Skin Injection Treatments

The most common benefit of injectable treatments is the elimination of unwanted wrinkles on the surface of the skin. In addition, injections can give patients a more youthful appearance by re-establishing pleasing contours.

Injectables work best on two kinds of wrinkles: those caused by movement of the muscle (such as those that appear around the mouth and eyes when smiling or frowning) and those caused by gravity (i.e., sagging skin). There are a number of different kinds of injectables, each with its own risks and benefits.

Alloderm is a frequently used material prepared from human skin. It is inserted in small sheets through tiny incisions. Cymetra is a form of Alloderm that has been frozen and fractured into tiny particles so it can be injected through a needle.

Cymetra is more easily injected than Alloderm, but it doesn’t last as long. The benefits of both Alloderm and Cymetra can be quite impressive. Allergic reactions are rare.

Botox is extracted from the bacteria that cause botulism -- Botulinum Toxin A. It is most commonly injected into wrinkles in the forehead and around the eyes, but is also used on the lips, nose, chin and neck.

Collagen is one of the most frequently used injectable materials. This substance is found in the connective tissues of the human body. Patients can therefore choose to donate collagen from parts of their own body (this is known as Autologen) for use in the injection treatment. This requires removal of some of the patient’s own skin.

If you were undergoing a facelift, breast reduction or removal of a scar, you would probably have extra tissue available for collagen injections. If not, you’d have to have an incision made (with a resulting scar) in order to remove skin tissue for collagen. Injected human collagen can last a year or longer. However, you don’t have to donate your own skin to have collagen injections. Cowhide collagen is widely available as well.

One benefit of collagen is that it stays in place quite well, and no incision is required. (Some injectables such as silicone tend to move around in the injected site.) With collagen injections, you can continue your daily routine without interruption. Collagen usually lasts 3 – 5 months, and complications are quite rare.

Fat injections use material gathered from the patient’s own body. This reduces the chance of adverse reactions. However, fat injections don’t last as long as other materials. The amount of re-absorption by the body is variable.

Silicone is a rarely used injectable. It does present an advantage in that it is not absorbed by the body. Drawbacks of silicone injections include infection and rejection of the material by the body.

During the consultation, you and your physician will discuss the changes that you would like to make in your appearance. He/she will explain the different options available to you, the procedure itself, and its risks and limitations. He/she will also explain the kind of anesthesia required, where the procedure will be preformed, and costs.

Be sure to ask all the questions you have about the procedure, and ask to see photos of the doctor’s recent patients, before and after their surgery. Also ask for, and follow up on, patient references. Learning everything you can about your options, risks and benefits is the key to making an informed decision. See Questions to ask your doctor below.

The amount of pain during any cosmetic surgery varies from patient to patient. However, the discomfort associated with injectables is relatively mild. In many cases, injectables are given without anesthesia.

Patients may experience some discomfort during and immediately following the procedure. Injections done on the cheek, chin and close to the eyes are usually less painful than those around the lips, but this varies from patient to patient. If you are particularly concerned about pain, be sure to discuss this with your doctor before the day of the procedure.

The recovery period for injection treatments is relatively short. Bruising is usually minimal, and swelling depends on the extent of the procedure.

Patients should stay away from activities that can aggravate the injection site. Heavy exercise and alcohol consumption should be avoided for the first few days following the procedure. Recovery times will depend on the site and the extent of the procedure.

An extended period of pain, discomfort, itching and burning may be a sign of infection. If you experience in of these symptoms, you should call your doctor.

• Individuals with scarring, sagging or wrinkling on the face
• Individuals with loss of fat, plumpness or high contours of the soft tissues in the face
• In good physical health
• Psychologically stable
• Wanting to improve their appearance
• Realistic in their expectations
• Aware of the options and the limitations

Most patients who have had an injectable procedure are pleased with the results. The treatments can, in many cases, significantly reduce facial wrinkling and sagging skin. However, most injection treatments have a relatively short life span. Autologen, fat and collagen are quickly absorbed by the body, and most of the filler from these injections disappears within a year. Other injectable materials are associated with more frequent side effects. Be sure to discuss all of the various options with your doctor, who will help you to decide which is the best option for you.

Alloderm - A portion of the sheet alloderm may remain permanently, or it may eventually be completely absorbed. In any case, it lasts longer than most injectables, including collagen. There is not enough long-term information on Cymetra to know if a portion of it will last permanently, but early reports suggest that it probably will not.

Botox – The effects of Botox wear off in 3-5 months, but patients are often extremely satisfied with the results it produces. They may require only 2 treatments per year with almost no swelling at the time of injection. Except for the fact that a healthy muscle is plump and contracts, Botox is an excellent way to achieve a youthful, smooth face. Its popularity is due to its effectiveness.

Collagen -Standard collagen will be completely reabsorbed within a few months. Autologen lasts somewhat longer. Some lucky patients may have collagen last 5-6 months, but most will find that 3-4 months is typical. Occasionally, it lasts only 2-3 months. While they like the results, some people are frustrated by the need for frequent injections.

Fat - A portion of the injected fat will remain in place permanently, but a second procedure may be needed to completely correct sagging or wrinkling. Fat is perhaps the only injectable material available for recreating a youthful look in those patients requiring large volumes for a fuller, more youthful-looking facial structure.

Silicone – Silicone remains permanently. However, it can cause scarring hardening and lumpiness in the face years after the procedure is performed. Correction may require surgery to cut out the areas of silicone and scars, leaving the face permanently scarred. While a small percentage of patients have had an excellent result, it is risky; many others have had significant problems.

Recently, a new method of fat injection has gained popularity. This procedure is called lipostructure. Like fat injections, this treatment calls for a removal of fat from the patient’s own body. However, lipostructure is significantly different from traditional fat injections because it attempts to keep these fat cells alive. The idea behind lipostructure is that by keeping the fat cells alive, they will not be reabsorbed into the body, and the results will last longer.

This procedure is quite new, is more extensive, and requires very specific training on the part of the physician. Consult your doctor to see if lipostructure is an option for you.

One of the greatest risks associated with injectable procedures is the risk of infection. However, under most circumstances, properly trained doctors can minimize the chance of such complications. Depending on the filler material that you and your doctor choose, there may also be a risk of an allergic reaction or rejection of the material by your body. It is always a good idea to discuss the different options and risks with your doctor before you decide on a particular injectable material.

Consult your doctor for more detailed information on the availability and safety of new injectables.

The costs associated with injectables vary from procedure to procedure. To obtain the most accurate pricing, consult with a physician in your area to get the up to date costs for the procedure you are interested in.

Use our payment calculator to see what your monthly payments might be if you financed this procedure.

• Tell your doctor about any allergies you have (to foods, drugs, environmental elements)
• Tell your doctor about all medications you are taking (both prescription and non-prescription)
• Carefully follow any instructions your doctor gives you.
• Avoid aspirin and aspirin containing medicines, as well as anti-inflammatory medicines such as Nuprin, Motrin, and Advil for two weeks prior to surgery. Also avoid herbal remedies such as St. John’s Wort, gingko biloba, some types of Chinese black mushrooms and other natural medicines and foods that may thin the blood.

1. Are the desired results I described realistic?
2. Where is the procedure performed? How long will the procedure take?
3. Am I good candidate for injectables? Why or why not?
4. Is one particular injectable filler better than others for me?
5. What kind of anesthesia is used?
6. How much does it cost?
7. What is your experience in performing this procedure? (How long has he/she performed this procedure, and how many has he/she performed in the past year?)
8. What percentages of patients have had significant complications? (The physician should disclose this information to you.)
9. Will you repeat or correct procedures if it does not meet the agreed upon goals? And if the procedure must be repeated/corrected, will I be charged again? (The physician should provide you with his/her policy on this issue.)
10. May I see "before and after" photos of recent patients? The physician should provide many photos of recent patients.
11. May I have the names and contact information for several recent patients? (Follow up to get first-hand information on the procedure and the physician.)
12. Could I observe the exact procedure I am considering before I decide to have the procedure done? (Either on videotape or ask to view one in real life.)
13. What should I expect post-operatively, in terms of soreness, what to watch for, medication, bathing, and level of activity?
14. Who will be assisting during the procedure? What are their qualifications? (Does the dermatologist perform the entire procedure?)
15. Have you ever had your malpractice insurance coverage denied, revoked, suspended?
16. Do you offer patient financing?

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