Many prospective patients come in for a consultation about facial rejuvenation and immediately declare they do not want a facelift. They also have significant time constraints on recovery. There are certainly times when only a significant surgical procedure will get the desired result. However, more often than not there are simpler alternatives that can provide the desired outcome. Two of the procedures that can offer a quick lift are Botox injections and the use of injectable fillers.

These two modalities are often thought by patients to be interchangeable — but they are not. Wrinkles that are caused by constant motion of specific muscles are typically treated with Botox. Wrinkles caused by gravity and the loss of facial volume tend to be addressed with fillers.

Botox injections are most frequently used to treat wrinkles in the forehead, the area between the eyebrows at the root of the nose (the glabella), and crow’s feet. The injections take only a few minutes and the patients can immediately return to full normal activities. The results are seen gradually over the next few days and maximum benefit is achieved between one and two weeks. Patient satisfaction with this simple procedure is among the highest of any cosmetic procedure currently performed.

Reducing wrinkles by the injection of “fillers” is a technique that has gained enormous popularity over the last few years. Plastic surgeons have come to appreciate that adding lost volume back into the face can sometimes be much more rejuvenating than reducing the extra skin by more classic facelift techniques. The increasing number of these types of procedures has led to multiple injectable materials being introduced into the market. Two of the most commonly used materials are Restylane and autologous fat.

Restylane is a synthetic form of hyaluronic acid — a polysaccharide that is found throughout our bodies. This natural substance provides volume and fullness to the skin and tends to be present in larger quantities in youth. The non-animal based hyaluronic acid used in Restylane virtually eliminates any risk of animal-based disease transmission or allergic reaction. The injections are done using topical anesthesia or local nerve blocks. Patients can immediately return to normal activities and any swelling or bruising that may occur typically resolves in a few days.

Many patients elect to have their own fat used to restore facial volume. A small amount of fat can be taken from the thigh or abdomen and then reinjected into areas of facial wrinkling. The fat will ultimately pick up blood supply from local tissues and thus can provide a very long lasting result. More fat is injected than is ultimately needed to account for some reabsorbtion by the body. This over filling can result in swelling and bruising that may take a week or so to resolve. This procedure can often be comfortably done in an office setting using local anesthesia.

Dr. Thomas Leach, M.D. is a diplomate of The American Board of Plastic Surgery and a member of The American Society of Plastic Surgeons. Dr. Leach can be reached at The Princeton Center for Plastic Surgery. 609-921-7161.

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