Updated 21 February 2013

Botox, fillers and needles

Needles have become widely used in a variety of applications from Botox – the most commonly requested procedure of all – to injectable fillers, skin needling and mesotherapy.


Needles have become widely used in a variety of applications from Botox – the most commonly requested procedure of all – to injectable fillers, skin needling and mesotherapy.  


According to Dr Kevin Adams, Senior Specialist at the University of Cape Town’s Plastic, Reconstructive and Maxillo-Facial Surgery Division, and Dr Halley-Stott, this is far and away the most popular weapon in the anti-ageing arsenal and is very often the first aesthetic procedure chosen. It’s an injectable form of Botulinum Toxin A that is injected into muscles (most commonly on the face), where it blocks nerve impulses, temporarily paralysing    muscles and smoothing wrinkles.  

Both doctors Adams and Halley-Stott warn against having it administered by anyone other than a cosmetic surgeon, as they point out that only those  sufficiently trained can have learnt the aesthetic sense and knowledge of facial contours, structure and musculature to achieve optimum results. A full consultation and a discussion with your doctor is essential, and the procedure itself takes no more than about 20 minutes. Results are visible after three days and reach their peak in two weeks. The effects last for anywhere between three to six months.  

New kid on the block is the ‘Baby Bo’, as it is affectionately called in Hollywood. Fewer units are injected to shorten the effects. (Note that it is illegal for beauty therapists to administer Botox.)


The most popular are Restylane and Perlane, soft tissue gel fillers made of synthetic hyaluric acid (a naturally occurring substance that is a component of connective tissues). The acid binds  water into the skin, providing lift and new firmness while adding to the body’s own supply of acid. The gel adds volume, minimises wrinkles and adds contours to enhance facial lines.

Restylane is particularly good for filling and treating wrinkles, for correcting thin, superficial lines, particularly around the mouth, forehead and smile lines, and for lip plumping. Perlane is usually used for deeper lines and folds, lip enhancement and facial contouring. Both are long-lasting, take less than half an hour to be performed, and should be done only after consultation with your surgeon.  

The effects last from six months to a year. Another means of filling is by a Dermo-Fat-Graft, which is most effective for lip augmentation. Usually while having another surgery (like a tummy tuck), a portion of skin (dermis), along with underlying fat, is shaped into a graft. The graft is then sized to fit the area and threaded through a small incision.  Because some fat will be absorbed back into the body, the surgeon will use more than necessary. The effects can last for around five years.

Cautionary Note: If there is anything that Dr Halley-Stott does not recommend, it is permanent or semi-permanent filling. ‘These eventually cause granulomas, hard inflamed little bumps along the nasolabial folds and other filled areas,’ he warns.

Skin needling

The Ionzyme Focus-CIT (Collagen Induction Therapy) is an innovation from South African Plastic and Reconstructive Surgeon Dr Des Fernandes, of Environ fame. This is a tool that is used on the skin in the evening, its tiny needles penetrate the stratum corneum (uppermost layer of the skin), activating efficient blood circulation and making the skin ‘open’ to better penetration of active ingredients in your night cream. There are more intense skin needling options, such as Dermaroller™ Skin Needling.

These are performed by trained medical personnel and create thousands of tiny wounds that trigger growth-factors that form new tissue layers and natural collagen.


While this is a popular treatment, Dr Halley-Stott warns that its effectiveness and safety has not nearly been clinically or scientifically proved. It’s essentially a less invasive form of fat reduction than liposuction, and entails tiny ‘medicinal bullets’ delivered directly into the mesoderm (middle layer of skin) by micro injections.

A series of treatments, with one every 10 days in the first month, is recommended, followed by one treatment every six to 12 weeks as a maintenance programme. 

(This is an edited version of an article that originally appears in the August issue of Elle Magazine.)

Plastic surgery flops


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