Knife Styles

Botox - Anti-ageing Injection

What is it?

Botox is the leading brand of injectable botulinum toxin type A and has become known as a 'friendly poison' because it's related to botulism, a form of food poisoning.

Botox works by blocking signals to the muscles, stopping them contracting. It's used in tiny quantities with high margins of safety and affects only the muscles - it has no effect on the central nervous system.

It was originally used as a medical treatment for patients with crossed eyes. Then an ophthalmologist noticed that her patients' wrinkles disappeared when treated for eyelid spasms. Soon, it became the hottest cosmetic wrinkle slayer on the beauty menu.

Botox works by interfering with the muscles' ability to contract. Not only does it smooth existing lines but, over time, it appears to prevent new ones appearing.

Medically, it's also used to control excessive sweating - which makes it a popular treatment among A-listers on red carpet duty - and to relieve migraines.

What can it do for you?

Botox can be used to soften and smooth expression lines and wrinkles around the eyes and mouth, across the forehead and between the eyebrows.

Although it's no substitute for a surgical facelift, the results can be amazing. For example, when it's injected into the muscles above the brow, any excess skin around the eyes will lift.

New uses for Botox are being discovered all the time. A number of women have been treated with Botox in the neck and chest area.

The decolletage area is particularly prone to sun damage and injections can be administered to soften the crinkled look. The neck can also be treated with Botox to smooth ageing lines and improve the angle of the jaw.

Other uses, include the treatment of wrinkly elbows. It's the latest craze in Brazil.

The procedure

Before starting, the doctor should spend time observing the dynamics of your face to determine which areas need the most work.

Using a very fine needle, the Botox is then injected into the muscle, often in several places. Some doctors may apply a local anaesthetic cream first.

The treatment takes around 10 minutes. It can take around 48 hours for the first effects of Botox to be seen. The complete effect is often visible after a week.

Cost

From approximately £200 per session.

Recovery time

Botox isn't known as a lunchtime fix for nothing - those who've undergone the treatment can carry on as normal afterwards. The only signs of treatment may be slight bruising or redness at the site of injection, but this should quickly fade.

It's important to remain upright for four hours after the injections - so no lying down or bending over. You shouldn't massage the area or exercise during this time, either. These precautions limit the spread of Botox from the site of injection.

What can go wrong?

Done well, Botox can wipe years off your face without it looking like you've had any 'work'. Done badly, it can put years back on or leave your face looking unnatural and expressionless.

Among the more alarming possible side effects are drooping of the brow and eyelid. Either can happen when the Botox is injected in the wrong place or in the wrong amount. You may also end up 'freeze-framed' - when your face can't form any expressions.

Other possible, but rare, side effects include transient headaches and numbness.

How long does it last?

The effects of Botox last between three and six months for most patients. Further injections are recommended every three to four months to keep the muscles inactive and allow the lines to remain smooth.

Clinical studies have shown that subsequent injections last progressively longer, owing to muscle weakening and breaking frowning habits.

Once satisfied with an area, patients need only return for further injections when they notice muscle movement again - and this may not occur for up to a year.

Thermage - The Radio Frequency Lift

Thermage skin-tightening heat treatment recontours the face by shrinking the skin's existing collagen and stimulating new natural collagen production.

What is it?

Thermage is a pioneering, non-invasive facelift developed in the US to treat oily skin, acne, wrinkles, sun damage and skin laxity. It's the latest US Food and Drug Administration-approved skin-tightening and lifting procedure and its maker says it delivers renewed facial contours and healthy new collagen.

This treatment uses a patented radio frequency (RF) technology called ThermaCool, which has been clinically proven to tighten and lift the skin. Transmitting radio frequencies deep into the skin, as well as into the underlying tissue, causes the collagen fibres within the skin to heat up.

In essence, the treatment 'cooks' the existing collagen layers that lie under the skin. It also immediately kick-starts and stimulates the production of new collagen.

What can it do for you?

Thermage can help to smooth out the visible signs of ageing, such as crow's-feet and smokers' lines around both the eyes and the mouth, as well as treating acne scars.

Loose skin under the chin and drooping eyelids can also be improved. Thermage can lift the brow slightly and gives good results on the neck and chest areas. As well as tackling wrinkles, sagging and scars, it's said to give an all-over fresher skin tone.

The procedure

A single treatment is all that's required, taking from 20 minutes to over an hour, depending on the size of the treatment area. It can only be carried out under medical supervision.

First the area is treated with anaesthetic cream, then a controlled amount of RF energy is applied by the system using a ThermaTip. With each touch, you'll experience a brief 'deep heat' feeling, similar to splashes of warm fat pinging on to the skin. This warming sensation is thought to be the collagen reaching effective temperatures for that all important tightening.

The ThermaTip is cooled before, during and after heating to protect the skin and make the treatment more pleasant. Results are visible immediately.

Cost

From £1,500 to £4,000 per area.

Recovery time

The treatment can be uncomfortable, but most people are able to return to their day-to-day activities shortly afterwards. You might experience mild redness, similar to a slight sunburn, and a bit of swelling, but this usually disappears within 24 hours. Good skincare and sunscreen are recommended for after the procedure.

What can go wrong?

Apart from being slightly uncomfortable and the risk of swelling, redness, bumps and blisters on or around the treated area - which will disappear in a few days - this procedure has a good safety record.

With more than 190,000 estimated treatments worldwide, the reported incidence of side effects is less than 0.4 per cent. A rare (less than 0.11 percent) but longer-lasting side effect, described as 'surface irregularity', has also been reported.

How long does it last?

Although immediate tightening of the skin's collagen structure will be visible, measurable improvements continue to appear gradually over two to six months after a single treatment. This is due to the natural production of new collagen. Results can last up to five years, depending on the individual.

Ear Pinning - Otoplasty or Pinnaplasty

Around 1,200 adults and children have their ears altered with plastic surgery each year. Known officially as otoplasty or pinnaplasty, the operation can prove a huge boost for the people who suffer from sticking-out ears.

What is it?

Otoplasty is any surgery that deals with the ears.

It's used to repair ears that have been damaged in accidents or deformed from birth. It can alter the size and shape of the lobes or other parts of the ear for cosmetic reasons-or in the case of ear pinning, the most common operation, bring sticking out ears closer to the head.

What can it do for you?

Otoplasty can dramatically boost your confidence. People who have a thing about their ears find it overrides their entire thinking. But with surgery they can make their ears fit their perfect image.

The 'perfect' ear tends to stick out exactly 17mm from the side of the head and that's what surgeons aim for when pinning ears back.

The procedure

Ears stick out because they lack something called the antihelical crease, which normally pulls the ear flatter to the head.

During surgery we cut the skin behind the ear to expose the cartilage, then gently scratch it. This scores a line, which then creates this crease.

To see what this means, push a non-sticking-out ear forward with your fingers. You'll notice that the crease just by the hard bit in the middle of the ear disappears and the ears 'stick out'. The crease is your antihelical and that's what's created during ear surgery.

Cost

Ear pinning is free on the NHS for children in most parts of the UK. If you choose to have the operation carried out privately, expect to pay £2,000-£2,500.

Recovery time

You'll spend two to three days with throbbing ears and will probably need painkillers to tackle the discomfort. Your ears will also be bandaged tightly during this time - the bandaging should remain in place for five to seven days.

After this, you'll also need to wear a night support bandage for up to four weeks to stop the ears kinking on the pillow while you sleep.

Ideally, adults should book a week off work. Most surgeons recommend that children should have at least this amount of time off school to avoid the possibility of any damage being caused by playground incidents.

What can go wrong?

As ear surgery is usually performed under general anaesthetic, particularly for children, it carries the normal concerns related to such procedures.

Other than that, it's very uncommon for serious side effects to occur during this operation. The biggest risk is that the operation doesn't take and the ear 'pings' back out. This happens in around eight per cent of cases and the operation then needs to be repeated.

The other problem that can occur is people having the wrong operation in the first place. If it's the size of your ears that upsets you, altering the angle at which they protrude won't help.

Make sure you know exactly what it is about your ear that upsets you and be sure to tell your surgeon so that they can find the best solution to your problem.

How long does it last?

Assuming you aren't one of the eight per cent mentioned above, this is a one-off deal. Once the operation is done, the ears are fixed for life.

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