Botox and Injectable Fillers

BOTOX® Cosmetic, Restylane®, Restylane Silk®, VolumaXC®, Sculptra®, and Radiesse® are injectable materials which can improve the look of the eyes, forehead, mouth, area around the mouth, the area around the eyes, and facial wrinkles. They last variable lengths of time and work by various mechanisms.  While initially fillers were used to treat individual wrinkles, they are now also used to replace volume lost to aging and even to shape the face or correct asymmetry.

BOTOX® Cosmetic and BOTOX® are the same purified protein used to relax facial muscles so they no longer contract with such force, thereby reducing the appearance of wrinkles for 3–4 months. Dr. de Ramón has decades of experience treating patients with Botox® Cosmetic.  As a plastic surgeon with intimate knowledge of facial anatomy, Dr. de Ramón is able to selectively weaken certain facial muscles to minimize wrinkles without “freezing” your face into a motionless expression. He can shape your eyebrows, lift your eyebrows, correct asymmetry, or just erase the scowl between your eyebrows without making you look frozen or unnatural. The medicine in placed using tiny needles in the office. The results are visible after only a few days to a week and results last 3–4 months, sometimes longer.

Result do vary among practitioners, so it pays to come to Dr. de Ramón, an experienced board certified plastic surgeon, for your Botox®.  Although many physicians, nurses and estheticians claim to be trained to inject Botox® Cosmetic, Dr. de Ramón believes patients are best served by having BOTOX® injected by a Diplomat of the American Board of Plastic Surgery. This is the reason Dr. de Ramón does all his own consultations and injections of Botox® Cosmetic and why he is considered an expert injector.

Restylane® is a cosmetic dermal filler which restores volume to skin and subcutaneous tissue to correct wrinkles and volume loss. It is a non-animal based form of hyaluronic acid which virtually eliminates the risk of allergic reaction.  First used to treat the wrinkles around the mouth, its uses have expanded over the years.  Galderma now makes a family of products with varying characteristics and particle size.  Some are better suited than others depending on the region of treatment and the goal.  Dr. de Ramón will make recommendations based upon your concerns and his knowledge of the available products.  Restylane® can be used for lip enhancement to improve the appearance and fullness of the lips. It can also be used to restore cheek volume.  Results from Restylane® injections can last 6–18 months depending on the location of injection, the number of injections, and the exact placement of the product. Dr. de Ramón believes patients are best served by having Restylane® injected only by an experienced plastic surgeon who is also a Diplomat of the American Board of Plastic Surgery.

VOLUMA® XC is an injectable filler from Allergan that is used to restore volume to cheeks which commonly display age-associated fat atrophy or volume loss. It is the first filler FDA approved for this application. By restoring cheek volume, the face has an immediately lifted appearance and many patients find that it can minimize jowls.

VOLUMA® works by supplementing levels of hyaluronic acid (HA), which is naturally found in the human body and which begins to decline after age 30. VOLUMA®’s effect can last up to 2 years.

Restylane Silk® is also the same hyaluronic acid as Restylane® but it is a smaller particle size.  It is FDA approved for lip injection.  It is commonly used by Dr. de Ramón for lip augmentation in patients desiring fuller lips and for correction of age-associated lip atrophy and volume loss.  As people age, the lips lose volume, lose projection, flatten, and can become wrinkled.  Restylane Silk® is a great product to treat these concerns.  Injection in this anatomic area demands precision, skill, and artistry to produce natural looking lips.  While any physician can legally inject fillers, Dr. de Ramón believes that patients are best served by physicians who have met the rigorous requirement to become Diplomates of the American Board of Plastic Surgery and who have many years of experience.

Radiesse® is another option which lasts 12–15 months. Patients have seen excellent results with this product which can be used for nasolabial creases. Radiesse® can also be injected into the back of the hands to restore volume and reduce the appearance of large veins or obvious bony structures. As with all injectables, there are many variables that impact results.

Sculptra® is a subcutaneous injectable (not a dermal filler) filler used to correct fat atrophy and volume loss frequently seen in aging faces by stimulating collagen production. Faces looking drawn or sunken may benefit greatly and be rejuvenated with a series of Sculptra® injections. Fat grafting is one option, but Sculptra® allows more predictability, greater simplicity, and no donor site. It easier to repeat as necessary and lasts for 3-5 years.

Is there pain associated with treatment? What are the side effects?

Injecting Botox® Cosmetic or dermal filler into the facial area may cause slight discomfort. In order to make the process as painless as possible, some fillers contain a local anesthetic. Dr. de Ramón also uses micro-cannulas from France to inject many dermal fillers which cause significantly less pain and bruising in the treated areas than sharp needles. After the procedure, some patients may experience mild bruising, tenderness, redness, firmness, swelling, bumps, and lumps. Patients who do experience side effects can expect to be back to normal in about a week.

What is the downtime after treatment?

Dermal filler and Botox® Cosmetic have no downtime. Unlike other more invasive treatments that require days or weeks of downtime, filler and Botox® patients can expect to return to normal functions right after treatment. However, some actions should be avoided for 24 hours including exposure to direct sunlight and heat, performing exercise, and consuming alcohol.

What are the costs of fillers and other injectables?

Each filter has a different price. Dermal fillers range in price from $625-900 per vial. Botox® is $13 per unit. Remember, Dr. de Ramón performs ALL injections on his patients in order to provide safe, natural results.

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