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Botox, Dysport, Xeomin or Jeuvveau?

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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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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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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Non-Surgical Blepharoplasty

We are the only medical facility to offer a Non-Surgical blepharoplasty.  A surgical blepharoplasty removes excess skin from the upper eyelid when it is interfering and hanging over the eye. A non-surgical approach to a blepharoplasty is to use a small hand help device to perform “Fibroblast Skin Tightening”.  Glo Medspa is the ONLY place in all of Arizona to perform this procedure. The upper and lower eyelid can be corrected by performing a series of small burns with a plasma laser to tighten the skin.  Results are permanent, and there is very minimal downtime associated with this procedure.  There will be small marks on the eyelid that will flake off after 5-7 days. This treatment can also be used on any other past of the body to help tighten loose skin.  This is great for stretch marks, crepey skin on the face, sleep lines, neck, arms, knees, stomach.

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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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PDO Facial Threading

PDO facial threading has become a very popular procedure recently.  This procedure has actually been around for over 10 years, but has again gained traction in aesthetics.  Many years ago the “Threads” were made of a material that did not dissolve.  The new threads are now made of a material called Polydioxanone which dissolves over a period of time.  There are many different types of threads, which all depend on what area of the body you are working on. The results all depend on the providers experience and training.  Many providers try and use 3 or 4 threads to lift sagging skin.  When I perform a “thread lift” i generally do not like to limit myself on how many threads I use.  I always explain to people that the more threads I use, the better the weight is distributed and not relying on a few threads to hold everything up.  This is one of my favorite procedures because I get such great results.

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PDO Threadlift

Glo Medspa has been performing the PDO facial threadlift for over 2 years, and was the first in Arizona to offer this service.  We have seen many other medical facilities that have attempted to perform this procedure, but the results were very poor.  A few things I highly recommend before having this procedure performed.  First I highly recommend that you ask the person performing injections for “Before & After” photos.  Many medical professionals try and use 3 or maybe 4 threads to lift the face. Complications – Unfortunately when you only use 3-4 threads, the results are not the best.  The reason clinicians will use only 3-4 threads is to save money.  A few complications I have seen from other facilities are threads that are poking out, or threads coming out of the mouth.  When a thread is poking out against the skin, it means the thread was placed too shallow.  When a thread protrudes into the mouth, that means it was placed too deep.  There are other complications such as puckering or buckling that may resolve on it’s own.  Threads can also slip out of place or even break. Facial threading is a great alternative to a face lift if you are a candidate.  PDO threads will last up to 18 months and then slowly breakdown and are absorbed by the body.  The best thing about threads are that they appear very natural and reduce the amount of dermal fillers by over 50%.  There is generally no downtime with this procedure, but swelling can be expected for 4-5 days and tenderness for 2 weeks.

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