Category: Blog

Give yourself the jawline you’ve always wanted

Dr Harry Singh explores the treatment options available to define and contour the perfect jawline using dermal fillers, the puppet face lift and anti-wrinkle injections

If you look in the bathroom mirror and the image staring back at you appears to be that of a ‘sad-looking’ face, complete with wrinkled, sagging or lax skin, then I hate to break it to you, but these are all signs of ageing.

That naughty gravity has an annoying habit of sending everything in a southerly direction as we get older. With our face, this means that as wrinkles start to form, volume and elasticity is lost, and this all heads in a downwards direction. This creates marionette lines from the corners of the mouth to the chin, and a loss of the chiselled, angular line of the jawbone which becomes shrouded with loose skin and small fatty deposits called jowls. The effect of ageing hits both men and women, and ultimately definition is lost along the jawline, but thankfully we have a range of medical aesthetic treatments at Aesthetics in Stevenage, Hertfordshire which can recontour, build volume, redefine and provide lift to the lower face, restoring a more youthful aspect and the jawline you always wanted.

Dermal Fillers

Dermal or soft tissue fillers are a great treatment for adding volume, filling depressions, folds, lines and wrinkles, as well as creating shape and structure, which is exactly what we want to achieve when redefining the jawline.

Using a non-animal, hyaluronic acid gel, which is a temporary injectable gives the best results. I use the Restylane® range which are available in different gel thicknesses for different actions such as volume building or contouring shaping. Restylane has a safety record going back over 25 years meaning that it has one of the largest documented histories of clinical studies. As a dentist and Aesthetic Practitioner, I have been carrying out treatments with Restylane since 2002 and love the flexibility that the products such as Lyft, Volyme and Defyne give me to define, volumise and hydrate the jawline. The best thing about it is that hyaluronic acid is a natural component of our own bodies, which we produce daily. As we age though, we produce less of it, which leads to the loss of hydration in our skin and deeper tissue. By making hyaluronic acid into differing gel thicknesses, which last for 6 to 9 months, in some case 12 months, we can rebuild what ageing is taking away. The Restylane products also come with added lidocaine which is a local anaesthetic, meaning that every injection is comfortable.

Botulinum Toxin

Botulinum toxin, most commonly known as Botox®, is a prescription only medicine which can be used to treat lines and wrinkles on the face, but also has many other applications which are less familiar to most people. I use a brand called Azzalure®, and it can be used to treat various areas of the lower face to help bring back jawline definition. Because it’s a prescription only medicine, you will need to come to a face-to-face consultation with me, so we can discuss if you are suitable for treatment. Azzalure can be used to reduce activity in the Depressor Anguli Oris (DAO) which drags the corners of the mouth downwards towards the chin, in the chin itself to reduce a so-called ‘scrotal chin’ whereby an over-active chin muscle creates dimpling. It can also be in the masseter or chewing muscles to stop teeth grinding, and to soften a square or wide jaw, which is often unattractive in a female.

Silhouette Soft Threads

Addressing volume loss and overactive muscles will have a significant effect on reshaping the jawline, but to really achieve a long-lasting result against gravity, we need to consider treatments which offer a lifting action. One of the best for this is the Silhouette Soft Thread Lift, sometimes referred to as a puppet face lift. Silhouette Soft threads are made from Poly-L-Lactic Acid (PLLA) with small cones made from lactic and glycolic acid along their length, separated by knots. These cones are therefore free-floating and bi-directional, acting as little hooks and anchors when the thread is placed into the skin and pulled upwards into position. The PLLA has a stimulatory effect in the skin over time and this makes the body produce new collagen to support the lift, even after the original thread has been dissolved by the body. This is a great lift for younger women who are not ready for a surgical face lift and will last 18-24 months.

If you’re concerned about the lack of definition in your jawline, then you can come in for a consultation with me, Dr Harry Singh and we can discuss if cosmetic injectables such as Restylane, botulinum toxin injections or Silhouette Soft threads are the right solution for you. Call 01438 300111 to book an appointment at Aesthetics in Stevenage, Hertfordshire.

Is your skinbetter? Let me tell you about the new skincare revelation to arrive in Hertfordshire, skinbetter Science®

Dr Harry Singh discusses this ground-breaking range of professional skincare products.

Are you looking for an effective skincare regime that will improve your skin tone, texture, ageing and pigmentation concerns, but haven’t got the time to devote to fiddly, time-consuming rituals? Then skinbetter Science® is just the answer for you, and I’m really pleased to say that it is now available at Aesthetics clinic in Stevenage, Hertfordshire.

Like many of my aesthetic clients, I’m a busy person, which often leads to being time poor. I want results, good results, in everything I do, with every minute of my day, which is why I was attracted to the benefits of skinbetter as a professional skincare system to offer to you.

skinbetter provides an uncomplicated approach to skincare whilst being scientifically-advanced to achieve real results. Many people struggle to follow strict, multi-step skincare routines. The tedium of a step-by-step process doesn’t readily fit into most people’s lives; this leads to a lack of commitment and before you know it you’re not getting the results you want, but you haven’t the time to spend in front of a mirror applying a serum, followed by another, plus a cream and a sunblock, then repeating the same morning and night.

skinbetter can deliver remarkable results with a single product; but adding in one or more additional products can make a real difference to your skin health without making an onerous demand on your time! Fitting into your real life, the application of your product mix becomes quick and simple and part of your daily routine, rather than a daily chore.

You will not find this range on the high street, the exceptional wealth of active ingredients available in the products can only be dispensed by a medical aesthetic clinic where your skin health can be properly assessed, and the product choices optimised and recommended just for you.

skinbetter products work on four different levels, allowing an optimal product choice to ‘refresh’, ‘rejuvenate’, ‘transform’ and ‘protect’ your skin. What could be easier!

Primary focus for discussion with me, your aesthetic practitioner, starts with the Rejuvenate selection of face, eye and neck products which include innovative ingredients including hyaluronic acid, alpha hydroxy acids (AHAs), glycolic acid, peptides, retinoids and lactic acid (in their specialised ingredient, AlphaRet) to rejuvenate and re-texture the skin, and improve the appearance of fine lines and wrinkles. Rejuvenate is preceded by Refresh products which are ideal for cleansing, exfoliating and moisturising your skin. Think of them as preparation products, akin to a wash and scrub before you apply the all-important advanced rejuvenation products. If you’re looking for a boost for your skin, then you can consider adding a Transform product to offer immediate lifting-like effects, whether with a quick 3-minute mask to reduce lines and wrinkles or a daily refreshing eye gel. These are the pick-me ups of the skinbetter Science range. Finally, and all important is to Protect your skin, with an award-winning antioxidant product containing 19 antioxidant ingredients which act as a shield against oxidative stress. Acting as your built-in ninja warrior against marauding free radicals, this will defend your skin from attack whilst you get on with your day, helping to fight off ageing and skin redness.

I’m thrilled to be able to offer skinbetter to my clients as it has the best of everything – proven technology, rigorous research, award-winning products, a scientific approach to skincare, real life results and all with simple, uncomplicated products and basic daily protocols.

If you want to find out more about the skinbetter professional skincare range then please call 01438 300111 to arrange a consultation appointment with me, Dr Harry Singh at Aesthetics in Stevenage, Hertfordshire and we can work out the best combination for you.

Chin Up! Treatments for the chin rejuvenation

Dr Harry Singh discusses aesthetic treatments available to redefine the chin.

Whether you are bothered by a weak chin, a dimpled chin or a double chin, there are treatments which can be combined to redefine your chin to the prominence you desire.

Many of us by-pass the chin when we think about the beauty and definition of the face, focussing instead on lips, cheeks and eyes, yet the chin is a vital component which creates facial proportions that are considered optimal for beauty. Mathematical balance is important, so imperfections in the chin can throw a spanner in the works.

Being concerned about the cosmetic appearance of your chin is an issue for both men and women, and treatment can be tailored equally to produce a strong and appropriately contoured-look to the area to suit both the female and male face.

At my clinic in Stevenage, Hertfordshire, I offer many treatment options specifically aimed at improving the area of and around the chin. A combined approach is common-place in facial aesthetic treatments as it provides a more targeted option aimed at optimising results and providing the most effective solutions to volume loss, overactive muscles, stubborn fat and lax tissue.

Chin Fillers

In some people their chin just simply doesn’t protrude far enough outwards from their face, this is known as a weak or recessive chin. This means there is no clear definition between the chin and the neck. This can make the mouth and lips look out of proportion. Using the Restylane range of hyaluronic acid (HA) based dermal fillers, I can build volume and shape into the chin. The natural enhancement will last between 6 and 9 months, as the body will naturally metabolise the HA over time, so you will require repeat treatments to maintain the desired look.

Scrotal Chin

Dimpling on the chin, likened to the bumps that you see on the outside of a golf ball, or less flatteringly a ‘scrotal chin’, can be troublesome if they are present even when no muscle contraction or facial expression is being made. The cause of the dimples is over activity in a muscle called mentalis. This means that the dimples which would usually only appear when the chin is moved by mentalis are present all the time, as deep wrinkles or creases or visible depressions and craters. To reduce the action of this muscle, we can use botulinum toxin injections, perhaps in combination with dermal fillers to treat the deeper wrinkles and folds. Specifically, I use a brand called Azzalure™, but you may also have heard of Botox®. The use of botulinum toxin is a prescription only medicine, so first we will need to have a face-to-face consultation, so I can diagnose the over activity in the mentalis and decide if Azzalure treatment is appropriate. Botulinum toxin treatment lasts about 4 months before the reduction in muscle activity is restored, so repeat treatments are needed to maintain the reduction in wrinkling of the chin.

Double Chins

Ageing often leads to small, stubborn pockets of fat in places that we’d rather not have them, and a double chin is a very common concern for both men and women as they get older. A double chin is a combination of the extra fatty tissue alongside sagging skin which has its lost elasticity. Injection lipolysis with Desoface provides a great solution to essentially melt the fat cells, allowing them to be flushed out naturally by the body. Desoface uses an ingredient called sodium deoxycholate (deoxycholic acid) which breaks down the fat cells allowing them to expel their lipid contents. Multiple treatment sessions are needed, and the results will develop over a few weeks as the body flushes out the lipids and the overlying skin starts to tighten up again.

If you are not happy with the appearance of your chin then please arrange a consultation appointment with me, Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire and we can discuss the most suitable treatment options for you. Please call us on 01438 300111.

Treatment for Cellulite that works – introducing Celluerase

Dr. Harry Singh explains how Celluerase can reduce the appearance of cellulite

Plagued by orange peel-looking skin or lumpy, cottage cheese-like bumps on your thighs? Well, you’re not alone. The appearance of cellulite is one of the primary dissatisfactions for most women. Many will spend thousands of pound and hours of their lives trying to alleviate it with creams, massage devices, brushes and compression pants. All of which do not work.

In this blog I’m going to tell you all about Celluerase, which is now available at my clinic, Aesthetics in Stevenage, Hertfordshire.

First things first, what is cellulite and how do you get it?

It’s a myth that having cellulite is just due to being overweight. It’s true that if you are carrying a few too many pounds, the cellulite will stand out more and be more obvious, but cellulite has a lot to do with genetics and hormones as well. Even slim, fit women can get cellulite. In fact, it’s estimated that between 85-98% of women have some cellulite! This means that you are very much not alone if you are worried about it.

The problem for women, and why men rarely, if ever, suffer from cellulite is all down to the way that they store fat and the structure and shape of their fat cells. The orange peel or cottage cheese appearance on the skin of the thighs and buttocks is because the fat cells underneath the skin start to push through the overlaying fibrous, connective tissue, which is characteristic in these areas of the female body. The fibrous tethers mean that as the fat is pushed up, it herniates through the spaces and makes the bumps or dimpled look appear on the outside of the skin. Put simply, imagine an old-fashioned string shopping bag with a blancmange inside it and how this would bulge through the air holes in between the bag’s strings!

Celluerase is designed to release these fibrous bands to reduce the appearance of the dimpling characteristic of cellulite. It is a minimally invasive procedure which must be performed under local anaesthetic, which numbs the area to avoid discomfort. We can treat multiple areas at once, e.g., thighs and buttocks, and only one treatment session is usually required to achieve the desired result. Celluerase can be combined with other active ingredients such as mesotherapy or injectable lipolytic products to help break down the fat and aid lymphatic drainage, to produce the smoother appearance to the skin in the treated area. The lymphatic drainage in the thighs and buttocks is often sluggish so we can use a combined treatment approach to help the body to flush out the area and detoxify. Because this is a minimally invasive treatment, you can expect a little downtime and bruising, but the results you will achieve are significantly better than you will ever get by slathering on expensive creams or rubbing a brush up and down your thighs in the shower every day!

If you are concerned about cellulite and want to discuss if Celluerase is right for you, please call 01438 300111 to book an appointment to see Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire.

Desobody, the latest in fat dissolving injections

Dr. Harry Singh introduces Desobody, injection lipolysis for reducing or melting fat in the thighs, buttocks and tummy

Okay, hands up, we’ve all got a little bit of wobbly fat, here and there, which will just not go, haven’t we? I know I have!

No matter how good our best intentions are to eat well and exercise, spending hours and hard-earned money on kale smoothies and gym visits, stubborn pockets of fat remain in areas such as love handles or bra rolls, muffin tops around the tummy, saddle bags on the outer thighs and other areas around the male and female abdomen. It can be very disheartening, for both men and women, when they just won’t shift!

Well the good news is that at my clinic, Aesthetics in Stevenage, Hertfordshire, we have a solution for dissolving these fat pockets, which are resistant to diet and exercise, called Desobody.

Let me tell you more…

Desobody is a product used for a treatment called injection lipolysis. Lipolysis literally means fat-dissolving and that is what the injection of Desobody into targeted areas will do over a course of treatments. The active ingredient is called sodium deoxycholate (deoxycholic acid) which is a special medical detergent which breaks down fat cells. It has a concentration of 1.25% sodium deoxycholate in Desobody.

We also have another product called Desoface which is a lower concentration of sodium deoxycholate (0.5%) for treating double chins, which I will tell you all about in another blog.

Treatment with Desobody uses a thin cannula (non-sharp needle) which is placed under the skin through a single insertion point. This means that we can evenly deliver the active ingredient in a fan-like pattern across the whole area where we are wanting to dissolve the fat cells. The amount of Desobody needed will depend on the size of the area(s) being treated. Each session will take around 45 minutes, with only mild discomfort as a local anaesthetic is used to numb the area. Following treatment, you can expect some redness and swelling as the product gets to work on disrupting the fat cells, so they release their contents. There may also be some bruising and mild to moderate pain in the first 24-72 hours, which can be managed with over-the-counter pain medications like paracetamol. Over the coming weeks your body will slowly metabolise and expel the released lipids from the fat cells. Repeat treatment is required, and depending on the area being treated, we recommend 2-4 sessions, spaced 4-8 weeks apart, for optimum results and fat reduction.

It’s important to remember that this is not a weight-loss solution or slimming aid. The best candidates for treatment are those who have a medium body weight (BMI), who may be just slightly overweight, and have localised fat deposits, i.e. small, specific areas of fat around their back, stomach, hips, buttocks, inner and outer thighs or knees.

Following completion of the treatment, you can expect the area of fat targeted to be reduced and the firmness of the overlying skin to also be improved.

If you are concerned about stubborn pockets of fat and want to discuss if Desobody is right for you, please call 01438 300111 to book an appointment to see Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire.

Have you heard of Sunekos for rejuvenating your face?

Dr. Harry Singh explains how the new injectable hyaluronic acid and amino acid treatment, Sunekos can rejuvenate your skin

Ageing presents in many ways on the face and isn’t just limited to lines and wrinkles or a loss of elasticity to the skin. As we age, skin will lose tone, becoming dry and uneven in texture, perhaps feeling rough. Skin can also suffer from changes in pigmentation or photo-damage which creates uneven patches of skin colour, or age spots, as well as dark under-eye circles. Exposure to sun is partly to blame but genetics, lifestyle choices and the natural pathway of getting older all play a part.

This means that as well as addressing deeper lines and wrinkles with dermal fillers or relaxing dynamic wrinkles, such as frown lines or crow’s feet, with botulinum toxins to allow the skin to recover; it’s important to consider treatments which can help to restore the whole of the skin, rejuvenate and stimulate the building blocks of new skin.

I’m very pleased to announce that to provide additional options for my patients, I now offer Sunekos® at my clinic in Stevenage, Hertfordshire. In fact, I am a UK trainer for other medical practitioners in the use of this product and have been very impressed with the results.

Sunekos is a new cosmetic injectable product, which like the Restylane® dermal filler range that I use contains hyaluronic acid. But, what makes Sunekos special is the patented formula of amino acids, which is added alongside the hyaluronic acid to create the injected product. This potent mix of amino acids which includes glycine, L-proline, L-leucine, L-lysine HCI, L-valine and L-alanine help to regenerate the Extra Cellular Matrix (ECM) – the building blocks which help to make the wall – by stimulating fibroblasts, or skin cells, to produce new collagen and elastin, repairing and rebuilding skin. This process is referred to as a dermal biogenesis, literally skin regeneration.

Hyaluronic acid (HA) is a natural component of our skin which draws in water to act as a natural moisturiser, keeping skin hydrated and plump, both of which are signs of youthful skin. HA is made by our bodies daily, but, as we age, we produce less natural HA and our skin suffers in appearance because of it. Amino acids are made by our bodies and are essential for the creation of healthy skin, acting as the precursors to the formation of new collagen and elastin.

Sunekos offers two different treatment options for skin regeneration, which can be performed separately or in combination – Sunekos 200 and Sunekos 1200.

Sunekos 200 contains a low molecular weight HA and Sunekos 1200 is a medium molecular weight HA. The former can be used alone to treat the face, neck, décolletage and hands and is great for younger people. If additional ‘cushioning’ is required in the case of lax, sagging skin or deeper lines and wrinkles, then the Sunekos 1200 can be combined to give extra scaffold support for the dermal biogenesis.

Clinical trials have shown that hyaluronic acid products on their own can cause biorevitalisation in the skin, stimulating fibroblasts, but the addition of the amino acids is like adding extra fuel to a fire, their presence stimulates and directly targets the ECM fibroblasts which is important when it comes to rebuilding the dermal layers of the skin. Participants in trials reported improvements in wrinkles, skin plumpness and hydration, as well as a lifting effect.

I recommend a course of three to four weekly treatments to achieve the best results with Sunekos 200, followed by a repeated course of treatments every six months. If extra support is required with Sunekos 1200, then this will be injected a few days before treatment commences with Sunekos 200. You will start to notice the effects of treatment after a week or so as skin begins to rejuvenate.

If you want to discuss if Sunekos can help your skin, then please call 01438 300111 to book and appointment to see Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire.

The Puppet Face Lift with Silhouette Soft Threads

Dr Harry Singh explains how Silhouette Soft Threads could give you the non-surgical face lift you’ve been looking for.

Mention the words ‘face lift’ and everyone starts thinking about scalpels, cutting into skin and then pulling back on the face, but what about a non-surgical face lift?

Times have changed, and we now have many more options in medical aesthetics which allow practitioners to work with a patient to produce the cosmetically-enhanced results which once could only be achieved with surgery. Surgery still has a place for those with considerable ageing and skin laxity, but if you’re not quite there yet, then we can do wonders with thread lifting or a puppet face lift.

The puppet face lift is a term coined, probably by the media I think, to refer to a thread lifting technique with Silhouette Soft threads to achieve a non-surgical form of face lifting.

The Silhouette Soft threads are lengths of suture material containing Poly-L-Lactic Acid or PLLA. Along each thread, which varies in size depending upon where it will be used, are small ‘cones’ made from lactic and glycolic acids. These cones are separated by knots along the suture line to stop them from sliding up and down the thread but keeping them free-floating between the knots. The cones are bi-directional which means that from the centre of the thread either 4, 6 or 8 cones will go in each direction out towards the end of the threads. The cones are the anchors for the threads so that when a thread is implanted in the skin, pulled and tightened into place, the cones secure themselves to maintain the lift. Threads are inserted using a fine needle through an entry and exit point. The same entry point will be used for multiple threads which are usually laid out in a pattern to achieve the designed amount of lifting needed. Treatment takes about 30 minutes and can be used along the jawline, the mid-face and the neck.

These threads are full re-absorbable, meaning that they do not remain permanently in the body but dissolve over time, usually after a year. PLLA has a stimulatory effect on the skin tissue, so as well as providing a mechanical lifting and skin tightening when the thread is put into position, it also increases the production of the body’s natural collagen around the thread for a longer-term result. Known as a foreign body reaction, the presence of the thread tricks the body into making more collagen so the lift from the thread remains in the natural tissues after the PLLA has been dissolved.

Due to the nature of the procedure, it’s important that you only seek treatment from an experienced medical practitioner who has undergone manufacturer-approved training, specifically in the placement of Silhouette Soft threads.

Thread lifting with Silhouette Soft is ideal for women and men, aged between their mid- to late-30s and their mid-50s, who have a good underlying skin structure but who are showing some slight sagging in the cheeks and jawline, consistent with the early signs of ageing. Such individuals would not yet be candidates for surgical intervention but would benefit from tissue lifting and tightening to improve the laxity. Results from a puppet thread lift last between 18 months to 2 years and treatment can be combined with other aesthetic treatment options such as dermal fillers.

If you’re not ready for a surgical face lift, but think a thread lift might be for you, then please arrange a consultation appointment with me, Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire and we can discuss if Silhouette Soft threads and a puppet face lift are suitable for you. Please call us on 01438 300111.

Is your Depressor Anguli Oris (DAO) muscle the reason for your ‘frowny face’?

Dr Harry Singh explains how we can relax this muscle with botulinum toxin to turn your smile from ‘upside down’ to ‘happy clown’!

Do people often ask you if ‘everything is alright?’, or tell you to ‘cheer up’? If so, then this could be a sign that you have a reverse or ‘upside down’ smile, such that the corners of your mouth, even when you are not moving your mouth or lips, have a tendency to point downwards, creating an uphappy look.

The cause of this downwards ‘tugging’ is an overactivity in one of the many muscles that we use to move our mouth so we can speak, eat and make facial expressions.

The muscle in question is called the Depressor Anguli Oris or DAO for short. The clue in its name is the word ‘depressor’, as this is the muscle that is responsible for lowering the corners of the lips and mouth, often used when we wish to express displeasure or repulsion. We have a DAO muscle on each side of the mouth. It is triangular-shaped with an anchor at the corner of the mouth and a flat side along the chin. If this muscle is too active, then it can start to tug down on the corner of the mouth even when we aren’t calling on its services to make faces. This repeated action can lead to the formation of marionette lines, as the overlying skin is constantly being pulled down by the overactive muscle. As we age, these lines will become more and more pronounced.

In another recent blog, I looked at treating deep marionette lines with dermal fillers. Marionette lines are the lines, folds or wrinkles which start from the corners of the mouth and head in a downwards direction, eventually reaching the chin. They get their name from the mouth shape of marionettes or ventrilloquist’s dummies.

If you try to do a sad face, you will be able to see and feel the constriction of the DAO muscle at the jawline and can see how strong it is at tugging down the corners of your mouth.

As well as treating deeper lines and wrinkles in this area with dermal fillers, such as the Restylane range which I use in my clinic in Stevenage, Hertfordshire, the DAO can also be relaxed with the use of botulinum toxin injections. This is a prescription only medicine and isn’t right for everyone, but after a face-to-face consultation with me, I will be able to diagnose if you have an overactive DAO and if injections with botulinum toxin, on its own, or with dermal fillers would be the most appropriate treatment for you. In my clinic, I like to use the Azzalure™ brand of botulinum toxin, other products include Botox®.

Treating the DAO and marionette lines in this way, in fact any injections of botulinum toxin in the lower face, i.e. below the usual areas of crow’s feet and frown lines, is very much an advanced technique and must be performed by someone with significant training and experience. I have been prescribing and performing wrinkle-relaxing treatments of this kind for over fifteen years. In the wrong hands, complications could arise through incorrect placement of the treatment in the muscles which could have an effect on the positioning of the mouth, lips and teeth, and even effect your ability to bite, chew, suck or talk. That’s why it’s important to see someone like me, with years of experience; plus as a dentist, I am very familiar with the anatomy of the mouth.

If you are fed up of everyone asking you to ‘smile’ or thinking that you’re miserable, then please call 01438 300111 to book an appointment to see me, Dr Harry Singh at Aesthetics in Stevenage, Hertfordshire.

Everything you need to know about the signs of skin ageing

Dr Harry Singh is here to enlighten you on the changes in your skin as you age

Ageing, yes, I know it’s a dirty word and none of us want to think about, but like death and taxes, it is sadly unavoidable. The first signs of ageing will start to appear around your late 20s or early 30s, maybe not until your 40s, depending on luck and lifestyle. Luck in terms of your genetics – have a look at how well your mother and father are ageing – and lifestyle in terms of how good you are to your body – smoking, drinking, bad diet and sun exposure all lead to premature skin ageing.

Most us expect to see fine lines and wrinkles as we age, but there are other signs that show that your skin is not as youthful as it once was. When we are young, we have plump, smooth skin, but as we age skin becomes more dehydrated, dull, poor in texture and tone and everything starts to sag and lose volume. Other signs of skin ageing, and photo-damage caused by ultra-violet radiation from the sun, include pigmentation changes, often referred to as ‘age spots’, ‘sun spots’, or ‘liver spots’, which are like oversized freckles plus areas of dark patches or hyperpigmentation.

Fine lines and wrinkles will usually start to appear around the dynamically moved areas of the face and are most commonly noticed as crow’s feet around the eyes, noticeable when smiling. Other common early wrinkles are ‘eleven’ lines in between the eyebrows, caused by frowning. Reduction of lines and wrinkles, caused by dynamic movement, can be achieved with botulinum toxin injections such as Azzalure™ or Botox®. Deeper wrinkles can also be smoothed out or filled with the use of dermal filler injections, with hyaluronic acid-based gel products like Restylane®. Skin tone and texture can also be improved by stimulating new collagen production using treatments like medical-skin needling with Dermaroller.

Hyaluronic acid (HA) is an important component of the skin and an essential, natural moisturiser that we produce daily. HA helps our body to draw in moisture to our skin and it is this which gives it the plump, youthful appearance. In our youth, we produce HA in abundance, but as we age, production slows down and we simply don’t make as much HA as our body would like to keep skin at its optimum levels of hydration. A lack of adequate HA leads to lacklustre skin which is dry, rough, lacking in firmness and elasticity, as well as prone to sagging in places such as the jawline. Dark circles around the eyes may also become more apparent. Thankfully, hyaluronic acid can be put back into the face with products such as the Restylane® SkinBoosters which can be used to deliver small droplets of HA gel across the whole face using superficial or mesotherapy style injections to restore hydration. Regular maintenance treatments can make a real difference to the quality of your skin as moisturisation is returned.

As well as reduced levels of hyaluronic acid, skin can suffer from volume loss, both due to a loss of collagen and elastin structures as well as shrinkage of the fat compartments in the face, most noticeably in the cheeks. With gravity being the enemy, this loss of elasticity and skin firmness leads to a drooping of the tissues. Eyes may start to ‘bag’, the forehead and brows will lower leading to droopy upper eye lids, jowls will form in the lower face and naso-labial folds, or nose-to-mouth lines, will appear as the cheeks lose their volume.

But it’s not as terrible as it sounds, careful placement of dermal fillers and botulinum toxin can address many of these signs of ageing, and Silhouette Threads can also be used to lift tissue in a non-surgical thread lift. Alongside a good skincare regime, we can hold back the flood gates of ageing, as well as rejuvenate the skin to a more youthful appearance.

If you’re worried about the signs of facial ageing then why not arrange a consultation appointment with me, Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire and we can discuss which facial aesthetic treatments can help. Please call us on 01438 300111.

Bothered by a dimply ‘golf ball’ chin? Find out how to soften it with Botox

Dr Harry Singh explains how Azzalure™, botulinum toxin injections, can be used to relax the muscle in the chin which leads to dimple and wrinkle formation.

The chin is an important area of the face. As well as adding balance to the overall facial profile, achieving markers of beauty and masculinity, it is also involved in the movement and facial expressions made with the mouth area. The chin itself is controlled by one big muscle called mentalis.

If you try to tighten the area by clenching your chin muscles and pushing out your bottom lip, you will be able to feel the effects of mentalis as the area becomes more solid to the touch and has both a dimpled appearance and feel, much like the outside of a ‘golf ball’.

In some people the mentalis muscle can become hyperactive, or overused, and this can lead to the dimples or wrinkles generated from its dymanic action being visible all the time, even at rest, when they are not tightening the chin. Having visible depressions, roughened skin or deep creases in the chin can make a person look sad, doubtful, disdainful or maybe even angry, when they’re not, as these are all emotions where we use the chin to display such feelings. All of this can lead to self-consciousness.

One very unpleasant description for this appearance, which can affect both men and women is ‘scrotal chin’, not very appealing I’m sure you will agree! Thankfully, as with treating other hyperactive facial muscles, such as those involved in teeth grinding or squinting, which can cause crow’s feet, modern cosmetic medicine has a solution – botulinum toxin injections.

I have been practicing facial aesthetics since 2002 and at my clinic in Stevenage, Hertfordshire I prescribe and use the botulinum toxin brand called Azzalure™. Like other brands of botulinum toxin, including Botox®, Azzalure is a prescription only medicine which requires a face-to-face consultation to correctly diagnose and prescribe treatment.

Botulinum toxin injections are most commonly used and licenced as an anti-wrinkle treatment for reducing crow’s feet, frown lines and forehead lines, but the medicine also has many other cosmetic and medical applications to treat over-active or spasming muscles. This means that we can also use it to treat the muscle in the chin to weaken it slightly and reduce the appearance of dimples and wrinkles.

Treating the chin is an advanced technique and should not be done by inexperienced or under qualified practitioners. It is important that you seek out someone with adequate prescribing qualifications, training, experience and understanding of the underlying anatomy and botulinum toxin doses required. Incorrect treatment of this area could lead to over-weakening of the muscles, impacting on jaw movement, and in the worst case, inadvertently affecting your ability to chew properly, or even open and close your mouth.

As a dentist and facial aesthetic practitioner, you can be assured that I am fully qualified to diagnose and prescribe treatment for the chin and mentalis muscle and have a detailed knowledge when it comes to the anatomical structures involved in the mouth and jaw. This means that during a consultation I can advise you whether Azzalure is the right treatment for you based on the concerns that you have and your medical history. Combining other facial aesthetic treatments, such as dermal fillers, may also be an option, depending on the depth of creases around your chin and mouth.

Any treatment with botulinum toxin is not permanent, usually lasting 4 to 6 months before a repeat dose is required to maintain the correction.

If you think you have too many wrinkles or dimples on your chin, then make an appointment for a consultation with me, Dr Harry Singh at Aesthetics in Stevenage, Hertfordshire and we can discuss if botulinum toxin injections are the right thing for you. Please call us on 01438 300111.