Injectables: Botox®, Dysport®, Sculptra®, Facial Dermal Fillers

A Premiere Medi Spa for Botox®, Dysport®, Sculptra®, and Injectable Dermal Fillers.

Visible signs of facial aging occur over time as a result of sun exposure, heredity, gravity and life style. Over the years, our faces lose their fullness, skin loses elasticity, and a lifetime of laughs and frowns become etched on our faces leaving permanent creases, lines, and wrinkles. Frown lines between our eyes can become particularly annoying, making us look angry or worried even when we are not.

Facial wrinkles and folds begin to show in part because collagen beneath the skin's surface starts to break down. In the past, facial plastic surgeons only had surgical options in their armamentarium to correct wrinkles, folds, and creases. Procedures like excision or implantation of fat, collagen, or silicone often provided minimal improvement and exposed patients to the risks associated with surgery. Fortunately, thanks to science and technology, things have changed and nowadays softening of facial lines and restoring volume and contour can often be achieved non-surgically with lasers, such as laser resurfacing, injectable products, such as dermal fillers, and muscle relaxers, such as botulinum toxin type A (Botox, Dysport, and Xeomin).

It is important to note that different type of creases, folds, and wrinkles require different types of treatments. Generally speaking, under eye hollows, creases and folds on the lower part of the face (like between the nose and the mouth, the angle of the mouth or the smile lines) are best treated with fillers. These creases and folds may be made worse by facial expressions but are usually present at rest. On the other hand, creases and wrinkles in the upper face (like the crow's feet, frown lines and forehead lines), known as dynamic wrinkles (related to movement) because they are commonly most obvious with facial expressions, are best treated with a muscle relaxer, such as BOTOX or Dysport, which limit the movement of the muscles that give rise to these wrinkles. Although classified as dynamic, in advanced cases upper facial wrinkles often become permanently etched in even at rest. In these cases, additional filler injections or laser resurfacing may be needed for optimal results. When the predominant presenting problem is widespread superficial static wrinkling of the face, the best option may be full or fractional laser resurfacing as well as chemical peels.

Applications of Botox, Dysport, and Xeomin in Cosmetic Surgery

These Botulinum type A formulations work by temporarily blocking the signals from the nerves to the muscles, thereby relaxing muscles and reducing their movement — the root cause of dynamic wrinkles. Botox, Dysport and Xeomin have a lot in common, but they also have some differences that are likely to mean more to the physician than the consumer. For example, Xeomin is the only one of the three that does not need to be refrigerated before use. Dr. Dishakjian, the cosmetic surgeon at the Center, will decide, after consulting with you, which product works best for you.

BOTOX® is a purified protein produced by the Clostridium botulinum bacterium. Botox injections smooth out wrinkles and creases by reducing the activity of the muscles that cause frown lines, crow's feet, and the frontalis (forehead lines) that form over time. One 10-minute treatment, a few tiny injections, and within days there's a noticeable improvement in furrowed brows and moderate to severe glabellar lines (the vertical lines between the eyebrows), crow's feet, and the frontalis. The improvement can last up to four months. Results may vary; however, in general, fewer injections are needed after the second or third year.

Although considered off-label use, Botox is nowadays being used for many other aesthetic enhancement purposes; jaw line contouring or slimming being one of the most important applications. This is a convenient alternative to a complicated jaw bone reduction plastic surgery, because Botox injections require no downtime and the procedure is safer, faster, and less expensive. The full slimming effect becomes apparent approximately two weeks after the treatment and the results can last anywhere from four to nine months.

Please go to applications of Botox in cosmetic surgery to read about the conditions that are conveniently treated with the product.

You may also be interedted to read Botox, Dysport, and Xeomin FAQs, for answers to frequently asked questions about these products.

BOTOX FOR CROW'S FEET

BOTOX FOR JAW LINE REDUCTION

Dysport® - Although Dysport has been successfully used in Europe and the Americas for over 17 years, and has a proven track record of safety and success in the United Kingdom, Germany, and many other European countries, the U.S. FDA approved Dysport for cosmetic use only on May 2009. Like Botox, Dysport is administered via injections at the site of wrinkles and acts by temporarily weakening the facial muscles, which then smooth and soften the facial wrinkles and lines caused by excessive action of these muscles. The result is a face that looks fresher and younger.

Dysport is made from the same active ingredient as Botox (made by Allergan), Clostridium botulinim toxin type A. However, the manufacturing process of Dysport is slightly different, resulting in slight differences in its clinical use for cosmetic purposes. For instance, Dysport may provide a little faster onset of action and has a greater 'spread' (giving a more 'natural' look) compared to Botox. Botox, on the other hand, tends to remain more localized, allowing for greater precision in the treatment area, but possibly requiring more injections in the course of a treatment. There are also claims and suggestions that Dysport results might last up to a month or even two beyond that of Botox. The unit dosage of each product is also different and accordingly different number of units have to be used to achieve comparable results.

Dr. Dishakjian, of the Medical Spa, has worked with both products and is fully comfortable using either product to his patient's benefit. Having alternative products to choose from is always beneficial for patients, as it enables the physician to choose the best treatment according to each patient's individual needs, previous responses to treatment, and patient expectations.

Xeomin® - The Food and Drug Administration (FDA) approved Xeomin in July 2011 for the treatment of severe frown lines or "11's" between the eyes. Like Botox and Dysport, Xeomin is Botulinum type A formulation in which the complexing proteins present in the other two commercial preparations have been removed. Xeomin is said to be more like Botox than Dysport. It takes about one week for the full effects of Xeomin injections to be realized, and once this occurs, the results last from three to six months.

Dermal Fillers for Folds, Hollows, and Creases

Dermal fillers are a range of products that fill depleted facial features. Sagging skin in the jaw line and cheeks, under-eye hollows and wrinkles around the mouth and nose are best treated with dermal filler injections. Advanced dermal fillers include Restylane, Perlane, Radiesse, Juvederm, and Sculptra. Although each dermal filler has its unique attributes, in general, most dermal fillers plump and lift the skin gently either by replacing the lost collagen or stimulating the body to produce its own natural collagen; some help more than others. With the exception of a few, the plumping effect of most dermal fillers is almost instantaneous and last from several months to a year or two before touch up treatments are necessary to extend results.

Restylane® - approved by the FDA in late 2003, is an effective, non-surgical facial treatment designed to slow and hide the effects of aging. Restylane® filler injections are composed of a clear hyaluronic acid-based gel that not only fills in lines and wrinkles in the face, but also adds moisture and lubrication to the skin, making it feel younger and more comfortable. Results are particularly effective around the mouth and nose and are shown to last six months or more.

Restylane® is administered in the doctor's office performed under local anesthesia and takes anywhere from a few minutes to a half hour.

Perlane® - This dermal filler is manufactured by Medicis Aesthetics. This is the same company that makes Restylane. Both Resylane and Perlane are hyaluronic acid-based soft tissue fillers. Perlane is slightly thicker and more viscous than Restylane, and may be a better bet for filling deeper lines.

Radiesse® is a safe, next generation dermal filler that volumizes the facial structure. Radiesse® treatment restores a natural, youthful look that may last for a year or more. Numerous medical studies have shown that Radiesse is a safe and effective treatment for filling and correcting smile lines, nasolabial folds, and wrinkles around the nose and mouth. Radiesse stimulates the body to produce new collagen, providing immediate, visible improvement of folds and wrinkles, and provides long-lasting and beautiful results.

Radiesse® is made of unique calcium-based microspheres that are suspended in a water-based gel and injected into the skin through a simple, safe, and minimally invasive procedure.

RADIESSE FOR NASOLABIAL FOLDS AND UNDER EYE HOLLOWS

BEFORE & AFTER GALLERY. Click here...

Juvéderm™ is a smooth consistency gel made of hyaluronic acid, a naturally occurring substance in your skin, which helps add volume and hydration. Your physician injects Juvéderm™ under the skin to instantly restore your skin's volume and smooth away facial wrinkles and folds, like your "smile lines" or "parentheses" (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth).

FILLER INJECTION FOR UNDER EYE HOLLOW AND CHEEK AUGMENTATION

Sculptra® Aesthetic is indicated for the correction of shallow to deep nasolabial folds (smile lines) contour deficiencies and other facial wrinkles, which are considered to be the hallmark signs of facial aging. On average, three treatment sessions are needed over a period of a few months to produce gradual, subtle results that can last up to two years after the last treatment session. Patients who have undergone Sculptra® Aesthetic injections are described as not only looking younger, but also looking like themselves.

RESTORING FACIAL VOLUME AND FILLING FOLDS WITH SCULPTRA AESTHETIC

While the Sculptra® Aesthetic has been available in Europe for a decade and has been used off-label in cosmetic applications for a long time, the injectable facial filler received FDA approval for its cosmetic use only in 2009. The FDA approval of Sculptra® Aesthetic broadens the landscape of what plastic and cosmetic surgeons can offer to patients seeking long lasting and natural looking results from an aesthetic injectable. In fact, Sculptra® Aesthetic, previously marketed under the name Sculptra®, was the first product of its kind approved by the FDA for restoration and/or correction of the signs of facial fat loss, or lipoatrophy, in people with human immunodeficiency virus (HIV).

Sculptra® Aesthetic is a synthetic biocompatible (does not harm the body) and biodegradable (able to be broken down by the body) product. Hence, it does not require a skin test. Unlike most other facial fillers, Sculptra Aesthetic is a collagen stimulator; that is, it reshapes the face with the patient's own collagen. Sculptra® Aesthetic works by filling a wrinkle with small amount of PLLA beads, which gradually break down as the body produces its own collagen at the site of injection. No serious adverse events are reported with the dermal filler, except for occasional small bumps and lumps, which resolve on their own.

Click Sculptra Aesthetic - FAQs for answers to frequently asked questions about Sculptra Aesthetic.

Fat Grafting or autologous fat transplantation or micro-lipoinjection plumps up facial features using the patient’s own fat. Fat transfer to the face is a safe, natural, non-allergenic procedure designed to recontour your face or other areas of the body, and can provide definition to your cheeks and chin. It can also be used to correct facial deformities. Since fat transfer uses your own fat cells, allergic reactions are avoided. Results are long-lasting, and have been proven to last about three years.

Fat transfer is performed in our facility using local anesthesia on both areas affected by the procedure - from where the fat is taken, and the treatment site where the fat is re-injected. Using a small needle attached to a syringe, fat is removed from a donor site where your fat is most tightly packed, such as your abdomen or your buttocks. Read more about body contouring and fat transfer procedure...

Questions About Cost or a Treatment?

You may reach our Los Angeles medical spa and clinic by clicking the "Contact us" button at the top of the page, or by calling 818-832-4500. Our receptionist will be delighted to assist you with any enquiries regarding cost, additional information, or scheduling a free consultation session with Dr. Dishakjian, a cosmetic surgeon and phlebologist.