# Understand before you *decide.* > Plain-language articles on aesthetic medicine: the difference between Botox and fillers, what happens at a first treatment, and how GOÄ pricing works. - Source: https://www.vivaderm.de/ratgeber-en.html - Language: en - Publisher: VIVA DERM, Privatpraxis für ästhetische Medizin, Rosastraße 6a, 45130 Essen, Germany, +49 1520 8367711 - Responsible physician: Katayoun Mostaghimi (Fachärztin für Allgemeinmedizin) - Updated: 2026-10-05 Aesthetic medicine needs explaining. Here are factual answers to the questions that come up most often in consultations – no promises, no marketing language. ## Latest articles. - [Botox or filler?](https://www.vivaderm.de/guide-botox-or-filler-en.html) – Difference, durability, uses - [Your first treatment](https://www.vivaderm.de/guide-first-treatment-en.html) – From consultation to review - [What does it really cost?](https://www.vivaderm.de/guide-costs-en.html) – GOÄ, 'from' prices, discounts - [How long does Botox last?](https://www.vivaderm.de/guide-botox-duration-en.html) – Duration and what affects it - [Aftercare](https://www.vivaderm.de/guide-aftercare-en.html) – What to do, what to avoid - [Dissolving filler](https://www.vivaderm.de/guide-dissolving-filler-en.html) – Hyaluronidase explained - [For men](https://www.vivaderm.de/guide-men-en.html) – What is different for men - [Botox: from what age?](https://www.vivaderm.de/guide-botox-age-en.html) – Prevention explained - [Pregnancy & breastfeeding](https://www.vivaderm.de/guide-pregnancy-breastfeeding-en.html) – What is possible - [How long does filler last?](https://www.vivaderm.de/guide-filler-duration-en.html) – Durability by area - [Preparation](https://www.vivaderm.de/guide-preparation-en.html) – The checklist ## How these texts are meant. These articles are general information. They replace neither a medical examination nor the legally required information consultation (§ 630e BGB). Whether a method suits your case is decided after history and examination – and sometimes the answer is that no treatment is advisable. Responsible for the content: Katayoun Mostaghimi, specialist in general medicine, Rosastraße 6a, 45130 Essen. ## What bothers you – and what helps. - [Drooping mouth corners](https://www.vivaderm.de/concern-drooping-mouth-corners-en.html) – Downturned mouth corners make a face look sad or dissatisfied. Causes (muscle… - [Dull skin](https://www.vivaderm.de/concern-dull-skin-en.html) – Grey complexion, no freshness, make-up does not hold: why skin looks dull… - [First wrinkles](https://www.vivaderm.de/concern-first-wrinkles-en.html) – The first line that no longer disappears: what is normal, what prevention… - [Jowls](https://www.vivaderm.de/concern-jowls-en.html) – Jowls arise when cheek fat descends and the jawline blurs. What hyaluronic… - [Large pores](https://www.vivaderm.de/concern-large-pores-en.html) – Pores cannot be 'closed' but refined. Why they look larger (sebum, sun damage… - [Laugh lines](https://www.vivaderm.de/concern-laugh-lines-eyes-en.html) – Crow's feet are expression – and sometimes too much of it. When botulinum… - [Looking stern](https://www.vivaderm.de/concern-looking-stern-en.html) – Frown line, drawn-together brows, line across the nose bridge: why some faces… - [Looking tired](https://www.vivaderm.de/concern-looking-tired-en.html) – Dark circles, drooping lids, hollow temples, frown line: why faces look tired… - [Receding chin](https://www.vivaderm.de/concern-receding-chin-en.html) – A set-back chin makes the nose look larger, the neck shorter and a double chin… - [Thin, dry skin](https://www.vivaderm.de/concern-thin-dry-skin-en.html) – After menopause the skin becomes thinner, drier and crepey – on cheeks, neck… - [Thin lips](https://www.vivaderm.de/concern-thin-lips-en.html) – Naturally thin lips or lips that have thinned with age: what hyaluronic acid… - [Wide lower face](https://www.vivaderm.de/concern-wide-lower-face-en.html) – A wide jaw can be bone, muscle or fat – and only one of them can be treated… ## Understanding how skin and face work. - [Acne scars](https://www.vivaderm.de/guide-acne-scars-en.html) – Ice-pick, boxcar and rolling scars need different procedures. What… - [Botox myths](https://www.vivaderm.de/guide-botox-myths-en.html) – Botox gives you a mask face, is a poison, is addictive, helps against all… - [Collagen supplements](https://www.vivaderm.de/guide-collagen-supplements-en.html) – Collagen powders, capsules and drinks promise firmer skin. What the studies… - [Double chin](https://www.vivaderm.de/guide-double-chin-lipolysis-or-exercise-en.html) – Why a double chin often has nothing to do with being overweight (genetics… - [Filler myths](https://www.vivaderm.de/guide-filler-myths-en.html) – Fillers look overfilled, stretch the skin, are forever, are all the same… - [Hair loss men](https://www.vivaderm.de/guide-hair-loss-men-en.html) – Hereditary hair loss affects most men. What DHT does in the hair follicle, the… - [Hair loss women](https://www.vivaderm.de/guide-hair-loss-women-en.html) – Diffuse hair loss, thinning parting, hair loss after childbirth or in… - [How the face ages](https://www.vivaderm.de/guide-how-the-face-ages-en.html) – Facial ageing is more than wrinkles: bone recedes, fat compartments shift… - [Using retinol](https://www.vivaderm.de/guide-how-to-use-retinol-en.html) – Retinol is the best-proven anti-ageing ingredient – and the most often… - [Sweating at work](https://www.vivaderm.de/guide-hyperhidrosis-at-work-en.html) – Wet shirts in meetings, damp hands when shaking hands: what hyperhidrosis is… - [Home devices](https://www.vivaderm.de/guide-led-masks-home-devices-en.html) – Red-light masks, dermarollers, microcurrent devices and gua sha promise… - [Menopause and skin](https://www.vivaderm.de/guide-menopause-skin-en.html) – Why the skin loses up to 30 % of its collagen in five years around menopause… - [Nasolabial fold](https://www.vivaderm.de/guide-nasolabial-fold-treatment-en.html) – The fold between nose and mouth corner is the most common request – and the… - [Natural lips](https://www.vivaderm.de/guide-natural-lips-en.html) – Why some lips look overdone and others do not: proportions (golden ratio… - [Neck & décolleté](https://www.vivaderm.de/guide-neck-and-decollete-en.html) – Neck and décolleté often age faster than the face: horizontal lines, neck… - [Nutrition and skin](https://www.vivaderm.de/guide-nutrition-skin-en.html) – How sugar stiffens collagen (glycation), which nutrients the skin actually… - [Pigment spots](https://www.vivaderm.de/guide-pigmentation-melasma-en.html) – Sun spots, melasma, marks after acne: why they arise, why sun protection is… - [Skincare](https://www.vivaderm.de/guide-skincare-what-works-en.html) – Retinoids, vitamin C, sunscreen, hydration: the four ingredient groups with… - [Sleep and skin](https://www.vivaderm.de/guide-sleep-skin-en.html) – Why the skin regenerates at night, what chronic lack of sleep does to… - [Smoking and skin](https://www.vivaderm.de/guide-smoking-skin-en.html) – How smoking breaks down collagen, throttles blood flow and deepens lines… - [Sun protection](https://www.vivaderm.de/guide-sun-protection-en.html) – Why UV light causes about 80 % of visible skin ageing, how much sunscreen is… - [Tear trough](https://www.vivaderm.de/guide-tear-trough-why-difficult-en.html) – Dark circles have many causes – thin skin, pigment, volume loss, eye bags.… - [Splint or Botox?](https://www.vivaderm.de/guide-teeth-grinding-splint-or-botox-en.html) – Bruxism damages teeth, jaw joint and sleep. What the bite splint does, what… - [Drips: hype or benefit?](https://www.vivaderm.de/guide-vitamin-drips-evidence-en.html) – What vitamin C, B-complex and micronutrient infusions can do, where the… - [Face after weight loss](https://www.vivaderm.de/guide-weight-loss-face-en.html) – After major weight loss – by diet, weight-loss injection or surgery – the face… ## Risks, warning signs, conditions. - [Allergies](https://www.vivaderm.de/guide-allergies-aesthetic-treatments-en.html) – Hay fever, nickel allergy, lidocaine intolerance, protein allergy: which… - [Autoimmune diseases](https://www.vivaderm.de/guide-autoimmune-aesthetic-treatments-en.html) – Hashimoto's, rheumatism, lupus, MS, myasthenia: which autoimmune diseases… - [Cheap offers](https://www.vivaderm.de/guide-cheap-offers-counterfeits-en.html) – Why Botox for 99 euros and fillers from the internet are dangerous:… - [Medications](https://www.vivaderm.de/guide-medications-interactions-en.html) – Which medicines matter before aesthetic injections: blood thinners, aspirin… - [Rosacea](https://www.vivaderm.de/guide-rosacea-aesthetic-treatments-en.html) – Redness, visible vessels, flushing: rosacea is common and sensitive. Which… - [Skin cancer screening](https://www.vivaderm.de/guide-skin-cancer-screening-en.html) – Aesthetic treatments care for the skin – they do not examine it. Why skin… - [Warning signs after filler](https://www.vivaderm.de/guide-warning-signs-after-filler-en.html) – Normal swelling or emergency? The signs of a vascular occlusion, infection or… ## Good practice, good decision. - [Aesthetics & mental health](https://www.vivaderm.de/guide-aesthetics-and-mental-health-en.html) – Aesthetic medicine can strengthen wellbeing – or mask a symptom. What studies… - [Salon or practice?](https://www.vivaderm.de/guide-beauty-salon-vs-medical-practice-en.html) – What beauticians may do (care, light peels, needling up to 0.5 mm) and what… - [Choosing a practice](https://www.vivaderm.de/guide-choosing-a-practice-en.html) – How to recognise a reputable practice for Botox and fillers: twelve questions… - [Unhappy – what now?](https://www.vivaderm.de/guide-unhappy-with-result-en.html) – You don't like the result, it looks asymmetric or too strong: when to wait… ## Timing, sport, holidays, durability. - [Exercise & treatment](https://www.vivaderm.de/guide-exercise-after-treatment-en.html) – How long after botulinum toxin, fillers, skin boosters, microneedling or… - [Making results last](https://www.vivaderm.de/guide-making-results-last-en.html) – Why botulinum toxin and hyaluronic acid wear off faster in some people, which… - [Summer & holiday](https://www.vivaderm.de/guide-summer-holiday-treatments-en.html) – Botox, fillers, microneedling in heat and sun: what works fine in summer, what… - [Timing before an event](https://www.vivaderm.de/guide-timing-before-an-event-en.html) – When should a treatment take place before an important date? Timeline for… ## What daily life does to the skin. - [Alcohol & skin](https://www.vivaderm.de/guide-alcohol-skin-treatment-en.html) – How alcohol ages the skin, why it promotes bruising before injections and how… - [Stress & skin](https://www.vivaderm.de/guide-stress-skin-en.html) – Chronic stress ages the skin faster, deepens lines through tension and teeth… - [Winter skin](https://www.vivaderm.de/guide-winter-skin-en.html) – Heated air, cold and little light stress the skin in winter. Why the barrier… ## What does it cost in Essen? - [Cost of Botox](https://www.vivaderm.de/cost-botox-essen-en.html) – Botox in Essen costs from €190 per zone at VIVA DERM, 2 zones from €280, 3… - [Cost of hyaluronic acid](https://www.vivaderm.de/cost-hyaluronic-acid-essen-en.html) – Hyaluronic acid fillers in Essen cost from €250 per millilitre at VIVA DERM, 2… - [Cost of hyperhidrosis](https://www.vivaderm.de/cost-hyperhidrosis-treatment-essen-en.html) – Hyperhidrosis treatment of the armpits in Essen: from €500 at VIVA DERM… - [Cost of lipolysis](https://www.vivaderm.de/cost-injection-lipolysis-essen-en.html) – Injection lipolysis in Essen: from €190 per session at VIVA DERM, billed under… - [Cost of lip filler](https://www.vivaderm.de/cost-lip-filler-essen-en.html) – Lip filler in Essen: from €190 for 0.5 ml, from €290 for 1 ml hyaluronic acid… - [Cost of masseter](https://www.vivaderm.de/cost-masseter-botox-essen-en.html) – Masseter Botox for teeth grinding or a slimmer face in Essen: from €400 at… - [Cost of microneedling](https://www.vivaderm.de/cost-microneedling-essen-en.html) – Medical microneedling in Essen: with PRP from €300 per session at VIVA DERM… - [Cost of polynucleotides](https://www.vivaderm.de/cost-polynucleotides-essen-en.html) – Polynucleotides in Essen: from €250 per area and session at VIVA DERM, billed… - [Cost of PRP hair](https://www.vivaderm.de/cost-prp-hair-essen-en.html) – PRP hair treatment in Essen: from €250 per session at VIVA DERM, billed under… - [Cost of skin boosters](https://www.vivaderm.de/cost-skin-booster-essen-en.html) – Skin boosters in Essen: from €250 per area and session at VIVA DERM, billed… - [Insurance & reimbursement](https://www.vivaderm.de/guide-health-insurance-reimbursement-en.html) – When aesthetic treatments are self-pay, when botulinum toxin is reimbursed… ## X or Y – honestly compared. - [Baby Botox or classic?](https://www.vivaderm.de/compare-baby-botox-or-classic-en.html) – Baby Botox is not a different product but a lower dose in more points. What… - [Filler or threads?](https://www.vivaderm.de/compare-filler-or-thread-lift-en.html) – Fillers replace volume, threads pull tissue upward. What both achieve, where… - [Jawline: HA or Botox?](https://www.vivaderm.de/compare-jawline-filler-or-masseter-botox-en.html) – Two treatments for the jawline with opposite effects: hyaluronic acid defines… - [Lipolysis or liposuction?](https://www.vivaderm.de/compare-lipolysis-or-liposuction-en.html) – Fat-dissolving injection or liposuction: for small deposits such as a double… - [Microneedling or PRP?](https://www.vivaderm.de/compare-microneedling-or-prp-en.html) – Mechanical stimulus or biological stimulus: microneedling and PRP both… - [Minoxidil or PRP?](https://www.vivaderm.de/compare-minoxidil-or-prp-hair-en.html) – Minoxidil is the proven standard, PRP the medical supplement. Principle, time… - [Needle or cannula?](https://www.vivaderm.de/compare-needle-or-cannula-en.html) – Sharp needle or blunt cannula: the choice affects bruising, precision and the… - [PRP or polynucleotides?](https://www.vivaderm.de/compare-prp-or-polynucleotides-en.html) – Own-blood plasma or DNA fragments from salmon: both stimulate the skin to… - [Skin booster or filler?](https://www.vivaderm.de/compare-skin-booster-or-filler-en.html) – Both are hyaluronic acid – yet two different treatments. Skin boosters improve… - [Skin booster or meso?](https://www.vivaderm.de/compare-skin-booster-or-mesotherapy-en.html) – Both are injected across the skin – with different substances. Skin boosters… ## What makes sense in which decade. - [At 60 and beyond](https://www.vivaderm.de/aesthetics-at-60-and-beyond-en.html) – From 60 it is about freshness and skin health, not youth. What skin boosters… - [In your 30s](https://www.vivaderm.de/aesthetics-in-your-30s-en.html) – Between 30 and 39 it is about prevention: sun protection, retinoid, if needed… - [In your 40s](https://www.vivaderm.de/aesthetics-in-your-40s-en.html) – Between 40 and 49 lines become static, cheeks and temples lose first support… - [In your 50s](https://www.vivaderm.de/aesthetics-in-your-50s-en.html) – Between 50 and 59 volume loss, thinner skin and first slackening shape the… ## Getting here from the Ruhr area and Rhineland. - [From Bochum](https://www.vivaderm.de/aesthetic-medicine-bochum-en.html) – Private practice for aesthetic medicine in Essen-Rüttenscheid, easy to reach… - [From Bottrop](https://www.vivaderm.de/aesthetic-medicine-bottrop-en.html) – Private practice for aesthetic medicine in Essen-Rüttenscheid, easy to reach… - [From Dortmund](https://www.vivaderm.de/aesthetic-medicine-dortmund-en.html) – Private practice for aesthetic medicine in Essen-Rüttenscheid, easy to reach… - [From Düsseldorf](https://www.vivaderm.de/aesthetic-medicine-duesseldorf-en.html) – Private practice for aesthetic medicine in Essen-Rüttenscheid, easy to reach… - [From Duisburg](https://www.vivaderm.de/aesthetic-medicine-duisburg-en.html) – Private practice for aesthetic medicine in Essen-Rüttenscheid, easy to reach… - [Essen-Rüttenscheid](https://www.vivaderm.de/aesthetic-medicine-essen-ruettenscheid-en.html) – Private practice for aesthetic medicine in Essen-Rüttenscheid: Botox, fillers… - [From Gelsenkirchen](https://www.vivaderm.de/aesthetic-medicine-gelsenkirchen-en.html) – Private practice for aesthetic medicine in Essen-Rüttenscheid, easy to reach… - [From Herne](https://www.vivaderm.de/aesthetic-medicine-herne-en.html) – Private practice for aesthetic medicine in Essen-Rüttenscheid, easy to reach… - [From Mülheim](https://www.vivaderm.de/aesthetic-medicine-muelheim-en.html) – Private practice for aesthetic medicine in Essen-Rüttenscheid, easy to reach… - [From Oberhausen](https://www.vivaderm.de/aesthetic-medicine-oberhausen-en.html) – Private practice for aesthetic medicine in Essen-Rüttenscheid, easy to reach… - [From Wuppertal](https://www.vivaderm.de/aesthetic-medicine-wuppertal-en.html) – Private practice for aesthetic medicine in Essen-Rüttenscheid, easy to reach… ## Sources - [NHS: non-surgical cosmetic procedures](https://www.nhs.uk/conditions/cosmetic-procedures/non-surgical-cosmetic-procedures/) - [Medical Association North Rhine – patient information](https://www.aekno.de/patienten) - [§ 630e BGB – duty to inform before treatment (German Civil Code)](https://www.gesetze-im-internet.de/bgb/__630e.html) - [DGBT – German Society for Aesthetic Botulinum Toxin Therapy](https://www.dgbt.de/) - [AWMF – German clinical practice guidelines](https://www.awmf.org/) --- This page is general information and does not replace medical consultation and informed consent (§ 630e BGB). No guarantee of results. Prices are guide prices per GOÄ. Quoting with attribution (VIVA DERM, Essen) is expressly permitted.