Botox & Non-surgical Facial Rejuvenation in Greater Philadelphia

Injectable Fillers - Botox

Botox®, Hyaluronic acid (Restylane/Juvederm), and Fat Injections are popular non-surgical techniques for treating wrinkles and facial lines. Most patients are pleased with the results of these minimally invasive procedures. These procedures, however, cannot correct facial sagging or achieve the same results as face lift, eyelid surgery, browlift, or skin resurfacing.

Botulinum toxin injections (BTX), often referred to by the product names Botox® Cosmetic or Myobloc®, are biological toxins (botulinum toxin type A) transformed into a therapeutic agent. Botox® Cosmetic (cosmetic form of botulinum toxin type A), which was  FDA approved for treatment of glabellar and forehead wrinkles, is most effective in treating the lines and wrinkles caused by muscle contraction during facial expressions such as frowning or squinting. While the FDA approval for Botox® is specifically for the glabellar (between the eyebrows) and horizontal forehead wrinkles, it has also been used from many years for the treatment of crow’s feet around the eyes. The Botox® is injected directly into the muscles in these areas in a series of injections with extremely small needles. The procedure takes approximately 10 to 15 minutes to perform and the expression lines in the treatment areas will usually appear noticeably softer within a few days. While most patients are very pleased with the results, they are however not permanent and generally last for approximately three to four months.

Benefits:

• No downtime. Patients can immediately resume normal activities.
• Long experience has proven BTX to be safe. To date, no systemic complications associated with BTX injections have been documented.
• Treatment is reversible within several months.
• May be beneficial for treatment of migraine headaches.

Other Considerations:

• Botox® injections are a temporary solution for the treatment of wrinkles. The effects last from 3-4 months and require repeat treatments.
• Possible side effects include local numbness, swelling, bruising, or a burning sensation during injection. Some patients have reported temporary headache and nausea. Most complications are of short duration and can be avoided with proper injection techniques.
• A small percentage of patients are reported to experience no improvement at all.

The American Society for Aesthetic Plastic Surgery (ASAPS) maintains that BTX injections for aesthetic purposes appear to be safe and effective. Patients who show early signs of aging, as well as those who may not be suitable candidates for more extensive aesthetic facial surgery, may be good candidates for this procedure. Certain medications (some antibiotics, anti-inflammatories, or aspirin) and even some vitamins and herbs may increase the potency of BTX and may increase bleeding and bruising at the time of injection. Therefore, patients should be candid with their surgeon about all medications and supplements. Pregnant or nursing women should postpone undergoing this procedure. It is not known whether injection of BTX has any effect on a fetus or whether it is found in breast milk.

Hyaluronic Acid (Restylane/Juvederm)

Hyaluronic acid is a natural polysaccharide, that in appropriate form, is a versatile soft tissue filler. Currently available as the product name Restylane (also Restylane Fine Line and Perlane) distributed by the Medicis company, and Juvederm Ultra (also Juvederm Ultra Plus) distributed by a company named Allergan. Hyaluronic acid is being widely used for the management of wrinkles, fine lines, contour deformities, and volumetric deficiencies of face, cheeks, and lips associated with aging, developmental anomalies, and certain diseases. Restylane/Juvederm does not represent the final answer in the search for an ideal tissue filler but provides a predictable, safe, user-friendly approach.

Technique:

Restylane/Juvederm is usually injected when the patient is in the office, rather than requiring a hospital visit. The areas of the skin to be treated are first coated with a topical anesthetic, which is usually sufficient for the patient's comfort, although a nerve block may be preferable for some patients. Hyaluronic acid is a hydrophilic agent, which means that it attracts water much like a sponge. This expansion contributes to the final volume that is achieved. Overfilling can lead to bumps and irregularities which, although rare, can represent a small, temporary cosmetic problem. For many, but certainly not all patients, the results can last up to six months. It is especially effective for the nasolabial folds, lip augmentation, and areas of contour deformities. It is also an ideal adjunct for Botox® treatment and is frequently used in conjunction with Botox® to correct lines and creases that persist.

Benefits:

• A natural substance that does not require pretesting for allergic reactions
• Injections can last for approximately six months
• Minimal discomfort
• Very few side effects
• Can apply makeup immediately and return to normal activities

Other Considerations:

• Bruising and swelling can occur
• Small bumps are infrequently visible or are palpable
• After about three weeks, repeat injections are often necessary to achieve an ideal result

For additional information, please visit:
www.plasticsurgery.org

Fat Injection

Body fat makes excellent soft tissue filler material. Fat injection (also called autologous fat transplantation) transfers fat from one part of the body to another to recontour the face; diminish frown lines, crow's feet and nasolabial folds (smile lines); and provide definition to areas like the cheeks and chin. It can also be used to fill out depressed scarred areas on any part of the body. Fat injection is not permanent, and may require an effective maintenance program.

Microdermabrasion

Microdermabrasion is a non-invasive, safe approach to correcting minor imperfections in your skin. Micro crystals are applied to the skin through a hand-piece which also vacuums the dry, dead cells away from your skin showing you a prettier complexion. The procedure targets fine lines and gently smoothes the skin, while stimulating new cell production. In our medical setting, microdermabrasion may be done with a peel depending on the advice of the DiBello Plastic Surgery Skin Care team. Best results are attained with a series of treatments.

Medical Glycolic Peels

Experience in the science of skin care has taught us that the benefits of these procedures are greater when the client has a steady home routine. Your program begins with a complimentary consultation to specifically focus on your concerns and show you the greatest positive result. Glycolic peels are incorporated into the medical skin care program. Glycolic peels are done to minimize fine lines, eliminate brown freckles caused by sun damage and smooth the overall complexion. These treatments range to more mild "lunchtime peels" to more aggressive procedures which include salicylic and TCA peels. The TCA peel is designed to go deeper and is used for acne scars and severe hyperpigmentation.

Skin Care

Dr. DiBello offers a full line of medically-based products that are designed with the patient in mind, and are offered only through physicians. Dr. DiBello and his Skin Care team utilizes the best, most proven part of each line of skin care products and combines them for the best result for the patient’s skin.

Technology

Dr. DiBello is always current on the newest technologies being used, though he is extremely selective when it comes to what is proven technology that will be used to the best benefit of his patients. This is important to note, as it reflects the level of his care for those who put their trust in him.

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