skin. Lips are fuller with a more sensuous contour. Cheeks are plumper and more youthful combating that hollow, drawn appearance that characterises the ageing face.
A variety of products are available. I prefer to use products that are not animal based and have a very low incidence of allergic reactions, therefore negating the need for a skin patch test in advance. This means that I can treat your facial lines at your first visit with Restylane, Perlane, Restylane Sub Q or Juvederm/Sculptra.
Factors such as the depth of the lines and the mobility of the face influence the choice of product. For example Restylane is particularly suited to the finer lines of the superficial dermis such as lines above the lip. Perlane is preferable for deeper lines such as those from nose to mouth. Perlane is also suitable for enhancing the lips, a highly vascular and mobile area which needs the extra staying power of a deeper dermal product.The Juvederm/Sculptra products can be used in both the superficial and deeper dermis.
Restylane Sub Q is placed beneath the dermis in the cheek area. Its deep position over a wide surface area ensures that cheek augmentation looks natural with soft, gradual contours.
Nose to mouth (nasolabial) lines and those in the frown area (glabella) and above the lip (perioral lines) are the most common. ‘Marionette’ lines can give the corners of the mouth a sad, downturned look, which is greatly improved by using an appropriate dermal filler.
Restylane Sub Q is evenly deposited in the area beneath the cheekbones using a very fine cannula. Local anaesthetic is used to ensure that the procedure is as comfortable as possible.
Dermal fillers produce fuller, more sensual lips by injection along the vermilion border in either or both upper and lower lip. The effect achievable is dependant upon the quality of product injected.
Shallow scars which are not tethered to underlying tissue are often suitable for injection using an appropriate dermal filler. The quality and type of product indicated depends on the depth and length of the scar.
A local anaesthetic is offered prior to lip enhancement, cheek enhancement and the treatment of nasolabial lines and those above the lip. It takes five minutes to perform and the effect lasts for up to two hours.
Topical agents such as Anestop or Emla can also be used. These need to be applied at least fifteen minutes in advance of treatments.
This depends on the area injected and the type of product used. In general terms the less mobile the product, the longer it will last. A good example is the treatment of lines in the frown area which should last a year if the area has been previously immobilised with Botox® Guidelines are:
Initially there may be some redness and swelling of the treated lines which may last 2 or 3 hours. A small bruise may last a few days but can be concealed with make-up 6 hours after treatment.
The lips are particularly sensitive and swelling as a result of enhancement with dermal fillers can last for several days. Therefore the effect immediately following treatment should not be viewed as indicative of the final result. Mild swelling following cheek augmentation can last up to five days. Clients are advised to undergo lip enhancement or cheek augmentation when they have no important social or business functions in the ensuing few days.
Loss of volume in the under eye area can lead to shadowing and bagginess of the skin leading to a tired look. Until recently, the only available treatment option was surgery ( lower blepharoplasty ).
I have been successfully treating this area, almost on a daily basis, for several years non surgically using hyaluronic acid based fillers such as Juvederm and Restylane. It is often advantageous not only to treat the tear trough but also to build up subtle volume in the upper cheek in order to best correct the whole area. Everyone’s needs are different. I give each client a thorough assessment in which I discuss with them what is necessary to rejuvenate the eye area as a whole. In my view, correcting the signs of ageing around the eyes is the single most important thing we can do to rejuvenate the face. If we consider the face of a child, there is no change in contour from the lower eyelid to the cheek. Our goal is to eliminate any hollowing, shadowing or creasing of skin in this area.
The great advantage of these fillers, and of great comfort to many, is the fact that although they are long lasting, they are not permanent .In fact they can be removed within hours/ days if desired. The filler stays soft and becomes quickly integrated into the tissues so it ends up correcting the area in completely natural way.
This technique is an advanced one and should only be carried out by experienced doctors. Unlike many others I do not charge double for tear trough treatment The usual price paid is £500 which is the cost of 1ml of the product used.