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The Marylebone Clinic

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Providing excellence in Dermatology

+44 (0) 7834 722 282

Frequently Asked Questions

Click on any of the subjects below to find questions and answers on some of the most popular issues our patients ask us about. If you have a question about a topic, issue or concern that doesn’t appear in this section but you would like to know more about, please email us zenatd@hotmail.com or maryleboneclinic@icloud.com and we will do our best to answer it.


I suffered from acne as a teenager and have been left with terrible scarring on my cheeks, shoulders and back. What options are available to me to help lessen the scarring and are they painful?

There are a number of cosmetic treatments available to alleviate the impact of acne scarring although it cannot be eliminated altogether.

Dr Bazzini has found that N-Lite laser treatment has produced excellent results when treating patients with all forms of acne. It works by targeting the bacteria that causes acne and works well on all skin types. The N-Lite laser emits a unique light which stimulates the natural repair mechanism of the skin and kills spot-causing bacteria. It also increases the production of collagen, helping to reduce any pitting and scarring. It can be used on the face, neck, back and chest. It produces little or no side effects and there is minimal recovery time after a treatment session.

Each N-Lite treatment takes around 30 minutes and most patients require around three to four sessions over a three month period though that can vary slightly.

Acne can also be dramatically improved with chemical peeling, often carried out in conjunction with or at the end of, a course of laser therapy.

Peels are chemical solutions which allow the skin of the face to be improved and smoothed by removing its outer layers damaged by pathological events (scars, acne, precancerous lesions, etc.), by hyperpigmentation or by the effects of the ageing process (wrinkles, loss of skin elasticity or tone, etc.).

The treatment with superficial and intermediate peels do not require anaesthesia, while deep peels need local anaesthetic with sedation and are performed in outpatient care or with one-day hospitalisation.


What are anti-ageing injectables used for?

They are most frequently used in the treatment of dynamic lines of the upper part of the face such as glabellar wrinkles (frown lines), forehead lines, crow’s feet, brow lift. They are also effective for the treatment of the lines around the mouth, lift of the nose tip, the neck area and to decrease the appearance of the lines on the décolleté.


How are the injections administered?

A very fine needle is used to deliver the anti-ageing treatment in very small doses into the areas to be treated. The treatment sessions last 15-30 minutes. Treatment of areas of the face, neck and décolleté is practically painless.

Patients should just be aware of the possibility of injection-related immediate effects such as bruising.


How long does the effect last?

The muscle activity is blocked for 3-6 months and muscle mobility will recuperate gradually.


How often do treatments need to be repeated?

Every 4-6 months however, the effects of treatment do build up. The longer the skin over the muscle is free from stimulation of the underlying muscle contraction, the longer it takes for the wrinkles to become deeper.


How often should chemical peels be performed?

The number of sessions depends on the type and severity of the condition to be treated.


I’ve heard about the VI peel. What is it and how is it different from other peels?

The Vi Peel (Vitality Institute) is a gentle yet powerful medical-grade chemical peel for the treatment of acne and acne scarring, fine lines and wrinkles, age and sun spots, hyperpigmentation, melasma, rosacea and it also helps to make the skin more radiant.

The Vi Peel is safe and effective on all skin types and colours and can be used on the face, neck chest, arms, back, and legs, and is the only peel safe for the under-eye area. It is also painless and requires minimal downtime. With the Vi Peel, the magic is in the formula. A blend of Trichloroacetic Acid (TCA), Tretinoic Acid, Salicylic Acid, Phenol, Vitamin C, and other minerals work together to safely remove the damaged layers of the skin, promote cellular turnover, and refine the surface layer for a smoother, clearer, firmer skin.


Is it important to prime the skin before a chemical peel?

It is very important to prime the skin before medium and deep peels. Before very superficial and superficial peels it is not always necessary to prime the skin.

Skin priming is prescribed by the doctor during the consultation and usually consists of the application of AHA and retinoid based creams for about 15 days prior to the treatment.


Can chemical peels be used in dark skin individuals?

Yes. Expert doctors can use chemical peels on patients with dark skin. Very superficial and superficial peels have a very low risk of transitory hyperpigmentation.

However, patients with dark skin must bear in mind that when their skin goes dry it often becomes darker. Therefore should expect a slight darkening and patchiness of the skin for 5-7 days after the peel.

Medium and deep peels may be performed on dark skin individuals as long as the patient accepts the risk of transitory hyperpigmentation for 3-9 months after the peel.


Do significant after-effects occur after the treatment with chemical peels?

After very superficial and superficial peels the skin is pink for a few hours. The skin then becomes dry and exfoliates during the following 5-7 days.

After intermediate peels the skin is pink for 1-2 days then becomes violaceous-tanned for 2 days and on the 4th-5th day the exfoliation begins and lasts for max 10 days. It is advisable to take 5 days off work.

After deep peels the skin will be red and the area might be swollen for 2 days. On the 2nd or 3rd day the skin will become violaceous-tanned for 2 days and on the 4th-5th day the exfoliation begins and lasts for max 10 days.


What is important during the post-peel period?

It is very important to follow the instruction the doctor will give. It is also very important not to pick the skin and tear it. No sun-exposure for 2 weeks up to 2 months according to the depth of the peel. No saunas (and similar) and no swimming pool for 5-10 days according to the depth of the peel.


What are the risks and the complications of this treatment?

Chemical peeling is normally very safe. However, it is a delicate procedure, complications (such as hyperpigmentation, flushing, infections and scars) are rare but may occur and can be easily resolved if the situation is closely followed up by a specialist in dermatology or plastic surgery.


I’m 60 and small and quite deep wrinkles have appeared around my lips. I would like to know what the best treatment for this problem is.

The wrinkles that appear vertically above and under the contour of the mouth (perioral wrinkles) are frequent among thin-skinned people and among those who often tense the orbicular muscle of the mouth. This is common among those who smoke for example. In male skin, which is much thicker, this defect hardly ever occurs.

Perioral wrinkles can be improved (though not eliminated completely) by a combination of various treatments acting on all the factors that cause them to appear. More precisely, the skin should be treated with techniques that smooth its outer layer, such as dermabrasion, CO2 laser and intermediate (TCA) or deep peelings such as phenol.

The subcutaneous fat that has thinned out and can be replaced through the use of filling materials such as hyaluronic acid.. Finally, the orbicular muscle of the mouth can also relaxed through small injections of anti-ageing injectables to prevent this muscle from contracting, which inhibits the appearance of worry lines.

Your consultant would be able to discuss the most appropriate course of action with you based following an examination of your skin and current state of health.


What are fillers and how do they act on wrinkles?

Fillers are filling materials that are injected into the wrinkles to fill in the areas lacking in subcutaneous tissue. Fillers can be absorbable, semi-permanent or permanent.

Absorbable fillers have the advantage of being easily tolerated by the body but provide a temporary volume increase (from 4 to 12 months). The absorbable materials are essentially two: collagen and hyaluronic acid.

Semi-permanent fillers have the advantage of providing a more durable result (from 12 to 36 months) though in exceptional circumstances, may produce foreign-body reactions.

Permanent fillers have the advantage of providing a permanent result but, sometimes, they can induce a rejection reaction that is not easy to control and to correct.

We favour the use of absorbable fillers because they allow the patient to decide whether to continue the treatment or to regain his/her natural state and do not cause any side effects. Due to the risks that both semi-permanant and permanent fillers carry, we do not offer them to our patients.

At The Marylebone Clinic we use more than just fillers to treat wrinkles. We find that the best results come from a combination of treatments which include: dermal rollers, mesotherapy, chemical peeling and PDO thread lift.



Do feel free to ask Dr Brazzini for more information in your consultation.

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