Injectables
The development of fine lines and wrinkles is often the earliest sign of facial aging. Many forces conspire to produce these wrinkles including loss of skin elasticity, loss of subcutaneous (fat) volume and the constant movement of our muscles of facial expression.
Fine lines and wrinkles are either “static”, meaning they are always present, or “dynamic”, meaning they are only visible when we are expressive, or both. The distinction between these two types of wrinkles is important when selecting an appropriate injectable.
An “Injectable” is any substance that is placed beneath the skin, typically in the face or neck, with a very small needle or cannula (blunt tipped needle). In general, injectables fall into one of two basic categories: volumizing (“filler”) agents or neurotoxins (muscle paralyzing agents).
Get In TouchVolumizing Injectables (Fillers)
If you think of a fine line or wrinkle as a valley, volumizing Injectables help to smooth these valleys out by adding volume underneath them, effectively pushing them out and making them more shallow. This provides patients with a more youthful and rested appearance. Features that are most frequently treated by volumizing injectables are:
- Static Wrinkles or lines (shallow, intermediate and deep) anywhere on the face
- Deep creases and folds (typically on either side of the nose or mouth)
- Hollows (cheeks, lower eyelids, temples)
- Recessed or indented scars
- Thin lips
Types of Volumizing Fillers
Two of the most popular, FDA-approved volumizing fillers are JUVÉDERM® and RADIESSE®. Both of these fillers are made of a natural sugar gel (hyaluronic acid) and both come in a variety of preparations. During your consultation Dr. Gougoutas will discuss the results you are trying to achieve and determine which product is most appropriate for you.
JUVÉDERM® XC
JUVÉDERM® XC improves the appearance of moderate to severe facial wrinkles, lines, and folds around the nose and mouth and restores natural contours to the face. JUVÉDERM® XC effectively treats nasolabial folds (parentheses lines on either side of the nose), vertical lip lines, lines at the corners of the mouth, and marionette lines *extending from the mouth to the chin). With just one treatment, the results from JUVÉDERM® XC may last up to a year.
JUVÉDERM VOLBELLA® XC
JUVÉDERM VOLBELLA® XC increases fullness in the lips and softens the appearance of lines around the mouth. Results from a single treatment with JUVÉDERM VOLBELLA® XC may last up to one year.
JUVÉDERM VOLUMA™ XC
JUVÉDERM VOLUMA™ XC is the first and only dermal filler made of hyaluronic acid that is FDA approved to instantly add volume to the cheek area for patients over 21 years of age. Results from JUVÉDERM VOLUMA™ XC may last up to two years.
Restylane®
Restylane® is an injectable gel made of hyaluronic acid that restores volume, smooths fine lines and wrinkles, enhances facial contours, and creates fuller lips. Results from Restylane® are instant and generally last six months to a year, although some studies show that results can last up to 18 months.
Fillers: The Procedure
Injectable fillers are strategically injected into the targeted areas with a small needle. The injections only take a few minutes per site, and the entire treatment process is usually complete within 15 to 60 minutes. Most fillers are also formulated with a local anesthetic which makes the region being treated progressively more numb as the treatment progresses.
Neurotoxin Injectables
Unlike injectable fillers, all of which add volume, neurotoxins work by temporarily paralyzing select muscles of facial expression that cause the most common furrows and wrinkles of the face and / or neck. Though neurotoxins are most effective in treating dynamic wrinkles, there is frequently also an improvement in superficial, static wrinkles as the resting tone of the underlying muscles is weakened.
Features that are most frequently treated by neurotoxins are:
- Central furrows between the eyes (“11” lines”) which become exaggerated with pensive expression
- Small wrinkles around the eyes (“crow’s feet”) that become exaggerated with smiling
- Vertical furrows of the central forehead which become exaggerated with a surprised expression
- Vertical bands that develop in the neck
- Small wrinkles across the bridge of the nose (“bunny lines”)
- Gummy Smiles
- Inversion of the upper / lower lip (“Lip Flip”)
Types of Neurotoxins
BOTOX® Cosmetic
Made of a protein derived from botulinum toxin A, BOTOX® Cosmetic relaxes the targeted muscles and is FDA approved for treating fine lines and wrinkles, deep lines on the forehead, frown lines and furrows between the eyebrows, and crow’s feet. BOTOX® Cosmetic typically takes 7 to 10 days for the onset to be noticeable, and the results usually last between 3 and six 4 months.
Dysport®
Dysport® has been FDA approved for use in the United States since 2009. Dysport® is similar to BOTOX® Cosmetic but has a slightly faster onset, with results becoming apparent in one to two days. Dysport® offers natural-looking results that last up to four months.
Neurotoxins: The Procedure
Neurotoxins are strategically injected into the targeted areas with a small needle. The injections only take about 5 minutes to complete depending on the areas being treated.
Injectables FAQs
Q. Will injectable treatment hurt?
A. Most volumizing injectables are pre-packaged with a local anesthetic to reduce any potential discomfort. The skin may also be chilled, treated with a topical anesthetic ointment, or injected with an anesthetic for increased comfort, though this is rarely necessary.
Q. How long is recovery after treatment?
A. No downtime is required after injectable treatment. However, some swelling, brusing, and tenderness may be present immediately after treatment and, depending on the type of injectable, may persist for a few days.