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We are pleased to share something a little different from our usual updates. ALLOR Cosmetic Medicine is proud to sponsor the Child Safety Awareness Program  at Hobsonville Primary School, an initiative designed to help young students learn practical skills that support their well-being and confidence. As part of the program, the school receives educational exercise books created to teach children about personal safety in a gentle, age-appropriate way. These resources guide students through important topics while keeping the learning process positive and engaging. We chose to support this initiative because safety matters at every age. For children, having clear, accessible information helps them understand how to look after themselves and when to reach out for help. For families, it provides reassurance that these conversations are being introduced thoughtfully within the school environment. It has been a privilege to contribute to this work and to support a school within our own community. We are grateful to Hobsonville Primary School for the opportunity and look forward to continuing our involvement in future community programs.

Should I save up for a facelift or have injectable treatments? Anon, Kumeu  Ask Dr. Heather article discussing "Facelift vs Injectables" This is something I get asked a lot - Facelift vs Injectables ? - should I save up for a facelift, or start with injectable treatments ?    The honest answer? It depends on where you're at and what you're hoping for.   Injectables like dermal fillers and Botox® can work beautifully for smoothing lines, restoring volume, and refreshing your look without surgery.  They’re especially helpful if you’re noticing changes but aren’t quite ready for something more invasive.  Many of my patients use them as a way to delay the need for surgery altogether - or to make the most of the years leading up to one.  A facelift, on the other hand, is a surgical procedure.  It can offer a more dramatic lift, especially for deeper sagging or looser skin around the jaw and neck .  But it also comes with more downtime, higher costs, and longer recovery.  It’s a commitment, and it’s not always the best “first step.” Facelift vs Injectables  If you’re unsure, starting with injectables often makes sense.  You can target specific concerns , adjust as you go, and see how your face responds.  There’s no one “right” choice.  But you don’t have to figure it out alone.  Choose an injector who you feel comfortable with who will respect your journey, because the path to looking and feeling good is a personal one.  Just remember to always remain firmly in the driver’s seat.   If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz Dermal Filler, Medical Device Class III to smooth facial wrinkles and folds, correct facial atrophic scars, restore or enhance the lips or restore facial volume. Dermal filler has risk and benefits. Ask your doctor if dermal filler is right for you.  For product information check with your doctor or from product details with the supplier. Botox®, Prescription Medicine For the treatment of frown lines and crow’s feet around the eyes.  Botox® has risks and benefits. Ask your doctor if Botox is right for you. Botulinum toxin type A 50, 100, 200 Units. For product information check with your doctor or Consumer Medicine Information on  www.medsafe.govt.nz . Click for further details. Allergan, Auckland.

Can men get cosmetic treatments too? Anon, Riverhead Ask Dr. Heather Column Absolutely! Cosmetic treatments are for everyone, regardless of gender.  Men generally don't talk about it as much, but there are plenty who like a wee tweak now and then to keep them looking and feeling their best (Brad Pitt anyone?). Fortunately the stigma of cosmetic treatments is diminishing, however it can still feel stigmatised for some, especially men.  Discretion is key and something every injector should adhere to as dictated by the Health and Disability Code of Rights .   You should also never feel judged by your injector.  Our journeys are personal, so always choose someone who makes you feel safe, comfortable, seen and heard. If any of those niggly uneasy feelings surface, best to move on as our intuition is a great guide to picking out what is right for us. Every gender requires a different approach, as masculine and feminine features manifest differently in our faces. Feminine features include wider cheekbones and fuller cheeks whereas masculine features include a wider jaw in line with cheekbones and flatter cheeks. Understanding and appreciating these differences applies to men, women and gender diverse individuals. All facial features must be respected and discussed , so you feel confident your goals are addressed. Skin quality should also be taken into consideration.   We are all humans who deserve to feel great in our skin, regardless of gender, ethnicity or age. It all depends on your priorities and your injector must respect these and involve you at every step, in a kind, discrete way.

I see many patients who come to me feeling frustrated, embarrassed, or just plain tired of dealing with excessive sweating. This isn’t the kind of light perspiration most of us experience on a hot day or when we’re nervous. Hyperhidrosis is something else entirely - it can happen out of nowhere, and it often interferes with daily life in ways most people don’t talk about. It affects confidence, comfort, and even simple things like what clothes you wear, how you greet someone, or whether you feel at ease in your own skin. The good news? There’s a safe and highly effective treatment available. At ALLOR , we use botulinum toxin to treat hyperhidrosis by gently blocking the nerve signals that overstimulate your sweat glands. It’s especially effective in the underarms, but we also use it with great success on the hands, feet, and face. Results usually begin within a few days, and for most people, the dryness lasts between six to nine months. If you're curious whether this treatment might be right for you, we’ll walk you through exactly how it works, what to expect, and how we approach it here at ALLOR. Because once you understand your options, it becomes much easier to take that first step towards relief.   What is Hyperhidrosis? Hyperhidrosis is a condition where your body produces far more sweat than it needs to. This isn’t about being hot or exercising - it’s a medical issue where the sweat glands become overactive, often without any clear trigger. It is sweating that simply doesn’t match the situation. You might be sitting calmly in a cool room, yet still find your underarms, hands, or feet completely drenched. It can be unpredictable, and for many people, incredibly disruptive. There are two main types. Primary hyperhidrosis usually starts early in life, often during childhood or teenage years and tends to affect specific areas like the underarms, palms, soles of the feet, or face. It often shows up symmetrically on both sides of the body. Secondary hyperhidrosis , on the other hand, tends to involve larger areas and is usually caused by an underlying medical condition or certain medications. This type is more likely to begin later in life and sometimes continues even during sleep.   Primary and Secondary Hyperhidrosis Understanding the difference between these two types helps determine the best treatment approach for your specific situation. Primary hyperhidrosis has no underlying medical cause that we can identify. Your sweat glands simply produce more sweat than necessary in response to normal triggers like stress , heat, or emotions. Secondary hyperhidrosis results from another medical condition or medication. The sweating usually occurs across larger body areas and may happen during sleep. Common causes include diabetes, thyroid disorders, menopause, certain medications, or infections. If you develop excessive sweating suddenly as an adult, we recommend investigating potential underlying causes with your family doctor (GP). Primary hyperhidrosis is more common and responds well to treatments like Botox® injections . Secondary hyperhidrosis often improves when the underlying medical condition is addressed.   What Causes Hyperhidrosis? The exact cause of primary hyperhidrosis remains unclear, but does involve your sympathetic nervous system sending stronger signals to your sweat glands than necessary. Genetic factors also play a role. About 30 - 50% of people with hyperhidrosis have family members with the same condition ( Haider A, Solish N. Focal hyperhidrosis: diagnosis and management. CMAJ. 2005;172(1):69–75 ) . Emotional triggers like stress, anxiety , or embarrassment can worsen symptoms. Many patients say their sweating increases in social situations, which creates a cycle where worry about sweating causes more sweating. Physical triggers include heat, spicy foods, caffeine, or physical activity. However, people with hyperhidrosis sweat excessively even without these triggers. The condition isn't related to fitness level or personal hygiene. Hyperhidrosis is a legitimate medical condition and not something you can control through willpower alone.   How Sweat Glands Work To really understand how we treat hyperhidrosis, it helps to first understand what’s going on with your sweat glands. Your body has two main types of sweat glands: eccrine and apocrine . The eccrine glands are the ones we focus on when treating hyperhidrosis - they’re small, numerous, and found all over your body. They produce the clear, odourless sweat that kicks in when your body’s trying to cool itself down.   How Botox® Works for Excessive Sweating When we’re treating hyperhidrosis, the goal is to calm the overactive sweat glands in specific areas without affecting the rest of your body’s ability to regulate heat. That’s exactly what Botox® allows us to do. Botulinum toxin works by blocking the nerve signals that normally tell your sweat glands to turn on. When injected into the right area, it essentially creates a temporary barrier between your nerves and sweat glands so your glands simply stop overproducing sweat. The result? Far less sweating - without affecting your body’s ability to regulate temperature in other areas. You’ll still sweat naturally where you need to, like during exercise or in the heat. But in the areas we’ve treated, the overactive response is switched off. The effects typically begin within 2 to 4 days  and can last up to nine months . Common treatment areas include: Underarms (most popular) Palms and fingers Soles of feet Face and scalp for facial hyperhidrosis The beauty of this treatment is its consistency. Research shows that patients typically see a significant reduction in sweat production, with many experiencing up to 80 - 90% average reduction in sweating in treated areas. I find that patients are often amazed by how quickly their quality of life improves. Within weeks, they're choosing clothes based on style rather than sweat concealment.   What to Expect from a Botox® Treatment for Hyperhidrosis We recommend stopping any antiperspirants 24 hours before your appointment and shaving the treatment area. This helps us see exactly where your sweat glands are most active. You'll want to avoid blood-thinning medications and alcohol for 24 hours before your session. Also, avoid active skincare ingredients like retinoids or exfoliants for 3 - 5 days beforehand on the treatment area. On the day of treatment: Wear loose, comfortable clothing Arrive with clean, deodorant-free, hairless skin Avoid caffeine, which can increase sweating Bring a list of current medications If needed, we may perform a starch-iodine test to help map the sweat-prone zones before treatment. The injection process is straightforward but requires precision. we use a very fine needle to inject small amounts of product just under the skin surface.  Each injection feels like a quick pinch. Most people find the discomfort minimal and brief. Numbing cream or distraction tools can be used to enhance comfort.   Results, Safety and Potential Side Effects Most patients begin seeing improvement in 2 to 4 days , with peak dryness usually by 2 weeks . You’ll likely feel very dry for the first few weeks, before returning to pre-treatment levels around the 6 - 9 month mark.   Botox Side Effects for Treating Hyperhidrosis Side effects are generally mild and temporary: Redness or swelling at injection sites Soreness or slight bruising Muscle weakness near treated areas (less common) Rarely, compensatory sweating in untreated zones Complications are very rare when the treatment is performed by an experienced practitioner.   Is Botox® Right for You? You may be a good candidate if: Excessive sweating affects your daily life You've tried antiperspirants without relief You prefer a non-surgical option You want targeted results in specific areas We’ll assess your medical history and lifestyle at your consultation to ensure this is the safest, most effective approach for you. If hyperhidrosis is holding you back, let’s change that. Book a consultation and we will guide you through your choices step by step. Book online or reach out to the clinic today.   Botox®, Prescription Medicine For the treatment of frown lines and crow’s feet around the eyes.  Botox® has risks and benefits. Ask your doctor if Botox is right for you. Botulinum toxin type A 50, 100, 200 Units. For product information check with your doctor or Consumer Medicine Information on  www.medsafe.govt.nz . Click for further details. Allergan, Auckland.

If you’ve been curious about softer, subtler options for smoothing wrinkles, you might have heard about something called Baby Botox ® .  Baby Botox® is a treatment that uses smaller doses of Botox® to gently soften lines, while keeping your natural look and facial movement.  It can also treat enlarged pores and improve skin tone and is often called “ micro-Botox® ” or “ MicroTox ” because of the small doses used. People often tell me they want to look well-rested and not dramatically different, and that’s exactly what this trend is all about.  By using less product, Baby Botox ®  can give the skin a smooth, fresh feeling without making you look like you’ve had anything “done.” That touch of freshness - without giveaway shine or stiffness - has made this approach especially popular with people who value a natural appearance but still want results. If you’ve ever hesitated about more traditional Botox ® because you worried about looking too stiff or losing your expressions, Baby Botox ®  might be a gentle introduction.  I find that it’s a helpful option for anyone just starting out with wrinkle relaxers, or for those who want to maintain a softer look.   What is Baby Botox® and How is it Different? Baby Botox® is a cosmetic treatment that uses smaller, more precise doses of Botulinum toxin type A than traditional Botox®.  This approach aims for a softer refresh, allowing facial movement and subtle expressions to shine through.  Baby Botox® can also be injected directly into the skin to tighten pores and improve skin texture .   Comparing Baby Botox® to Traditional Botox® Traditional Botox® treatments often focus on smoothing out deeper lines and freezing muscle action in targeted facial areas to create a smooth surface, especially in areas like the forehead, frown lines, and around the eyes. Baby Botox® uses the same botulinum toxin type A, but with smaller doses.  By reducing the amount injected with each treatment, patients tend to see subtle, natural results . Facial expressions remain soft as movement isn’t as restricted. Here’s a simple table for a side-by-side look   Why Choose a Subtle Approach? Many people - especially younger adults or those new to cosmetic procedures want a gentle refresh where lines are softened without that “frozen” look. With Baby Botox®, tiny tweaks deliver a subtler finish.   Crow’s feet soften, but your laughter still shows.   Frown lines ease, but you don’t look motionless.  Some people even use it as a preventative, starting early to keep fine lines from deepening as they age. It’s worth noting, though, that Baby Botox® will not offer as dramatic a result for more obvious wrinkles and longevity of results will be less than that of traditional Botox®.  The right choice depends on your goals and how much correction you want to see.   Understanding the Technique The Baby Botox® technique is really about precision and balance.  I use a subtler approach, spacing out small amounts of botulinum toxin in very careful spots beneath the skin.  This allows me to soften specific lines - like around the eyes or forehead - without flattening out your natural expressions.  Each treatment is a little different, tailored to what you actually need, rather than relying on a one-size-fits-all pattern. Most people notice the effects within a few days, with peak effect expected at two weeks.  The results tend to last up to three to four months, depending on dosage used (higher doses last longer).  Dose adjustments can be made at subsequent appointments to suit any changing needs or preferences.   Baby Botox® Treatment Experience Baby Botox® isn’t just about smoothing lines - it’s a blend of personal goals, tailored care, and subtle changes that still look natural.  Each step, from the first conversation  to the days after your appointment, is shaped to your needs and comfort.   What Happens During a Consultation? When I meet with someone for a Baby Botox® consultation, I start by asking about their goals and what concerns they’d like to address.  There’s no pressure and definitely no rush to have any treatments.  You get the chance to show me the areas you’re noticing changes, whether that’s faint lines, forehead movement, or a general wish for softer expression. I ask about your medical history, any previous injectables you’ve tried, and what you hope to achieve.  We talk openly about the risks and benefits so you feel confident about both the science behind the treatment and what results we expect you to experience. By the end, I give you a clear treatment plan, an idea of the Baby Botox® cost involved, and answer any questions you might have.   How an Appointment Unfolds Once we’ve settled on a treatment plan and you’re ready, the actual appointment usually takes less than 30 minutes.  I ask you to gently move your face - raise your eyebrows, frown, smile - so I can see those little dynamic lines in action.  It’s a bit like seeing where paint would settle on a canvas. I use a fine needle and carefully inject very small amounts of Botulinum toxin into specific muscles.  This is the key difference with Baby Botox®: much lower doses are used compared to traditional treatments, which helps you keep your natural expressions.  Most people say the sensation is mild, like a tiny pinch or a mosquito bite. I check in on your comfort the entire time and can use numbing cream and/or a distraction tool if you’re sensitive.  Afterwards I apply a clean, tinted SPF and you’re usually able to head back to your day straightaway.  Aftercare instructions are provided detailing what to expect and what activities to avoid in the days following your treatment, with a contact number in case you have any questions or concerns. Your First Few Days After Treatment Most people find that the first days after Baby Botox® are uneventful.  There may be a little redness or swelling at the injection sites, but it fades quickly.  Sometimes there’s a light bruise, but it’s small and easy to cover with make-up. I advise avoiding heavy exercise, rubbing the area, or lying on your face for about 48 hours after your treatment.  This helps the product settle just where it’s supposed to.  You can wash your face gently and go about most other normal activities. Within three to seven days, you’ll start to notice the softening of lines, but not a frozen or “done” look.  You’ll still look like yourself - just a little fresher.  If you have any concerns, I’m always just a phone call or message away.   Areas Treated and Results you can Expect Baby Botox® is designed for small, precise improvements in facial lines and subtle changes that keep natural muscle movement.  By targeting specific muscle groups, it can soften lines and wrinkles without freezing your expressions or creating an artificial look.   Natural-Looking Changes Most people who come to me want to look like themselves - just a bit more refreshed. Baby Botox® is about supporting your own facial expressions rather than hiding them and keeping your skin looking its best .  I focus on preserving your unique features and making sure movement is never frozen. One thing I notice: the best results are the ones where nobody can quite put their finger on what’s different.  There's improved smoothness, but you can still smile, frown, or laugh as you always have.  That’s why I always start conservatively and adjust based on your specific anatomy and goals. If you’re worried about losing your natural charm or looking too “done,” Baby Botox® is a good option to explore.  We can always add more, but starting with less is the gentlest path to subtle changes. Results will gradually fade, making it easy to decide when you’d like another treatment.  This flexibility is actually one of the reasons both younger patients and seasoned Botox® regulars like it.   Creating a Maintenance Plan If your goal is to keep your skin looking consistently smooth, a regular schedule helps.  Most people find that booking touch-up treatments every 3 or 4 months works well.  These appointments don’t have to be set in stone, but keeping a routine does make a difference for ongoing results. Think of maintenance as “topping up” your treatment before old lines creep back in.  A steady approach can mean you need fewer units each visit, and you’ll avoid the cycle of peaks and valleys that sometimes happen with longer gaps in between.  This also gives you a sense of control with your anti-aging plan , so you’re never caught off guard. I also suggest reviewing your plan together at each visit, especially if you notice changes in how your skin responds or if your lifestyle shifts.  Treatments should always fit where you are right now, not just what worked last year.   Using Baby Botox® as a Preventative Measure There’s a growing trend of people in their 20s and 30s starting Baby Botox® before deep lines form.  The thinking here isn’t just about turning back the clock, but slowing it down a little.  By gently relaxing the muscles that cause expression lines, smaller doses can help prevent fine lines from setting in as strongly over time. This preventative approach is subtle - it doesn’t mean you’ll look like you’ve “had work done.”  Instead, it’s like smoothing a piece of paper just before it gets creased.  You stay looking naturally yourself , just with less wear showing in the usual places. Not everyone needs to start early.  It depends on your family history, how expressive your face is, and your personal preferences when it comes to anti-aging.  I always encourage an open conversation about your goals so we can make sure your plan feels right for you.   Safety, Side Effects, and Recovery Like many aesthetic treatments, Baby Botox® is generally considered safe when performed by a qualified professional.  There are a few side effects you’ll want to be aware of, and the recovery process is almost always straightforward, with little to no downtime required.   Possible Side Effects to Know Most people experience only mild and temporary discomfort after Baby Botox®.  The ones I see most often are a little redness or swelling where the needle went in.  Sometimes, people notice a bit of bruising, which is a lot like what you might get after a standard blood test or injection. If you’re unlucky, you might have a mild headache or feel slightly achy for a short time after your treatment.  These usually settle with simple pain relief such as paracetamol within a day or two without needing any special treatment.  Some notice the area feels a bit tight or odd for a while, but this sensation fades as the product settles in. Very rarely, more significant issues like eyelid drooping or persistent discomfort can happen, but these aren’t the norm - especially when you’re seeing someone with skill and experience.  If anything feels off, it’s always worth checking in, just to be on the safe side.   Prioritising Safety and Comfort When it comes to safety, who you see matters more than anything.  I always recommend checking your practitioner’s qualifications and not being afraid to ask about their experience.  Good technique and clean conditions reduce the chance of infection, pain, or unusual side effects. If you’re nervous about discomfort, you can ask for numbing cream, but most people find the treatment very tolerable - like a quick pinch.  I always take time to explain what to expect so you feel informed and relaxed beforehand. Your comfort is my priority throughout, not just during the injections.  If you have questions , want to pause, or need reassurance, it’s completely okay to speak up.  Feeling looked after is just as important as the results themselves.   Questions to Ask and Alternatives to Consider Deciding on Baby Botox® isn’t just about saying yes or no. It helps to get curious about your goals, understand what goes into the treatment, and know what other options are available when it comes to smoothing lines or keeping your look fresh.   Is Baby Botox® Right for your Goals? When people ask me about Baby Botox®, the first thing I want to know is what they’re hoping to achieve.  If the goal is to gently soften fine lines while keeping as much natural movement as possible, this treatment might be a good fit. Some people imagine Baby Botox® as a preventative tool, starting in their late twenties or early thirties to slow down the development of wrinkles.  Others are looking for a subtle refresh, rather than a dramatic change.  In both cases, clear communication with the injector is essential. Asking the right questions helps set realistic expectations.  I encourage people to be honest - What areas are you most concerned about? Are you open to just a little improvement, or looking for something more noticeable? Every face is unique, and so is every decision in aesthetic procedures.   Making sense of Dosage and Price The “baby” in Baby Botox® really comes down to the amount of product used.  While standard Botox® treatments rely on regular doses to freeze larger muscles, Baby Botox® uses smaller, precisely-placed amounts.  This gives softer results with less risk of a stiff or “frozen” look. Pricing can vary quite a bit.  Clinics often charge per unit, so the fewer units needed, the lower the cost - at least in theory.  But costs add up with multiple areas or repeated touch-ups.  It’s worth asking: How many units will I likely need for my goals? Will more frequent visits end up costing about the same as a traditional treatment? Here’s a quick comparison Feel free to use this as a way to start the conversation at your consultation.   Considering Fillers and Other Injectables Botox® isn’t the only player in town, and sometimes the best result comes from combining options.   Dermal fillers , for example, can restore volume in cheeks or lips and fill deeper lines that even Botox® can’t touch.  Think of them as the plump to Botox’s smooth. There are also newer injectables, like Profhilo® and NCTF® , or even non-injectable treatments for boosting collagen such as microneedling and chemical peels .  Each has pros and cons, and some people rotate between several.  If you’re curious about what would work best - or just want to compare - bring this up with your provider.  Sometimes a tailored blend gives the best and most natural outcome. Botox®, Prescription Medicine For the treatment of frown lines and crow’s feet around the eyes.  Botox® has risks and benefits. Ask your doctor if Botox is right for you. Botulinum toxin type A 50, 100, 200 Units. For product information check with your doctor or Consumer Medicine Information on www.medsafe.govt.nz. Click for further details. Allergan, Auckland. ART FILLER® containing low & high molecular weight hyaluronic acid, is a Class III medical device for the treatment of facial contours for redefinition, laxity and remodelling where skin laxity is a problem. ART FILLER® has risks and benefits. Do not use with treatments such a laser resurfacing or medium deep skin-peeling. Caution in people on blood thinning medicines. Do not inject into inflamed areas or intravenously or intramuscularly. Possible side effects: pain and swelling at injection site. Distributed by Cryomed Aesthetics Ltd. Auckland. PROFHILO® containing low & high molecular weight hyaluronic acid, is a Class III medical device for the treatment of the face and body for contours redefinition and laxity remodelling where skin laxity is a problem. Profhilo® has risks and benefits. Do not use with treatments such a laser resurfacing or medium deep skin-peeling. Caution in people on blood thinning medicines. Do not inject into inflamed areas or intravenously or intramuscularly. Possible side effects: pain and swelling at injection site. Accelagen Pty.  Ltd. Whanganui.  Dermal Filler, Medical Device Class III to smooth facial wrinkles and folds, correct facial atrophic scars, restore or enhance the lips or restore facial volume. Dermal filler has risk and benefits. Ask your doctor if dermal filler is right for you.  For product information check with your doctor or from product details with the supplier.

How much filler do you use during a treatment? Anon, Waimauku Dermal filler is a fantastic tool used to replace volume and enhance structure to achieve facial harmony.  It is designed for injection into different areas of the face, at variable depths, depending on what it is trying to replace such as bone loss, fat loss and/or skin smoothness.   As each treatment is individually tailored, it can be tricky to know exactly how much filler is needed.  We as injectors are pretty good at estimating, however tissues can respond differently, and some require larger volumes than expected.  This is why a volume range is often quoted when planning a treatment, the more deficient tissues requiring more filler to achieve the desired harmony and favourable light reflections we are looking for (think makeup contouring without makeup).   Dermal filler is typically manufactured in 1mL syringes.  Most injectors plan their treatment around what they can do with each syringe so they minimize waste and obtain the most bang for buck.  As filler is packaged sterile, it is best to use each syringe at the time of treatment to reduce the risk of contamination and therefore complications such as infection.    Cheeks, chin, jawline , temples and central face require at least 1-3mL of filler and more may be necessary for optimal results.  Smaller quantities however can also achieve lovely softening of problem areas, especially if done with a tactful artistic eye.  If your injector is clever, they will be able to target specific areas that will achieve overall improvement with minimal product.    Lips typically require the least amount of filler (less than 1mL), however this also depends on the surrounding tissues, as it is imperative lips are supported by their surroundings, so they look natural .  Forcing an entire 1mL syringe of filler into one’s lips is not a good idea for most of us to avoid looking overdone or puffy.    A good honest conversation with your injector is always a great place to start if you are looking at having dermal filler treatment.  Multiple considerations must be discussed including your needs, wants and budget.  You should always feel heard and in the driver’s seat so be sure to ask questions (writing them down can help).  The aesthetic journey is a personal one and should be respected, so listen to your instincts and ensure your injector is listening to you. Belotero® Medical Device Class III to smooth facial wrinkles and folds, correct facial atrophic scars, restore or enhance the lips or restore facial volume. Belotero has risk and benefits. Ask your doctor if Belotero is right for you. For product information check with your doctor or from productdetails with the supplier.  Click for further details. Contains Sodium Hyaluronate Gel. Merz, Sydney. Distributed by Healthcare Logistics, Auckland.

I've been wanting to have filler in my lips, but am feeling unsure. How do you make sure they look good?Anon, West Harbour  Luscious lips are something many of us desire, and multiple things should be considered to ensure they look and feel good.  It is natural to feel nervous, as there are a lot of overdone lips out there that are enough to scare even the bravest of souls (Married at First Sight anyone?).   As injectors we firstly have to take into account overall facial proportions and surrounding tissues. Lips should never look stuck on, so there must be adequate support from tissues around the mouth in order to achieve a natural result . Correct filler choice (softer rather than firmer), injected at the correct depth (close to the skin surface) in the correct amount (not too much) and correct location (only in the pink area, also known as the "pink lip"), will ensure it looks natural. Specific areas of deficiency, width of your nose and eyes, in conjunction with your own natural lip shape, ethnicity and lip projection will also help yield a lovely result where you look subtly enhanced, but still yourself. Very few of us look good with large lips and none of us looks good with sausages. Harmony is key, so always see an injector who will respect this, so you look and feel like the best, most luscious version of you .   If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz

How long does filler last? Anon, Riverhead. Dermal filler is an injectable gel made of hyaluronic acid.  Every gel on the market varies in terms of firmness and in general, the firmer the filler, the longer it lasts. Filler selection is based on how well it mimics tissues, whether that be skin, fat or bone. Firmer fillers are usually injected deep onto bone and tend to last up to 1-2 years on average based on manufacturer information.  Softer fillers such as the sort that is typically injected into lips and wrinkles tend to last 6-12 months as they are metabolized quicker by our tissues. Recent MRI (Magnetic Resonance Imaging) studies have shown filler can last much longer, up to 8 years, possibly longer.  This has created quite the stir on social media.  Many injectors have claimed this is a bad and scary thing; even going as far as to say they will not inject filler anymore.  This is bogus in my opinion, as the product itself is inert and mimics naturally occurring hyaluronic acid we have in our tissues, so is safe to remain for years, unless there is a complication.  Thankfully complications are rare and minimised by appropriate patient selection and precise sterile injecting technique at the outset, so it is always best to choose your injector wisely. The trendy concern regarding longevity of filler is often aimed at people who look progressively odd, where filler on top of filler is administered over many years without a good objective eye keeping everything looking natural.  This is crucial, as there are many instances where filler may no longer serve us, the tear trough (under eye area) a classic example, where under eye bags become puffier over time.  The wonderful thing about hyaluronic acid filler however, is that it can be dissolved. Regular clinical photography and a good, sensible eye are imperative to prevent the slow deterioration of one's appearance, often coined "Boiled Frog Syndrome."  This phenomenon is where one is treated with multiple treatments over time just as a frog tolerates slow heating in a pot.  When the pot boils, the frog does not realise how hot it is and dies, much like the natural appearance of someone who falls victim to too much filler.  On the contrary, if a frog is placed into a pot of boiling water at the outset it quickly jumps out, just as one should stop and correct unnatural results that can only be seen with a keen, objective eye.  This is sadly variable amongst injectors, but a great rule of thumb is if your injector looks a bit puffy or odd, you probably will too. Restylane®, Medical Device Class III to smooth facial wrinkles and enhance lips by restoring volume and fullness. Restylane® has risks and benefits. Ask your doctor if Restylane is right for you. For product information check with your doctor or from product details with the supplier.  Click for further details. Stabilised Hyaluronic Acid 20mg/Ml. Galderma, Australia, Sydney or distributor Healthcare Logistics, Auckland.

Can Botox ® be used for sweating? Anon, Kumeu Botulinum toxin (commonly known as Botox®) is a versatile beast.  In addition to its well-known function of relaxing muscles , it can also stop sweat glands from working so is a great treatment for sweating.   When injected at a superficial depth (very close to the surface of the skin), it acts to interfere with sweat glands and results can last up to 6-9 months.  It is particularly helpful for those who experience excessive sweating ( hyperhidrosis ), which can affect a variety of areas including armpits, hands, feet and face.  The very superficial nature of the injections minimize muscle involvement, however sometimes muscles close to the skin surface are also weakened, so a tailored approach is needed to ensure treatment is appropriate.   It is also important to ensure your injector is confident other causes of hyperhidrosis have been excluded such as tumour, thyroid disturbance, medications and diabetes.  If any doubt, it is always best to check with your GP in the first instance.   As the warmer months approach (yay!), so too does sweating.  This can be embarrassing and affect quality of life significantly.  It is helpful to know reliable treatments for this exist and our good ol’ friend Botox®  can help us once again. Botox®, Prescription Medicine For the treatment of frown lines and crow’s feet around the eyes.  Botox® has risks and benefits. Ask your doctor if Botox is right for you. Botulinum toxin type A 50, 100, 200 Units. For product information check with your doctor or Consumer Medicine Information on  www.medsafe.govt.nz . Click for further details. Allergan, Auckland.

There’s lots of talk about “new year, new you”, so it has me thinking about what my options are for looking good, but I have no idea where to start.  Any suggestions? Anon, Whenuapai Ask Dr. Heather Blog as featured in the K umeu Courier   Welcoming the new year can feel intimidating as it sets expectations for what we should achieve.  Looking good helps us feel good and thankfully there are multiple options down the cosmetic track if you feel you need a bit of a tweak.   The cosmetic treatment options range from dermal filler (injected hyaluronic acid gel that replaces volume and structure) to botulinum toxin (colloquially known as Botox®, a neurotoxin that relaxes muscles to stop skin creasing).  Skin treatments and skincare are also important, as one can never truly glow if their skin is dull.    Skin treatments include microneedling (tiny needles penetrate the skin to stimulate collagen ), chemical peels (controlled peeling of skin cells generating radiant, less pigmented new skin) and injectable skin treatments (injectable hyaluronic acid such as Profhilo®  or mineral cocktail such as NCTF® with or without Art Filler® ).    Navigating what’s on offer can feel just as overwhelming as entering the new year.  Its best to consult an injector to discuss what will work best for you, as many treatments target multiple areas and provide bang for your buck.  A thorough, initial consultation is a great time to chat whilst also ensuring you feel comfortable.  Our faces and bodies are precious, so only put them in the hands of someone you can trust.  And remember, if your injector looks weird, you probably will too! Botox®, Prescription Medicine For the treatment of frown lines and crow’s feet around the eyes.  Botox® has risks and benefits. Ask your doctor if Botox is right for you. Botulinum toxin type A 50, 100, 200 Units. For product information check with your doctor or Consumer Medicine Information on  www.medsafe.govt.nz . Click for further details. Allergan, Auckland. Dermal Filler, Medical Device Class III to smooth facial wrinkles and folds, correct facial atrophic scars, restore or enhance the lips or restore facial volume. Dermal filler has risk and benefits. Ask your doctor if dermal filler is right for you.  For product information check with your doctor or from product details with the supplier. PROFHILO® containing low & high molecular weight hyaluronic acid, is a Class III medical device for the treatment of the face and body for contours redefinition and laxity remodelling where skin laxity is a problem. Profhilo® has risks and benefits. Do not use with treatments such a laser resurfacing or medium deep skin-peeling. Caution in people on blood thinning medicines. Do not inject into inflamed areas or intravenously or intramuscularly. Possible side effects: pain and swelling at injection site. Accelagen Pty.  Ltd. Whanganui.  ART FILLER® containing low & high molecular weight hyaluronic acid, is a Class III medical device for the treatment of facial contours for redefinition, laxity and remodelling where skin laxity is a problem. ART FILLER® has risks and benefits. Do not use with treatments such a laser resurfacing or medium deep skin-peeling. Caution in people on blood thinning medicines. Do not inject into inflamed areas or intravenously or intramuscularly. Possible side effects: pain and swelling at injection site. Distributed by Cryomed Aesthetics Ltd. Auckland.

Does Botox get rid of all wrinkles?  Anon, Whenuapai Botox® is a clever tool used to paralyse muscles , so can tactfully be injected to stop skin from creasing.  A common source of confusion however, is the extent to which Botox® can treat wrinkles.    Two different types of wrinkles exist – dynamic and static.  Dynamic lines are present when muscles are contracting during facial expression, so respond very well to Botox®.  Static lines however are caused by repetitive contractions over time in conjunction with ageing, where skin and fat become thinner .  The smoothening effect of these tissues is therefore diminished, leaving behind lines that stay there even after Botox® treatment.  This can seem disheartening, however with repeated Botox® treatments, good skincare , injectable skin treatments and sun protection, pesky static lines can eventually fade.    Botox® also indirectly stimulates skin cells (fibroblasts), leading to improved skin quality and a fresher appearance , regardless of how many static or dynamic lines are present.  Facial expressions associated with negative emotions such as frowning are also minimised, leading to a lighter, positive demeanour.  This is in turn causes re-wiring of our brains, triggering us to feel happier, and as we subconsciously mirror each other’s expressions, people around us feel happier too.    The beauty of cosmetic treatments such as Botox® lies within its diversity and depth of action.  Not only does it act on muscles, it also acts on our brains, in the most wonderfully positive way.  In addition to its ability to stimulate skin cells , it is the perfect treatment for that refreshed glow we are all looking for. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz Botulinum toxin injections are prescription only medicine for the treatment of frown lines, horizontal forehead lines, and crow’s feet round the eyes. Botulinum toxin injections have risks and benefits. Ask your doctor if botulinum toxin injections are right for you. If you have side effects, see your doctor. You will need to pay for your botulinum toxin injections and clinic fees will apply. For details on precautions and side effects consult your doctor or go to www.medsafe.govt.nz. Botulinum toxin injections last about 4 months and further courses of treatment may be necessary. Should only be administered by trained medical professionals. Botox®, Prescription Medicine For the treatment of frown lines and crow’s feet around the eyes.  Botox® has risks and benefits. Ask your doctor if Botox is right for you. Botulinum toxin type A 50, 100, 200 Units. For product information check with your doctor or Consumer Medicine Information on www.medsafe.govt.nz. Click for further details. Allergan, Auckland.

Are there any differences between different brands of Botox ® ? Anon, Huapai.   Botulinum toxin comes in many forms, manufactured differently by different brands.  “Botox®” was a clever name coined by the company Allergan and is still readily available today.  Other players on the New Zealand market include Xeomin®  by Merz and Dysport® by Galderma.  Multiple other brands exist worldwide, however in Aotearoa MedSafe approval only exists for these three players, meaning only they can be used legally in New Zealand.   Every brand will tell you theirs is best, for the simple reason they want people to use their product.  Interestingly, all research around individual brands usually come to the same conclusion: the higher the dose used, the longer the effects last .  So the more frozen you are to start with, the longer it will take for full muscle strength to return.    Xeomin® is formulated without complexing proteins, so is considered purer than the other brands.  Injectors may prefer this option as it theoretically minimizes risk of neutralizing antibodies developing over time and hence less risk of resistance to repeated treatments.  Other brands argue this effect is negligible as complexing proteins are released when the product is injected into and metabolized by muscles.   Dysport®  is formulated and concentrated differently to Botox®  and Xeomin®.  Less volume of Dysport® is therefore needed to achieve the same effect, so injections may be less painful.  This is a subjective advantage however, as many do not notice a difference, especially if certain saline preparations are used to take away the stingy sensation.  Some argue Dysport® is more spready in its effect, so is advantageous for larger treatment areas, however other companies argue against this, claiming all brands spread equally from their respective injection sites.    So there are many ways to skin a cat.  So long as injectors are aware of the properties, advantages, and disadvantages of the products they use, then it probably doesn’t make much difference at the end of the day.  The most important considerations for injectors are to ensure the products they use are made by legitimate manufacturers (i.e. not counterfeit), are stored and reconstituted correctly, and are used before they expire.  It always pays to ask your injector what they use and why, to ensure you have confidence they understand what they are using, so you receive the best possible care you deserve. Xeomin® (incobotulinum toxin) Prescription Medicine for the treatment of upper facial lines: glabellar frown lines, crow’s feet around the eyes, horizontal forehead lines.  Xeomin® has risks and benefits. Ask your doctor if Xeomin® is right for you (incobotulinum toxin A, purified Botulinum toxin type A 50 Units and 100 Units). For product information check with your doctor or Consumer Medicine Information on www.medsafe.govt.nz . Click for further details. Merz, Sydney. Distributed by Healthcare Logistics, Auckland. Dysport®, Prescription Medicine For the treatment of frown lines and crow’s feet around the eyes. Dysport® has risks and benefits. Ask your doctor if Dysport is right for you. Botulinum toxin type A 300 or 500 Ipsen Units. For product information check with your doctor or Consumer Medicine Information on www.medsafe.govt.nz . Click for further details. Galderma, Auckland. Botox®, Prescription Medicine For the treatment of frown lines and crow’s feet around the eyes.  Botox® has risks and benefits. Ask your doctor if Botox is right for you. Botulinum toxin type A 50, 100, 200 Units. For product information check with your doctor or Consumer Medicine Information on  www.medsafe.govt.nz . Click for further details. Allergan, Auckland.