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Question: What brand of injectable filler best eliminates deep wrinkles from the sun?
Answer: My personal opinion about injectable fillers is that the hyaluronic acid fillers are the filler of choice for virtually any sort of facial concern, such as your deep wrinkles from the sun. The filler that we use most is Juvederm, but we also use Restylane especially in the lower eyelids.
Question: My lips have a lot of fine wrinkles on them. If I plump them up with a filler, will this also smooth out the lines?
Answer: Yes, if you plump up the lips with a filler, the fine wrinkles that are on the lip itself or along the lip line will be stretched out just like the concept of a raisin as opposed to a grape. I have not found that the enlargement of the lips creates worsening of the wrinkling over time.
Question: Are you always able to return to work and your normal routine immediately after receiving injectable fillers, even if you get them to plump the lips?
Answer: Yes, you are virtually always able to return to work and your normal routine immediately after injectable fillers to the lips. You could, however, get some visible bruising and certainly initially in the first day or two you may have some slight swelling and you, therefore, may not look exactly the way you would like to, but it certainly should not limit your ability to do routine activities. If you bruise, you can cover this up with makeup and swelling is typically not bad enough to draw the eye or make you look strange.
Question: For the past thirty years I have been a two pack a day smoker. Because of this I have very deep wrinkles all over my face that make me look ten years older. Would you recommend a facial filler to help correct this problem?
Answer: I would have to personally evaluate your facial features to determine what would be the best option, but certainly fillers would be a good option for most people with deep wrinkles across their face. The down side is that if you have these all over your face, you will end up using a large amount of filler, which can be rather expensive. The up side is that there is really no downtime and the results last relatively long at about nine to twelve months. I would personally use the hyaluronic acid fillers, such as Juvederm and Restylane; however, after evaluation I may recommend a more permanent solution to your problem, such as a full face laser resurfacing and if you have significant laxity, I may even recommend some sort of surgical procedure, such as some sort of a lift. Often times, I will combine various treatment options together to give people a truly natural looking yet extremely rejuvenating result.
Question: What type of injectable filler is the longest lasting for filling out the wrinkles in the forehead? What, if any, complications are associated with injections of this particular filler?
Answer: Well, first of all, I typically do not recommend filling forehead wrinkles since, for the most part, these are dynamic wrinkles, which means that they are there due to overactive muscles, and I do not feel that filler injections tend to last all that long in these types of lines due to the activity of the muscle. I, therefore, typically recommend Botox to these areas as this will dramatically improve forehead lines and though it is a temporary solution, is extremely safe and effective. For patients that insist on a filler, I would first insist that they get Botox and should there be any significantly deep lines afterwards, we could consider filling these areas, but I would not recommend any sort of long-term filler for fear of complications in this area. I would, however, be willing to use a hyaluronic acid filler such as Restylane or Juvederm since these can be reversed should there be any concern about the viability of the skin. In other words, in some areas of the forehead or especially between the eyebrows, if the filler is placed in the skin underneath these wrinkles, it can cause so much congestion to the blood vessels that it prevents oxygenation of the tissue, which can lead to damage to the skin and resulting scarring. This could potentially be reversed if the filler was hyaluronic acid but can really not be reversed if the filler is a longer lasting filler such as a calcium-based filler.
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.
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.
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.
Question: I am in my early 50s and about to become a grandmother and I really need a little work done. I want to look and be natural. Is it true that hyaluronic acid used in this kind of work promotes more collagen production?
Answer: I do not know that I can honestly say that hyaluronic acid fillers can produce more collagen production but the hyaluronic acid filler does volumetrically enhance the face and can fill folds and lines. These products are excellent due to the fact that they are extremely safe, reliable, and consistent in the way that they can produce esthetic improvements. They also are relatively long lasting at about 9 to 12 months.
Question: What is Perlane and what can it improve? How long do the results last?
Answer: Perlane is a hyaluronic acid filler made by the same company that makes Restylane. The only difference between Perlane and Restylane is that Perlane has a larger particle size and therefore has a higher viscosity and is slightly thicker; otherwise, they are identical. Areas where Perlane can be useful are thicker areas of the face such as the area between the corner of the mouth and the chin or in placement of the product deep in the cheek to augment that area. Restylane and Perlane last about the same amount of time, both being about 9 to 12 months. A repeat injection can get you about a 2 year result.
