The following description provides a brief summary of the cosmetic treatments used at NSAD. Your dermatologist will be pleased to discuss your needs and recommend the appropriate treatment.
Botulinum Toxin [or Botox®] is a muscle relaxant used to reduce dynamic skin wrinkles. These are lines which are produced by one’s facial muscles that are involved in facial expression. Frown lines above the nose, crow’s feet on the temples, and upper forehead lines can all be reduced to give a more youthful and fresh appearance.
Botox is injected into the muscles under the skin with fine needles. The relaxation takes up to two weeks for full effect. An assessment is often done at that time to determine the need for a ‘top-up’. The effect typically lasts 6 months or more, at which time many patients would return for another treatment. The more often one uses Botox, the longer the effect lasts.
Botox is not suitable for deep ‘passive’ lines typically found on the lower face. These are better treated with dermal fillers.
Botox is also used in patients with excessive sweating of the armpits and hands (see our section on hyperhidrosis).
Many of the deep lines on the aging face are due to gravity and the gradual decrease in elasticity of the skin. Examples include the folds between the cheek and the lips, marionette lines, and ‘smokers’ lines on the lips. Unlike dynamic skin lines, which are caused by muscular action, these ‘passive’ lines are best ‘filled’ by injecting a dermal filler such as hyaluronic acid (HA). HA can also be used to make lips fuller and correct naturally occurring asymmetry.
HA is a naturally-occurring substance found in the skin, and serves to fill in space between structures in the skin. Once injected into the folds or creases, HA absorbs water and ‘plumps’ up the crease shallow it out. It is not practical to completely remove the lines, but rather decreasing their depth and thus their appearance in light, giving the face a more youthful appearance.
Different brands of HA are available, the most common being the Juvederm® series, Restylane ®and Perlane®.
Intense Pulsed Light
Intense Pulsed Light (or IPL) is a form of light treatment used for facial rejuvenation. It is different to a laser only in the way in which the light is produced and filtered. An intense light is produced through a handpiece which is applied in a pulse to target specific elements in the skin.
Freckling and pigmentation, broken capillaries and nasal vessels, as well as excess hairs can all be treated.
Whilst only targeting specific structures in the skin, many patients also experience a general improvement in the overall appearance and texture to their skin.
Lasers are high-powered devices that produce a very strong beam of light with a single wavelength. Different laser wavelengths are needed for different applications.
Vascular lasers are used for treating broken capillaries, veins and various vascular birthmarks. In cosmetic dermatology, they are useful for the background redness caused by sun exposure or rosacea. Vascular lasers are also ideal for the large vessels we often get around the nose and small ‘starburst’ veins on the legs.
Laser light can be tuned to target pigment within the skin. Freckling and patchy pigmentation can be treated. Unwanted tattoos can be removed, however, a different laser is required to treat each different colour. Some colours are near impossible to remove.
Resurfacing lasers are used to remove layers of skin. These lasers are useful for facial rejuvenation including smoothing out sun-damaged skin, removing age-related lines and wrinkles, as well as treating acne scarring. Healing of the resurfaced skin can take days to weeks. Higher powered lasering leads to more time needed for healing, but this generally gives a better result.
A variation of this laser is the fractionated laser, commonly know by the trademark Fraxel®. Fractionated laser places multiple tiny holes in the skin, which stimulates collagen production and thus plumps up and reduces wrinkling and also reduces the pitting caused by acne scarring. As most of the surface of the skin is intact, healing occurs much faster and only days.