Neurotoxins/Fillers

Soft tissue volume loss plays a significant role in the natural process of aging. In simple terms, the face tends to “deflate” with the passage of time. Volume is progressively lost in the temples, the cheeks, and around the lips. This in turn leads to “jowling”, deepened naso-labial folds, and peri-oral wrinkling. Injectable fillers are designed to help restore this age-related volume loss.

  • Your skin naturally contains hyaluronic acids. These are substances that attract and bind to water molecules, and that help to cushion and lubricate the connective tissues of the body. In doing so, they also keep your skin well hydrated and youthful in appearance.

    Unfortunately, as we age, the levels of hyaluronic acid in the skin also decline. Furthermore, environmental factors - such as smoking and air pollution - can also diminish hyaluronic acid levels. The result is a loss of hydration and volume that can ultimately contribute to wrinkling and other classic signs of facial aging.

    Dermal Fillers, such as Restylane and Juvederm, are hyaluronic acid gels that can be injected directly into the soft tissues of the face to help restore the volume that has been lost with aging. Although many other facial injectables are now available on the market, these two fillers have the longest track records of safety and efficacy and are the most popular HA fillers used at our office.

Types of Neurotoxins/Fillers

Botox Cosmetic (onabotulinumtoxinA) weakens the expressive muscles that create frown lines and fine wrinkles on the forehead, around the eyes and the mouth. Injection of Botox can soften these lines to give a  more relaxed, refreshed look to the face as a whole. The most common target areas include, forehead wrinkles and frown lines, crow’s feet wrinkles around the eyes, fine wrinkles and creases around the mouth and lips. The entire process takes as little as fifteen minutes with no downtime, making this minimally invasive procedure a quick fix for anyone wanting a more youthful rejuvenated appearance. Results can be seen within 24 hours and will last anywhere from 3 - 6 months depending on the area being treated.

Dysport (abobotulinumtoxinA) is an injectable neuromodulator that smooths fine lines and wrinkles for up to five months. It is fast acting with noticeable effects occurring in 2-3 days after injection. It’s FDA-approved to treat moderate to severe frown lines, also called glabellar lines or “11s,” between the eyebrows. However, Dysport May also be used to treat forehead wrinkles as well as crow's feet.

The formulas of Restylane and Juvederm use the same active ingredient: hyaluronic acid (HA). Hyaluronic acid can hold up to 1,000 times its weight in water. This ability is what allows both fillers to add volume and plump the skin. While the two products are very similar in nature, there are some minor differences in cost and duration of effects. More importantly, some patients may simply prefer one product over the other based upon the results they have had with it in the past.

The formulas of Restylane and Juvederm use the same active ingredient: hyaluronic acid (HA). Hyaluronic acid can hold up to 1,000 times its weight in water. This ability is what allows both fillers to add volume and plump the skin. While the two products are very similar in nature, there are some minor differences in cost and duration of effects. More importantly, some patients may simply prefer one product over the other based upon the results they have had with it in the past.

woman sunshine benefits facial fillers

Benefits of Neurotoxins/Fillers

Botox and Dysport (neurotoxins) commonly target:
• Forehead wrinkles and frown lines
• Crow’s feet wrinkles around the eyes
• Fine wrinkles and creases around the mouth and lips

Facial dermal fillers can target:
• Smile and laugh lines
• Marionette lines (running vertically downward from the corners of the mouth)
• Vertical lip lines
• Volume loss in the cheeks
• Volume loss in the lips

Post Neurotoxin
Treatment Instructions

For the best results, it is prudent that you follow these simple guidelines immediately following your Neurotoxin treatment. It can mean the difference between a fair result and a great result. 

    1. Avoid straining, heavy lifting, or vigorous exercise for the remained of the day following your treatment. It can take up to 4 hours for neurotoxins to bind itself to the nerve and start to take effect. These activities can increase circulation to the area and wash away the neurotoxin.

    2. Avoid rubbing or applying heavy pressure to the injection site. This can cause the neurotoxin to migrate to surrounding areas and cause undesired results. Wash your face and apply make-up gently. It is recommended to avoid facials for 10 days following your treatment.

    3. Refrain from direct sunlight exposure for the remainder of the day. Neurotoxins can cause the skin to be photosensitive, increasing your risk of sunburn.

    4. Do not lie down for 4 hours following the treatment. This is to avoid risk of pressure on the treated areas and avoid the risk of rubbing the area accidentally.

    5. Be assured that the tiny bumps or marks will go away within a few hours. If you need to apply make-up within the 4 hours following your treatment, only use gentle touch to avoid rubbing the treated area.

    6. Bruising may also occur. This should resolve fully by your 2 week re-evaluation

    7. Avoid drinking alcohol and use of anti-inflammatory medications such as Ibuprofen, Motrin, naproxen, Aleve, etc 24 hours PRIOR to and 24 hours following your injection to reduce risk of bleeding and bruising.

    8. Results of your treatment may take up to 14 days to take full effect. Please wait at least until the 14 days have passed before assessing if you are pleased with the result. We will re-evaluate if more neurotoxins are needed at your 2 week follow up appointment. Neurotoxins are a temporary procedure that can last up to 3-6 months.

    9. It is recommended to wait 2 weeks after neurotoxin injections to undergo any other facial/dermal treatment such as laser treatment to allow skin to fully heal.

Pre-Care Instructions
for Dermal Filler 

Pre-Treatment Considerations: Schedule your injection at a time when minor swelling or bruising will not disrupt your social obligations. Each time you are treated, outcomes may vary. To lessen the likelihood of bleeding or bruising, discontinue use of blood thinning products for 10 days prior to treatment, if approved by your primary care provider. This includes: aspirin, ibuprofen (Motrin or Advil), naproxen, Aleve, fish oil, St. John's Wort, flax, Vitamin E, Vitamin D, garlic, Ginkgo Biloba, ginseng, etc. Alcohol is also to be avoided 24 hours pre- or post injectable treatment, as it is also a blood thinner. You can consider taking Arnica Montana natural supplement to help bruising (take 5 tablets three times per day starting one week prior to treatment). 

  • Please notify your provider if you have any history of cold sores, as we will consider pre-medicating with an antiviral prescription prior to injections. Cancel your appointment if you have any open sores in the treatment area. It is important that you alert us of any medical conditions you may have and/or any prescribed medications you are taking prior to your treatment. 

    Any injection introduces the risk for infection. For this reason, the following is taken into consideration when proceeding with injections. We will delay injectables if you: 

    • Have had any infection, cold, virus, or flu in the past 30 days? 

    • Have had any dental procedures in the past 30 days or are anticipating dental procedures or cleanings in the next 30 days?

    • Have had a surgical procedure in the past 30 days or are anticipating a surgery or procedure. o Have had any immunizations in the past 30 days or if you’re anticipating immunizations? 

    • Have had any tattooing or permanent makeup within the past 30 days?

    • Take any immunosuppressive/injectable medications (ex: Biologics such as Humira, Skyrizi, Stelara, Enbrel, Taltz, Cosentyx, Tremfya)? 

    • Additional contraindications: Pregnancy, breastfeeding, allergies to lidocaine or previous dermal fillers, open sores in areas to be treated. 

Post-Care Instructions
for Dermal Filler 

Swelling, bruising, tenderness, numbness, and areas of firm nodules may occur. 

Cosmetic fillers are long-lasting, but not permanent. Longevity depends on the areas treated and your body’s metabolism. Can last up to 6- 12 months.

DO NOT massage, touch, or manipulate the injection site. Avoid heavy exercise the day of your treatment. 

Ice packs may be used to the treated area during the first 12 hours. Ice for 15 minutes on every hour. 

Avoid dental work for 30 days after filler injections.

  • Avoid sleeping on your side or stomach for 24 hours post-treatment to prevent dispersing the product. We recommend you sleep elevated on your back and use pillows to stabilize yourself.

    If experiencing swelling, sleep with head elevated for 2-3 days to decrease swelling.

    You may take acetaminophen/Tylenol if you experience any mild tenderness or discomfort.

    Wait a minimum of 2 weeks (or as directed by your provider) before receiving any skin care or laser treatments.

    For most patients, the benefits of dermal fillers can be enhanced by using a medical-grade skincare system. Please contact your provider or a member of the staff for product recommendations.

    If you experience any of the following symptoms, contact our office immediately: dusky or white discoloration of injected areas, mottling or unusual bruising, severe or increasing pain, redness, increasing warmth or coolness to touch, severe swelling, itching, blisters, difficulty swallowing or smiling, fever, or chills. If you notice onset of any of these symptoms, call our office immediately at (706) 369-8440 to speak with a provider

Before and After Transformation

Janna Baker administers our neurotoxins and fillers here at Stephen Lober Plastic Surgery. Her before and after photos of facial transformation showcase her work. Follow along on her Instagram page to see more!