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Restylane Kysse for lips

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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Med Spas To AVOID

I have spoken to a lot of people about miserable experiences they have had with other medspas.  Here is what I have learned, and maybe this can help you find the right place. -Does the medspa or office offering services refuse to give out prices over the phone?  This is a red flag.  A reputable office should be transparent with pricing so that you can get an idea of what you will spend before going in. -Do you get stuck in a room with a “Sales Consultant”?  I would say to just walk out at that point, because they are trained to suck as much money out of you as possible.  Sales associates work on commission and don’t care about your financial situation.  They will be more than happy to set you up on Care Credit to get you financed for your services. -Is the office dirty, and the front desk personal rude?  As they always say, first impressions are everything. -Always make sure you know how long the person has been performing the treatments that you are going to get.  Typically a new person will not have the same amount of experience as someone that has been doing that procedure for over a year. -Groupon?  Sometimes Groupon is great, but when it comes to messing with your face spend the extra couple of dollars. -Bait and switch.  I really hate to say it, but there are places that will advertise cheap prices for Botox, then switch another product.  Always offer to come back if they are out of something you really want.  Make sure the product is where you can see it. -Avoid places where people always talk bad about other medical spas.  When people talk bad about other places, it shows they are threatened by competition.  A good medspa will keep their opinions to themselves and focus on you the client.

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Voluma – Radiesse

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

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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Will I bruise with Botox

When doing Botox, it is hard to say if you will bruise.  There area areas that have a higher tendency to bruise, such as around the eyes.  There area a few things that will help reduce the chances of bruising, but there is never 100% chance of not bruising.  Many times it depends on the injector, whether they are aggressive with the needle, or do they take their time to look for blood vessels.  Things you can do to help reduce your chances of bruising are – Arnica Montana is a great homeopathic drug sold over the counter.  I typically recommend starting Arnica 3-4 days before injections.  Avoiding alcohol for a couple days before any injections will also help keep your blood from getting too thin.  Do not apply numbing cream to the area where you are getting injections.  Numbing cream causes the blood vessels to become dilated and puts you at a higher risk.  Ice before hand can help, but I never recommend ice after Botox, because it will interfere with the absorption.  If you get a really bad bruise, IPL laser can help break down the blood and help it heal much quicker.

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Botox

Botox is a great way to help reduce and eliminate wrinkles and fine lines.  I typically recommend starting Botox when you start to see fine lines in the forehead or around the eyes.  When adding Botox into your routine of anti-aging the benefits will pay off greatly down the road.  Many people ask what a good age to begin Botox?  Unfortunately there is no right answer since everyone has different types of muscle strengths.  I have had clients as young as 20 begin Botox, and other women starting at the age of 45.  When getting Botox for “preventative” measures, I generally let people know they need a smaller amount and not as frequent.  The best idea is to have a consult to determine whether Botox is right for you. Dangers of Botox… When injected incorrectly, Botox can cause a “Droopy eye” or when injected inside the orbital rim it can migrate into the muscles that move the eye causing a lazy eye.  I have personally injected hundreds of thousands of Botox units and have never had any serious problems.  The good thing is that Botox is not permanent and will wear off in 3-6 months.  I always encourage people to do their research before undergoing any type of cosmetic procedure.  There are plenty of good injectors, but finding the one you like can take time, so be patient and do your homework.

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Fractora

Fractora is a great non-invasive skin renovation without surgery.  Fractora is a subdermal tissue coagulation device that bridges the gap between fractional lasers and surgical procedures.  This is NOT a laser treatment.  Fractora has multiple functions such as helping to even out skin texture and improve collagen production.  Fractora is great for removing fine lines and wrinkles, cystic acne, scars, eliminate hyperhydrosis (excessive sweating), skin tightening, and stretch marks. Treatments with Fractora will not cause damage to the epidermis which typically leads to Post inflammatory hyperpigmentation (PIH) as most other lasers will.  Another amazing benefit is that Fractora can be used on darker skin types, which traditionally are not candidates for many laser treatments.

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Fibroblast Skin Tightening

Fibroblast skin tightening has become a hot new trend in 2018 for achieving permanent, long lasting results.  Fibroblast has been very popular in Europe and Canada, and now made its way into the US.  Fibroblast creates small currents of plasma energy to burn off a small portion of the skin, causing a reaction that tightens the skin.  The plasma energy stimulates the small fibroblast cells to produce more collagen and tighten up the skin. During the procedure, you are first numbed with a topical numbing cream to decrease the amount of pain.   Depending on the size of the area being treated, the procedure may take 20-30 minutes.   We generally suggest to split up big areas to allow swelling to resolve.  Areas you can treat would include upper eye lid, lower eyelid, face, labia, stomach, stretch marks, jowls, and much more. The downtime is about 5-7 days where you will have small dots from the device creating small burn marks.  These spots will scab up and flake off in about a week.  We recommend not picking at them or scratching them off since this may cause scars or hyperpigmentation. This is a fantastic new procedure that offers long lasting results.

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Lip Injections

Lip injections are defiantly an art.  Before getting your lips done, always look for pictures of what you like.  By showing photos to the injector, this will help them get a better idea of what they need to do.  Before lip injections, it is good to know if you have a tendency to get cold sores.  If you are prone to getting cold sores, I would highly recommend starting on an antiviral such as Valtrex the day before and day of the procedure. Do you research as far as what type of product they like to use for lip injections.  I prefer to use Juvederm Ultra XC, because of its longevity.  Other fillers such as Restylane, Volbella, Vallure, Bellotero are a total waste of time and money.  The reason I say this is due to the fact that the molecules in these fillers are very small and break down quickly.  Many inexperienced injectors like these fillers because they are easily correctable when they make a mistake. Always research and look at their before & after photos of lip injections that they have done.  Believe it or not, some places do a very poor quality of lip injections and actually steal pictures from other medspas and take credit for the work.  I hope this blog helped inform you about the decision to get your lips filled.  We perform thousands of lip injections and create some of the best lips.

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Botox

What to know before getting your first Botox treatment.  First, it is important to know if you have any muscular issues such as myasthenia gravis or bell’s palsy.  Many times when someone is getting Botox for the first time I recommend being a bit conservative.  With Botox, you can always put more in, but you can’t take it out.  By being a little more conservative it will possibly keep you from having any complications.  The dose of Botox needs to be enough to achieve results, but too much may cause complete lack of movement or possibly a droopy eye.  Typically it is not recommended to have Botox when you are pregnant or breast feeding.  Although Botox does not have systemic effects, I always recommend to be safe, rather than sorry. Is bruising common?  The face have many blood vessels and the chances of bruising is always present.  The most common place for bruising to occur is around the eyes.  The bruising has no effect on the results of the Botox.  Above all else, I always recommend doing your research and you get what you pay for.

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