BOTOX® Cosmetic (Botulinum Toxin)
In the mid-1990’s, plastic surgeons began using BOTOX® Cosmetic injections to treat facial wrinkles. It has been used safely for decades to treat eye twitches, excessive sweating of the hands, feet and underarms, and for the treatment of some types of headaches. Commercially produced BOTOX® Cosmetic is very safe in the small doses used for cosmetic purposes.
BOTOX® Cosmetic can significantly improve frown lines between the eyebrows. It can also be used off-label to improve horizontal forehead wrinkles, crow’s feet, “bunny lines” on the nose, and vertical wrinkles of the upper lip. These are wrinkles caused by the movement of facial muscles pulling on and wrinkling the skin. BOTOX® Cosmetic works by temporarily weakening or halting the muscle movements that cause these wrinkles. Even young people in their 20s and 30s can benefit from BOTOX® Cosmetic by treating wrinkles just as they are beginning to form and potentially preventing them from ever becoming a real problem.
BOTOX® Cosmetic can be used for so much more than just eliminating wrinkles! It can be used to elevate and shape the eyebrow, widen the eye opening, decrease a “gummy smile” (when too much of the upper gum shows when smiling), decrease chin wrinkling, elevate the nasal tip, and decrease the vertical bands in the neck. The effect of BOTOX® Cosmetic lasts approximately three months, but even if you only have it done a few times a year, your wrinkles will still be better than if you never do it at all. If your wrinkles are not due to muscle movement (for instance, if they are on your cheeks or the nasolabial fold area), BOTOX® Cosmetic will not be effective. Instead, you may want to consider fat grafting, a filler, or possibly a chemical peel or laser treatment (see below).
BOTOX® Cosmetic can also be used to treat a condition called hyperhidrosis, or excessive sweating of the underarms, palms of the hands, and soles of the feet. BOTOX® Cosmetic injected into these areas for sweating tends to last seven months or longer.
Restylane® and Perlane® are substances called hyaluronic acids, which are similar to the slippery fluid that you have in your joints that helps the bones to glide on one another. They are “fillers” approved by the FDA to diminish the visibility of fine lines and wrinkles in the skin. They can also be used off-label to augment and sculpt the cheeks, lips, lower eyelids, nose, chin, and jawline. Restylane® may last for four to eight months, but in some areas of the face where there is a lot of mobility (for instance, around the mouth) it may be slightly less. Perlane® is slightly thicker than Restylane® and has the potential to last slightly longer. There is tremendous variability from patient to patient regarding how long the product lasts. Some fine wrinkles may not be amenable to filling with Restylane and may be better treated with a chemical peel or laser treatment.
Restylane Lyft, formerly known as Perlane-L®, is an injectable hyaluronic acid gel used to correct volume loss and treat wrinkles in the face. Restylane Lyft is the first and only FDA-approved filler indicated to provide lift to cheeks and add volume to correct and smooth smile lines (nasolabial folds).
JUVÉDERM® is also a type of hyaluronic acid. Like Restylane®, JUVÉDERM® is an FDA-approved that temporarily smooths wrinkles and folds in the skin. It can also be used off-label to augment and sculpt the cheeks, lips, lower eyelids, nose, chin, and jawline. JUVÉDERM® may last four to eight months, but in areas of the face where there is a lot of mobility, it may be slightly less. There is tremendous variability from patient to patient regarding how long the product lasts. Some fine wrinkles may not be amenable to filling with JUVÉDERM® and may be better treated with a chemical peel or laser treatment.
RADIESSE® is a different type of filler that is also FDA-approved for correcting wrinkles and folds in the skin. It is made up of tiny bits of calcium suspended in a natural gel. You will see an instant correction after the injection of RADIESSE® as the gel fills in the wrinkle or fold. Over time, the gel gets reabsorbed by your body, and the calcium bits remain behind and stimulate the growth of your own collagen. RADIESSE® can last for four to twelve months, and there is tremendous variability from patient to patient regarding long the product lasts. It is a slightly thicker filler than JUVÉDERM® and Restylane® and works well to contour the cheeks, chin, and jawline. Because RADIESSE® is thick, however, it isn’t a good choice for the lips or the lower eyelids where the skin is particularly thin.
Sculptra® Aesthetic is an injectable product made from poly-L-lactic acid and water. It has been approved by the FDA to fill wrinkles and folds of the skin. The effects of Sculptra® Aesthetic are not immediate, but instead you will see a build-up of your own collagen after two to three injection sessions spaced a month or two apart. After completing these injection sessions, the results can last for up to two years. It works particularly well when there is a large area to be treated, as the product is relatively thin and will spread easily. Since the effects are not immediate, it can be combined with JUVÉDERM®, Restylane®, or RADIESSE® to give you an immediate result as well as to achieve a more lasting filling.
The Coleman Technique of Fat Grafting
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If you are interested in injectable fillers, please call TriBeCa Plastic Surgery to schedule a consultation with Dr. Cangello at (212) 571-5200 or fill out our online contact form today. As a highly skilled and knowledgeable plastic surgeon, Dr. Cangello looks forward to meeting you during your initial consultation and helping you achieve beautiful, natural-looking results.