Facial Treatment at Castle Gate Surgery

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At exposure Dental Surgery, we've done our best to create a Web site that anticipates and satisfies our customers' needs. With that goal in mind, we've compiled a list of frequently asked questions. If you do not find an answer to your question here, contact us at 01453 542109 or castlegate.face@virgin.net.

What causes wrinkles?
Crease lines and wrinkles are part of a natural process due to a combination of factors including: aging, sun damage, gravity and the muscle activity when laughing, talking, frowning and crying.
Facial lines including smile lines (crow’s feet), glabellar lines and lines at the corners of the mouth often begin to materialise during the thirties, becoming more noticeable in the forties. The deeper, nasolabial folds (creases from outer edge of nostril to corner of mouth), become more apparent in the late forties, increasing in depth during the fifties. This is also the case with vertical lines, radiating from the lips. Unfortunately this may happen much earlier for individuals who have had a lot of sun exposure.

The Cosmetic Use of Botulinum (Muscle Relaxant)

What exactly is Botulinum?
It is a natural, purified protein produced by the Clostridium botulinum bacterium. In facial rejuvenation is used in very small doses, administered via a few small injections directly into the specific muscles that cause lines to form. Botulinum works by blocking the transmission of nerve impulses to the treated muscles.

What does Botulinum treatment consist of?
This is a simple, non-surgical procedure that softens facial lines which develop as part of the aging process. A few small injections cause relaxation of the muscles that cause those lines to form, keeping them relaxed for approximately 4 months. It has been widely tested and has a well proven track record.
Your practitioner will determine the specific areas requiring treatment on discussion with you. No anesthetic is required; however a cold pack will be applied prior to injecting. The entire procedure should take approximately 10 - 15 minutes. Discomfort is minimal and transitory. You may resume normal activity immediately.
Within days, you'll see a marked improvement which may continue to improve for as long as a week and should last up to 4 months.

What are the possible side effects?
The most common side effects are headache, temporary eyelid droop, bruising at injection site can be covered with make-up. It should not be used if there is an infection at the injection site.

Will my lines look worse if I choose not to continue treatments?
No. Your lines gradually revert to their pretreatment appearance.

Is it expensive?
Like other appearance-related investments, such as hair and beauty treatments, teeth whitening, and chemical peels, the cost must be considered in relation to expectations. Treatment not only improves current appearance, but also helps to slow the facial signs of aging.

Contraindications to treatment
Infection at the proposed injection site(s) and in individuals with known hypersensitivity should not have this treatment. It should not be administered more frequently than 4 monthly. Those who have a Bell’s palsy should not have treatment.

How does Botulinum work?
Frequent use of the facial expression muscles often leads to the development of deep frown lines, forehead lines and/or smile lines (crow’s feet). By injecting botulinum into the area affected, the underlying muscles responsible for wrinkling are temporarily inhibited. This results in a more relaxed face and pleasant appearance. The wrinkles become smoother or may actually disappear altogether.

How long does it take to work?
Initial effects of treatment usually become noticeable visible within 48 to 72 hours, with maximum effect achieved by 2 weeks. A top up may be necessary at this point to attain the result required. Facial expression will become more relaxed but not at all mask-like; resulting in a very natural look.

How long will the effect last?
The effect of treatment generally lasts for 3 to 4 months, at this point further treatment is necessary. Subsequent treatment effects are usually progressively longer lasting.

Do the injections hurt?
Generally injections cause some discomfort. When using dermal fillers, the area is anaesthetised. In the case of Botulinum, the injection is via a very fine, small needle.

In what areas does Botulinum work?
For Frown Lines
Between the eyebrows, the vertical frown lines result from repetitive muscles activity, muscles often used when concentrating. By drawing the eyebrows inward, expressions of anger, confusion or anxiety are often shown, when repeated frequently permanent skin creases develop and even when relaxed, these frown lines will eventually remain. Reducing the effect of these overactive muscles helps remove these negative appearances.
For Crow’s Feet
Wrinkles that radiate from the outer corner of the eyes caused by smiling, laughing or squinting can be upsetting. Until relatively recently, no reasonable medical or surgical solution improved this problem owing to the strong muscles underlying this region. In spite of techniques including the deepest chemical peels or laser resurfacing procedures, rapid reappearance of lines around the eyes is unavoidable. However treatment with botulinum has proved to be effective at preventing the recurrence of wrinkles by inhibiting the underlying muscles.
Horizontal Forehead Lines
Some individuals use different muscles for raising the brows; others “talk” with their forehead. A more dilute toxin is used when treating the horizontal forehead lines.

The Cosmetic use of Dermal Fillers

What are dermal fillers?
Dermal fillers are one of the fundamental treatments used in modern facial rejuvenation techniques. They are injected just under the skin, improving firmness and smoothness, to provide a youthful appearance. They are one of the most popular non-surgical treatments among people who wish to reduce signs of aging. Facial rejuvenation using injection therapy provides instant results.

When can dermal fillers be used?
Dermal fillers are available in a number of viscosities, depending on the indications of the area to be treated. Finer fillers can be used to eliminate vertical lip lines, the nasolabial lines, glabellar lines, smile lines (crow’s feet) and forehead wrinkles and are introduced more superficially than thicker fillers. The latter can be used to improve volume to hollow cheeks and soften deep acne or other scars. They are introduced deeper into the skin’s dermal layer. Fillers may also be used to subtly accentuate lips.

What are dermal fillers made from?
Dermal fillers are made from a number of natural and synthetic materials. There are various fillers available, including permanent and resorbable (non-permanent). Non-permanent fillers, for example, hyaluronic acid are the primary choice amongst practitioners and individuals. Hyaluronic acid occurs naturally in all living organisms and is consequently biocompatible. It is involved in a variety of essential roles within the body, including mechanical and transport purposes. It also gives the skin volume, provides shape to the eyes and elasticity to the joints. The use of hyaluronic acid is well documented in specialities such as eye surgery and orthopaedics. It is the filler substance of choice due to its high safety record.

How long will dermal fillers last?
No pre-treatment skin test is required, due to the compatibility of these products with the dermis. They can last between 8 to 10 months, however duration varies amongst individuals and dependent on the area treated. The only side effect (occurring once in every 2,000 patients) is a low grade allergy that equates to redness/papules. These may last for 3 to 4 weeks and can ordinarily be covered up with light make up. Some people may develop swelling for up to a week, but instant application of ice generally minimizes this affect.

At the present time temporary fillers are the best available option. It would be ideal if a filler lasted for 2 or 3 years, however those that presently do can result in long-lasting problems, including more severe allergic reactions.