An overview of different treatment methods

Frown lines above the eyebrows and forehead lines are mainly caused by overactive mimic muscles, as are the prominent platysma wrinkles (neck folds). If the whole gum is visible when laughing, the corresponding muscle in the face is overactive. Botulinum slows down these muscles so that the skin above them becomes more relaxed. The dose determines the appearance. The face should look natural after the aesthetic treatment and not mask-like, but simply younger and friendlier.

It comes as a powder in a vial and has to be dissolved with sterile water before injection. The powder does not contain bacteria, but only botulinum. The correct number of units is injected using a fine needle. I use the product BOCOUTURE® manufactured by Merz. The injection takes approximately 15 minutes. In addition, there is the duration of the consultation, which can vary depending on the patient's previous experience and needs. A botulinum treatment lasts from 3 to 6 months on average and differs from person to person.

Botulinum treatment causes minimal pain from the insertion of the fine needle and usually does not require anesthesia; however, you are welcome to let me know if you want local anesthesia.

Volume loss of the cheek bones and the cheeks can be rebalanced with dermal hyaluron fillers. The lip contour and volume can be modelled with hyaluron filler. Deep nasolabial folds as well as mouth angle folds can be corrected. Bony hands get a softer body feeling with the filler. Deepened tear troughs and dark eye rings can be smoothened with a suitable hyaluron. Men may want to accentuate the jaw line with a filler.

I use Croma®, Juvederm® and Teoxane® fillers, with which my patients and I have had the best experience. The injection of dermal fillers takes around 15 to 45 minutes, depending on the area of application. In addition, there is the duration of the consultation, which can vary depending on the patient's previous experience and needs. The longevity of the filler varies from 6 to 12 months and is determined by the product and the mechanical stress on the area.

Filler treatments usually do not require anesthesia; however, you are welcome to tell me if you want local anesthesia. For the lips, I always recommend anesthesia, usually with a strong lidocaine cream – upon request, also by injection of lidocaine.

PRP can be applied to improve skin quality in the face, the neck and the décolleté. For these parts of the body, a combination with e.g. injection of vitamins, amino acids and antioxidants and/or needling is also useful.

Furthermore, PRP is a suitable treatment for androgenetic alopecia (AGA). This term describes the hair loss that usually begins with adulthood. The hair starts to thin out, but there are still functioning hair follicles in the scalp. A small blood test (ANA, TSH, ferritin, CRP, ALAT) before PRP application is recommended in order not to miss other causes of hair loss. Supplemental intake of iron and B vitamins may help.

For the preparation, a blood sample of approx. 25ml is taken from the patient. This autologous blood is then centrifuged so that about 13ml of plasma is produced in the upper part of the sampling vessel. This plasma contains the thrombocytes, colloquially known as platelets. The lower part of the vessel collects red blood cells, which are not used for treatment and are therefore discarded. I opted for the World-PRP^® system, because high concentrations of platelets can be achieved.

If you want to improve the appearance of your skin, I recommend 2 initial treatments at intervals of 2 weeks. The results become visible only after a month and last about 3 months. After that, 1 to 2 treatments can be performed at intervals of 3 months. The skin develops more shine and collagen fibers through treatment with PRP.

During the revitalization of the skin, vitamins, antioxidants, amino acids and non-cross-linked hyaluronic acid are injected into the top layer of the skin. For this purpose, various products are available (with and without hyaluronic acid, different ingredients). The injection can be performed on the entire face or décolleté, maintaining a safe distance from the eyes.

For a visible increase in hair production, at least 3, or even better 6 to 8 treatments are necessary. The treatments can be performed once a month. The results are visible with a delay of about 4 to 8 months. After that, 1 to 2 treatments should be performed every 3 months for maintenance. A vitamin supplement can be added during the injection.