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Spa, MD: The Results-oriented Revolution

cosmetic treatment with botox injection

Tables

  • Neuromodulator Options

    Neuromodulator Options

     

    Botox*

    Reloxin**

    Product source

    Purified form of botulinum exotoxin A

    Purified form of botulinum exotoxin A

    Indications

    Frown lines between eyes, forehead wrinkles, crow’s-feet, upper lip, lower face and neck

    Frown lines between eyes, forehead, crow’s-feet, upper lip, lower neck

    Onset

    Three days—the peak effect takes place 7–10 days after treatment

    2–3 days—the peak effect takes place 7–10 days after treatment

    Duration

    3–4 months

    3–4 months

    Treatment protocol

    A series of injections every 3–4 months

    A series of injections every 3–4 months

    Cost

    $400–1,500, depending on the number of injections and the amount of material used

    $400–1,500, depending on the number of injections and the amount of material used

    Benefits

    Temporarily paralyzes the muscles that cause lines through negative facial expressions

    Temporarily paralyzes the muscles that cause lines through negative facial expressions

    Risks

    If performed properly, almost none, although bruising, an incomplete effect, brow droop, eyelid droop, lip droop and asymmetry of the effect can occur.

    If performed properly, almost none, although bruising, an incomplete effect, brow droop, eyelid droop, lip droop and asymmetry of the effect can occur.

  • Collagen Options

    Collagen Options

     

    Bovine collagen

    Human collagen

    Porcine collagen

    Product source

    Naturally occurring protein from purified cow skin

    Naturally occurring protein from lab-grown human foreskin tissue

    Porcine (pig) tendons

    Indications

    Fine and moderately deep lines and creases around eyes and lips; lip and lip edge augmentation; scars

    Cosmoderm* for superficial lines, glabellar lines, lip edge; Cosmoplast* for superficial and moderately deep lines and wrinkles, lip edge, lip body and acne scars

    Evolence Breeze** for superficial lines, glabellar lines, lip edge, lip body; Evolence** for lip edge, lip body, and superficial and moderately deep lines and acne scars

    Duration

    2–6 months

    2–6 months

    Long-lasting temporary—at least 12 months

    Treatment protocols

    A series of injections every 2–6 months

    A series of injections every 3–4 months

    One time per year

    Cost

    $400–800 per syringe

    $400–800

    $600–1,000 per syringe

    Benefits

    Versatile, short-acting filler

    Versatile, short-acting filler

    Versatile, short to mid duration-acting filler

    Risks

    Allergic reaction, required skin test, bruising, swelling, incomplete correction, asymmetric results

    Rare allergic reaction, bruising, swelling, incomplete correction, asymmetric

    Rare allergic reaction, bruising, swelling, incomplete correction, asymmetric

  • Hyaluronic Acid Options

    Hyaluronic Acid Options

     

    Restylane and Perlane*

    Juvéderm Ultra and Ultra Plus**

    Product source

    Genetically engineered streptococci

    Hyaluronic acid

    Indications

    Lips, nasolabial folds, marionette lines, tear trough, adding volume to cheeks

    Lips, nasolabial folds, marionette lines, tear trough, adding volume to cheeks

    Duration

    6+ months

    6+ months

    Treatment protocols

    A series of injections every 4–8 months

    A series of injections every 4–8 months

    Cost

    $600–1,000

    $600–1,000

    Benefits

    Natural looking results; lasts for at least 6 months; Restylane good for finesse areas; Perlane good as an underlay and for volume enhancement

    Natural looking results; lasts for at least 6 months; Ultra good for finesse areas; Ultra Plus good as an underlay and for volume enhancement

    Risks

    1–2 days of redness, swelling, bruising, tenderness

    Less redness and swelling than with Restylane and Perlane

  • Semi-permanent Filler Options

    Semi-permanent Filler Options

     

    Radiesse*

    Sculptra**

    Autologous fat

    Product source

    Calcium hydroxyl apatite

    Poly-L-lactic acid

    Fat harvested from other parts of the body.

    Indications

    A volume filler for deep nasolabial folds, marionette lines, and hollow cheeks.

    A volume filler for deep nasolabial folds, marionette lines, and hollow cheeks.

    A volume filler for deep nasolabial folds, marionette lines and fat loss related to aging

    Duration

    12–18 months after a single treatment; if a touch-up treatment is provided, results are even better and duration is longer

    1–2 years after a series of between 3–6 treatments

    Six months to life-long; results are best and effect is longer if one or two touch-ups take place

    Treatment protocols

    Every 12–18 months

    May need touch-ups

    May need touch-ups; varied by individual

    Cost

    $800–2,000 per treatment

    $800–2,000 per treatment

    $1,000–4,500

    Benefits

    Allergic reactions are rare, and results are long-lasting.

    Allergic reactions are rare, and results are long-lasting.

    No possibility of allergic reaction, ubiquitous material, natural appearance

    Risks

    Swelling, redness, bruising and lumping

    Redness, swelling, bruising and lumping; requires a series of treatments to obtain the desired effect

    Redness, swelling and bruising

  • Permanent Fillers Options

    Permanent Fillers Options

     

    Artefill*

    Silicone

    Product source

    Synthetic beads of methyl methacrylate in a base of bovine collagen

    Liquid form of the chemical polymer silicone

    Indications

    Superficial, moderate and deep lines and folds, acne scars, volume loss

    Lips, acne scars, sunken cheeks, nasolabial folds and marionette lines

    Duration

    Permanent

    Permanent

    Treatment protocols

    One treatment with one or two touch-ups provides the best result

    Depends on number of sites and amount of correction desired

    Cost

    $2,500

    $500–1,000 per injection

    Benefits

    Long-lasting benefit; once the desired result is achieved, touch-ups are needed only as the client ages and lines deepen with time

    Long-lasting benefit after a series of treatments; once the desired result is achieved, touch-ups are needed only as the client ages and lines deepen with time

    Risks

    Swelling, redness, bruising and permanent lumps; should not be used in the lips

    Swelling, redness, bruising permanent lumps, and the rare possibility of a late foreign body reaction or migration of the material

By: Jeffery S. Dover, MD, and Amy Kamin
Posted: May 29, 2008, from the June 2008 issue of Skin Inc. magazine.

Until recently, the only effective procedure available to the individual wanting appearance enhancement was a face lift. Throughout the past few years, treatments featuring Botox and fillers, as well as laser and light procedures—in conjunction with good skin care—have revolutionized the ability to rejuvenate an aging face.

Statistics

According to a consumer survey by the American Society for Aesthetic Plastic Surgery (ASAPS) of 1,000 American households in 2007, 83% of women and 78% of men would not be embarrassed to undergo cosmetic surgery. This has been a major shift in society’s views toward cosmetic procedures. It has become trendy to openly contemplate procedures with peers, discuss a physician’s techniques and compare results. This trend, however, is occurring in regard to noninvasive, nonsurgical procedures. Recent statistics from the ASAPS reveal that, of 11.4 million procedures performed, 17%—or 1.9 million—were surgical, such as face lifts, eyelid lifts and liposuction, while 83%—or 9.5 million—were nonsurgical, such as the injection of Botox and fillers, and laser and light-based treatments.

Fillers and injectables

While face lifts are surgical procedures associated with anxiety, high cost,and significant recovery periods, filler and Botox treatments are relatively simple, safe, quick, relatively inexpensive and, in many instances, without downtime. Many individuals who would never consider a cosmetic surgical procedure are happy to have a noninvasive procedure. Because of this, the potential pool of candidates has increased dramatically.

At the same time, there have been incredible technological developments related to these noninvasive options. Product and equipment manufacturers have initiated more aggressive marketing approaches, using increasingly sophisticated and expensive direct-to-consumer television and print campaigns.

History

Since the early 1900s, there has been an interest in finding filler substances to enhance the face. The goal was safe and effective tissue augmentation. The early history, however, is full of examples of poor results and terrible reactions.