You love your Botox result.  And while you ideally want to keep up the treatment, you may be concerned about the financial cost and time required to maintain its effects. Does this sound familiar? Well, read on for some silver lining.

 

 

First of all, how does Botox work?

Botox, a popular anti-aging treatment, has continued to grow in popularity over the last 20 years. This neuromodulator works by blocking the nerves in and around your forehead and prevents those muscles from moving. The result? A softer and more relaxed face. 

Botox is currently approved as a cosmetic procedure for facial muscles including forehead lines (frontalis muscle), glabellar furrows (the combined action of the corrugators and procerus muscles), and crow’s feet (orbicularis muscles) around the eyes.

And while Botox was initially popularized by women in their 40s and 50s, younger patients including millennials are now scheduling regular treatments with prevention in mind. The dosing and location of injection should be tailored based on a patient’s desired goals, skin quality, and muscle function. Learn more about our botox services offered in New Jersey. 

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How often should you get Botox treatments?

While most patients are thrilled with their youthful look, the treatment is only effective for about 12 weeks on average.

However, research has suggested that after two years of treatment, results may last with less frequent injections.

The study looked at 50 women aged 30-50 years who received regular Botox injections every four months for the first two years of treatment. After two years, the injections were reduced to every six months instead of every 3-4 months.

The results? Doctors found that after two years of treatment, reducing treatment frequency to six months led to similar results as the more frequent treatments.

Read more about this in the June 2011 issue of Dermatologic Surgery.

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Can I do too much Botox?

Theoretically, yes. If you continue to receive treatments every 2-3 months for years on end, the muscle will continue to get weaker and flatter. This may give the appearance that the skin can appear thin and lose. 

Additionally, the muscles nearby which have not been paralyzed may get larger as they are being recruited to compensate for the muscles that have been inactivated by Botox. 

What’s the next step?

To avoid a bad Botox experience or a long-term side effect, make sure you research your doctor diligently. See a board-certified Plastic Surgeon or Dermatologist in consultation in order to understand what treatment is best for you and tailor it to your needs. 

Can I combine Botox with any other procedures to improve signs of facial aging?

Botox can safely be combined with skin resurfacing treatments including chemical peels, laser resurfacing, and medical-grade skin care to combat dyspigmentation, fine lines, and wrinkles. Make sure you talk to your plastic surgeon or dermatologist about the timing of these procedures. Many offices have an associated medical spa so you can receive all treatments in the same place.

As always, it’s important to eat a healthy diet, sleep, and wear sunscreen can also help prevent future photoaging changes to the skin.

Dr. Parcells is a board-certified plastic surgeon in New Jersey. She is certified by the American Board of Plastic Surgery.

It’s 2020, and lip augmentation is now all the rage. Luckily, many women are doing their research and asking important questions before undergoing treatment. 

Unlike getting your hair highlighted or a massage, lip augmentation is a medical procedure and can have long-lasting issues if done incorrectly. The goal of course, is a natural result that highlights your beauty.

What happens to our lips as we age:

Time and gravity take their toll on all parts of our bodies. For our lips, we naturally lose collagen and dermal elasticity. 

As a result, our lips thin, shorten, and fold into our mouths. Our cupids bow is no longer as prominent and we lose the appearance of a full lip.

The goal of a lip filler or surgical procedure is to reshape the lips and replace lost collagen and hyaluronic acid. 

How can I rejuvenate my lips?

There are different ways to augment lips. Dermal fillers are currently the most popular way, as the procedure is minimally invasive with little discomfort and downtime. These hyaluronic acid fillers are temporary and resorbed by your body over time.

For women who want a more permanent look, fat may be suctioned from an area of the body and injected into the lips in a small surgical procedure.

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And to reshape your lips, a lip lift or bullhorn lift is a great surgical option.

Tell me more about lip fillers:

Lip fillers are currently the most popular way to increase lip size. 

There are a variety of different filler products on the market that are used to augment the lips. 

You may have heard of Juvederm or Restalyne, and within these brands, there are different products that range in their consistency (think honey vs. whip cream) depending on your anatomy and desired result. 

Ask your physician about her philosophy on choosing a specific filler for you and what the alternatives are in order to make an informed decision. 

How can I prepare for my appointment?

I often recommend bringing a few photos of lips to understand the look you want, and to discuss whether the desired outcome is feasible given your individual anatomy. Just like any other part of the body, everyone’s lips are slightly different.

Additionally, discuss with your doctor how much volume you desire. I prefer filling lips to give a natural, subtle enhancement and often recommend underfilling as opposed to overfilling on a first visit. Ask questions about the type of filler, amount of filler to be injected initially, and its side effects in order to make an informed decision.

It’s important to avoid blood thinners such as aspirin, Motrin, Aleve, and alcohol, herbal supplements or multivitamins several days before and after the procedure to reduce bruising

How long does lip filler last?

Your body absorbs the filler over time. Fillers last approximately 6-12 months. 

Is the injection painful?

Filler injections may be mildly uncomfortable, and for patients who are apprehensive, we recommend coming a few minutes early to have some local numbing cream applied to the area. 

The injectable also has a local numbing agent that is introduced along with the filler, so patients are comfortable post-procedure. 

Can fillers be removed?

Most likely. Ask your physician what they are injecting and if it is dissolvable or permanent. Most on-label lip fillers are dissolvable and can be removed by injecting an enzyme called hyaluronidase to break up the particles and cause the filler to break down. This can be performed in the office.  

What should I expect in terms of aftercare?

Expect a moderate amount of swelling 1-3 days after the procedure that may initially distort the shape of your lips. Monitor your progress, and I recommend you follow up with your physician within 2 weeks to address any ongoing issues. 

By 2 weeks. The lips usually have had enough time to adjust to their increased volume and you can visualize a final result.

Are there risks?

Although fillers are a straightforward procedure when performed by an experienced board-certified physician, minimal side effects such as swelling and bruising have the potential to occur. 

Additionally, this potentially invasive procedure can rarely cause vascular occlusion and result in a wound on your lip (tissue necrosis) requiring wound care and lip reconstruction. 

How do I find the right physician?

You should only see a board-certified professional, such as a plastic surgeon or dermatologist who is highly experienced in this specific procedure. 

Ask to see before and after pictures and ask questions to make sure you are comfortable with the procedure and its effects. 

Interested in trying Botox? A Juvéderm filler? A laser resurfacing procedure? 

You may want to see a Board-Certified Plastic Surgeon for that.

Individuals seeking out a cosmetic procedure often assume that cosmetic surgeons and plastic surgeons have the same training and that the word plastic and cosmetic are interchangeable. 

This is misleading, confusing, and can even be dangerous. 

As a board-certified Plastic surgeon, I often refer to my practice as a mix of reconstructive (i.e. breast reconstruction) and cosmetic, because I’ve had extensive training in both. 

However, properly Board-Certified Plastic Surgeons do not refer to themselves as “cosmetic surgeons.”

What is Plastic Surgery?

The goal of plastic surgery is to restore the form (appearance) and function to a damaged area of the body. 

Plastic surgeons use a variety of techniques to move healthy tissue to an area affected by a birth defect, burn, traumatic injury, tumor, or other condition. Some plastic surgeons may focus on congenital defects (cleft lips), hand trauma, breast reconstruction, as well as cosmetic surgery.

What is Cosmetic Surgery?

Cosmetic Surgery is a combination of nonsurgical and surgical techniques to enhance appearance. Examples include facelifts, abdominoplasty (tummy tuck), liposuction, and Botox or Juvéderm fillers. 

What’s the difference between a Plastic Surgeon vs a Cosmetic Surgeon?

Legally, any physician with a valid medical license can perform cosmetic procedures, regardless of their training. I know, this is unbelievable. However, because of a number of factors - including declining insurance reimbursement and stress of keeping a practice financially secure - many physicians are looking towards elective cash-based procedures to survive.  

Several organizations have established “cliffs notes-type” courses with the goal of training these physicians in the same procedures that I, as a Plastic Surgeon, was trained to due over 6 years in my residency. 

Think about it: an emergency room physician with no surgical training goes to take a 2 week “crash course” on breast augmentation and is now ready to advertise as a cosmetic surgeon. 

And while your OB/GYN is offering you Botox or filler after a weekend training in cosmetic surgery, he or she may not be offering the best treatment, nor be able to handle complications (because OB/GYNs did not have focused training in facial anatomy). Scary, right?

On the flip side, a board-certified plastic surgeon would be able to offer the full scope of cosmetic options and let you know what works best for your body and your desires because we have been specifically trained to do so, without any shortcuts. Expertise cannot be achieved with a quick weekend course.

What does it take to become a board-certified plastic surgeon?

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In order to become a board-certified plastic surgeon, an individual must complete 

1. Four years of medical education and obtain a medical degree (MD or DO) 

2. A minimum of 6 years of accredited surgical residency training with at least 3 years of education dedicated to cosmetic and reconstructive surgery

3. Pass both written and oral examinations. At this point, he/she is board-certified by the American Board of Plastic Surgery (ABPS).

4. Remain in good ethical standing within their community and the board, as well as routinely participate in continuing medical education (CME) on the latest innovations and abide by up-to-date patient safety recommendations.

What if my doctor says he/she is Board Certified in Cosmetic Surgery?

At this time, there is no formal certification in Cosmetic Surgery and so anyone claiming to be board certified in this area is actually recognized only by a self-created organization (American Board of Cosmetic Surgery) and not an official licensing board by the American Board of Medical Specialties (ABMS).

In this situation, I encourage you to ask him or her a few more questions.  Ask about his/her background training (what is he really certified in), ask him/her how many of these specific procedures he has performed, and ask him/her how many years he/she has been practicing.  You might be surprised at what he/she says…and even more by what he/she does not.

How do I know if my surgeon is board-certified in plastic surgery?

Check online, and if in doubt, as your potential surgeon which board they are certified in. 

How do I find a Board-Certified Plastic Surgeon? 

You can easily find a list of local board-certified plastic surgeons by visiting the American Board of Plastic Surgery website.

When meeting with your surgeon, ask which board (i.e. Internal Medicine vs. Plastic Surgery) she or he is certified in

Lastly, If the surgeon routinely does procedures within an office operating room, as them where they have privileges. A reputable hospital will only accredit a board-certified plastic surgeon.

At the end of the day, it’s your body. And when it comes to your time, energy, and money, you should do the proper background research to ensure you are in the best hands.