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 A Conversation with Brian A. Pinsky, MD

Q. Injectable rejuvenation solutions like Juvederm® and Restylane®  as well as Botox® and Dysport®  seem to be available at a wide variety of aesthetic providers.  Why go to a plastic surgeon to have these treatments done?

A. A plastic surgeon has a unique understanding of the anatomical aspects of aging. We understand the face on multiple levels: skin, fat and bone.  Each layer is affected by aging differently.  There is loss of volume, as well as sagging and loss of tissue elasticity, that need to be dealt with.  A trained plastic surgeon has the medical knowledge along with the aesthetic skill to be able to look at your face and tell you expertly, what can be done to produce the best anti-aging result.   In addition, having injectables done by a plastic surgeon ensures that if you have any adverse reactions to the product we are best skilled to deal with them.

Q. Can you do a combination of Botox or Dysport and Juvederm or Restylane at the same time?

A. Yes, absolutely. Botox or Dysport  is used to freeze or paralyze the muscles that cause wrinkling, usually in the forehead and around the eyes.  Juvederm or Restylane and other fillers are used to create volume in areas like the under eyes, cheeks, and laugh lines.  They can all be used in the same procedure and are often complementary to achieve the desired aesthetic result. Although Botox or Dysport requires more frequent treatments (about three times a year), volumizing fillers only need to be renewed about once or twice a year. As a matter of fact, some studies have shown that using denervating procedures in the area that fillers are being used, slows the natural reabsorption of the fillers.

Q. Are injectables cost effective?

A. Depending on how much work you want done, they can be. Every patient has a different level of comfort in terms of the financial commitment.  However, your aesthetic goals may be better achieved by surgery if a great amount of filler (volume) is needed.  My job is to give the patients all the options that are available to achieve their desired result, and help them choose the one that’s the best for them.

Q. All those images online and in the movies of women with giant, poofy lips are daunting. Do people still end up with that sort of result?

A. The images you see in the media of over-inflated, collagen-infused lips is an “old school” one. I like to think of treating lips as lip “enhancement”, rather than lip “augmentation.” Unless you really want a very full lip, the new injectables will not give you that look.  You’ll have a very natural, yet fuller more aesthetically pleasing lip profile.  Personally, I like to work around the lip line where many clients have a need for volume.  It’s not just the lip area alone that benefits from injectables.

Botox or Dysport is used to address excessive sweating in the armpits, palms, and soles of the feet. Volumizing fillers such as Radiesse can be used to address the ageing appearance of other areas such as the hands or earlobes.

Q. What if I don’t like the look I achieve with my first session? Can I reverse the process?  Is it permanent until the material is absorbed into the body? 

A. No, that’s one of the best aspects of hylauronic acid injectable fillers such as Restylane or Juvederm. If you’re not happy with the result, it can absolutely be reversed.  There would be no scarring and maybe a bit of redness.  We work with our clients to achieve the look they want. If that means reversing the procedure if you don’t like the finished product, we will. However, that is extremely rare.

Injectable facial volumizers create a result that clients are almost uniformly happy with.  The time needed for the effect is minimal. There is almost no pain involved and you can go right back to work looking rested and natural–but younger and fresher.

Q. What are some other uses of Botox and fillers?

A. Interestingly enough, excessive underarm sweating can be also be treated with injections of botulinum toxin A. It works by preventing the release of a chemical that signals the sweat glands to activate. You may need to have several Botox injections, but the results can last for almost a year.

Our hands are one of the first parts of the body to show the signs of age. Fillers such as Radiesse, Sculptra, and Juverderm can be used to plump and smooth the tops of the hand. Filler injections provide immediate results and can last for up to 2 years.

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If you have any questions on injectables and what you’d like to learn more about, Dr. Pinsky would like to hear from you. Send an email to blogs@lipsg.com.