JONK – RSG 8 August 2024 – Translation

What is the next step & How can a doctor help you to look younger?

Martelize: Welcome back dr Ria Smit. She is a doctor at the Mooikelder Estate in Paarl with her practice focused on Women’s Health and Aesthetic Medicine.
Last week we looked at products and ingredients, what works, what doesn’t. Today we want to discuss what is the next step. Going to the doctor with certain concerns about your skin – you want to look a little better. What can the doctor do? Welcome doctor.

Dr Ria: Thank you Martelize, I appreciate the opportunity.

Martelize: So, I do a facial about once a year – sometimes once every 5 years. There is no good translation into Afrikaans for facial. What exactly is a facial for those of us that do not know.

Dr Ria: A Facial as the word explains is focused on the skin of the facial and directly adjacent areas. It aims to gently remove superficial dead skin cells and to moisturize the skin. Different products are used to obtain this, but part of such a treatment is also the massage that help to improve lymph drainage and stimulate blood flow to the skin. A facial is usually done in a calm, quiet environment to provide the added benefit of that – so, a holistic approach to general wellbeing.

Martelize: I love a facial and prefer this to a body massage. How many times a year do you recommend this treatment? Does it help at all to do this once a year?

Dr Ria: This really depends on the individual’s skin and what it is that you would like to obtain with these types of treatments. We’ll probably discuss this soon. Essentially every little bit helps.

Martelize: So, someone would like to do more than just a facial. What options are there, doctor?

Dr Ria: This is where I recommend that one visits the practice of a doctor with the necessary training in Aesthetic Medicine. At such a practice – even if the doctor does not perform all the treatments – the therapists (somatologists) that may perform some treatments would do them under the guidance and supervision of the aesthetic doctor. Typically, we would compile a complete treatment plan taking into consideration your medical history, your preferences, expectations and aims. Some of the advance treatments may have potential side effects.
So, we must decide if you want to focus on skin only, or also treat deeper than skin level which would be the ideal. We must decide what is best for you as the individual.

Martelize: So, you want to tell me it is also about what you eat and what you drink? Your skin reveals these things also?

Dr Ria: Absolutely correct. These things play a role and as we discussed previously it has to be addressed to obtain optimal results. I do see it often in practice even when it comes to medical conditions. It does affect the skin and if these medical conditions are not appropriately addressed and treated, we struggle to obtain effective results for the skin. For us ladies hormones also play a role – especially around the years when things typically change – the teenage years and again around menopause.

Martelize: So many things! We are talking to dr Ria. We already discussed in previous episodes what you can do at home, today we are discussion what is next – more advanced. Next question: What is Botulinum Toxin?

Dr Ria: Yes, Botulinum Toxin is a protein produced by the Clostridium Botulinum bacteria. It has been isolated and researched since the early 1900’s. It’s first use medically was to treat strabismus in children and subsequently the cosmetic benefits were noted. In the 1980’s it entered the Aesthetic Medicine market and is currently the most commonly used treatment in Aesthetic Medicine.

Martelize: Is this now what we refer to as BOTOX? In the common language?

Dr Ria: To be correct I have to refer to botulinum toxin in order not to advertise or give unjust advantage to a particular product. BOTOX was the original botulinum toxin manufactured by the company ALLERGAN. Since, other toxins were also produced and licenced. In South Africa we have DYSPORT and XEOMIN as other licenced products. The toxins work on muscles. By reducing the action of a muscle or muscle group the forming of lines and wrinkles are reduced.

Martelize: I know now there are different versions, but I am going to refer to BOTOX. The use has really changed over the years. People’s foreheads looked really frozen because of these muscles they cannot use anymore. Where do we stand currently? Where should we inject?

Dr Ria: Right, this can be used for most muscle groups in the face. The group that we treat most is the frown that make us look angry, the forehead when we lift the eyebrows and then also the lines around the eyes that form when we pinch the eyes tightly for example with laughing. It can also be used in the lower part of the face: the chin or the muscles that lead the mouth corners to turn down to make a sad face, then we get an upturn of the mouth corners. It also helps to create a defined jawline by treating strong muscles in the neck. As you mention however the approach to treatment is individualized, we analyse muscle groups to see how exactly you use your muscles to adjust injection points to the individual. We can also adjust the amount of toxin used in order to soften the effect of a muscle without removing the movement completely. Injections must be done and monitored by a doctor. Recurrent low dose injections too often may lead to a tolerance developing and subsequent total lack of effect.
We want to treat with enough to have good effect, but also treat as such that it does not look unnatural.

Martelize: Not to go too far.

Dr Ria: Yes, not go too far. We repeat treatments typically every 3-4 months to maintain effect.

Martelize: Why do they say that you must start treatment as a young person if you are worried about lines developing? Before you get a line you have to start Botox – is it true?

Dr Ria: Every person has to decide for themselves of course. This is an elective treatment and therefore it depends on your preferences if you would like to address this or not. To treat as prevention is however better or easier than trying to treat a line that is already well established. In the latter case it may take a year or two – sometimes even longer for the skin to respond and heal itself by treating the underlying muscle.
Thus, if you treat early, you will prevent a line from becoming prominent, permanent or prevent it from forming altogether.

Martelize: This is the most diplomatic answer. This concludes our conversation. Taking the next step when you are ready.
– This was Dr Ria Smit. Her practice is focused on Women’s Health and Aesthetic Medicine.