Ask an Expert: Fillers & Botox

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I recently found a wrinkle on my forehead and it has given me the fear. Every single day I scour my face for the next inkling of wrinkling, and the thought of living the rest of my life waiting for lines to appear as if I'm an ageing rocker in the backroom of a nightclub puts the fear of bejesus into me. So, I decided next year, I may well venture into the world of botox and fillers. But the only thing scarier than being a bit shrivelled? Getting that awful filler face you see in magazines... So how does someone go about dabbling in a bit of, ahem, self-improvement without risking semi-permanent 'just had a mild allergic reaction' face? 

You speak to someone like Dr Jules Nabet. World-renowned cosmetic doctor with over 25 years experience, he specialises in 'baby Botox' - a super natural appearing filler - from his Ominya medi-clinic in Knightsbridge. He agreed to answer all of my stupid questions and give me the actual lowdown on what's going on under the needle. 

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What should you ask for to get the most natural results?

Simply asking for natural results should be enough to get natural results. We take the first step, the consultation, very seriously and if the client wants to achieve results that blend in and fit the features one already has then that's noted. You should always keep an eye out for a doctor who takes this seriously.

Botox is used to banish frown lines and crow’s feet as a preventative (the sooner you start the less you will need as you age) and corrective treatment. We pioneered “baby Botox,” a lower dosage, which means that the patients’ face can actually move afterwards. Your face shouldn’t be frozen, if you can’t move your face it hasn’t been done correctly. It’s all about where you put it and how much is used. It should be impossible for the untrained eye to tell if you’ve had any.  People should say 'you look well' not 'what have you had done?!', so the key is subtle, understated approach, keeping expression in the face.

What age should you start getting injectables?

Each person is different and may prefer to begin getting injectables at a different stage in their life. The majority of my patients are still women in their 40s and 50s. Botox is increasingly being used at a younger age, and I often see women as young as their mid-twenties but if they don't need botox injectables, I will turn them away.  My actual clientele are models, actors and TV personalities, but I am in confidence with them and will not reveal their names! Botox is my speciality, and the most important thing for me is that my patients look natural, Botox that looks refreshed, not frozen.  I am seeing lots of models and sometime they are just too young and don’t need any treatment and I will not treat them if they don't need it. 

How do you avoid ‘filler face’?

Fillers are a minimally invasive way to add volume to your cheeks and lips as well as soften any vertical lip lines and wrinkles around the area. Filler face is typically caused by less experienced doctors or the patient requesting an extreme surgery.  Botox and fillers are NOT the same thing, although often administered together to treat the face as a whole, the two products are very different. Botox relaxes the muscles, while filler is used to add volume to areas that become hollow with age.

People should say ‘you look well’ not ‘what have you had done?!’, so the key is subtle, understated approach, keeping expression in the face.
— Dr Nabet

What new products have you seen on the market?

We're currently pioneering the motorised Botox pen - it offers less pain and more accuracy, and I'm so excited to be able to offer it! It's about 50% less painful for the patient and more accurate as it's a motorised syringe. 

There's also a new filler that we're one of the first clinics in the UK to offer called Teosyal RHA. It's a new type of filler that's been created to take into account facial movement, hopefully to avoid filler face! Since the introduction of the first hyaluronic acid (HA) dermal fillers more than 30 years ago, a number of advances in composition, production and applications of the products have been made. Despite the huge number of available fillers on the market, a patient need is not currently answered; the dynamism of the face. None of the current available products takes into account the daily movements of the face and the facial expressions.  Facial dynamics and emotional expressions changes during ageing. Facial expressions convey emotions and messages that form the basis of social relationships. With ageing, the face is changing and unpleasant expressions arise: sadness, sternness and fatigue. Ageing doesn’t only change the structure of the face, but also promotes these expressions.

To accomplish this, fillers must have rheological properties compatible with facial dynamics. Nowadays, more than 160 different products are available worldwide from more than 50 companies. Despite the advances in the design and the productive of HA fillers, none of the current products take into account the daily movements of the face so that the natural expressiveness of patients is not optimally kept after treatment. Current fillers only allow a non-invasive facial rejuvenation in a static way. The face is mostly dynamic: the lips, the cheeks, the forehead, the chin, the nasolabial folds, the marionette lines… All these areas have been treated with fillers for years and many positive results have been shown. However the fillers were always designed to take into account the static outcome of the treatment even though all these areas are actually moving! So this new filler is a real game-changer.