What you should know about the aesthetic mark left on the face by botulinum toxin, hyaluronic acid and collagen inducers

After a certain age (I have never really known what that 'certain age' is), it is said that our face reflects with a certain clarity what our life has been like up to that moment.

Expression wrinkles , printed on our skin,

.

They reveal our tendency to get angry or worry excessively;

to gesticulate like Jim Carrey;

to smile without hiding a single tooth from our jaws;

to cry even with television commercials, to smoke as if there were no tomorrow (also, to drink too much and sleep little).

At least that was how things had been until recently, specifically, until the

gave us the possibility of combating, mitigating and even erasing the traces of the passage of time on our skin or to 'correct' those 'defects' that have been with us since our early years (and that, sometimes, only we perceive).

Puncture here, puncture there, they are reaffirming the facial oval, relaxing between the eyebrows and raising the eyebrows.

Where before there was laxity, there is firmness again and that feels so good that, not only is it difficult to stop, but, each time, we start

and, unfortunately,

because what we are looking for are

and , put to order,

In recent years, as Gema Mancha -CEO of Merz Aesthetics for Spain and Portugal- explained in a recent meeting with journalists- "the average age of girls who undergo some aesthetic medicine treatment has dropped to

".

Although, by boat soon, the data is already quite revealing on its own, the issue becomes more relevant if we realize that this arithmetic mean implies that the patients, in some cases, have not even reached the age of majority.

"We even find

, letting themselves be guided by 'influencers', what they see on Instagram, as if this consisted of applying a cream that, at best, can cause you a rash. We are talking about rhinomodeling, injectables, etc. that, beyond their undeniable benefits, carry -as with everything in life- certain risks. Therefore, one must be very rigorous with what one counts. And assume, each one ( industry, doctors and media),

because aesthetic medicine is, as its name indicates, a

", added Mancha

The story is that all this, each new protocol to which we submit, logically,

: "The

is the impact that the treatments leave on the face. It can be

, when the treatment and the product used it adapts to the needs and characteristics of the patient and the result is natural and without problems

, when the product, the technique or the lack of knowledge of the reality of the patient leave residues of the product, cause an abnormal reaction in the tissues or produce an artificial aesthetic result", explains Dr. Miguel Sánchez Viera, coordinator of the Spanish Aesthetic Dermatology Group and Therapeutics (GEDET) of the AEDV (Spanish Academy of Dermatology and Venereology)

Ana Rodríguez-Villa, dermatologist and director of the Aesthetic Medicine Unit of the Ricart Medical Institute (IMR), helps us to delve into the matter: "In the pejorative sense of the word, the aesthetic trace is understood as the application of treatments, both fillers and collagen stimulation,

, which would bring us closer to hyper-treatment than to the search for proportion and harmony on a face".

On the contrary, in the good sense of the word, "it shows us the

of what we want to achieve with the treatments. For example, if the aesthetic imprint that I produce in a patient is to better reposition the chin, it is welcome because, probably , had a deficit that caused a disproportion in the lower middle third ".

The aesthetic mark, explains Dr. Ana Revuelta, "is going to be marked on our face from the first years of injections, that is,

".

and, on occasions, totally disproportionate faces

come to mind to all of us. It is associated with not respecting

the injection times, nor the degradation of the product, nor the quantities. It is marked by an 'ill-recommended' aesthetic medicine and, on many occasions, by malpractice".

The most positive, on the contrary, is "one that does respect the times, that is committed to biostimulation and, above all, respects the patient's expression and canons of beauty, giving rise to luminous, firm and healthy skin that expresses health and beauty".

In recent years, Revuelta continues, "the number of patients who come to the clinic to

over the years has grown. When they are biocompatible or resorbable products, we have a wider margin of manoeuvre, thanks to the use of state-of-the-art equipment".

The problem, however, arises "when we are faced with fixed filler products, such as the silicones that were applied in the past that, to remove them, we must resort to

and, sometimes, this is not even possible due to the internal degradation and integration with our fabrics, with which the aesthetic mark it leaves is tremendously negative".

HOW TO AVOID A NEGATIVE AESTHETIC FOOTPRINT

How can we avoid that unwanted aesthetic footprint?

"First of all, we must be aware that we cannot treat patients equally. In other words, we cannot universally establish closed protocols and we must know how to say no to requests that can cause irreversible negative aesthetic traces, such as

treatments that can produce fibrosis in the tissue or an inflammatory reaction that would leave an imprint that is impossible to reverse," says this specialist.

Before letting ourselves 'touch our faces', emphasizes Ana Rodríguez-Villa, we must be very clear

.

"

who correctly assesses what the deficits or problems to be treated may be, to address them in a staggered and progressive manner... Sometimes, when treating a specific facial area, indirectly , we improved another with which we would not have to perform the complete treatment on the patient".

Lying on the stretcher to "let yourself be done" without being informed beforehand is another of the big mistakes that we can make, as the director of the Aesthetic Medicine Unit of the Ricart Medical Institute points out: "There are many people who are treated without knowing why

. As in any other field of medicine, it should be encouraged that the patient is a participant in his treatment who understands the reason, how it is applied, its effects, etc. It is essential that, before submit to any aesthetic protocol, it is explained to us and we understand what the planning to follow will be and, of course, keep a record of what they are putting on us".

To better understand '

Dr. Ana Revuelta details some of the questions we should ask ourselves.

"How can we know that the botulinum toxin they put into us is the right one? How long does it last? What happens when its effect wears off? Does it disappear? Does it leave a trace? Do we become immune over time?"

In addition, he stresses that "neuromodulators must always be

, that is, from commercial houses authorized to manufacture them. The aesthetic imprint of a well-injected neuromodulator is positive, since, in addition to preventing static wrinkles, it treats dynamic ones , helping to slow down the aging of the upper third".

In this sense, Dr. Miguel Sánchez Viera emphasizes that "the product used in aesthetics must not only be of quality, but it must also be suitable

because what can have an aesthetic impact positive in one person, it may not be the same in another. For example, there are products that persist, such as calcium hydroxyapatite or highly modified hyaluronic acids in the laboratory, which can produce an excess reaction in some patients".

Rodríguez-Villa stresses the importance of this point.

"We should never allow ourselves to be treated with products that are not degradable. Unfortunately, in our day to day, we can see people with swollen cheekbones with

due to having used materials such as methacrylate, which do not degrade."

What would be the ideal number and frequency of infiltrations to prevent aesthetic traces from being produced?

"The ideal quantity and frequency is marked by a

and depends on several factors such as age, the degree of aging of the patient, the quality of the skin and its daily care. For this reason, put yourself in the hands of of a quality aesthetic doctor is essential to achieve a positive aesthetic imprint", replies Dr. Revuelta.

In his opinion, "the treatments that produce a more positive impact are

, those that cause our skin to recover its functionality and internal structures to go back years. As if we were talking about a house, it is ideal that both from the foundations to the roof, we have a strong and robust organization and we achieve this at the skin level by biostimulating collagen".

BOTULINUM TOXIN AND HYALURONIC ACID

What about

?

First of all, Ana Rodríguez-Villa stresses that "all the botulinum toxins on the market have passed the different registries of the national and European

, and all have studies that support both their safety and their efficacy, so that they are of quality".

How long does it last?

"There is a lot of diversity between

. Knowing the brand of the toxin is important to assess its possible duration, but the patient should also ask: how have they diluted it? How many units are they giving us? How do I Are they putting it in? Have they combined it with hyaluronic acid?"

Dr. Mercedes Sáenz de Santamaría, Head of Aesthetic Medicine at the International Dermatological Clinic (Madrid), adds that "

; it is reabsorbed 4-6 months after treatment. In the long term, it is said to have an effect preventative, since it re-educates the muscle, avoiding the formation of expression wrinkles, but not due to the accumulation of product in any case".

If we go from 'punctures', can we become immune?

Rodríguez-Villa clears up our doubts: "

. It is that, when the motor plate is inhibited with the toxin, a compensatory effect is physiologically generated that tries to reverse that blockage. This is what is This is known as

For this reason, it is important

so as not to generate early 'sprouting'", says Rodríguez-Villa.

And what do we have to know about

?

"For me, at the level of the aesthetic trace, it has a completely different reading from that of the toxin -says this doctor-. There are magnetic resonance studies that show that it can last even for years, although it is normal that it ends up degrading

with over time. Depending on the layer in which it is injected, on or under the muscle, it will be subjected to more or less traction, which means that it will have more or less capacity, both for movement and modulation".

Also, he continues, "it depends a lot on the

that is used and, based on this, we can say that the densest ones

than the less cross-linked ones and they are in more intermediate layers" .

In addition, "those that are on the bone, in principle, would not have the ability to migrate. However, those that are between different muscle packages, depending on the anatomical region, could change their shape."

For this reason, he emphasizes, "it is so important

".

Regarding the 'reabsorption' of hyaluronic acid, Dr. Sáenz de Santamaría says that "it lasts approximately one year depending on the patient, the treatment area, the amount, etc., it is also a resorbable product. It is exactly the same molecule that we have in our skin and we have enzymes that break it down.

However, he points out, "lately, there has been a lot of talk about

effects that last over time beyond the duration of the hyaluronic itself. What is unquestionable is that both this type of treatment and those of

, produce an improvement in the quality of the skin".

The question is: will there come a time when we can no longer put things on our faces?

"There is no age limit to be able to perform aesthetic medical treatments. And all of them can be combined with each other, so we could continue

, "concludes the head of Aesthetic Medicine at the International Dermatological Clinic.

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