Neuromodulators: Botox and Dysport

Treatment with neuromodulators like Botox and Dysport can be some of the best “preventive medicine” you invest in to minimize the appearance of unwanted expression lines and prevent the development of deeper wrinkles.  Since it was first discovered that patients with muscle spasms around the eyes being treated with Botox looked younger than their untreated counterparts, the treatment of frown lines and adjustment of brow appearance using neuromodulators has been elevated to a bit of an art form.  Dr. Owens is a surgeon with advanced understanding of the anatomy of facial expression and how modifying some muscle movement can enhance your appearance by softening lines of expression or allowing for a gentle lift of the brow.  Some patients are worried about looking “frozen” or having unnatural expression but using these medicines strategically can result in beautiful natural improvements that are subtle.  It is important to recognize the impact treatment can have on neighboring muscle groups and Dr. Owens will spend the time needed to fully assess your baseline movement and discuss with you all the considerations of this type of treatment.  She will recommend follow up evaluation for all first-time patients to be sure you are completely satisfied with your result and make any needed adjustments so you will absolutely love how you look.  The most common risks from injection are mild headache and injection site reaction including possible bruising (which is very rare with neuromodulators but can happen with any injection).   While Dr. Owens will take the necessary time to fully determine the best treatment plan for you, the treatment itself takes only a few minutes and you may return to your normal routine immediately, although we recommend avoiding strenuous activity or exercise for 24 hours after treatment.  Results are fully appreciated between 4 and 10 days after treatment and will last 3-4 months. 

Hyaluronic Acid Fillers

Modern hyaluronic acid fillers are gels available in varying thickness or viscosity and used in many different ways to best address need for volume and support, whether to enhance lip fullness or restore losses seen with normal aging.  While respecting normal anatomy, these fillers can be effectively used to beautifully rejuvenate the cheeks, jawline, lips and tear trough areas.  Hyaluronic acid is found naturally in our own skin and helps to hydrate and plump areas that have been injected.  Dr. Owens uses both the Restylane and Juvederm families of HA fillers and during your consultation she will discuss available products with you and how best to employ them to get beautiful results!  She will review important safety considerations and techniques.  Expect to arrive an hour before treatment to discuss the plan and apply topical numbing cream.  Treatment takes between 15 and 45 minutes depending on areas treated.  Any injection can cause bruising, but this is more common when treating the lips. Dr. Owens recommends planning filler treatments at least 2 weeks prior to any special events and considering use of arnica and bromelain formulations to minimize bruising (available in commercial form as SinnEcch or in other homeopathic products).  Hyaluronic fillers last anywhere from 6-18 months depending on the specific product used and area treated, and they can be longer lasting in some areas if used in combination with toxins like Botox or Dysport.

Liquid Rhinoplasty

One of the newest applications of the very versatile HA fillers is in correction of minor nasal contour issues.  Through precise placement of hyaluronic acid gel, bumps can be smoothed, and overall contour improved in an office visit.  This technique does not replace surgery but can make some dramatic improvements!  Downtime is almost none, and the procedure is comfortable to have performed in the office with topical numbing cream.

Bellafill

Bellafill is a unique dermal filler that stimulates your skin’s own collagen formation, used to treat nasolabial folds and smile lines and the only filler FDA approved for treatment of acne scarring.  It is a combination of a collagen gel and tiny polymethylmethacralate (PMMA) microspheres that gives immediate improvement and then creates new collagen that gives improvement lasting up to 5 years and longer.  Since it lasts for such a long time and is not reversible, Dr. Owens recommends a series of treatments to build toward the desired result, and recommends that Bellafill be considered by patients who have been using other fillers but wish to reduce the frequency of treatment visits.  The collagen component lasts for about 3 months and a touch up treatment is performed to reach the optimum result.  Once that is achieved, improvement lasts for many years.  Dr. Owens will let you know at the time of consultation how much Bellafill is recommended to achieve your desired result.  Bellafill is not used in the lips or under eye area, but if you are a patient who loves your filler results and wants a more lasting option, or if you have acne scars you wish to address, this may be just the product you have been looking for!

Radiesse

Radiesse is a filler made from calcium hydroxylapatite, a collagen stimulator that is biodegradable over time and has been used in surgical applications for many years.  It is most often used in the lower face for correction of smile lines at the nasolabial fold or for adding volume to cheeks or jawline.  It can also be used to rejuvenate the hands for a more youthful appearance.  Dr. Owens does not recommend using Radiesse in the lips or under eye area.  Results last over a year.

Sculptra Aesthetic

Sculptra is an injectable treatment unlike other fillers.  It is composed of poly-L-lactic acid (PLLA), which acts as a biostimulatory treatment to correct overall volume loss, helping the body to create more collagen and improving the quality of the skin in the areas treated and giving very natural results.  Because it requires more extensive injection sites, there can be more downtime related to bruising and swelling after treatment.  The results develop over time, and your appearance continues to improve over several months.  More than one treatment is usually recommended for best results and complete correction.  You will notice improvement for up to 2 years following completion of your treatment.  This is one of Dr. Owens’ favorite treatments for early signs of aging both because of the natural improvements that are achieved and the ability to treat some areas that other fillers may not be suited for, including body areas like the chest/décolletage, and the buttocks. 

Kybella

Excess submental fat, or double chin, can make you feel older and heavier than you truly are, blurring definition between jawline and neck.  Often this fat deposit is genetic so you may see no improvement even if you are working hard to maintain a normal weight.  Kybella is an injectable treatment that permanently dissolves fat cells under the chin to improve the contour.  The treatment can give similar results to liposuction but requires no incisions or surgery and can be done in a few short office visits.  When you consult with Dr. Owens, she will examine you and determine the approximate number of treatments required to achieve the best result.  These treatments are done in the office over several visits spaced weeks apart.  After determining your needs, Dr. Owens will carefully mark your skin.  Ice is used to numb the area, and after thoroughly cleaning the skin a series of injections is performed with a tiny needle.  The area is iced again but requires no special care.  Following injection, your lymphatic system removes the broken down fat and results will stabilize 6-8 weeks after treatment.  Expect some swelling and bruising at the site for several days; you may want to plan for a day or two off, or wear a scarf or turtleneck to cover the area.  Numbness and tingling are common but will return to normal in 6 weeks or less in most cases. Once the fat has been completely treated, the results are permanent!  The best candidates for Kybella treatment are patients who inherited double chin and maintain a normal weight, and those with good skin elasticity in the submental area. If the skin at your neck is loose, you may not be a candidate for this treatment, and Dr. Owens will review other options with you.

Chemical Peels

One of the most economical ways to brighten and improve the skin is with a chemical peel.  Dr. Owens will advise you about important skin care routines to use in preparation for the peel to get the best results, typically to be done for at least 6 weeks prior to the peel.  Dr. Owens uses trichloracetic acid (TCA), a water soluble acid that can be easily customized to individual patient needs, and allows her to offer you anything from a light skin refresher that has very little downtime to a deeper peel in series to address more substantial sun damage or pigment problems.  Deeper peels may have downtime of 5-7 days.  These treatments are best performed when you will be able to avoid sun exposure and at least a few weeks before any special event.  Results last several months to a year and can be maintained for many years with regular good skin care.

Profound RF Microneedling

Profound combines microneedling with the power of radiofrequency to treat the skin, achieving improvement in texture and thickness, as well as stimulating elastin and collagen production to improve the jawline definition for subtle, natural results. For patients with fullness under the chin, the subcutaneous treatment can diminish fullness and improve contour.  The treatment is done with numbing medicine in the comfort of the office setting and there is virtually no downtime.  While most often sought for facial treatment, other areas of the body may benefit from the improved elasticity and skin quality and decreased subdermal fat achieved with Profound treatment.  Ask at your consult if this might be a good option to improve your trouble spots! Read More about the Profound treatment.