Apparence Medicine

Apparence Medicine

Botulinum Facial Treatments
Botulinum Toxin A – the more commonly known Botulinum products are Botox® and Dysport – both are registered medicines with New Zealand Ministry of Health and have been used in our clinics for over 16 years. Both are absolutely brilliant, if you have a preference for the American product or the British product please let us know as we can offer either. They are frequently used for diminishing facial expression lines, such as crow’s-feet and in particular the vertical line between the eyebrows that makes a person look worried. The treatment is best done subtley and our aim is to please rather than over-do, our clients are able to enter the public arena without looking “botoxed”. More recently small amounts (microbotox) are often used for a pan-facial treatment to achieve smoother skin all over. This doesn’t cost the earth but works very well with some stunning results following repeat treatments and is nearly risk free. More men are using this treatment, recovery is quick and the effects are youth enhancing without being noticable. (Bro-Tox!)
The positive feedback from clients having had this treatment is overwhelming and there has been very good coverage by the glossy magazines. The vertical frown line is caused by the repetitive creasing of the skin when the muscle running along the eyebrow contracts during the facial express of a squint or frown. This wrinkling in the glabellar area is associated with anger, anxiety and sadness, all negative emotions. This is certainly one muscle and emotional expression that anyone can do without. The objective of this treatment is to weaken or relax this tiny muscle and hence reduce the crease making you look serene and relaxed. A tiny injection of the medicine is placed in the belly of the muscle and within the following week and for the next 3-4 months, the ability to crease the skin at the frown line is diminished.

“We guarantee our Botulinum products- we use only the freshest product and would offer any client further treatment if they have not achieved the desired result within 2 weeks of their treatment.”

After four or more treatments the length of time between treatments increases as each session appears to be cumulative. It may be that this treatment allows you to lose or unlearn the urge to frown as after several treatments there appears to be some permanent effect.

Discomfort from the injections is really neglible and has now been lessened by the use of preserved saline in the administered mixture. The preservation contains Benzyl alcohol which prevents the sting.

This product has been used safely for years in New Zealand, by ophthalmologists for belpharospasm (a nervous eye tick) and by neurology specialists for neck muscle spasms. This new indication use was researched favourably in Canada and the USA and is now being used successfully for cosmetic enhancement worldwide. No allergy test is necessary so treatment can begin immediately. It is so simple. The use of Botulinum Toxin A for successful cosmetic treatmentscontinues to increase; over the past 15 years or more we have given well over 20,000 treatment sessions with Botox or Dysport. The areas treated and uses for Botulinum products continues to expand, our clinicians are now treating the lower face and even using larger doses to thin the jowls to slim down the lower law.
These are unregistered uses of this medicine and need further evaluation but for your interest please read on. The main area treated cosmetically has been the upper third of the face.

Warning: Botox® and Dysport are Prescription Medicines containing clostridium botulinum Type A toxin complex for injection. The registered use is for the treatment of severe frown lines and associated “crows feet” around the eyes. It should be administered only by trained medical professionals. Cautions: people with defective neuro-muscular transmission disorders, presence of infection at site of injection, glaucoma, pregnancy and lactation. Possible side effects include headaches, pain, burning or redness at injection site, local muscle weakness including drooping eye lids, lack of feeling & nausea. If you have side effects or concerns speak to us, or your own doctor. Note: Botox® or Dysport treatment lasts pharmacologically for about four months and after this time further courses of treatment may be necessary. Speak to us about your own situation and full explanation of risks need to be understood prior to treatment

Dermal Fillers & Collagen Injections
Fillers are an ideal treatment for frown lines, brow lines, crow’s-feet, smile lines at the side of the mouth and the small vertical lines on the upper lip (smoker’s lines). More recently creating a more beautiful oval face shape is achieved by dermal fillers. This is replacement of facial volume mostly fat which is lost with age, often called the “Gel Face Lift” or “the liquid face lift” – thicker longer-lasting injectable dermal implants are used around the cheek bone and mid cheek areas for enhancement. Notice how children have fat chubby faces which look youthful, however we will shape your face to look stunning rather than fat. Nose re-shaping, non-surgical rhinoplasty and asian rhinoplasty, are also achieved with dermal fillers with spectacular results often surpassing results that can be achieved with surgery.

So now, it is all about lifting the face out rather than up, adding volume to the loss that comes with aging as you want to get rid of a gaunt look.

Fillers are also been used in boosting lip areas where shape and definition have become less defined.

“Lip enhancement is an ideal treatment for women in the forties and fifties as it restores a shapelier contour to lip lines as well as preventing lipstick bleeding. Older lips can be left looking more youthful but not too big. Younger women achieve a more sensuous look with fillers such as the Paris Lip, currently very popular.” The end result is often so subtle that noone but you would notice the enhancement.

Treatment is effected under local anesthesia by a series of placements under the lines using a very fine needle. The procedure usually takes less than 30 minutes and recuperation time is minimal. Most clients will return to their usual activities on the day of treatment without notice from friends or family. The freshening effect of softening noticable facial lines gives an amazing face lift without surgery.
Collagen has been until recently the most widely used material as a dermal filler, it is a natural protein that supports the skin making it strong and resilient. All clients are given test doses prior to treatment to rule out the tiny risk of an allergy reaction to the collagen. If no reaction occurs treatment is begun one month later, the implanted collagen is gradually absorbed but the effects of the treatment last from 4-12 months. More recently the use of human based collagen (Cosmoderm or Cosmoplast) from tissues cultures offer less risk of allergy and no longer require allergy testing.

Acne scars and other scars can respond well to dermal fillers.
Newer, longer lasting fillers are now available now, mostly from Europe, some are biosynthetic and have practically no risk of allergy. Restylane, Esthelis, Prevelle are commonly used at Transform Clinic, these products are a Hyalan (Hyaluronan) gel which is a precursor of collagen but last much longer having undergone molecular crosslinking. These products are from non animal sources and molecules of Hyalan are non-species specific and really exactly as you have in your own body. The science is in the crosslinking of the molecular bonds to make them last longer without creating bumps in the skin. Some of these products will have a a longevity of more than a year. We started using these products around 10 year ago and still carry many different fillers. If you chose Transform, then we are one of the most experienced clinics in different fillers around, we are then ideally placed to chose the correct product for your needs.

Permanent Fillers. Other companies have used polyacrylamide (Aquamid) or micronised spheres of polymer for a permanent effect (Artefill). These products are not advised for first time users and require a full consultation with the doctor to explain possible long term risks.

Non surgical Rhinoplasty (nose shaping) is winning an increasing market share as doctors realize it can achieve detailed results not possible with conventional surgery. The long lasting filler Aquamid is ideal for this indication, due to both consistency and the duration of the result.

All fillers can be implanted carefully on a repeat basis for perfecting results and are often used in conjunction with Botulinum.
NEW OFFERING – Facial rejuvenation with Sculptra®. It won’t give you away.

An exciting development for our clinic and patients is the addition of Sculptra® to our treatment range.

Sculptra® stimulates your own collagen production, significantly restoring facial volume and improving the appearance of wrinkles, folds and sunken areas that occur with ageing1. Unlike most other facial rejuvenation products, Sculptra®targets one of the underlying causes of facial ageing, giving noticeable results that emerge gradually and can last up to 24 months2.

Sculptra® contains a compound called poly-L-lactic acid, or PLLA. PLLA is biocompatible and biodegradable1. It has been widely used as an effective, well-tolerated product for medical purposes, such as resorbable sutures, for more than 40 years1. Several published studies have assessed the safety, effectiveness and longevity of treatment with PLLA3.

Treatment involves a series of injections which stimulate new collagen fibre production at the site of injection. The average person typically requires two-to-three treatment sessions spaced four-to-six weeks apart.

Further information is available by calling Transform on 03 3432880.

REFERENCES:
Burgess CM. Treatment of facial asymmetry with Poly-L-lactic acid: a case study. Aesthetic Plast Surg 2008;32:552-54
Butterwick K, Lowe NJ. Injectable poly-L-lactic acid for cosmetic enhancement: Learning from the European experience. J Am Acad Dermatol August 2009 Vol 61;2:281-93.

Lacombe V. Sculptra: A Stimulatory Filler. Facial Plastic Surgery 2009 Vol 25;2:95-99
Sculptra® is a Prescription Medicine containing 30mg/ml Poly-L-lactic acid per vial used to increase the volume of depressed areas, particularly to correct skin depressions by injection deep under the skin. Sculptra should only be administered by trained medical professionals. Talk to your specialist about the benefits/risks of this procedure in appearance medicine. Cautions: Sculptra must not be used if you have an allergy to any of its ingredients, in areas with acute or chronic skin disease such as infection or inflammation. Sculptra should be used with caution in patients: under 18 years; on anticoagulants; who are pregnant or breastfeeding or who are susceptible to keloid formation and hypertrophic scarring. Exposure of treated areas to excessive sun, UV lamp should be avoided.Possible Side Effects: Injection site reactions.

Botox® is a Prescription Medicine containing 100 units of clostridium botulinum Type A toxin complex for injection. It is used for the treatment of severe frown lines and associated “crows feet” around the eyes. It should be administered only by trained medical professionals. Talk to us about the benefits/risks of this procedure in appearance medicine. Cautions: people with defective neuro-muscular transmission disorders, presence of infection at site of injection, glaucoma, pregnancy and lactation. Possible side effects include headaches, pain, burning or redness at injection site, local muscle weakness including drooping eyelids, lack of feeling & nausea. If you have side effects or concerns please talk to us or your doctor. Botox® treatment lasts pharmacologically for about four months and after this time further courses of treatment may be necessary. Speak to us about your own
situation.

Restylane® is natural cosmetic dermal filler that restores volume and fullness to the skin to smooth facial wrinkles and folds,enhance facial shape or to create fuller lips.Restylane®is available through prescription only from a medical professional and is delivered by injection into or below the skin.It is not to be injected into blood vesselsas this may lead to a lack of blood supply to the skin and ulceration and scarring.Restylane®contains hyaluronic acid, naturally found in the human body and is thought to help increase moisture in the skin.Treatment benefits are instant,do not affect facial expressionand results usually last 6-12 months.Ongoing treatments are needed to maintain best results.After a Restylane®treatment you may expect some degree of redness,swelling,pain or tenderness,itching and/or bruising which generally only lasts a few days.Inflammatory reactions may last upto 2 weeks in rare cases.Adverse effects from treatment are extremely rare and may include allergy, infection, granuloma formation,persistent discolouration at the injection site and/orulceration of the skin.Exposure to sunlight should be avoided during the initial post-treatment periodespecially if you have any redness or bruising in the treated areas.Restylane®should not be used in or near sites where there are active skin disease,inflammation or infection nor should Restylane®be placed into an area where a permanent implant has been placed.Restylane®is not to be used on people taking blood thinning medications or Roaccutane for acne.Restylane®has not been tested in pregnant or breastfeeding women and is not recommended at these times.Restylane®is an unfunded medicine.A charge for the medicine will be made in the itemised cost of the consultation.Contains:Hyaluronic Acid 20mg.ml,Phosphate buffered saline pH

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