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Ageing causes changes in the facial contour, especially hollowness of the cheeks caused by fat loss and accentuated by fat accumulation in the jowls. In addition, movement creates creases, especially between the nose and mouth. The lips shrink over time, producing lines about the mouth and loss of lip ‘pout’. Facial implants can be surgically inserted or injected to remedy many of these problems.
Collagen injectionsCollagen injections have become increasingly popular over the last few years. Collagen, which is derived from calf skin, is injected into wrinkle lines, scars and lips.Two types of collagen are used, called Zyderm and Zyplast. Zyderm is a very fine collagen and is useful for fine lines around the eyes and mouth. Zyplast, on the other hand, is a coarse, dense collagen which is more suitable for deep furrows and acne scars. It is especially useful for lip augmentation.Although collagen is a safe and effective filling substance, it only lasts for four to six months. Allergic reactions are possible so collagen must be tested twice before being injected into the face. Because collagen implantation is very simply performed, many people request collagen rather than a more appropriate procedure such as face-lifting or chemical peeling. Collagen is certainly not a substitute for some of the other cosmetic operations.To try and overcome the cost and allergic potential of calf collagen, several techniques are now available to remove a person’s own collagen and then inject it into his or her own wrinkle lines. This technique is still very new, so the long-term results are not yet known.
Silicone implantsAlthough silicone rubber is still the major material used in cheek and chin implants, liquid silicone has largely been abandoned as a filling material for facial wrinkles and contour correction. Although pure grade medical silicone was excellent and safe for facial augmentation, the recent media publicity concerning breast implants has created such adverse reaction among health officials that its use is becoming increasingly prohibited. If silicone is used, it is important that only microscopic amounts of silicone are used. If too much silicone is injected, beading can occur, and if impure silicone is used, severe reactions such as lumpiness of the skin are possible. The main advantages of silicone are that it is inexpensive and permanent.

In more than thirty years of practice I have never come across as many cases of Lichen planus as recently. Although it is by no means a common problem, I am concerned at the increased incidence of this particular skin disorder. Lichen planus is an inflammatory dermatosis which manifests itself in multiple, small, flat-topped patches, with a reddish colour and a horny appearance. This skin disorder affects both sexes, and it is quite likely that its greater incidence is due to increased stress, anxiety and nervous disorders. If not the actual causes of this disease, they are more than likely to be serious contributory factors. Although this condition can be short-lived, I have also seen chronic cases, which are very difficult to overcome once they have been allowed to establish themselves. There is a general belief that improper nutrition and insomnia are also possible factors that aggravate this condition.
Initially I would choose to treat the nervous system and, for this purpose, I would suggest breathing exercises, which exert a relaxing influence. The ‘Hara Breathing Exercise’, explained in detail in my book Stress and Nervous Disorders, is of great help, as are a number of exercises that encourage relaxation. Treatments that produce good perspiration are also helpful. For this reason Turkish baths and saunas are suggested, since they are relaxing, at the same time as encouraging perspiration. When taking a sauna, the temperature of the entire skin increases to between 40 and 43 degrees Celsius. This increase in temperature intensifies the circulation while the increase in perspiration stimulates cell renewal and can eliminate some 20 to 30 grammes of fluid per minute from the body. Showering with cold water and warm foot baths causes the pores to open and the blood vessels to widen, which gives these bathing methods therapeutic value.
It is also a good idea to do some breathing exercises while taking a sauna, as the circulation through the lungs and air passages is excellent at high temperatures. At any time, go out into the fresh air and inhale deeply to fill the lungs with oxygen, thus stimulating the sympathetic nervous system. Due to increased hormone production, stress will be reduced when taking a regular sauna. Centuries ago in Finland, when the sauna was no more than a hole in the ground with some heated stones, saunas were recognised for their therapeutic value. Even though a sauna is taken under more luxurious conditions nowadays, that therapeutic value has not diminished, but take care not to stay in a sauna for too long. It is better to increase the frequency of saunas, with a good rest period in between, than to take occasional saunas for a long time, which may be unwise. I often advise that a first sauna should not be longer than eight to twelve minutes, with a cooling-off period of about the same length of time. During this time apply some Kneipp methods and use a good body spray. Have a warm foot bath and, if accompanied, joining in a conversation will aid relaxation. If possible, try some sunray treatment, but better still if it is possible, go outside to enjoy the sun: any ultra-violet treatment after a sauna course will be of great help for a lichen planus condition.
Infra-red treatment on the affected areas is also beneficial, but mostly I prefer ultra-violet treatment, because under the influence of ultra-violet rays, substances such as ergosterin are converted into vitamin D which is of great benefit to the overall condition of the skin.
From time to time a skin brushing session is helpful. Use a natural brush and allow twenty to thirty minutes to brush every part of the body that is not affected by lichen planus, remembering always to brush towards the heart. It is best to start with the soles of the feet and a dry body. Brush the skin surface with regular movements, avoiding any affected areas, the face, and genital areas. Use clean, upward-sweeping strokes remembering that below the heart all brushing movement should be upwards, while over the heart downward strokes only. Use light and gentle pressure and perhaps a herbal ointment or a herbal oil afterwards, e.g. Symphosan, lemon or orange oil from the Bioforce range. Another remedy from the same source, Petasan, should be taken three times a day, ten drops after meals, and to encourage quick healing, use evening primrose oil and Violaforce. This is the best possible advice to get a lichen planus condition under control.
Because of the influence of stress on this skin condition, I sometimes recommend a juice diet, or even a fasting regime allowing fruit and vegetable juices only. However, I would advise excluding citrus fruit juices in such a regime. A period of fasting will be beneficial to most of the body’s systems and functions, such as digestion, blood circulation, elimination from the bowels and kidneys, nerve vitality, respiration and oxygenation. I recommend fasting courses for diverse purposes, but especially for lichen planus as so many bodily functions and systems are affected by it.
On the first day of a fast there might be some slight discomfort, but a few days of fasting will be extremely beneficial. Better still, if after an initial period of fasting, one selects a specific day of the week on which to fast on a regular basis. Fasting allows the body to rid itself of some of the many toxins that are present, and you will soon recognise the feeling of well-being that takes over after one or more days. Don’t worry if you experience a slight dull headache, because this often occurs when the tissues eliminate toxins, which are disposed of into the bloodstream and work their way to the head.
Many patients report a feeling of cleanliness (inside as well as out) after fasting and most repeat the experience. Simply replace meals with a drink of vegetable or fruit juice. The age-old naturopathic principle that an occasional period of fasting is beneficial, has never held more truth and wisdom than at present.

Certain vitamins and medications, such as vitamin E and aspirin, can make you more prone to bruising at the injection site. Avoid them for approximately ten days before being treated with Botox.
It’s important to remain upright for a minimum of two hours following treatment to ensure that Botox doesn’t migrate. One of my new patients came prepared with an anti-snooze gadget created for drivers that gets tucked behind the ear. It works by emitting a loud buzzing sound whenever it senses that the head is lowering. The best part of this story is that her mother, also a patient, had given it to her!
Excessive smiling and frowning are what brought you to seek Botox in the first place. Funnily enough, you’ll have to do a lot of both immediately after the treatment to ensure that the Botox binds properly.
I’ve found that while patients are all too aware of their problem areas, they’re usually at a loss as to which procedure will help to restore their looks. This confusion is quite understandable and it’s one of the reasons why the consultation is an invaluable factor in ultimately having a fulfilling experience. When I meet a patient for the first time I’m not only listening to what they’re saying, but I’m also observing their facial expressions. That, in itself, will tell me a lot. If, for example, they’re constantly pursing their lips when speaking, then I know that the lines on the upper and lower lip are due to muscular contractions, making this patient an ideal candidate for Botox. I would then explain to them how tiny drops of Botox would simply relax this area, not paralyse it. Afterwards, I might suggest that they follow up with a peel or a laser treatment. The combination of treatments will assure that the area remains smooth for even longer.