Wrinkles and fine lines develop for a combination of reasons: intrinsic genetic ageing, loss of elasticity, poor hydration, sun damage, smoking and habitual facial expressions. While wrinkles can be viewed as signs of character and a life well lived; they are also associated with the loss of youth. Wrinkles can be static (evident at rest) or dynamic (evident on expression). Often dynamic wrinkles become static wrinkles over time.

Wrinkles can broadly be treated by three techniques at Purity Bridge:

Wrinkle-relaxing injections, in the form of botulinum toxin, are a highly effective way of reducing and softening facial wrinkles.

Areas commonly treated include the forehead, around the eyes (crow’s feet) and the area between the eyebrows. However, other areas can also be treated using these muscle-relaxing injections, including fine lines around the mouth (vertical furrows, often caused by previous smoking), bunny lines (wrinkles at the top of the nose) as well as wrinkles and bands that appear on the neck (plastysma bands).

Dermal fillers are ideally suited to treat established static wrinkles and grooves in the face. Common areas to address with these hyaluronic acid fillers include the nose to mouth lines (nasolabial folds), lines around the mouth and established wrinkles between the eyebrows.

Customised facial skin peels are an excellent technique for freshening and rejuvenating the face, neck and hands with resepct to fine lines. A course of chemical peels can smooth out fine lines and wrinkles very effectively.

• Anti-wrinkle injections
• Customised skin peels
• Dermal fillers

“Marionette lines” is a common term used to describe changes that occur on the chin area with facial ageing. The corners of the mouth begin to turn down and create a ‘sad’ or ‘grumpy’ appearance. Skin changes, changes in our jaw position and facial movement all contribute to the development of ‘puppet’ or ‘marionette’ lines.

Non-surgical options to help address this area of concern and rejuvenate the lower face include:

Dermal fillers that can be used to soften the deep set lines as well as offer support to the corners of the mouth (addressing the sad look that can appear when the corners of the mouth droop).
Muscle-relaxing injections can be used to weaken the muscles that pull down the corners of the mouth, to allow the corners to come up.

• Dermal fillers
• Anti-wrinkle injections

Whilst smiling and laughing are infectious and keep people in a great mood, the downside is that these expressions result in fine lines and creases developing around the mouth due to repetitious muscle activity. We definitely don’t want people to stop making these expressions; however, it is very common for people to want to reduce the lines that become deeper over time. Simple procedures are often all it takes to soften the appearance and help prevent them from worsening.

Fine lines developing on the cheeks have been coined ‘accordion’ lines due to their accordion like appearance that is accentuated when we smile. Volume loss in the cheek region and deterioration in skin quality contribute to the development of these lines and create an area many people dislike. Improving the skin quality and texture in this area is possible through non-surgical treatments.

Anti-wrinkle injections can weaken the muscles that produce the fine lines around the mouth – when performed carefully they do not stop facial expressions, but simply soften the lines produced by these expressions

Customised facial peels are an excellent way of rejuvenating the skin and improving its quality. They will help to smooth out and soften fine lines in all areas of the face.

Dermal fillers also have a role in these areas by softening the deeper and more established lines

• Customised facial peels
• Anti-wrinkle injections
• Dermal fillers

Located between the eyebrows in both men and women is the glabella, otherwise known as the frown area. Whether it is a facial expression that comes from concentrating, anger, squinting or thinking, frown lines develop as a result of making the same movement over and over again. Gradually the lines become static and are evident at rest with no facial expressions. As these frown lines are associated with negative expressions like ‘anger’ and ‘dissatisfaction’, it is a common area to have treated to create a smoother, and more relaxed appearance.

Muscle-relaxing injections into the frown area is an ever popular treatment. It reduces the muscle activity here, thereby softening the wrinkles.

Dermal fillers are used for more established static lines –hyaluronic acid filler is injected into the lines to fill out the grooves and soften the lines.

In some cases a combination of both treatments is used – normally the muscle-relaxing injections are given first, and at further review after around 2-weeks, dermal filler can be used if still required.

• Dermal fillers
• Anti-wrinkle injections

As part of the ageing process, fine lines often develop around the eyes radiating outwards, known as crow’s feet or laughter lines. Smiling, laughing, squinting and smoking cause these lines and make them deeper and more obvious. It is possible to reduce the appearance of existing lines and prevent the development of any additional lines.

Muscle-relaxing injections are the gold standard method of treating crow’s feet. Small injections into the skin around the outside of the eye are an excellent way of softening these lines.

Customised facial peels used as part of a whole face rejuvenation strategy will also improve fine laughter lines

• Anti-wrinkle injections
• Customised skin peels

When lines start developing at the bridge of our nose, going out towards the eyes, squinting is usually to blame. Affectionately known as ‘bunny lines’, these begin to deepen as you continuously ‘screw up’ your face. Fortunately they are easily reduced and easily prevented.

Anti-wrinkle injections into bunny lines are a very effective treatment for this problem area.

• Anti-wrinkle injections

Continually lifting our eyebrows during expression can start to leave lines that run across our foreheads. Sun damage to the forehead can also produce fine lines that deepen over time. These lines are often more notable when wearing makeup and at the end of a long day. It is possible to reduce these lines leaving a smoother, more youthful appearance by the following treatments:

Anti-wrinkle injections are the mainstay of treating forehead lines. They contain botulinum toxin - this works by reducing the action of the wrinkle creating muscles

Dermal fillers can also be used in this area. They tend to be reserved for use after the muscle relaxing injections to treat any remaining static wrinkles.

• Anti-wrinkle injections
• Dermal fillers

Also known as nose to mouth lines or nasal folds, these lines run from the corners of the nose down towards the corners of the mouth. It is very normal to have these folds already, however as we age they often deepen and grow in length. It is a very simple procedure to reduce these lines and folds, in order to rejuvenate the lower face

Dermal fillers work extremely well in this area. They do not eliminate the nasolabial folds, but soften them, and reduce their depth.

• Dermal fillers

Spider veins (also called thread veins, telangiectasia or broken capillaries) are formed by the dilation of the small veins under the surface of the skin. Although they can appear anywhere on the body, spider veins are most commonly found on the face. The exact cause of spider veins is not known, but contributing factors include heredity, local trauma and hormonal levels. Spider veins become more numerous with age, and mostly occur in women. Treating thread veins often gives people back the confidence to get back into shorts and skirts.

Thermavein is a reliable treatment for thread veins on the face. A tiny needle is inserted into the individual thread vein and a short burst of heat thermo-coagulates it to make it instantly disappear. Several Thermavein sessions may be needed for each area.

• Thermavein

Skin pigmentation is caused by pigment cells (melanocytes) releasing melanin (pigment) – whether as a result of a sun tan, or as localised pigment spots (freckles or lentigines) or pigment patches (melasma).

Different skin types are more prone to producing patches of pigmentation, and these can be stimulated by changes in hormones, trauma, and chemical alterations to the skin. Treatment methods for pigmentation patches will vary depending on the individual involved but they can include creams. Often referred to as sun spots, age spots and liver spots, pigmented lesions are often a concern for people who are looking at improving their complexion. After professional diagnosis, pigmented lesions can be treated and a clearer complexion maintained in the long term.

Customised chemical peels used in conjunction with specialised medical grade skin care can help address pigment spots and patches. It is important to use strong sun protection during the treatment process to ensure the best possible result.

• Customised skin peels
• Medical grade skin care

Years of sun exposure is detrimental to any skin type. Whether you spent your youth sunbathing with coconut oil, or preferred the more controlled environment of a solarium, your skin will have suffered as a result of UVA and UVB rays. Perhaps years of playing sport in the sun and holidays at the beach have also contributed to damaging your skin and changing the skin integrity and quality. Non-surgical treatments can help tackle the effects of sun damage:

Customised chemical peels stimulate collagen production to help revitalise and rejuvenate the skin. They can also tackle pigmentation spots and fine lines, all evidence of sun damage to the skin.

Medical grade skin care used on its own or in conjunction with chemical peels contains active ingredients that tackle the effects of sun damage.

• Chemical peels
• Medical grade skin care

Often as we get older, we notice that our face isn’t as ‘full’ as it used to be and we seem to be deflating. The loss of facial volume is a normal part of ageing, but it can also affect people who are very athletic and have recently undergone weight loss. Cheeks are often associated with youth, and this deflation is often obvious and can be quite distressing for some individuals. Replacing this lost volume is possible, restoring a youthful appearance whilst maintaining a natural looking result. Creating a subtle enhancement can restore high cheek bones and lift a deflated face.

Dermal fillers are now available that specifically target these areas, and are designed to improve the contours of the cheek area. They can also be used to lift the deflated soft tissues of the face as well as smooth out wrinkles.

• Dermal fillers

As a result of acne, many individuals are left with scars as a result of the trauma that was inflicted on the skin. Acne scarring can be quite superficial, or quite pitted and obvious. Purity Bridge is able to offer a variety of options to help combat acne scarring and reduce the visible appearance of the scars with our proven treatments.

Customised skin peels combined with medical grade skin care can improve acne-prone skin. It is important to continue a bespoke skin care regime after treatment to minimise the risk of further acne flare-ups

Dermal fillers can be used to fill out long term acne scarring that has caused contour irregularities in the face.

• Customised skin peels
• Medical grade skin care
• Dermal fillers

As we age, our lips start to lose volume and thin. In addition, some people have naturally thinner lips.

Dermal fillers are an effective treatment to shape, add volume, and better define the lips. Lip enhancement with these hyaluronic fillers can refine, fill, lift or plump the lips as well as re-define the shape of the lip or lip line. As we age, it often appears as though the top lip is getting thinner and losing volume. Dermal fillers can help to restore this volume and define the lip line. In some people, even a young lip may tend to disappear when smiling, so some gentle filling of the lip tissue can help create a more attractive or sensual lip. Different products can be used in the lips to achieve specific results. This will be discussed with you during your consultation. At Purity Bridge we like to take a conservative approach to restoring lost volume to the lips, to ensure you walk away with a natural looking result while addressing your concerns. Further dermal filler can always be added at another appointment, should more be desired.

• Dermal fillers

Many people suffer from dark circles and bags under their eyes making them look ‘tired’ and ‘sad’, even after a good night’s sleep. There are many factors that contribute to the deterioration of this area including pigmentation, loss of elasticity, visible veins under the eyes, and a loss of volume creating a groove (known as the tear trough). If you are looking at non-surgical options to improve this area, an individualised treatment plan can be devised for you to address any of the contributing factors.

Customised skin peels will help to refreshen and tighten the thin skin in this area. A course of peels will stimulate collagen production which will improve the skin quality and tighten the skin in this area.

Dermal fillers will help to restore volume in this area and improve the contour. They are becoming an increasingly popular alternative to lower eyelid lifts in the right individuals.

• Customised skin peels
• Dermal fillers

The thinner skin of the upper chest area, or décolletage, is particularly prone to the signs of ageing, predominantly from continual exposure to the sun during the warmer months. This results in a crêpey and sun damaged appearance, however, the décolletage is an area that is often neglected when rejuvenating one’s appearance. Improving the skin quality to this area helps to restore a youthful, supple, and firmer décolletage.

Customised skin peels can be used very effectively in this area to tackle the thin skin, fine lines and pigment spots.

• Customised skin peels

Pores are normally-occurring openings in the skin that allow us to sweat and also secrete protective oils. During puberty, pores often enlarge to handle the increased oil output from sebaceous glands. In women, particularly after pregnancy and later during the menopause, these pores often stay enlarged due to hormonal changes. The nose, forehead and chin are especially prone to developing enlarged pores because they contain more sebaceous glands than other area of the face.

Customised skin peels can be used to reduce the size of the enlarged pores. A course of chemical peels is used to remove the debris from the skin surface as well as the upper layers of skin, stimulating new collagen production. This shrinks down the pore size as the skin rejuvenates.

• Customised skin peels

Fine lines, prominent veins, sun spots, and weathered skin are giveaway signs of ageing on the hands. Our genetic ageing, as well as exposure to sunlight, pollutants, and countless household chemicals start to reduce skin quality and texture. It is possible to reduce the signs of ageing and restore volume, hydration, and even out skin tone.

Customised skin peels are an excellent way of rejuvenating the skin of the hands. A course of TCA peels is required, with extra focus paid to age spots (liver spots) on the back of the hands.

Dermal fillers can be used to naturally plump up the thinning backs of hands, which masks the prominent veins that are associated with ageing.

• Injectable skin care
• Dermal fillers

Also known as perioral lines, upper lip wrinkles tend to develop and worsen over time due to repeated muscle movement from speaking, chewing, and smoking. These fine lines can be improved with simple treatments, helping to rejuvenate the mouth area.

Anti wrinkle injections will help to relax the muscle that causes these lines (the orbicularis oris muscle). Using tiny injections to both upper and lower lips, these lines can be softened and relaxed very effectively.

Dermal fillers can also be used here to fill out any established lines. They can also be used to help fill out the lips which in turn improves the upper lip lines. In addition, hyaluronic acid dermal fillers can be used to support the corners of the mouth, giving an overall improved look to the mouth.

Customised skin peels used as part of an overall face treatment will help to soften fine lines around the mouth

• Anti-wrinkle injections
• Customised skin peels
• Dermal fillers

Some people grind their teeth or frequently clench their jaw, resulting in the development of a square jaw. This excessive muscular movement causes enlargement of the masseter muscle which contributes to the ‘square-like’ appearance of the jaw.

Anti wrinkle injections can be used to reduce the size of this muscle, slimming the jawline and enhancing the lower face.

• Anti-wrinkle injections

Loss of elasticity to the skin of the neck starts to show over time as we age. Whether it is the development of neck ‘creases’, or the much feared ‘turkey’ neck, a range of treatments is available. Improving the skin texture and quality, whilst restoring lost collagen, will help to rejuvenate this area.

Customised facial peels will refresh & tighten the skin in this area, stimulating new collagen production, and improve the quality of the skin.

Muscle-relaxing injections can be used to address the neck bands (plastysma bands) that can occur as we age. A series of injections to these bands will improve the appearance of this area – the so-called Nefertiti neck lift.

• Customised skin peels
• Muscle-relaxing injections

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Skin cancer is unfortunately becoming more and more common. However, if most types of skin cancers are removed early enough, the prognosis is usually very good. There are three more common types of skin cancer – basal cell carcinoma (BCC, also known as rodent ulcers), squamous cell carcinoma (SCC) and melanoma (or malignant melanoma). The mainstay of treatment for all three types is surgical excision (minor surgery). At Purity Bridge, our consultant surgeons are all experts in treating skin cancer, and anyone diagnosed with skin cancer has their case discussed at the regional specialist skin multi-disciplinary team meeting (MDT). This is a group of specialists from different medical disciplines that meets every week to discuss everyone who has had a diagnosis of skin cancer. The aim is to formulate a bespoke treatment plan for each person that can result in the best possible treatment.

Benign skin lesions include moles and cysts as well as other “lumps and bumps”. This group of skin lesions do not spread outside their normal boundary to other parts of the body (in contrast, a malignant tumour is made of cancer cells that have the capacity to spread). Types of benign skin lesions that can be treated at Purity Bridge include:

Moles
Skin tags
Sebaceous cysts (epidermoid cysts)
Seborrhoeic keratosis (age warts or basal cell papillomas)
Lipomas
Dermatofibroma
Trichoepithelioma
Lumps and bumps

With an increase in the number of sunny holidays that are taken over the last few decades, we strongly recommend that you check your skin regularly and seek professional assessment by a qualified doctor without delay if any suspicious skin spots or lumps appear. Skin cancer is diagnosed by physical examination by a trained doctor and sometimes requires a biopsy. Other parts of your skin also need to be checked for suspicious lesions.

Warning: pigmentation is a common cosmetic problem and dramatic improvements are achievable; however, pigmentation is also usually the first sign of early skin cancer. If treatment of a pigmented spot or patch is performed by someone without proper training in the signs of skin cancer then removal of the pigment may hide an otherwise detectable melanoma or other skin cancer. As skin cancers can be life threatening it is recommended that all assessment and treatment of pigmentation be performed in a medical facility. All consultants at Purity Bridge are specialists in skin cancer. If you feel you have a suspicious skin spot or lump this should be assessed without delay.

As we start to age, one of the first places to be affected is the upper eyelid area. Excess skin starts to develop and sag, eventually hooding and resting on the eyelashes. This not only makes us look tired, or even unhappy, it also interferes with the application of make-up. Upper blepharoplasty is a safe and extremely effective surgical procedure to carefully remove the excess skin. This results in a brighter, fresher appearance.

In some women, the labia minora (the inner vaginal lips) become enlarged. This may well be a variation of normal, developing in puberty, but the labia can also enlarge after pregnancy, and other times of hormonal change.

Labiaplasty (or labial reduction surgery) is a safe and reliable clinic-based surgical procedure that can reduce the size of enlarged labia. It can also be used to correct the asymmetry that often develops between both sides.

Earlobes (or lobules) can develop a split in them as a result of wearing heavy earrings, or after trauma, when an earring may have got caught. It results in an unsightly split in the earlobe that can make many people self-conscious.

Split earlobe correction can be performed under local anaesthetic at Purity Bridge by one of our consultant plastic surgeons. The results are very satisfying and the ear can be re-pierced once the scar has matured and settled down.

Some people are unhappy about the shape of their belly button – they may have an “outie” when they would prefer an “innie”. Others may have problems with their belly buttons after previous surgery, such as a tummy tuck. Both of these situations can be amenable to surgical correction.

Belly button reshaping can be performed under local anaesthetic. However it is important that the belly button is carefully examined first to rule out a hidden hernia that causes some people to develop an outie, such as after pregnancy. The surgery takes around 40-minutes and stitches are in for 10-14 days.

Some people’s earlobes seem large and out of proportion with the rest of the ear. This worsens with age, as our ears generally keep growing in to later life.

Earlobe reduction is a surgical procedure that reshapes and reduces the earlobe to suit the individual ear. It is performed under local anaesthetic and fine stitches are used that are removed after 10-days. It has a high satisfaction rate, and the precise shape of earlobe desired can be discussed with one of our specialist plastic surgical consultants.

Many people end up with scars as the result of surgery, accidents or burns. These can be both cosmetically unsightly, and also emotionally traumatic, being unwanted reminders of how we sustained the scar in the first place.

Scar revision encompasses a range of plastic surgical techniques that can be used to improve and hide the scar. Scars cannot be made to go away completely, but there are often ways of getting them to look better and more subtle. Occasionally, non-surgical techniques can be used if the scar is lumpy or keloid – this will be discussed with you if appropriate.

The one-stitch jaw-lift is a type of local anaesthetic “mini” facelift (also called 1-stitch facelifts). We perform the 1-stitch jaw lift using subtle incisions hidden behind the ears. From there the underlying SMAS layer (the supporting layer of the neck and face) is pulled and lifted to refine and smooth the jawline.