Botulinum & Filler2023-01-24T01:04:58+01:00

Botulinum and dermal fillers

Botulinum is mainly known under the name of Botox®, which is actually a product name of Allergan. Nevertheless, most patients refer to botox when speaking of botulinum. The medical substance botulinum is derived from the clostridium botulinum bacteria and reduces muscle activity, according to the dose injected.

How to apply botulinum and dermal fillers?

«Anger wrinkles» and forehead lines are the result of overactive mimic muscles, just as prominent platysma wrinkles (neck folds). If a smile shows too much gingiva, then the corresponding muscle lifts the lips too much. Botulinum reduces the muscle activity, so that the skin is able to relax. The right dose, adjusted to your needs, makes the right appearance. A face should always look natural, not artificial.

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 feel with filler. Tear troughs and eye rings can be smoothened. Men may want to accentuate the jaw line with a filler.

Treatment with botulinum causes minimal pain when punctured with a fine needle. Furthermore, 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 with a syringe.

What is botulinum, what is dermal filler?

Most dermal fillers are made of hyaluron and are a transparent gel, packaged in a sterile injection set. The hyaluron in dermal fillers is a copy of the human substance and therefore well compatible with the human body. The difference from one product to another is the concentration of hyaluron and the number of crosslinks between the hyaluron molecules. In other words, some fillers are softer, others thicker. Depending on the facial area, the appropriate filler has to be chosen. The longevity of the filler varies from 6 to 12 months and is determined by the product and the mechanical stress on the area. I use the fillers which my patients had the best experience with: Princess®, Juvederm® and Teoxane®.

For certain filler treatments, Radiesse® is an alternative filler. Its active substance is calciumhydroxylapatit. This biological substance is a natural ingredient of the human bone. In cosmetic medicine, it is prepared as a white, intransparent gel that can be injected into the deeper layers of the skin. Its main effect is volume substitution, but it also stimulates collagen fiber production.

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 injection takes a few minutes, the right number of units is injected using a fine needle. Fillers require a little more time.
A botulinum treatment lasts from 3 to 6 months on average. I use the product BOCOUTURE® manufactured by Merz.

The procedure

A personal consultation helps to find the right treatment for you. You will need to provide details of your medical history and possible side effects and precautions to take will be explained. Please bring your medical record and a list of your medication, if you are under other medical treatment. The treatment itself takes from 15 to 45 minutes, the consultation time depends on your knowledge and experience in aesthetic medicine.

Risks and important advice

The longevity of treatment varies and cannot be guaranteed. Every treatment may cause bruising and swelling. Possible serious adverse effects will be explained during a personal consultation.

FAQ

Can I choose whether I want to have wrinkles treated with filler or rather with botulinum?2023-01-09T12:37:51+01:00

Generally speaking: No. Of course, you decide which wrinkles you want to have treated. Some wrinkles are caused by volume loss of the skin, e.g. the nasolabial folds. Volume loss is compensated with the volume replacement material hyaluron. Likewise, lips can only increase in size by adding volume, i.e. hyaluron filler. Botulinum would only cause severe movement disorders in the lips. Conversely, frown and laugh lines are caused by overactive muscles. Only botulinum intervenes in the muscle activity. In addition, deep frown, forehead and laugh lines can be treated with a thin liquid filler. At the express wish of the patient, treatment with filler alone is also possible, but not optimal.

How long does the effect last?2023-01-09T12:38:48+01:00

The effect of botulinum usually lasts 3 – 6 months, the effect of hyaluron fillers lasts 6 – 12 months, depending on the product and the treated facial region.

I have a cold, can I still come for treatment?2023-01-09T12:25:37+01:00

If you have mild cold symptoms without fever, we can still perform treatment. However, if you have a fever or are more seriously ill, we should postpone the treatment for your safety.

I have inflamed or itchy skin in the area to be treated2023-01-09T12:34:34+01:00

In this case, you should postpone the treatment. Infections, whether bacterial or viral, should heal completely first. Eczema can be aggravated by irritation with peeling (acid). Give the skin another 2 – 3 weeks to recover before making another appointment.

I have often had herpes on my lips. What to do?2023-01-09T12:40:14+01:00

An injection with filler can trigger a new episode of herpes labialis. If these episodes are very pronounced, prophylactic treatment with aciclovir 2x400mg may be advisable. Alternatively, a treatment with Zovirax cream can be kept ready after the injection, or oral therapy with aciclovir 5x200mg can be started immediately at the first signs of an outbreak.

Botulinum injections in other facial regions do not trigger a herpes spurt.

I have swelling after treatment with filler. What should I do?2023-01-09T12:41:27+01:00

Slight swelling after the treatment is normal. Cool with ice. If you should feel the filler, you may massage with light pressure after 24 hours. If, on the other hand, you have severe redness, swelling and pain, contact me immediately on +41 (0) 76 578 11 11 or go to an emergency ward. If you are unsure, do not hesitate to call.

Isn’t botulinum a poison?2023-01-09T12:39:33+01:00

All things are poison, and nothing is without poison. The dose alone makes a thing not a poison”. The statement comes from Paracelsus. Botulinum in the right dose in the right place has no poisonous effect. For a lethal dose, an injection of about 50 ampoules intravenously would be necessary. For aesthetic applications, the dosages are far, far lower.

What do I need to have ready for counselling/treatment?2023-01-09T12:25:03+01:00

Please have your medication list ready and, if available, a list of known diagnoses or chronic diseases.

What is the cost?2023-01-09T12:48:32+01:00

The cost depends on the number of hyaluron injection sets or the facial areas treated with botulinum, respectively. Depending on the place of residence of the patient or the location of the place of your choice, I calculate a travel allowance. Please get in touch for an individual quote.

What should I do or not do before and after a botulinum treatment?2023-01-09T11:44:40+01:00

Avoid alcohol 24 hours before and after a botulinum treatment. This reduces the risk of bruising.

After a botulinum treatment, you should avoid intense physical activity and intense heat (sauna, intense sun exposure) for 24 hours. Normal physical activity, also on sunny days, has no negative effects.

Do not massage the facial area that has been treated with botulinum.

What should I do or refrain from doing before or after treatment with PRP?2023-01-09T12:28:58+01:00

  • Avoid alcohol 24 hours before and after the treatment. This will reduce the risk of bruising.
  • Avoid intense exercise for the first 24 hours after treatment.
  • Let the treated facial area rest and do not touch it too often to avoid infections.
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