Botox and Beyond

Forget the knife. Bay women are turning to non-surgical procedures to combat ageing. Annemarie Quill talks to two of the Bay's most sought after 'appearance doctors' to see if they really can make us 10 years younger
Shane Warne is under fire in the gossip magazines again - but not for womanising. Having morphed from rough Aussie cricketer to Hollywood toy boy under the influence of Liz, he is accused of going under the knife. Shane denied a facelift, but did he have subtler treatment?
While facelifts still tend to be the domain of the rich and famous (it can set you back $30,000 in New Zealand), more people are turning to non invasive procedures which are less expensive but can be effective.
Latest figures from the American Society of Plastic Surgeons report Botox treatments are up 12 per cent from the previous year. While other procedures may be sagging in the recession, appearance medicine - Botox, fillers and lasers - is a rapidly growing industry, boosted by a plethora of makeover shows like Extreme Makeover and Ten Years Younger.
The Bay is reflecting the global trend and appearance medicine has never been so popular says Adam Bialostocki, plastic surgeon at Bay Plastic Surgery in Tauranga. Adam "guesstimates" that 20 per cent of Bay women over 40 have had Botox.
"Demand is increasing for non-invasive cosmetic enhancement. More women - and men - see it as part of their beauty regime.
"The hardcore of my clients tend to be between 40 and 55, but lately I am seeing more women in their 30s use it as a preventative measure."
Like the celebrities, local women are not 'fessing up to having work done. A recent survey by skincare brand Olay found that 66 per cent of Kiwi women said they preferred to age gracefully rather than seek cosmetic treatment.
"Don't believe it!" says Adam. "The people who say they prefer to age gracefully are usually my best clients!"
Dr Neil Mortimer, dermatologist at the Skin Centre in Tauranga, says Botox is their most popular treatment to combat wrinkles.
Both doctors warn women to seek out professionals.
 "You get what you pay for. There is a trend towards Botox and IPL being offered by mobile practitioners in beauty salons. I believe women should be seen initially by a trained plastic surgeon who can clinically assess what a person needs and manage expectations," says Adam.
Can we really turn back time? Adam and Neil give indulge the lowdown on the latest techniques.
Botox
Most popular cosmetic treatment in New Zealand. Botilinium Toxin is injected into facial muscles in tiny amounts to relax facial muscles and so reduce facial lines.
Upside: Improves wrinkle lines and can reshape the face to give a more youthful appearance, for example elevating brows. It can take up to two weeks to have an effect - if you have it in your lunch hour you are not going to look younger that afternoon. The over-Botoxed look is out. Says Adam "No one wants an expressionless face, as facial expressions are an important part of communication. The skill is in making subtle improvements."
Downside: Not permanent and needs to be repeated. "Allow three months minimum because if you repeat too often other muscles can waste too much and cause a hollow."
Adam says Botox is often best used in combination with other treatments. "Some lines need more than Botox alone. If your wrinkle is there in your sleep you need a filler too."
Where: Trained nurse or physician. Adam says, "Nurse injectors are very good at what they do. They are injecting all day.
Cost: Depends on volume used and area. At $18 per unit, could be between $200-$400.
Dermal Fillers

Injectible fillers are used to enhance the contours of the face, return fullness to lips and smooth frown lines and crow's feet. "The fillers we use are made of complex sugars [Hyaluronic Acid] not strange chemicals. We don't use collagen any more as although it can have good results it causes an allergic reaction in 3 per cent of people. Hyaluronic acid normally exists in your tissue in-between cells, so these fillers are just are adding to what's already there," says Adam.
Upside. The technique is minimally invasive, with almost instant results. It lasts longer than Botox - up to nine months, or even longer for thicker fillers.
Downside. The results are not permanent and treatment needs to be repeated. Untrained hands can inject in wrong place - with horror stories of fish lips.
Who: Trained nurse or physician
Cost: $350 -$1500 plus. The new very thin fillers can be as little as $200
Fat Transfer/Grafting

Growing in popularity as the non surgical facelift. Fat is extracted from the tummy or thighs and implanted into the face to improve volume.
Upside: Essentially permanent. "Fat grafting has great results, for deep set wrinkles/hollows. I always use it when performing a face lift or on its own," says Adam.
Neil adds that as it is your own fat, allergic reactions do not occur.
Downside: May need more than one treatment to get final result. Not suitable for small filling like lips as cannot put in tiny syringe.
Who: Only physician. Done under local anaesthetic
Cost: $1500-$3000 depending on site and quantity.
IPL (Intense Pulsed Light) Therapy

Delivers light pulses that are absorbed by skin to treat blood vessels, pigmentation and hair removal.
Upside: You can treat large areas; it is a versatile treatment with minimal downtime.
Downside: Multiple treatments required. Burns have been caused in rare cases.
Who: "Only go to an experienced practitioner. Inexperience and variations in machines can produce variable results and even complications," says Neil Mortimer.
Cost: Starting from $95-$880+ (depending on area treated)
Peels

A wounding substance, such as Glycolic Acid or Trichloroacetic Acid, is applied to the skin surface to remove the damaged outer layers and promote remodelling to improve fine lines and wrinkles and sun damage.
Upside: For stronger peels you do not need multiple different treatments
Downside: Strong peels can leave skin raw for 10 days so long downtime.
Who: Says Neil, "Light peels may be done by a beauty therapist but stronger peels must be done by a physician as there is a greater risk of scarring"
Cost: Peels with a doctor: Starting from $2040+ (depending on area treated)
Erbium Laser Resurfacing

Removal of layers of sun damaged skin in a precise manner with laser energy such as erbium YAG or CO2.
Upside: Significant reduction in superficial facial lines and wrinkles with improvement in skin pigmentation and texture usually after one treatment.
Downside: Downtime while skin heals in approximately 10 days, significant risk of infection or scarring without expert treatment. May lead to loss of skin coloration leading to pale areas.
Who: Must be done by a doctor.
Cost: Starting from $2965+ (depending on area treated)
Creams
Cosmetic companies are jumping on the bandwagon of cosmeceuticals - creams that claim a wonder scientific ingredient like Elizabeth Arden Prevage, pioneered by Allergan the parent company of Botox. Olay Professional - Olay's latest wrinkle buster sold out in less than an hour when it was launched in the UK last month.
"Creams promise the world but the only scientifically proven topical treatment to combat ageing is vitamin A. Whereas most anti-ageing creams contain Vitamin A [retinol], to get it in high enough concentration for it to be effective you need it on prescription. It is inexpensive and I recommend it first before trying any of the more expensive creams," says Adam.
So is it worth it?
Neil adds that there is no point in spending big on any skin treatment if your lifestyle doesn't take care of your skin.
"Maximise results with a good diet rich in protein, fatty acids and plenty of vitamins. Drink lots of water. Use a high SPF suncream even in winter. Cut down on alcohol, and caffeine, and reduce stress."
And if all that sounds too hard, dial Botox.
- These treatments must be administered by someone with adequate training and expertise. Ask your doctor or nurse about specific qualifications and experience.