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What makes hyaluronic fillers different from each other?

The more dense or thick the hyaluronic gel, the deeper it needs to be injected and the larger the needle size needed to inject it. These thicker gels, like Perlane or Juvéderm Ultra Plus, are most appropriate for building volume, like in the cheeks, and because of their size are more likely to cause visible needle marks and some bruising after treatment. The less dense—lighter in molecular weight—hyaluronic acids, like Juvéderm Ultra and Restylane, can be injected with a finer needle and do not need to be injected as deeply as the weightier formulations. These work well for fine wrinkles around the eyes or bleed lines on the upper lip.

Is there anything I can do before or after an injectable treatment to minimize side effects?

Before your injections, avoid Aspirin, Ibuprofen, anti-inflammatories, vitamin E, ginkgo biloba and St. John’s wort for a week before treatment to reduce the potential for bruising and swelling. If you are having your lips enhanced and you’re prone to cold sores, ask your doctor for an antiviral medication to take prior to the injections. A local anesthetic can often cause more swelling than the injectable itself, so keep cold compresses handy. You’ll also want to dot injection spots with an antibacterial ointment or cream until the sites have healed.

What if I don’t like the results of my injectable treatment?

Satisfaction with injectables, when performed by an expert, is very high. However, it’s nice to know that this is one cosmetic procedure that, in general, is not permanent. Most fillers will gradually be absorbed, and results will slowly diminish within months. But if you’ve been injected with a hyaluronic acid and you don’t like the outcome, an injection of hyaluronodase, an enzyme that degrades hyaluronic acid, can speed up the absorption so results diminish within a few weeks. The results of other injectables cannot be reversed, and non-hyaluronic fillers require either time or surgical excision to undo the effects.

What is a "liquid facelift"?

A "liquid facelift" or "injectable facelift" can create a younger, plumper look and address common aging concerns like lines, wrinkles and volume loss. But unlike surgery, the results are not long-term or as dramatic as a traditional facelift, since there is no substitute for surgery. Using a combination of different injectables, aging cheeks, under-eye hollows, nasolabial folds and thin lips can be addressed. This option is ideal for those experiencing earlier signs of aging and a little looseness in the skin. However, if you have more severe signs of aging, like extreme skin laxity, then a traditional facelift is most likely a better option. Keep in mind that this combination is usually performed in one visit, but your doctor may recommend follow-up injections for optimal results and maintenance of the correction.

How does an "injectable nose job" work?

To fix a bump, injectables can act much like spackle. The depressions surrounding the bump can be filled in to create the illusion of a more even profile. Keep in mind, though, that using injectables off-label to hide a bump means making a larger nose, so this is only useful when a little volume can enhance your appearance. As a temporary solution, hyaluronic acid fillers like Restylane, Juvéderm Ultra Plus and Perlane, as well as longer-lasting fillers like Radiesse, are most frequently used for “injectable nose jobs”. The filler recommended for you will depend on your personal nasal flaws, where your ExpertInjector™ plans to inject the product, and the thickness of your skin. Radiesse is injected deeper to fix contour irregularities, while the hyaluronic acids are great for finer creases at the bridge. Botox can also be used as part of a “nonsurgical nose job” to relax the muscle that pulls the tip downward, creating a more upturned appearance.

I've heard of "injectable nose jobs", but what about injectable chin augmentation?

If you're considering a chin implant but you're not sure you're ready for surgery, you may want to try an injectable first. Using Juvéderm Ultra Plus or Perlane off-label, or even your own fat, in the chin and jaw can yield results that last from a few months to many years, depending on the option you choose. The wide array of fillers can also be used in many ways to address your individual concerns, whether you're looking to augment your chin without surgery, fill in marionette lines, lift up jowls, or plump up volume along the jaw line where youthful definition has been lost. In the right patient—namely one with early signs of aging—injectables alone may be able to provide enough of a temporary anti-aging boost.

What are my options for lip-plumping injectables?

Your ExpertInjector™ can restore volume and fullness to your lips with hyaluronic acid injectables like Restylane, Juvéderm and Perlane in an off-label use beyond their FDA labeling to achieve significant volume for six months, and sometimes longer. Your own fat can also be used to augment thin lips. After it’s removed from a fattier area of your body, it’s washed with saline and then reinjected into the lips. It lasts longer than hyaluronic acid injections, but because the lips are constantly in motion, the fat can be partially reabsorbed by the body. Because the lips are a delicate area, anesthesia may be used during these treatments.

Will my lips "deflate" when a filler wears off?

Some patients are under the impression that, should they discontinue using injectable fillers, their lips will sag once the filler wears off, but this is not true. Fillers generally do not damage the existing tissue in any way; they simply add volume by allowing the material injected to be interspersed among the fibers and cells already there. As fillers gradually disappear, volume returns to its previous condition, but not less voluminous. Keep in mind that lips get thinner with age, so if you do volume-enhancing treatments for a while and then quit, you’re going to see the change that would have naturally occurred over time. Also remember that you may have forgotten just how thin your lips actually were before treatment.

Will injectables leave a mark on my skin?

In patients prone to PIH, or post-inflammatory hyperpigmentation, even a needle puncture can pose a problem. Since different injectables require different-gauge needles—some are thicker than others—anyone with a history of PIH may be better off sticking to formulas injected with thinner needles, such as hyaluronic acid fillers. Patients with darker skin may also see better results with clear hyaluronic acid fillers (as opposed to white semi-permanent fillers), which won't alter skin tone, especially when placed in areas of thinner skin, like under the eyes.

Can I get Botox Cosmetic or Dysport and a filler at the same time?

Absolutely. An ExpertInjector™ can use a combination of injectables to personalize your treatment. For example, Botox Cosmetic or Dysport can relax frown lines, and a hyaluronic acid injectable like Restylane can lift the crease left behind. In fact, studies have shown that hyaluronic filler results may last longer when used in tandem with Botox Cosmetic. Many doctors believe that by reducing muscle contractions, the toxin helps slow down the breakdown of the filler due to less movement in the area. In fact, in a “liquid lift”, a combination of fillers and Botox Cosmetic or Dysport is usually used.

I don’t really have wrinkles yet. Is it too early to consider Botox Cosmetic or Dysport?

In addition to their ability to temporarily reduce wrinkles, these formulations of botulinum toxin can actually prevent wrinkles before they're etched into your face. By stopping the repeated muscle contractions that contribute to wrinkles, Botox Cosmetic and Dysport can be used to help stop lines that arise from frowning or squinting, so you can stay furrow-free for the foreseeable future. And compared to the price of more extensive corrections down the line, it may prove to be cost-effective.

How does Botox Cosmetic help stop excessive sweating?

Botox Cosmetic is being used more and more beyond the treatment of expression lines between the brows to control sweating in areas like the underarms, palms, feet, forehead and scalp, according to the International Hyperhidrosis Society. If you have a big event coming up, ExpertInjectors™ will probably recommend getting the treatment about a month beforehand. By blocking the communication between the nerves and the sweat glands, it temporarily stops the sweating. The treatment involves multiple injections and takes a few weeks to kick in, but once it starts working it lasts for up to six months.

Is it safe to let a nurse administer injectables?

If your doctor has a nurse or physician's assistant who performs injections regularly at the physician’s office, and if you feel comfortable with the training and expertise of this nurse or PA (including an appropriate injectable training workshop), it’s your choice to have this person inject you. Make certain, however, that your injectable treatment always includes the informed-consent process; that the injector reviews your past treatment, your previous outcomes and your current state of health and goals before injecting; and that if there are any significant changes to the course of treatment you regularly have (like injecting a new area or using a new injectable), the doctor is involved in this decision.