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Lip Fillers Before and After with Dr Wade Merchant

Dr Wade believes that lips should always look natural – and these lip fillers before and after photos are a testament to that. Not only is every patient completely unique, but each lip filler treatment is completely unique. As we age, volume changes occur. A younger person can not be treated in the same manner as an older person – and vice versa.

Lip Fillers Before and After

As seen above, this younger patient was able to get a volumised appearance with just a single syringe of filler. That is because her foundations were still good – Dr Wade just had to deal with the layout and design of her lips (if we were to continue with the construction metaphor).

Lip Fillers Before and After

As you can see with this more mature patient, a volumised appearance was not possible with only one syringe of filler. Dr Wade focused on her lip border and mouth corners  – so essentially he did “renovations” on the foundations of her lips. She was very happy withe the result as her smokers lines improved and she looked less tired. That said, if she wished to have more volume she would require an additional syringe at a later day.

As you can see – not only are different age groups treated differently, but the results that can be expected are also different. At the end of the day, all that Dr Wade wants for his patients are natural results that make them look and feel better.

APPOINTMENTS

Contact us today if you would like to know more about treating wrinkles or if you would like to schedule a consultation to discuss the various aesthetic treatments we offer. Dr Wade practices in Green Point and Somerset West, Cape Town. To book an appointment please contact:

Telephone: 087 135 3017
Email: bookings@naturalcape.com


NATURAL AESTHETICS – BOTOX

Cape Town| Green Point | Somerset West

Botox | Fillers | Silhouette Soft | Chemical Peels | Micro-needling (Dermapen) | Filorga Mesotherapy

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Lip Filler – The new normal

A Lip Filler treatment adds definition to the mouth, lips as well as adding volume to the lip where it matters most.

There are fillers that are specifically developed for lips and there are fillers that are not meant to be used in lips. Knowledge of which one to use and when requires medical training and experience. Choose your doctor based on their prior results as well as what other people have said about them – word of mouth referral is the best – but if not, do your research and ask questions. Ask as many questions as you need to in order to feel comfortable that the treatment that you are going to receive is the best for your individual taste and style.

lip filler

Lip Filler is a hyaluronic acid smooth gel that is injected by your doctor, using an ultra-fine needle. It has been specifically developed as a smooth gel to give a soft, natural feel. The gel fills in lip lines and wrinkles while the hyaluronic acid within attracts and retains moisture, so results can last up to a year.

Lip Filler

These rules must be obeyed by the injector in order to maintain a natural look.

Prior to being injected, your lips will be medically numbed using either a potent medical grade numbing cream or local anaesthetic injections within the mouth. Usually, the potent numbing cream is more than enough to suppress the pain associated with lip injections. That said, if you desire local anesthetic injections instead of the cream, mention it to your doctor so that you can have the best experience possible. Fillers should never be painful!

 

APPOINTMENTS

Contact us today if you would like to know more about treating wrinkles or if you would like to schedule a consultation to discuss the various aesthetic treatments we offer. Dr Wade practices in Green Point and Somerset West, Cape Town.To book an appointment please contact:

Green Point Practice (Based at Legs 11 Aesthetic Centre):

Telephonic: 086 132 4752
Email: greenpoint@legs11.co.za

Somerset West Practice:

Telephonic: 081 301 3277
Email: bookings@naturalcape.com


NATURAL AESTHETICS – BOTOX

Cape Town| Green Point | Somerset West

Botox | Fillers | Silhouette Soft | Chemical Peels | Micro-needling (Dermapen) | Filorga Mesotherapy

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Dermal Fillers

Dermal Fillers go by many names; Fillers, Facial Fillers, Injectable Fillers – essentially they are all the same thing. And that thing is a very broad category of products that can be very different to one another. Now that I’ve made it look complicated, let’s take a step back to review what exactly a filler is.

A filler fills. It’s as easy as that – although where it fills and how it fills are the more difficult questions! A filler can either be permanent or non-permanent – that is they either get absorbed over time or they last for life.

Dermal Fillers

Permanent Vs Non-Permanent Dermal Fillers – Table courtesy Wollina and Goldman (Fillers in the improvement of acne scars).

The current thinking is that non-permanent dermal fillers such as Hyaluronic acid based fillers are the safest to use. As they are not permanent, if you don’t like the result, it will eventually go away. Also, in special circumstances if the dermal filler needs to be removed, it can be dissolved using an injectable enzyme. So for the most part, most doctors today use Hyaluronic Acid based dermal fillers.

And what is Hyaluronic Acid you may ask? Hyaluronic acid is a carbohydrate that is found naturally in our skin. It is a water holding molecule (so it hydrates) and fills the spaces between our collagen and elastin fibers in the dermis of our skin.

Dermal Fillers

Hyaluronic acid is a molecule made up of N-acetyl glucosamine and Glucuronic acid. It provides hydration to the deeper layers of the skin. Image: source unknown.

Initially dermal fillers were used to fill the lines associated with facial aging. So doctors would typically inject the lower face (nasolabial folds and marionette line). This would reduce the visibility of the lines but it never dealt with the cause of the line – which is facial fat loss.

Dermal Fillers

Over the decades our faces lose fat from the fat pads in our cheeks. Image source: unknown.

The current thinking is that instead of injecting the lines in the lower part of the face, we inject the cheeks first – to replace the fat that has been lost. What happens when we do this is that the cheeks are lifted and the lines under the eye, between the nose and mouth and below the mouth are all reduced. If then the person still has lines in these areas, the second treatment would be to directly inject these lines – although most of the time this is unnecessary as the client looks and feels rejuvenated.

The type of Hyaluronic Acid dermal filler we use depends on where we inject it and how deep we inject it. All filler brands have a variety of different fillers within their brand – from the thick gel-like ones to the thin silk-like ones, each has its use. The thicker gels tend to be used for deep injections in the cheeks – they provide the “foundations”. The thinner silk-like ones are injected more superficially – they are like the “curtains”. Foundations of a house provide support and generally last a long time – cheek fillers lift the cheeks (support) and last longer than thin fillers. The curtains of a house get blown around in the wind (thin fillers can easily be moved by the injector) and are usually changed frequently (thin fillers only last around 9 months to a year).

Dermal FIllers

The size of the Hyaluronic Acid particle influences whether it’s a thick or thin filler. As seen above, large sized particles like Restylane Sub Q are thick fillers, which are injected deep. Small sized particles like Restylane Touch are thin fillers and are injected superficially. Image courtesy Galderma.

All of the above is just a very small introduction into the world of Dermal Fillers. There are so many more things to know! At the end of the day, one thing stands true: For the most part, it is the injector that you should be concerned with and not the dermal filler choice!

 

–  Dr Wade

 

Appointments

Contact us today if you would like to know more about dermal filler treatments in Somerset West, Green Point or Camps Bay, Cape Town. Let us know if you would like toschedule a consultation to discuss the various aesthetic treatments we offer. Dr Wade practices in Green Point, Camps Bay and Somerset West, Cape Town.

For Bookings:

Cape Town | Green Point | Camps Bay | Somerset West

Botox  | Dermal Fillers | Chemical Peels | Micro-needling (Dermapen) | Filorga Mesotherapy

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Does she have Botox Lips?

One common misconception that pops up when talking to people is that they actually don’t know the difference between Botox and Fillers. Recently, one of my friends asked me if I thought that the lady sitting across from us in the restaurant had Botox in her lips. To clear up all of the confusion – there is no such thing as injecting Botox into someones lips. Botox Lips are a fallacy!

Botox is a protein that is used to block muscle movements and in so doing treat the wrinkles that are formed by muscle movements. The following wrinkles can be treated with Botox injections:

  • Frown – Glabellar
  • Forehead – Frontalis
  • Eyes – Crows feet
  • Brow Lift
  • Nose – Bunny lines
  • Gummy Smile
  • Mouth – Smoker’s lines
  • Chin – Dimple reduction
  • Neck – Nefertiti lift and contouring

Botox Lips

Botox has no volumising effect – that is, it can never add volume to the area that it is injected. Fillers on the other hand are the treatment of choice for volumising. When you think of Kylie Jenner and her full, plump lips it is not Botox that has created them. Botox Lips are a fallacy – it is Filler Lips that you want. Fillers volumise lips  – the extent of volumising is determined by how much filler you use. Kylie Jenner may not have a natural result, but she definitely has filler in her lips. Lip Filler treatments can in fact be very natural looking.

Botox Lips

Kylie Jenner – Here too much Lip Filler has been injected into the upper lip – creating a sausage like appearance.

 

Botox Lips

The ideal lips – the natural dimensions have been maintained.

So the answer to the question, Does she have Botox Lips…

Definitely not!

– Dr Wade Merchant

 

Appointments

Contact us today if you would like to know more about treatments in Somerset West, Green Point or Camps Bay, Cape Town. Let us know if you would like to schedule a consultation to discuss the various aesthetic treatments we offer. Dr Wade practices in Green Point, Camps Bay and Somerset West, Cape Town.

For Bookings:

Cape Town| Green Point | Camps Bay | Somerset West

Botox Lips | Fillers | Chemical Peels | Micro-needling (Dermapen) | Filorga Mesotherapy

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Eye Fillers

Eye fillers are a treatment that can have an astounding affect on the way a person looks and feels. Many people walk around looking tired and sad –  most of the time this is as a result of the way their face looks. When we age we lose the fat in our cheeks and they begin to sag. The sagging cheeks then pull on the skin just below the eye, and a line forms – known as the tear trough line (named so as it makes you look sad). Before eye fillers came along, the only way to restore volume here was to inject fat that had been taken from somewhere else on your body. Now while a bit of liposuction and some facial rejuvenation are great, they require sedation and surgery – and with that comes downtime, pain, bruising and swelling. Since the arrival of under eye fillers, we have been able to offer clients an in and out service that is relatively painless and has little to no downtime.

Under Eye Fillers

Deep lines under the eyes can be treated with fillers.

The eye fillers procedure takes about an hour – most of that time is spent explaining the treatment and how it works as well as marking out the face to ensure that the correct areas are injected. The markings are made with a white eyeliner – so it easily comes off with a facial wipe – so no need to worry about walking around with lines on your face after your eye fillers treatment! If you are concerned about pain, a topical cream can be applied before the treatment to numb the area. As a general rule, mid face fillers aren’t sore! Below is a video of a doctor injecting eye fillers – it really is a great treatment!

Appointments

Contact us today if you would like to know more about Eye Fillers in Somerset West, Green Point or Camps Bay, Cape Town. Let us know if you would like to schedule a consultation to discuss the various aesthetic treatments we offer. Dr Wade practices in Green Point, Camps Bay and Somerset West, Cape Town. Eye Fillers are great for rejuvenation!

For Bookings:

Cape Town | Green Point | Camps Bay | Somerset West

Botox Injections | Eye Fillers | Chemical Peels | Micro-needling (Dermapen) | Filorga Mesotherapy

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Cape Town Fillers with Dr Wade

When looking to get a Cape Town Filler treatment, one must consider several things. Firstly, they filler brand. In Europe, there are over one hundred fillers on the market. In Cape Town Fillers can only be imported legally under the auspices of the Medicines Control Council – that is they need to be safe and legal before our Medical Board will even consider allowing anyone to import Cape Town Fillers.

 

FDA and CE approved Cape Town Fillers.

FDA and CE approved Cape Town Fillers.

 

If you are still unsure as to whether your Cape Town Fillers are safe to use then you need to find out whether they are either FDA or CE approved. The FDA is the American regulatory body and the CE is the European body – they oversee the criteria and ingredients that are used – and if they are given the stamp of approval then the Cape Town Fillers are safe to use.

For the most part in South Africa, it is the injector that you need to choose wisely and not the filler. If the Doctor know how and where to inject then that will create the best results. A novice with a really great filler will create poor results. That said, in our practice, we only use FDA or CE approved fillers sourced from reputable long standing suppliers.

 

 

 

Cape Town | Green Point | Camps Bay | Somerset West

Botox | Fillers | Chemical Peels | Micro-needling (Dermapen) | Filorga Mesotherapy

 

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Wrinkle Treatments Cape Town Somerset West

 

What causes the skin to age?

External factors such as increased sun exposure, wind exposure and pollution can all result in wrinkles and discolorations. Wrinkle Treatments by Dr Wade can be done in Somerset West and Cape Town. Diet and poor lifestyle habits such as smoking and not exercising also play a role. A lifetime of stress (in some cases only half a lifetime!) results in the repetitive muscular movements of facial expression – these cause wrinkles. Sudden weight loss, although great, can also cause the skin to age as you lose fat within the facial fat pads – and your face droops and sags.

 

Wrinkle Treatments Cape Town Somerset West

Wrinkle Treatments Cape Town Somerset West

When we are born we have the most beautiful young, supple skin – the reason being as our skin is full of a substance called Hyaluronic Acid which acts to hydrate the skin. As we age, we lose Hyaluronic acid and our skin loses the soft supple nature that it once had. This is an internal factor as to why we look older. This process accelerates from the age of 30 – our skin produces less and the rate of destruction is higher.

Wrinkle Treatments Cape Town Somerset West

Wrinkle Treatments Cape Town Somerset West

The above factors cause lines, wrinkles and folds to develop. Your skin loses volume and your face changes shape. How fast all of this happens is dependent on what we have already mentioned. Living a healthy life today and protecting your skin from the sun can help to reduce the speed to which you age. In anti-aging medicine it is never to late to change your life and see results.

What are wrinkles?

Wrinkles are folds in the skin and there are two types. Dynamic wrinkles occur over time from repeated muscle use like frowning and smiling – if present for long enough they can develop into static wrinkles. Static wrinkles are always visible and are due to a lack of skin elasticity. They are caused by sun damage, smoking, genetics and prolonged dynamic wrinkling.

Frown Wrinkle Treatments Cape Town Somerset West

Frown Wrinkle Treatments Cape Town Somerset West

Forehead Wrinkle Treatments Cape Town Somerset West

Forehead Wrinkle Treatments Cape Town Somerset West

Wrinkle Treatments Cape Town Somerset West

Static Wrinkles – notice the Tear Troughs, Naso-Labial Lines and Marionette Lines

 

Injectable Treatment Options

Botox

Botulinum Toxin (Botox) is a purified protein derived from Clostridium Botulinum that is used to reduce unwanted dynamic facial wrinkles. It acts by blocking the signal from the nerve to the muscle and in so doing prevents muscular contraction. Botox only works on dynamic wrinkles – static wrinkles will need different treatment options. The effects of Botox last anywhere from 3 to 6 months – it really just depends on the dose, your metabolism and if you have had Botox before. The more often you have Botox, you will need less amount of treatments per year.

Wrinkle Treatments Cape Town Somerset West Wrinkle Treatments Cape Town Somerset West

Hyaluronic Fillers

Hyaluronic acid is a naturally occurring substance found in our skin. As we age we lose this substance and our skin loses its once youthful tone and appearance. Aging also results in loss of fat from our facial fat pads. A young-looking face has round contours, high cheekbones and a well-defined jawline. The reason we look the way we do is partly because of the bones in our face but partly due to these fat pads beneath the skin. As they lose fat the skin above them begins to sag and as a result our cheek bones move down our face and we get static lines around our nose and mouth. The pulling of the sagging skin then also creates depressions and bags under our eye.

Wrinkle Treatments Cape Town Somerset West

Juvederm Filler Range

The treatment of facial sagging and static lines is Fillers. These fillers are injected with a very fine needle into the area overlying the cheek bone. Once injected the results are immediate and a gentle lift occurs whereby a new cheek is pulling up the skin from the lower face and as a result the lines around the mouth and nose are visibly reduced.

Wrinkle Treatments Cape Town Somerset West

Wrinkle Treatments Cape Town Somerset West

Before and After Cheek Fillers

Fillers generally last from 9 to 18 months depending on where they are placed. Over time they are naturally reabsorbed by our body. The old way of injecting fillers was to inject only in the facial wrinkles of the lower face – this would remove the wrinkles but leave the client with an unnatural result. Current science and thinking points towards the cheek injections as the most effective method to give the most natural results.

Wrinkle Treatments Cape Town Somerset West

 

Below is a video explaining cheek fillers for rejuvenation:

– Dr Wade

For Bookings in Somerset West, Camps Bay and Green Point, Cape Town:

bookings@naturalcape.com

081 301 3277


Cape Town| Green Point | Camps Bay | Somerset West

Botox | Fillers | Chemical Peels | Micro-needling (Dermapen) | Filorga Mesotherapy

 

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Botox and Fillers: The next generation in treatment styles.

Dr Wade Merchant uses Botox and fillers to enhance the facial aesthetics of his patients. The medical name for Botox is Botulinum Toxin Type A (BTX). They are both injectables but they act in different ways:

BTX: Acts by deactivating muscles that cause wrinkles. The wrinkle then cannot form and the line disappears over time.

Fillers: Hyaluronic acid gels that are injected into the face in order to provide volume to  certain areas where it may be lacking or has been lost as a result of the aging process.

Botox and Fillers

BTX lasts around 3 to 4 months if the recommended units are used – if less than recommended units are used, the results will not last as long as they should. This is important to remember when attempting to reduce the amount of units because of cost – if you use less units now you will need more units sooner, and will probably end up spending more money than if you had just received the recommended units. Medical doctors are specially trained to assess and prescribe the amount of units needed – just in the same way that they know which dose of your anti-depressant to give you.

Filler treatments last different amounts of time depending on the filler used as well as your particular metabolism:

Voluma (Cheeks): 18months.

Volift (Lips and nasolabial folds): over 1 year to 15 months.

Volbella (under eyes and lip border) – 9 months to a year.

At the end of the day, each face requires a different approach and normally a combination of both BTX and Fillers are used.

 


 

APPOINTMENTS

Contact us today if you would like to know more about treating wrinkles or if you would like to schedule a consultation to discuss the various aesthetic treatments we offer. Dr Wade practices in Green Point and Somerset West, Cape Town.To book an appointment please contact:

Green Point Practice (Based at Legs 11 Aesthetic Centre):

Telephonic: 086 132 4752
Email: greenpoint@legs11.co.za

Somerset West Practice:

Telephonic: 081 301 3277
Email: bookings@naturalcape.com


NATURAL AESTHETICS – Botox and Fillers

Cape Town| Green Point | Somerset West

Botox | Fillers | Silhouette Soft | Chemical Peels | Micro-needling (Dermapen) | Filorga Mesotherapy

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Tear Trough Filler Cape Town Somerset West

 

One of the most common problems that I am faced with in my practice are lines below patients eyes. Many people present to me saying that they look tired all of the time and that they need Botox for the line just below their eye. Unfortunately, in this case Botox will not work – this is as Botox works only on wrinkles and lines caused by muscular movements – for the eyes it will only work for crows feet (the lines on the outer corner of the eye). Tear Trough Filler Cape Town Somerset West – the aesthetic treatment for lines under the eyes.

 

Tear Trough Filler Cape Town Somerset West

 

Patients are often not aware that it is the Tear Trough deformity that is making them look tired all of the time. Some people can be born with this line (and it deepens with aging) or some people can develop it as a part of the aging process – usually from their late twenties onwards. Sun exposure, poor diet and smoking can all speed up the process of developing this deformity.

The only way to correct this deformity is to use a filler to “fill” the space that has been de-volumised. Before we can talk about the method of filling, we must understand why this line develops.

Our faces look the way they do as a result of three main structures – our bones, our muscles and our fat. Interestingly enough, it is the fat that we as aesthetic doctors are most interested in. In our face there are two levels of fat – the deep fat pads and the superficial (shallow) fat pads. Aging results in loss of fat from the deep fat pads. These pads usually support all of the tissue in our face to make us look the way we look. When we lose the fat, the supporting structure is lost and everything moves downwards with gravity. This downward shift pulls on the ligaments just below the eye and they then pull on the skin – the result is a line just below the eye known as the tear trough deformity.

 

Tear Trough Filler Cape Town Somerset WestTear Trough Filler Cape Town Somerset West

 

In order to fill this area we must use a filler that is very soft and fluid-like. If we use a hard, gel-like filler we will end up with a poor result as the area will swell and it will be over-corrected. It is important for your doctor to have a clear understanding of the chemistry and physics of fillers before injecting this area. There are two methods of injection – either by a needle or by a cannula (a blunt tipped needle). Cannulas have been shown to cause less bruising – so speak to your doctor when deciding on a treatment method (some practices also charge you for the cannula in addition to the filler).

Needles vs Cannulas - Lower risk of bruising.

Needles vs Cannulas – Lower risk of bruising.

 

If a needle is used, 3 to 5 injections below each eye are performed. If a cannula is used, there is only one needle prick and the filler is injected using a blunt needle passed through the first needle-prick site.


Tear Trough Filler Cape Town Somerset West Tear Trough Filler Cape Town Somerset West

Tear Trough Filler Cape Town Somerset West

Juvederm Product Range

For more information and to make a booking with Dr Wade in Green Point, Cape Town or in Somerset West please contact us via telephone or email – our relationship manager will gladly be of assistance.  Tear Trough Filler Cape Town Somerset West – for eye rejuvenation.

t: 081 301 3277

e: bookings@naturalcape.com

 


 

Tear Trough Filler Cape Town Somerset West

 

Cape Town| Green Point | Camps Bay | Somerset West

Botox | Fillers | Chemical Peels | Micro-needling (Dermapen) | Filorga Mesotherapy

 

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The way we think about facial aging has changed significantly in the last 5 years. Previously, when we saw a line on the face, our first thought was to fill it with something like a dermal filler. For some patients this worked – the line was filled and everyone was happy, but for others, the results were less than perfect.

Nasolabial Fillers Cape Town Somerset West

As we age, the first line that seems to bother us in the lower face is the nasolabial fold – this is the line from the corner of the nose to the corner of the mouth. When fillers first came out, this was the line that everyone had filled. The problem comes when you think about what makes a youthful face look youthful. In a youthful face there is very little volume (forward projection of tissue) in the area between the nose and the mouth. The bulk of facial volume is held in the cheeks.

When you place a filler in a nasolabial fold you run the chance of over-filling the area. This phenomenon has been referred to as the “baboon face” effect. The images seen below are examples of the typical face that results when fillers are injected incorrectly.

Nasolabial Fillers Cape Town Somerset WestNasolabial Fillers Cape Town Somerset WestNasolabial Fillers Cape Town Somerset West

The new and correct approach is to look at the face in 3 dimensions. Rather than filling lines, we aim to rejuvenate the face by adding volume where it has been lost. Once facial volume has been restored to what it once was, we see a marked improvement in nasolabial folds – without adding any filler to this area. This is as a result of the lifting effect that the fillers give. The end result is a more natural look.

I like to think of the face as if it’s a 3 dimensional diamond, rather than a 2 dimensional triangle. A diamond sparkles from all angles, whereas a triangle is invisible when turned sideways!

 

Nasolabial Fillers Cape Town Somerset West

 

At the end of the day, the lack of a nasolabial fold in a person doesn’t make them look younger or more attractive. As seen in the well-known actress, Blake Lively, in the right circumstances a nasolabial fold can be an attractive feature rather than a flaw. What we notice in her is that she has great cheek volume – this is the reason why she appears youthful. Without the use of fillers in years to come, her cheeks will lose volume and her face will sag downwards. This will deepen her nasolabial folds as well as create a line under her eye called the tear trough. Looking at the face as a whole prevents us from treating incorrectly or over-treating.

Nasolabial Fillers Cape Town Somerset West

CANNES, FRANCE – MAY 15: Blake Lively attends the “Mr Turner” premiere during the 67th Annual Cannes Film Festival on May 15, 2014 in Cannes, France. (Photo by Ian Gavan/Getty Images)

To restore volume to the cheek area and reduce the appearance of the nasolabial folds we typically inject 3 to 4 points on either side of the mid-face. Everyone is different and therefore we map out the face using anatomical landmarks. This allows us to see where volume has been lost – it also allows us to be precise so that the result can be a symmetrical one.

Nasolabial Fillers Cape Town Somerset West

Results from this treatment are immediate. Sometimes there may be some swelling or redness – this usually only lasts 1 to 2 days.

For more information and to make a booking with Dr Wade in Green Point, Cape Town or in Somerset West please contact us via telephone or email – our relationship manager will gladly be of assistance. Nasolabial Fillers Cape Town Somerset West – for natural results.

t: 021 433 0967

e: bookings@naturalcape.com

 


Nasolabial Fillers Cape Town Somerset West

Cape Town| Green Point | Camps Bay | Somerset West

Botox | Fillers | Chemical Peels | Micro-needling (Dermapen) | Filorga Mesotherapy

 

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