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The EV guide to injectables

Types of procedures, who can administer them and key questions to ask your practitioner

What are injectables?
Cosmetic injectables are substances injected into the skin with a needle or through a cannula, and include dermal and lip fillers, wrinkle relaxing injections (botulinum toxins), mesotherapy and skin conditioning injections. These minimally invasive cosmetic procedures, now also known as ‘tweakments,’ have numerous benefits, with the ultimate aim of giving a fresh, rested and more youthful result. Millions of these procedures are performed every year and they are considered safe, with a good track record.

Types of injectables

Fillers, sometimes called injectable face or lip fillers, were once used purely to soften obvious lines such as the nasolabial folds, but are now used more globally to sculpt, shape, add fullness and definition, and replace lost volume. The most common type of fillers use hyaluronic acid gel, a natural substance found in the body. However, the end result is determined how the hyaluronic acid particles are linked together: different sized particles are better for filling different areas of the face, and it’s common for injectors to mix and match product variants to achieve the best result. This type of temporary filler lasts between six and 18 months, and popular brands include Restylane, Teoxane, Teosyal, Perfectha, Belotero Balance and Juvederm. There are no restrictions on who can train in, buy or inject fillers so it’s vital to do your research before undergoing a procedure.

Collagen stimulating dermal fillers work by stimulating the skin’s natural collagen formation over a period of time, which helps fill out facial contours, smooth wrinkles, regenerate volume and improve skin health. Also temporary but longer-lasting than hyaluronic acid fillers, results last between one and four years. Designed for use in the deeper layers of the skin, unlike traditional dermal fillers, these products are composed of substances such as polycaprolactone (PCL) microspheres, poly-l-lactic acid (PLLA) and calcium-based particles. At the time of writing, not all collagen stimulating fillers are FDA-approved. Brands include Ellanse, Sculptra and Radiesse.

Fat-dissolving injections contain an ingredient that’s naturally produced by the body called deoxycholic acid, which dissolves fat permanently by breaking down cells, which are then carried out of the body through the lymphatic system. Ideal for stubborn, localised fat deposits including double chins, bra strap fat and ‘bingo wings’, results are not immediate but should be seen after four weeks. Brand names to look out for include Aqualyx, Belkyra and Kybella.
 
Skin conditioning injections or injectable moisturisers, are gels made from hyaluronic acid—they are much runnier than normal filler gels, and sit just beneath the skin’s surface. Profilho, which also kick-starts the skin’s production of collagen, elastin and hyaluronic acid to give the impression of smoother, more hydrated skin, has been incredibly popular; it can be injected into the face, neck and decolletage. Other brands include Volite (Juvederm), Redensity (Teoxane) and Skin Boosters (Restylane). Results last between three and six months.

Mesotherapy has been popular in France for many years, and involves injecting a cocktail of ingredients into the middle layer of the skin to smooth, hydrate and rejuvenate. It’s a temporary treatment—with results lasting around a couple of weeks it’s often used by clients looking for a skin boost before a big event.

PRP (Platelet Rich Plasma) has also been dubbed the ‘vampire face lift’. Platelet-rich plasma is extracted from the patient’s blood, then injected into the skin to promote regeneration, improve skin texture and simulate the growth of collagen and elastin. The patient has a small amount of blood taken which is then spun until the red blood cells have separated from the clear plasma. This plasma contains platelets which can generate growth factors, which in turn can help repair skin damage. The effects last around 18 months. More recently, the procedure has involved using concentrated PRP and stem cells – cells in the body that can develop into different types of tissue—extracted from fat, to rejuvenate the face.

Wrinkle relaxing injections, often colloquially known as 'Botox' which is a brand name for botulinum toxin type A. There are many different brands of botulinum toxin available on the UK market, and all deliver tiny amounts of neurotoxin to block the action of some nerves and temporarily paralyse muscles. In aesthetics, it is injected directly into the tiny muscles of facial expression to relax lines and wrinkles: it only works on wrinkles caused by muscle movement such as dynamic wrinkles, also called expression lines caused by smiling, frowning and squinting. Other uses include blocking sweat glands in the case of excessive sweating, and treating migraines. As this is a prescription-only drug, it needs to be administered by a medical professional (see below). Effects last between three and six months.

Who can administer injectables?

For a safe and successful result, it’s vital to choose a reputable practitioner. By this we mean someone who is qualified, experienced and interested in your health and safety – there is a distinct lack of proper regulation around cosmetic procedures in the UK. Often personal recommendation is a good way to find a practitioner, or be prepared to do a fair amount of research; it’s not advisable to undergo a procedure at a private party or in someones’ home as these are not safe environments in which to be treated. Your practitioner needs to be a cosmetic doctor, surgeon, dentist, qualified nurse prescriber or pharmacist prescriber. Despite being able to offer treatments and procedures, beauty therapists will not be medically qualified. Ask to see before and after pictures at your consultation, and if you’re looking for facial sculpting it’s advisable to find an injector that has a creative eye and understanding of facial aesthetics and symmetry. Qualifications to look for include BCAM (British College of Aesthetic Medicine), BACN (British Association of Cosmetic Nurses) BDA (British Dental Association), BAD (British Association of Dermatologies) and BAAPS (British Association of Aesthetic Plastic Surgeons).

What should you ask a practitioner beforehand?
The most important thing is that you feel safe and confident in their ability, and you should never feel pressured into booking. You might want to ask about their qualifications and experience, how long they have been doing the procedure, and what products/brands they use. You may also wish to enquire about emergency numbers should something go wrong after your treatment. Also, if a price seems too good to be true, it probably is. In this instance, the adage ‘you get what you pay for’ could not be more apt, so expect to pay more for quality care.



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