Dermal Fillers: Friend or Foe?

Cosmetic medicine specialist, Dr Peter Forrester answers some questions and clears up some misunderstandings about dermal fillers.

Are dermal fillers safe?

Restylane was the first HA filler and has been in use for over 20 years. Since introduction HA filers have been used tens of millions of times. Hence, we now know a great deal about both their benefits and safety. Because the HA in fillers is very similar to the HA that exits naturally.

How long do HA fillers last?

Dr. Peter Forrester and Ms. Helen McEvoy offer:

• Wrinkle reducing and skin smoothing injections: A highly effective way to reduce forehead lines, frown lines and crow’s feet.

• HA Dermal Fillers: smooth deeper lines and furrows as well as returning lost volume to the face.

What are dermal fillers?

The term Dermal Filler refers to a group of injectable clear gels designed to lift and plump skin. They are commonly based on hyaluronic acid (HA). Hyaluronic acid occurs naturally in many body tissues including the skin where it has important functions maintaining structure and hydration. HA binds to water in the skin, locking in moisture. As we get older the amount of hyaluronic acid in skin gradually diminishes which in part is responsible for many of the appearances of skin ageing.

Will it be obvious that I have had a filler treatment or will I look pumped up?

Images in the media of hugely plumped lips and cheeks and the so-called trout-pout have given HA dermal fillers an undeservedly bad reputation. Correctly used they will result in a natural and rejuvenating appearance with no risk of an overtreated look. The paradox of filler treatments is this, when they are obviously over-done everybody notices but when properly used the results are subtle. People see the ‘bad’ ones but don’t notice the ‘good’ ones – this leads to a belief that all filler treatments will produce a bad result.

What areas can be treated with fillers?

Fillers can be used to:

• replace lost volume in cheeks and lips

• reduce deep and fine surface lines including smokers lines around the mouth

• lift the jowls

• stimulate and hydrate the skin

Injected hyaluronic acid is slowly broken down in the body. The beneficial effects of a treatment can be expected to last for up to 12 months. However, this will depend on a number of factors including patient age, area treated, quantity of filler injected, skin quality, general health and lifestyle including smoking. It was once believed that once all the hyaluronic acid had been broken down it would have no further benefit. However scientific studies have shown that HA fillers can stimulate the formation of heathy skin tissue and new collagen. This boost to the body’s own collagen may help to explain why smaller volumes of filler are often required during top up treatments and why some people seem to derive significant benefit for 18 months or longer.

Dr Peter Forrester and Ms Helen McEvoy, 6 Esher Park Avenue, Esher, KT10 9NP Tel: 01372 890890 enquiries@cosdocs.co.uk cosdocs.co.uk

• Profhilo: Increasingly popular skin rejuvenating injections designed to improve skin hydration, stimulate the production if collagen and elastin thus improving skin tone and reducing theappearance of fine lines and wrinkles.

• IntraCel: Cleverly combining the proven techniques of microneedling and radio frequency (RF). INTRAcel may improve skin tone, tighten sagging skin, smooth fine lines and wrinkles and reduce acne scarring.

• Facial Peels: Returning a healthy glow to a dull looking complexion; revitalising sun damaged skin, improving fine lines, wrinkles and uneven tone are all part of the chemical peel’s appeal.

• Dermaroller: May improve the appearance of facial lines, wrinkles, sun-damaged skin, and acne scarring.

• Hand rejuvenation: Mesotherapy (a non-invasive non-surgical technique) in combination with hyaluronic acid reverses the appearance of ageing.

• Hyperhydrosis: Significantly reduces excessive underarm sweating.

Advanced skincare: Scientifically proven strategies for skin; including anti-ageing and long term skin health.

Cosmetic Surgery procedures include:

• Breast Enlargement

• Breast Mastopexy (uplift)

• Breast Reduction

• Abdominoplasty (tummy tuck)

• Liposuction

• Body contouring

• Skin lesion and Mole removal

Many people take extreme pleasure from gardening. Pottering around the garden, making it look beautiful so that you can enjoy the fruits of your labour and relax surrounded by nature may be one of your favourite pastimes.

But regular weeding, digging, planting, hedge trimming and mowing can cause lower back pain. This pain can become so severe that it prevents you from getting out into the garden and doing what you love.

In this article, King Edward VII Hospital physiotherapists give their top tips for reducing the risk of back pain associated with gardening. They also discuss how to manage back pain that may have been caused by working in the garden.

Top tips for preventing, reducing and managing back pain

1. Warm up thoroughly before beginning work on your garden. You might think that because gardening isn’t a sport, you don’t need to warm up. But bending, digging, pulling and lifting all require the muscles to be in full working order. The warmer the muscles, the less likely they’ll be to suffer injury. Try doing some gentle stretches just before you start gardening, and every hour or so whilst gardening if you can. They’ll also help to ease any lower back pain you may have after gardening (see your doctor before exercising if your back pain is severe).

2. Have a plan that spreads the harder jobs out over time. Don’t aim to get all of the harder jobs such as digging and pruning the tops of bushes and trees all in one day. Mixing up the jobs also will put less strain on one particular area of the back. You could try 20 minutes of kneeling down to weed followed by 20 minutes of cutting the grass and then 20 minutes of hedge trimming. Use a timer to make sure you don’t go over.

3. Learn to lift properly. Proper lifting is essential for protecting the back in any environment. Gardening often involves lifting heavy pots or bags of soil or sand, or machinery from the shed or up a ladder. Safe lifting involves careful planning, not rushing, keeping the feet stable and crucially, bending from the knees rather than the back.

4. Always push your lawnmower properly. Push forwards in a straight line with your arms extended, and refrain from looking over to your side. Always keep the lead of an electric mower behind you. Putting it over one shoulder can help. If possible, upgrade to a lighter weight electric lawnmower rather than a heavier petrol mower or a difficult to push non-motorised one.

5. Match your tools to your job. If you’re kneeling down to do some weeding, use short handled, lightweight tools and keep them all close by so that you don’t have to overstretch to reach them. Long handled tools are ideal for reaching

The Details

If you’re experiencing back pain, speak to physiotherapist in King Edward VII’s Hospital’s state of the art physiotherapy department on 0203 930 1392 Mon – Fri 9am – 5pm kingedwardvii.co.uk higher up branches without using a ladder but take care not to lose your balance when looking upwards. Keep your tools sharp and free from rust too, as this will make each job much easier and less time consuming.

6. Use a knee pad. A knee pad will make weeding and digging with a small trowel easier on your knees. This in turn will make you more comfortable all over, putting less pressure on your back. A knee pad with a frame around it will assist you in getting up and down which will help your back, too.

8. Aim for raised planters. This is a long term solution, but having raised planters and beds for both plants and vegetables means less bending over to tend to them in the long run.

9. Take rest breaks. Taking regular breaks will give your spine a chance to stretch back the other way after being bent over. This will help to reduce the compression experienced by the spine when bending and lifting and can mean that you have less chance of experiencing a back injury.

Always stop gardening immediately if your lower back pain, or any other pain, becomes severe. You could put yourself at risk of further damage if you continue.

When to see a doctor for help

These tips will help you to enjoy gardening free from pain. If you do experience back pain, rest, hot or cold compresses and pain killers can help, although if persistent lower back pain can require further treatment, physiotherapy or even surgery.