Non-Surgical Rejuvenation with Injectables in San Francisco, CA

What Are Non-Surgical 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

The neuromodulators that Dr. Fisher offers include Botox Cosmetic, Jeuveau, 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.

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Botox Cosmetic is a neuromodulator 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
  • Migraines

Baby Botox

Many young people in their 20s and 30s are interested in the idea of preventive Botox. This is a procedure referred to as “Baby Botox” where small amounts of Botox Cosmetic are placed in certain areas that are overactive allowing a subtle outcome which also results in the prevention of deep wrinkles over time. This works well before any lines have formed in the first place but where it is clear that the muscles are hyperactive with movement, for example as on the forehead where are horizontal lines tend to form due to genetics, stress, or aging.

Dysport, Xeomin, and Jeuveau/Newtox

Dysport, Xeomin, and Jeuveau are also neuromodulators like Botox, with similar mechanisms of action and similar indications. Other than being different brands, they may also vary somewhat in their onset of action, duration, side effects, and price point. These different products work more or less effectively in different people and having alternatives for different patients is important.

Recently-released Jeuveau, also called Newtox, is the latest neuromodulator on the market.

If you have questions regarding which one is right for you or would like to try a neuromodulator for the first time, please schedule a consultation or treatment appointment with Dr. Fisher online or by calling ‭650-460-7260.

What Are Dermal 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. Dermal Fillers can also be used for Non-Surgical Rhinoplasty.

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 nasolabial 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 the 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 severe facial lines & wrinkles. Belotero is ideal for delicate areas around the mouth.


Other Injectables

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:radiesse

  • Nasolabial folds
  • Marionette lines
  • Corners of the mouth
  • Jowl pre-sagging
  • Chin wrinkles


RenuvaRenuva 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 Injections

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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Contact Us today at ‭650-460-7260 if you would like to schedule a consultation with Dr. Orna Fisher at our office in Palo Alto, CA in the San Francisco Bay Area.

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