Tag Archives: botox injections london

lip filler, lip enhancement, facial balance. Dr Vidal London

A lip filler can be useful for the whole facial area and not simply for the lips themselves.  Sometimes lips are not correctly aligned with the chin and the nose on a profile view.

Lips before after lip filler.Dr Vidal London

Lips are rebalanced with a lip filler. The projection improves the appearance of the chin and the nose

This can give the false impression of  a chin or a nose too long or too big when in fact they are not. It’s just that the lips need a bit more projection forward.

This highlights the fact that it is really important not to be focused only on one thing but to replace each element within the whole context, an harmonious and balanced face.

This also shows that the profile view needs to be respected. Injecting to much will project the lips too far and the result will be the “duck lips” effect.

Injecting the chin or the tip of the nose can sometimes also be used for the same purpose of facial balance. For instance, restoring the volume under the chin muscle can improve the appearance of the lower lip and enhance the jaw line.


Contact form consultations booking Dr Vidal

lips before picture. Lip filler Dr Vidal Londonlips after injection. lip filler Dr Vidal London
Back to the lips themselves, you can see on the pictures above that the projection of the upper and lower lips improves the corner of the mouth and shortens the white upper lip. The projection of the lower lip shortens the chin.

We prefer to use  a good Hyaluronic acid filler than can mix easily with the surrounding tissues without getting lumpy.

Lips are a good indication for injection when they lie onto a good facial support ( teeth, middle face facial volume). When this support is not good it is better to fix this problem first and plan the lip enhancement later.

Cost : 1 syringe Juvedem Smile £ 260.

Hyperhidrosis Treatment London. How it works


Hyperhidrosis Treatment London

Hyperhidrosis is a medical term to define overactive sweating. This means sweating more than it would normally be required to regulate your body temperature. It is a very common problem and its cause is still not really well understood . While not a life threatening illness it nevertheless does severely impact people’s quality of life, confidence and even performance at work. The severity of hyperhidrosis can be very simply assessed by the Hyperhidrosis Disease Severity Scale HDSS. You can rate yourself as follow:

1 pt -My sweating is never noticeable and never interferes with my daily activities
2pts– My sweating is tolerable but sometimes interferes with my daily activities
3pts– My sweating is barely tolerable and frequently interferes with my daily activities
4pts– My sweating is intolerable and always interferes with my daily activities

A score of 3 or 4 indicates severe hyperhidrosis. A score of 1 or 2 indicates mild or moderate hyperhidrosis.

hyperhidrosis treatment london - Dr Vidal

hyperhidrosis affects patients quality of life… and others too

The HDSS can be used to follow the efficiency of your hyperhidrosis treatment . A 1-point improvement in HDSS score has been associated with a 50% reduction in sweat production and a 2-point improvement with an 80% reduction.
(ref: A Comprehensive Approach to the Recognition, Diagnosis, and Severity-Based Treatment of Focal Hyperhidrosis: Recommendations of the Canadian Hyperhidrosis Advisory Committee, Dermatologic Surgery, August 2007, pages 908-9230)


Botulinum Toxin (Botox) has revolutionised the treatment of this embarrassing problem. It works by blocking the release of acetylcholine which is the messenger between the nerve and the sweat gland. The gland does not receive any order. It stops working and you stop sweating.

Similar to the effect on facial wrinkles this anti-sweating effect is temporary because your body will rebuild functioning connexions between nerves and glands. This effect can last 6 to 8 months so you can relax and perform for that period of time.

Technique : quick and simple , botox is injected into the dermis,exactly as for a facial procedure. The quantity used for underarms hyperhidrosis is just higher than for the face.

Costs :

£ 500.00


Hyperhidrosis treatment london doctor:

   London- Consultations- Appointments  Dr Thierry Vidal . 25-27 George Street W1 London                               Tel: 020 7486 5134


  • Safety and prolonged efficacy of botulinum toxin in hyperhidrosis  Clin Ter. 2014; 165(6):e395-400. doi: 10.7417/CT.2014.1780.   S. D’Epiro, L. Macaluso, M. Salvi, C. Luci, C. Mattozzi, F. Marzocca, V. Salvo, M. Scarnò, S. Calvieri, AG. Richetta Dermatology Clinic, ‘Sapienza’ University of Rome, Italy
  • “Quality of Life in Patients with Focal Hyperhidrosis before and after Treatment with Botulinum Toxin A”  Anargyros Kouris, Kalliopi Armyra, Christos Christodoulou, Polixeni Karimali, Dimitrios Karypidis, and George Kontochristopoulos,  ISRN Dermatology, vol. 2014, Article ID 308650, 4 pages, 2014. doi:10.1155/2014/308650

Botox even more popular in 2014

Botox and cosmetic procedures american survey

According to a study made by the American Society for Aesthetic Plastic Surgery, the number of non surgical cosmetic procedures such as Botox and fillers  performed in the USA was 740.751 in 1997.

In 2012 this number was 8,416,470 !!!

Click on the link to see the chart from the ASAPS  2012- Plastic surgery timelines

Botox was by far the most popular non surgical procedure with 3,957,913 treatments performed in 2012. The second most popular was fillers (hyaluronic acid) with “only” 1,423,705 procedures performed in the US.

Click on the link to see the chart of the top 5 for surgical and non surgical cosmetic procedures 2012-top5 cosmetic procedures

The ASAPS writes :

“The most popular nonsurgical procedure was injections of Botulinum Toxin Type A (including Botox and Dysport). Cosmetic minimally-invasive procedures increased over 10 percent in the past year, with almost 8.5 million procedures in 2012. Nonsurgical procedures accounted for 83% of the total number of procedures performed representing 39% of total expenditures.  The top five minimally-invasive procedures were:

  • Botulinum Toxin Type A:  3,257,913
  • Hyaluronic Acid: 1,423,705
  • Laser Hair Removal: 883,893
  • Microdermabrasion: 498,821
  • Chemical Peel: 443,824

This is the second year this survey asked the doctors for the total number of non-surgical procedures being performed in their practices by BOTH physicians and their physician assistants and nurse injectors.  When procedures performed by physician assistants and nurse injectors are included, the total number of cosmetic surgical and nonsurgical procedures performed in the United States in 2012 increases to 12.7 million. Below is the TOTAL number of procedures performed in the practices surveyed:

  • Botulinum Toxin Type A:  4,125,179
  • Hyaluronic Acid:  1,806,806
  • Laser Hair Removal: 1,224,920
  • Chemical Peel: 718,465
  • Microdermabrasion: 672,430

The Aesthetic Society, which has collected plastic surgery procedural statistics since 1997, says the overall number of cosmetic procedures has increased 250% since the tracking of the statistics first began. “We are confident that these statistics continue to accurately report cosmetic procedure trends as performed by the physicians who are most likely to perform them,” said Dr. McCafferty, MD. “For the past 16 years, the interest in and demand for cosmetic plastic surgery has risen exponentially, a 250% increase in surgical and nonsurgical procedures, and our comprehensive statistics continue to show that.”

You can read the original publication here

Botox injections: 1, 2 or 3 areas ?

Botox injections

Botox injections are generally offered by clinics and doctors on an area basis. The most widely known are :

  • the frowning area to treat the vertical lines between the eyebrowsbotox injections dr vidal london
  • the forehead area with its horizontal lines above the eyebrows
  • the crow’s feet area and the lines around the eyes.

So there is a price for one, two or three areas. Unfortunately you are a little bit tight on the budget so you can afford one area only… How do you make the most of it ? Simple, you need a good advice.

How these botox injections areas work ?
Facial muscles are not independent like two flats on a same floor. They interact with each other and are in balance with each other. Using botox to weaken one (by blocking the muscle contraction) will simply reinforce the others and this can have consequences. On the other hand, a good understanding of this phenomenon can help to decide which area to treat.
For example you use the forehead muscle to pull your eyebrows upward as when one expresses surprise. But your frowning muscles do exactly the opposite and pull your eyebrows downward as you do now because you read this article.
Treating your forehead with botox will make the frowning stronger and the result may be a low position of your eyebrows which might not be aesthetically pleasant. Botox injections into the frown without considering the forehead or the eyes area could give a poor result as well.
The same concept apply when you pair the forehead and the eyes area. When you smile or close your eyes you pull the tail of the brow downward.
It is perfectly possible to treat the forehead only. It depends on your age, your facial anatomy, the relative strength of each muscle. Young people with good quality muscles may do this because a little bit of botox will not have a massive impact on this muscular balance. But this doesn’t mean it is a good cosmetic result because what is better ? a flat forehead with a strong frown and a severe look or a normal forehead with a nice relaxed look ? (please remember, you just can afford one area).
It is not very different with older people as with time they develop natural muscles imbalances . Not understanding these imbalances for botox injections can result in a poor aesthetic outcome. What is better ? a flat forehead with collapsed eyebrows and microscopic eyes or a wrinkled forehead with the eyes well defined ? or nothing ? or may be something else you even didn’t think about ?
So how do I choose my botox area ?
It is the job of a good professional botox practitioner to help you understand what is going on with your face, your muscles, your expression, your personality. It is also their job to take the time to explain these things to you. Irrespective of what your budget is but relevant to how your face looks.
The most common mistake made by people is to go to a botox provider and ask firmly for a specific area to be treated. They do this because it is difficult to see themselves objectively. Chances are they will get this area treated whether or not it was the best aesthetic choice.
A good professional will do very well if you can afford three areas. A very good one could just do as well with less. If you can afford only one area please first ask your doctor what would be the best choice and listen to their explanations. You will certainly be wisely advised.
If they cannot give you a clear explanation you may consider finding another clinic. By the way repeat this process even if you can afford more than one area . You will happily make the most of your botox injections and your money.

This article was originally written by Dr Vidal and published on apparentlifestyle.com

advanced botox in London

advanced botox london.the doe eye technique by dr Vidal in london

Advanced Botox London

                                                                           london doctor dr Vidal is one of the very few practitioner to offer this advanced technique of rejuvenation for the eye and eyelid area. This is an article about the eye area management and the “doe eye” technique written by Dr Thierry Vidal and published on ezinearticles.com.

The eye area (upper and lower eyelids, eyebrows, eyelashes) is one of the most important cosmetic unit of the face. The main facial muscle of this area is the orbicularis oculi muscle.

Ageing of this zone will lead to a tired aspect with a diminished eye size, a skin excess or eyelid heaviness, some wrinkles (crow’s feet) and a hollowness of the lower eyelid area.

Dr Claude le Louarn (1) has shown that one of the most important cause of the facial ageing process was the repeated facial muscles contractions leading to some fat being expelled toward an adjacent area. This is associated with an increased resting tone of the facial muscles leading to a shortening and a straightening of these muscles.

The orbicularis oculi muscle straightening and shortening with age will attract the eyebrows downward which creates a pseudo skin excess and a heavy upper eyelid.

At the lower eyelid level the repeated contractions of the orbicularis oculi will modify the fat layer and expel some fat toward the medial palpebral pocket thus creating a hollowness of the area.

As the muscular participation in this ageing process is so important, Botox (botulinum toxin A) is naturally the best way to manage and prevent the ageing of the peri-orbital area.

For the rejuvenation of the peri-orbital area we use botox by doing three to four injections laterally on the orbital part of the orbicularis muscle. Each point is 2.5 units (2ml saline in a 100 units botox vial). We also inject another point into the palpebral part of the orbicularis. This latest point is the very advanced one.

We start straight under the tail of the eyebrow. This first point is the highest. Exact injections sites are determined by asking the patient to smile. These sites follow the orbital rim curve. The last site is situated on the same vertical line than the first. This last point is located on the pars malaris of the orbicularis muscle.

The most remarkable point, the one that makes this procedure an advanced one, will be done into the palpebral, pretarsal part of the upper eyelid. This will slightly lift the lateral canthus (corner of the eye). This point has been first described by Dr Le Louarn in 2006 (2).

This point is the “doe eye” in french “oeil de biche ” injection.

1 to 2 units are injected along the eyelashes line with the needle hold horizontally. This injection is done very superficially, in a sub-dermal plan above the muscle, creating a small bubble visible at the surface of the skin. The muscle is not directly injected.

This point is done only to female patients as it enhances a feminine shape of the eye by lifting the lateral canthus (it is a “doe eye” effect).

This technique will re-open a tired eye and ease the heaviness of the upper eyelid. Eyelashes are nicely enhanced and a beautiful almond shape is accentuated.

We started to inject like this in 2006. Today, after several hundred of these palpebral injections we have not seen any adverse effect such as a ptosis, a dryness or a diplopia. Side effects are rare and limited to a minimal bruising of the upper eyelid.

To see before after pictures of this advanced botox london eye rejuvenation please click on this link

(1) Claude Le Louarn, Bathias, Buis: structural aging: The Facial Recurve Concept Aesth Plast Surg: 31: 213-218, 2007.

(2) C.Le Louarn: Botulinum toxin and the Face Recurve concept: decreasing resting tone and muscular regeneration. Ann Plast Chir Esthet. 2006;52:165-176

Dr Thierry Vidal is a cosmetic doctor practicing in London. He specializes in advanced non surgical procedures such as Botox and laser liposuction.

Article Source: ezinesarticles.com

Advanced botox london: the eye area management and the doe eye technique by Dr Thierry Vidal