BY DR. LINDSEY PENNINGTON

The world of cosmetic injections is rapidly growing year after year. As technology advances, it can be difficult to know the difference between a marketing ploy or fad, and what is truly an innovative advancement. With the growth of social media and the increase in general acceptance of noninvasive procedures, many patients are well versed; however, there are still large areas of information missed when scrolling through Instagram.

As a patient there should always be discussions about what your goals are with injections, the look you are going for, how subtle you would like results, and how long you would like them to last. It is so common for patients to be worried about looking “done” or overfilled. When performed correctly by a licensed trained cosmetic physician, after a physical exam, medical history, and full informed consent are obtained, results can be a great way to refine appearances in a very natural way.

Cosmetic injections are commonly thought to consist of neurotoxin and or filler. It is amazing what a good skincare regimen and a neurotoxin routine can do to help age delay the skin’s aging process.

Basics of Neurotoxins

Botox Cosmetic is the original  neurotoxin with the most studies done on safety over the longest periods of time. It works by blocking certain nerve signals that make muscles contract. When muscles can’t contract, the movement in the area treated stops, causing less lines and wrinkles in that area. Botox is best used to treat “dynamic” lines, those that happen when moving. If a line or wrinkle is there at rest, the best option for treatment will likely not be neurotoxin but filler instead.

Botox usually takes about 4-7 days to start working and 2 weeks for full effect. Results can last on average 3-4 months. Botox has been on the market the longest, has been studied the most, and is very reliable. It can be placed very precisely in small muscles to get very specific results. In the hands of an expert injector this can make a very big difference!

Other Neurotoxin Brand Options

Dysport is a neurotoxin like Botox that blocks specific nerve signals to prevent muscle contraction in the specific area that it is placed. Dysport usually starts working a little faster than Botox (about 48 hours) but can still take up to 2 weeks for full effect. Results last on average 3-4 months. A recent study showed some Dysport users who received treatment every 6 months were satisfied with the overall results and effect on anti-aging. If your goal is prevention more than the reversal of aging, treating with smaller amounts or treating less often is very reasonable. Dysport has a “greater area of effect” so when treating a larger area like the forehead, a smaller amount can be used to achieve a more cohesive result. Xeomin and Jeuveau are other neurotoxins on the market with slight differences in the specific proteins that make them up. Both tend to kick in a little faster like Dysport, but don’t seem to last quite as long. Duration tends to be about 2-2.5 months.

What’s New in Neurotoxins

A new neurotoxin coming to market early next year called Daxxify and is unique as it will last longer than any other toxin currently on the market: on average 6 months. Our own Dr. Skylar Souyoul, Board Certified Dermatologist, participated in the FDA clinical trial to get Daxxify approved. She knows firsthand what a game changer this product will be for patients who want to get longer lasting results from their established neurotoxin routine.

Basics of Filler

There are a wide range of options in fillers, which can be overwhelming. But it’s not your job to know what you need or where. It’s best to ask questions and discuss your areas of concern and make sure your physician injector has the same treatment goals as you. Fillers can be used in most areas on the face, most commonly in the nasolabial folds, cheeks, and lips, but can also be used in temples, jawline, chin, glabella, lateral brow, nose and more. Certain anatomical locations, such as the nose, are considered higher risk and should only be performed by an experienced advanced injector physician.

Hyaluronic Acid (HA) Fillers

HA fillers are the most known and asked about fillers. Brand names such as Juvederm and Restylane have been on the market the longest with the most safety studies performed. Other brands have come along in the last few years with Versa and RHA making the most headway. Hyaluronic acid is found naturally throughout the body with highest concentrations in joints, eyes, and skin. HA naturally attracts and retains water in the skin which helps the skin become more hydrated. As we age, the amount of HA we have decreases in addition to overall volume loss leading to fine lines, wrinkles, folds, along with appearing dehydrated and sallow. When HA is synthetically made in the form of dermal fillers it is temporary and will break down like natural hyaluronic acid in our bodies does. When injected it can help areas appear more hydrated, plump, while smoothing lines and wrinkles. They break down slowly over time and the area goes back to how it was before anything was injected. The fact that fillers are temporary is great, because it helps patients feel safe trying them and knowing that they aren’t committing to anything permanent. There is a chemical enzyme (Hyaluronidase) that can be used to quickly dissolve hyaluronic acid fillers in the case of a complication or unsatisfactory result. It is very important for your safety to make sure your physician has this enzyme in their office at the time of your injection.