BOTOX® Cosmetic and Dysport®
BOTOX® Cosmetic and Dysport® are two FDA-approved brands of botulinum toxin Type A, which work by relaxing muscle movement. In the aesthetic world, neurotoxins are used to soften lines that are created by a repetitive muscle contraction and are commonly injected in the forehead, between the eyebrows for scowling, and around the eyes for crow’s feet. They also have several “off label” uses to lift the nasal tip, relax chin dimpling, enhance the look of the upper lip, upturn the corners of the mouth, soften bunny lines on the sides of the nose, and reduce sweaty underarms and palms for patients with hyperhidrosis.
According to Sarah Burchett, PA-C, the best time to start BOTOX® Cosmetic or Dysport® injections is in your late 20s or early 30s, before your lines set in at rest.
“If you wait until you have a line that stays on your face even when you aren’t making an expression, the BOTOX® will still help to soften that line and keep it from getting deeper, but it will take longer and may also require some facial treatments to get rid of the line – it will not miraculously disappear with one BOTOX® treatment. This is an important point for patients to understand.”
During your initial consultation, we will discuss your goals and recommend the number of units and placement needed. Cosmetic treatment cost can vary from about $200 to upwards of $600 depending on the area covered and number of units used. We only charge by the units used, not a flat fee per area, so you pay for what you use! Hyperhidrosis treatments require a large number of units, so pricing begins at $800.
BOTOX® Cosmetic and Dysport® both last approximately 3 months, so budget to be injected 3-4 times annually. Dysport® will set in quickly, within 3 days, whereas BOTOX® Cosmetic may take up to 7 days to set in.
To learn more about the differences between BOTOX® Cosmetic and Dysport®, check out our blog!
Injectable Dermal Fillers
Fillers are used to volumize, plump, and smooth fine to moderate wrinkles. Common uses include plumping the lips, softening the nasolabial and Marionette lines, and volumizing the cheeks and temples.They are most beneficial for patients in their 30s, 40s, and 50s who have mild to moderate skin laxity and are not ready for surgical correction.
Most fillers are made of hyaluronic acid, a water-loving sugar molecule that occurs naturally in our skin and joints. They have different viscosities and amounts of cross-linking, which make certain fillers appropriate for supportive, lifting action, and other fillers great for smoothing fine lines. Hyaluronic acid fillers are considered nontoxic and safe, as they can be dissolved with an enzyme called hyaluronidase in cases of emergency. They are gradually broken down by the body over the course of months to years, depending on the filler.
The injector’s toolbox of fillers has grown significantly over the past decade. Since there are so many hyaluronic acid fillers on the market now, it is key to see a skilled injector who keeps current with education and training on the different products. We currently offer the following fillers and participate with Brilliant Distinctions® and Aspire® rewards.
- Juvederm Ultra®
- Juvederm Ultra Plus®
- Juvederm Voluma®
- Juvederm Vollure®
- Juvederm Volbella®
- Restylane Lyft®
- Restylane Defyne®
Please review the following FAQs about dermal fillers, and check out our blog postings for even more good information from our injector, Sarah Burchett, PA-C!
What will I look like after the filler is injected?
You will be able to see an immediate improvement after the filler is placed! Over the next 2 weeks, the filler will settle and integrate into your skin, any bruising that occurs will fade, and swelling will decrease. Bruising is an expected side effect of getting injections, but most patients have one or two small purple spots less than the size of a penny. However, if you are on any type of aspirin or blood thinner, you can expect to have larger bruises that take longer to go away. Swelling is typically minimal except for lip injections. When the lips are injected, expect to have noticeable swelling for 2 to 7 days. Icing can help reduce soreness and swelling.
Is it safe? Is there anything bad that could happen to me as a result of getting filler?
Filler is very safe overall, with a low incidence of complications. Some amount of bruising is normal and to be expected after injections. The uncommon and more serious side effects include infection, bacterial growth on the filler, allergic sensitization to the filler, and vascular occlusion. If you notice any skin paleness, mottling, blistering, or have increasing pain at rest after filler is injected, call our office immediately so that we can address possible complications as soon as possible.
What do you do to protect my safety?
Prior to filler placement, your skin is cleansed with a presurgical scrub containing chlorhexidine to remove surface bacteria. Hypochlorous acid solution is also used as a skin antiseptic during and after injections, which reduces the risk of infection. We keep Hylenex® on site at all times in the event that filler needs to be dissolved. Our primary injector, Sarah Burchett, PA-C, has completed over 30 hours of supervised hands-on education on injectable technique, and countless hours of reading and webinars to stay up to date. Continued education is something Sarah considers invaluable to a skilled injector, and is required to maintain Physician Assistant licensure. She works closely with Dr. Zinsser, who is accessible during office hours. We also offer an after-hours emergency contact number.
How long will the filler last?
This depends upon the product, the amount injected, and your body. Filler in and around the mouth lasts the shortest amount of time, from 3 to 9 months, because this area moves so much. Filler placed in the upper cheeks, temples, and tear troughs tends to last 9 to 24 months. Every patient has different anatomy and, therefore, different needs, so we encourage you to start with a consultation to develop a personalized plan. Sarah Burchett, PA-C, also recommends that all filler patients reevaluate and maintain their investment at 6 month intervals. You may inject multiple syringes initially to achieve your goals, but it is easier to maintain the filler by injecting one syringe every 6 months versus waiting 2 years and needing multiple syringes for a good correction.
What is the price range for filler?
When you come in for your consultation and develop a plan, you will receive a quote personalized for you. Our fillers range from $450 to $725 per syringe, and the number of syringes recommended for you will depend upon your goals and the condition of your skin. For example, a patient in her 50s who needs a “makeover” correction may invest $4000 in her appearance.
Whether you want plump volume or a natural, soft pout, we can help make your lips more attractive and appealing. Our primary injector, Sarah Burchett, PA-C, loves to perform lip augmentation! Here is what she wants patients to know before having their lips injected:
“The lips are one part of the face where you see a wide range of anatomical variation. Just look around at a group of your friends and notice the different sizes and shapes of their lips! It’s important to inject each patient as an individual, and the first step in doing this is selecting a product that will produce the result they are looking for. On my younger patients in their 20s, the trend is to have big volume, so I usually suggest Juvederm Ultra® for good plump. However, most of my patients who are moms don’t want to look like they have had anything done, so I typically start with Volbella®, which will be super soft and natural. Restylane® can be a good option for a patient who falls in the middle. Everyone loses volume in the midface and the lips as we age, so if you don’t replenish lip volume, the mouth will be a giveaway of your age.”
“Before and during the injections, I evaluate the balance of your lips from the front and profile to make sure we are working towards the aesthetic ideals of proportion and projection. I use direct injection techniques rather than a blunt cannula when I do lips. The reason why is because you can place the filler in a more precise fashion and it’s easier to address details and do a little sculpting. Also, the lips have natural pockets of volume called tubercles, and I try to respect the boundaries of these areas. Some people have noticed, over time, that pushing a cannula all the way across the lip, through these boundaries, seems to damage the connective tissue that gives our lips shape, and you end up with a sausage lip look. You want your lips to be curvy and shapely, not just big.”
Sculptra® is a unique filler made of poly-L-lactic acid (PLLA) that stimulates your own collagen production over the course of several months. It is an excellent choice for very lean patients, those with thin skin, and those with volume loss in multiple areas of their face, such as the midface, cheeks, nasolabial folds and Marionette lines. Results are natural-looking because you are relying on your body to produce its own collagen.
“What I notice with my Sculptra® patients by the end of their series is a noticeable change in their skin quality. It looks thicker and more radiant in their before/after photos. This makes sense because of the increase in collagen in the dermis,” according to Sarah Burchett, PA-C. Sculptra® is injected in a series of 3 sessions spaced 6 weeks apart. You can expect your results to gradually build with each treatment and last 2 years or more! (Initial clinical trials of Sculptra® ended at 25 months.)
Find the filler or injectable that's right for you! Please call Zinsser Plastic Surgery at 804-474-9805 today for more information about all of our non-surgical treatments. Our team serves patients in Richmond, Fredericksburg, Williamsburg, and nearby areas of Virginia.