Dr Tasneem Mitha | 04 Sep 2021
Whether you like it or not, the reality is that anti-wrinkle injectables like botulinum toxin and dermal fillers are no longer just a celebrity “Hollywood” thing…..EVERYONE is doing it! Your neighbour is probably doing it, and so is your mum!! No longer heavily guarded secrets, words like “Botox”, “Juvederm” and “Lip filler” have become as familiar as “Pepsi”, “Panado” and “Vicks”!!
So, if you’ve been sitting on the fence, and you’re not quite sure what it’s all about, if you’re shy to ask your neighbour, just because you don’t want her to know you’re considering it (let’s face it, we’re all still faking it and don’t want to admit that we’ve had a little help in the anti-ageing department….), then look no further. Here’s everything you need to know to make an informed decision!
The cosmetic industry is so saturated with conflicting and incorrect information, that it can be a bit difficult to wade through it and find the facts you’re looking for. It never fails to surprise me when a patient sits in my chair, asking for an injectable, but they don’t really know what is and what it does, or why they want it in the first place! Here are some of the myths you may have heard….
Myth 1: Botox gives you big lips….
Botox and fillers are the two most common cosmetic injectable treatments that are offered by practitioners, however they are different products and used for entirely different outcomes.
Botulinum toxin, commonly known by its trade name Botox, or Dysport, is a muscle relaxant, used to soften the appearance of fine lines and wrinkles, most popularly in the upper face and around the eyes (crows feet). More importantly, botox can be used to prevent wrinkle formation if it is started at the right age (more on that later…). There are other less common indications for botox, such as lifting the corners of the mouth, reducing a gummy smile, or for facial slimming, treating migraines as well as to reduce night grinding/bruxing habits and to treat axillary or palmar hyperhidrosis (excessive underarm or palm sweating).
Dermal fillers on the other hand are hyaluronic acid injections which are used to volumise, or project or reshape certain areas of the face. As we age, we lose fat volume in our faces, and everything starts heading south….. dermal fillers help us to replace the lost volume, such as the tear trough under the eye, or the lips, and to accentuate and define certain areas of the face such as cheekbones, forehead, nose, chin and jawline.
Myth 2: I will look frozen and fake with Botox and fillers
Cosmetic injectables have come a long way from the frozen fake looks that we were accustomed to seeing in the 80s and 90s! There is so much more education and skill development out there, and facial injectors are constantly learning more and newer techniques to improve their results. Injection materials and techniques have become very sophisticated, we are no longer just filling lines. Injectables, if placed in the correct quantities and the correct depths are able to lift, volumise, and contour and will provide a natural, beautiful, long lasting result. It is very important to discuss your expectations with your injector. My motto is to “start low and slow”, and gradually build up the result with time. This way my patients learn to trust me, and it keeps things looking natural.
Myth 3: Cosmetic injections are very painful
I always say that pain is a very individual and relative thing…yet the outcome makes it worth the effort! Some people have high pain thresholds compared to others. Botox injections are quick, and any discomfort is very short-lived. For those who are concerned about pain, topical anaesthetic can be applied before-hand in some procedures, to minimize the pain and discomfort. Most dermal fillers also contain lidocaine, which is a local anaesthetic, so that as the area is being injecting, the numbing effect will occur. If you are particularly averse to pain, discuss this with your doctor, so that they can minimize the discomfort and make the procedure as comfortable as possible for you.
Myth 4: Anti-wrinkle injectables are only for (old) women!
False, false and false again!! The young women of today are very informed about skin and facial ageing, and young women make up the majority of patients that we treat in this industry. I love to treat younger women mainly because less product and work is needed to get a great outcome, and also I feel proud to be a part of their anti ageing journey.
The age old question…when to start with aesthetic treatments??? The best time to start considering anti-wrinkle injectables is, in my opinion, your early to mid 30s, before the ageing actually starts setting in. This way you work on being more preventative and keeping things natural, rather than doing large volumes of corrective work on your face.
Older women seeking non-surgical cosmetic treatments are often more challenging to treat, they have unrealistic expectations, they require much more work (and cost), and they will often require a combination of treatment modalities in addition to botox and fillers such as lasers, thread lifting and even surgical procedures.
Then enter the metrosexuals – young (and old) men want to look good, healthy and age better, and we see a rising proportion of young men doing injectable procedures, especially botox injections. Filler treatments can also be used to enhance or produce more masculine features such as widening of the chin or creating a more prominent cheek or jawline.
Myth 5: Botox and fillers are toxic.
We’re all concerned about what we put into our bodies, and it’s no different when it comes to facial injectables. Botox is the purified protein version of the true botulinum toxin, which means that it is largely non-toxic, when injected in the recommended amounts. The toxin is injected directly into the muscles to help relax them, and is not systemically absorbed into the bloodstream.
The active ingredient of dermal fillers is hyaluronic acid (HA), which is a substance occurring naturally in the body. If the layers of our skin were compared to a sponge, then HA can be thought of as the lubricant that keeps the sponge moist. As we age, our bodies begin to drastically slow the production of this vital substance leading to dehydrated, wrinkled skin lacking elasticity and youthfulness. Dermal filler and other hyaluronic injectables such as skinboosters help to refill the “sponge”, allowing skin to appear more youthful.
Myth 6: Botox and fillers are permanent and non-reversible.
How long will it last? This is one of the most common questions I get from patients.
Botox injections typically last 3-4 months, but it varies in individuals; in some people it can last longer, in others less. So the good news is that if you don’t like the effect of the botox on your face, it will gradually disappear over the next 6-8 weeks!
Dermal fillers can be of 2 types – permanent or temporary. Most practitioners (including myself) use mostly temporary dermal fillers. They last approximately 6-18 months, depending on the type of filler used and the location it was placed. Filler treatments can be reversed, by dissolving it with an enzyme called hyaluronidase.
Anti-wrinkle injectables 101 in a nutshell.