Botulinum toxin is a naturally occurring protein produced by the bacterium Clostridium botulinum. The main one we are concerned with his Type A toxin, of which we currently haver the following available:

Botox (Vistabel)

Dysport (Azzalure)

Xeomin (Bocouture)

Each practitioner will have their favourite of which they know and are comfortable using in terms of mixing, concentrations and doses.

There is no right or wrong one when it comes to the results our patients desire. You may get some patients asking for a particular brand of botox, but as long as the botox practitioner is experienced and understands how to use their own particular brand, do not overly concern yourself as to which botox brand they are using.

With each of the botox brands they come in a powder form and your practitioner will mix saline with the powder to form a liquid which is then injected. There are various concentrations of saline we will use to mix with the botox. Each particular botox brand comes in different sizes and thus the amount of saline you use to mix with will vary.

Where some botox practitioner get confused is that they try to interchange the units of one particular botox brand with another. The units for each botox brand is specific to each bot brand.

If you have changed practitioner recently, it is vital that you let them know which botox brand you have had or if there are any particular botox brands that you may have been resistant to.

For more information about botox hertfordshire, please call us on 01438 300111.

Have the side effects of Botox put you off from having the treatment to reduce your wrinkles? Botox is a very popular treatment to reduce wrinkles, however you need to be aware of certain side effects associated with this procedure. If you are unsure on what to expect after the procedure, we will explain all the common side effects and want you can do to minimise these or even eliminate them.

Botox is a very effective treatment and we don’t want you to be put off by scare stories you have read in the press or seen on the television. If you are informed and prepared for the side effects associated with Botox you will have peace of mind and not let it put you off the procedure.

Here are the different side effects you can expect:

1. Headaches

Botox can dehydrate your body and you will need to follow a couple of instructions to minimise and prevent this. We recommend to drink plenty of water after the procedure, at least 2 litres of water in the first 24 hours.We also advise to avoid alcohol for the first 24 hours.

2.Drooping eyelids

There are a number of reasons why this may occur:

(a)  Too much Botox has been given in the forehead. This muscle lifts your eyes, so if it is relaxed too much it will not be able to maintain the position of your eyes.

(b)  Not enough Botox has been administrated in your frown muscle. This muscle pulls your eyes down, so if this muscle is still active, then it will have a downward pull on the eyes

(c)  The Botox may have travelled downwards to the eyes. This could have been caused by exercising straight after the procedure or bending downwards. So we recommend not to exercise for 24 hours after the procedure and also not to bend down too excessively

3.Frozen look

This will occur if too much Botox has been administrated. We would normally recommend to underdose initially and if you require further treatment then to have the Top Up after a couple of weeks. The frozen look will disappear over time as the effects of Botox begin to wear off. This is different for each person and can be anything between 3-6 months.

4.Wrinkles still there

The effects of the treatment will normally take around 2 weeks to work. The first few days your skin will feel tighter at the injection area. You should have a review appointment 2 weeks after the initial visit. At this visit the Doctor will see if you require any further Botox, known as the Top Up. This will take on average a week for you to see the results. If the wrinkles are still present then either you will need more Botox or you were not suitable for the procedure, e.g deep lines or lines at rest only (i.e no lines on facial expression).

5.Inflammation and Swelling

You will experience slight redness at the injection sites. This is common, so don’t be alarmed. This will normally resolve within an hour of having the procedure.

Due to the amount of fluid being injected you will also expect to see some swelling at the injection sites. This will be similar to a bee sting and will resolve within an hour of the procedure.

For more information about botox hertfordshire, please call us on 01438 300111.

Immediately after administering botox, you may experience some redness and swelling at the injection point. The swelling is normally caused by the botox fluid build up and takes on average around 30 minutes to disappear, and the same applies to the redness.

The other reason why you may have a swelling is if the botox injection has hit a blood vessel. In this case the swelling will take a lot longer to go down. In this instant, your botox practitioner should compress the area and advise you to press some ice in that area when you get home. You amy be able to reduce the effects of the bruising by either applying arnica cream or taking some arnica tablets.

You will be give some advice about what to do and not do after the botox treatment. The main advice would be to avoid any exercise or pressure to the areas injected for the next 24 hours.

In the next few days you will begin to feel the skin tightening around the areas that the botox was injected in.

Between 5 and 10 days the results of the botox would have kicked in and you will now see your lines and wrinkles either disappear or reduce considerably when carrying out facial expressions. Each person is different and the time taken to see the full results will vary.

Normally after 2 weeks you will see your botox practitioner for a review appointment and at that stage if you require any botox top ups, you will be given these. In my experience the top takes effects within the week.

For more information about botox hertfordshire, please call us on 01438 300111.

Psychological Factors

A recent market research report found that fewer than 10% of cosmetic interventions were carried out primarily for health reasons. Most people opt for cosmetic interventions based on dissatisfaction with appearance, a desire to improve confidence and self-esteem, and to look younger.3 Patient satisfaction with procedures is based on the quality of services provided but also relates to patients’ expectations and their psychological profile. There is no standardised way to measure patient satisfaction across the sector, even in the case of cosmetic surgery. A new tool to collect this information is being piloted by BAAPS.

Academic research has highlighted that those who undergo cosmetic interventions are statistically more likely to worry about their weight, have been subject to domestic violence or bullying, or be on medication for sleep disorders and anxiety. Those seeking treatments are also statistically more likely to have mental health issues.6 Such research draws attention to the potential vulnerabilities of some groups seeking cosmetic interventions. In response there have been calls for better screening of patients undergoing surgery for pre-existing psychological disorders. One screening initiative is discussed in Box 2.

Risks of Cosmetic Procedures (such as botox)

Health Risks
There are a wide range of known risks and complications associated with surgery, injectable products (botox), cosmetic implants, chemical peels and laser treatments. These range from localised infection and scarring to permanent and debilitating effects, such as blindness and nerve damage.1

There is no centralised and comprehensive data on the scale of adverse health complications associated with cosmetic treatments. This includes treatments occurring on premises registered with UK health care regulators (such as the Care Quality Commission, which regulates hospitals in England). Independent hospitals in Scotland are regulated by Healthcare Improvement Scotland. Reporting of adverse incidents is sporadic across the sector.

Systems of reporting in relation to specific products to manufacturers and regulators have also faced criticism. For example, in the wake of the PIP scandal it was estimated that only 15-18% of incidents were reported to the relevant regulator.7 Current estimates of health complications are based largely on small scale investigations by industry and professional bodies, as well as anecdotal evidence. Data on adverse outcomes from using injectable cosmetic products is given in Box 3. Even less is known about non-surgical procedures carried out on other types of premises. These may be carried out despite providers having no professional or legal responsibilities to report adverse incidents or to provide suitable aftercare.

Economic Risks

The annual cost of complications from cosmetic interventions to the NHS is unknown. However the NHS bears the costs for a large proportion of complications that result from treatments carried out by less reputable providers. This issue is particularly acute for non-surgical procedures, as there is no guarantee that practitioners will be insured, or have systems of patient aftercare in place. One recent small scale survey of admissions to a single London hospital recorded 12 cases of patients presenting with complications resulting from dermal filler injections over a 15 month period. The average cost of each patient to the NHS was over £3,000.8 This suggests significant costs to the NHS hospitals across the UK and in relation to other non-surgical procedures that carry comparable levels of risk.

Box 3. Complications Associated with Injectable Products

1.   The Independent Healthcare Advisory Service (IHAS) recently gathered data on 12 of its member clinics. It was reported that medical complications arose from 0.13% of Botox® procedures, 0.25% of dermal fillers procedures and 0.07% of cosmetic procedures.4 However these figures represent only those providers registered with the trade body who chose to share data.
2.   A recent BAAPS report highlighted that around two-thirds of its members had treated a patient who has suffered complications after filler injection treatments between 2011-2012.5
3.   The BAAPS report also highlighted that 84% of cases of medical complications resulting from dermal fillers that were presented to its surgeons required surgery or were untreatable.

Box 2. Identifying Vulnerable Patients

Cosmetic procedures (botox) may be inappropriate for some vulnerable patients. Academics based at the Centre for Appearance Research at the University of West England have been working with practitioners to develop standardised tools to screen patients for psychological disorders, such as body dysmorphia. The screening involves assessing patient responses to a series of questions. Patients deemed to be at risk may then be referred for further assessment. This project has received funding to roll out the screening tool to a larger number of providers during 2013.

For more information about botox hertfordshire, please call us on 01438 300111.

Advertising Cosmetic Procedures (such as botox) and Products

For more information about botox hertfordshire, please call us on 01438 300111.

Wrinkles and facial lines result from ageing, muscle activity (and over-activity) and your genetic predisposition. In addition, excessive sun exposure, alcohol consumption, emotional and hormonal influences and smoking can also increase the likelihood of wrinkles. Whilst you may be able to reduce or control some of the factors, you cannot influence all factors and that’s why we all develop some wrinkles as we age.

Aesthetics can offer professional consultations and treatments, such as botox to reduce the appearance of facial lines and wrinkles. Dr Singh has knowledge of head and neck anatomy and physiology together with training in the use of cosmetic treatments, which can subtly enhance your appearance to make you look younger.

If you are interested in talking about skin health treatments, please book a consultation appointment. Harry has had treatments and will be happy to talk with you or answer any questions.

What is botulinum toxin?

Botulinum is a substance that is produced by a bacteria; it is then highly refined, purified, diluted and used in therapeutic doses. Botulinum is administered by injecting it into a specific facial muscle where it acts as a muscle relaxant.

Who would benefit from this treatment?

Anyone can benefit from botox injections, both men and women. Botox is most effective in improving lines or wrinkles due to facial expressions; for example, worry lines or frown lines on the forehead and between the eyebrows. This is because these lines are usually caused by overactive muscles and the treatment stops these muscles from contracting and causing the wrinkles.

You should not have treatment with botox if you are pregnant, breast-feeding, have a neuro- logical disease or a known hypersensitivity to it.

How long does the treatment take?

In most cases the treatment will take between 10 and 20 minutes. Effects will begin to appear very quickly within 48 hours to 72 hours, although the full extent of the treatment may not be visible for up to 10 days. Approximately two weeks after the first treatment, the effects will be reviewed with Dr Singh and any further treatments or top-ups can be discussed.

For more information about botox hertfordshire, please call us on 01438 300111.

This review of cosmetic procedures such as botox and dermal fillers were brought baout after the recent PIP scandal. The paper startred by giving an overview of the industry.

Then the paper discussed the recent Keogh report and its recomendations.

 The Keogh Review: the Department of Health’s Independent Review of the Regulation of Cosmetic Interventions Primarily in response to the PIP breast implant scandal, the DH commissioned a review by Professor Sir Bruce Keogh of the regulation of cosmetic interventions. The PIP scandal involved breast implants which had unusually high rupture rates. The report identified ethical and regulatory challenges raised by the cosmetic sector, including:
 loopholes in European and national regulation of cosmetic products and devices

 the use of prescription products and other treatments by unlicensed
professionals

 lack of professional oversight of those performing non-surgical
cosmetic procedures

 absence of or inadequate screening of patients for psychological
and health issues by some providers

 lack of legal redress for consumers when things go wrong

 misleading advertising and marketing practices.

For more information about botox hertfordshire, please call us on 01438 300111.

Last week on TV, ex football star Paul Gascoigne, let the media into in his personal life and his battle with alcohol for the last 15 years.

One surprising revelation that came out of this documentary was the fact that Paul has been undergoing botox injections for a number of years.

There are a couple of reasons why Paul has decided to undergo botox injections. One is for cosmetic reasons, after years of abusing his body, he will have aged prematurely and by having botox injections he can literally roll back the years.

The second reason, why I feel is much more vital, is that it regains his self confidence. If he feels confident about the way he looks then there is less chance of him abusing his body with alcohol.

My patients have various reasons for undertaking botox treatments and the number 1 reason by far is to improve their self confidence.

I have to admit that Paul’s complexion dod look good for his age.

For more information about botox hertfordshire, please call us on 01438 300111.

Firstly a big thank you to Smita Mistry for researching this, adding text and basically doing the blog!

On the BBC website today there was an article regarding the dangers of getting an infection with dirty needles, when having botox procedures.. The media are out there to get attention grabbing headlines, so lets examine more closely the potential risks involved with having botox injections.

The article talks about people injecting themselves with botox and sharing needles and botox injections being undertaken in non clinical set ups, such as beauty salons.

As well as sharing needles, it talks about the proper disposal of any needles via a sharps bin.

Next I outline how regulated I am and what precautions I personally take to make sure that the botox procedure is as safe as possible.

• I pay for a licensed carrier to provide me with all the clinical waste bags and sharps bins I will need, in addition they are licensed to remove and dispose of this clinical waste in an appropriate manner
• All botox and other prescription based medicines are kept secured in locked cupboards or fridges
• I only use single use disposable needles
• I regularly update and check the medical history of all my patients
• Where possible all items are disposable and single use, such as gloves, masks, couch roll
• All clinical surfaces are smooth and easy to disinfect

I take patient safety very seriously, so I can minimise the risks.

For more information about botox hertfordshire, please call us on 01438 300111.

What changes occur in our face as we age. Once we know the process of aging we know what treatments and procedures we will need at different stages of the aging process, whether this be fillers, botox injections.

There are certain external factors that contribute to premature aging, such as over exposure of sun, stress, smoking, lifestyle, nutrition. There are also genetic pre dispositions that can effect how quickly you age.

In this article I will concentrate on the structural changes that occur when we age, and most commonly these will relate to; loss of collagen, bone changes and fat reduction.

Lets start of with the loss of collagen. This is a natural process that occurs with aging. More importantly it is the loss of elastin that marks out the signs of aging. In babies there is an enormous amount of elastin giving the skin its soft and flexible nature. As this elastin loss occurs, the skin looks thinner. This can be noticeable especially in the lips and eye areas.

Coming onto bone changes now. Over time the bone in the face will loose thickness and density. In some areas of the face, such as the jaw bone do not change but most notbable it is under the eye that the biggest changes in bone loss occur. This is critical to understand, so it can be readdressed with the correct procedure.

With fat reduction the face will appear older. We dont loose fat evenly on our face, some areas loosing it much quicker than others.

For more information about botox hertfordshire, please call us on 01438 300111.