Elanamie Refresh Combination Therapy

- A Winning Formula

A growing trend in aesthetic medicine is for a combination therapy approach to rejuvenation and correction, and Anti Wrinkle Injections (AWI) and Dermal Fillers are one such winning combination. The latest research has found that the two procedures have equal applications, but together, they can produce a synergistic effect that last longer and looks better (see research papers below).

The key ingredient is comprehensive facial analysis. We have unique faces, skin, musculature and wrinkles. We all age differently. One size, emphatically, does not fit all.

Don't get caught up with "number of units" and pricing per area. That might be a good metric when throwing down grass seed but it's not appropriate for a medical procedure on your face.

25 units of AWI injected into one face or one area is entirely different from 25 units of AWI injected into the right spots for you.

How we age over time

How we age over time

Many of the changes that have taken place in approaches to facial rejuvenation have come about because of increased understanding of facial aging, expansion in the numbers and types of products available, and associated refinements in aesthetic goals—specifically, providing a balanced, harmonious, and natural look. 

Anti Wrinkle injections (AWI) work on the underlying muscle structures under the skin. The muscles not only provide movement, but affect our facial positioning and expressions. Certain large muscles such as those in the jawline, around the lips and eyes, as well as the forehead areas, can change the entire facial structure noticeably. Deep frown lines can make a person look permanently angry, while pronounced jaw muscles can give someone a belligerent or argumentative demeanor. Proper usage of AWI not only relaxes the facial expression, but also can give a more pleasant, uplifted look.

Dermal fillers work hand in hand with AWI to restore fullness to areas that are sunken or lined, and also helps to reshape and redefine the overall facial structure. By combining fillers with AWI, the volume of both substances can be reduced to achieve a more natural, harmonious look.

Many patients find that in areas of the face that are in constant motion, such as in the mouth area, fillers do not last very long, as the muscle motion works to break up the fillers faster. A combination treatment including AWI decreases muscle activity, so that the fillers are not broken down so quickly.

The synergistic effect of AWI and fillers is such that the combination of both is better than either treatment alone, and it has been theorized that effects of this dual-treatment lasts longer because the collagen production stimulated by fillers help the skin to form correctly in a way that muscle movement would have disturbed.

At Elanamie Clinic we use vials of Dermal Filler with a sprinkle effect of AWI and have three very popular combinations. The type of Dermal Filler used is decided in the consultation after a facial assessment as many factors determine which fillers or combination of fillers are ideal. 


Elanamie REFRESH PACKAGE €600

Dermal filler 1.0ml and an average of 30 units of Anti Wrinkle injections (AWI) drugs. This does not include specialised treatments (e.g. Lips and Under-eye). We use the AWI drugs where needed as support for the Dermal Filler as opposed to being tied to particular areas. This is appropriate for moderate lines. It works to give support at a deeper level to smooth out lines. The AWI reduces the muscle action to allow the filler to last longer and stay in the correct position. The Dermal Filler part lasts 9 months approximately and the AWI needs to be topped up on average at 4 months.  The facial analysis at consultation is vital to get the ideal treatment combination designed specially for each client. 

The cost for this treatment is €600. Contact (021) 241-9113 or manager@elanamie.ie for a no-obligation consultation.


Elanamie REFRESH Radiesse PACKAGE €650

Radiesse Dermal filler (1.5ml) and an average of 30 units of Anti Wrinkle Injection (AWI) drugs. This does not include specialised treatments (e.g. Lips and Under-eye). We use the AWI drugs where needed as support for the Dermal Filler as opposed to being tied to particular areas. This is appropriate for moderate lines. It works to give support at a deeper level to smooth out lines. The AWI reduces the muscle action to allow the filler to last longer and stay in the correct position. The Dermal Filler part lasts 9 months approximately and the AWI needs to be topped up on average at 4 months.  The facial analysis at consultation is vital to get the ideal treatment combination designed specially for each client. 

The cost for this treatment is €650. Contact (021) 241-9113 or manager@elanamie.ie for a no-obligation consultation.


Elanamie REFRESH ULTIMATE PACKAGE €850

This uses a 2 x standard ampoules of Dermal filler (1ml x 2) and an average of 40 units of AWI. This does not include specialised treatments (e.g. Lips and Under-eye). We use the AWI where needed as support for the Dermal Filler as opposed to being tied to particular areas. This is appropriate for deeper, more persistent lines and supporting volume loss in particular areas of the face. The AWI reduces muscle action to allow the filler to last longer and stay in the correct position. The Dermal Filler lasts 12 months approximately and the AWI needs to be topped up at 4 months, on average. The facial analysis at consultation is vital to get the ideal treatment combination designed specially for each client. 

The cost for this treatment is €850. Contact (021) 241-9113 or manager@elanamie.ie for a no-obligation consultation.


Typical Volumes Dermal Filler

Volume use depends on each individuals face. However, we have found the following volumes would be typical for a woman 35-45 years old.

One Syringe usually fills one of the following areas:

  • Naso-labial folds

  • Marionette lines

  • Smoker’s lines around the mouth

  • Lips- mild correction

  • Glabella (frown lines not responsive to Botox or Dysport)

  • Ear lobes

  • Nose (Non- Surgical Rhinoplasty)

Two Syringes usually fill one of these areas:

  • Cheek hollows

  • Tear troughs, Eye Hollows

  • Lips- full correction- fuller lips

  • Hands (both hands)


Supporting Studies


Combination therapy with BOTOXTM and fillers: the new rejuvenation paradigm

Carruthers et al looked at the use of Botox Cosmetic in combination with Restylane, one of the first of the hyaluronic acid products available in the United States. Thirty eight women with severe glabellar furrows were randomized to receive Restylane treatment alone or Restylane plus Botox Cosmetic. The study showed that those who received combination therapy had a better response at rest and at maximum frown compared to those receiving Restylane alone. The time frame to return to baseline in these patients was 18 weeks with Restylane alone and 32 weeks for those who received the combination of Restylane and Botox Cosmetic.

Advances in Facial Rejuvenation: Botulinum Toxin Type A, Hyaluronic Acid Dermal Fillers, and Combination Therapies

A multidisciplinary group of aesthetic treatment experts convened to review the properties and uses of botulinum toxin type A (BoNTA) and hyaluronic acid fillers and to update consensus recommendations for facial rejuvenation using these two types of products. The group considered paradigm shifts in facial aesthetics; optimal techniques for using BoNTA and hyaluronic acid fillers alone and in combination; the influence of patient sex, ethnicity, cultural ideals, and skin color on treatment; general techniques; patient education and counseling; and emerging trends and needs in facial rejuvenation.