BOTOX® Cosmetic
Injectable Fillers: Restylane®/Perlane® - Juvéderm™ - Radiesse® - Sculptra™ - Autologous Fat
BOTOX® Cosmetic
 Over the past several years, Botox® has been the number one non-surgical aesthetic treatment performed in the United States. Botox improves facial appearance by softening unwanted lines of facial expression.
Facial lines develop perpendicular to muscle contraction. When a muscle is overactive, deep creases are seen. This is commonly seen between the eyebrows (glabella), in the crow's feet around the eyes, and on the forehead. Botox injected into these muscles reduces their activity and dramatically diminishes these lines. The effect from Botox typically takes 3-5 days to be seen and usually lasts 3-4 months.
Prior to a Botox treatment, patients should take a few precautions to minimize bruising and bleeding. These include avoidance of aspirin and non-steroidal anti-inflammatory medications such as Advil or Motrin for 2 weeks prior, and avoidance of St. John’s Wort or high doses of vitamin E for 1 week.
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Injectable Fillers
In youth, skin is smooth and elastic with a healthy glow. With aging, the ability to maintain that youthful texture and elasticity diminishes, resulting in skin that becomes drier, thinner, and less able to replenish itself. The body’s natural collagen levels decrease, and skin becomes loose, resulting in wrinkling and deepening of the folds from the nose to corner of the mouth (nasolabial folds) and from the corner of the mouth to the chin (marionette lines). Typically, there is also a loss of volume in the lips and cheeks. In conjuction with a comprehensive skin care regimen, injectable fillers can help to rejuvenate the face.
Restylane®/Perlane®
Restylane® is a clear, transparent gel composed of hyaluronic acid, a natural substance found throughout the body, which can be used to smooth wrinkles, sculpt lips, and fill facial contours. Approved by the FDA, Restylane has been used safely by plastic surgeons worldwide since 1996. The hyaluronic acid found in Restylane is not of animal or human origin, so there is no need for skin tests, and the risk of side effects is extremely low. With its unique ability to bind with water, Restylane will typically provide results that last 4-6 months. Perlane is a modified form of hyaluronic acid from the makers of Restylane which lasts at least 6 months.
Juvéderm™
 Juvéderm™ is also a hyaluronic acid filler which was released for general use in the United States in late 2006. This product is similar to Restylane, but is more cross-linked, which will theoretically allow slower resorption of the injected material and maintain a longer lasting effect.
Radiesse®
 Radiesse® consists of very small, smooth calcium hydroxyapatite microspheres (CaHA). These microspheres form a scaffold through which your body’s own collagen grows, producing a long-term effect which lasts at least 12 months. It is a good alternative for both nasolabial folds and marionette lines, and can also be used to correct volume loss in the cheeks.
Sculptra™
 Sculptra™ is an excellent option for people with significant volume loss in the face, especially in the cheek region. Microparticles of Poly-L-lactic acid provide a gradual increase in dermal thickness. More than 1 treatment may be required to fully correct the contour deficiency, but the effects have been shown to last up to 2 years.
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Autologous Fat
Autologous fat grafting involves removing the patient’s own fat cells from one area of the body and injecting in into another to provide volume. This can be performed as a separate procedure or in conjuction with liposuction elsewhere in the body. The amount of fat that stays where it is grafted is less predictable than with commericial products, so patients are typically overcorrected to compensate for the initial resorption. Autologous fat can not only be used to improve volume loss in the nasolabial folds, marionette lines, and lips, but also in the hands and buttocks. Additionally, it can be used to correct contour defects from previous surgery. Fat is the only injectable filler which has the potential to last many years.
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Age: 40yo
Procedure: Fat grafting to nasolabial folds
Time after surgery: 6 months |
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Age: 34yo
Procedure: Fat grafting to upper and lower lips
Time after surgery: 6 months |
Prior to treatment with any injectable fillers, patients should take a few precautions to minimize bruising and bleeding. These include avoidance of aspirin and non-steroidal anti-inflammatory medications such as Advil or Motrin for 2 weeks prior, and avoidance of St. John’s Wort or high doses of vitamin E for 1 week.
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