The Gray Area

I have been open for  business here in Austin for almost 3 months now and there seems to be a common concern among most patients.  They say to me, “I am afraid of injections, because I don’t want to look like one of those Beverly Hills housewives”.  Well I am here to tell you, you won’t. 
It has taken most of those women years of injections and plastic surgery to acquire that “look”.  There are a number of dermal fillers on the market and what you notice or see in that “look” is commonly, Sculptra, Artefill, and sometimes Radiesse.  These are the more permanent fillers that have a high G Prime (the measurement of viscosity and elasticity) and are not as soft in the tissue as Hyaluronic Acid fillers, commonly known as HA’s.
  Sculptra is a not an overnight fix.  There is usually a series of three injections about three weeks apart, that overtime help replace lost collagen and can usually last more than two years.   Sculptra is a miracle drug for those with severe facial fat volume loss and is popular among the HIV community.  The problem with Sculptra is that is an injectable poly-L-lactic acid that can have some pretty bad side effects, i.e. visible lumps and bumps, skin discoloration, pain and inflammation.  The only way to remove these lumps and nodules is surgically.  Learn more at
  Artefill is the only “permanent” or longer lasting filler in the US that is FDA approved.  It is made of a material called polymethylmethacrylate (PMMA).  These microspheres are not degraded and not absorbed by the body.  Again the only way to remove any lump or nodule is surgically and I have always been cautious of anything “permanent”.
  Radiesse is a volumizing filler comprised of Calcium Hydroxylapatite (CaHA) microspheres suspended in a water gel carrier.  It provides immediate volume and correction and also continues to correct by stimulating the body to produce its own natural collagen.  Over time the body absorbs the (CaHA) leaving behind your own collagen.  This is a great product but having the highest G Prime doesn’t always make for the softest more natural look. 
 I am partial to the Hyaluronic Acid fillers and will always claim, when injected correctly and conservatively,  that these are the most natural looking dermal fillers.  These include Juvederm, Restylane, Perlane, and the latest on the market, Belotero.  
  Juvederm Ultra and Juvederm Ultra Plus are the most popular HA’s on the market.  Juvederm Ultra Plus last 3 months longer than the Ultra and is $50 more.  These products are great for volumizing and have a natural look and feel.  They are also very hydrophilic which means the product binds to water in the skin.  The more hydrated you are the more result you can see.  The only downfall to this is that sometimes, you don’t want to have that hydrophilic filling response and that leads us to Restylane.
  Restylane is another Hyaluronic Acid filler that I use specifically for tear troughs.  This filler has a low G Prime and is less hydrophilic.  It stays where you put it, which is great under the thin skin around the eyes.  This treatment can last up to 2 years because of the lack of movement in this particular area.
  Perlane is a great volumizing product that is similar to Juvederm Ultra Plus.  In my experience it starts off with a great result and a beautiful lift but doesn’t last as long over time.
  Belotero is the latest HA on the market and has the lowest G Prime of them all.  This product is designed in a way where it can be injected very superficial, close to the surface, in the skin.  Belotero is being used for those “hard to treat” vertical wrinkles around the mouth and in crows feet lines, for the patient who fears Botox.  I am excited about carrying this new product.  Its only downfall, it last 6-9 months.
With Botox you don’t have to be frozen to be fixed!  There is a way to do a soft treatment and have you maintain a little movement.  If it is your first time for this type of treatment, I suggest you start with one area, to get used to the way it feels.  One of the greatest things about Botox is chemical brow lifts.  Arched eyebrows can be beautiful and who doesn’t want a more open eye, however when over done some women can look “spockish” and permanently surprised, and that is what turns people off.
 You do not have to settle for too much or nothing at all.    
 There is a gray area that will leave you looking rested and refreshed. 🙂    

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