Age causes changes to the skin and deeper soft tissues. As your skin ages, it loses the collagen that helps to shape and support it. Natural lines and wrinkles deepen. Sun exposure, smoking, air pollution and even stress can all age your appearance. The face can also begin to lose volume giving sunken cheeks a ‘dragged down’ appearance and lips can lose their fullness and appear thin and lined. Other hallmarks of ageing include hollow under eye area (tear troughs), hollow temples, deep nasolabial folds and marionette lines. Such features that can cause a tired, aged appearance include:
Tear trough hollowing, also known as deep orbito-malar groove
Orbital rim hollow at the junction between the lower lid and the cheek
Heaviness and drooping to the upper eyelid
Laxity with sagging and drooping to the lower face, jawline and jowl areas
The depression descending across the cheek from the lower lid/upper cheek junction, known as the zygomatic hollow
Naso-labial folds, the lines between the nose and the corner of the mouth which, become deeper and more apparent with age. Naso-labial folds are accentuated by cheek volume loss and descent and loss of the malar mound)
Deepening of creases to the Glabella area or frown lines between the eyebrows sometimes referred to as your ‘number eleven’
Vertical depressions below the corners of the mouth, known as marionette lines
Thinning of lip volume and loss of definition to the vermilion border (known as the lip line)
Thin, lined and crepey skin on the neck and decolletage area
Dry, thin and wrinkled looking hands
Facial and tear trough hollows can be effectively treated with injections of a hyaluronic acid gel fillers or volume bio-stimulation of deep collagen, for instance with poly L lactic acid (Sculptra).
Hyaluronic acid (HA) gel dermal fillers such as Restylane® and Perlane® or the Juvederm® range of hyaluronic acid gels, are used to fill tear trough, temples, cheek and facial hollows, and smooth the contours of your face. They also have a secondary effect to help reduce deep lines and wrinkles. Anti-ageing facial fillers are the non-surgical way to achieve younger looking skin and provide volume for age and smokers lines and wrinkles. Although dermal fillers are used to replace or increase volume, only the Skinboosters® are used superficially to rehydrate the skin. The other fillers are injected or introduced by cannula into deeper tissue hollows for their volume effect.
Botulinum toxin A
Botulinum toxin A, filler, or a combination of Botulinum toxin and filler can treat all of the above age related aesthetic changes.
Sometimes fillers are combined with other cosmetic treatments such as Ultherapy® Skin lifting and tightening, Skinroller®, Trichloracetic Acid (TCA) or pHformula® chemical peels and other aesthetic skin treatments.
A filler is a substance used to treat soft tissue volume loss and hollowness in the face and periorbital area. We can fill hollows, cheek volume loss and depressions with volume restoring fat or synthetic filler.
There are many different types:
Hyaluronic acid gels
Hyaluronic acid gels – including Restylane®, Perlane® and Juvéderm® are the most popular types of filler. The effects of hyaluronic acid gels reverse with time and can also be dissolved very rapidly with the injection of an enzyme which will reverse the gel with our unique treatment Hyalofix™.
The oculoplastic surgeon will decide on the best gel to use.
We inject the gel into the specific area of the face during a routine visit using a fine needle. The Restylane® and Hyaluronic Acid fillers we use at Clinica London also contains a local anaesthetic to reduce any pain and discomfort.
We then apply firm pressure to the area in order to reduce the risk of bruising and to ensure an even distribution of the gel. We may use ice packs and numbing creams, but they are often not essential.
Hyaluronic acid gel injections generally have few side effects, complications or allergic reactions and have been throughout the world for many years.
Restylane Skinboosters® are a brand new approach to improve skin quality. Skinboosters® improve the skin’s quality by boosting hydration levels deep inside the skin. The treatment improves the skin’s firmness, elasticity and radiance.
Restylane Skinboosters® treatments can be used to improve the general skin quality of the face but also to improve exposed areas such as neck, décolletage, and a very popular treatment for the hands as well as areas with acne-scarred skin.
There are three treatment options depending on the level of depth of hydration treatment required: Skinboosters® Light, Skinboosters® Medium and Skinboosters® Deep. These treatments are done in courses consisting of 3 separate sessions at 2 to 4 weeks apart.
Once the initial 3 treatments have been performed, maintenance of results can be achieved with a re-treatment approximately every six months.
Other fillers do exist, which are not hyaluronic acid gel based. These are semi-permanent or permanent fillers which we use seldomly but are still favoured by some surgeons and patients.
These filler alternatives include Radiesse® (Calcium Hydroxyapatite spheres), Restylane Skinboosters®and Sculptra® (Poly-L Lactic acid). These fillers can be used for both medical and cosmetic purposes.
Autologous fat transfer
One alternative to hyaluronic acid gel or other fillers is an autologous fat transfer (also known as a Coleman fat transfer).
We usually use autologous fat transfer to treat cheek atrophy in patients who may not be keen on hyaluronic acid gel or who want a more permanent effect. We make deep Injections into the sub-muscle area and existing fat reserves. We avoid injecting substances into superficial areas to prevent lumps, which can be difficult to eradicate.
Autologous fat transfer is a technique where fat is taken from the patient’s abdomen or thigh using a liposuction technique. This is done either under a local or general anaesthetic in an operating theatre. The fat is then prepared for injection in a centrifuge and injected with fine cannulas.
Autologous fat has a longevity of up to five years with a very low rate of allergic reaction. It is sometimes difficult to estimate the exact volume to be injected as up to thirty per-cent of the fat can be re-absorbed in the first three to eight months. An autologous fat transfer is also a more invasive surgical procedure than a hyaluronic acid gel filler injection. It causes more swelling and requires a longer recovery period. We use an autologous fat transfer in conjunction with eyelid, cheek and other facial rejuvenation surgery.
“Dr. Jane Olver was fantastic! She was so caring and sweet and it was clear that she knew what she was doing – very professional! I am absolutely over the moon with my results now!”
“Jane Olver is your woman – I wish I had found her at the start. I will be forever grateful for her care and expertise.”
“Just wanted to thank you for your exceptional assistance with my eye condition. I was so worried but you really helped me feel at ease.”
“I felt much better after speaking to you and being reassured. I am much calmer and actually got some sleep last night.”
“I was deeply impressed by the politeness and empathy shown to me. I found the surgery very peaceful and beautifully decorated and I hope to see Jane again soon.”
“I highly recommend Jane Olver. The whole experience was calm and highly professional.”
“I am writing to you to say thank you to you, Cloe and Jane for taking care of me this week. You were all really lovely and professional and I am very grateful. Big cheer for The Clinica London Team.”
“Many thanks for taking care of my ptosis surgery today. I am now back home and resting but wanted to send a quick note to thank you for taking such good care of me.”
“The treatment was a great success; within 24 hours of starting the treatment the pain and swelling subsided and as a result, I was able to enjoy a great holiday in Argentina.”
“Thank you, my eye is recovering brilliantly (you almost can’t see I had it). Jane was amazing, please pass on a huge thank you.”
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Most people say that they feel little or no pain during the injection of fillers. If a patient is more sensitive to pain, it is possible to take painkillers and tranquilising tablets beforehand. Both the Restylane® and the Juvéderm® contain the anaesthetic Lignocaine. If we are using Restylane® LIP, additional injectable local anaesthetic may be desirable.
We usually carry out autologous fat transfer under a general anaesthetic and the patient should only feel a mild discomfort following the procedure.