Dermal fillers may be recommended when creases and wrinkles are deep, or when there has been a natural volume loss in tissue; an unfortunate, but totally normal result of age related skin change. Wrinkle relaxation with neurotoxins works awesome with “animation” wrinkles, and can soften the appearance of some wrinkles at rest when used consistently. But other folds may remain and if they distract you, you might want to consider alternative treatment options--this is where fillers might come into play.

There are many brands and several types of particles used in dermal fillers currently approved by the Food and Drug Administration (FDA). And it's important to know fillers have both similarities to one another, as well as differences-- no one filler is perfect in all instances. Choosing the correct filler should be done by your injector, one who has experience in matching your goals and needs with the right product. As you can imagine--deeper folds might be better off with a thicker product, and areas around the mouth do better using one that has stretch. Fillers may be calcium based, poly-L-lactic acid, or even microspheres; but the most popular in use today are based of hyaluronic acid (HA) gel filler. Your skin has naturally occurring hyaluronic acid already, but as we age the level of this declines. HA is a key component to maintaining moisture in tissue and a great replacement for fluff. HA fillers are biodegradable and are non animal based products (so they are less likely to cause an allergic reaction than a collagen injection might). HA expands and attracts moisture when it is injected into the skin—giving a nice plumping effect from the inside. It serves to elevate fine lines and folds, making them less apparent.

Hyaluronic acid is broken down by hyaluronidase enzyme (also naturally found in skin) making this a semi permanent enhancement. The results typically last 6-12 months in most, longer in some people. I suspect you want to know if it hurts. Well, it is a needle in your face, but it’s a pretty darn small needle. Most clients tolerate the injections well, and most filers include lidocaine, which helps to numb the area during the injection. Of course all procedures have risks, fortunately the most common side effects are temporary and include local tenderness, bruising or swelling. Take comfort in cool packs and on occasion, medication.

So now you know, a little more!

So I just wanted to share a story, a blast from my pre-COVID-past, when participated in a FANTABULOUS educational session and had a very masculine male ask, “Do guys do Botox”? BUT OF COURSE! THANKS FOR ASKING!

Neurotoxin (Boxtox, Dysport, Xeomin, Jeuveau) works terrific for both men and women to temporarily relax wrinkles caused by years of smiling, laughing, frowning and worrying. Men’s muscles are generally stronger (yes men, you love being called virile and strong!) the number of units recommended for dosing is typically higher for men than for a ladies face, but the mechanism of action is the same. That is the only reason my pic for dosing is specifically labeled “common dosing for the female face”.

Do men really do Botox? HECK YES! Fact of the matter is, we live in a youth-based society. With social media and rampant photo sharing opportunities, people have become more aware of how they appear to others. And younger appearing folk are often regarded as happier, more talented, more charismatic and more confident. Men are now largely conscious of what it takes to care well for the skin (remember, skin is the largest organ you’ve got (ahem), and it protects you from many environmental insults – as far as I’m concerned, this makes it a top contender for a little extra effort!). No longer is it unmanly to pamper your integument!

How does it work? Well, neurotoxin is injected strategically into muscles of the face with an uber-tiny needle (you’ll feel a tiny prick, light pressure, and a sting for a second or two…then its gone!) It works by inhibiting a signal between nerve cells that trigger a muscle to contract, whereby relaxing the skin and softening the look of the wrinkle. The results generally last 3-4 months, less in some and longer in others. The old school of thought was to wait for wrinkles, then start treating—nowadays many elect to start treatments younger (late 20’s early 30’s) to reduce the deeper creasing in the dermal layers and delay wrinkle formation to a later stage of life.

Toxin can be charged by the unit or by the treatment area—depends on who you see. The number of units needed is dependent on the area of interest as well as how tight your muscles are, making it hard to generalize on price. Any reputable provider will offer a consultation and give you a range specifically for you (expect 200-500$....more if you want total “correction”). Injectors may be nurses, nurse practitioners, physician assistants, or physicians; the key is that they do it frequently, and that you trust them.

After an injection, you should start seeing results in 2-7 days, with full effect in 2 weeks. The impact should be subtle and natural, though some prefer no movement at all—to each his own! Of course you could be one of those people who talk down those who elect non-invasive aesthetic care; or you can embrace the fact that we have options. If you’re already exercising to look fit and attractive—you're already on the train! I mean really, there is nothing wrong with self-care and confidence!

Bottom line—sure real men do Botox! Give me a call and we can make a plan for you!

Sure wish there was an easy answer for that one! Neurotoxin for wrinkle relaxation is sold by the unit, or the area; depending on the clinic you choose. The amount of product it will take for wrinkle reduction is truly individualized. Lot's of things play into this including anatomy, age, treatment area and amount of correction desired. One overly simplified answer you may find on the internet is ‘one-unit-per-year-of-age for full correction’. Of course that may or may not be true for you, and serves only as a loose reference!

You may recall an earlier blog post where I mentioned that toxin works very well for “wrinkles of animation” (those that you see when you scrunch your face). Some rest-wrinkles may soften with toxin, but not disappear completely. Dosing can be aggressive or conservative. If you’re a first timer, you might want to “go light”—with the option for additional product at your follow up visit. If this approach is used just keep in mind that you may not achieve full correction (complete relaxation) and that the effect should not be expected to last the anticipated 3-4 months. But there isn’t a clear long term issue with this approach! Some deeper animation wrinkle lines benefit from relaxation “training”, and if you are committed to full correction every three to four months treatment you may note more dramatic relaxation and longer treatment effect after a year or so!

After a treatment I encourage you self-analyze its effect at two weeks or a month post treatment--that helps guide dosing for the next session. And as you evaluate focus on whether or not you continue to have movement, not whether or not a wrinkle remains. Repeated contraction can cause a little etching in the deeper layers of skin. Those may reduce over time with repeated relaxation, or you might be a candidate for other treatments to complement the neurotoxin, like lasers, microneedling or threads.

On label (meaning the FDA approved the product based on scientific data for efficacy and safety) dosing for onabotulinumtoxin A (aka Allergan's Botox®) is 20 units for the glabella (area between your brows); frontalis (forehead) is up to 20 units, and lateral canthal lines around the eyes (crows feet) is 12 units per side. There are other areas which are commonly treated "off label" (the industry generally feels it is safe, however there is no FDA formal approval simply because the cost of doing a study may be cost prohibitive).

Bottom line: there are generalities for dosing, but you are unique, and your goals and aspirations guide my recommendations. Come in! Let's chat about it!

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