The Power of Injectable Treatments for Facial Rejuvenation

Many patients are curious of the benefit and value of injectables such as Botox, Juvederm, Radiesse and Sculptra. In many instances these work very well and will buy some time for those wishing to postpone a surgical treatment. Patients are encouraged to meet with a Board Certified Plastic Surgeon to decide which treatment is best for them.
Presently, Botox is the most popular and widely used injectable. It does a wonderful job relaxing wrinkles on the forehead and crows feet while enhancing the appearance of the brows. Injections are relatively pain free and can be administered anytime even during a lunch hour. Currently, Botox is FDA approved for the forehead and glabella, this area is right between the brows. This being said I rarely use it for the lips to help enhance the use of a filler in the region. When injecting Botox into this area you must be careful not to use too much since it will affect smiling, talking and eating. In addition, Botox does work well in the lower lip commissure retractors to help correct a downturn smile. It also will help with a gummy smile. Occassionaly, I will inject Botox for the treatment of masseter hypertrophy. This helps patients who brux or grind their teeth. Botox has a variety of excellent uses for maintaining a youth appearance and lasts approximately three to four months per treatment.

Fillers are commonly used to fill in wrinkles and lines of the face due to the early effects of aging. The most common facial fillers I use are the hyaluronic acids such as Restylane or Juvederm. These are commonly used in the lips, nasolabial folds (the area between the nose and mouth) and inferior oral commissure region. Recently, I have started using hyaluronic acid fillers under the eyes to fill defects in the lower lid. Caution must be used in this area as it is unforgiving due to the thin skin of the lower eyelid. In addition, other facial fillers including Radiesse work well in the nasolabial folds and nasal region. I have also found Radiesse useful as a filler in the cheeks of patients desiring a mild cheek augmentation. Choosing the right filler is a personal decision that should be made with the assistance of a board certified Plastic Surgeon. Patients can expect results to last about one year.
Sculptra also is another injectable for improving facial atrophy or loss of fullness. Results are gradually requiring several treatments until optimal results are reached. A plus for Sculptra is that is lasts for about two years and consists of poly-L-lactic acid which is a substance that helps replace lost facial collagen. This being said, it is not recommended for the lips or eyelids. Sculptra can be used as a standalone procedure or in conjunction with a surgical face lift procedure. It is important for patients to appreciate the gradual results and to be committed to receiving several treatments in order to appreciate the full benefits of Sculptra.
Fat transfer to the face is another injectable choice for those with signs of aging to restore volume and soften rhytids (wrinkles). This does require more than local anesthesia but usually can be done with IV sedation. Patients can expect some swelling and bruising with a fat transfer procedure. Some of the fat will not last, particularly in the peri-oral region; but in this area all fillers tend to re-absorb sooner.
In conclusion, injectables are a great choice for many patients desiring to maintain a more youthful appearance. There are many choices and products to help you achieve your goals. Also, I am sure that newer and more natural synthetic fillers will be available in the future. But I tell patients not to choose a “permanent” filler since the surrounding tissues will not stay permanently the same.

This week Dr. Donald Nunn’s focus is on facial rejuvenation, specifically nonsurgical facial rejuvenation vs. surgical rejuvenation. Many patients are interested in understanding the appropriate uses of fillers verses surgical procedures. Below is Dr Nunn’s thoughts, please contact the office directly at (404) 255-2975 with specific questions. Also, before and after photos are on the website, http://www.drnunn.com. These are valuable tools to establishing which approach is best for varying patient presentations.

Facial rejuvenation:
“One of the most common things I encounter as a Plastic Surgeon in facial rejuvenation is when to use nonsurgical techniques versus surgery. Of course everyone would like the least invasive treatment possible with the maximum result and no downtime. But as we all know this is not always possible. We have made great strides with facial fillers (Juvederm, Sculptra, Restylane), Botox and skin treatments over the past several years and these can definitely delay the need for more invasive treatments. But there comes a time when surgical treatment will be the only technique that will give the patient an adequate improvement. Generally this is the older patient with significant amounts of excess skin that no filler will adequately correct. The difficulty lies in educating the patient in that fillers alone will not give them the result they desire. It may in some cases give slight improvement but when one considers the cost of both treatments and the need for maintenance the surgical solution is often the best. That said even surgical techniques are evolving with the use of short scar techniques and fat transfer in a lot of facial rejuvenation cases. This may in many cases help speed the recovery and decrease the risks involved with surgery. I am sure that we will continue to find new and better techniques in the future with the exciting research being done on stem cells.”

Donald R. Nunn, M.D.

About the Author:

Dr. Nunn practices in Atlanta, Georgia and has the distinction of being the only doctor in the United States who is triple-board certified in Plastic Surgery, Otolaryngology/Head and Neck Surgery, and Oral and Maxillofacial Surgery. Because of his extensive knowledge and treatment of both hard and soft tissues, Dr. Nunn is capable of performing a wide range of cosmetic and reconstructive facial surgeries, as well as breast and total body aesthetic surgery. His commitment to a natural look makes him the premier choice in Atlanta and the Southeast. Please visit Dr. Donald Nunn’s website at http://www.thebeautyofknowledge.com or call 404-255-2975 for further information.

The Value of Triple Board Certification

Triple Board certified Plastic Surgeon, Donald Nunn, utilizes his vast training to provide patients with a youthful natural result.  Many wonder why he why spent 21 years training, Dr. Nunn shares his answer below.

“I have been asked multiple times why I did so much surgical training; Doctor Degrees in medicine and dentistry; completing three residencies and one fellowship and becoming Board certified in Plastic Surgery, Otolaryngology/Head and Neck Surgery and Oral and Maxillofacial Surgery.  I compare the multiple degrees and residencies to cross training in different sports.  Each surgical discipline enhances the other giving a different perspective or viewpoint of a problem or deformity and how to approach the issues, much as different sport activities enhance one another.  Plastic Surgery allows me to utilize all my training to their fullest.  It uses my Maxillofacial training to contour and shape the facial skeleton by orthognathic (jaw) surgery to correct malocclusion (incorrect bite) and facial implants, genioplasty or bone grafts to augment deficient cheeks or chin.  My Otolaryngology / Head and Neck training further allows me to shape noses, ears and faces knowing the anatomy and physiology of underlying structures such as the nasal airway and the effect of rhinoplasty on key issues.  My plastic surgery residency gave me further perspective in the handling of soft tissues of the face, breast and body for both reconstructive and cosmetic reasons. And finally my year of Aesthetic Surgery allowed me to focus specifically on cosmetic surgery and how I could tie the disciplines together.  Multiple colleagues question why I did so much training but my patients do not.”

 

About the Author:

Dr. Nunn practices in Atlanta, Georgia and has the distinction of being the only doctor in the United States who is triple-board certified in Plastic Surgery, Otolaryngology/Head and Neck Surgery, and Oral and Maxillofacial Surgery. Because of his extensive knowledge and treatment of both hard and soft tissues, Dr. Nunn is capable of performing a wide range of cosmetic and reconstructive facial surgeries, as well as breast and total body aesthetic surgery. His commitment to a natural look makes him the premier choice in Atlanta and the Southeast.  Please visit Dr. Donald Nunn’s website at http://www.thebeautyofknowledge.com or call 404-255-2975 for further information.

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