Fight time and gravity with soft touch plastic surgery at Australia Plastic Surgery

Perhaps nothing is more gratifying for cosmetic patients than having an immediate correction of wrinkles or scars as a result of simple injection. Using fillers requires no knife, sutures or downtime. In the aging face there is a loss of skin elasticity, fat and muscle tissue, hence a loss in skin supportthis causes sagging wrinkles and folds.

Results from injectables and fillers can push the clock back few years. Fix any bump or dent in the nose, redefine a slack jaw line, vanish away wrinkles and crows feet. Fillers can also lift sagging brows, and improve the lines in the neck and mouth. Lips and lips borders can be beautifully sculpted with fillers, made to look fuller, giving you a natural beauty look.

Planning your treatment

The treatment is performed on an Outpatient basis and can be done immediately after a consultation if appropriate

Soft treatment: Includes:

1. Injectable fillers (such as Restylane®, Juvaderm™, Perlane®, etc..) to improve wrinkles and skin quality, lips enhancement and lifting, eyelids enhancement, facial groove fillings, tear trough filling, and other parts of the body
2. Botox to relax muscles and improve wrinkles, targeted face and neck area
3. Laser for skin rejuvenation. If you require Laser, we advise you to start Antiviral treatment one day before the procedure.

Dr. Barnouti insists on performing these procedures himself, rather than have his staff provide these services. Despite the extra time it takes, the surgeon feel that their in-depth knowledge of facial anatomy gained from his surgical experience allows for more refined injection techniques. The key to the injections is achievement of a balance between your upper and lower lips, while maintaining the appearance of a natural fullness.

The effects usually last three to six months, at which time another injection is required. After several treatments, the effects may begin to last longer, sometimes up to six to eight months. We recommend treatment every three months for the first year, and then repeat treatment as needed.

This treatment is provided at the same day of consultation in the office and may require local anaesthetics. You will be able to drive a car after the treatment.

Soft tissue fillers

Temporary skin fillers can be used to correct small defects in the skin such as fine lines and wrinkles, and to add volume to lips. Coarser fillers can also be used to fill deeper lines in the forehead and around the eyes and mouth, and the deep lines that develop between the nose and the corners of the mouth (naso-labial folds).

Fillers containing coarser particles are more slowly absorbed by the body, and are therefore used for filling deeper folds and augmenting lips and facial contours, whilst finer lines and wrinkles are treated with a product which contains smaller particles and gives a more subtle increase in skin volume. There is no damage to the skin and tissues as the products integrate with adjacent tissues to allow the free passage of vital nutritive elements like oxygen and hormones to pass between fragments of the gel.

Facial, Forehead and Neck wrinkles

For the injection of lines or wrinkles, treatment involves some discomfort, and in occasional cases an anaesthetic cream may be applied up to an hour beforehand. The filler is simply injected in tiny amounts into the skin beneath the area to be treated with a very fine needle. The gel then gives natural volume and smoothes the wrinkles. The results are immediate.

Paris Lips

When enhancing the lips, pain relief in the form of a local anaesthetic injection to numb the area is often used. The procedures generally take around 30 minutes. Make-up can be applied immediately after treatment and you can return to work or home straight away. The effects last anywhere between four months to a year, but the length of time is extremely variable. Due to variations in the individual response and also the degree of fullness desired, the complete effect can only be accurately assessed at 3 to 4 weeks after treatment. You can request further treatments at this stage, and can enhance your appearance exactly as you wish.

What are the side effects?

After treatment some common injection-related reactions may occur, such as swelling, redness, pain, itching, discoloration and tenderness at the implant site. These typically resolve spontaneously within one to two days after injection into the skin and within a week after injection into the lips. Occasional cases of lumpiness in the form of nodules, sometimes accompanied by redness, have been described after injection, and may occur a few days to a few weeks after the injection.

Is the treatment for everyone?

Treatment with hyaluronic acid-based fillers is not recommended for patients who are pregnant or breastfeeding; those with a medical history of autoimmune-type diseases or of multiple allergies; or those who have used Roaccutane in the last three months. Exposure to extreme temperatures (severe cold, saunas, UV or sunlight) should be avoided during the days following the injection.

Botulinum toxin (btx) Injection

Aging is associated with the development of lines and wrinkles caused by sun damage, gravitational effect, and muscular action.

Btx is a purified protein toxin produced by the clostridium botulinum bacteria, a potent substance that temporarily disables the muscles of the face and neck, which when flexed can create an angry or upset appearance. It has been used in the medical field since 1973 and for cosmetic purposes since 1988. It is given with a fine needle, Injection techniques often vary among practitioners. Patients usually notice a clinical effect 1-3 days following injection, and the effect is maximal by 1-2 weeks. The benefits usually last 3-6 months and then resolve.

Planning your treatment

The treatment is performed on an Outpatient basis and can be done immediately after a consultation if appropriate

First, the muscles to be treated are identified by observing the patient making different facial expressions. Btx, which comes frozen and dried, is reconstituted and diluted to a very specific strength. A few drops of Btx are injected with a tiny needle into the muscle that creates the wrinkle. When Btx is injected into a muscle, it blocks the nerve impulse from reaching that area, and as a result, the muscle weakens. As the muscle weakens, the skin overlying the muscle relaxes and the wrinkle in the skin gradually softens and often disappears. When Btx is injected there is an initial minor sting for a few seconds. Once the injection is complete, there is usually no discomfort. The procedure itself usually takes less than 10 minutes. There is no immediate response to the Btx injection. It takes several days for the muscles to be affected, at which time, one will notice the gradual loss of ability to frown or to create the lines affected by the treated muscles.

What are the area that can be cosmetically treated with Botox?

1. Horizontal Forehead Lines
2. Glabellar Frown Lines
3. Temporal brow lift and elevation of the eyebrow
4. Nasal dips: contraction of LLS muscle during "scrunches" of the nose, producing "mad dog" appearance to the face. This muscle can be injected on each side of the nose lateral to the nasion.
5. Nasal flare
6. Mental or chin crease
7. Facial asymmetry
8. Upper lip wrinkling
9. Lifting the corners of the mouth
10. Neck bands
11. Adjunctive use of Botox injections before, after or during surgery

How long does a Btx treatment last?

The effects of Btx usually last three to six months, at which time another injection is required. After several treatments, the effects of Btx may begin to last longer, sometimes up to six to eight months. We recommend treatment every three months for the first year, then repeat treatment as needed.

Does it work for everyone?

No. About 2% of patients have pre-existing antibodies to Btx, which render it ineffective. Unfortunately there is no way of identifying this small group of people beforehand.

What are the risks?

Btx has been used safely and successfully in ophthalmology for over 20 years and for wrinkle therapy for over 10 years. In the amounts used for wrinkle therapy, the only possible side effects are temporary and localized to the area of injection. In rare cases this may cause a droopy eyelid or eyebrow. This seems to occur because some of the material injected finds its way into those muscles unknowingly. The problem usually goes away in two or three weeks and may be expedited by taking eye drops. Allergic reactions to Btx are extremely rare. Other possible side effects are temporary bruising, pain or headache and double vision, which is extremely rare and will usually disappear within two weeks.

Does Btx affect other facial expressions or create numbness?

Btx doesn't affect the sensory nerves, so there is no numbness in the area of the injection. Also, the effect of the Btx is only in the immediate area of the injection. Therefore, the muscles related to other expressions are unaffected.

Is the treatment for everyone?

There are very few restrictions regarding Btx treatments. Patients who are pregnant, have a neurological disease, or are taking antibiotics should not be treated.

Australia Plastic Surgery provides soft tissue fillers and Botox at the same day of consultation. Book a consultation online, click here, or call us onWe aim to helping you making a right decision about your health

Read more about the Science of Botox

The Science:

Botulinum neurotoxin is produced by the gram-positive anaerobic bacterium Clostridium botulinum.

Eight serologically distinct botulinum neurotoxins exist, designated as A, B, C1, C2, D, E, F, and G.

Mechanism of action

Botulinum toxins block acetylcholine release, causing a chemical denervation. Neurotransmission at the neuromuscular junction involves the release of acetylcholine from the presynaptic nerve terminal. Acetylcholine release requires docking and binding of the neurotransmitter vesicles to the presynaptic membrane.Once chemical denervation begins, axon terminals form new unmyelinated sprouts, and the motor endplate regions expand. After several months, the inactivated terminals slowly recover function, and the new sprouts and end plates regress. Recovery of inactivated terminals appears to be the basis of the loss of clinical effect several months after injection.

Botox Dose

BOTOX injections of less than 100 units usually are used for cosmetic purposes, thereby allowing a wide safety margin. Recognizing that doses are not interchangeable among different formulations of botulinum toxin (BOTOX®, Dysport, Myobloc) is important; to achieve similar clinical effects, different doses are used.

Contraindications to BOTOX injections

Contraindications include prior allergic reaction, injection into areas of infection or inflammation, pregnancy (category C - safety for use during pregnancy has not been established), or breastfeeding. Women who inadvertently were injected during pregnancy thus far have had uneventful deliveries, and to date no teratogenicity has been attributed to botulinum toxin. Nonetheless, it is a category C medication, and delay of injections is recommended until pregnancy is complete and breastfeeding has ended.

Some medications decrease neuromuscular transmission and generally should be avoided in patients treated with botulinum toxin. These include aminoglycosides, penicillamine, quinine, and calcium channel blockers.

Adverse effects of injection

minimal swelling and bruising, this can be kept to minimal with soft approach

patients should avoid platelet inhibitors, including aspirin and nonsteroidal anti-inflammatory drugs, for 7-14 days prior to injection.

Therapeutic failure

Some patients do not respond to injections and, having never previously responded, are designated as primary nonresponders.

Immunologic Considerations

An estimated 5-15% of patients injected serially with 79-11 BOTOX® developed secondary nonresponsiveness from the production of neutralizing antibodies.

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