Cosmetic Clinics

The number of clients having medical cosmetic treatments is increasing each year. Much of this is due to more affordable procedures as well as increased awareness and knowledge. Not only is demand for the more well known treatments such as Botox and dermal fillers increasing, but there is considerable demand in the number of clients requesting treatments to rejuvenate the hands and the décolleté.

These areas are often neglected and whilst most women are now very aware of the risks of sun damage to their faces, they often neglect their hands, neck and chest. Many of our clients complain that their faces look great, but their age is given away by their hands, neck and chests.

Dr Lucy Glancey recalls one of her patients proudly showing her new 4 carat diamond ring, a present for her 60th birthday and she commented that life wasn’t fair! “How so?” I asked, “Well just as you are able to afford a huge diamond ring your hands look so aged that you are embarrassed to show them off.”

“These types of comments have prompted cosmetic Doctors to look at rejuvenation procedures available and develop new techniques” says Dr Glancey. “First and foremost we ensure that our patients protect these areas from the sun by using a good sun protection of at least an SPF of 30. Most of us are so careful about putting sun block on our faces, but how many remember the neck and décolleté? While driving in the car on a sunny day our hands are exposed to the sun light and if unprotected can become pigmented. While in our twenties and early thirties we get a nice even chocolate tan which looks attractive, later on in life our sun damaged melanocytres tend to produce patchy pigment which results in ‘sun spots’. The natural ageing process also causes our hands to lose fat and again this can give a very aged look. The décolleté can be easily damaged by spraying perfume on the neck and chest area and then exposing it to the sunlight. This causes a photosensitive response and increases the ageing process. As we sleep the décolleté can become ‘squashed’ and particularly in larger breasted ladies. This produces the lines and wrinkles running up from the breast as well as creepy looking skin. The hands, neck and décolleté are areas of the body that ladies like to be able to show off and therefore they are looking for effective anti ageing treatments.”

There are various procedures for hand rejuvenation and one of the more drastic ways is to remove the veins on the back of the hands. Because of the loss of fat the veins become more prominent so rather than this drastic approach it is better to replace this lost volume. “Another reason why we do not like to remove the veins” says Dr Glancey “is because the veins can be life savers and should you collapse on the street you may need the intravenous access”.

One way of replacing the volume in the hands is by redistributing the patients’ own fat. Autologous fat transfer can be performed with a device called Lipivage. A small amount of fat is harvested from areas such as the inner thighs, tummy or knees. The fat is then ‘washed’ and then immediately injected back into the treatment area. The patients are required to wear bandages for a few days after the procedure and there may be some bruising. However, once this has all settled the hands look beautifully plump and rejuvenated.

A disadvantage of this technique as with any procedure involving the patients own fat is that the body may metabolise it quickly and therefore we cannot predict how long the effects will last. An alternative to using fat is to replace the volume using synthetic soft tissue filler. A technique known as Mesotherapy which involves multiple injections used to plump up the hands and décolleté with a product that re-hydrates and replaces hyaluronic acid. A new product called Restylane Vital® can be used in both the hands and the décolleté area over three sessions. Dr Glancey comments “we are getting really nice results which can last from 6 months to a year.”

Restylane Vital® a crystal clear gel which is injected into the dermis to moisturise the patients own skin from within. The active ingredient, hyaluronic acid, is found naturally in the body, but its production decreases with time. Restylane Vital® stimulates skin cell activity to increase the production of collagen and elastin, so hands and the décolleté looks plump and youthful.

Another procedure that can be very effective on these areas is Intense Pulsed Light. This treatment modality not only rejuvenates the skin, but eliminates any pigment such as age spots and broken capillaries. “A typical condition that patients complain about on their neck and décolleté” says Dr Glancey “is telangiectasia and poiklioderma. This condition is characterised by matted broken capillaries either side of the neck and across the chest. Intense Pulsed Light will target the dilated capillaries as well as any sun spots. Another great advantage of using IPL is that is stimulates collagen production and when combined with Mesotherapy the results are fantastic.”

If you require further information about Mesotherapy or have any other questions please visit www.cosmeticclinics.co.uk

Mesotherapy is a technique designed to introduce a small amount of active ingredient/product into the superficial layers of the skin (mesoderm) in order to achieve a protector aim depending on the type of product used.

Mesotherapy is used in various areas of medicine for example rheumatology and also in support medicine; it is used for pain relief and cosmetic medicine for rejuvenation purposes.

It is particularly good to rejuvenate the superficial layers of the skin and target fine lines and wrinkles that are usually seen on the surface as a criss-cross pattern which is very difficult to treat via other means.

It can be used to treat such lines on the face, not only on the face but also décolleté, neck and hands, which are very popular areas.

Depending on the active ingredient used for the purpose there are different goals that can be achieved with mesotherapy. For example, their products are aimed at treating alopecia, and there are other products that contain small amounts of non-cross linked hylauronic acid which is very pure and by injecting this into the skin it plumps up the fine lines and just gives a very hydrating effect on the skin without making it look lumpy.

Also products like polilatic acid can be injected to achieve some skin tightening and salmon calcutoning can be injected to give the skin a nice healthy glow because this product has a vasial dilatory property.

Recently, a new technique was developed by which a very small amount of Botulinum toxin or Botox is diluted into a larger amount of skin hydrating agents like vitamins and minerals and injected into the skin in a mesotheraputic fashion in order to achieve filler effect of reducing fine lines and wrinkles which are due to attachment of small muscle fibres to the skin that pull the skin and create both lines which cannot really be treated by any other means. By adding vitamins and minerals to the skin that achieves re-hydration and the total effect is smoother and plumper skin without the very fine criss cross pattern of lines that can be seen especially if using a magnifying mirror and that worries a lot of women when they look at the mirror and again the decollette is a very specific area which very rarely responds to anything else rather than mesotherapy.

Considering the small amounts of Botox that I have given via this technique it does not by any means achieve any so called frozen look and only effects those very superficial muscles that sometimes pull on the skin creating very fine lines sometimes even puckering effect on the skin. The patient is able to fully move all muscles and there is no changes in expression. If they want to treat things like frown lines or crows feet properly then they should have a proper Botox treatment which involves much higher doses and it is a completely different type of treatment form meso-botox.

Usually the treatment will involve a course of six every 2-4 weeks depending on the problem and then again maintenance every 6-12 months depending on the problem and the amount of sun damage that the patient incurs in the interim period.

Continuing from our previous article we will discuss the colour changes that can be responsible for dark circles and ways to combat them.

Pigmentation
Some people with dark skins ( Fitzpatrick types 4 to 6 ) inherit a genetic tendency for darker pigmentation around the eyes. This of course becomes obvious from a very early age even in childhood.

Treatment
The famous ‘touch éclat’ is the make up of choice for many women as it creates a light reflection which counteracts the dark shadow along with camouflage make-up.

Some lasers can be very effective in particular the Ruby laser. Laser skin pigmentation treatment is particularly effective on Asian and Middle Eastern patients with dark brown circles due to excess pigment.

Skin bleaching agents such as Hydroquinone, retinoic acid, azelaic acid, alfa–hydroxy acids, kojic acid and trichloroacetic acid can be used to lighten the skin. Some of these preparations can be very strong and may provoke skin reactions. They should be used under doctor’s supervision only and can only be obtained on prescription. Decades ago the accepted treatment for bleaching skin lesions included products containing mercury salts. Their use is now prohibited because of their high toxicity. Hydrogen peroxide can also bleach melanin by oxidizing it, but because it can cause skin irritations it is mainly used for bleaching hair.

Vascular
The skin of the lower eyelid is the thinnest in the face so it is not surprising that it can show the underlying blood vessels which could sometimes appear as a blue/ purple tinge. This is especially obvious in pale skinned individuals (Fitzpatrick skin types 1 and 2) but other skin types can also be affected. Another factor that determines the appearance is the density and the extent to which the blood vessels are dilated. The more closely packed and the more dilated the blood vessels are the redder the skin looks. The amount of oxygen in the blood is also important. High levels of oxygen in the blood makes the skin bright red while a low level of oxygen gives the skin a bluish colouration.

Treatment
Cosmetic laser surgery. Lasers are used to help improve this condition and the pulsed dye lasers are especially effective. Bruising may result therefore the patient may have one to two weeks down time. If the vessels are very large they can be surgically removed.

In conclusion dark circles having once been considered untreatable can now be dramatically improved by advancements in aesthetic techniques. The good news is that in most patients this can be achieved without surgery.

by Lucy Glancey

If you have any further enquiries about dark circles or it's treatments including dermal fillers, cosmetic laser surgery, botox or any other treatments visit www.cosmeticclinics.co.uk.

Continuing from our previous article we will discuss the texture changes that can be responsible for dark circles and ways to combat them.

Eye Bags
Eye-bags are due to herniation (protrusion ) of fat in the lower eyelid which in some cases can be hereditary and can be visible from a very early age. Usually it is a result of the normal aging process when the skin looses its elasticity and allows the fat to protrude and become more visible. There are two types of eye bags, true eye bags which are due to genuine fat protrusion and pseudo eye bags which are caused by severe eye hollowing creating an impression of a “bulge”. Quite often there are both types present in the same individual to varying degrees.

Treatment
This will be dependent on the type of eye bag. True eye bags require surgery (lower blepharoplasty) while pseudo bags will require a dermal filler as described above. When there is a combination of both types, surgery will be required, followed by dermal fillers once the healing process is completed.

Wrinkles
Fine wrinkles under the eyes create a different texture and when excessive can give the appearance of dark circles. This condition is age related and the process is greatly accelerated when there is a degree of sun damage. The lower eyelid skin is very thin and therefore this is an area where wrinkles to appear first. In some individuals this can be exaggerated by the lack of natural bony structure therefore people with higher cheek bones have less wrinkles under the eyes.

Treatment
Wrinkles can be difficult to cover with make up as it tends to settle in the wrinkles making them more obvious. Prevention of sun damage is important especially in the delicate skin around the eyes, so the use of sun block is even more important than eye creams. There are certain eye creams that contain sufficient amounts of active ingredients (e.g. Retinoids) and are effective in preventing, and even reversing sun damage and consequently wrinkles. The most potent creams are available only on doctor’s prescription. Wearing good sunglasses in the sun can also be a good preventative measure.

In a younger patient (35 -40 yrs) a low dose of Botulinum Toxin type A (Botox or Dysport) can be effective, however this can result in discreet widening of the eye which may change the eye shape. It is important that the Botox procedure is performed by a well trained practitioner as an incorrect placement of this product in the lower eye lid can result in severe consequences leading to ulceration of the eye.

Chemical peels and laser resurfacing can work but are associated with higher risks of delayed healing, hyper and hypo pigmentation. The downtime for these procedures can be lengthy and can be a traumatic experience for the patient. Intense pulse light (IPL) can be used in the form of photorejuvenation ( photofacial) but requires several sessions and the results can often be modest.

Over the next few weeks we will outline the differing reasons or causes for dark cirles under the eyes and what treatments are avialble to combat them, so keep an eye out for Part 4!

by Lucy Glancey

For more information on dark circles and treatments including dermal fillers, Botox and chemical peels visit www.cosmeticclinics.co.uk

Originally developed by scientists to treat muscle spasms in the eye region, the Clostridium Botulinum bacterium we know today as Botox is one of the most highly desired anti-aging treatments available on the market today.

Thanks in part to Hollywood; the supply and demand has risen so wildly that Botox is quickly becoming an affordable luxury, even for middle class mums and dads who secretly crave that "ten-year younger" look. Below, you'll read about several sensational benefits of getting a Botox treatment.

1. Anti-Aging - Without a doubt, this is the most popular reason that Botox injections are administered by trained medical professionals every single day. The ability to walk into a clinic and receive a treatment that reduces those highly noticeable wrinkle regions such as crow’s feet, frown lines and brow lines, is nothing short of a modern day fashion miracle. How would you like to walk into a room and drop jaws because you look like you're 10 years younger? That's quite a common reaction that many Botox recipients receive, and with today's more lenient societal acceptance of cosmetic enhancements, one no longer has to keep it a secret.

2. Migraine Killer - Statistics say that over 6 million people in the UK are affected by the dreaded migraine headache. Thanks to recent breakthroughs with the help of modern day medical science, it's been discovered that Botox treatments won't only give you the ability to look twenty years younger, but it can also be used to treat and lessen migraines. For those with especially debilitating migraine issues, this is phenomenal news.

3. Prostate Shrinker - Another absolutely amazing discovery (and also a reason to bring your hubby to the doc's office) is that Botox, when injected into the male prostate gland, can actually give relief to those with enlarged prostates. The effect lasts up to a year, and the main reason it works is simple - it shrinks the gland, which in turn reduces the annoying and painful effects of an enlarged prostate such as frequent urination and urinary tract infections.

4. Excess sweating – Also known as Hyperhidrosis, this form of excess sweating can be generalized or localised to specific parts of the body. Hands, feet, armpits and the groin are among the typical regions of perspiration due to the relatively high concentration of sweat glands; however, any part of the body may be affected. Botox injections can be used to effectively reduce this sweating even where traditional toiletries such as anti-perspirants and talc have failed.

All in all, Botox, while having some potential for minor side effects, is a rock star substance that seems to be solving new problems every day. It is always advised to check with a qualified cosmetic doctor first, but if you're ready to treat yourself, both materialistically and medically, then Botox just may be the magic shot you need.

With another year over, we though we'd have a look back at those cosmetic procedures and treatments that were the most popular during 2008.

No. 1: BOTOX (Botulinum toxin) maintains the top slot.

Botox is most commonly used as a treatment for frown lines on the forehead, though it is also an effective treatment for wrinkles, crow’s feet and neck bands as well. Botox is very popular with many celebrities.

No. 2: The Restylane family of treatments continues as market leader and our favoured choice of dermal filler.

Restylane is an injectable treatment that contains hyaluron gel. The treatment help restore volume to the skin, provide lift and smooth away and soften facial lines. He procedure involves I injecting the Restylane compound into the desired areas in the face.

No. 3: Laser Treatments – these still offer the best results for hair removal, thread-veins and sunspots.

There are many laser treatments available. They range from hair removal and skin rejuvenation to treating leg and facial veins, acne scarring and Rosacea

No. 4: Facial peels and microdermabrasion - wonderful ways of freshening and brightening the skin without any disruption.

Microdermabrasion is a popular cosmetic procedure used to treat conditions such as fine lines and wrinkles, age spots, blotchy skin and blemishes and acne scarring among other things.

Chemical Peels and facial peels are used to remove the outer layer of skin. This makes the skin fresher, removes some sunspots and rough scaly patches, and reduces freckles and irregular pigmentation. It also reduces fine wrinkles.

Big movers up the charts in 2008 have been Sculptra, and OBAGI Nu-Derm prescription skincare and we predict that these will see a continuing increase in popularity during 2009.

You can read our previous article on Sculptra here.

One to watch for 2009! – Vavelta is a new treatment for scarring and skin rejuvenation. We are focussing on its use in scarring and are already seeing good results.

For more information on any of these cosmetic treatments contact Mulberry House Clinic on 01604 702630 or visit www.lasertreatmentsnorthampton.co.uk

After my first BOTOX treatment I was 100 per cent confident in Dr Tanqueray, and the next thing we discussed was the effects of sun damage – in my case problems with freckles and little broken capillaries and redness. John suggested cosmetic laser treatment and he recommended a course of six of these skin treatments.

Gel was applied to my face and then a probe was slowly run all over my face backwards and forwards. It felt like mild pins and needles over the skin; it felt cool but scratchy.

Directly after treatment my cheeks were quite red, but John assured me it was only temporary and I could apply make-up straightaway. By the time I went to bed, about five hours later, the redness had completely gone.

After two or three treatments I have noticed the improvement in skin texture by the evenness of my complexion, the thread veins have gone and my cheeks don’t flush so readily. The colour is definitely corrected and I am often asked what foundation I use! Of course, I am happy to recommend Mulberry House Clinic.

by Lyn Keable

Cosmetic laser treatments and many other skin treatments are available through Mulberry House Clinic, Northamptonshire 01604 702630 or www.lasertreatmentsnorthampton.co.uk

I am a beauty therapist and with a little knowledge of aesthetic treatments I decided to go to Mulberry House Clinic for some education. I saw Dr John Tanqueray and asked John to go through all of his treatments with me. He was happy to explain in detail, instilling confidence.

BOTOX was the first treatment on the list. The needle is so fine that it felt like tiny pin pricks. I was on the treatment couch for no more than five minutes when John said, “That’s it, you’re done!” There was no sensitivity and the only reaction was a few little spots which looked like tiny insect bites but they disappeared within an hour, i would neve have though Botox treatments were so quick!

I noticed the effect the next day. Already I could see a difference in the smoothness of the forehead. John had told me that the effects of the Botox treatment would take up to two weeks but within a week my forehead was totally without a single line and there were no crow’s feet around my eyes. My concern about ending up with a frozen look was unfounded as the muscle between the eyebrows still had free movement.

My clients and friends commented on how well I looked. They used the word “radiant” and asked whether I’d changed my make-up. I had to confess to my husband and he was amazed that I’d taken such a “risk” but was seriously impressed at the result! I was only too happy to tell them that I’d joined the Hollywood elite and there was nothing to fear from botox or other medical aesthetics, providing you go to a reputable company such as Mulberry House! I was relieved that it wasn’t so obvious that I’d had something done, but delighted that some people noticed I was looking so refreshed.

by Lyn Keable

Lyn had her Botox treatment at Mulberry House Clinic in Northamptonshire – 01604 761876 or visit www.lasertreatmentsnorthampton.co.uk