Are you thinking about trying botox to erase wrinkles and fine lines but want to know more about it first? Or maybe you’re new to Singapore and looking for an aesthetics doctor to continue your treatment. Here, we speak to Dr Rachel Ho to get the lowdown on botox treatments she offers at La Clinic in Paragon Medical Centre Singapore. Curious, I went down to try baby botox for myself, and here’s what I thought of the experience!
What is botox and how does it work?
Botulinum toxin, known as botox, is a neurotoxin derived from the bacteria, clostridium botulinum. This toxin acts on nerves to disrupt the signalling process between nerves and muscles by preventing the nerve endings from secreting a neurotransmitter called acetylcholine. Acetylcholine acts on the muscles to cause muscle contraction, so when this process is disrupted, the muscle does not contract and remains relaxed, reducing the appearance of wrinkles. It can also be used to shrink the size of enlarged muscles such as jaw and trapezius muscles.
I’m worried about looking like Nicole Kidman. Is looking frozen a common side effect of botox?
You are not alone, I often get asked this! A frozen, expressionless look can happen when Botox is administered in a heavy-handed manner. This is because botox has the effect of relaxing facial muscles – so a large dose has the effect of paralysing muscles, causing an expressionless face.
Thankfully, with more strategic administration of smaller doses of botox, known as baby botox, parts of the facial muscles are relaxed, while some parts of the muscle can actively contract for facial animation. This allows for reduced appearance of wrinkles, but also very dynamic facial animations and expressions.
Who is a candidate for botox and when is a good time to start considering it?
If a person meets the treatment indications for botulinum toxin injections; and are above the age of 18, they can consider getting botox to reduce their wrinkles or to treat conditions like bruxism (teeth grinding).
What’s becoming more prevalent is the concept of “preventive botox” – using botox to prevent or delay signs of ageing before they appear. Wrinkles can form in our 20’s and over time, deepen and form static lines. This means that the wrinkles have evolved from being dynamic wrinkles that appear when we laugh, smile or frown; to static wrinkles that are permanently etched on our face, making us look angry or older when at rest. Botox is used to treat and erase these lines to give your face a younger and more refreshed look.
As an aesthetics doctor do you think botox is enough on its own, or do you use it with any other procedures?
Botox can be used in conjunction with other aesthetic procedures such as lasers, dermal fillers and injectable moisturisers. Combining botox with other treatments can improve a patient’s appearance by addressing other signs of ageing that are not addressed by botox. For example, using lasers to treat hyperpigmentation, dermal fillers to replenish volume loss and lift face, injectable moisturisers to hydrate and build collagen in the skin. These treatments complement the outcomes of botox treatment for wrinkles.
You mentioned baby botox. Can you tell us about the pros and cons of this procedure?
Baby botox is a style of botox where more natural looking outcomes are achieved; and is preferred by younger patients who want to address early wrinkles. Instead of completely relaxing the facial muscles as with conventional botox injections, a smaller dose of botox is injected strategically into the facial muscles. This partially relaxes the facial muscles and preserves some movement/animation in the muscle. This allows the person to express normal emotions, looking happy, sad and angry without wrinkles, while not looking paralytic.
The additional pros of baby botox include a lower risk of complications like eyelid droop, and less sensation of heaviness and tightness. It’s also cheaper than traditional botox given fewer units of botox are used. The cons are that it may last slightly shorter (around four months compared to up to six months for botox), and it’s inadequate for older patients with deep set or static wrinkles.
Should we worry about muscle atrophy with long-term botox?
This is one of the key misunderstandings about botox. Yes, it causes controlled atrophy in the muscle injected – but what many don’t realise is that this outcome is intended. By relaxing specific muscles, the muscle naturally atrophies. It becomes smaller in bulk but is still present and functional.
An example is masseteric hypertrophy due to bruxism. With botox injections into the masseter muscles to relax them, bruxism can be controlled. The enlarged masseter muscles that contribute to a broad/square looking face and blunt jawline definition, naturally shrink in size. Patients notice a more defined and contoured jawline and slimmer face shape.
It’s also reassuring to know that when the effects of botox wear off, the atrophy reverses and the muscle becomes active and hypertrophic again.
How much does botox cost at La Clinic?
The cost of botox at my clinic is from $220 onwards.
What is your approach to patient care at La Clinic?
I’m very focused on providing a personalised, comfortable, evidence-based approach. So I’ve worked hard to create a safe, clean and calm environment. I want every person who walks into the clinic to feel at ease and un-rushed. Taking my time to listen, I offer advice and craft a treatment plan tailored to the individual’s treatment goals. While I do offer multi-modality treatments, I don’t provide blanket recommendations. I know from first-hand experience how off-putting upselling can be when trying to enjoy a beauty or cosmetic appointment!
When not being an aesthetics doctor, what do you do for fun?
I have an educational blog that discusses skincare science, beauty trends and industry news. It started as a passion project and creative outlet for my skincare and cosmetics obsession, but it’s evolved over the years into an educational resource for my patients. I also like to discover local beauty experiences and cosmetics when I travel – and I compile these as guides on my blog too!
Want to know more? I had a botox consultation with Dr Ho. Here’s what I thought!
I’ve had botox once before with a GP as I knee-jerk reaction to turning 40. I wasn’t thrilled with the heavy-handed application and droopy eyelid result (yes, you get what you pay for). I did my research this time around and wanted to go to a specialist aesthetics doctor. Dr Ho has had specialist dermatological training and years of experience, so I felt confident I’d be in safe hands.
In-depth consultation with an aesthetics doctor at Paragon Medical Centre Singapore
Five years down the track at 45 my frown lines seem more pronounced, vertical lines have settled on my forehead, and I’ve noticed fine crow’s feet lines around the corner of my eyes. I explained all of this to Dr Ho during our in-depth consultation, and I felt reassured as she was really receptive, understanding and knowledgeable about the nuances of ageing.
Dr Ho noticed subtle things like my tendency to over-express when raising my eyebrows, but wisely advised she wouldn’t inject too close to the brow as it could cause it to drop and affect my upper eyelid. Given my preference for a more natural look, she recommended baby botox.
In the treatment room
Settled in the treatment room at La Clinic, photographs were taken to compare the before and after looks. Numbing cream was applied to my skin and I relaxed for 30 minutes to for it work. My face was then marked with a white pencil to target the exact areas.
The botox was injected with a very small needle into my forehead, glabella and crow’s feet. Dr Ho’s assistant Stella used a small massaging tool near the injection sites, and gently rubbed my arm to distract and soothe. The very slight stings were barely noticeable! Gentle pressure was applied after each injection to prevent bruising, and later an arnica cream applied.
How I feel now
I’m thrilled with the result one week later, the frown line between my eyes is eased, fine lines erased and my face just looks fresher. I like that my classic eyebrow raise is still visible, giving a softness. I’ll be heading back next week once the full effects are in place. I can have a little top up if I feel any of the areas need more, which is the beauty of baby botox. I’d definitely recommend this procedure to friends looking for an easy entry into anti-ageing treatments.
La Clinic is at #08-01/02 Paragon Medical Centre Singapore, 290 Orchard Road
6235 4040 | laclinic.com.sg
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