Wrinkle Management, Botox Perth, Skin Rejuvenation, Skin Resurfacing, Blepharoplasty Perth, WA

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Wrinkle Management

With inevitable aging and accumulated skin damage there is a gradual development of facial wrinkles and photoaging or sun damage. This can be in the form of fine surface lines or deeper creases and folds which all lead to a less than desirable appearance. Natural substances such as collagen, elastin and hyaluronic acid provide the skin with structure and volume and these substances decrease with age. Factors which accelerate skin damage include excessive exposure to the sun, overactive facial expressions muscles, cigarette smoking, alcohol, stress, poor nutrition, and skin disorders.

Persistent facial wrinkles, especially those involved in negative emotional expressions, may mistakenly portray to others the look of worry, anger, anxiety, disgust or sadness, despite one's own positive internal feelings.

There are two types of wrinkles: dynamic and static.

The dynamic wrinkles are due to contractions of specific facial expression muscles giving rise to forehead lines, frown lines, crow feet, lip lines and bunny lines. The treatment for these types of wrinkles is injectable muscle relaxants (Botox or Dysport).

When lines and folds occur at rest they are static wrinkles such as nasolabial folds, tear troughs, mouth frown, marionette lines, vertical lip lines and neck banding. The treatment options are injectable fillers, skin resurfacing and surgical lifting (eg. Facelift). With loss of collagen, elastin etc there is atrophy or thinning of structures such as the lips. The dermal fillers can also used to increase volume and definition of the lips (lip enhancement).

Wrinkles can now be safely and successfully treated to produce a more youthful, rejuvenated appearance. Treatments for facial wrinkles are usually performed by Dr Pham and his staff in the procedure room within our offices which is convenient and private for you. Upon consultation Dr Pham will outline which method will be best for you depending on your needs, medical conditions, location, severity and tolerance of potential side effects. For optimum results repeated treatments or a combination of treatments may be required.

These treatments can provide additional and complimentary aesthetic benefits when combined with other facial rejuvenation procedures such as facelift, browlift, blepharoplasty or skin resurfacing.



Methods used to Manage Wrinkles are

1. Wrinkle relaxers - Botox, Dysport
2. Wrinkle fillers - Restylane, Juvéderm, Esthélis, Aquamid
3. Skin resurfacing - laser, chemical peel
4. Surgery - facelift

Botulinum toxin (Botox, Dysport) is a sterile, purified protein produced from the bacteria, Clostridium Botulinum, in the laboratory. Botox is injected in small amounts into facial muscles binding to the nerve endings supplying the muscle and preventing nerve impulses from traveling to the muscles. When injected into muscles, it weakens or paralyses the muscles around the area injected for a period of several months. The resultant weakening or paralysing effect on the facial muscles temporarily reduces or eliminates previous skin creasing. New skin creasing is also avoided. Botox may take several days to take effect, and these effects typically last 3-4 months, in most individuals, before full muscle movement returns. Repeated treatments may increase the duration of effect and over time you may require fewer injections.

Are Botox Treatment Safe?

Botox has been extensively used for over 10 years for the treatment of cosmetic wrinkles and other medical conditions. It is now the most widely used cosmetic treatment. Botox injection is a simple and safe procedure. Using a tiny micro-needle, a very small amount of Botox is injected, very precisely, into specific locations on the face. There may be some discomfort with each injection and slight temporary bruising may occur. Usually no local anaesthetic or sedation is required but cold ice packs can help in some patients. It only takes a few minutes to perform and you can resume normal activities immediately and drive back to work or home.

What To Expect After Each Treatment

Minor local irritation, redness, bruising, or swelling at the injection sites are the most commonly observed side effects, all of which typically abate within a few hours. They are easily covered with make up. On very rare occasions Botox can migrate and cause a temporary weakness of nearby muscles, droopy eyelids or asymmetry of facial expressions. These are all temporary and last for a few weeks and in some cases may be improved by medication.

How can I find out if I am a candidate for Botox?

If you would like to learn more about your cosmetic options, or find out if Botox treatment is for you, please call our office and schedule an appointment with Dr Pham or our Nurse Coordinator.

Postoperative Botox Injection Instructions

1. Do not take any Aspirin or any anti-inflammatory medications for seven days before
BOTOX injections, as these may contribute to a greater risk of bleeding problems.

2. The effect of BOTOX may be exaggerated by aminoglycoside antibiotics or other drugs known to interfere with neuromuscular transmission.

3. Remain upright for 4 hours after injections.

4. Do not touch injection area for 4 hours.

5. Use the injected muscle as often as you can for the first hour after injection.

6. Take no naps in a reclining position the remainder of that day.

Fillers

Wrinkles and certain folds and depressions can be treated with fillers. They can be

1. Autologous fat and fascia (from your own body). This has a high absorption rate and may leave unevenness. Only 30-50% is retained long term. Newer techniques of microfat injections allow for higher retaining rates.

2. Synthetic

      a. Collagen (a test dose is necessary). Lasts for 3-4 months.

      b. Hyaluronic Acid

           i. Restylane or Hylaform. Lasts for 6 months

           ii. Juvéderm or Esthélis. Lasts 6-9 months.

     c. Aquamid. May last up to 3 years or more.

     d. Expanded polytetrafluoroethylene (ePTFE) - Gortex

Hyaluronic Acid is a natural complex sugar found in skin and body tissues that have a role in tissue hydration, skin structure and elasticity. The synthetic form such as Restylane, Hylaform, Juvéderm, and Esthélis are manufactured into an injectable gel that is easily used and does not require a pre test for allergy. This is the most commonly used filler at Perth Facial Plastic & Cosmetic Surgery and other cosmetic practices.

Injectable Collagen is an animal protein filler material formulated for safe use in nearly all areas of the face, including the lips and crow's feet. Fine wrinkles are filled in by the material to reduce their visibility. Other prominent facial creases and folds around the forehead, cheeks and chin can be treated as well with this material. Initially a Collagen Allergy Test must be performed. Repeated treatments every 2-4 months are typically needed to sustain the desired results. The treatments are easily performed in the office and usually have minimal side effects.

Alloderm, a human collagen matrix, is an implant used for the reconstruction of soft tissue defects. It may be threaded beneath the deep creases of the brow or cheek folds or placed within the upper and lower lips, to flatten and reduce wrinkle visibility. Typically, this material maintains the majority of its volume correction, similar to injectable Collagen.

Expanded polytetrafluoroethylene (ePTFE) is a non-reabsorbable synthetic polymer material, which can be used as an implant (Gore-Tex® and SoftForm®) in the forehead, cheek folds, and lips to produce volume enhancement and effacement of deep facial creases. This material is not incorporated into surrounding tissues, but it does not lose volume either. It provides more long lasting change and may be placed during an office procedure using local anesthetic and small incisions. The recovery period is relatively short.

Fat grafting / fat injections create a natural augmentation for the face, especially for the lips and mouth regions. Fat is usually harvested from the abdomen and about one third of the volume remains after the treatment. Fat grafting can be repeated for additional fullness.

What To Expect After Each Treatment

In comparison to typical cosmetic surgical procedures, the office time for these procedures and the subsequent recovery period until one returns to normal function are minimal. Botulinum toxin therapy typically takes a few minutes to perform, and most patients may return immediately to home or work. Minor local irritation, redness, bruising, or swelling at the injection sites are the most commonly observed side effects, all of which typically abate within a few hours. Likewise, wrinkle filler injections can be accomplished within a 5-15 minute consultation and this has similar attendant side effects. Some mild irritation at the injection sites is unavoidable but can easily be camouflaged with standard make-up, if necessary.

Filler implant insertions typically take up to an hour to perform in the office, depending upon the number and extent of treatment locations. Several sutures are used to close the insertion sites. More swelling redness and discomfort may accompany these procedures, which require the use of a local anesthetic. Local applications of cold compresses may feel comforting. Most early swelling subsides within a day or two, though minor swelling and irritation may last for several weeks during the implant healing phase. Your activity level and medication for pain after the procedure are dependent upon your doctor's recommendations.