Interventions to graceful ageing Question Title * 1. What is your Name and Surname? Question Title * 2. Which Renewal Institute branch do you visit most often? Bedfordview Brooklyn Cape Quarter Claremont Constantia Durban Fourways Illovo Irene Morningside Parkhurst Paarl Stellenbosch Umhlanga West Rand Willowbridge Question Title * 3. If you would like to receive communication from The Renewal Institute, please enter your email address below Question Title * 4. Please select your gender? Male Female Question Title * 5. Please select your age group: 18-25 26-35 36-45 46-55 56-65 Above 66 Question Title * 6. In your opinion, what is a good age to start anti-ageing injection treatments? from 25 year of age from 35 years of age from 45 years of age As soon as I see the first wrinkle Question Title * 7. Injectables such as botulinum toxin and dermal fillers are the most popular anti-ageing treatments. Have you had either of these intervention treatments done to prevent signs of ageing? Yes No Question Title * 8. At which age did you have your first botulinum toxin or dermal filler treatment? Between ages 20 - 30 Between ages 31 - 40 Between ages 41 - 50 Between ages 51 - 60 61+ I have never had this treatment done before Question Title * 9. In which of the below areas have you had botulinum toxin done: Between the eyes Crow's feet (around the eyes) Forehead Eyebrow lift Chin Smoker's lines Under Eyes Jowls, or for jawline definition Botulinum toxin for migraine treatment Botulinum toxin for TMJ / Bruxism (teeth grinding) I have not had botulinum toxin (Botox / Dysport) treatment. Other (please specify) Question Title * 10. As we age, the body's collagen and elastin fibers break down. This leads to volume loss, and crepey skin that can be corrected with the strategic use of dermal fillers. In which of the following areas have you had dermal fillers done: Cheeks for volume replacement and smoothing of wrinkles Around the eyes for Crow's feet Temples to add volume and shape Under eye for reduced eyebags Corners of the mouth, for correcting a mouth frown Around the mouth to treat smoker's lines Jowls, or for jawline definition Lips, for added volume and shape I have not had any dermal filler treatment. Other (please specify) Question Title * 11. Have you ever had PDO or Silhouette Soft skin threading treatments, to lift and tighten sagging skin? Yes No Question Title * 12. The skin needs regular in-salon treatments for effective anti-ageing benefits. Products alone are not enough. Have you had any anti-ageing skin treatments done? Yes No Question Title * 13. What facial anti-aging treatments, aside from injectables, have you had: Laser treatments (Laser Genesis, Fraxel Dual, Titan, Limelight) Skin Needling Chemical peels Radiofrequency Carboxytherapy Photo Dynamic Therapy Other (please specify) Question Title * 14. Following a skin care regime, customised to your skin's needs, is vital to give your skin daily nourishment, corrective and protective benefits. Do you have prescribed skin care and a daily routine? Yes No Question Title * 15. To help prevent premature ageing the most important factor is to stay out of the sun! To protect your skin it is vital that you apply a broad spectrum SPF each and every day. Do you use daily SPF? Yes No Sometimes Question Title * 16. Which area of your face is the most bothersome, and showing signs of ageing? Eye area (dark circles, fine lines, and thinning skin) Hollow cheeks and temples Deep mouth frown lines Decreased volume in lips Excessive frown lines Excessive facial wrinkles Sun damage and pigmentation Other (please specify) Question Title * 17. Would you like a Renewal Institute staff member to contact you to discuss the survey and what we can do for ageing concerns? Yes No Done
