Sunday 16 June 2013

Why other clinic's lip fillers (lip enhancements) are only half the job

Lip augmentation (plumping) without proper contouring can leave the lips looking like fat sausages. A practitioner or clinic offering only a lip augmentation is offering only half a job!


Skin Beautiful Medical and Cosmetic Clinic provides expert advanced dermal filler treatments at clinics in Exeter Milton Keynes Bristol Coventry Swansea Warwick Daventry Evesham Carmarthen Llanelli and Neath.


Fuller lips, lip plumping, lip fillers, lip enlargement, lip injections, etc, etc are all offered by cosmetic clinics across the UK. These treatments are nothing more than adding volume to the lips. Surely that is what every client seeking a lip enhancement wants, isn't it?

If I tell you that these treatments can result in loss of definition, natural shape or symmetry then you may think a little differently about these advanced dermal filler treatments. To "plump up the lips" changes their dimensions. A little saying I often use to explain this to clients:

"As we change the dimensions of the lips then we must also redraw the contours."

Introducing lip sculpting, shaping, contouring and outline definition!


Lip plumping is only half the job

What happens to a balloon when one adds water to it? It changes shape and size. In other words its outer perimeter contours are altered to compensate for the volume of water contained within them. This is very much the same with the lips when liquid gel hyaluronic acid dermal fillers are injected into them. Clients are left with larger, fuller lips but in some cases the outline of the lips have been eroded. In these cases the client has literally gained a fuller pair of lips at the expense of them losing their shape. This is only half a job as the lips have not been finished off correctly.

What is lip contouring and why is it important?

Lip contouring is particularly important as part of a lip enhancement procedure because it redraws the natural contours of the lips, particularly the upper lip. When volume is added to the lips the contours can then be redrawn using advanced needling techniques.

The diagram below is from a previous lip enhancement treatment performed at our clinic. It shows the particular points of interest that together make up the contours of the lips. Notice how the natural contours have been redrawn after the lips have been augmented (plumped). Without lip contouring the lips would just look like fat shapeless sausages!
Diagram of the lips showing points of interest
Lip contouring is about the areas around the border outline of the lips

Sausage lips, balloon lips and the trout pout!

Many young women desire fuller lips and realise how easy it is to get treatments for them at high street cosmetic clinics throughout the UK. Clients I have consulted with generally have no prior knowledge of lip enhancement other than to have larger lips. When I consult I explain that the contours will change once the lips are enlarged (augmented). Of course any client is quite welcome to have just a lip augmentation treatment at our clinics, but many choose to have them contoured too.

I have spoken with several clients whom, having had consultations with other clinics have been offered only lip plumping and so their understanding of lip enhancements goes no further than the size of the lips. Some practitioners make the mistake in over filling the lips as a way to reintroduce shape. This is not the correct way to redraw contours and will only make them look like ugly, fat sausages or over inflated balloons. This is commonly referred to as the "trout pout!"

Advanced lip enhancement procedures

Advanced lip enhancement treatments involve lip sculpting, shaping, contouring and definition. this is quite different from the basic lip augmentation (plumping). I always advise clients to get the best for their money when considering dermal filler treatments. At the basic end a client pays for one, two or more syringes of dermal filler. The vital question then is what is the practitioner going to achieve with that syringe of dermal filler? If they cannot perform advanced treatments because they don't know the necessary advanced techniques then the ceiling for potential creativity is instantly lowered and the client is not going to benefit from the true potential of the dermal filler.

Advanced needling techniques - Lips created by Helen Bowes!

For every two syringes of dermal fillers a client pays for then some of this filler must go into contouring. Clinics that charge for lip augmentation and do not contour may be wasting a client's money. I am not about to give away my knowledge of advanced needling techniques and procedures for other practitioners to attempt in their clinics but the video below demonstrates how advanced needling can really make a difference to a client both in terms of discomfort and precise results

Expert lip augmentation - No bleeding, bruising, lumps or bumps.


Watch Helen Bowes RGN, BSc (hons) AMAP perform the perfect lip augmentation






I don't use a cannula or dental block! A cannula is not a good tool for precision in lip contouring and sculpting. Patient discomfort is kept to a minimum by advanced needling techniques.



Links to our lip enhancements:
LIPS! by HELEN BOWES®
All of our other lip enhancements
Lip augmentation (plumping & volume)
Advanced lip sculpting, shaping contouring and definition


Other Skin Beautiful links
Skin Beautiful Medical and Cosmetic Clinic homepage
Treatments available at our clinics
Dermal fillers and advanced techniques

Skin Beautiful YouTube channel







Saturday 27 April 2013

Who wants a wrinkle free sagging face?

Could filling wrinkles with dermal fillers really leave you with a sagging face? Find out why facial contouring and advanced dermal filler procedures matter.

Skin Beautiful Medical and Cosmetic Clinic provides expert advanced dermal filler treatments at clinics in Exeter Milton Keynes Bristol Coventry Swansea Warwick Daventry Evesham Carmarthen Llanelli and Neath.


Wrinkle free sagging face anybody?

No, I didn't think so. The point being made is that whilst cosmetic treatments such as dermal filler injections with Juvederm, Restylane, Radiesse and Teosyal can certainly correct lines folds and wrinkles they can offer so much more. You pay for the product so you should not be limited by treatment options just because a practitioner cannot perform the more advanced treatment(s) for your needs.

As a paying client it is the duty of your medical aesthetics practitioner to offer honest and appropriate advice about the cosmetic treatment options available to you. If you have deep nasolabial folds (laughter lines or nose to mouth lines) then it may not be money well spent to have these treated alone. Why? Because they are likely to be a symptom of another problem not the direct cause.

What are advanced Botox or dermal fillers techniques?

Advanced Botox & dermal fillers techniques may be defined as any treatment which adds volume, lift or definition to the face (e.g facial contouring) or, cosmetic Botox and/or dermal filler treatments other than to correct lines & wrinkles. Some examples are: Botox for eyebrow lift; dermal filler treatments for cheek augmentation, lip enhancement, jaw definition, jowl lift and non surgical facelift.

What am I paying for?

In my own medical & cosmetic practice: Skin Beautiful, we charge for most dermal filler treatments by the syringe. Clients literally pay for the product according to the treatment being given. So, for example a syringe of Restylane or Juvederm may be used for one treatment or another all at similar prices. Where a client presents themselves with visible lines and wrinkles it is appropriate to look under the surface, so to speak. Often the lines are accompanied by visible signs of loss of fat or volume in the face. In such cases it may not be appropriate to offer treatment for lines and wrinkles. I tell my clients "you are paying for the product so you should get the best treatment available for your needs."

Consider all treatment options

During consultation with clients I take time to explain the properties and potential uses for a range of dermal fillers. For example, a lady client came to our clinic last year with multiple lines and wrinkles around the eyes, cheeks and mouth. Her expectation was to pay for several areas of lines and wrinkles treatment. When she explained that other clinics had quoted her for 4 areas of treatment I advised her that this was the wrong way to treat her condition and that all areas could be treated under a single treatment. Yes, the lines were indeed visible and there was a genuine need for treatment. However, the previous clinic clearly did not understand that loss of volume was the cause of her wrinkles. In my experience it was a case of treating the cause not the symptoms. After all, who wants a wrinkle free sagging face?

Getting the best treatments for your money

Case example: Lip plumping

I've seen many clinics offer "lip plumping" or "lip filler" treatments. This is simply no more than an inflation of the lips. Yes, it will make them larger, but may also destroy their shape, contours and symmetry. The lips are an incredibly beautiful feature of the human face with very intricate contours. A lip enhancement procedure should respect these contours. In other words, as the dimensions of lips are enlarged then the contours must be redrawn.

Sausage lips!

Some of the very worst lip enhancements i've seen literally resemble "sausage lips!" That is, lips that have undergone a lip augmentation and have been inflated to look like fat sausages with absolutely no shape or contours whatsoever. This is a very bad waste of a client's money. Furthermore, I doubt the practitioner consulted with these clients properly.

The very same syringe of dermal filler could have yielded much better results for a similar if not identical cost. It is down to the ability of the practitioner with the syringe in hand to effect these results. Nobody wants to pay to lose their natural lip contours at the expense of sausage lips, but this practice is quite common amongst clinics with poorly trained staff. They simply do not know how to use lip fillers beyond basic augmentation.

Lip augmentation with beautiful contours



The images below represent a treatment I performed in 2012 (hence the copyright). Notice how the vermilion border of the upper lip and has been raised and philtrum to lip border has been redefined relative to the size of the upper lip. This is an advanced dermal filler technique known as lip sculpting (also referred to as lip shaping, lip contouring or lip definition). In addition, the treatment has also improved symmetry between top and bottom lips.


Lip enhancement before treatmentLip enhancement after treatment

















*N.B. a cupid's bow definition has not been performed on this client. The illustration is to show the relative position of the cupid's bow to neighbouring areas.

For further details of advanced lip enhancement treatments and techniques including shaping and sculpting please visit the following pages on the Skin Beautiful website:

Lip enhancement treatments: Advanced techniques with dermal fillers
Lip augmentation treatments (plumping, enlargement)
Lip contouring treatments (Advanced sculpting, shaping & definition)

Conclusion

Advanced lip sculpting, shaping and contouring treatments are just one example of getting the best from a syringe of dermal filler. Many of the advanced cosmetic treatments with dermal fillers often use the same or similar products as used for more basic volumising, augmentation and wrinkle filling treatments.

In essence it's all about the level and understanding of the practitioner. A good practitioner with skill in advanced procedures will take time during consultation to explain all treatment options. Clients are often at the mercy of practitioners as many charge by the syringe for basic dermal filler treatments. "Lip fillers" is not a treatment. In fact it isn't a product either. There are various categories of lip enhancement.

Please see our other blog titled "Good practice begins with a proper consultation" to find out what constitutes a good consultation.

http://hm-skinbeautiful.blogspot.com/

Blog author: Helen Bowes RGN, BSc (hons), NISP, AMAP

Helen Bowes is the pioneering developer of the first advanced dermal filler systems for lips, cheeks and non surgical facelift. She is a qualified advanced medical aesthetics practitioner, registered general nurse and nurse prescriber. Helen holds regular clinics at over ten locations across England and South Wales.


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Useful links:

Skin Beautiful homepage
About Helen Bowes and Skin Beautiful

Botox & dermal fillers treatments
Advanced Botox treatment for eyebrow lift
Advanced dermal fillers treatments for cheek augmentation
Advanced dermal fillers treatment for jaw definition & jowl lift
Advanced dermal fillers treatment for Non surgical facelift

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Sunday 17 February 2013

Botox Treatment - Getting The Most From It

How long can a Botox treatment really last? How can I get the most from my treatment? This article explores some Botox myths and offers practical advice for clients.

Skin Beautiful Medical and Cosmetic Clinic provides expert advanced dermal filler treatments at clinics in Exeter Milton Keynes Bristol Coventry Swansea Warwick Daventry Evesham Carmarthen Llanelli and Neath. 


Getting the most from a Botox treatment and ensuring it lasts for as long as possible is an area that clients must take responsibility for.

In my own practice many first time clients present themselves with differing expectations as to how Botox (Botulinum toxin type A) works and how long its visual effects will last. This is one half of equation.

Putting the record straight


1. How long can I reasonably expect Botox to last?


In facial aesthetics Botox is the essential ingredient in removing facial lines and wrinkles (albeit temporarily). For those of you that are interested in calculating costs based on longevity then a rule of thumb is three months. Yes, that's right, only three months. This is the average time it takes for neuromuscular contractions to resume. Remember that creases, lines and wrinkles are visible as a result of muscular contractions. Once the Botox has ceased to block muscle contractions then there is 'X' amount of time before those lines become visible again.

A common misconception amongst clients is that Botox works on the skin and that there is a direct relationship between Botox and lines and wrinkles. This misconception in turn leads to the belief that if wrinkles are kept at bay for 5 months then the Botox works for 5 months. The scientific response should be that Botox works on local groups of muscles and has no direct effect on the skin whatsoever. Botox will stop certain muscles from contracting for approximately 3 months. In fact that's all it does. The interesting thing here, and one of the many wonders of science is that there can potentially be a delay between the time muscle contraction resumes and lines and wrinkles become visible once again.


2. How soon after Botox stops working will lines and wrinkles become visible?


it is scientifically impossible to give an objective answer to this question, and here's why. Once muscle contractions have resumed then Botox is no longer governing the behaviour of those muscles. In a sense it is retiring and handing the job back to the neuromuscular system. So, if the time it takes for the lines and wrinkles to reappear from this point forward is not determined by Botox it must be determined by something else. Indeed, it is determined by your own body, its metabolism, physical state and a whole conundrum of other factors.


3. I've had my Botox treatment. Now what?


There are clients whose perceptions of Botox is that they visit a clinic, receive their Botox injections and will not see any lines or wrinkles for around 6 months. Botox is a drug, and drugs go through the stages of absorption, distribution and metabolism within our bodies. Hence, the speed and effectiveness with which a drug is absorbed and then distributed is largely dependent on the environment in which the drug has to work. Similarly, metabolism is an important factor in the effectiveness and longevity of the drug too.

It's all about shared responsibilities. Where the practitioner has a responsibility to advise it is the responsibility of the client to action post treatment advice at a personal level and, where longevity and effectiveness is a priority then to create the right environment for Botox.


4. Are there any possible reasons why Botox wouldn't last three months?


Yes there are. Although, at the time of writing there remains inconclusive evidence to support the many theories out there. We need further scientific evidence in order to better inform our clients. There are those in the industry who believe the effectiveness of Botox in temporarily correcting facial lines and wrinkles may be reduced by alcohol, smoking, recreational drug use, sports activities, stress, diet, environmental factors, sleeping patterns, etc, etc.

Whilst it is generally recognised that a healthy, active lifestyle leads to better metabolism in the body certain physical activities may lead to problems elsewhere. For example, through exertion we often use our facial muscles more than at rest. A good example might be weight lifting. The activity in itself is unlikely to have a negative effect on the longevity of Botox. However, the tightening of facial muscles that accompanies exertion when lifting very heavy weights results in overuse of certain facial muscle groups. This in turn could be a factor working against the effectiveness of Botox.

In a different way alcohol and smoking may affect the absorption and metabolism of Botox within the body. Other factors such as excessive exposure to sunlight may cause the skin to appear more wrinkled than it would otherwise do so.


5. What advice can you offer to help me get the best from my Botox treatment?


Much of the advice given to clients is centred around research conducted by drugs manufacturers. For example, I always provide general advice to clients regarding alcohol consumption, exercise, flying and head position but I like to go further in offering advice too.

Following treatment it may take up to or even beyond 14 days for Botox to take full effect. My personal belief is that advice to refrain from alcohol for a period of just 6, 12 or even 24 hours post treatment is not sufficient. That is not to say that if a client consumes a small glass of good quality wine then he/she will see no visual effect with the Botox on the treated area. My advice is based on effectiveness and optimisation. For Botox to be as effective as possible then it is important to create the right environment to support its distribution and metabolism within the body. Furthermore, the process is also dependent on how the body metabolises alcohol.

For anyone interested in optimising the effectiveness of their Botox treatment then a sensible course would be to look after one's skin and neuromuscular system. For the skin it is better to stay away from excessive strong sunlight than to receive exposure to it and then apply creams or lotions to counter its effect later on. As mentioned above, exercise that puts stress on facial muscles is also something that should be avoided as much as possible.


About the author:
Helen Bowes RGN, BSc (hons), NISP, AMAP
Registered Advanced Practitioner No. MD1248/12

Helen is a qualified advanced medical & cosmetic aesthetics practitioner, specialising in advanced Botox & dermal fillers treatments. She practices regularly at Skin Beautiful clinics in Exeter Milton Keynes (England) Bristol Coventry Swansea Warwick Daventry Evesham Carmarthen Llanelli and Neath.

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