Refill

Full rejuvenation of this complex region requires attention to all the R’s of skin rejuvenation.  The Periocular region is a common area of concern amongst patients who often experience advanced signs of skin aging.  This complex area is also poorly understood by aesthetic clinics, often only providing unidimensional approaches with unsatisfactory outcomes.  Patients will often comment that “my botox doesn’t work in my eye area”.

Relaxing treatments with botulinum is essential in reducing the micro-trauma that takes place in the surrounding skin which becomes progressively prone to damage as it thins and is less able to withstand the repeated stress from movements.  This is amplified by the loss of supporting volume of subcutaneous fat as well as decrease in supporting fat pads and bone loss. 

Patients often experience a lack of satisfaction with their expensive botulinum treatments in the eye area as the underlying causes of skin aging are not addressed holistically.  It would be more advantageous to redirect the funds to address resurfacing and refilling of the eye area prior to using botulinum for the eye.  Another favorite amongst patients is to use the botulinum normally placed in the eye to add to the frown or forehead, increasing its effectiveness and duration.

Resurfacing treatments using skin boosters are essential in restoring chronically depleted hyaluronic acid (HA) reservoir levels in this high movement area.  Skin texture and quality is in need of HA therapy for full rejuvenation.  Injectable crosslinked HA will reactivate your skin’s ability to heal itself, improving laxity, fine lines, pigmentary unevenness, and to plump the skin.  Not only healing the ageing skin signs but also becoming more resistant to future ageing stress.  Once your skin is plump, it will enhance the effect that botulinum toxin therapy normally has.  A clinical give away that the skin around the eye needs rejuvenation is when the normal botulinum therapy is becoming less effective.

The restoration of HA in the skin will also synergistically amplify the benefit from all other resurfacing treatments with specialized eye chemical peels, micro-needling, as well as energy-based devices such as various laser therapies and LED light therapy.  These treatments in their own mode of action cause an insult to the skin which will then result in a healing reaction.  These treatments are far more efficient and effective when HA is present in the skin as it activates and enables the mitochondria and fibroblasts, maximizing the skin’s ability to react to stimulus.  Always restore your HA reservoirs prior to other resurfacing and retaining therapies.

Refilling treatments.  The aged eye can be from fine and coarse lines, dark tired under eye regions, deep sunken tear troughs, gaunt or hollowed appearance and saggy thin skin.  Each region of the eye has its own complexities in respect to the aged appearance.  From loss of deep mid-cheek malar fat pads leading to a loss of support to loss of the various fat pads around the bony orbit.  Loss of volume in more remote regions such as the cheek bone arches and temple amplify worsening sagginess. 

Treatments cost 3,500-4,500 rand per 1 ml of the various dermal fillers and boosters.  Exact costing is discussed during consultation after an accurate assessment has been made vs using a template approach.  Treatments are planned and staged to provide the most results with the least amount of down time for the perfect natural rejuvenation.  Below is an example of various approaches that may be required, which are dependent on your expectations as well as baseline skin condition.  Long term split treatments can be more affordable and just as effective as a complete restoration in one setting.

Resurfacing treatment with 1 syringe of crosslinked hyaluronic acid (3,500 Rand) is sufficient to cover both eyes.  The cross-linked HA lasts more than 9 months.  Advanced skin ageing with very low HA reservoir levels may benefit from a second treatment which will be assessed at month 4. 

Initial rejuvenation can require a double treatment and then retain gains yearly.  Expect visible improvements in pigment and glow, textural improvements in fine and coarse lines, mechanical improvements in laxity and skin thickness.

Refilling treatment for fine and coarse lines of lateral 1/3 of eye, 1 syringe of soft dermal filler costs 4,000 rand.  Depending on the severity of the volume loss 2 syringes may be required.  These can be done in one setting or added at a review 4-8 weeks later.  The advantages and disadvantages will be discussed in your consultation.  Refilling treatments when done correctly are very satisfactory as the correction is immediate.

Refilling of the malar cheek fat pad can be achieved with 1 syringe of volumizing specific dermal filler (4,500 Rand).  Expect immediate improvement in your tear trough region and still look natural with movement. Some cases with advanced fat and bone loss may require additional treatments.  These are always staged to achieve the perfect balance of a natural rejuvenation without the appearance of a treatment having taken place.  Staging the treatment allows for tissues to settle and balance.

Refilling of lost volume in the temple and cheek arches can be paramount in addressing excessive laxity or sagginess in the periorbital region.  At times these lateral “lifting” dermal filler treatments (4,500 Rand per syringe) correct a lot of the sagginess allowing for less need of refilling centrally.  Requirements are related to the amount of sagginess and volume loss.

Refilling of lost volume for under eye hollowing, tear trough deformities and “tired eyes”.  Essential in the restoration of mid-face volume loss, are the SOOF and ROOF structures (sub-orbicularis oculi fat of the lower eyelid / retro-orbicularis oculi fat of the upper eyelid).  These supportive structures contribute to the overall contour and volume of the youthful eye.  Refilling requires advanced anatomical knowledge, experience and technique.  Gentle soft refiling allows for the perfect restoration.

The ageing skin around the upper lip and chin area can be a frustrating region for patients, often not in keeping with more youthful areas of their faces.  The ageing accelerates suddenly as estrogen levels change, together with loss of supporting fat structures and bone of the upper and lower jaw.

The upper lip becomes longer from base of nose to cupid’s bow, flatter as fat thins, as well as wider with loss of bone.  The normal ski slope flattens and the pink of the lip inverts, adding further injustice to the ageing perioral region. 

The skin texture and quality worsens as it looses its support structures forming smoker’s or barcode lines.   These lines are a result of the skin forming creases with repetitive movement instead of moving smoothly in the youthful volumized skin.

Much like the rejuvenation of the periorbital region, the R’s of skin rejuvenation are addressed to treat the perioral region in a 3-dimensional approach.  Addressing all the underlying causes of the advanced skin ageing from the superficial epidermis to deep dermis and supporting fat volume loss.

Cross linked hyaluronic acid (HA) is essential in resurfacing of the scared lines.  These lines are deficient in the normal architectural proteins (collagen and elastin).  Cross linked HA reactivates the skin cells, not only improving the quality of these proteins which are already present, but also increasing their production.  1 syringe (3,500 Rand) is sufficient for a resurfacing treatment.  Patients are often amazed at the improving smoothness which can occur as early as 4-6 weeks.  The treatment continues to heal for 9 months.  Excess cobblestone type skin over the chin as well as accordion lines at corner of mouth will need an additional syringe to address fully.

Relaxing therapy with botulinum toxin to the DAO muscle (4-6 units per side) and mentalis muscle (20 units) can assist with downward turned mouth corners as well and the mental crease which forms between lower lip and chin.  Peau d’orange or dimpled / cobblestone skin will also be improved by relaxing the mentalis muscle.  The skin texture changing from smooth to cobblestone as a result of repetitive movements in skin that is losing its supporting structures, hence forming dimples with movement as a result.

The Modified Nefertiti is a beautiful relaxing treatment using approximately 32 units of botulinum toxin (3,000 Rand). It relaxes the downward-pulling platysma muscles in the neck and along the jawline, creating a subtle lifting effect and improving the appearance of jowls and neck bands.  The modified Nefertiti version includes strategically placed injections in the chin and jawline to achieve a more contoured, defined, and “snatched” jawline.  The goal is to enhance lower face definition and create a more youthful, elegant profile.

Resurfacing (cross-linked HA 3,500 Rands) and Redraping  treatments (collagen stimulating treatments 6,500 Rands) are essential in peri-oral rejuvenation.  Healing the superficial visible, textural, and mechanical related ageing as well as treating the deep laxity with collagen treatments will greatly enhance your results as well as maximize the benefits you gain from any refilling treatments.  By completely addressing your skin you can truly rejuvenate your advanced aged regions.  This approach allows for completely natural end results which also last much longer while avoiding any sign of the classical “done” appearance.

Refilling the underlying skin of the upper and lower lip costs 4,000 Rand for both sides of the mouth.  To minimize swelling and the appearance of having had a treatment, 1 syringe is used at a time.  The specific soft dermal filler is designed for high movement regions and integrates effortlessly for the perfect result.  Your barcode lines will be immediately lifted and largely corrected instantly without the appearance of having had a treatment. 

Refilling mid and lower face anatomical structures which were previously more prominent will assist with the correction of the various folds and skin laxity around the mouth as well as structures such as the jowls.  Natural results are maintained through placement of filler in specific anatomical structures which allows for preservation of your natural balance and features. 

Prior to your treatment, a thorough examination and identification of the responsible structures of your aged concerns are highlighted.  Various treatment solutions will be discussed with you including their specific benefits. 

A full or staged treatment will be planned, systematically restoring your youthful appearance while always emphasizing complete natural results.  The perfect outcome is a rejuvenated refreshed look with no downtime or indication of a treatment having taken place. Specific filler properties are used to address volume or lift of the supporting mid and lower face structures.  Prices range from 4-4,500 rand per 1ml syringe.

Amourage Skin Clinic always enhances your natural features by using techniques and science based anatomical structures to rejuvenate your lips, giving you the perfect glossy revolumized balance. Precision and subtle refilling forms the foundation for the desired refreshed treatment.

As we age, the supporting collagen, fat pads, and muscles in and around the lip area are steadily diminished, resulting in thinner lips that are more visibly lined.  Simultaneously, the redistribution of soft tissue can result in a flatter inverted lip look.  Bone loss may also contribute to a more caved in appearance of the mouth/lip area.  Blood vessels decrease in the lip vermillion (the border between your lips and the surrounding skin) causing the richness of lip color to weaken, resulting in a more aged, “drained” appearance.

These changes and signs of aged lips typically start becoming noticeable in your 40’s, progressing more rapidly as you age.  Beyond genetics, contributing factors such as cumulative UV damage from unprotected sun exposure, smoking, and other lifestyle habits play a role in lip volume loss.  UV damage is thought to be the most destructive.

Finding a lipstick or gloss with SPF 30 that you are likely to reapply throughout the day is key in prevention of lip ageing.  As the product will rub off with eating and drinking, taking the protection with it.

Lip restoration is complete when you address the surrounding skin’s hydration needs, enabling the skin to naturally heal itself to its previous youthful appearance.  One syringe of cross-linked HA (3,500 Rand) is the perfect adjuvant for treating and preventing the visible, textural, and mechanical signs associated with skin ageing in this area. Healing the skin around your lips not only restores a balanced restored look, but also enhances your refill procedure and aids to prevent further ageing. 

Lip refill treatments range from 3,000-4,500 rand per syringe. The desired natural rejuvenation can be achieved through small staged treatments.  Specific 1ml or 1/2 ml dermal fillers can assist with structural support or light revolumizing and hydration depending on the desired requests.  Follow up treatments can address the perfect lip while minimizing swelling allowing your dermal filler to seamlessly integrate with you lip tissues, giving you the desired natural rejuvenation.