Facial fillers articles

Nearly everyone has heard of Groupon, the coupon site for daily deals. If you are on the receiving end as a consumer, it can be a great way to get some great deals. For over a year we have been seeing other plastic surgeons and dermatologists sell Botox® at huge discounts. Not wanting to be outdone by our competitors, we decided to explore our options for selling facial injectables such as Botox, Restylane, Juvederm and Sculptra via Groupon. Find out why we won’t be offering Botox discounts via Groupon.

Just a few nights ago I was getting milk at the convenience store, and on the checkout line I saw another one of those countless celebrity Plastic Surgery magazine covers. This one caught my attention because it shows pictures of Tom Cruise with a very pronounced left lower eyelid bag, then poof!, its gone. Or is it? Therein lies the story of smiling, fillers, and what makes a person look younger.

What can one do for bags under the eyes? For many years, patients would come to me asking to remove the bags under the eyelids, saying the bags made them look old and tired. I usually recommended a standard blepharoplasty or Eye lift. That involves making an incision right under the eyelashes, lifting skin and the muscle that is right under the skin. I would then remove the fat. It was the standard solution but it had several drawbacks.

The Liquid facelift. I first heard about it from Heidi Rebuck, a Juvederm and Botox rep from Allergan. “The Liquid facelift” is basically what I did with my male patient, using a filler with Botox, but I think these pictures of “The Liquid facelift” are worth a thousand words. Basically, the patient in the photo (courtesy of Allergan) had Botox to forehead and “crow’s feet” wrinkles around the eyes, with tissue fillers to the lips, nasolabial folds (folds that go from side of nostrils towards the corners of the mouth), and possibly under the eyes. The change is dramatic and substantial.

For forehead wrinkles, a cosmetic dermatologist will tend to recommend “therapy”, or facial fillers such as Restylane, or BOTOX. All of these injectables have to be repeated over time, with the full knowledge that if therapy is stopped, the wrinkles will come back. The plastic surgeon, on the other hand, will think of a more permanent solution, such as lifting the muscles that cause those wrinkles in the first place. Thus he may recommend an endoscopic forehead lift.

Collagen, fascian, Restylane, etc., are wonderful options for tissue fillers, but their effect seems to be measured in months. If a patient repeats the procedure enough, the costs soon approach those of surgery. I found myself suggesting to more and more patients that they should just have surgery and make the result more permanent. Fat injections in the facial area do provide a longer lasting result than most fillers. However, fat injections are more of a surgical procedure rather than a quick injection. With fat injections, I use the patient’s own fat as a filler. The results can be dramatic and long lasting. Fat injections can be used in areas besides the face. I use a special type of fat injection is to fill out areas we never thought could benefit from large volume injections, such as the butt. I love doing fat injections, but there are a certain amount of pre and post op issues associated with it. So I look upon fat injections as a surgical procedure with a recovery time.

Most patients who come to my office don’t come in asking for a full facelift. Most come asking for a specific face procedure to “make them look younger”.   If they are relatively young, they focus on the nasolabial folds the lines that go from the side of the nose to the corners of the lips). Or they may mention the lips, how they are getting thinner. If they are somewhat older, they will focus on the jawline and neck. I listen to them, because that is what they are concerned about, but then I have to ask: Do you want to look better to yourself or to others?