Seeking out the right practitioner for you

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! 

Time off but back finally

So it has been a while since I last blogged. There are many reasons for this; busy life with small children, renovating our home, covid crisis, several family members dying and I am also just a bit lazy when it comes to getting down to actually writing things. It is a long-held trait of mine. I found school books from my primary school years with only one or two pages actually written on! No idea how I got away with that or, in fact, how I got to where I am now! Still, here I am so I will see if I can change a habit of a lifetime and actually knuckle down and do some writing. 

Currently, I am in the fun part of covid infection – the ‘so over it but still too tired to be normal’ part. Basically, I continue to have a heavy cold, tight chest and headache. And I need to be in bed by 7pm or all hope is lost for tomorrow! Covid has been such a big part of my life for the past 2 years and I have been both surprised and pleased not to have personally encountered it that when it actually arrived, I felt quite taken aback.  

The first day I knew I had covid was my 40th birthday happy birthday to me – best gift ever! I was totally in denial as I felt so perfectly well, I only did the test as my son had been sick and I was trying to convince him to join me in testing. In fact, I actually bragged about how I felt so well so the course of 2 vaccines and then my booster must be keeping me well in the face of this illness which has taken the lives of so many during the past few years. That outpouring of thoughts came back to bite me that night as I lay in bed, shivering with fevers, feeling sick with a numbing headache and sore, dry throat and snot pouring out of me from any orifice available. 

Day 2 and I couldn’t breathe through my nose or be up off the sofa for more than 15 minutes without feeling like I was going to collapse. Day 3 bought more lethargy following another feverish night with breathing troubles due to snot volume. It was spent supine on the sofa in front of the fire with a lot of lemsip, tea and water. Around 3 boxes of tissues later and I realised that I now cannot smell or taste anything. I can just about make out salt or spice but I think that is more of a sensation than actual taste. Good-oh. That night I slept a little better and the snot flow had definitely settled. 

Day 4 and I felt a lot better generally but found out quickly that my energy levels remain low. I tried to do a few loads of washing and the sides soon fell off that plan and I found myself again sitting on the sofa with the fire on. So here I am on day 5 and whilst I feel massively improved from 3 days ago, I still feel tired and sore nosed. I look forward to seeing if I start to test negative from tomorrow to allow me to get back to work. I hope that the vaccines and booster I have had will ensure this happens as I am certainly getting bored of sitting on the sofa! 

So, do I think that getting vaccinated was worth it? Well hell yes I do! I have seen how awful this fun new illness can be and how deadly it has been. I am a type 1 diabetic and so imagine how much more sick I could have been; imagine how much sooner I could have been ill and how much longer it could have taken to recover. Imagine how many less people I could have helped in the time it may have taken for me to recover. I see (face to face!!) roughly 20 people per day and call a similar number in my GP work and I work 2 days a week. That is a lot of people who would have not been helped. I know that the vaccine is not for everyone but I would use this opportunity to urge anyone who has not had it to consider taking it up.  

Vaccines are important in improving public health and allow us all to live in relative freedom. For example, how many times have I seen Measles face to face in my life? Twice. Just twice. And both times, the patient was VERY ill and also either unvaccinated or partially vaccinated. 50 years ago, Measles was fierce. It was common place in the list of childhood illnesses but it was pot luck as to whether you actually made it through unscathed or at all. Now it is rare (although it is making a resurgence curtesy of unfounded research papers published in the late 80s and early 90s which have now been largely disproved. 

Anyway, I’ll jump off my soap box for now and catch up soon with more aesthetics-related blog posts. 

What is Botox anyway?

So you have decided on having facial injections to help deal with those lines that have been bothering you for a while now (how long has it been anyway?). Ok great but what to have? And what is Botox anyway? This is your face, your look, your body. You need to know what it is you are asking for and what it is you can expect.

Honestly, I’ve probably heard it all with regards to Botox – ‘rat poison’, ‘I won’t be able to move my face anymore will I?’, ‘will I look different’, ‘will I still look like me?’, ‘will I still be able to smile?’, ‘will it cause me a medical problem if I use too much?’. Let me clear a few things up for you.

Botox is actually a trade name for the neurotoxin botulinum toxin type A but as most people know it best by the former, we shall use Botox in this discussion.

Botox is, as I have said, a neurotoxin derived from the bacterium Clostridium Botulinum which is a naturally occurring organism found in the environment. In this state, it is relatively harmless but as botulinum toxin, it is a powerful toxin which blocks the transmission of signals from nerves to muscles. In fact just 2kg of botulinum toxin is enough to wipe out the entire human race! Scary right?

Well yes, so Botox is a paralyzing agent and yes, it is deadly in large quantities but in the doses used in cosmetic application (which are TINY) it is just enough to relax the muscles in the face which pull the skin and cause those pesky lines and wrinkles! The body is able to eventually fight off and process the Botox which is when you know you need to come back for more – the lines return as power returns to the muscles.

Cosmetic use is just one of a host of uses for Botox in fact. Other uses (in much greater doses than those used for lines and wrinkles) include relaxation of spastic limbs in patients with brain injury, migraine  and some bladder and bowel problems.

With regards to how much you will be able to move your face after injections and whether you will still look like you and be able to pull facial expressions; yes. The amount of Botox and its placement is key in this. I aim for just enough Botox to relax the muscles and allow the lines to settle but not enough to stop your face from moving.

As for Rat poison……No.  That is probably Warfarin you are thinking of. And that has good medical roots too!

So now you know and hopefully you can make a more informed decision.


The natural botox look

Ok, so botox is not necessarily natural. And obviously everyone expects those who have had botox to be unable to move their face or make expressions. The frozen look is generally regarded as what you get with botox right? Wrong! The frozen look is generally something that is asked for specifically by the client and personally it is not something that I am keen to do. Of course it can be a result of the inconsiderate practitioner and that is one reason to research the practitioner you are looking to use and especially to look at their ‘before and after’ portfolio.

In my opinion, if you are spending this much money to improve how you feel about yourself and freshen up your looks, you really shouldn’t be left with a flashing, neon sign advertising that you have done so. My ethos is simple, spend the money on someone who will take the time to look at what you want and make you look like you have been on a wonderful holiday and are fabulously rested. Static lines (those which are there all the time whether moving your face or not) will never be removed completely by botox. Over time they will improve as the skin is allowed to relax – think of a crumpled shirt, if you leave it to hang then the creases will settle – but they won’t necessarily disappear completely. But then would you really want them to? Is it natural to have no wrinkles at all in your 60s and above? Would it not be noticeable if all of your wrinkles completely disappear overnight?

Botox is especially good for the dynamic lines (those which appear when you move your face but then disappear) and therefore very good for preventing the formation of dynamic lines. In my own opinion (and other people’s do vary!), you should still have movement in your face after botox injections. You should still be able to frown, raise your brows and smile. This is all part of the ‘natural botox’ look I endeavour to achieve. Of course, at the end of the day if you are paying the money you should get the final say. As I keep saying, your consultation is an open dialogue and you should tell your practitioner honestly what you want.

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Brow lift saves eyes

I have noted over my time working with botox that people can sometimes have a problem with a brow droop. In fairness, this can often be predicted due to eyebrow setting, lid heaviness and previous surgeries or related eye problems but it cannot always be expected. This side effect is something to be discussed at the consultation stage.

If this does occur when having your Botox done, it is very important to talk to your practitioner and let them know, and as always it is very important to attend the two week top up! There is an option to help treat this little set back.

Although it may be disappointing after spending money to have your face ‘freshend up’, let me shine a positive light on this problem: we now know two things -1) smaller doses are needed to achieve the desired effect, 2) you need your injections slightly higher up. Knowledge is power so never think of it as a negative!

At the two week top up, if you feel your lids are dropping, discuss this with your practitioner. Small doses (maybe one or two units) of botox can be injected to the under side of your eyebrow along the obicularis oculi which will relax the muscle which is pulling the eyebrow down (remember the muscle which opposes this action and elevates the eyebrows has already been weakened with botox to relieve the frown wrinkles). These injections can be targeted to provide a lift in the brow wherever it is needed to raise the brow.

Equally, it is possible to help with heavy lids – where the skin of the eyelid sits on the eyelashes – with small doses of botox under the eyebrow. The eyebrow can be lifted by up to 2mm which makes a big difference. Definitive treatment is surgical and is probably the most cost-effective option in the long run but botox is also an option.