Injectables are among the most popular and predictable products used in cosmetic dermatology.  Many types of injectables are available to the dermatologist to achieve different types of improvement.  Injectables are useful in softening wrinkles, reshaping areas of volume loss, relaxing frown lines, and treating unwanted spider veins. With an experienced injector, these products represent an invaluable array of tools to create subtle but pleasing and natural results.  Dr. Malouf has been injecting these products for 20 years on a daily basis and has been well known in the community and field, for his experience and skill.

Injectable fillers have been around for over 30 years. They are a useful group of products in the treatment of wrinkles and volume loss. The earliest products were very popular but had several limitations. The main problem was the high incidence of allergy since many were derived from bovine collagen. In addition, the effects from these products lasted only 2-3 months. The early collagens were also notorious for leaving a lumpy sensation in the skin. In the early 2000’s, a new type of filler was introduced. The new filler group was a type of hyaluronic acid which is a water-loving molecule, present in most living organisms including humans. This substance acts as a natural shock absorber for cells and becomes depleted in the skin with aging. This group of fillers had many advantages over collagen. First, since it is not a protein from an animal source, it is impossible to develop an allergy to hyaluronic acid (Ha). Ha also lasts many months, and produces a much more natural improvement since “it belongs” there. Although there are several other types of fillers that have been developed and FDA approved, ha’s are the most safe and predictable, and for that reason, Dr. Malouf chooses to use them exclusively for wrinkle softening, facial contouring, and volume loss replacement. There are many different viscosities (thickness) and now some are more “flexible” than others, which offers a variety of different choices for addressing different problems.

Hyaluronic Acid Fillers

Restylane

Products: Restylane Silk, Restylane l, Restylane Refyne, Restylane Defyne, Restylane Lyft

Juvederm

Juvederm  XC, Juvederm XC Plus, Vollure, Volbella, Voluma XC

Toxins

The classic product which has become a household name in this category is Botox.  Botox has been around since the mid 80’s and probably represents the most widely used injectable worldwide.  The purified protein is very potent and causes the neurologic impulse to muscles, and sweat glands to be blocked thereby creating a desired effect. By blocking the impulse to certain facial muscles, the resulting wrinkle is reduced.  Although extremely popular many untoward effects may result in the case of the inexperienced injector. There are many variables which can affect the outcome, which can result in an un-natural look, or a frozen look which can include brow drop or asymmetry.

The three different brands are very similar in the effects with very few distinguishing features and are all roughly priced the same.  Botox, Xeomin, and Dysport.

Sclerotherapy

Sclerotherapy is an injectable procedure used to target spider veins on the legs.  There are many different types of sclerosing agents with different properties. The end result is to cause selective damage to unwanted veins, which results in gradual removal by the body.  The process takes time to achieve the desired result and often requires maintenance.  Dr. Malouf prefers to use polydocanol since it hurts less, causes less side effects and has good efficacy.

Schedule a consult with Dr. Malouf to see which filler combination would be most useful in achieving your goals.