Injectables

When we talk about injectables we typically refer to two types of substances: neuromodulators (Botox), fillers (hyaluronic acid such as Juvederm) or biostimulators (Sculptra or Radiesse).

It is important to understand how these 3 products work. First, let’s talk about neuromodulators or neurotoxins. There are 4 FDA-approved neuromodulators in the United States: Botox, Dysport, Xeomin and Jeuveau. All of these help relax the muscles of facial expression in order to smoothen dynanamic lines (those that appear when we express). Neuromodulators are typically used on the third upper portion of the face (forehead, midbrow and crow’s feet) to reduce lines that usually form from squinting, smiling, raising the eyebrows, or frowning.

Second, let’s go over fillers, what they are and what they are used for. Fillers are gel-like substances composed of hyaluronic acid that come in different formulations depending on the viscosity and cohesivity of the product. Fillers can be injected superficially in the upper dermis, deep dermis or on top of bone depending on the need and type of product.

Importantly, we favor the use of fillers that are temporary over those that are permanent (silicone or Bellafil) given safety concerns.

Here are some of the reasons for using injectable fillers:

• Smooth out lines around the mouth and nose, also known as marionette lines or smile lines.
• Remove vertical lip lines.
• Enhance or plump the lips.
• Smooth over a crease in the chin.
• Improve the symmetry of the face.
• Improve indented surgical or acne scars
• Improve dark circles and grooves under the eye

Today, fillers come in various FDA-approved formulations. To ensure your safety, the injectables you use should always be FDA-approved and only be obtained through a licensed medical professional, such as a board-certified plastic surgeon or dermatologist. Examples of FDA-approved hyaluronic acid fillers include Juvederm Ultra, Volbella, Vollure, Volluma, Restylane, Restylane Lyft, Restylane Silk, Revanesse Versa, Belotero, and the new RHA Teoxane family of fillers (1,2,3 and 4).

Lastly, biostimulators such as Radiesse (calcium hydroxyapatite) or Sculptra (poly-L-lactic acid) are collagen fertilizers injected in the deep dermis or on top of bone to stimulate collagen production. The full results take many weeks to show and multiple sessions (typically 3) spaced out a month a part are recommended. These products should not be used around the eyes or mouth, but they can be used in a diluted way to correct dimples on the buttocks (cellulite), and skin laxity on the neck, abdomen, arms and legs.