Forehead
Younger, no expression wrinkles
Forehead fillers are used for reducing the appearance of facial lines. Is an anti-aging treatment to reduce wrinkles, target fine lines and for facial contouring.
It depends on the shape of your forehead and what results we are trying to achieve.
Fortunately, dermal fillers work very quickly, and you won’t have to wait twelve months to see the full benefits of your injections. That said, these injectable treatments take some time to integrate into your tissues, and it’s normal for your dermal filler to take up to two weeks to fully settle into your face.
Dermal filler doesn’t ‘normally’, move after treatment. Immediately after treatment, in certain areas of the face, I do gently massage the area/s that were injected to help mold the product and prevent lumps. It does take about 2 weeks for the filler to settle and integrate into the tissue.
NATURE AND SCOPE OF THE TREATMENT
The dermal fillers, from the medical and aesthetic point of view, can be used for corrections, such as: face asymmetries, wrinkles, filling lines, correcting lip ptosis. Dermal fillers are used to correct volume loss, shape, contour and reduce the appearance of fine and/or deep lines.
PROCEDURE & PRODUCT
The procedure consists of implanting the appropriate product in the subcutaneous areas. For this purpose a CE approved medical device shall be used. The product contains hyaluronic acid, cross-linked agent for hyaluronic acid, may contain sodium chloride and water for injection purposes.
The doctor shall inform you at the consultation regarding the product composition and meaning and health implications of each compound.
PROCEDURE STEPS
The Consultation aims to discuss the procedure in detail, including past medical history, risks, expectations, alternative treatments, quantity needed and any other information about the procedure. All your questions will be answered and please feel free to ask anything so that you fully understand the procedure. If you are deemed suitable for the procedure, considering your medical history, then you will be given as much time as you need for making a decision whether you would like to proceed with the treatments (Patient Time for Reflection “Cooling Off”).
Please note that even if you decide to proceed with the treatment, after your time for reflections, you can choose to stop the procedure at any time, if you do not feel comfortable or if you do not believe it is in your best interest to proceed.
BEFORE THE PROCEDURE RECOMMENDATIONS
Before the Procedure the following activities are forbidden: alcohol use for a period of minimum 12 hours, inform us if you are using medication, aminoglycosides, spectinomycin or any medicine that interferes with the neuromuscular system, or with blood clotting or skin. Please try to have a full breakfast in the morning of the procedure.
Injecting the product is contraindicated in the following situations: sun exposure, smoking, pregnancy and breastfeeding, certain medication for blood, muscles, skin or for psychological disorders, individuals with hypersensitivity to any of the compounds of the product, autoimmune diseases, leukemia, infectious diseases, blood clotting problems, infectious diseases, herpes, acne, unhealed skin problems, individuals with complications after surgeries or with permanent products injections (silicon, acrylic polymers, dextran), untreated infectious peridontitis, severe myasthenis, multiple sclerosis, Lamberton-Eaton syndrome, ALS, Parkinson or any other diseases that affect the muscles, blood or skin.
DURING THE PROCEDURE
Before the procedure, the agreed areas will be marked and discussed with the patient, afterwards the area is cleaned and disinfected, with the targeted area isolated. Multiple sessions may be required to achieve the desired outcome, the doctor shall inform you on this aspect. Once localised, the product is then injected. Once the agreed quantity has been injected the area may be massaged, if needed, to spread the product which will create a softer and more comfortable feel. There is no need to massage the area again once this is done, and it is not recommended at all to do so after the procedure, unless the doctor specifies this in the post-op care you will receive.
The patient is then able to view the results. Results after the procedure are not final due to potential swelling and other body reactions. The final results will begin to appear after 1 to 3 weeks.
In any case, top-ups may be required.
RISKS & SIDE EFFECTS
Every procedure involves a certain amount of risk and it is important that you understand these risks and the possible complications associated with them. In addition, every procedure has limitations. An individual’s choice to undergo this procedure is based on the comparison of the risk to potential benefit. Even though Hyaluronic Acid is a natural component of the body, with injecting it there is a small possibility to provoke a body response as if the molecule was a foreign body. Usually, such reactions are temporary, but in very rare cases they are permanent and require melting of the filler. The possibility of additional risk factors or complications attributable to the use of hyaluronic acid filler as a soft tissue filler may be discovered, but highly unlikely. In general, side effects occur within the first few days following injection. They usually last only for a short time, but they may last for several months and in rare cases, longer. The quality of the clinical outcomes of the treatment cannot be evaluated apriori, and precise guarantees cannot be given about the result obtainable with this treatment, since the response and the individual conditions may be essential in determining the clinicalresponse of the treated patient. Among the risks and side effects of the procedure include bruising, infection, swelling, pain, needle marks, acne like skin eruptions, skin sensitivity, erythema (skin redness) andasymmetry. These risks are usually temporary and solved on their own. If the asymmetry is not corrected on itsown, touch-ups may be required, with a risk of under/ over correction. The less likely risks include migration of filler, skin lumpiness, bleeding, visible tissue filler material, granulomas and unsatisfactory results. Some very unlikely risks are severe complications, damage to the deeper structures, leakage of filler material, skin necrosis, open or draining wounds, healing problems, allergic reactions, hypersensitivity, drug and local anaesthetic reactions, depigmentation, venous thrombosis (clot) and sequelae, fat/air embolism, persistent swelling (lymphedema), antibodies to fillers, accidental intra-arterial injection, scarring. Unforeseen risks may require hospitalisation and/or extended outpatient therapy to permit adequate treatment.
AFTER THE PROCEDURE
The practitioner/doctor will inform you on the post-op recommendations, what to expect in terms of healing process, and answer any questions that you might have. After the Procedure the following activities are forbidden, for at least 3 weeks in most cases: manipulating the area(s) of injection, alcohol use, exposure to sun or other types of radiations, extreme temperatures (such as hot/cold showers, sauna, etc), using products for skin that are not recommended by the doctor for the area undergoing the procedure, makeup (may be not recommended for a period of time), any movements or actions of/on the area that can affect or traumatize the area (such as massaging the area, hitting, procedures or treatments on the area unless previously being assessed and deemed suitable by a healthcare practitioner).
There may be some swelling and bruising post procedure whichis a normal reaction, if any concerns please contact the Dr Ducu London team. Dr. Ducu London team will always keep in contact with you to ensure you are well and for any enquires please feel free to contact us any time.
The dermal fillers, from the medical and aesthetic point of view, can be used for corrections, such as: face asymmetries, wrinkles, filling lines, correcting lip ptosis. Dermal fillers are used to correct volume loss, shape, contour and reduce the appearance of fine and/or deep lines.
PROCEDURE & PRODUCT
The procedure consists of implanting the appropriate product in the subcutaneous areas. For this purpose a CE approved medical device shall be used. The product contains hyaluronic acid, cross-linked agent for hyaluronic acid, may contain sodium chloride and water for injection purposes.
The doctor shall inform you at the consultation regarding the product composition and meaning and health implications of each compound.
PROCEDURE STEPS
The Consultation aims to discuss the procedure in detail, including past medical history, risks, expectations, alternative treatments, quantity needed and any other information about the procedure. All your questions will be answered and please feel free to ask anything so that you fully understand the procedure. If you are deemed suitable for the procedure, considering your medical history, then you will be given as much time as you need for making a decision whether you would like to proceed with the treatments (Patient Time for Reflection “Cooling Off”).
Please note that even if you decide to proceed with the treatment, after your time for reflections, you can choose to stop the procedure at any time, if you do not feel comfortable or if you do not believe it is in your best interest to proceed.
BEFORE THE PROCEDURE RECOMMENDATIONS
Before the Procedure the following activities are forbidden: alcohol use for a period of minimum 12 hours, inform us if you are using medication, aminoglycosides, spectinomycin or any medicine that interferes with the neuromuscular system, or with blood clotting or skin. Please try to have a full breakfast in the morning of the procedure.
Injecting the product is contraindicated in the following situations: sun exposure, smoking, pregnancy and breastfeeding, certain medication for blood, muscles, skin or for psychological disorders, individuals with hypersensitivity to any of the compounds of the product, autoimmune diseases, leukemia, infectious diseases, blood clotting problems, infectious diseases, herpes, acne, unhealed skin problems, individuals with complications after surgeries or with permanent products injections (silicon, acrylic polymers, dextran), untreated infectious peridontitis, severe myasthenis, multiple sclerosis, Lamberton-Eaton syndrome, ALS, Parkinson or any other diseases that affect the muscles, blood or skin.
DURING THE PROCEDURE
Before the procedure, the agreed areas will be marked and discussed with the patient, afterwards the area is cleaned and disinfected, with the targeted area isolated. Multiple sessions may be required to achieve the desired outcome, the doctor shall inform you on this aspect. Once localised, the product is then injected. Once the agreed quantity has been injected the area may be massaged, if needed, to spread the product which will create a softer and more comfortable feel. There is no need to massage the area again once this is done, and it is not recommended at all to do so after the procedure, unless the doctor specifies this in the post-op care you will receive.
The patient is then able to view the results. Results after the procedure are not final due to potential swelling and other body reactions. The final results will begin to appear after 1 to 3 weeks.
In any case, top-ups may be required.
RISKS & SIDE EFFECTS
Every procedure involves a certain amount of risk and it is important that you understand these risks and the possible complications associated with them. In addition, every procedure has limitations. An individual’s choice to undergo this procedure is based on the comparison of the risk to potential benefit. Even though Hyaluronic Acid is a natural component of the body, with injecting it there is a small possibility to provoke a body response as if the molecule was a foreign body. Usually, such reactions are temporary, but in very rare cases they are permanent and require melting of the filler. The possibility of additional risk factors or complications attributable to the use of hyaluronic acid filler as a soft tissue filler may be discovered, but highly unlikely. In general, side effects occur within the first few days following injection. They usually last only for a short time, but they may last for several months and in rare cases, longer. The quality of the clinical outcomes of the treatment cannot be evaluated apriori, and precise guarantees cannot be given about the result obtainable with this treatment, since the response and the individual conditions may be essential in determining the clinicalresponse of the treated patient. Among the risks and side effects of the procedure include bruising, infection, swelling, pain, needle marks, acne like skin eruptions, skin sensitivity, erythema (skin redness) andasymmetry. These risks are usually temporary and solved on their own. If the asymmetry is not corrected on itsown, touch-ups may be required, with a risk of under/ over correction. The less likely risks include migration of filler, skin lumpiness, bleeding, visible tissue filler material, granulomas and unsatisfactory results. Some very unlikely risks are severe complications, damage to the deeper structures, leakage of filler material, skin necrosis, open or draining wounds, healing problems, allergic reactions, hypersensitivity, drug and local anaesthetic reactions, depigmentation, venous thrombosis (clot) and sequelae, fat/air embolism, persistent swelling (lymphedema), antibodies to fillers, accidental intra-arterial injection, scarring. Unforeseen risks may require hospitalisation and/or extended outpatient therapy to permit adequate treatment.
AFTER THE PROCEDURE
The practitioner/doctor will inform you on the post-op recommendations, what to expect in terms of healing process, and answer any questions that you might have. After the Procedure the following activities are forbidden, for at least 3 weeks in most cases: manipulating the area(s) of injection, alcohol use, exposure to sun or other types of radiations, extreme temperatures (such as hot/cold showers, sauna, etc), using products for skin that are not recommended by the doctor for the area undergoing the procedure, makeup (may be not recommended for a period of time), any movements or actions of/on the area that can affect or traumatize the area (such as massaging the area, hitting, procedures or treatments on the area unless previously being assessed and deemed suitable by a healthcare practitioner).
There may be some swelling and bruising post procedure whichis a normal reaction, if any concerns please contact the Dr Ducu London team. Dr. Ducu London team will always keep in contact with you to ensure you are well and for any enquires please feel free to contact us any time.
Important Background to the Consent Process
Your clinician wishes to help you make an informed decision about your treatment options and any relevant alternative options. You may at any time decline treatment even after giving your consent.
Whilst your clinician will make every effort to understand what significance you would attach to any particular risk it is important to us that you feel comfortable enough to question the clinician on any point of concern during this process. Please feel you have as much time as you wish to reflect on the information given before agreeing to proceed with the treatment.
Purpose of Treatment
You have presented with concerns which have formed the basis of a clinical discussion and examination. The purpose of the proposed treatment is to address your concerns either individually or in combination with other modalities of treatment.
Outcomes
Your clinician will endeavour in good faith to employ the principles of best practice in delivering your treatment. Each patient is individual and response to treatment will vary from patient to patient and treatment to treatment. As such it is difficult to guarantee outcomes will always meet your expectations.
Background Information
Bo.tox is a purified protein of the toxin normally produced by Clostridium botulinum. Wrinkles and fine lines develop over time by the repeated contraction of facial muscles. By injecting Bo.tox precisely in these specific muscles, the nerve impulse traveling to the muscle is blocked. This blockage prevents contraction, therefore relaxing the muscles. Typically, you will see an improvement in the appearance of those fine lines and wrinkles within 1 week following treatment, the maximum effect being observed 5 to 6 weeks after injection. The treatment effect can be seen for up to 4 months after injection. Your clinician will be available to review your treatment to ensure that optimum results have been achieved.
Commonly Experienced Adverse Events
Redness or bruising at the injection site
Headache
Ptosis- Drooping of the eyelid
Localised muscle weakness
Facial Pain
Skin Tightness (when treating sites additional to the forehead)
Less Common Risks
Muscular motor dysfunction
Infection
Anxiety
Numbness/Dizziness
Disturbances of the eye
Swelling
Nausea
Muscle twitching
Fever/Flu manifestations
Pain/Bleeding/Numbness/Tingling at injection site
Eye Brow drooping
Breathing difficulties and death have been reported in patients that have received high doses in unusual (non-aesthetic) applications
Important Considerations
Every care is taken to deliver the products in a manner which will minimise risk, however you should be aware of the risks, as one may exist upon which you place particular significance.
Patients are advised to take in to account all these potential risks before consenting to treatment. Please make your clinician fully aware of your expectations prior to giving consent.
Safety Profile
Bo.tox treatment for the conditions which have been discussed with your clinician today has been well studied over the last 40 years and no special hazard has been observed in humans except in high doses.
Contraindications and Relative Contraindications to Treatment
Allergy to botulinum toxin type A, Human albumin, or sodium chloride (salt)
Infection at site of injection
If you are pregnant, or breastfeeding
Have ever suffered from a disease which affects your muscles or nervous system, or have any other known muscular or neuromuscular issues
Inflammation in the muscle or skin to be injected
Any active disease of the cardiovascular system (please discuss with your clinician prior to commencing treatment)
Previous history of seizures
Closed angle glaucoma or risk of developing closed angle glaucoma
You plan to undergo an operation soon
Limited or no clinical data exists regarding the efficacy and tolerance of this treatment in patients having a history of, or currently suffering from, auto-immune disease or auto-immune deficiency or being under immunosuppressive therapy. The clinician shall therefore decide on the indication on a case by case basis according to the nature of the disease and its treatment and the need for monitoring post-treatment. Your clinician will discuss the need for a preliminary skin testing for hypersensitivity if necessary, or in the case of patients with severe or multiple allergies. Patients on coagulation medication or other substances known to increase coagulation time must be aware of the potential increased risk of bleeding and haematoma during and following treatment.
Your clinician will also discuss the suitability of treatment having considered your medical history and any medications you currently take, as appropriate. As such, it is imperative you disclose such medications at the time of your treatment.
Additional Information
Your clinician will discuss with you strategies we may employ to minimize pain during the procedure, such as the use of topical anaesthetics or ‘cold applications’. Please advise your clinician if you have an allergy to, or have ever had a reaction to, any such anaesthetic.
Post Treatment
Exercise should be avoided for 4 hours after treatment, and the area should not be massaged for three days. You should remain in an upright position for 4 hours following treatment to limit the spread of substance at the injection site. There is particular risk of eye lid or eyebrow complications should you have pressure on the area treated such as placing your face in the breathing hole on a physio or massage couch. This should be avoided for at least 2 weeks.
Your clinician wishes to help you make an informed decision about your treatment options and any relevant alternative options. You may at any time decline treatment even after giving your consent.
Whilst your clinician will make every effort to understand what significance you would attach to any particular risk it is important to us that you feel comfortable enough to question the clinician on any point of concern during this process. Please feel you have as much time as you wish to reflect on the information given before agreeing to proceed with the treatment.
Purpose of Treatment
You have presented with concerns which have formed the basis of a clinical discussion and examination. The purpose of the proposed treatment is to address your concerns either individually or in combination with other modalities of treatment.
Outcomes
Your clinician will endeavour in good faith to employ the principles of best practice in delivering your treatment. Each patient is individual and response to treatment will vary from patient to patient and treatment to treatment. As such it is difficult to guarantee outcomes will always meet your expectations.
Background Information
Bo.tox is a purified protein of the toxin normally produced by Clostridium botulinum. Wrinkles and fine lines develop over time by the repeated contraction of facial muscles. By injecting Bo.tox precisely in these specific muscles, the nerve impulse traveling to the muscle is blocked. This blockage prevents contraction, therefore relaxing the muscles. Typically, you will see an improvement in the appearance of those fine lines and wrinkles within 1 week following treatment, the maximum effect being observed 5 to 6 weeks after injection. The treatment effect can be seen for up to 4 months after injection. Your clinician will be available to review your treatment to ensure that optimum results have been achieved.
Commonly Experienced Adverse Events
Redness or bruising at the injection site
Headache
Ptosis- Drooping of the eyelid
Localised muscle weakness
Facial Pain
Skin Tightness (when treating sites additional to the forehead)
Less Common Risks
Muscular motor dysfunction
Infection
Anxiety
Numbness/Dizziness
Disturbances of the eye
Swelling
Nausea
Muscle twitching
Fever/Flu manifestations
Pain/Bleeding/Numbness/Tingling at injection site
Eye Brow drooping
Breathing difficulties and death have been reported in patients that have received high doses in unusual (non-aesthetic) applications
Important Considerations
Every care is taken to deliver the products in a manner which will minimise risk, however you should be aware of the risks, as one may exist upon which you place particular significance.
Patients are advised to take in to account all these potential risks before consenting to treatment. Please make your clinician fully aware of your expectations prior to giving consent.
Safety Profile
Bo.tox treatment for the conditions which have been discussed with your clinician today has been well studied over the last 40 years and no special hazard has been observed in humans except in high doses.
Contraindications and Relative Contraindications to Treatment
Allergy to botulinum toxin type A, Human albumin, or sodium chloride (salt)
Infection at site of injection
If you are pregnant, or breastfeeding
Have ever suffered from a disease which affects your muscles or nervous system, or have any other known muscular or neuromuscular issues
Inflammation in the muscle or skin to be injected
Any active disease of the cardiovascular system (please discuss with your clinician prior to commencing treatment)
Previous history of seizures
Closed angle glaucoma or risk of developing closed angle glaucoma
You plan to undergo an operation soon
Limited or no clinical data exists regarding the efficacy and tolerance of this treatment in patients having a history of, or currently suffering from, auto-immune disease or auto-immune deficiency or being under immunosuppressive therapy. The clinician shall therefore decide on the indication on a case by case basis according to the nature of the disease and its treatment and the need for monitoring post-treatment. Your clinician will discuss the need for a preliminary skin testing for hypersensitivity if necessary, or in the case of patients with severe or multiple allergies. Patients on coagulation medication or other substances known to increase coagulation time must be aware of the potential increased risk of bleeding and haematoma during and following treatment.
Your clinician will also discuss the suitability of treatment having considered your medical history and any medications you currently take, as appropriate. As such, it is imperative you disclose such medications at the time of your treatment.
Additional Information
Your clinician will discuss with you strategies we may employ to minimize pain during the procedure, such as the use of topical anaesthetics or ‘cold applications’. Please advise your clinician if you have an allergy to, or have ever had a reaction to, any such anaesthetic.
Post Treatment
Exercise should be avoided for 4 hours after treatment, and the area should not be massaged for three days. You should remain in an upright position for 4 hours following treatment to limit the spread of substance at the injection site. There is particular risk of eye lid or eyebrow complications should you have pressure on the area treated such as placing your face in the breathing hole on a physio or massage couch. This should be avoided for at least 2 weeks.
Gallery
The pictures are from the patients' personal archives
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