Medical Aesthetics — Frequently Asked Questions

The effect usually begins to become noticeable within the first 3 days and fully settles in 10–14 days. The check-up to assess the result is usually done after 2 weeks.

It is not permanent; muscle strength returns over time. The effect lasts an average of 3–4 months and in some people up to 6 months. For armpit sweating the effect lasts an average of 4–12 months. It is recommended that treatments are not repeated at intervals shorter than 3 months.

It is recommended that for the first 2–4 hours you stay upright, do not lie down and do not bend forward. For the first 24 hours do not rub or massage the treated areas; avoid make-up, saunas, steam baths, hot baths and strenuous exercise.

The most common are bruising at the injection sites, mild swelling, redness and a temporary headache. Less commonly, drooping of the eyelid or eyebrow, asymmetry and, after treatments around the mouth, temporary difficulty speaking or swallowing may occur. These effects fade as the effect of the medicine wears off.

No. Its licensed uses include excessive sweating of the armpits, spasticity of the arm after a stroke, dynamic equinus foot deformity in cerebral palsy, blepharospasm (spasm of the eyelid) and hemifacial spasm. Long before its cosmetic use it began to be used in the 1960s and 1970s in the treatment of squint.

There are many areas considered for cosmetic purposes — the forehead, between the eyebrows, crow's feet, the lower eyelid, the side of the nose, around the mouth, a downturned corner of the mouth, the jaw muscle, neck lines and so on. But some of these areas are outside the list of licensed uses. Which area is suitable for you should be decided together with your doctor.

No. Pregnancy and breastfeeding are a contraindication (a situation in which a treatment is inadvisable); that is, they are among the situations that are an obstacle to treatment.

Some may. Aminoglycoside antibiotics, penicillamine, quinine, calcium channel blockers, magnesium and ciclosporin are among the situations listed as obstacles. For this reason you need to declare all the medicines you take before treatment. Nerve–muscle diseases such as ALS, myasthenia gravis and Eaton-Lambert syndrome are also an obstacle.

Photographs before and after treatment are taken sitting upright, and the muscles are assessed both relaxed and contracted. This is so that the injection points and the dose can be determined correctly and the result can be compared. The photographs and the record of the procedure are filed together with the batch number of the product.

Temporary drooping of the eyelid (ptosis) is one of the possible side effects and is a manageable situation. Eye drops with an alpha adrenergic action can be used 3–4 times a day at intervals of 3–4 hours; radiofrequency, ozone and PRP treatments are also among the options. This is a decision for the doctor — do not use drops on your own; see your doctor.

Yes. In people who are not mentally stable and who have excessive expectations — in conditions such as body image disorder, borderline personality, obsessive-compulsive disorder or narcissism — treatment is not considered appropriate. For this reason the assessment before treatment covers not only the skin but how realistic the expectation is.

For hyaluronic acid, the substance most often used, no allergy test is needed; it has been FDA approved since 2003. Even so, the medicines you take, the illnesses you have had and your history of allergy are assessed before treatment.

It depends on the substance: the effect of PLLA lasts on average 18–24 months and calcium hydroxylapatite on average 12–18 months. But the duration does not depend on the substance alone — how mobile the area is, the depth of injection, the amount of cross-linking, smoking, alcohol, excessive exercise and weight loss also affect it.

No, there are two different ways of working. Hyaluronic acid gives volume directly and holds water. PLLA, polycaprolactone and calcium hydroxylapatite work by stimulating the production of your own collagen — which is why their results appear later.

They are not recommended. The most important advantage of a fat (autologous) filler is that it does not cause an allergic or foreign-body reaction; but it is not preferred under the eyes or in the lip area. It is a suitable option for people with marked hollowing of the face after severe weight loss.

For fillers containing calcium hydroxylapatite, yes — calcium is radiopaque (visible on X-ray) and can be seen on imaging. This appearance is not permanent. Even so, if you are going to have imaging it is worth telling your doctor that you have previously had a filler.

PLLA has been found to carry a high risk of forming papules and nodules under the skin (small firm lumps) in the areas around the mouth and the eyes. For this reason care is advised in these areas and the choice of substance is made accordingly.

A filler is not a simple injection. The vascular structure of the face is complex, and injections made in the wrong direction can lead to a pulmonary embolism. For this reason the distribution of vessels and nerves in the area is assessed before treatment, and it is confirmed before injecting that the needle is not inside a vessel. The procedure being carried out by a doctor and in appropriate conditions is the basis of its safety.

There is no single standard protocol; the session schedule varies between sources. For the face, an example schedule is 3–4 sessions 2 weeks apart, followed by a top-up session every 3–4 months. Results appear gradually as the sessions progress.

The most common are pinpoint bleeding at the injection sites, redness, swelling, bruising and tenderness; these are usually temporary. Less commonly, infection, an allergic reaction, small painful lumps or a temporary change in skin colour may occur.

It is not given during pregnancy and breastfeeding, if there is an active infection or an open wound in the treatment area, with a bleeding disorder or when taking blood thinners, with a history of cancer, with diabetes that is not under control, with a known allergy, or with unrealistic expectations.

Not fully. The sources state that the way many of the substances used work has not been proven, and that randomised controlled trials and guidelines on doses and effectiveness are lacking. That is why it is important to keep expectations realistic.

It is a method carried out with small-volume injections into the skin and beneath it. In skin rejuvenation it is one of the approaches that aim to stimulate the production of collagen — it appears on the same list as microneedling, chemical peels, energy-based devices, hyaluronic acid injections and biostimulant agents.

With these methods a period of 3–4 months is needed for results to be seen. The reason is this: biostimulation does not give volume immediately as a filler does; it stimulates the production of your own collagen, and that takes time. Not seeing a result straight away does not mean the treatment has not worked.

The slowing of collagen production begins after the twenties; in the same period its breakdown also starts to increase. After the thirties and forties there is a loss of 1–1.5% of collagen each year. In women this process speeds up with menopause.

It is a regenerative treatment carried out with biocompatible substances that stimulates the fibroblast (collagen-producing) cells responsible for the production of collagen and elastin in the skin and the tissues beneath it to increase in number and in their capacity to produce. The substances used are biologically degradable and absorbable; their end products are water and carbon dioxide.

On the contrary, it matters even more. Among the external factors that speed up skin ageing, sun damage caused by ultraviolet rays is the greatest threat. Smoking, alcohol and stress also speed up the biological clock. The result of treatment is determined together with daily habits.

Ageing of the face is not only about the skin. It is the combined result of changes in the skin, the fat tissue beneath it, the muscles, the deep fat pads, the connective tissue and the bone — with age there is also marked loss in the bone of the face, and this reduces the support for the tissues above. For this reason the assessment looks at the whole rather than a single layer.