Frequently Asked Questions
We often get the same questions about fillers, anesthesia or glutathione. To answer your quesitons we have written down basic information about the products and procedures that we use and do. If you have any additional questions please feel free to ask any questions on the form below or send us a message on 079 572 9468
What are dermal fillers?
- Adding volume to sunken facial areas, like the cheeks.
- Augmenting face contours for better definition and symmetry.
- Augmenting lip shape and volume for plump and well-defined lips.
- Restoring the youthful appearance of the hands.
- Improving skin hydration.
- Improving the appearance of acne scars.
The success rate of the aesthetic treatment depends on the age and lifestyle of patients, the type and amount of filler administered, and the condition of the skin. Although regulatory agents have not approved certain uses, some face fillers are still used:
- To augment foot shape by increasing the fullness.
- To inject into a tendon, ligament, muscle, and bone.
- For breast augmentation.
- For buttocks augmentation.
What type of dermal fillers are there?
Collagen (absorbable/temporary filler)
Collagen is a type of versatile protein that provides the structure of varying mechanical strength to countless tissues. It is derived and purified from bovine sources or even human cells. When injected, this type of filler restores the lost collagen, making the skin appear smoother. Collagen is bioresorbable, so the effects only last for about 3 to 4 months, making them the shortest acting filler material.
Hyaluronic acid (absorbable/temporary filler)
Hyaluronic acid is actually a complex polysaccharide (sugar) molecule found naturally in large quantities in the human body. These molecules are strong humectants, which retain water to provide hydration to other cells for optimal performance. When injected, the gel works to volumize and hydrate skin structures. In addition, new cell growth (e.g. collagen) is also promoted, and the network of collagen and elastin fibers get strengthened. This is a widely used ingredient in skincare and aesthetic treatments due to its effectiveness and minimal risks of foreign body reactions. The hyaluronic acid gel can be manufactured using gram-positive bacteria like streptococcus and staphylococcus. The cell structures of these bacteria are rich in hyaluronic acid, which can be easily extracted and purified without altering the efficacy. It can also be derived from animal sources. Due to its high biodegradability, the gel is slowly disintegrated into the surrounding tissues making the results non-permanent. Usually, the desirable effects of hyaluronic acid gel can last 6 to 12 months or more. Examples of hyaluronic acid-based fillers include Juvederm XC, Juvederm Voluma, Belotero Balance and Restylane Silk.
Calcium Hydroxylapatite (absorbable/temporary filler)
Calcium hydroxylapatite is a mineral deposited abundantly in the skeleton system. Cosmetic fillers made with this material consist of uniform microparticles of calcium hydroxylapatite suspended in a smooth gel carrier. Besides providing a filling effect on deep lines and folds, this aesthetic filler promotes the formation of new collagen cells in a process known as neocollagenesis. This material is also biodegradable and biocompatible, with very little risk of osteogenesis (new bone formation) in soft tissues. The consistency of the gel is usually thicker compared to hyaluronic acid gel. Hence, it is a semi-permanent filler with effects typically lasting around a year or more in most patients. Radiesse is a popular calcium hydroxylapatite-based filler.
POLY-L-LACTIC acid (PLLA) (absorbable/temporary filler)
Poly-L-Lactic Acid is a non-toxic biodegradable synthetic polymer. This polymer has been used extensively for medical applications such as sutures, intra-bone plates, and screws, as it is very durable and compatible with human tissue. When injected, these fillers do not produce instant results. Rather, PLLA works to help stimulate the body’s own collagen production. Over time, deep lines and sunken areas get filled in subtly, yet effectively. Patients suffering from lipoatrophy (significant facial fat loss), as a result of the human immunodeficiency virus (HIV) or other medical conditions, respond well to PLLA injections. This semi-permanent absorbable filler can last up to 2 years after administration, after which it will be metabolized by the body. Sculptra is a popular brand made from PLLA.
Polymethylmethacrylate (PMMA) (non-absorbable/permanent filler)
This synthetic material is actually an acrylic polymer. For aesthetic treatment purposes, PMMA is manufactured into microspheres or small beads suspended in a gel-like solution. This solution usually contains bovine collagen. When injected, the microspheres remain underneath the skin to provide a lifting effect. PMMA fillers include Artefill.
What are dermal fillers used for?
Under eyes
The tear trough refers to the fold from the corner of the inner eye that extends outwards and downwards. Commonly referred to as “eye bags,” the tear trough can appear puffy, making a patient appear tired, or they can appear sunken in due to ageing or weight loss. The result is an exhausted appearance. Facial fillers are injected into this area to make it appear more even.
For dark circles
Also known as raccoon eyes, panda eyes or eye rings, dark circles occur when the already thin skin of the eye areas becomes even thinner due to ageing or loss of orbital fat tissues. Since the skin is thinner, the underlying vast network of blood vessels and muscles become more noticeable and give a dark discolouration to the skin. In addition, other factors like genetics, dehydration, lack of sleep, and stress can also cause dark eye circles. Cosmetic fillers aim to diminish the appearance of dark circles and give the patient a youthful, bright glow.
For acne scars
Acne is a type of skin inflammation that occurs when the dead and keratinized skin cells clump together resulting in blocked pores. This process feeds common skin bacteria, P.Acnes, which multiplies and causes inflammation, redness, and sometimes pain. As well, this can lead to unwanted scarring. Due to the bacteria, the skin doesn’t have the materials necessary to repair itself, and scar tissue is formed. The appearance of atrophic scars such as ice pick, boxcar, and rolling scars can be reduced using dermal fillers as they help fill in depressions in the skin. When the cosmetic fillers are injected, collagen production is increased and the uneven scars can be improved.
For cheeks
Besides the formation of wrinkles and lines, another major sign of ageing is the loss of facial volume. This happens because the collagen and fat reserves get depleted gradually. Some patients with HIV and other medical conditions experience lipoatrophy due to weight loss. Some medications, such as antiretroviral drugs, bring about localized loss of fat tissues, especially in the cheeks. So, soft tissue fillers are administered to bring back fullness to the cheeks by stimulating collagen production.
For lips
A lot of patients opting for lip augmentation treatments are unhappy with their undefined lip shape and/or thin lips. However, the shape and size of the lips is determined by genetics, which alters with age. Moreover, some lifestyle habits like smoking may actually cause the formation of smoker’s lines (fine wrinkles around the lips which are sometimes known as lipstick lines because they cause lipstick to bleed when applied). Furthermore, some patients may suffer from persistent dehydrated lips. So, when face fillers are injected, the vermilion borders of the lips can be augmented for a shapely pair of lips. The volume and hydration can also be increased for a voluptuous pout.
For wrinkles and fine lines
The skin is made of 3 layers: epidermis, dermis and subcutaneous fat layers. There are a lot of cells and tissues that work together to ensure the optimal performance of the skin. However, the three most important cells are collagen, elastin and hyaluronic acid. The first two cells are actually protein fibers that make the skin pliable. Hyaluronic acid, on the other hand, provides hydration and nourishment to the collagen and elastin fibers, so that they can function without breaking apart. Some factors like ageing, excessive sun exposure, unhealthy diet, stress, undiagnosed and uncontrolled medical conditions, and smoking can cause these cells to work more slowly. As a result, skin elasticity and hydration deteriorate. Combine this with repeated facial movements, and you get fine lines and wrinkles. These skin depressions might make your patients appear tired or upset, even when they are not. So, soft tissue fillers help to reduce the unsightly appearance of these wrinkles by providing a filling and lifting effect. So, the skin appears smoother and more radiant.
For facelift with threats
Besides wrinkles, lines, and scars, sagging skin can be distressing for patients, too. Once the volume is lost, the skin can start to sag, especially around the neckline. The ageing process coupled with other influences like weight loss, sun damage, stress, and gravity affect the skin’s integrity, resulting in loose skin. Dermal fillers can be injected in these areas to give more definition and support. Hence, the skin appears tauter and more contoured.
What are the side effects?
Common side effects
- Most of the common side effects experienced by patients are due to inflammatory reactions. These injection site reactions are actually the body’s physiological process in combating trauma (i.e. injections). These reactions should subside on its own within 2 weeks.
- Inflammatory reactions such as pain, swelling, redness, itching, bruising.
- Undesirable reactions like poor/weak filling effect, Tyndall effect (bluish discolouration of the injected areas) and lumps may be caused by inaccurate injection techniques.
Severe side effects
- Severe or adverse reactions occur when proper precautionary methods are not followed. Patients’ medical records (e.g. health condition, allergies, medications and/or supplements taken, previous aesthetic treatments) must be obtained before starting treatment.
- Symptoms of an allergic reaction (e.g. swelling of the mouth, tongue, throat or other parts of the body, nasal congestion, difficulty breathing, rashes, dizziness) may occur if your patients are not properly tested prior to treatment.
- Other adverse reactions like vision abnormalities, stroke, and occluded blood supply may happen when the filler gel is injected with the wrong technique at the wrong location by inexperienced physicians.
- Formation of hard nodules, granulomas (inflamed mass of tissues), abscesses (pus) and necrosis (tissue death) can also happen at the injected site.
- Some rare cases such as leakage of dermal filler material at the treated area or migration/displacement of filler material from the original site have also been reported to FDA.
What are threads?
Collagen fibres form the fundamental foundation for other cells to cling onto, resulting in firm and plump skin. Unfortunately, as age progresses, the synthesis and regeneration of collagen fibres dwindle drastically.
This biological ageing is usually aggravated by external influences like smoking, pollution, and excessive sunlight exposure that expose the body to unprecedented free radical damage. Hence, skin loses its laxity and forms unattractive skin folds (e.g. nasolabial folds, jowls).
This multi-functional structural protein is present in many parts of the human body and in various forms. From hard and unyielding bones to extremely supple skin, collagen cells are very versatile when providing important mechanical support.
Collagen fibres form the fundamental foundation for other cells to cling onto, resulting in firm and plump skin. Unfortunately, as age progresses, the synthesis and regeneration of collagen fibres dwindle drastically.
This biological ageing is usually aggravated by external influences like smoking, pollution, and excessive sunlight exposure that expose the body to unprecedented free radical damage. Hence, skin loses its laxity and forms unattractive skin folds (e.g. nasolabial folds, jowls).
Patients can opt for a cosmetic procedure known as thread lifting to combat skin laxity. Aesthetic threads serve a complex and beautifying purpose as a medical device used to tighten lax skin. This non-surgical, minimally-invasive device is sometimes known as a “puppet” facelift.
What are they made of?
This is an ideal thread material as it actually helps to stimulate collagen production deep within the skin. Besides PLLA, threads can also be composed of polydioxanone (PDO), another biodegradable synthetic polymer.
There are 2 main thread types:
- Free-floating cogged or barbed thread, which is self-supporting and does not need to be suspended as it has been integrated with traction cones.
- Smooth or suspension thread, which can only lift the skin if it is anchored to a secure structure like the scalp.
What are the well known brands?
While PLLA thread subtly lifts the skin and promotes natural collagen production, the cones act as traction points to secure the thread properly and reduce the risk of thread migration.
How do they work?
The thread is then inserted into the skin via small incisions in the perimeter of the face. Medical practitioners can adjust the lifting actions based on what is deemed safe and suitable for patients
What are the side effects?
These inflammatory reactions occur as the skin is recovering from the incisions. Patients may also exhibit other more serious side effects like dimpling of the skin and in very few cases infections that can be resolved at Dr. Sandy Medical Spa.
Common side effects: pain, redness, swelling, bruising, the formation of blood clots.
These inflammatory reactions occur as the skin is recovering from the incisions. Patients may also exhibit other more serious side effects like dimpling of the skin and in very few cases infections that can be resolved at Dr. Sandy Medical Spa.
What is fat removal?
Not only that, but too much fat also poses a risk to health. Fat removal products effectively dissolve excessive fat and sculpt various problem areas.
Unfortunately, problems arise when too much fat is stored, causing body image dissatisfaction and feelings of unattractiveness.
What are fat removal products used for?
In fact, patients experience very brief downtime with excellent results. For some, fat dissolving injections are the best course of action for certain areas. Some of the frequently used non-surgical methods include:
- Cryolipolysis: This non-invasive procedure makes use of cold temperature to preferentially break down fat cells. During the process, only fat cells are removed while other cells are spared from injury.
- Radiofrequency lipolysis: This treatment uses radiofrequency to heat up and “melt away” stubborn fat cells. The instrument does not make any physical contact with body parts but rather heats the fat cells from a short distance.
- Laser lipolysis: Just like radiofrequency lipolysis, this therapy involves breaking down the adipose tissues using heat. The only difference is that laser energy is used to heat the fat cells.
- Injection lipolysis: This procedure requires the use of ingredients to chemically disintegrate unwanted fat stores.
Injection lipolysis is extremely popular for targeting certain areas that were missed during liposuction or other procedures, or areas that the patient simply can’t get rid of with diet and exercise.
What are the types of fat dissolvers?
Fat dissolvers are usually known as injection lipolysis. This procedure involves administering specific ingredients to areas laden with stubborn adipose tissues. The fat dissolvers cause disruption and death of fat cells. They are then excreted through the body’s lymphatic system.
The fat dissolvers cause disruption and death of fat cells. They are then excreted through the body’s lymphatic system.
What are the ingredients?
What are the side effects?
In addition, administering fat dissolver into or close to facial nerves can lead to facial muscle weakness.
On the other hand, patients can also experience other more severe reactions. Injecting a fat-dissolving into unintended areas will only result in tissue damage and skin ulceration.
In addition, administering fat dissolver into or close to facial nerves can lead to facial muscle weakness.
Fat injections are the best on the market and that is why we offer them here at Dr. Sandy Medical Spa. The results are permanent, no surgery/operation with surgical knives, no risk of general anaesthesia complications, you can go back to work after the procedure.
Come in for a consultation with Dr. Sandy and you’ll be guaranteed gorgeous results.
What is Glutathione?
Glutathione has also been known to have anti melanocytic activities which then translates to brighter, glowing, healthier skin with less pigmentation.
L-glutathione’s whitening process starts inside the skin (dermal layer) going outside (epidermal layer), that’s the reason why it takes a little time for you to see the initial change in your skin tone.
The whitening process goes head to foot, meaning that you will have an even more fair skin tone all over your body.
How long does it take to see the initial results?
NB please stay away from products that promise immediate 1-week changes because those products almost always contain either mercury, hydroquinone or steroids which results in ochronosis nigricans (an incurable condition at the moment)
Glutathione would not only help you to correct your skin flaws but also glutathione is known for its immune-boosting properties to help you stay healthy. This is not an overnight fix; therefore you would undergo the natural process “reap what you sow”.
Why does glutathione have different effects on other people?
People have different metabolism, weight, and skin colour. The very reason why some people see the results quickly is because they’re taking the right dose of glutathione as well as understanding how glutathione works, which is something Dr Sandy loves to explain.
Are there any harmful side effects?
The above problem may lead to unqualified people administering fake/unsterile glutathione, this can lead to sepsis and ultimately death!
Glutathione is water-soluble, meaning that if there would be an excessive amount of intake it would still be excreted through urine.
Zinc levels have also been reported to deplete in people using the drip frequently (more than once a week).
What makes L-Glutathione different compared to other whitening pills/capsules?
Are the whitening effects of the Glutathione permanent? Will my skin tone go back to its original colour once I stop using it?
In regards to the exposure of sunlight, will it affect the whitening process?
I wanted to see the results fast and also I want to lose weight while I am taking the whitening capsules, is it ok to take diet / slimming pills or other products?
As it was stated above Glutathione is a whitening capsule that is considered to be a supplement. Therefore it is fine to take it with other vitamins, supplements and other medications except for antipsychotic drug and chemotherapeutic drug.
I am very dark and I just want to improve my skin tone, will Glutathione make me white?
Is L-Glutathione safe for young adults (teenagers)?
Is it true from what I’ve heard that whitening of the hair is a side effect in taking these whitening capsules (L-glutathione)?
Is it much better to take Glutathione with an empty stomach or should I eat my meal first before taking it?
Is it FDA or BFAD approved?
What are anaesthetics agents?
For example, an injection will activate both mechanical and silent nociceptors. For those seeking minimally invasive procedures, this can make treatment uncomfortable.
Fortunately Dr Sandy is skilled in using Anaesthetic agents are then formulated to numb the proposed treatment areas adequately, so that patients can enjoy a comfortable and pain-free treatment session.
What are they made off?
What are popular anaesthetics brands
- Emla™ Cream 5%: This cream contains both prilocaine and lidocaine in a ratio of 1:1. The cream is applied in order to numb the skin.
- Pliaglis® Cream 7%: This cream contains both ester- and amide-based anaesthetic agents, tetracaine and lidocaine, in a ratio of 1:1. The cream is applied to the skin directly and is then peeled away.
- Coolsense Pain Numbing Applicator: This anaesthetic device is kept frozen until ready to use, and is then applied to numb the skin. This device simply numbs the proposed treatment areas using very cold sensation delivered by a metal pin.
How do they work?
What are skincare products?
Why use these products?
What are the types of skincare products?
- Cleansing: This first step involves the removal of makeup, dirt, and excessive sebum. Patients are advised to cleanse at least twice daily using a suitable and gentle cleanser. Patients can even use soft-bristled cleansing brushes or gentle cleansing pads to do a thorough job of cleansing the face.
- Exfoliating: This step is usually done a few times every week to help unclog pores and increase new cell production. Exfoliants exist in 2 forms which are physical and chemical agents. Physical exfoliating agents physically slough off dead cells using use a fine brush or small grains (e.g. sugar grains, fruit seeds, ground coffee). Physical exfoliating products must be used with care as large grains to avoid micro-tears in the skin. Chemical exfoliants refer to chemicals like alpha hydroxy acid and beta hydroxy acid that remove dead and keratinized cells. They are also very efficient in penetrating the skin to gently unclog the pores.
- Toning: Cleansing is followed by toning. This process helps to completely remove any remaining makeup, dirt, sebum, and even cleanser as well as to tighten the pores. Toner also reverts the skin pH back to normal in preparation for absorbing the upcoming products.
- Moisturizing: It is necessary to maintain the integrity and health of the protective barrier layer. Appropriate moisturizing products hydrate and nourish this barrier layer to ensure optimal health.
- Sun protection: This important step is, unfortunately, being skipped by many people. A good sunscreen reduces the amount of skin-damaging free radicals reaching the skin, which, in turn, reduces the risk of wrinkle and skin cancer formation. Sunscreen also exists in 2 forms: physical and chemical sunblock. While the former (e.g. titanium dioxide or zinc oxide) physically deflects UV rays, the latter (e.g. Ethylhexyl triazone) absorbs and converts the UV rays into heat which are then released from the skin.
- Targeted treatment: This optional step can be done based on patients’ personal preferences and skin concerns. Products intended for targeted treatments generally have more potent bioactive ingredients for fast improvements, such as acne-control and brightening effects.
What are the side effects?
- Poor quality: Some skin care products contain harmful ingredients like strong fragrance and alcohol that deteriorate the protective barrier of the skin. When this happens, the skin tends to break out.
- Presence of an allergen: The ingredients list is there for a reason. Patients—especially those with a known hypersensitivity to certain ingredients—must read the list carefully to avoid a reaction.
- Unsuitable product for skin type: Incompatible products will only aggravate skin conditions. For example, applying thick moisturizers or balms on oily skin might result in clogged pores and blemishes.
- Product overload: Sometimes, the patient may not need as many products as they or using, or they are using too much of a product. It is even worse when patients use different products but with the same potent ingredients. Instead of caring for the skin, these products might irritate the skin altogether.
- Abrasive products or methods: Abrasive items like cleansing brushes with stiff bristles can actually cause micro-tears on the surface of the skin resulting in premature wrinkle formation. These micro-tears also make the skin to be very sensitive and easily irritable.
- Overly sensitive skin: Some patients can still experience skin irritations despite using the gentlest products. They might just have sensitive skin.