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Brows commonly lose their support as we age, by loss of volume under, and the thinning/stretching of the skin. With the use of Botox, Dysport, and Xeomin, as well as fillers such as Juvederm or Restylane, the brow shape can be conformed to a more lifted and rejuvenated position and appearance. (off-label)
An important aging sign that some fail to address is the sagging that can occur in the ear lobe. With a minimal amount of fillers, earlobes can be rejuvenated and ear piercings can be supported so that earrings can stay upright. (off-label)
As we age, the fat in the hands may decrease, causing the ligaments and veins to stand out. Fillers such as Radiesse can be used to rejuvenate this area, softening the grooves between these ligaments and veins. (off-label)
Hyperhydrosis can be treated with local injection of Botox, Dysport, or Xeomin and can last about 6 months. (off-label)
While in severe cases, facelift may be the best option for jowls, in milder cases the jaw can be contoured with fillers (off-label) or with Novathread. Under-developed jaw line can also be enhanced using similar technique. Botox, Dysport, or Xeomin can also be used with a technique called Nephrotiti to allow a lifting effect on the jaw region (also off-label).
Fillers such as Juvederm Ultra Plus, Perlane, or Voluma can be used off-label to enhance the chin. This can also help decrease the appearance of jowels (off-label).
Botox, Dysport, or Xeomin can be used in this area to decrease the cobblestone appearance of the chin (off-label).
Is it hard to remember to wear your nightguard? Do you grind your teeth at night? Is it hard to remember to wear your night guard? Do you have bulky masseters/wide lower face? Botox, Dysport, or Xeomin in this area can relax the muscle and decrease the unconscious clenching of the teeth, and decrease a bulky lower face (off-label).
If an excess of gums during smiling is a concern, the upper lips can be lowered to cover this region a bit (off-label) with Botox, Dysport, or Xeomin.
Several techniques and products are available to treat lips. If increased volume is desired, cosmetic injectable fillers such as restylane can be used in the border and/or body of the lips, and depending on strategy of placement of the fillers, the shape of the lips can sometimes be changed as well (if desired). If the lines within the lip body are to be reduced only, for a rejuvenated look rather than enhanced volume, restylane silk and belotero are good products of choice. Philtrum columns which are two vertical lines attaching from the nose to the lips, flatten as we age. These two lines can also be enhanced with the use of fillers (off-label). Botox is another option that can enhance lip form and size. When used properly, it can create a soft eversion of the lips (off-label).
Also called lipstick lines or granny lines, thin fillers such as Restylane Silk or Belotero can be used to create firmness. Botox, Dysport, or Xeomin can also be used off-label to decrease the pursing of the lips, thereby decreasing the lines.
Also called the smile lines, this area can be treated by filling the lines directly, or lifting the overhanging cheeks with fillers. Botox is not appropriate for this area.
Fillers in this area can enhance cheek size or lift when there's a droop. They can widen a narrow face, or refill emaciated lower cheeks to re-establish a healthy looking proportion to regenerate a well rested appearance. In proper amounts, they can also help smooth out lumpy fat degeneration. Great care must be taken not to overfill these areas and to maintain a natural looking result.
Fillers can be used off-label on the nose to camouflage and hide a hump, make a wide nose appear thinner, or widen a thin nose, elevate the tip, narrow the nasal orifice, and decrease asymmetry of the two sides. Botox can also be used in this area off-label to decrease the downward pulling of nose when smiling.
The sides of the head can loose their fat with aging, especially in thinner individuals. The result is a sunken-in look that can make a person look malnourished and tired. These areas can be filled (off-label) with cosmetic injectable products such as Sculptra, Voluma, Juvederm Ultra Plus, Radiesse, or Perlane. Deep injection techniques with needle vs. superficial technique with cannulas can be used to administer the treatment after pros/cons of each is discussed.
The horizontal lines that are formed by elevating the eyebrows are called forehead lines. There are no FDA approved products for this area, but Botox/Dysport/Xeomin are commonly used as treatment here off label. There are many different techniques and distribution options here that can result in elevating or even lowering the eyebrows. It is important to tailor the treatment based on the patients facial features. While fillers can be used to support lines in this region off-label, it's not commonly used due to the possibility of nodules. Finer fillers such as Belotero or Restylane Silk may be more favorable options.
These refer to the small radiating lines next to the eyes that form with smiling or squinting. While they can give the eyes warmth, they can also have an aging appearance. They are best treated with muscle relaxing injectables such as Botox, Dysport, or Xeomin, but they can also sometimes be supplemented with very fine fillers such as Belotero or Restylane Silk (off-label).
Some call them the elevens, others call them glabellar lines, or the vertical lines between the brows. These lines are formed by the contraction of the frown muscles and over time etch into the skin, leaving permanent appearance of anger even when a person feels happy. The best way to prevent these lines is the early use of muscle relaxing injectables such as Botox, Dysport, or Xeomin. These agents also help decrease established lines when they are not too deep. Once the lines are deep, fillers (off-label) may also be needed to strengthen the foundation under the skin and help support the effects of Botox in reducing these lines.
Kybella, a natural substance that dissolves fat, can be injected into the upper neck area (under the chin) to reduce the symptoms of fullness in the area.
Upper chest area as with other areas of the body can become thin with age and less resilient to creases formed by sleeping sideways. Fillers such as Sculptra and Novathread injections can be used in this area to firm the skin and decrease the appearance of wrinkles (off- label)
Insufficient volume under the eyes, either genetically or due to loss of fat can give a tired appearance to the eyes. Bags may also develop while cheeks lose volume with age. This can create a shadow below the bag which can make the area appear hollow. Fillers, in various amounts depending on an individuals facial structure can be used to rejuvenate the eyes, leaving a natural looking enhancement and decreasing the tired look (off-label).
Also referred to as "Turkey lines" by some, these are vertical lines on the neck that can stand out when the neck is contracted. Relaxation of these muscles can soften the harsh shadows formed by them and allow a softer, more youthful neck appearance. (off-label)