I. Juvederm Ultra Plus® has been shown to last for one year. This is the longest lasting filler that we use. Juvederm Ultra Plus® is a hyaluronic acid product developed in Europe and approved by the FDA. It is very useful in correcting nasolabial folds and in enhancing the upper cheeks.
II. We have become very happy with two newer uses for Restylane®.
A. Some people get a hollow groove under their lower eyelids (this is called the "tear trough"). This hollow makes any bags you might be getting more obvious.
Now, this groove under the eye can be nicely erased and filled with skillfully applied Restylane®.
B. As we get older, the cheek fat begins to sag, and this sagging creates a triangular hollow over the cheekbone. This little triangle makes us look worn and tired and - for people in show business - the camera catches this little triangle in an unflattering way. This is another area - small but important - that can be nicely filled with Restylane®.
III. Botox is very effective in the lower face and neck.
A. The corner of the mouth can be tilted up with Botox. Botox relaxes the muscles that pull the mouth down, and therefore the corner of the mouth naturally rises. This is done with a few units of Botox injected between the corner of the mouth and the jaw line.
B. The "smoker's lines" or the little vertical lines in the upper lip which cause lipstick to run can be improved by injecting a few units of Botox into the lip. This injection relaxes the muscle that causes our lips to purse.
C. Botox can also make the neck look younger. A loose neck can be caused by contracting muscle bands. This is called the platysma muscle which pulls the neck skin downward. The platysma muscle is large and it must be adequately treated with Botox. When this is done well, the platysma muscle relaxes and this produces a cleaner, more youthful neck and jaw line.
George J. Beraka, M.D.