Many patients who are just beginning to show signs of facial aging desire improvement, but cannot justify the cost or time investment required for surgical intervention.  For these patients, the rapidly expanding repertoire of injectable treatments is perfect to suit their needs. Fillers and Botulinum Toxin are pre-formed materials, prepared in injections and ready to be administered directly. Fat transfer on the other hand is taken from your body, treated in a special way, and re-injected in another part of your body. All procedures can be done without anesthesia or under local anesthesia. 

Temporary Fillers:

Juvederm, Esthelis,  Restylane, Varioderm, and many others in the market are short-lasting gels that, once injected into the skin with an ultra-fine needle, lifts and adds volume to the areas being treated.

Similar to one of the body's own natural substances (hyaluronic acid), it is a completely safe treatment.
The hyaluronic acid in these fillers simply supplements the body's age-depleted hyaluronic acid to plump-up the lip or to raise the skin and 'fill in' the particular wrinkle being treated and has three major benefits.

In a totally natural, but not definitive way, these products will restore the sensuality of your lips and smooth curves to your face. Through a simple injection, without a prior test, minor imperfections and signs of aging are softened  evenly.

Dr. Wilson recommends that you apply a local anesthetic cream (e.g. Emla, prilocaine ...etc.) for at least 60 minutes before the injection time to avoid feeling even the pinprick of the injection.

These fillers are an excellent treatment option for:

• Deep folds
• Lip enhancement
• Facial lines
• Wrinkle correction
• Volume augmentation of the lips
• Shaping facial contours (such as cheeks and chin correcting)
• Smile lines (correcting thin, superficial lines around the eyes, mouth and forehead)

Fillers are used to fill nasal furrows and oral commissures and smooth medium and superficial wrinkles They are also an excellent volume creator which, when injected into your cheeks, gives you back your good looks.

The effects of these fillers usually last six to nine months, but sometimes more or sometimes less depending on skin type, the area treated, the volume injected, and the technique used for the procedure.

FAT TRANSFER

This is the same type of treatment but instead of using synthetic fillers your own fat is used. A donor area usually the abdomen is used to harvest the fat and it is treated first by centrifugation and purification, then injected with a special cannula in the recipient area. It has a much longer longevity than fillers, upto 5 years and maybe more. 

Patients who benefit from fat injection are people who desire augmentation or filling of volume-deficient areas. The most commonly grafted areas include the hands, face (including the lips), and depressions in the skin contour such as those that have developed following liposuction and scarring.

BOTULINUM TOXIN INJECTIONS

Wrinkles are part of the aging process and can be  caused by muscle contraction such as frown lines, forehead lines and crows' feet, and these can be improved by Botulinum Toxin treatment.

Botulinum toxin, is produced by bacteria called Clostridium botulinum and is commercially available as Botox® or Dysport® or Refinex. It acts by blocking  a chemical that is responsible for transmitting electrical impulses that cause muscle contraction. This results in muscle paralysis. The resultant paralysis, however, is temporary, as the new growth of nerves will re-innervate the muscles.  Since 1990, it has been  used cosmetically to reduce facial wrinkles arising from muscle contraction.

What can you expect at the time of your procedure?
Botulinum Toxin is injected directly into the muscles that cause the wrinkles, using a very small needle. Several injections are usually needed at specific sites, depending on the area treated. Normal activities can be resumed immediately.

What are the results?
Botulinum Toxin usually takes effect 24-72 hours after injection, with maximum effect at about 1 to 2 weeks. Its effects generally last for approximately 3-4 months. When injected into the muscles that are responsible for expression wrinkles, it gives the face a more relaxed and smoother appearance. When a gradual fading of treatment effect is noticed you may return to have another treatment.

What are the limitations?
Whilst Botulinum Toxin can be very effective in reducing wrinkles due to muscle contractions, it has no effect in reducing the fine lines on the face caused by sun damage, or sagging lines due to  gravity.In those patients with very heavy lines, repeated treatments may be needed for maximum effect. Repetition of treatments every 6 months for 2-3 years may produce permanent paralysis of target muscles, and thus a long lasting effect is attained and alleviates the need for further injections.

Atrophic cheeks and sunken contour in a 43- year old female: 5 ml of permanent filler were injected in each side. 

 Thin cheeks and sunken contour in a 23- year old female: 2 ml of permanent filler were injected in each side.

Deep forehead lines in a 43-yr. old male: Treated with 50 U of Botulinum toxin.

 Deepforehead lines in a 32-year old lady:100 IU of Botulinum Toxin were injected.

Thin atrophic lips  in a 73- year old lady: 1 ml of temporary filler were injected in each lip.

 Sunken cheeks in a 27- year old female: 9 ml of fat were injected in each side.

 Disfiguring wrinkles around the mouth in a 68 yr. old female: 2 ml of temporary filler were injected in each side.

Empty cheeks in a 27- year old female: 3 ml of fat were injected in each side.