Frequently Asked Questions
BOTULINUM TOXIN INJECTIONS
What is Botox?
Botox is the drug formulation of Botulinum Toxin Type A, which comes from Clostridium species.
How does it work?
Botox interrupts the signal transmission between the nerve and the muscle, resulting in the inability of the muscle to contract to the same level as before. New junctions between nerve and muscle forms within about three months, which is why the effect only lasts for that time.
How much Botox is injected?
The amount of Botox ® units differs amongst patients as some patients require more Botox because of:
- Larger muscle mass such as with men.
- Facial expression differences, some people have a dead pan face whilst others have very expressive faces.
- Recruitment of other facial muscles outside the norm after Botulinum Toxin has been given.
- Badly sun damaged skin changes the amount of Botulinum Toxin units needed.
What kind of wrinkles do Botulinum toxin treat?
Dynamic wrinkles occur when muscles contract during expression. Static lines or wrinkles are those facial lines that are evident even when our face is at rest and are due to volume loss and are better treated with Dermal Fillers. These two types of wrinkles are what separates Botulinum Toxin from any of the Injectable Fillers.
Botulinum Toxin is for dynamic wrinkling. It is a muscle relaxing agent so it will soften the wrinkles and lines that occur from a dynamic facial movement, such as between the brows with frowning or crow’ s feet from smiling or around the mouth from excessive pursing of the lips. With ageing, this repetitive motion strains the skin to produce deep folds and tiny wrinkles. Botulinum Toxin will also help prevent a mouth frown by relaxing the muscles that exert a downward pull to the mouth.
How long does it last?
Botox lasts around 3 months. After this period, one needs to inject again.
How long before I see results?
Botox starts to work within 4-7 days, but the optimal result is only visible after two weeks. We therefore insist that our patients book a follow-up appointment after two weeks to assess the aesthetic result.
What to expect afterwards?
Bruising and swelling may occur at the site of the injected area. The injected site may also be sensitive and red for a few hours. In the case of Therapeutic Injections, one can have sensitivity from the trigger point release for a day or so.
What are the aftercare instructions?
Since we do not want the toxin to move from the injected site, any activities that cause pressure is not advised for 4 hours after injection. This includes massaging the area, having a facial, exercise or other exertion, wearing a helmet or being in excessive heat. Alcohol is also not indicated for 12 hours afterward, because it can cause tissue to swell, again resulting in pressure on the injected areas. Lying down should also be avoided for 4 hours after injection.
Is Botox dangerous?
The most dangerous side effect is what is called the “Spread of Toxin Effect” that Botulinum Toxin effects may, in some cases, be observed beyond the site of local injection. The symptoms are consistent with the mechanism of action of Botulinum Toxin and may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These are, however all reversible and there is minimal risk of it occurring if proper injection technique and adequate after care is taken.
Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, serum sickness, urticaria, soft tissue edema, and dyspnea. The possibility of these effects occurring is one of the MANY reasons only doctors are allowed to inject Botox. In safe practice, adrenaline and other emergency medications are always on hand to treat any adverse reactions.
What is important to know, is that currently, Botox is the most studied drug in the world. No other drug has been subjected to as many tests, and the dosage injected is very low. Considering that taking a mere 5 Paracetamol pills may lead to liver toxicity, Botox can be used with great safety.
How does Botox work for therapeutic muscular interventions?
Botox can be used therapeutically for all painful muscular conditions, especially where hyperfunction of the muscle is present, such as in clenching and with tension headaches. With Therapeutic Botox, the affected muscle is injected in order to stop the hyperfunction, but the muscle will still maintain its normal function. In the case of trigger points, the actual area is injected with Botox to prevent the trigger point from forming again. When used for these conditions, Botox has no cosmetic effect and it never changes the appearance.
What kind of Dermal Filler injections are used and how does it work?
Hyaluronic Acid fillers are used. These are injectable fillers that are used to combat effects of ageing on the skin and face.
Hyaluronic acid is an essential component of the extracellular matrix of all animal tissues and is therefore completely organic. It attracts water, and this helps it form large concentrations that can occupy a large volume relative to its mass. When water is drawn into the matrix, it leads to swelling, thereby ‘filling’ out areas.
What are the indications for Dermal Fillers?
- Loss of volume in the face is one of the hallmarks of ageing, and fillers can be used to correct this (the so-called “liquid facelift”).
- Deep static wrinkles, such as around the lips.
- Deep facial folds and lines, such as “marionette lines” around the mouth of the Naso-Labial fold
- It can also be used to define the lip areas.
- It can be used to volumize lips and other areas.
How long does it last?
Fillers generally last around 9 months.
What if I do not like the result?
Since it is an organic matrix product that is used, it can also be dissolved by certain drugs. If you are dissatisfied with the result, there is no reason to suffer with it for 9 months.
What should I expect afterwards?
Since it is injected, some redness and bruising may occur at the site of injection. Slight sensitivity in the area is also possible.
What is Microneedling?
It is also called Collagen Induction Therapy (CIT). Needles painlessly puncture the skin, which stimulate fibroblasts to lay down collagen. These microinjuries also allow temporary fine channels to be created in the skin that can carry up to 80% more topical nutrients to fibroblasts. These channels close within an hour. The results are seen 1-8 weeks later. Lasting and more significant results can be seen with 4-6 treatments spaced 4-6 weeks apart.
What does it work for?
- Aged, sagging skin
- Fine lines
- Smokers lines
- Skin tightening
- Large pores
- Stretch marks
- Acne scars
- Surgical scars
What should I expect afterwards?
The skin can feel warm and appear red for 24 hours afterwards. The sensation is similar to sunburn.
The skin may feel rough and can even start to flake for up to 2-3 days. Swelling and bruising may also be present. In some cases, there may be minimally visible marks, but these disappear in a few days.
A breakout can occur, especially if there were active lesions present during the procedure.
What to expect of the treatment?
Topical anesthetic cream is applied to the entire face and allowed to work for about 15 -20 minutes. A Hyaluronic Acid serum is then applied to the face and a Dermapen in used to do the Microneedling procedure. The needle speed and depth are altered according to the area of the face. After the treatment, a mask is applied to the face for optimum results. The area can then be cleaned and cooled. Hilotherapy is highly recommended to ease the discomfort following the procedure.
What is phototherapy?
LED phototherapy is the non-invasive use of continuous light (rather than light pulses). Different wavelengths are used to treat various skin conditions from ageing skin to acne.
The light stimulates the photoacceptor cytochrome c oxidase, which results in increased energy metabolism and production, with increased wound healing. It therefore stimulates mitochondrial oxidative metabolism and accelerates cell and tissue repair.
What is it used for?
RED: To promote cell regeneration and stimulate collagen production (anti-ageing).
GREEN: To sooth, speed up healing and even out the skins complexion.
BLUE: Acne and skin inflammation treatment, as it starts the bactericidal function of human cells
YELLOW: To decompose pigment, increase lymphatic drainage and treat skin redness.
PURPLE: Dual blue and red-light treatment, combines these actions.
WHITE and laser: Penetrates the skin, accelerates active tissue metabolism, decomposes color spots, improve fine lines, scars and pores.
CYAN: Calms and soothes irritated skin. Reduces the size of swollen capillaries.
How long before I see results?
Typically, you will start to see improvement after about 4 sessions. The results are cumulative, so once the desired result has been achieved, you will only need a couple of sessions per annum to maintain it.
As the entire treatment is a non-invasive one, the patient can return to normal function immediately.
CHEMICAL PEELS AND SKIN RESURFACING
What to expect during the treatment
If the patient is wearing makeup, the makeup is ﬁrst removed. A cleanser is then used to thoroughly clean the skin and removed with gauze. Often an added treatment is applied to ensure that no residual dirt or oil is present on the skin.
The resurfacing agent is then applied to the skin in layers. Often a tingling or slightly itchy sensation is experienced, but it must never be painful.
What to expect afterwards
The skin may be sensitive (similar to sunburn), slightly swollen and red following the treatment. This resolves within a few hours. The peel can take up to a week to start working optimally, and then the skin may start to feel “ﬂaky” and peel, revealing the new skin.
How long before I see results?
The peel can take up to a week to take eﬀect, but after about two weeks one can start seeing visible results.
How often should it be repeated?
Usually 4-6 monthly treatments are adequate to obtain the desired result, and then maintenance treatments can be done as often as needed.
What aftercare should be taken
The most important step in aftercare is sun protection. Directly after the treatment, no makeup should be applied for the rest of the day. A complete sunblock should be religiously applied for at least a week. Often, a home-care regimen is prescribe that will optimize the results.
What is Hilotherapy?
Hilotherapy is the application of cold compression at a regulated temperature through a face mask. The thermal effect is generated by the medium of distilled water. It is adjusted to the desired temperature, from +10 to +35 °C, accurate to the nearest degree, in special dedicated therapy devices constantly maintained at this level.
This helps to ensure the medically required temperature is consistently and precisely provided. It can be applied for many hours or even days on end without any deviations. Sensors constantly monitor the relevant figures and ensure consistency.
Within a closed-loop system, the cooled water flows through anatomically formed cuffs, available for various parts of the body in the form of disposable or reusable devices.
What is the science behind it?
Surgical interventions or injuries massively disrupt the supply of oxygen and nutrients to the tissue. The accelerated metabolic rate causes overheating due to inflammation of the affected tissue, alongside circulatory disturbances. Under these circumstances, the need for oxygen surges dramatically. The increased oxygen requirement means that the existing amount of oxygen that actually reaches the affected tissue is insufficient for regeneration. The oxygen requirement for the damaged tissue must be reduced.
These findings sparked the development of Hilotherapy. The ideal therapeutic temperature varies depending on indication, so the system can be adjusted to the nearest degree over a spectrum from +10 to +35°C, on the affected portion of the body. Lowering the temperature of the affected tissue by 10°C reduces the metabolism by 50%, this also reduces the oxygen requirement. The oxygen quantity now suffices for regeneration.
What are the Indications for Hilotherapy?
Hilotherapy is intended for traumatic, perioperative (pre, intra and post-operative) indications as follows:
- Oral and maxillofacial surgery
- Plastic/aesthetic surgery
- General post-operative wound healing
Areas of Therapy:
- Pain relief
- Inflammatory rheumatism
How is it administered?
A removable, anatomical mask is placed on the affected area. Cooling water kept at a certain temperature is circulated through this mask. The water is also then circulated through a unit that keeps the temperature constant, leading to a close system.
What is plasma pen treatment?
This hand held device emits a small electrical arc from the tip of the pen without actually touching the skin. This plasma arc vaporises the skin giving an immediate tightening effect to the surrounding skin. These small points form scabs that drop off over the following week post treatment revealing a smoother and tighter skin. It is suitable for lines and wrinkles, loose skin, scars, skin tags, warts, moles and pigmentation. Skin tags will be treated instantly, whilst warts and pigmentation spots form crusts that will fall off within a few days.
What to expect from the treatment
The treatment itself is really straight forward. To ensure it is as comfortable for you as possible, a local anaesthetic cream is applied 30 – 40 mins before commencing the procedure. You can expect a small degree of swelling when treating the eye area, which will go down within 3 or 4 days. Tiny, circular scabs form at each treatment point that take about 3 days to start falling away, but will take about a week to completely clear.
What to expect after the treatment
The controlled damage is superﬁcial. However, a certain amount of discomfort will be experienced and some down time will be advisable for the more lengthy intensive procedures. Immediate following the treatment you may experience:
- Heat (the use of cooling packs recommended)
Swelling (especially the eye area, some seeping may occur)
Redness (the skin is red and slightly swollen)
Crustations – mild crustations will be present on the skin where treated. This will disappear in about 3 to 4 days.
How long does the effect last?
The results from this treatment are permanent, so usually a single treatment is enough to achieve the results you want
How many treatments are needed?
SIngle treatments are usually enough, but if you do want a stronger result then we can repeat the procedure after 3 months. Because of its permanency you will only need to repeat it if required further down the line as we genetically age.
MESOTHERAPY FOR SLIMMING AND SKIN REJUVENATION
What is Mesotherapy?
Mesotherapy is a medical specialty that involves injecting microscopic quantities of natural extracts, homeopathic agents, pharmaceuticals and vitamins into the skin. It can be used to eliminate cellulite, promote weight loss, treat aging skin and redundant (sagging) skin, and rejuvenate the hands and neck.
What are the beneﬁts of Mesotherapy over surgical techniques such as liposuction?
Liposuction does not treat cellulite. In fact, liposuction often causes existing cellulite to appear more prominent. Mesotherapy treats cellulite directly, promoting smoother skin and reducing fat in selected areas. Fat deposits are ﬂushed from the body, and do not reappear in other areas, which often occurs after liposuction. Mesotherapy does not require hospitalization, general anesthesia or downtime.
How does Mesotherapy reduce or eliminate cellulite and fat?
Mesotherapy treats three factors involved in cellulite formation. Your doctor creates a speciﬁc formula to reduce the fat in your cellulite, improve impaired circulation and break down damaged connective tissue – thereby smoothing the skin’s surface. Mesotherapy can treat cellulite located anywhere on the body.
What are Mesotherapy's anti-aging and skin rejuvenation uses?
Subdermal vitamin injections rejuvenate the cells, making them more active, and thereby stimulating the production of collagen and elastin. You can begin anti-aging treatments in your mid twenties to prevent wrinkles from forming. Treatments for the face, neck, arms and hands are recommended several times each year.
When Will I see Results?
Results vary depending on your body type and the condition being treated. On average, patients notice visible improvement in two to three sessions. For certain conditions, patients see results after the ﬁrst session.
Will the results last?
The results do last, especially when combined with exercise and proper nutrition. However, we cannot stop the natural aging that affects your appearance. For this reason, we recommend regular maintenance visits.
Are the treatments painful?
You may feel a slight pinching or burning sensation when the injections are administered.
Are there any side effects?
A common side effect of Mesotherapy is bruising, which generally resolves over one week.
What are the advantages of having a thread lift instead of a facelift?
For many patients, the biggest advantage of having a thread lift rather than a facelift is the greatly reduced recovery time associated with thread lifts. It is done in the doctor’s rooms and not in theatre, under local anesthesia, not general. Thread lifts are low risk, thanks to how noninvasive they are. There is virtually no risk of scarring, severe bruising, bleeding or other complications after having a thread lift. In rare cases, patients may experience irritation, infection or their sutures becoming visible under their skin. If this occurs, however, the sutures can simply be removed and the patient’s face will return to its prior state. While thread lift recovery is not particularly intensive, patients will still have to take a few minor precautions while healing. It’s important to make sure that you don’t rub your face vigorously while cleansing it or applying moisturizer for at least a week after having threads placed. You should also try to prop your head up slightly so that you don’t roll over directly onto your face while sleeping.
How do threads build a scaffold for collagen deposition
This is a new lifting method of injecting multi-strand threads in order to boost cell attachment and rejuvenate aged & damaged skin. Multi-strand threads used in ThreadLift are made of material-synthetic absorbable sterile surgical suture composed of Polydioxanone, which performs a role as a scaffold / stimulus for new collagen cells to attach to and create a vector of collagen that will lift sagging tissue which will last for 2 to 3 years.
Is it painful
Most patients indicate that they only feel the needle slightly when it enters the skin, after which the procedure is virtually painless.
Common side effects
Bruising can occur in the area of the thread placement, and a slight inﬂammatory action may be present. Normal anti-inﬂammatory medications should relieve all discomfort.
What to do after thread placement
We discourage patient’s to wear makeup for 24 hours following the threading procedure, to avoid sun and heat for the day, Massaging the area is also not ideal for the ﬁrst four hours.
How soon do I see results
Threading produces immediate results, but due to the collagen deposition that occurs, it continues to improve over the next few months
How long does it last?
Depending on the type of thread used, it can last around 18 months.