Botox and fillers

Patients willing to undergo surgery to improve their appearance, have carefully considered this and deserve clear and realistic advice. We remedy unwanted changes in the appearance in a suited and simple way. We strive for a fine and natural result. This requires an extensive observation and ample knowledge of a plastic surgeon.

Treatments with Botox and fillers are grateful procedures for facial embellishment. These procedures can be performed in a safe and quick way at our clinic.


Treating wrinkles

The facial aging process includes the occurrence of wrinkles and the loss of volume. Wrinkles occur because of sun damage, the regularly contracting facial muscles, the loss of subcutaneous fat volume and gravity causing this volume to lower.

Wrinkles can be “fine”; usually around the eyes, forehead and on the cheeks. Wrinkles can also be “deeper”, for example the line running from the nostril to the corners of the mouth. The wrinkles occurring due to muscular contraction are called “dynamic wrinkles”.

Additionally, “static wrinkles” exist. These remain visible even when the facial muscles completely relax. To treat the various kinds of wrinkles, one can choose from Botox, “fillers” or a facelift. Before Botox- or filler treatment, an anesthetic cream can be applied on the skin. This causes the skin to be less sensitive to the treatment.

Botox treatment
Botox (botulinum toxin) is used to treat wrinkles caused by the contraction of the facial muscles. It makes the wrinkles smoother and less deep, causing them to stand out less. Wrinkles caused by sun damage, gravity or loss of volume do not respond to Botox.

Botox blocks the signal the neurons send to the facial muscles. Subsequently, the facial muscles cannot be contracted anymore. This causes the wrinkles to show much less. The effect and the duration of the effect of the Botox differs from individual to individual. This also depends on the area of the face that is treated.
The effect remains for about 3 to 6 months. After the muscular action gradually returns, the wrinkles become more visible again and treatment could be repeated. After several treatments, the wash out period is longer. The muscles become less active and the wrinkles reappear less quickly.

In the hospital, this anesthetic is used to treat spastic muscles. In the clinic, it is used for treatment of crow’s feet around the eyes, expression lines between the brows and lines on the forehead. Excessive sweating (hyperhidrosis) can also be treated through the use of Botox.

Treatment with fillers (hyaluronic acid)
Fillers literally “fill” the wrinkle or facial area with volume loss. It smoothens the wrinkle and adds volume where the fatty tissue is diminished during the years.
Fillers consist of Hyaluronic acid. The Dutch Association for Plastic Surgeons decided, for the sake of safety and health, that fillers are not allowed to have a permanent effect, but have to be soluble.

The body itself produces and contains Hyaluronic acid, for example in the joints, eyes and the skin. However, the substance we use for injections, is a moderated extract. It binds with water and fills the skin or wrinkle in a safe way. This may contribute to an improvement your skin quality.

In our clinic, we regularly treat deep and fine wrinkles with hyaluronic acid. Hyaluronic acid is available in gel form. This is fabricated in a thin, or a thick substance. Usually, lidocaine is added as an anesthetic to make sure you experience less discomfort during the treatment.

The effect and the duration of the effect of the Botox differs from individual to individual. This also depends on the area of the face that is treated. The effect usually remains for 6 -12 months. If the effect weakens too fast, a second treatment can be necessary. A 2-year effect is also mentioned. The substance disappears gradually and the wrinkles will slowly reappear. In this case, treatment can be repeated.

The plastic surgeon will choose which concentration of hyaluronic acid is needed for your treatment, depending on the location and sort of wrinkle or volume loss on your face


If you want a small, not conspicuous but refreshing treatment for the face.

With a small amount of botox and / or fillers, your face can get a "touch-up". Drs. Michels carefully weighs up the most balanced treatment for your face.