Tag: Botox®

Treating nose-to-mouth lines is simple with dermal fillers

Dr. Harry Singh explains how cosmetic injectables can be used to treat nasolabial folds.

Firstly, I know what you’re going to say…what is a nasolabial fold?

It’s certainly a mouthful of a word, but what it refers to is very simple, and most of us get them, especially as we age. Nasolabial folds or nose-to-mouth lines refer to the depressions or grooves that run from the lower corners of the nose, the medical term for which is ‘naso’, down to the corners of the lips, the ‘labia’; hence nasolabial or nose-to-mouth lines.

As simple as they are to define, they are also simple to address by plumping up the area, reducing the mild dip, moderate crease or deep depression, creating a more youthful look with the use of injectable dermal fillers.

Both men and women start to see the appearance of nasolabial lines as they age. This occurs as we lose volume in the cheeks and upper face, which causes sagging in the area and the dropping of the fold of the cheek into the nose area. Dermal fillers can be used very effectively on male and female faces to add back volume and structure to the ageing face in the cheek and nasolabial region.

I use hyaluronic acid-based dermal filler products at my clinic in Stevenage, Hertfordshire. Hyaluronic acid, or HA for short, is a natural component of our skin that our body makes daily. It draws in water to our skin and helps it stay plump and hydrated, which is more youthful-looking. Our bodies need to produce lots of HA each day because natural HA doesn’t last very long before we metabolise it. Sadly, as we age, we produce less and less natural HA daily; this is why children have such plump faces compared to adults. Scientists have, in the last 3 decades, discovered ways to manufacture synthetic, longer-lasting HA from non-animal sources, which is perfectly safe to use in humans. I use the Restylane product range which has been clinically-proven since the early 1990s for cosmetic use and has one of the longest records for safety and efficacy of any dermal filler brands. Restylane is non-animal-based and comes in different formulations or ‘thicknesses’ for use in different areas of the face for maximum benefit. It also comes with built in local anaesthetic, by the addition of lidocaine into the product syringe. This means that the area is numbed as it is treated to make it much more comfortable. All the products are temporary, but you can expect the results to last between 6 and 12 months, depending on the severity of your nasolabial lines and which specific product we use to treat them. How deep the folds are, and the amount of volume loss, with also determine the optimum amount of Restylane syringes I will require to give you the result you are looking for. Your body will still metabolise the HA over time but will do so a lot slower than it does with its natural HA, hence the long-lasting results. You can maintain the correction with repeat treatments at Aesthetics clinic and I will call you back for regular appointments to see how things are looking.

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.

‘What’s Up Doc?’ Botox Makes ‘Bunny Lines’ Just For Rabbits

Dr Harry Singh explains why botulinum toxin injections, using Azzalure™ could be the right solution for your nose wrinkles.

Bunny lines may look good on Bugs Bunny, but many people wish they could get rid of theirs. Well, the good news is you can with wrinkle relaxing injections.

Firstly, let’s clarify what we’re talking about here – what are ‘bunny lines’?

Bunny lines are part of the family of wrinkles referred to as ‘dynamic lines’, the ones which are created in your skin from repeated movement, usually on expression and during common facial movements involved in speaking, smiling, eating etc. Dynamic wrinkles which can be treated with wrinkle relaxing injections include frown lines and crow’s feet, as well as bunny lines. Some people scrunch up their nose during some expressions and this creates the ‘bunny lines’ across the bridge and sides of the nose, in a fan formation. Over time, these fine lines will start to remain in the skin, even when there is no underlying facial movement.

As you age, and the more you express yourself and use your facial muscles, the more the overlying skin gets repeatedly wrinkled and creased as you do so. Therefore, lines eventually become somewhat ingrained in the skin and are visible even when you stop making the expression. But, we have the answer to bunny lines at my clinic in Stevenage, Hertfordshire.

The solution is anti-wrinkle or wrinkle relaxing injections, which can be prescribed for you after a face-to-face consultation and discussion with me, Dr. Harry Singh. I will ask you to move your face, by making certain expressions, paying particular attention to the areas that you are concerned about, such as if you think you have bunny lines. I will review your skin quality and take a detailed medical history to make sure that you are suitable for treatment. Other options, such as dermal fillers, can also be used to help with wrinkles or lost volume to plump out your skin, so we can discuss the best option and treatment programme for you.

Wrinkle relaxing injections refer to a medicine or drug called botulinum toxin type A. This is available as several different brand names including Botox® and Azzalure™. I prefer to use Azzalure in my clinic.

Azzalure works by reducing the strength of certain facial muscles for a short period of time, approximately 4 to 6 months. The botulinum toxin is injected in very small doses into specific points on the sides of your nose to target the bunny lines. You won’t get an instant result as it takes about a week to get to work. In the days after the injections, the botulinum toxin starts to stop the communication channels between your nerves and the muscles in the nose area where we have treated, so that movement can be restricted. Once the botulinum toxin has reduced the muscle movement, but not so much that you can’t make any expression or look unnatural, the overlying skin will start to become less wrinkled. Over time you’ll start to notice a real improvement in your skin quality if you maintain regular repeat treatments every 4 to 6 months.

So, if you’re bothered by bunny lines please arrange a consultation appointment with me, Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire and we can discuss if Azzalure botulinum toxin anti-wrinkle injections are the solution for you. Please call us on 01438 300111.

Why are dentists best placed to offer facial aesthetics

You may be wondering why a dentist would be working in non-surgical facial aesthetics. The truth is that dentists are actually ideally placed to perform such treatment, since we have undergone five years of undergraduate education focusing just on the face, never mind the postgraduate training that inevitably follows!

A large part of what we learn involves not just teeth but also the anatomical structures allied to the mouth, as well as providing oral treatment that is in proportion with the patient’s face, and we are experts at administering pain-free injection.

We dentists, just like any other healthcare professional that patients see on a regular basis, are in the fortunate position of being able to build rapport and therefore trust. Who better then, for our patients seeking non-surgical facial aesthetic treatment, to deliver it when that all-important trust is already there?

Perfect partners

In addition, cosmetic dentistry and non-surgical facial aesthetic treatment are ideal bed fellows. In my experience, patients who have elected to undergo cosmetic dental procedures tend to be interested in the possibility of facial aesthetics, and vice versa.

So what are the possible treatments to complement our patients’ smiles? They include, but are not limited to:
1. Plumping of lips subtly (injecting the hyaluronic acid dermal filer just in the borders of the lips) or by increasing the volume (injecting in the body of the lips) to enhance a smile with white, straight teeth
2. Volumisation in the mid face area, especially in patients who have lost some teeth in the cheek area, as well as replacing lost volume or filling deep lines in the nose to mouth (naso labial folds) and mouth to chin (marionette) lines with dermal fillers
3. Botulinum Toxin to target dynamic muscles. One example of its use is to reduce a gummy smile; weakening the muscles responsible for raising the lip with a small amount of toxin results in a gentler and softer upward pull when a patient smiles, allowing all of the teeth to be seen but decreasing the amount of gum on show
4. Temporomandibular joint disorders can be treated with Botulinum Toxin as part of a comprehensive treatment plan, and it can be added to treat bruxism in addition to normal dental procedures.


Don’t be a line chaser

Don’t be a line chaser. Look at the whole face and determine the best course of action to give the patient the best results possible.

However there is a fine balance between under selling and over selling. I’ve seen many patients that initially saw a competitor and only wanted a particular problem sorted, but were handed a treatment plan for over £2k.

I generally address just the concern the new patient comes with. Obviously if their concern cannot be treated in isolation, I would advise them accordingly. If it can be treated in isolation, then I would solve that particular problem. When I see them at the review appointment, I have solved their problem, hence my credibility has skyrocketed and they trust me. Now, I can consider the whole face and a more holistic approach.

However, you don’t want to scare patients away. I use this analogy (by the way, its not mine, heard it in a conference many years ago!). I let the patient imagine I’m a train driver. They have come aboard my train. They can either stay on the train for the whole journey. Or they can get off at any stop. If they do get off at any stop, they are more than welcome to rejoin my train and start the journey again.

This solves a number of problems and possible objections that the patient maybe thinking. They do not necessarily have to have everything that I have prescribed, its ok and I’ll understand. Many patients feel guilty if they don’t undergo everything your recommend or its been a while since they have seen you and may wrongly assume you’ll be upset with them and decide to see someone else to avoid this situation. I explain that they are happy to return to me whenever they are ready.



Whats the difference between Botox® and Dermal Fillers?




Whats the difference between Botox® and Dermal Fillers?

There are 2 main differences between these two types of treatments.

The first is what problems they can solve. Botox® works on motion lines. These are fine lines or wrinkles that occur on movement or contraction of the muscle. Botox® relaxes the muscle by stopping the nerve sending a signal to the muscle to contract.

Patients will fall into one of four groups.

Group 1 – no lines at rest and no lines upon muscle contraction. This group are too early for Botox®, as there is no muscle involvement.

Group 2 – no lines at rest, but lines appear upon muscle contraction. These are the best group to treat because the lines are caused by the muscles only.

Group 3 – some lines at rest and upon muscle contraction these lines worsen and/or new lines appear. We can still treat this group with Botox® as there is some muscle involvement, but we would not be able to guarantee to eliminate those lines at rest.

Group 4 – some lines at rest and upon muscle contraction nothing happens to these lines. These patients are too late for Botox® as there is no muscle involvement.

Whereas Dermal Fillers work on stain lines or folds. These lines/folds are not caused by muscle contraction but due to loss of volume in the skin. Dermal Fillers plump up the skin and restore loss of volume. However they do not lift. This is an important point, where if you have lose/saggy skin and you require lifting, Dermal Fillers would not be your treatment of choice.

Bradley speaking, Botox® is normally used for the upper third of the face and Dermal Fillers for the lower third of the face.

The second major difference is the onset of action and reversal.

Botox® has a delayed onset of action and you would not see the optimal result until two weeks. After the Botox® procedure, you will feel your skin tighten in 3/4 days and then over a period of 14 days see the effects.

In addition, Botox® cannot be reversed. Therefore it is imperative that you are baby stepped and not over dosed. We can add to the botox but we cannot take it away!

In regard to Dermal Fillers you can see the result immediately and you can reverse the effects. 80% of the effects of Dermal Fillers will be instant, in addition most Dermal Fillers attract water, so in the course of the next 10-14 days, the area will be re hydrated causing the skin to plump, hence the remaining 20% of the result is seen at this time.

Most of the Dermal Fillers we use are reversible. If we have over filled or the patient doesn’t like the look, we can reverse the effects and start again.

Botox® – how young can you have it

Dr Singh who runs his botox clinic in Stevenage, Hertfordshire, in his latest blog shares his thoughts on botox and hoy young can you have it.


I personally would not treat anyone under the age of 18.
For more information about botox hertfordshire, please call us on 01438 300111



botox regulation

Dr Singh who runs his botox clinic in Stevenage, Hertfordshire, in his latest blog shares his thoughts on botox and the future regarding regulation.


Earlier in 2014, the new European Aesthetics Surgery regulatory standards gained CEN approval. Much of the legislation will crack down on the inconsistency of botox procedural standards, training requirements and the condition of both surgical and non-surgical aesthetic treatment centres.

On the whole, the Aesthetics Surgery Services bill is designed to provide an overall set of minimum standards and quality guidelines for any practice carrying out cosmetic/botox and aesthetic surgery – and it will apply to any EU member states governed by CEN (European Committee for Standardisation). This includes the United Kingdom, as well as other European countries.

However, the UK has been allowed what’s known as an ‘A-deviation’ to the legislative standards – and this has been approved by the CEN in exceptional circumstances.

What will likely happen upon the legislation’s publication is that there will be two separate drafts – one which applies to surgical procedures (such as face-lifts or breast augmentations), and another which applies more specifically to non-surgical procedures (like Botox® injections).

If you are providing botox within your Dental Practice, then it will come under CQC remit. If you are providing these services away from your premises, then currently it will not come under the CQC remit.

***A word of warning here, if you are treating hyperhidrosis (excessive underarm sweating) with botox, irrespective of the premises, the CQC may feel it comes under their remit due to the fact that this is because, the condition of hyperhidrosis is classed as a disorder which must be diagnosed and then it can be treated. It is further defined as such by the NHS. This makes it a ‘regulated activity’ with the Care Quality Commission (CQC) in England (with similar requirements in Wales, Scotland and Northern Ireland).

Regulation of botox is nothing to be scared of and in fact should be encouraged to outlaw these back street/beauty clinics proving non surgical facial aesthetics in an unsafe and unethical manner. Regulation will improve the patients experience and result and allow them to trust credible practitioners.

For more information about botox hertfordshire, please call us on 01438 300111.