This name covers the procedures that improve the face without going through theatre: botulinum toxin, hyaluronic acid fillers and technologies for the quality of the skin. They are done in the consulting room, in a short session, and let you go back to normal activity the same day.
The advantage is obvious: little time, no general anaesthetic and practically no downtime. So is the limit, and it is worth being clear about from the start: the results are temporary. None of these treatments is permanent, and keeping them means repeating them at intervals.
They also have a ceiling. They work on expression lines, loss of volume and skin quality, but they do not reposition tissues that have already dropped. When the problem is a marked drop, insisting on injectables gives a poor result and sometimes an overloaded face. In those cases the honest thing is to say the indication is a different one, even if it means surgery.
It usually helps when there is
- Expression lines on the forehead, between the brows or around the eyes.
- Loss of volume in the cheekbones, under the eyes or in the lips.
- A chin or a jawline you want to define without surgery.
- Pigmentation, pores or uneven skin texture.
- Excessive sweating in the underarms or hands.
- Wanting a visible improvement with no recovery time.
Worth discussing first if
- The tissues have already dropped markedly: injectables do not lift that.
- Pregnancy or breastfeeding at the moment.
- Active infection or a skin lesion in the area to be treated.
- Neuromuscular disease, in the case of botulinum toxin.
- Treatment with blood thinners or a clotting disorder.
- Previously injected material whose nature is unknown.
None of these rules the procedure out on its own; all of them change the conversation.
Three tools for three different problems
They do not compete with each other: each solves something different, and they are often combined in one plan. Which one your case calls for is decided in the consultation.
Botulinum toxin
Temporarily relaxes the muscles that produce expression lines. The effect appears within a few days and lasts three to six months. It is also used for excessive sweating.
Hyaluronic acid
Replaces volume and defines contours: cheekbones, under-eye area, lips, chin. The effect is immediate and lasts nine to eighteen months depending on the area and the product. It is absorbable.
Skin technologies
Laser and other devices that work on pigmentation, texture, pores and firmness. They usually need several spaced-out sessions and strict sun care in between.
What is injected, and who injects it
Two questions before any others: what the product is, and who is applying it. Only absorbable products with current health registration, in their original packaging, are used, and they are applied by a qualified surgeon, not by staff without medical training. Any treatment that cannot answer those two questions should be turned down, however cheap it is.
This deserves to be said by name: biopolymers, liquid silicones and the so-called "oils" or permanent fillers still offered outside the medical circuit cause damage that in many cases has no complete solution, even years later. They are not used here, and if you come in with that kind of material already injected, the first thing is to identify it before proposing anything.
On dosage, the criterion is the same as in surgery: conservative. It is easier to add at a follow-up session than to reverse an overloaded face, and with fillers over-correction is precisely what produces that artificial look almost nobody is after.
What a session is like
There are few steps between the first consultation and the follow-up, but none of them is dispensable: the assessment beforehand is what separates a medical treatment from an application made blind.
Consultation and assessment
Your face is examined at rest and in movement, your history and medication are reviewed, and a plan is set. If what you need is something else — surgery included — you are told there and then.
Instructions beforehand
You are asked to stop anti-inflammatories and other medicines that encourage bruising, where possible, and to avoid alcohol the day before. The informed consent is signed.
The session
In the consulting room, with topical or local anaesthesia depending on the treatment. The product is shown to you in its packaging before it is applied. You walk out and carry on with your day.
Follow-up
A check-up at two or three weeks, which is when the result has settled. If anything needs adjusting, it is adjusted then.
How it develops, day by day
There is no recovery in the surgical sense, but there is a period in which the result is still settling and is best not judged.
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First 24 hours
There may be redness, small welts or some bruising at the injection points. You are asked not to lie down, not to exercise hard and not to touch the area.
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Days 2 to 5
Any bruising can be covered with make-up. With hyaluronic acid the area may feel slightly swollen or uneven to the touch: that is normal at this stage.
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Days 7 to 15
Botulinum toxin reaches its full effect. The filler finishes integrating and the swelling settles. This is the moment to judge the result, not before.
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Month 1
Check-up and, if appropriate, adjustment. With laser treatments, this is when the next session in the series is scheduled.
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From 3 months on
The effect of the toxin starts to fade gradually; hyaluronic acid holds for longer. The maintenance plan is set according to how your case develops.
Risks, and what is not promised
That these treatments involve no operating theatre does not mean they are free of risk. What usually happens is mild and temporary: bruising, swelling, redness, temporary asymmetry, and with botulinum toxin a passing droop of the eyelid or the brow if the product spreads further than intended.
With fillers there is also an uncommon but serious complication: vascular occlusion, which happens when the material compresses or blocks a vessel. It can cause damage to the skin and, in areas near the orbit, threaten vision. It is an emergency, and that is why we work only with absorbable hyaluronic acid — which has an antidote, hyaluronidase — and keep that antidote available in the consulting room. On leaving you are told which symptoms mean calling immediately: severe pain, pallor or a change in skin colour, disturbance of vision.
No treatment in this group is permanent, and none stops ageing. The results are temporary by definition, vary from person to person and cannot be guaranteed. These risks are reduced by a sound indication, products with health registration and application by a doctor. They are not eliminated. The ones that apply to your case are explained to you in the consultation and set down in writing in the informed consent you sign before treatment.
The information on this page is for guidance and does not replace an in-person medical consultation. Medical practice is an obligation of means, not of result.
What people ask most about these treatments
That look comes from high doses applied indiscriminately. The approach here is the opposite: relax enough to soften the line while keeping the expression, starting below and adjusting at the two-week check-up if needed.
It is always easier to add units than to wait months for them to wear off.
Botulinum toxin, three to six months; hyaluronic acid, nine to eighteen months depending on the area and the product. Skin technologies depend on the protocol and on the aftercare, above all on sun exposure.
These are usual ranges, not promises: each person's metabolism, the area treated and muscle activity make them vary quite a lot.
No. When the effect of the toxin or the filler wears off, the area returns to its previous state, plus whatever ageing has happened in the meantime. There is no worsening caused by the treatment.
The feeling of "ending up worse" usually comes from comparing yourself with the recent result rather than with the starting point.
They are permanent substances — liquid silicones, oils, "permanent fillers" — still being injected outside the medical circuit. The body does not absorb them, and over the years they can cause chronic inflammation, hardening, deformity and migration of the material.
There is no procedure that removes them completely, and the operations to treat their consequences are complex and limited in what they achieve. Only absorbable products with current health registration are used here. If you think you have been injected with something of the kind, bring it to the consultation: identifying it is the first step.
If it is hyaluronic acid, yes: there is hyaluronidase, an enzyme that dissolves it. That is one of the main reasons this material is used and not permanent fillers.
With non-absorbable products that option does not exist, which is why they are not used.
Yes, but with time to spare. For botulinum toxin, at least three weeks before, because the full effect takes a few days and you want room for an adjustment. For fillers, two or three weeks, in case any bruising or swelling appears.
What is not advisable is doing it two or three days beforehand: that is when you are most likely to arrive at the event with the area still settling.
We do not publish prices, because it depends on the treatment, on the number of areas and on how much product your case needs: any figure on its own would end up being wrong.
After the consultation you receive a written quote, itemising what is and is not included, and how long it is valid for.
Question not answered here? There are more answers in the frequently asked questions.
