Author: dermisskin

Tor is Dr. Hannah’s good friend and long time treatment guinea pig. She writes blogs for Dermis Skin to explain her experiences for others who are considering having an aesthetic treatment to help them decide if it’s right for them.

Fines lines? Wrinkles? Nope these were more like deep troughs. I was fully intending on embracing old age because I didn’t want my face to be permanently frozen in an expression of mild surprise. Because that’s what I thought aesthetics was: Botoxing the life out of my face and losing my expressions. But ultimately I started to become unhappy with my appearance and decided to do something about it.

You can see in the image above the before and after photos. Lets start with the forehead: I hated it. The lines were deep and established and had the audacity to not even be horizontal. Between my eyebrows I had a fixed deep crease making me look partially scowling. Around my eyes the crows feet were doing their merry attention seeking dance. And my smile lines had become fixed around my nose and mouth.

First step was a consultation with Dr Hannah. We talked through the options, risks and pricing. She reassured me that it would be subtle – because I didn’t want anyone to know. And we went though my questions: would my face be frozen or paralyzed? Unlikely. Would it hurt? A little bit perhaps but manageable. And would it really work? Results are not guaranteed but Hannah assured me she would work with me over the long term to get the best results.

We first tried a small amount of Botox. It did not hurt and was not at all obvious. But the lines were still very much there although reduced. Hannah also studied my face to establish they way various facial muscles had responded to the treatment. It was better, but not quite the transformation I had hoped for. The eyes and mouth lines were ok, but I felt that the forehead, though improved, gave the same creased appearance.

A few weeks later I was back. This time we combined the Botox with some fillers and a chemical peel. Because the forehead lines were so established; Hannah wanted to try padding the area out a bit. And the peel was designed to remove the top layer of skin and trigger the production of new skin cells.

The filler was a bit intense. It involved Hannah injecting from a single point in my forehead outwards in a star/spiders web formation. The skin was numbed to a degree but I could feel the movement and tugging of the needle as it reached out underneath the skin. The chemical peel though was lovely and relaxing. Like having a facial, although one treatment was a weak form of acid and I could feel it tingling.

The results were instant and exactly what I was hoping for. My face was literally glowing and the lines on the forehead were significantly reduced and satisfyingly plumped out. I could see the creases in the skin where they has held their ridges for so long, But Hannah said this would fade as the skin recovered and relaxed into its new position.

I was so happy with the results, I looked natural and healthy, the lines were finally retreating, and best of all no one ever suspected a thing. The filler has lasted well over a year now although I still need to have the Botox topped up every now and again. But it is well worth it and I never want to go back to the way it was before.

A question that I am often asked when consulting with a new-to-aesthetics client is whether once you start using Botulinum Toxin, do you have to continue forever? Well the truth is that really, it is entirely up to you. You see, Botulinum Toxin (which I will hereon-in refer to as B’tox) is not able to permanently change anything. It is a toxin which temporarily paralyses or weakens muscles which in turn, lessens the effect of pulling on the skin – outcome: wrinkles be gone! The body will eventually recover and the muscles will build up strength again and the lines will return. The reason, we as aesthetic clinicians, suggest returning every three months to repeat the process is that after this time, the muscle activity returns and to keep yourself fresh faced, re-administration of the B’tox is required.

So what happens if you choose not to re-inject? Absolutely nothing! The lines will return as they were before and things will return to how they were. Your face will not drop off, your lines will not be worse and nobody will know any different.

Regular use of B’tox will weaken the muscle and over time, this muscle’s power will be reduced meaning you will not need to have your B’tox so regularly. It also means that your face will look consistently refreshed and aging will slow down considerably. It is now thought that early introduction of B’tox into your skin maintenance regime improves overall aging outcomes. What do I mean by ‘early’? Well, I would suggest late 20s/early 30s – let’s face it, that is when the most damage is done right? Dare I say late-night parties? Of course this depends on lifestyle choices and genetics too because a person with dark skin who gets good, quality sleep and does not drink or smoke heavily will age slower than a person with light skin who loves to sunbathe, parties hard and smokes.

Of course there are things you can do to slow things down yourself and also to prolong your B’tox. Lifestyle changes such as reducing your alcohol intake, stop smoking, keep out of the sun between 11am and 4pm and wear SPF! Dietry changes such as avoiding over-processed foods, eating fresh fruit and vegetables daily – aim for 5 portions per day and drink plenty of non-caffeinated, low sugar fluid. Another top tip from me is Retinol; this stuff is the elixir of youth and works by increasing cell turnover so wrinkles cannot form. Go for a pure, unbuffered retinol though and do not go wild with it for the first few weeks. An anti-oxident, vitamin C serum will also help to brighten and firm the skin.

But, to be crystal clear: how often you want B’tox or if you even want to continue with B’tox is entirely down to you. I promise, nobody will know either way.

Aesthetics is an ever-changing and fast-pace area to be in. You have to really be paying attention to what the fashions are and what is popular at any moment in time, but also be big enough to evaluate the merits of any treatments available and how they would be implemented in your own daily practice. Russian Lips for example. They have been a really big thing in social media and celebrity culture for a short while now. Before this, the ‘keyhole’ (or Angelina) look was big and before that it was the bigger the better. Now, I can see some of the benefits for these techniques (bar the ‘bigger the better’ look, that is never flattering) but not in every situation. It is a bit like going to the hairdresser with a photo of Jennifer Anniston and asking them to change your thin, wispy hair into her thick flaxen hairdo. It doesn’t work does it? This is where you need a trained, honest professional who can guide you to what is and is not achievable with lip filler. 

There is some merit to techniques used in the Russian Lip. Although I am not a huge fan of the results of this technique when used to create huge, crisply defined, drawn on lips; I love using it to create a top lip in ladies of a certain age who have lost any hint of top lip or whose lip rolls under when they smile. I think that using a broad range of techniques to create a natural, harmonious, attractive lip shows a well-trained and responsible injector. When I see adverts touting ‘Russian Lip’ or ‘Kim K’ packages, I do despair because it shows an uneducated injector who is offering a ‘one-size fits all’ (but suits none) product. The client is not necessarily going to understand this because you are being offered this by someone how knows what they are doing right? This is why I always advocate doing some research. Talk to previous clients if you can. Ask them what they thought of the service. Did they get what they wanted? Does the injector have verified reviews? Can the injector talk you through what they can do if anything goes wrong? What guarantees can they offer you if you are unhappy with what you get? Do they have any pictures of previous clients they have treated?  

Lips especially are important to get right. As we all know at the moment, people will often watch your mouth when you talk – it helps so much with communication. If it is not done right or is overdone, people will notice! Lips have a huge blood and nerve supply so it is important to understand that if things go wrong, they can go very wrong. I have seen people left with significant and life changing scars from lip injections. Blocked blood vessels can cause skin necrosis (death), infection and in worse case scenarios, blindness. The less experienced you are in injecting and the anatomy involved, the more danger you put the patient in. I have seen people who have had lip fillers go wrong and their original injector has not arranged to see them – usually palming them off with ‘it is normal bruising and swelling’. Any time a client has concerns (unfounded or not), they should be seen (ideally face to face) to discuss the concerns, for examination and correction of whatever is happening. Whether this is with antibiotics, steroids, dissolving or just plain and simple reassurance, it needs to happen immediately. This is where dealing with someone who is medically trained and able to diagnose, manage and prescribe is so important. It is not about costs, this is your face; cheaper is most definitely NOT better.  

Make a note of the above things to ask when looking for any aesthetic treatments and bare in mind, if you are being promised the world for a cheap price, it is not likely to be safe or legit!