Injectables FAQ

Many people have questions about injectable treatments and want answers from an expert. Read below to find board-certified dermatologists Dr. Melda Isaac’s and Dr. Daniel Yanes’ answers to the most frequently asked questions about BOTOX, Juvederm, Juvederm Voluma, Sculptra Aesthetic, Radiesse, Restylane, Restylane Lyft and Belotero.

Frequently Asked Question

Q: Is Dysport the same as BOTOX?

A: Dysport is another neuromodulator that works similar to Botox. Patients can alternate between Dysport and Botox to determine which treatment they prefer.

Q: Can you alternate Dysport and Botox shots?

A: There is no problem alternating among all neurotoxins: Botox, Dysport or Xeomin.  Our providers encourage patients to see if they get better duration of benefit with one product over another. The products are similar if prepared/reconstituted and injected properly.

Q: How much longer does Dysport last than other injectables for crow’s
feet?

A: There is no significant difference in the longevity of
Dysport vs. other wrinkle treatments. Both
will last approximately 3-4 months when injected into the crow’s feet. Dysport does diffuse more readily and has a slightly faster onset of action. Always be sure to visit an experienced, board-certified dermatologist when thinking of having Dysport treatments done.

Q: How soon can I expect to see results from my Dysport treatment for crow’s feet? 

A: While some people may start to see results earlier, results may begin to appear after 5-7 days in some cases. Be patient, and if you are still not seeing results after 10 days, visit your injector again for reevaluation.

Q: Will Xeomin help with excessive sweating (hyperhidrosis)?

A: Xeomin has been tested and proven to prevent hyperhidrosis under the arms and is FDA-approved for that use. Xeomin works by preventing the release of a chemical, which signals activation of the sweat glands. Results generally last around three months, but depending on the person can last for up to a year.

Q: Why Does BOTOX make my forehead look shiny?

A: In my practice, I use very fine needles and the least amount of BOTOX necessary to relax the dynamic muscles that cause brow wrinkles. If Botox is done correctly, there are no tell-tale signs – including shiny foreheads! Please consult a board-certified dermatologist with expertise in BOTOX injection to make sure you receive the most natural results possible.

Q: How many units will I need for a few forehead wrinkles?

A:  I would need to see you in person in order to decide exactly how many units of BOTOX would be optimal to prevent the wrinkles on your forehead from deepening.  An average dose from the frown lines between one’s brows is 20 units.  An average dose for reducing horizontal forehead lines is 10 units. Treatment does not depend as much on the age of the patient as on the quality of the skin, strength of the muscle, and the depth of the wrinkles and of course individual genetic variation. Request a consultation to find out how to maintain the youthful quality of your skin.

Q: How long does Juvederm last?

A: How long Juvederm lasts varies depending on a number of factors, including individual metabolism, injector technique, and the location the Juvederm was placed in. A general rule of thumb is that Juvederm will last longer in areas with less movement, such as the tear troughs or cheeks. A rough estimate would be that Juvederm lasts around 6 months to a year in areas with less movement, while it can last from 4-6 months in areas with more movement, such as the lips. These results will vary on an individual basis, however.

Q: How can I prevent bruising from Restylane or Juvederm?

A: While it is difficult to guarantee that there will be no bruising following a dermal filler injection, there are certain things you can do to minimize the chances. Finding a skilled injector with good technique is at the top of the list, and you should also avoid taking any blood thinning medications or supplements for at least 10 days prior to treatment. If bruising does occur, you can manage it through ice, over the counter medications, and arnica.

Q: Which is better, Juvederm or Restylane?

A: Restylane and Juvederm are very similar; they are both hyaluronic acid gel fillers used to help smooth wrinkles and add volume. The products are also similar in their duration of benefit.  I think restylane is a bit more firm which helps lift the corners of the mouth or wrinkle better than juvederm. Juvederm is softer and more malleable and I prefer it for lip volume. The technique of the injector should not be underestimated.  Rather than focusing on which product to choose, it’s better to find a skilled, board-certified dermatologist who can help you achieve your goals in the best manner. 

Q: How many units of filler are needed for upper lip plumping?

A: To plump the lips, a dermal filler such as Juvederm or Restylane is appropriate. Fillers add volume with a
gel formulated with hyaluronic acid and are very safe and effective for lip
augmentation.

Q: What is the best option for plumping up thin lips?

A: If you are looking to add volume to thin lips, you
may want to consider a hyaluronic acid lip filler such as Restylane or Juvederm.

One can often see a mild plumping of the lip with as little as 4 units. I recommend requesting a consultation to determine how much filler you would need for optimal lip rejuvenation.

Q: Is swelling after lip injections normal?

A: Yes, it is perfectly normal to experience swelling after Juvederm or Restylane lip injections. It’s nothing to panic about. Apply ice to the treated area.  Wait two weeks for the swelling to go completely down before evaluating your final results, and if you are unhappy with your results at that time, you can consider having the filler dissolved with hyaluronidase.

Q: How common is lip augmentation in men?

A: The occurrence of male lip enhancing treatments increases by more than 10% year over year. Thinning lips are a common problem among men as well as women, as aging and stress reduces collagen production, which is responsible for keeping lips full and youthful. Fillers are administered in a series of small injections on each side of the lips over a half hour treatment time, giving natural, immediate results. There is no downtime to the treatment, making this the perfect treatment for men.

Q: Does technique matter, or will one syringe of Juvederm injected into the lips look the same no matter who does it?

A: Technique absolutely matters when it comes to injecting fillers, not only in the lips but anywhere on the face or body. It is essential to visit a board-certified, skilled injector who has experience with lip augmentation and who understands facial anatomy and where best to inject the filler for the best results. They will also be able to tell you approximately how much you need, and whether one syringe will be enough.

Q: Is Belotero as good as other fillers to volumize the cheeks in order to reduce nasolabial folds?

A: Belotero can be a great choice for reducing nasolabial folds and smoothing fine lines, as well as for under the eyes or lip plumping. However, for cheek volumization, thicker fillers tend to work better. Juvederm Voluma or Restylane Lyft are better for long-lasting midface rejuvenation. Ultimately, the product is not as important as the person doing the injecting, however. Make sure that you see a board-certified dermatologist with experience in volumizing the midface and treating nasolabial folds for your injections.

Q: Can Juvederm help fill laugh lines and expression lines but still look natural?

A: Absolutely!  Juvederm is perfect for filling lines around the mouth. When injected by a board-certified dermatologist with good technique and experience, you can achieve very natural looking results. Visit a board-certified dermatologist for a consultation to see if you are a good candidate for Juvederm treatment.

Q: Should I try Juvederm Voluma for skin laxity?

A: I think you would be very happy with the results of Juvederm Voluma for building up your face and cheekbones. You can get a nice, elegant curve to your cheekbone area that will pull up the jowls and marionette lines. Voluma also works to stimulate the production of collagen, helping your results last up to 18 months or more and making your skin thicker and more resilient. Please find a board-certified dermatologist who is expert in facial sculpting with Juvederm Voluma.

Q: How long does Belotero last?

A: Belotero is a hyaluronic acid filler. It is thinner or finer in size and flows easily when injected into fine lines. I particularly like it for filling fine lines around the mouth and reducing superficial acne scars or imperfections. Because of smaller particle size, it lasts 6 months, on average, depending on where anatomically it is injected and how much or quantity of filler used.

Q: How long does Juvederm last?

A: Juvederm results last an average of 6 months. Duration of benefit will also vary based on location where Juvederm is placed. For example, Juvederm may last longer in the temples than in the lips. In very rare instances, genetically susceptible people can metabolize or breakdown Juvederm more quickly than 6 months. There are other longer-lasting fillers such as Restylane and Sculptra that may be more ideal for your situation.

Q: How is Juvederm different from BOTOX?

A: Juvederm is a dermal filler made from hyaluronic acid, which acts to restore lost volume to the face and smooth wrinkled skin. Botox is a neuromodulator that reduces the appearance of fine lines by relaxing the muscle contractions that cause wrinkles in the face. While both can be used to diminish signs of aging, they work in completely different ways.

Q: Can I combine fillers and BOTOX?

A: Yes! Many patients see ideal results from combining BOTOX with filler treatments. In fact, results last longer when these treatments are combined. It is best to see an expert dermatologist like Dr. Melda Isaac or Dr. Daniel Yanes who has years of experience working with injectable treatments and can maximize your results.

Q: What is Juvederm Voluma?

A: Juvederm Voluma is a hyaluronic acid filler that is FDA-Approved to treat volume loss in the cheek area. When expertly injected, Voluma can provide plumpness and enhancement to the cheek area for a more youthful appearance. Patients can enjoy the natural results of Voluma for up to two years!

Q: Can fillers be used to treat scars?

A: Yes! Radiesse is an injectable filler made from calcium hydroxyapatite that works to reduce the appearance of scars. Radiesse can also be used to treat wrinkles and facial folds.

Q: How does Sculptra work?

A: Sculptra is an injectable filler treatment that provides natural and gradual results by stimulating your body’s own collagen growth. Dr. Isaac and Dr. Yanes feel Sculptra is best for volume restoration for hollows of the cheeks and temples. Sculptra results can last up to two years and can be combined with other fillers to provide the most ideal outcome.

Q: Is it true that Sculptra can help lift the eyes and brows if injected in a certain way?

A: By injecting Sculptra and/or other fillers into the hollows of the temples, cheeks and forehead, volume is restored and areas around the eyes are more supported. Supporting these surrounding areas by injecting fillers can lift the brows and reduce the sunken and tired appearance of the entire eye area.

Q: What is Belotero?

A: Belotero is a new addition to the filler family and is best used for fine lines and to fill imperfections close to the surface of the skin. Belotero is light weight and cannot be seen if injected close to the surface by an expert injector like Dr. Melda Isaac or Dr. Daniel Yanes. Because it is made from finer and lighter weight hyaluronic acid, it does not last as long as Juvederm or Restylane.

Q: Is there a non-surgical facelift that works?

A: There are a number of non-surgical options available that can help to rejuvenate your appearance with minimal to no downtime. While you will not get the same results as you would from surgery, many people are very happy with the outcome of these procedures, and of course are happy that they require no recovery time. Subtle, natural rejuvenation of the face, neck, hands, and chest using non-invasive procedures is becoming more popular and more effective as technologies become more advanced. An in-person consultation is necessary to evaluate your concerns and come up with a custom treatment plan, but among the most popular rejuvenating techniques are laser skin resurfacing, which can significantly reduce wrinkles and sun damage, dermal fillers, which can restore lost volume to the face and hands, and skin tightening treatments such as Ultherapy and Genius RF microneedling for skin tightening which can provide lift and tightening of the neck and jawline.

Q: How long do the effects of Sculptra Aesthetic liquid facelift last? Are the results comparable to a surgical facelift?

A: Sculptra Aesthetic results can last for up to two years. Sculptra provides long-term volume restoration by stimulating collagen production, and can be a great choice in the right candidate. The results are not comparable to a surgical facelift, however. Facelifts address skin laxity, but do not restore volume. Sculptra addresses volume loss, but does not tighten the skin. Therefore a youthful face has both volume and tighter skin. I recommend visiting a board-certified dermatologist or plastic surgeon for an in-person consultation to come up with a personalized treatment plan that addresses your areas of concern.

Q: Are there any adverse effects from dermal fillers? 

A: It very unlikely for you to experience an adverse side effect from dermal filler injections. If a complication were to happen, it would be soon after the injection treatment. Injections should only be performed by a board-certified, experienced dermatologist precisely because of the complications that can occur if injected by someone inexperienced.

Q: How long before Juvederm bruising and swelling subsides?

A: Generally, bruising and swelling resolves within a week for most patients. Rarely, it can take up to two weeks to fully resolve. In the meantime, you can use arnica to help with the bruising and ice the area to help with swelling. Ask if your dermatologist has a pulsed dye laser at his or her office. Resolution of bruising can be expedited by using this laser.

Q: Can I have filler injections while on antibiotics?

A: While there is no contraindication to having fillers done while on these types of antibiotics, it would most likely be best for you to wait until your infection clears up before having them done. Fillers involve trauma to the skin, and there is a chance of your infection spreading because of it. Always tell your injector any medications you are on, and make sure to see a board-certified dermatologist for BOTOX and fillers.

Q: How long should I wait to be off Accutane before getting Juvederm lip fillers?

A: There is no need to wait before having lip fillers done when going off of Accutane. Accutane is not a contraindication to dermal fillers, only surgical procedures and skin resurfacing procedures such as chemical peels or laser resurfacing. Be sure to see a board-certified dermatologist for any lip filler treatments for the best results.

Q: What is a liquid facelift? Is it safer than a normal facelift? Can I get surgery-like results from one?

A: A “liquid facelift” is a general term that means using fillers such as hyaluronic acid, Sculptra or fat often coupled with different non-invasive methods such as laser, radio frequency or ultrasound devices to create a comparable and balanced result. I recommend visiting a board-certified dermatologist for an in-person consultation to evaluate your concerns and come up with a custom treatment plan for you.

Q: What are the side effects of a liquid facelift?

A: Side effects of cosmetic use of fillers and neuromodulators are generally mild and include bruising, tenderness, headache, redness or swelling.  These side effects don’t last long and will usually be gone within hours, but may last a few days if bruising occurs. Do not schedule treatment within 5 days of a special event.

Q: What’s the best dermal filler for acne scars? Is there one preferred injectable treatment for deep scarring?

A: Bellafill is the only current dermal filler FDA approved for acne scars. The scars should be relatively shallow and able to smooth out when pulled manually. Other dermal fillers can be used off-label to treat certain types of acne scars, but the effects are temporary. Generally, a combination treatment customized to your particular needs is best for treating acne scars, as there are multiple different types of acne scars as well as discoloration that can go along with them. Laser resurfacing, microneedling, and chemical peels are just a few of the various treatment options available for dealing with acne scars. The best thing to do is to see a board-certified dermatologist for an in-person consultation and evaluation to determine the best course of action for you.

Q: Can I buy Restylane online and inject it myself following instructed safety precautions?

A:  The short answer is no, you should never try to purchase fillers online and inject them yourself.  First, Restylane is a prescription product and can only be bought legally by a licensed physician. If you find Restylane to buy for yourself online, it is most likely a counterfeit product, and those can lead to myriad problems including, in the worst case scenario, death. At best you’ll most likely end up spending more money to fix the problems you end up with than you would have had you just gone to a reputable, board-certified doctor in the first place for your injections. We have extensive training and experience that the average patient at home simply does not. It’s not as simple as simply sticking a needle in your face; there are multiple techniques, and knowledge of anatomy plays a key role in knowing exactly where to place the injections and at what depth and with how much product for the best results.

Q: How long does swelling from Belotero Basic last?

A: Swelling from Belotero generally lasts just a few days. In rare cases, it may last for up to a week. Be patient, and you should see your final results soon.

Q: How often can you use Botox? Does prolonged use affect how long it lasts?

A: There have not been any findings that long term use of BOTOXproduces any negative effects. Many people use it for years to keep their wrinkles under control. Generally, BOTOX lasts for around 4 to 6 months, and this amount of time should not be affected by how many times you have had it. In fact, in some patients, they find that the more treatments they have over the years, the longer the BOTOX lasts, as their muscles are “trained” not to make the expressions that cause the wrinkles.

Q: Does BOTOX work for horizontal forehead creases?

A: BOTOX is often used to treat “expression lines” on the forehead very effectively. It works by relaxing the muscles that cause wrinkles, allowing the skin to smooth out and preventing future wrinkles as well. If your lines are particularly deep and remain in place even without raising the eyebrows though, you may need a different type of treatment. I recommend visiting a board-certified dermatologist for an in-person consultation to see what treatment would best address your concerns.

Q: Does BOTOX help reduce under eye bags?

A: BOTOX works well to reduce wrinkles caused by muscle contractions; however, it is not the best option to help reduce under eye bags. Laser resurfacing, dermal filler injections, or even surgery may be a better option for reducing eye bags, but an in-person consultation with a board-certified dermatologist or plastic surgeon is necessary to evaluate your condition and come up with the best treatment plan.

Q: How often do younger people need BOTOX injections? Is it less frequently than older people?

A: BOTOX lasts approximately the same amount of time in people of all ages, generally 4 to 6 months. The only difference would be the number of units needed in order to achieve optimal results. Younger people with fewer, shallower wrinkles tend to need less units than a person with numerous deep wrinkles would.

Q: Can smile lines be treated with BOTOX?

A: Smile lines, also known as nasolabial folds, should not be treated with BOTOX. Instead, dermal fillers such as Restylane Lyft or Juvederm are a much better choice for restoring volume to the mid-face area and reducing the appearance of smile lines. I suggest visiting a board-certified dermatologist for an in-person evaluation to come up with the best wrinkle treatment plan for your concerns.

Q: What are the best Botox alternatives? I have wrinkles on my forehead but I’m not sure I want to try BOTOX.

A: Neuromodulators such as Botox, Dysport, or Xeomin are generally considered the best way to treat expression lines on the forehead. Other treatments could include laser resurfacing, microdermabrasion, or chemical peels, but most people get the best results from a neuromodulator like BOTOX in this area, as it relaxes the muscles that actually cause the wrinkles. As long as you visit a board-certified, expert dermatologist for BOTOX injections, they are very safe and the results are natural.

Q: Will BOTOX help with the wrinkles on my forehead?

A: BOTOX is generally considered the best way to treat dynamic wrinkles on the forehead, as it is a neuromodulator that can actually relax the muscles that cause the wrinkles in the first place. If you have forehead wrinkles that appear even at rest, there are also other treatments that can help, such as laser resurfacing or microdermabrasion. I recommend visiting a board-certified dermatologist for an in-person consultation to evaluate your condition and come up with a custom treatment plan.

Q: When will I notice BOTOX results?

A: BOTOX does not take effect immediately, contrary to what many people think. Generally results will appear within a week, with full results visible after two weeks. If you are still unhappy with your results after two weeks, I suggest visiting your injector again for a touch-up, as it is possible you may need more units.

Q: How can I avoid BOTOX side effects, such as droopy eyelids?

A: The best way to avoid unwanted side effects and ensure a good, natural looking result is to visit the right injector. Make sure to only visit a skilled, board-certified dermatologist or plastic surgeon who has experience injecting BOTOX. Check out their before and after photos to make sure their aesthetic aligns with yours. Read reviews and testimonials from previous patients. BOTOX is an FDA approved, highly safe and effective treatment that can provide great results in the right hands.

Q: Is it normal for the doctor to draw on your jaw for BOTOX shots?

A: While drawing is not necessary for BOTOX, there is nothing wrong with marking the areas to be injected to ensure symmetry and correct placement. Precise and correct injections are key to good results.

Q: Can BOTOX lift the eyebrows?

A: Yes, BOTOX injections are a great way to provide a slight brow lift in the right candidate. By carefully placing a small amount of BOTOX into the muscle that pulls the brow downward, that muscle can be relaxed, allowing the upward pulling muscle to take over to create a brow lift. BOTOX brow lifts are good for very minor and subtle correction, which nevertheless can have a significant brightening effect on the eye area.

Q: Can BOTOX be used for crow’s feet?

A: Yes! BOTOX is considered the gold standard when it comes to treating lines of facial expression, such as crow’s feet, forehead lines, and frown lines. The crow’s feet are caused by dynamic muscle movement around the eye, so reducing that movement with BOTOX has a great effect in smoothing the wrinkles while still leaving patients with a natural looking result.

Q: Is there any benefit or harm in wrapping the chin and applying arnica for the first few days after KYBELLA?

A: There is no harm in wrapping the chin or using arnica after a KYBELLA treatment. Compression garments are not required, but some patients may want to wear one anyway. Arnica can be used to help with bruising, and ice will help with swelling. Be sure to try to keep your head elevated as much as possible as well, again to help with swelling.

Q: Can KYBELLA help with the jowl area? I don’t have a double chin, but my jawline has lost its definition.

A: KYBELLA should not be used on the jowl area. However, there are a number of other non-invasive options that can help to tighten the skin and improve the jawline contour, including Ultherapy and Exilis Ul tra. I suggest visiting a board-certified dermatologist for a consultation to see what options are available to help with your jawline definition.

Schedule an Injectable Treatment in Washington, DC, Today!

For more information on the best Washington, DC injectable treatments, schedule a consultation with expert injectors Dr. Melda Isaac and Dr. Daniel Yanes by calling MI Skin Dermatology Center in Washington DC at (202) 393-7546 today!