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Smoothing Lines & Wrinkles

"Our clinic's work reflects the rigorous German ethic - honest and high quality with creative attention to detail and an emphasis on safety. Realistic and never overdone." Dr Stefanie, MD, Dermatologist®

smoothing-lines-and-wrinklesOne of the three key areas of non-invasive Aesthetic Dermatology is smoothing facial lines and wrinkles. There are three different types of facial wrinkles which each largely determine the kind of treatment.

Firstly, 'dynamic lines' (or 'mimic lines') are caused by the contraction of underlying muscles. They include 'frown lines' (glabella lines) between the eyebrows, 'worry lines' on the forehead, 'bunny lines' on the nose and 'crow's feet' at the outer eye corners.

The second group, 'static lines', are independent of muscular movement. They can develop on their own ('primary static lines') or from long-established dynamic lines ('secondary static lines').

Lastly, gravitational folds are usually deeper furrows resulting from a combination of loss of volume and gravitation. A prime example of these are nasolabial folds running from your nose to the corners of your mouth. What happens is that as we get older, our faces tend to lose fat and first to go are the fat pads in our cheeks. This loss of volume leads to an envelope of loose skin which gravitation pulls downwards - hence the folds.

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Botulinum toxin (BTX), often referred to as 'botox' after its first brand name, is a substance that, when injected into a muscle, will temporarily stop it contracting. This is why BTX is an excellent treatment for dynamic facial lines. It has been used in cosmetic treatments for more than 25 years now and in the right hands is a safe and highly effective non-surgical solution for certain types of wrinkles. The great thing about cosmetic BTX is that it works at the root cause of dynamic lines by preventing the muscle from doing the very over-movement that has caused the problem in the first place. For this reason, botulinum toxin also plays a useful wrinkle-prevention role in people who tend to over-use certain facial muscles.
It takes on average five days for the effect to start kicking in. The effect on the muscle is fully reversible and lasts about three to six months and patients usually come for top-ups two to four times per year. However, many patients report that in time the intervals between clinic visits get longer, as the muscles seem to 'learn' not to do that wrinkle-causing over-movement so much. We are essentially re-training your muscles.

Good indications for BTX treatment include for example 'crow's feet', 'frown lines' between the brows, 'worry lines' across the forehead and ‘bunny lines’ on the nose. We can also treat so-called ‘turkey neck’ strands on the neck, perform a gentle, non-surgical brow lift with botulinum toxin and soften the downward pull of the corners of your mouth, so you lose that grumpy look.

It's important to know that for BTX to be optimally effective, you should start treatment when the line is still dynamic and not yet static. You can test this in the mirror by stretching the wrinkle between two fingers. If it disappears completely, it's still dynamic and easily treated with BTX. But if stretching the skin only softens the line, then it's starting become static and additional treatment may be needed. In these cases we can offer a filler or HA skin boosters as a follow-up treatment two weeks after BTX.

In our clinic we use both traditional Botox® (also marketed as Vistabel® for cosmetic purposes) and a new generation botulinum toxin, called Bocouture® (which is the same as Xeomin®). This a purified form of botulinum toxin, developed in Germany.

BTX treatment can be done in different ways. It can be administered in comparatively high doses that ‘freeze’ movement completely, but this looks unnatural and we don’t advocate that here at Eudelo. Alternatively, lower (‘baby botox’) doses of BTX soften movement without freezing muscles completely. This low dose can be delivered via a series of multiple tiny injections at certain points all over the face – the ‘sprinkle botox’ method. If we lower the dose even more, you get ultra-low-dose ‘meso botox’. We prefer these low-dose BTX regimes at Eudelo. We want to normalize hypermobile muscles and want you to retain your natural facial movements. It’s that ‘no-one would know you’ve had botox’ look.

Usually, injections with botulinum toxin only cause very mild discomfort, if any, and an anaesthetic cream isn't routinely needed - unless you really would prefer one. But rest assured, our practitioners have a gentle injection technique to maximise your comfort.

Fillers

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Dermal fillers are the main solutions we use for 'static lines' and 'gravitational folds'. They are injected directly beneath a line or fold to fill the depression it makes in the skin. There are countless fillers on the market and new ones are constantly being released. That's why it's so important to know which ones have the best safety records and give the best results.

Think of fillers as belonging to either 'permanent' or 'temporary' groups. Temporary fillers are preferable for several reasons. Firstly, our face changes with time and aesthetic treatments must be adjusted to keep pace with these changes. A permanent filler couldn't allow for this adjustment - you'd be stuck with it forever, like it or not! And while you may have been pleased with the initial result, it might look unnatural or out of place years down the line as your face ages further. The other reason is that scientific studies have shown that permanent fillers are associated with a higher risk of unwanted side effects and problems. For all these reasons, we only use gold standard non-permanent fillers containing hyaluronic acid. Hyaluronic acid fillers include for example Belotero, Juvederm and Restylane.

Hyaluronic acid (HA), also known as Hyaluronate, is an important physiological substance that all skin contains naturally. Its key roles are to maintain the plumpness and moisture that help keep the skin surface smooth and lifted. However, HA levels decline with age. We inject fillers containing sterile, transparent hyaluronic acid gel, which are degraded over time by your body's natural enzymes, just as happens with your natural hyaluronic acid. An extra advantage is that there is an 'antidote' for hyaluronic acid fillers - an enzyme called hyaluronidase. So, if for some reason you would like us to dissolve your filler, we can do that easily - not something you can say for other fillers.

Fillers can be used for all sorts of lines and wrinkles, from nose-to-mouth lines to superficial 'lipstick bleed' lines around the mouth. The effect is instantly visible, although there may be some temporary swelling and bruising. Occasionally we might need more than one session to obtain an optimal outcome. How long the effects last depends on the individual patient, their lifestyle, age and the areas injected. But they usually last around six to nine months. In certain areas of the face, such as when treating crow's feet, a filler will last longer in combination with botulinum toxin ('botox').

You'll also be pleased to hear that we offer several forms of effective pain prevention. Most of the fillers we use already contain a local anaesthetic. We also often use a very special cannula, which is less traumatic and tends to cause less discomfort and bruising than sharp, rigid needles. In most cases however, we will also apply an effective numbing cream. Our high-grade numbing cream is applied by one of our practitioners about an hour prior to your treatment, in order to numb the skin effectively and make your experience as pleasant as possible.

Skin Boosters

Bio-revitalisation with hyaluronic acid (HA skin boosters) is a great treatment for improving skin texture as well as softening fine lines. Here at Eudelo, we use a range of different skin boosters, depending on the individual’s skin, because not every skin is the same and has different needs.

Scientific studies have shown that skin boosters can not only enhance the visible appearance of the skin, but also improve its elasticity.

We also often use skin boosters with great results in the under-eye area, to gently plump the lips (‘Lip Feather Smoothie’), on the neck, the decolletage and the hands.

PRP & Exo Injections

As an alternative to hyaluronic acid skin boosters, Platelet Rich Plasma (PRP) and Exokine solution (Exo) can also injected to improve fine lines and skin elasticity.

PRP is a very natural treatment, as it uses the patient's own cells and growth factors to stimulate tissue repair, rather than injecting any synthetic substances. PRP encourages the skin to build more collagen and elastin and thus renew and rejuvenate itself. A PRP injection course consists of three to six treatment sessions in 2–4 week intervals.

Exokine can be seen as an advanced version of PRP, with higher levels of growth factors, plus antioxidant cytokines as an added benefit. The Exo solution we use at Eudelo delivers a much higher concentration of growth factors than PRP, as the patient’s blood is incubated for around six hours (in contrast, PRP is used straight away) prior to extracting the growth factors, which boosts levels significantly.

Unlike standard PRP, the Exo essence also includes a much wider variety of growth actors: this is achieved by not only harvesting growth factors from platelets, but from all the different types of cells in the patient’s blood. In addition, the Exo solution is completely cell-free, as all cells are removed from the growth factor solution prior to infusion. This is important, as certain types of cell contamination in the solution may cause an inflammatory response when injected into the skin. The Exo injection course consists of three to six treatment sessions in 2–4 week intervals.

The Eudelo Architect is a revolutionary non-surgical treatment package that results in a dramatic, yet completely natural and balanced rejuvenation of the entire face by combining four advanced, non-surgical treatment modalities, to address all the main signs of ageing including lines and wrinkles, sagging with decline of facial contours and impairment of skin quality.

When we are young, our facial skin is supported well by underlying structures such as facial bone and fat pads. Unfortunately, around mid-age, we start losing some of this useful scaffolding. Decline of supporting facial volume, plus gravity, will cause the overlying skin envelope to start sagging, leaving the entire face looking older and tired.

The Rolls-Royce of full-face treatments, the innovative Eudelo Architect has been devised based on our state-of-the-art understanding of facial balance, by assessing the entire face and its structure harmoniously, both static and in motion. Supporting the face structurally by strategically adding small aliquots of volume into key specific points, The Eudelo Architect improves the supporting scaffold of the face, making it appear more youthful, but in a completely balanced and natural way – nobody would ever know!

Completely tailored to each individual, The Eudelo Architect works gently to not only restore more youthful contours of the face, but also to soften lines and wrinkles (both dynamic as well as static) and tighten the skin non-surgically.

The treatment is made up of the following components:

  1. Full-face facial contouring – using a combination of gold standard injectable HA volumisers to work together in perfect concert.
  2. Eudelo SoundLift – using highly advanced simultaneous ultrasound visualisation and high-intensity, focused ultrasound to tighten and lift the skin non-invasively.
  3. Hyaluronic acid fillers and/or skin booster – to complete the treatment, soft hyaluronic acid fillers and/or skin boosters are injected into the skin to reduce lines and wrinkles.
  4. Full face botulinum toxin – using a Eudelo low-dose scheme to re-train non-advantageous facial movement patterns such as over-expressive frown muscles or depressor muscles, which pull the corners of the mouth downwards.
The Glow Architect, The Rolls-Royce of Aesthetic Treatments

Eudelo’s Glow Architect is an even more advanced, non-surgical treatment package that garners the greatest possible, yet completely natural and balanced looking rejuvenation of the entire face.

Combining different non-surgical treatment modalities, all working in concert, the Eudelo Glow Architect addresses all of the main signs of ageing including lines and wrinkles, deflation of facial contours, sagging, enlarging pores, crepey skin and irregular pigmentation. The Eudelo Glow Architect essentially combines the Eudelo Architect and the Eudelo MelaOut for a most comprehensive approach.

Decline of supporting facial volume and contours often comes along with skin quality and texture impairments, as well as irregular pigmentation, as we get older. Completely tailored to each individual, the Eudelo Glow Architect works gently to not only restore more youthful contours of the face and soften lines and wrinkles, but also retrain non-advantageous muscular movement patterns leading to mimic lines, as well as improve skin quality and texture, and dramatically soften irregular pigmentation.

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