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Botox/Dermal Fillers

Botox: An Exciting Treatment for Facial Lines

BotoxMaintaining a youthful appearance has become an accepted part of mainstream American culture. The aged appearance of the face may be related to sagging of tissues, sun damage to the skin, and the development of deep “dynamic” lines caused by the repeated action of the delicate facial muscles found under the skin’s surface with laughing, frowning, and smiling. Dynamic lines usually appear between the eyebrows, on the forehead, and at the outside corners of the eye in the “crow’s feet” region and may suggest that someone looks is worried, tired, or angry. An effective, safe, nonsurgical, treatment for dynamic lines is now available.

With a procedure known as chemodenervation, Botox, a purified version of the substance responsible for botulism, is used to soften or even eliminate dynamic facial lines. Botox exerts its effect by blocking the impulses from the nerve to the facial muscles responsible for the development of dynamic lines. Following a Botox injection, the muscles gradually become relaxed, allowing the overlying skin to appear smooth and unwrinkled. Untreated muscles are not affected by a Botox injection, allowing normal facial expression to be unaffected.

The cosmetic denervation treatment is simple and safe. A tiny microneedle is used to deliver a minute, exact amount of Botox into several locations on the face. Because the needle is so fine and the amount of liquid injected is so small, the pain associated with injections is minimal. Sedation or anesthesia is not required, and there is no special recovery Period necessary. Mild bruising may occur at injection sites, but they may be easily covered with makeup. The result of the injection usually becomes apparent within 2 to 4 days.

The effect of a Botox injection generally lasts from three to six months. Injections are given when the effects of the previous treatment begin to wear off. Initially, patients receive from 2 to 4 treatments per year. After receiving several treatments, many patients find that they require Botox even less often. Some even find that they have achieved a permanent improvement, although this is the exception rather than the rule.

The side effects of Botox are minimal and are not permanent. Each molecule of Botox is relatively large, and thus does not migrate far from its injection site. Consequently, the effects of a Botox injection are limited to the area into which it is delivered. Rarely, an eyelid may droop temporarily. Many patients express concern about the total dose of drug administered. While this is a valid question, Botox has been used in doses many times greater than that required for cosmetic denervation for more than ten years to treat patients with various muscular spasms and disorders. There have been no reports of adverse systemic side effects even with administration of large doses on a regular basis for many years.

There are very few (if any) cosmetic procedures which may be performed as quickly, safely and effectively as Botox injections and, not surprisingly, patient acceptance of this procedure is extremely high. Botox injections do have limitations. Sagging of the jowls, eyelids, or eyebrows requires surgical lifting, and sun damaged skin is best rejuvenated with a laser treatment or chemical peel. Botox should be given only by a physician experienced in its use.

Fat Transplantation: Another Technique

Fat Transplantation is another technique that can be used to treat dynamic wrinkles. It is also useful for correcting facial grooves and depressions. The patient’s own fat cells are removed with low-pressure liposuction using local anesthesia. The fat is processed and then injected into the area that requires treatment. In most cases, two to three transplants are needed to achieve the best results.

Dermal Fillers

BotoxAs our bodies age, our skin also ages and begins to show changes that may be undesirable. The fat and collagen underlying our skin begins to diminish due to the natural aging process. Therefore, our skin starts to sag and develop wrinkles. One way to correct these effects is a surgical procedure called a face lift, which is costly and is an invasive procedure that has risks. Dermal fillers are a minimally invasive procedure with little or no recovery time, which costs less then surgery and has minimal risks. Dermal fillers have become a very trendy way to address the aging process.

Dermal fillers can be injected into areas with fine lines and wrinkles. Most of the problem areas include the area around the eyes, brow, bridge of the nose, mouth, jaw line and cheeks. Other areas that can be enhanced by dermal fillers include the lips, which can look fuller and younger after an injection. Scarring from injury to the face or acne can also be corrected with dermal fillers.

There are many different types of dermal fillers which include human collagen, hyaluronic acid, donor tissue fat and even one’s own fat (autologous fat). Each of the dermal fillers has different strengths and weakness, some last longer than others, sometimes a combination of different fillers may be used for best results. Dermatologists can formulate a specific treatment for each individual patient.

Bovine collagen was the first legally approved soft tissue augmentation in the U.S. Bovine collagen is derived from domestic cattle; therefore, Mad Cow Disease is a risk factor that may limit their use. Some patients may be allergic to bovine collagen therefore skin testing is required before they can be used. Bovine collagen is not used much anymore due to the availability of human collagen and other more superior filling agents.

Human collagen does not require skin testing and therefore may be more favored. Hyaluronic acid gives skin volume by binding to water and requires no skin testing. Autologous fat is usually taken from the thighs, buttocks or stomach by a micro liposuction procedure. Calcium hydroxyapatite degrades slowly; therefore the result is longer lasting. Some other dermal fillers include, poly-L-lactic acid, polymers and collagen related implants, and many new products that are constantly being researched.

Common side effects of dermal fillers include bleeding or bruising after the procedure. Allergic reactions have also been reported. Superficial beading of the overlying skin immediately after the procedure may be disturbing to the patient; reassuring the patient that it usually resolves spontaneously with time may be necessary. Patient should expect some degree of pain during the injection and redness for up to 36 hours after the procedure. Application of ice to the injection sites can decrease these symptoms.

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