Botox and Facial Wrinkles

Botox or botulinum toxin A is a substance produced by Clostridium bacteria that is known to inhibit muscle contraction. By using Botox to "weaken" specific muscles in the face that are creating deep wrinkles or furrows, the depth of the wrinkles can be lessened. The ideal wrinkles to treat are the horizontal forehead lines, the vertical lines between the brows and the "crow's feet" around the corners of the eyes.

The activity of Botox in reducing wrinkle lines is temporary as, over time, the muscle activity will gradually return. Fortunately, the muscle function will rarely return full strength and with each successive treatment, the muscle becomes gradually weaker and the wrinkles gradually less noticeable.

The treatments are repeated at 3-6 month intervals. Each patient is different in his or her response to Botox with some patients experiencing return of muscle function within 2-3 months and some having a much longer duration of results. Much of this variability lies in the concentration and amount of Botox injected, and the injection technique. It is important to target the specific muscle creating the wrinkle and thus, your physician should have thorough knowledge of facial anatomy.

Botox is injected with a tiny needle similar to that used for allergy injections. The skin can be cooled with ice or an anesthetic cream can be applied prior to injection although most individuals do not require these maneuvers and complain only of an initial "pinch" of the skin.

Radiesse®

Radiesse is a filler material made up primarily of Calcium. As such, it is not recognized as "foreign" to the body and is well tolerated when injected into the lips or facial folds. The "spheres" of material are small enough to be able to be injected, yet large enough so that they are not eliminate. Over time, the patients own collagen will form a capsule around each sphere maintaining the filling effect.

Radiesse is currently FDA approved for injection into vocal cords and as an injectable tissue marker and has a very safe biocompatibility profile.

Unlike collagen or similar injectable materials which last on average 2-3 months, Radiesse has been shown to persist for at least 2 years and as long as 3 years in studies out of Canada and Europe where it has been used since the late 90's.

The technical material composition is hydroxyapatite in a methylcellulose gel. Since it is a material found naturally in human bone, no allergy testing is required

Radiesse can be injected as an office procedure using an anesthetic cream applied to the skin or using small amounts of local anesthesia prior to the injections.

Restylane®

Restylane is a dermal filler made of hyaluronic acid, a substance that naturally exists within human cells. Unlike other filler products, that are derived from animal sources, Restylane is Non-Animal hyaluronic acid. Restylane is "cross-linked" or stabilized making the material less likely to be degraded and helping with persistence of the volume injected.

Restylane has been used extensively in Europe and Canada since 1996 and received FDA approval for use in the U.S. in 2003.

Restylane can be used to fill lines and wrinkles on the face and to enhance the appearance and fullness of the lips. As the material is soft and pliable, the results are extremely natural.

An anesthetic cream is applied to the skin or a small amount of local anesthetic can be used to lessen the discomfort associated with injection. Most patients will experience mild swelling and temporary redness at the injection site. These effects typically resolve within 1-3 days.

Most of the correction achieved with Restylane will persist at least 3 months with some persistent correction for as long as 6 months.

The cost of Restylane is equivalent ot the cost of collagen injections with twice the longevity of results.

Sculptra™

Sculptra™ (injectable poly-L-lactic acid) is a synthetic biodegradable, biocompatible lactic acid polymer. Lactic acid is a naturally occurring material in human cells and, as such, the body will not reject the material and no allergy testing is required.

The material, used in Europe since 1999, can help fill hollows and folds in the face by gradually increasing the thickness of the skin. It is the injectable material of choice for replacing lost facial fat as, for example, in patients with lipodystrophy.

Small amounts of the material are injected into a fold or depression and gradual thickening of the skin is noted over the ensuing two to three weeks. At this point, additional material can be injected if further correction is desired.

The thickening and filling effects have been shown to persist for up to two years after the initial injections. Because of the smooth consistency of poly-L-lactic acid and its safe biocompatibility profile, the results are soft and natural with little tendency to create clumping or nodules beneath the skin surface.

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