Search Results

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.  Quick Answers: Can men get cosmetic treatments? Yes. Cosmetic treatments are suitable for men and can help improve confidence, refresh appearance, and support skin health. Are cosmetic treatments for men different from those for women? Yes. Men and women have different facial structures, so treatments are tailored to respect masculine features such as jaw width, flatter cheeks, and overall facial balance. What cosmetic treatments are popular with men? Common options include anti-wrinkle injections, dermal filler for structure, and skin treatments to improve skin quality and texture. Is cosmetic treatment for men still stigmatised? Less than it used to be, but some men still feel hesitant. Discretion and privacy are important parts of good cosmetic care. Should I feel judged when asking about cosmetic treatments? No. You should never feel judged. A good injector will make you feel comfortable, respected, and involved in every decision. How do I choose the right injector for men’s cosmetic treatments? Choose an injector who understands male facial anatomy, respects your goals, and prioritises natural, discreet results. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz .

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.  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.

I always feel very anxious over Christmas time, any recommendations on how to get through it all without being a nervous wreck? Anon, Whenuapai. Anxiety is very common.  Add in pressure to attend multiple events, cook, host, buy presents, all whilst coping with the ever-increasing cost of living?  Relentless. It's a stressful time.  All wrapped up with feelings of guilt for not enjoying it as we are supposed to, it can leave many loathing the holidays.  For those with children, the seemingly endless school holidays add another layer of pressure. Firstly, it is important to realise you are not alone.  As humans we are built to feel anxious as a natural response to threatening situations.  The adrenaline rush dilates our pupils, increases our heart rate, and puts our digestion on pause so we are ready to fight or flight.  Sometimes less threatening situations trigger this response and we feel just as intensely when we aren't actually going to be physically harmed in the same way (although it feels a lot like it we are when dealing with tantruming children!). Social media, news and endless information at our fingertips triggers us to think more about issues we never used to.  We are constantly bombarded so sometimes don't obtain the respite we need to switch off, so this must be done intentionally.  This means forcing ourselves to stop.  Really  stop. Mindfulness and meditation are one of the ways we can achieve this.  Thinking about our breath and body in real time helps ground our thinking and reminds us to be in the present.  Taking even 1 or 2 minutes a day to do this can be so powerful.  You can even do it whilst going for a walk.  A great alternative is guided mediation or Hatha yoga, where yoga is combined with meditation (Google these and you will discover a raft of excellent free resources).  These practices settle the mind, helping the clouds to clear and reminds us that just as aeroplanes escape clouds as they ascend, so can we. Even when it is raining, the blue sky is always there. Another great technique is writing down what triggers your anxiety.  Be specific and really think about where it comes from, then write what would actually happen if the worst-case scenario played out.  Then write how it makes you feel.  Finally, write an affirmation of a positive way you can respond to the trigger.  Something along the lines of "I am strong" or “I can…” to re-programme the mind to switch automatic negative thoughts into automatic positive ones.  Doing this and re-reading your affirmations can really help you believe in your strength and power.  Because we all have these qualities, we just need to realise them. Anxiety is best faced head on.  That may feel scary, but just as a shadow monster grows in the eery darkness, it disappears once the light is switched on.  You too, can switch the light on.  If that still feels overwhelming, talking to you GP will help as there are pharmacological and professional services available if you need them. And finally, be kind to yourself.  This is a busy time; however it can be wonderful if we pace ourselves and keep our boundaries.  Say no to things that don't serve you, if it's not a "heck yes!", it's a no.  A polite one of course. Quick Answers: Is it normal to feel more anxious over Christmas? Yes. Extra social pressure, costs, and family demands can make anxiety feel more intense at this time of year. What’s one simple thing I can do daily to calm anxiety? Try mindfulness or meditation. Even 1–2 minutes a day focusing on your breath and body can help ground you. How can I work out what’s actually triggering my anxiety? Write it down. List your triggers, imagine the worst-case scenario, note how it makes you feel, then write a positive affirmation for how you can respond. Should I talk to my GP if my anxiety feels overwhelming? Yes. If anxiety feels too hard to manage alone, your GP can help and can talk through professional supports and medication options if needed. How do I reduce holiday stress without feeling guilty? Set boundaries and pace yourself. Say no to things that do not serve you, and be kind to yourself. If you have a question for Dr. Heather yo u would like answered anonymously, please email askdrheather@allor.co.nz .

How do you know if you need cosmetic treatments? Anon, Whenuapai. A great question. Often pondered by the masses, taking the leap to having "work done" can be a daunting one.  First, we must clarify what "work" entails. Cosmetic treatments are designed to help us look and feel better.  The looking better part is really up to you.  It ranges from glowy, clear skin to less wrinkles to restructuring facial features , creating harmony and a refreshed appearance, where people comment you look great, but can't quite put their finger on it.  A holiday to the tropics?  A new diet?  New earrings? Therein lies the beauty of well-executed cosmetic medicine.  Both an art and a science, the delicate balance lies in the hands of the injector.  One who sees your unique beauty with acute awareness of the aesthetic end point. Various media have highlighted the dark side of cosmetic treatments, where aesthetic end points were crossed so fiercely, naturally beautiful people were given new identities.  Lovely lips turned to sausages, cheeks turned to chipmunks and jawlines turned to jagged messes. Such stories are wonderfully entertaining, alas not helpful for those seriously wanting the odd tweak to help them look and feel their finest.  Thankfully, there are a raft of ethical practitioners out there, properly trained with your best interests at heart. So it really all depends on you.  If that pesky frown is making you look grumpy, those forehead lines are becoming crevices for your make up, your skin is looking dull , you're tired of looking tired or if you just want a professional someone to cast an objective eye, then you are ready. The key is to sit firmly in the driver's seat, accept no pressure and do what feels comfortable for you and your budget.  The right practitioner will guide you, support you and care for you at every step. Your face and feelings are precious, so should always be handled with kindness, dignity and respect.   Quick Answers: How do I know if I need cosmetic treatments? If something about your face or skin is bothering you, or you feel you look tired, grumpy, or less refreshed than you feel, you may be ready. What are cosmetic treatments meant to achieve? Cosmetic treatments are designed to help you look fresher and more balanced, while still looking like yourself. What kinds of cosmetic treatments are included? They can range from improving skin clarity and glow, to softening wrinkles, to subtle facial restructuring for better harmony. What should good cosmetic treatment results look like? People may say you look great, but they should not be able to tell exactly what has changed. How do I avoid overdone or unnatural cosmetic results? Choose an ethical, properly trained practitioner who has a clear aesthetic end point and does not pressure you into treatment. If you have a question for Dr. Heather y ou would like answered anonymously, please email askdrheather@allor.co.nz .

A friend asked me the other day, why is sunscreen so important? With the upcoming long hot summer El Nino is expected to deliver (wahoo!), it got me thinking. Why do we bang on about sunscreen ? It must seem like sunscreen companies are sponsoring us to (they aren't). It all comes down to science. When the sun stuns us with her rays, she emits Ultraviolet Radiation (UV). There are different types of UV, the main ones that affect us are UVA and UVB. The energy they carry penetrates our skin and cooks us in a similar way to how a microwave heats up our dinner. Limited amounts of cooking (up to 15 minutes or so) are good for our tissues as it stimulates beneficial pathways in our body such as the production of Vitamin D, good for anti-ageing, bone and immune system maintenance. Too much of a good thing causes changes in our skin including altered pigmentation (spots), damaged collagen and dysfunctional deposits of elastin leading to wrinkles . Pigmented lesions/spots can also be triggered to mutate, leading to formation of cancer cells and the dreaded Melanoma. Sunscreen protects us from this radiation, broad spectrum the preferred choice to combat UVA (penetrates deeper and through glass, causing us to tan) and UVB (penetrates less deep and causes us to burn). Using this every day (even in Winter and when its cloudy) helps prevent and treat these changes. Like the necessity of wearing clothes, sunscreen should be part of the wardrobe. To be worn every day, except when the curtains are drawn and one is hiding inside. Quick Answers: Why is sunscreen important for your skin? Sunscreen protects your skin from ultraviolet (UV) radiation, which damages collagen, alters pigmentation, accelerates ageing, and increases the risk of skin cancer. What damage does the sun cause to skin over time? Too much UV exposure can cause pigmentation spots, wrinkles, collagen breakdown, elastin damage, and mutations that can lead to melanoma. What is the difference between UVA and UVB rays? UVA penetrates deeper into the skin, contributes to ageing and tanning, and passes through glass, while UVB causes surface damage and sunburn. Should I wear sunscreen every day, even in winter or when it’s cloudy? Yes. UV radiation is present year-round, even on cloudy days and in winter, so daily sunscreen use helps prevent long-term skin damage. How should sunscreen fit into a daily routine? Sunscreen should be part of your everyday routine, like clothing, and applied daily whenever your skin is exposed to daylight. If you have a question for Dr. Heather y ou would like answered anonymously, please email askdrheather@allor.co.nz .

What is Botox®? Anon, Whenuapai . A great question. Many assume they know as it's well splashed over the media, however I imagine many don't know more than "it freezes your face, Susan". Botox® is actually a brand name for Botulinum toxin (other brand names include Dysport® and Xeomin® ). All of these contain variable concentrations of toxin produced by the bacteria Clostridium botulinum.  Originally used by the United States Army as a bioweapon in World War II, this chemical has a powerful effect on paralyzing muscles. In large quantities Botulinum toxin can be dangerous, causing muscles needed for breathing to stop working. When used in much smaller concentrations, such as those used in Cosmetic Medicine , it is an effective tweaker of facial musculature, acting as a relaxant for muscles that cause pesky wrinkles. In skilled hands the result is a lovely, refreshed face, without looking frozen (think post-holiday-in-the-tropics glow).  In not-so-skilled hands it can lead to something that resembles a stroke. Botox® also acts on other parts of tissue such as sweat glands, providing an effective treatment for hyperhidrosis (excessive sweating).  It has also been shown to help reduce the appearance of scars.  The effect of this chemical is transient, lasting 3-4 months on average (up to 6-9 months in some).  Muscle fibre and sweat gland function completely returns once it wears off, so top-ups are required to maintain results.   Despite function recovering, repeated treatments on muscles leads to wasting, as one slowly diminishes their desire to do certain expressions targeted by treatment injections, such as frowning.  This alters the connectome in the brain, the complex wiring of brain cells connecting muscles of facial expression with emotion.  Gradual weakening of muscles leads to altered emotions, hence less frowning triggers us to feel happier.  Our animal instincts cause us to mimic each other, so if we look happier, so too do our peers. Like so many historical discoveries, Botox® began as a beast and morphed into a thing of beauty.  In the right hands, you too can benefit from its clever brilliance. Quick Answers: What is Botox® and how does it work? Botox® is a brand name for botulinum toxin, which relaxes targeted muscles in small, controlled doses to soften wrinkles and refresh facial expression. Is Botox® the same as botulinum toxin? Yes. Botox® is one brand of botulinum toxin, along with others such as Dysport® and Xeomin®. Is Botox® safe when used for cosmetic treatments? Yes, when used in very small doses by a trained practitioner. The doses used in cosmetic medicine are carefully controlled and safe. How long do Botox® results last? Results typically last around 3–4 months, although some people may see effects for up to 6–9 months. Can Botox® be used for anything other than wrinkles? Yes. Botox® can also be used to treat excessive sweating (hyperhidrosis) and has been shown to help reduce the appearance of some scars. Can repeated Botox® treatments change facial expression or mood? Over time, repeated treatments can weaken targeted muscles, which may reduce habitual frowning and can influence how emotions are expressed and perceived. If you have a q uestion for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz . 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.

What is the best treatment for acne? Anon, Kumeu.   Acne is a frustrating beast.  It can rear its ugly face at all ages and can fluctuate at different stages of our lives.  Back in the infomercial days of acne skincare, many of us will remember the “miraculous” treatments all the popstars used that seemingly served to only irritate our skin, without any real solution (sorry Beibs).   Several types of acne exist, all relating to different stages of hair follicle blockage and inflammation.  These stages are referred to as Comedomal Acne (red spots and blackheads), Acne Vulgaris (pimples and blackheads), and Nodulocystic Acne (angry red pimples and sores).  Often an array of these features co-exist, and are further categorized as mild, moderate and severe.    Treating hormonal imbalances, tweaking medications, restricting the use of occlusive cosmetic products and reducing intake of dairy and high GI foods can all help as a starting point to minimizing acne .  Cleansing the face twice daily with a pH-balanced cleanser, ideally containing salicylic acid is the next step, followed by use of topical Retinol (Vitamin A).  The latter is famous for not only controlling acne, but also sports marvelous anti-ageing effects, plumping skin and evening pigmentation.  Hardy versions of retinol are available on prescription.   Chemical peels and microneedling can also help settle the skin; however need to be done on skin without active infection present.  Failing that, oral medication such as doxycycline and isotretinoin (Roaccutane) are an option to really help things clear.  Like any oral medication, these must be prescribed by a Doctor and monitored closely to ensure safety and adequate response.    As acne clears and scars emerge, these too can be minimized by treatments such as chemical peels and microneedling.  As complex as acne can be, advancements in skincare , topical and oral medications have thankfully altered the course of how we can treat this problem.  Goodbye pizza face, hello smoothness! Quick Answers: What is the best treatment for acne? There is no single best treatment for acne. The right approach depends on the type and severity of acne and often involves a combination of skincare, lifestyle changes, and medical treatment. What types of acne are there? Common types include comedonal acne (blackheads and small red spots), acne vulgaris (pimples and blackheads), and nodulocystic acne (deep, painful red pimples and sores). Can skincare alone help treat acne? Yes, for mild to moderate acne. Using a pH-balanced cleanser twice daily, salicylic acid, and topical retinol can significantly improve breakouts. Do diet and hormones affect acne? Yes. Hormonal changes, certain medications, dairy intake, and high-GI foods can all contribute to acne and may need to be addressed as part of treatment. When are medical treatments needed for acne? Moderate to severe acne may require prescription treatments such as oral antibiotics or isotretinoin, which must be prescribed and monitored by a doctor. Can acne treatments also help with acne scarring? Yes. Once active acne has settled, treatments such as chemical peels and microneedling can help improve acne scarring and skin texture. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz .

What is filler made of? Anon, Whenuapai.   Dermal filler is commonly made of Hyaluronic Acid (HA).  HA naturally occurs in our tissues and attracts water to help hydrate them.  Filler contains artificially made HA, chemically bonded together with various degrees of cross-linking to create different gels.  The more cross-linked a filler, the firmer the gel.  The firmer the gel, the longer it lasts in tissues and the better it is as mimicking bone lost to ageing.   Different fillers are injected into different areas of the face to replace lost tissue.  When done appropriately, this leads to a harmonious, natural result where it is difficult to tell if someone has had “work” done.  Too much filler leads to a puffy overdone look, as does too firm filler too close to the skin’s surface as modelled by many in the media (think girls of “Married At First Sight Australia”).   HA filler can be dissolved with the enzyme Hyaluronidase, also a naturally occurring entity we make in our tissues.  Cosmetic injectors should always have this at hand for dissolving HA filler in cases of emergency such as blocked blood vessels, as well as correcting overdone or undesirable results.  Irreversible fillers such as calcium hydroxyapatite are used less frequently; the latter used more commonly for skin rejuvenation and reduction in fine lines, although some also use it to alter facial structure.   Historically fillers such as silicone have been injected, however thankfully this is no longer a common occurrence as a raft of complications have been described with its use including chronic inflammation, lumps, swelling and skin changes.   The world of fillers is a rapidly growing one.  Products are becoming increasingly safer with better testing leading to improved outcomes.  Better results are achieved by injectors who appreciate the nuances of these products existing amongst a saturated market, coupled with their technical skills.  Just as our faces are multifaceted, so too should be our injectors. Quick Answers: What is dermal filler made of? Most dermal fillers are made from hyaluronic acid (HA), a substance that naturally occurs in the body and helps attract and retain moisture in the skin. Is hyaluronic acid filler safe to use in the face? Yes. When used by a trained practitioner, HA fillers are well studied, biocompatible, and widely used in cosmetic medicine. Why are some dermal fillers firmer than others? Fillers vary in how much they are cross-linked. More cross-linking creates a firmer gel, which lasts longer and is better suited to deeper structural support. Can dermal filler be dissolved if needed? Yes. Hyaluronic acid filler can be dissolved using hyaluronidase, an enzyme that naturally exists in the body and should always be available to cosmetic injectors. Are all dermal fillers reversible? No. Some fillers, such as calcium hydroxyapatite, are not reversible and are used more selectively, often for skin rejuvenation rather than major structural change. Why do some people look overfilled? Overfilled results can occur when too much filler is used, the wrong type of filler is chosen, or it is placed too close to the skin’s surface. 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.

I think about doing cosmetic treatments but feel guilty.  I always put my family first, but my husband keeps telling me not to feel bad for wanting to put myself first for a change.  How do people get around feeling guilty?  Anon, Riverhead. Parental guilt is real for parents, so it is entirely understandable you feel this way.  We always put our family first and so naturally feel as if we don’t deserve the same.  Interestingly this concept often stems from us suffering low self-worth.  Taught to us by generations above, it is surprisingly common to feel as if we don’t deserve certain things because we feel we aren’t worthy.    Self-worth is a core belief we possess similarly to any other core belief such as religion.  It is different from low self-esteem as it does not fluctuate easily (think good hair day versus bad hair day).  It is instead a static mental space where one is so secure within themselves; they know they will be okay if they lost everything (a scary but very powerful space to be).   The seeds of low self-worth are often planted when we are children and continue to grow with dysfunctional adult relationships, where we suffer emotional abuse ranging from not feeling heard, through to being yelled at, severely criticised, or even physically abused.  Identifying this is not to necessarily lay blame on our parents, partners, or friends, as they are a product of their own experience, but instead allows us to identify patterns of intergenerational and interpersonal trauma that lay the foundations of low self-worth, so toxic cycles can be broken.    Low self-worth is often developed alongside an inner critic who negates our decisions and tells us we shouldn’t do things because we aren’t worthy.  It can also develop as a reflex of receiving criticism from influential figures in our lives and can be hard to turn off.  One of the most liberating things we can do to counteract our inner critic is to say DELETE every time it rears its ugly head.  Saying it aloud, with conviction is an extremely effective way to diminish its power and allows us to instead turn up the volume on compliments.  Sometimes naming our inner critic can further help disconnect from its influence.    When we shift our thinking in this way, we become more positive and allow ourselves to internalise positive feedback.  We then start to really respect and love ourselves.  We get to know ourselves.  We become our own best friend.  It then becomes okay to put ourselves first just as we are always told in flights to put our oxygen mask on first.  This also allows us to build stronger boundaries and we become happier with more capacity for acts of kindness, as we are no longer stomped on by negativity.    Whether it be cosmetic treatments , going out for that lunch with a friend or eating that piece of cake, being kind to ourselves by silencing our inner critic and welcoming in positivity can be a life changing experience.  The warm hug of grace we give ourselves can be just what the Doctor ordered. Quick Answers: Why do I feel guilty about wanting cosmetic treatments? Guilt often comes from low self-worth and the habit of always putting others first, which can make it feel undeserved to prioritise yourself. Is feeling guilty about self-care a sign of low self-worth? It can be. Low self-worth is a deep-seated belief that you are not worthy, and it often shows up as guilt when you do something for yourself. What is the difference between low self-worth and low self-esteem? Low self-esteem fluctuates with circumstances, while low self-worth is a more fixed core belief about your value as a person. Where does low self-worth usually come from? It often develops in childhood and can be reinforced by critical or emotionally unhealthy relationships later in life. How can I stop my inner critic from controlling my decisions? Actively interrupt it. Saying “delete” when critical thoughts arise can help reduce their power and make room for more positive thinking. Is it okay to put myself first sometimes? Yes. Looking after yourself builds stronger boundaries, improves wellbeing, and allows you to show up more positively for others. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz .

What is the best skincare regime? Anon, Whenuapai.   Skincare is complex.  There is a lot of noise in the market with zero regulation.  Most of us start (and often continue) a very basic regime inspired by supermarket shelves, television adverts and people we know.  I myself have been victim of using all the no-no things including face cloths, soap and the dreaded St Ives Apricot Scrub.    A good regime consists of a few basics.  Firstly, a pH balanced cleanser should be used to gently cleanse the skin without compromising the naturally acidic skin barrier.  It doesn’t really matter what product you use if the pH is balanced, however be weary of marketing ploys such as foam (foam does not equal better cleaning) and addition of ingredients such a hyaluronic acid as they are washed away during the cleansing process.   After cleansing, application of an antioxidant serum is a great idea.  Vitamin C is a fantastic option for daytime as it is great for environmental protection, minimising pigmentation and encouraging collagen production.  A good alternative for day (or nighttime) is Vitamin B, which helps minimise wrinkles , improve skin tone and also acts to enhance collagen production.   Another great serum for nighttime is the famous Vitamin A, AKA, retinol.  The hero ingredient to any skincare regime , this powerful micro-nutrient speeds up skin cell turnover, minimises pigmentation, reduces acne, stimulates collagen production and diminishes wrinkles.  Care must be taken when starting retinol however as it can cause skin irritation, so staggering its use initially and slowly building to nightly application is recommended.  Many products on the market claim to contain retinol , however shop around as some instead contain very weak retinoid esters (retinyl palmitate, retinyl acetate and retinyl linoleate), that take many years of consistent use to have effect.    On top of serums, one should then apply a quality moisturiser that suits your skin type.  Dry skin needs thicker moisturisers, whereas oily skin prefers oil-free concoctions.  Choose something that smells and feels good and be sure to also apply it on the neck and backs of the hands as these areas are often neglected and eventually become telltale signs of a person’s true age (you’ll start noticing those celebrity close-ups now).   Finally, during the day don’t forget SPF!  Super important to minimise ageing as the harsh ultraviolet rays from the sun (on cloudy and clear days) will undo all the good work you do with your skincare regime.  Just be sure to pick a product that you like that doesn’t make you look and feel like a greaseball.    Everyone can benefit from a good skincare regime; the key is to understand the basics and resist marketing tactics by big brands.  A good rule of thumb is if it’s advertised in mainstream media, it probably isn’t worth your time (and money) as quality products don’t need big advertisements to demonstrate their worth. Quick Answers: What is the best skincare routine? There is no single best routine. An effective skincare regime is built around a few core steps tailored to your skin type. What are the essential steps in a daily skincare routine? A good routine includes a pH-balanced cleanser, targeted serums, a moisturiser suited to your skin type, and daily sunscreen. What cleanser should I use for healthy skin? Use a gentle, pH-balanced cleanser that cleans the skin without stripping the natural skin barrier. Foam and added “hero” ingredients do not mean better cleansing. Which serums are most important in a skincare regime? Vitamin C or B serums are useful during the day for protection and collagen support, while Vitamin A (retinol) is best at night for cell turnover, acne control, pigmentation, and wrinkle reduction. How should I start using retinol safely? Introduce retinol slowly. Start a few nights per week and build up gradually to avoid irritation. Is moisturiser necessary if my skin is oily? Yes. Oily skin still needs moisturiser, but lighter, oil-free formulas are usually best. Why is sunscreen essential in a skincare routine? Daily sunscreen protects against UV damage, which accelerates ageing and can undo the benefits of even the best skincare products. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz .

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. Quick Answers: Are there differences between Botox® brands? Yes. Different brands of botulinum toxin are manufactured differently and have varying formulations, concentrations, and properties. Which Botox® brands are approved for use in New Zealand? In New Zealand, Medsafe approval exists for three brands only: Botox® (Allergan), Xeomin® (Merz), and Dysport® (Galderma). Is one Botox® brand better than the others? Not necessarily. Research generally shows that results depend more on dose and technique than on brand alone. How does Xeomin® differ from other Botox® brands? Xeomin® is formulated without complexing proteins, making it a purer form of botulinum toxin, which may reduce the risk of resistance over time. How is Dysport® different from Botox® and Xeomin®? Dysport® is more concentrated, meaning less volume is needed for similar effects. Some people find injections more comfortable, although results are comparable. What matters more than the brand of Botox® used? The skill and knowledge of the injector, correct dosing, proper storage, and using legitimate, approved products are more important than brand choice alone. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz . 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.

How long does Botox ® last? Anon, Whenuapai. Botulinum toxin, more commonly known at Botox®  is a neurotoxin that relaxes muscles.  It is injected in different areas at different doses, in order to target muscles we no longer want to contract.   Results tend to last approximately 3-4 months, however this is dependent on a few factors.  Some injectors (and companies) argue certain brands of Botulinum toxin last longer than others, however research has consistently shown dose injected is the most important factor, as the higher the doses used, the longer results last.  Higher doses however are associated with more muscle paralysis, so a more “frozen” look, which can appear less natural.  A more targeted approach to individual anatomy can also yield longer results as no unit of toxin is wasted on muscles that do not need treatment.    Even though typical results last 3-4 months, repeat treatments often aren’t required for a bit longer as the facial muscles take time to re-train and catch up to the rest of the face to resume normal expression.  This means one can often obtain 5-6 months of longevity out of their anti-wrinkle treatments , which has the added benefit of allowing muscles to regain full strength before repeat treatment, so are less likely to waste and lead to an odd appearance long term.  It is also fantastic for the budget!   Utilizing evidence-based products from reputable brands that are reconstituted correctly, not expired and stored correctly will also enhance results.  It is always important to ask your injector what they use and why, and check they store their products correctly.  Make sure you also keep an eye on long-term changes in your face as result of anti-wrinkle injections, as repeated high-dose treatments when not required can often lead to heaviness and/or an odd appearance with strengthening of other muscles in order to maintain normal facial expression. Quick Answers: How long does Botox® last on average? Botox® typically lasts around 3–4 months , although this can vary between individuals. What factors affect how long Botox® lasts? The dose used, injection technique, and individual muscle strength all influence how long results last. Higher doses tend to last longer but can look less natural. Do different Botox® brands last longer than others? Not usually. Research shows that dose matters more than brand , with higher doses producing longer-lasting effects. Can Botox® last longer with repeat treatments? Yes. With repeat treatments, muscles often take longer to regain full strength, meaning results can last 5–6 months  for some people. Is it better to wait until Botox® fully wears off before repeating treatment? Often, yes. Allowing muscles to fully recover can reduce the risk of long-term muscle wasting and help maintain a more natural appearance. Does product quality affect how long Botox® lasts? Yes. Using reputable brands known to be stored, reconstituted, and injected correctly can help optimise results and longevity. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz . 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.