Questions and Answers
Neurotoxins (BOTOX/Dysport equivalent)
Mechanism for anti-wrinkle: It temporarily reduces muscle activity wrinkle prone areas thereby facilitating smoother skin that does not fold as much with facial expressions. Dosages are tapered to create a natural even result and follow up is advised if touch ups are needed. Procedure can be done same day as consultation and entire process takes about 15 minutes. Injections are placed gently with small bore needle therefore discomfort is minimal.
Onset of effects: 2-7 days, maximum peak is 14 days
Duration of effects: 3-6 months, when regularly treated, it can last longer
some first timers and high metabolizers last 2 months
After effects: There is no down time. There will be a small "whelp" looking bump in the area of injection for up to 20-30 minutes
Typical dosages: can vary slightly depending on musculature, however, there is a standard dose to give an estimate:
Forehead lines: 8-16 units
Between eyebrows: 12-30 units
Crows feet around eyes: 16-20 units
Nasal Bunny Lines: 8-12 units
Lip Lines: 4-8 units
Eyebrow lift: 6-8 units
Botox usually supplied as 100 units per vial. Galderma’s Dysport Equivalent (300 units per vial) is available but 2.5-3x amount is needed for treatment. Price is usually very much the same for either treatments. Both are reputable and safe brands, good options.
General Precautions and Contraindications:
Avoid high dose aspirin, ibuprofen, fish oil, vitamin E, warfarin, xarelto, plavix or any other blood thinning type medication 48 hours before injection. These can increase risk of bruising. While not an absolute contraindication, notify your provider of all medications prior to injection.
contraindicated during pregnancy and nursing
Those individuals with Active Herpes Simplex ulcers of the mouth or those who are prone to breakout of old lesions
No side lying 4 hours post injection
no heavy exercise 2.5 hours post injection
Common Side Effects:
Swelling and bruising, temporary asymmetry
Report Allergic reaction such itching, rash, red itchy welts, wheezing, asthma symptoms, dizziness or feeling faint.
Refer to Botox/Dysport Pamphlet for additional rare but life-threatening side effects
Less commonly eyelid or brow drooping which can be treated, report promptly
Double Chin Treatment with Kybella (deoxycholic acid)
FDA approved, manufactured by Allergan
Mechanism for neck contouring: Permanently destroys cell wall of fat causing adipolysis causing improved contour of the neck. Secondarily may tighten if skin still has good elasticity. All clients are evaluated prior to injection to see if they are an appropriate candidate. Entire process takes about 20 minutes.
Requires 1-5 treatments spaced 4-6 weeks apart
Side effects- Mild swelling, nodules, numbness and soreness is common first week to two weeks afterward, must drink extra water to flush out cellular material.
Aftercare: Advised to take NSAIDs or tylenol first three days to help with soreness. Light ice compression is helpful as well. No massaging.
Contraindicated in pregnancy/breastfeeding, active infection of treatment area, and patients with trouble swallowing.
Dermal Filler Questions and Answers
Mechanism of facial enhancement/anti-wrinkle: Hyaluronic Acid fillers are naturally occurring substances gently injected into the soft tissues. It is an implantable gel that becomes a natural part of your face. It has a hydrating effect as well and creates more suppleness. After age 30 we begin to lose facial volume resulting in sagging, wrinkles, folds, and indentations. Dermal fillers, when injected appropriately can provide lift. Effects are immediate. It can also be used to literally reshape facial features non invasively to give a more beautiful youthful and rested appearance. Before and after photos are always taken to monitor results.
Areas most commonly enhanced: cheeks (lateral or med), lips (body and/or border), chin, folds from nose to mouth and tear troughs.
Wrinkle Filling: Marionette lines, smile lines, lip lines, occasionally between the brows with extreme caution, chin lines, crows feet lines, nasolabial lines.
Duration: Depending on which filler selected, can last 6 months to 2 years.
Cost: dependent on area requiring treatment and amount needed. Care is taken to enhance slowly and add in future visits.
Most Common Side Effects:
Benzocaine/Lidocaine/Tetracaine cream administered 20-30 min prior to injection to minimize discomfort.
Precautions/Contraindications: essentially the same as the neurotoxins.
Reversal with Hylenex/Halozyme injection which begins to work immediately-24 hours.
Skin Care Services:
Derma planing – A form of manual exfoliation with a special designed surgical blade of the epidermis to remove hair, dirt, dead skin cells, whiteheads etc. to renew skin restore radiance and allow serums and creams to penetrate further. Also allows make up to cover more smoothly. there is no downtime. Safe for pregnant/nursing. This procedure is becoming very popular.
Chemical peel -medium grade prescription chemical peel using glycolic acid tailored to your skin type and degree of correction needed reverses sun damage, evens skin tone, removes dead skin cells brighten skin, restores moisture, rejuvenates from inside out, improves skin health. Skin may be pink about 30 minutes after procedure. Contraindicated in pregnancy/nursing. Aftercare instructions will be provided such as use of sunscreen and avoid harsh skin treatments two weeks after procedure. Patients with susceptibility to cold sores may be prescribed a preventative anti-viral medication 2-3 days before treatment.