Basic facts on the two most common aesthetic treatments – botulinum toxin A and fillers – you should know before choosing a doctor for your treatment.

Every patient is unique with unique needs. Many factors determine the nature of the treatment such as the type of product used (whether botulinum toxin A or fillers, or both), the number, position and depth of the injections, the amount of product required, the patient’s skin type and the severity of a skin condition such as acne scars, etc.

Toxins relax, fillers fill

Botulinum toxin A such as Dysport, and fillers such as TEOSYAL® Hyaluronic Acid Dermal Fillers range are used to achieve different objectives and give different effects depending on which layer of the skin it is injected into.

Fillers are usually made of biodegradable material such as hyaluronic acid, while botulinum toxin A, as the name suggests, contains the purified toxin derived from a bacteria called clostridium botulinum. Fillers come in pre-packed sterile syringes and Botulinum toxin A come in sterile bottles.

Botulinum toxin A relaxes tense muscles that are responsible for dynamic wrinkles that can make your face look stern or angry. Dynamic wrinkles occur when the muscles that are attached to the overlying skin contract, causing the skin to bunch together.

Fillers fill areas where there is volume loss due to ageing. Fillers also improve hydration and collagen regeneration in the treated area. The density of the fillers vary depending on its use. For example, less dense fillers are made for evening out acne scars or for improving hydration levels of the skin. More dense fillers are used for parts of the face where there is volume loss such as the hollows of cheeks and where more structure and support are needed such as the chin, tear troughs and hollows of cheeks.

What is a typical treatment like?

The injections sites are first mapped out. Botulinum toxin A injections are usually administered on crow’s feet and glabellar lines (the vertical lines between the eyebrows caused by frowning or squinting). Fillers on the other hand, depending on the density can be administered in the chin, on the nose bridge and under the eyes where more structure and support are needed or in the hollows or apples of the cheeks where more volume and hydration are needed.

The skin is thoroughly cleansed and numbing cream is applied and allowed to set before the injections are performed. The numbing cream is applied to make the treatment more comfortable for the patient. The injections are then administered via fine needles or cannulas at different depths of the skin to achieve desired results. Most fillers contain lidocaine which helps in reducing any discomfort during the treatment.

Care is taken to avoid the blood vessels while injecting as this may cause bruising which while unsightly, is temporary. The doctor may mould the skin that has just been injected with fillers by hand after an injection to ensure that it takes on the desired shape particularly for areas such as the chin and the nose bridge.

Antibiotic cream is then applied on the affected areas after the treatment is finished to avoid infection. The patient is then asked to return one or two weeks after the treatment so that the doctor can see if the desired results have been achieved or if there have been any side effects. The doctor may also top up the filler or toxin where needed. The effects of fillers and botulinum toxin A injections may last anything from six months to a year depending on the patient’s skin condition, where it is injected and the type of product used.

WARNING: You are putting your health, looks and money at risk by buying fillers online or going to an unqualified person (such as a beautician) for your aesthetic treatments instead of a medical professional. To know more about the dangers of using fake products, please read our interview with Dr Hew Yin Keat.