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 (Master, 2024). 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. Quick Answers: How long does dermal filler last? It depends on the type of filler used and where it is placed. Firmer fillers can last 1–2 years, while softer fillers often last 6–12 months. Does the type of filler affect how long it lasts? Yes. Firmer, more cross-linked fillers last longer than softer gels because they are metabolised more slowly by the body. Do fillers really last longer than advertised? Yes. MRI studies show hyaluronic acid filler can remain in tissues for many years, sometimes up to 8 years or longer, even if the visible effect fades earlier. Is it dangerous if filler lasts for years in the face? No. Hyaluronic acid filler is inert and mimics a substance naturally found in the body, so it is safe to remain unless a complication occurs. Why do some people start to look worse over time with filler? Problems usually come from repeatedly adding filler without reassessment. Over time, this can lead to puffiness or distorted features if not monitored carefully. What can be done if filler no longer looks right? Hyaluronic acid filler can be dissolved. Regular review, clinical photography, and an objective injector eye help prevent long-term overfilling. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. References: Master, Mobin et al. “Hyaluronic Acid Filler Longevity in the Mid-face: A Review of 33 Magnetic Resonance Imaging Studies.” Plastic and reconstructive surgery. Global open vol. 12,7 e5934. 15 Jul. 2024, doi:10.1097/GOX.0000000000005934 Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland 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.

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. Quick Answers: How can I get natural-looking lip filler? Natural-looking lips come from careful assessment of your face, using the right type of filler, and avoiding overfilling. What makes lip filler look unnatural? Too much filler, filler that is too firm, poor placement, or lack of support from surrounding tissues can make lips look puffy or artificial. What type of filler is best for natural-looking lips? Softer hyaluronic acid fillers are best, as they move naturally and blend better with lip tissue. Where should lip filler be injected for the most natural result? Filler should be placed in the correct depth and location, typically within the pink part of the lip, and only where volume is needed. Do facial features affect how lip filler should be done? Yes. Nose width, eye spacing, natural lip shape, ethnicity, and overall facial proportions all influence how lip filler should be planned. How do I avoid overdone lips? Choose an injector who prioritises balance and harmony, uses conservative amounts, and aims to enhance your natural lip shape rather than change it. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, 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.

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. Quick Answers: How much dermal filler do I need? It depends on your facial structure, areas being treated, and the degree of volume loss. Filler amounts are always individualised. How is dermal filler measured during treatment? Dermal filler is supplied in 1 mL syringes, and treatment plans are usually based on how each syringe can be used most effectively. How much filler is usually needed for cheeks, jawline, or chin? These areas often require 1–3 mL or more, depending on how much structural support or volume replacement is needed. How much filler is typically used in the lips? Lips usually require less than 1 mL. Using too much filler in the lips can lead to an overdone or puffy appearance. Does using more filler give better results? Not always. Strategic placement and injector skill often achieve better, more natural results than simply using more product. How do I know what amount of filler is right for me? An open discussion with your injector about your goals, facial balance, and budget is essential. A good injector will tailor the plan and adjust as needed. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, 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.

If you’ve ever looked in the mirror and thought, “I’d love just a little more shape or volume to my lips,” you’re not alone. Lip fillers are one of the most popular cosmetic treatments and for good reason, it can gently enhance what’s already there giving your lips more structure and definition. Before you decide to go ahead with lip fillers, it's crucial to prepare for your consultation and understand what to expect. What are Lip Fillers made of? Lip fillers are a type of injectable filler treatment made of hyaluronic acid, a natural substance in our bodies that attracts water, and hence volume. Common brands of filler used in lips include Restylane®, Belotero® and Juvederm® however there is no particular “best lip filler”, as it depends on how it is injected. Some hyaluronic fillers are softer and perfect for smoothing out fine lines, while others are designed for more structure and volume. That’s why a personalised consultation matters so much. It’s not about copying someone else’s lips; it’s about finding what works beautifully for your unique face and features. The Importance of a Personalised Initial Consultation During your initial consultation, we discuss your desires and concerns and tailor a customised treatment plan together that works for you and your budget. Creating lips that look natural and feel like your own is our top goal. With strategic placement of filler, we aim to enhance your natural lip features rather than drastically change them. The objective is to achieve a lip enhancement that compliments your face and lips that reflect your individuality while feeling naturally yours. BEFORE YOUR APPOINTMENT: WHAT TO KNOW A little preparation goes a long way when it comes to lip filler treatments. After your initial consultation you will be provided with a pre-treatment instruction sheet explaining what to expect and general measures to follow in preparation for your treatment. These include: 1. Avoid Blood Thinning Medication and Alcohol Avoid alcohol and blood-thinning medications (like aspirin, ibuprofen and other anti-inflammatories) for 24 hours before treatment to minimise bruising and swelling. 2. Arrive at Your Appointment with Clean Skin Your skin is always cleaned before any treatment, however coming to your appointment make-up free is helpful to ensure a clean canvas and hence minimise risk of infection. 3. Pause other Treatments Avoid facials, chemical peels, laser treatments, hair removal and microdermabrasion for at least one week beforehand and one week after. It is also a good idea to avoid active skincare ingredients like retinoids (retinol/vitamin A), AHAs and exfoliants for at least three to five days beforehand, as these can make the skin more sensitive. 4. Stay Hydrated Drink plenty of water in the days leading up to your treatment to support healthy, hydrated skin. 5. Let us know about any Skin Conditions If you have any active skin infections, cold sores, or other concerns, please inform us ahead of your appointment so we can guide you accordingly. 6. Check Your Schedule Try to schedule your treatment at least two weeks before any important events and ensure you remain in Auckland for one week after your treatment, to ensure any complications can be swiftly treated. 7. Plan Your Future Trips Try to avoid flying overseas four weeks after your treatment ensure no unwanted swelling occurs due to in-flight pressure treatments. 8. Leading up to Your Treatment If you feel unwell, have dental work or vaccinations in two to four weeks prior to your treatment, let us know as we may need to re-schedule your treatment. Dermal filler must only be injected when someone does not have an active immune system, to avoid complications such as granulomas or nodules. WHAT HAPPENS DURING THE TREATMENT? When you arrive, we’ll go over everything again - your goals and any questions you may have. A numbing cream will be applied so you’re as comfortable as possible. Most of the time, the filler itself also contains a numbing agent, so it’s surprisingly gentle. We’ll take our time, using a tiny needle or a blunt-tip cannula to place the filler precisely where it’s needed. The process usually takes around 60 minutes, and you’ll see an immediate difference, although there may be some swelling right after. AFTERCARE: TREAT THOSE LIPS WITH LOVE Post-treatment, your lips will need a little TLC: · Expect some swelling and possibly a bit of bruising - that’s normal. · Sleep with your head slightly elevated to help reduce swelling. · Avoid alcohol, caffeine, and spicy foods for 24 hours. · Skip lipstick or lip balm for a day or two. · No kissing, saunas, or heavy exercise for at least a day or two (yes, really!). And remember don’t poke, prod, or press your lips. Let them settle naturally into their new, beautiful shape. POSSIBLE RISKS (AND HOW TO STAY SAFE) Lip filler treatments are generally very safe when performed by experienced hands, but like all medical treatments, they do come with risks. Most are minor and short-lived, swelling, bruising, or mild tenderness. In very rare cases, more serious complications can occur, such as filler being injected into a blood vessel (vascular occlusion). That’s why seeing a trained professional who knows facial anatomy inside and out is absolutely essential as they also know how to reverse the filler in case of any emergency. If you have an autoimmune condition or allergies, we’ll discuss that during your initial consultation to make sure this treatment is right for you. A FEW QUESTIONS YOU MIGHT BE WONDERING… 1. Do lip filler injections hurt? Most patients say it’s far more comfortable than expected. Between numbing cream and local anaesthetic in the filler, discomfort from the lip injections is minimal. 2. Are lip fillers right for me? During the initial consultation we will go through the process and decide if lip filler is right for you. However, we cannot provide this service if you are pregnant, breastfeeding, have severe allergies or autoimmune disorders. 3. Are lip fillers permanent? No, on average lip fillers last between 6 to 12 months but can in some instances last for up to 2 years. The exact duration depends on your metabolism, the type of filler used, and how much was injected. 4. How much does lip filler cost? Lip filler typically costs around $800, depending on the product and how much is needed. We’ll go over all the details with you in clinic - no surprises. 5. What will my lips look like right after treatment? They might look a little puffier than you expect at first - that’s normal. They will improve over the first few days, with some swelling for up to 1–2 weeks. You’ll start seeing the final results at four to six weeks afterwards, when the filler has fully integrated into your tissues. 6. Are there lip fillers near me? ALLOR Cosmetic Clinic is located in Whenuapai, Auckland only a few minutes drive from Westgate, Hobsonville, West Harbour, Kumeu, Greenhithe and the North Shore. If you are interested in lip filler in Auckland, book online today for an initial consultation with Dr Heather to start the process. YOUR LIPS, YOUR WAY If you’re thinking about getting lip augmentation, know that you’re in control. There’s no pressure, no one-size-fits-all, and no need to chase trends. This is about feeling confident in your own skin and your smile. When done safely and thoughtfully, lip fillers can be a wonderful way to bring balance and softness to your features. If you're curious, come in for a chat. No pressure - just good advice, expert guidance, and a caring space to explore what feels right for you. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland 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. ​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. Juvederm Ultra™ & Ultra Plus™, Medical Device Class III. For the filling of medium size and deep facial wrinkles by injection into the skin. Juvederm™ has risks and benefits. Ask your doctor if Juvederm™ is right for you. Volume (mL) 0.8mL Volume (mL) 1.0m hyaluronic acid + lidocaine. For product information check with your doctor or from product details with the supplier. Allergan, Auckland.

I had lip filler recently and I hate the way it looks. How do I know whether it is normal swelling or bad lip filler, and can it be fixed? Bad lip filler is often fixable, but not every swollen, uneven or lumpy lip immediately after treatment is a bad result, so the first job is working out whether you are seeing normal healing, an aesthetic problem or a medical complication that needs urgent attention. Lip filler should look natural. The aim is not simply to add more material, but to place the right amount in the right places so the finished result fits your natural lip shape and the proportions of your face. When that balance is lost, the lips can look as though they belong to someone else, even when the amount injected was not enormous. Is it bad lip filler or normal swelling? The first few days after lip filler are not a reliable preview of the final result. Lips have a generous blood supply and react quite enthusiastically to being injected, which means swelling, tenderness, bruising, temporary asymmetry and small areas of firmness can occur while the tissues are settling. Swelling may remain noticeable for the first one to two weeks, whereas the filler continues integrating with surrounding tissues over approximately four to six weeks. A lip that looks uneven on day two may therefore look completely different once the swelling subsides. Bruising alone does not mean your injector has done a poor job either. Even an experienced injector can nick a small blood vessel, particularly in an area as vascular as the lips. What matters is whether the bruising is behaving like a normal bruise and gradually improving, rather than becoming increasingly painful or being accompanied by unusual changes in the skin such as pallor or blistering. Unless there are warning signs, resist the urge to judge the result too early or ask another injector to add more filler immediately to balance it. Trying to correct swelling with more product is a little like altering a dress while the person wearing it is still moving around. You may end up correcting something that was never truly wrong. Lip filler gone wrong: what does it look like once settled? Lips that look overfilled Overfilled lips may appear heavy, stiff or disproportionately projected, particularly from the side. The natural curves of the lips can become blurred, the upper and lower lips may lose their normal relationship, or the mouth may dominate the rest of the face. This does not always happen because an enormous amount was injected at one appointment. Repeated treatments without allowing older filler to settle, treating the lips in isolation from the rest of the face, or adding product every time a patient notices a small reduction can gradually create an overfilled result. Filler sitting above the lip border A ridge, shelf or persistent puffiness above the upper lip is commonly described online as “lip filler migration”. It may occur when product is placed outside the intended area, when too much filler is injected around the lip border, or when repeated treatments gradually distort the normal outline. The lip can then lose definition rather than gain it, with the area between the nose and upper lip appearing fuller while the actual pink part of the lip looks less clearly shaped. Persistent lumps or uneven texture Small areas of firmness can be normal while filler settles, but lumps that remain visible or distinctly palpable after the healing period deserve assessment. These may relate to superficial placement, uneven distribution, too much product in one location or, less commonly, a nodule or granuloma. Redness, warmth, increasing tenderness, discharge or swelling that appears after the lips have previously settled raises a different concern of infection and should be assessed by a Doctor rather than treated as a simple cosmetic lump. Uneven lip filler, asymmetry or an unnatural shape Human lips are rarely perfectly symmetrical before treatment, so a good injector works with the anatomy that is already there rather than promising perfect mirror-image lips. A poor result may exaggerate an existing difference, create too much height or projection on one side, flatten the Cupid’s bow (pointy bits at the top of the pink lip), or produce an upper lip that looks strangely uniform from one side to the other (also known as “sausage lips”). This is where technique matters more than the number printed on the syringe. How much filler is appropriate depends on the individual anatomy, half a mL placed badly can look less natural than a larger amount used carefully across several areas. When bad lip filler is medically urgent There is an important difference between lip filler that looks aesthetically disappointing and filler that is affecting the blood supply to the skin. Severe or increasing pain, bruising that is painful when not touched, skin turning pale, white, dusky purple or mottled, skin that feels unusually cool, blistering, pustules or an area that remains white after being gently pressed can indicate a possible vascular occlusion. Any change in vision, eye pain, double vision or sudden severe headache after filler requires urgent medical assessment. This is not something to photograph and review at your routine follow-up. Contact the treating clinic immediately, send clear photographs in good light and describe exactly what you are experiencing. Early recognition and treatment provide the best chance of restoring blood flow and preventing tissue damage. For a fuller explanation, see Vascular Occlusion After Filler: Signs, Symptoms and What to Do. Can bad lip filler be fixed? Usually, yes, although the right correction depends on what has actually gone wrong. Waiting for the filler to settle If the issue is early swelling, bruising or temporary unevenness, the most appropriate solution may simply be time and a planned review six weeks after treatment. This can feel unsatisfying when you are staring at your lips every five minutes, but intervening prematurely can create a larger problem. A small, carefully planned correction A genuine asymmetry or contour issue may sometimes be improved with a very small amount of additional filler, but only after swelling has settled and the whole lip has been reassessed with a thorough examination and good clinical photography. Adding more product should not be the automatic solution to every concern, particularly where the lips already look heavy or overfilled. Dissolving hyaluronic-acid filler Hyaluronic Acid (HA) filler can be broken down using an enzyme called hyaluronidase. This may be used when filler has been misplaced, has created persistent lumps, resides outside the intended area or has produced an overfilled result. Dissolving filler however is not quite the magic eraser social media sometimes makes it appear to be. Hyaluronidase also dissolves your natural HA and may spread beyond one tiny spot, the amount required can vary, and more than one treatment may sometimes be needed. The goal should therefore be to dissolve what needs correcting, allow the tissues to settle and only then decide whether any filler should be replaced. Dissolving and immediately refilling the lips can simply begin the same cycle again. Treating infection or inflammatory nodules Inflammatory or infected lumps require medical assessment and should not simply be massaged or covered with more filler. Treatment depends on the cause, which is why it is useful to know exactly what product was injected, when it was injected and whether there were any illnesses, dental procedures, vaccinations or skin infections around the time of treatment or when symptoms appeared. How can you avoid bad lip filler? Choose an injector who is willing to say no, because the ability to inject filler is only one part of the job. Knowing when the lips have reached their limit, when another area is affecting the overall balance, or when filler is unlikely to achieve what the patient wants is just as important. Ask what product will be used, why it suits your lips, how complications are managed, whether hyaluronidase is kept on site and how you can contact the clinic after hours. Look at settled lip filler before-and-after photographs, rather than photographs taken immediately after treatment when swelling can make the result appear more dramatic. Most importantly, start conservatively. We can always add a little more after the result has settled, rather than add too much filler initially, which will produce an undesirable result. Good lip filler should look tailored to your face, not borrowed from somebody else. Quick Answers What are the signs of bad lip filler? After healing, signs may include an overfilled or stiff appearance, loss of the natural lip border, filler sitting above the lip, persistent lumps, obvious asymmetry or a shape that does not suit the rest of the face. How long should I wait before deciding my lip filler looks bad? Swelling can remain noticeable for one to two weeks, while the result can continue settling over approximately four to six weeks. Urgent symptoms such as severe pain, pale or mottled skin, blistering or vision changes should never be watched and waited on and requires urgent medical attention. Are lumps after lip filler normal? Small areas of firmness can occur initially as the filler integrates with the surrounding tissues. Lips are made up of tubercles which can cause small defined areas in the lips after filler, that usually settle with massage, time and integration. Visible, painful, red or persistent lumps are more concerning, so should be assessed by an appropriately qualified injector. Can migrated lip filler be dissolved? Hyaluronic acid filler can be dissolved with hyaluronidase. The treatment needs to be planned carefully because dissolving filler is not always straightforward and can take more than one session to achieve the desired result. Should more filler be added to fix uneven lips? Sometimes a small correction is appropriate, but only after swelling has settled and the cause of the asymmetry has been assessed at least six weeks after filler treatment. Adding filler to already overfilled or poorly placed product can make the problem worse. Does bad bruising mean my lip filler was badly injected? No. Bruising can occur after any injection as the lips contain many blood vessels. Bruising that gradually changes colour and improves is common. Bruising that is painful when not touched however with or without increasing overall pain, pale skin, unusual mottling or blistering is suspicious for vascular occlusion, which requires urgent medical attention. What should I do if I think my lip filler has gone wrong? Contact the clinic that treated you and provide clear photographs and details of your symptoms. Seek urgent medical assessment for vision changes, severe or increasing pain, pale or mottled skin, cool skin, blisters or pustules. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, 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.

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 Kumeu 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! Quick Answers: Where should I start with cosmetic treatments if I’m new to them? Start with a consultation. A good injector can assess your face and skin and help prioritise treatments that suit your goals and budget. What are the main cosmetic treatment options available? Options include botulinum toxin (Botox®) to relax muscles and soften lines, dermal filler to restore volume and structure, and skin treatments to improve texture and glow. What skin treatments can help improve overall skin quality? Common options include microneedling, chemical peels, and injectable skin treatments such as hyaluronic acid or mineral-based skin boosters. Do cosmetic treatments work better when combined? Yes. Many treatments complement each other and can target multiple concerns at once, often giving better overall results than a single treatment alone. Why is a consultation important before cosmetic treatments? A consultation ensures treatments are tailored to you, helps avoid unnecessary procedures, and allows you to feel confident and comfortable with your injector. How do I choose the right cosmetic injector?Choose someone you trust, who explains your options clearly, prioritises natural results, and makes you feel heard and supported. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, 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. 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.

I had the pleasure of joining The Smart Girls Club podcast for Episode 14 - a conversation that felt both honest and rejuvenating. Exactly what great cosmetic treatments and conversations should be. In the episode, we dive into everything from the myths surrounding Botox® and fillers, to how cosmetic medicine can be approached in a way that feels natural, thoughtful, and personal. We also talk through the subtle shifts in how confidence, identity, and beauty evolve as we age and how important it is to feel informed and in control of your choices. If you’ve ever felt curious (or cautious!) about aesthetic treatments, this is a great listen. I share insights on lip fillers, Botox®, Profhilo®, and how I work with patients to achieve results that still feel like you - just a little more rested and refreshed. At ALLOR, my goal has always been to create a space where people feel seen, heard, and never judged. This conversation was a wonderful extension of that ethos, and I’m so grateful to have been invited. A big thank you to Sarah Cavanagh, the lovely host of The Smart Girls Club, for having me on and guiding such a thoughtful, engaging chat. You can listen now to Episode 14 on iHeartRadio or Spotify on the links below or just search The Smart Girls Club and look for my name. Written by Dr. Heather Anderson, MBChB, BSc, Urgent Care FRNZCUC, Cosmetic Medicine PGDip - NZSCM | ALLOR Cosmetic Medicine, 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. 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.

Someone told me to wait until winter before booking a chemical peel. Is that true? Anon, Huapai. Mostly, yes. The cooler months can be a good time for certain skin treatments, but not because there is anything magical about the season. The main reason is sunlight. Treatments such as chemical peels can make the skin more sensitive. Winter usually means less intense sun exposure and fewer long days outside, which can make aftercare easier, however that does not mean you can forget sunscreen. We all need daily SPF, especially after treatments that affect the skin barrier. Winter light may feel softer, but UV exposure doesn’t disappear just because the weather is cold. I also find winter a useful time to reset the skin. Many people come in with dullness, congestion, uneven texture, pigmentation or dryness that has built up over time. A carefully chosen chemical peel can help refresh the skin surface by stimulating regeneration of baby skin cells. So yes, the advice has truth behind it. Winter can be a good window for skin treatments such as chemical peels because the timing often suits recovery with less time spent outside. It should not however be treated as a seasonal sales push by injectors. The right treatment still depends on your skin, your goals and what your skin can safely tolerate. If you are unsure, start with a consultation with an injector you trust. A good plan should feel measured, not rushed. Quick Answers Is winter the best time to get a chemical peel? Often, yes. Cooler months may mean less intense sun exposure and less time spent outdoors, which can make aftercare easier. However, the right timing still depends on your skin, the peel selected and what your skin can safely tolerate. Can you get a chemical peel in summer? Yes. Chemical peels are not limited to winter, but careful sun protection and following your aftercare instructions become particularly important during warmer months. Do you still need sunscreen after a chemical peel in winter? Yes. UV exposure continues during cold and cloudy weather and recently treated skin may be more sensitive. Daily broad-spectrum SPF remains important after a chemical peel. What skin concerns can chemical peels help with? Depending on the peel selected, chemical peels may help with dullness, congestion, uneven texture and some types of pigmentation. The treatment needs to be matched to your skin rather than simply choosing the strongest peel. How do I know which chemical peel is right for me? The choice depends on your skin type, concerns, sensitivity and previous treatments. A consultation allows the practitioner to assess what your skin can safely tolerate and recommend a measured treatment plan. Should I avoid the sun after a chemical peel? You should minimise unnecessary direct sun exposure and follow the aftercare advice provided for your particular peel. Sunscreen remains necessary, but it does not replace sensible sun avoidance while the skin is recovering. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland

Is Botox® used for helping migraine headaches the same as the Botox® used for lines and wrinkles? Anon, Kumeu Yes, it is the same medicine. The difference lies in how it is used, where it is placed and what the treatment is trying to achieve. In cosmetic treatments, Botox® is injected into specific facial muscles that create lines. The focus is on softening lines, while keeping your natural expression. Migraine treatment is completely different. The goal is not cosmetic. Botox® is used to interrupt muscle and nerve activity that contributes to migraine attacks, leading to a decrease in severity and/or frequency of headaches. The injections are tailored to areas of pain and can include the face, temples, back of the head, neck and shoulders. The beauty of Botox® for migraines is that is also achieves wonderful cosmetic results when used correctly on facial muscles. Looking and feeling good? Yes please! A common concern however, is whether migraine Botox® will “freeze” the face. When the procedure is performed correctly, it usually doesn’t, so it is important to see an injector who understands facial anatomy so you achieve good functional and cosmetic results. If you are considering this treatment, start with a conversation with your GP and/or Neurologist to see whether it fits into your migraine plan to ensure it is safe for you and that other causes of migraines have been excluded. Results are often very effective with huge improvements in pain and function, which many describe as life-changing. Quick Answers: Is the Botox® used for migraine the same as the one used for wrinkles? Yes. It is the same botulinum toxin medicine. The difference is in the injection pattern, dosing and treatment goal. How is Botox® for migraine different from cosmetic Botox®? Cosmetic treatment targets specific facial muscles to soften expression lines. Migraine treatment follows a medical injection protocol across the head and neck to reduce headache frequency and severity. Where is Botox® injected for migraine treatment? It is typically placed across the forehead, temples, back of the head, neck and shoulders. The pattern is designed around the PREEMPT protocol. Will migraine Botox® freeze my face? When performed correctly, it usually does not. An experienced injector adjusts placement and dose to preserve natural expression while still delivering therapeutic benefit. Who should consider Botox® for migraine? It is generally considered for people with chronic migraine, defined as 15 or more headache days per month. Assessment by a GP or neurologist is recommended first. How long does it take to see results? Improvement often begins within several weeks, though full benefit may take two treatment cycles given approximately 12 weeks apart. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, 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.

"I keep seeing people online talking about vascular occlusion after filler. How would I actually know if it was happening to me, and what should I do?" It is a fair question, and the online chatter has made a lot of people nervous about it. Vascular occlusion is rare, but it is one of the filler complications that needs to be taken seriously. It is the reason filler should never be thought of as "just a beauty treatment", when in fact it is a medical procedure, so the person treating you needs to know how to recognise and manage complications straight away. Vascular occlusion is when filler blocks blood flow in a blood vessel, leading to compromise of the tissue the vessel supplies, and in extremely rare cases it can affect vision. Early recognition is key. The sooner a true vascular occlusion is identified and managed, the better the chance of re-establishing blood supply. After filler treatment some tenderness, swelling and bruising are normal. What is not normal is severe or increasing pain, skin that turns pale or white, a dusky purple or mottled, lace-like discolouration, skin that feels cool, blisters, pustules or an area that does not pink back up when you press it. A vascular occlusion can happen during treatment, soon after treatment, or several hours or days later, sometimes after you have already left the clinic. That is why aftercare instructions are important and not something to lose in your handbag. If anything looks or feels wrong, always contact the clinic that treated you immediately rather than waiting until the next day to see how it goes. Send clear photos in good light and describe exactly what you are feeling, as that helps your clinician act quickly. If you have any vision symptoms after filler, such as blurred vision, loss of vision, double vision, eye pain, or a severe headache, seek urgent medical attention and tell your injector straight away. Hyaluronic acid fillers can be dissolved with an enzyme called hyaluronidase, which is only stocked by injectors and not routinely stocked by the hospital, so it is important to see an injector you trust. It is worth asking what their clinical training and registration is, whether they keep hyaluronidase on site, and what is their plan if a complication occurs, and how would you reach them after hours? A confident clinician will welcome those questions. So, to answer your question directly: know the signs, but do not let them put you off. Choose your injector carefully before anything goes wrong, ask them how they manage risk, keep their after-hours contact handy, and take your aftercare seriously. This combination is what keeps you safe during the filler experience, which should be an enjoyable one, rather than a scary one. Quick Answers What is a vascular occlusion after filler? A vascular occlusion happens when filler blocks blood flow in a blood vessel. This compromises the tissue that vessel supplies and, in extremely rare cases, can affect vision. It is rare but serious, which is why filler is a medical procedure, not just a beauty treatment. What are the warning signs of vascular occlusion? Severe or increasing pain, skin turning pale or white, dusky purple or mottled lace-like discolouration, cool skin, blisters or pustules, or an area that doesn't pink back up when pressed. Mild tenderness, swelling and bruising are normal. These warning signs are not. How soon after filler can a vascular occlusion happen? It can occur during treatment, soon after, or several hours to days later, sometimes after you have already left the clinic. That is why aftercare instructions matter and why you should keep your injector's after-hours contact handy. What should I do if I think I have a vascular occlusion? Contact the clinic that treated you immediately rather than waiting until the next day. Send clear photos in good light and describe your symptoms. If you have any vision changes, eye pain or severe headache, seek urgent medical attention and tell your injector straight away. Can vascular occlusion be treated? Yes. Hyaluronic acid fillers can be dissolved with an enzyme called hyaluronidase, which injectors keep on site but hospitals do not routinely stock for this purpose, so your treating clinic is your first call. Early treatment gives the best chance of restoring blood supply. How do I choose a safe filler injector? Ask about their clinical training and registration, whether they keep hyaluronidase on site, their plan if a complication occurs, and how to reach them after hours. A confident clinician will welcome these questions. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, 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.

I keep seeing terms like “biostimulators” and “bioremodelling”, and it’s getting confusing. Are they actually different, or just names for the same thing? Anon, Hobsonville It is understandable to be confused, especially as the names are similar and with the growing cosmetic industry, there always seems to be a new term to learn! The short answer is yes, there is a difference, but they are more closely related than you might think. Biostimulators such as Sculptra® and Radiesse® are treatments designed to encourage your skin to produce more of its own collagen. Rather than adding volume, they work by stimulating your body’s natural processes to improve firmness, structure and skin quality. Bioremodelling, on the other hand, focuses more on improving the skin’s behaviour. Treatments such as Profhilo® spread through the skin to also stimulate collagen whilst enhancing hydration, elasticity and texture. If we simplify it, biostimulators are about rebuilding support whereas bioremodelling is about improving skin quality. In practice, both approaches do the same thing by creating healthier, more resilient skin. The difference lies in how they get there and what they prioritise. Which one is more suitable depends on what you are noticing in your skin. The important thing is not the label. It is choosing the right injector who will guide you to the best approach for your skin, and use it in a way that still looks like you. Quick Answers Are biostimulators and bioremodelling the same thing? Not exactly. Biostimulators and bioremodelling are related, but they work slightly differently and are usually chosen for different skin goals. What do biostimulators do? Biostimulators encourage the skin to produce more of its own collagen. They are often used when the goal is to improve firmness, structure and support over time. What does bioremodelling do? Bioremodelling focuses more on improving skin quality. It helps with hydration, elasticity and texture, rather than adding volume or changing facial shape. Is Profhilo® a biostimulator? Profhilo® is usually described as a bioremodelling treatment rather than a traditional biostimulator. It can support collagen and elastin activity, but its main focus is skin hydration and quality. Are Sculptra® and Radiesse® biostimulators? Yes. Sculptra® and Radiesse® are commonly described as biostimulators because they are used to encourage collagen production and improve skin support. Which is better: biostimulators or bioremodelling? Neither biostimulators nor bioremodelling is automatically better. The right option depends on what your skin needs, what you are trying to improve, and how your face is assessed during consultation. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland Sculptra® Medical Device Class III, to increase volume of depressed areas, particularly to correct skin depressions. Sculptra® has risks and benefits. Contains Poly-L-Lactic acid implant suspension. Ask your doctor if Sculptra® is right for you. For product information check with your doctor or from product details with the supplier. Click for further details. Galderma Australia Sydney. Distributed by Healthcare Logistics, Auckland. Radiesse® Medical Device Class III. Lidocaine injectable implant is indicated for plastic/reconstructive procedures in adults, including deep dermal and subdermal soft tissue augmentation of the facial area and is also intended for restoration and correction of fat or volume loss (lipoatrophy) in the facial area and for rejuvenation of the hands. Radiesse® has risks and benefits. Contains Calcium Hydroxylapatite. Ask your doctor if Radiesse® is right for you. 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. 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.

Is sunscreen really that important? Anon, Whenuapai When we look at someone’s skin and try to guess their age, what we’re really seeing is sun exposure over time. Fine lines, pigmentation and uneven texture are far more influenced by ultraviolet radiation than by the passage of time. That’s why sunscreen sits at the top of my anti-ageing list. Not serums, not injectables, not treatments. Sunscreen. Ultraviolet radiation quietly damages the skin, even when it’s cloudy. UVA rays penetrate deeply and break down collagen and elastin, the structures that keep skin firm. UVB rays cause surface damage and sunburn. The result? Long-term DNA injury, leading to wrinkles, brown spots and skin cancer. Sunscreen works differently to most skincare. Rather than trying to repair damage, it prevents damage from happening in the first place. Used consistently, it protects collagen, stabilises pigment production and minimises skin cancer risk. Sunscreen also allows the skin to age more slowly. This is why people who wear sunscreen daily tend to have smoother, clearer skin, regardless of other products they use. This matters even more when you are investing in cosmetic skin treatments. Treatments such as chemical peels, microneedling and active skincare can help improve texture, pigmentation and overall skin quality, but ongoing UV exposure can work against those results. Daily sunscreen helps protect the collagen, pigment control and skin clarity we are trying to preserve, which is why I see it as the foundation of any sensible anti-ageing plan. That doesn’t mean other factors aren’t important. Skincare, skin treatments and injectables all have their place. But without daily sun protection, it’s like constantly mopping up water while the tap is still running. The best sunscreen is one you’ll use every day. Broad spectrum protection and an SPF of at least 30 are good starting points. Apply it as the final step in the morning, including your neck, chest and back of your hands. For more on choosing and using sunscreen in New Zealand conditions, visit our Sunscreen & SPF Guide. Dr. Heather Anderson features in the All or Nothing Podcast (available on Spotify, YouTube and iHeartRadio). If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz Written by Dr. Heather Anderson, MBChB, BSc, Urgent Care FRNZCUC, Cosmetic Medicine PGDip - NZSCM | ALLOR Cosmetic Medicine, Auckland