Month: July 2018

Treating teeth grinding, clenching and a square jaw with Botox

Dr Harry Singh explains how botulinum toxin injections, using Azzalure™ can be used to treat bruxism, teeth clenching and reduce the appearance of a square jaw.

Our jaw is a pretty clever thing, we move it up and down regularly throughout the day as we talk, chew, bite and yawn. It also plays an important role in creating a pleasing and attractive shape to the human face. A wide jaw, which can create a square-shaped-look to the lower face, is quite a common occurrence, and although desirable in men as a sign of strength and masculine beauty, it is not considered as attractive in a female.

The appearance of a square-like jaw, is caused by prominent masseter or chewing muscles. If you place your hands at the end of your jaw bone, just below your ears and then clench your teeth together you will feel the masseter muscles as they harden under your fingertips.

In the case of a square jaw, the masseter tend to be excessively active muscles, which means that they have become somewhat ‘pumped up’ through additional exercise, usually as a result of teeth grinding or clenching. The medical name for teeth grinding is bruxism, and it is an incredibly common condition whereby you move your jaw, usually whilst sleeping, and grind the surfaces of your teeth together. This has an effect on both wearing down the surface of your teeth, usually corrected through the wearing of a dental shield at night, but also it exercises your masseter muscles making them more bulky and strong, leading to the square jaw appearance. Thankfully though we now have a solution to both – botulinum toxin injections.

I have been using Azzalure™ botulinum toxin, which is a prescription only medicine brand just like Botox®, at my clinic in Stevenage, Hertfordshire for well over fifteen years. Although these products are most commonly used as anti-wrinkle injections for reducing crow’s feet and frown lines, botulinum toxin also has many medical and practical applications where over-active muscles or muscle spasms are causing a problem. In this case, we would use it to treat the masseter muscle to reduce its activity to more manageable levels.

As a dentist, I am very familiar with the anatomy of the jaw and have encountered many hundreds of patients over the years who regularly grind their teeth in their sleep, so I can advise you during a face-to-face consultation if prescribing botulinum toxin to treat your masseter muscles will both reduce the dental implications of your bruxism, as well as improve the square-like appearance of your jawline, if this is of concern.

Treating the masseter muscles with Azzalure is an advanced technique, so it is important that you see someone with experience, training and understanding of the appropriate dosing required and the effect on the anatomical structures. Seeing an advanced practitioner, like myself, means that you will reduce your risk from over treatment which could weaken the muscles too much and impact on the movement of your jaw and your ability to bite or chew properly, or even open and close your mouth.

Treatment for a square jaw and bruxism with botulinum toxin is not a permanent solution but will last for approximately 4 to 6 months. You will require regular, repeat treatments to maintain the correction but you should notice a reduction in the dosing required to maintain the muscle activity at a level which helps you to stop grinding your teeth and brings your face back into a more attractive shape.

Why not arrange a consultation appointment with me, Dr Harry Singh at Aesthetics in Stevenage, Hertfordshire and we can discuss if you have over-active masseter muscles which could benefit from Azzalure injections; please call us on 01438 300111.

Correcting Smoker’s Lines with Botox

Dr Harry Singh explains why botulinum toxin injections, using Azzalure™ could be the right solution for you if you have smoker’s lines around your mouth.

Do you, or have you ever smoked? If the answer is yes, then you’re probably expecting a lecture about how bad smoking is for your lung health, but that’s not what I want to talk about; I want to talk about smoker’s lines.

Smoking is actually pretty bad for your skin too, and is a significant contributing factor to the premature ageing of your skin, alongside sun exposure. The effects of smoking start to show after about a decade of the habit, speeding up normal ageing and leading to the early appearance of wrinkles. This is because the nicotine in the cigarettes causes a narrowing of the blood vessels that supply the surface layers of your skin. This reduction in blood flow means that the skin cells don’t get as much oxygen or vital nutrients needed to support them and keep them healthy. It’s also been shown that many of the other chemicals present in tobacco smoke damage the collagen and elastin found in your skin; these are your skin’s support structures, so when they get damaged skin starts to sag and wrinkle.

Finally, I know, it’s starting to sound like a lecture isn’t it; the physical act of smoking, and the facial expressions made can also lead to the production of certain dynamic wrinkles. As you suck on and inhale from a cigarette, much like a straw, you purse your lips, leading to the formation of straight-line wrinkles in the area which surrounds the top and bottom lips, usually worse above the top lip, under the nose. After many years of smoking, these lines don’t just appear when you smoke, but are present when your face is at rest and you are not moving your mouth. It is these lines which are referred to as characteristic smoker’s lines. Similarly, you may also squint your eyes to avoid the smoke as you inhale and this adds to the formation of crow’s feet and frown lines.

All in, being a smoker will lead to you looking old before your time.

Now, of course I would advise you to quit the habit and your NHS GP can help you with solutions to achieve that, but what I can offer is a solution to the premature ageing and wrinkles associated with smoking.

During a face-to-face consultation with me, Dr Harry Singh, at my clinic in Stevenage, Hertfordshire, I can assess your medical and smoking history, current health and the presence of smoker’s lines. If botulinum toxin injections are the right solution for you, I can prescribe them as a cosmetic treatment. I use a brand called Azzalure™; Botox® is another brand that you may have heard of too. This prescription medicine can be used as an anti-wrinkle treatment for crow’s feet, frown lines, forehead lines, bunny lines around the nose, and smoker’s lines around the mouth. Treating these lines is an advanced technique, so it’s important that it is performed by someone with advanced training and experience. As a dentist, I understand the anatomy of the mouth area and have been performing cosmetic injections for over 15 years.

Azzalure acts by reducing the strength of certain muscles, in this case the large muscle that circles the lips, so that the production of the dynamic lines associated with smoking is reduced, and the overlying skin does not form the lines so readily, allowing it to recover and the wrinkles to reduce in appearance. Because this is a very important muscle for other actions such as speaking, smiling, drinking, chewing and kissing, we use very small doses of the botulinum toxin to reduce the smoker’s lines without affecting anything else. Treatment is not a permanent solution, lasting 4 to 6 months, but with regular injections we can prolong the recovery of the skin in the area and the lines will continue to fade.

If you are concerned about smoker’s lines and want to discuss whether Azzalure injections could be suitable for you, please arrange a consultation appointment with me, Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire by calling 01438 300111.

What are temple fillers and why do we use them to correct facial volume loss?

Dr. Harry Singh explains why enhancing your temples can improve the cosmetic appearance of your whole face

Wondering where your temples are? You’re probably not the only one as it is an area of the face which doesn’t get discussed all that much, especially when it comes to cosmetic enhancements.

The temples, yes there are two of them, one on either side of your face, are the small flat areas that you will find if you place your fingers just above your crow’s feet area, in line with the tops of your ears, and just below where your forehead starts.

The temporal region, as it’s medically called, is quite bony with little volume in terms of fat compared to say the cheeks where you can pitch a good amount of tissue if you try. Yet, as we age, the temples start to lose the small amount of volume they have, and this affects the overall appearance and youthful aspect of the face.

A youthful face is round or oval, with a ‘full’ appearance to the shape. As we age, the overlying tissue and the bone density of the skull changes and this leads to a loss of this fullness. The easiest way to explain this is that the face goes from a round or oval shape to a ‘monkey-nut’ appearance with a distinct concavity or dent in the shape of the face. This changes the face from a youthful appearance to a more skeletal, aged look.

Correcting the hollowing of the temples due to this volume loss can be done with dermal fillers, the same products often used to augment lips, recontour the jawline, plump up cheeks and correct nose imperfections non-surgically. However, the temple area is also considered to be one of the more complex areas of the face where a good knowledge of the underlying anatomy is paramount, so any practitioner performing temple fillers should have advanced training and experience. I use hyaluronic acid-based dermal filler products at my clinic in Stevenage, Hertfordshire and have been performing cosmetic injectable treatments, including advanced techniques for over fifteen years.

Usually, adding dermal filler products to the temples will not be a stand-alone treatment, but part of an overall facial rejuvenation treatment. The temples also affect the structure around them so adding volume back, which will return the round-ness of the face, can have secondary effects such as lifting the side of the brow area and can also lessen other changes in the lower face affecting the cheek and nose-to-mouth (naso-labial) lines. Often overlooked, you may be surprised to discover how much difference can be achieved with some hyaluronic acid gel to the temporal region.

Hyaluronic acid (HA) is a natural component of human skin and something that our body makes daily. Our bodies need to produce lots of HA because it acts as a natural moisturiser, drawing in water to our skin to keep it plump and hydrated, but our natural HA doesn’t last very long before we metabolise it and then need to make more. Unfortunately, as we age, we are not able to produce as much HA as we did in our youth, so skin becomes dehydrated and less plump. Some clever scientists have synthesized HA from non-animal sources so that it is safe for use in humans. The difference being that the injectable HA is made into a longer-lasting gel, so it stays within the tissue for much longer than our natural hyaluronic acid.

I use the clinically-proven Restylane range of dermal fillers which has been proven to be safe and effective since the early 1990s. Restylane comes in different HA gel ‘thicknesses’ for use in different areas of the face to achieve maximum volume replacement and contouring. It also comes with the local anaesthetic lidocaine for a more comfortable treatment. By using these products in the temporal region, as well as other areas which could benefit from rejuvenation and volume correction, you can expect an improvement in your facial appearance to last between 6 and 12 months. We can then come up with a bespoke treatment plan to maintain the correction with future appointments at Aesthetics in Stevenage, Hertfordshire with me, Dr Harry Singh.

If you want to discuss if temple fillers are the right treatment for you, then please call 01438 300111 to book an appointment.

All you need to know about cheek fillers for cosmetic enhancement

Dr. Harry Singh explains how dermal filler products can be used to give you the cheek ‘bones’ you always dreamed of.

Well-defined cheek bones and the plump pockets of fat which sit above them are a key facial structure and an important element of what makes a face look beautiful. This area represents a point of beauty in a woman and defines a strong face in a man. As we age we lose both elasticity in our skin and fat or volume from the face, leading to a less-balanced, less-youthful and undefined facial profile.

This volume loss leads to a loss of cheek fullness and goes on to impact in the direction of gravity to create a sagging jawline and an overall dower look. Augmenting or enhancing the cheeks, in both men and women, can put back the lost volume, instantly raising the face and bringing back a more youthful look. We can achieve this using dermal fillers which create a more natural improvement in the face than traditional solutions of the past such as surgically placed cheek implants.

I use hyaluronic acid-based dermal filler products at my clinic in Stevenage, Hertfordshire. Specifically, I use different thickness dermal filler products from the Restylane range which has been clinically-proven for cosmetic use since the early 1990s. Restylane products have one of the longest records for safety and efficacy of any dermal filler brands.

So, what is hyaluronic acid? It is a natural component of our skin and we make it daily to aid hydration and keep our skin plump and young-looking. Hyaluronic acid is a natural sponge and it draws in water to an area of tissue. Unfortunately, as we age we produce less and less of our natural hyaluronic acid and this, along with the ageing processes in our skin and fatty layers, results in the loss of volume in our mid-face, or lower and upper cheeks.

Thanks to Restylane, we now have long-lasting, synthetic hyaluronic acid products which are made from non-animal sources and are safe to use in our skin to put back both volume and hydration, where needed. The placement of the hyaluronic acid gel will contour the cheekbone area to bring back that attractive facial profile, whilst also providing lift in the mid-face to correct minor sagging which presents in the jawline. Putting the structural support back into the cheeks with dermal fillers can achieve as significant anti-ageing result, rejuvenating the face.

Restylane comes in different formulations or ‘thicknesses’ so we can use it in different areas of the face, but also in layers within the skin tissue to achieve different structural support, for maximum benefit. It comes with lidocaine within the syringe, alongside the hyaluronic acid, so has a built in local anaesthetic to make injection more comfortable.

All Restylane products are temporary, so this is a far cry from permanent dermal fillers or implants, making the products much safer than past solutions. You can expect the results to last between 6 and 12 months, depending on the cheek correction required and which specific product we use to treat the area. The amount of correction needed to address the volume loss in the cheek will also determine the optimum number of syringes of Restylane that are needed to achieve the result that you are looking for. Over time your body will naturally metabolise the synthetic hyaluronic acid so long-lasting results can be achieved with regular maintenance treatments, here at Aesthetics clinic to top-up the correction.

If you want to discuss if dermal fillers are the right treatment for you, then please call 01438 300111 to book and appointment to see Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire.

How to correct a ‘gummy smile’ with Botox

Dr Harry Singh explains why botulinum toxin injections, using Azzalure™ could be the right solution for you when you smile and show too much gum.

A smile is a beautiful thing. It signals an emotional response of joy and happiest, or amusement to those around us. A smile is commonly said to ‘light up someone’s face’. But sadly, some people don’t like their smile, and this isn’t always because they don’t like their teeth. Some people feel that when they smile they show too much of their gums, usually above their top teeth, or that their gums looks too prominent compared to their teeth – this is referred to as a ‘gummy smile’ or an ‘excessive gingival display’ if you want to be technical.

Having a gummy smile can make a person feel self-conscious and less willing to smile, especially in social situations or in photographs, so the beautiful expression of their emotions is stifled. If this is your concern, then keep reading and learn how we can effectively treat this.

When it comes to remedies for a gummy smile, the traditional route, available to dentists and their patients was fairly invasive and involved a procedure called a ‘gingivectomy’. Basically, this is oral surgery to reduce the look of a gummy smile by removing gum tissue. All in this is costly for the patient, painful and requires time to recover and is a radical approach to what is in the main a cosmetic problem. (Gingivectomy is appropriate for some medical and dental conditions however).

Thankfully, we now have botulinum toxin products, and at my clinic in Stevenage, Hertfordshire, we use a brand called Azzalure. Most people are familiar with the use of Botox or botulinum toxin as a cosmetic solution for wrinkles such as frown lines and crow’s feet, but these anti-wrinkle injections can also be used in all sorts of places, and for various medical problems where muscle spasms are causing a variety of conditions.

Using Azzalure as a solution for reducing a gummy smile can be prescribed for you after a face-to-face consultation and discussion with me, Dr. Harry Singh. I will ask you to smile and will review your concerns about how much gum is on show. As a dentist I will be able to assess if this option is right for you and we can discuss whether other dental concerns are also affecting your smile and whether these require addressing, to create a treatment programme that will give you an effective solution.

The botulinum toxin injections would be used to reduce the strength of certain muscles around your mouth to depress your lips when you smile, in other words, we weaken the muscles a little so that your lips do not rise as high above your teeth when you smile. This is achieved by injections of very small doses of the Azzalure into four specific points. It’s important that you go to an advanced practitioner for treatment like this as they must understand the anatomy of the muscles around the mouth, and the dose of botulinum toxin required to correct the gummy smile but not impact on the general movement of the mouth or your ability to smile, chew, talk, drink, kiss etc.

Treatment for a gummy smile with botulinum toxin is not a permanent solution but will last for approximately 4 to 6 months and will require regular, repeat treatments to maintain your ‘new smile’.

So, if you’re self-conscious in your selfies due to a gummy smile please arrange a consultation appointment with me, Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire and we can discuss if Azzalure injections are the right solution for you. Please call us on 01438 300111.