Neuromodulator medications contain botulinum toxin which inhibits neuromuscular junction synapses and lead to temporary paralysis. This medication was originally used for treatment of blepharospasm and is now approved for many conditions including migraines, cervical dystocia, hyperhidrosis and the treatment and prevention of wrinkles which is what we most aim to treat in the field of aesthetics. These neuromodulators come in several brands which are more alike than different but there are specific instances where using a specific brand may be of benefit.

Dysport is the Galderma branded version of abobotulinumtoxin A. It is well known and is one of the most studied one of the neuromodulator brands. Its effects begin within 3-5 days with final results within 10-14 days. It is protein bound and is known to diffuse a little more than other brands which means it can reach a little further per injection. With that said caution must be taken in high-risk areas as that increased diffusion factor may lead to unwanted effects.

Botox was trademarked by the Allergan brand. Its effects usually start on day 7 with full effects on day 14. It is considered to have a smaller diffusion factor than Dysport although this may lead to an anecdotal slightly lower time of effect. Botox is also protein bound just as the Dysport formulation. Rarely patients develop antibodies to the proteins bound to the toxin in Botox and Dysport which may lead to diminished effects and need for higher doses.

Xeomin, developed by Merz Aesthetics, is another formulation of botulinum toxin A. Xeomin, unlike Dysport or Botox, has no protein bound to it which may make it less prone to antibody development in the body from multiple injections. Therefore, if it seems the neuromodulator being used for your injections does not seem to have the same effect changing brands or formulations may help. Xeomin had been studied less than the other two brands mentioned above but has shown to have similar duration and effect to its peers.

While these neuromodulators have garnered popularity for their cosmetic benefits, they remain a subject of ongoing research and development for its potential applications in treating a range of medical conditions. One of those we treat here is hyperhidrosis. Hyperhidrosis is a condition in which you sweat constantly even if it isn’t particularly hot. This usually happens due to overactive sweat glands most commonly affecting the axilla or the hands. Neuromodulators block the chemical that activates the sweat ducts responsible for excessive sweating, thereby treating hyperhidrosis. These results may last from 4-6 months and the sweat gland activity baseline may be ameliorated as well.

As with any medical or cosmetic procedure, individuals considering neuromodulator treatments should consult with qualified healthcare professionals to ensure safe and effective use. Exposure to neurotoxins can lead to a range of neurological symptoms, including paralysis, convulsions, cognitive impairment, and even death in severe cases. However, at this point neurotoxin or neuromodulator use is amongst the safest of cosmetic treatments.

Injectables hyaluronic acid (HA) dermal fillers have been used in aesthetics since the early 2000’s. The research and progress in this field has made this a very popular cosmetic treatment as it provides instant visible results with little to no down time. HA is found naturally throughout the body, with the highest concentrations in the joints, eyes, and skin. As we age we lose volume in our bones, fat pads, muscles, and skin leading to a sunken or saggy appearance. In the skin hyaluronic acid attracts water, which allows the skin to become more hydrated. Injectables HA is used to reduce the appearance of fine lines and wrinkles, facial folds, and to create structure, framework, and volume to the face and lips.

There are many HA filler varieties with different characteristics. These characteristics are dictated by the size and reticulation of the HA in the injectables. The most common fillers in the market today include Juvederm, Voluma, Volbella, Restylane, Restylane Silk, Restylane Lyft, Restylane Kysse, and Restylane Contour. Each of these HA fillers has unique characteristics and these properties allow us to appropriately choose what face location to inject with them.

In correcting fine lines and shadows, you can use lighter product like Restylane contour or silk. Volbella or Kysse can be used for lip augmentation or shaping. Treatment of nasolabial folds and marionette lines can be done with options such as Juvederm, Restylane Contour, or Restylane Lyft. Finally, cheek augmentation is most commonly performed with either Voluma or Restylane Lyft to create structure, elevate, and reposition the cheek.

The tasteful use of these dermal fillers depends on the amount and type of HA filler used in the appropriate facial location. Outcomes and longevity vary from patient to patient and are influenced by the location of the injection, the individual properties of the HA filler, the age of the patient, and the individual characteristics of the patient’s skin.

We will perform a full evaluation with science and experience founded recommendations to create subtle but drastic changes. We will review the medical history and use the highest standards in safety. This includes using cannulas when appropriate to prevent vascular injection, sterile techniques to prevent infections, and respecting the anatomical compartments of the area being injected. High risk locations include the nose, the tear drop area, nasolabial folds and mid forehead. Contraindications include infection in the treatment area, uncontrolled diabetes, blood-clotting problems or blood thinning medication (can be suspended with physician supervision), allergies to HA filler components, or pregnancy and breast feeding.

Biostimulators have been studied extensively in the treatment of tissue repair, burns, arthritis and skin. As we age our skin loses 1% of its collagen every year after we turn 25. The effect is multifactorial and can be prevented in many ways including protection from the sun, laser therapy and biostimulators.

Radiesse is a dermal filler that has gained popularity in the field of aesthetic medicine for its ability to address facial wrinkles and volume loss. Composed of calcium hydroxyapatite microspheres suspended in a gel, Radiesse is known for its dual action providing an immediate volumizing effect while stimulating the body's natural collagen production over time. Radiesse can address wrinkles and folds when injected at the dermal level most commonly treating nasolabial folds, marionette lines, and other facial creases. It can also be injected right at the level of bone to ameliorate the effects of receding facial bone structure that comes with age. Common sites include the chin area and maxilla.

Sculptra is designed to address signs of facial aging by stimulating collagen production. Composed of poly-L-lactic acid, a biocompatible and biodegradable substance, Sculptra is injected beneath the skin to restore volume and improve skin texture gradually. Unlike dermal fillers, Sculptra works by stimulating the body's natural collagen synthesis, resulting in a more natural and subtle rejuvenation.

This treatment is commonly used to counteract the effects of facial fat loss, providing a lifting and firming effect over time. Sculptra is popular for its ability to create long-lasting results, often lasting up to two years or more. The gradual nature of the treatment allows for a subtle enhancement that evolves over several weeks, providing patients with a refreshed and revitalized appearance. Its effects start in 30 days and usually reach peak at 60 days. We recommend a treatment with a minimum of 3 syringes within 6 months to methodically evaluate and rejuvenate the collagen of your skin.

Sculptra should not be used by people that are allergic to any ingredient of the product or have a history of keloid formation or hypertrophic scarring. Safety has not been established in patients who are pregnant, lactating, breastfeeding, or under 18 years of age.

Platelet-Rich Plasma (PRP) is a cutting-edge medical treatment that harnesses the healing power of one's own blood to stimulate tissue regeneration and accelerate the natural healing process. Platelet-rich plasma (PRP), a biological product, is a portion of the plasma fraction of your own blood. PRP not only contains a high level of platelets, but also has a full range of clotting factors. Moreover, it is enriched with several growth factors (GFs), chemokines, cytokines, and other plasma proteins. PRP stimulates the secretion of hyaluronic acid and type 1 procollagen in skin fibroblasts.

In the preparation of PRP a 20-50 cc blood sample is taken from the patient. Anticoagulants, such as acid citrate dextrose or sodium citrate, are added to whole blood to prevent coagulation and premature secretion of alpha granules which contain inflammatory factors which aid in healing. The blood is then spun and three layers are obtained. The top layer is the platelet rich plasma desired. This PRP full of growth factors, platelets and bioactive proteins can then be injected in many areas including joints, tendons, undereye or skin promoting cell growth and tissue repair. This treatment is great as an adjunct after abrasive facial treatments that injure the skin to produce an inflammatory regenerative response. The PRP then provides the building factors for an efficient and potent repair. It is also a great treatment for the undereye to help regenerate this fragile skin.