7 posts tagged “dermal fillers”

The number of clients having medical cosmetic treatments is increasing each year. Much of this is due to more affordable procedures as well as increased awareness and knowledge. Not only is demand for the more well known treatments such as Botox and dermal fillers increasing, but there is considerable demand in the number of clients requesting treatments to rejuvenate the hands and the décolleté.

These areas are often neglected and whilst most women are now very aware of the risks of sun damage to their faces, they often neglect their hands, neck and chest. Many of our clients complain that their faces look great, but their age is given away by their hands, neck and chests.

Dr Lucy Glancey recalls one of her patients proudly showing her new 4 carat diamond ring, a present for her 60th birthday and she commented that life wasn’t fair! “How so?” I asked, “Well just as you are able to afford a huge diamond ring your hands look so aged that you are embarrassed to show them off.”

“These types of comments have prompted cosmetic Doctors to look at rejuvenation procedures available and develop new techniques” says Dr Glancey. “First and foremost we ensure that our patients protect these areas from the sun by using a good sun protection of at least an SPF of 30. Most of us are so careful about putting sun block on our faces, but how many remember the neck and décolleté? While driving in the car on a sunny day our hands are exposed to the sun light and if unprotected can become pigmented. While in our twenties and early thirties we get a nice even chocolate tan which looks attractive, later on in life our sun damaged melanocytres tend to produce patchy pigment which results in ‘sun spots’. The natural ageing process also causes our hands to lose fat and again this can give a very aged look. The décolleté can be easily damaged by spraying perfume on the neck and chest area and then exposing it to the sunlight. This causes a photosensitive response and increases the ageing process. As we sleep the décolleté can become ‘squashed’ and particularly in larger breasted ladies. This produces the lines and wrinkles running up from the breast as well as creepy looking skin. The hands, neck and décolleté are areas of the body that ladies like to be able to show off and therefore they are looking for effective anti ageing treatments.”

There are various procedures for hand rejuvenation and one of the more drastic ways is to remove the veins on the back of the hands. Because of the loss of fat the veins become more prominent so rather than this drastic approach it is better to replace this lost volume. “Another reason why we do not like to remove the veins” says Dr Glancey “is because the veins can be life savers and should you collapse on the street you may need the intravenous access”.

One way of replacing the volume in the hands is by redistributing the patients’ own fat. Autologous fat transfer can be performed with a device called Lipivage. A small amount of fat is harvested from areas such as the inner thighs, tummy or knees. The fat is then ‘washed’ and then immediately injected back into the treatment area. The patients are required to wear bandages for a few days after the procedure and there may be some bruising. However, once this has all settled the hands look beautifully plump and rejuvenated.

A disadvantage of this technique as with any procedure involving the patients own fat is that the body may metabolise it quickly and therefore we cannot predict how long the effects will last. An alternative to using fat is to replace the volume using synthetic soft tissue filler. A technique known as Mesotherapy which involves multiple injections used to plump up the hands and décolleté with a product that re-hydrates and replaces hyaluronic acid. A new product called Restylane Vital® can be used in both the hands and the décolleté area over three sessions. Dr Glancey comments “we are getting really nice results which can last from 6 months to a year.”

Restylane Vital® a crystal clear gel which is injected into the dermis to moisturise the patients own skin from within. The active ingredient, hyaluronic acid, is found naturally in the body, but its production decreases with time. Restylane Vital® stimulates skin cell activity to increase the production of collagen and elastin, so hands and the décolleté looks plump and youthful.

Another procedure that can be very effective on these areas is Intense Pulsed Light. This treatment modality not only rejuvenates the skin, but eliminates any pigment such as age spots and broken capillaries. “A typical condition that patients complain about on their neck and décolleté” says Dr Glancey “is telangiectasia and poiklioderma. This condition is characterised by matted broken capillaries either side of the neck and across the chest. Intense Pulsed Light will target the dilated capillaries as well as any sun spots. Another great advantage of using IPL is that is stimulates collagen production and when combined with Mesotherapy the results are fantastic.”

If you require further information about Mesotherapy or have any other questions please visit www.cosmeticclinics.co.uk or www.glanceymedical.co.uk

Continuing from our previous article we will discuss the colour changes that can be responsible for dark circles and ways to combat them.

Pigmentation
Some people with dark skins ( Fitzpatrick types 4 to 6 ) inherit a genetic tendency for darker pigmentation around the eyes. This of course becomes obvious from a very early age even in childhood.

Treatment
The famous ‘touch éclat’ is the make up of choice for many women as it creates a light reflection which counteracts the dark shadow along with camouflage make-up.

Some lasers can be very effective in particular the Ruby laser. Laser skin pigmentation treatment is particularly effective on Asian and Middle Eastern patients with dark brown circles due to excess pigment.

Skin bleaching agents such as Hydroquinone, retinoic acid, azelaic acid, alfa–hydroxy acids, kojic acid and trichloroacetic acid can be used to lighten the skin. Some of these preparations can be very strong and may provoke skin reactions. They should be used under doctor’s supervision only and can only be obtained on prescription. Decades ago the accepted treatment for bleaching skin lesions included products containing mercury salts. Their use is now prohibited because of their high toxicity. Hydrogen peroxide can also bleach melanin by oxidizing it, but because it can cause skin irritations it is mainly used for bleaching hair.

Vascular
The skin of the lower eyelid is the thinnest in the face so it is not surprising that it can show the underlying blood vessels which could sometimes appear as a blue/ purple tinge. This is especially obvious in pale skinned individuals (Fitzpatrick skin types 1 and 2) but other skin types can also be affected. Another factor that determines the appearance is the density and the extent to which the blood vessels are dilated. The more closely packed and the more dilated the blood vessels are the redder the skin looks. The amount of oxygen in the blood is also important. High levels of oxygen in the blood makes the skin bright red while a low level of oxygen gives the skin a bluish colouration.

Treatment
Cosmetic laser surgery. Lasers are used to help improve this condition and the pulsed dye lasers are especially effective. Bruising may result therefore the patient may have one to two weeks down time. If the vessels are very large they can be surgically removed.

In conclusion dark circles having once been considered untreatable can now be dramatically improved by advancements in aesthetic techniques. The good news is that in most patients this can be achieved without surgery.

by Lucy Glancey

If you have any further enquiries about dark circles or it's treatments including dermal fillers, cosmetic laser surgery, botox or any other treatments visit www.cosmeticclinics.co.uk.

Continuing from our previous article we will discuss the texture changes that can be responsible for dark circles and ways to combat them.

Eye Bags
Eye-bags are due to herniation (protrusion ) of fat in the lower eyelid which in some cases can be hereditary and can be visible from a very early age. Usually it is a result of the normal aging process when the skin looses its elasticity and allows the fat to protrude and become more visible. There are two types of eye bags, true eye bags which are due to genuine fat protrusion and pseudo eye bags which are caused by severe eye hollowing creating an impression of a “bulge”. Quite often there are both types present in the same individual to varying degrees.

Treatment
This will be dependent on the type of eye bag. True eye bags require surgery (lower blepharoplasty) while pseudo bags will require a dermal filler as described above. When there is a combination of both types, surgery will be required, followed by dermal fillers once the healing process is completed.

Wrinkles
Fine wrinkles under the eyes create a different texture and when excessive can give the appearance of dark circles. This condition is age related and the process is greatly accelerated when there is a degree of sun damage. The lower eyelid skin is very thin and therefore this is an area where wrinkles to appear first. In some individuals this can be exaggerated by the lack of natural bony structure therefore people with higher cheek bones have less wrinkles under the eyes.

Treatment
Wrinkles can be difficult to cover with make up as it tends to settle in the wrinkles making them more obvious. Prevention of sun damage is important especially in the delicate skin around the eyes, so the use of sun block is even more important than eye creams. There are certain eye creams that contain sufficient amounts of active ingredients (e.g. Retinoids) and are effective in preventing, and even reversing sun damage and consequently wrinkles. The most potent creams are available only on doctor’s prescription. Wearing good sunglasses in the sun can also be a good preventative measure.

In a younger patient (35 -40 yrs) a low dose of Botulinum Toxin type A (Botox or Dysport) can be effective, however this can result in discreet widening of the eye which may change the eye shape. It is important that the Botox procedure is performed by a well trained practitioner as an incorrect placement of this product in the lower eye lid can result in severe consequences leading to ulceration of the eye.

Chemical peels and laser resurfacing can work but are associated with higher risks of delayed healing, hyper and hypo pigmentation. The downtime for these procedures can be lengthy and can be a traumatic experience for the patient. Intense pulse light (IPL) can be used in the form of photorejuvenation ( photofacial) but requires several sessions and the results can often be modest.

Over the next few weeks we will outline the differing reasons or causes for dark cirles under the eyes and what treatments are avialble to combat them, so keep an eye out for Part 4!

by Lucy Glancey

For more information on dark circles and treatments including dermal fillers, Botox and chemical peels visit www.cosmeticclinics.co.uk or www.glanceymedical.co.uk

Continuing from our previous article we will discuss the texture changes that can be responsible for dark circles and ways to combat them.

Hollow Eyes
Hollowing under the eyes creates the so called exposed ‘tear trophs’ or ‘tear ducts’ which is a groove running from the inside corner of the eye to the lower part of the eyelid and quite often into the cheek.

This is usually related to the normal ageing process. We loose approximately 5 ml of fat from our face every year and this fat loss is what is to blame for the appearance of deep folds and sagging in the skin as well as hollowing of the cheeks and eyes.

The human face can be likened to a balloon which is well inflated when we are young and our faces are full of “puppy fat” and gradually deflates with age as we loose fat. This process can be greatly accelerated by a rapid weight loss following yo-yo dieting. The skin is often unable to adapt to the rapid change of volume and sags as opposed to recoiling back into the new shape and can lead to premature ageing and increased wrinkles. In younger individuals and also in males, where the skin is thicker and more elastic yo-yo dieting is less risky. However women over 30 yrs should be careful and plan any weight loss over a longer period of time in order to avoid this problem.

Hollow eyes can also be hereditary in which case they are apparent from a very early age (usually 20 -25 yrs). We ask patients to bring photographs of themselves when they were younger and also pictures of their parents. This is useful to determine hereditary factors.

One important cause of premature eye hollowing is following surgery to the lower eye lid (lower blepharoplasty). When the problem is lower eyelid bags many patients resort to surgery which can be effective way of removing the bags. ‘Eye-bags’ are due to protruding fat and therefore removing some fat usually brings an immediate good result. However in the long term this lack of fat together with the natural ageing process can speed up the appearance of hollowing around the eye. There are many techniques for operating on the lower eyelid and some of the older methods involved removing too much fat. Modern techniques used in today’s surgery are more sparing towards the eyelid fat and involve repositioning of the fat rather than removal.

Treatment
The best treatment for correcting hollow eyes is by using a non-permanent dermal filler. My choice when it comes to dermal fillers is stabilised hyaluronic acid. The advantage of using this type product is that the effects can be fully reversed even earlier than the natural absorption of the product, which can be reassuring to the patient.

The dermal filler is placed deep over the bone in order to fill in the groove. The procedure is almost painless and rarely requires an anaesthetic. The success rate is very high ( 80 -90%) and the results can last for over a year. It can however be a dangerous procedure in un-experienced practitioner as it can quickly turn the hollow eyes into baggy eyes if the product is placed incorrectly i.e. too superficial. For this reason always seek out an experianced cosmetician and go ensure you are completely happy with everything discussed with you. If you have any questions, you should always ask them.

Over the next few weeks we will outline the differing reasons or causes for dark cirles under the eyes and wat treatments are avialble to combat them, so keep an eye out for Part 3!

by Lucy Glancey

For more information on dark circles, treatments and dermal fillers, visit www.cosmeticclinics.co.uk or www.glanceymedical.co.uk

Dark circles under the eyes together with cellulite are probably the most commonly talked about aesthetic imperfection. This is partly due to the fact that there is very little one can do to completely eliminate either of them. For both conditions a variety of over the counter creams are sold that promise the world but deliver less than modest results, as many of us who have tried them can confirm. However in the treatment of dark circles new advances in cosmetic medicine, such as laser surgery and dermal fillers, the condition can be improved up to 80 – 90 % (depending on the reason for the dark circles) which is good news for those who have been long suffering.

What are dark circles?
This is the appearance of different colour, texture or a mixture of both on the lower eyelid area. It is far more difficult to treat the so called complex circles where there is a combination of colour difference and textural changes. In our clinic we use grading system for patients with dark circles. There are 4 grades;

Grade 1 – these are very mild and only visible without any make up. They disappear totally when make up or concealer is applied.

Grade 2 – these are visible even with make-up but of moderate severity. A good way to demonstrate grades 1 and 2 better and especially for the purposes of medical photographs is to ask the patient to put their chin down and look up to the ceiling without moving their head. This is important when we take before and after pictures in order to clearly demonstrate the results of the treatment

Grade 3 – these are severe and give the impression of baggy eyes (the so called false or pseudo – eye bags)

Grade 4 – these are the complex dark circles where there is a combination of not only texture but a colour change as well. They require more treatment sessions compared to the other grades.

Over the next few weeks we will outline the differing reasons or causes for dark cirles under the eyes and wat treatments are avialble to combat them.

by Lucy Glancey

For more information on dark circles, treatmetns and dermal fillers, visit www.cosmeticclinic.co.uk or www.glanceymedical.co.uk

There are a lot of dermal fillers on the market at the moment and we have decided we would compare some of the market leaders; or rather the differences in what they are composed of, rather than specifically choose products themselves (as many are fairly similar).

So what are the 2 differing types we are going to compare? Hyaluronic Acid and Polylactic Acid, the former being used in products such as Restylane and Juvederm the latter in Sculptra.

Hyaluronic Acid Gel is the main component in many dermal fillers and, just like Polylactic Acid, offers excellent results. It is an injectable gel that offers immediate results to the treated area. The gel lifts folds and wrinkles and is perfect for nasolabial (nose to mouth) folds, frown lines, fine lines and wrinkles, tear troughs, hands and the neck and cleavage areas. Hyaluronic acid dermal fillers are perfect for lips and lip lines as well.

As stated the results show immediately, and it offers a very natural looking results. It has very little if any side-effects associated with it but does have some minor after-effects such as minor redness, swelling and possible bruising. It normally requires one or two treatments to get the desired results, and they will normally last around 4 – 12 months depending which brand of filler is used. Fillers such as Restylane and Juvederm are proceeding in around to £200 to £1000 mark.

Sculptra uses the suspension of polylactic acid to achieve its results, this involves the acid being released in the desired are over time and in turn this causes the stimulation of new collagen. This means the effects are not immediate but instead they improve over several weeks. However as it stimulates new collagen formation in the skin it means it looks completely natural.

Like hyaluronic acid, polylactic acid suspension is perfect for all facial areas, hands, neck and cleavage areas, but it is not suited to lips or lip lines. However Dr Tanqueray of Mulberry House believes that Sculptra offers a more comprehensive approach as it allows him to look at the face as a whole and restore volume in a more general and balanced way, so it may not be as good for lips, but is arguably the better option otherwise.

Again there are little to no side-effect associated with this treatment and the side effects really only include possible bruising as a common factor. It normally requires 2-4 treatments for the best results and costs start at £400 and go up to around the £2000 mark. However this treatment tends to last 18 months to around 2 years, making it a much longer term solution.

Both of these dermal fillers can actually be used together to give outstanding results were needed and both are available from Mulberry House Clinic.

At Mulberry House Clinic, we have been offering the OBAGI Nu-Derm system for over 2 years now and we are extremely impressed with the results, along with our clients who are seeing the benefits for themselves. OBAGI Nu-Derm was first developed 20 years ago by Dr Zein Obagi, a dermatologist who practices in Beverley Hills.

We started off feeling a little reserved about recommending it too strongly but we now have a lot of experience with it in all skin types and take the view that it would almost be negligent of us not to make sure that you are aware of the benefits!

You should consider OBAGI if you would like:

- smoother, firmer skin
- healthier skin function
- brighter, fresher appearance
- significant reduction in pigmentation of virtually all types
- even skin colour
- improved fine lines and wrinkles
- improvement in acne or acne scarring
- reduced oiliness
- long term skin protection
- potential reduction in skin cancer risk
- improvement in skin quality and colour in the neck and décolleté regions .

These are big claims, but ones we are happy to make on the basis of the results we have seen (to hear what our client’s have to say click here). For even greater improvement in skin tightness, scarring or deep pigmentation there is the option of an OBAGI blue peel, but quite often the results with the skincare alone mean a peel is not necessary.

Improvement is usually noticeable within 2 weeks, with best results taking up to a few months.

Research has shown that Nu-Derm also improves the results of other cosmetic treatments - the degree of improvement and satisfaction with Botox, dermal fillers, laser treatments and Thermage were all greater in people who had been using OBAGI Nu-Derm.

If you are serious about improving and looking after your skin in the long term OBAGI will deliver.

Whether you are already using it or are new to the range Mulberry House Clinic is offering a £20 discount on purchase of a full pack of OBAGI Nu-Derm, Crx or Elastiderm Decolletage from now until the end of February. As prices will be increasing after this now is an excellent time to start your OBAGI programme.