Are you curious about injectable facial treatments? Have you been considering trying them but aren't sure how they work or where to start? I've got you covered here with my basic guide for newbies.
In the last several years, aesthetic treatments have been all over social media. The industry hit a boom during the pandemic, probably since so many people were scrutinizing their own faces on those little Zoom meeting cameras. But they've been around for a long time, and the products on the market today have become a commodity. They are much more affordable now, but that said, please don't use a "Groupon" sale to try your first injectable treatment. You want to visit an experienced injector with a good track record, who puts safety first.
The two most common injectable facial treatments are neurotoxins (also called neuromodulators) like Botox, Dysport, Nutox/Juveau, and Xeomin, and dermal fillers like Juvederm, Restylane, Versa, and others.
Neurotoxins: Botox, Dysport, Xeomin, Nutox/Juveau:
How do they work? These are a liquid medication injected into muscles of the face to cause them to relax. As a result of the muscles relaxing and contracting less, it's harder to form wrinkles in the treated areas, so this can be a preventative treatment, as well as a treatment for existing lines. The active ingredient in these products is botulinum toxin, which is derived from a bacteria (Clostridium botulinum), and inhibits nerve signals in the area, causing the muscle to contract less, the skin to smooth and wrinkles to diminish. Therefore this treatment is best suited for those who have wrinkles that are due to muscle movement or facial expression, such as frown/scowl lines ("the 11's" between the brows), "worry lines" which are horizontal lines on the forehead, and crow's feet around the eyes. Neurotoxins are also used for non-aesthetic purposes, such as injecting the muscles that cause jaw clenching or teeth-grinding (bruxism), headache prevention, and to treat excessive sweating under the arms (axillary hyperhydrosis).
When should I start getting treated with neurotoxins? If you're starting to notice lines forming on your forehead, between the eyebrows, and around the eyes, you may consider starting treatment to smooth these lines and prevent future lines from forming. Even people in their twenties may notices lines forming due to facial expression. If your dentist is concerned about you grinding your teeth at night, or clenching your jaw, treating the muscles that cause this in order to relax them may be beneficial. Over time, excessive tooth grinding will lead to damaged and even broken teeth, not to mention headaches.
How long does the treatment last? This will depend on a couple of factors, including the individual's metabolism of the medication (which varies), and the dose or number of units injected. In general, an adequately treated patient can expect the results to last on the average around 3 to 4 months (but the range may be 2 to 6 months). In order the maintain the results, the treatment will need to be repeated at regular intervals. Over time with regular treatments, the muscles treated will shrink or atrophy slightly, which makes them less strong and may allow you to space out your treatments a little more.
Who should not get treated with neurotoxins? The main contraindications to treatment are: women who are pregnant or nursing, people who have neuromuscular conditions or inability to contract the muscles in the treatment area, active infection in the area to be treated, people with severe bleeding disorders, and people who have an allergy to the constituents of the botulinum toxin product. You should have a discussion with the doctor performing or supervising your treatment to make sure you're an appropriate candidate.
What are some potential side effects or complications of treatment with neurotoxins? Mild redness or swelling can occur at the injection sites, but generally resolves within a few hours. Bruising is not common but can occur. Headache can occur but usually will resolve within days. Heavy feeling or drooping eyebrows or eyelids may occur, and is more of a risk if the patient has "hooded" or droopy eyelids before treatment. If this occurs, it will resolve once the treatment has worn off. Prescription eye drops are also available that can help improve this condition in the interim.
Dermal Fillers: Juvederm, Restylane, Versa, & Others:
How do they work? The most commonly used dermal fillers on the market are made of hyaluronic acid, a clear injectable gel. Hyaluronic acid is a normal component of our skin that helps it hold in water/moisture and maintain a plump and youthful appearance. Dermal fillers are injected in areas of the face where volume loss has occurred, helping fill in lines or folds, or adding volume to areas such as the cheeks, chin, lips, and smile lines. Lip filler injections have gained huge attention on social media due to some notoriously big lips seen on some celebs; but it doesn't have to look overdone. Dermal fillers can bring back a youthful look to the face, as well as help balance facial features and correct asymmetry. Dermal fillers made from other materials are also on the market, such as Radiesse, which is made of calcium hydroxylapatite. It is intended to be used in areas where the filler will be injected on top of bone, such as in the cheeks, chin, or the backs of the hands.
What areas of the face can be treated with dermal filler? The most commonly treated areas are the cheeks, lips, smile lines (nasolabial folds), chin, undereye area (tear troughs) and jawline.
How long do dermal fillers last? Like neurotoxins, the duration of the results obtained with dermal filler will depend somewhat on the metabolism of the patient. Your body will gradually break down the product over time, so the result will not be permanent. In the upper face i.e. cheeks and under eye area, fillers can last on the average 9-12 months, although possibly up to 2 years with some cheek fillers. In the lower face (lips, chin, smile lines), the filler tends to get broken down a little bit faster. In this area filler tends to last around 6 to 9 months.
Who should not get treated with dermal fillers? Women who are pregnant or nursing, anyone who has an active infection at the treatment site or an active cold sore outbreak, a known allergy to the filler material or to lidocaine (a numbing medication that is added to many dermal fillers)
What are the potential side effects or complications of treatment with dermal fillers? Common side effects are mild swelling and/or bruising, lumpiness which may resolve once the filler "settles", possible asymmetry, and overcorrection or under correction of wrinkles. The most feared complication of treatment with dermal fillers is what is called a vascular occlusion. This occurs if the filler is injected into a blood vessel or is compressing a blood vessel, causing compromised blood flow to that area of the skin. This presents differently than the usual side effects. It typically causes changes in the skin color (very pale white or very dark and dusky), discomfort, and normally is noted within the first 24 hours after treatment; although it could rarely present days later. It may appear initially as a large bruise with a "lacy" appearance. This must be treated by the injector within 48 hours to prevent long term consequences, and is normally treated by dissolving the filler. If you have any concerns after dermal filler treatments, you should not hesitate to contact your provider and be seen if needed.
I hope this serves as a good intro to injectables for those who are considering trying them for the first time. Don't forget to choose your injector wisely, and never be afraid to ask questions. :)
In good health,
Dr. B
#dermalfiller #neurotoxin #wrinkletreatments #hyaluronicacid #Xeomin #Botoxandfillers #antiaging #lipfiller #youthfulface
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