A Beginner’s Guide to Natural-Looking Botox

If Too much Botox is injected into the tunes in the forehead, you could end up looking like Mr Spock with quizzical brows for days. So find a doctor who knows what they’re doing.

What they treat: Moderate sun damage, minor scars, mild to moderate wrinkles, skin texture.

How they work: Fractional lasers hit the skin in a pixelated pattern, with some columns receiving a dose of light, and other tissue going untouched. Their main role is to refresh and rejuvenate by building new collagen, helping to smooth out the skin and eliminating some of the pigment caused by sun damage.

‘In our laser clinic, we use the Mosaic fractional laser that delivers deep rays of microscopic laser beams to the skin,’ says Dr Webster. ‘It is an erbium glass laser with a wavelength of 1 550nm that penetrates to the deeper levels without damaging the surrounding tissues.’ The laser beams heat up and remodel the collagen, resulting in skin tightening and rejuvenation on the face, neck and chest.

Those looking for a minor touch-up can try the baby fractional laser, Fraxel Clear + Brilliant. ‘This laser transmits minimal energy for a quick radiance boost, but it’s only a subtle improvement.’

HOW they feel: ‘Local anaesthetic cream is applied and it takes about 45 minutes,’ says Dr Webster. ‘There’s very little pain, but the skin will be pink, almost like sunburn.’

Downtime: There is minimal swelling for two to five days afterwards. ‘The skin might look darker and feel a bit rough,’ says Dr Webster. ‘It’s best to avoid the sun for a few days; sunblock is very important.’

Risks: Prone to fever blisters? They can be triggered by fractional lasers.

A Beginner’s Guide to Natural-Looking Botox Photo Gallery



INTENSE PULSED LIGHT (IPL)

‘IPL in its simplest form is a way of saying short flashes of very bright light,’ says Dr Webster. ‘It’s not a true laser, because a laser focuses just one wavelength of light at your skin; IPL releases light at many different wavelengths.’ IPL penetrates to the second layer of the skin without harming the top layer. Pigment cells absorb the light energy, which is converted into heat. The heat destroys the unwanted pigment.

What it treats: Age spots, sun damage, freckles, varicose veins, broken blood vessels in the face, rosacea

How it works: At Dermalaser, Dr Webster uses the Nordlys Ellipse Intense Pulsed Light System. The Dermalaser website says: ‘Nordlys uses short, safe bursts of carefully controlled filtered light that is emitted from a flash lamp to treat specific skin conditions. For brown marks on the skin it targets melanin and for treatment of vascular problems it targets haemoglobin, which causes redness.’

How it feels: ‘I use a cooling gel and the pain is very minimal,’ says Dr Webster. ‘Some of my patients describe it as snapping an elastic band around your wrist.’

Downtime: Immediately after your session, capillaries will be more visible and all your brown spots will darken, and remain darker for about five days. Avoid any form of heat as it could cause severe swelling.

Risks: ‘We don’t usually perform this treatment on people who have a tan. IPL is popular in winter as the skin is very sensitive to the sun,’ says Dr Webster. There are very few risks if this treatment is performed by an experienced professional.

Go to dermalaser.co.za for information about IPL and laser therapy.

NEUROTOXIN INJECTABLES – AKA BOTOX

Injectables have become pretty commonplace – perhaps you’ve even been invited to a Botox party (we hope you declined the invitation; that’s something best left to the professionals’). Cosmetic botulinum toxin therapy, better known as Botox, is an injectable neurotoxin. The frozen-faced stars of The Real Housewives of Beverly Hills have probably given you nightmares, but if administered correctly, going under the needle can soften wrinkles.

What it treats: Horizontal forehead lines, vertical frown lines and crow’s feet. It can also lift the corners of the mouth, and soften smoker’s lines around the mouth and vertical neck cords.

How it works: Neurotoxins act on the muscles underneath the skin. Each time muscles contract, the skin on top folds, causing a wrinkle,’ explains Dr Lulli. ‘By relaxing the muscle (completely or partially) we decrease that folding and the skin is left to lie smooth. The deeper the line, the more destruction has occurred in the skin, and the more intensive the treatments required to decrease the depth of that wrinkle.’

How long it lasts: About three to four months, maybe six if you’re lucky,’ says Dr Lulli. ‘Treatments must be done regularly for the first 18-24 months. Movement should not be allowed to return to normal or we’ll be back to square one.’

HOW it feels: An injection to the face is always going to be slightly painful, especially right between the eyebrows. Doctors typically apply numbing cream 10 minutes before.

Downtime: ‘About 20-30 minutes unless there’s a bruise,’ says Dr Lulli. ‘However long your body takes to resolve a bruise is your “recovery” time. It takes about 10 days for Botox to take hold; that’s why we don’t inject more within a two-week period, as the evaluation of its effect will be skewed.’

Risks: Let’s stick with the sci-fi references: if too much is injected into the horizontal lines in the forehead, you could end up looking like Mr Spock from Star Trek, with quizzical brows for days. So find a doctor who knows what they’re doing. Other risks include mild droopiness of the eyelid or brow, which goes away within a few weeks, slight bruising and headaches.

FILLERS

Ever heard of a ‘liquid facelift’?

It conjures up scary images of tight, shiny foreheads and cartoonishly large lips, right? In reality, the effects are much more subtle – provided you don’t go overboard. Facial fillers are synthetic or naturally occurring substances injected into the lines, folds and tissues of the face to decrease the appearance of wrinkles and define the contours of the face.

What they treat: They can fill m sunken scars, plump lips, re-inflate hands, brighten hollow under-eyes and sharpen jawlines.

How they work: Fillers are gels made of hyaluronic acid,’ says Dr Lulli. Hyaluronic acid occurs naturally in the body and is a humectant, which means it ‘traps’ moisture. Marketed under brand names Juvederm and Restylane, ‘the gels draw in water, swell and integrate into the tissues, causing a “plumping” effect’. Other families of fillers are made of calcium hydroxyapatite for deeper wrinkles; poly-L-lactic acid, which stimulates collagen production; and polymethyl methacrylate, which consists of collagen and lasts for about five years — it is marketed under the name Bellafill. ‘Fillers are injected into the face where support structures are located,’ says Dr Lulli.

How they feel: A needle to the face is a needle to the face. Topical anaesthetic will help, but lip fillers will be a bit sore as the lips have a ton of nerve endings.

How much you need: ‘A general guideline is to use two fillers per decade of life: four in your 20s, six in your 30s and so on,’ says Dr Lulli. ‘Ideally, we try to stick to the same family of filler, using varying compounds within that family.’ Fillers range from R3 750 to R5 000 per syringe, which is generally in a 1ml volume.

Risks: While some fillers can be dissolved with a quick shot, not all mistakes are so easily undone. ‘With every kind of filler, there’s a risk of unintentional injection into a blood vessel, which can result in skin death, scabbing and even blindness,’ says Dr Lulli. ‘Side-effects of fillers include swelling, bruising, discolouration, lumpiness, muscle weakening or strengthening, slowing of bone resorption, infection, nerve damage and necrosis.’

A ‘GUMMY’ SMILE

‘A neurotoxin is commonly used, but this is a tricky one. These patients require consultation with orthodontists and dentists prior to injection as they often have underlying dental and orthodontic problems. A sleep study is also a must – patients often exhibit breathing disorders during sleep. Injecting a neurotoxin in these cases could negatively affect functionality and could even worsen these issues. It’s not simply a cosmetic concern.’

HABITUAL TEETH GRINDING

‘Neurotoxin is also commonly used. The same examinations and evaluations for a gummy smile apply. Also be aware that there will be a loss of muscle definition, which will result in a weaker jawline and will add to the lower face sag that we experience in later years.’

11’LINES BETWEEN THE EYEBROWS

‘Neurotoxin is the gold standard, provided that it is administered when lines are still shallow or fine.

Dr Lillians Lulli of the Skin Renewal Institute

If we’re talking deep furrows then additional measures such as microneedling, plateletrich plasma (PRP) therapy, radio frequency or threads need to be added to the arsenal. NEVER inject fillers in this area.’

THIN LIPS

‘Use lip fillers sparingly. They should not be used to change the structure of your lips. Work with what you have.’

DOUBLE CHIN

‘A combination of skin tightening, fat-dissolving injectables, fillers to improve the jawline and midface and threads might be needed, depending on skin quality and bone structure.’

DARK CIRCLES

‘Diet and lifestyle are major determinants here; if the cause is largely genetic then our hands are tied. In some cases, all we can do is improve the quality of the skin, with skincare developed for the eye area, laser treatments, circulation boosting, radio frequency, Botox, fillers or chemical peels.’

CROW’S FEET

‘Neurotoxin and fillers in the support structures around the eye are effective, provided the skin is primed to receive fillers. I would recommend a course of collagen-producing treatments prior to the introduction of fillers around the eye area. If the lines are deep, you can also try needling, PRP, radio frequency and laser treatments.’

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