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Facial Fillers / Botox

Will i lose normal facial expression?

No. Great botox means looking younger but not looking frozen. Botox can be carefully placed so it minimizes facial muscle contraction and the overlying wrinkles but still allows you to show the world your smile or your anger.

Will i have to use it forever?

Botox lasts anywhere from 3-5 months. The muscles are not permanently paralyzed so your muscles will regain their function. At that point, you can choose to have the injections again. Some patients have reported that after several repeat injections, their lines never return as deep.

I’m considering a dermal filler to help smooth the lines and wrinkles on my face. i’m a woman, 58 years old, and i don’t have any significant sun damage. what’s my best choice?

That will depend on several factors: how pronounced your lines and wrinkles are, any allergies that might react with the ingredients in the filler, and where you want to see improvement.

If you’re looking to ease “lines of expression” that form because of muscle action beneath the skin, a dermal filler is not your best choice. The underlying muscle will continue to cause repeated motions that will bring those lines back quickly. A muscle relaxing injection will be a better answer.

For the lines and wrinkles that simply form with the passage of time, as the face loses collagen and volume, there are a number of dermal fillers that will do a fine job.

Most popular are the hyaluronic acid fillers like those in the Juvéderm line, Restylane, or Perlane. Hyaluronic acid is found naturally in the human body. These products are approved for treating moderate to severe facial wrinkles and folds, and effects last six months to a year.

Fillers can also be made of synthetic materials, substances that do not occur naturally in the skin. These include Radiesse and Sculptra. Addressing deep lines and folds, they sometimes have longer-lasting effects than hyaluronic acid fillers, and all have similar side effects of redness, swelling, and/or bruising at the injection site.

Collagen wrinkle fillers were among the first dermal fillers developed, and while their effects are not as long-lasting, the results may look more natural than those delivered by other fillers. These fillers are effective on the small lines that form around the lips (bleeding lipstick lines), the lines that form between the nose and the corners of the mouth, crow’s feet, frown lines, and lines on the forehead.

Finally, there are fillers that make use of fat or other tissue taken from another part of your own body. They are not commonly used, but these fillers can treat fine lines and creases on your face, and results can be permanent in some cases.

Keep in mind, though, that none of these fillers halts or reverses the aging process. Natural changes over time will require additional treatment to maintain our smoother appearance.

I am a gentleman 53 years of age residing in brooklyn in new york with crow’s feet. Can these be resolved with injectable dermal fillers?

Yes, hyaluronic acid dermal fillers can be used to resolve crow’s feet. Botox, however, would be more effective in alleviating the appearance of crow’s feet. Botox works by relaxing the muscles and decreasing these fine lines.

After having juvederm and botox injections when can i start my normal daily routines including riding my motorcycle and exercising? I live in the suburbs of new york city and am a female 33 years of age.

Following Juvederm and Botox treatment there are not any severe limitations on your activities. I would recommend not touching the treated areas and also not going to the gym that same day. For the week prior to the injections as well as two days after I would avoid ibuprofen, aspirin, vitamin E and omega fish oil to minimize bruising. Otherwise you are able to go right back to work and that is why these are referred to as “lunch time” treatments.

I am an extremely busy woman in my mid-50s living in bronx county in the state of new york. Taking a close look in the mirror this morning i realized i have not only lip lines but marionette lines and wrinkles!! I would like to be rid of all of these! what would be the most effective wrinkle filler?

As an experienced Board Certified Facial Plastic Surgeon in New York, I find Juvederm and Restylane have excellent outcomes when used for fine perioral lines including lip lines. These dermal fillers are also effective with marionette lines. Sculptra and Radiesse also have excellent results with marionette lines as well.

Hi! I live in richmond county in new york and am a woman 40 years of age. Please explain what granulomas are and if they are or can be a side effect of dermal filler injections. thanks!

Inflammation of tissue is described as a granuloma. A tissue injury and/or the effects of an infection can be some of the causes of granulomas. It is very unusual for dermal filler injections to cause granulomas; however, if too much filler was injected into a specific area this can create a small lump/bump. Try gently massaging the area to see if this helps dissipate the section in case too much filler was injected. If massaging the area is not helpful in a day, consult your doctor as this excess material may need to be removed.

I am a woman in my mid-50s living in staten island in richmond county, new york. Over my natural aging process i have more or less developed wrinkled areas over my entire face. Would botox be the safest and most effective treatment to return my face to a revitalized and younger-looking appearance?

Generally we don’t use filler for crow’s feet but Botox or Dysport, which last 3-6 months. For marionette line, a filler such as Juvederm or Restylane will lend a nice result. These fillers can last anywhere from 6-12 months.

When a person has wrinkles in the upper facial areas such as on their forehead, lines between their brows or crow’s feet Botox is extremely effective in treating these areas safely.

However, if there is the need for volume restoration or you have deeper folds and creases, fillers are best suited for rejuvenation. After speaking with your doctor regarding your facial restoration, he/she can recommend, depending on the location on your face, the most effective treatment for these areas.

Born and raised in california i have now moved to new york city as part of my changes following a divorce after 22 years of marriage. I am 49 years of age, female and would like a nonsurgical facelift for rejuvenation as i start out on my new adventure. Please tell me how long it will take to see any changes.

Welcome to the New York! A nonsurgical facelift is a great option. Depending on the fillers used, the results can be instantaneous. Botox and other smoothing agents can take 3-7 days to set in while fillers such as Juvederm and Restylane offer immediate results. These are great non-surgical rejuvenation procedures that can help you really enjoy being in your new city.

When botox is used for facial rejuvenation can other dermal fillers also be safely used? I am a female 53 years old residing in bronx county in new york.

Absolutely. There are no contraindications to using both. Usually, the two are not used to treat the same areas of concern anyways. May patients come in for one and decide to go forth with both in order to truly achieve facial harmony.

I volunteer as a school crossing guard in the suburbs of new york. I am a 55-year-old gentleman and enjoy spending my time volunteering. the harsh cold, wind and sometime overwhelming heat have been hard on my face. Is there a prescription medication i can apply or long-lasting protective chemical peel?

Sunscreen is key to protect your skin during the summer or winter. After an examination of your skin we can create a treatment plan to ensure your skin is in the best possible condition no matter the season. The treatment plan may include chemical peels, laser treatments or prescription ointments.

When looking into different methods of a facelift i read about a laser technique that will tighten sagging, loose skin without surgery. Are the results of this method permanent and how is it done? i am a 53 year old woman who is a resident of new york county.

There are several lasers and treatments that promise to address and correct sagging and loose skin around the face, neck and jowls. While some provide a nice amount of tightening and reduce laxity along the jawline, they are not a substitute for a facelift. Pay a visit to a board certified facial plastic surgeon in New York in order to determine if a surgery or minimally invasive laser treatment is a possible solution to your facial concerns.

What if i don’t like how the facial fillers change my look? Will i be stuck that way until it finally wears off?

No, there are short-term facial fillers that only last for six months and some of these are reversible if the results are not ideal. Restylane and Juvederm both contain hyaluronic acid that can be dissolved, if needed.

I’d like to get rid of my wrinkles but i don’t want to return to the doctor every six months for a repeat treatment. Is there any facial filler that will last longer?

The facial filler Radiesse can last up to a year or more, however the effects of this filler can vary. It is a water-based gel made of calcium hydroxylapatite, a natural human protein that is great at relaxing wrinkles and folds.

My lips are so thin! are there any facial fillers that work really well to give lips volume?

Restylane is a great choice of facial filler to add volume to lips. The gel produces a soft look that is also especially good for cheeks. It’s made of hyaluronic acid, a protein that exists naturally in your body, and lasts for about six months.

What is botox made of and how does it work?

Botox is made from Botulinum toxin, a protein produced by bacteria that paralyses the muscle that is causing the wrinkles.

I don’t like the idea of injecting a foreign protein into my face that is made from bacteria associated with causing food poisoning. Are there any facial fillers made from natural proteins available?

Even though Botox is made from botulism, it has been diluted to a harmless level and it is very safe. Botox does provide amazing results, however there are many choices of facial fillers made from natural proteins available. Restylane and Juvederm are made from hyaluronic acid, a natural protein already found in the body. Also, Radiesse is made from calcium hydroxylapatite, another natural protein already found in the body. Each of these facial fillers works best in different areas of the face. Make sure you do your research so you know which would be best in the area you’d like to improve.

I have deep forehead wrinkles that won’t disappear! Can i use a facial filler to reduce my forehead wrinkles?

Definitely! Facial fillers are great a great way to reduce forehead wrinkles. I would recommend the use of Botox for this area, which can decrease the depth of wrinkles and prevent new ones from forming for three to six months.

I think the time has come for my first botox injection! i am 31 years old living in ny. How can i avoid any unwanted side effects of botox

Botox, when administered correctly, is generally safe. Experience is key when assuring your Doctor is injecting the correct areas to avoid “drooping” of the eyelids. Make sure your doctor has injected hundreds, if not thousands, of patients successfully. As a patient, you can avoid aspirin, fish oil or anything else that may thin the blood and increase the risk of bruising.

I am a 29 year old woman in nyc and want to try injecting my lips for the first time. Which is best for lip definition- juvederm or restylane?

They are comparable products. Personally, I tend to use Juvederm more frequently for the lips since it has a tendency to attract water and just slightly increase the volume. Restylane is my number one choice for around the eyes as well as other delicate areas. I recommend coming in for a consultation and we can take a look and determine what is best for you.

Lately my nose has been bothering me when i look in the mirror. Im 32 years old and i live in ny. at this time i do not want to have surgery. Can dermal fillers be added to other parts of the nose such as the columella and lateral sidewalls?

Dermal fillers are a great option for adding volume to the nose. Used correctl;y by a skilled practitioner, they can also be used to change the shape and appearance of the nose. Restylane, Juvederm and Radiesse are a few examples of good options.

I had botox injected in ny last week and i have some swelling and bruising. It has been 5 days and i am a little worried. i am a 47 year old healthy male. Is this normal?

While slight swelling or bruising occurs in a small percentage of patients, do not be alarmed as this is temporary and will subside around day 4-7. If you have any additional swelling, bruising or pain, call your Facial Plastic Surgeon’s office and request an appointment.

I have noticed my undereye area starting to hollow and keep hearing about sculptra. I am only 36 years old and live in new york city. Help!

While I do admire Sculptra for areas of the face such as the cheeks, temples and lower face, the results of Sculptra injected under the eye (directly over muscle) has not been so wonderful. I would stick to something like Restylane or Juvederm for the undereye area as it is not as thick and I have had natural, beautiful results with this.

Question: I have sunken cheeks that make me look old, tired, and malnourished. I don’t want surgical implants. is there another option i can use to fill in my cheeks?

Sculptra® is a facial volume filler that actively stimulates the natural production of collagen. The results are gradual and natural looking. It takes a series of two or three treatments at four-week intervals to complete. Then, maintenance every three years is required. This may be a great option for you to consider but it is important that you find an experienced surgeon with great aesthetic judgment and knowledge of aging.

I am undergoing juvederm treatments wednesday. How long will it be before i see noticeable effects?

You will be able to see noticeable effects with your Juvederm injections immediately. When you achieve your desired result, the treatment will be stopped and you’ll leave with a rejuvenated and youthful new look.

Are there any side effects associated with facial fillers?

Even though fillers are extremely safe, they do come with a few side effects. You may experience bruising at the injection site that will disappear shortly, or you may develop a rare case of sensitivity to the filler. You could also experience some uneven volume under the skin, which can be corrected with massage or removal of a small amount of filler.

How long can i expect my results to last with juvederm? I’m interested in minimizing the wrinkles in my upper lip, beneath my nose.

Juvederm lasts about six months and after that time can be repeated to achieve the same great look. It works best for smile lines and upper lip wrinkles so it is a great choice for you!

As a 48 year old man in manhattan, i have recently adopted a healthier lifestyle and quit smoking. I have many fine lines that feather outward from my lips that haven’t gone away. I definitely do not want bigger lips but was told that a filler around the perimeter of my lips may help soften these lines. Is that so?

Good for you for embracing a healthy lifestyle. Without examining you and assessing the depth and severity of your peri-oral lines, it is difficult for me to give you an accurate recommendation. I have seen this work although there is typically a slight increase in volume of the lip. An in person consultation and examination is your best bet for an in depth discussion of your options.

Written by Dr. Halaas

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