DR STASI BOTHA’S AUGUST NEWSLETTER

WELCOME!

Welcome everyone to my August newsletter which will be about one of my favorite topics! I am excited to take you through some major technique advancements when it comes to dermal fillers injections, possibly the most requested procedure at my practice.

Dermal fillers offer many applications:

  1. Lip shaping and volume
  2. Cheek volume
  3. Wrinkle correction
  4. Skin rejuvenation

But using a micro-cannula all these procedures and more can be offered with less risk of bruising and swelling…

Have any of you heard of a micro-cannula?  I hope to give you some valuable insight into this popular treatment and to explain why I believe it is the greatest non-surgical anti-ageing option.

Lastly, remember to follow my Facebook page which is full of resources about all the procedures and treatments I offer at my practice. And if you would like to book an appointment, then feel free to phone my rooms on 011 616 4040

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SO WHAT ARE THE BENEFITS?

The benefits are massive and micro-cannulas are revolutionizing dermal filler techniques, but a word of caution. Micro-cannula techniques are only for experienced doctors so please make sure to check the credentials of your doctor before undergoing any aesthetic procedure.

What are the benefits of using a micro-cannula vs. a needle?

First: The blunt tip

A needle causes trauma as it enters the body, this leads to risk of bruising and pain. The micro-cannula is blunt so trauma is greatly reduced.

A second benefit of micro-cannula treatments is that micro-cannulas are highly polished:
This means that the flow of the product is smooth and in controlled hands treatment accuracy is improved.

A less risk, more accurate dermal filler treatment! What more could you ask for.

Perhaps my most favourite benefit from injecting dermal fillers with a micro-cannula is that treatments can now be performed using fewer skin punctures.

A micro-cannula offers both you and me advantages:

  • Convincing results with low levels of pain and tissue trauma
  • Low risk of bruising and swelling
  • Individual treatment plan
  • No downtime
  • Ease of injection

WHAT I USE MICRO CANNULAS FOR

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A micro-cannula is longer than a needle and has multiple length options available. This means I could possible treat:

  • A tear trough
  • Midface (cheek)
  • Cheek skin rejuvenation

Another common area for multiple treatments via a single entry point is the lips:
by making a single entry on the outside of the lips, I can now, using a a micro-cannula:

  • Add volume to the upper lip
  • Add volume to the lower lip
  • Define the lip border on the upper lip
  • Define the lip border on the lower lip
  • Treat the corners of the mouth

All that from a sinle entry each side. Not bad, where in the past that same protocol would involve at least 12 injection sites.

In the past we had limited success with:

  • Tear troughs
  • Temples

But today, the rejuvenation procedure covers many more areas:

  • Lips
  • Skin rejuvenation
  • Tear troughs
  • Cheeks

These areas were notoriously difficulty to treat due to the thin skin and many vessels. Now we can accurately treat these areas with minimal risk and fill out hollow temples or remove dark circles and bags from under the eyes.

A comfortable treatment too…
Due to the lack of trauma the only discomfort reported by patients during a micro-cannula treatment is the entrance hole being made with a traditional needle.

The treatment duration is the same, the long lasting results are the same, and you simply have less pain and downtime.

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THE STAR OF THE SHOW: THE MICRO CANNULA

What is a micro-cannula?

Well first off a cannula is a thin metal tube that is often used in Liposuction and fat transfer to either remove fat or re-inject fat.

A micro-cannula is a specifically designed hollow tube for the injection of dermal fillers.

Micro-cannulas come in varying sizes and lengths. This is to allow the correct size cannula and length to be used in conjunction with the matching dermal filler product and treatment area.

Many people are put off when they first see a micro-cannula. This is because they look like they are thicker than a traditional needle.

This is simply the length playing tricks on the eye. All the micro-cannulas I use match the gauge sizes of the dermal filler equivalent needle.

I’m sure you will agree that micro-cannulas are the future of dermal filler injecting. They were designed to improve patient satisfaction and result accuracy.

The choice in micro-cannula will be discussed with you during the consultation.

A dermal filler treatment with a micro-cannula is just the same as with a needle. The preparation is identical; the only difference is method of application.

Micro-cannula tips are flexible! This is why only experienced doctors should use them, as control can be an issue.

In experienced hands however this flexibility allows for easy insertion into the tissues and therefore reduces the risk of bruising and swelling further.

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I hope you enjoyed this newsletter about micro-cannulas and the advancements in dermal filler injection technique.

Remember to visit and like my Facebook page to stay up to date with the latest news at my practice! 

Dr Stasi Botha’s June Newsletter: Teeth Whitening

Welcome to my June newsletter!

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One of the first things that people notice in a person when they meet you for the first time is your smile. There is nothing more beautiful than a gorgeous smile unveiling bright white, sparkly teeth. First impressions last so maybe you should ask yourself if your yellow teeth make you self-conscious. This is why this month I am going to explain the process of teeth whitening at my practice.

Have you ever wished your teeth were whiter? If so, have you ever considered professional teeth whitening?

Did you know that the shade of your teeth should generally match the white of your eyes? After a teeth-whitening session, your newly whitened teeth will create an increase in vertical symmetry, enhancing your natural beauty. This is another step in the anti-ageing protocol of any modern man or woman.

I hope you enjoy what follows and remember, my Facebook page contains much more information on a daily basis so make sure to head over there and to “Like” the posts!

What causes the teeth to lose their whiteness?

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Most of us start out with sparkling white teeth, thanks to their porcelain-like enamel surface. Composed of microscopic crystalline rods, tooth enamel is designed to protect the teeth from the effects of chewing, gnashing, trauma and acid attacks caused by sugar.

Age and lifestyle can affect our teeth. Many of our day-to-day activities can stain and darken our teeth, such as drinking coffee, tea, red wine and cola, and of course smoking. These are bad habits one should be aware of and control as much as possible in order to prevent the quality of the teeth from being impaired.

What happens is that over many years of daily chewing, the dentin remains intact while millions of micro-cracks occur in the enamel. It is these cracks, as well as the spaces between the crystalline enamel rods, that gradually fill up with stains and debris.

As a result, the teeth eventually develop a dull, lack-lustre appearance and no longer seem as healthy as they once were.

Whitening your teeth will not only brighten your smile but take years off your visible age.

What  I can do for you

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There are various options that you have when it comes to teeth whitening. Some of these methods and procedures can be done at home too. Beware of over the counter whitening gels or toothpastes as they cannot provide the perfect and even whiteness that a professional whitening product/service can.

My patients who decide to undergo teeth whitening always see moderate to substantial improvement in the brightness and whiteness of their smile but like I always remind them, teeth whitening is not a permanent solution and requires maintenance or “touch-ups” for a prolonged effect.

Thanks to professional teeth whitening, I can safely remove the stains and debris. Some of the cracks are quickly re-mineralized by saliva, while others are filled up again with organic debris. This is why maintenance is required.

Today, with the ever-evolving science in the cosmetic and aesthetic industry, two major teeth whitening options are available. One being the in-office procdure and the other a professional take-home kit. Both rely on varying concentrations of peroxide and varying application times. We will decide which option best suits your needs, budget and timeframe during the consultation.

As your physician, I will judge which option is best for your teeth in terms of efficiency and expected results. Before the sessions we will discuss your needs and wishes, I will assess your case and plan out your teeth makeover accordingly.

This protocol involves the carefully controlled use of a relatively high-concentration peroxide gel, applied to the teeth after the gums have been protected with a paint-on rubber dam. The peroxide remains on the teeth for 4 x15 minute intervals.

Of course there are more considerations to take when thinking of this teeth-whitening procedure, but feel free to ask away and I’ll get back to you.

LASER TEETH WHITENING

The latest laser whitening techniques use the help of laser technology to remove a very thin coating of the teeth. Porcelain veneers were used in cases of poorly stained teeth. However the procedure is damaging to the tooth as enamel has to be removed and no further teeth-whitening can be done..

While the latest laser technology is relatively inexpensive, the professional whitening gel procedure is the most cost effective option and does not damage your teeth.

In order to extend the longevity of newly whitened teeth, I highly recommend that you follow the instructions below.

  • At-home follow-up or maintenance whitening – implemented immediately or performed as infrequently as twice / three- / four times a year, depending on your habits
  • Avoiding dark-coloured foods and beverages for at least 2 days after whitening.
  • Whenever possible, sipping dark-coloured beverages with a straw.
  • Practicing excellent oral hygiene – brushing and flossing after meals and at bedtime.
  • Using a whitening toothpaste

HOW LONG DOES TEETH WHITENING TAKE?
The procedure takes a total of 2 hours and includes:

  • A general assessment of the teeth, viability of whitening and pointing out any problematic areas.
  • A professional cleaning of the teeth done by a dental professional
  • Preparation of the teeth, enclosing of all the soft tissue and possible sensitive / problematic areas on the teeth
  • 4 sessions of 15 minutes each – exposure under the laser!
  • Post whitening instructions
  • An at home post whitening maintenance kit, to maintain your white teeth

Teeth whitening procedures are safe, quick and effective. If your teeth are discoloured, yellowed, blackened or simply not as white as you prefer them I can help you.

So if you really want teeth that are pearly white and those that help you give a flashing smile, phone my rooms on 011 616 4040 to book an appointment and discussing the best options for your teeth.

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DR STASI BOTHA’S MAY NEWSLETTER: AFTERCARE

 WELCOME TO MY MAY NEWSLETTER! 

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This month I thought it would be interesting for me to talk about aftercare and how to make sure you take the right steps when it comes to recovering after an aesthetic treatment.

As your physician, I cannot stress enough the importance of protecting and soothing your skin after a session at my practice. Whether you came for Botox, dermal fillers, Skin needling or Fraxel, you need to know exactly what to do once you leave my rooms in order to maintain beautiful, long lasting results.

Of course, after your treatment I will give you all these recommendations again and will guide you through the aftercare process. I will answer any questions and make sure you know exactly how to proceed once you get home.

Remember to visit my Facebook page regularly; this is where I post about all the procedures and treatments I offer and also where you will find out about any specials I may run!

I hope you enjoy what follows!

→After Fraxel

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After your Fraxel Laser treatment, you should clean the treated area by washing with non-allergic cleansers that are soap-free but you should not clean the area more than twice daily. After you have washed the area, it is recommended you pat it dry lightly.

This patting is also great advice for after a shower. Try it, you’ll see what a difference it makes to your skin.

Do not rub the treated area after the Fraxel treatment as it may irritate the treated skin.

There is no need to take time off work after a Fraxel treatment but there will be 2 to 3 days of redness and in some cases you might experience some swelling, which can be covered with makeup. This is completely normal and of short duration.

Knowing that you can be back in the social world within a day gives you great confidence in the procedure.

It is important that you keep the treated areas moisturized by using creams and moisturisers that I will recommend. I will explain how to use these creams, how often to apply them and for how long.
After a Fraxel treatment, it is important that you eat and sleep well in order to ensure the best recovery and results possible.

I always advise my patients to apply large amounts of SPF and make sure they stay out of the sun. If you have to go in the sun, you will need to make sure that the treated area is well covered. Sunblock must be applied hourly and a hat must be worn.

SPF should be part of your daily anti-ageing routine too, sunblock actually only lasts for one hour, therefore you should apply it often.

→After Skin needling

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It is very important for you to avoid direct exposure to sun rays for at least 4 days after the procedure. But I will still ask you to wear a high quality SPF for more protection.

This is because of the damage caused by the needling, and additional sun damage will delay the healing process. This is why winter is also a great time for micro-needling, because the sun is not so harsh.

Carefully following my guidelines is very important as it will prevent any skin damage. You must keep in mind that a good healing is a process that cannot be rushed or overlooked as it would counteract the benefits of the actual procedure.

After the micro-needling, I need you to avoid the use of sensitizing drugs or skin cosmetics or cosmetics that contain mineral oils, Vaseline, lanoline, petroleum or acids. It is also important to avoid steam bath or sauna the first day after the treatment. Make up and after-shave (because men love micro-needling too) cannot be applied within the first two days post treatment.

→After Botox

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Botox is a popular procedure at my practice that most patients enjoy without any complications. However, it is always good to be reminded that after the injections you may notice some small red dots and bumps which usually fade after a few hours. Minor bruising may occur and last a few days.

It is still very important that you follow my instructions for BOTOX® after care to help ensure that you achieve optimal results.

After a Botulinum toxin session, some patients like to apply a lightweight cold compress to the treated area for a few minutes after the procedure. Even though the injections are not painful per-se, you may still want to get some immediate relief in order to be as comfortable as possible.

If you make sure to carefully follow my instructions, your recovery after Botox will be quick and pleasant. You will be able to resume normal activities immediately after the treatment.

Nonetheless, I usually advise my patients to wait 24 hours before taking part in any strenuous activity i.e. gym or cardio sessions. I also recommend that you avoid lying down for four to five hours following the treatment and that you avoid touching the treated area.

We just want the Botulinum Toxin to settle down. It does take a few days for the treatment to take effect and these tips assist with more accurate results.

→After Dermal Fillers

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Like with any other procedures, there are some risks. With dermal fillers, there is a small possibility of allergic reaction. There is usually localised redness and swelling that can last a day or two.

Should this be the case, a simple script for antihistamines will do, but this is a very rare occurrence.

Bruising is a more common side effect after dermal filler injections which can last up to a 5 days. But together during the consultation we will go over the possible risks and complications. I want you to feel as comfortable and confident as possible.

If you do bruise we do have great medical make-up available in the shape of Oxygenetics, which we can match with your skin tone.

Healing time varies from person to person, however, so some may experience redness and swelling slightly longer than others but overall the recovery and healing process after dermal filler injections is quick and easy.

There should never be any healing side-effect that cannot be covered by well placed make-up, and this is why dermal fillers are proving so popular.

I usually advise my patients to avoid touching and massaging the product situated in the treated area for the first 24 hours after their dermal filler injections as this could disturb the dermal filler gel and impair the results.

Of course this can be difficult, but the advice is to be aware of your treatment area. These are simple tips to prolong the life of your result.

As part of the dermal filler aftercare procedure, it is also advisable to use a cold pack as needed to reduce swelling and redness at the injection site. With the use of cannulas bruising and swelling is reduced, but should you swell a cold pack will do nothing to the result, but will get you out and about again.

A cold pack will be available at the time of treatment.

Remember to follow me on Facebook and “Like” my page. This is where you will find all the updates and news about the treatments and procedures I offer at my practice. 

Dr Stasi Botha’s March 2013 Newsletter: Skin Needling

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Welcome to my second blog post! As a physician, I like to know that you are aware of all the treatments and procedures within your reach that can help you feel more confident and beautiful.  Feeling self-conscious about your skin or body can be a real handicap in day to day life and I want you to know that you don’t have to live with those worries.

This month, my newsletter is about Skin Needling and I am thrilled to be sharing my knowledge about this treatment that I offer at my private practice in Bedfordview.

Remember that you can follow my Facebook page to find out more about my specials and read my daily posts. And don’t be shy; if you have a question, don’t hesitate to leave a comment on my page and I will happily respond.

Also, feel free to book an appointment with me by phoning (011) 616 4040 I hope you enjoy this post!

→What exactly is Needling? 

Skin needling, also known as Facial Mesotherapy and Collagen Induction Therapy (CIT) involves using a digital hand-piece infused with multiple, fine-pointed needles on the skin’s surface to stimulate its own regenerative properties and rejuvenate it.

Some techniques also involve handheld needling, but as technology develops so too does the techniques. At our practice we utilise the latest Vee Way needling technology.

Skin needling is a unique process that stimulates the body’s natural production of collagen and elastin.  My objective with this procedure is to smooth your skin and reduce scars or stretch marks through your skin’s natural wound healing and regeneration process.

It’s a very clever treatment to achieve results using your body’s healing process.

What happens during a Needling session?

During the needling session, I use a sterile needle grouping that are usually 1-3 mm long and I gently insert them into the epidermis and the top layer of the dermis. This, in turns, tells your brain to send collagen to the injured site in order to repair it.  This signal creates an abundance of collagen, which will plump up the injured area. 

This is how I will proceed with my hand piece during the needling session.

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Pain of course varies from one patient to another. Skin needling is a semi-invasive procedure.  I will apply a topical aesthetic to the area to be treated for you to feel as little pain as possible.  Most of my clients feel very little discomfort, if any at all

→What can you expect after your needling session?

What is left after a needling session? Softer, yet tighter skin. Your wrinkles, acne scars and other depressed areas will be a lot less noticeable. As an added benefit to skin needling the efficiency of serums and moisturizers is increased as they can now penetrate deeper.

After the needling session it is extremely important that you do not expose the treated area(s) to the sun, heat, hot water or tanning beds for 5-7 days.  It is highly recommended that a serum be used between treatments to enhance the results, due to the deep penetration of the serum.

After the needling treatment, it is normal for your skin to show red ‘pin point’ marks that can be covered by makeup the day after the needling application. 

The most exciting element to skin needling is that your skin’s production of new collagen continues for up to 12 months after the procedure.

The amount of needling sessions necessary varies from 1 to 6 depending on your skin’s needs and the results you are looking for. The initial treatment sessions may be weekly for the first month and two weekly thereafter. Maintenance can be once monthly as an alternative to a traditional facial, or at your discretion. 

Remember to visit my Facebook page for daily info on all the procedures I performs and treatments I offer at my Bedfordview pratice.

Before and After Botox Photos

Today I would like to post some photos of men and women at different stages of their “Botox experience”.

These Botox sessions were specifically aimed at improving moderate to severe frown lines between the brows.

I want to mention that these photos were NOT taken by me at my practice and these people are not my patients. They were taken from the official Botox website which you can visit by clicking here.

I hope you enjoy and as always, feel free to leave a comment or a question here or on my Facebook page.

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Long-Term Effects of Botulinum Toxin Type A (Botox) on Facial Lines

A Comparison in Identical Twins
William J. Binder, MD
Arch Facial Plast Surg. 2006;8(6):426-431

INTRODUCTION

Hyperfunctional lines such as horizontal forehead lines, glabellar lines, and crow’s feet can develop from the repeated contractions of certain muscles (the frontalis, procerus, corrugator, and orbicularis oculi muscles). By blocking the release of acetylcholine from the presynaptic terminal of the neuromuscular junction, botulinum toxin type A (Botox; Allergan Inc, Irvine, Calif) can inhibit the contraction of these muscles.

Botox is approved by the US Food and Drug Administration for the treatment of glabellar lines, and its efficacy in the treatment of these and other hyperfunctional facial rhytides (eg, horizontal forehead lines and crow’s feet) is well documented. 1-10 Its duration of effect when used for the treatment of glabellar lines is generally at least 3 to 6 months and has been reported to be effective up to 11 months. 6, 11 Furthermore, it appears that repeated treatments can result in a progressively longer duration of action.5 (Note: Dosing and results reported in this study are specific to the formulation of Botox manufactured by Allergan Inc. The Allergan Inc formulation is not interchangeable with other botulinum toxin products and cannot be converted by using a dose ratio.)

Most published studies evaluate the efficacy and tolerability of Botox for no more than 1 year, and there are few reports evaluating the clinical benefits of repeated treatments over the course of many years. Nevertheless, patient satisfaction is generally high, and it is likely that many patients will continue treatment for several years. 2, 12-15 Although controlled studies of this duration are impractical, the evaluation of facial lines in identical twins who have had different exposures to Botox can offer insight into the long-term benefits of Botox treatment. This report evaluates the presence of hyperfunctional facial lines in identical twin sisters, one of whom had regular Botox treatment in the forehead and glabellar regions over many years and one of whom did not

METHODS

Hyperfunctional facial lines were evaluated in identical 38-year-old twin sisters. The first twin (hereafter, the regularly treated twin) had received Botox injections in the forehead region and the glabellar region approximately 2 to 3 times each year over the past 13 years ( Figure 1). She had also received a total of 2 treatments with Botox in the crow’s feet area in the last 2 years ( Figure 1). She was last treated with Botox more than 4 months before the “at rest” photographs of the forehead, glabellar, and crow’s feet were taken and 7 months before the “when smiling” photographs of the crow’s feet were taken. The other twin (hereafter, the minimally treated twin) received only 2 treatments with Botox, both in the forehead and glabellar regions. The first of these was administered 7 years ago, and the second was administered 3 years ago

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Figure 1. Approximate sites of botulinum toxin type A (Botox; Allergan Inc, Irvine, Calif) injections in the forehead, glabellar, and crow’s feet regions.

RESULTS

In this study, neither twin experienced any adverse effects from Botox.


FOREHEAD AND GLABELLAR LINES 
Photographic documentation shows that hyperfunctional forehead and glabellar lines are not evident at rest in the regularly treated twin. In contrast, they are visible in the minimally treated twin (Figure 2 and Figure 3).

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Figure 2. The minimally treated twin (images on the left) and the regularly treated twin (images on the right). Hyperfunctional lines in the forehead and glabellar regions are visible in the minimally treated twin but not in the regularly treated twin.

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Figure 3. Oblique views of the forehead and glabellar lines that are visible in the minimally treated twin (left side images) but not in the regularly treated twin (right side images). The crow’s feet are also shown at rest

CROW’S FEET 
At rest, there were no marked differences between the twins in terms of crow’s feet (Figure 3). This is not unexpected because the regularly treated twin had started receiving Botox injections in the crow’s feet area only 2 years previously.
When the twins smiled, there was a marked difference between their crow’s feet (Figure 4)

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Figure 4. Crow’s feet when smiling are more visible in the minimally treated twin (left side images) than in the regularly treated twin (right side images), even though the crow’s feet of the regularly treated twin had been treated with botulinum toxin type A (Botox; Allergan Inc, Irvine, Calif) only twice in the last 2 years

NASOLABIAL FOLDS 
Neither twin received any Botox injections in the lower half of the face, and the nasolabial folds in the regularly treated twin were at least as noticeable at rest as those in the minimally treated twin (Figure 3). This suggests a generally similar degree of aging in untreated areas of the face in both twins, giving credence to the belief that the differences between the twins in the severity of their forehead and glabellar lines are attributable to the difference in the number of Botox treatments that each received over a long period of time (rather than a greater propensity for skin aging in the minimally treated twin)

COMMENT

It is well known that a single injection of Botox into a target muscle can inhibit a patient’s ability to contract that muscle for several months and so reduce the appearance of facial lines that would have been apparent during active muscle contraction. The results presented herein suggest that long-term treatment can also result in additional benefits and prevent the formation of permanent lines—so-called imprinted lines—that slowly manifest over time as part of normal aging as a result of dermal and epidermal tissue breakdown caused by repeated muscle contractions. This comparison of identical twins (one of whom received regular injections of Botox in the forehead and glabellar region for 13 years and one of whom did not) demonstrates that long-term treatment with Botox can prevent the development of these imprinted facial lines.

Once these lines develop, they can be rectified only by using other treatment modalities such as fillers or skin resurfacing techniques. As long-term Botox treatment appears able to dramatically slow, if not halt, this aspect of the aging process, it would also appear able to delay, if not avoid, the need for such treatment.

It is likely that long-term treatment with Botox is able to prevent the development of imprinted lines not only by inhibiting the patient’s ability to contract the target muscle but also perhaps through behavioral modification. With long-term treatment, the patient may become used to having little, if any, need or ability to contract the target muscle and may eventually “learn” to avoid even trying to contract it. It is also thought that, by relieving the mechanical pressure of chronic muscle contraction in this way, dermal remodeling may be facilitated. 6

In the regularly treated twin, the clinical effect of Botox was consistently sustained for at least 6 months after each injection, and the duration of effect did not diminish with repeated treatments. The dosage also remained stable over the 13 years of treatment. It has been reported in the literature that, compared with a single treatment, repeated injections may enhance response rates, prolong the duration of action, and lower the incidence of adverse events. 5, 10 If greater or more prolonged efficacy is achieved with continued treatment, this may afford the opportunity to treat patients less frequently or with lower doses.

In conclusion, long-term treatment with Botox can prevent the development of imprinted facial lines that are visible at rest. Botox treatment can also reduce the appearance of crow’s feet. Treatment is well tolerated, with no adverse events reported during 13 years of regular treatment in this study

AUTHOR INFORMATION

Correspondence: William J. Binder, MD, 120 S Spalding Dr, Suite 340, Beverly Hills, CA 90212-1800 (info@doctorbinder.com ).
Accepted for Publication: June 1, 2006.
Financial Disclosure: Dr Binder is a stockholder of and a consultant to Allergan Inc.
Previous Presentations: This study was presented in part at the Rejuvenation of the Aging Face Course–2006, sponsored by the American Academy of Facial Plastic and Reconstructive Surgery; February 19-23, 2006; Boca Raton, Fla; and as a poster at the 64th Annual Meeting of the American Academy of the Dermatology; March 3-7, 2006; San Francisco, Calif.
Acknowledgment: I am grateful to Gill Shears, PhD, for assistance with the writing of this article.
Author Affiliation: Department of Head and Neck Surgery, UCLA School of Medicine, Los Angeles, Calif