The ageing of the décolleté and bust
The skin on the décolleté and bust area is more sensitive than skin on other parts of the body. The processes involved in the ageing of these areas go through all skin layers, subcutaneous tissue and muscles just below the skin. Due to the breakdown in production of collagen and hyaluronic acid the skin is more likely to get dry and thinner over time. As a result, the skin loses its firmness and volume and begins to change due to factors such as lifestyle and gravity. The bust is especially at risk of rapid stretching (typically in pregnancy and breast feeding). Another significant factor is the loss of subcutaneous tissue and weakened muscles which, together with gravity and lifestyle factors, diminish the skin’s ability to stay firm.
What is hyaluronic acid?
Hyaluronic acid is a natural ingredient of human skin. It is produced by fibroblasts which form the structural framework for human tissues. Hyaluronic acid fills intercellular areas and makes perfect environment for skin cells. It is also responsible for stimulating the production of collagen and protecting all skin elements from exposure to free radicals. Hyaluronic acid also contributes to tissue hydrodynamics; it is responsible for the amount of water tied in the skin which makes it an ideal moisturizing factor. However, over time human skin begins to lose its natural resources of hyaluronic acid which affects the work of fibroblasts. Consequently, the amount of collagen decreases which contributes to the loss in its volume. This process can be stopped with a single injection of hyaluronic acid to help your skin regain its youthful look.
Products rich in hyaluronic acid
There are many products rich in hyaluronic acid. Brands available on the Polish market include: Restylane, Juvederm, Succeev, Stylage, Teosyal. Each of the brands offers a wide variety of different texture, such as Restylane Vital (light texture), or Juvederm Voluma (rich texture).
Products rich in natural hyaluronic acid (Juvederm Hydrate) are mainly used for mezotherapy which instantly improves hydration and rejuvenation of skin. Other similar products are additionally supplemented with glycerine, glicerol and mannitol which make the product perfect moisturizers.
There is a variety of different dermal fillers depending on the area to be treated, ranging from hydrating fillers which are perfect for the décolletage, smooth fillers ideal for the lips or denser fillers for volumising which are most suitable for the cheeks. Sometimes a combination of fillers are used on a particular area to achieve the perfect result. Products which are used at Ekoderm as dermal fillers all have a proven track record for safety and so you can be assured that they are perfectly safe. We use world’s best known brands such as Restylane, Juvederm and Succeev. Every client is unique so at Ekoderm our practitioners make sure that the best possible treatment is chosen for each individual client. For non surgical lifting of the décolletage and bust we choose from a wide variety of treatments: Restylane Vital, Restylane, Restylane Perlane, Juvederm Ultra 3, Juvederm Ultra 4, Juvederm Voluma, Succeev Two.
How does the treatment work?
The area of breast and decollete, especially the areas which need enhancement is injected with product rich in hyaluronic acid. It is injected evenly all over the bust with particular attention paid to the area between the breasts, just above them as well as the subclavian area. The treatment is performed with special elastic canniula which have been designed so as not to make numerous punctures. With such canniula it is possible to distribute the product evenly all over bust and décolleté. The canniula makes it possible to cover a relatively large area with a fan of threads, while limiting the number of puncture sites. This technique will also enhance the soft tissue and help skin to regain its hydration and firmness.
The treatment with the application of Restylane is called “hyaluronic thread” while the treatment with the application of Juvederm is called “Juvelift”. The amount of 2 ml to 5 ml of the product is injected. After the injection, the product is evenly distributed and massaged properly by the practitioner.
Do I need local anaesthetic?
Our usual practice is to apply an anaesthetic cream (Emla) 30-40 minutes before the injection. We can also inject local anaesthetic which is normally used in dental surgery so that the area that is to be treated feels numb and discomfort is kept to minimum. In any case, however, the practitioner needs to be informed about possible allergic reactions.
Who is the treatment for?
The treatment is designed for any woman who has observed decreasing condition of the bust and décolleté skin which may include wrinkles and the lack of firmness. With slim women these processes usually occur over 50 years of age. However, they can be increasingly observed among younger mothers, women who have lost considerable amount of weight as well as women who do not apply sunscreen on their bust or décolleté.
What are the results?
After the treatment the result is an instant filling-out effect so that the skin looks smoother, less wrinkled, lighter and hydrated. The natural property of hyaluronic acid is to gradually absorb water and increase its volume so the volumising result of the treatment remains distinct even many weeks after the treatment. As a result the skin slowly becomes denser as it regains its ability to produce bigger amounts of collagen. The final result is replenished volume, denser and smoother skin.
When do I see the final results of the treatment?
The final results should be expected after 3 to 4 weeks after the treatment. It is usually then that the practitioner together with the patient make the decision concerning additional treatments which are sometimes necessary. Our usual practice is to achieve the desired effect gradually rather than with one big application of the product. Such approach sometimes means the need to repeat the treatment after 3-4 weeks before the patient can enjoy the final result.
How many treatments do I need to see satisfactory results?
Younger patients under 45 years of age are usually satisfied with a single injection of 2ml to 5ml of hyaluronic acid. To see satisfactory results, older patients usually require another treatment performed 3 to 4 weeks after the first injection.
How long do I see the results of the treatment?
Satisfactory results, which have been achieved after 1 to 2 treatments, can usually be enjoyed for 6 up to 10 months. This period of time depends on the patient’s age, the kind and amount of the filler as well as the patient’s lifestyle and their general physical condition. It must be emphasized that smoking can significantly diminish the results of the treatment.
How often do I need to repeat the treatment?
The treatment should be repeated every 6 to 10 months, depending on how long the patient can enjoy the results. Further treatments usually require less product as the increased amount of collagen in the skin strengthens its structure and helps it look younger. Such treatments are usually called “maintenance therapy”.
Contraindications include
How do I look just after the treatment?
After the treatment you should expect the area to be a little swollen, red and tender which is caused by the filler and swelling. Shortly after the treatment hematocele and bruising may occur but these usually disappear within a few days. Bruising sometimes takes a couple of days to develop and 10-14 days to change colour and resolve with no further damage to the final result.
Before the treatment: guidelines
There is no need for any preliminary medical preparation, but patients have to be in good physical condition. One week before the treatment patients should not take aspirin or any other medication that decrease coagulability. We advise our patients to take aescin (Aescin 3x2tabl, Reparil 3x2 tabl), a few days before the treatment as it decreases the risk of hematocele. Patients who tend to suffer from herpes should prophylactically take acyclovir (Heviran tablets 400 mg twice a day) two days before the treatment.
After the treatment: guidelines
After the treatment you should apply a thin film of soothing gel and massage the area twice a day (use: Cicalfat, Cetaphil MD, Cicaplast Baume B5, Sensicure). If bruising occurs, it can be treated with Auriderm, Ortholan Vein, Lioton 1000 or Reparil. Patients are also advised to continue taking Aescin or Reparil. Finally, when redness, tenderness, hardening and bruises clear up, patients can discontinue medication and resume their usual skin care practices. It is recommended that patients use high quality skin care products with sun filter SPF50+.
How can I keep the result for longer?
At Ekoderm we believe the aftercare is just as important as the treatment itself which is why we advise patients to look after their skin properly on a daily basis. You can do it by using a high factor sun protection that will protect against both UVA and UVB radiation (SPF 30-50), as well as products which contain antioxidants such as vitamin C, vitamin E or flavonoid. We also advise our patients to take diet supplements which contain vitamin C, vitamin E, coenzyme Q10 and flvonoid. It is important to refrain from smoking which is responsible for accelerating ageing processes and greatly diminishes all results of aesthetic treatments which have been achieved so far. The whole range of skin rejuvenating treatments such as medical skin peels and mezotherapy are also highly recommended.
Recommended supplementary treatments
We recommend that our patients who have been given treatment with hyaluronic acid should follow skin rejuvenating therapy. This will help to stimulate skin for better production of collagen. The therapy includes a series of medical skin peels (pyruvic acid, glycolic salicylic acid,) along with mezotherapy with hyaluronic acid (Juvederm Hydrate) or products rich in multiple ingredients (NCTF HA, NEWEST, UP GRADE). Peels and mezotherapy should be repeated a few times every 2 to 4 weeks. Another therapy we recommend is an intensive regenerating treatment REGENERIS. Patients who are planning HYDROBALANS treatment should also consider resurfacing performed with the use of a fractional laser Palomar StarLux500 Lux 1540 or photorejuvenating treatment with laser handpiece MagG.
Who can perform treatments?
At Ekoderm all treatments are performed by experienced doctors trained in aesthetic medicine who have been given appropriate certificates.
