Mr Ferrando on how he uses Botox and Fillers

We asked Mr Ferrando to explain how he uses Botox and Fillers to look at which is most effective.

What are both Botox and dermal fillers used for?

Botox and dermal fillers are both used for the reduction of wrinkles, but the indications and the actions are completely different. Botox is the brand name of a toxin but there are similar products like Dysport, Azzalure, Xeomin, Bocoture, and others on the market. The correct area to treat with Botox is the upper portion of the face on the horizontal forehead lines, the wrinkles around the eyes and between the eyebrow frown lines, the so called: “11s”. Fillers are used for the purpose of filling wrinkles and replacing the lost volume on the face, especially on the cheeks, the jawline and the temporal area. Soft fillers can be used superficially either for the improvement of fine lines or creating a net under the skin for a better texture.  

Is Botox effective?

Botox is very effective. It was used for the first time in the 1980s by a Canadian ophthalmologist and dermatologist, Alastair Carruthers, who accidentally discovered the toxin’s anti-aging properties. Botox works because it temporarily blocks the signal from nerve to muscles. That means a small and reversible paralysis of those muscles and consequently a relaxation of the muscles, softening of the wrinkles and youthful appearance.

How effective are dermal fillers?

Dermal fillers are effective too but the areas we treat are different and the scope is different. Wrinkles on the lower face are generally caused by gravity and sun damage so in these areas we use dermal fillers not Botox. Since the wrinkles of the upper third of the face are due to excessive muscular action, Botox remains the best treatment for these particular areas.

What are the side effects of both?

Both can have side effects if used incorrectly. We must be careful to make sure sterilisation is carried out effectively to avoid infections. This can occur with any injectable such as fillers, vitamins, PRP etc If fillers are not correctly injected asymmetries or bumps can occur.

As for Botox, in addition to the previous side effects we may have a temporary descent of the eyebrow or an asymmetry of the eyebrow, or a temporary descent of the eyelid. Practitioners who take only courses for a couple of days and who have no real knowledge of facial anatomy and cannot deal with any complications, are not the right professionals to choose for this kind of medical procedures.

Which is more likely to produce long-term results?

Both, (filler and Botox), if used correctly, with the right timing and right frequency, can give excellent results  and are a great solution for keeping patients  looking young. This way we can postpone more aggressive interventions such as plastic surgery for a while.

How do they compare in price?

The price of Botox and normal fillers is the same. For different fillers, such as RADIESSE, that need different injection techniques (often with microcannulas), the price is higher.

Mr Ferrando talked to Top Doctors

Interviewer: Mr Ferrando, thank you for your time today. In your opinion what are the important things someone should consider when choosing a plastic surgeon?

Mr Ferrando: I think the first most important criteria has to be the surgeons’ preparation and background.

You can choose a general aesthetic practitioner for small procedures (such as Botox / filler etc), but, please, ask what kind of preparation, knowledge and experience he or she has in this area. Participating in an aesthetics training course for two or three days is not sufficient! Obviously Plastic Surgeons have more knowledge than other Doctors or aesthetic practitioners when it comes to these types of procedures. 

One must certainly choose a Plastic Surgeon when it comes to more complex surgical procedures. This is because he/she has the preparation and has studied many years to perform this kind of operations.

The experience of a Surgeon is of course very important, and it makes the difference.  You can see that from his/her results.

Interviewer: So, the importance of researching who will perform the surgery is paramount. What would you consider to be your strengths and why should a patient consider you when choosing a plastic surgeon?

Mr Ferrando: I would consider myself to be a very precise surgeon almost painstakingly so if I may say so. This can be seen in my patient’s results especially after more complex operations that require more ability to perform. I would also say that I possess a passion for taste and have appreciation for the pursuit of excellence and beauty!

Interviewer: Mr Ferrando what drives and motivates you in your profession? What are your goals long term?

Mr Ferrando: what drives me forward is the great satisfaction I receive from seeing my patients so happy with the results I have managed to obtain for them. Continuous research and continuous effort to give it my all at all costs without settling for anything mediocre is what differentiates someone carrying out this profession with real passion or not. 

Interviewer: How do you value the relationship between you and your patients?

Mr Ferrando: I believe this to be the most important thing of all. Firstly, I need to fully understand exactly what my patient desires and then without exaggerating or going for a result that is both unachievable and unnatural will follow the patients’ desire whilst still maintaining harmony and natural results. 

Interviewer: What gives you the most satisfaction in your work?

Mr Ferrando: A patient seeing their results that is so happy they are filled with emotion. That’s what gives me the most satisfaction of all.  To correct an imperfection even if small but that matters to the patient or creates issues for them in some way is something that can change their lives. The plastic surgeon that believes in his work must feel this sense of responsibility. If the surgeon doesn’t understand this, he hasn’t understood his position properly. A French plastic surgery from the previous century described his job as “la chirurgie de l’ame”, “surgery of the soul”. 

Interviewer: What impact in your view is the current climate having on plastic surgery in general?

Mr Ferrando: I believe that at this present moment in time we all need somehow to believe that soon it will all pass and that things will be better than before. Looking after oneself and being healthy is more important now more than ever. This can give us the boost to keep moving forward in a positive direction and can be more powerful than an antidepressant. 

Interviewer: What are your recommendations on how to stay safe in these challenging times?

Mr Ferrando: we all need to follow the rules and guidance that the scientific bodies are giving us and that the politicians are taking onboard issuing   governmental guidance and regulations and sometimes sanctions that we all must follow to make sure we get the numbers down. If we follow the rules we will get out of this faster!!


How does Botox really work and how can I avoid the ‘frozen look’?

If you are thinking about getting Botox but worried about looking unnatural, expressionless or ‘frozen-faced’, you shouldn’t. When done right and by an experienced professional, Botox can offer a subtlely rejuvenated and natural look, and can even help to prevent wrinkles forming in the future.

Mr Giovanni Ferrando is a highly experienced consultant plastic and reconstructive surgeon based privately in London and Genoa, Italy. As an expert in administering Botox, he explains what the substance is, how it works and what you should be looking out for when choosing a Botox provider to avoid undesirable results.

How does Botox work?

Botox – also known as botulinum toxin – is a neurotoxic protein that temporarily blocks impulses from the nerves to the muscles, resulting in a weaker, or paralysed muscle that can’t contract. The affected muscle appears more relaxed which consequently reduces the presence of wrinkles and in some case, slightly raises the eyebrow. This effect gives the face a younger and more rested appearance; however, it isn’t permanent, and after five or six months the effect will disappear and the muscle will regain its strength.

Which area of the face should I get treated?

Botox can work in various areas of the face and body. However, it is typically used in the face and more specifically, the superior third of the face. This consists of the area above the eyes and the forehead and is where the ageing process is more prominent due to the over contraction of the muscles which over time results in wrinkles. Relaxing the right muscles in this area using botox is one of the best anti-ageing treatments.

How can I avoid looking unnatural?

Avoiding an unnatural result depends on the ability and experience of the doctor or surgeon carrying out the procedure. Some types of botox are stronger than others therefore, it is important to correctly calculate the dosage otherwise if the injected units are not well calculated, you can end up with an unnatural appearance, ‘Spock brows’, or how many describe it; the ‘frozen look’.

How often should I get Botox treatments?

You can repeat the treatment two or three times per year. I don’t recommend having it more often than that, however, it depends on the strength of the muscle and other individual variables.

Are there possible side effects?

Side effects from Botox are very uncommon. They depend mainly on the experience of the doctor or surgeon. If the professional doesn’t have sound knowledge of the substance and skill in administering it, the final result may not be as desirable as you’d hoped. It is very important that the specialist carrying out the procedure full understands the anatomy of the head muscles and has sufficient experience to reach the best result.

What should I look for in a Botox provider?

In a nutshell, the specialist who performs the Botox procedure has to have expert knowledge of the facial anatomy and know how any single muscle will look once it has been injected and relaxed. It is only in this way we can move away from an excessive contraction of the muscles and wrinkles to a more youthful and harmonic appearance.

If you are interested in receiving Botox treatment, visit Mr Giovanni Ferrando’s Top Doctors profile and book a consultation to see him.


Blepharoplasty eyelid surgery: before and after

A blepharoplasty can completely transform the region around the eyes. This procedure is most often desired for its aesthetically pleasing outcome, but it also serves a purpose to those with excess skin that hinders their vision. Mr Giovanni, renowned consultant plastic and reconstructive surgeon, demonstrates how this procedure achieves natural-looking results using his own examples.

What is a blepharoplasty?

The blepharoplasty is one of the most common operations in cosmetic surgery. The aim of this procedure is to remove the excess of skin from the upper eyelid, the lower eyelid or both. Also, if there are eye bags present, they are treated at the same time.

Why do people opt for a blepharoplasty?

People undergo the blepharoplasty procedure because excess of skin on the upper eyelid (and sometimes the lower eyelid) can result in functional problems of the eye. However, the procedure is most often performed purely for cosmetic reasons: the appearance after the operation is a younger and fresher look.

What considerations should be taken before the procedure?

Before the operation, the surgeon has to consider the entire face while focusing on the area around the eyes: the position of the eyebrows, the elasticity of the lower eyelid, the asymmetry and the shape of the eyes.

How is it performed?

The operation is performed under local anaesthesia with sedation and it takes less than one hour to do the upper eyelid. The same goes for the lower eyelid.

How long until results show and are results permanent?

The result is permanent but, obviously, we cannot halt the ageing process

Are there alternative treatments that offer similar results?

There are no alternative treatments that offer a similar result.  No treatments can remove either an excess of skin or remove the bags.

More before and after examples:


Dr Giovanni Ferrando is the ONLY surgeon I will ever trust again with my face

Dr Giovanni Ferrando is the ONLY surgeon I will ever trust again with my face and I would follow this man to the end of this Earth. That’s how amazingly talented he is!
God answered my prayers!

Unfortunately, I am a patient who has had bad surgical experiences and as a consequence suffered over the years and been damaged by previous surgeons and so became a very complex case.
I wholeheartedly believe no other surgeon in this country can come close to Dr Ferrando. He is in a league of his own. I hope anyone that is reading this will trust what I am saying because I have been to hell and back and would not want any other person to have suffered the way I have.

After having had VERY bad experiences with previous reputable and well -known surgeons in the UK I NEVER thought I would ever come out of my ‘Living nightmare ‘and be able to look at myself again in the mirror and like my reflection.

For the last 7 years, I have spent most of my days in hiding – too ashamed and afraid to go out because of my botched appearance – Those painful days are now long gone and I can now confidently say that my darkest days are almost over and I am on the right road to recovery.

I turned to Dr Giovanni Ferrando at my most vulnerable. I had hit rock bottom, overweight and genuinely thought there was no hope for me anymore. I thought I was going to have to live with this horrendous botched face forever. I couldn’t see light at the end of this never-ending tunnel.

Many years ago I had a permanent filler which became infected and caused a lot of damage to my face. I had put my faith and trust in various surgeons throughout the years to repair the damage but they all let me down and caused further damage to my face and took no responsibility for the damage they had done. They left me without a care in the world and I was faced to deal with the aftermath alone. I was in despair, not knowing who I could trust and I lost my faith in people.

One plastic surgeon inserted incredibly large cheek implants in me which made my face look so unnatural and very wide. I looked ridiculous and heavily operated.

Before Mr Ferrando, I had been to see so many respected and so-called ‘Top’ surgeons in this country and none of them filled me with confidence and not one showed any passion or drive to give me my ‘face’ and ‘life’ back. They all expected me to live with it.

I found that many surgeons in this country will NOT take on ‘Botched or complicated cases’ I assume we are too much hard work and of course a higher risk and for them, their ‘reputation’ is more important than giving a patient their life and confidence back.

When I first met Dr Ferrando I knew from my first consultation that he was going to be the surgeon who was going to put me right. He listened carefully to what had happened to me, he analysed all my pictures from pre-surgery and to every surgical intervention I have had. He was patient and together we discussed what I was hoping to achieve and my expectations of surgery.

Nothing fazed him and we addressed every single concern carefully. Together we devised a step by step plan on how we would approach my face and what could be done to correct the damage. He carefully explained all risks, drew pictures for me so I was able to understand, showed me where my scars would be and showed me pictures of his previous patients who had gone through a similar situation as me. Seeing pictures of previous patients reassured me and gave me confidence that he could work his magic on me.

Dr Ferrando gave me ‘hope’ and for anyone that is BOTCHED that is what one desperately clings on to. We want to be told that we are fixable and we can get through this together.

Dr Ferrando explained all procedures in great detail explaining all the risks and I was not under this great illusion that everything was going to be perfect. My expectations were made real and I was aware I was going to be on a long journey as all my issues could not be resolved in one operation whereas with previous surgeons I had always undergone one big operation consisting of multiple procedures and when monies were exchanged that was it. They no longer wanted to know me or take any responsibility for the mess they had made of my face. They left me heartbroken and feeling worthless.

Reflecting back it was not the right approach for someone with such complex issues and Dr Fernando’s step by step approach was more sensible and more importantly implemented with precision.
Dr Ferrando’s knowledge and experience are paramount and from examining my face he knew how he could improve it and what could safely be considered. I felt safe and completely at ease around him and no question was left unanswered.

I have undergone removal of cheek implants and a facelift correction. It cannot be underestimated that removing the cheek implants was such a significant operation but at all times I knew I was in capable hands.

It has been 7 months post-op and there is a massive improvement to my face. I look un-operated as if this was my first facelift and the scars have healed nicely.

Dr Ferrando is a highly experienced professional, considerate kind and honest surgeon who takes great pride and care in his work.

He is caring and considerate and alongside him, he and his wife make a fantastic team. They both understand what it is like for when things go wrong and they have a tremendous amount of empathy and knowledge. They recognise what a painful and difficult time it has been for me and they constantly provide the reassurance I need that everything moving forward will be ok.

Dr Ferrando is a gifted and talented reconstructive genius who has helped me to get back on the right path. I thank my lucky stars to have found him and trust him with my life.

I no longer feel ‘alone’ and feel blessed to be looked after by Dr Ferrando, his wife and medical team.

Many thanks

Giuseppina and Michael


Mr Giovanni Ferrando


Mr Giovanni Ferrando Plastic Reconstructive and Cosmetic Surgeon

Read more about Mr Ferrando


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What are the techniques used for a facelift procedure?


If you are considering having a facelift, you may want to know what the procedure is. Leading consultant plastic surgeon, Mr Giovanni Ferrando explains the rules he likes to stick to. If you would like to make an appointment with Mr Giovanni Ferrando, you can do so by visiting his profile here:

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How a natural-looking rhinoplasty is achieved


If you are considering a rhinoplasty procedure, you want to have the most natural-looking results possible. Renowned consultant plastic surgeon, Mr Giovanni Ferrando explains how he achieves these results. If you would like to make an appointment with Mr Giovanni Ferrando, you can do so by visiting about him:

Read more about Nose Job



New procedures in rhinoplasty

Leading consultant plastic surgeon, Mr Giovanni Ferrando discusses the latest techniques in rhinoplasty surgery, and explains the methods for nose surgery that he prefers to use. If you would like to make an appointment with Mr Giovanni Ferrando, you can do so by visiting his profile here:

Watch Video :  Mr. Ferrando explains about new procedures in Rhinoplasty


Read more about Rhinoplasty



How do you achieve a natural-looking facelift?

If you’re considering facelift surgery, you might easily be overwhelmed by the ever-expanding range of procedures and techniques available. In this situation it is important to find a consultant who can recommend the right procedure for you. In this article, renowned plastic surgeon Mr Giovanni Ferrando explains his personalised approach to facelift surgery and his core aim to achieve a natural, authentic result.

What are the different kinds of facelift you perform?

When I perform a facelift, I always adapt my surgery to the patient, depending on what we agree they need. It may be that the patient only requires work on their skin rather than their muscle, to reduce the appearance of wrinkles. A different patient might benefit instead from more volume on their cheeks, which can be achieved with grafting techniques. For some of my patients, the main problem is with the neck, so I will need to use special manoeuvres and techniques to target any loose skin. Finally, for some patients, the best option might be a combination of a full facelift and mid facelift, otherwise known as an extended facelift. The important thing is that the operation I perform is always personalised, and will therefore be different for each patient.

How do you work with the patient to decide how the final results should look?

Before performing any surgery I work hard to understand the patient and their expectations. I personally draw a portrait of the patient to visualise the desired result and discuss this with them. This helps me to personalise the surgery to the patient.

I have found that, above all, the result has to look natural – a fake-looking result would be a bad result. I combine various approaches to achieve a natural final result, including looking carefully at old photos and studying how the patient looked when they were younger.

What is the procedure for a facelift?

Before the patient has surgery, they will need to have a blood test as well as an electrocardiogram (ECG). They can choose whether they would like to receive the operation under a local or general anaesthetic. The operation will take at least 3 hours.

When I perform facelift surgery I make an incision along the edge of the ears. With my personal technique the incisions are almost invisible, because they are made along a natural facial crease.

What happens afterwards?

After the facelift, the patient will need a follow up appointment after 15-20 days. We will also need to change the dressing every 3-4 days. It should take about two weeks to fully recover from the operation.

If you are interested in having a facelift, and would like more information, you can make an appointment with a specialist here.


Juvéderm Hydrate®

Leading skin care company Allergan recently launched a new Dermal filler, Juvéderm® HYDRATE. Containing hyaluronic acid (HA) and the anti-oxidant, mannitol. Juvéderm® HYDRATE was given a European CE mark in December 2009 and has been clinically proven to deeply hydrate the delicate skin of the face, neck and décolletage areas.

Mr Ferrando has been successfully using Juvéderm Hydrate® on his patients since it’s launch in 2009.