A new approach to achieve a natural looking outcome by Dr Gina Messiha

Q&A with Dr Gina Messiha Cosmetic Physician, Perth

What is your approach to facial rejuvenation?

As a doctor, it is my responsibility to ‘first, do no harm’. This means choosing the least invasive option possible. My approach is to address each patient’s concern in the most natural, minimalistic and safe way possible.

If my patient is seeking a non-surgical solution without any downtime, I recommend combining EMFACE^® and EXION™ to harness the body’s natural ability to help repair and rejuvenate itself, the new concept of what we refer to as ‘regenerative aesthetics’. The goal is for my patients to look like the best versions of themselves, with a face that reflects natural beauty and emotions. If the face doesn’t respond to movement or appears overfilled, it can be noticeable and appear unnatural. We can still use injectables as an option, however we should choose to use it sparingly and artfully.

How do EMFACE^® and EXION™ differ from injectables?

As we know, injectable fillers increase volume in certain areas of the face, while neuromodulators temporarily immobilise muscle movement to soften wrinkles. In comparison, EMFACE^® and EXION™ work in harmony to address the different layers of the face, ie, skin, subcutaneous fat, muscles, and facial bones and connective tissues.

With EMFACE^®, we can help restore the muscle tone and reposition the facial structure back to a more youthful state. Previously, the focus was primarily on the skin and volumising the soft tissue with injectables, however we were unable to address deeper tissues such as muscles and the SMAS layer in a non-surgical manner. Now we can non-surgically target each of these specific layers by using EMFACE^® and EXION™ to stimulate collagen, elastin and increase HA naturally.

Older patients require more specific needs for correction, but this combination can help restore their facial features and also lay the groundwork for any potential future enhancements.

How do you decide whether to choose botulinum toxin (BOTX) or EMFACE^® for patients?

It depends on many factors, such as the age of the patient, their concerns, my assessment and more importantly their readiness for injectables.

BOTX complements and does not compete with EMFACE^®.

My preferred approach is to use EMFACE® to stimulate the elevator muscles and BOTX to relax the depressor muscles; I find the results achieve great lift.

For younger patients, I might recommend EMFACE^® as a standalone approach to help naturally promote and sustain their youthful appearance. If they are older, BOTX can help target the depressor muscles like the glabella complex, upper orbicularis, DAO and platysma. However, overuse of BOTX in certain areas like the forehead can create weaker and flatter muscles, resulting in thin and loose tissues, or even brow ptosis, hence it is an area I hardly recommend treating with muscle relaxers.

With over 40 facial muscles in the face, I use EMFACE^® to selectively target and strengthen the muscles responsible for lifting to improve the density and tone. The results I am observing match up with the clinical studies, resulting in 37% wrinkle reduction² and 23% more lift³.

Adopting this approach for over 12 months now, I have seen more natural-looking results, more lift, subtle yet noticeable improved volume in the upper and mid face, skin firmness and less wrinkles when using EMFACE^®.

How do you implement BTL face contouring devices in your practice?

Usually, I opt for the EMFACE^® procedure as the initial step since it reduces wrinkles, lifts the brows and enhances the cheek volume, which reduces the necessity

for larger quantities of filler. The HIFES™ energy not only tones the muscles but also, in combination with the smoothing effect of the synchronised RF, diminishes our reliance on significant amounts of BOTX of the forehead muscles to create a more natural appearance.

With the introduction of the new EMFACE^® Submentum applicator, I can reduce the double chin and turkey neck effect – this is a common area of concern for most of my clients (especially those with a weak jawline). I will then complete the treatment with EXION™ as it can boost your own natural hyaluronic acid production by 224%⁴, improve skin laxity by 50% and increase hydration 23% on average⁵. With this combined approach I am not just addressing skin laxity and sagging but also skin texture and tone to give clients more overall lift, firmness, reduced pores and fine line reduction.

What results can you expect to see?

EMFACE^® works to lift and sculpt, while EXION™ utilises both RF and targeted ultrasound energies and can be applied comprehensively to address the skin quality across the entire face, neck, jowls and even the area around the eyes, including eye bags and loose upper eyelids.

In addition to the face, I am seeing fantastic results on the neck and décolletage in my older patients.

You get this natural blending with improved collagen, elastin, and HA production from the jawline all the way to their chest. There’s nothing worse than having a rejuvenated face with an old neck.

My patients love this combination as it’s such a quick treatment, without any downtime. They witness the initial tightening effects, and the improvement continues to enhance over the following months.

What are the ROI benefits?

EMFACE^® and EXION™ have transformed the way I approach the treatment of facial ageing. Offering a holistic approach that delivers superior results leads to higher patient satisfaction and loyalty. Both devices have an easy learning curve, offer efficient use of staff time, and are highly profitable as they can be delegated to my team.

The technology is intelligently designed with built-in AI for safety, which is very important for any procedure I bring into the office. BTL’s devices are designed to be simple and straightforward to set up and perform. My staff not only enjoy delivering these treatments but also love educating patients about the treatments and other special packages we offer. AMP