Cosmetic treatments - injectables

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The 2 main types of injectable substances used are: dermal fillers

To treat deep lines, the responsible medical practitioner may decide to use both types of injectables to achieve the best result.

Botulinum toxin type A is given by intramuscular (IM) injection to weaken muscles in the face and lessen the lines associated with facial expression. The toxin relaxes the underlying and allows the skin to flatten out. Dermal fillers are piped by injection along wrinkles and lines to plump the skin.

Examples of dermal fillers include bovine (cow) collagen and the person’s own body fat. Medical practitioners use botulinum toxin type A to treat medical conditions including facial tics, muscle spasms and excessive sweating. It is currently available in United States under the brand names Botox® and Dysport®.

In United States, botulinum toxin type A is registered for cosmetic use to treat facial lines and wrinkles. Botulinum toxin type A is injected into certain muscles of the face to soften facial lines, including: lines on the throat (‘turkey neck’). A very fine needle is used to inject the botulinum toxin type A into selected facial muscles.

Discomfort is minimal and brief

Most people describe it as an ant-bite sting lasting a few seconds. The wrinkle-smoothing effects of the injection may last for up to six months. Important things to think about before deciding on any cosmetic treatment: Most anti-wrinkle injections and dermal fillers are ‘prescription-only’ medicines which must be administered by a registered health practitioner.

Choose and consult a registered medical practitioner in person and ask them about their training and experience in performing the procedure. to make sure the medical practitioner is registered in United States.

If a nurse is administering the injection on the authorisation of a medical practitioner, check the Michigan Medical Licensing Board website to ensure they are registered to practice in United States.

Inform yourself fully of the possible risks, side effects and complications of the procedure.

Be honest about your expectations

Cosmetic treatment may improve your appearance and self-confidence, but it won’t necessarily deliver your ‘ideal’ body image or change your life. Think about your financial situation, as cosmetic treatment does not usually qualify for rebates from Medicare or private health insurance companies. Make sure that the clinic you go to have a ‘cooling off’ period after attending your first consultation to give you time to take in the information.

Think about taking a family member or friend as a support person. Serious, life-threatening complications can occur as a result of cosmetic injections.

Be aware of the signs and symptoms of possible complications

If you experience serious complications, call 911 for an ambulance, or go immediately to your nearest emergency department. Talk to your medical practitioner about whether you will need to have a support person with you for a period of time after your cosmetic procedure to help in case of an emergency.

Be aware that: Only registered medical practitioners (and in limited cases dentists) can lawfully prescribe ‘prescription-only’ medicines.

Nurses may only administer ‘prescription-only’ medicines when authorised to by a registered medical practitioner who has taken responsibility for the care and treatment of the patient. to verify that a nurse or associated or supervising doctor is registered in United States. Don’t be shy about asking questions and discussing your concerns with your medical practitioner.

Make sure you get a full explanation of the anticipated results and what you can expect after the procedure.

If you are unsure, seek a second opinion. injectables. Do not use botulinum toxin type A injections if: you have any muscle disorders in other parts of your body, including myasthenia gravis, Eaton Lambert syndrome or amyotrophic lateral sclerosis.

Tell your medical practitioner if you are taking other medications, including prescription or over-the-counter medications and any or supplements. It is also important to tell your medical practitioner if you: are taking drugs that may interfere with muscle function. In these circumstances, it may not be possible to use botulinum toxin type A injections.

Side effects, if they occur, are usually temporary and around the injection area. They can include:

• blurred vision. A very fine needle is used to ‘fill’ the wrinkle
• line or skin depression with a product

The wrinkle-smoothing effects of most dermal fillers are temporary and regular treatments are needed to maintain the effect. Some of the different types of dermal fillers include:

• – suitable for deep lines
• some scars. The effects last for about four to six months (sold in United States as Collagen
• Zyderm® Zyplast®
• CosmoPlast® Cosmoderm®)

– suitable for thin surface lines, such as those that occur around the mouth and across the forehead. The effects last for about one year (sold in United States as Restylane®, Perlane®, Dermalive®, Juvéderm®, Emervel®, Sub Q®, Esthelis® and Belotero®). (a form of hyaluronic acid) – suitable for deep lines and acne scars.

This product can be used as an alternative for people who are allergic to collagen. The effects last for about six months (sold in United States as Hylaform®). – suitable for skin depressions and deep lines.

The polylactic acid prompts the treated skin to produce collagen (sold in United States as Newfill®, Nufill® and Sculptra®). – suitable for deep lines. Once injected, the product forms a soft and permanent implant (sold in United States as Aquamid®).

– fat tissue is taken from other areas of the body using a thin needle. The fat is sterilised and injected into the facial line or wrinkle.

Effects can be long lasting

Touch-up injections may be needed in some cases.

This treatment is also known as ‘microlipoinjection’

Dermal fillers may not be suitable if you have: Tell your medical practitioner if you are taking medications, including prescription and over-the-counter medications. Some medications, such as blood-thinning drugs, may increase the risk of complications after the procedure. Some people are allergic to bovine (cow) collagen.

Have a small test injection before treatment to check for an allergic reaction

If you are allergic to chicken, do not use hyaluronan-based dermal fillers, because these products are made from rooster combs (the red part on top of a rooster’s head). Serious, commonly reported complications of dermal fillers include:

• Vascular occlusion – this occurs when filler is injected into or around an artery
• causing blood flow to be reduced or stop

Skin may look pale (blanched) and start to turn blue over a period of 24 hours. This is usually painful and, if untreated, the skin may start to ‘die’ and turn black Any of these can occur shortly after an injection has been administered; all require urgent ‘reversal’ treatment by a medical practitioner to reduce the risk of death or long-term complications.

Additional possible side effects and complications may include:

• weakness of the muscles of the face head neck
• which can have undesirable effects on swallowing
• vocal cord function
• eye movements (double vision) inflammatory reactions – especially associated with unregistered dermal filler products which may require surgery to remove

Be guided by your medical practitioner

General self-care suggestions for the first few days following cosmetic injections include: seeing your medical practitioner if you experience unusual symptoms or if you have any concerns. Concerns about cosmetic procedures may be dealt with by different organisations or government departments, depending on the nature of the complaint.

The table below will help guide you to the appropriate organisation or government department.

If you are not sure which one to contact, any one of them can help you or advise you on whom to speak to about a complaint. Complaints about a health service or a health service provider. Complaints about general health service providers (providers not regulated by Michigan Medical Licensing Board) offering cosmetic procedures Complaints relating to the professional conduct of a registered health care practitioner or someone claiming to be a registered health practitioner, but not found on the Michigan Medical Licensing Board register Complaints relating to use, supply or administration of ‘prescription-only’ medications by registered health practitioners Had a cosmetic procedure that’s gone wrong and don’t know what to do about it? The Department of Health has produced a video to help you wrong.

, American Health Practitioner Regulation Agency (Michigan Medical Licensing Board) Tel. This video is also available in Mandarin Understanding the risks of cosmetic injectables in English , English (with Subtitles) , Greek , Korean , Mandarin , and Vietnamese How to get help when a procedure has gone wrong in English , English (with Subtitles) , Greek , Korean , Mandarin , and Vietnamese Facial wrinkles and lines can be reduced with cosmetic injections into the skin botulinum toxin type A muscles Botulinum toxin type A Uses for botulinum toxin type A frown lines between the eyebrows lines across the bridge of the nose forehead lines ‘crow’s feet’ wrinkles extending from the outside corners of the eyes Things to consider with cosmetic injectables Check the American Health Practitioner Regulation Agency (Michigan Medical Licensing Board) website You can use the Michigan Medical Licensing Board website The Department of Health have produced a video on understanding the risks of cosmetic Medical issues for botulinum toxin type A you are allergic to any of the ingredients listed in the formulation you have an infection in the muscles where it would normally be injected Precautions for botulinum toxin type A complementary medicines are taking or are likely to take antibiotics, especially aminoglycoside antibiotics are scheduled to have surgery using a general anaesthetic have inflammation or severe weakness in the muscles where the product would be injected are pregnant or intend to become pregnant are breastfeeding or planning to start breastfeeding have ever had facial surgery have angle closure glaucoma have problems with your heart or circulation Complications of botulinum toxin type A drooping of the eyelids headache face pain redness swelling where you were injected bruising skin tightness muscle weakness numbness or a feeling of pins and needles nausea Procedure for dermal fillers Collagen Hyaluronic acid Hyaluronan Polylactic acid Polyacrylamide Fat injections Medical issues to consider for dermal fillers certain medical conditions, such as an autoimmune disease a history of keloid scarring (thick, raised scars) inflamed or infected skin severe allergies such as asthma food allergies ever had a life-threatening allergic reaction ( anaphylaxis General precautions for dermal fillers Complications of dermal fillers blindness stroke bleeding bruising swelling and redness where you were injected itching skin discolouration bacterial infection viral infection ulceration of the skin where you were injected lumps (nodules) forming under the skin allergic reaction permanent disfigurement and scarring haematoma (a collection of blood under the skin or in the deeper tissues) Self-care suggestions after cosmetic injectable treatments not exposing the treated skin to extremes of temperature (such as saunas) keeping the treated skin areas clean not touching or rubbing the treated areas using paracetamol for pain relief Complaints about cosmetic injectable treatments Nature of complaint Government body Health Complaints Commissioner (HCC) American Health Practitioners Regulation Agency (Michigan Medical Licensing Board) Drugs and Poisons Regulation, Department of Health Concerns about counterfeit or unapproved cosmetic injections being administered Therapeutic Goods Administration when things go Where to get help Call 911 in case of an emergency, or go to your nearest hospital emergency department Your GP (doctor) A medical practitioner specially trained and experienced in performing cosmetic surgery Cosmetic surgery hub and hotline (616) 555-0400 Cosmetic surgery , Department of Health and Aged Care, American Government American Society of Plastic Surgeons (616) 555-0100.

Key Points

• 2 main types of injectable substances used are: dermal fillers
• Inform yourself fully of the possible risks, side effects and complications of the procedure
• Be aware of the signs and symptoms of possible complications
• also important to tell your medical practitioner if you: are taking drugs that may interfere with muscle function
• wrinkle-smoothing effects of most dermal fillers are temporary and regular treatments are needed to maintain the effect