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The latest articles and resources from Skin Essentials

What I am doing differently in 2023

The most seasoned business owners know firsthand that in order to succeed, you have to be willing to fail, sometimes many times over. Each time this happens, you pick yourself up and keep moving, learning from what worked, and what did not. Why do this to ourselves? While it seems like an exercise in self flagellation, the key is in the mindset it teaches you. I’ve learnt far more from my failures than I ever have by cruising and through success, even if none of us actively chases failure. In many ways, failure teaches us what we are truly made of, and teaches us grit and resilience. So why is this relevant in 2023 to Skin Essentials? In 2023 I am bringing about changes to the way I do business and I’m terrified if I am honest. Terrified because it’s raw, honest and comes from a place of wanting good for my patients, my staff and myself. Terrified because honesty, no matter how kind, can always be taken the wrong way when people receiving it feel defensive. Terrified because there’s always the fear that in making the changes, I will lose business and my business will tank and…and…and… I’ve done a lot of hard things in my life, as we all have; and one of the things I love about myself is my innate optimism, my ‘glass half full” approach to things especially when they are hard, and the immense privilege I have of having an education in a field where, even if Skin Essential does tank and I do close, I’ll have other options. So what are the changes and why? I entered medical aesthetics reluctantly in 2015/2016. I really didn’t want to do it because of all the fake faces I saw around me. It seemed fake, vapid and entirely unnecessary. At the same time, I was beginning to see early signs of ageing in my own face and a visit or two to the local chain clinic for skin needling left me with disastrous and painful results. I was stumped for next steps based on evidence rather than hype and fads. So I began to look into it, initially for myself, then as my knowledge increased I met patients and friends who wanted someone reputable, who would do good work, give them results and a longterm plan for ageing well. Like me, they were mostly women who had tried many things and had little success, and occasionally bad outcomes and they wanted someone they trusted to do the planning for them, so they could just show up, and get the work done and be told what to do. These are my best longterm patients, who come in when told to, get on the chair and say “whatever you think best doc!”. They trust me, trust the process, are realistic about what is achievable including over what period of time; they are patient, they remain calm with common side effects such as bruising, swelling, lumps and bumps and they show up. These are, quite simply, my ideal patients. Price is important, but not the most important factor, and as long as they know what they need to save in time for the next appointment, they plan appropriately. In 2023, I am moving away from a lot of the interactions that I found draining in 2022 with patients who, quite simply, were not aligned with me and the way I work, in part as I was not clear enough about it. So what are some examples of patients for whom I am unlikely to be the right doctor?  1. They are not looking for a longterm plan to help them age well.  Full face rejuvenation is my signature treatment and the one that gives me the greatest joy and the best results for my patients.  I am really not a fan of just some anti wrinkle to one area and  lip/ cheek filler as and when a patient feels they need more and orders some. It is not how I work. I look at the whole face as pieces of a jigsaw puzzle - as the ageing process begins to take hold, pieces of the puzzle go missing, and it takes more than just 1-2 mls of filler or some anti wrinkle treatment initially, to begin to correct this. For those patients who start at a good time, as early as their 20s and early 30s, it’s true that initially there’s not much to do beyond a focus on the basics including excellent, personalised skincare but having a comprehensive plan allows us to stay on top of it and to plan for what is likely to come and to prepare for it. These patients may need either occasional enhancement eg lip filler or maintenance by way of some anti wrinkle treatment to target early lines and wrinkles, some undereye correction and any other early signs of ageing. Costs are usually around $3000 a year or thereabouts depending on where you start and what’s needed. The older patient, as early as mid 30s and up, needs far more work if nothing has been done until then. This is the work I refer to as restorative. Many pieces of the jigsaw puzzle are missing and there are changes under the skin that need to be looked at. For these patients, the work involved at the beginning is more extensive over several months, usually in stages to get to maintenance and involves skin improvement as well as injectables and possibly permanent fat dissolving. Costs are typically $6000-10000 during this period depending on what is needed then maintenance is closer to $3000 a year or thereabouts. I won’t do just tear trough filler when what you need is mid face support to your temples and cheeks also. I won’t do just lip filler if you also need support around the mouth and to the chin to avoid a Marge Simpson lip. I won’t do just some anti wrinkle so your forehead and upper

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Lip Fillers and why we don’t offer 0.5ml options

It has been some time but every now and again I get asked if I offer 0.5ml lip filler. Equally, I get asked occasionally why I don’t offer 0.5ml lip filler as an option for touchups.  It’s a great question, so I thought I’d take the time to explain, rather than 1:1 as the occasion arises.  0.5ml filler is an option in many if not most, chain clinics, especially for lip filler, which is among the most commonly sought out injectables among young people seeking enhancement rather than rejuvenation.  Young people also have smaller budgets so it makes sense that they’d seek what they consider to be better value for their money by pursuing options they can downsize.  And yet…. Anytime I’ve given in on the spur of the moment, I’ve regretted my decision & lost money saying yes and risked feeling resentment towards the person asking, which is not my preferred method for dealing with tricky conversations especially around money and boundaries.  My personal feelings & business health aside, I’ve some solid reasons why I don’t offer 1/2 syringe options, ever. you’re paying for a service that includes my assessment, opinion & treatment. The syringe and how much of it I use is irrelevant to your stated and our agreed-to goal for what you wish to achieve.  I rarely agree to do touchups if I don’t feel you will need a decent amount of filler, usually > 0.5ml when you buy a meal you pay for the whole thing even if you only eat half of it, so why do we expect a 1/2 syringe option when the syringe comes in 1ml size?  once opened, that syringe can’t be stored so if I don’t use it, it’s wasted assuming I do it, it’s twice as long with two people, and more consumables including numbing cream on two people for the same price as 1 syringe.  legally that syringe is yours and yours only. I know many clinics will split a syringe between two friends on the same day but technically it’s not legal to do that. On the occasion I’ve done it, I’ve felt annoyed for feeling pressured to do it on the spot.  I dislike people “ordering” aesthetic treatments as if off a menu including number of units or mls.It’s not how I work and it doesn’t work for my business.  limiting me to your budget also limits what I’m able to achieve clinically. On the few occasions I’ve done this, patients have invariably come back for more because the dose (eg anti wrinkle) was inadequate to do the job or was barely visible (eg filler) once swelling settled. the dose I suggest we use, is the bare minimum to achieve the desired result/ outcome - this is a basic, sound medical principle, and dropping that dose to suit your budget often means you’ll get less than ideal results or need retreatment sooner.  I work in 3D and often need to use 0.6-0.8ml of a syringe on lips to achieve good results front, side and in aiming for symmetry, even for touchups.  In saying all that, there are many people who do offer 1/2ml syringes. I’m just not one of them. At Skin Essentials, I am all about as much transparency and healthy boundaries as possible and I like to think that patients who choose to see us understand and accept this. If they don’t then they should not be seeing me and I encourage them to go elsewhere. We value safety and following rules more than a quick sale, any day. 

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6 Things you need to know when considering temple fillers.

Much of medical aesthetics done well, is subtle, so very subtle. People often believe they would not consider aesthetics because of the many, many examples of bad aesthetics we see walking all around us. They don’t want “duck lips” or “trout pouts” or “avatar cheeks”, “chipmunk cheeks” and more.   Many people never notice the temples hollowing even as other indirect signs of this begin to bother them - sagging around the eyes and cheeks, are a great and common example. The temples lose volume with age as fat pads are lost, overlying collagen in skin is lost, and bone gradually erodes. Since there’s already a natural concavity to the temples—actual hollows in the skull itself—you may see this area changing faster than other parts of the face or not be aware that this is what is contributing to your aged look: worsening of the crow’s-feet, dropping of the outer brow, giving a more mannish appearance, and even changing the shape of the face, giving it a peanut-shell shape. So what do you need to know to determine if you might be a suitable candidate for temple filler, or if it is what you need instead of more cheek filler? 1. Temple filler is subtle Almost all the work we do at Skin Essentials is subtle but with temple filler, we often get some pushback “I’ll cover the area with my hair/ scarf” except it doesn’t quite work like that. In order to address the areas that you do see, which bother you, we do need to begin with the temple if they are contributing or responsible for some of those changes. Done well, the temples still remain slightly hollow, but with better blending in of bones between your forehead and eye socket, which become more and more pronounced over time with temple hollowing. 2. Some people are more prone to hollowing in this area People who are naturally slim will look gaunt earlier, which can give an unhealthy look, but equally, in women, an overly angular appearance to their face which can be displeasing for them. Equally, people who are athletes and into high intensity cardiovascular exercise, are more prone to temple hollowing at earlier ages. 3. The Temples will hollow out in everyone, and those of with big cheeks may look worse than those with symmetrically slim faces Dr Joshi has yet to have any filler to her cheeks and around her eyes but she had temple filler 2 years ago and is likely due for more now, because when she smiles, her cheeks look “too big” next to her temples and out of balance. 4. Temples are a high risk area, so please choose your doctor carefully. Experience and qualifications matter here. Big blood vessels are close to the surface here, and you don’t want an inexperienced clinician treating you here. Look at the price as your insurance in the event something goes wrong and choose wisely. 5. Temple fillers are sensitive They can feel funny going in, and due to the tight space here, with swelling after treatment, they can cause a tight/swollen sensation, a headache as well as discomfort chewing for a day or two until it all settles. Any lumps or bumps, a given with any fillers, may also look or feel more apparent for a few weeks until they settle. 6. Temples are rarely treated alone By the time we see patients there’s significant ageing going on in the face, beginning at the temples and extending down to other areas - around the eyes, cheeks, the ears and the lower face. The skin is no longer held up by the loss of fat pads in these areas, and pools around the lower face, giving “eyebags”, hollows, sagging cheeks and eventually, jowls. This is exacerbated if sundamage also contributes to faster collagen loss, with more laxity.    The problem is to begin to address the concern from where it began and it can add up to a fair bit initially (8-10 mls or more depending on the degree of volume loss) over 3-6 months till we’ve addressed all the volume deficit. After that, you may need 1-2 mls a year as and when the need arises. Left too late, as with the patient on the left, who had a face and neck lift (not my patient), there’s not much we can do non surgically to help, so timeframe matters.      Ready to get started? If I can offer some advice, it would be to find someone who has a plan with a clear timeframe and budget to help you decide if you want to start at all - if you start, will you make it work and invest in yourself? As always, none of this is medically necessary, so if you are unwilling or unable, then my opinion is, you should not start. If you do decide to start, take a leap of faith with your trusted doctor, invest and trust. As always, I encourage you to seek the longterm therapeutic relationship over vending machine style aesthetics, wherever you go. 

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What you need to know about Biostimulator Filler R

Ok, so we’ve been getting a lot of enquiries about biostimulatory fillers, and we wrote a post on one of them here. Here is the other one on offer here at Skin Essentials, also known as calcium hydroxyapatite. What do you need to know about it to help you decide if you might be a candidate for it? Here is some initial information :  FDA approved since 2006 versatile biostimulatory filler to restore volume loss and improve lines and wrinkles also the only FDA approved injectable to date for use for rejuvenation in hands like other biostimulatory fillers, NOT reversible (so choose your clinician wisely)    How can it be used?  1. As a straight out filler, for cheeks, jawlines and more, where it has among the best ability to volumise sunken faces.  2. Diluted, in a ratio of 1:2 or higher, as a “wash” under the skin, to improve fine lines and wrinkles, crepiness, acne scars and even cellulite. Used this way, it can be used for overall subtle rejuvenation of the face, neck, hands, arms, abdomen and buttocks to improve skin quality by inducing collagen without adding volume.    So how does this filler work?  unlike hyaluronic acid fillers, the base material is calcium hydroxyapatite which stimulates collagen induction offer time. like HA fillers, CaHa works immediately to provide subtle volume and improvement to the treated area and over time, as the gel carrier is absorbed by the body, it stimulates your own collagen which lasts 18-24 months. used as a hyperdilute wash, this improves texture of skin where it is injected including in areas affected by chronic sun damage such as the face, neck, chest and hands.  Are there any side effects?  As with any injected medical procedure, commonest side effects include bruising and swelling and temporary lumps and bumps.  There is minimal aftercare unlike with the other brand of biostimulatory filler and I’d suggest 2-3 sessions in total a month apart for the initial course and then annually to maintain.  How much are you likely to need?  This filler comes in syringes of 1.5ml usually. Depending on the part of the body being treated and whether it is used diluted or undiluted will make a difference how much is needed.  Here is a guideline as to number of syringes needed, though the consultation is designed to address this with an accurate quote as well as detailed informed consent prior to proceeding with treatment (usually on another day unless time permits).  face and neck - usually a single 1.5ml syringe each per session hands - usually a single 1.5ml syringe for both hands, diluted to 3mls total buttocks - 1 syringe per cheeks for cellulitis and sagging skin (not for non surgical BBL which is much more) thighs - 1 syringe per thigh area (inner or outer) abdomen - minimum 2 syringes arms - usually 1 syringe per arm  2 sessions are initially needed for any given treatment area, spaced a month apart then repeated 6-12 months for maintenance and results last upto 2 years. 

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9 Things to know about Biostimulator Filler S before you say “Yes Please!”

Biostimulator fillers seem to be on the rise and gaining popularity rapidly. We are seeing many more enquiries for these fillers compared to years gone by, including from patients prepared to travel some distance who want to have the initial consultation and treatment on the same day, especially with poly-L-lactic acid. Due to Australian AHPRA regulations, we are not permitted to use drug names here. Invariably, the answer to consultation for a new patient and treatment on the same day is a no. Why is that, especially if they are coming from some distance? Read on to find out! There are two main brands of biostimulator fillers on offer at Skin Essentials, brand S and brand R. The one we are discussing here, is brand S  The aging process catches up with us all eventually, as seen in the loss of skin elasticity, sagging as well as (deep) lines, wrinkles and seemingly enlarged pores. The bulk of these skin changes are due to progressive collagen loss over the years:  we begin to lose around 1% of collagen production from our mid 20s for women, the menopausal process accelerates this through loss of oestrogen, with an estimated 30% collagen loss over 5 years thereafter, collagen loss continues at an accelated rate in women at 2% per year by age 70, it is estimated we’ve lost 80% of our collagen producing capabilities  So in addition to bony changes with ageing, most prominent around our eyes, our jawlines and around our mouths, thinning and sagging skin due to collagen loss over time contributes in large part to the loss of youthful glow in most of us.  This is why, beyond volume replacement, rejuvenation and maintenance should rightly shift to collagen induction and maintenance of healthy, supple skin in a variety of ways.  So what is this brand of biostimulatory filler and how does it work?  1. Full Face Rejuvenation  it is an injectable powder that is made up to form a solution that is injected into the skin where it stimulates collagen production it is usually an initial series of 3-4  treatments a month apart results are gradual, from around 6 weeks, look natural and last longer than most other injectables, as it is your own collagen. In studies, results lasted at least 25 months by inducing collagen production, this product works to restore some of the underlying structure of the face/ body that has become gaunt due to significant volume loss and improves skin radiance by thickening skin quality the added fullness, over time, improves the appearance of fine lines, wrinkles and folds. Bony areas can be softened and gaunt areas of the face, such as under the cheeks, and temples, can be rejuvenated also.  2. No PillowFace  the initial course recommended is 3-4 treatments a month apart over areas of the face that need the volume and skin improvement thereafter, maintenance is recommended with a single session annually unlike hyaluronic acid based dermal fillers, which can look overfilled, this is not possible with biostimulatory fillers, which can only stimulate your own collagen production, done well  3. Long Lasting Results  in studies, treatment with biostimulatory filler lasted at least 25 months, and likely longer. because it stimulates your own collagen production, with care to protect and maintain this collagen, the results are much longer lasting than many other treatments.  4. Low Maintenance Treatment Option  initial treatment is a series of 3-4 monthly sessions with a significant cost depending on how many vials are used thereafter, maintenance is a single annual session this is a great option for the face, crepey skin in the neck as well as décolleté and hands    Sold? Great, so why can’t you have it on the same day as the consultation, especially if you’re already familiar with it via Google?  1. Adequate informed consent is key  Results depend on the injector and their skill but no outcome can be guaranteed as the medication relies on your collagen induction powers AND your compliance with instructions  training for biostimulator fillers is not as common as with hyaluronic acid fillers. they’re also more expensive than hyaluronic acid fillers, especially for the initial course of treatments in terms of time commitment, consistency and budget this is not a treatment to be having with a new injector (or a new patient whom I do not know well)  2. Biostimulator Fillers are not reversible  unlike hyaluronic acid fillers, which can be reversed in the event of an adverse outcome, all biostimulatory fillers are not reversible in the event of an unexpected side effect or if you do not like the result  3. There is some aftercare needed and some side effects are reliant on aftercare  with this biostimulatory filler, I advise people to massage the treated area 5 times a day for 5 minutes, for 5 days, firmly. I show them how to do this to distribute the filler evenly among the tissue where it was injected, unlike with hyaluronic acid fillers lack of attention to this, rarely, may lead to nodules that need to be surgically  4. Results are gradual, over months  patients need to understand this they need to commit to the initial 3-4 sessions monthly and budget for it as delays will lead to a suboptimal result they need to understand aftercare and commit to it to minimise risk of adverse outcomes  5. It needs preparation prior to injection because it is prepared as a powder, it needs to be diluted and prepared with adequate mixing at least 24 hours prior to injection, preferably slightly longer. at Skin Essentials, this usually means that we spend our time in consultation addressing your concerns, assessing your suitability for it, and then talking you through what is involved including aftercare and then giving you some time to think about it and decide without any pressure. should you decide to go ahead, you’ll be required to pay an upfront non refundable deposit of 50% of the cost of each session before we start preparing

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Injectables. What can go wrong?

What is interesting to me, and strikes me during cosmetic clinics, is that most people that I see, are drawn into cosmetic clinics by the (cheap) prices, BUT: – have no idea what they had in the past elsewhere (brand, anti-wrinkle vs filler; amount; injector experience and qualification)– sometimes I see these people because they have had poor experiences elsewhere and want correction, or because the clinic has closed; or because there is a special on- go in, tell them what you want, it is done and they are out the door. But did they get what they paid for, even if it was “only” $200? What is also interesting, to me, is the way consent is done- several people have had filler to their deep frown lines, without being advised, reportedly, that it can cause permanent, irreversible blindness. It is one of the riskiest areas to inject with filler due to the catastrophic consequences though theoretically, the face being a minefield, any part of it could lead These patients, “clients” have signed a consent form without an actual discussion of side effects and expectations. So what do you need to know about cosmetic injectables before you sign up, whether with me, or anyone else? 1. who your injector is.2. how long they have been doing this.3. what their qualifications are – at minimum they need, in Australia, to be a doctor with appropriate training; or a dentist; or a registered nurse working with a doctor who can authorise the medication for him/her, ONLY after a consult with the doctor.4. how do you feel with them? Do they spend time to get to know you or do you feel rushed? Do they understand what your concerns are, even if you think you know what you want/need? Are they willing to advise you if they believe your expectations are unrealistic, or if you may need more product than you have budgeted for? Are they willing to turn you away if what you are expecting for your budget won’t get you the desired result?5. Is there a followup planned with them? Do you have access to them if something does go wrong (and something CAN go wrong, it is a medical procedure, no matter how much it is sold as a beauty procedure.)6. how good is their understanding of facial anatomy, especially if something goes wrong? Can they fix the problem or are they likely to need to call someone else? So, having said all that, what CAN go wrong? None of these are my patients’ photos, but here are some examples from Google. Another more common risk is vascular occlusion or blockage of the vessels supplying parts of the face: This is not to scare you, nor to put you off anti wrinkle treatments or fillers. It is more to highlight the fact that I see too many people who attend for treatments at places where 1. price alone is the determinant of what is done. 2. consent is a token thing, a form for patients to sign, rather than a process whereby it is explained to each person the small but real risk of real complications. As I am fond of saying, “It is your FACE” and, “You get what you pay for.” Want to discuss it further with me? Book here for a consultation to discuss your expectations, budget and cost for you. Hope to see you in a clinic soon! Any questions? email us at contact@skinessentials.com.au

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Expectations and Financial Consent

Common, recurring themes that come up when I am discussing treatment with patients is that of expectations, and cost. When I meet people for the first time, or they contact me to chat, if inexperienced, most are unaware of the basics – the difference between anti wrinkle and filler treatment for example. What each does and how it works. How long each may be expected to last. Different types – permanent, semi permanent and temporary Animal vs non animal origin Brands and costs Who the injector is (I often have to ask if they had to have a Skype consult to determine who the injector may have been), some of which is covered in my post last week I spend a fair bit of time, during the initial obligation-free consult discussing: your face, because every face is different- injectables are not a One Size Fits All approach your concerns what you think would help with your concerns your budget what I see, to help with your  concerns the amount of product you are likely to need, and the cost. So. What does appropriate financial consent mean and involve? a guide to how much anti wrinkle or filler a person is likely to need in TOTAL, even if we only use a fraction of that on the day. the amount of time over which that product is likely to be needed- usually 3-6 months initially and then for maintenance, around 3-6 months and then yearly. how much may be expected in terms of maintenance to help you decide if it is worth investing in. how much they need to budget for if they wish to retain the lip volume/ cheek volume/ wrinkle free areas. whether realistically this is something they wish to undertake, or spend on a holiday instead. Sometimes, I get it wrong, and it is not obvious till we have begun and I see product being sucked into someone’s cheeks, or their chin, or their temples. In that case, I think it is important to be honest. Without this information, it is not really informed financial consent. Sometimes people may be tempted to cut corners, to haggle, to ask for discounts, or to budget, and to get “half of what you say I need”. I understand the desire for that, I truly do. My response is still – “My job is to tell you what I think you need, and what the cost of that is likely to be. It is not to fit within a budget that will not give you the results you want, if your budget, or your expectations are unrealistic. Likewise, I don’t haggle because this is not just about the product, but about the service. If someone cannot value that, then we probably are not a good fit and you should keep looking for another injector.” Let me share some examples with you, especially around the area of fillers. Most people understand the principle of wrinkle relaxants- it’s a lot of money, but it’s relatively straightforward, with few things that can go wrong, and it gives you the most bang for your buck. Effects kick in as early as 2-3 days, peak at around 14 days and last around 3-4 months when a topup is needed. It gives you a refreshed, rejuvenated look that people notice and it’s immediate gratification. Fillers are a bit different. Work with filler, done well, takes time, good knowledge of facial anatomy and the effect though immediate, grows over time and serial treatments to avoid an odd looking face; the hallmark of fillers, if done well, is so subtle, only you and your injector knows that you’ve had anything done. People mainly notice you look fresh, less tired. That is the desired outcome BUT it may not be worth it to many, to spend thousands, to simply look “fresh”. It is more a delayed gratification. By the time most people notice enough that bothers them, they’ve left it too late and need decent volumes of fillers- around 2-3mls in someone in their late 20s and 30s. Upto 8mls or more over 6+ months in someone in her 60s. So financial consent at the beginning is essential- there is no point charging someone for 2mls and $1200 if you know they’re unlikely to follow through with further treatment they need in 3 months. Fillers build on each other and each layer and can last for a year or more. By the time most people notice enough that bothers them, they’ve left it too late and need decent volumes of fillers- around 2-3mls in someone in their late 20s and 30s. Upto 8mls or more over 6+ months in someone in her 60s. So financial consent at the beginning is essential- there is no point charging someone for 2mls and $1200 if you know they’re unlikely to follow through with further treatment they need in 3 months. Fillers build on each other and each layer and can last for a year or more. Some examples: These are just some examples of people I see regularly. Most of these patients don’t want to look fake- they are professionals, with careers- they want to look subtly refreshed and rejuvenated and to feel better about the quality of their skin. Filler is a great way to achieve that as the product stays under the skin for 6-12+ months per treatment session and reduces need for more potions and lotions. Additionally, the process of injecting these products acts in a similar fashion to microneedling and other techniques, stimulating more natural collagen production- win/win! Want to discuss it further with me? Book here for a consultation to discuss your expectations, budget and cost for you. Hope to see you in a clinic soon! Any questions? email us at contact@skinessentials.com.auBook Now

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Dermal Fillers in Practice

I often get people coming in and asking for filler, afraid it’ll change the way they look, or be too obvious. Most of the time, they underestimate how much they need; occasionally, I get caught out too. Most people don’t want to look like The Real Housewives of Sydney. They don’t want to look fake, fat or like they’ve had filler or botox. They simply want to look like the best possible version of themselves. To these people, I always say, that filler, if done well, is almost unnoticeable. The change is gradual and subtle. Likewise anti wrinkle treatment. YOU know something has happened, but the results are subtle, and usually, due to the cost involved for most people, gradual. Rather than going for what’s cheapest, possibly to regret it, I suggest budgeting for what’s better, if more expensive. There’s a reason why chain clinics are cheap. So, let’s look at some examples of cheek fillers, and how they work to help with many “problem” areas on the face- eyebags; nasolabial folds and marionette lines; jowls. Here, this lady had 1ml to each of her cheeks and cheekbone area in total as well as in her tear trough area, with significant improvement in her downturned mouth as well as nasolabial folds/lines. With age and further fat loss in the cheeks and around the jaw near the angle of the jaw, skin pools around the jaw, giving a jowled appearance. As may be apparent by now, many signs of ageing are related to loss of volume from the midface so correction necessarily begins with replacement of this volume with fillers in this area first. And filler is never wasted- the 1-2mls you spend money on, even if results aren’t striking, goes to form the base for further filler that will effect a change, and last anywhere from 9-12 months or more, depending on thickness and where it is used. So it’s money well spent, and an investment. Want to know more? Get in touch, make an appointment and let’s set up a treatment plan for you with Dr Joshi. 

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