Face is the focus of human communication and the perception of attractiveness which does not escape the passage of time. Creases or lines on the face can be caused due to aging, gravity, actinic damage (photoaging), positional pressure (during sleep), smoking, harsh weather and from repeated muscle contractions as occurs with facial expressions (dynamic lines or rhytides). These dynamic facial lines gradually change to static lines ingrained on the face even at rest which are regarded as a sign of aging and can have a negative impact on the self esteem of an individual. There has been revolutionary approach for facial rejuvenation over decades using modalities like skin care, skin resurfacing, soft tissue augmentation and surgical intervention. Botulinum Toxin or Botox is the wonder drug of the last decade combating cutaneous signs of aging (wrinkles, frown lines, neck bands) and hyperhidrosis through cosmetic denervation. Botox is a neurotoxin that temporarily paralyses striated muscles by blocking the release of acetylcholine at neuromuscular junction.
Am I a candidate for Botox?
Yes if you want prevention and amelioration of dynamic wrinkles (wrinkles in motion) such as: crow's feet (lateral ocular canthi rhytides), vertical (glabellar frown) or wrinkles on nose (Bunny nose), upper lip rhytides, angle of the mouth, pebbly chin, nasolabial fold, jaw line, venus rings (horizontal neck rhytides), turkey neck (vertical platysmal bands).
Is Botox safe?
Yes it is generally a safe procedure. Contraindications include neuromuscular disorders eg. myaesthenia gravis. It is of paramount importance to avoid botulinum toxin injections in patients with neuromuscular disorder. Many such disorders are inherited and hence it is mandatory to rule out a family history of the same. Since the teratogenicity of BTX has not yet been established, it is contraindicated during pregnancy as well as breast feeding.
Duration of effect?
It takes three to five days for the effect of botox to begin. The results last anywhere from from 9 to 12 months, when it has to be repeated.
Fillers are the best tool to defy ageing signs of the skin. Fillers can effectively:
• Restore fullness to cheeks, areas under the eyes, and deep creases.
• Diminish scars.
• Erase fine lines.
• Plump lips.
• Lifting of brow.
• Rejuvenated hands.
Am I a candidate for fillers?
The use of dermal fillers depends on the nature of the product, for example some fillers are suited for superficial wrinkles and folds whereas still others are best used for deeper wrinkles or scars. By and large some of the common indications are - depressed scars (post surgical, traumatic, resulting from acne or other diseases), wrinkles and creases caused by facial expression and aging, lip sculpting, dermal atrophy from disease or injection of steroids, angular cheilitis, periocular melanoses and sunken eyes.
Are Fillers safe?
Usually fillers are safe provided done with proper precautions. Contraindications to using fillers include: positive skin testing, patients with autoimmune diseases, active local disease like acne, keloidal tendency and unrealistic expectations.
Is fillers application painful?
It can be made absolutely painless by use of surface anaesthetic agents.
Post procedure precautions?
• Area should not be touched for 6 hours after treatment.
• Make-up should be avoided for 12 hours.
• Patient should avoid extremes of heat, cold or UV radiation.
• Sauna bath should be avoided for 1 week.
• Chemical peels, laser treatment etc. should be spaced out for at least 2 weeks to avoid inflammation of injection site.
How much time does the effect of fillers last?
Repeat injections are spaced after 9-12 months or longer depending upon the longevity of the material, site of injection and the technique used.