Forever young; Botox and Fillers

 Throughout the ages people have used various methods to appear more attractive and reverse the signs of ageing: Cleopatra famously bathed in asses’ milk; Italian beauties of the middle ages dropped belladonna in their eyes to make the pupils larger; Queen Elisabeth the I used a mixture of   lead and vinegar as foundation while Geishas favoured a paste of nightingale’s faeces as face cream.

Bizarre as these methods sound, it would also  have seemed inconceivable 50 years ago that the magical formula to a  younger looking face would  be contained in  bacteria  botulinum toxin A, better known  under  its trade name Botox.

Botox is now the number one cosmetic treatment for women and men in the United States. According to the American Society of Plastic Surgeons, 4.7 million women and 314,000 men were injected with Botox. In 2008.

The next most common procedure was Dermal Fillers.

For those wanting to maintain their appearance, Botox and Fillers  have obvious advantages over plastic surgery: there is no anaesthetic and operation, you can get it done at your convenience ,the recovery period is minimal and it is not permanent. But to ensure that you get the look you really, really want its worth researching the subject before you commit your face to the needles.

Wrinkle types
Botox and Fillers are used in different ways to treat different types of wrinkles.

Dr Paul Greham, a cosmetic and reconstructive dental surgeon, specialising in facial aesthetics, explains how they work. “Botox works by blocking signals from the nerves to the muscles. This means the muscles can no longer contract and this causes the wrinkles to relax and soften.”

“Dermal Fillers on the other hand work on the lines or folds in the skin caused by gravity and sun damage (i.e., the lines Botox does not work on!)”

In the field of facial aesthetics they have terms for the different types of lines. Deborah Gjerness, registered nurse at Beyond Basics Medical Spa, elucidates further.“Dynamic lines are caused by frowning and grimacing where the muscles keep clamping down. Over time it’s like folding a piece of paper and then unfolding, you end up with creases. Botox works well with these types of wrinkles, frown lines crow’s feet and forehead creases.” She adds “Static lines on the other hand are usually down to loss of collagen , elastin  and hyaluronic acid and include the  nasolabial fold, smokers lines around the mouth and marionette lines from the corners of the mouth.”

Greham   usually tells his patients to remember that, “Botox works on lines that come and go (caused by muscle contractions and fillers wok on the lines that are always there (unaffected by muscles) such as deep creases in the skin.”

Botox getting it done

Greham says “The procedure takes only a few minutes and no anaesthesia is required.  Because Botox is injected with a fine needle into specific muscles there should be only minor discomfort.”

Gjerness agrees that it is not painful. “It should feel like a slight sting”.

Filling in the cracks
Fillers work on the parts Botox can’t reach. Fillers are injected into soft tissue and unlike Botox which arrived and conquered; Dermal Fillers have changed over the years in an effort to find the perfect one. Both Grehem and Gjerness favour Hyaluronic  acid fillers. “Hyaluronic  acid works by pulling water into the area which plumps the skin up”, says Gjerness. It occurs naturally in the body and when it is applied in a concentrated dose it results in a filling effect.”

Fillers are injected directly beneath the surface of the skin.

Both practitioners say that again, this procedure should not be painful and both use local anaesthetics.

Dermal Fillers results are immediately visible and typically last about six months.

Both Greham and Gjerness say that along with finding out a full medical history, it is essential to discuss the expectations of the client and what actually can be achieved.

A lot of people are scared off the idea of Botox and fillers by the frozen chipmunk looks of some Hollywood stars, but unless that is a look you particularly want, go easy on the Botox.   Gjerness advises. “The trick is to inject so that people will notice that there is a change but not know why.It should look natural and still have movement. I tend to be a light injector as you can always put more in but you cannot take it back out.”

Post Botox
* You should not lie down for 4 hours because gravity will move the Botox from the pinpoint area where it has been put

* Muscle contraction is recommended to ensure the Botox stays put

*   Avoid manipulation of the area

* Do not take Ibuprofen or Advil if you have a headache as they thin the blood and can cause bruising.

* The full effects can usually be seen after about seven days

*  The results may last for three to six months but the average is four months

Side Effects

* Temporary bruising is the most common side effect. Headaches, which resolve in 24-48 hours, can occur, but this is rare.

* A small percentage of patients may develop eyelid drooping. This usually resolves in three weeks

You can find out more from Paul Greham’s website at

Beyond Basics 1 Medical Day Spa# 7 Smith Road Plaza.