Botox® Cosmetic
BOTOX is a protein derived from botulinum toxin that is injected underneath skin to minimize or smooth out lines and wrinkles on the face. When low doses of BOTOX® are used, it selectively weakens or relaxes facial muscles, giving the recipient a clean, smooth facial appearance.
Although there are risks, they are rare. Injection site redness, swelling and bruising are possible and temporary if they occur. Eyelid droop, asymmetry, and lack of effect are also rare occurrences. One can have an allergic reaction to BOTOX®. Those taking certain antibiotics are at risk for an adverse reaction. Anyone who is taking an antibiotic is advised to make your provider aware of this before being injected with BOTOX®. Women who are pregnant or breastfeeding are advised to postpone BOTOX® injections until their little ones are no longer dependent upon them for nutrition.
Is It Safe?
BOTOX® procedures are completely safe when performed under proper sterilization and sanitation guidelines. These guidelines include the following:
Where Can BOTOX® Be Used?
BOTOX® can be used on virtually any area of the body. Areas that are commonly treated include the eyebrows, forehead, eyelids, lips, neck, jawline and the breast areola after breast surgery. BOTOX® is also commonly used under the arms for excessive sweating (Hyperhidrosis).
How Long Does BOTOX® Last?
Results vary depending on the area and amount used. It typically lasts up to 4 months.
Your Treatment
BOTOX® treatment includes an initial consultation, and facial evaluation. An individualized treatment plan to achieve your goals is created. The treatment takes only a few minutes and is nearly painless. Details about how your BOTOX® treatment will be performed will be provided during your initial consultation.
Post Treatment Instructions
Xeomin®
XEOMIN® was developed by Merz Aesthetics and is one of the latest treatments for wrinkle reduction on the market today. XEOMIN (incobotulinumtoxinA) has been approved by the FDA for the temporary improvement in the appearance of moderate to severe glabellar lines (frown lines between the eyebrows) in adult patients.
Is It Safe?
XEOMIN® procedures are completely safe when performed under proper sterilization and sanitation guidelines. These guidelines include the following:
Where can it be used?
XEOMIN® can be used on virtually any area of the body. Areas that are commonly treated include the eyebrows, forehead, eyelids, lips, neck, jawline and the breast areola after breast surgery. XEOMIN® is also commonly used under the arms for excessive sweating.
How long does it last?
Results vary depending on the area and amount used. It typically lasts up to 4 months.
Your Treatment
XEOMIN® treatment includes an initial consultation, and facial evaluation. An individualized treatment plan to achieve your goals is created. The treatment takes only a few minutes and is nearly painless. Details about how your XEOMIN® treatment will be performed will be provided during your initial consultation.
Post Treatment Instructions
Dysport®
Dysport® is an injection used to temporarily improve the look of your moderate to severe frown lines without changing the look of your whole face. The untreated facial muscles still work normally, allowing you to freely show facial expressions, such as smiling, in untreated areas.
Dysport® is a formulation that has been shown to deliver temporary improvement in moderate to severe frown lines, even with repeat treatments. So, the effect of repeat treatment with Dysport® may be comparable to your first use.
Where can it be used?
*off label-use
How long does it last?
On average Dysport can last up 3 to 4 months. In some cases, it can last up to 6 months.
Your Treatment
With each treatment an initial consultation will be performed to make sure you are candidate for this procedure. An individualized treatment plan will be created for you to achieve optimum results.
Post Treatment Instructions
Radiesse®
Radiesse® is a non-surgical, cosmetic procedure that supplements your skin’s own depleted collagen to smooth out deep facial wrinkles and creases and minimize scars. It is injected just below the surface of the skin and is particularly effective smoothing out the deep wrinkles or creases that appear as folds between the nose and mouth or on the sides of the nose. Radiesse® contains the same compounds found in human bones and teeth so there is almost no risk of allergic reaction. Radiesse® is a safe and proven alternative to bovine collagen injections and solid facial implants.
Radiesse® is approved by the FDA and has been successfully used by thousands of men and woman over the last seven years. Treatment results are immediate, and the results typically last several months. Of course, results may vary among individuals. Our providers will work with you to develop a collagen replacement program to meet your individual needs and to give you the results you desire.
Is it safe?
Radiesse® was approved by the FDA nearly a decade ago and since then has undergone continued testing in accordance with strict FDA requirements. Thousands of men and women have used Radiesse® to safely and successfully smooth out deep facial wrinkles, creases, and folds.
Where can it be used?
Radiesse® is injected just below the surface of the skin, filling in the deep creases and folds that often form between the nose and mouth and on either side of the nose. It can also be used to enhance the area surrounding the lips and to minimize acne scars. The doctor will determine which areas to inject with Radiesse® based on an evaluation of the skin on your face and neck.
How long does it last?
Radiesse® supplements your skin’s own depleted collagen, smoothing out wrinkles, minimizing scars, and improving the appearance of deep frown lines and nasal furrows. Radiesse® is a safe, effective, non-surgical wrinkle treatment that provides immediate, natural looking results. Depending on the area treated, the improvement in wrinkles, creases, and folds may last for several months or even years. Some touch-up treatments may be necessary. As with all cosmetic procedures, results may vary, and it is best to discuss your individual case with our Medical Director.
Your Treatment
Radiesse® is a collagen replacement therapy especially suited to smoothing out the deep wrinkles or creases that appear as folds between the nose and mouth or on the sides of the nose. No anesthesia is required for your Radiesse® treatment, although the doctor may numb the area with a cold pack or anesthetic cream. The doctor uses an ultra-fine needle to inject Radiesse® into the areas of the face and neck that appear folded, creased, or wrinkled. Most patients compare the injection to the feeling of a small pinprick.
Unlike other dermal fillers, Radiesse® is not absorbed into your system, therefore, the provider does not need to overfill the wrinkled area. The entire treatment takes less than an hour, depending on the number of areas being treated. Results with Radiesse® are immediate, so you can determine at first glance if you are happy with the results or if you wouldlike additional injections of Radiesse®. Usually one treatment is enough because Radiesse® is not absorbed by the body and is long lasting.
No recovery time is required; you may resume normal activity immediately. Side effects of the procedure are minimal, other than short- term swelling and redness in the areas of the injections. Results appear immediately and can last for several months or even years.
Pre-Treatment Instructions
Post Treatment Instructions
Belotero Balance®
BELOTERO BALANCE® is an injectable filler that is used to smooth moderate-to-severe etched-in lines and wrinkles on your face. Upon injection, it quickly and evenly integrates into your skin.
BELOTERO BALANCE® is a hyaluronic acid injectable filler designed to integrate into facial skin tissue. The unique manufacturing process for BELOTERO BALANCE® yields a soft and cohesive gel that, once injected, instantly fills the skin to help smooth moderate-to-severe etched-in lines and wrinkles. While the product is versatile enough to handle moderate nasolabial folds (smile lines around the mouth), it may be an ideal option for treating delicate areas such as etched-in smile lines and vertical lip lines (thin lines that appear above and around the lips)
BELOTERO BALANCE® is made of a material called hyaluronic acid (HA), which naturally exists as a component of your skin. By binding to water, it fills in wrinkles and folds, allowing immediate and smooth correction.
Is it safe?
BELOTERO BALANCE® is FDA approved and clinically proven safe and effective.1 Hyaluronic acid products for wrinkle correction have been available for a long time and used in thousands of treatments.
How long does it last?
Individual results may vary, but BELOTERO BALANCE® may last about 6 months or more. Some factors that affect how long it lasts are the amount of product used and the area it is injected into. In areas that experience a lot of movement due to eating, talking, and smiling, the product may not last as long as other less active areas.
Who should not use BELOTERO BALANCE®?
BELOTERO BALANCE® should not be used in patients with a history of or presence of multiple or severe allergies, including those with a history of anaphylaxis. BELOTERO BALANCE should not be used in patients with allergies to gram-positive bacterial proteins.
What is the most important information I should know about BELOTERO BALANCE®?
Introduction of BELOTERO BALANCE® into the vasculature may lead to embolization, occlusion of the vessels, ischemia, or infarction. Take extra care when injecting soft tissue fillers, for example inject the product slowly and apply the least amount of pressure necessary. Rare but serious adverse events associated with the intravascular injection of soft tissue fillers in the face have been reported and include temporary or permanent vision impairment, blindness, cerebral ischemia or cerebral hemorrhage, leading to stroke, skin necrosis, and damage to underlying facial structures. Immediately stop the injection if a patient exhibits any of the following symptoms, including changes in vision, signs of a stroke, blanching of the skin, or unusual pain during or shortly after the procedure. Patients should receive prompt medical attention and possibly evaluation by an appropriate health care practitioner specialist should an intravascular injection occur.
As with all events that involve an injection through the skin, there is a risk of infection. Laser treatments or chemical peels or any other treatments that affect the skin can increase the risk of infection. Do not use BELOTERO BALANCE® if you have a skin inflammation or a skin infection. Do not use until the infection is healed.
Patients getting BELOTERO BALANCE® may have an injection site reaction. These reactions can include inflammation and usually last less than seven days. For approximately 24 hours after treatment, avoid:
It is not known how BELOTERO BALANCE® will work in areas of the face other than the smile lines. It is not known how BELOTERO BALANCE® will work in women who are pregnant or breastfeeding or people who are less than 21 years of age.
What should I tell my doctor before injections with BELOTERO BALANCE?
Tell your doctor if you are taking medicines that affect blood clotting, like aspirin, an NSAID or warfarin. These medicines may put you at an increased risk of bruising or bleeding at the treatment site. Tell your doctor if you have a skin reaction like cold sores, cysts, pimples, rashes, hives, or an infection. Treatment with BELOTERO BALANCE® should be delayed until the reaction goes away. Tell your doctor if you are taking medicines that affect your immune system.
Restylane®
Restylane® was the first hyaluronic acid dermal filler specifically designed to treat moderate facial wrinkles and folds.
Restylane® is an injectable gel made of hyaluronic acid, a substance naturally found in the body that attracts and binds water molecules to add volume. When injected into the face, results are instant, adding volume to restore skin contours for a more youthful appearance.
Restylane® replaces lost volume to smooth away wrinkles and define facial contours providing immediate results. Restylane is a clear gel formulation of hyaluronic acid that is specifically formulated to act like your body's own hyaluronic acid. Restylane can be used to visibly reduce moderate-to-severe facial wrinkles and folds for a more youthful appearance.
Is it safe?
Restylane® is the world's most studied wrinkle filler with more than a decade of use. With over 80 clinical publications and more than 20 million treatments worldwide, Restylane products have an unparalleled legacy and a well-defined safety profile.
Is it Natural?
Restylane® contains hyaluronic acid that closely resembles your body’s own hyaluronic acid, giving a natural-looking result. Biocompatible with the human body, Restylane products are eventually broken down naturally.
Restylane is not a toxin and does not affect facial expression or movement. Restylane is also non-permanent.
How long does Restylane® last?
The unique hydrophilic nature of Restylane delivers results that generally last for about six months. And, because Restylane binds to the water in your body, its cosmetic effects are maintained until the injected material is nearly gone. Of course, individual results may vary, and it is best to discuss your individual case with Dr. Ruff and the team at West End Plastic Surgery during your initial consultation.
Restylane® Treatment
Restylane®, a crystal-clear gel, is injected directly into the skin in tiny amounts using an ultra-fine needle. The gel fills the skin’s wrinkles and depressions by plumping the skin with water-binding, naturally occurring hyaluronic acid. The doctor may numb the treated area, however, there is minimal discomfort during or after the procedure. The procedure is simple and convenient, and results are practically instantaneous.
Restylane® treatments produce a low occurrence of side effects. The most commonly reported side effects are temporary redness and mild swelling at the injection site. Both the redness and the swelling generally disappear within seven days of your treatment.
Restylane® Pre-Treatment Instructions:
Restylane® Post treatment Instructions:
Where do you use Restylane®?
Contraindications
Restylane® Lyft 1.0
Over time, natural fat begins to deteriorate, resulting in sagging skin, more prominent wrinkles and a reduction of volume. Restylane® Lyft, formerly known as Perlane-L®, is an injectable hyaluronic acid gel used to correct volume loss and treat wrinkles in the face and hands. Through nonsurgical injections, Restylane® Lyft is specifically designed to add fullness to the cheeks, midface area, and the back of the hands to help complete your aesthetic look — for face and hands.
Is it safe?
Restylane® is the world's most studied wrinkle filler with more than a decade of use. With over 80 clinical publications and more than 20 million treatments worldwide, Restylane® products have an unparalleled legacy and a well-defined safety profile.
How long does Restylane® last?
The unique hydrophilic nature of Restylane delivers results that generally last for about six months. And, because Restylane binds to the water in your body, its cosmetic effects are maintained until the injected material is nearly gone. Of course, individual results may vary, and it is best to discuss your individual case with Dr. Ruff and the team at West End Plastic Surgery during your initial consultation.
Restylane® Treatment
Restylane®, a crystal-clear gel, is injected directly into the skin in tiny amounts using an ultra-fine needle. The gel fills the skin’s wrinkles and depressions by plumping the skin with water-binding, naturally occurring hyaluronic acid. The doctor may numb the treated area, however, there is minimal discomfort during or after the procedure. The procedure is simple and convenient, and results are practically instantaneous.
Restylane® treatments produce a low occurrence of side effects. The most commonly reported side effects are temporary redness and mild swelling at the injection site. Both the redness and the swelling generally disappear within seven days of your treatment.
Restylane® Pre-Treatment Instructions:
Restylane® Post treatment Instructions:
Where do you use Restylane® Lyft?
Contraindications
To ensure a safe procedure, your doctor will talk to you about your medical history to determine if you are an appropriate candidate for treatment. You should not use products within the Restylane family if:
Are there other precautions that I should discuss with my doctor?
What are the possible side effects?
The most commonly observed side effects are swelling, redness, pain, bruising, headache, tenderness, lump formation, itching at the injection site, and impaired hand function. These are typically mild in severity and typically resolve in less than 7 days in nasolabial folds and less than 14 days in lips. Serious but rare side effects include delayed onset infections, recurrence of herpetic eruptions, and superficial necrosis at the injection site.
One of the risks with using this product is unintentional injection into a blood vessel. The chances of this happening are very small, but if it does happen, the complications can be serious, and may be permanent. These complications, which have been reported for facial injections, can include vision abnormalities, blindness, stroke, temporary scabs, or permanent scarring of the skin.
Restylane® Silk 1.0
Restylane® Silk is the first filler formulated with lidocaine that is FDA approved specifically to for rejuvenation of the lips and lines around the mouth. Like the well-established Restylane® filler, Restylane® Silk is a hyaluronic acid (HA) filler made from long chains of sugars that occur naturally in the skin. It is uniquely formulated and cross-linked to create a softer consistency that fills in lines with a very natural look. And since it is an HA filler, it can be carefully molded and shaped into the desired contour after injection.
What makes Restylane® Silk different?
The loss of volume is one of the hallmarks of facial aging. This occurs in varying degrees of severity and can lead to significant changes in the facial appearance. One of the most noticeable changes is the loss of cheekbone definition. Historically, this was addressed with surgery to tighten the overlying skin and lift the deeper soft tissues. More recently, volumizing fillers have been used to provide a similar ‘lift’ without surgery. The goal is to restore volume in the midface to create a natural, youthful face.
What are the goals of a Restylane® Silk treatment?
Patients who are good candidates for treatment either desire more fullness of their lips or a lip rejuvenation. Using small amounts of Restylane® Silk filler placed correctly, natural lip fullness can be created. However, many patients do not desire fuller lips, but would rather like to rejuvenate the lips and eliminate the fine lines around the mouth. This can also be accomplished, with no significant change to the size of the lips. Rather, this type of lip rejuvenation will serve to define the lips, rather than augment them.
Does Restylane® Silk treatment of the lips look unnatural?
One of the major misconceptions about lip filler treatments is that the results look unnatural. While in inexperienced hands this can certainly occur, a proper lip treatment result should always look natural.
What should I expect after a Restylane® Silk injection?
Results are immediate and typically last for several months, and often up to one year. The duration of filler correction depends on the facial area treated, the injection technique, and the rate that the patient’s tissues break down the filler. Most patients can resume their daily activities immediately after treatment. Some patients may experience slight swelling and bruising, but this typically improves rapidly.
Is there any downtime after a Restylane® Silk injection?
There is no downtime after treatment, and patients may return to their normal activities. In some patients, there are temporary side effects, such as minor swelling and bruising, but these are usually mild.
What are the common side effects of a Restylane® Silk treatment?
Side effects are generally minor, such as bruising or mild swelling, and can be easily concealed with makeup. Avoiding certain medications and supplements, such as baby aspirin and fish oil, can minimize bruising.
How do I know if Restylane® Silk is right for me?
To learn if Restylane® Silk is right for you, Dr. Greene will perform a thorough consultation. Dr. Greene has experience with several different fillers and will select the best filler combination for you.
Can Restylane® Silk be removed or dissolved?
One of the major advantages of Restylane® Silk is that it is composed of hyaluronic acid (HA). If necessary, HA fillers can be dissolved with an enzyme in a very simple procedure.
Does Restylane® Silk require any special training or experience?
All facial fillers require extensive experience to achieve the absolute best results. Use of a filler such as Restylane® Silk requires experience and advanced understanding of anatomy of the face. There is significant variability among patients’ anatomy and each treatment is unique, requiring a trained eye and artistic understanding of the lips and surrounding area.
Are the treatments with Restylane® Silk painful?
Patients usually report only minimal or mild discomfort during treatment. Restylane® Silk is formulated with lidocaine to enhance patient comfort.
Can Restylane® Silk be combined with other facial fillers?
Restylane® Silk is often used with other facial fillers during a patient’s treatment. While Restylane® Silk can be used safely in most areas of the face, it is ideally suited for the lips and areas around the mouth.
What ages are most appropriate for treatment with Restylane® Silk?
While theoretically any patient with deficiency in the lips and/or perioral area (around the mouth) could benefit from Restylane® Silk treatment, there are some important principles to understand when it comes to selecting appropriate patients for Restylane® Silk treatment. Younger patients with minimal volume loss may desire more fullness to their lips, while older patients often want to rejuvenate and enhance the area around the lips, eliminating the fine lines and sunken look. Regardless, there is no absolute age limit for Restylane® Silk treatment.
Restylane® Defyne
The core idea behind Restylane® Defyne is to reduce the appearance of wrinkles by increasing support under the skin. One of the reasons why nasolabial folds develop is the deterioration in collagen and elastin support network, which causes the skin to become inelastic. Using a filler like Restylane® Defyne can create a subtle increase in volume at the treatment site, which helps to smooth out the folds. Further, the hyaluronic acid in this filler will draw moisture to the area, thus increasing support and providing greater hydration to skin cells and fibroblasts.
What Restylane® Defyne Treats?
Restylane® Defyne was primarily developed for the treatment of nasolabial folds (the lines that run from the corners of the nose to the corners of the mouth). It’s typically a good choice for this area because the filler is formulated with XpressHAn technology, which allows for greater support while generally being more flexible than traditional hyaluronic acid fillers. However, Restylane® Defyne is not necessarily limited just for use around nasolabial folds, and may be administered to treat other issues, like marionette lines.
How long does Restylane® Defyne Last?
One of the benefits of Restylane® Defyne is the longevity of the results. For example, many patients have reported positive effects that lasted if 12 months after just one treatment. However, touch up treatments can be performed to extend positive results.
Additionally, this injectable can be combined with other procedures, like Intense Pulsed Light therapy, chemical peels, or retinol creams to help you achieve your aesthetic goals.
What to expect during Restylane® Defyne Treatment?
When visiting our office for Restylane® Defyne treatments, keep in mind that your doctor can be a great resource for choosing the best injectable treatment in your situation. There are many dermal fillers currently available, and each produces somewhat different results. Based on your aesthetic goals, your doctor will help you select the best treatment plan for your unique situation. When it comes time to administering Restylane® Defyne, many patients are surprised by how comfortable the treatment is. Our providers use very small needles and are experts in performing injections in a way that is quick and virtually painless.
Does Restylane® Defyne have Side Effects?
Common side effects from Restylane® Defyne are typically associated with the injection process rather than the filler itself. During the injection, a small needle will penetrate the skin, which will elicit the body’s inflammatory response. Therefore, it’s common to experience mild redness and inflammation for 24-48 hours after treatment. However, any such side effects are easily addressed with makeup and typically will not impact your social calendar.
Restylane® Refyne
Restylane® Refyne and Defyne are the newest additions to the Restylane family. They are specifically formulated hyaluronic acid dermal fillers that are specifically used to correct smile (marionette) lines for a more natural and youthful looking face.
The main difference between the two is that Restylane® Refyne treats mild to moderate lines and wrinkles, while Restylane® Defyne is used to treat moderate to severe smile lines. Both fillers are long lasting – up to 12 months.
Restylane® Refyne is for mid-to-deep injection into the facial tissue for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds, in patients over the age of 21.
What is Restylane® Refyne for?
As you age, your facial skin begins to lose its elasticity and volume. As a result, your “laugh lines”, the creases that run from the sides of your nose toward the corners of your mouth, become more pronounced. Restylane® Refyne injectable gel is designed to temporarily help counter this by smoothing out these wrinkles and folds and restoring a natural, soft look to your face. Restylane® Refyne has been shown to maintain this effect for up to 12 months.
How is Restylane® Refyne used?
Restylane Refyne® is injected into the facial skin through a small needle to smooth facial wrinkles and folds (laugh lines), resulting in a more youthful appearance of the skin. For most patients, the procedure only takes 15 – 30 minutes.
Are there any reasons why I should not receive Restylane® Refyne?
Before using Restylane® Refyne, your doctor will talk to you about your medical history to determine if you are an appropriate candidate for treatment. You will be asked questions about possible allergies to ensure that Restylane Refyne can be safely administered. Tell your doctor about all your medical conditions, including if you:
What happens in the office before the injection?
The following is an example of what your doctor may do before the injection procedure.
What happens during the procedure?
Your doctor may do the following during your procedure:
Your doctor will also tell you what to expect following treatment. For the first 24 hours, you should avoid or minimize hard (strenuous) exercise. You should also avoid or minimize exposure to extensive sun or heat. Exposure to any of these may cause the area where you were treated to temporarily become red, swell and/or itch. If you experience any of these, an ice pack can be applied for relief.
Juvederm® Ultra 1.0
Recently approved by the FDA, JUVÉDERM® injectable gel is a “next- generation” dermal filler. The smooth consistency gel helps to instantly restore your skin’s volume and smooth away facial wrinkles and folds, like your “smile lines” or “parentheses” (nasolabial folds-the creases that run from the bottom of your nose to the corners of your mouth).
JUVÉDERM® is made of hyaluronic acid-a naturally occurring substance in your skin that helps to add volume and hydration. JUVÉDERM® injectable gel employs its unique manufacturing process to provide the highest concentration of cross-linked hyaluronic acid of any currently available hyaluronic acid dermal filler for long-lasting results. This advanced manufacturing process works to create a smooth consistency gel that flows easily into the skin and provides a smooth, natural look and feel. All other currently approved hyaluronic acid dermal fillers are made of granular consistency gels. And, JUVÉDERM® is the first hyaluronic acid dermal filler that has demonstrated its safety and effectiveness in persons of color.
Where can it be used?
JUVÉDERM® injectable gel temporarily adds volume to facial tissue and restores a smoother appearance to the face.
By injecting JUVÉDERM® into the mid to deep dermis (below the outer layer of skin), the appearance of moderate to severe facial wrinkles and folds, such as nasolabial folds (the creases running from the bottom of your nose to the corners of your mouth), can be dramatically improved.
How long does it last?
The unique formulation of JUVÉDERM® provides results that last up to 6 months or longer.
The treatment
No anesthesia is required for your JUVÉDERM® treatment, although your doctor may numb the area with a cold pack or anesthetic cream. The injection site will be determined by examining the appearance of the skin throughout your face and neck area. Your doctor will use an ultra-fine needle to inject JUVÉDERM® into those areas of your face and neck that appear sunken or hollow. The entire procedure takes about 10 minutes and there is minimal discomfort during or after the procedure. Most patients compare the injection to the feeling of a pinprick.
Most side effects are mild or moderate in nature, and their duration is short lasting (7 days or less). The most common side effects include, but are not limited to, temporary injections site reactions such as: redness, pain/tenderness, firmness, swelling, lumps/bumps, bruising, itching, and discoloration. As with all skin injection procedures, there is a risk of infection.
Post Treatment Instructions
Within the first 24 hours, you should avoid strenuous exercise, extensive sun or heat exposure, and alcoholic beverages. Exposure to any of the above may cause temporary redness, swelling, and/or itching at the injection sites. If there is swelling, you may need to place an ice pack over the swollen area.
Be sure to report any redness and/or visible swelling that last for more than a few days or any other symptoms that cause you concern.
Juvederm® Ultra Plus 1.0
Juvederm Ultra Plus ® is a part of Juvederm’s modified Hyaluronic Acid Dermal Fillers product suite and an upgrade from its predecessor, Juvederm Ultra. Hyaluronic Acid or HA is a naturally occurring acid in the human body. HA is touted for its ability to lubricate joints and retain skin’s moisture. It is also known for aiding the body in delivering nutrients.
Specifically designed to correct age related facial volume-loss, smooth perioral lines and create fuller more youthful lips Juvederm® Ultra Plus has a slightly thicker consistency than Juvederm® Ultra. This thicker formula is often recommended for lips and for deeper lines, folds and wrinkles.
Who is a good candidate for Juvederm® Ultra Plus?
Anyone who shows signs of aging around the chin and mouth or who would like fuller, smoother lips is most likely a good candidate for Juvéderm Ultra Plus ®. Please contact us and schedule your free consultation online to find out more about Juvéderm® Ultra Plus and to discuss your individual requirements.
When can I expect to see results?
As a rule, most providers agree that you will see immediate results after your first treatment; however, full results will not be seen for a week to several weeks as swelling and bruising fades over time. It is important to follow-up with your provider in 2-3 weeks to be sure that you are both pleased with the results.
Does Juvederm® Ultra Plus hurt?
Most clients report little or no pain during the injection process. A mild dose of lidocaine, a highly effective numbing medicine, is added to each dosage of Juvéderm® Ultra Plus. In addition, the needle used for Juvéderm® Ultra Plus is much thinner than the average medical needle, such as those used to draw blood.
How long does it last?
The unique formulation of JUVÉDERM® provides results that last up to 6 months or longer.
The treatment
No anesthesia is required for your JUVÉDERM® treatment, although your doctor may numb the area with a cold pack or anesthetic cream. The injection site will be determined by examining the appearance of the skin throughout your face and neck area. Your doctor will use an ultra-fine needle to inject JUVÉDERM® into those areas of your face and neck that appear sunken or hollow. The entire procedure takes about 10 minutes and there is minimal discomfort during or after the procedure. Most patients compare the injection to the feeling of a pinprick.
Most side effects are mild or moderate in nature, and their duration is short lasting (7 days or less). The most common side effects include, but are not limited to, temporary injections site reactions such as: redness, pain/tenderness, firmness, swelling, lumps/bumps, bruising, itching, and discoloration. As with all skin injection procedures, there is a risk of infection.
Post Treatment Instructions
Within the first 24 hours, you should avoid strenuous exercise, extensive sun or heat exposure, and alcoholic beverages. Exposure to any of the above may cause temporary redness, swelling, and/or itching at the injection sites. If there is swelling, you may need to place an ice pack over the swollen area.
Be sure to report any redness and/or visible swelling that last for more than a few days or any other symptoms that cause you concern.
Juvederm® Voluma
Juvederm® Voluma is the first filler formulated with lidocaine that is FDA approved to restore age-related volume changes in the cheeks. Unlike other fillers commonly used to treat the midface, Voluma is a hyaluronic acid (HA) filler. HA fillers are made from long chains of sugars that occur naturally in the skin.
Does it hurt?
Voluma is pre-mixed with lidocaine (a numbing agent) so most patients find the treatment to be very comfortable. The only discomfort is the injection into the skin which is done through a very fine gauge needle and feels like a quick pinch. As the Voluma gel is placed, you will feel mild pressure.
How long does it last?
Voluma is the longest lasting of the FDA approved facial fillers, lasting up to 2 years or more. In fact, Voluma is the only hyaluronic acid filler approved by the FDA to specifically contour and volumize the midface. Other fillers typically have a life cycle of between 6-9 months.
What do I have to do to prepare for Juvederm® Voluma?
The preparation is essentially the same as with any filler. Patients should discontinue any nonessential vitamins, herbal supplements and pain medication such as aspirin or Advil. This will reduce the chances of bruising.
A homeopathic supplement that we recommend helping with swelling and bruising is Arnica. Arnica gel can also be applied 2 or 3 times a day to the injection sites. People who swell easily can prepare by taking Claritin or Zyrtec for a few days before the treatment.
Patients should refrain from heavy alcohol consumption the night before and day after treatment.
What are the benefits of Juvederm® Voluma?
Everyone can experience different results. A dose in one person can result in a dramatic change, while it may have a very minimal impact on someone else. The effects of a Juvederm® Voluma injection should be immediately visible, with continuous correction as new collagen regenerates. Contoured areas will immediately appear fuller, rounder, and more lifted.
Juvederm® Volbella
Juvederm® Volbella is a hyaluronic acid dermal filler, specifically formulated for the delicate skin covering the lips. Volbella is a thinner, more pliable substance compared to other facial fillers, providing a smooth, natural effect. Volbella adds volume and plumpness to the lips, while smoothing fine lines around the mouth as well. This filler is rapidly gaining popularity over other lip fillers, especially since Volbella contains lidocaine which reduces swelling at the injection sites and makes the procedure much more comfortable.
Juvederm® Volbella is a colorless injectable gel of hyaluronic acid, a natural component in the skin. It includes a small amount of lidocaine for an anesthetic effect, improving the comfort of the injection. Fillers provide immediate correction with long lasting effects.
Does it hurt?
Although the lip area may be slightly more spicy than other areas of the face the product includes lidocaine for improved your comfort. Your provider can also topically numb the area prior to treatment to give you an even more comfortable experience. Most report minimal discomfort.
How long does Juvederm® Volbella last?
Although correction is temporary, it is immediate and long lasting (up to 1 year). The filler is naturally broken down and absorbed by the body. Repeat injections are usually needed to maintain optimal correction.
How many of Juvederm® Volbella treatments do I need?
Only one treatment is required to achieve optimal results but remember, correction is temporary. The product will naturally break down and be absorbed by the body over time.
How do I prepare for my Juvederm® Volbella appointment?
Prior to your treatment appointment you will need to remove all makeup, or the provider can do it for you. The skin is then prepped with an antiseptic topically to prevent the introduction of bacteria during the injections.
What should I do or expect post Juvederm® Volbella treatment?
Your provider may recommend that you do not exercise strenuously, have extensive sun or heat exposure (like hot tubs or saunas), and drink alcoholic beverages for 24 hours. This can help to prevent temporary redness, swelling, and/or itching of the injection sites. Your provider may advise you to place an ice pack over any swollen areas. Ask when makeup may be used after your treatment.
Kybella®
Fat below the chin is difficult to eliminate, even for women and men who watch what they eat and get plenty of exercise. A double chin is a common concern for many people, no matter how thin they are.
Kybella® is the first safe and effective minimally invasive treatment that specifically targets the submental fat that causes the appearance of a double chin. It uses a chemical that occurs naturally in the body, deoxycholic acid, which helps break down and eliminate dietary fat. When it’s injected, Kybella® destroys fat cells in the treatment area. The damaged cells are then flushed away naturally by the body, resulting in a slimmer, smoother contour. Most patients see optimal results after 2 to 4 treatment sessions.
Are there alternatives?
Kybella® represents a groundbreaking alternative to other surgical and non-surgical procedures that improve the appearance of the neck and jawline. It is the only injectable treatment specifically designed to eliminate fat under the chin. Other treatments include:
Your provider may recommend one of these other treatments if the skin on your neck has lost elasticity or the underlying tissue and muscle of your lower face and neck need lifting to get the aesthetic results desired.
What are the side effects of Kybella® treatments?
Kybella® treatments require little to no downtime, but there are some minor side effects that typically last a few days. The most common side effects are swelling and bruising. Icepacks and pain relief medication are typically enough to manage any discomfort associated with the treatment. Some patients notice redness or tenderness around the treatment area. These are temporary and resolve quickly.
Are the results permanent?
Yes. Fat cells destroyed by Kybella® injections are eliminated from your body, so the results are considered permanent. Even patients who gain a moderate amount of weight after getting Kybella® treatments should not notice the re-emergence of a double chin. The aging process continues, which results is the loss of skin elasticity, and patients who gain significant weight likely will see the Kybella® results compromised.
Sculptra®
Sculptra® is a non-surgical, cosmetic treatment for reducing facial lines and wrinkles and creating a fuller, more youthful appearance to your face. Also known as the “liquid facelift,” Sculptra® works by both filling in lines and wrinkles and by stimulating your body to produce new collagen and underlying tissue. Sculptra achieves excellent results in treating all parts of the face including the areas around the eyes and lips, between the mouth and nose, and throughout the cheeks and neck. It adds volume to the cheeks, to folds around the chin, and to hollow areas around the eyes.
Sculptra® is a safe, Federal Food and Drug Administration (FDA) approved synthetic material that is injected below the surface of the skin directly into the areas of the face that appear sunken or hollow. Unlike many of the injectable facial fillers, the results achieved with Sculptra® can last two years or more because it causes the body to stimulate its own collagen. Of course, results may vary among individuals.
Sculptra® has been used in over 30 countries to treat a variety of facial volume and contour deficiencies. It is only available through a licensed practitioner and has helped hundreds of men and woman restore the fullness and youthful appearance of their facial features.
Is it safe?
The material in Sculptra®, poly-L-lactic acid, is a synthetic version of the substance that your muscles naturally produce during exercise. This material has been used in plastic and reconstructive surgery for more than 20 years. Sculptra® treatment has been used worldwide to improve the appearance of folds and sunken areas of the face and neck.
Approved outside the United States for many years, Sculptra® was recently approved by the U.S. Federal Food and Drug Administration (FDA) as the only product for the restoration of areas of the face and neck that have become hollow or sunken due to age or illness. While there are some possible minor side effects, medical research shows that Sculptra® injections are safe for most people. However, Sculptra® treatments should only be performed by a Board-Certified plastic surgeon experienced with all aspects of the procedure.
Where Can Sculptra® Be Used?
Facial fat loss is the loss of fat beneath the skin, which can result in sunken cheeks, indentations, and hollow eyes. This condition can occur because of aging or certain illnesses. Sculptra® is a safe, synthetic, and biocompatible material that is injected below the surface of the skin around fat loss. It achieves excellent results in all parts of the face including the areas around the eyes and lips, between the mouth and nose, and throughout the cheeks and neck. It adds volume to the cheeks, to folds around the chin, and to hollow areas around the eyes.
How Long Does Sculptra® Last?
Sculptra® treatment provides a gradual and significant increase in skin thickness, improving the appearance of folds, indentations, and sunken areas in the face and neck. The results achieved by Sculptra® are natural looking and appear gradually over a few weeks’ time. Because Sculptra® stimulates the body to produce its own collagen, the results can last up to two years or longer in some cases. Our team may suggest minor touch-up treatments to maintain the desired effect. Of course, results may vary, and it is best to discuss your individual case with Dr. Ruff and his staff at West End Plastic Surgery during your initial consultation.
Sculptra® Treatment
Sculptra® is a crystal-clear gel. Its injected directly into the skin in tiny amounts using an ultra-fine needle. The gel fills the skin’s wrinkles and depressions by plumping the skin with water-binding, naturally occurring hyaluronic acid. The doctor may numb the treatment area, however, there is minimal discomfort during or after the procedure. The procedure is simple, convenient, and results are practically instantaneous.
Sculptra® treatments produce a low occurrence of side effects. The most common side effects are temporary redness and mild swelling at the injection site. Both the redness and the swelling generally disappear within seven days of your treatment.
Pre-Treatment Instructions
Prior to your Sculptra treatment please make sure you have not been taking aspirin, ibuprofen, or any other blood thinning medication or supplement for 5-7 days.
Please come to your appointment with clean skin, free of any make-up or lotions/creams.
If you have a history of facial cold sores, please inform your provider about medications that you take to minimize risk of reoccurrence.
Post Treatment Instructions
A temporary amount of mild-moderate swelling and redness at the injection site can occur immediately after treatment. This is a normal occurrence and will reduce over the next few days. Cold compresses or ice packs on the treatment area can improve comfort.
Bruising at the injection site is a common side effect. The extent and duration of bruising can decrease by applying cold compresses and using a topical arnica gel within the first 24 hours after treatment.
It is normal to experience some tenderness at treatment site for a few days.
Massage the treated areas with a firm circular motion 3 times daily, for 5 minutes and continue this for 7 days following any injection session.
A few hours after treatment you may wash the injection site. Please avoid aggressive scrubbing or rubbing.
Makeup can be applied shortly after treatment unless otherwise noted by treatment provider. Please make sure to apply gently over treatment site. Avoid exercise or alcohol for 6 hours after treatment.
DO NOT have laser, microdermabrasion, chemical peel, or any other aggressive treatments over treatment site for a minimum of 2 weeks. Avoid sunbathing or excessive UV exposure until the redness and swelling subside.
Immediately report any worsening, persistent symptoms, or side effects to the office. Follow up injections should be within 4-6 weeks.
