Non-Surgical

Our office performs the largest number of Botox and Juvederm injections in Nevada.  We’re proud of our experience.

Advances in non-surgical treatments continue every year.  Over the last few years we’ve seen an explosion of different products.  But remember, ‘newest’ doesn’t necessarily mean ‘best’.  Some products came and went quickly due to poor quality or products which didn’t live up to claims.  We’ve tried every product on the market and will make recommendations to you based on our experience, your goals and individual anatomy.

Patients commonly ask, “What’s the difference between Botox and fillers?”  They are completely different!  Botox decreases wrinkles by weakening muscle movements that cause the wrinkles.  Fillers work by injecting them directly into the wrinkle and plumping it up (think internal spackle!).

Botox works well on wrinkles that are caused by muscle movement.  As the muscle relaxes, the wrinkle improves.  However, it has to be an area which still looks good with decreased movement!  For example, although you can decrease wrinkles around the mouth (smoker’s lines) with Botox, you wouldn’t want to  use so much that you drool, or can’t speak.  That’s why fillers or laser treatments are more common in this area.  The frown lines and crowsfeet however, are an easy trade-off… you  can always yell instead of scowl.

It is very important that injections be individualized for  each patient.  Every person has specific anatomical considerations and specific preferences for how they want to look (and not look).

COMMENTARY ON NON-SURGICAL TREATMENTS

Do not be intimidated by the wide range of anti-aging options.  The process of aging is extremely complex.  Because there are multiple factors responsible for aging of the face, we need multiple tools.

Early aging begins with volume loss.  The difference between a 20 year old face and a 30 year old face is due to changes in fat volume and distribution.  Later we develop changes in skin texture, thickness and elasticity; wrinkles develop.  True laxity and skin excess occur over time.  Remember these changes with aging affect every layer of tissue in the face: skin, fat, fascia, muscle and even bone.  As a consequence, anti-aging therapies must address each layer.  We need to combine treatments for a more comprehensive, modern approach.

A facelift will remove excess skin and allow the surgeon to improve facial contour by tightening and shifting existing tissue.  Think of it as a change in the envelope.  But in order to replace lost volume, fillers (including fat) are needed.  Think of it as ‘filling the envelope’.  A younger patient may only require the envelope to be filled, but as aging progresses, the envelope may need to be tightened in order to make the ‘fill’ more effective.
So, it is not a question or WHICH (surgery OR fillers), but rather, WHEN.

Then, the question is which filler to use.  If a patient is going to surgery anyway (for facelift, eyelid surgery, etc) then I will recommend autologous fat.  See Fat Injection.  Fat transfer requires a longer recovery time with more bruising and should be considered a surgical procedure.  ‘Off the shelf’ fillers require little down time with mild bruising and swelling.