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Botox, Dysport, Xeomin or Jeuvveau?

Botox /

Botox & Dysport…What is it used for and what age should I start? It might seem hard to imagine there was ever a time before Botox, but it is actually newer than you probably think. Botulinum toxin A has only been used for cosmetic purposes since 1996.  Over the course of its short history, Botox has become a household name. New applications have also been found for Botox in the cosmetic realm, from scalp injections to keep hair clean and styled longer, to foot injections to help avoid the pain associated with wearing high heels. Botox is used for treating areas of the face that are prone to developing lines and wrinkles from muscle activity.  Botox will typically last about 3-4 months, depending on the person and their activity level.  We find that people who workout a lot tend to need Botox / Dysport much sooner.  Immediately after the injections you can expect small bumps in the area that the Botox / Dysport was injected.  These small bumps will resolve in about 5-10 minutes as it is absorbed into the muscle. How long until it begins to work?  Botox will usually start working in 8-10 days, where Dysport will begin working in 3-4 days.  Xeomin and Jeuveau will typically take about a week to start working.  We recommend waiting at least 2 weeks before you see your final results. Which one will last the longest?  This is a very difficult question to answer, because there are many factors.  Some men have very strong muscles and may need more botox than others.  The more Botox, Dysport, Xeomin ect. that you put in, the longer it will typically last.  When you only use a small amount of Botox, Dysport the results tend to not last as long.  It is a very personal preference regarding how much Botox a person may want, and how much movement they want as well.  Too much Botox or Dysport may tend to have a negative effect by causing the eye lids to become droopy. What age should I begin Botox or Dysport?  This question should really be – How strong are the muscles?  I have women in their 50’s who have never had Botox or Dysport and they have no wrinkles.  I have women in their early 20’s already developing deep lines, so I goes to show age has nothing to do with it.  I generally recommend around 30 being a good age to start with a small amount.  Women doing Botox or Dsyport in their early 20’s as a means of prevention, I will recommend smaller doses at 6-9 months or even once a year.

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Science behind Facials

Hydrafacial /

Have you ever wondered what are the actual benefits of a facial?   Many people enjoy a facial because it is very relaxing and makes your skin glow.  There are actually many benefits you can gain from having a facial or HydraFacial. If you think that facials are a waste of an hour (and money), think again! Because your skin is missing out on something that’s good for it.  There are hundreds of pressure points on your face that are connected to various systems in your body. When these pressure points are massaged, your body will respond.  A good facial massage not just keeps your skin glowing, but it also affects the functioning of the other organs.  And since it is not possible for you to know all the pressure points, you need to visit a professional to get that facial massage. Facials help to thoroughly clean the face by unclogging the pores and exfoliating dead skin.  Exfoliation is the process where the dead skin cells are gently sloughed off your skin’s surface. The cells die and tend to pile up on the surface (if not removed), making your skin rough and dry. While you can exfoliate your skin using a scrub at home, if you want to remove the dead skin cells properly, going for a facial is the best option. It involves using chemical peels that thoroughly clean the skin surface, revealing a healthy layer of skin beneath. Regular facials and face massages increases cell regeneration and promotes collagen.  This gives you younger looking skin!  With age, your skin loses its elasticity as the production of collagen diminishes. During facial treatments, the professionals use chemical peels, face packs, masks, lotions, and creams that are enriched with botanical extracts that stimulate the production of collagen and reduce the signs of aging. Even if you do not have blemishes, hyperpigmentation, severe acne, or any other problems, your face needs to be pampered by a trained professional to keep it healthy. How often should you have a facial?  In an ideal world, a facial should be performed every 4-6 weeks to keep your skin looking fresh and remove old dead skin. HydraFacial uses patented technology to cleanse, extract, and hydrate. HydraFacial super serums are made with nourishing ingredients that create an instantly gratifying glow. HydraFacial is a skin treatment available in medical spas and dermatology offices. It’s also sometimes called “hydradermabrasion” because it involves microdermabrasion-like exfoliation combined with hydrating serums. Known for its three-step process, the HydraFacial works to deep-clean, exfoliate, and hydrate your skin. This professional procedure may help treat a variety of skin conditions, including acne, dryness, and wrinkles. The noninvasive procedure is similar in principle to a regular facial you might get from a spa but is said to provide more dramatic results. This is achieved by a mechanized wand used on your skin to deeply clean and exfoliate while delivering serums customized to your skin type. If you’re curious about whether a HydraFacial is worth the hype, read on to learn more about the potential benefits, the possible side effects, and how it compares to similar treatments.

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Get Rid of Cellulite Permanently

qwo /

The newest drug on the market for cellulite is called Qwo.  Qwo is an injectable medication that is painless, and uses a very small needle to administer it under the skin.  QWO is the first and only FDA-approved injectable for moderate to severe cellulite in the buttocks of adult women.  Visible results may be achieved in 10 weeks. In clinical studies, women received 3 treatments of QWO, 21 days apart. After the injections, there is typically some bruising that occurs, which is to be expected.  You should not receive QWO if you are allergic to any collagenase or the ingredients in QWO, or have an active infection in the treatment area.

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Restylane Kysse for lips

Injections /

For many years Restylane Kysse has been used overseas in Europe for lip injections.  Recently Restylane Kysse was approved by the FDA in 2020 for use in the lips for plumping and making fuller lips.  Restylane Kysse is also approved for perioral lines above the lips as well.  Up until now Juvederm has been our favorite filler to use in lips due to its longevity and ability to hold a shape longer.  The makers of Kysse have promised us that this new filler will last 12 months, which we are currently putting to the test.  The nice thing about this filler is that it is very soft and natural feeling.  As far as swelling goes, it is difficult to say if the swelling is less than that of Juvederm or other fillers.  As far as bruising, this all depends on the injector and their technique. Traditionally in the past, soft fillers would mean that it would not last long in the lips.  Because there is so much movement in the area of the mouth, soft fillers tend break down quicker.  Restylane Silk still remains our least favorite and we do not use it in the lips.  Restylane silk breaks down far too fast and we have many unhappy customers who were talked into Silk at other facilities.

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Best Filler For Lip Injections?

Juvederm /

After using every filler on the market in search of the holly grail, I have narrowed it down to only a couple of fillers.  I have injected every type of lip, with every type of filler, and we are talking about THOUSANDS of lips.  If you ever spend enough time on Instagram you will see all types of fillers being used to perform lip injections.  I will list the worst and best for lip injections- Starting with the WORST…Restylane wins hands down.  Unfortunately this filler is a very thin filler and looks great for a couple weeks, then say goodbye to those lips and you money.  Restylane is a great filler for people who do not like to do lip injections, or they are not good at lip injections.  Restylane is very pliable and corrects easily after any mistakes.  I have so many complaints, and people upset that they were pushed to use Restylane in the lips.  Restylane is sold as a “Natural and Soft” lip filler.  Unfortunately these injectors are heavily influenced by sales reps who have never touched a syringe, but regurgitate what their company tells them to say.   The second worst filler for lips would be Volbella, Vollure, or Belotero.  Again, these are too thin of fillers and break down extremely quickly.  These fillers do not hold their shape and are just too soft to last in a very animated area of the face.  The sad thing is I see many plastic surgeons using these fillers for lips… most likely because they are not good at doing lip injections.  These fillers should be reserved for other areas of the face, which they work very well in. My favorite is good old Juvederm Ultra XC.  Many years ago the drug reps told me to use Juvederm Ultra Plus XC in lips because “It lasts longer” which was not true.  Why did the rep want me to inject Ultra Plus???  Because it cost more.  Unfortunately now both Ultra and Ultra Plus are the same cost to buy.  Juvederm Ultra lasts about 6-12 months.  This filler will have a stiffer fell for the first 3-4 weeks until it softens.  We have had patients lip filler last Juvederm last 2-3 years!!! A new filler on the market as of today is Restylane Kysse.  So far we have heard good things about this filler, but we have not injected enough to know its true potential.  This filler has a much smaller needle (which generally means it is not a thick filler) which makes it much less painful for patients getting their lips done. These views on fillers are strictly our own point view, and the findings are after thousands of lip injections performed.

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Benefits of a Facial

Uncategorized /

Facials can be very relaxing as well as great for your skin.  Many people do not understand how important a facial is when it comes to detoxifying and cleaning the skin. Even if you do not have blemishes, hyperpigmentation, severe acne, or any other problems a trained professional will help keep your skin healthy and free of skin issues. The best way to find out if your skin needs anything or how it is reacting to hormones, pollution, stress, and other elements is to have a professional examine the tone and texture of your skin. At 48-72 hours after a facial, the skin is hydrated and plump.  In 28-48 days, the long term benefits of a facial kick in when cells begin to regenerate.  Facials should be done every 4 weeks to help maintain the beauty of the skin.  Remember, skin is the largest organ and you need to take care of it.

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Voluma – Radiesse

Injections /

Voluma and Radiesse are two favorites for cheek fillers.  Both produce great results, but each one has it’s own pros and cons.  Voluma is a nice soft filler that comes in a 1ml syringe, whereas Radiesse is a 1.5ml syringe. Radiess has some characteristics that are called “biostimulators”.  A biostimulatory filler will cause the body to produce more collagen over time.  We have seen Radiesse last for over 2 years due to these biostimulatory traits, where Voluma will last about 12 months.  Depending on how Radiesse is placed, it mimics a injectable implant and can be firm.  Radiess can also have a soft feel when slightly hyperdiluted to help fill in large hallow areas.  Voluma is much softer and very natural feeling, which many people like.  Radiesse will tend to cause more swelling after injections than Voluma. Both are great fillers, but we recommend having your provider let you know what would be the best for you.

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Botox – Dysport

Botox /

Botox is great for helping to reduce the lines on the forehead, between the eye brows and around the eyes.  Botox works in the muscle by blocking the impulse going to the muscle which causes it to contract.  When there are strong muscles, it causes micro injuries into the epidermis of the skin which cause lines to form where the muscle squeezes together.  Botox or Dysport will not fill in deep lines or wrinkles, so we suggest a “filler” at the point.  Fillers are gel substances that help plump up sunken areas or deep lines. What is a good age to start Botox?  It is hard to say exactly what age is appropriate, but we typically recommend around the age of 30.  A lot of this has to do with the strength of the muscles, and not so much about the age of the person.  We have had 20 year old women with very strong muscles, and I have had 60 year old women with no lines and have never had Botox or Dysport before.  When you are younger, we typically recommend Botox every 6-9 months as more of a preventative measure. Is Botox Safe?  We uses thousands of units every month and have never experienced any severe side effects.  Possible side effects may include a slight headache, blurred vision and flu like symptoms.  These possible side effects only last 24-48 hours and resolve on their own.

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Botox

Botox /

When injecting Botox, you can not inject everyone the same way.  Muscles vary in location from one person to the next.  Having a trained injector who has a great deal of knowledge about the facial muscles will make your Botox come out much better.  When doing an assessment of a person’s facial muscles it is best to have them make different facial expressions to evaluate the muscles. When going to a new place, it is important to know what you want and what you don’t want.  Many places work on commission and will try and up sell you on more Botox than you may even need.  The problem is, when you have too much Botox it can cause the forehead to get very heavy and make the eyelids droopy.  If you don’t get enough injected you will still have a lot of movement and the lines will never go away.  The other problem with treating sub-therapeutically, or placing too small of an amount is that it will not last very long. Typically for the forehead I find the sweet spot to be 30 units of Botox or 60 units of Dysport.  Around the eyes can be a tricky place to inject because it is the highest rate of bruising associated with this area.  Blood vessels are very difficult to see around the eyes and it is a very tender area.  If you place too much Botox around the eyes it will effect the way you smile.

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Facial Injections

Injections /

When performing facial injections I prefer to achieve a natural look.  One way of avoiding over filling of the face is to make sure you see plenty of before and after photos.  I always recommend asking for photos and bringing a photo of what you looked like 10 years ago.  A major problem as we age is volume loss.  We loose fat, muscle and bone over the years.  This fat loss will lead to sagging of the face, because fat acts as a support structure under the skin.  There is deep fat as well as superficial fat.  Area that may have a lot of animation, such as around the mouth area, tend to get more lines and wrinkles.  Over filling the face may leave you with no lines or wrinkles, but it will also make people appear very artificial and overweight.  There are many fillers on the market such as Juvederm, restylane, voluma, radiesse.  A good provider will know which filler is appropriate for different parts of the face.

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