Category “Dr Peter Forrester”

I have very pale skin, if i had a dermal filler would you be able see it under my skin?

October 17th, 2012
Q.
Hi Peter, unfortunately my skin is very very pale, it has been all my life. I am considering having a dermal filler in my cheeks but i was just wondering if my skin is very pale is there any trace of the filler under my skin?? I’ve heard a few different things about this, someone said about injecting it very deeply under the skin but i wasn’t sure if it was placed deep under the skin would you still get noticeable results? Hope you can clear this up for me! Thanks Peter!
A.
Hello there,

Thanks for your question. To give a smooth and natural result, cheek filler is best given a little deeper compared to some sites on the face. In this position there would be no risk of it being visible, even with pale or thin skin. The volume of filler used would determine how much enhancement was achieved and this is best decided during a full consultation to look at what you want to achieve.
I hope this answers your query.

Best wishes,
Dr Peter Forrester
Cosmetic Doctor

Dr Peter Forrester

Dr Peter Forrester

6 Esher Park Avenue, Esher, Surrey, KT10 9NP
Web: www.drforrester.co.uk Tel: 01372 890 890

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I need multiple dermal filler treatments, will you do this in one sitting and how much will it cost?

October 12th, 2012
Q.
Hello Peter, My question to you is that i feel i need multiple dermal fillers in different places on my face. I need around my nose and lips, forehead and cheeks. Will you do this in one sitting or break up the treatment? Also do you use a different filler for each particular area? If so do they last the same amount of time? I know its hard not seeing my face but could you give me a ballpark figure for the 3 different treatments together? Thanks!
A.
Hello,

There is no reason why you cannot have multiple fillers at one sitting. Most hyaluronic acid (HA) filler manufacturers produce a range of fillers, each of which will differ in their consistency, the thicker fillers being used more deeply under the skin. If I were treating different areas of the face I might use Restylane superficially, Restylane Perlane more deeply and perhaps Restylane Sub-Q or Emervel Volume in the deeper layers. These decisions would be made depending on the facial area and what we were trying to achieve.

With regards to how long they would last, in general the thicker the filler and the deeper they are placed, the longer they last.
Fillers are almost always priced by the syringe. Beware when comparing prices that some practitioners quote prices per syringe without stating the volume of the syringe. Usual syringe volumes will vary between 0.5ml to 2.0mls. The volume needed will depend on the areas and how much enhancement you were looking to achieve and because of this realistic figures are difficult to quote. Cost might vary anywhere from £300-£900.

Best Wishes,
Dr Peter Forrester
Cosmetic Doctor

Dr Peter Forrester

Dr Peter Forrester

6 Esher Park Avenue, Esher, Surrey, KT10 9NP
Web: www.drforrester.co.uk Tel: 01372 890 890

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I want lip enhancement treatment but i want it to look natural, what do you suggest?

October 12th, 2012
Q.
Hi, its a question regarding lip enhancement. I have very thin lips bottom lip is slightly larger but still not very plump. I am currently wearing a brace and its filled them out but once this comes off theyll be back to normal. Ive seen the celebs that have had there lips done and it looks terrible, is there any product on the market for thin lips that doesn’t make you look like a duck that literally just fills them out abit?. I also suffer with cold sores will the treatment bring one out?thanks
A.
Hello there, thanks for your question.

I can see why you are concerned, in my opinion there are lots of folks out there with badly & over done lips. If that’s what they want, then fine but it’s not what most people want from a lip enhancement. The problem is that it gives the impression that this is how it’s always done. However there are lots of people with very natural-looking lip enhancements, but you won’t notice them – you’d think that they had nice, naturally full lips.

The secret is not which product, but how much volume is used. A full discussion with your practitioner should ascertain what you are looking to achieve and importantly what you are not looking to achieve.

I favour Restylane Lip Volume but there are other hyaluronic acid fillers that also would work well.

With regard to your cold sores I would prescribe a short course of aciclovir tablets (zovirax) for 5 days after treatment so that this was not a problem.

Best wishes,

Dr Peter Forrester
Cosmetic Doctor

Dr Peter Forrester

Dr Peter Forrester

6 Esher Park Avenue, Esher, Surrey, KT10 9NP
Web: www.drforrester.co.uk Tel: 01372 890 890

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I’m a male with deep wrinkles in my forehead, what would be the best treatment?

October 5th, 2012
Q.
Hi Peter, Hope your doing well. I’m in my mid 40’s now and have developed some unsightly wrinkles on my forehead. To tell the truth i was slightly embarrassed to go into a clinic and ask about dermal fillers so i thought i’d just ask on here. With male wrinkles i know they are a lot more pronounced on the face so i was wondering what the best type of dermal filler would be for myself? How many times per year would i have to receive treatment for these? Hope to hear from you soon!
A.
Hello there,

Most people develop forehead wrinkles because of the action of forehead muscles repeatedly folding the skin. This usually results in vertical frown lines between the eyebrows and horizontal lines that get worse when looking surprised or raising the eyebrows. As the skin progressively ages, this repeated folding slowly changes from being visible only during movement to being there all the time. There are two main approaches – either to weaken the muscles temporarily with Botox or fill the lines with dermal filler.

Any of the hyaluronic fillers would be suitable, however I tend to prefer Restylane because of its long safety record. In this situation fillers may appear to have advantages over Botox particularly with regard to longevity. However, most people who are bothered by these lines are likely to have strong muscles (which is why they’re getting the lines) this means that their muscles will tend to crease the fillers, significantly reducing their effect and length of action.

Because of this the best approach is often to weaken the muscle action with Botox and then consider the addition of a small amount of filler to treat any lines remaining after Botox. This approach might need to be repeated 2-3 times in the first year but then perhaps only 1-2 per year.

The best option for you can only be decided following an examination of your forehead and discussion of the pros & cons.

I hope this helps, best wishes

Dr Peter Forrester
Cosmetic Doctor

Dr Peter Forrester

Dr Peter Forrester

6 Esher Park Avenue, Esher, Surrey, KT10 9NP
Web: www.drforrester.co.uk Tel: 01372 890 890

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I have silicone cheek implants, is it okay to have Juvaderm cheek fillers to add volume?

October 1st, 2012
Q.
Hello. I had silicone cheek implants 6 years ago. Is it okay to have Juvaderm cheek fillers for volume. I recently spoke to an aesthetic nurse who said she wouldn’t do fillers as she might pierce them but the implants are solid plastic like implants. I am very keen to have them as my face has sagged over the years. I am 57. I recently messaged you about fillers but forgot to mention my implants. I would really appreciate your advice, Thanks! 
A.
Thank you for your question, your cheek implants could be solid silicone in which case inadvertently piercing them with filler is unlikely. However, some implants are made of a more porous polyethylene that could possibly be more problematic. The best way forward would be to find out what cheek filler you have and then discuss the options with an experienced practitioner.

Kind regards,

Dr Peter Forrester

Dr Peter Forrester

Dr Peter Forrester

6 Esher Park Avenue, Esher, Surrey, KT10 9NP
Web: www.drforrester.co.uk Tel: 01372 890 890

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I would like a permanent filler, I’ve heard Aquamid is the best but do you know of any that are equally as good?

October 1st, 2012
Q.
Hi there, I am 61 and I would like a permanent filler to fill in deep lines above my upper lip & creased going downwards from edges of my mouth. I am not interested in short term fixes. I have read that Aquamid is recommended as the best, or do you know of any others equally as good. Also my main concern is finding a very experienced surgeon in this field, as I have read that the permanent fillers need to be injected deeper into the skin that the temporary ones, and preferably in the Liverpool / Manchester area. How do I find one please. Thank you!
A.
Hello there,

I would suggest that the best way to find a properly trained and qualified surgeon would be to look for a member of BAAPS. You would also need to check that your chosen surgeon is also experienced with non-surgical, injectable treatments. For obvious reasons many excellent surgeons tend to concentrate on surgical solutions. Alternatively you could look for a Cosmetic Doctor (rather than Cosmetic Surgeon). Cosmetic Doctors, like myself, are trained and experienced in a range of non-surgcal options including dermal fillers.

Personally I am very hesitant to use permanent or semi-permanent fillers. In the past, most of the long-term problems that have occurred have been with this type of filler. Some permanent fillers have late-onset complications; this means that everything seems to be OK for a few years and then out of the blue serious inflammatory reactions can appear. Hyaluronic Acid filers such as Restylane and Juvederm do not have this problem. Restylane has been used millions of times over the last 15 years and has an unparalleled safety record.

The advantage of HA fillers is the low incidence of complications and we used to believe that their disadvantage was their lack of longevity. Recent scientific studies have shown that although the HA does slowly disappear it does stimulate some natural collagen production. This partly explains why in some people HA fillers seem to last a long time and why people returning for top-ups often require smaller volumes than initially used.

With best wishes,

Dr Peter Forrester
Cosmetic Doctor

Dr Peter Forrester

Dr Peter Forrester

6 Esher Park Avenue, Esher, Surrey, KT10 9NP
Web: www.drforrester.co.uk Tel: 01372 890 890

View My Profile Dr Peter Forrester

Would a filler with hyaluronic acid be suitable for me?

September 28th, 2012
Q.
I would like to use a filler containing hyaluronic acid for my lines around nose, etc. I have underactive thyroid condition (Hassimoto) and take 125 mg of levothyroxine daily. Will any product containing Hyaluronic Acid be suitable for me or am I one of those patients who cannot have this type of treatment? If so is it are there any alternatives except for a surgery?
Many thanks 
A.
Hello,

There is certainly no reason why a hyaluronic (HA) filler would not be suitable for you. Although synthetically produced, the HA in dermal fillers is almost identical to the natural HA that is widespread throughout the body including the skin.
Q-Med have been making the HA filler, Restylane for 15 years and it has been used millions of times in patients giving it an unparalleled safety record.

Surgery may be an option for you but if you are concerned about the nose-to-mouth lines (naso-labial) then a HA filler would be a good choice.

Best wishes,

Peter Forrester

Dr Peter Forrester

Dr Peter Forrester

6 Esher Park Avenue, Esher, Surrey, KT10 9NP
Web: www.drforrester.co.uk Tel: 01372 890 890

View My Profile Dr Peter Forrester

What are the best dermal fillers for the tear trough area?

September 28th, 2012
Q.
Hi, I am having dermal fillers on the 9th October hopefully for tear trough area and upper cheek. have lost volume under my eyes and upper cheek which makes me look tired. I would like to look fresher. I will be 40 this year and feel that I need to look fresher as I work with the public and in the beauty industry.I just want a natural look and to add volume where it has disappeared I have told that they may be using Juvederm Voluma. What are the best fillers for this area and is Juvederm Voluma safe for the tear trough area?

Thank you 

A.
Hi there,

Juvederm Voluma is an excellent filler to replace volume lost from the cheek and mid-face area. However, it is much too thick a product to use on the Tear Trough.

In the wrong hands the Tear Troughs can be a problematic area to treat. Tear Trough treatment is a particular interest area of mine and I believe that the secret to a successful result is to use the correct product, in the correct place, in the correct amount and importantly with the correct technique. Over-treatment is a concern in this area and I rarely use more than 0.5-1.0ml of filler in total, to treat both sides. It is one of those areas where it may be better to slightly under treat and review a few weeks later rather than risk adding too much volume. The Tear Trough is an unforgiving area and even a small amount too much will look obvious.

Having said that, Tear Troughs are a satisfying area to treat and are probably the only area of the face where a relatively small amount of filler can produce such a dramatic improvement.

From a product point of view I believe that for Tear Troughs it is difficult to beat the classic Restylane (not thicker products such as Restylane Perlane/Sub-Q)
I hope that this is of some help.

Best wishes,

Peter Forrester

Dr Peter Forrester

Dr Peter Forrester

6 Esher Park Avenue, Esher, Surrey, KT10 9NP
Web: www.drforrester.co.uk Tel: 01372 890 890

View My Profile Dr Peter Forrester
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