You may have earned every line on your face. However, with the range of options currently available you can choose to live with wrinkles or you can choose to live without them.

Now, more and more people, men included, are turning to cosmetic rejuvenation techniques to help their face reflect the way they feel inside. This brochure provides an overview of the latest non-invasive techniques including injections, fillers, and chemical peels and provides information that you can use during consultation with your doctor to determine which treatment is right for you. Your doctor may offer additional treatments not listed in this brochure. Speak to your doctor to evaluate which treatment is right for your type of skin condition and expectation level.

Botox (botulinum toxin type A)

Botox is a natural, purified protein that relaxes wrinkle-causing muscles creating an improved appearance. Botox is a prescription only medicine and as such is only available from your doctor. It is registered for the treatment of glabellar frown lines which are the vertical lines that appear between your eyebrows when you frown. Many facial wrinkles occur when we make repeated facial expressions. Botox relaxes the facial muscle that cause expression lines. Once the muscle is relaxed, you cannot contract it and continue to make the undesirable facial expression. Thus the lines gradually smooth and new lines are prevented from forming.

This treatment relaxes the muscles that cause those lines to form and helps keep them relaxed for up to four months. Botox in is injected into selected facial muscles using a very fine needle. Discomfort is minimal and brief and no anaesthetic is usually required. After injection it takes 2 to 3 days for Botox to begin taking effect and around 7 days to see the full effect. The effect can last up to 4 months before lines slowly begin to return. If you have repeated treatments the effect tends to last longer.

If you choose not to have further Botox treatments your muscles will eventually return to normal activity and your wrinkles will gradually revert to their pre-treatment levels.

Botox works on the specific areas treated. The usual dose recommended for the treatment of frown lines is 20 units which are injected in 5 different sites. However, this may vary depending on your individual situation and the severity of your frown lines. Your doctor will know what the best dose is for your and which muscles to inject to give you the best results.

In the amounts used for the treatment of frown lines, the side effects are usually temporary and localised to the area of injection. Possible side effects include headaches, pain, burning, bruising or redness at the injection site, local muscle weakness including drooping eyelids, lack of feeling, skin tightness and nausea.

In addition to its use for cosmetic reasons, Botox is also used to treat patients of most age groups in a variety of therapeutic indications including cerebral palsy in children, movement disorders (head, neck, shoulder, face), and hyperhidrosis (excessive sweating).

Chemical Peels

Although our skin is able to replace old cells with new ones, over time this natural exfoliating process begins to slow down. With chemical peels, a solution of one or more exfoliating agents is applied to the face to remove the rough upper layer of skin and to stimulate rejuvenation of new skin cells. The result is tighter, smoother skin that is relatively free of lines and blemishes. It is recommended for fine wrinkles, age spots, sun damage and uneven pigmentation. There are several types of chemical peel techniques: light and medium peels are used to remove superficial wrinkles and discolouration, and deep chemical peels are used for more severe conditions.

Generally, the deeper the peel, the longer the recovery time required. After light peels, patients may return to their normal activities immediately and wear cosmetics to conceal the redness. Medium and deep peels, however, may result in swelling and blisters that break open and form a crust, followed by peeling which can last up to two weeks. These peels may require dressings on some or all of the treated skin and this is why medium do deep peels are best administered by a doctor. Bacterial, viral or fungal infections or prolonged redness may also occur after peeling. These can be treated with appropriate medications.

Following any skin peel, you new skin will be sensitive, so you must use maximum sun protection. Peels can be repeated as necessary to achieve and maintain desired results.

Collagen Implants (Zyderm & Zyplast)

When you body's natural collagen begins to wear out due to ageing, wrinkles and creases begin to appear. Injectable Collagen is a substance derived from purified bovine (cow) collagen that can help fill out and smooth wrinkles. It is injected into the skin to plump up the wrinkle. Areas most frequently treated with collagen include nasal furrows, deep smile lines and lips. The treatment usually last from 3 to 6 months and normal activities can be resumed immediately following injections.

Zyderm and Zyplast are only available from your doctor. There are a number of preparations available within this range of products and your doctor will advise you on the appropriate product for your individual situation.

While discomfort is minimal in this procedure, the treatment site may have a little swelling or redness immediately following implantation. Bruising or discolouration have also been noted at one or more of the implantation sites. This may be covered up with makeup. In some patients a swelling response may also involve the feeling of hardness at the implant site and at times mild itchiness or redness. These reactions may last only a few hours and to date they have resolved spontaneously, although they may persist throughout the life of the implant. Other reactions may occur depending on which product you receive. You should discuss this with your doctor.

Collagen is gradually absorbed into the body. However, a very small percentage of patients can be allergic to bovine-derived collagen, so you will need to have an allergy test prior to your treatment.

Hyaluronic Acid

Hyaluronic Acid is a viscoelastic gel made of hyaluronic acid. It is a modified form of hyaluronan which is a substance found naturally in the human body. One of the functions of hyaluran is to help keep the skin moist and elastic. Hyaluronic Acid is only available from your doctor. It provides quick, easy and immediate corrections without the need of a skin test. It is injected just under the skin's surface at intervals along the wrinkle until the desired correction is achieved. Hyaluronic Acid gel can be sued to "fill" and smooth out deep facial furrows, acne scars and smile lines. It can also be used to enhance the border of the lips for those who desire a fuller look.

Hyaluronic Acid treatments take less than half an hour and may required a little local anaesthetic to numb the area. One treatment may not be enough for particularly deep smile lines and a second treatment may be required 2 to 4 weeks later. For most people however, a top-up injection is needed every 5 to 12 months to maintain the desired level of correction. Side effects which are temporary, may include mild redness, itching, swelling and pain. Acne like lesions have also been reported at the injection site. In rare cases, persistent redness, red spots and bruising may occur.

Hyaluronic Acid is produced from materials of avian (bird) origin and contains trace amounts of avian protein. People with known allergies to material of avian origin should not be treated with Hyaluronic Acid.

Hyaluronic Acid dissolves over time, and your skin will gradually return to the way it look before treatment.

Restylane / Esthelis / Juvederm

Restylane is a clear, transparent and viscous gel containing non-animal stabilised hyauronic acid which is a natural compound. It is only available from your doctor.

As you age, the amount of hyaluronic acid in you skin decreases, resulting in drier skin and increased wrinkles. When injected into your skin, Restylane works with your body's own hyaluronic acid to create the volume needed to lift fine lines and wrinkles. It can be used to correct frown lines, deep smile lines and enhance lips. In general, follow-up treatment is needed after 6 to 12 months. Touch ups can be performed any time you like after the previous treatment.

The treatment takes about 30 minutes and the results can be seen immediately with no pre-tesing required. Usually a local anaesthetic cream is applied before treatment. During treatment the crystal clear gel is injected into the skin with a very thin needle. The gel then given natural volume and smoothes the wrinkles.

Side effects are usually injection related and transient such as swelling, redness, pain, inching, discolouration and tenderness at the implant site. These typically resolve spontaneously within 1 or 2 days after the injection in the lips. Additionally, localised reactions, which are thought to be due to hypersensitivity, have been reported. These have usually consisted of swelling at the implant site, sometimes affecting the surrounding tissues. In rare circumstances acne like lesions have also been reported.

What treatment is right for you?

Speak to your doctor to evaluate which treatment is right for your type of skin condition, and expectation levels. Be sure to make an appointment with a doctor: cosmetic physician, cosmetic surgeon, dermatologist or plastic surgeon to discuss your individual case. Your doctor will help you make choices based on your age, skin condition, expectation level and overall health.

What do these treatments cost?

The cost of these treatments will vary between the different options. You should discuss this with your doctor prior to treatment.

These treatments are not listed on the Pharmaceutical Benefits Scheme and as a general rules, private health insurers do not cover these treatments. This means that individuals seeking the rejuvenation treatments outlined above will incur the full treatment cost