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The latest articles and resources from Skin Essentials

How much is my treatment likely to cost?

This question is a regular via email and DMs on social media. Sometimes people also send us selfies to help with the quotes. Prospective patients may be asking about specific treatment options such as injectables - anti wrinkle treatments and dermal fillers - or skincare or fat dissolving treatments. The short answer is, it depends. As an AHPRA registered professional, I cannot conduct consultations via DMs and even emails until we have established a therapeutic relationship with you that must be documented. Even after we have met in person, much as you’d expect with other doctors, it is not possible to provide ongoing regular advice via emails or text messages. AHPRA specifically requires us to maintain an appropriate doctor-patient boundary that is meant to safeguard you, and us. This is why unless it is a quick yes or no answer or we have planned a followup, most replies will result in brief advice and “please book another appointment if you wish to discuss this further”. As to the rest - how much is it likely to cost and how much should I budget? The answer to this, truly, is “it depends”. What factors might play a role? 1. Your age   The younger you are, the less ageing related changes and the less outlay needed to begin to address the concern at hand. Whether that is acne, or pigmentation or volume loss in the face or even lines and wrinkles. 2. Your basic genetics Not all of us will age the same. Our ethnicity as well as lifestyle factors and other medical history (or lack thereof) will play a significant role in how we age, as will our basic bone structure. 3. LIfestyle factors By now we all know, I hope, that chronic sun exposure, even if unintended, can have a lasting impact on how your skin will age, including lines and wrinkles, pigmentation, faster collagen depletion and volume loss. The WHO estimates that as much as 90% of skin ageing is due to UV exposure. Add in factors such as smoking and these will add up quickly to more work needed just to begin to undo some of the damage. The Initial Consultation The initial consultation is where we meet and begin to address some of these and other factors, in conjunction with your concerns. We take a medical history of not only your health, but any illness, medications as well as prior aesthetic work which may have an impact on future work.  We take baseline pictures of your face at different angles and then we assess your concerns together - what they represent, and how and IF we can address them. We discuss what can be improved non surgically, what needs surgery if you can budget for it and what cannot. At this stage, I can give you a pretty good idea of what your concerns mean, and how I can help, the timeframe needed and degree of investment required, both of time, frequency and money so you can decide whether you want to proceed or not. Due to my training I tend to approach everything as a continuum - what can we do now, in the medium term and then longterm and how they can all build on each other to give you the best possible result if you stay the course. My goal, always, is a longterm therapeutic relationship with my patients because we know that gives best results.  At our initial consultation, I can also more acccurately guide you as to “how much” in terms of quantities as well as costs and timeframe. As a guide:  anti wrinkle treatments, if begun in your late 20s to early 30s when you begin to see faint lines present at rest, may need slightly lower doses compared to starting at a later age, when lines are very visible even at rest and will take continuous treatment with higher doses to begin to fade. If you stop, lines and wrinkles will gradually reappear over time.  with dermal fillers to replace volume loss, every face is different but as a guide, a minimum of 2 mls in your 20s, 3 mls in your 30s and so on. If you have a slim build, you are likely to need much more. If you look gaunt already, you will need more than this. with biostimulator fillers, and most skin therapies, there is an initial series of treatments in close succession for best results eg a session every month for 3 months, then maintenance every 6-12 months. skincare is ongoing and lifelong, beginning with the best and cheapest option of all, daily sunscreen. If you stop, your skin will gradually revert to your pre treatment state.  When we meet, I am assessing your face not only in still photos but also in animation because this is where many people go wrong - they may look great in selfies but “wrong” when animating if overfilled or overtreated. All this planning and execution takes time, attention to detail and education. It also needs a realistic discussion about your willingness to commit and to budget because you will not get best results if you are likely to struggle to remain consistent. For this reason and many more as well as the medicolegal concerns, my opinion is that it is always a good idea to invest in an initial consultation with an open mind to understand what your concerns mean, and how they can be helped, and then to decide if you want to invest in the treatment options so as to avoid shortchanging yourself. Our price guide is regularly updated, but should give you some idea of how much you can expect to spend - the more concerns you have, the more significant the cost initially. I always say to patients it is like buying a car - there is a big upfront cost, then servicing is more manageable to keep it all running smoothly.  No two faces are the same or have the same

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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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8 Things to Do to Prepare for your Injectables Appointment

Injectables! Despite the booming popularity of these office procedures, there are many people who are still new to the choices available, and who may enter their 30s, 40s and even their 50s, having never had a needle near their face. On these occasions, I like to allow for enough time to address concerns, answer questions and sometimes, manage unexpected anxiety that may rear its head as they get on the treatment bed. Some say to me “I was all psyched up, ready to go, when I booked and signed the consent form, but now I’m having second thoughts…” Why these second thoughts? At Skin Essentials, we mail out as many of the relevant forms to you prior to your appointment to fill out as possible, to maximise your allocated appointment time in clinic with your treating doctor. So common side effects we warn you about: bruising swelling temporary headache (with anti wrinkle injections) lumps and bumps (with fillers) asymmetry (fillers and anti wrinkle)   Additionally, we talk to you about rarer side effects and some medical emergencies, so it is no wonder some patients, on reading consent forms, begin to worry.  Informed consent is an important part of any consultation and not something to be simply rushed into. Equally, it helps you prepare to minimise the chances of adverse effects on the day. Having said that, how can you present to your appointment and have the best possible outcome? 1. No makeup means no makeup. Patients will often present with a full face of makeup, or “on my eyes since you’ll be treating my cheeks” etc. For anti wrinkle, it is less important than fillers, which are semi permanent implants, but an absolutely clean surface is vital to reduce risk of contamination of equipment and minimise risk of not only infection but also nodules down the track. This is non negotiable for me, not to mention makeup affects the quality of the pictures we take for our records and makeup removal especially of layers, can take up precious time in clinic. 2. Hair tied back or off the face Another big thing. Taking pictures before and after procedures is part of the process and hairstyles and hair in the face can affect results so it is imperative that hair is held off the face, and that you come with suitable hair bands and ties to do this, and during the procedure also. 3. Please avoid any supplements and medications as well as social drugs that may increase risk of bleeding Common culprits include Vit E, ginseng, fish oil, ginkgo biloba and some medications such as aspirin and ibuprofen. Also, alcohol. All of these will increase risk of bleeding and bruising. 4. Please plan to go home after the procedure and ice the area treated Patients often plan their treatments just prior to a lunch meeting, or a shopping date, and while with many minor procedures this is fine, if we are doing a fair bit in one go, it is safer to simply go home and to keep icing the area for best results and to minimise bruising risk. 5. Please don’t plan to exercise or get a facial or a massage immediately before or after your appointment Lying face down for a massage or having a facial may move freshly injected medication to an unwanted area, so these procedures are off limits at least for a day or two. 6. Please plan your injectables at least 2 weeks before any big events such as birthdays, weddings and more. Some of this is logistics - it takes anti wrinkle injections anywhere from 3-5 days to begin to kick in and to peak at 2 weeks. Fillers can take 2-4 weeks to settle and lumps, bumps and some asymmetry are common. Likewise, bruising is a common and well known side effect of all injectable treatments, so please plan these at least 2 weeks prior to any big events. 7. Please plan your appointment at least a week prior to any planned trips and flights away I like to have patients around for at least 2-3 days post treatments in the event that there is an unexpected and serious side effect. There are limited options to help if you are interstate, or worse, overseas. 8. Keep your mind open and your expectations realistic This is a big one. Please be guided by your clinician as to what is possible with your unique anatomy rather than insist on what you have seen on social media, complete with filters and photoshop. The face is a highly mobile area of the body, and subtle changes can make for big impact, but only if done well. Have an idea of what you’d like, but be willing to listen to your provider and take their advice on board if it is not possible (or out of your budget). What else would you add? What else would you wish to know if you were to consider injectables? 

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Green Flags when seeking your Aesthetic Practitioner

Every few weeks of late, it seems, we are seeing posts on social media of young women with rare complications due to injectables, namely, dermal filler. Not that long ago, it was a young woman who posted of her experience on TikTok. Shortly after, well known influencer Lily Ghalichi posted of her own experience with a blocked blood vessel, ie a vascular occlusion, a well known, if rare side effect of dermal fillers, to her Instagram and how it was treated when caught (early). Yesterday another young woman from the USA posted and what stood out to me this time, was the way she presented her story and the red flags present within it, to anyone who knew what to look for. It got me thinking, why are more people not aware of what red flags to look out for and by the same token, what green flags to indicate you are in safe hands?  So I posted on my own IG, to try and educate those who choose to have dermal fillers. What are some safety features, or GREEN flags you should be looking out for in your aesthetic practitioner? their qualifications - in Australia currently, injecting S4 drugs (anti wrinkle treatments, dermal fillers and other related drugs) are limited only to AHPRA registered medical practitioners - nurses, doctors, dentists. Is your practitioner registered and of good standing with AHPRA? their experience? How many years post graduate are they? Injectables flooded the market two decades or more ago, and it is becoming more and more common to see people taking up the briefest of training simply to be able to go into aesthetics, often without much if any, post graduate experience. "Would a reputable clinic or clinician take someone with no experience on?" and if not, where are these people likely to find work and at what prices?  do they take their time with you in the consultation or is it designed to convert you? Do you feel pressured to proceed with the treatment on the day? Do they cover complications in a way that is designed to be realistic or simply to get you to proceed? when, not if, when, something does go wrong, do they have a safety net in place to help you until the concern is resolved, or a way to refer you to someone else who can help? Do they have the necessary drugs stocked and ready to go? Do they practice in a location whereby if you had an emergency at 11pm, they can open the clinic or salon to see you if needed? do they have a clear aftercare plan and system to check all is well and a means for you to contact them if you have concerns? When and if there are complications, can you rely on them to be there with you and to refer you appropriately if it is out of their skillset, until the issue is resolved? Beauty and Aesthetics especially, is a multi-billion dollar industry and it feels some days like everyone wants in because the demand is so huge. Unfortunately even though we are not like the UK, where literally anyone can inject and buy drugs off eBay, we are still a largely unregulated industry and people are frequently sold the illusion that it is “just beauty” and the “customer is always right”.  Many practitioners seem to undersell the gravity of rare but serious complications when talking to and consenting patients. It is often sold as “fun”, “sexy” and with minimal complications for patients, and simply, great revenue for practitioners.  In my clinic, patients are often shocked when they’re told about the rare but serious risk of vascular occlusion or even blindness, even though they have had filler elsewhere before, prior to proceeding.  They are similarly surprised when I turn some of them away and refuse to do anything because of : unrealistic expectations they bounce from injector to injector and remain unhappy with results  they do not know what was done where, or by whom, or what product was used they are unprepared for any downtime or the time taken to build results, which may involve several sessions on a tight timeframe they've left it too long and done the bare minimum and then woken up, often in their 40s, 50s or later, and hate what they see but do not want the cost or downtime of surgery so go from practitioner to practitioner who give disparate advice, none of which is appropriate or right.  Others report feeling pressured into it on the day due to hefty consultation fees redeemable only with treatment on the day and then have regret around proceeding.  It is worth remembering that as AHPRA registered practitioners, doctors, nurses and dentists have a duty of care, which includes “first do no harm”, to act always in the patient’s best interests, to not be seen to be inducing vulnerable people (incentives, specials, posting testimonials and even using drug names are all prohibited in Australia) even and especially if that means saying no and not placing undue pressure on the day to “convert” regardless of whether that is what the patient wants or expects and the loss of revenue that may entail.  I admit it, as a small business owner who has limped along due to Covid, I'm the first to feel my heart sink when I see a new patient who has done nothing to date, and now feels desperate for a quick, low budget fix; or a patient who's been to several practitioners and been dissatisfied with all of them, or someone who wants to "look younger" but is opposed to everything suggested...I know I am going to spend the time they have booked to educate them and then wish them well and generally refuse to touch them if it'll not make them happy.  I tend to tell patients not to rush, that aesthetic treatments, by their very nature, are entirely non essential, and to take the time; I

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Platelet Rich Plasma

Last week my staff and I added Platelet Rich Plasma treatments to our list of offerings.  It generated a fair bit of buzz on Facebook and Instagram, and with good reason, so read on if you’re curious!  What is Platelet Rich Plasma (PRP)? PRP is blood plasma, or the golden liquid left behind after blood is spun down, leaving a high concentration of platelets, the cells in whole blood responsible for healing after injury and formation of new tissue over the injured site.  PRP is thought to help regenerate and revitalise damaged tissues.  While the jury is still out on robust evidence (eg injection of PRP in a patient compared to injection of just saltwater for example and comparing skin improvement) it is an area that is continuing to provide some promising results for use not only in skin rejuvenation, but also hair regrowth and inside joints for injuries and it is believed by many that the evidence does exist, pending appropriately planned clinical trials.  How does it work?  Direct injection of PRP is thought to help accelerate the process of tissue regeneration and repair with production of collagen, elastin and new blood supply to the injected site, much as happens when you cut yourself for example.  How many treatments are required?  This is best discussed with your doctor based on your situation. For most patients, a series of treatments are recommended, usually 2-3 treatments, 4 weeks apart and then maintenance.  There is good evidence PRP works better in some areas compared to others, example under the eyes for wrinkles and eyebags, less so for pigmentation under the eyes, which requires different treatment options. ARTICLE: Platelet-rich Plasma for Skin Rejuvenation and Treatment of Actinic Elastosis in the Lower Eyelid Area  There is also promising evidence of this working for female hair loss, usually requiring x3 monthly treatments of PRP to the scalp, with new hair growth unto 6 months after the last treatment, less breakage and increased volume. Read more about PRP and Hairloss. How quickly does it work? You may notice improvement as quickly as 3-4 days and then gradually over a few weeks with injection under the skin.  Unlike dermal fillers, this is NOT a quick lift/ volume replacement. If you have significant volume loss in your face, PRP is best used in addition to, and not instead of, dermal fillers, biostimulator fillers, thread lifts and other modalities to improve skin quality and volume over time.  Will I need much downtime? There is minimal downtime. There may be some redness at the injection sites, which will fade, and a small chance of bruising but that is it for most patients.  Are there side effects? PRP utilises your own blood cells, which Dr Joshi will collect on the day, spin down and then use to inject you. This is known as A-PRP or autologous PRP, so risks and side effects are minimal, and if any, irritation at the site of injection, bruising and some swelling.  Where can I have PRP injected? PRP may be injected on the face, the neck, décolletage as well as backs of the hands for skin rejuvenation. Bear in mind, a single treatment is usually NOT enough for lasting change and a series of treatments usually 3 monthly treatments, is recommended as the minimum.  How much will it cost? We are offering this treatment from $500/tube, depending on the areas of concern. As a guide, PRP under the eyes and around the mouth is approximately 1 tube.  To the entire face, 2 tubes. Face and neck or face and décolletage 2-3 tubes. The number of tubes will also depend on how much PRP is obtained from your collection in volume – this is dependent on you, and may range anywhere from 5mls of PRP/ tube to 7+ml/tube, as with our model above. Please enquire at contact@skinessentials.com.au for more info or to book online please do so here:

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What can anti-wrinkle injections be used for?

As we age, depending on our ethnic background, our age, the amount of pigmentation as well as genetics and other factors such as smoking and regular use of sunscreen, we develop lines where the muscles of our face regularly move under the skin. Over time, these give rise to wrinkles- first these are dynamic; these only occur when our muscles are moving. Over time and with age, these may become static- these are wrinkles that are visible even when our face is at rest. It is important to realise that anti-wrinkle treatments mainly treat dynamic, not static wrinkles, though many will notice some benefit even to these over multiple treatments. Following  are some examples of some areas that can be treated on the face using anti-wrinkle injections to help reduce or even remove dynamic wrinkles. Over time, with back to back treatment, even static wrinkles can be reduced, failing which, filler may be an option. Some more examples… While the mid and lower face usually needs filler for optimal results, sometimes some improvement can be achieved with uses of small doses of anti wrinkle treatments too: There here are many other things that a small dose of anti-wrinkle treatment can help with, such as excessive sweating on the face, underarms and even hands, as well as for gummy smiles, bunny lines around the nose etc, so if you are wondering how I can help you look your best, book your  consultation and ask!

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When should I start?

Question: I don’t need anti wrinkle or filler treatment! Do I? Dr Imaan:  Before I began training in this field, I used to think similarly. When we are in our 20s and even early 30s, we are blessed with beautiful plump skin and provided we look after our skin with some basics, a skincare regime, a decent diet with enough fresh fruits and veggies and sun care, we radiate the glow of youth effortlessly even if we stay up late, drink too much every now and again. So I used to think that most people wouldn’t need anything till they began showing signs of ageing, whether premature, due to lack of care, or age appropriate. Training and working in Cosmetic  Medicine has led me to change my viewpoint slightly When I see patients in their late 30s and 40s and 50s, with static wrinkles, thinning skin, deep wrinkles and a gaunt hollow look or a jowled appearance around the jaw, I realise that to halt these changes takes a fair bit more time and a lot more money, than if they’d begun preventative care 5-10 years earlier. Age related skin changes aren’t just skin deep. As mentioned elsewhere, fat pads around the face are lost; skin thins and loses its elasticity; gravity begins to drag skin down, towards the jaw; bones change shape underneath the skin, leading to shadows and hollows and a general look of fatigue, anger or sadness. Wrinkles are more set in and harder to erase with some anti wrinkle treatment and many of the changes related to thinning requires large amounts of filler to replace. My approach now tends to be that of maintenance and prevention. in your twenties, when skin is still smooth, plump and beautiful, small amounts of anti wrinkle treatments help relax muscles without freezing and delay wrinkle formation. Filler may not be needed at all, or only used to plump naturally thin areas such as lips or cheeks for definition. in your thirties, preventative maintenance continues, with some anti wrinkle treatments aimed at reducing wrinkle formation and depth. Fillers may again only be needed as enhancement. in your forties, anti wrinkle treatments may be used in the lower face together with fillers, which may now have a bigger role in replacing lost collagen in the face- temples, forehead, cheeks and around the mouth. in your fifties and beyond post menopause ongoing maintenance would require a combination of anti wrinkle and fillers with great subtle results that will have you looking great for your age and even a few years younger and refreshed. So my advice would be: if you can afford to do so, consider incorporating some basic treatment when able so as to age gracefully and naturally in your 40s and beyond.

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Does your downturned mouth get you down?

Question: I look after my skin and it’s in fairly good condition but it’s starting to sag around my mouth and jaws, making me look sad and old. It upsets me to see this in the mirror. What can I do about it? Dr Imaan: It can be upsetting to look at ourselves in the mirror after a certain age, and see someone older than our mental image of ourselves. As we approach our 40s, no matter how good our skincare, gravity begins to take its toll, which is seen mostly in the changes you describe- a sagging in the lower face that can be seen as the nose-mouth lines, the nasolabial folds; the downturned mouth, or marionette lines and the beginning of jowls, as the skin around the mid face loses its elasticity and volume and begins to sag. If budget isn’t an issue, ideal treatment of this issue is with dermal filler to replace the lost volume in the cheeks, as discussed in my post on cheek filler – that will usually also treat a variety of other issues, such as hollowing and circles under the eyes, hollowing of the cheeks and smoothing out of the lines around the nose and mouth. For most people, this would require 3-4mls or more over 1-2 months until the desired effect is achieved, which can be expensive. As a guide, a woman in her 30s would need around 3mls, one in her 50s 5 mls and so on. Thick filler lasts around 12 months and costs around $650-700/ml, depending on the brand. The filler would be injected around the mid face to replace lost volume, smoothing out hollows under the eyes, nasolabial folds and rejuvenating the face subtly. It can be expected to last around 12 months, and then need regular topup yearly or so, depending on the individual. In experienced hands, results may be similar to this photo below.   For those for whom budget is an issue, all is not lost. Targeted use of fillers can soften the areas of most concern- in this case, some filler to the corners of the month as well as to the marionettes themselves directly with 1-2mls filler together with some anti wrinkle treatment to the DAOs.

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Full Face Rejuvenation

This lady has been my patient for a full year now. I first met her on November 26th last year. She’d never had any injectables but was keen to try some anti wrinkle treatment in her early 40s. This is with her full consent. This lady took a year almost to the day- dark sunken eyes; hollowing cheeks. Deep smile lines that bothered her. And wrinkles. She was worried abt the wrinkles. She went from being someone who was terrified to let anyone know she was seeing me to showing everyone because she feels she looks fresh and happy, which reflects her inside. I’ve taken pics static and animated so it can be seen that she looks natural. The cost of something like this isn’t cheap. For eg: Anti wrinkle treatments up to 50 uts x 4/year= $3000Fillers, 2 mls medium and 4 mls thick over the year $3500 Going forward is maintenance- anti wrinkle every 3-4 mths $750Fillers 1-2 mls/year $600-1200 So that’s what a full face rejuvenation looks like – upfront cost and ongoing maintenance.  Any questions? email us at contact@skinessentials.com.au Hope to see you in a clinic soon!

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Markers of Ageing

So why is that a problem? Well. This is where my passion for primary prevention, ie General Practice, which is the speciality focused on preventing things from going south in the first place, shows. Prevention is always better than cure, so I encourage people to be proactive about their skin just like their health. So if it feels like one day, we literally wake up, and there is a mass of wrinkles where there used to be lovely smooth skin: If that is you, then we’ve missed the opportunity to prevent and have moved to the “cure” stage. Which is more time consuming, worrisome and expensive. Some will simply say, “Why bother!” and carry on. Others will say “I embrace my wrinkles!” to which I say, more power to you, and good for you. But, for someone who is very much wash-and-wear, I am rather vain about my face, especially since I don’t wear makeup but do like to look good for my age. Exercise, as great as it is for your heart and general health and mood, isn’t as good for the rate at which you lose fat, including from your face; it predisposes to fat loss from the face, resulting in the “runner’s face” – wrinkles, hollows, eyebags and jowls. Some examples of ladies I have done subtle work on: 29 year old busy mum of many, looking tired and drawn with early under-eye hollows and mid face volume loss. Top: before anything. Bottom: after 0.5ml filler to each cheek. Lady in her late 40s with years of midface volume loss. Her deep eyebags worried her the most, but we had to restore the cheeks first before her eyes began to look better. Total volume used over 3 months- 5 mls. So what can you do? Like all preventative care, begin before the damage has occurred if possible focus on a diet that is low in processed foods and high in fruits and vegetables get enough sleep – most adults need 7-9 hours/ day quit smoking! watch your alcohol intake use sunscreen, rain, hail or shine! care for your skin – it is the biggest organ of the body, and will be with you from birth to death, so it deserves that you care for it like you would the rest of your body! Get exercise and work on your heart and bone health with a good mix of cardio and weight bearing exercises. bear in mind that cardiovascular exercises, like running and aerobics, will stimulate more fat burning and cause a more gaunt appearance over time. BUT they are also great for mood, and the increased blood flow to the skin will help circulation so that’s a win! weight bearing exercises are important for bone health, and an important role in osteoporosis prevention as we age. Don’t shy away from spending on quality products to care for your skin try not to be penny wise but pound foolish – many of the OTC products you slather on your skin will do only so much, especially once past a certain age. fillers will not only plump up skin from within, they will also attract water to the site, evening out lines and wrinkles and they provide a lasting hydration that surface moisturisers don’t mimic as well. anti-wrinkle injections will relax muscles that predispose to wrinkles, smoothing them out over a year or more of sustained use. So, budget for quality care and care for your skin, look after it and it will repay you for years and years to come! Any questions? email us at contact@skinessentials.com.au Hope to see you in the clinic soon!

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