INJECTABLES AND SKIN CARE
(Botulinum Toxin) BOTOX®
FACIAL FILLERS (Juvederm ®, Restylane)
Volumising filler (Radiesse®)
Also known as BOTOX® or Botulinum Toxin Type A.
is an aesthetic injection which inhibits the nerves that cause the muscles to contract. This effect relaxes and softens the appearance of wrinkles caused by repetitive movements of the face. These lines include: crows’ feet around the eyes, forehead creases and frown lines. Botulinum toxin is also used to balance facial asymmetry and relax the bands that can be present on the neck. It can also be used medically to treat headaches and problems with excess sweating as well as muscular spasticity.
The Botox market is worth more than 100 million Brazilian Reals per year per country. This ranks Brazil internationally as second ranking place for use of this product.
Botox® applications are ideal for those individuals who do not want, or do not need aesthetic surgery to eliminate lines or wrinkles. However, the idea that facial expressions can decrease after Botox® applications can scare people who were looking into this treatment.I help people with this, and personalize the Botox to suit their needs. Botulinum toxin is applied to the facial muscles. This helps stop the muscular contraction. This can last around 3 months.
Muscles in the Face:
- Corrugators (frown lines)
- Orbicularis oculi (crow’s feet)
- Levator labi superioris (gingival smile).
- Depressor anguli oris
- Mentalis (Chin dimpling)
Eyebrows (lifting, arching)
- Masseter (can treat a square jaw-line)
The application is relatively fast and uses very fine needles, one usually used for Insulin. Half an hour before, some anesthetic is used in the points. Each point receives a drop of 0,1 ml. The patient may feel some mild discomfort but nothing too uncomfortable.
During the first 24 hours, do not massage the area treated with Botox, do not put cream on the area or do physical activity, during the first three hours it is not recommended to lie down.
Individuals with an egg allergy (due to albumin), pregnant women or people with any type of infection should not be subjected to Botox.
How do I prepare for a Botulinum toxin procedure?
Botulinum toxin injections are usually low risk, and do not require an intensive selection process like the one required by aesthetic surgery. A full medical history should be completed and any medication in use should be divulged. Hydration before and after the procedure is very important. The medical practitioner may ask you to stop smoking at least 6 weeks before the treatment.
Inform the plastic surgeon if:
you have had Botulinum Toxin injections in the past.
If you are using aspirin, anti-coagulants or ibuprofen.
If you are taking muscle relaxants, anti-histamines or sleeping pills.
Any medicines that can cause complications, haemorrhages or bruises. You may have to speak to your medical practitioner about stopping a medication for a few days.
After Care Instructions
After injections, you can return to your normal activities immediately. However, you should avoid physical activity the first day. Redness and swelling can occur at the moment of injection but this usually goes down quickly. Bruising can sometimes occur but these usually fade completely in one or two weeks maximum.
Some quick tips to improve results:
n order to get the best result do not massage or touch the injected area, this can cause the botulinum toxin to expand into another area unintentionally.
Lying down immediately can cause complications.
Call us if you need to take medication for pain or other medication straight after treatment.
How long will the results last for?
This depends on the age and skin condition. The effects of botulinum toxin can last approximately 3-6 months.
Keep under the care of your plastic surgeon.
A consultation after application can be scheduled to check the results or “touch-up” if necessary. If you are concerned about any aspect this appointment can be sooner rather than later. As the effect of botulinum toxin injections is not permanent, it’s good to develop a good relationship with your plastic surgeon and plan future injections.
The costs of botulinum toxin can vary a lot and depends on a number of factors including the number of injections and the location of what is being treated.
The plastic surgeon will talk to you about this during the consultation.
A great concern is that the results will look artificial. After 10 days the individual can look approximately 5 years younger. It is an option to use botulinum toxin to improve the effects of cosmetic surgery.
Individuals can repeat the injections every 4-6 months to keep their appearance wrinkle free.
But the use of BOTOX® has not only aesthetic purposes. Initially used in ophthalmology, BOTOX® is now used for corrections and treatment of various diseases. Among the new indications are using the product to headache and myofascial pain(A regional neuromuscular dysfunction with sensitive regions strained muscle bands that produce referred pain in distant or adjacent areas).
Hyperhidrosis– People who suffer from excessive production and elimination of sweat have found botulinum toxin a relief for your discomfort. In these individuals there is an exaggerated stimulation of the autonomic nervous system, the brain area responsible, among other functions, by sweating. This mainly affects the underarms, but may affect any area of the body where there are sweat glands. Thus, there may be too much sweat on the hands, feet, face or groin. Today, for those who want not face the scalpel, botulinum toxin is a good choice, enough simple local applications performed without the need for anesthesia, in the case of underarm so that sweating is attenuated for periods that can range from four to eight months, a factor that depends on the reaction of each person to the substance.
Nervous Tics -Also called facial spasms or from facial hemiespasmo ,BOTOX® can be treated and have excellent results. The nervous tic is an involuntary stimulation of a particular muscle group. Applying it on the botulinum toxin are interrupted contractions and the symptoms disappear. The duration of effect depends on several factors such as muscle strength, quantity and the applied areas. In many cases, when the treatment is carried out for a long period, the problem may become almost imperceptible.
different uses –Surgeons say the valuable toxin is traditionally used in the treatment of strabismus, eye disorders and eyelids,Problems in the vocal cords and tremors. They also reveal the recent positive results in the treatment of facial paralysis, ocular prosthesis deviation and hypertrophy masseteric(Formed when the muscles that help in chewing increase in volume, creating huge bumps in the area of the cheeks).
And the benefits do not stop there. Botox is being studied to combat migraine, pain, improvement of scars, burns and even as slimming feature. A recent study was conducted to observe its use in the treatment of chronic neck and back pain.
Facial fillers with hyaluronic acid are indicated for facial volume and to even out lines. They are gels of high viscosity that can cause a lifting effect when injected properly.
New trends in rejuvenation point not just to evening out of wrinkles, but also to replacing facial volume. Over time the effect of gravity on our facial features can cause the face to develop depressions and to lose definition. This can be seen, for example, in the nasal labial folds and the region under the eyes.
Hyaluronic acid can improve hydration of the skin and so make wrinkles more superficial and less visible. With practice, hyaluronic acid injections can assist in creating “facial sculpture”.
WHAT IS HYALURONIC ACID?
Hyaluronic acid is a substance produced naturally by the body mainly in the skin. It functions to retain water, and to hydrate and volumise the skin. With the passage of time, the aging process results in volume loss and the appearance of wrinkles, giving an older and more tired appearance.
WHAT PLACES ARE MOST COMMON TO APPLIED FILLERS?
Most parts of the face can receive filler injections.
The most common areas are the cheekbone region, lines between the eyebrows and around the eyes. It can also be used to augment lips.
Is anesthesia necessary?
In most cases no. The procedure is relatively quick: it can often be done in ten minutes. Sometimes a topical (local) anesthetic is applied. Lidocaine is usually present in the filler syringe and this reduces discomfort.
HOW LONG DOES THE RESULT LAST?
The effect can last between six and eight months. There exist thicker consistencies for deeper lines where the effect can last up to a year.
WHAT ARE THE ADVERSE EFFECTS?
In the case of permanent fillers (PMMA and methacrylate) there exists the risk of the body rejecting the product.
With hyaluronic acid, however, there is practically no risk. There can be redness around the site of the injection, swelling and bruising.
Is it common for Botox® to be used with fillers?
Botulinum toxin can make the effect of the hyaluronic acid last longer, and can improve lines and wrinkles in some areas.
When a filler is used does the face change?
When a filler is used by a professional with the right technique and with a product that is safe, the results are subtle and harmonious. It does not disfigure or drastically change the face. Products of high quality permit more natural results.
The most common hyaluronic acid brand names are: Juvéderm®, Surgiderm®, Restylane®.
We now know that the facial skeleton profoundly changes with age. Certain areas of the facial skeleton are susceptible to reabsorption and the loss of the soft tissue can lead to the skin sagging as time passes. Therefore, patients with signs of facial aging would benefit from this volumising filler for a smoother and more youthful result.
The facial skeleton is the foundation of our appearance. This is evident in individuals with prominent facial features as a strong supraorbital rim (the part of the bone under the forehead), prominent cheekbones and a strong jaw line. Due to the good skeletal support for the soft tissues of the face, these individuals have a more pleasing appearance as they grow older. Nevertheless, patients with little projection of the facial skeleton and/or who have had loss of this due to the aging process can benefit from a facial filler with materials that reach the bone.
WHAT IS CALCIUM HYDROXYLAPATITE?
t is a synthetic compound in the form of microspheres suspended in aqueous gel. It is safe and well tolerated by the body, it does not require a hypersensitivity test, it does not migrate, it is inert and stable at the implantation site.
Calcium Hydroxylapatite is absorbable by the body and its main components are phosphate and calcium, which are important mediators in cell stimulation of protein formation having the same characteristics of human bones. It is an option for patients and after two or three years this product is absorbed.
The treatment with calcium hydroxylapatite is performed under local anesthesia. Its main feature, compared to other products, is not definitive duration of the results, which is around two and a half years. Hydroxylapatite, although re-absorbable, should only be applied by a professional with experience in liquid implants. The treatment may be performed on the same day of the consultation. The treatment is performed under local anesthesia. There are no cuts and no scars. The procedure is performed with special microcanulas which cause little trauma and are disposable. This removes the risk of vascular and nerve damage. Daily activities can usually be continued as normal.