Typically, patients will come into the clinic and point to a specific line that they don't like. Good practitioners shouldn't just look at treating this specific line, but will look beyond the line at how the face looks as a whole (as treating an individual line might make the face look unnatural). Sometimes patients come in and say their colleagues and friends keep telling them that they look tired or grumpy when this isn't the case. In these cases, it's usually not a single line that is creating this impression, but multiple factors, and the practitioner should talk through treatment options with the patient.


What are the key questions to ask your consultant before considering a treatment?

• What qualifications do you have?
• Which brands of products do you use and why?
• How satisfied are your patients with the results?
• Do you have any examples of before and after pictures you could show me?
• What are the potential side effects?

What are Fillers and how do they work?
As we age, the natural collagen and elastin in the skin lessens, as cells lose their ability to produce more of their youthful component. The skin becomes drier, thinner and less able to fix itself. When we are born, we have plentiful amounts of Hyaluronic Acid (HA) in our body, but as we get older this store of HA diminishes, leaving the skin less well supported, and so lines and wrinkles develop. By lifting and smoothing targeted folds and wrinkles by adding subtle volume, dermal fillers can make a difference to a person's appearance, giving them a fresher look.

The treatment of wrinkles with dermal filler will usually involve injecting this naturally occurring product (HA) through a tiny needle. The discomfort is minimal as the treatment does not take long to perform. The aesthetic outcomes of treatments with dermal filler are seen immediately after the treatment. Treating wrinkles with dermal filler is fast, leaving no scars. HA fillers contains a variety of products, which can be used to treat different areas, from fine lines on more delicate parts of the face to deep skin depressions.

What does the treatment involve?
The procedure takes around 45- 60 minutes and patients can expect to notice the effects for as long as 18 months after treatment. There is even precedence of results lasting up to 24 months in some cases. However, treatment with fillers is completely reversible. With any injectable treatment, there can be some slight bruising or swelling that accompanies it. This should not persist much longer than a day, and is easily coverable with makeup.

Who would this treatment suit?
Facial fillers can be used on a wide range of patients, and are primarily used for skin rejuvenation and the reduction of lines and wrinkles. Other suitable candidates are those seeking to add structure and volume to the face. I see a lot of patients who have lost volume in their face due to living a very active, high impact lifestyle (such as runners). Fillers help to restore the volume loss that naturally begins to occur when we reach our late thirties, and in turn gives a fresher, brighter appearance.

Who should avoid this treatment?
There is no known risk to those who are pregnant or breastfeeding, but we would advise against having treatment under these circumstances. C connective tissue diseases are also a contraindication for dermal fillers.

What results does the treatment aim to provide?
The results should be subtle, leaving our friends and family believing that we are simply looking our best and great for our years. Treatment lasts between 18-24 months but, naturally, towards the end of this period the effects begin to gradually soften, so there is no dramatic change. When the effects begin to soften, we aim to 'top up' the treatment.

Patients will often come in to the clinic and point to a specific line that they don't like. Good practitioners shouldn't just look at treating this specific line, but will look beyond it to how the face looks as a whole, since treating an individual line could make the patient look unnatural.

Sometimes the patient will say that people tell them they look sad, tired or grumpy when this isn't really the case. In these instances, it's usually not a single line that is causing this impression but multiple factors and the practitioner should discuss treatment options with the patient. It is really key that you feel safe and reassured by your chosen practitioner: a partnership should develop where you can speak freely about what concerns you, as this will allow the practitioner to truly understand your hopes and desired outcomes.

I use only HA (hyaluronic acid) fillers in my practice and only the brands licenced in the UK. My favourites are Juvederm, Restylane and Teosyal but on request I can order any other licenced filler.

Clients who choose to enhance their lips tend to divide into three distinct groups:

Firstly there are the clients aged between 18-30 who simply want to enlarge their lips rather than correcting any signs of ageing such as fine lines or wrinkles, for example. The main aim for these clients is to get more of a pout and look more sexy. They may have seen a model or other personality with this fashionable look and decided that it would also suit them.

Secondly I have a number of clients who are aged 30+ who would like to prevent the first signs of ageing such as mimic wrinkles or fine lines. Sometimes clients in this age group also want treatment to enhance thin lips to give them more volume.

Lastly I have clients who show more advanced signs of ageing like deep wrinkles around the lips or on the lips themselves. In this case we are not just preventing further ageing but also correcting existing changes such as volume and contour loss, dropping to the corners of the mouth and wrinkles in this area.

Today fillers based on hyaluronic acid are the safest and most widely used methods of correcting and enhancing lips. It is injected into the problematic areas under local anaesthetic. The main side effect from injections is swelling and bruising, which will improve within a day or two. The final result will be seen after a couple of weeks.

The Non-Surgical Facelift with Dermal Fillers
The 8 Point Lift is a specialised volumising and lifting facial treatment, also referred to as a non-surgical facelift or liquid facelift. The treatment uses dermal fillers to enhance and discreetly lift the face for a total rejuvenating effect.
The 8 Point Lift targets key areas of the mid-face to lift, contour and revitalise the whole mid-face and lower face.
I only use the highest quality dermal filler brands.

The Problem
As we age we lose elasticity in our skin and gravity takes its toll on the face, drawing the skin downwards and ageing us considerably. Skin sags and thins as we get older, affecting us all in different ways and typically more so for women, whose skin is naturally thinner.

Many patients come to Rakushka Clinic to hold back the excesses of ageing and to restore lost volume. More and more men and women are looking to dermal fillers and dermal filler treatments like the 8 Point Lift to look after their skin and help them look and feel good.

The Treatment
The 8 Point Lift uses high quality dermal fillers to restore volume to the mid face using an advanced and precise technique for total rejuvenation. It combats the soft tissue loss associated with the ageing process and offers a more complete solution compared to individual dermal filler treatments.

The Results
The results last for up to 18 months and there is no downtime associated with the procedure making it a very popular treatment.

Plasmatherapy
Plasmatherapy is also known as Platelet Rich Plasma or PRP with nicknames like "Dracula therapy" and "Vampire lift". This therapy is a powerful anti-ageing treatment that uses your own blood. A sample of blood (no more than an average blood test) is taken from your arm, and placed in a centrifuge to separate it into red blood cells, clear serum and platelets. The serum is then injected into the area to be treated.

The serum is richin growth factors, natural proteins that can expedite healing and reverse damage in the body, stimulating DNA repair, healing scars and making dry, wrinkled and lacklustre skin look and feel younger.

The treatment involves injections all over the required area and you will notice a significant improvement in a matter of weeks. Plasmatherapy appeals to anyone looking for a more natural approach to facial rejuvenation as it is toxin and animal product free and simply uses your own cells.

Results are noticeable within 3 – 4 weeks. However, more then one procedure may be needed. It works especially well for the forehead, cheeks, neck, décolletage, hands, knees and elbows.

Indications for PRP: Platelet Rich Plasma Therapy can be used to treat numerous cosmetic problems, such as fine lines and wrinkles or ageing skin around the mouth and nose, crow's feet around the eyes and mild drooping or sagging skin around the eyes or on the cheeks.

PRP therapy can also be used to improve the appearance of dehydrated or mildly sagging skin on the backs of the hands, on the tops of the feet, elbows and knees. Other applications include thin hair and hair loss, stretch marks and scars treatment.

In terms of medical treatment rather than cosmetic treatment, PRP therapy can be used to treat a multitude of problems, including osteoarthritis and ligament and muscle injuries. It has been used widely in medicine for a number of years.

The following medical conditions are a contraindication for use of PRP:

• Critical thrombocytopaenia (low platelet count)
• Hypofibrinogenaemia
• Haemodynamic instability (collapse)
• Acute and chronic infections
• Chronic liver disease
• Anti-coagulation therapy (warfarin, dabigatran, heparin)
• Diabetes
• Pregnancy

What are the risks and potential complications from PRP treatment?
There are few side effects associated with Platelet Rich Plasma Therapy. Immediately after the procedure, you can expect some bruising, swelling and redness at the injection sites. You may also experience some tenderness and pain at the injection sites. However, any side effects should dissipate within a few days following the procedure.

Biorevitalisation is a biological way of returning natural beauty back to your skin. The procedure is non-surgical and widely applied to fight ageing and variety of other skin problems. The technique makes use of small doses of pure hyaluronic acid (non-animal origin) which are injected into the skin.

Hyaluronic acid is the main structural element of connective tissue and is related to many vital processes in the body. Most importantly it is responsible for maintaining skin moist and young.

The amount of hyaluronic acid diminishes radically with age, thus reducing the tightness, elasticity and liveliness of the skin. Wrinkles are also formed due to this process. In addition to the natural ageing, photo-ageing (loss of hyaluronic acid caused by exposure to UV rays) affects the condition of skin as well.

When is Biorevitalisation recommended?

• Young skin – ageing prophylaxis;
• Diminished elasticity in skin;
• Insufficiently moist skin;
• Poor nutrition;
• Minor wrinkles;
• Gravitational changes of face oval;
• „Tired"‚ „smoker's" skin;
• Before or in combination with other dermatology treatments in order to improve results of cosmetic surgeries;
• Post acne, stretch marks, scars;
• Skin revitalisation due to sun exposure

In which areas is Biorevitalisation most common?
Usually, the injections are done in the areas of face, neck, décolletage, hands and forearms. These are open body areas that require the most attention as the exposure to UV rays and photo-ageing is the greatest. However, biorevitalisation can generally be performed in any part of the body.

How many procedures are required?
The preparation and course of the procedure is chosen by an experienced practitioner depending on the age and the current state of skin. For each individual case, a plan of procedures is presented after analysing the patient's skin during a free consultation.

The effect of biorevitalisation is seen immediately after the first procedure. However, the standard recommendation is 2-3 procedures about a month apart. After completing the course, additional "maintaining" procedures may be performed as necessary.

How is the procedure carried out?
The procedure takes 45 – 60 minutes depending on the part of the body where the treatment is performed. Usually, there is no pain involved but in the case of hypersensitivity, the skin area is prepared with local anaesthetic cream. It is possible that there will be slight swelling after the procedure and redness for a short period of time is also a normal skin reaction.

Recommendations before and after the procedure
One week before the procedure it is recommended to avoid aspirin and other non-steroid anti-inflammatory medications. After the procedure, it is recommended to avoid saunas, bathhouses, swimming pools and UV rays for 3 to 7 days. Of course an individual consultation will be given to you on how to look after your skin after biorevitalisation.

Contraindications

• Pregnancy and lactation period
• Autoimmune diseases
• Local skin infections in planned treatment area
• Acute infectious diseases.

Microneedling is the use of tiny needles to penetrate through the skin to induce a wound healing reaction. This results in hundreds of microchannels created in the skin which increases the delivery of the specialist product and stimulates the production of new collagen and elastin fibres.

This increased production of natural fibres within the skin means the treatment works very well at treating scars such as post acne scarring, stretch marks as well as fine lines and wrinkles, and smoother, firmer, more toned skin.

Microneedling is mostly used on the face and may treat various scars, wrinkles, and large pores, but also could be used on the neck, decollete, and scalp.

A series of treatments is usually recommended 4-6 weeks apart, although 1-2 sessions works well as a general skin refreshment. It is suitable for all skin types.


Microneedling Benefits:

1. Pain free (due to topical anaesthetic use pre treatment) treatment with little downtime
2. Increased collagen production, for natural skin rejuvenation
3. Effectively repairs scars. Acne scars, pock marks and stretch marks are eliminated. Instant results, that actually improve over time
4. Reduces discolouration
5. Renews tired looking skin. Lines and wrinkles are reduced
6. Instant results, that actually improve over time

The SkinPen advantage vs Derma Roller skin needling:

SkinPen has revolutionised micro skin needling, making it easier, safer and less painful to get maximum results by using skin precision – produces significantly more microchannels with one pass (98,000 channels per minute)

Procedure about 60 min:

• Patient evaluation
• Face cleansing
• Numbing for 30min
• Microneedling (duration depends on indication for the procedure from 15 to 45 min)
• Post procedure patient self evaluation and home care instructions

Treatment schedule:

• Skin rejuvenation – 2- 6 treatments are required at an interval of 4-6 weeks apart.
• Skin refresh 1-2 treatments at an interval of 4-6 weeks apart.
• Acne scars - 6 – 10 treatments are required at an interval of 6 weeks apart
• Pigmentation – 4-6 treatments given monthly
• Stretch marks - up to 10 treatments are recurred at an interval of 4-6 weeks apart.

Treatment areas:

• Face
• Neck &decollete
• Body
• Scalp

What is a chemical peel?
A chemical peel is a technique used to improve the appearance of the skin on the face, neck or hands. A chemical solution is applied to the skin that causes it to exfoliate and eventually peel off. The new, regenerated skin is usually smoother and less wrinkled than the old skin. The new skin is also temporarily more sensitive to the sun. There are three basic types of chemical peels:

Superficial or lunchtime peel:
Alpha-hydroxy acid or another mild acid is used to penetrate only the outer layer of skin to gently exfoliate it. The treatment is used to improve the appearance of mild skin discoloration and rough skin as well as to refresh the face, neck, chest or hands.

Medium peel:
Glycolic or trichloroacetic acid is applied to penetrate the out and middle layers of skin to remove damaged skin cells. The treatment is used to improve age spots, fine lines and wrinkles, freckles and moderate skin discoloration. It also can be used to smooth rough skin and treat some precancerous skin growths, i.e. actinic keratosis.

Deep peel:
Tricholoracetic acid or phenol is applied to deeply penetrate the middle layer of skin to remove damaged skin cells. The treatment removes moderate lines, age spots, freckles and shallow scars. Patients will see a dramatic improvement in skin appearance. The procedure is used on the face and only can be performed once.

Chemical peels are used to treat a number of conditions including:
•Acne scars
•Aging skin
•Crow's feet
•Scars
•Sun damaged skin
•Sagging skin
•Wrinkles

Who is not a candidate for a chemical peel?
Generally light-haired and fair skinned people are the best candidates for chemical peel. The procedure does not work as well on dark-skinned patients. The procedure is not recommended for individuals with infections, active skin disease, cut or broken skin, sunburns or active Herpes simplex 1 sores. Other counter-indications include patients who are:

•Nursing or pregnant.
•Have taken Accutane in last six months.
•Have psoriasis, eczema, dermatitis or rosacea.
•Have used Retin-A, Renova, prescription skin care products, products that contain ascorbic acid, bleaching or skin-lightening agents or other acid-based products in the last 48 hours.

What are the complications or potential side effects of a chemical peel?
•Temporary or permanent change in skin colour, particularly for women on birth control pills, who subsequently become pregnant or have a history of brownish facial discoloration.
•Scarring
•Reactivation of cold sores

IV Vitamin Therapy (VitaDrip) – can effectively deliver replenishing fluids, vitamins and minerals into the bloodstream with 100% absorption resulting in quicker recovery times and improved overall performance.

A Vitamin Drip could in fact benefit anyone from athletes (to support performance in a safe way), overworked executives and employees (to support a healthy immune system as well as stress-fighting hormones such as cortisol that improves concentration), to seniors (to improve nutrient absorption and support healthy ageing), and women (to reduce wrinkles and improve overall complexion).

Other indications include:
Chronic Fatigue Syndrome
Chronic depression
Acute or chronic muscle spasm
Fibromyalgia
Migraine and tension headaches
Alcohol and Narcotic withdrawal
Seasonal allergic rhinitis
Respiratory problems (Sinusitis, Bronchitis, asthma)
Cardiovascular disease
Acute viral illness/colds
Acute infections

One dose of vitamin cocktail contains:

Thiamine (B1) 250mg
Riboflavin (B2) 4mg
Pyridoxine (B6) 50mg
Ascorbic Acid(C) 500mg
Nicotinamide (В3) 160mg
Anhydrous Glucose 1000mg

Magnesium Sulphate 8 mmols and Calcium Glucanate 10% 10ml could be added via separate drip.

Much more effective than taking oral vitamins
More than 1 in 3 people take daily supplements and we know they are certainly beneficial. However, few people realise that when you ingest vitamins by mouth, only 10% of the active nutrients may eventually find their way into your bloodstream. With Intravenous Nutrition the nutrients enter your bloodstream directly and immediately to help the body to begin healing itself. You get much higher concentrations of nutrients delivered directly to your body's cells through intravenous therapy, thus allowing your body to better absorb and utilise these nutrients.

Fast delivery with fast effects
Our IM Boosters take just seconds and the IV Infusions take 30-60mins. Many patients begin to feel the effects during the IV therapy, which then continues over the following hours and days. Soon you will be feeling refreshed, re-energised and revitalised.

Safety
The substances used in IVNT are Vitamins, Minerals, and Amino Acids. These are classified as 'Essential Nutrients' – aptly named as they are 'essential' for life. Essential Nutrients, however, are nutrients that the body cannot synthesize on its own and, therefore, traditionally, they were obtained from the food that we eat. In modern times, however, our over-cropped soil, genetically modified and over processed foods mean that many of us are severely deficient in these Essential Nutrients. By replenishing your levels, under the expert advice of a properly qualified healthcare physician, your body can be restored to its peak fitness and maximum energy performance.



We are offering a variety of drips:

IV MODIFIED MYERS PLUS
Helps to boost your immune system and energy levels with the Multi-Vitamin Drip. A great all-rounder drip containing essential nutrients for optimal health.

What's in the bag?
B1, B2, B3, B5, B6, B12, Magnesium Chloride, Calcium Chloride, Potassium Chloride.



IV IMMUNO BOOSTER
"Reboot your system" with our IV nutritional drip that boosts your immune system.

What's in the bag?
Lysine, Cysteine, Ornithine, Taurine, B1, B2, B3, B5, B6, B12



IV FAT BURNER PLUS
"Gorgeous on the outside" our diet and detox drip combines a special blend of vitamins, minerals and amino acids to help you achieve fat burning and detoxification"

What's in the bag?
Galactose, Ornithine Methionine, Arginine, Glycine, Lysine Hydrochloride, Cysteine, Taurine, Carnitine, B1, B2, B3, B5, B6, B12 in an isotonic solution of Sodium Chloride.



IV SKIN BRIGHTENING
'Brighter overall complexion', our intravenous Glutathione skin lightening treatment can lighten your skin naturally, safely, evenly and in a healthy manner.

What's in the bag?
High Dose Vitamin C (8g and 15g)
PLUS SEPARATE: High Dose Glutathione



IV ATP-ENERGISER BASIS
'Need a healthy pick me up?' Our high-octane energy boosting drip is the ideal pick-me-up. With high doses of B vitamins and amino acids.

What's in the bag?
Arginine, Taurine, Glycine, Carnosine,
Magnesium DL Hydrogen Aspartate,
B1, B2, B3, B5, B6, B12



IV AMINO MUSCLE PLUS
"Powering you to peak performance" this IV drip is packed with high concentrations of amino acids for those people with an active lifestyle.

What's in the bag?
Lysine, Leucine, Isoleucine, Valine, Glycine, Carnitine, Methionine, B1, B2, B3, B5, B6, B12



IV PERFORMANCE BOOSTER
"Rediscover your get up and go" with our performance boosting cocktail packed with energy boosting B vitamins and amino acids.

What's in the bag?
Calcium Chloride, Magnesium Chloride, Potassium Chloride, Zinc, Lysine, Cysteine, Arginine, Carnosine, Carnitine, Taurine, Folic acid, B1, B2, B3, B5, B6, B12



IV ADVANCED ATP
'The ultimate power hit', if you need a bigger
energy boost, this Advanced ATP formula
will get the energy flowing.

What's in the bag?
Taurine, Phenylalanine, Tryptophan,
Tyrosine, Ornithine Aspartate,
Methionine, B1, B2, B3, B5, B6, B12



IV HEALTH BOOST PLUS
'Give your body a health boost', This ultimate
blend of amino acids helps your body maintain
optimum health.

What's in the bag?
Alanine, Glycine, Histidine, Isoleucine, Leucine,
Lysine, Methionine, Phenylalanine, Proline, Serine, Taurine, Threonine, Tryptophan, Tyrosine, Valine, Calcium Chloride, Potassium Hydroxide, B1, B2, B3, B5, B6, B12 in an isotonic solution of Sodium Chloride.



IV ANTI STRESS
"Let it go" with this vitamin drip packed with amino acids for a calming effect.

What's in the bag?
N-Acetyl-L-Tyrosine, Phenylalanine Taurine, Carnitine, Arginine, Magnesium Chloride, Calcium Chloride, Potassium Chloride, Glycine, B1, B2, B3, B5, B6



IV DETOX
"After party" drip will help to instantly rehydrate you and replace those essential electrolytes and get you feeling great again.

What's in the bag?
Arginine, Ornithine, Citrulline, Taurine, Glycine, Methionine, Carnitine, Lysine, Alanyl-L-Glutamine B1, B2, B3, B5, B6



IV FITAMIN BOOST
This drip can contribute to healthy muscles, help to increase endurance and energy levels, as well as help to boost the metabolism. This drip is suitable if you're training or have specific fitness goals that you want to achieve.

What's in the bag?
Methionine, Taurine, Lysine, Phenylalanine, Carnitine, Calcium Chloride, Potassium Chloride, Glycine, B1, B2, B3, B5, B6



IV REHYDRATION with ELECTROLITES
This is our basic IV drip hydration package, designed for pure and simple rehydration. As we know, everyone is different, so you can add any of our Add-On options to this depending on your needs.

What's in the bag?
Magnesium Chloride, Calcium Chloride, Potassium Chloride



GLUTATHIONE SHOT
'The guardian of the cell', Glutathione is
considered the Master Anti-oxidant in each
cell as well as the Master Anti-inflammatory
in each cell. Glutathione also increases
energy, slows down the ageing process,
detoxifies the liver and improves the skin.



B-12 BOOSTER SHOT
We have two different types of B12 Shots,
Hydroxocobalamin and Methylcobalamin
to help energy boosting and to speed
up the metabolism.



IV VITAMIN C
Vitamin C is a potent antioxidant that helps to boost the immune system, contributes to collagen formation, and helps to prevent premature ageing. Our high strength drip contains large doses for maximum health benefits.

The cutting-edge mask is the new secret to clearer, and more youthful looking skin.

This mask features three wavelengths to provide a multitude of skin rejuvenation treatments to the face and neck. It also incorporates the use of galvanic currents to further enhance results.

Featuring: Infra-red Red (630nm and 830nm), Blue (415nm and 830nm), & Purple (415nm, 630nm and 830nm) light, with the option of oxygen therapy. Each of which have their own clinically proven benefits.

How it works

The SF LED Mask uses 192 LED's (light emitting diodes), often known as Low Level Light Therapy, to stimulate the facial cells, and kick starts a number of processes, which help rejuvenate the skin. This therapy is 100% safe, and doesn't give harmful radiations and heat, unlike other laser treatments. It also doesn't damage your skin, has absolutely zero side effects and recovery time. This therapy is 100% safe, doesn't give harmful radiation, and heat, unlike other laser treatments. It also doesn't damage your skin, has absolutely zero side effects and recovery time.

Galvanic Mode:

The Galvanic mode can be used in conjunction with any of the LED lights.
It is very beneficial for the skin by helping to increase blood circulation, thus delivering oxygen and nutrients to the skin cells. This helps purify the skin and removes waste.
It furthermore stimulates muscle tone via the positive and negative charges of current.

Treatment Benefits

Led LED Light
ANTI AGEING – 630nm + 830nm

Increased Collagen Production
Increased Elasticity
Wrinkle Reduction
Tighter and Youthful Skin
Reduces Rosacea
Aids in the Recovery of Chemical Peels
Heals Sun Damaged Skin

Blue LED Light
ANTI BACTERIAL – 415nm + 830nm

Reduction in Acne
Prevention of Breakouts
Kills Bacteria on Skin
Clears Blemishes
Prevents Oily Skin

Purple LED Light
Combined ANTI AGEING & ANTI BACTERIAL –
415nm + 630nm + 830nm

Reduces Swelling
Speeds up recovery after Botox and Fillers
Stimulates mitochondrial and ATP within the skin cells, which creates and extends the life of anti-ageing enzymes

Profhilo is an EXCLUSIVE skin remodelling treatment that will give you visible results in just 2 visits. It stimulates 4 different types of collagen and elastin due to the slow release of hyaluronic acid, and it is this stimulation that results in significant improvement of tissue quality: Improves skin tone, texture, hydration and radiance, increases firmness and elasticity – for healthier and softer skin.

Profhilo® is manufactured by IBSA Farmaceutici Italia. It is the first stabalised hyaluronic acid (HA) based product which is manufactured without the use of chemical cross-linking agents (BDDE) and is used for skin remodelling and treating skin laxity, not just for filling lines and wrinkles. It is considered to be safe, effective and 'a true breakthrough' in anti-ageing medicines.

Profhilo is most commonly used for facial areas, but can also effectively be used for rejuvenating the neck, decollete and hands.

Thanks to the unique characteristics of Profhilo®, remodelling skin laxity is easily obtained in only 2 sessions, with a 1 month interval, injected in the superficial subcutaneous layer.