Aesthetic medicine

Botulinum endotoxin commonly called "botox" is a drug.

Different laboratories have the authorization to produce it and therefore each have a different name: Vistabel, Bocouture, Azzalure. The mechanism of action and effectiveness is the same.

This medicine has been used since the 1970s in adults and children to treat strabismus, spasms of the eyelids, face or neck. In comparison, the doses of botulinum toxin used in aesthetic medicine against wrinkles and fine lines are very low.

These are microinjections distributed over the muscles responsible for eye and facial wrinkles. The needles are very fine and the injection is almost painless.

Disadvantages and Risks of Botulinum Toxin

The injection itself is almost painless. Immediately after the injection one may see small "bumps" and redness at the injection site. These disappear after an hour. A few hours after the injection, a few rare headaches have been described. There is no pain after the injection. Small bruises may appear but are rare and disappear within a few days. After 4 days, it is possible to feel numbness in the forehead.

Here is some information about this technique:

Duration: 30 minute session

Procedure: in consultation at the office. This is a product injection carried out with a needle. The injection is almost painless.

Sequels
Immediately: redness at the injection site for 1 hour
Visible effects from day 5 with slight asymmetry possible
Final result obtained after 15 days: the forehead is smooth, crow's feet wrinkles and frown lines disappear. The look is rested.
Precautions
Do not massage or press product within 48 hours of injection
Do not swim or play sports for 24 hours
Headaches can appear the same evening for 24 hours
Do not take aspirin within 24 hours
Contraindications:
myasthenia gravis
myopathy
Frequency of appointments
The effectiveness varies between 4 and 6 months.

The ideal dose will be determined with the help of Dr. Bela and will be repeated at intervals for a long-term result.

Hyaluronic acid is a medical device

It is naturally present in the skin and helps with the elasticity of the skin tissue. It is compounded and synthesized in the laboratory and does not contain any animal protein.

Different types of hyalurinic acid exist depending on the degree of cross-linking to have a more or less volumizing effect depending on the area to be treated and the desired effect. Different laboratories market it: Teoxane, Allergan, Maerz, Galderma, Fillorga.

Here is some information about this technique:

Duration: 30 minute session

Procedure: in consultation at the office. It is about injection of product carried out with the needle or the cannula in the hollow zones to be filled. The injection is almost painless.

Sequels
Immediately visible effects: dark circles are filled in and eye harmony is restored
Rarely: bruising at the injection site for a week
Extremely rarely: immune reaction around the product creating granulomas which are treated by injecting an antidote: hyaluronidase.
Precautions
Do not swim or play sports for 24 hours
You can resume your activities when you leave the office
Contraindications:
thyroid and autoimmune diseases (lupus, Graves' or Hashimoto's disease, ankylosing spondylitis, rheumatoid arthritis)
Frequency of appointments
The effectiveness varies between 8 and 12 months.

The ideal dose will be determined with the help of Dr. Bela and will be repeated at intervals for a long-term result.

PRP or Platelet Rich Plasma and Microneedling
Platelet extracts have been used for more than 10 years in reconstructive surgery for their healing properties.

In aesthetics, PRP consists of using these tissue regeneration properties to improve the quality of the skin. After a blood sample, the collection tube is centrifuged to obtain platelet-enriched blood plasma.

These platelets are enriched with growth factor and the reinjection of PRP into the dermis will restore its radiance to devitalized and sluggish skin caused by excess tobacco, sun and pollution.

Duration: 30 minutes

Procedure:
blood test followed by a 5-minute centrifugation to obtain the PRP
after a microneedling the PRP is applied to all the areas to be treated
treatment by needle “blanching” technique of superficial wrinkles
injection in the dark circle and topping in the lower eyelid
Sequels
edema and redness is often observed for a few hours after the session until the 3rd day sometimes. It testifies to the release of growth factors by platelets for the regeneration of the dermis.
Contraindications
There are several: pregnancy, anti-coagulant treatments, autoimmune diseases, blood disease, dermatological cancer

Frequency of appointments

 An appointment is scheduled at 1 month for a check-up
 Second session at 3 months
 One maintenance session per year.

Rate:

1 PRP session: 500-

A protocol of 5 PRP sessions is recommended to optimize the results of this treatment.

Pack of 5 sessions: 2000-

The objective of the peel is to stimulate tissue regeneration.
There are 3 categories of peeling depending on the depth of action of the products used:

• superficial (glycolic acid, salicylic acid), mainly concern women or men under 40 who want to keep their skin young and fresh. They are intended particularly for skin beginning to show fine lines.
• medium (TCA acid < 50%) are more suitable for people with spots or acne scars.
• deep (TCA > 50%, phenol) are indicated for people over 40 with deeper wrinkles. In particular, around the eyes and around the lips.
•  depigmenting peels are used to treat dark circles

Duration: 30 minutes

Procedure: at the office in consultation

During the session, the skin is cleansed and the peeling is applied with several passes.
The treatment is painless.
Immediately after the treatment, the skin turns pink and heats up for a few minutes.
Precautions and risks
A protocol is carried out at your home before the treatment to prepare the skin for the peeling
Sun protection is essential by total screen for 2 to 3 weeks
Results: at the end of the treatment, we observe a disappearance of the spots, a tightening of the pores and an attenuation of the small wrinkles: we gain a real "radiance of the complexion".
Social eviction: Superficial peels do not cause social embarrassment.
 Medium peels produce controlled desquamation for 3 to 7 days.
 Deep peels are spectacular, but the aftermath is longer and more disabling and is only performed by doctors trained in the technique.
The pain depends on the type of peel. Almost painless when it is superficial, it can lead to pain comparable to a burn when it is deeper.
Contraindications:
Peelings are prohibited for naturally pigmented skin (phototype 3 and 4) and if there is recent sun exposure

Frequency of appointments
Four sessions on average at 1 month intervals are necessary for superficial and medium peels as well as for depigmentation.

An annual maintenance session each winter can be carried out for a long-term result.

Rate:

A peeling session: 250 -

Depending on the intensity of the peeling, between 1 to 4 sessions are recommended for visible and lasting results.

Fractional CO2 laser
This laser can treat:

• the pleated appearance due to excess skin in the lower eyelid
• resection of small skin lesion
• unsightly post-operative scars

This laser emits a large number of tiny laser beams, creating multiple impacts on the entire surface of the treated area: on average, on 1 cm², 100 to 1000 puncture points are thus created.

By reaction, the skin regenerates naturally by healing at the level of each of these impacts or columns, in a harmonious way.

The source of heat that is released around each impact activates the cells of the skin with the synthesis of collagen and elastin, which restores the skin's volume and suppleness.

Duration: 20 minutes

Procedure: under local anesthesia in the operating room

Precautions and risks
 

Immediately after the treatment the skin turns brown
After two days crusts form then gradually fall off over a few days and turn pink for about 4 months.
The eyelid is then more tense, the fine lines have disappeared, the skin improvement is visible.
Healing creams will be prescribed to be applied daily for 1 month.
The skin must then be protected from the sun with a total screen for 1 year.
 

The result is lasting for up to 3 years after a single session.

Rate:

A CO2 session: 1000-

A single session is enough to obtain visible and lasting results.

Nanofat
Nanofat or "stromal vascular fraction" is a technique of regenerative medicine which consists in taking the patient's fat, purifying it and filtering it in order to obtain a liquid product.

This cell concentrate is extremely rich in regenerative stem cells. Once injected into the dark circle or the face, they release growth factors to improve skin radiance and treat pigmented dark circles.

The advantage of this technique is its long-term effectiveness and the total absence of rejection.

The technique is simple: a millimetric incision is made on the inside of the thighs or on the stomach under local anesthesia. A few milliliters of fat are removed using a cannula. The fat is then centrifuged and purified through filters to make a cellular precipitate of NanoFat. It is then injected into the face in the pigmented ring or by coating on the complete face.

Duration: 1 hour in outpatient surgery

Anesthesia: local with sedation or general

Procedure:

Anesthesia consultation before surgery
Fasting on the day of the operation
Exit the same day without dressing and without sutures on the face
Be accompanied when leaving
Post-operative follow-up:

Do not play sports or put your head under water for a week
Edema and bruising visible for a week
A suture thread at the sampling point next to the knee
Frequency of appointments:

D1: Appointment with Dr Bela for monitoring
D7: removal of suture threads
Final results obtained after 2 to 3 sessions spaced 2 months apart

Frequency of appointments
This treatment is visible in the long term but must be repeated every 2 years for a lasting result.

Price: see Lipofilling