Injectables & Fillers

Psst…it’s our secret (weapon).

Whether to smooth away the signs of aging or to subtly enhance features, our injectable and filler options restore lost volume, plump, and provide lift where you need it.

Find the topic on the right that you’re most interested in for some Q & A’s from our skilled professionals.

Pricing

Injectables for Reducing Facial Lines & Wrinkles:
Xeomin™: $11 per unit
Botox™: $12 per unit
Belotero™: $550 per syringe

Fillers for Restoring Facial Volume & Fullness:
Volbella™: $350 introductory price per syringe
Radiesse™: $550 per syringe
Voluma™: $695 introductory price per syringe
Vollure™: $650 introductory price per syringe

Injectables for Neck & Jawline:
Kybella™: $700 introductory price per vial

Injectables for Dermal Laxity & Sculpting Jawline:
Novathreads™ Novalift Face: $1,500
Novathreads™ Novalift Face & Neck: $1,800
Novathreads™ Novamesh: Consultation required

Learn More

Novathreads™

What are Novathreads™?
Novathreads™ are absorbable polydioxanone synthetic surgical sutures which have been widely used in cardiovascular surgery for 30 years. Novathreads™ offers three types of thread procedures using barbed, smooth, and twist techniques.

How are they used aesthetically?
Novathreads™ are inserted under the skin to provide lift for dermal laxity. Improvement is noticed in the folds of the skin, crepiness, skin texture, lower face, jawline, and neck. Barbed threads provide a grip underneath the skin and the lifting technique results in an immediate repositioning of the skin. Novathreads™ naturally resorb over six months. The threads stimulate collagen in the area of treatment.

Consultation with your provider is recommended to establish a customized treatment plan.

When do I see results?
The lifting effect is seen immediately after placement.

How long will I experience results?
The effects are temporary. The threads resorb in six months. However, the collagenesis process provides results for 9-15 months depending on the area treated and the number of threads placed. The results from new collagen formation remain from the treatment. However, the procedure does not stop the aging process.

What areas are treated?
Novathreads™ for lift can be placed in the midface area (cheek), lower face to improve jawline, neck, and brow.

Are there other applications for the threads?
Yes, the Novamesh™ procedure can improve the skin texture, laxity, and crepiness using smooth threads for collagen stimulation. Improvement in softening lines is also possible: necklines, lines of the décolleté, cheeks, under the chin, and around the lips. Twist threads can be used for adding volume to the nasolabial folds, marionette lines, and creases across the chin.

Can Novathreads™ be used with Botox and fillers?
Yes, these treatments can be combined for overall aesthetic improvement depending on the patient’s goals.

Is the procedure painful?
A topical numbing anesthetic is used prior to treatment. In addition, lidocaine is injected into the insertion sites and throughout the treatment area prior to the procedure. Most patients find the procedure very tolerable.

The lift or barbed threads are passed through the tissue using a blunt-tipped cannula which glides over nerves and vessels. The cannula technique also reduces the possibility of bruising.

What are the common side effects?
Generalized swelling occurs for 3-5 days. Bruising is not common with the procedure but may be patient dependent. Patients are more predisposed to bruising when taking aspirin, vitamin E, fish oil/omega supplements, blood thinners, NSAIDs (ibuprofen), and also with alcohol consumption.

Soreness, tenderness, and tightness are observed for several days. Patients notice these effects when eating and chewing. Ibuprofen is recommended immediately post procedure.

Why use threads when fillers can be injected?
The available fillers have limited ability to lift and provide improvement in laxity especially in the lower face and jawline. Biostimulating fillers such as Sculptra™ are used in conjunction with threads to improve volume in the temples and to improve cheek crepiness.

Contraindications
These procedures are not recommended for pregnant or breastfeeding women or in areas of active infection, pre-existing scar tissue, or areas of keloid scarring.

Fillers™

How are fillers used aesthetically?
Fillers have multiple applications depending on a patient’s aesthetic goals. Particular fillers are used based on physical characteristics of the dermal filler and clinical studies.

Lip fillers
Lip augmentation is one of the most requested treatments in our practice for patients of all ages. Celebrities such as Kylie Jenner have elevated awareness of lip augmentation and lip fillers as well as social media.

Hyaluronic acid fillers are used for lip enhancement/augmentation, smoothing lines within and around the lips, to provide definition to the lip border, or to improve asym-metry. Over 90% of lip filler patients in our practice desire cosmetic improvement of the upper lip through augmentation. Many relate that when they smile, the entire upper lip disappears.

We may use Botox™ or Xeomin™ in combination with a soft lip filler to treat perioral lip wrin-kles or “smoker’s lines.” Best outcomes occur when patients consult with their provider regarding their particular goals. We follow our patient’s treatment using before and after photos. Great results are often a result of a step by step lip filler treatment for patients who have never had lip augmentation. The patient’s own anatomy, lip structure, and age are considerations.

What areas of the lip are injected?
Augmentation of the cupid’s bow, the lip’s natural pillows, and the philtral columns are considered as well as improvement of the patient’s profile. Augmentation is customized such as adding volume for a more prominent pout.

Are the injections painful?
A small sterile needle is used for the lip injections. Before injection, a topical numbing agent is applied to the lip area and ice is also used during treatment. The filler products contain anesthetic numbing agents which provide pain relief once injected. Dental blocks can be provided for those requiring more pain control. Numbing may be present up to one hour post injection. Patients are advised to avoid hot beverages until the numbing effect subsides.

What are the common side effects?
The most common side effect post injection is lip swelling which can be significant in some patients. Swelling generally lasts about three days but is also dependent on vol-ume injected. Patients become accustomed to the swelling in 24 hours and appreciate the look. After the swelling subsides, most relate that they wish the swelling would have remained. It is estimated that 10-20% of the immediate effect is swelling. Patients are encouraged to return for additional product in one to four months to achieve nine to twelve months longevity and/or achieve the augmentation goals.

Bruising is also a potential side effect and varies among patients depending on medica-tions. Patients are advised to discontinue ibuprofen, aspirin, fish oil, and vitamin E sev-eral days prior to treatment to reduce the chance of bruising . Ice is the patient’s friend post treatment.

What are the post care instructions?
Post care includes ice and mild lip massage which is demonstrated with the patient. Avoiding vigorous exercise may help reduce chances of swelling.

How long is the effect present?
Augmentation is appreciated immediately after injection (along with swelling). Lip filler typically does not last as long as treatment in other areas of the face due to movement from speech, eating, animation, etc. See the list below for more info.

Lip fillers:
Juvederm Ultra Plus™: typically lasts 6 months but longevity may be increased to one year with a touchup
Vollure™: soft and smooth; may last 9-12 months
Volbella™: soft filler used for lip border definition, perioral lip lines (smoker’s lines), and softening lines within the lip; lasts 4-6 months

Line Fillers
Belotero Balance™, Restylane™, and Restylane Silk™ are fillers used for lines that are “etched” into the skin. Typically, these are used to fill the line only and not specifically to add volume.

How do these fillers work?
These hyaluronic fillers provide volume below the wrinkle and also provides localized plumping. Belotero Balance™ allows the injector to place the product more superficially in the skin and erases lines in this fashion.

How long do these fillers last?
These products may last 6-12 months depending on the area of treatment.

Are the injections painful?
A small sterile needle is used for the injections. Before injection, a topical numbing agent is applied to the area and ice is also used during treatment. The filler products contain anesthetic numbing agents which provide pain relief once injected.

What are the common side effects?
Injection site swelling, redness, tenderness, and bruising may occur. Redness and swelling generally subsides within 48 hours depending on the volume injected and the location of the treated area.

What lines can be be softened with these fillers?
Typical areas of injection include forehead, cheek, chin, perioral, horizontal neck lines, smile lines, and lines etched into the nasolabial folds.

Fillers for facial volume loss: cheeks, temples, chin, jawline & lower face

What causes volume loss?
As we age, facial volume loss occurs through the loss of facial fat and bone resorption. Genetics, chronic illness, and rigorous physical activity can also contribute to volume loss.

How do these fillers work?
Voluma™, a hyaluronic acid filler, adds volume to the cheeks with its characteristic ability to lift and contour and is FDA-approved for this indication. Voluma™ can also be used along the jawline for cosmetic improvement of the lower face/jowls. Hyaluronic acid is a naturally occurring substance in the body.

Radiesse™ is a calcium-based filler FDA approved for wrinkles and folds of the face. Due to its unique viscosity and ability to stimulate collagen, it is not only used for the nasolabial folds but also for cheek and chin augmentation and along the jawline for cosmetic improvement of the lower face/jowls. Calcium is a naturally occurring substance in the body specifically bones and teeth.

Sculptra™ is a substance called poly lactic acid which acts as a biostimulator in the dermal tissue. It encourages the formation of new collagen over time. Sculptra™ does not provide immediate correction but the results are seen over time as new collagen infiltrates the treatment area. Sculptra™ is used for the temples and can also create lift of the brow. It is also injected over the medial and lateral cheek area, jawline, chin, and other folds. This product can be used to improve skin crepiness in the lower cheek and for improvement in the appearance of the décolleté.

These fillers provide natural looking results when used appropriately.

How are these products injected?
Providers use multiple techniques for injecting these fillers into the various areas of the face. An aesthetic consultation can provide a customized treatment plan for each individual and may include multiple fillers for optimal correction.

Are the injections painful?
Topical anesthetic numbing cream may be applied to the area prior to injection. The var-ious fillers contain anesthetic agents providing additional numbing during the injection process. Ice is also used during treatment for comfort.

When will I notice the results?
Voluma™ and Radiesse™ provide immediate results but also produce swelling. Sculptra™ demonstrates results over several months with the collagenesis process.

How many treatments are needed?
Individualized treatment plans for each patient provide the best patient outcomes.

Voluma™ and Radiesse™ are provided in syringe form. Amounts required for volume restoration depends on the severity of volume loss and the areas of injection. Multiple syringes may be needed over a period of time to achieve optimal correction.

Sculptra™ is supplied in vial form and usually requires 1-2 vials per treatment depend-ing on the number of areas treated. More than one treatment may be needed for optimal correction and is tailored to the patient’s aesthetic goals. Sculptra™ treatments are usually spaced 4-6 weeks apart.

What are the most common side effects?
Injection site swelling, redness, and bruising are common side effects. Generalized swelling and tenderness to touch are common with widely treated areas. Lumpiness and bumpiness may be noticed as the filler integrates within the skin. These side effects usually resolve over several days up to one week.

How long do the effects last?
Many of these fillers require more than one syringe/vial for optimal treatment and longevity. The clinical studies for Sculptra™ indicate longevity for two years but patients often opt for yearly maintenance treatment. Voluma™’s clinical studies indicate lasting effect for two years after achieving optimal correction which often requires multiple syringes. Radiesse™, a collagen stimulator, provides correction for 9-12 months after optimal correction is achieved.

What are the post care instructions?
Ice is the best treatment during the post injection period to reduce swelling and bruising.

Avoiding exposure to intense heat and vigorous exercise within the first 24 hours helps with post injection swelling. A massaging regimen is suggested for patients for 5 days post Sculptra™ injection.

Chin augmentation
Fillers are injected into the chin area to provide augmentation and improved appearance of the facial profile. Radiesse™, Voluma™, and Sculptra™ are fillers used to treat this specific area.

See detailed information about these fillers under the section for facial volume loss.

Hand augmentation
Radiesse™ is an FDA approved, calcium based filler for hand augmentation. This procedure improves the appearance in the back of the hand where the aging process reveals a bony and veiny appearance. The filler contains an anesthetic agent for pain control. Treatment usually requires two syringes for optimal results. Swelling in the back of the hand may last up to two weeks with tenderness and bruising as common side effects. Use of ice post treatment is recommended for swelling. Results typically last a year or more.

Décolleté
Line fillers such as Belotero™ Balance can improve the appearance of lines and creases along the décolleté. See the “Line Filler” section for more information.

Sculptra™ Aesthetic can improve the cosmetic appearance of the décolleté including improvement of lines, crepiness, and skin texture. See the “facial volume loss” section for information about this filler.

Filler Contraindications
These injections have not been clinically studied in pregnant or nursing women. Active infection at the injection site is a contraindication for treatment.

Visit SculptraAesthetic.com, Radiesse.com, Belotero.com, and Juvederm.com for more information and to view before and after photos.

Kybella™

What is Kybella™?
Kybella™ is an FDA approved injectable, prescription medication used to improve the appearance of fat below the chin also called “the double chin.” This area of adipose tissue may be genetic and may be resistant to diet and exercise. Many patients experience this fullness even if they are at normal weight. You may notice the fullness in pictures, social media, and profile photos. Deoxycholic acid is the active ingredient that permanently destroys fat cells in the treatment area.

Can it be used in other areas?
Yes, it is used for other areas of localized fat such as bra fat or knee fat.

How is the treatment performed?
The treatment is given by injection using a small sterile needle in the area of fullness. There are multiple injections given in the area based on the size of the treatment area.

Is the treatment painful?
Most patients report discomfort level 3/10, “10” being the worst pain experienced. Ice is applied for two minutes prior to the injections to numb the area. The discomfort occurs during the course of the injections, plateaus over 5 minutes, and then subsides. Ice is applied immediately post treatment.

What can I expect after the treatment?
Swelling occurs for 3-5 days with patients experiencing fullness and “sloshiness” reminiscent of a pelican swallowing too many fish. Ice is recommended for swelling after treatment. Injection site redness and bruising also occur. Patients are predisposed to bruising when taking aspirin, vitamin E, fish oil/omega supplements, blood thinners, NSAIDs (ibuprofen), and also with alcohol consumption. Make sure you plan your injection treatments around your schedule and social plans with swelling as a common side effect.

What are the potential side effects from Kybella™ treatment?
Kybella™ clinical studies noted swelling as the most common side effect. Other side effects included bruising (72%), numbness (66%) resolving in two-three months, and areas of hardness (nodules) 13%. Nerve injury (4%) may temporarily cause an uneven smile or facial muscle weakness.

How many treatments are required?
Kybella™ is used to improve and sculpt the chin/jawline profile. Kybella™ is provided from the manufacturer in vials. Generally, 2-3 vials are required per treatment. Treatments are spaced 2 months apart. On average, 2-3 treatments are required for optimal effect. However, this product is individually tailored and depends upon the patient’s aesthetic goals. We monitor our patient’s progress with before and after photos.

When can I expect to see results?
The effect is not considered immediate. Patients begin to see results in 60 days. The body removes the destroyed fat cells using normal metabolic processes.

Are there patients who should not receive treatment with Kybella?
Patients with active infection in the area should not be injected with Kybella™. We do not provide treatment for pregnant or nursing women as this population has not been studied. Patients with prior neck/chin surgery or medical conditions in the area of treatment may not be suitable candidates.

Visit MyKybella.com for more information and to view before and after photos.

*Download the Brilliant Distinction app to earn points/coupons for future treatment with any Allergan product including Botox™, Juvederm™, Voluma™, Vollure™, and Volbella™.

Botox™

What is Botox™?
Botox Cosmetic™ is an FDA-approved injectable, prescription medication for the treat-ment of frown lines, crow’s feet, and forehead lines.

Can it be used for other wrinkles or applications?
Yes, it can also be injected in treatment for chin wrinkling (“orange peel”), jaw clenching, downturned corners of the mouth, wrinkles around the mouth (“smoker’s lines”), neck bands, horizontal neck lines, décolleté wrinkles, lateral eyebrow lift, bunny lines, and ex-cessive underarm sweating (hyperhidrosis).

How does Botox™ work?
Botox™ relaxes the muscles that contract to create the wrinkles.

Are the injections painful?
Very small needles are used for the injections. Ice is used pre-treatment for comfort. Most patients experience just a pinch and find the treatment very tolerable. If you are concerned about discomfort, topical numbing cream may be used prior to the injections.

How long does the treatment take to perform?
The injections generally require less than 5 minutes depending on the number of areas treated. Plan 30 minutes for your appointment.

When will I see the treatment work?
Results are not immediate. Most patients notice the treatment beginning to work in 3-5 days. The manufacturer recommends allowing 14 days to view the effects.

How long will the treatment last?
The treatment effectiveness peaks at 30 days post treatment and gradually declines over three to four months.

Is the treatment different for men and women?
Men often require more units due to the size of the muscle being treated and muscle service area.

How much Botox™ will I need?
For frown lines, most patients require 20 units of Botox.

Allergan’s prescribing dose is the following: 20 units for the frown lines, 24 units for the crow’s feet, and 20 units for forehead lines.

It is best to consult with your provider to customize your dosing requirements.

Treatment for excessive underarm sweating requires 50 units per underarm.

What if the muscles are still contracting (moving) after 2-4 weeks?
Some patients may require an extra dosing units to achieve full therapeutic effect. This is considered a dose adjustment and represents what the patient requires for treatment.

Do you dilute your Botox™?
Botox™ is contained in a sterile vial in vacuum dried form. It must be diluted for injection. We dilute our product with strict concentration for the best accuracy.

What are the common side effects after injection?
Injection site redness, pain, tenderness, and swelling are common post injection but re-solve quickly. Bruising may occur. Patients are more predisposed to bruising when taking aspirin, vitamin E, fish oil/omega supplements, blood thinners, NSAIDs (ibuprofen), and also with alcohol consumption.

Are there other possible side effects?
In the clinical trials, eyelid drooping occurred in 2-3% of patients (depending on treatment type) and headache occurred in 9% of patients receiving treatment of forehead lines.

Contraindications for Botox™ injections:
We do not provide Botox injections for pregnant or nursing women as there are no available clinical studies in these populations. In addition, patients with a diagnosis of ALS, myasthenia gravis, or Lambert-Eaton syndrome are not treated due to increased risk of serious side effects.

What instructions do I need to follow after treatment?
These injections are given in the superficial muscles so we ask patients to refrain from rubbing or massaging the area for 48 hours. Clarisonic facial brushes may be used 48 hours after treatment.

You may gently cleanse the area or apply makeup.

Visit BotoxCosmetic.com for more information and to view before/after results.

*Download the Brilliant Distinction app to earn points/coupons for future treatment with any Allergan product including Botox™, Juvederm™, Voluma™, Vollure™, and Volbella™.

Xeomin™

What is Xeomin™?
Xeomin™ (incobotulinumtoxinA) is an FDA-approved injectable, prescription medication for the temporary improvement of frown lines.

What is the difference between Botox Cosmetic™ and Xeomin™?
Both medications are botulinum toxin type A. Xeomin™ (pronounced “Zeo-min”) is a newer medication manufactured by Merz Aesthetics. Xeomin™ is an extremely purified neuromodulator. The unique manufacturing process removes the extra proteins that don’t play a role in the treatment process.

Can it be used for other wrinkles or applications?
Yes, it can also be injected in treatment for chin wrinkling (“orange peel”), jaw clenching, downturned corners of the mouth, wrinkles around the mouth (“smoker’s lines”), neck bands, horizontal neck lines, décolleté wrinkles, lateral eyebrow lift, bunny lines, and excessive sweating (hyperhidrosis).

How does Xeomin work?
Xeomin™ relaxes the muscles that create wrinkles by blocking the release of chemicals that cause muscle contraction.

Are the injections painful?
Very small needles are used for the injections. Ice is used pre-treatment for comfort. Most patients experience just a pinch and find the treatment very tolerable. If you are concerned about discomfort, topical numbing cream may be used prior to the injections.

How long does the treatment take to perform?
The injections generally require less than 5 minutes depending on the number of areas treated. Plan 30 minutes for your appointment.

When will I see the treatment work?
Results are not immediate. Some patients observe effects within 24 hours. Most patients notice the treatment beginning to work in 3-5 days.

What if my lines or wrinkles are deeper?
Most wrinkles soften and improve with one treatment. More than one treatment may be required to soften deeper lines. Should you say something about static lines: Some deeper lines may require dermal fillers, in addition to Xeomin™, to fill in the underlying structures.

How long will the treatment last?
The treatment effectiveness peaks at 30 days post treatment and gradually declines over three to four months.

Is the treatment different for men and women?
Men often require more units due to the size of the muscle being treated and muscle service area.

How much Xeomin™ will I need?
For frown lines, most patients require 20 units of Xeomin™.

The prescribing dose is 20 units for the frown lines.

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It is best to consult with your provider to customize your dosing requirements.

What if the muscles are still contracting (moving) after 2-4 weeks?
Some patients may require an additional dosing to achieve full therapeutic effect. This is considered a dose adjustment and represents what the patient requires for treatment.

Do you dilute your Xeomin™?
Xeomin™ is contained in a sterile vial in freeze dried form. It must be diluted for injection. We dilute our product with strict concentration for the best accuracy.

What are the common side effects after injection?
Injection site redness, pain, tenderness, and swelling are common post injection but resolve quickly. Bruising may occur. Patients are more predisposed to bruising when taking aspirin, vitamin E, fish oil/omega supplements, blood thinners, NSAIDs (ibuprofen), and also with alcohol consumption.

Are there other possible side effects?
In the clinical trials, eyelid drooping occurred in 0.2% of patients and headache occurred in 5.4% of patients receiving treatment for frown lines.

Contraindications for Xeomin™ injections:
We do not provide Xeomin™ injections for pregnant or nursing women as there are no available clinical studies in these populations. In addition, patients with a diagnosis of ALS, myasthenia gravis, or Lambert-Eaton syndrome are not treated due to increased risk of serious side effects. Xeomin™ should not be injected into skin where active infection is present.

What instructions do I need to follow after treatment?
These injections are given in the superficial muscles so we ask patients to refrain from rubbing or massaging the area for 48 hours. Clarisonic facial brushes may be used 48 hours after treatment.

You may gently cleanse the area or apply makeup.

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