What does Plasma Do?

http://www.dailymail.co.uk/health/article-5418499/Planning-going-knife-Think-again.html

I'm sure you have seen videos on social media where skin seems to be burnt with a probe leaving lots of dots with boasts about "fibroblast therapy" or even "plasma treatments."  Unfortunately these machines are very unlikely to be true plasma machines because there is no trademark on the use of the word "plasma" so they are often radio frequency, or use radio frequency to operate. Like Louis Vuitton, there are lots of fakes out there.

Plasma therapy was introduced 12 years ago by Professor Fippi. In physics, it is the 4th meta state (the others being solid, liquid and gas). A true plasma device emits alternating currents that ionise the gas in the air to produce nano plasma - a small electrical arc that when it touches skin can either tighten, bio-stimulate, rejuvenate or remodel skin. A true plasma machine should never have mains current otherwise a device can transfer electricity to a patient. A good test of whether a person has a true plasma machine is if it can be used in the eye, toot canal, on children, for people with a metal plate, heart conditions or on warfarin. These other machines create an arc via an electric current and there are lots of risk factors (such as burnt and scarred skin) as a result of the use of electricity.

So now you have the knowledge to choose a clinician who uses a true plasma machine, how can it benefit you? Each plasma treatment will give a 35-40% retraction in the skin so it has a very wide range of uses. Most popular applications are for area of skin tightening where volumising with dermal fillers is not possible for instance - upper eye lid tightening, lower eye lid tightening, barcode lines on the top lip (peri-oral area), treatment of stretchmarks, skin tag removal, improving pigmentation and acne scarring.

Nano plasma does not burn the skin, it sublimates it by taking a solid and turning it into gas so there should not be severe swelling that lasts weeks or crusting

Prices - The area being considered for treatment will be assessed on the degree of skin laxity minor (1), moderate (2) and severe (3).  If you are skin type Fitzpatrick 4 and above - you will need to have pre-treatment otherwise you are at risk of post inflammatory hyper-pigmentation.

I often say to my patients that the best machines (the safest and most effective) are invariably expensive and need to be used by a skilled and experienced clinician. So you should expect to pay upwards of £600-£1000 for treatments.

 

PGAGE Revolutionary Deep Peel

I have been getting such great results with the PQAGE peel I had to let you know it is available!

It is a peel that is a combination of TCA (peel with a deep action) stabilised with urea peroxide, in association with gentle exfoliating agents (kojic acid) and antioxidant agents (Q10 enzyme). This combination enables a deep revitalising, lifting and stimulating action of the dermis without the side effects of peeling.

Thanks to the combination of TCA and urea peroxide, the peel does not damage the epidermis and so there is increased permeability of the TCA across the cell membrane because the proteins in the dermis are denatured in a targeted and controlled way. The peel also increases the oxidant effect of hydrogen peroxide which is released from the urea peroxide giving a strong temporary whitening action as well as the direct oxidation of membrane proteins and dermal proteins.

This is great for a TCA peel because it means that it can be performed on delicate and sensitive skin and the peel will remove skin blemishes, aid tissue regeneration, treat pigmentation and firm looser skin.  It is a painless treatment and can be used all year round, at intervals of every week if required.

This peel is ideal for people with:

  • inflamed acne
  • skin discolouration and pigmentation
  • skin that requires revitalisation
  • stretch marks
  • recent scars
  • loose skin on the face, neck and decollete

This peel is only £75 per treatment (30 minutes) and 5 sessions can be purchased for £250.

You really must try it to believe it! I have been thrilled with the feedback I have had from my patients.

Hello to clients of the Secret Brow Society!

Every 3 months I will visit the Secret Brow Society in Sheffield to do a pop up clinic! Bookings, prices and deposits are strictly via Maria at The Secret Brow Society. Please do contact her for more information on dates or to be placed on the waiting list.

Here are some Frequently Asked Questions:

1. What brands of filler do you use?

I prefer to use brands that are the market leaders - such as Juvederm, Restylnae/Emervel and Perfectha. This is because the more widely a product is used worldwide, the more confident I can say that it is safe to use. Also I want you to feel assured that these companies are going to be here in 20 years time and therefore have long-term accountability. My concern with these new companies is that if they go out of business, in the future you will not have a company to seek guidance from regarding their product.

2. How long does filler last?

This depends on your body, the type of filler we use, the volume, the way I place it and where I use it on your face. For lips, I would say you are doing well if the filler lasts 6 months. Of course, I hope it lasts much longer but I would rather be pessimistic with you so that you are not disappointed. Filler in other regions like the cheeks, nose or mouth to nose lines are likely to last 6-12 months on average, even up to 18 months for some patients.

3. What volume should I have?

This depends on how naturally full your baseline lip is and what your desired result is. If it is your first treatment, in 80% of cases I advise 0.5ml volume. But there are many other factors to consider. For instance, the more natural volume in your lips, the more the HA filler will be "diluted."  It also depends on your definition of subtle. I like all my lips to look natural but I will get some patients who do not want a noticeable result and others who want to see a definite increase in volume.

4. Does it hurt?

There is some discomfort associated with the procedure but everyone's different - some people feel no pain at all! I prefer to use numbing cream as opposed to a dental block because I need you to move your mouth during your procedure. Most people are used to experiencing and managing discomfort well, for instance when they encounter period pains, waxing, threading, tattoos etc. Your procedure is not likely to last more than 15-20 minutes so I ask that you stay as calm and still as possible and before you know it, the procedure will be completed.  Many of my patients return for repeat treatments so I think that speaks volumes that whilst there is a degree of pain, it is worth the result!

5. What if I don't like the result?

That is a risk you must expect. Whilst I will spend a significant part of the appointment with you discussing your expectations and taking you through the consent, there is a chance you might not like the result. Do remember that it can take up to 3 weeks for a procedure to settle and getting dream lips is often a journey. If you already have asymmetry or scarring, this can make the treatment more challenging and future treatments may be required for incremental improvements. However, do remember that hyaluronic acid fillers are temporary are are likely to be broken down by the body in 3-4 months (for 0.5ml treatments). There is also the option to use hyaluronidase to reverse the treatment completely but this is undertaken once other options have been exhausted and only if you are suitable for this treatment.

Are you ready for an injectable treatment?

My heart sinks when I get a potential patient inquiring about a cosmetic injectable treatment and the first question is "how much is the treatment?"  Whilst I try to keep my prices reasonable so I can reward my loyal patients and help them manage the upkeep of continued treatments, please be aware it would be foolish for price to be the deciding factor when choosing to undergo a cosmetic procedure.

Roughly 25% of patients who contact me do not seem ready for a treatment. Firstly, you must be over 18 years old and I would prefer you to be over 21 years old.  You need to have emotional maturity and resilience to undergo a cosmetic procedure.  There are certain common complications that you can expect following a treatment and you must have the resources to handle them. It can take 2-3 weeks for the body to heal post-procedure and you must be able to manage your emotions and expectations should that occur. 

It is also best to wait and schedule your appointment well before any holiday or big event - at least 4-6 weeks. Not only is there often a wait to have a treatment from cosmetic medicine specialists but also it is ill-advised to have a treatment prior to travel (how could you be reviewed in the event of a complication or undesired outcome?!) or big event (again, what if you encounter severe swelling and/or an undesired outcome?) In many respects, you will benefit from being patient by scheduling your appointment with plenty of notice - especially if before a holiday or big event and taking time off work, if required.

Lastly, there are lots of good resources out there for you to read up about before you come to your consultation. Do check out www.consultingroom.com and www.realself.com and www.saveface.co.uk. I would be wary of videos from non-medical professionals discussing procedures because you are best seeking the views of the specialists in the field.  Whilst you will receive a comprehensive consultation and consent, it's great to be prepared and that way you won't feel overwhelmed with information.

 

Travelling to the Juno Clinic

I hope my new clients do not take offense when I first ask how nearby to Manchester they are!  If you are more than a 50 minute drive away, I ask you to consider http://www.saveface.co.uk to see if there is anyone more local.

It is always an honour and a privilege if a client travels from a distance to visit and so far I have nearly fallen off my chair when I have found out people have travelled from Dubai, Glasgow, Kuwait, Spain, Channel Islands, London, Birmingham and Lancaster!

As explained in my previous blog about complications, there are some very rare one that if you were to encounter, you would need to return to me immediately.  Fortunately, they are extremely unlikely, and even further less likely because of my technique and cautious approach.  However, there are other more common complications that you might want to return to me for, such as: top up of your filler, smoothing any lumps that might have formed once you have left or review of bruising and selling. In which case, you must be prepared to commit to return to me so I can resolve these issues for you.

 

Aesthetic treatments such as lip fillers are medical procedures that take some time to settle but each person is different and so for the most optimum effect, you may need to return within a fortnight for a follow up appointment.

Getting Ready for your Lip Filler & Possible Complications

It has been lovely to recently have some new clients express an interest in lip filler injections.  At our consultation, I will take a medical history and advise you of the risks and benefits of the procedure before making a recommendation of the most appropriate lip filler product for your requirements.  However, I cannot predict how your body will react to the product and the procedure.  You will have a safer, more informed and stress-free recovery if you are aware of the commonly occurring and rare complications.  With this in mind, I ask you to consider...

Preparation for Lip Filler Injections

  • Do not take aspirin/ibuprofen the week before a treatment.
  • Consider using arnica in the week before your treatment.
  • Do not exercise beforehand.
  • To prevent blood pressure from being high - try to stay calm.
  • Have the lip area clean and make up free - avoid using make up for at least 4 hours after your treatment.

Complications

Injections are a form of trauma which cause bruising, bleeding and swelling (including asymmetric swelling). You should expect a degree of swelling and bruising after your lip filler procedure. Also the hyaluronic acid filler is designed to attract water to the area is is placed giving a puffy appearance at first.

Examples of swelling are:

Examples of bruising are:

Help is at Hand!

In the first two days after your lip filler treatment:

  • Do not rub or massage your lips.
  • Do not take aspirin/ ibuprofen and avoid alcohol.
  • Use a cold compress on your lips for 15 minutes in every hour.
  • Sleep with your head raised.

Swelling is most noticeable in the first two days after your treatment but if there is some swelling after 48 hours, an over the counter anti-histamine like Benadryl might help.  Bruising might take longer to improve, depending on its severity.  In approximately 1 in 10 procedures, there is the complication of an internal bruise - also called a haematoma/blood blister.  It is an enlargement of tissue due to the accumulation of blood cells and fluid.  Blood fills the area, creating a bulge.  Over the next 1-2 weeks, the body will reabsorb the blood cells and fluid from the region.

Another potential complication for you to consider is if the filler does not settle evenly with the formation of a lump.  They can be evened by massage but if that is not effective then you need to come back to the clinic for me to smooth them.

Very Rare Complications

Every reputable aesthetics professional is mindful of the risk of filler affecting the blood supply to the area treated and other regions of the face.  The risk of this occurring is estimated to be 1 in 30,000.  This is caused when the dermal filler is either injected into an artery or around an artery to the point that the blood flow is reduced or completely stopped.  The area of skin or other tissues that are supplied by the affected vessel will start to die without the necessary blood supply.  

Almost always, if this complication occurs, there will be an immediate blanching (paleness, tissue turns white) when the blood flow is interrupted, often in areas far away from the actual injection (see the photo of the blanched cheek). There is usually immediate pain but there have been cases reported that occurred 12-24 hours after being injected.

If no treatment is initiated to improve the vascular flow, the skin will start to appear dusky, a bluish tint, with fine reticulations (lace like) to areas beyond the site of injection (see the mottled appearance of the cheek in the top right photo).  This occurs within 24 hours.  If still no therapy is done, the skin will start to die, turning black, and sometimes there is an associated infection. 

Is it important that you tell your aesthetics professional:

During the treatment:

  • If you are experiencing any unexpected pain or tenderness that feels different to the usual lip injections.

In the first 24 hours after the treatment:

  • Any paleness or dusky appearance to the skin and surrounding area.
  • Any mottled/lace like appearance to the skin and the surrounding area.
  • Any goosebumps/blisters to the skin and the surrounding area.
  • Severe pain and tenderness.

Though it is rare in the extreme, this is an urgent complication that requires immediate attention so you must call and send a photo should you suspect this event.

 

 

 

How do Fillers Work?

Gone are the days of pillow face and expressionless face, we are a modern aesthetics service that prides itself on being able to deliver a treatment to any age group with its specialist and advanced aesthetics techniques.  Meticulous care is crucial to injecting into the deep dermal plane or intradermal plane. This expertise makes the difference between a great result and an average result.


How does it work?

Modern injectable fillers are made from hyaluronic acid, a naturally occurring substance that the body breaks down gradually. Depending on the purpose and the viscosity of the filler, it can last for different time frames but that is a good thing. Although you might feel inconvenienced by returning for further treatments, your face will change as it ages which is why refreshing a treatment is advised.  As the company's Lead in filler treatments I am trained in the advanced treatments and only use products that are the market leaders in effectiveness and safety.  Anaesthetic cream is used topically to minimise the pain of injecting but the filler also contains an aesthetic chemical so if you are one of the minority who experience some discomfort, the pain should not worsen. 

 

How long do fillers last for?

For lips: Lip filler commonly lasts 6-9 months though we hear reports from our customers that they are still pleased with their results 12 months later. For other customers who are looking to work towards longer-term pouty lips, they stagger 3-6 months between treatments in order to reach a stable end result 18 months later.

 

Cheeks: Juvederm Voluma restores lost volume to regain a youthful curve in the cheek. The product is elastic, viscous and supports structures to enhance the cheeks, it lasts 18 months and is seen as a great investment as an alternative to a face lift and is known as a liquid face lift. A commonly occurring issue is that it may highlight deficits in the tear trough and so dependent on your consultation, it might be worth considering a simultaneous tear trough enhancement.

 

Laughter lines: Juvederm Ultra 3 is used to fill the nasolabial lines that are a deeper wrinkle.  The product plumps up the skin and stays in place for a result that will last about 9 months, though we have reports of 12 months from our customers.

 

Tear Troughs: I call this treatment the "cherry on the cake" because all the other filler treatments aim to take the viewer's aim to the mid face.  The eyes really are the windows to the soul which is why a beautifully proportioned face keeps a person's attention in that area.  Depending on whether or not other treatments are required, the tear troughs are "airbrushed" with a light filler because it sits next to the service of the skin, only the best product is used and it is meticulously applied. Unlike other fillers that encourage water being drawn to the area for a plumping effect, Juvederm Volbella aims to restore lost volume in the orbital rim without causing swelling to the area, it lasts about 12 months.

 

How quickly can you see the results?

Unlike toxin treatments (like Botox) the result is instant and your clinician is guided by what they see as they deliver it in order to complete the entire procedure. However you can expect swelling and bruising after a filler treatment so don't feel alarm if there is more volume initially than you expected.  In exceptional circumstances filler can be reversed with an enzyme (because it is a naturally occurring substance).

How does Botox Work?

How do wrinkle reducing treatments work?

Wrinkles are mainly caused by muscle contraction. For example, when you are angry or confused, you draw your eyebrows together and downwards. This causes pleating of the skin which results in frown lines. Similarly, elevation of the eyebrows causes horizontal lines on the forehead and smiling/squinting causes crows feet around the eyes.

Toxins are injected into the target muscle directly below the wrinkled area and blocks the transmission of signals from the nerve ending to the muscle. This causes temporary paralysis of the treated muscle the causes the wrinkles, which results in the reduction or loss of wrinkles.

How long do results last?

Results will start to show after 3-10 days and will last 3-5 months. The result is not permanent because the nerve ending re-establishes it’s signalling by forming new nerve sprouts. This sprouting takes approximately 3-4 months, at which point the muscle regains it’s activity and the wrinkles begin to reappear. Clients who have treatments 2 or 3 times per year tend to find the results may last longer after the first 2 years of treatments. When combined with other skincare treatments, it is an essential component of anti-aging.

What is Microneedling?

Microneedling stimulates collagen production in your skin to give you better-looking skin on every level. The skin has a natural ability to repair itself whenever it encounters physical damage such as cuts, burns and other abrasions. Immediately after an injury occurs to the skin our body reuses the damaged collagen and elastin fibres as well as other damaged skin components to produce new ones. Skin needling allows for controlled induction of the skin’s self repair mechanism by creating micro “injuries” in the skin which triggers new collagen synthesis, yet does not pose the risk of permanent scarring. The result is smoother, firmer and younger looking skin.

After the procedure the clients skin will be red and flushed in appearance in a similar way to moderate sunburn. Skin will feel tighter with mild sensitivity to touch on the area being treated. This will diminish greatly after a few hours following treatments and within the next 24 hours the skin will be completely healed. After 3 days there is barely any evidence that the procedure has taken place.

Myth: Microneedling hurts.
Fact: For the most part, microneedling may be uncomfortable but it’s not totally unbearable. At Juno Aesthetics microneedling procedures done in a clinic setting and are performed with topical anesthesia depending on the depth of the procedure being performed.

Myth: Microneedling leaves holes in the skin.
Fact: While microneedling does create a controlled injury in the skin to incite collagen production and does it by creating microscopic holes, the holes it creates are so tiny that they can’t be seen by the naked eye. You may notice more of a red or pink flush to the skin, which will dissipate soon afterwards, and potentially some bleeding. No need to worry, it’s totally normal. Plus, makeup can easily cover up anything that you don’t want exposed.

Myth: The treatment can’t be done around the eyes or lips.
Fact: Thanks to advancements in both science and skin care, microneedling can safely be done in these areas as long as the right device is used. Companies like Aesthetic Dermal, which manufacture microneedling tools, have specially designed rollers that can be used on the upper eyelid, close to the eyelashes of the lower lid, the areas on the side of the nose and the upper lip.

Myth: The only benefit you’ll get from microneedling is an anti-aging one.
Fact: The treatment works to create smoother skin but it has been shown to be effective in correcting acne marks, too. The microneedles stimulate collagen production to help with scarring—when retinoids and other collagen stimulating topicals are applied to the skin after a treatment they are able to penetrate better for more improvement.

10 Bot Toxin Myths Busted!

There are A LOT of inaccuracies and untruths out there about B-Tox. Here are 10 myths that we are going to bust!

MYTH 1: B-Tox can be used anywhere on the face
There’s a filler and injectable to treat just about every line and wrinkle on the face, but Botulinum Toxin cannot be used for everything.  While it may seem like B-Tox can be used all over the face, there are only certain areas where it works; other injectables are an option for problems that B-tox cannot correct.

MYTH 2: It works immediately
Because B-tox acts on the nerves that control muscle movement, its can take anywhere from three to five days for it to set in before you notice results.

MYTH 3: You can never develop an allergy to Botox
Anyone can be allergic to anything, B-tox included. Although rare, there have been cases of allergies following Botox injections though it can be hard to distinguish between a true allergy to B-tox or an allergy to the dilutent used to dilute the B-tox.

MYTH 4: If you workout a lot you’ll need more B-tox than the average person
Whether you’re a workout fiend or you haven’t seen the inside of a gym in years, it’s not your workout choices that dictate how much B-tox you need, but rather the degree of your lines and wrinkles.

MYTH 5: B-tox alters your emotions
In actuality, if done correctly and in proper moderation, B-tox will look natural and emotions will still be expressed on your face. But angry appearances emotion that occurs when you furrow your brow will be diminished. But in the right amount, B-tox will not affect any other movement in the face like lifting your brows or smiling so you remain expressive.

MYTH 6: You can never become immune to B-tox
It is extremely rare but it is possible to develop resistance to B-tox due to the formation of antibodies to it following repeat injections.  Techniques to deal with these cases include using a different brand of toxin to inject, using the minimum dose required to achieve the desired effect at the longest interval between treatments.

MYTH 7: B-tox is the same exact thing as botulinum found in food
Some people believe that B-tox injected is the same as the bacteria that causes botulism.  Actually the B-tox manufacturers produce an isolated toxin that is not the entire bacteria.

MYTH 8: B-tox gives a fake looking result
The majority of my patients tell me no one knows they have had anything done. That's what I want.  In Aesthetics anything done correctly and in moderation can look natural. My goal is to under-treat so you look renewed and refreshed.  Celebrities that look over injected and fake or plastic have been over treated and good aesthetics practitioners should have conversations with their clients about keeping treatments looking natural.

MYTH 9: B-tox won’t do anything for super-heavy lines on the forehead
B-tox can work wonders on deeply etched lines in the forehead. It can sometimes take multiple rounds of treatment and time before the muscles become weak enough to really soften the lines.

MYTH 10: It’s safe to have anyone inject B-tox as long as they are some sort of doctor
Aesthetics practitioners should be MEDICAL professionals with advanced training and clinical experience in aesthetics. Each person will have differences in their anatomy and expectations of treatment and so the skill of an appropriately trained aesthetics practitioner is pivotal in planning injection sites, dosages and considering vector movement changes to deliver a beautiful aesthetic result.