DR JOHANNA WARD

FAQs

Botox

It’s a way of referring to Botox which is a brand name. Botox is a small protein that gets injected into fine lines and wrinkles to soften facial lines and wrinkles. It works by relaxing the small muscles of the face that cause wrinkles.

Botox is commonly used to treat frown lines, forehead lines and crows feet lines. It can also be used in the lower face for very specific areas to soften certain muscles that cause a down turned /sad mouth, or to muscles that exaggerate jowling, or to reduce lines around the mouth and to help show more of the lip. It can also be used to soften very strong masseter muscles that can become overactive with teeth clenching and jaw grinding or excessive chewing of gum. Botox injections into the masseter muscles can also help to slim the appearance of the lower face.

Botox lasts about 3-4 months for most people. It is a treatment that needs repeating several times a year to get and to maintain the best results. It takes 2 weeks to kick in after the injection and then peaks at about 4-6 weeks then slowly it wears off. You can have it every 3 months regularly if you want to make sure that your lines don’t have a chance to come back.

Yes. We all metabolise drugs at different rates so there will be variability on longevity from person to person. Also some people request a lighter and more conservative dose so they will experience their Botox wearing off a little quicker than someone who asks for stronger doses. Your muscle expression, lifestyle, exercise and unique genetic makeup also have an impact on Botox longevity. Dr Ward has been treating patients with Botox for 15 years so she will assess your muscle movement and strength and together you will decide what type of dose you want/need. The stronger the dose the less movement you will retain. If you want a natural look you will likely need a lighter dose sprinkled across the muscles. You can decide this after having an opportunity to discuss it with Dr Ward.

No you can’t. Not because it’s dangerous but because no clinical trails have been done on pregnant women as it would be unethical and therefore we don’t know the safety of it. If you accidentally have treatment without realising you are pregnant you don’t need to panic. This has happened to countless women around the world and usually everything is fine. We don’t think it causes a problem. Just tell your Doctor in charge of your pregnancy about your concerns. Botox isn’t thought to move around the body but rather is contained within the treated muscle. Nonetheless we never recommend Botox treatment during pregnancy or breastfeeding.

Dermal Fillers

People who have overfilled their face can look odd and can end up obliterating much of the natural contour and movement of the face. Normally to get to this point you would have to have had many, many rounds of filler treatment. Most people don’t want to look ‘done’ and this can easily be avoided.
Dr Ward will guide you on what areas you would benefit from having treated and she will also tell you when to stop and have no further treatment. She will guide you honestly and transparently and is known to prioritise a natural look.

Fillers are made of hyaluronic acid but not all fillers are created equal. There are over 200 brands of filler available on the UK commercial market but only a very small handful are FDA approved for human safety. Dr Ward only ever uses fillers that are FDA approved which means they have been vigorously tested in human tissue and checked for efficacy and longevity. All fillers used in clinic are ordered through quality UK Aesthetic Pharmacies (Health Xchange, Wigmore Pharmacy and MedFX) to ensure that there can be no counterfeit product or chain. All products used in your treatments are recorded with batch and expiry numbers documented for safety. Many practitioners use poor quality fillers that are not FDA approved that are purchased off sites like Alibaba which is unethical and unsafe. These are often sourced from unregistered places have not been tested on humans for tissue compatibility and could pose a potential hazard or danger. Please always be sure to ask your practitioner about the quality of the products they use in treatments because once it’s injected into the tissue it needs to integrate well and not cause reactions and inflammation.

Firstly don’t panic. The tissue after filler often swells and looks more volumised for up to a week or two. If after it has all settled down you still don’t like your filler then there is a prescription enzyme called Hyalase that Dr Ward can prescribe to dissolve it away.

It’s very important that everyone has a thorough and complete medical assessment before any treatment. If you are deemed suitable for treatment then fillers can be used in the temple area to support the brow and revolumise the brow. To the cheeks to add volume and support, to the jawline, chin, lips and nose. Dr Ward will assess the amount of volume loss in your face and assess your skin quality and general ageing and will advise on what fillers to use in what areas of the face. She will created a complete treatment plan that gives you an idea of how many syringes you might need. Temples, cheeks, noses, chin and jawline filler tends to be thicker and more structural and lip filler and filler around the eyes tends to be lighter and softer to match the tissue thickness and dynamicism. Dr Ward is an expert in dermal fillers and will explain which fillers will suit your skin best.

This is a common request, especially for patients new to aesthetic treatments. You can of course go slowly with all treatments. It’s actually a good idea to go slowly and to check that your skin responds well to any treatment and that you like the results. Dr Ward is very gentle and natural in her approach so you will be in reassuring and safe hands.

Micro-needling

Micro-needling helps to improve and enhance the quality of your skin. It activates the skin’s natural collagen and elastin pathways and helps to regenerate any damage in the skin. Tiny needles are used to create lots of micro columns on the skin causing very localised and controlled damage without affecting the epidermis. It can help improve lines, wrinkles and scars and is good to do several times a year. Micro-needling is considered safe for this with hyperpigmentation but speak to Dr Ward during your consultation further if you are worried. She can always give you a course of prescription Hydroquinone before your treatments to suppress your pigment cells.

It really depends on the depth of the needles used. Most people will find that anything up to 0.5mm is tolerable without any numbing cream. If you are needling in deeper depths like 1-2mm then Dr Ward will offer you some topical numbing cream 30 minutes prior to your treatment.

Your skin will look red and will be a little sensitive to touch for a few hours after your procedure. You may get some very tiny pinpoint bruises that will last only 24-48 hours. You should avoid any makeup or skin creams for at least 6 hours after treatment. Makeup can be worn the next day.

In clinic Dr Ward uses the SkinPen device. It is an FDA, high quality micro-needling device that is made in the USA and is used by leading healthcare providers. It is surrounded by a custom sheath that prevents cross contamination and uses single use sterile needle cartridges built with safety in mind.

SkinPen is clinically evidenced and backed by numerous scientific papers. It’s a precise needling device and is thought to cause less collateral damage than traditional dermarollers. In clinical trials 94% of SkinPen patients reported an improvement in fine lines and wrinkles after 1 month, 80% noticed an improvement in scars after 1 month and 90% of patients said they would recommend it to family and friends.

WOW fusion facial

The Wow Fusion is medical mesotherapy that uses 24 carat gold needles to treat oiliness, enlarged pores, acne, pigmentation and facial flushing. The 24 carat gold plated device penetrates the skin to allow skin ingredients to fuse down into the epidermal/dermal junction. With this treatment you get the benefits of micro-needling with mesotherapy. The micro-needling helps to bio-regenerate the skin and stimulate collagen and elastin and the mesotherapy allows for the infusion of ingredients like hyaluronic acid, peptides, antioxidants and Botox to help reduce facial flushing, improve skin hydration and add luminosity.

Yes it can. We can choose various different ingredients to create a bespoke cocktail for your mesotherapy according to your skin concerns and skin goals. We can also add Botox to the infusion to relax the tiny muscles around the skin pores and sebaceous glands. This reduces pore size, skin oiliness and facial flushing so can be great for patients with acne or rosacea. The facial helps to give the skin a smooth and matt finish.

- Vitamin C for skin brightening
- Multi-peptides to stimulate collagen
- Antioxidants for skin renewal
- Hyaluronic acid for deep cellular hydration
- Botox to reduce oiliness, facial flushing and to contract pores

Profhilo

Profhilo is injected very superficially so it will likely leave some visible blebs on your skin for several hours after treatment. On the face these go down very quickly but on the neck and décolletage these can last 12-24 hours. We advise that you schedule your treatments to a time when having these visible blebs wouldn’t be a problem.

No you don’t need to do anything. Profhilo is a hyaluronic acid treatment that cleverly knows how to diffuse through the tissue so it doesn’t need you to massage the treated area. It will settle in its own time.

Profhilo isn’t licensed for use under the eyes as it would draw in too much hydration to the area. Instead we use treatments like skin tightening devices or polynucleotides/exosomes and other bio-regenerative treatments to improve the delicate skin in this area. If you have deep eye hollows you may also benefit from tear trough dermal filler. Dr Ward will guide you through your options.

Profhilo is a treatment that needs to be repeated every 3-6 months. In people who have a lot of sun damage, dehydration or fine lines and wrinkles then it is recommended to maintain your treatments every 3 months. If you have good skin quality then you can repeat Profhilo every 6 months.

Botox and Profilho are very different treatments. Botox is great for lines in the upper third of the face. Profilho is used in the mid and lower face, neck and décolletage as well as all over the body to improve skin texture, hydration and laxity. It works by stimulating collagen and elastin production whilst Botox works by relaxing the muscles of facial expression. Botox and Profhilo work really well together and are often used in combination. They can be performed at the same time on the same day.

Scupltra and Radiesse

Both of these bio-regenerative treatments are powerful collagen stimulators and require massage for 5 days after treatment. This is to prevent collagen clumping or clusters of collagen cells. Scupltra and Radiesse have both been modified in recent years to reduce this risk and they are often injected in a more dilute solution so as to prevent collagen clumping. But the manufacturer still advises patients to massage the area firmly five times a day for five minutes for five days. It’s best to do this with a moisturiser. If you have any concerns after your treatments please contact the clinic.

Scupltra and Radiesse are both powerful FDA approved bio-regenerating treatments. They are great for people who would otherwise need large volumes and multiple syringes of dermal filler. Over the years the formulas have been adapted and diluted for better results. The dilution doesn’t mean that you get less per treatment. It just means that the treatment is blended with saline or water so that it’s less likely to cause any collagen clumping. It’s just as effective when mixed with sterile water and it spreads in the tissue better giving better results for patients.

Chemical Peels

Chemical peels are a controlled process involving the removal of surface layers of skin to reveal a brighter, healthier and more vibrant skin layer underneath. Most gentle peels or superficial depth peels only cause a mild bit of shedding of the skin which shouldn’t be too noticeable. You should be able to continue your normal daily activities. Medium depth peels often cause a little more shedding normally from day 3-6. You may want to schedule this to land on a day off or weekend but you can certainly continue all of your normal daily actives. We advise that you don’t try to peel the skin off as this can cause trauma and that instead you let it shed naturally in its own time. Dr Ward uses the Obagi Radiance peel, the Perfect Peel and the Neostrata Retinol Peel 3%.

This superficial peel is suitable for all skin types and has minimal downtime so you can have it in your lunch break. It combines 2% Glycolic & Lactic Acid and 20% Salicylic peel to gently exfoliates and resurface the dermis to resurface and expose healthy, new and glowing skin. The peel solution is completed by a strengthening concoction of peptides, retinol and willow bark extract that helps shed dead skin whilst also unblocking clogged pores. It’s the ideal peel for those with acne, blackheads, skin congestion and dulling. It needs no prior skin preparation but we would recommend that you avoid retinol and acids in your topical skincare for 5 days before the peel.

You will see results from just one Radiance peel but most people will benefit from a course of 3-6 peels to get the skin healthy, clear and congestion free. Dr Ward will also recommend a topical skincare regime that will complement these peels.

The Perfect Peel is a fantastic treatment for skin pigmentation, sun damage and to treat the signs of ageing. It contains the body’s major player antioxidant glutathione and is a masterful way of flooding the cells with antioxidants to stimulate skin renewal and repair. As long as you don’t have an allergy to aspirin(acetylsalicylic acid) you should be ok to have the peel.

We cannot perform peels on patients who are on Roaccutane. It is also a good idea to avoid treatments that might irritate your skin like waxing/micro-needling or strong acids and retinol/tretinoin before a chemical peel. We cannot peel skin that has any open wound, cold sores or sunburn. You will also need to follow Dr Ward’s guidance on skincare before and after your peel. This will all be covered in your consultation. Sun protection must be worn after your peel as the chemical peel will remove the outer most protective layer of your skin so it makes it more vulnerable to UV rays for the first few weeks post peel.

We recommended two peels initially. This will give most people a great treatment outcome. If you feel you need further treatment this can be performed at 6 weeks.

This Medical grade peel contains 3% Retinol plus a patented Retinol Boosting Complex. Its a very safe and easy peel for those looking to improve their skin tone and texture and for those wanting to go the extra mile in anti-ageing. The peel exfoliates to improve the appearance of fine lines and wrinkles, helps reduce acne, and improves skin laxity while promoting a bright, even and clear complexion. There is minimal shedding or downtime.

It can be done as a one off treatment for anti-ageing with best results after 7 days. Its also a fantastic peel for the treatment of acne. You will see powerful visible results within 2-3 treatments.

General

Radiesse is great for the hands. It’s ideal for older, more mature hands that are volume depleted where you can see the veins visibly and the tendons in between all the fingers. Radiesse is ideal for these types of hands. It can also be combined with profhilo, polynucleotides or dermal filler. These treatments can also be used as stand alone treatments in younger patients with less volume depletion and skin laxity.

There are lots of options for under eye treatment but mostly we use polynucleotides, exosomes, skin boosters or dermal filler. Sometimes we use combinations of these. For example if you have deep under eye hollows you may need some cheek filler and under eye filler to put the foundational support back into the tissue as well as polynucleotides for the most surface layers of the skin. If the skin is very loose then it might also be a good idea to do a skin tightening/energy based treatment or micro-needling. Dr Ward will guide you on which options will be best for your unique issues and will advise you on what results you can realistically expect.

Bruising is common after injections and energy treatments to the skin. Normally bruises are small and transient but occasionally people get larger bruises. If you get a bruise during treatment Dr Ward will compress the area firmly for 3 minutes and will apply a cold pack to the area. If you notice a bruise come up the day after treatment then just check in with Dr Ward who may request a photo to of it. Normally bruises last only a few days and can be easily covered with a few layers of a good concealer. If you have a bruise that isn’t going or you are worried about any discolouration after your treatment then please contact the clinic. Emergency numbers are on all of your aftercare forms or you can use the Whats App number provided on this website. Dr Ward will be in touch promptly to guide and manage you further.

Much like bruising swelling can last a day or two after treatments due to disruption of the tissue and placement of product. Tissue swelling is normally transient and resolves quickly. We tend to see it more if the tissue bruised or in delicate areas like around the mouth or around the eyes. A daily anti-histamine tablet can help as well as application of cold packs. If you are worried about prolonged swelling please contact the clinic for further advice.

Most treatments combine well and can be performed at the same time. The only treatments we tend not to combine on the same day are strong energy treatments like Morpheus 8 and injectable treatments. These are best done on separate days. Dr Ward will always guide you on which treatments can be safely combined and how to schedule your treatments.