Search Results

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.

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. 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 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.

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.

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 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’m struggling to sleep as Christmas approaches, any tips? Anon, Whenuapai The holiday season can be stressful. Events, presents, gatherings, spending time with people you may not want to, it’s a lot. Squeezing in too many things can make us feel the weight of the world on our shoulders, and this commonly leads to poor sleep. Sleep hygiene is a great place to start when trying to achieve more slumber. It is where we do things to encourage our body clock to tick as it should, so we secrete the right amounts of the hormone melatonin and therefore achieve quality sleep. This means getting up and going to bed at the same time each day (easier said than done when there are presents to wrap). If that is difficult to achieve during the holidays, other tweaks such as exposing yourself to natural daylight as soon as you wake and darkening your bedroom with block out curtains can help. Our bodies like to be between 16 and 18 degrees Celsius for optimal sleep, so unless you have air conditioning (heaven!), it would be sensible to invest in a fan. There are clever mattress protectors that cool when you touch them, so are also a great option. A cold shower just before bed and sleeping with your hair wet is a great way to lower and maintain core body temperature as well - much easier to achieve if you start warm then go cold right at the end for a minute or so. Cold showers are also fantastic for stimulating release of anti-ageing proteins, strengthening the immune system, releasing endorphins and stimulating production of brown fat (fat that keeps us warm and helps us lose weight). A great option to add to your routine for multiple benefits – I now miss it if I don’t go cold at the end of my showers! Other great ways of stimulating sleep is to exercise during the day (a good walk can do wonders), avoid daytime naps and reduce blue light exposure from screens before bed. Avoiding caffeine at least 6 hours before bed is also recommended, as is having a solid bedtime routine, where you wind down with same sequence of events. A great example would be a cold shower, reading a book, meditating and a non-caffeinated tea such as chamomile. Writing a list of things you need to do to remove them from your mind is also a great way to minimize brain chatter when lying in bed. If these fail, the next step would be to have a chat with your family Doctor about medications and to address any other possible causes of insomnia, such as anxiety or thyroid dysfunction. Sleep is something we don’t miss until it’s gone. Sleep disruption is common, especially around the holidays so remember to be kind to yourself. Sometimes letting go of our own self-criticism can unlock the barriers we have with sleep, allowing a much more enjoyable slumber and holiday season .

I've noticed more brown spots on my skin in the past few months and was wondering what I can do to get rid of them? Anon, Whenuapai   Brown spots can be very frustrating and are common at the end of Summer (cue crying emoji face). All the wonderful long sunny days pepper us with bits of ultraviolet radiation, even when wearing sunscreen .  Now that's not to say SPF isn't necessary (if anything it shows just how necessary it is), but even with the best sun protection, we can develop unwanted pigmentation just from the increased exposure over the glorious long days of daylight savings.   Thankfully there are treatments that can help.  Chemical peels in particular are wonderful at lifting pigmentation, and as the weather cools, they are the perfect treatment as we start to spend more time inside.  Peels also are fantastic for anti-ageing as they remove old skin and expose fresh, clearer baby skin.  Winter glow anyone? The real key to a successful peel is for skin to be prepared with the right skincare in the weeks prior to ensure it is ready for pigment removal, followed by maintenance after the peel to sustain results. Just as the old, brown leaves shed off the trees in Autumn to make way for new growth, you too can shed old aged cells to reveal a glowy new you.  After all, we have to make most of all the seasons of life, even if it means cold weather (cue crying emoji face).