Beauty injections

What are aesthetic injectables and which types are available in Estonia?

Aesthetic injectables is the collective term for preparations injected under the skin or into muscle that correct the signs of ageing or improve the quality of the skin. Botulinum toxin (known on the market under names such as Botox, Bocouture and Azzalure) temporarily relaxes the muscles of facial expression and smooths, for example, the lines on the forehead, between the brows and around the eyes. The result appears within 3–14 days and lasts an average of 3–6 months.

Hyaluronic acid based dermal fillers (Juvéderm, Restylane, Belotero, Teosyal) add volume — they fill the nasolabial folds, shape the lips and restore the cheekbones and the jawline. The result is immediate and lasts 6–18 months depending on the product and the area. Biostimulators (Sculptra, Profhilo, Radiesse) work differently: they stimulate the body's own collagen production, which makes the skin firmer and more elastic over 6–24 months.

Mesotherapy and biorevitalisation are superficial injectables that improve the quality of the skin, containing low-concentration hyaluronic acid, vitamins and amino acids. The aim is not to fill wrinkles but to improve the hydration, radiance and elasticity of the skin. These procedures are suitable as prevention from the age of 25 upwards.

Aesthetic injectable prices and how the procedure works

The price of aesthetic injectables depends on the product used, the quantity (botulinum toxin is calculated in units, dermal fillers in millilitres) and the clinic. A botulinum toxin procedure (the forehead, the lines between the brows) usually falls in the 150–350 € range, while hyaluronic acids cost 250–500 € per 1 ml syringe. Sculptra and Profhilo sessions start from 350 € and often require 2–3 procedures with months in between.

A typical visit begins with a consultation in which the doctor assesses the proportions of the face, the strength of the muscles, the condition of the skin and the patient's wishes. Once consent has been given, the skin is cleansed and, where needed, a topical numbing cream is applied (10–20 minutes). The injecting itself takes 10–30 minutes. In some patients a small lump, a haematoma or swelling forms at the injection site, which subsides within 1–7 days.

Experienced doctors, for example at Health Clinic, ProAge Ilukliinik in Tartu and Dr. Mari Laasma Ilukliinik in Tallinn, follow the principle that less is more. To achieve a natural result, smaller quantities are injected and, where needed, topped up 2–4 weeks later at a follow-up visit. With this approach it is harder to over-inject and the result stays more discreet.

How to choose a clinic for aesthetic injectables?

The first thing to check is a Health Board licence — without one, aesthetic injectables may not be offered in Estonia, not even in beauty salons. Check the clinic's licence on the Health Board website and the doctor's registration in the Health Care Professionals Register (Tervishoiutöötajate register). Injecting may only be done by a doctor, not by a beautician or a cosmetic nurse — this is laid down in law in Estonia.

Pay attention to the products used. A quality clinic uses original packaging, shows the patient the name on the syringe before it is opened and keeps the batch code. Injectables offered at a suspicious price (an 80 € botox procedure, for example) point to cheap products from Asia with no marketing authorisation, which bring unpredictable side effects with them. The list of preparations permitted in Estonia is held in the register of the State Agency of Medicines (Ravimiamet).

The consultation has to have substance. An experienced doctor talks through the anatomy of the face, the possible risks (the risk of vascular compression with fillers, for instance), the side effects and what to do if you do not like the result. Hyaluronic acid can be dissolved with an enzyme (hyaluronidase) where necessary, and the effect of botulinum toxin fades naturally over a few months. Choose a clinic where these "safety nets" are used.

Risks, side effects and contraindications

Aesthetic injectables are relatively safe when administered by an experienced doctor in a clinic licensed by the Health Board. The most common side effects are swelling, redness and a haematoma at the injection site, which subside within a few days. With botulinum toxin there can be temporary drooping of the brow or asymmetry, which disappears within 4–8 weeks. The more serious complications associated with fillers — vascular compression, infection, granulomas — are rare, but they require immediate medical intervention.

The contraindications are pregnancy and breastfeeding, allergy to the components contained in the product, neuromuscular diseases (myasthenia gravis, for example), active skin infections in the injection area, and autoimmune diseases in an active phase. Relative contraindications (taking antibiotics or recent dental treatment, for example) must be discussed separately with the doctor.

After the injections, avoid the sauna, intense exercise, alcohol and make-up on the injection site for 24 hours. Those who have had botulinum toxin are advised not to lie down for 4 hours and not to massage the face — to prevent the product spreading into muscles where it is not wanted.

Aesthetic injectables in the most popular Estonian cities

Tallinn has the widest choice of aesthetic injectable providers — the capital is home both to large aesthetic medicine clinics such as Health Clinic and Dr. Mari Laasma Ilukliinik and to more narrowly specialised practices. In Tartu, ProAge Ilukliinik and Medical Aesthetics offer aesthetic injectables, and the wait for a consultation there is typically shorter.

The aesthetic medicine clinics of Pärnu, Narva and other county centres cover the most common needs for botulinum toxin and dermal fillers. For more specific procedures (courses of larger biostimulators or complex filler corrections, for example) the patient is often referred to a partner clinic in Tallinn or Tartu. Choose a clinic you can conveniently reach for repeat visits — aesthetic injectables call for regular maintenance, not a one-off visit.