Non-Surgical Rejuvenation with Injectables
Dr. Fisher performs a variety of non-surgical injectable procedures. These are procedures done for facial rejuvenation without requiring surgery. There are a number of products used for facial injections.
As with any cosmetic procedure, not every treatment is for every person so it is very important that someone qualified analyzes your face and helps you decide which procedure or procedures are right for you. This personalized assessment is key for avoiding the unattractive stereotype appearance that can result when one is injected by an unqualified person. These looks may include a frozen expression, “mephisto” or “Spock” brows, or “ducky” lips. Dr. Fisher specializes in personalized evaluations and treatments.
There are a number of injectable options depending on your needs. From Botox to hyaluronic acid fillers and Sculptra, a consultation with Dr. Fisher will help you determine what is right for you.
The neuromodulators that Dr. Fisher offers include Botox Cosmetic, Dysport, and Xeomin. These injectables work by paralyzing specific muscles of facial expression, for example the wrinkles between the eyebrows. When too pronounced, those wrinkles can make one look older, angry, or stressed. These injectables can soften these lines so that you appear smoother and more relaxed.
Using a very fine needle, the neuromodulator is injected directly into the facial muscles. No anesthetic is required for the treatment. Sometimes a numbing cream or ice packs are placed on the treatment area prior to injection.
The effect of neuromodulators is temporary and needs to be redone every 4 to 6 months in order to maintain the effect. Side effects of these neuromodulators are usually mild and temporary. Possible injection side effects include pain, infection, inflammation, tenderness, swelling, redness, bleeding, and bruising.
Botox Cosmetic is an injectable that treats moderate-to-severe facial lines and wrinkles caused by muscle contraction in the face. Treatment with Botox is the most popular non-surgical cosmetic procedure performed in the United States. The Botox injection includes a safe and purified form of botulinum toxin A. This blocks nerve impulses sent to muscles and stops them from contracting. Your Botox results are visible within 24-48 hours and are maximized in 30 days.
Botox is also used to treat a number of medical problems, including:
- Excessive sweating
- Overactive bladder
- Neck spasms
- Chronic back & jaw pain
Like Botox, Dysport also treats moderate-to-severe frown lines between the eyebrows. The injectable is placed directly onto the muscle and weakens it so it no longer contracts. Dysport is made by the same neurotoxin that is used in Botox. Dysport can also be used to treat excessive sweating, neck pain, and symptoms of cervical dystonia. Results of dysport are seen within a few days and can last up to 4 months.
Candidates for Dysport are adults less than 65 years of age who want temporary improvement in the look of the lines between their eyebrows and forehead. People who are pregnant, breastfeeding, or have a neuromuscular disease should not receive Dysport injections.
Slightly different from Botox and Dysport, Xeomin does not completely stop the facial muscles from contracting. Instead, this injectable modifies the contractions by inhibiting a body chemical from signaling all the nerves within the muscle to contract. Xeomin is useful in treating blepharospasm, or eyelid spasms. The number of injections necessary depends on the number of muscles to be treated. Results can be seen within a week and can last up to 12 weeks on average.
Hyaluronic Acid Fillers
The hyaluronic acid fillers, or HA fillers, include the Juvéderm and Restylane brands as well as Belotero & Versa. These are gels used to fill in deep lines on the face, such as the nasolabial folds (“smile line”). The gel is made from hyaluronic acid which is a naturally occurring substance in our skin and that’s why it makes such a great filler. These fillers can also make the face look more youthful by adding fullness to areas that have lost volume or to areas needing augmentation. Some HA fillers can be used specifically to augment the lips or to fill in lines around the mouth. Others can specifically be used to add fullness to the midface.
The effect of HA fillers needs to be redone periodically to maintain the effect. The exception to this is Voluma. This long-lasting new HA filler lasts for at least 2 years and is the only approved filler specifically for use in the cheeks and midface, restoring those youthful contours of the face.
Juvederm is the most popular hyaluronic acid injectable filler in the United States. Each product within the Juvederm family adds volume to different areas of the face including the cheeks, lips, and lines/wrinkles such as nasiolabial folds. The results of Juvederm are subtle, yet long lasting.
- Juvederm Ultra – This member of the Juvederm family add more fulness and plumps thin lips. Patients who receive the Juvederm Ultra treatment experience long-term results and satisfaction up to a year.
- Juvederm Voluma – Over time, with age, cheeks will begin to flatten and the skin may begin to sag. Juvederm Voluma will add volume to your cheeks for a more contoured and younger appearance. Voluma results are proven to last 2 years.
- Juvederm Volbella – Volbella is used to add subtle volume to the lips and to smooth the appearance of vertical lip lines. Most patients are satisfied with the results for about a year.
- Juvederm Vollure – Vollure is the newest addition to the Juvederm family. Vollure softens moderate to severe facial lines and wrinkles. This injectable will create a smoother and younger appearance that will last up to 18 months.
The Restylane family of fillers treat moderate to severe facial wrinkles and folds as well as volume to the lips. Restylane has proven to give natural looking results that create a more youthful appearance.
- Restylane Silk – This dermal filler will give you smoother, natural looking lips. This is the first FDA-approved product for lip augmentation and smoothing wrinkles around the mouth. Improvement in the lips are visible in under two weeks and results last up to 6 months.
- Restylane Lyft – This member of the Restylane family help lift and adds volume to your cheeks for a more contoured look. Lyft also treats moderate to severe wrinkles and folds. Most patients see 95% improvement 2 months after treatment and results can last more than a year.
- Restylane Refyne – Refyne was made to help smooth out those laugh lines (nasolabial folds). Restylane Refyne helps restore a natural look while continuing facial expressions. Patients are usually very satisfied with results.
- Restylane Defyne – Similar to Refyne, Restylane Defyne smooths out deep laugh lines using innovative cross-link technology. Defyne allows you to look younger and continue the natural movement and expression in your face.
Belotero Balance is another injectable filler that smooths and fills moderate to sever facial lines & wrinkles. Belotero is ideal for delicate areas around the mouth.
There are other categories of injectables that Dr. Fisher offers at her Palo Alto office. These include Sculptra, Radiesse Alolfill, Renuva, and PRP injections.
One example is Sculptra Aesthetic. Sculptra can be used to subtly add volume to your face over time. The improvement is gradual and gives a natural more youthful appearance. Multiple injections are generally required and the number depends on how much facial volume needs to be restored. The results are long-lasting compared with the HA fillers, lasting over 2 years.
Sculptra is particularly useful in the temple area. Temples atrophy or become more hollow as we age. In most people this starts in the late 40’s or early 50’s and is a tell-tale sign of aging. Sculptra restores volume to this area very effectively. Sculptra requires special training and can only be injected by specially-trained physicians.
Radiesse is an injectable filler used to reduce moderate-to-severe wrinkles, folds, and creases around the nose and mouth. Radiesse works by augmenting the skin’s natural collagen supply. It is a safe, effective, and long-lasting alternative to collagen injections and other dermal fillers.
Radiesse is effective in treating the following areas:
- Nasolabial folds
- Marionette lines
- Corners of the mouth
- Jowl pre-sagging
- Chin wrinkles
Renuva is an injectable that treats small-volume aesthetic irregularities. These include liposuction divots, cellulite dimples, and minor cosmetic irregularities that detract from smooth contours and flawless skin. This simple and fast treatment only takes 10 minutes.
PRP (platelet rich plasma) injections use components of the body’s own blood cells to rejuvenate and stimulate healing of the skin. There are several benefits to PRP therapy, including:
- All natural – it comes directly from the patient
- No risk of cross-reactivity, immune reaction, or disease transmission
- Minimally invasive
- Facilitates healing
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