Cosmetic Injections

Dermal filers can be used to enhance specific parts of the face to improve the overall appearance by adding volume and sculpting. As we age, we begin to lose collagen and elasticity, which ultimately leads to fine lines, wrinkles and volume loss. Fillers are used to reduce the appearance of wrinkles, but are also useful for creating contours on the face such as fuller, higher checks; and defined, structured chins.

The primary uses of fillers include:

• Plumping lips
• Enhancing or filling in shadowed areas of the face such as cheeks
• Improving overall symmetry and definition of facial features
• Diminishing or removing under-eye shadows or wrinkles caused by the lower eyelid
• Filling in recessed scars
• Softening static lines around the mouth and nose

Are filler injections painful?
Usually, no. The only discomfort you should feel during the procedure is the initial pinch from the injection. Topical anesthetics may be used to reduce pain during treatment. Some fillers, such as Juvederm and Restylane include lidocaine which reduces pain. A microcannula, rather than a needle, may be used to prevent damage to blood vessels and reduce the amount of bruising you experience.

Precare

• Avoid dental procedures 2 weeks prior to fillers before and after
• It is recommended to discontinue the use of anticoagulants, Aspirin, NSAIDs, Vitamin A, Vitamin E, St. John’s Wart, Garlic, Ginseng, or Cod Liver oil for at least 3 days to 1 week before and after treatment. This will minimized bruising or bleeding
• Please consult with your physician prior to discontinuing any medications
• Avoid alcohol and caffeine for 24-48 hours before and after treatment
• Please notify the provider if you have a history of cold sores. An antiviral will be prescribed due to risk of recurrence of the cold sores
• Vaccinations should be avoided for 2 weeks before and after treatment.

Aftercare

• Avoid significant movement or massage of the treated area.
• You may notice swelling, bruising, or tenderness after the procedure. This is typically minor and resolves within 2-3 days, but can last up to 7-10 days. It is normal to feel “firmness” in the injection area after the treatment, but over time this area will soften leaving you with natural looking results.
• May take over the counter medications such as Tylenol for the discomfort. It is recommended to avoid NSAIDs such as Ibuprofen (Motrin), Aleve, and Aspirin because they have a blood-thinning effect and can lead to more bruising.
• May also take an other the counter antihistamine such as Allegra, Claritin or Zyrtec to help with the swelling.
• Warm or cool compresses can be applied for 5-10 minutes a few times a day the day after treatment. Avoid using ice.
• Avoid strenuous exercise for 24-48 hours after treatment as it can cause areas injected to swell more.
• Try to sleep face up and slightly elevated which will also help reduce swelling. -Dental procedures should be avoided for at least 2 weeks after treatment.
• Change your pillow case after the injection

How long do fillers last?

It depends on which filler is used and where it is injected. Lip fillers can last 4-12 months. Facial filler can last longer at 12-18 months. Much of the endurance of a product has to do with its molecule size. Some fillers have smaller molecules which makes them easier to spread and this better suited for delicate refinements. However, the smaller particles also mean that the body more readily absorb it.

Are fillers reversible?

Most fillers are reversible. Hyaluronic acid-based fillers can be reversed with Hyaluronidase also known as Hylenex. For those who are unhappy with the volume or look of their fillers, Hylenex is a simple way to remedy this. Please let your provider know if you have any allergies or are taking any medications, as Hylenex is contraindicated in some instances due to medication interactions.

Are you bothered by wrinkles or fine lines on your face? Also called dynamic lines, these skin issues develop from repeated expressions such as squinting, smiling and frowning. Botox, Dysport and Xeomin are neuromodulators used to temporarily reduce the appearance of the dynamic lines. Neuromodulators block nerve signals to muscles causing relaxation of the muscle resulting in reduction of appearance of the fine lines. Some popular areas of treatment are the forehead, crows feet, platysmal bands, jaw/TMJ, and lip (lip flip).

Precare

• It is recommended to discontinue the use of anticoagulants, Aspirin, NSAIDs, Vitamin A, Vitamin E, St. John’s Wart, Garlic, Ginseng, or Cod Liver oil for at least 3 days to 1 week before and after treatment. This will minimized bruising or bleeding.
• Please consult with your physician prior to discontinuing any medications.
• Avoid alcohol and caffeine for 24-48 hours before and after treatment.
• Please notify the provider if you have a history of cold sores. An antiviral will be prescribed due to risk of recurrence of the cold sores.
• Vaccinations should be avoided 2 weeks before and after treatment.

Aftercare

• Do not massage or manipulate the area for 4 hours after treatment.
• Do not wear a hat or have any type of firm pressure on the injected areas for 4 hours after treatment.
• Do not lay down for 4 hours after treatment (could spread neurotoxin to muscles not intended to be injected).
• Do not exercise or sit in a sauna for 24 hours.
• Avoid wearing makeup for 12 hours after injections.
• It is recommended that you wait at least 2 weeks before having any other facial treatments.
• Neuromodulators can take up to 14 days to fully take effect. Treatment every 3-4 months is recommended for best results.

Contradications to injectables/neuromodulators

• Neuromuscular disorders (myasthenia gravis, ALS)
• Previous hypersensitivity reactions, or severe allergies
• Your skin is actively inflamed
• Active auto immune diseases such as lupus, rheumatoid arthritis, or Hashimoto’s thyroiditis
• Pregnant/ breastfeeding
• Acute infectious diseases (viral and bacterial) such as influenza, sinusitis, COVID 19
• Inflammatory to the skin in the ares being treated
• Immunocompromised state due to chemotherapy
• Bleeding/coagulation disorders
• Vaccination within 2 weeks of treatment
• Dental work within 2 weeks of treatment
• Certain medications ( tetracycline antibiotics and aminoglycoside antibiotics) should be avoided as they can enhance the effects off the neuromodulators