A ESTHETIC TREATMENT

Transcription

1 THE UK GUIDE A ESTHETIC TREATMENT Treat the signs of ageing to create more youthful and rejuvenated skin Jane M Olver BSc, MB, BS, DO, FRCS, FRCOphth American Academy Ophthalmology American Society Ophthalmic Plastic and Reconstructive Surgery European Society Ophthalmic Plastic and Reconstructive Surgery British Society Oculoplastic Surgery

2 Table of contents Introduction 1 Toxine and Fillers: 2 Botulinum toxin A 2 Fillers 5 Restylane Skinboosters 9 Tearfill 11 HyaloFix 13 Filler alternatives 15 Sculptra 16 SculptEyes 20 SculptVisage 22 Autologous fat transfer 24 Non-surgical face, neck and eye lift 26 Ultherapy 26 Face and body rejuvenation 29 Intraceuticals 29 Chemical peels and skin resurfacing treatments 33 TCA Peel 33 Final words 35 Download all of our guides! 40

3 Introduction My name is Jane Olver and I am the Medical Director and Consultant Eye Surgeon at Clinica London. The treatments in this guide are primarily concerned with restoring and maintaining what we call the "triangle of beauty". This upside down triangle is what most people visually associate with youthfulness: smooth, round contours, high cheekbones and a thin, well-defined jawline (the tip of the inverted triangle). This triangle get flipped around with the natural ageing process. As our face loses volume and skin begins to sag we end up with a squarer jawline and the youthful triangle effect is typically diminished. In this guide, I will tell you about the most common and effective aesthetic treatments that you have available to restore your triangle of beauty to a more youthful and revitalised state by addressing the most common skin and eye issues that impact us as we age. My special expertise is in eyelid and facial surgery. I have over 20 years experience in treating people with eye and facial contour concerns. After initially starting out as an NHS Consultant I chose to further enhance my patient s options by offering them more comprehensive solutions via my private practice. My personal ethos is to provide you with the best private aesthetic treatment and eye care in the world. I look forward to meeting you to discuss your aesthetic options in the coming months. This guide was created out of conversations I ve had with patients. I ve recently sat down and answered similar questions on video so I could share this information online as well as here in written form. I hope you like the conversational and straight forward nature of this guide. Best regards, Jane M Olver BSc, MB, BS, DO, FRCS, FRCOphth 1

4 Conditions Treated Ageing Skin Treatable Areas Forehead lines / Glabellar lines / Crows feet / Eye bags / Tear troughs Practitioner Doctor / Nurse Downtime Normally no real downtime, but it depends on the chosen treatment Your Specialists Jane Olver Consultant Ophthalmic Surgeon Toxine and Fillers: Botulinum toxin A The Problem Ageing causes skin and tissue changes in the face, especially around the eyes. The hallmarks of ageing include a tired wrinkled appearance, with lines in the forehead, the glabellar area between the eyebrows, the crow s feet and the bunny lines around the nose. Laughing, smiling, frowning and lifestyle factors all contribute to the development of these facial lines and wrinkles. The Treatment Tiny injections of Botulinum toxin (Botox, Azzalure, Dysport ) into specific locations around the face and eyes, temporarily reverse and smooth away the lines and wrinkles to give a more rejuvenated look. Botulinum toxin injections are very popular for anti-wrinkle treatments in the glabellar area (area between the eyebrows), the crow s feet and forehead lines. Some people have anti-wrinkle injections around the mouth, but this is always done cautiously as it is a more difficult area to treat. Other problems treated include facial spasms, sweating (underarm, feet and hands), and large calf (leg) muscles. Call us with any questions on:

5 Botulinum toxin A is a very powerful toxin which when injected in tiny amounts into a muscle, will cause a temporary paralysis of that muscle. Botulinum toxin A is made naturally by the bacteria Clostridium Botulinum and acts to chemically prevent release of the acetylcholine at the motor end plates of skeletal muscles which affects muscle contraction. Injections of Botulinum toxin are used in minute quantities to reduce the muscle tone or strength, giving a smoother, more relaxed, less angry or tired look. It also has an action on sympathetic smooth muscle and glands such as sweat glands and is often used to stop underarm sweating (axillary hyperhidrosis) and sweaty hands and feet (palmar and plantar hyperhidrosis). Several medical companies have developed a synthetic form of the toxin which has exactly the same effects as the natural toxin but can be used safely in microdoses. Some of the mainstream brand names include Botox, Dysport, Azzalure, Xeomin, Vistabel, Bocouture and Neurobloc. In the UK, Dysport and Azzalure are commonly used to treat periocular wrinkles, brow ptosis, blepharospasm, hemifacial spasm, facial palsy rehabilitation, and other areas including those for sweating and calf muscle reduction. Call us with any questions on:

6 FAQs Does the treatment hurt? the treatment take? What is the downtime after the treatment? When will I see results? As the needles are very small, the treatment does not hurt even though some areas can be more sensitive than others. Cooling the skin with the Coolsense device helps numb the skin before each injection Botox treatment is usually a very quick treatment of about minutes There is no real downtime, but we recommend you not to lay down for at least 4 hours and not to exercise for at least 24 hours The effect starts from between 3 to 7 days after injection. The peak action is at 7 to 10 days after injection with complete paralysis of the muscle area treated, which then it gradually wears off the result last? The result lasts between 2 and 6 months (average 4 months). Call us with any questions on:

7 Fillers The Problem Age causes changes to the skin and deeper soft tissues. As your skin ages, it loses the collagen that helps to shape and support it. Natural lines and wrinkles deepen. Sun exposure, smoking, air pollution and even stress can all age your appearance. The face can also begin to lose volume giving sunken cheeks a dragged down appearance and lips can lose their fullness and appear thin and lined. Other hallmarks of ageing include a hollow under eye area (tear troughs), hollow temples, deep nasolabial folds and marionette lines. A more complete list of the physical impacts of ageing skin are listed below. Call us with any questions on:

8 These common skin changes can lead to a tired, aged appearance: Tear trough hollowing, also known as deep orbitomalar groove Orbital rim hollow at the junction between the lower lid and the cheek Heaviness and drooping to the upper eyelid Laxity with sagging and drooping to the lower face, jawline and jowl areas The depression descending across the cheek from the lower lid/upper cheek junction, known as the zygomatic hollow Nasolabial folds, the lines between the nose and the corner of the mouth which become deeper and more apparent with age Nasolabial folds are accentuated by cheek volume loss and descent and loss of the malar mound Deepening of creases to the glabellar area, or frown lines between the eyebrows sometimes referred to as your number eleven Vertical depressions below the corners of the mouth, known as marionette lines Thinning of lip volume and loss of definition to the vermilion border (known as the lip line) Thin, lined and crepey skin on the neck and décolletage area Dry, thin and wrinkled looking hands. Call us with any questions on:

9 Facial and periocular areas that can be treated with filler The Treatment Facial and tear trough hollows can be effectively treated with injections of a hyaluronic acid gel filler or volume bio-stimulation of deep collagen, for instance with poly L lactic acid (Sculptra). Hyaluronic acid (HA) gel dermal fillers such as Restylane and Perlane or the Juvederm range of hyaluronic acid gels, are used to fill tear troughs, temples, cheek and facial hollows, in order to smooth the contours of your face. They also have a secondary effect to help reduce deep lines and wrinkles. Anti-ageing facial fillers are the non-surgical way to achieve younger looking skin by providing more facial volume and reducing the Call us with any questions on:

10 appearance of smoker's lines and wrinkles. Although dermal fillers are used to replace or increase volume, only the Skinboosters are used superficially to rehydrate the skin. The other fillers are injected or introduced by cannula into deeper tissue hollows for their volume effect. Botulinum toxin A Botulinum toxin A or a combination of Botulinum toxin and filler can treat all of the above age related aesthetic changes. Sometimes fillers are combined with other cosmetic treatments such as Ultherapy Skin lifting and tightening, Skinroller, Trichloracetic Acid (TCA) chemical peels and other aesthetic skin treatments. Ask your treatment specialist about the best combination for your unique skin. Hyaluronic acid gels (HA s) Hyaluronic acid gels including Restylane, Perlane, Skinboosters and Juvéderm are the most popular types of filler. The effects of hyaluronic acid gels reverse with time and can also be dissolved very rapidly with the injection of an enzyme which will reverse the gel with Hyalofix treatment. The oculoplastic surgeon will decide on the best HA filler to use. We inject the gel into the specific area of the face during an outpatient visit using a fine needle or cannula. The Restylane and HA fillers also contain local anaesthetic to reduce any pain and discomfort. Call us with any questions on:

11 A cannula allows fewer entry points through which a wide area can be treated. We then apply firm pressure to the area in order to reduce the risk of bruising and to ensure an even distribution of the gel. We may use ice packs and numbing creams, but they are often not essential. Restylane Skinboosters Restylane Skinboosters are a brand new approach to improve skin quality. Skinboosters improve the skin s quality by boosting hydration levels deep inside the skin. The treatment improves the skin s firmness, elasticity and radiance. Restylane Skinboosters treatment can be used to improve the general skin quality of the face but also to improve exposed areas such as the neck, décolletage, and hands as well as areas with acne-scarred skin. There are three treatment options depending on the level of depth of hydration treatment required: Skinboosters Light, Skinboosters Medium and Skinboosters Deep. These treatments are done in courses consisting of 3 separate sessions at 2 to 4 weeks apart. Once the initial 3 treatments have been performed, maintenance of results can be achieved with a re-treatment approximately every six months. Call us with any questions on:

12 The Result After the treatment with fillers the face will be rejuvenated by the soft increase in volume. Skin looks softer than before, the natural convexities of the face return to a younger appearance. When fillers are combined with other cosmetic treatments such as botulinum toxin A, Ultherapy Skin tightening,tca chemical peels an enhanced effect is seen. FAQs Most people say that they feel little or no pain during the injection of fillers and this can vary according to the area being treated. If a patient is more sensitive to pain, it is possible to Does the take painkillers and tranquilising tablets beforehand or use the treatment hurt? Coolsense device to cool and numb the skin. Both Restylane and Juvéderm contain the anaesthetic Lignocaine. If we are using Restylane Lip, additional injectable local anaesthetic may be desirable the treatment take? What is the downtime after the treatment? When will I see results? the result last? The treatment takes as little as 30 minutes but depends on the number of areas treated The downtime for filler treatment is minimal, about an hour. There can occasionally be light to moderate bruising but this can be easily covered with a mineral make-up like Vitage Minerals. With Restylane Skinboosters you may see tiny little dots on the hands (if treated) which fade within a day or so You will see the results immediately You will see the results of HA fillers for 4 months to more than a year. This is dependent on which HA is used, the location injected, your body s metabolism and how quickly you naturally biodegrade the filler. Call us with any questions on:

13 Tearfill The Problem The patient with deep tear trough hollows in the under eye area can look very tired as if they have not had enough rest. The Treatment At Clinica London the oculoplastic doctors treat tear trough hollows and dark circles under the eyes with hyaluronic acid (HA) gel delivered into the tear trough area and upper cheek eyelid junction via a tiny entry point on each side of the face. This is called Tearfill. A fine cannula is used, occasionally aided by tiny direct injection. This reduces the risk of bruising and greatly diminishes discomfort. The Result We gently introduce the HA gel to give a natural refreshed look. This technique is minimally invasive and is done by eye doctors skilled in the anatomy and surgery around the eyes. Call us with any questions on:

14 THE UK GUIDE AESTHETIC TREATMENTS Ms Jane Olver FAQs Does the treatment hurt? the treatment take? What is the downtime after the treatment? The Restylane used in Tearfill contains lignocaine and so it is virtually painless. The Tearfill is done using a single entry point on the upper outer cheek and that entry point is first prepared with a local anaesthetic to prevent discomfort. The canulla is passed through the soft tissue to the tear trough hollow and this is barely felt at all. The actual injection is not felt at all Usually the Tearfill treatment takes between 25 and 40 minutes Puffiness and bruising occurs for 1 to 5 days. This id usually discreet and can be concealed with concealer cream. Patients can return to work or go out to dinner or theatre the same day When will I see results? The results are seen immediately the result last? Tearfill lasts a minimum of 6 months and, depending on how much is used and precise location, can last up to a year. Call us with any questions on:

15 HyaloFix The Problem When patients are unhappy with their hyaluronic acid filler we recommend HyaloFix. You may have been treated elsewhere and been over-treated or simply had too much filler in your lips or face over a period of time and now feel that you would like to reverse the effects and return to a more natural state. Fear not as we have a treatment that can help you. The Treatment HyaloFix is reversal of hyaluronic acid (HA) gel (typically used in most dermal fillers) using titrated concentrations of the enzyme hyaluronidase which are appropriate to the volume and distribution of HA gel. The enzyme works very quickly to fix problems of either too much filler or the wrong placement of filler, in patients who are unhappy with their HA filler and do not want to wait for the filler to naturally disappear, (especially as some cross-linked fillers can take over a year to disappear). Its use is off licence and should only be done after an informed medical consent by a skilled and experienced professional. The Result You can quickly get rid of wrongly placed or overdone fillers to end up with a smoother facial contour. Call us with any questions on:

16 One question I m often asked is if this enzyme affects the normal soft tissue. There s absolutely no evidence that I or other practitioners could find that using hyaluronidase enzyme off licence to reverse fillers could also affect your own tissue longterm. This is because your body is continually making new hyaluronic acid gel, every hour, every day. FAQs Any injection into the skin is felt a little. The actual HyaloFix Does the treatment is hardly felt and as soon as the injection is over, it is treatment hurt? only minimally tender or not at all Most treatments take 30 minutes. It can take between one to 4 tiny injections and then we observe the area for 10 to 15 the treatment minutes to make sure that it is working well and that there are take? no reactions What is the downtime after the treatment? Immediate puffiness and mild erythema (redness) for two to 6 hours, which then settles. You can go out the same day as treatment or to work following the treatment When will I see results? There is an immediate effect which can be seen within half a minute of the injection and the effect carries on until the morning after the result last? The effect of HyaloFix lasts forever. All the hyaluronic acid gel reversed enzymatically will remain reserved. Any untreated areas remain with the hyaluronic acid gel unaffected. If at a later stage you would like to again have filler this is not a problem and the same areas of the face can be treated. Call us with any questions on:

17 Filler alternatives Other products are used to increase facial and periocular volume, which are not hyaluronic acid (HA) gel based. These are semi-permanent or permanent fillers which are favoured by some surgeons or patients wishing for a longer lasting result. These filler alternatives include Radiesse (Calcium Hydroxyapatite spheres) and Sculptra (Poly-L Lactic acid), a biostimulator of your own deep collagen. Autologous (from your own body) fat can be harvested and re-injected by cannula into the peri-orbital area and face. These fillers can be used for both medical and cosmetic purposes. Call us with any questions on:

18 Clinica London offers a unique treatment called SculptEyes. This technique uses Sculptra for bio-stimulation of the patients own deep collagen around the eye area to lift and enhance the appearance of the eyes, by targeting the temples, outer brow bone, upper cheek / eyelid junction. This minimally invasive technique is a combination of fine cannula and direct injection performed by an oculoplastic surgeon, which carefully avoids the delicate immediate eye area. Sculptra The Problem With increasing age, people experience a loss of fat along with a descent of tissue in the temples and the upper cheeks. This contributes to the sag and descent in the cheek and mid-face, which gives a square appearance to the face. The hollowness below the eyes gives a tired and aged appearance with deep tear trough hollowing and descended flattened cheeks. The orbitomalar groove and trans-cheek depression is called the zygomatic hollow. The temples become hollow and depressed and the face takes on a more square look, losing its youthful triangular appearance between the two eyes and mouth. Nasolabial folds the lines between the nose and the corner of the mouth become deeper and more apparent with age. Cheek volume loss accentuates nasolabial folds with a descent and loss of the malar fat mound (the apples of your cheeks). Call us with any questions on:

19 Vertical depressions known as marionette lines appear below the corners of the mouth. Sculptra can help re-volumise these hollows and depressions. The Treatment In older patients, Sculptra can treat depressions in the periorbital area, upper cheek, nasolabial folds, marionette lines, temple area and in front of the ears. The treatment can give a very natural and healthy look without obvious cheek apples. Only healthcare providers who have expertise in the correction of volume defects, have undergone training, and then become fully familiarised with the product and its i "Only healthcare providers who have expertise in the correction of volume defects, have undergone training, and then become fully familiarised with the product and its uses, are qualified to use Sculptra." uses, are qualified to use Sculptra. Sculptra is an injectable product that contains micro particles of poly-llactic acid (PLLA) a synthetic polymer from the Alpha Hydroxy Acid family. It s been around for a very long time. Initially, it was used for volumisation of patients with a facial atrophy. This product has also been used for over 30 years as dissolvable sutures and for tissue regeneration. It is typically non-toxic even in large quantities within the body, hence its suitability as a facial volumiser. Call us with any questions on:

20 Sculptra is biocompatible and biodegradable. It is reconstituted several days before use, using sterile water, and is therefore a liquid rather than a gel. The active particles are suspended in the liquid. Lignocaine is then added to the suspension to provide a more dilute suspension and local anaesthesia. Sculptra used for age related facial volume loss is injected with its local anaesthetic into the areas of depression such as the peri-orbicular area, the temples, over the malar cheek area, zygomatic hollow and towards the tear troughs. It is used very lightly in the tear troughs as a very dilute suspension in that area. Injection is typically by cannula which reduces the number of entry points and is less traumatic to the tissue than multiple injections. The art of injection is to concentrate on creating a fuller face around the temple and cheeks which helps to support the area of the tear troughs. It is also used to volumise the marionette lines, nasolabial folds, jawline and chin. Two or three treatment sessions 8 weeks apart are required in which one to three vials are reconstituted and injected. We assess each patient at consultation to determine their individual need. The Result The initial effects of the volume increase appear for two days, then gradually fade. This may seem alarming to you, but it represents the water disappearing. Once the water is gone, the small particles are left which gradually help to lay down collagen in the deep planes of the face Call us with any questions on:

21 and increase the volume. Sculptra is only used in the deep dermis or subcutaneous layer. Four to six weeks after the first treatment, the second treatment is performed. By 3-4 months improved volume should be noticeable and should last for months before a top-up is required. FAQs Does the It is extremely rare for patients experience pain during and after treatment hurt? Sculptra treatments. We use preventive local anesthetic cream to reduce any discomfort from the injections The duration of the treatment is highly dependent on the amount of product that will be injected. Nevertheless, half an hour to one hour before the procedure begins, local anesthetic the treatment cream is used to reduce any discomfort from the injections. take? There is also time required after the treatment, so the patient can rest in another treatment room where we can apply ice packs or give specific facial massage What is the downtime after the treatment? This varies from person to person. It is dependent on the amount of product the patient had been injected. Also some persons bruise more than others.typically the patient can go back to daily activities on the same day When will I see results? You should notice improved volume by 3-4 months the result last? The result should last for months. Call us with any questions on:

22 SculptEyes The Problem SculptEyes is a unique procedure to Clinica London which has been designed and created by Ms Jane Olver. Using Jane s vast experience in oculoplastics and aesthetic treatments she has devised SculptEyes to help rejuvenate the peri-ocular area, including the temples, upper lateral brow, the tear troughs and upper cheek area. It is for ageing with loss of volume, and hollows and descent affecting the periocular area. The Treatment This technique uses Sculptra (poly L lactic acid) for bio-stimulation.this is a combination of fine cannula and direct injection, performed by an oculoplastic surgeon. The Result The area around the eyes gets lifted and the appearance of the eyes are enhanced. Call us with any questions on:

23 FAQs Does the treatment hurt? the treatment take? When will I see results? There is minimal discomfort with the cannula delivery of Sculptra as we can use techniques to numb the skin and the product also contains a local anaesthetic. After an initial consultation to assess the problem area, treatment can take place on the same day if suitable, and this will take approximately 30 minutes to several hours depending on complexity and whether you will also be treating additional areas on the face. There are three stages to the results, immediate, at one week and by 8 weeks as the Restylane works immediately. If this treatment is used in conjunction with Botulinum toxin, that part of the procedure will take around a week to work and the Sculptra takes up to 8 weeks to see the effect and the effects will then continue to improve. Ultherapy is similar in lifting gradually after 8 weeks as bio-stimulation of the patients own collagen occurs. the result last? The results can last up to 18 months. How long is the downtime after the treatment? There is minimal downtime with only slight swelling, mild tenderness and risk of bruise. The patient can carry on normal activities immediately afterwards. Call us with any questions on:

24 SculptVisage The Problem SculptVisage is a unique procedure to Clinica London which has been designed and created by Ms Jane Olver. Drawing on her cast experience in oculoplastics and aesthetic treatments, she has devised SculptVisage to help rejuvenate the whole face and particularly the cheek to create a healthy rejuvenate face and eye area. SculptVisage is a so called medium size treatment, that combines several treatments. The Treatment The SculptVisage technique uses Sculptra (poly L lactic acid) for biostimulation of the face, particularly the cheeks, in association with SculptEyes and Tearfill, to give a healthy rejuvenated face and eye area. The Result The result is, that the area around the eyes get a more youthful, healthy and natural refreshed look. The appearance of the eyes are enhanced. Call us with any questions on:

25 FAQs Does the treatment hurt? the treatment take? When will I see results? the result last? There can be little discomfort depending on which treatments you need. The duration of the treatment is highly dependent on the treatments you get. This depends on the treatment, for some you can see results immediately for some you can see the results after 1 to 3 months. Results will last about 6 months up to 2 years depending on the treatment. Call us with any questions on:

26 Autologous fat transfer The Problem One alternative to hyaluronic acid gel or other deep collagen biostimulators such as Sculptra, is an autologous fat transfer (also sometimes known as a Coleman fat transfer). We usually use autologous fat transfer to treat cheek atrophy and temple hollowing in patients who may not be keen on hyaluronic acid gel or who want a more permanent effect. We make deep injections into the submuscle area and existing fat reserves. We avoid injecting substances into superficial areas to prevent lumps, which can be difficult to eradicate. An autologous fat transfer is also an effective choice for patients who have suffered trauma or who have a congenital deformity or post enucleation socket syndrome (PESS). The Treatment Autologous fat transfer is a technique where fat is taken from the patient s abdomen or thigh using a liposuction technique. This is done either under a local or general anaesthetic in an operating theatre. The fat is then prepared for injection in a centrifuge and injected with fine cannulas. Autologous fat has longevity of up to five years with a very low rate of allergic reaction. It is sometimes difficult to estimate the exact volume to be injected as up to thirty per-cent of the fat can be re-absorbed in the Call us with any questions on:

27 first three to eight months. An autologous fat transfer is also a more invasive surgical procedure than a hyaluronic acid gel filler injection. It causes more swelling and requires a longer recovery period. We use an autologous fat transfer in conjunction with eyelid, cheek and other facial rejuvenation surgery. We usually carry out autologous fat transfer under a local anaesthetic with light sedation and the patient should only feel a mild discomfort following the procedure. FAQs Does the Autologous fat is collected then transferred to its new site under treatment hurt? local anaesthesia therefore very little discomfort is felt the treatment take? What is the downtime after the treatment? When will I see results? The duration of the treatment is highly dependent on the amount of fat being harvested for transfer. Half an hour to one hour before the procedure begins, the area of the stomach where the fat is harvested from is numbed, as are parts of the face, in order to reduce the chance of you feeling any discomfort This varies from person to person. It is dependent on the amount of fat the patient has been injected. Also some people bruise more than others. Typically the patient can go back to daily activities within 48 hours You should notice an immediate improvement in volume the result last? The result should last for months. Some transferred autologous fat lasts for ever Call us with any questions on:

28 Non-surgical face, neck and eye lift Ultherapy Ultherapy is the latest innovation in skin tightening used by A-list celebrities such as Courtney Cox and Jennifer Aniston. In a single appointment this remarkable treatment can offer a non-surgical facelift in a lunch hour with no downtime. The Problem The ageing skin on the face, neck and décolletage can look dull and tired. The deep layers of the skin lose their elastin and collagen with age, which can create a tired appearance. Approaches to rejuvenation include good skin care with serums, moistures and exfoliation to increase cell turnover. Call us with any questions on:

29 Ultherapy is a non-surgical ultrasound treatment to counteract the effects of ageing by working on the deeper layers of the skin. Ultherapy is practical and quick, hence attractive to the active person who does not want a surgical face or eye lift. It aims to lift the skin. The Treatment Ultherapy is a non-invasive FDA approved ultrasound thermocoagulation treatment that bio-stimulates the body to produce new collagen in the deep skin in order to help tighten and elevate your skin. It is known as the non-surgical face and eye lift. At Clinica London we specialise in using Ultherapy around the eyes, face, neck and décolletage. Ultherapy can also help rejuvenate the lower eyelids without surgery by its effective skin tightening. If there are prominent little fatty pads protruding, this may still require an eyelid operation such as Blepharoplasty. Call us with any questions on:

30 FAQs Does the treatment hurt? the treatment take? What is the downtime after the treatment? When will I see results? Yes, it can be uncomfortable but we help to alleviate this with pain relief medication and anaesthetic cream at least 45 minutes before treatment It takes about 60 to 90 minutes depending on the number of areas treated. You can also have top-up treatments if required There is usually no downtime and you may feel a little tenderness but should see no visible bruising to the area The effects can be noticeable as soon as 6 weeks after treatment but the optimum results will take place after 3 to 6 months and continue to improve as time goes by the result last? It will usually last between 2 and 3 years. Call us with any questions on:

31 Face and body rejuvenation Intraceuticals The Problem Ageing skin loses volume and dehydrates, making it look dull and flat. Intraceuticals helps hydrate the skin by providing water into the dermis. Hyaluronate stores water. It is infused into the skin using hyperbaric oxygen. This will re-hydrate both the epidermis / dermis and make the skin look healthy and glowing. Call us with any questions on:

32 There are 3 different types of intraceuticals 1. Rejuvenate treatment: Done either by itself or with Atoxelene. Rejuvenate serum contains hyaluronate, Vitamins A, C and E, green tea, and aloe vera. It is very soothing and revives the skin by deep hydration. The Atoxelene is used as an adjuvant to either the Rejuvenate or Opulence serum. 2. Atoxelene: Likened to Botox and works in a mild form on wrinkles / fine lines especially around the mouth, eyes and glabellar, due to its properties with acetyl octapeptide 3. It also contains hyaluronate and Vitamins A, C and E. Atoxelene comes both as a serum and also a line wand which is used at home to apply the Atoxelene directly to fine lines. 3. Opulence: For patients who have more pigmented skin or patches of pigmentation that they want to be lightened. It is an alternative to hydroquinone and contains an anti-tyrosine to reduce pigmentation. It contains hyaluronate, Vitamins A,C and E and its special lightening ingredients alpha arbutin and yellow dock. Similar to the Rejuvenate Intraceuticals, the Opulence range is used with Atoxelene if there are wrinkles and fine lines. There is also an Opulence wand for spot use on pigmented areas such as melasmas. The Treatment As no needles or injections are involved in the treatment, intraceuticals are being hailed as a pleasant alternative for those who might be reluctant to try Botox or fillers. Call us with any questions on:

33 Each patient is assessed first by the doctor or nurse and they discuss which type of Intraceuticals is best: Rejuvenate or Opulence, either with or without Atoxelene. The best results are when the patient is using the 3 step layering technique: maintenance "It is especially useful to have a treatment a day or two before a big event, whether it be a wedding, serum, gel i film premier, first date, anniversary, interview, or and binding Christmas party etc." cream, every day. The treatment is like a very nice luxury spa facial with added benefit. Each treatment begins with a thorough cleansing to prepare the skin for the infusion. A fine mist of the specially selected serum is then sprayed on to the area to be treated the face, hands or chest. Due to the tiny precision tip used to administer the pressurised oxygen, it is also possible to treat the area extremely close to the eyes. Finally, a moisture binding cream is applied to seal in the moisture. The Result Intraceuticals provides the skin with a more fresh glow. The intraceutical oxygen enriched cocktail of ingredients includes vitamins and antioxidants. In addition there are three specific courses Rejuvenation, Opulence and Atoxelene each specially formulated to address the most common skin problems: wrinkles, hyperpigmentation and sun damage as well as blemishes. Call us with any questions on:

34 It is especially useful to have a treatment a day or two before a big event, whether it be a wedding, film premier, first date, anniversary, interview, or Christmas party. FAQs Does the No, the treatment is absolutely pain-free treatment hurt? the treatment The treatment takes about 60 minutes take? What is the downtime after There is no downtime after an intraceutical treatment the treatment? When will I see results? Results are visible directly after the first treatment. The results improve greatly if home care treatments are applied as advised the result last? The results of the first treatment will last 3-7 days. The 6th and last treatment will commonly last days. These timeframes dependent on the initial condition of the skin. For long term the treatment works best with a series of 6 weekly treatments and then monthly maintenance treatments. The result is cumulative and improves after every treatment, even though results are also seen immediately. Call us with any questions on:

35 Chemical peels and skin resurfacing treatments TCA Peel The Problem As we age, we can get fine pigmented blemishes and fine lines both around the eyelids and areas such as the décolleté, shoulders and neck. The Treatment A Trichloroacetic acid chemical peel (TCA peel) is a medium depth peel that does cause noticeable redness and exfoliation. We use TCA peel in different concentrations to be either a superficial (20 30%) or medium depth peel (30 50%). The exact percentage we use depends on the patient s age, the amount of skin rejuvenation required and their skin colour or Fitzpatrick skin number. We most commonly use TCA 35% concentration. The Result A Trichloroacetic acid chemical peel helps reverse solar lentigines and actinic keratosis and improves skin texture while having a marginal effect on fine wrinkles and tightening the skin. It helps correct epidermal atrophy and atypia and helps lay down new sub-epidermal collagen. Call us with any questions on:

36 THE UK GUIDE AESTHETIC TREATMENTS Ms Jane Olver FAQs Does the treatment hurt? the treatment take? What is the downtime after the treatment? Deep chemical peels can be a bit uncomfortable. After the actual peel, pain is normally minimal. It is possible that the skin is itchy during the healing process In most cases the procedure takes about 40 minutes The downtime depends on the depth of the peel. But most patients have no problem going back to work 5-7 days after the treatment When will I see results? From day 1 to 14 the skin begins to peel. The duration is depending on the depth of the peeling. After this time the results shows up the result last? The longevity of results depend on how good the patient takes care their skin after the treatment and their skincare routine and products used. Call us with any questions on:

37 Final words I know from experience that it is not always easy to choose which aesthetic treatment is best for your particular skin and face shape. You may have noted that several treatments covered in this guide can tackle very similar skin concerns in slightly different ways. It's best to have someone review your skin and then make a professional recommendation as to which options are best for you. Call us with any questions on:

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