Questions and Answers
Will I be looked after once I’ve had my treatment?
We treat our aesthetic clients just like we treat our surgical patients in our hospital practice.
Every client will be given details of how to contact us in case of emergency following treatment.
Routine follow up is roughly 2 weeks after treatment, and we offer this either in person or remotely, depending on your preference.
What is botulinum toxin?
“Botox” is the brandname of a product containing Botulinum Toxin A.
We use 3 different premium brands of toxin, Botox, Azzalure and Bocouture.
Botulinum toxin is an injectable prescription drug which acts on the junction between nerves meet muscles. The toxin acts to prevent the muscle from contracting and therefore weakens it. Over time, with repeated injections this effect becomes more pronounced. A toxin injection lasts for 3-6 months (6-12 months when used for excessive sweating in underarms, hand and feet).
Facial movements, including those that cause wrinkles, come from the balance of different muscles that pull against each other. We can selectively weaken certain muscles to reduce the appearance of wrinkles and balance the shape of the face.
What are fillers?
Modern fillers are made from a substance called hyaluronic acid. This is actually a sugar which occurs naturally in our bodies. The filler simply adds bulk to the site into which it is injected and is used either to restore facial contours lost through ageing, or to augment and enhance parts of the face, such as the lips, nose and jawline.
After injection, the sugar incorporates into the tissues and so results last for 6-18 months depending on the area.
What type of fillers will I receive?
We only use premium fillers in our clinic. These come from trusted manufacturers with stringent manufacturing standards, and proven clinical evidence of safety and efficacy.
Different treatments and parts of the face require fillers with specific physical and biological properties, we therefore use several products from two manufacturers to accommodate the needs of our clients.
JUVÉDERM® made by Allergan in Ireland and Teosyal® made by Teoxane Laboratories in Swizerland are world leading brands of hyaluronic acid facial fillers. These are currently the only two fillers we use in our clinic.
When should I not have filler treatment?
we would advise you to avoid any filler treatments if:
You have any history of connective tissue disorders (e.g. rheumatoid arthritis)
You have a bleeding disorder
You have active herpes simplex (a flair up of cold sores)
When should I not have toxin treatment?
we would advise you to avoid toxin treatment if:
You are pregnant, breast feeding
You have muscular activity disorder (such as myasthenia gravis or Eaton Lamnbert disease)
You have any infection or
You have any known hypersensitivity to botulinum toxin
What are the possible complications of treatment with fillers?
Short term complications:
Pain at the site of injection
Vascular compromise
Allergies which are rare but may lead to painful, itchy red patches on the skin
Palpability and visibility of the fillers
Triggering of herpes simplex infections (cold sores)
Lumpiness and asymmetry (wait 2 weeks for final result) and
Infection.
Long term complications:
Delayed onset nodules or hardness
Blue tinge to skin overlying fillers
Superficially placed filler
Delayed infection
What are the possible complications after treatment with toxin?
You might experience:
Dry eyes or double vision
An unpredictable change in the shape and position of the eyebrows which may droop or lift
Drooping of the eyelids (blepharoptosis)
An adjacent muscle may be weakened for several months after injection and muscles affected will not contract thereby reducing your facial expressions or your eyelid function.
Headache
Pain and/or bruising either temporarily or permanently
Can I become resistant to the effects of toxin?
The body can develop antibodies to botulinum toxin. If this occurs, then larger and larger doses would be required to have any effect, and eventually the toxin would have no effect.
Due to this risk we recommend using the Bocouture brand of toxin in our young patients who are likely to have many decades of toxin use ahead of them.
Bocouture is free from “complexing proteins” which are a part of the toxin not needed for its clinical effect, but which have a large roll in the development of immunity. The absence of these complexing proteins means that Bocouture carries a lower risk of developing immunity to toxin.
Can I wear make up after my treatment?
We would recommend avoiding using makeup on the treated area for 24 hours.
Can I drink alcohol before or after my treatment?
We would recommend avoiding drinking alcohol for 24 hours before and after your treatment.
What should I avoid after my treatment?
Do not touch the injection site for 24 hours where possible. Do not have any facial massage or electrical stimulation to the face for 2 weeks following treatment. Avoid heat treatments such as facial steaming, saunas or stream rooms for 2 weeks following treatment. Avoid prolonged exposure to direct sunlight/UV courses for 2 weeks following treatment.
How long does the consultation and treatment take?
We will book you in for a 30 minute time slot for your consultation and any treatment you opt for.
How often should I have toxin?
Toxin treatments are often repeated every 3 to 4 months to obtain long term effects.
How often should I have fillers?
Dermal fillers are often repeated every 6 to 12 months.
Can I have toxin if I suffer from acne?
If you are taking antibiotics for your acne (tetracycline) you will need to wait 2 weeks after finishing you course before you can have any treatments. This is required as botox and tetracycline antibiotics cannot be used together.
Can I have fillers and toxin if I suffer from cold sores?
If you suffer from cold sores we will prescribe a course of prophylactic antiviral medication for you to take before your treatment in order to reduce the risks of infection and complications.
Will I have bruising and swelling after my medical injection treatments?
Bruising, swelling and tenderness are a normal part of any injection treatment. Usually this is not significant and will clear within a few days.
It is, however possible to be “unlucky” and have bruising which takes days, or even weeks (in extreme cases) to fully resolve.
Why do you not offer “Tear Trough” filler treatment?
Like many others in the industry, we have stopped performing the “tear trough” procedure because we feel it has an unacceptably high rate of complication and dissatisfaction from our clients.
In recent years more has become known about the anatomy of the tear trough, and the ligament that tethers the skin directly to the underlying bone. This goes some way to explain why the results of this procedure can be a little unpredictable.
There is still a role for cheek fillers to be placed to “support” the tear trough ligament and smooth its contour.
How often can I have an injection for hay fever and seasonal allergies?
We recommend having your first hay fever injection about 3 weeks prior to the season starting. Many people have had their lives transformed by starting treatment early and continuing treatment regularly throughout the season. We do not recommend more than 3 injections per year, however, 1 to 2 injections is usually enough for most people.