-
Botox injections for wrinkle reduction as well as for unwanted or excessive sweating
Botox is a purified protein toxin produced by the Clostridium botulinum bacteria. Although it is a toxin, the doses used for medical treatment are so small that serious side effects have not been seen and are unlikely to develop.
Botox works on dynamic wrinkles - wrinkles caused by repeated contraction of specific muscles just beneath the skin's surface. Many wrinkles or expression lines are actually creases formed in the skin from making the same expressions repeatedly. The most common areas for the use of Botox are the frown lines between the eyebrows, the horizontal forehead creases, and crow's feet or laugh lines alongside of the eyes. Neck creases can also be improved with Botox.
How does Botox work?
A tiny amount of Botox is injected with a very small needle into the muscle creating the wrinkle. Botox then blocks the nerve impulse from reaching the muscle and, as a result, the muscle becomes weaker. Botox's intended effect on the muscle develops gradually over 7 to 10 days. In some cases, the muscle becomes so weak that it will not contract at all and at other times it becomes weaker while still allowing some contraction. The overlying skin then relaxes and the wrinkles gradually soften and often disappear.
Over a period of time, the injected muscle gradually regains normal function. This recovery of function varies among patients and ranges anywhere from 6 weeks to 6 months. Once the muscle is able to contract again, wrinkles will reappear. Repeat injections will again weaken the muscle and flatten the wrinkles. After several treatments, the effect of Botox may last longer as the muscle becomes weakened through disuse atrophy.
Are Botox injections painful?
When Botox is injected, there is a minor stinging sensation, which lasts for a few seconds. The dermatologist may apply ice to the treatment area for a few minutes immediately before the injections to reduce the discomfort and the amount of swelling. Usually there is no lasting discomfort after the injection. Patients can almost always resume normal activities immediately after the procedure.
After the treatment, there may be slight swelling at the injected spots, which resolves within a few hours. Occasionally, a small bruise may develop at an injection site. If this occurs, it may take a few days to fade, but makeup can be used to cover the bruise as needed.
What are possible side effects?
Botox has been used for more than 10 years for the treatment of wrinkles and longer than that for the treatment of eye disorders. Side effects are rare and are almost uniformly temporary. The most common side effect is a temporary weakness of muscles near the injection site. When this happens, a patient may develop facial asymmetry or droopiness of the eyelids and/or eyebrows. Muscle function usually returns to normal within a few weeks. Rarely a patient may develop resistance to Botox so that additional injections are not effective. In that case, alternative treatments for the wrinkles should be explored. Very rarely, severe headaches have been reported after Botox injection, but more often, Botox will improve or eliminate headaches.
How much does Botox cost?
The cost of the treatment varies depending on the number of wrinkles will be treated and depends on how much Botox will be needed. Treatment costs are discussed in advance of treatment. Insurance coverage or reimbursement is not available for the treatment of wrinkles.
-
Soft tissue augmentation with fillers for filling in wrinkles and depressed scars
A filler is a soft substance that can be injected into the skin to improve the appearance of fine lines and wrinkles, plump lips, fill out hollow cheeks, improve scars, elevate deep folds, and repair various facial imperfections. The result is a smoother, more youthful appearance.
The aging process generally causes a loss of volume in fatty tissue as the underlying collagen and elastin fibers begin to deteriorate. This most commonly occurs around the eyes, mouth, cheeks, jawline, brow, and bridge of the nose.
These age-related changes produce lines, depressions, and furrows. Fillers have the ability to plump and contour the aging face, restoring a more youthful appearance. Fillers can also be used safely with Botox and lasers.
The procedure is a simple in-office treatment. After the filler to be used is determined, the face is cleaned and a topical anesthetic is injected. A needle is used to inject the filler directly into the wrinkle or depressed area. A stinging or burning sensation may be felt as the filler is being inserted. Immediately after the procedure there may be some temporary swelling, redness, or minor bruising at the injection sites. Persistent lumpiness, allergic reactions, and skin necrosis are rare and should be reported immediately. Makeup can be applied immediately after the treatment.
The length of time the improvement lasts depends on the type of filler used, the areas treated, and the ability of the patient’s skin to use the materials. Most fillers last anywhere from four months to one year.
Cosomoderm and Cosmoplast are human-based collagen fillers. No skin test is required. Smile lines, lips, and scars do well with this filler. Results usually last two to four months.
Restylane is the first cosmetic filler made of non-animal based hyaluronic acid. Juvederm is another hyaluronic acid–based filler. Hyaluronic acid is a natural substance that exists in the human body. No skin test is required. Most areas on the face can be treated. Results usually last six months.
Sculptra is made of microparticles of poly-L-lactic acid, which is a biocompatible and biodegradable synthetic polymer from the alpha-hydroxy-acid family. No skin test is required. Sculptra is used mostly for larger volume filling like sunken cheeks or deep nasolabial folds. Several treatments spaced apart are needed for optimal results and the collagen build-up is gradual over several months. Results have been shown to last up to two years.
Radiesse is composed of synthetic calcium hydroxylapatite microspheres suspended in a carrier gel. The microspheres form a scaffold through which your body’s own collagen grows.
No skin test is required. Most areas of the face can be treated, except the lip. Occasionally a second treatment is required for full filling. Results can last up to two years.
-
Chemical peels and microdermabrasion to improve skin texture and reduce surface irregularites
The process of "chemical peeling" is the application of an acid exfoliating agent on the skin in a controlled manner with the goal of renewing the very top layer of skin. The most commonly used chemical peels are salicylic and glycolic acid peels.
Chemical peels can help improve superficial irregularities, skin texture and discoloration on the skin. Certain types of peels are also used in the treatment of acne. Specific indications for peeling include photoaged skin, various pigmentation disorders, and epidermal precancerous growths called actinic keratoses.
Often, a series of chemical peels is needed for maximal improvement.
-
Sclerotherapy or laser surgery for unwanted leg spider veins
Sclerotherapy for spider veins:
The micro-injection sclerotherapy technique consists of instilling a concentrated saline (23.4% sodium chloride) solution into these tiny blood vessels using needles so small that a magnifying glass is required. This solution irritates the inner lining of the blood vessels so that they stop carrying blood and the body slowly replaces them with scar tissue that is invisible on the surface of the skin.
Some blood vessels fade after one injection while others may require several injections for significant fading to occur. The smallest blood vessels (red; purple) respond the best while the larger blood vessels (blue) respond less well. Some vessels do not respond at all to sclerotherapy.
Laser therapy for spider veins:
Blood vessel specific lasers can be used to treat leg veins, commonly referred to as spider veins. The lasers target and these superficial blood vessels. Depending on the size of the blood vessel several treatments may be required for resolution. Some vessels, unfortunately, do not respond to laser therapy.
Total fading of all spider veins is often not possible with these treatments, but most patients can achieve significant mprovement. It usually takes several weeks after a treatment to note fading of the injected or lasered blood vessels. Therefore, treatments are usually scheduled at four- to six-week intervals and, depending on the extent of the spider veins, the number of treatments may range from two to six. Laser and sclerotherapy do not prevent new spider veins from developing. Therefore, a periodic "touch-up" is usually necessary. Preventive measures include use of prescription support hose, regular exercise and maintenance of ideal body weight. It is important to note that sclerotherapy and laser therapy are not the treatment for varicose veins.
Back to Top