Cosmetic medicine – beyond cosmetics

At Green Square Health we’ve been delivering cosmetic medicine to patients ever since we opened. But we don’t really advertise as offering ‘cosmetics’. The reason is we don’t want to be pigeonholed as a cosmetic clinic, and all the positive and negative connotations that come with it.

We believe that cosmetic medicine is medicine, and often it’s more than just cosmetic, but it’s a shame that anti-wrinkle injections all get lumped under the same banner.

So lets go through the services we do offer at GSH to our regular patients, and why we offer them.

Anti-wrinkle injections

The simplest thing, is purely injections to reduce obvious lines and wrinkles! As we age, and as we receive more environmental stressors (stress, sun, pollution), the skin that overlies facial muscles tend to show lines more readily.

Initially these lines appear when we express ourselves like frowning, smiling and laughing. As time goes by, they begin to be obvious even at rest. The upper third of the face (the forehead, brows and around the eyes) are first and most obvious, and are the quickest and safest to treat.

We like to offer this option to our regular patients, because you might already be interested in getting some anti-wrinkle treatment, but are hesitant about how safe it might be. This way it’s at a clinic you already know and trust, with a team that takes medical safety, consent and procedure very seriously.

Tension headaches and bruxism (tooth grinding)

Some people grind their teeth. They do it without noticing, and they might do it in their sleep. They often wake up with jaw or temple pain, or they might see a dentist because they’ve worn their teeth down.

Traditionally the steps to improve this would be to reduce stress, improve sleep, wear a custom made mouth guard, do massage to your masseter muscles or have a physiotherapist help.

Following all this, you might find you still grind too much.

By injecting anti-wrinkle medication into the masseter muscle (the big chewing muscle of the jaw) we can make it weaker. You might still clench, but you won’t clench as hard. And a lot of people find this reduces the frequency and severity of their jaw pain or headaches.

We offer this because it’s a medical solution to a medical problem, and often needs the workup associated with headaches.

The same mechanism might be responsble for headaches of the temple, and people can often feel a really strong temporalis muscle. Anti-wrinkle injections here achieve the same thing and can reduce headaches in most people with this type of headache.

Hyperhidrosis

A really interesting use of anti-wrinkle injections is to stop excessive sweating.

The receptor that is used to reduce muscle activity also works on sweat glands, and this effect can last 2.5-3.5 months – at times longer. This works well for excessive sweating that hasn’t been well controlled with other means such as medication or aluminium containing roll on compounds.

If your hyperhidrosis is in the axilla (armpit) and hasn’t responded well to treatment, a neurologist is the best person to provide treatment as they can get anti-wrinkle injections under the PBS on a prescription for this reason.

However if the excessive sweating is on your forehead or brow – then we would be best as it takes smaller amounts and is more cost effective.

The palms can be quite tricky to treat for sweating – many injection sites and high doses. However there are good alternative treatments such as tap water iontophoresis devices, and aluminium hydroxide. Talk to your doctor about this treatment.

Facial slimming

This is again a cosmetic reason, but some people have rather large masseter muscles that don’t give them headaches or cause tooth grinding, but they would like them to be smaller. Anti-wrinkle injections can help shrink the muscle to make the face appear smaller.

Now this doesn’t work for every face shape, as sometimes it’s the bone structure, and other times the facial fat pads are responsible, but if you clech your jaw and it protrudes out and there’s little fat over it – this can be a quick way to acheive facial slimming. Typically people would require about 50 units (25 in each masseter), and might need to do this every 3-6 months, with doses typically declining with ongoing treatment, and a longer timeframe between treatments.

Dermal fillers

A broad term that covers injectable gel like substances that act like structural tissue. Most of the time it refers to hyaluronic acid based gels that are crosslinked in a way to give them structure.

Dermal fillers are what people use to add volume, typically to the face but technically anywhere to change the way things look.

I know our mind jumps to lips and cheeks, but at our clinic we use it more often to replace hollows and troughs like the corner of the nose, corners of the lips/mouth, and to try fill up some defects left by acne scars.

I (Dr Daniel Chanisheff) do offer dermal fillers to my patients for the above reasons, but am very conservative with how I inject. I feel that a subtle balance is most appropriate, and I like to take things slowly instead of trying to inject a lot at once. If you’ve been on the fence about it then you can always book in to see me (Dr Daniel) regarding fillers.

Costs

At present we charge for units of anti-wrinkle injection used, or per vial of dermal filler. Though its not the most ideal way, as we are a small volume clinic focused on quality, this is the simplest way.

Anti wrinkle injections are $15 per unit, but most people are surprised it may cost them less here than other clinics for the overall treatment as we tend to be more conservative with dosing. If a single unit is used beyond what is needed – then it only costs you more without adding anything to the overall result.

For dermal fillers a similar price structure exists, with most fillers costing $650 per vial. The exception to this is a special type of collagen stimulating treatment which costs $950 – but this is only suggested after consultation and discussion about goals and not a typical dermal filler people ask for on their first visit. We would use that more for overall volume, collagen and scar treatment – and this is used at a much lower frequency. Speak to Dr Daniel about dermal fillers the next time you have a consultation with him.

Booking in for treatment

If booking in to talk about or receive anti-wrinkle injections or dermal fillers (for cosmetic or medical reasons) make sure you book the right appointment type. We have two appointment types, ‘Anti-Wrinkle Injection’ or ‘Dermal-Filler Injection’.

If you need both procedures in the same consult, please select ‘Dermal-Filler Injection’ as only Dr Daniel Chanisheff provides these injections at the current time. Dr John-Alec Tynan offers anti-wrinkle injections, and has a lot of expertise in this field.

The cost of the consultation is the same for regular medical consults, $145 for a long 30 minute consultation, or $85 for a standard 15 minute consultation, however this will also cover the cost of treatment up to that value.

So if you have $300 worth of treatment, that’s all you’ll pay.

If your appointment is for cosmetic reasons such as lines and wrinkles, dermal filling in general – then there is no medicare rebate on the consultation.

I hope this has been helpful!