TA Mag chats to Dr Michael David Aicken of Belfast and London based Visage Aesthetics and training academy. This time about the increase in his male clientele and the most popular treatments both in his clinics and at his medical training academy
I’ve been seeing a steady increase in the number of male aesthetics patients over the past year. Men generally want a more subtle result than their female counterparts, and will often wait until their lines are more pronounced. Treatments we are seeing a particular surge in for males are crows’ feet Botox and ‘tear trough’ filler.
Also known as ‘nose-to-mouth’ or ‘smile’ lines, nasolabial lines or folds are amongst the most popular of aesthetic treatments. The mechanism for formation of nasolabial folds as part of the natural aging process is two-fold: natural fat pads in the upper face migrate downwards due to gravity acting upon them over time and; the subcutaneous tissues of the medial lower face, atrophy. Combined, these two processes result in a ‘step’ down between the lateral and medial lower face. A similar process occurs at the mouth corners, resulting in the formation of the marionette lines; a similar treatment rationale can therefore be used for marionette lines also.
There are other fillers out there, but Dermal Revolution is a product that I developed myself, with all of the characteristics that I enjoyed from other brands, combined. It is also competitively priced and achieves excellent results. Despite that, we are still blown away by the ‘fan-club’ we have seen develop around the brand, particularly with the buzz we are starting to see on instagram (www.instagram.com/dermalrevolution), with practitioners sharing before and after photos of their patients and patients blogging very positive testimonials about their experience receiving Dermal Revolution filler, even when administered by trainees on our courses.
On our Visage Academy course, I teach four types of injections for treating the nasolabial folds / lines (pictured): a) Deep bolus; b) Cross-hatching; c) Deep linear; d) Superficial linear. I’ll describe them a little more here.
Deep Bolus Injections
This is usually my starting point. For me it works best to start at the top, and work my way down the nasolabial folds. I ask the patient to sit upright as I find that this gives the best impression of how the nasolabial folds ‘hang’. If you haven’t seen this effect in action, just try taking a selfie of yourself lying flat, versus standing upright and you’ll be surprised how much more pronounced your nasolabials are when you are upright! A bolus injection means that after aspirating to confirm that the needle tip isn’t inside a blood vessel, all of the filler is placed in one location. The slower the injection is delivered, the less painful it will be.
This method is good for lifting folds, so this isn’t required for all nasolabial lines. If the line is worse with gravity (i.e. worse when the patient sits upright than when they lie flat) then it may benefit from this method. By injecting perpendicular to the direction of the fold, the fold can be lifted and held in place by filler. The longer the injection is in length, the higher the volume of filler used and the more viscous the product, the better the lift that will be achieved.
Deep Linear / Superficial Linear Injections
These are the most intuitive of the injections for nasolabials and marionettes. The rationale is this: if there is a line, fill it up. The line might be deep, it might be superficial or it might be both. I normally use a deep product such as Dermal Revolution (DEEP) for both in the nasolabial and marionette line area, but others might prefer to use a less viscous product for the more superficial lines as it is slightly easier to mould if the practitioner accidentally creates a lump and needs to smooth it out. The downside of using a softer product is that it tends not to last as long.
The 32-year-old male pictured, was treated with 1ml of Dermal Revolution (DEEP) by a group of trainees on a Visage Academy course in London, under my supervision. 0.2ml was injected as a bolus into the proximal aspect of each nasolabial fold and a 0.2ml deep linear injection and 0.1ml superficial linear injection into each mid-distal portion of each nasolabial fold. This result would be expected to last for 9-12 months but if significant swelling or bruising was present at the time of the initial treatment, it may be necessary to repeat with similar doses earlier than this.
About the Author
Dr Michael David Aicken is the primary trainer and course director for Visage Aesthetics UK LTD / Visage Academy. Michael has been training professionals in the use of Botulinum Toxin type A and Hyaluronic Acid for 8 years and has built up busy training clinics in central London and back home in Belfast.
Read more about training with Dr Michael Aicken here:
Read more about Dermal Revolution here: