This section of our website is directed toward the consumer interested in learning more about non-surgical aesthetic procedures to enhance one’s beauty safely and optimally.

What Should You Know About Your Medical Practitioner, the Product and Procedure/s

• Choose a licensed medical doctor who is trained and experienced in aesthetic procedures, including injectables.
• In many states, licensed practitioners (physician assistants, nurse practitioners and nurses) work in collaboration with and under the supervision of the doctor to provide these treatments.
• Inquire about the name brand and amount of injectable to be used for your procedure, where it will be injected and why it is recommended for you.  Don’t be afraid to ask to see the syringe or vial.
• Ask how long the practitioner has been using the product/s recommended for you, if it has FDA approval or is in clinical trials approved by the FDA.
• Find out how many people have been treated by the practitioner for similar indications.
• Be informed about any need for allergy testing, discomfort during treatment and if any topical or injection anesthetic may be used.
• Inquire about how long your results are expected to last, what to expect following the treatment, any restrictions or down-time, potential risks and side effects and the total cost involved.

Preparing for Your Treatment and Optimizing Your Healing Process

• One week before your injections, avoid over-the-counter medications and supplements such as aspirin, ibuprofen, vitamin E, ginseng, ginko biloba, St. John’s Wort, fish oil and garlic; this will help decrease bruising.
• If you are having any treatment on or around your lips and you have experienced cold sores, inform your practitioner and inquire about an antiviral medication to take prior to and following your injections.
• For certain treatments such as dermal fillers, cold compresses may be beneficial to reduce swelling following your injections.  Your practitioner should advise you whether this is recommended.
• You may inquire whether applying an antibacterial ointment (i.e., Polysporin, Neosporin, Bacitracin) to your post-injection sites would be beneficial.
• Sun protection and avoidance of certain skin care products may be recommended following specific treatments.
• Ask if there are any restrictions with exercise, lying down, massaging treatment areas, or alcohol consumption following your injections.

Types of Injectables for Non-Surgical Rejuvenation

Denervating Agents (BotulinumToxin Type A (BOTOX(R) Cosmetic)
 Cosmetic, Reloxin*, Puretox*)

Since the early 90’s,Botulinum Toxin Type A (BOTOX(R) Cosmetic) has been used safely to eliminate or soften facial lines and to enhance facial shape.  When injected into specific facial muscles, the neurotoxin botulinum type A blocks the nerve action required for the injected muscles to contract.  This results in eliminating or softening facial lines and furrows.  Advanced techniques can also facilitate lifting of the brows, and other facial enhancements.  The effects of botulinum toxin type A can be preventative and restorative, depending upon the individual’s age and areas desiring treatment.

• *Reloxin is currently in FDA trials in the United States..  It is used in Europe under the brand name, Dysport, for the same areas as Botulinum Toxin Type A (BOTOX(R) Cosmetic)Cosmetic.
• *Puretox is also used in Europe for the same areas as Botulinum Toxin Type A (BOTOX(R) Cosmetic) and has recently entered clinical trials in the United States. 

Dermal Fillers

Dermal fillers have been around in various forms for over 25 years.  Today, injectable fillers restore lost volume and structure in the soft tissue of the face, fill in facial lines and creases and enhance facial features.  Areas that may benefit from facial contouring include sunken cheeks, lower eyelid depressions and lifting effects to the outer eyebrows.  Re-defining and enhancing the lips may be achieved beautifully and naturally with the dermal fillers now available.    

Many practitioners today are offering to their clients the option of combination treatment where pairing products can provide optimal, three-dimensional results.  Dermal fillers may be categorized as temporary, semi-permanent or partially permanent as the results of treatment will lessen over time as one continues to age.  Despite the variance in longevity, maintenance is essential for continued results.  Inquire with your practitioner how long the product/s are expected to last based upon the type, amount used and specific areas treated.

Temporary Fillers

COLLAGEN-BASED:  Zyderm I, Zyderm II, Zyplast (bovine collagen), Cosmoderm 1, Cosmoderm 2, Cosmoplast (human-derived collagen).  FDA approved in the United States.

HYALURONIC ACID-BASED:  Restylane®, Hylaform®, Hylaform Plus®, Captique™.   Hyaluronic acid is a natural component of human skin and restores volume and elasticity.  These products are widely used in the United States and are all FDA approved.

HYALURONIC ACID FILLERS PENDING FDA APPROVAL:

Juve’derm (non-animal hyaluronic acid) – approved for use in Canada.  There are three formulations to target fine lines and deeper creases.

Hyalite (non-animal hyaluronic acid) – approved for use in Europe, beginning to enter U.S. clinical trials.

Restylane Touch (non-animal, low-density hyaluronic acid) – approved for use in Canada and Europe.  A form of Restylane for filling fine lines, where the skin is thinner and the creases are more superficial.

Perlane (nonanimal, high-density hyaluronic acid) – approved for use in Canada and Europe.  A denser form of Restylane to address deeper creases and restore volume to the midface and cheeks.

Longer Lasting Fillers

Radiesse – calcium hydroxyapatite microspheres suspended in polysaccharide gel.  This product is intended for deeper folds and creases in addition to contouring of various areas in the face.  The results may last up to two years.  This product has FDA approval for other medical indications, though is off-label use (see explanation below) as a dermal filler despite being used safely and effectively for over four years in the U.S..

Sculptra – microscopic particles of Poly-L-Lactic Acid (PLLA), a synthetic product which is best used to restore facial volume and deep folds or depressions.  It is FDA approved to treat facial fat loss in HIV patients and used off-label for cosmetic purposes.  This product typically requires more than one treatment for desired results and may last 18-24 months. 

The FDA Approval Process

In the U.S., FDA approval means that a drug or device has gone through review for safety and efficacy based upon independent scientific information that is gathered from medical studies (a clinical trial).  The data is turned in for review by an FDA advisory panel of physicians and scientists.  From there, the drug or device is either recommended for approval, conditionally recommended for approval, sent back for more research or denied approval.  With the advisory recommendations, the FDA may officially grant approval, request further data, take no action (leaving the drug or device in a holding pattern) or deny approval.

Off-label use of a drug or device means that it is FDA-approved but in use for a different application or condition than defined by its FDA approval.  It is important to keep in mind that off-label use can be safe and appropriate, however, if the off-label use is far different from the drug’s approved use, one should question their practitioner and inquire further about the application it may be recommended for.