Hyaluronic Acid

Treatment of wrinkles, facial rejuvenation and harmonization of the face with Hyaluronic acid

As we age, our skin loses moisture and elasticity and begins to show the signs of aging. Facial fillers can gently relieve wrinkles and increase the volume of certain areas in a subtle way.

It is a minimally invasive aesthetic procedure that allows us to hide a lot of static wrinkles (aging wrinkles not directly related to the muscles) and depressions.

If you want to reduce facial wrinkles, hyaluronic acid can be a good option as a dermal filler because of its compatibility with the human body.

In fact, this substance is found in almost all living things. In humans it acts as a network that transfers essential nutrients from the bloodstream to skin cells.

Hyaluronic acid is a natural substance found in your body. High concentrations are found in soft connective tissues and in the fluid surrounding the eyes. It is also in some cartilage and joint fluids, as well as in the skin.

This same substance is often injected into the joints of people with arthritis to relieve pain and provide additional cushioning.

When this gel is injected, it acts as a cushion that is inflated to support facial structures and tissues that may have lost volume or elasticity due to normal aging. It also brings water to the surface of the skin to make it look fresh and supple.

Hyaluronic acid is not derived from animal sources. In recent decades, several synthetic forms of hyaluronic acid have been developed and used to correct disorders in the fields of rheumatology, ophthalmology, and wound repair. More recently, synthetic forms of hyaluronic acid are manufactured for aesthetic use especially at the facial level.

Types of Hyaluronic Acid:

Depending on the area to be treated, it is necessary to use different products. We have different preparations of hyaluronic acid with different density and durability that allow us to treat different areas in a personalized way such as:

  • Fine wrinkles of the face.
  • Medium wrinkles
  • Lips – profiling and filling.
  • Deep wrinkles.
  • Frown wrinkles previously treated with Botox.
  • Cheekbones – cheeks.

Method of application of hyaluronic acid:

Very small amounts of hyaluronic acid are injected into the face through very fine needles. Treatments usually take less than 30 minutes, depending on how many wrinkles are treated and the discomfort is usually minimal.

First, the surgeon will listen to the desired targets and then evaluate your facial appearance and skin tone, examining the areas of the face to be augmented with hyaluronic acid as a filler material.

Facial evaluation:

Next, the surgeon will mark strategic points on your face as guides to the right injection sites for filling, as part of your wrinkle removal treatment.

Anaesthesia. Topical local anesthesia can be applied, infiltrated by small punctures or hyaluronic acid containing anesthesia can be used.

Your injection sites will be cleaned with an antibacterial agent.

Injection. After cleaning the area to be treated, the product is injected. This step usually lasts a few minutes.

Clean again and apply cold to avoid inflammation. At this point you can apply makeup.


The result is immediately appreciated. If a small hematoma has occurred, it usually disappears soon.

Scars and deep wrinkles often require multiple injections to achieve the desired results. If a deeper injection is required, you will be offered a local anesthetic to be comfortable.

Common places for deeper tissue fillers are nasolabial folds and marionette lines, or to improve fullness in the cheeks.

The duration of the result varies depending on the product used and the depth of application of the same.

Botox for expression wrinkles

Botox or Botulinum Toxin is today one of the most performed aesthetic medicine procedures and has managed to enhance the knowledge of facial anatomy and the way of working the muscles that provide expression. Not only can we eliminate the famous crow’s feet or frown wrinkles, but we can modify a smile that shows too much the teeth or the position of sadness of the angles of the mouth. It can also act by weakening the bands of the neck or on the wrinkles of the neckline. Although popularly the botulinum toxin that we use for facial cosmetic treatment is known as Botox. 

In February 2004, the Drug Agencies gave their approval to the use of Botulinum Toxin Type A for its cosmetic use, since then, it has become one of the most successful non-surgical treatments to treat expression wrinkles. Similarly, Botulinum Toxin Type A has been approved under the name BOTOX® for therapeutic use. The other brands of botulinum toxin have subsequently been approved. The quality of life of people has improved a lot and we look for facial rejuvenation treatments that are not aggressive and delay a facelift.

Cosmetic applications:

Currently the use of cosmetic Botox is authorized worldwide for the treatment of expression wrinkles such as frown wrinkles. Other cosmetic treatments that are usually performed are wrinkles of the forehead, crow’s feet, gingival smile, to raise the corners of the lips or neck bands.

Medical Applications:

Hyperhidrosis or excessive sweating. Strabismus. Dystonias. The blepharospasm. Vertebral algias. Migraine. Urinary incontinence in paraplegics. In the field of reconstructive surgery, it is a weapon of great help in the face of the treatments of patients with facial asymmetries at levels such as eyebrows or smiles, which connects us directly with the adjuvant treatment of facial paralysis or muscle spasms. In these cases, the doctor-patient relationship is the fundamental basis for the consolidation of the treatment.

Mechanism of action of botox for expression wrinkles:

The application of Botox is done through a very fine needle and directly on the facial muscles. Injections of this substance block muscle nerve signals, which in turn weakens the muscle so that it cannot contract and decreases unwanted facial wrinkles. Botulinum toxin can be combined with other cosmetic skin procedures such as chemical peels, dermal fillers or microdermabrasion to further improve results. This combination of therapies can even help prevent the formation of new lines and wrinkles. Although Botox injections may seem like a very easy procedure to perform, it is important that it is performed by an experienced specialist since we seek the application of the amounts that each patient needs individually to reduce the contraction of certain muscles and thus achieve a natural and relaxed result. A botox prick in the wrong place can lead to unwanted expression. No anesthesia is required. You may notice results in a few days, but it may take up to a week to see the full effect. This overall improvement lasts four to six months. When the effects of botulinum toxin begin to fade, your muscle reactions and wrinkles will return.

Special considerations, risks and recovery:

You can resume your normal activities immediately. Do not massage or press on the treated areas after treatment as it may cause the botulinum toxin to migrate to another area of the face. It is preferable to avoid going to bed the first few hours after treatment. Although the injection well done is a safe technique it could present: 

  • Purple and pain at the injection site. 
  • Redness. 
  • Headache.
  • Flu-like symptoms.
  • Nausea. 
  • Temporary facial weakness. 
  • There have been no cases of dangerous spread of the effect of Botox away from the injection site when it has been used at the recommended dose for the treatment of heavy underarm sweating or when BOTOX has been used at the recommended dose for the treatment of wrinkles.

Japanese Threads

Japanese thread treatment is a facial rejuvenation technique to prevent and treat sagging. It is a technique that consists of the insertion of resorbable threads of polydioxanone or polylactic acid at the subdermal level in the face and / or neck.

Its objective is the restructuring and elevation of facial contours and occurs thanks to the formation of collagen and fibroblasts.

It is an effective, safe, fast and painless treatment.

Procedure of tensioning threads, magic threads or Japanese threads:

First of all, a design of the treatment we want to perform is made, drawing on your skin the direction in which we will place the tensioning threads. Applying anesthetic cream 30 – 45 minutes before starting the session.

The area to be treated is cleaned and an antiseptic is applied.

The magic threads are distributed with a fine needle that serves as a guide at the level of the subdermal tissue (below the dermis) and evenly. Between 10 and 20 threads are inserted with small spicules (in the form of a spike) that allows them to anchor in the tissue that are implanted without other anchors or sutures, very easily and quickly. There are several thicknesses and lengths for the specialist to choose the most appropriate for each case and circumstance.

They have no ability to produce allergies or autoimmunity mechanisms. It leaves no signs or marks. It does not require cuts or sutures. It does not produce intolerances and the inflammatory reaction is minimal. Adverse effects (edema, erythema and hematoma), which are minimal, can last a few hours and allow makeup the next day.

After three months, a reassessment is made and sometimes some more threads are reinserted.

Retouching can be made and treated again, depending on the patient’s evolution.

The procedure requires specific medical knowledge so it must be performed by a professional trained in the technique.


As the magic threads do not perform a mechanical effect, the results are progressive and natural, in harmony with the physiognomy of the patient. You can see the effect at three weeks, continuously improving and reaches the maximum effect at about 3 months. The result lasts up to 18 months. The face acquires a more rested appearance, without artificial changes.


  • There are no allergies or rejections.
  • Undetectable on palpation and sight.
  • From its application you can observe the natural result and in harmony with the physiognomy.
  • No bleeding and no scarring, PDO threads do not have anchoring artifacts, nor do they have to be sutured.
  • They are resorbable and biocompatible.
  • The procedure is quick and painless and you can join your usual life immediately.
  • Perform a dimensional projection, without adding volume.
  • It does not require incisions or cuts, it does not have to be sutured, avoiding tears, bleeding, scars, complications and allergies.
  • It is compatible with other medical-aesthetic treatments.
  • There is no problem with repeating the treatment over time.

Side effects:

Side effects are minimal: Edema, redness or some bruising, which disappear soon. Patients can immediately join their usual activity.


Treatment of Hyperhidrosis or Hypersweating with Botox

Hypersweating or hyperhidrosis refers to an excess of sweating that is usually located in the palms of the hands, soles of the feet or armpits, although it can occur in other areas of the body, such as the head and face.

Botulinum Toxin a (Botox) is the only non-surgical alternative that manages to interrupt the hyperactivity of the sweat glands, through selective action on the peripheral cholinergic nerve endings. The product infiltrates the affected area through an extremely fine needle. It is a highly tolerated, safe and proven procedure that improves the quality of life.

The effects can last between 4 months and a year, depending on the area and the particular characteristics of each case (the average duration in axillary hypersweating, for example, is 7 months). Treatment with Botulinum Toxin does not require hospitalization, it is performed in the specialist’s office on an outpatient basis.

It is usually done once a year before the hot season although there are patients who perform it more often.



Most of the time it is performed after the application of topical anesthetic (cream) in the affected area and is very well tolerated.

In cases that affect the palms of the hands, it can be performed with local anesthesia punctured because it is a very sensitive area.

The application of Botox is very fast. The entire procedure is performed in less than 15 minutes.

Aesthetic Treatment of the Lips

A good aesthetic treatment of the lips allows to have them filled, profiled and in good position, which is considered a sign of good health, beauty and youth. The lips are a fundamental part of facial aesthetics and also act during speech, while we eat, when we give a kiss etc.

As such a special area, the treatments must be very specific and very careful, so as not to break the harmony of the lip on the face.

There are many features that make lips look pretty. Those that are seen with the naked eye are the thickness and the profile but there are other factors that greatly influence the appearance of the lips such as:

The direction of the buccal commissure, perilabial wrinkles, nasogenian grooves, correct and not excessive exposure of the teeth during the smile etc. All these factors must be evaluated in each person and perform a specific and differentiated treatment to offer a better result.

1. Filling and profiling of the lips with hyaluronic acid

It is the star product for the aesthetic treatment of the lips. It is a biodegradable material that is already part of our body so it integrates very well into the fabric, allowing very natural results.

We currently have a very exclusive lip filler. It is dermal filling gel with hyaluronic acid. It is a product specially designed to define the contour of lips, and treat “the barcode” that forms around the mouth.

2. LIP LIFT or Upper Lip Lift:

What is a lip lift?

A lip lift is a procedure that elevates the position of the upper lip to give a more youthful and relaxed smile. Candidates for the procedure include patients with these symptoms:

  • Their teeth are not shown when they smile.
  • Space greater than 1.5 cm between the nose and the vermilion edge of the upper lip.
  • Thin, flat lips.
  • Lip corner downwards giving a constant expression of anger.

There are two types of Lip Lift:

  • Upper Lip Lift shortens the distance of the skin between the upper lip and the base of the nose. This increases the amount of visible lips, exposes the teeth more and gives an appearance of lips
  • Corner Lip Lift involves only the edges of your mouth and is designed for the patient who always shows the corner of the lips looking down as if he were always angry.

The two procedures can be performed together or separately.

3. Other techniques that are performed in very particular cases are:

-Lip lipofilling (Fat tissue grafts): It consists of the infiltration of fat tissue previously treated by filtration and centrifugation. The fat is obtained by a small liposuction with local anesthesia or more usually in the context of another surgical intervention such as a facelift.

Vermilion advancement surgery:

This procedure involves making an incision along the border of the colored part of the lips, removing a strip of skin outside the lip boundary. It is used only in major aging in the context of a facelift.

  • Botox: It is sometimes used to correct the gingival smile (when the gums are taught during the smile), to correct downward-facing oral corners (giving an image of bad temper), to correct wrinkles in the upper lip (often combined with other procedures)
  • Micropigmentation of the lips to draw the contour of the lips.