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November 5, 2011
I often hear about injectable fillers being used for treatments that are “off-label”
Filed under: Botox / Dysport,Facial Fillers,Injectable Fillers — Dr. Andrew Campbell @ 7:52 am

Question: I often hear about injectable fillers being used for treatments that are “off-label,” which I understand refers to a use not approved by the FDA. This sounds fairly common but is it something to be concerned about?

Answer: I do not know that it is anything to be concerned about as long as the professional that is treating you is ethical in their use of this product. One good way to think about this is to make sure that the product is FDA approved for a similar use. Botox is FDA approved for treatment of lines between the brows, but many providers use it in other areas of the face that would be considered off-label, but it is still used in a very similar way and for a similar goal. On the other hand, there is injectable silicone, which is an FDA-approved product, but if it is used as a facial filler, this is not what the FDA approval was actually for and, therefore, this is not only used off-label, but it is being used in a situation that is completely different than for what it was FDA approved for.

September 10, 2011
Which injectable filler would you recommend for crow’s feet?
Filed under: Botox / Dysport,Injectable Fillers,Juvederm,Restylane — Dr. Andrew Campbell @ 9:06 am

Question: Which injectable filler would you recommend for crow’s feet? Do patients often get several areas of the face treated at the same time?

Answer: I would have to personally examine you but, for the far majority of my patients, I recommend Botox for the crow’s feet as in this area the lines are mainly due to excessive muscle motion more so than deep folds or lines that are present all the time. I have had some patients that have a combination of problems where they have significant deepening of these crow’s feet lines with smiling but even when they are not smiling they have a significant depth to them that can be filled with the filler. We will, therefore, provide a combination treatment of both Botox and a filler to give them the best result. Regarding the filler, I recommend the hyaluronic acid fillers such as Juvederm or Restylane and would recommend that virtually any other style of filler not be used in that area other than maybe collagen. I have found this combination effect to be very rejuvenating and long-lasting in my patients. Furthermore, you can get virtually any area of your face treated with Juvederm or Restylane and, therefore, we can treat multiple different areas of the face all at one time giving you a very long-lasting, rejuvenating effect.

September 1, 2011
The sides of the forehead lines are still present.
Filed under: Botox / Dysport,Injectable Fillers,Wrinkle Fillers,Wrinkles & Dermal Fillers — Dr. Andrew Campbell @ 10:15 am

Question: It has been close to two weeks since my Botox treatment on my forehead. The lines in the middle of my forehead have disappeared, but the sides of the forehead lines are still present and look awful. Will this resolve itself, or do I need to get this fixed?

Answer: By two weeks the effects of the Botox should be complete, and if you still have lines that are present when you move the forehead muscle, I would recommend that you see your injector so that they can touch up this area with additional Botox.  At the Quintessa Aesthetic Center we provide touchups to our patients at no additional cost, and we are certainly very happy to see them so that they end up getting the result that they desire and are ultimately happy with their injections.

August 25, 2011
I have had injections in the past to plump my lips temporarily.
Filed under: Botox / Dysport,Injectable Fillers,Lips & lip Augmentation — Dr. Andrew Campbell @ 10:25 am

Question: I have had injections in the past to plump my lips temporarily. What procedure can make my lips permanently plump?

Answer: Now there are several procedures that can permanently plump lips but at this point in time I personally prefer the fillers as they are easily customizable, very natural appearing, and overall give patients exactly what they desire. Other options, however, are a lip lift which can be performed through small incision up underneath the nose, a vermillion advancement which leaves a scar right along the lip line between the skin of the upper lip and the lip itself or even permanent lip implants which can be soft silicone that is passed underneath the tissue to permanently enhance the lip. These all have drawbacks when compared to injectable fillers but the upside of these other techniques are that they are considered permanent.

August 21, 2011
What exactly is hyaluronic acid and how does that compare to Botox?
Filed under: Botox / Dysport,Injectable Fillers,Wrinkle Fillers,Wrinkles & Dermal Fillers — Dr. Andrew Campbell @ 1:20 pm

Question: What exactly is hyaluronic acid and how does that compare to Botox? I am considering some face touchups and want to explore all of my options.

Answer: Hyaluronic acid is a chemical that is composed of sugar molecules all linked together thousands of times in a chain. These chains are then linked across themselves so that they last longer in the human body. This is a natural substance that is found in our bodies and it is located between all of the cells in our tissue. Botox is a neuromodulator which means that it binds to nerve endings and prevents the nerve from making the muscle contract. This allows the muscle to relax and the wrinkles that are caused by the muscle motion are then improved. These two products are very different in that one treats dynamic lines or lines due to muscle motion and that would be the Botox situation whereas one treats lines that are static or lines that are there all the time which are typically in the lower face and this is where hyaluronic acid fillers would be useful. Ultimately I always recommend the patients see a board certified facial plastic surgeon who is experienced in comprehensive approaches to facial rejuvenation so that combination treatment such as Botox fillers and other procedures or techniques can be employed to give the patient the best result possible.

August 19, 2011
Does Botox alleviate the pain from headaches or is this a coincidence?
Filed under: Botox / Dysport,Injectable Fillers,Wrinkle Fillers,Wrinkles & Dermal Fillers — Dr. Andrew Campbell @ 9:37 am

Question: I had Botox injected into my forehead a few weeks ago. Since then I have noticed that my tension headaches have been much milder. Does Botox alleviate the pain from headaches or is this a coincidence?

Answer: It is definitely not a coincidence that your headaches are better with Botox and it has been scientifically proven that Botox can improve patient’s headaches; in fact, I see may many patients that have a complete elimination of their headaches when they have Botox that is effective. This obviously does not occur in everyone but it is a very pleasant side effect for those that get this effect.

August 5, 2011
I am interested in getting a facelift.
Filed under: Botox / Dysport,Restylane,Wrinkles & Dermal Fillers — Dr. Andrew Campbell @ 12:10 pm

Question: I am interested in getting a facelift, but I have been using Restylane and Botox for about 6 months now. Will the injectables interfere with the surgery and do I need to wait until their effects wear off?

Answer: For the most part any injectable will not interfere with any sort of surgical intervention other than when we are trying to provide volumetric enhancement, such as fat grafting in areas where filler has been placed.  For your particular circumstance, I see no issue with having had Botox and fillers prior to a facelift as this really will not affect the ability of the surgeon to perform the facelift and will not affect your results regarding the facelift in any negative way.

August 4, 2011
Injectable to minimize the small lines and wrinkles.
Filed under: Botox / Dysport,Wrinkles & Dermal Fillers — Dr. Andrew Campbell @ 3:15 pm

Question: I am considering using an injectable to minimize the small lines and wrinkles developing around my eyes and mouth. A couple of my friends use Botox, but I recently heard about Dysport. What is the difference between the two?

Answer: Well, the active molecule, which is botulinum toxin A is identical in both Dysport and Botox.  The difference lies in some of the proteins that surround this molecule in each formulation.  Overall, the effectiveness of each of these is relatively similar, though a recent study did show that Dysport may be more effective in the crow’s feet area than Botox is.  Otherwise, I typically use them interchangeably and do not have a problem treating someone with either product.

July 25, 2011
What are some of the risks associated with getting either Botox or Dysport?
Filed under: Botox / Dysport — Dr. Andrew Campbell @ 10:21 am

Question: What are some of the risks associated with getting either Botox or Dysport?

Answer: In essence, there are 3 things that can happen with the use of Botox or Dysport. One, is the injection is placed in an area where there is no muscle and therefore there is really no effectiveness to the treatment. The second is that it can be placed into the muscle that we desire to relax and they can get an excellent result. The third is that some of the Botox or Dysport can either be injected into or leach into a surrounding muscle, which is not intended to be relaxed and this can therefore give a side effect, such as a droopy eyelid. Otherwise, there is some remote risks of injection site irritations and bruising, but overall in well experienced hands, both Botox and Dysport have an extremely small risk of any sort of complication.

June 8, 2011
I have very fine lines at the corners of my eyes. Is this something that microdermabrasion can treat?
Filed under: Botox / Dysport,Crow's Feet,Microdermabrasion — Dr. Andrew Campbell @ 5:15 pm

Question: I have very fine lines at the corners of my eyes. Is this something that microdermabrasion can treat? Is it safe so close to the eyes?

Answer: Microdermabrasion may be able to improve those lines slightly, but I really do not consider microdermabrasion a very effective way to treat wrinkles. Otherwise, microdermabrasion is exceptionally safe, even in and around the eye area when a crystal-free microdermabrasion is performed. Otherwise, I would recommend consideration of Botox for the crow’s feet.

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