Skin Club by DermaGenesis

Correction of facial lines and wrinkles with Botox or Dermal Filler injection has revolutionized the field of non surgical cosmetic procedure. Imagine, walking into a physician office and walking out 10 minutes later looking 10 years younger.

The choice of procedure depend solely on the nature of the lines. Botulinum Toxin Type A, popularly known as Botox or BTA is used to treat facial lines and wrinkles that appear during facial expression due to muscle contraction; while Dermal Filler (DF) is used to treat lines that appear at rest due to breakdown of underlying collagen. It is not uncommon for the physician to suggest both Botox and Dermal Filler for correction of the lines.

Type of facial lines

Even though there are many biological changes a person experiences with aging, one of the most foremost-recognized concerns in aging is the formation of facial lines, wrinkles, folds, loss of skin elasticity and increased skin laxity.

There are two types of facial wrinkles:

• Wrinkles that appear during muscle contraction or expression; known as dynamic wrinkles
• Wrinkles that appear at rest due to loss of underlying elastin and collagen

Dynamic wrinkles are caused by contractions of the underlying facial muscles, whenever you smile, laugh, or frown. Years of squinting and frowning tend to leave deep wrinkles in the skin between the eyebrows and on the bridge of the nose, across the forehead, and at the corners of the eyes. Frown lines produce an angry or sad look that detracts from a pleasant facial appearance.
Wrinkles that appear at rest due to loss of underlying elastin and collagen is due to aging, either primary or secondary aging. As we age, skin cells replace themselves more slowly, and the dermis begins to thin. The network of elastin and collagen fibres beneath the skin gradually breaks down. On the face, the thinner and less elastic skin tends to form wrinkles and fold. Permanent crease lines and crow's feet form on the brow and around the eyes. The eyebrows drop, and loose skin folds around the upper and lower eyelids. Tiny wrinkles form around the lips. The tissues of the jaw and neck droop into jowls and double chins. The skin of the neck droops into folds and wattles.

Facial muscles and the type of lines they produce are shown in the diagram below.

Botox for facial lines and wrinkles

About Botox
Botulinum Toxin Type A, popularly known as Botox or BTA, is a chemical neuro-peptide which blocks nerve impulses to muscles and sweat glands. When Botox is injected into a muscle, it blocks impulses from the nerve to the injected facial muscles. The muscles are relaxed and cannot "scrunch up" for a period of time. Since the muscle is unable to contract, the overlying skin remains smooth, firm and unwrinkled. Botox is target specific, which means only the injected muscles do not contract while the untreated facial muscles continue to contract in a normal fashion allowing facial expression. The physician, after analysing the lines and wrinkles, shall plan the site of injection and the amount of Botox required for the procedure. Treatment involves injection of very small amounts of Botox using a very tiny needle into specific muscles. The Treatment is well tolerated and takes just a short time with minimal recovery. The skin can also be prepared with a topical anaesthetic cream to make the procedure more comfortable. Botox takes effect on the injected muscles about 3 to 7 days after Treatment.

Duration of Botox effects
The effects of Botox in any of its cosmetic or medical procedures last anytime between 4 to 6 months. In some individuals, for no known reason, the effects may last longer or shorter than the published information. Once the longevity of Botox wears out, the nerve impulse gradually re-establishes and the muscle activity reverts to its original condition. When muscle activity is restored, the facial lines gradually reappear. In contrary to the myths that facial lines become more obvious once Botox wears off, the lines actually become less obvious and delay the onset of permanent lines.

Side effects of Botox
Botox procedure is considered as one of the safest and well-regulated cosmetic procedures ever. It has been in practice for more than 20 years and leading Medical Societies, along with the US FDA regulate most of the Botox procedures. Regular injections of Botox into the facial muscles have been clinically proven harmless, produces longer-lasting results and effectively delays the onset of aging skin.
Side effects are minimal and typically relate to the local injection. Soreness or mild bruising, while uncommon, may occur around the injection site. Rarely, there might be temporary weakness of the neighbouring muscles, a temporary droopy brow or eyelid, or a headache. There is no limitation to the patient’s normal activity / lifestyle after the procedure and the patient can proceed with his / her routine chores as usual. Botox injection is contraindicated during pregnancy and lactation, while on antibiotics or at sites that has any infection

Common questions about Botox

• Is it safe?

Yes it is! It has been in use for more than 20 years and as long as it is administered by professionals, it is one of the safets cosmetic procedure.

• Will the lines become worse if I discontinue the procedure?

NO, definitely not. As a matter of fact, regular treatments with Botox have PROVEN to reduce the onset of permanent lines and wrinkles.

• Will I look frozen?

NO. The conventional methods (as practiced in some places) may give you a frozen look, but the newer advanced Botox techniques allows you to maintain your facial expression without the lines.

• What is the minimal age a person can do Botox?

Age is not the deciding factor. As long as the expression lines are noticeable, Botox can be performed.

• Why is there so much of negative publicity about Botox?

Unqualified or poorly trained individuals who “practiced” on their patients are the main reason for such negative publicity. Botox when used properly, offers one of the best and safe cosmetic results.

Cost for Botox procedures
The cost of Botox or Dysport for treatment of facial lines and wrinkles ranges from RM 800 to RM 2000 depending on the area and the amount of BTA (units) used.

Dermal Filler for facial lines and wrinkles

About Dermal Filler
Dermal Filler (DF) is a gel like pharmaceutical substances that is injected, with a thin needle, underneath the skin to reduce wrinkles, facial lines and scars. The injected gel gives natural volume under the wrinkle, which is lifted up and smoothed out. Dermal Filler is also used to augment the eye area, chin, nose, lips and cheek and to add volume to larger areas such as the breast and buttock. Longevity of the Dermal Filler varies depending on the patient's lifestyle and physical characteristics as well as the part of the body treated. Generally, the injected material is likely to be absorbed faster in areas that are more affected by muscle movement, such as the mouth. The injected gel, over time, gets degraded naturally and safely by the body’s enzyme system.
The physician, after assessing the facial anatomy, shall plan the type and amount of Dermal Filler required for the procedure. The amount of Dermal Filler required can range from 0.5 ml to 3 ml for facial procedures. The Treatment area is prepared with an anaesthetic cream. Occasionally a light sedation is given to make the procedure more comfortable. The procedure is fast, safe and appears natural. There are no scars or other traces on the face after the procedure and the effects are noticed immediately. Due to the initial swelling, the results may reduce by about 10% a week after the procedure.

Duration of Dermal Filler effects
The longevity of DF depends on the composition or type of DF used. Generally, there are two types of Dermal Filler, semi permanent and permanent. The most popular semi permanent Dermal Filler is Hyaluronic Acid, which normally lasts anytime between 10 to 12 months. The Permanent Dermal Filler, despite their name, lasts between 20 to 24 months only. In some individuals, for no known reason, the effects may last longer or shorter than the published information. Once the longevity of Dermal Filler wears out, the effects gradually fades and reverts to its original condition.

Side effects of Dermal Filler
Dermal Filler procedure is a safe and well-regulated cosmetic procedure. Side effects are minimal and typically relate to the local injection. The common side effects are pain, bruises, redness and / or swelling for few days. In rare cases, some patients may experience lumpiness or infection, which can be effectively treated with a course of antibiotics. Patients are advised to adhere to the following guidelines after the procedure:

• Keep the treated area clean;
• Do not perform any facial massages or facial treatments on the treated area for at least 2 weeks;
• Avoid exposure to direct sunlight or extreme cold conditions in the first 2 weeks after injection.

Cost for Dermal Filler procedures

The cost of Dermal Filler (Hyaluronic acid) for treatment of facial lines and wrinkles depends on the amount of Filler used. Each ml costs about RM 1200 - RM 1400 and corection of facial lines and wrinkles normally requires 2 - 3 ml of Dermal Filler.

Photo gallery

Picture of correction of facial lines using Botox / Dysport or Dermal Filler. Click on the thumbnail for larger image.
(Pictures are copyright protected and are the property of DermaGenesis (Australia) Pty Ltd. Unauthorized use or reproduction is strictly prohibited.)