Botox & fillers

by | March 27, 2014

You can’t reverse the ageing process, but there are ways you can hide the inevitable signs.

BY: Esther Low


Crow’s feet (laugh lines), fine lines, sunken cheeks, droopy eyes … most of us would probably be able to relate to one or the other as we grow older. Still, if you don’t feel your age, and don’t want to look it either, there are things you can do.

Dr Wong Soon Tee, consultant dermatologist of Assurance Skin, Laser & Aesthetics, shares more on botox and fillers, two of the most common medical procedures targeted at treating such conditions:


What is the difference between botox and fillers?

Botox and fillers are common medical procedures carried out for appearance enhancement. Botox is a chemical/drug that blocks the signal transmission between the nerve ending and the muscle (or sweat glands). When injected into the appropriate muscle, it will render the muscle inactive. Therefore, it is useful in the following areas:

a)    Wrinkles resulted from dynamic activity of facial muscles, e.g. forehead lines, crow’s feet and frown lines.

b)    Facial slimming to reduce bulky jaw muscles from overuse.

c)     To reduce excessive sweating as well.

Fillers’ main purpose is for volume replacement/augmentation, e.g. correcting furrows, depressed scars, sunken cheeks, or augmenting a flat nose or recessive chin. It also has hydrating- and collagen-stimulating activity.

Very often, you need both as they are complementary to each other given they each have their specific role and purpose.


How long does a treatment last on an average? Cost?

On average, just one treatment will last three to five months for botox and six to 18 months for fillers. Cost varies with the quantity required, the region of treatment as well as in the different clinics. It can start anywhere from $200 to $2,000.


What are the side effects?

As both are injection treatments, bruising may sometimes happen when a blood vessel is nicked.

Side effects specific to botox include drooping of eyelids (due to inappropriate placement of the injection) and asymmetry. Side effects specific to fillers include asymmetry, infection, product migration (fillers moving away from original position), bluish discolouration because of too superficial product placement, and blood vessel occlusion (this occurs when the product is accidentally injected into the blood vessel lumen, resulting in blockage of blood supply to the skin).

Thankfully, besides bruising and asymmetry, the rest of the side effects are uncommon.


How long does it take for the results to show? How short/long is the downtime for both treatments?

Results for fillers are immediate, with a downtime of half to two days. Results for botox start to show on the third to fourth day and reach their full effects after 10 to 12 days. There is no downtime.


Which are the more common areas/trend where the procedures are carried out on?

Upper face dynamic wrinkles are the most common area for botox treatments, e.g. forehead lines, frown lines and crow’s feet. Others include chemical brow lifting, correction of bunny lines (wrinkles beside the nose) and gummy smiles (show gum tissue when smiling), perioral wrinkles (around the lips), neck bands, etc.

Common request for filler treatment include skin-plumping and volumisation, skin-hydration, augmentation of cheeks, lips, nose and chin, and scar correction.


Are there any age limits to having these procedures? At which ages are people (men and women) more likely to go for treatments?

Usually people tend to be between 35 to 50s but there is no age limits set. In fact, botox is being used by paediatricians to treat children with muscle problems.


Which types of botox and fillers are safer and what should people who want these treatments watch out for? Any cautionary tales, etc?

In good hands, the treatments are safe. If I had to give a piece of advice, it would be to choose a good doctor – one with experience, good credentials, good experience and if possible, recommended by friends!


1 Comment

  1. Stephen Teng

    Do we need chemicals & needles to stay young, to be biologically more than 10 yrs younger than our chronological age? There are other natural nutrients for that and much safer to boot.

    In a long-term study involving 913 pairs of twins, Danish researchers discovered that the twins who looked younger than their true age had better health and longer survival rates than their older-looking siblings.

    Also, the larger the difference in how old each twin looked, the more likely it was that the older-looking twin died first.

    The researchers discovered that the reason for this difference is that the twins who looked younger had longer telomeres.

    Damage to telomeres shortens them and makes you age more quickly. You look older, feel older, and are more vulnerable to age-related disease.

    For instance, people with telomeres only slightly shorter than average have a 320% greater risk for heart attack? The risk increases for people with the shortest telomeres.

    Keep your telomeres from getting shorter and you can stay healthier as you get older.

    There’s a little-known nutrient that can help.

    It will give you a younger immune system, make your cells act younger, and you’ll be able to keep doing what you love no matter your biological age.

    It is citrulline.

    Citrulline is an amino acid. And it’s the main facilitator in the process that turns on a natural telomere protection factor called nitric oxide. Nitric oxide protects your cells and your telomeres, maintaining their length.

    Citrulline helps and improves the process that makes these telomere protection factors work. In fact, when researchers looked at citrulline’s effect, it increased your telomere protection factors by 300 percent!

    Citrulline is not easy to get in food. In Africa, the melon that grows in Namibia and South Africa, has some citrulline.

    On Bali, they have bitter cucumber, which also contains citrulline. Here at home, the melon with the most citrulline is from the same family. It’s watermelon.

    However, most of the citrulline you get in watermelon is in the rind and not the delicious red fruit.

    Watermelon juice also has more citrulline than the flesh, but you have to drink three glasses a day to get a good amount of citrulline for a telomere boost.

    Other members of the cucurbit family like cucumbers and cantaloupe have citrulline, too, but not much. You could also eat walnut seedlings, but it is not recommended. They’re bitter.

    The easiest way to get citrulline is through a powder or an extract.

    You can get pure citrulline powder as a supplement. But a tastier way to go might be dried watermelon. It will have quite a bit of citrulline, and it’s very pleasant to add to a glass of water.

    The most concentrated form is an extract. Fortunately, for telomere protection, you don’t need much. Just 50 mg a day of citrulline should provide you an additional telomere protection boost.


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