Botox and Fillers

The vertical lines that appear between your brows, the horizontal lines across your forehead, and wrinkles around your eyes actually result from muscle movement and the passage of time. If you're angry or annoyed, for example, you knit your brows together.  When you smile, the wrinkles around your eyes become accentuated. Underneath your skin, your facial muscles contract, cause a pleating of the overlying skin, and then, as anyone can see, you're frowning.

After years of crinkling, wrinkling, and smiling, facial wrinkles on the forehead, between the brows, and around the eyes start to linger longer and can become more pronounced.

Fortunately, there is a way to temporarily reduce moderate to severe glabellar lines. BOTOX® Cosmetic was approved by the Food and Drug Administration (FDA) in 2002 for the temporary treatment of moderate to severe frown lines between the brows in people ages 18 to 65, and almost 3.3 million procedures were performed in 2005 alone. Botox has an excellent safety profile. It has been used by neurologists and ophthalmologists for the past 17 years to correct facial tics and to relax the eye muscles responsible for lazy eye. These types of procedures require many times the amount of Botox that is used to treat facial wrinkles and have not resulted in any toxic effects to patients.

BOTOX® Cosmetic is a purified protein made from botulism bacteria. This protein binds to the nerve endings, preventing the release of the chemical transmitters that activate muscles. When injected into specific areas of the face, BOTOX® Cosmetic temporarily reduces the contractions of the muscles that cause those persistent frown lines that have developed between your brows over time.

Used safely in medicine for over decade, BOTOX® has truly revolutionized the field of cosmetic dermatology with a safety and efficacy profile that supercedes almost all other cosmetic procedures. With tiny injections into select muscle groups, you can rid yourself of lines of laughter, anger, and grief that have etched into your skin over the years without losing the natural expressions of who you are.

With an artistic touch, Dr. Khrom can enhance the shape of your eyebrows, widen the glimmer in your eyes, and soften the neck creases with no downtime. This treatment can also be used to create a browlift and improve the appearance of fine lines above the lips.

Within days, you may see an improvement that can last up to 4 months. Fully reversible, BOTOX® is safely absorbed and requires re-treatment at 4-6 months intervals. If you do not continue treatments, the frown lines between your brows will gradually look like they did before treatment.

BOTOX® Cosmetic is not for you if you:

• have an infection where BOTOX® Cosmetic will be injected
• are allergic to any of the ingredients in BOTOX® Cosmetic
• are pregnant or think you might be pregnant.

Fillers

Whereas BOTOX® works well in the upper face to smooth out frown and squint lines, it doesn't work quite as effectively in the lower two thirds of the face. This area is where FILLING SUBSTANCES HAVE PROVEN TO BE EFFECTIVE.

One of the most overlooked changes of the face from the aging process is the profound volume loss that takes place over time.  Facial volume loss results from resorption of bone, muscle, and fat and thinning of the skin from loss of collagen and elastic fibers.

Facial volume replacement can be localized to specific areas of volume loss (folds extending from nose to lips) or full facial (pan-facial) correction.  Pan-facial volume correction with fillers is best handled by Sculptra OR Radiesse , which represent the most cost-effective solution.

Facial fillers come in four varieties:

1. Hyaluronic acids are substances that are normally present in our bodies and fill in wrinkles and creases by binding water. 
2. Radiesse and Sculptra and new generation of longer lasting temporary fillers that stimulate our own bodies to produce new collagen
3. Fat is a natural filler that can be harvested from areas to abundance and injected into areas of need.  Its longevity has been argued in the literature from surviving several months to many years.
4. Finally, there are permanent fillers, like silicone – a substance that also stimulates an inflammatory reaction around itself and causes new collagen production.  However, due to the controversy surrounding liquid silicone, many physicians choose not to use it in their practices.

Hyaluronic Acid Fillers – Temporary (for more details)

Hyaluronic acid is a naturally occurring substance in your skin that helps to hydrate and add volume and fullness to the skin. Hyaluronic acid may diminish with age, contributing to the formation of wrinkles and folds.

Longer Lasting Fillers(Radiesse® and Sculptra®)
Other Fillers (Juvederm, Restylane, Cosmoderm and Cosmoplast)
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