Navigating Aesthetics

Following on from our previous blog debunking common aesthetics myths, our advanced aesthetics practitioner is here to give you a guide to navigating the increasingly popular aesthetics market…

The past decade has seen a significant increase in the preference for minimally and non-invasive aesthetic procedures over traditional surgical options.  In terms of revenue, the global medical aesthetics market was estimated to be worth $13.9 billion, poised to reach over $23 billion by 2027.  The non-invasive procedures segment, which encompasses treatments such as anti-wrinkle injections and dermal fillers, has dominated the market since 2021 with a share of over 50%, and is expected to expand at the fasted compound growth rate.

In terms of the marked increase in these non-invasive aesthetic procedures in comparison to the invasive/surgical options, low cost, less pain, minimal treatment/recovery times and instant results are some of the factors that have boosted the demand for these treatments. The media show increasingly ageless celebrities, with many influencers offering frank insights into their aesthetics of choice, treatments now increasingly available to all of us.  Getting filler or anti-wrinkle injections in your lunch hour is now as accessible as getting a leg wax.  A quick Google search will bring up pages of results for various procedures and the practitioners offering them.  

Whether dipping your toe into the world of aesthetics for the first time, or looking to try further procedures beyond your 3-month Botox-injections, navigating the various treatments to find the right one for you, and finding a practitioner you trust and feel comfortable with, can be daunting…

Popular Aesthetic Treatments

Hyaluronic Acid Dermal Fillers:

Hyaluronic acid is a naturally occurring sugar peptide, a glycosaminoglycan, produced by the body and found within epithelial (skin), connective and neural tissues. It can attract and bind to water molecules, carrying 1000 times its weight in water, and it is this ability that makes it so effective as a dermal filler.

HA fillers are made from cross-linked, biocompatible HA gel, injected under the dermis to provide structure under the skin, restore lost or create additional volume, restore hydration and to ‘plump out’ fine lines and deeper wrinkles.  HA is in time naturally broken down by the body’s natural enzymes, and the cross linking allows the filler to remain in place for longer, often 12-18 months on average.  

Used on the lower face, the main areas treated with dermal fillers are:

Nasolabial Fold: lines that run from the side of the nose to the side of the mouth

Marionette lines: lines than run from the sides of the mouth down to the chin

Cheek/chin/jaw filler: in isolation or combined, this procedure replaces lost volume and helps provide structure under the skin, thus providing a more lifted result.

Lip filler: Providing additional volume where appropriate, to enhance the fullness and shape of the client’s lips. Can also help to smooth fine lines around the mouth.

Pain?

The majority of fillers contain lidocaine, a local anaesthetic, but most procedures are remarkably tolerable. Tiny needles are used, alongside cannulas which are blunt and designed to cause less trauma to the tissues.  The lips, a vascular area with over one million nerve endings, are the most sensitive area of the body, therefore this area can be a little more uncomfortable. We can however use topical local anaesthetic cream to help numb the area, and alongside the Lidocaine in the filler itself, the overwhelming majority of clients find it quite tolerable.

Increased swelling is to be expected over the following 48 hours post treatment, specifically after lip filler, but any swelling etc should be settled within a week, fully settled after two.

Cost?

Depending upon location, you can look to pay approximately £200 per area

Anti-Wrinkle Injections:

The main substance contained within anti-wrinkle injectionsis Botulinum toxin, a neurotoxin protein, produced by the bacterium Clostridium botulinum.  The most well-known brand of anti-wrinkle injections is Botox, but there are many other brands on the market, such as Azzalure or Bocoture. Its key action is to prevent the release of the neurotransmitter acetylcholine at the neuromuscular junction, thus causing (temporary) paralysis. This neurotoxin is safely utilised as an FDA approved aesthetic treatment to improve the appearance of fine lines and wrinkles, and successfully treat several health conditions such as migraine and hyperhidrosis (excessive sweating). Its effects last an average of three months, depending upon the lifestyle and metabolism of the individual; for example,those who train often, with a faster metabolism, will see the effects decrease faster than a more sedentary person.

As a prescription-only medication (POM), the use botulinum toxin is well-regulated, and whilst there is the potential for some side effects, these are both minor and rare, when administered by qualified, skilled practitioners.

Not only effective at improving the depth and appearance of lines and wrinkles around the eyes, forehead and between the brows, these injections also help to prevent these ‘mechanical lines’ we use so often, from becoming any worse, or forming in the first place. Hence, we therefore also see patients for this treatment in their late twenties and early thirties, prevention being better than cure. It can also be used to prevent “bunny lines” around the nose, correct a “gummy” smile, treat downturned corners of the mouth, or to create a “lip flip”,

Pain?

Tiny 32-gauge insulin needles are used to inject the toxin, and so it is a very tolerable procedure. Any redness at the injection sites should disappear within 20 minutes.  Takes two weeks to take full effect, whereupon the client has a review with their injector, and any further top-ups are administered if required.

Cost?

For the main three areas to be treated, the eyes, between the brows and the forehead, location dependent, one area would cost a minimum of £150, three areas £200+.  

Skin Boosters:

Skin boosters are another hyaluronic acid based injectable treatment that improves hydration, skin firmness and elasticity, and radiance. Due to the increase in hydration and the stimulation of collagen and elastin production, fine lines and wrinkles are improved, creating younger looking skin.  An excellent treatment for those clients whose skin may have been damaged or dehydrated by smoking, genetics or environmental factors, maximum benefits are seen when two (max three) sessions, four weeks apart, areperformed every 12 months.  The neck and handsand eye area are treatable in addition to the face.The most popular products on the market are Profhilo, Seventy Hyal, Nucleofil, and Lumi Eyes.

Pain?

A relatively painless procedure, small amounts are superficially injected into the dermis across five points, either side of the face, allowing the product to diffuse underneath the skin. Tiny needles are used, making this a comfortable, and quick treatment. Small, raised bumps may appear immediately after treatment but normally disappear rapidly. The speed of administration and lack of downtime make this a great lunch-hour treatment.

Cost?

A course of two x 2ml treatments will cost in the region of £400-£500.

Choosing a Practitioner:

Feeling comfortable with your practitioner is vital. Take your time and do your research when choosing both a practitioner and any aesthetic treatment.  A good injector should be willing to take the time to answer any questions you may have, and should, after a thorough consultation, be able to advice you on the best treatment option for you, in line with best practice and your individual goals and objectives.

• The key to good aesthetics, people noticing you look good, but not knowing why.  Ask to see photos showing examples of the practitioner’s work. It’s worth remembering that not all clients consent to their photos being used for this purpose, so a small number of examples does not necessarily equate to limited experience. If you are concerned about looking ‘over-done’, seeing a natural results in examples of their work will reassure you.

• Ask for a consultation, prepare a list of yourareas of concern and questions to ask.

• Check they are fully trained, qualified, and suitably insured, and ask about their experience

• Be wary of and don’t be swayed by cheap prices… there may well be a reason why their prices are cheap.  A well-trained practitioner will value their specialism and training, and their prices will reflect that. The cost to the injector of training, insurance and good quality products will also be reflected in the prices charged.  Minimally invasive aesthetic procedures are very specialist, the practitioner must have excellent tissue handling knowledge and ability, with advanced understanding of anatomy and the implications of correct and incorrect placement of injectables.  Aesthetics is one area in which corners and costs, should not be cut.

• Be wary of a practitioner repeatedly offering, or willing to ‘top-up’ areas that already have filler present.  Best practice and client safety dictate that only specific limited amounts of filler be used in specific areas of the face, likewise with anti-wrinkle injections. Too much will lead to an unnatural result at best, or to complications at worst. Filler migration beyond the natural borders of the lips, leading to the dreaded ‘duck-pout’, is one such side effect of too much filler being used in the lips.

• Upon booking, ask for a medical and a consent form to complete, and ensure the injector goes through the forms with you on the day, prior to treatment.  Be wary if neither of these are offered.

• Ask around, positive word of mouth is the best recommendation.

Risks - how we practitioners avoid them

Anti-wrinkle injections risks:

A well-trained injector will have excellent knowledge of the relevant muscles of the face and correct toxin placement.  Complications sometimes can occur through no fault of the practitioner but will resolve within three months as the effects of the injections wear off.

• Ptosis - dropped brow/eyelid

• ‘Spock brow” – A high, exaggerated brow arch due to incorrect product placement

• Undesirable change to the smile or expressionthrough incorrect placement once again.

Filler risks:

Practitioners who are well-trained and follow best practice at all times will ensure their knowledge of the vital arteries, vessels, planes and symmetry of the face, governs their filler placement and the equipment used, cannula or needle for example.This is to ensure not only a great aesthetic result, but patient safety as the number one priority throughout.  

We as practitioners ensure we are well trained in how to efficiently and safely deal with any complication that may arise.

• Vascular occlusion – the greatest concern, filler in or on a vessel, potentially occluding blood supply to other areas of the face and head, including the eyes.  We can dissolve any filler by injecting an enzyme that safely breaks it down, hyaluronidase.  

• Bruising/swelling – although a certain amount is to be expected, severe bruising or swelling is not.  For example, lips can swell more in the 48 hours following treatment, but, as with other areas, all should be resolved and settled after seven days, within two weeks maximum. Ibuprofen can be taken, and a cold compress can be gently applied. Any severe or protracted bruising or swelling should be reported to your practitioner who can advise you accordingly.

• Infection – your injector should be working as aseptically as possible, wearing gloves and ensuring the area to be treated is clean and prepared accordingly.  Follow your given aftercare advice to avoid risk of infection.

Preparing for your Treatment:

Pre-treatment advice:

• Take Arnica tablets for five days prior to treatment (to help avoid/treat bruising).

• Avoid alcohol 48 hours prior to treatment

• If you have had COVID-19 or the vaccine allow 4 weeks before booking your procedure.

• Increase your water intake in the run-up to your appointment.

• Inform your practitioner if you bruise easily, are needle phobic, on specific medications or experienced any previous complications prior to booking.

Aftercare Advice:

• Continue to take Arnica until any swelling has subsided.

• Avoid alcohol, sunbeds, swimming, saunas, heat treatments, make-up, perfumed skin products and exercise for 48 hours post treatment.

• Continue to drink plenty of water.

• Take paracetamol if needed, but not aspirinunless told to by your injector.

• A cold compress can be gently applied for ten minutes each time if needed.

• Minimise risk of infection by keeping the area clean - try not to touch it!

• Your injector will give you specific advice relating to the treatment you have had, ask any questions and follow the instructions to the letter.