Non-Surgical Facial Fillers General Considerations Realistic expectations are the key to success Facial fillers and injections can be a complementary procedure to enhance results of other cosmetic procedures. What will usually be helped? Relative improvement in the appearance of horizontal forehead wrinkles Improvement in vertical frown lines Improvement in crows feet Improvement in nasolabial fold area Improvement near or below the corners of the mouth or marionette lines Reduction in appearance of shallow to moderate acne scars What will not be helped? Major asymmetries in the face Extremely deep wrinkles or acne scars Jowls and skin laxity of the neck and under the chin Limitations of procedure Cannot achieve perfection Cannot prevent continued aging Cannot solve personal problems Goals may be only partially met Natural asymmetries are difficult to completely correct Other options and alternatives No treatment, chemical peel, laser resurfacing, facelift or fat injections Facilities, anesthesia and surgery Outpatient procedure No anesthesia or topical anesthesia Local (dental) blocks are also available Recovery Average time off of work – none Resume normal activities 1 day Resume exercise 1 day Redness: majority gone in 1-2 days Bruising may occur, resolves in 3 days May consume alcohol same day Massage lumpy areas for 3 days Temporary trade-offs Discomfort, pain, sensitivity during injections Swelling, prolonged redness Psychological depression Lumpiness Bruising Permanent trade-offs The products usually either wear off or reabsorb, restoring native structures Minor changes in appearance may remain due to permanent alterations in facial skin muscle structure Minor potential problems Prolonged swelling and bruising Asymmetry Granuloma Prolonged redness Allergic reaction to medications Droopy eyelids Major potential problems Scarring of the skin Necrosis or sloughing of the skin Infection Vessel occlusion in very rare circumstances Any and all of the risks and complications can result in: Additional surgery, hospitalization, time off Important considerations prior to your procedure It is important to stop using any blood thinners to include aspirin, ibuprofen, NSAID containing medications, Vitamin E, herbal supplements such as ginko biloba 1 week prior to your procedure. Please start removing all makeup and cleanse your face 1-2 days prior to your procedure. All makeup has to be removed in the areas treated. Notify your doctor if you are prone to getting cold sores or fever blisters. Prophylactic antiviral medication will be prescribed. Smoking can have serious side effects on the healing process. Additional procedures may need to be performed in 4-12 months. Multiple procedures are usually needed if you have extensive damage from aging or injury. Skin consistency, type, ethnic background, and age are important factors that should be discussed before the procedure. The practice of medicine and surgery is not an exact science. Although good results are expected there cannot be any guarantee, nor warranty, expressed or implied, as to the results that may be obtained. List of common medications to avoid prior to your procedure: Aspirin Ibuprofen NSAIDs Vioxx Celebrex Vitamin E Fish oil Garlic Ginco Biloba Heparin Coumadin Lovenox Eyebrow & Forehead Treatment options No treatment Eyelid surgery Eyebrow Lift with botulinum toxin Eyebrow lift with Fillers Aesthetic nonsurgical options include eyebrow lift with botulinum toxin injection around the brow area. This is also known as a chemical eyebrow lift. The concept is based on selective chemodenervation of select muscle groups around the eye to help elevate the lateral brow in a more favorable position while slightly depressing the medial portion or club head of the brow, thus restoring a youthful ark of the brow. Another option for restoration of a youthful eyebrow is injection of a filler around the brow or fat grafting. This technique restores lost volume and fullness in the lateral aspect of the brow which also gives a brow a lift.