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Non-invasive non-surgical cosmetic Medicine can address some problems ageing problems such as : Wrinkles, folds, crease, depression, furrow, crow's feet, line, crow's foot, frown line. Then the skin itself need rejuvenation by non-invasive non-surgical techniques to improve these imperfectness, defects,flaws and imperfections. Wrinkles filling by the same injection technique or with

non-permanent fillers such as hyaluronic acid or dermal fillers. Wrinkle and lines can be treated by botox injections. Face peels and laser are used by Dr. Philippe Chout for skin resurfacing with diluted trichloracetic acid TCA

for lines around the mouth, or fine lines on the cheeks, after a preparation with retinoic acid creams. Read more about wrinkles and lines anti-aging non surgical treatment ... Botox botulinum toxin injections, Hyaluronic acid dermal fillers injections, facepeels with TCA or laser , IPL are walkin easy procedures. Alone or combined together, they can efficiently treat aging skin.

Review Dr.Philippe Chout Botox & Hyaluronic acid injections, lipofilling, anti-aging use. review-dr-philippe-chout-botox-injections-avis.jpg

What are facial dermal fillers like hyaluronic acid?

As our skin ages, the dermis gradually loses its major natural constituents: collagen, elastin and hyaluronic acid. Collagen acts as the major support protein for our skin; elastin allows our skin to stay firm though elastic and resist wrinkles; hyaluronic acid helps to trap water and add volume and shape to our skin giving it its plumpness. Dermal fillers are substances that are injected just below the surface of the skin to fill in lines, wrinkles, and scars. Unlike face-lifts that stretch the skin, fillers add volume for a more natural youthful appearance. Fillers can also increase the fullness of the lips (see section on lip enhancement) and lessen the downward slant of the corner of lips. The most common areas treated are the smile lines around the nose and mouth, fine lines above the mouth, frown lines between the eyes, and acne scars. This is a walk-in procedure done in 30 minutes under a local anesthetic with a numbing cream (Emla 5%). The pain is mild to moderate. The result is immediate and will last 6 months. Bruising or swelling is a very rare event and patients can appear socially or go beack to work the same day.

I rather recommend pure hyaluronic acid alone

The various names of Restylane, Perlane, Juvederm, Hylaform, Teosyal... Hyaluronic acid is a polysaccharide found in the dermis of all mammals. Hylaform gel, previously known as Hylan B gel, is a form of cross-linked hyaluronic acid (5.5 mg/mL) derived from the rooster combs of domestic fowl. It is reported to be less immunogenic and longer lasting than bovine collagen. One study showed 86% histologic persistence of Hylaform gel compared with 25% of bovine collagen in guinea pigs at 26 weeks. Besides being longer lasting than collagen, proponents say it has less risk of clumping and goes in more smoothly. Overcorrection is not needed with this product.

Although Hylaform gel TM is widely used throughout the world for dermal filling of scars and rhytids and in lip augmentation, and it has been recently approved in the United States. In the United States, it is approved for injection into the mid-to-deep dermis to correct soft tissue contour deficiencies (e.g., wrinkles, acne scars). It is used in a more concentrated form, Synvisc, to treat osteoarthritis of the knee. Restylane and Perlane Restylane is manufactured by Medicis. (perlane, teosyal ) Restylane TM is an FDA-approved non–animal-stabilized hyaluronic acid derivative used for soft tissue augmentation. Unlike Hylaform gel, it is derived from streptococcal bacterial fermentation and does not require an animal source. At 20 mg/mL, Restylane has a higher concentration of hyaluronic acid than Hylaform gel. It is used to treat rhytids and scars and in lip augmentation. Restylane correction was noted to be 82% at 3 months and 33% at 1 year in a study involving 285 wrinkles treated in 113 patients.
Perlane TM is also a hyaluronic acid derivative at 20 mg/mL, but it is a more robust form of Restylane for use in the deep dermis and at the dermal-fat junction. It is used in Canada but has not yet received FDA approval. Being hyaluronic acid derivatives similar to Hylaform Gel TM, Restylane and Perlane have less risk of clumping and go in more smoothly. Overcorrection is not needed with these products. However, neither product contains anaesthetics and patients need to be treated with local anesthesia or regional blocks prior to administration.

I do not recommend at all silicone injections

Silicone use for dermal Filling is forbidden for good reasons. The use of silicone fillers has been controversial in the past and is no more fashionable because of the risk of bumpy scars called granulomas that can form even decades after treatment. It is not used any more. I do very often remove silicon surgically when it creates ugly lips. This procedure allow to recreate a natural appearance. The incisions are hidden inside the mouth

I do not recommend the use of Sculptra, and never used it

Sculptra TM is manufactured by Dermik Aesthetics. Sculptra is poly-L-lactic acid is FDA approved for the treatment of HIV facial lipoatrophy. It serves as a volume enhancer and is used for indications similar to those for autologous fat transfer. Results are not immediate; treatment is performed as a series of 3-5 treatments approximately 1 month apart. New-fill is the name under which Sculptra was marketed in most countries outside the United States. New-fill is a non–animal-derived polylactic acid touted to be biocompatible, biodegradable, and immunologically inert.

I never used permanent fillers , but saw several patients who got this treatment by another doctor, and were so unhappy with the results , that I have had to remove surgically this Sculptra or aquamid .

FAT TRANSFER LIPOFILLING is from far the best permanent option

The autologous fat transfer (Coleman technique) is asurgical procedure is unique because it removesfat from one area of your body and transfers it to the area of concern. The main advantage of lipotransfer is that it eliminates the risk of an allergic reaction. Lipotransfer is a two-step procedure. First, liposuction is performed using local anesthesia to collect the “donor” fat commonly from the thighs, the abdomen or hips. Fat is then injected into the face, just below the second layer of the skin (dermis) or into the muscle. Bruising, swelling, and redness are common afterward and usually last a few days. Initially a part of the fat will disappear between 10 and 20%. What will stay after 3 months will stay permanently or will at least be very long lasting (3 to 15 years).

Fat tarnsfer lipofilling is very reliable and long lasting. This excellent permanent or at least long lasting filling method is operator dependant. When properly done it does stay forever and doesn't migrate and stay where the microdroplets are placed. The cost for a fat transfer start at £2,000. It requires a very special skill to be permanent. It is a real surgical procedure though and requires at least a local anaesthetics, and a stay for a few hours in the hospital. Bruising and swelling is mild to moderate. Patients are able to resume work after 3 to 4 days. For more information see our Liposuction & Fat transfer information form. The Choice between hyaluronic acid and fat transfer The ideal dermal filler should be easy to administer, provide reproducible cosmetic results, remain in the dermis for a significant period of time, and have a superior safety profile. Injection of fillers usually requires the use of either a topical numbing cream or a local injection of numbing medication. Then, using a small needle, the dermal filler is injected into each wrinkle or scar that requires treatment. Some mild burning and stinging is normal and quickly resolves. The results can last from three months to five years, depending on the filler being used. The cost is important in the final choice. Injectable fillers do not last as long as fat. The repeated cost should be compared to the one-off cost of fat transfer.
read more about fat transfer lipo filling...


Video before and after Lips augmentation by Hyaluronic acid injection

Video before/after lips augmentation with Hyaluronic acid injections. Natural lips appearance filmed 15 minutes afer the injections in the consultation room. Anaesthesia with Emla lignocaïn cream, plus lignocain in the injected hyaluronic acid.

Video testimonials : Lips augmentation with Hyaluronic acid injection.

Video before/after lips augmentation with Hyaluronic acid injections. Natural lips enhancement in 15 minutes. Enjoy this very pretty face bearing no make up at all!


AESTHETIC MEDECINE is the group of non-surgical treatments that can be performed in the consultation room with a topical anaesthetic cream or a block anaesthesia.

Doctor Philippe Chout non-surgical techniques include skin resurfacing prescriptions, skin peels, lasers, dermal fillers for collagen replacement often using hyaluronic acid (for example Juvederm Tm, Perlane Tm or Restylane ) and muscle relaxing injection with botulinum toxin (Botox Tm). Botulinum toxin injections into the muscles of the forehead, between the eyebrows or in the crow’s-feet, deactivate facial expression in these areas and temporarily reduce the appearance of lines and wrinkles.

The active ingredient of Botox or Dysport or Azzalure (which are registered trademarks of Allergan and of Galderma) is Clostridium botulinum type A haemagglutinin and it also contains albumin and lactose. Botox is very effective for:

• Horizontal lines to the forehead
• Vertical lines to the forehead (frowning lines)
• Crows feet lines to the external corner of the eyes upper lips vertical lines turkey neck (platysmamuscle bands)
• Excessive sweating of the palms or of the armpit

How long does it take to get it done ?

litteraly 20 minutes. It is a walk in procedure that can be done during the lunch break at work. Botox Tm is administered with a very fine needle after a local anaesthetic cream has beeen applied during 15 minutes. The injections are almost painless, adn would leave no marks or bruising if you didn't take aspirin before. The results are noticeable one week later and will last between 3 months up to nine months for regular users. The first time you do it , you will need to do it again after four months, because the product effect will disappear totally. But following several courses the effects may last longer than six to nine months.
The doses of injected Botox TM are very weak, thus there are usually no adverse side effects related to botulism toxin activity.

Side effect or complications are very rare. An allergic reaction to the product is unlikely and the risk of skin infection is also negligible. However, the eyebrows may become slightly more arched if the forehead is treated, but this is an initial reaction, which will soon subside. Botox relaxes the muscles, therefore sensation is still perceptible. Undesirable side-effects or complications are rare Skin rash and or flu-like symptoms indicate an allergic reaction or an infection but this only occurs in exceptional cases. Other possibilities experienced by patients are: dizziness, headaches, frontal tension, bruising, haematoma, and or swelling at the point of injection. Furthermore, if the product has dispersed deeply, exaggerated and asymmetrical drooping eyebrows and eyelids may result. Precautions You should not take aspirin five days before treatment because this drug facilitates bruising.

Precautions before and after botox injections
In all cases, one must refrain from sleeping or dozing for four hours after the procedure. During this time it is also necessary to avoid making facial expressions and massaging the area, as this will spread the product, which could cause undesirable side effects. The use of Arnica cream on your face is recommended afterwards. Botox injections cannot be given during pregnancy. Keywords : Botox lines treatment wrinkle treatment, anti ageing medicine treatment.


E-MAIL : or call for consultation bookings : + 33 6 46 69 56 37 . 21, avenue George V, Paris 75008 in France.