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Facial Contouring and Sculpting

Agnes /

When we talk about slimming the face or contouring the face, this can be done in different fashions.  Typically the lower part of the face is what people want to slim down in order to have that V shaped face.  Over time and with age, the lower part of the face tends to sag a bit.  With age we tend to get what are called “Jowls” that hang down.  These jowls result from a lack of supportive tissue and deep fat, which typically helps hold everything up and in place. Slimming the face can also be useful if you have a very round face, and you are looking for more definition. Fillers are the easiest way to lift up a small amount of sagging from the lower face.  Fillers need to be placed in the midface to help volumize the areas that have lost their deep underlying structures, such as fat.  Fillers can be a slippery slope, because you need to have the right amount of filler placed so that you do not become over filled.  People will often try and talk you into fillers and more fillers to lift the lower part of the face, leading to an over filled fat looking face.  Fillers in the face should be used with caution, and used more for balancing the face. Kybella can be used to remove fat from the lower part of the face as well.  Kybella is injected carefully into the lower part of the face, and only into the fat areas.  The injection of Kybella will result in swelling for 2-3 days.  You must keep in mind the swelling that happens when injecting Kybella, since some people have severe swelling after.  Kybella will need to be done at least 3-4 times to get the desired results.  The problem with Kybella, is that is indiscriminately kills fat, and not always in the exact spot you may want. Agnes is a new way to precisely destroy small areas of fat.  With this procedure, we can target very small areas of the face to remove fat.  Agnes allows us to actually chisel out and sculpt the face.  With this procedure, there will be some mild swelling as well, but not to the degree Kybella swells.  When we use this machine, we always like to combine it with Morpheus8 to help tighten as well for best results.  Agnes is currently the best way to remove small areas of fat, and it is what we get the best r with.

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Dark circles under eyes

Injections /

One of the biggest complaints that people have are the dark circles under the eyes.  There are many different causes of darkness under the eyes, such as being tired, lack of volume under the eye, thinning skin, blood vessels, dehydration.  Unfortunately there are no creams out there that will cover this up or make it better.  Most people are not aware that there is a simple fix.  By placing dermal fillers under the eyes, called the tear troughs, this restores lost volume.  In most people, there is a fat pocket in this area that keeps it full and plump.  Many people have had sunken in areas around there eyes for many years, while others notice it later in life.  As we age, we loose fat (deep fat and superficial fat), by simply replacing the lost volume it will bring about a more youthful appearance. Our technique is different…  We use what is called a “Microcannula” to access the area under the eye.  Why is this important?  By using a microcannula, it travels under the skin and is a small flexible tube.  Due to the flexibility, the microcannula will not puncture blood vessels as easily as a standard hypodermic needle.  For this reason, areas that were thought to be too difficult to get to, can now be easily accessed.

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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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Med Spas To AVOID

Glo Medspa /

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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Glo Medspa Rated Highest in Arizona

Glo Medspa /

Why is Glo medspa rated and reviewed as the top medspa in all of Arizona?  For many reasons, such as there is ZERO sales pressure.  We do not try and sell you stuff you do not need in order to make a few bucks.  Our injectors do NOT work on commission, like many other places do.  Why is this an important point?  When injectors work on commission they will want to place as much product into your face as possible (or as much as your bank account will allow).  If you do not have enough money, many places will want you to finance your cosmetic procedures. Glo Medspa always approaches cosmetic injections with a “Natural” appearance and no Duck Lips.  We will always fix and touch up small things at no cost, where most places will charge you for touch ups.  We offer a friendly environment and online scheduling.  All of our staff is trained and up to date on all the latest procedures and attend conferences.

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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

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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Will I bruise with Botox

Botox, Uncategorized /

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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