Dr Villy Rodopoulou on “Myths and reality about the injectables”

Dr Rodopoulou, when we are referring to injectables, what are the key substances we are talking about and what are they doing?

"We are referring to those substances which can be injected in the face and the body. These include the anti-wrinkle and muscle relaxant injections which prevents facial mascular contraction leading to smoothing out of wrinkles as well as hyaluronic acid in gel form which improves static wrinkles and volume loss. They also include hyaluronic acid and vitamins in liquid form which are used in mesotherapy in order to boost skin elasticity. Finally the substances also include phosphatidylcholine, which melts fat and improves cellulite".

Can someone start the injectable treatments at a certain age?
"There is no specific age for this, but there are certain indications. The injectables are mainly required in our 30s. However, someone may need to have such a treatment earlier, for example a 25 year old woman who needs a refreshed face or wants to improve the cellulite she has".

In which cases are the anti-wrinkle and muscle relaxant injections used? In the press we read that the famous actress Sharon Stone tried Botox to fix her child’s hyperhidrosis on feet.
"The usual and more regular use of the anti-wrinkle and muscle relaxant injections is the smoothing out of facial and neck dynamic wrinkles (expression wrinkles) but its action extends to the control of hyperhidrosis as well as the treatment of muscle spasm (for example blepharospasm, torticollis, migraine)".

Is a face with no wrinkles the goal or is this a medical mistake?
"The face is the most visible and exposed body part, our mirror, and this is why it should always be in harmony with the rest of the body and our age. A refreshed face is not motionless or plumpy/swollen. It should always be in harmony with the body. Our eyes are trained to recognize what is not normal. The latter is never attractive. This is why to my mind exaggerations are inacceptable, even if the patient asks for them".

How can you decide the ideal quantity allowing the face and the patient to make deep wrinkles disappear?
"This procedure is usually gradual. The first time that I will perform the treatment on a patient, I will give the injection which, according to my experience, will offer a satisfactory result. The patient returns after two weeks that the action of the substance has been completed and then I check the result with her. If necessary, I add some material and improve the result keeping into account that it should look natural. The reaction and the problem of every patient is unique and this is why the treatment should be customized and gradual. I prefer the most conservative dosage, because I can add but not remove in case of an unnatural result. I always write down the patient’s medical history in every detail, what I have done and I keep a personal photographic archive. In this way I know the next time what I must do in every detail".

In how many days will I see the results?
"The action of the drug usually starts within 3-4 days and is completed in two weeks".

Are there women in the media who are over 30 years old and have never tried an injectable treatment?
"Yes, why not? Genes and lifestyle play a very important role in our looks. A person after 40 may also need to get injections no matter if he/she is working in the media".

Who shouldn’ t do them?
"The contraindications are very few and that is why injectables are a very famous treatment. They should mainly be avoided by patients with autoimmune diseases of the muscles or by those who are in a pharmaceutical therapy with antibiotics".

Tell us about hyaluronic acid. Where do you use it and under what conditions?
"Hyaluronic acid is a natural substance of our body. To be more specific, it is a hydrophilic protein, component of the true skin or chorion. Hyaluronic acid used in the injectable treatments is made in the laboratories and it is biocompatible.

We use it to improve the wrinkles or the volume loss on the face, neck, décolleté, hands etc. We mainly inject it in the lower third of the face to improve nasolabial folds, starting from the base of the nose and extend to the outer corner of the mouth, the marionette lines starting from the corners of the mouth to the chin, the correction of the deep wrinkles on the glabella, the smoker lines (the vertical lines around the lips) and the under eye hollows. It also helps us add volume to the lips and improve their contour. We use it to add volume to cheekbones and define the facial contour too”.

What complications can someone have from the injectables?
"The most usual are mild oedema which lasts 1-2 days and maybe some bruising which goes away in a few days. Of course they are covered with makeup. In case the patient can touch it, we can easily smooth it out with massage".

We often notice that when some celebrities smile their face remains frozen. Why does this happen?
"I am against any exaggerations which give a fake look, especially to those people who are public figures. These examples should be avoided. The ideal result is something natural which is not visible by non-professionals".

When a woman gets a facelift, should she continue receiving injections?
"Yes, she may have to go on with them, especially with the anti-wrinkle and muscle relaxant injections, because dynamic wrinkles do not usually improve with plastic surgery".

Which specialties can perform injectable treatments?
"Any experienced and well trained plastic surgeons and dermatologists".

Up to what age can a man or a woman use injectables;
"As we said age is something so personal and it may have nothing to do with the way a face looks. There are men and women who have a very youthful skin even in their 50s, because they get injectable treatments early enough so that their wrinkles do not seem worse".

Women seem to have loved a lot these substances. True or false?
"Maybe that’s true, as women are more sensitive with their looks. However, the last years you will see lots of men going to a doctor’s office to improve their appearance with injectables".

To conclude, please mention some misinformation about injectables.
"There was and still is a lot of misinformation about injectables mainly about botulinum toxin. After 20 years that this pharmaceutical substance has been used and has been proven to be safe and effective, the best way to be convinced is to visit a plastic surgeon or dermatologist performing the injectables and ask to be informed".

Some myths about them are the following:
1. Do injectables change our characteristics?

Only their misuse.

2.If you stop the injectable treatment, will your face be worse than before?
This is not true! On the contrary, the systematic treatments improve the face and offer long lasting results, even if you suddenly stop them.

3. The more we cancel the treatments the better?
No, the opposite is true. Starting early is a kind of prevention and offers better results.

4. Are these treatments costly?
No, they are very economical.