Botox, Facial Fillers, and Lip Enhancement



Facial Fillers in NYC

As we get older, starting sometimes in the early 30’s, we lose volume in our face.  It starts with the cheeks and temple areas to areas around the mouth.  Also, the support of the cheeks and the lower face weakens, which accentuates the laugh lines and creates jowls. Hyaluronic acid (Juvederm, Restylane, Voluma, etc.) and SCULPTRA (polylactic acid polymer powder) are two excellent biologic filling materials designed to improve volume in the face.  A surgical option is fat grafting.  However, it does not replace the need for a face and neck lift.

One of the biggest mistakes that many, many doctors make is trying to do too much with fillers to compensate for facial aging.  This leads to the funny, swollen look, which we do not want for the people of the West Village, Chelsea, Greenwich Village, Soho, East Village, Lower East Side, Tribeca, all of Manhattan as well as for the Bronx, Brooklyn, Queens, Long Island and Staten Island or anyone else in the world.

Most of you want to look less tired and more youthful but not look swollen or puffy.  Replacing volume loss in your face with these products is quite challenging to do correctly and achieve an improved natural look.  What you think you may want is perhaps not what would benefit you the most.  Both hyaluronic acid and polylactic acid polymer powder are great products but work in very different ways in the body.  Hyaluronic acid attracts water while SCULPTRA, the polylactic acid polymer, stimulates collagen growth.  A masterful injector of these products will have the proper knowledge and algorithm to solve the problems of your face to give you The Natural Look.

Lip Augmentation with Hyaluronic Acid Filler: Juvederm VOLLURE, Juvederm ULTRA, Restylane SILK

Juvederm VOLLURE and Juvederm ULTRA and Restylane Silk are all excellent for lip enhancement and augmentation.  There are different reasons to use these three types of hyaluronic acid.   The latest might be the best yet: Juvederm Vollure!  It’s the newest generation of hyaluronic acid gels that last longer and causes much less immediate swelling response, which is what people want!!  However, it is a bit more expensive than Juvederm Ultra and Restylane Silk.

Juvederm Ultra in an intermediate lasting hyaluronic acid gel, which is equally as effective and costs a bit less than Vollure.  It may not last as long, but many of my patients have liked the Ultra and prefer to go with the same each and every time.

Restylane SILK is silky smooth and a thinner gel that diffuses evenly and more easily.   The advantage of this hyaluronic acid is that it does not last as long as VOLLURE and ULTRA.  So, for the novice who wants to try lip enhancement and not worry too much that it would last too long just in case it doesn’t fit how she wants her lips to look, then this is a great starter gel.  If there is great satisfaction of fuller and more sultry lips, then she can transition to the longer lasting ones, VOLLURE and ULTRA.


Botox in NYC

Botulinum toxin now popularized as Botox and Dysport and Xeomin have the same mechanism of action by paralyzing the muscles that cause wrinkles to the glabellar area (between your brows), forehead, and crow’s feet.  By using very small doses of botulinum toxin, a skillful injector will not only reduce or eliminate wrinkles but allow the forehead to still animate and raise the brow hairline as a chemical brow lift when needed.  The effect of each injection lasts for 3 to 4 months.  It takes at least 3 days to take effect and sometimes 2 weeks.

Don’t be surprised to see “bad jobs” done by many doctors and nurses who create a weird look, such as drooping funny shaped brows.  This is because of a poor understanding of the facial anatomy.  Just because a doctor, nurse or dentist offers Botox or facial filler doesn’t mean he or she knows the anatomy well enough to do a good job.

If it is done properly, almost everyone responds well to the treatment.  In a few, the results may last longer or may not last as long.  A lot depends on the person as well as how forceful the forehead, glabella and crow’s feet animate.  Botulinum toxin does not take away deep lines that are caused by years and years of wrinkling, especially between the brows.  The risk of a dropped eyebrow or eyelid is usually associated with migration of the toxin or improper injection.  However, the risk is very small for a skillful injector of botulinum toxin (Dysport, Botox, Xeomin), which will give you a more relaxed and aesthetic Natural Look.





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