Our office performs the largest number of BOTOX® treatments, Restylane® and JUVÉDERM™ Injectable Gel injections in Nevada. We’re proud of our experience!

Advances in non-surgical treatments continue to grow. Some of these are provided by Dr. Anson and Dr. Higgins, others by our extremely knowledgeable and talented RNs.

BOTOX® Cosmetic
BOTOX® Cosmetic treatments are one of the most popular procedures we provide. It’s simple, has very little downtime and can be tailored to individual tastes. The average effect of BOTOX® Cosmetic lasts about 4 months depending on the area treated. The most common areas treated are the corrugator muscles between the eyebrows which make you scowl. When those vertical scowl lines make you look mad when you’re not, it’s time for BOTOX® Cosmetic.

The other common areas treated are the crow’s feet. When your eyes crinkle up at the sides when you’re not laughing, it’s time for BOTOX® Cosmetic. Other, more subtle uses for BOTOX® Cosmetic include prominent neck bands, upper lip lines and down turning of the lip corners.

It can take up to a week to see the full effect of BOTOX® Cosmetic. Side effects can include bruising. Droopiness of the eyelid is a very, very rare (and reversible) occurrence.

FILLERS

Restylane® and JUVÉDERM™ Injectable Gel
Restylane® (Medicis) and JUVÉDERM™ Injectable Gel (Allergan) are both hylauronic acids which are a natural component of the skin in gel form. Depending on the site, they typically last 6 months or more. Injection requires a local anesthetic and may cause mild swelling and bruising for a few days.

These are the ‘work horses’ of fillers. Both are approved by the FDA for the nasolabial folds (smile lines). All other locations are considered ‘off label’ but are commonly done. Aside from the nasolabial folds, these fillers do a great job to fill in lips (to reduce wrinkles or increase size), the tear troughs (that valley between the lower lid and cheek which appears as a dark circle), oral commissures (indentations at the lip corners), marionette lines (lines between the lip corner and chin) and any wrinkle of the face that we want to fill in. There are slightly thicker versions of each of these products, JUVÉDERM™ Ultra Plus and Perlane®, for areas that require a more concentrated product.

RADIESSE®
Radiesse® is a filler made of calcium hydroxylapetite. It is used for deep wrinkles or thick skin. We use it commonly for smile lines in men and to enhance the cheeks (appears as a mini cheek implant). Radiesse® is not a good choice for lip enhancement due to potential irregularities. Radiesse® lasts 9-12 months or more. It can last longer in some individuals but promises of 2 years are somewhat exaggerated.

ArteFill®
ArteFill® is a ‘semi-permanent’ filling agent. It is made of methylmethacrylate microspheres in a collagen matrix. The complication rate is higher that with the other fillers. While it has a place in the filler armamentarium it should be used with caution.

SCULPTRA™
Sculptra™ is not a true filler. Rather, it stimulates your own collagen production. It is made of poly-lactic acid which is the material used for absorbable sutures internally. It requires multiple injections (average 3-4) spaced about a month apart. It takes about 2 months for results so it is not a quick fix. Sculptra™ is approved for use in patients with HIV who have developed lipoatrophy (fat loss) in the face from medications used to treat HIV. Use for cosmetic purposes is 'off-label'. This product is very useful in patients who have thin skin and fat loss from aging.

FAT INJECTIONS
We commonly inject fat from the abdomen into the face. It is most useful for the area around the mouth which becomes thinner and wrinkled as we age. The advantage of fat is that most of us have an abundant supply and a larger quantity of fat can be used to fill in a larger area. In this case, other fillers are not cost effective. Although fat can be placed in a smaller area, such as the lips for augmentation, we think it is most useful to increase the baseline thickness of the entire area around the mouth including the lips, smile lines, oral commissures and marionette lines. Not all the fat injected will ‘take’, but what does take is permanent. Beware that the fat injected into the face will behave as the donor site belly fat; weight must remain stable to maintain good results.

Fat can be injected in the office under local anesthesia. It is also commonly performed at the time of a facelift. Downtime of 7-10 days can be expected.

SKIN TREATMENTS

FRAXEL®
Fraxel® is arguably ‘state of the art’ for sun damaged skin. While it is not as effective as a full face CO2 laser resurfacing, it does not have the downtime and negative effects that can result from deeper laser resurfacing. CO2 laser resurfacing is ‘ablative’, meaning that the entire surface of the skin is removed and raw. Fraxel® is ‘non-ablative’ because the surface of the skin remains intact. Only microscopic laser beams are applied to the skin leaving intact skin surrounding each spot. This allows the skin to heal much more quickly. Since only a portion of the skin is treated during each session, 4 treatments are generally required to treat the entire skin surface. Each session results in swelling with approximately 4 day downtime.

Fraxel® is effective for treating sun damage to the face, neck, chest and hands. The new Fraxel® SR1500 is more powerful and can improve wrinkling and can mildly tighten skin.

IPL®
IPL®, Intense Pulsed Light™ or FotoFacial™ are all names for the same treatment. IPL® also treats sun damage to the face, neck and chest. It is better than Fraxel® for treating broken blood vessels, telangiectasia, but not as effective for brown spots from sun damage. It decreases pore size and improves texture. IPL® requires about 6 sessions but has no significant downtime and is less expensive than Fraxel®.

THERMAGE®
The Thermacool procedure, Thermage®, uses radiofrequency energy to heat collagen in the deeper layers of the skin which consequently tighten over time. One treatment is required but more can be beneficial. The newer treatment heads and better results than the original heads have allowed a resurgence of Thermage®. Mild swelling occurs for 1-2 days but the result due to changes in the collagen continues for 2-6 months. It is now used for the abdomen as well as facial tightening.

Results are fairly mild but Thermage® is still a good choice for patients with only minimal looseness or those who cannot undergo more significant procedures.