What Is Myomodulation?

5d5403ae-4ce.jpg

The aging process leads to hyperactivity of the muscles of the face. This movement leads to increased wrinkles and loss of the smooth, youthful appearance of the skin. In the upper face, neuromodulators such as Dysport and Botox, do a great job at relaxing this hyperactivity. What’s trending with aesthetic providers is dampening the muscle movement but not complete relaxation, leading to a more natural expression without “freezing” the patient.

Unfortunately, the neuromodulators can’t be administered throughout the entire face. In the lower face, low doses of neuromodulators are safe for the lips, chin, gummy smile, and DAO (AKA RBF) muscles for the most part. Inhibiting the lower face too much leads to changes with expression and smiling. What can be done to control the muscles in this area? Filler!

(Side note: Hyperactivity of the lower face has been described by Dr. Weiner in gum chewers in a previous blog. It leads to accelerated aging in the lower face and should be discouraged by aesthetic providers.)

An interesting study by Dr. Nowell Solish supports this concept. Using a rather large and sophisticated machine, Dr. Solish was able to determine muscle strain in the lower face during facial expressions. He compared patients in their 50’s to ones in their 30’s. As expected, the older patients had more muscle strain than the younger patients. He then injected the older population with Restylane Refyne and Defyne, 3-4cc in the perioral area. These fillers have XPresHAn technology and have flexibility – stretch capabilities. After the injections, the older patients were restudied for muscle strain. The findings: The muscle strain of the 2 groups (older vs younger) were basically the same. The filler was able to reduce the muscle strain about 15 – 20 years!

What’s the explanation? Dr. de Maio has coined the term myomodulation. His theory is that filler placed around hyperactive muscle leads to stretching and relaxation of the muscle. While this is plausible, there is probably a better way to describe this phenomenon.

Dr. Weiner’s theory: Think of an Aston Martin that has a top speed of 230 mph or more. However, in the US, to conform to the laws and regulations, governors are placed on the car to keep its top speed at 180 (This is purely hypothetical and used for illustrative purposes only). Dr. Weiner feels the fillers Refyne/Defyne limit the full range of movement of the hyperactive muscle, akin to a governor on the muscle. Why these fillers work so well at doing this is because they can stretch and recoil (akin to a tether), leading to some, but not excessive muscle movement. Other fillers would work but with a different and less natural mechanism. Think of the non-flexible fillers as acting as a wall, and not as a governor or tether.

With the new XPresHAn fillers, Refyne and Defyne, we now have a new treatment modality for the lower face which is highly effective. Myomodulation is real, exactly what is the underlying mechanism is still debatable

Reference: https://stevenfweinermd.wordpress.com/2019/05/23/what-is-myomodulation/

Identifying Acne Types and Treatments

Acne-Treatments.jpg

An estimated 50 million people suffer from acne every year in the United States, with 85% of those between 12 and 24 having experienced it at some point of their lives.1 The formation of an acne lesion occurs when the skin is oily and begins to shed excessively, clogging the pores and supplying a food source for Propioni­bacterium acnes (P. acnes). This creates inflammation and an immune response. In this article, we will identify the types of acne, discuss complicating factors and present some traditional and cutting-edge treatments for the condition.

Identify the Type

Comedonal, inflammatory and cystic acne are the main categories used to define this condition. Topical treatment for these types of acne are provided below. In addition, lifestyle plays an important role in how you can rebalance and correct acne. See Lifestyle Acne Tips for a list of tips we share with clients dealing with this condition.

Lifestyle Acne Tips

Keep it cool. No hot yoga when dealing with Acne. Yoga is great for keeping the mind and body de-stressed which in turn controls hormonal activity. Hot yoga involves excessive and sweating which can cause more breakouts and irritate an already unbalanced skin.

Probiotics. help to restore some of the unhealthy bacteria (microbiota) that antibiotics can wipe out. We recommend that our clients consult a nutritionist to find the great probiotics formula for their needs.

A healthy diet. encourages eating a healthy diet with plenty of fruits, vegetables and whole foods, and recommend a holistic diet with reishi mushrooms, red clover, peppermint, saw palmetto, black cohosh and green tea. These control the presence of androgens and can reduce the severity of acne

Watch the sugars. Simple sugars in particular are highly inflammatory. Candy, sodas, ice cream, alcohol and white food s are the main culprits. Dairy foods can also exacerbate acne as well as iodides in supplements

Clean tools. We recommend that our male clients sterilize their razors after each use and that our female clients clean their makeup brushes every week.

Good Habits. Make sure clients are removing all makeup at the end of the day with several cleansing steps and plenty of toning. Above all, advise them not to pick. For painful breakouts, we recommend ice 15 minutes, 2 -3 times a day and LED blue light to help reduce severity and scarring.

Clean surfaces. Changing pillow cases at least twice a week helps minimize the effects of indoor pollution. Have clients wipe smartphones, glasses, steering wheels, plane seats and food trays when travelling with an antiseptic wipe to cut down on bacteria exposure.

Hydration. Make your clients hydrate inside and out. Plenty of water keeps the system flushed and healthy. Also, a light topical serum or hydrating lotion will help to re balance the skin. Don’t eliminate moisturizers. The right one will help, not hinder, the healing process.

Source: http://skininc.texterity.com/skininc/may_2019/

 

Sexy Lips Less than 10 Minutes with Filler Treatment

lipfillers.jpg

Unfortunately, not all women are created with proportional lips. So it needs special "engineering" techniques to make it look more beautiful. One procedure that is very possible to try is filler treatment. Treatment or injecting fillers is a beauty procedure that is done by injecting special ingredients or substances into certain body parts using syringes. Even though this procedure is very classified and does not require long processing times such as plastic surgery, it still cannot be done by just anyone. Because if the action is not right then the results will be far from expected.

Involving professional and experienced beauty experts in their fields is the wisest decision before doing filler treatment. Toronto Beauty Clinic is one of the best clinic in Toronto for lip filler treatment.

Is Pain Filler Treatment Painful? The first thing people often worry about injecting lip fillers is the pain they cause. Filler treatment is a mild action. Injection done on any part of the body is actually not too painful. The injection process only causes pain for a moment but can still be tolerated. As long as following the advice of the treating doctor, after the injection process you will not experience further problems.

Benefits of Lip Filler Broadly speaking, injectable lip filler is beneficial for aesthetics. But for more details, this treatment can provide several benefits, including: The Shape And Volume Of Lips Become Better With the help of Hyluronic Acid, the lips will look more volume. Suitable for anyone who has too thin lips. The Lip Surface Becomes More Smooth In addition to increasing volume, injecting lip fillers is also useful for smoothing the skin of the lips. The lips surface feels softer and the lines on the lips are not too noticeable. Smooth and soft lip texture will help the application of lipstick to be more perfect and the color lasts longer. Lips Look Healthier Lips that do not get a touch of care at all will gradually disrupt. Without the help of lipstick, the appearance of the lips is not very attractive. Filler treatments help you get healthy, reddish lips. So you don't need a lipstick polish every time.

Will the results last long? Although lip filler injections can provide results faster than plastic surgery, the changes are not permanent. Hyaluronic Acid performance in the injected body only lasts about 8-12 months. Therefore, lip filler treatment needs to be repeated. To get maximum results when doing filler treatments, of course you will need to choose a well-known and trusted beauty clinic, such as the Toronto Beauty Clinic.

Experienced nurse will provide input to the patients for the treatment that best suits their individual needs, so that filler treatment will remain maximum and safe.

Want to immediately do filler treatment to get sexy lips but still safe, healthy and not problematic? You can contact Toronto Beauty Clinic here to do a free consultation!

Why are Blunt Microcannulas the Obvious Choice for Dermal Fillers?

cannulas.jpg

Dermal fillers are becoming increasingly popular worldwide. Contouring of the face, restoring volume loss, enhancing features such as lip plumping can all be obtained with very little downtime. Just 15 years ago, surgery was the only way these enhancements could be performed. There are some minor complications associated with fillers such as pain, bruising, swelling which are fairly common (>70%) and some major risks such as vascular occlusion, blindness, and stroke which are much less common.

The most common method to administer fillers is using the needle which is packaged with the product. While needles are very easy to use, in the author's opinion, they are more risky and lead to more downtime versus the blunt microcannula technique. Microcannulas were introduced to the United States about 8 years ago from Europe. These were a smaller version of the already widely cannulas which were used for fat transfer. When compared with a needle, cannulas are more flexible, longer, and their tip is more rounded. The following advantages are found with cannulas:

  1. Fewer dermal penetrations - cannulas are introduced through only a small number of pilot holes.

  2. Less discomfort - the dermis contains more pain fibers  than the deeper tissues. The injections with cannulas are below the dermis, so discomfort is less.

  3. Less trauma to tissues/less bruising - because of the rounded tip, the cannula is less likely to nick blood vessels leading to less bruising and swelling.

  4. Faster procedure times - With an experienced cannula user, placement of filler is done very quickly and efficiently. (Cheek/tear troughs <5 minutes per side, lips <5 minutes)

  5. Less vascular occlusion risks - While cannulas aren't 100% safe, the risks of injecting into a blood vessel are less because entering a vessel is more difficult with the rounded tip and flexible shaft. This is true for the larger gauge cannulas such as 22, 23, and 25. Recent studies by Dr. Pavicic and Cotofana have shown the 27g cannulas have the same force needed to enter a vessel as a 27g needle and therefore should not be used.

Galderma recognized the advantages of microcannulas and became the first company to get FDA approval for their use with Restylane Silk in lips in 2017, and for Restylane Lyft for the cheeks in 2018. While less than 10% of providers use cannulas in the US, there is a push by the top injectors to encourage their widespread.

Source: https://stevenfweinermd.wordpress.com/2019/05/12/why-are-blunt-microcannulas-the-obvious-choice-for-dermal-fillers/

Toronto Beauty Clinic has been using microcannulas since we established. Our Injector has more than 17 years experiences using cannulas for injection. call 4163980111 to find out more our services

Why Dysport Is Becoming More Popular?

botox-dysport.jpg

The most popular cosmetic procedure in the world is wrinkle reducing injections with neurotoxins or the friendlier term, neuromodulators. The injections work by reducing the activity of the muscles they are injected to, there by resulting in less movement and less dynamic wrinkles. Static wrinkles, ones that appear at rest, are less affected by these injections, but over serial treatments, improve as well.

The history of neuromodulators dates to the isolation of the botulinum toxin, the cause of botulism, in the 1928. It was later refined and made commercially available for injections in the 1989 and initially FDA approved for strabismus, lazy eye. Soon thereafter, blepharospasm, spasm of the muscles around the eye, treatments were approved. The team of Carruthers and Carruthers observed that during blepharospasm treatments, the wrinkles around the eye, crows feet, were also improved. Studies were later performed on the frown lines, and FDA approval for cosmetic use was achieved in 2002.

There are currently 3 FDA approved neuromodulators of botulinum toxin A for cosmetic use: Botox, Dysport, and Xeomin. They all work similarly by blocking the acetylcholine release at the neuromuscular junction. Each brand has their own definition of what a unit dose is, so this can be confusing to both the practitioner and the patients. The differences between the 3 is the associated inactive protein, or absence of this protein in the case of Xeomin. Studies have shown that once the drug powder is mixed with water or saline in the provider’s office, the inactive protein disassociates almost immediately. Why then, are there differences in clinical outcomes between the 3 neuromodulators?

There is a recent comparison of the active protein molecule in the 3 products dosing in the glabella. The study looked at the FDA approved doses for frown lines – glabella. A very interesting finding was that there was 0.27ng in Dysport using the 50u dose vs 0.18ng in Botox’s. Xeomin was a distant 3rd coming in at 0.08ng with their 20u dose. In essence, patients are receiving a stronger dose when using Dysport when compared to Botox or Xeomin.

It’s long been established that Dysport seems to be effective (in 1-2 days) sooner than Botox (3-4 days) but the reason was never clearly elucidated. It’s also well known that higher dosing of any of the neuromodulators will lead to longer durations of action. This higher level of active protein with Dysport can explain the clinical phenomenon of quicker onset and longer duration.

One other topic needing addressing is the myth of higher diffusion with Dysport vs Botox. Diffusion or spread, is a result of dosing, volume, speed of injection and not a function of the neuromodulator. As stated before, when reconstituted, all the products are free of their associated proteins and only consist of free, active protein. We now know that Dysport has more active protein in their approved dosing, so to compensate, lower volumes must be used for reconstitution. The author’s recommended reconstitution for Botox is 2cc and for Dysport is 1.5cc for the glabellar injections. When diffusion or spread is desired, larger volumes can be used.

With the recent comparison study of active protein in the dosing schemes of the 3 commercially available neuromodulators, it is easy to see why Dysport should be the standout choice. Dysport gives more effective treatments because of the higher active protein, leading to quicker onset and longer duration than Botox and Xeomin. Pricing is usually less with Dysport, so it becomes a “no brainer” 1st choice for Dr. Weiner’s practice.

Source: https://stevenfweinermd.wordpress.com/2019/05/03/why-dysport-is-dr-weiners-favorite-neuromodulator-neurotoxin/