Dr Allem answers questions, busts myths and addresses misconceptions about injectables…

Although injectables like Botox are among the most popular non-invasive skin treatments, there’s still a lot of mystery surrounding them. We know our readers are interested in finding out more about injectables, but it’s difficult to know who to turn to as a credible source of information.

That’s why we got Dr Maureen Allem to answer your questions about injectables like fillers, threads and Botox. She’s the founder and Medical Director of the Renewal Institute, she’s been looking after skin for more than 15 years and she really knows what she’s talking about when it comes to injectables.

We asked our readers what they wanted to ask Dr Allem and here are some of her answers.

1.     Do fillers move and why do people get pillow face?

Fillers do move a bit until they settle. This takes about 2 weeks and it is important to follow the precise post-care instructions to ensure the best outcome. Immediately after injecting, it might seem like a bit too much, but this is due to the initial swelling and will correct in a few days.

As we age, the collagen and elastin production in our skin decreases. When we sleep, our skin tends to “slide” on our pillows, causing creases and lines to appear. These normally go away after a few hours once we have woken up. But as we get older, and the collagen that is supposed to give our skin structure decreases, these lines tend to stay and get deeper. This is typically known as pillow face.

2.     Are there different types of Botox, and if so, which are the best to use for the glabella?

There are different brands of Botulinum toxin (which is a neurotoxin) injections available on the market. At Skin Renewal, we offer two brands: Botox and Dysport.

Deciding whether to use Botox or Dysport depends on a range of factors including your skin type, skin concerns, age and what you want from the treatment. Your doctor will advise you which will be more suitable for you.

3.     I am 58, and have tried lasers for tightening up the jowls and lines from nose to chin. No result for quite an expense. Will fillers be more effective, how many would typically be needed and how long does tightening effect last?

Fillers can be used to give a lifting effect, yes. The technique is used when we want to re-enforce volume to the areas of the face where we have lost natural fat, which then leads to sagging of the jowls and nasolabial folds (these are the lines on the cheeks).

Lasers work by stimulating collagen in the skin to help with tightening, but it can take a minimum of 90 days to start showing results, whereas fillers give a more immediate result.

The amount of filler that is needed depends on the severity of your concern, but as a standard rule we normally recommend two fillers for every decade of your age to give the best results. The results last roughly 18 months.

The amount of filler that is needed depends on the severity of your concern

4.     If skin tightening didn’t show any results, how well will thread-lifts really work and will you be able to see the thread after years? What can one expect from the treatment?

Thread lifts are a unique way of regenerating, lifting and tightening the skin on the face and body.

At Skin Renewal, we offer two types of threads at our clinics, PDO threads and Silhouette Soft® threads. Both of these threads dissolve and are re-absorbed into your body this takes between 18 and 24 months, so you don’t need to worry about the threads becoming visible later on.

While the threads dissolve, they encourage new collagen production in the treated area, resulting in smoother and firmer skin. They also lift parts of the skin, which is why thread lifts are seen as an alternative to surgical face lifts.

The treatment only requires local anaesthetic and is well tolerated by our patients.

I have over 20 years of experience in the field of injectables.

5.     How do I choose a reputable aesthetic doctor if my dermatologist doesn’t do thread lifting?

Always make sure of your doctor’s qualification and ask if they are registered with the Anti-Aging Medicine Society of South Africa. Aesthetic training and education are always key, so ensure that they have had extensive training and exposure to thread lifting.

At Skin Renewal, I train all the doctors at Skin Renewal myself. I have over 20 years of experience in the field of injectables. We also have monthly training sessions with myself and all the doctors to ensure we stay on the forefront of new technology and new techniques.

6.     I am 69 years old and lost 16kg. My neck has a lot of loose skin. What can I do about this and my jawline?

Injectables such as fillers and threads can definitely be used to treat loose and lax skin in those areas. The amount of fillers and threads really depends on the severity of your concern. But it is important to note that fillers and threads always work best if we first build the structure and integrity of the skin with preparatory treatments.

Your Skin Renewal doctor might recommend treatments such as carboxy therapy, laser treatments and radiofrequency to stimulate the fibroblasts in the skin to produce new collagen first. These treatments will help to tighten the existing collagen in the area to help firm up the skin before we do filler and threads.

7.     What is the maximum number of threads one can have? Can one expect marionette lines to disappear with threading?

The number of threads would need to be determined by the severity of the concern. We also need to take into account that we get different type of threads, such as monofilaments and anchor threads. The type of thread that is used will also affect the right number of threads.

Generally, a combination of filler and threads is done to soften the appearance of marionette lines. Whether the lines will disappear completely depends on how deep the lines were to start off with. In some moderate cases, yes, the lines can disappear, but in most cases, we aim to just soften the lines.

Generally, a combination of filler and threads is done to soften the appearance of marionette lines.

8.     How many times will I be required to have another injection for face and neck renewal after the first session?

The amount of Botulinum toxin required is determined by several factors such as the amount of muscle mass or how healthy or active the muscle is. As no two patients are the same, different people can require different amounts to treat the same area.

Botulinum toxin takes between 10 to 14 days to “kick in,” for that reason a follow-up appointment is made two weeks after the initial injections to assess the final result and to determine whether more units are required. The effects usually last between 3 to 4 months, but some factors can affect this including the body’s circulation, specific medication as well as the immune system.

Fillers last longer, as they take between 12 and 18 months to dissolve.

9.     What is the best for a droopy mouth and lines around the mouth area?

Our doctors would probably consider doing a combination of Botulinum toxin and dermal filler. The Botox will freeze the muscles that may be pulling your mouth down and the filler will plump and erase deep lines and volume loss.

10.  How much would it cost to do my smile lines?

The best thing to do to get an accurate cost estimate is to book a consultation. Because every person is different, costs can vary from person to person even when we’re treating the same areas.

In general though, our prices range from R2750 to R4100 per dermal filler syringe, and multiple syringes may be needed, depending on the severity of the concern. Results are seen immediately but take at least one week to settle and give the full effect. The results may last between 12 – 18 months, depending on the type of filler used and the severity of the concern.

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