Botox and Azzalure
What is the difference?
Botox® and Azzalure (aka Dysport) contain botulinum toxin type A, a neurotoxin produced by the Clostridium botulinum bacterium.
Botox was approved by the Food and Drug Administration (FDA) for the cosmetic treatment of wrinkles and frown lines in 2002; Dysport was approved for the same use in 2009.
For the treatments of wrinkles and frown lines, Botox and Azzalure work similarly: they both contain minimal doses of botulinum toxin, which blocks the stimulation of nerves, with the effect of relaxing the muscles that cause facial wrinkles. Azzalure spreads a bit farther from the injection point than Botox. In our practice, that has been proven to be an advantage for treating larger areas, as fewer injections are required (such as the forehead). Patients are usually please with the outcome of Azzalure treatments.
In more specific areas where small and precise doses are required, we prefer to use Botox®. For example, the lower face jowls, neck and chin are treated with Botox®.
We recommend booking an appointment at Atlantic Beauty Clinic to see which one is right for you.
At Atlantic Beauty, we are using mainly Filler of the Juvederm Brand.
Juvederm’s latest range of products of the “Vycross” Range
Cross-linked, non-animal derived hyaluronic acid gel with 0.3% lidocaine (lignocaine).
WHAT DOES IT CONTAIN?
They contain hyaluronic acid, lidocaine (a topical anaesthetic) and a phosphate buffer. The inclusion of lidocaine significantly reduces pain during and after treatment, although when particularly sensitive areas such as the lips are treated, your clinician may advise the use of an additional topical anaesthetic or nerve block to ensure that the treatment is pain-free.
HOW IS IT MADE?
Hyaluronic acid is formed by streptococci bacterial fermentation.
The products in the VYCROSS® Collection are manufactured using Allergan’s proprietary VYCROSS technology – cross-linking the hyaluronic acid molecules to create a smoother, more efficient filler that allows for a lower concentration of hyaluronic acid to be used. Many hyaluronic acid fillers use 100% high molecular weight, while the VYCROSS Collection uses 10% high molecular weight HA with 90% low molecular weight HA, creating a smoother filler with smoother results. A smoother filler means that clients are less likely to experience pain and swelling/after treatment, and results are long-lasting and natural.
IS A SKIN TEST REQUIRED BEFORE TREATMENT?
No allergy or skin test is needed.
IS IT TEMPORARY OR PERMANENT?
Hyaluronic acid is completely broken down by the body within approximately 12 months, leaving behind no trace of the filler. Juvéderm’s VYCROSS® Collection are among the first hyaluronic acid gel fillers to be clinically proven to remain in the body for up to, and above, a year.
CE marked medical devices.
SHOULD BE USED BY
Trained members of the medical profession only, including doctors, nurses and dentists.
There are four different formulations for Juvéderm’s VYCROSS® Collection available which include:
- Juvéderm VOLIFT (17.5mg/ml hyaluronic acid) 2 x 1ml
A hyaluronic acid gel filler, for use in treating deep wrinkles and skin depressions, to improve the contouring to the face and lips, and to restore lost volume. It is injected into the deep dermis or lips with a 30½G needle.This product is also available in a smaller syringe size, as Juvéderm VOLIFT Retouch 1 x 0.55ml, designed to allow a practitioner to refine a treatment at the follow-up appointment, if required, or offer only smaller corrections in the first instance, without you incurring the extra expense and significant product wastage were a larger syringe size opened to treat.
- Juvéderm VOLBELLA (15mg/ml hyaluronic acid) 2 x 1ml
A hyaluronic acid gel filler, for use in treating fine lines, medium-sized skin depressions and for the enhancement and contouring of the lips. It is injected with a 30½G needle.
- Juvéderm VOLITE (12mg/ml hyaluronic acid) 1 x 1ml
A hyaluronic acid gel filler, for use in improving skin quality, improving skin smoothness, treating fine lines, aiding hydration and skin elasticity; with long-lasting results after just one treatment. It is aimed at use on the face, neck, décolletage and hands and is injected intra-dermally with a 30G needle.
- Juvéderm VOLUMA (20mg/ml hyaluronic acid) 2 x 1ml
A hyaluronic acid gel filler, used for restoring volume to the face, e.g., the cheeks. It is injected with a 27G needle. See this separate page on Juvéderm VOLUMA
NOT TO BE USED IN
These products should not be used in people with a known intolerance to hyaluronic acid or those with a known intolerance to lidocaine.
Similarly, anyone with the following would not be a suitable candidate for treatment:
– those suffering from untreated epilepsy;
– those known to develop hypertrophic scarring;
– pregnant or breastfeeding women
– those with inflammatory skin complaints;
– those with cardiac or rheumatic complaints;
– or those taking anti-coagulant medication.
The fillers should not be used immediately following treatments such as chemical skin peels or lasers, although they can be used once the skin has settled down and healed following such procedures.
DURATION OF EFFECT
Treatment with Juvéderm VYCROSS products lasts for approximately 9 – 18 months, depending on the indication and specific product used. VOLBELLA has been clinically proven to last for 12 months, VOLUMA up to 18 months, VOLIFT up to 15 months, and VOLITE has been shows to provide significant improvements in skin quality for up to 6 months, although the manufacturers believe it can last up to 9 months and are embarking on further ongoing studies. The proven longevity of this range is significant compared to other brands of HA based fillers.
REPORTED SIDE EFFECTS
Transient erythema (redness), swelling, pain, itching, discolouration or tenderness at the implant site. This typically resolves in 24 to 48 hours, depending on the area treated. Lips may swell for a little longer, up to a week.
The price depends on the area treated and how much is required, the practitioner doing the treatment and their level of experience, and which product is used. Expect to pay approximately £250 – £450 per 1ml syringe of Juvéderm VYCROSS products. Discounts are often available if more than one syringe is required.
(1) A study of 60 patients injected with Juvéderm VOLBELLA into the perioral area (the lips) showed that the HA gel is well tolerated, and has been demonstrated to provide a smooth and natural improvement in lip fullness that lasts for up to 1 year.
(2) Another study of 62 patients injected with Juvéderm VOLBELLA into their lips showed that immediately after injection, at their first visit, 83.6% of participants were extremely satisfied, very satisfied or satisfied with improvement in the lips, which increased to 94.1% and 93.0% of participants with/without top-up treatment at follow-up, respectively.
After injection at the first visit, 61.7% of participants rated the look and feel of their lips as extremely natural or very natural, which increased to 75.0% and 93.0% of participants with/without top-up treatment, respectively.
In a clinical trial of 131 patients who were treated with Juvéderm VOLITE there was an improvement in skin quality at one, four and six months. One month after treatment, 96% of patients’ cheeks were smoother (based on investigator assessment) and 91% of patients reported they were more satisfied with their skin. Results were sustained at six months, where patients reported that they continued to see significant improvements in skin hydration and were satisfied with their skin.
(1) Juvéderm(®) Volbella™ in the perioral area: a 12-month prospective, multicenter, open-label study.
Eccleston D, Murphy DK.
Clin Cosmet Investig Dermatol. 2012;5:167-72.
(2) A prospective, open-label, multicenter, observational, postmarket study of the use of a 15 mg/mL hyaluronic acid dermal filler in the lips.
Philipp-Dormston WG, Hilton S, Nathan M.
J Cosmet Dermatol. 2014 Jun;13(2):125-34.
Lip and Perioral Enhancement: A 12-Month Prospective, Randomized, Controlled Study.
Raspaldo H, Chantrey J, Belhaouari L, Eccleston D, Saleh R, Acquilla R, Murphy DK.
J Drugs Dermatol. 2015 Dec;14(12):1444-52.
Rejuvenation of the perioral and lip regions with two new dermal fillers: The Italian experience with Vycross™ Technology.
Calvisi L, Gilbert E, Tonini D.
J Cosmet Laser Ther. 2017 Feb;19(1):54-58.