Botox and fillers - all you need to know

If you typically think of cosmetic surgery and plastic surgery interchangeably you are not alone. However, there are distinctions. Cosmetic surgery is also known as aesthetic surgery and focuses on enhancing appearance.

The American Board of Cosmetic Surgery defines cosmetic surgery as “entirely focused on enhancing a patient’s appearance. Improving symmetry, proportion and aesthetic appeal are the primary goals”.

Two of the most common cosmetic surgery procedures are Botox and Fillers.

We spoke to two experts in the field to find out more…

What is Botox and how does it work?
Botox is a drug made from a neurotoxin produced by the bacterium Clostridium botulinum called botulinum toxin. Purified to use in the human body safely it is used medically to treat certain muscular conditions and cosmetically to reduce lines and wrinkles by temporarily relaxing the muscles. Dr Jaffer Khan says that this anti-ageing injection can be used to “treat deep wrinkles which can appear on your forehead, crow’s feet and other signs of ageing. It can also prevent lines from forming in the future”.

Dr Sanjay Parashar adds that it can also “reduce episodes of migraine and tension headaches and reduce excessive perspiration in the underarms”.

What does the treatment involve?
The Botox is injected into the skin focusing on the target area, which will be discussed with your doctor. By preventing the muscles from contracting your skin will look smoother and tighter says Dr Khan.

“The procedure takes about 10 minutes and the results are visible in 5 to 7 days” says Dr Parashar. While there is no downtime, you should be aware that you may see some slight bruising and swelling directly afterwards. This is due to the needle and can be easily covered by make-up.

Who would this treatment suit?
Botox can be used on a wide range of patients, primarily for skin rejuvenation and the reduction of fine lines and wrinkles. “It is ideally suited for males and females from 25 to 40 years of age with very strong and dynamic lines. In people older than 40 years it may have to be used in combination with other rejuvenating methods to improve the facial lines and sagging” says Dr Parashar.

Who should avoid this treatment?
Botox is not advisable for those who are pregnant and breastfeeding. Or for those who have medical conditions, such as damaged nerves or muscle complaints. Dr Khan adds that “any patients with motor neuron disease should avoid this treatment”.

What results does the treatment aim to provide?
Botox is used to soften the lines caused by facial expressions and can be adjusted to ensure a natural looking result. The results are variable between individuals but generally last from three to six months.

It is also useful to prevent deep lines in future so works well as preventative method says Dr Parashar. “If used in a strategic method it helps to reduce facial lines, lift a drooping mouth and neck and rejuvenate the face” he adds.

What are Fillers and how do they work?
As we age, our cells lose their ability to produce natural collagen and elastin. The skin becomes dryer, thinner and less able to fix itself. When we are born, we have lots of Hyaluronic Acid (HA) in our body, but as we get older our stores of HA diminish, leaving the skin less well supported, and so lines and wrinkles develop. By lifting and smoothing targeted folds and wrinkles by adding subtle volume, fillers can be used to give a fresher look. “Hyaluronic Acid are the most widely used fillers today. They ultimately work by plumping up the target area, increasing the volume and definition and create a lifting effect” says Dr Khan.

Fillers are available in different consistencies for a variety of aesthetic purposes says Dr Parashar. “Very thin fillers are hydrating and are used as ‘skin boosters’ to replenish collagen. They can be used in face, neck, décolletage and hands in people with dry and wrinkly skin.”

He added that thicker filler gels are used to fill up deeper lines and are effectively used to volumise the face in people who have lost weight and volume in face resulting into sagging and gaunt look.

What does the treatment involve?
The procedure takes around 30 to 45 minutes and you can see the effects up to 18 months after treatment. It is carried out under topical anaesthesia and you may see some mild swelling and bruising for 3 to 4 days depending upon the extent and areas treated says Dr Parashar.

Who would this treatment suit?
Facial fillers can be used on a wide range of people, and are primarily used for skin rejuvenation and to reduce lines and wrinkles. It can also help those looking to add structure and volume to the face.

Dr Parashar says that fillers are useful in “young people to preserve skin hydration and collagen and to enhance cheeks, jaw line and lips. In middle aged people, it works well to reduce signs of ageing and boost skin hydration. Whereas in elderly patient it helps to volumise the face and work as nonsurgical face lift to some extent”.

Who should avoid this treatment?
There is no known risk to those who are pregnant or breastfeeding, but it is advised against having treatment.
“Generally, fillers are very safe. In thin-skinned individuals and who also have a lot of laxity, benefits of fillers may be limited and sometimes there is a risk of lumpiness in the skin” adds Dr Khan.

What results does the treatment aim to provide?
The results should be subtle, leaving friends and family believing that you are simply looking refreshed. “Once the chosen filler is injected into your skin, it will work on the creases and folds, adding volume to the area. It will help the skin to appear firmer and tighter, ensuring you are left with a fresh and rejuvenated look” says Dr Khan.

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