Some of the most popular anti aging face treatments performed around the world are botulinum toxin type A and dermal filler treatments. Millions of procedures are carried out regularly to reduce the appearance of wrinkles. In this article we will discuss these two treatments.
What is Botulinum Toxin type A and what is it made from?
Botulinum toxin type A is a purified protein produced by the Clostridium botulinum bacterium. It is a non-surgical treatment that can temporarily reduce lines caused by over-expression of certain muscles (such as frown lines between the brows and crow’s feet). During the treatment, very small amounts of botulinum toxin type A are administered using a tiny needle inserted directly into the muscles that cause the expression lines. Depending upon the number of areas that need treating and the experience of the practitioner such as a dermatologist, treatments take about 10 to 20 minutes and are usually painless. No recovery time is needed, and you should begin to see an improvement within one to two weeks. The result usually lasts three to four months.
How does Botulinum Toxin type A work?
Crow’s feet and frown lines between your brows form over time as the result of muscle activity. The theory behind treatment is to reduce this muscle activity. Botulinum toxin type A is injected directly into the muscles between your brows, and it works by blocking the signals between nerves in the injected sites, thereby reducing the activity of the muscles (through temporary paralyisis) that cause those lines to form.
When will I see results from my Botulinum Toxin type A treatment?
You may see a marked improvement in frown lines between your brows. However, the lines continue to improve and your skin appears smoother. Results are dependent on each individual.
How long does treatment with Botulinum Toxin type A last?
The result is dependant on each individual from treatment with botulinum toxin type A. However, if you do not continue with regular botulinum toxin treatment, your lines (frown lines and crow’s feet) will eventually come back to the level they were at prior to your treatment.
Who should administer Botulinum Toxin type A?
Anyone who is insured and has had the appropriate training can administer botulinum toxin type A. It is advisable to seek a practitioner who has a lot of experience in this field, as there are many people offering this service with little experience. Many argue that doctors, dermatologists, dentists and nurses are the best people for this procedure, since they are used to giving injections when administering local anaesthetic, so their injection technique should be more refined.
Does treatment with Botulinum Toxin type A hurt?
You may experience some discomfort during the treatment, but as the needle is so small, this is usually minimal. Some practitioners numb the area with a local anaesthetic cream prior to injection. Once you have had the treatment, you can get on with your everyday tasks.
Who should not have Botulinum Toxin type A treatment?
Botulinum toxin type A should not be used where there is local infection at the proposed injection site, or in individuals with known reactions to any of the ingredients in the injection formulation. Patients with neuromuscular disorders such as myasthenia gravis or Lambert-Eaton syndrome may be at increased risk of serious side effects and should avoid Botulinum toxin type A treatments.
What side effects could I experience?
Localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising may be associated with the injection.
Will my facial expressions look natural after treatment?
Although the effects and results are visible after about a week, treatment with botulinum toxin type A will not dramatically change your facial appearance. The extent of muscle activity is dependent on the dose of botulinum toxin type A being administered. This will be discussed with you in your consultation, so that the desired look is achieved. Most people still want to have some degree of movement range for their facial expressions, others prefer a complete paralysis. Both looks are achievable.
How much does treatment with botulinum toxin type A cost?
Botulinum toxin type A is quite an affordable treatment when compared to the surgical alternative. However surgical intervention results last longer. The price will depend on the person carrying out the treatment, as more experienced practitioners tend to charge more.
Non-cosmetic uses for Botulinum Toxin type A
Botulinum toxin type A is a commonly prescribed drug for a host of non-cosmetic medical conditions. It can help those with MS and cerebral palsy, as well as people suffering from teeth grinding, incontinence and more.
Botulinum toxin type A can treat excessive sweating (hyperhidrosis) by paralysing the sweat glands. It can be used on the armpits, face, hands and feet, and in some cases will be covered by health insurance. In the underarm area, one botulinum toxin type A treatment can relieve excessive sweating for more than six months and in some cases for more than a year. It wears off after about three to four months in the feet and about six months in the hands. The downside is that injections in the hands and feet can be painful.
Botulinum toxin type A can also help those with bladder weakness. It’s injected into the bladder muscle, causing it to relax, increasing storage capacity and reducing incontinence. The procedure lasts between six and 12 months.
To treat chronic migraines (those that occur more than 14 days in a month), botulinum toxin type A is injected every 12 weeks around the head and neck.
What are dermal fillers?
Dermal fillers are an injectable substance made from natural and synthetic material and have been developed for injection into the skin to restore its youthful appearance. Over 30 million people across the world have been successfully treated. The main type of dermal fillers in the market, are a soft gel consisting of stabilized, non-animal hyaluronic acid. The gel is tissue-friendly and closely resembles the hyaluronic acid that exists naturally in the body. It is long-lasting but not permanent.
What is hyaluronic acid?
Hyaluronic acid is a naturally occurring substance found in the body that helps to hydrate and add volume to our skin. Natural hyaluronic acid is broken down by the body in one or two days so is constantly replaced. As we age this replacement mechanism diminishes so the moisturising and plumping effects of hyaluronic acid decrease. Hyaluronic acid is used for aesthetic treatments, and has also been used for injection into arthritic joints to aid movement as well as eye surgery.
What are the benefits of dermal fillers?
A treatment with dermal fillers provides an easy way to enhance your looks. With dermal fillers you will achieve a natural looking result that does not affect facial expression. Remember your face changes over time, and treatments with dermal fillers allow you to control you looks subtly as you age. Rather than just smoothing or tightening skin, an injectable filler aims to change the facial profile to a more youthful one. The injection of filler materials under the skin can fill in deep folds, such as nasolabial folds (also called “bracket lines”, running from the corner of the nose to the corner of the mouth), create fuller lips and pad out hollow cheeks and eyes. Collagen used to be the standard filler, but now hyaluronic acid with brand names like is more popular.
How long is an appointment?
The injection process takes a mere 15-30 minutes, you’ll also need to allow time to discuss what you are hoping to achieve with our practitioner before treatment.
What areas can be treated with dermal fillers?
Dermal fillers can be used to smooth away facial lines and wrinkles, create fuller lips, shape facial contours and revitalise the skin. The most common areas treated are:
- The nose to mouth lines (Nasolabial fold).
- Lines around the mouth (Perioral lines and Oral Commissures).
- Natural lip enhancement and definition of the border.
- Natural cheek augmentation.
- Also can be used for replacing soft tissue volume loss and scar corrections.
Does dermal fillers treatment need pain relief? Will the procedure hurt?
Generally, pain relief is not necessary when injecting into the skin to correct lines and wrinkles. Some people may experience the treatment as a mild discomfort. A local anaesthetic cream can be applied to the area for a more comfortable treatment experience.
The lips are a highly sensitive part of the body and, therefore, anaesthesia is usually recommended before lip enhancement. This is achieved most effectively by using a local anaesthetic.
Dermal fillers are also available with a local anaesthetic for a more comfortable experience.
Are there any risks or side effects with dermal filler treatments?
Millions of treatments have been performed with dermal fillers in the past. Product related reactions are rare. There are some injection related reactions which may occur after any injection; they typically resolve spontaneously a few days after injection to the skin, within a week after injection into the lips. These reactions include redness, swelling, pain, itching, bruising or tenderness at the injection site. All skin injection procedures carry a small risk of infection. After lip enhancement, lips may swell for up to a week, but this typically reduces after two to three days. In case of more pronounced reactions or if they last longer than a week contact your practitioner.
How long will the effects of dermal fillers treatment last?
One of the great advantages of dermal fillers is that the effects are long lasting but not permanent. The length of the treatment depends on a number of factors including
- The area you have had treated
- Quantity of dermal filler injected
- Quality of skin
However, the range of dermal fillers in the market, are proven to last up to one year in nose to mouth lines and six months in the lips. After the initial treatment, follow-up sessions are normally recommended around every six to twelve months depending on the individual and the treatment.
Is there anything I need to know before I have the treatment?
We advise you to avoid using aspirin or other non-steroidal anti-inflammatory drugs a couple of days before your treatment (unless they are taken for chronic medical conditions). Avoiding these medications will reduce the risk of bruising and bleeding at the point of injection.
Can everybody use dermal fillers?
Most people can benefit from dermal fillers treatment. If you wish to reduce lines and wrinkles, create more defined or fuller lips, define the contours of your face, or boost your skin’s vitality, for a healthier more hydrated skin tone.
Dermal fillers should not be used in or near areas where there is or has been skin disease, inflammation or skin related problems. Dermal fillers have not been tested in pregnant or breast-feeding women, Individuals with medical conditions that lower the body’s immune response or individuals undergoing therapy that is immunosuppressive may be more prone to infection by a skin injection procedure.
Are there different dermal fillers products?
There is a range of different dermal fillers designed to be used at different levels in the skin to meet your treatment needs and maximise your treatment results.
Do I need to take a skin test?
No skin test is required as hyaluronic acid dermal fillers do not contain any animal-derived ingredients.
When will I need another injection?
Many patients like to book touch-up injections as well as repeat injections to maintain the effects of treatment.
This post is by Dr Jas Sagoo who is the principle cosmetic dentist at Perfect Smile Spa.