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The word 'fillers' can conjure up all sorts of preconceived ideas of faces looking not quite right or overdone. Volume loss in our faces is a fundamental component of facial ageing and this happens due a variety of reasons including fat redistribution, skin laxity and skeletal changes in our faces. Dermal fillers are not to be feared..they are a great way to enhance your beauty by replacing volume in a subtle and natural looking way... however choosing your injector wisely is essential as a good anatomical knowledge is needed alongside a thorough consultation so you are fully informed and educated in the process.


In this blog I'm going to address dermal fillers really try and breakdown the stigma and mis-information about them. I'm going to try and answer some of the most common questions I get asked in clinic during consultations.


WHAT ARE DERMAL FILLERS?


The most commonly used dermal fillers are biodegradable Hyaluronic acid fillers. These products contain hyaluronic acid which is a naturally occurring component in the skin. They attract and holds water to provide hydration, structure and volume to our skin. As we age the levels of hyaluronic acid in our skin declines. HA dermal fillers draw more water into the skin, so plump and more youthful, hydrated skin can be achieved.


WHAT IS THE DIFFERENCE BETWEEN BOTOX AND FILLERS?


Dermal Filler is made with Hyaluronic Acid to hydrate and add volume. It works by plumping fine lines and wrinkles and adding fullness to areas that are thinned due to ageing. The most common indications of dermal fillers is the restoration /addition of volume or a lifting effect to areas of your face that has depleted volume. Injection of areas of less volume can not only improve directly but also create a positive effect to areas distant to the injection site. They can restore volume or enhance areas of the face like cheekbones and lips. HA fillers are not permanent and can be dissolved.


Botulinum Toxin temporarily freezes the muscle. It works by temporarily weakening the underlying muscles and so smoothes the appearance of fine lines and wrinkles caused by ageing and facial expressions. Popular areas include crow's feet and frown lines. It's not permanent – it usually lasts for around 3 or 4 months.


WHAT ARE THE BENEFITS OF FILLER? I'M SCARED I WON'T LOOK NATURAL!

As we age, we lose volume in key areas of the face. This contributes to folds, wrinkles, developing and an older appearance to the face. Fillers can be used to restore this volume loss, smooth out folds and wrinkles, and improve contours to achieve natural results without altering your facial expression. When fillers are used in the appropriate amount and placed in the right location, the result is a natural, age appropriate and holistic outcome. Fillers are not meant to create totally different features. In the hands of an experienced provider that has extensive knowledge of facial anatomy, the outcome simply enhances your own facial features.



HOW MUCH DERMAL FILLER DO I NEED? AND HOW MUCH WILL IT COST?


Probably the most common questions asked! These questions can be answered after a detailed consultation. CONSULTATION IS KEY. Important factors will include... the type of filler needed? the indication of the filler, the depth of the injection, amount of correction needed. I always say to my patients that facial enhancement is a journey and treatment plans are always evolving according to needs and budget. In my opinion if your considering dermal filler treatment, most patients will benefit from replacing lost cheek volume. This not only enhances the mid face, but it also improves the appearances of the 'nose to mouth lines' and helps support structure around your eyes... and also helps to lift your lower face. This statement is obviously subject to individual facial assessment and consultation.


I will aim to give you an honest answer and it may be that we do your treatment in stages, say a month apart. Patients can sometimes get shocked when we say 6ml or 4mls or 2mls to reach your desired goal.. but it's important to remember that 1ml of filler is actually a 1/5 of a teaspoon. Having said that strategically placed fillers in small amounts can give maximum benefits. So generally your paying for the skill not the ml!



ARE THE RESULTS PERMANENT?

No, the result is temporary, and can last between 3-18months, depending on which product used, which facial area treated, and your body’s ability metabolise the injected material. Over time, you will notice the results of the treatment begin to fade, gradually returning your appearance to its pre-treatment state. Many patients undergo regular touch-up injections in order to maintain their rejuvenated appearance.

WHAT IF I DON'T LIKE THE RESULTS?

It would be unlikely as I only inject small amounts of product in at a time and I always let you share the journey. You are involved in the process throughout and your input is very important. Remember the dermal filler is not permanent and will gradually dissolve.

WHICH FILLER DO I NEED?

The choice of filler depends on the individual patient, your treatment goals, and personal facial anatomy...so it really depends. My products of choice are from Teoxane, Juvederm and Belotero ranges. Each range has its own portfolio of products used in different areas of the face with different thicknesses and properties. Consultation is essential as different fillers have varying thickness are suitable for different areas of the face.




ARE THERE ANY RISKS, SIDE EFFECTS AND DOWN TIME?


We understand the benefits of dermal filler now, but if I decide the risks outweighs the benefits the treatment should not be done.

  • Injection-related reactions: these reactions may include redness at the injection site immediately after the treatment.

  • Bruising: occasionally bruising can occur. However the use of micro-cannula (blunt needle) dramatically reduces the risk of bruising.

  • Contour irregularities can and do occasionally occur. Massaging can usually smooth out any ‘lumpiness’ however if persistent the filler can be easily and rapidly dissolved.

  • Infection – as with all injections, this procedure carries a risk of infection. The syringe is sterile and standard precautions associated with injectable materials are taken.

  • Necrosis – one of the worst possible complications of dermal filler. Fortunately, this is extremely rare. It happens when the dermal filler is accidentally injected into a blood vessel and it subsequently blocks the blood supply to the skin/tissue in that area. If that does happen, rest assured a reversal drug can be administered on site to dissolve the filler.

Well I hope this answers some of your concerns and questions:) As long as your informed and consented, dermal fillers are not to be feared.


With Love,


Dil x


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Hello everyone! Today we are going to talk about new vitamin A product available here via The Medished. So let’s remind ourselves what Vitamin A actually is ..well it’s an important ingredient to target skin health. It reduces and prevents the appearance of fine lines, boosts collagen production, helps to clear breakouts and improves skin tone and texture. It's a must have skin ingredient in your night-time routine.


RETIVANCE is Obagis' new Vitamin A product by Dr Susan Obagi who is a world renown dermatologist and plastic surgeon practicing in the US who has released her own micro range of products with Obagi. She is the daughter of Beverly Hills based dermatologist Dr. Zein Obagi... I mean how brainy is this family.. imagine the dinner table chat! The main focus of this particular product is for active ingredients BUT with purposeful exclusions.



Who is this product great for?


This product is for the patient who is conscious of reducing their chemical load on both their skin and the environment. Its also great for patients who want to use something stronger than a 1% retinol. Retivance really has active ingredients that work.. but with less irritation, less down time and less environmental and chemical exposure. It contains no sulphates or parabens as well as being an advanced form of antiageing.


So with that in mind it is suitable for ANY skin type, whether you have normal/oily or all the way up to sensitive skin including eczema, psoriasis and dermatitis. This makes it a very unique Vitamin A product. This product is STRONGER THAN A RETINOL and closer to a tretinoin, but with a lower irritation profile. It contains retinaldihyde which is a precursor to retinoic acid (the strongest form of vitamin A) which apparently works 11 times faster than retinol! Retinaldehyde thou still a bit rare in many skin care lines. IT'S NOW AVAILABLE WITH OBAGI!

  • it's great for texture

  • it's for reducing fine lines and wrinkles

  • it improves pigmentation

  • it softens your skin


Why should I try this if I'm already using Retinol?


Good question! So this product does have a higher price point of £165 but..it's a 3 IN 1 hero product containing:

  1. Retinaldehyde

  2. Peptides

  3. Antioxidants

It feels really luxurious when applied on your skin.. like silk as it has fatty acids, so while the Vitamin A is rejuvenating it's also very calming and moisturising on the skin. This product is different from other Vitamin A products as it's more powerful than a 1% retinol but with no downtime. This is perfect for even more sensitive skins and for people wanting to step up from a retinol as the results are way better!


ACTIVE INGREDIENTS BUT WITH PURPOSEFUL EXCLUSIONS! It's a winner here at The Medished! If you feel this is good product for you don't hesitate to get in touch.


With love,


Dil x

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Updated: Jan 9, 2021


While The Medished is closed for face to face appointments in line with government guidance, I thought I'd send out some educational content of interest.


Looking for a way to help your skin improve appearance in an uncertain time..? Look no more! The power of a chemical peel should not be underestimated. Many patients dread the words "chemical" and "peel". In this blog I will explain all and demystify chemical peels.

(Medical grade skincare can be delivered to your door).


THE SCIENCE


A chemical peel is a treatment used to improve skin texture and tone. A particular group of acids are applied to the skin to lower the pH, which then loosens the connections between dead skin cells. This process causes exfoliation and then stimulates new cell growth.

This process causes superficial layers of dead skin to peel off, revealing a smoother and more radiant complexion. Another fantastic result is that peels can thicken the top layer of skin, increase dermal volume and stimulate collagen. There are 3 basic types of chemical peels; superficial, medium depth, deep peel.


Here at The Medished I tend to use superficial or medium depth peels... however in my honest opinion if you commit to a course of 3 superficial peels one a month and combine with effective targeted home care...you WILL get good results. A superficial or light chemical peel will work on the epidermis.

Our skin sheds naturally, approximately every…

28-45 days in individuals ages 30-40

45-60 days in individuals ages 40-50

60-90 days in individuals ages 50-60


BENEFITS


  • Improved skin texture and firmness

  • Decreased fine lines and wrinkles

  • Improved acne-prone skin

  • Reduced appearance of pore size

  • Improved hyperpigmentation


THE JOURNEY


Consultation is KEY so time is spent discussing expectations with my patients. This includes a realistic idea of results, how many might be needed to achieve desired outcomes, and also downtime. Many of my demographic of patients don't want too much downtime. They want an instant glow with long lasting results... but hey that's cool as we are all so busy! Some form of guided pre-peel prep by me is needed hence don't try this at home! as you could cause chemical burns and hyperpigmentation. I tend to advise a minimum course of 3 superficial chemical peels.



SPOTLIGHT! AlphaRet Pro Peel 30 by SkinBetter


Let's talk about my current favourite chemical peel. The Alpharet Pro Peel 30 has the Power Of AlphaRet® in professional peels!

The Concern: Mildly photo damaged skin including signs of skin ageing and skin blemishes

The Science: Patented retinoid, AlphaRet and Triple acid (glycolic, lactic and salicylic acids)

The Benefit: An in clinic complement to a medical grade skincare regime to improve the overall skin tone and texture for patients with mild photodamage.

A course of 3 Peels recommended ...one peel every 4 weeks.



WHAT HAPPENS BEFORE, ON THE DAY AND AFTER MY APPOINTMENT?


  1. A 30 minute consultation regarding your skin and any other treatment

  2. Photographs of your face

  3. Patient Consult and Consent form will be signed

  4. I will instruct you to eliminate specific skincare products a few days prior to the peel, especially VITAMIN A products

  5. On the day your skin will be cleansed, prepped and peel applied

  6. Peel will be removed and skin cleansed.

  7. Alto Defense Serum & Trio Rebalancing Moisture Treatment applied for the SBS peel

  8. Sunscreen Applied 

  • Use non-comedogenic makeup post peel where possible

  • AVOID exercise post peel

  • AVOID Retinol/Retinoid based products 3/5 days post peel

  • AVOID chemical or mechanical exfoliation 3/5 days post peel

  • AVOID use of all heat sources: steam/saunas that day

  • SPF30 of higher essential daily 



Hope that's been informative, if your interested in trying some (almost as good as) in clinic peels/products whilst your safe at home don't hesitate to contact me and I can pop you on a tailor-made program suitable for you!


With love



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