Frequently Asked Questions

Botulinum toxin type A is an injectable neurotoxin, better known under brand names such as Botox Cosmetic®, Dysport®, Xeomin®, and Jeuveau®. Neurotoxin treatments are the most popular single cosmetic procedure in the U.S. and are mainly used to smooth dynamic wrinkles, or those wrinkles that form as a result of facial movements like frowning, squinting, smiling, and other expressions we tend to make day after day. Treatment works by blocking nerve impulses to the muscles, causing them to relax. As a result, your expressions soften and the dynamic wrinkles are greatly reduced.

• Glabellar lines (a.k.a. “elevens” or frown lines)
• Wrinkles around the eyes, such as crow’s feet
• Forehead creases
• Corners of the mouth
• A “cobblestoned” appearance to the chin

Dysport (brand of abobotulinumtoxinA) may contain trace amounts of cow’s milk protein. Patients known to be allergic to cow’s milk protein should not be treated with this product.

Botulinum toxin injections are non surgical and typically completed during an office visit. Your initial treatment will begin with a consultation, during which you will meet with your injector to discuss your concerns and goals.

During your consultation, your provider will evaluate your area of concern and go over your medical history. Even though there is little risk of major complications for most patients, it is still  imperative that you share your medical history fully and openly with your provider before treatment, as certain allergies, skin and neurological conditions, or medications can make treatment unsuitable for a patient. For instance, you need to tell your provider if you have been taking NSAIDs (e.g., aspirin, ibuprofen, naproxen) or blood thinners.

Just before the actual treatment, you may be  given a topical anesthetic to numb the area prior to injection, though many patients find this unnecessary, as the needles used to inject botulinum toxins are very thin and the injections are not very deep. Your provider will reconstitute the botulinum toxin into a solution, and inject this solution into the muscle  at strategic points. Most patients describe a pinching feeling during the injection, though not much pain.

You will be able to go back to your normal activities right after treatment, but your provider may ask you to take the day off from exercise or other strenuous activity, and to keep your head upright for the rest of the day. Mild redness, swelling at the injection site, and bruising are the most common side effects.

Following treatment, you will not see results immediately. This is expected, so do not worry that treatment hasn’t worked. Depending on the patient, product used, and area treated, final results are typically reached 3 to 7 days after initial treatments. If this is your first botulinum toxin treatment, your provider may initially inject a more conservative amount and touch up the results during a follow up treatment. This helps to ensure natural, optimal results without the risk of over-treating an area.

The wrinkle-reducing effects from botulinum treatments will vary depending on the patient, the area treated, and the product used, but results will typically last anywhere from 3 to 6 months. To maintain your results, your provider will simply repeat treatment, adjusting dosage and techniques as necessary to ensure optimal results.

While botulinum toxin type A is most commonly used to treat facial wrinkles, cosmetic surgeons can also use neurotoxins to address other aesthetic concerns that are associated with nerve and muscle activity:

• Reduce excessive sweating. Botulinum type A injections can be used to interrupt the nerve impulses that activate the sweat glands, helping alleviate embarrassment from excessive sweating on the armpits, hands or feet.
• Soften vertical neck bands. If you are bothered by prominent vertical bands on your neck, botulinum toxins can be used to relax the responsible muscles and give your neck a smoother, softer appearance.
• Migraine Headaches. Botox works by reducing muscle contractions and stopping neurotransmitters from sending pain signals to your brain. This can help reduce the pain caused by migraines and lets many patients enjoy daily life without interruption. The effect is only temporary, so patients will need to receive ongoing treatment. The most common treatment timeline involves an injection every 12 weeks, or four times per year. It may take several weeks to experience migraine relief after an injection. Your doctor may adjust this timeline according to your individual needs.

Botox is only recommended for people who fit the following criteria for chronic migraines:

• Experience headaches for more than 15 days a month where at least 8 days involve migraines that last at least 4 hours each
• Struggle with the above for at least 3 months
• Are at least 18 years old
• Depending on your symptoms, your doctor may recommend you try other medications or treatments before trying Botox.

The procedure varies with the filler your provider will use, the part of the body to be treated, and your medical history. Here are some general guidelines about what you can expect:

• Most filler treatments take between 30 and 45 minutes and require one office visit.
• Before getting the injections, you may need ice, an anesthetic applied to the skin, or a nerve block (an injection). This varies with the filler and area to be treated. Hands generally do not need anesthesia; lips often require a topical numbing agent and/or nerve block. 
• Your provider will inject the filler into the area, often giving you several injections to produce the best results. 
• You may feel a stinging or burning sensation as the filler is injected. 
• A few fillers require allergy testing to make sure you do not have an allergic reaction. 
• If you need allergy testing, you must wait for the results from the allergy test before you can get the filler. 

Most patients can return to their everyday activities after leaving the office. 

To reduce any redness and swelling from the injections, your provider may recommend icing the area for 15 to 20 minutes before you leave.

Before you leave the office, you should be able to apply makeup.

• Wait until the next day to exercise or do any other strenuous activity.
• Stay out of the sun and do not use a tanning bed or other type of indoor tanning. 
• Avoid touching the treated area for three days, unless you receive instructions to massage the area.
• One filler, poly-L lactic acid, requires you to gently massage the treated area for about 5 minutes several times a day for 1 to 2 weeks. Your provider will tell you if you need to massage the area. 

This varies with the filler. Most fillers do not cause downtime. Be sure to ask your provider whether you will have downtime.

This also varies with the filler. Most fillers fill the skin, so they produce immediate — or close to immediate — results. A filler also can stimulate your body to produce collagen, but this takes time.

Collagen

• Immediate

Hyaluronic acid gel

• Immediate

Calcium hydroxyl apatite

• Immediate

Poly-L-lactic acid

• 2 or 3 weeks

Fat taken from your body

• Immediate

PMMA (polymethylmethacrylate)

• Immediate

You may see other fillers advertised. All fillers listed above have been approved by the U.S. Food and Drug Administration (FDA), except for self-donated fat. This filler does not require FDA approval because it comes from your own body.

To get natural-looking results, the person injecting the filler must have expertise in placing the filler. 

Most fillers offer temporary results and require repeat treatments to maintain the results. Typically, fillers last 6-12 months depending on metabolism.

Collagen

• 2 to 3 months (often longer when treating scar)

Hyaluronic acid gel

• 6 to 12 months

Calcium hydroxylapatite

• 6 months to 1 year

Poly-L-lactic acid

• 1 to 3 years

Fat taken from your body 

• 1 to 3 years (often longer when treating a scar)

PMMA (polymethylmethacrylate)

• Permanent

If you get a temporary filler, you can usually have another treatment when the signs of aging reappear. 

After receiving filler injections, some patients have minor, temporary side effects where they were injected. You may have:

• Redness
• Swelling
• Tenderness
• Bruising (occasionally)

These side effects tend to clear within 7 to 14 days — if not earlier.

Serious side effects are less common and include: 

• Lumps
• Ridges
• Over-filled areas
• Allergic reaction
• Skin discoloration
• Infection
• Severe swelling

This is one of the safest cosmetic treatments available. For years, aesthetic providers have been refining the use of fillers to diminish signs of aging. Today, providers safely treat people of many ages and all skin colors. 

The PDO thread lift procedure itself involves the implantation of fine, absorbable polydioxanone threads, similar to those which are used in medical suturing, into the subcutaneous layer of the skin using tiny needles. Their placement causes a series of microinjuries that trigger the body to produce greater amounts of natural collagen and elastin in order to repair the microscopic damage that occurs. The threads remain in place for around 6 to 8 months, after which time they are absorbed into the body, leaving new collagen in their place.

There are several different types of thread that can be used. Which will be recommended for  you, will depend on the areas that you are targeting with the treatment and the type of improvement you are hoping to achieve. For example, cog threads are most commonly used to lift sagging tissue around the jaw and neck in order to improve the patient’s profile. Meanwhile, screw threads can be used for plumping and adding volume to deficient areas, such as the cheeks, as well as lifting.

PDO therapy can be successfully used on various areas of the face including the cheeks, brow, nasolabial folds, marionette lines, jawline and neck. It can also be used on the body, arms, thighs and abdomen.

Precisely how long a PDO thread lift will take will depend on the area being targeted, but in most instances, it can be carried out in between 45 and 60 minutes, including preparation and the time following treatment.

The procedure itself is minimally invasive and does cause micro injuries to layers within the skin. As such, patients are given a local anesthetic before their treatment which will ensure that they remain comfortable and relaxed throughout.

A great benefit of a PDO thread lift is that the side effects are minimal. You may notice a little swelling and bruising that lasts for a few days, after which time it should fade. There is no downtime and you can get back to your usual routine right away.

It is important for patients to be aware that the results of a PDO thread lift are progressive. This is because they rely on the body’s natural production of collagen which takes time, rather than administering man-made versions into the skin. The lifting effect of PDO therapy reaches a peak at around 6 months post-treatment, after which time new collagen and elastin will have formed around the threads to tighten the skin and make the area look firmer, smoother and more youthful. The effects of treatment can potentially last between 2 and 3 years, after which time further treatment may be necessary to maintain your results.