Filler and Botox gone wrong? Can you fix it!

February 15, 2022 in Botox, Fillers /by Ali Wagstaff

Let’s face it, there is nothing worse than getting poor results with injections. One will do anything to fix it ASAP! Check out our “how to fix it” guide below for all queries related to injectables and unwanted outcomes.

How to prevent bad filler and Botox

Having complete trust in a licensed injector is crucial. Receiving aesthetic injectables can be very nerve-wracking for people. Doing thorough research on the treatment itself, and the injector’s work is a must! Also, going in for a consultation is recommended before jumping in with two feet. That way, you’d have time to talk about all outcomes, including the bad ones and what can be done, before having your treatment.

In general, when administered correctly, most people do not want their dermal fillers or Botox to wear off quickly, at all! These types of treatments are used to enhance natural beauty, and can be done in a way to make one look better without attracting notice that something is different. They’re not usually used to try to recreate a whole new face. Remember that when considering treatments to be kind to yourself, and keep in mind that less is more when you are first starting.

BAD BOTOX: What are my options?:

Can you make botox "wear off faster"?

Botox, or Xeomin and Dysport, unfortunately cannot be reversed. Once this medication is injected into the intended muscle to relax wrinkles and soften existing lines, it limits or completely stops the muscle from moving. On a positive note, this is not a permanent treatment. Results gradually wear off and dissipate after two to three months. Usually the unwanted results wear off faster

High Stress

When there is an increase in stress hormone, we have seen in practice, that Botox may metabolize quicker. We certainly don’t encourage that you try to create stress as it can cause havoc on the body in other ways. Rather, consider controlled stress like exercise. (see below)

Lack of Zinc

A few studies have shown that if there is a diet lacking in zinc, the Botulinum Toxin medications cannot bind to the receptors correctly. So if you are nervous for a first time treatment, consider skipping the Zinc until you see your results.

Extraneous Exercise

Workouts that increase metabolism such as running, HIIT training, and hot yoga lead to higher metabolism rates. It’s possible that a higher metabolism could make results wear off faster

Acupuncture

There are no direct studies on this but we have seen anecdotal evidence in our office that when people are getting acupuncture their results often wear off faster. This is especially when needles are inserted near the treatment area (i.e. forehead)

Can you temporarily fix bad Botox?

Since there are no scientific studies that prove we can make Botox wear off faster, there are a few ways to fix, or alter, the undesired results. Less noticeable mistakes are always a plus! Consult with your injector to see what your options are.

Possible Botox techniques to alter a case of "bad Botox"

Droopy Eyelid– it is very rare to have a droopy eyelid caused by Botox alone, if it happens- this is called lid ptosis. Immediately see your injector and they will assess if prescribed eyedrops are needed to help prop the eyelid up. Sometimes counter injections of Botox on the actual eyelid can help as well. The good news is that this side effect typically wears off within a few weeks to a few months and it is not permanent.

Heavy Eyebrows– here are two potential causes of the feeling of heavy eyebrows:

1. the injector over-treated the forehead. If the injector properly treated the glabellar area, then, unfortunately, you have to wait for this to loosen up over a few weeks or months.

2. the injector did not treat the glabella area enough or not at all. This is an easy fix with additional Botox to the glabella to stop the pulling down of the brows.

One Raised Eyebrow– this is usually an easy fix, the injector needs to add more Botox to the eyebrow that is having more movement and causing you to have uneven eyebrows.

Once I start Botox, can I stop?

Yes! There is no reason you cannot stop doing Botox at any point in time. However, when injected properly, most people are addicted to “aging gracefully”.

Read more about reversing bad Botox and Fillers HERE

BAD FILLER: what are my options?

Again, the best way to prevent “bad filler” is to go to an experienced injector whose work you have seen. These are medical procedures that are just as much art as they are science. Both are crucial to good results. Trying to save money here, will usually cost more in the long-run if you have to have your filler dissolved and re-done.

Can you reverse dermal filler?

The good news is, yes, you can reverse many types of dermal filler! Most dermal filler injections are made from a substance called Hyaluronic Acid (HA), and there is an enzyme called Hyaluronidase, that dissolves HA. This is a prescribed medication that has to be administered by a medical professional only.

Can Hyaluronidase fix bad filler ASAP?

Yes it can. Once the enzyme is injected in the desired area, it immediately starts working over the next 24 hours. However, additional treatments may be needed if the filler used was a thicker product.

What fillers are HA?

Most FDA approved filler brands including: Juvederm, Restylane, Versa, and RHA products are made from HA. Again, emphasizing the importance of doing your research and consulting with your injector beforehand so you are aware of the types of products and potential risks.

Is there any scientific proof of dissolving filler?

This study, published in JAMA Network, displays the effectiveness, over a 4 week period, of injecting hyaluronidase into HA fillers; Restylane and Juvederm. The data determines that at a 4-week follow up from initial dissolving, hyaluronidase at low doses was effective at dissolving HA filler.

Are there fillers that can't be dissolved?

Yes, there are several types of filler that cannot be dissolved. These include PMMA fillers like Bellafill, PLLA like Sculptra (a collagen stimulator), Calcium Hydroxyapatite (Radiesse), as well as silicone and fat transfer.

As an aside, though Radiesse cannot technically be dissolved, it can be “dispersed” allowing the body to break it down faster

For more on reversing your filler read THIS article

Is it expensive to dissolve filler?

It is recommended to schedule a follow up appointment with your injecting provider to discuss your options. If your desired results are not achieved, or you experienced a bad reaction, some injectors may reverse the filler at no cost. If however, you want to go to a different injector or get a second opinion, costs vary from the amount of hyaluronidase the provider needs to use.

More about our injectable pricing HERE

Side note: it is very important to discuss with your provider what they use to dissolve the filler they are injecting with incase of emergency or high risk. With any injectable treatment there are risks that should be known.

Does dissolving filler hurt?

There are always initial pokes at the insertion site. The medication can be reconstituted with other drugs to make it more comfortable, but when injected alone it can sting quite a bit! Ask your injecting provider what to expect during your treatment, as each office is different. At Elite, we use Lidocaine and Sodium Bicarbonate to make dissolving more comfortable.

Book your filler dissolving here:

Wrap it up!

When administered safely, with a goal of natural results, to enhance your personal features, dermal fillers and Tox (Botox, Xeomin, Dysport, Jeuveau) are a true confidence boost! Trusting your licensed injector and being aware of risk factors, are highly advised before getting injectables. Luckily there are some ways to alter or fix these mistakes you may encounter.

With all of that being said, keep in mind that even if you go to the most experienced and credentialed injector, side effects and poor outcomes are always possible. They could do everything 100% right and you may just have strange anatomy or a strange response to treatment.

The most important thing here is that you are seeing someone that knows how to handle adverse effects and will continue to work with you for every step of the process to take care of you.

If you are located in the Lone Tree, CO area and have any lingering questions about aesthetic injectables, book a consultation below:

How to get into Aesthetic Nursing

July 23, 2021 in Uncategorized /by Ali Wagstaff

By: Ali Wagstaff, NP

One of the most frequent questions I get asked by friends, colleagues and random people on the internet is how to become an aesthetic injector.

This path is different depending on your medical title: RN, PA, NP or Physician and I have other articles that answer general med spa questions, like who can inject and even how to open a medical spa.

This article will focus specifically on nursing, for Registered Nurses (RNs) and Nurse Practitioners (NPs) that want to get into aesthetics.

Becoming a RN Injector

First off, know your state guidelines because in certain states, such as Florida, RNs cannot inject at all. Only providers (NP, PA and Physicians can).

In other states, such as here in Colorado, RNs can inject with a Physician Medical Director overseeing them or in some cases a Nurse Practitioner Medical Director.

In general it’s very competitive to get a job in this field. I get at least one email or DM every few days from nurses looking for a job or asking how to get into aesthetics.

I usually ask what experience they have and 9/10 times they have none and have done nothing to try to get any. Maybe they have applied for a few jobs but that is it.

I usually tell them to take some classes so they have something to put on their resume. Show that they’re interested and willing to put in the work. Also consider offering to intern at a place if you really want to work there! Showing that initiative will go a long ways.

It’s a huge investment training a nurse in this specialty and half the people want training so they can go start their own thing. If I am going to invest in someone they need to show they are willing to invest in themselves first and want to be part of a great team long-term.

Becoming a NP injector

If you’re a NP looking for a job as an injector then I would follow all of the same advice above. Take some initiative and get some training. Not only do you want to do trainings to make sure you like this specialty but also to have something on your resume when you apply.

If you are a NP and want to open your own practice, still get the experience. The laws are vague for NPs in independent practice and you have to be able to prove you had adequate education and training in whatever specialty you are going into.

You also have to have prescriptive authority in your focus area in order to be independent. So in CO you must have 3 years of work experience as a RN or NP and then complete the 1000 (may be 750 hrs now) of supervised prescribing before you can apply for prescriptive authority.

So for perspective I am a dual certified NP with prescriptive authority for AG-ACNP and FNP and I’m a fellow in aesthetic medicine. My fellowship was an additional 160 hours of aesthetic specific training on top of the hundreds of hours of experience and training I already had.

People often ask me if they can practice independently if they are a CRNA, acute care only NP, or other specialty. I don’t know as I am not a lawyer and I’m not on the state board of nursing. Unfortunately if you call the CO state board 1/2 will tell you you can’t practice and the other half say you can with adequate training and experience and must call yourself a “Nurse Medical Director”. Apparently the Nurse Practice Act was written to be vague in order to not limit our scope of practice but some people use it to try to limit our scope.

But if you’re a FNP or AGNP and in any position to advocate for NP independent practice in aesthetics for your state, here are just a few arguments for it:

NPs are holistic practitioners and aesthetics is part of caring for a whole person and falls under the primary care focus. It’s just another system like cardiac, pulmonary, or mental health. Anti-aging medicine is hugely important for holistic care and quality of life for many patients.
There is no aesthetics training for Physicians in residency. So NPs sit in the same classes as Physicians to learn aesthetic injectables and laser. My fellowship was about 75% Physicians in fact. So why should they supervise us if we do the same training?
In relation to the above, I recently reached out to a medical director agency after hearing NPs were being told in CO that they had to have a medical director. The agency told me it would be a minimum of $750/month and honestly it would be an ER physician that knew less than I did about aesthetics. How would that be beneficial or safer for clients?
If NPs have independent practice in the state but the state does not allow independent practice only in aesthetics then there could be legal ramifications against the state. They cannot support/endorse Physician owned practices in this one specialty of medicine only (per lawyers, not my language)
Lastly, many of us have prescribed and supervised much more dangerous drugs. For instance I worked in ICU and often prescribed opioids, sedatives, vasoactive drugs, and other dangerous meds. Botox and fillers are not even controlled substances and the prescription and administration of them fall under our prescriptive authority. If they didn’t, then pharmaceutical companies would not allow us to order them.

With all of that being said, don’t try to go out on your own in any specialty without getting adequate education and training. And if you have a great physician mentor or colleague there’s nothing wrong with teaming up! This is simply to say that it doesn’t make any sense (in my opinion) to be required to have a physician medical director just to have a physician on staff. Especially when most physicians have less training than the aesthetic NP they would be supervising.

Getting off my soap box… but long story short, you need to research your specific situation and scope, get lots of education and training and consider legal consults before practicing independently in aesthetics.

A Simple Guide to Skincare (by age)

June 13, 2021 in Uncategorized /by Ali Wagstaff

Ultimate Skincare Products

With how many products are available over the counter AND at your provider’s office, it can be overwhelming trying to decide which skincare products to buy. This is a quick guide on what products and ingredients are most important and we’ve broken it down by age. Now keep in mind that skincare, even by age, is not one size fits all. So it’s still good to have a trusted skincare expert you can go to to get recommendations based on your unique skin. If you’re near Denver, CO click below to book a consult with one of our experts!

A quick note on diagnosing skin conditions

Keep in mind that some skin conditions do really need to be diagnosed and treated by a medical professional. The only providers that can legally diagnose and treat are Physicians, Nurse Practitioners (NPs), and Physician Associates (PAs). Often what looks like acne could actually be a staph infection, a complex dermatitis or even rare types of herpes outbreaks. So if you’re ever unsure, please see a pro. A good aesthetician will also know when to refer to a medical provider. As usual, nothing in this article is meant as medical advice or to diagnose and treat. We can’t do that without seeing you in person so talk to your prescribing provider before trying anything new :-).

Basic Skincare Routine For Teen's

For teens, it’s recommended to use a gentle, non-medicated cleanser most days, with an option to incorporate a salicylic acid based cleanser a few times a week to prevent acne. The salicylic acid could be increased to daily use for moderate acne (more on acne in next section).
DO NOT use a toner or exfoliating pads (or at the very least use extreme caution). Many toners and pads, especially those tailored towards teens and acne-prone skin, are loaded with drying alcohols (SD alcohol, alcohol denat.) that strip the skin of oil, which may seem good in the short term, but this can lead to increased oil production, damage to the skin’s microbiome, and worsening acne. Consider witch hazel as an alternative to harsh toners.
Moisturizing is important, even for oily skin. They make moisturizers for all skin types for a reason, so just because someone has oily skin doesn’t mean their skin doesn’t need hydration—in fact it can help balance oil production and keep the skin from feeling and looking tight and shiny.
Always wear sunscreen every day. Usually hybrid organic/inorganic (“chemical” and mineral) filters are best for oilier skin types (ie. octinoxate and zinc oxide) because they tend to be less oily. Sunscreen not only protects from the sun but can prevent scarring from acne and is also anti-aging.
Keep the routine simple, and if you’re struggling, consider seeing an aesthetician for an initial evaluation or going straight to a dermatologist for more complex skin issues.

Teen skincare regime step-by-step

Cleanse nightly with a gentle cleanser
Optional salicylic cleanser for acne prone skin
Avoid alcohol based toners and exfoliating pads
Moisturize and use sunscreen daily
See an aesthetician or get referral to dermatology for complex issues

Best Skincare for Acne Prone Skin

The best acne skincare routine depends on the type of acne like shown in the image above.
Superficial and mild acne typically responds well to salicylic acid cleansers and light hydration. Salicylic acids can penetrate deep into the pores to break up oil and kill bacteria.
For moderate acne, a combination of a benzoyl peroxide face wash a few days a week to kill bacteria (and a gentle cleanser other days) and a topical retinoid serum/cream like retinol, retinaldehyde or adapalene gel can help unclog pores and speed up cell turnover. Remember to never use benzoyl peroxide with hydroquinone (a skin “lightening” agent) as dark staining of the skin may occur.
For severe and hormonal acne, seek out help from a specialist like a dermatologist, who may work with an esthetician as well to come up with a series of specific treatments such as chemical peels or laser, and at home care.
Also consider working with a nutritionist to determine if you have an imbalance in your gut or food sensitivities that could be contributing to acne.
In general, monthly chemical peels in a series of 3-6 are a great option for those suffering from mild to moderate acne.
Avoid products containing high amounts of drying alcohol.
Always wear sunscreen and keep skin hydrated to prevent scarring.
Blue LED light or IPL can also be very beneficial for acne.

Acne Prone Skin Summary:

Mild acne salicylic acid cleansers or pads
Moderate acne add in benzoyl peroxide and retinoid products
Severe acne or hormonal acne seek help from dermatologist or skincare expert
Consider working with a nutritionist to see if a gut imbalance or food intolerance is contributing
Do regular facials and peels
Always wear sunscreen
Blue light therapy may be helpful

What is the best skincare routine in your 20’s?

This is a great age to start coming in for regular monthly facials. Regular facials are very helpful to have your skin looked at monthly and they can also speed up cell turnover.
Weekly exfoliating cleansers or leave on exfoliants such as salicylic acid or glycolic acid can be started or continued.
Consider introducing a topical vitamin c serum. Vitamin C is an anti-oxidant that helps protect your skin from damage. It also acts a light exfoliant. Look for ascorbic acid, ascorbyl glucoside and/or tetrahexyldecyl ascorbate.
Consider changing to a more hydrating moisturizer as skin typically changes from puberty, and ends up producing less oil. Look for ceramides and fatty alcohols.
Consider starting a retinoid. Look for retinol or retinal/retinaldehyde as they tend to be more gentle. Start slowly and always reduce use if there is irritation.
Continue to wear sunscreen daily.
In the mid to late 20’s consider starting preventative Botox.
Microneedling can also be great for those with acne scars or those that want to do something to prevent lines and wrinkles.

Skincare in 20's Summary:

Start monthly facials and peels
Use at home exfoliants
Start retinoids
Always wear sunscreen
Consider preventative Botox and microneedling

What is the best skincare routine in your 30’s?

Consider switching to glycolic or lactic based exfoliants instead of salicylic acid for non-acne prone skin.
Start to consider quarterly Botox and even yearly preventative fillers. We all lose about 1 syringe of filler per side of volume after age 25-30.
Consider microneedling and IPL to help tighten skin, rebuild collagen, address any scarring or hyperpigmentation caused from past acne or sun exposure.
See an esthetician for monthly facials/peels.
Continue using a retinol in the evening (or every other evening) and vitamin c in the morning (if able to tolerate both), and wear sunscreen daily. Don’t forget to reapply sunscreen every 1.5-2 hours when in direct sunlight! There are great powder SPF sunscreens available that can be used over make-up

Skincare in 30's Summary:

Use lactic acid or glycolic acid exfoliates if having less break-outs
Consider quarterly Botox and yearly preventative fillers
Consider microneedling and IPL
Monthly facials and peels
Continue retinoids, vitamin C and sunscreen

What is the best skincare routine in your 40’s?

Skin is usually dryer, so using a lactic acid or enzyme-based exfoliant can be helpful.
Consider deeper, more nourishing creams that contain things like ceramides, plant sterols, and amino acids/peptides. This product is a great option.
Quarterly Botox, yearly fillers and IPL are usually more essential now to make up for volume loss and to smooth out expression lines.
See an esthetician for monthly facials/peels.
Continue using retinol and vitamin c serums, and of course wearing sunscreen every single day.
See a dermatologist for annual skin cancer checkups if you haven’t already (can start at any age, the sooner the better).
Consider resurfacing lasers for deeper lines and wrinkles.

Skincare in 40's Summary:

Use lactic acid or enzyme based exfoliants.
Use nourishing creams that contain ceramides, plant sterols and amino acids/peptides.
Quarterly Botox, yearly fillers and IPL are more essential now.
Continue monthly facials and peels.
See a dermatologist yearly for skin checks.
Continue retinoids, vitamin C and sunscreen.
Consider resurfacing lasers.

What is the best skincare routine in your 50’s and 60's?

Use enzyme and lactic based exfoliants as they are gentler and less drying on mature skin.
Use hydrating, cream-based cleansers that can nourish the skin and keep it more hydrated.
Use thick cream moisturizers with fatty alcohols, oils, plant sterols, and amino acids/peptides. Maybe even consider adding a facial oil to the evening routine for extra moisture.
Quarterly Botox, yearly fillers and IPL treatments are essential. You may even want to consider laser.
See an esthetician for monthly facials/peels.
Continue using retinol and vitamin c serums, and wearing sunscreen daily.
See the dermatologist for annual skin cancer checkups.

Skincare in 50's and 60's Summary:

Use lactic acid or enzyme based exfoliants
Use nourishing creams that contain ceramides, plant sterols and amino acids/peptides
Quarterly Botox, yearly fillers and IPL are essential
Continue monthly facials and peels
See a dermatologist yearly for skin checks
Continue retinoids, vitamin C and sunscreen
Consider resurfacing lasers

Were do I start with skincare?

If you’re reading this and you’re feeling way behind because you haven’t started anything, that’s ok! It’s never too late to start good skincare. At any age here are the absolute essentials with each additional add on:

What are skincare essentials?

Wash your face every night with a gentle cleanser. It’s important to wash off make-up, dirt, oil, grease and whatever else from the day, every day.
Wear sunscreen EVERYDAY! No, your tinted moisturizer or makeup does not count! Wear a broad spectrum SPF 30+ every day under your make-up. Then re-apply every 2 hours if by a window, driving, or in direct sunlight. You can use a sunscreen powder over make-up to make this easier.
Consider adding in a retinoid. Retinoids help speed up turnover of skin cells which in turn, reduces fine lines and wrinkles, decreases discoloration and they can actually reverse DNA damage from the sun.
Consider adding in a Vitamin C serum, if you can tolerate this with a retinol. If you can’t, prioritize the retinoids.
Consider Botox or Xeomin, Fillers, and IPL/Lasers. We never think we need services, until we start to age and see the years catching up with lines, wrinkles, lost volume and discoloration. Maintenance treatments are key when aging gracefully and naturally.
Consider monthly facials and peels for regular skin assessments. Consider getting a VI Peel that is more advanced, a few times a year, too.

What is medical grade skincare?

Medical grade skincare requires more rigorous testing and has to be proven to be 99% pure. Cosmetic grade, or what you can get over the counter, only has to be 70% pure. So many over the counter products are great but if you have any skin conditions or want to be able to guarantee the quality of your products you want medical grade.

When it comes to skincare products, do your research or talk to your skincare expert to decide what is best for you.

What should I avoid to prevent aging?

In conjunction with the information above, here are 2 things that you must avoid to prevent aging!

Avoid tanning beds unless it’s just for the red light therapy. You may look good tan in your 20’s and 30’s but as you age you will look older and older because of damage from tanning beds. Consider a spray tan, instead. Many people will say things like, “well fat looks better tan”, but tanning damages skin making it thinner- this causes more cellulite to show and skin to appear thin and wrinkly.
Quit smoking tobacco. This is tough because it’s a very hard habit to break. However, if you are prioritizing anti-aging, you have to quit smoking! Smoking is the next biggest contributor to premature aging, after sunlight.

Need help with your skincare routine?

Book a consult below. You can book a skincare consult with a licensed aesthetician or book with one of our medical providers to talk about more invasive procedures.

Botox VS. Dysport- Which Is Right For You?

March 8, 2021 in Botox /by Ali Wagstaff

Choosing the right wrinkle relaxer can be confusing for many patients with so many options available. Two of the most popular products on the market are Botox and Dysport. Both Botox and Dysport are Botulinum toxin medications that work to block muscle contractions to reduce lines and wrinkles. In this article we’ll compare the two, to help you decide which is right for your treatment.

How do Botox and Dysport Work?

Botox and Dysport are both injectable medications that work by stopping communication between the nerve and muscle. When the muscle doesn’t get the signals to contract it can’t move to create lines and wrinkles. For more information on general Botox information, read the blog below.

What are Botox and Dysport made from?

What is Botox made from?

Botox (onabotulinumtoxinA injection) is a toxin created by Clostridium botulinum bacteria. This is the same toxin that causes botulism, but it has been purified and studied extensively to be used safely in medicine. Each vial of Botox also contains human albumin and sodium chloride. When injected correctly it can be used to block muscle signals to reduce lines and wrinkles.

What is Dysport made from?

Dysport (abobotulinumtoxinA injection) is a toxin created by the bacterium Clostridium botulinum. After being purified it is used to block signals to muscles which reduces their ability to fire. This can help eliminate lines and wrinkles. Each vial of Dysport also contains serum albumin and lactose.

Dysport and lactose intolerant allergy

Like mentioned above, Dysport contains serum albumin and lactose, so if someone has a severe lactose allergy, it is best to choose a different product to reduce the chances of a reaction.

Are Botox and Dysport the same?

Botox and Dysport are both made from Botulinum toxin type A and have the same mechanism of action to stop the muscle contractions that lead to fine lines and wrinkles. However they do have a few key differences:

It takes 2.5-3 units of Dysport to equal 1 unit of Botox.
Dysport contains lactose (a milk protein) as a stabilizer and can not be used by people with milk allergies or sensitivities, or people that are vegan.

How much does Botox and Dysport cost?

How much does Botox cost?

Botox usually costs $12-$14 per unit and most treatment areas require about 20 units, which is $240-280 per area. A full treatment, frown lines and forehead will be closer to the $400+ range.

How much does Dysport cost?

Dysport costs $4-$6 per unit but usually takes 2.5-3x more units to equal a Botox or Xeomin treatment. With the number of units so much higher, the cost ends up being about the same.

Is Dysport cheaper than Botox?

As above, Dysport is cheaper per unit but takes 2.5-3 units of Dysport to equal one unit of Botox. So the cost ends up being about the same. For example: if one unit of Botox costs $12 and one unit of Dysport costs $4 the cost is the same because Dysport usually requires 3 units to equal one of Botox 4×3=$12. To learn more about Botox pricing, check out this article.

What are Botox and Dysport used to treat?

Both Botox and Dysport can be used to treat the same things including:

Crow’s feet
Frown lines
Bunny lines
Lip flips
Glabella frown lines
Forehead lines and wrinkles

Botox and Dysport before and after images

Below are some before and after images that show some of the various areas that Botox and Dysport can treat.

Does Botox have more uses than Dysport?

Botox has more FDA approved indications than any other toxin on the market but it is very common to use each medication “off label”. This means that the clinician is experienced and knows how to use the medication in one FDA approved area (say for 11’s lines), but also knows how to apply that knowledge to safely treat another area like the crow’s feet that is not explicitly FDA approved. So theoretically all of the toxins can be used off label to treat anywhere indicated that the clinician is trained to administer the drug safely.

Is Botox or Dysport better than filler?

There is no comparison between Botox injections and filler because they treat completely different aesthetic concerns. Botox is meant for muscle movements that cause wrinkling, whereas filler is used to plump, fill, shape, and contour areas of loss volume. Even though this can be a confusing topic, it is best to learn more about injectables with a trusted provider. In the mean time, watch this video below about Botox vs. Fillers.

What are Botox and Dysport procedures like?

Both Dysport and Botox are quick outpatient procedures that will not be extremely painful. After arriving at the office the injector will walk you through the procedure and probably ask you a few questions to make sure it is safe to treat you. When performed by a highly trained professional, the injections themselves should take under 10 minutes and the experience should feel like a quick pinch. After this you’ll be free to head on your way with minimal downtime.

What are the side effects of Botox and Dysport?

Botox and dysport have the same side effects including:

Swelling at the injection site
Bruising
Redness
Itching
In some cases patients can have an allergic reaction to the toxin

It is best to discuss these side effects with your injector prior to treatment.

Is Dysport less safe than Botox?

Due to the fact that Dysport takes more units to be effective (remember 2.5-3 units equals one of Botox) it has the highest potential to spread of any of the toxins. In some areas, like the forehead this may be desired. But it can also cause more unwanted side effects when it spreads where you don’t want it to go.

Is Dysport safe to use if you are a vegan?

No, Dysport contains lactose which is a protein from cow’s milk. This means it is not safe to inject on people with milk allergies and can not be used by vegan individuals.

What is aftercare like for Botox and Dysport?

Both Dysport and Botox require little down time after the procedure, though you will want to avoid strenuous activity for a short period of time. Though specific instructions from your injector may be slightly different, aftercare for both Botox and Dysport may include:

Avoid touching or rubbing the injections site for 24 hours
Consider waiting to apply makeup for 24 hours after your treatment
To avoid spreading the toxin consider not laying down for 4 hours
Refrain from drinking alcohol if you have any bruising
Always apply sunscreen to protect your skin

When will the results of Botox and Dysport show?

When will the results of Botox show?

Results of your Botox injections may begin to show within a week of your injections, the final results will show in 1-2 weeks after your injections.

When will the results of Dysport show?

Dysport has been known to show quicker results than Botox, with it only taking 2-4 days to start showing results and final results within 1-2 weeks depending on the person.

Does Botox have better results than Dysport?

When injected by an experienced injector that is familiar with each medication they can both get great results. However, Dysport does run the risk of causing more unwanted side effects due to the higher risk of spreading.

Can Botox be reversed?

There is no scientific data that shows reversal of Botox injections. However, there are alterations your provider can do to help if you are unpleased with results. The good news is Botox is not permanent, and will start to wear off, and be completely gone within 4 months. To learn more about Botox reversal, read more below.

Does Botox or Dysport have longer lasting results?

In general both medications will last an average of 3 months depending on the area injected. The length of time Botox lasts for depends on your body’s ability to metabolize it, the area being treated, and the amount injected. If you are curious about making your Botox last longer, read the article below for tips and tricks.

Is Botox better than Dysport?

Botox and Dysport can both be great medications and give wonderful results. However, due to the increased risk of spreading as well as containing lactose (could trigger allergy response) it is not for everyone.

At the end of the day it is more about the injector than the product you get. With the right injector, you can get great results with any of the wrinkle relaxing medications. Learn more about our experienced providers below.

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Everything You Need to Know About Laser Skin Tightening

February 17, 2021 in Laser and IPL /by Ali Wagstaff

As we age our bodies slow down their production of elastin and collagen. When this happens our skin can start to loosen, losing its firm look. To keep skin tight many will seek surgical skin tightening options. But in many cases, clients could have amazing results without surgical procedures by using laser skin tightening treatments. In this article we’ll talk about laser skin tightening, the types of treatments, how they work, and how much laser skin tightening costs.

What is laser skin tightening?

Laser skin tightening is a non-surgical procedure that uses lasers to increase collagen production for skin tightening. This can help the skin appear firmer, tighter, and less crepey.

How does laser skin tightening work?

There are many different types of lasers but the general premise is that they cause controlled damage or heating of the skin in order to increase collagen production. Some of them are ablative, meaning they remove the outer layer of skin or parts of it. Others are non-ablative, meaning they do not break the skin. They all cause controlled damage that stimulates a wound healing response and collagen production.

Read more info about laser skin tightening with ResurFX and how it works HERE.

Who should get laser skin tightening?

Laser skin tightening works best for clients ages 30-65 who would like tighter, firmer, and less crepey skin. Those who haven’t had noticeable loosening of the skin yet may also find it to be beneficial as a preventative measure. If you are a patient with skin that has become extremely lax, a better alternative may be a surgical lift procedure.

What types of treatments are used for laser skin tightening?

There are many different types of lasers available for skin tightening so we’re just going to focus on a few of our favorites that we offer here at Elite.

IPL

IPL is technically not a laser but a light energy that targets skin discoloration. However, the light beams are able to heat up water in the skin creating a tightening effect when the treatment is done consistently. For more info visit our IPL page or read our IPL 101 BLOG.

ResurFX

ResurFX is non-ablative fractional laser technology that is able to resurface and tighten the skin. It’s great for fine lines, wrinkles, and crepey skin. For more info visit our ResurFX page.

RF Microneedling

RF microneedling combines the power of microneedling, well known for increasing collagen, with RF (radiofrequency) to heat up the skin. It’s like getting a 2-in-1 to tighten loose, crepey skin as well as reduce the appearance of acne scars, fine lines, and wrinkles. RF (radiofrequency) technology is often used alone for skin tightening as well. For more info visit our RF Microneedling page.

How much does laser skin tightening cost?

Laser skin tightening treatments will vary in cost based on the type of procedure you’re having, what part of the body the procedure is being done on, and who is performing it. Remember, each of these procedures will require 3-6 treatments to see desired results. Below is a guide on how much it may cost based on the type of treatment.

IPL

$250-450/treatment

ResurFX

$700-900/treatment

RF Microneedling

$500-700/treatment

What areas can you have laser skin tightening done on?

Laser skin tightening can be done on any part of a patient’s body, but is most commonly used to tighten skin on the:

Face
Neck
Stomach
Arms
Legs

For example, the neck is a common area we see that clients want treated. To read more about laser skin tightening for just the neck read the blog below.

What should you do before laser skin tightening?

Always follow the instructions given by the provider doing your procedure for the best results. In general though you’ll want to :

Avoid sun exposure for 2-4weeks before treatment
Avoid Retinoids and other products that could lead to sensitivity for 2-4 days before treatment
Stay hydrated and drink plenty of caffeine-free fluids for 24 hours before your treatment (many lasers target water in the skin so you want to be hydrated)
Let your provider know about any medical conditions you have and any medications you are on

What is laser skin tightening treatment like?

Most treatments require numbing prior to the procedure to help with pain. So usually while the provider is talking to you about what to expect and going over any necessary medical history, they will have a numbing cream sitting on the treatment area for 15-45 minutes.

Then your face will be washed and the treatment will start. Usually the procedures are quite tolerable but some areas can still be sensitive.

After treatment, as the numbing wears off, some discomfort is expected. Most people feel like they have a sunburn after laser treatments and their skin is quite sensitive. Your provider will go over aftercare or you may already have instructions that were given to you.

Is laser skin tightening painful?

Most laser procedures are quite tolerable but even with numbing cream there are always a few sensitive areas. Talk to your provider about the specific type of laser treatment you are having and what to expect. There are always things that can be done to minimize pain and discomfort.

What is laser skin tightening aftercare like?

Talk to your provider about aftercare for your specific treatment, in general:

You’ll want to avoid any harsh chemicals or scrubs for up to a week post-treatment for non-ablative treatments and longer for ablative
Avoid touching or picking your treatment area as this can lead to infection, scars, and permanent changes in pigment
You’ll want to avoid sun exposure for 4-8 weeks post-treatment depending on what you had done
You’ll want to keep your skin clean and dry and use only products approved by your provider
Avoid hot tubs or any soaking of the treated area until approved by your provider

What are the side effects of laser skin tightening?

Side effects for this procedure are generally mild but may include:

Warm or stinging skin in the area treated
Bruising
Changes in your skin color
Redness
Swelling
In rare cases loss of pigment or darkening of pigment may occur
If the skin is broken, infection is another rare side effect that can occur

How much downtime is there for laser skin tightening?

Skin tightening is a favorite procedure for Elite Medical and Aesthetic clients because the types we offer have very minimal down-time. Most clients are able to get back to light activities immediately after the procedure and feel fairly normal within 24 hours.

Before and after laser skin tightening

How long does it take to see results from laser skin tightening?

You may begin to see some changes immediately after your first treatment but these are not permanent and are usually from mild swelling. It is recommended that you have 3 treatments spaced out every 4 weeks to achieve the best results for most types of treatments. Some practitioners say the best results will appear 3 months after your last treatment because the skin continues to produce collagen and remodel itself for 3-6 months after.

How long does laser skin tightening last?

For patients that use sunscreen and work to take care of their skin, laser skin tightening should last for 2-3 years. After this point, patients can book the procedure again to maintain the results. Many people will do maintenance treatments yearly to keep up with their results.

Does laser skin tightening really work?

Depending on the technology, and the provider administering the technology, laser skin tightening can really work. Here are just a few studies on the various technologies we talked about in this article:.

IPL has been shown to be extremely effective in tightening the skin, as highlighted in this piece. As above, this is because it is able to not only reduce pigment but also create new collagen production by heating up the water in the skin.

RF microneedling also has great studies on skin tightening and is being used more and more for not only the face but also the body, as highlighted in this case study.

This study talks about non-ablative fractional resurfacing technology (like ResurFX) and how it is safe and effective for all skin types, even darker tones.

What is the difference between laser skin resurfacing and laser skin tightening?

These two terms go hand and hand. When the goal is skin resurfacing, to reduce unwanted pigment as well as fine lines and wrinkles, there is also a skin tightening effect. This is because the controlled damage to the skin increases collagen production therefore tightening the skin.

However, some products are better for skin tightening and others better at resurfacing. Talk to your provider about your goals and what technology is best for you.

What is the best non-surgical skin tightening procedure?

When we’re talking about a goal of skin-tightening usually the RadioFrequency (RF) technologies are the best (in Nurse Practitioner, Ali’s, opinion) when weighing risks, benefits and outcomes. This is especially true when combined with microneedling to get a controlled depth of tissue damage with controlled energy. This helps to tighten the skin without going too deep and causing unnecessary damage or also dissolving fat in areas we don’t want to (like in the face).

These treatments are also much more tolerable and come with less side effects than some of their competitors such as ultrasound skin tightening technologies like Ultherapy.

Should you get laser skin tightening?

Whether something is “worth it” or not is highly subjective but we have had immensely positive feedback about IPL, ResurFX, and RF Microneedling. These minimal downtime procedures work across many different areas and can last 2-3 years.

If you live near Lone Tree, CO consider coming in for a consultation at Elite Medical & Aesthetics by booking an appointment below.

Chin Filler 101

February 8, 2021 in Fillers /by Ali Wagstaff

Introduction

When most people think of dermal fillers, chin filler is probably not on their minds. But for many clients, precisely injected chin filler gives them the opportunity to enhance the shape and proportions of their chin.

In this article we’ll break down:

What chin filler is
What the procedure is like
How much chin filler costs
Other commonly asked questions

If you are new to filler injections, in general, read our Filler 101 Guide for more commonly asked filler questions

What is chin filler?

Chin fillers are dermal fillers injected into the chin with the goal of enhancing the shape, size, or proportion of the chin. It can be done as a single treatment or as a series of injections spaced 2-4 weeks apart, depending how much the chin needs to be built up.

It is a nonsurgical procedure that is not permanent but can last several years. Many clients getting chin fillers hope that the procedure will give them a stronger, more balanced chin.

How much does chin filler cost?

Chin filler cost is mainly dependent on the type of filler used, the amount of filler needed, and where you have the procedure done. For most procedures chin filler will cost between $500-$1500. This is the point where we have to remind you that the most expensive type of filler is the kind you have to have twice. Make sure you pick the right injector, not just the cheapest.

What is chin filler treatment like?

A chin filler treatment is a very quick outpatient procedure that should take an hour or less. The injection portion of the procedure may only be a few minutes. When you get to the office the injector will walk you through the procedure and assess the structure of your face.

After going through any questions you may have, they will carefully select where to place their injections using a needle and syringe or in some cases a cannula. The injections will be done quickly and without much discomfort and after some brief aftercare instructions, you will be on your way to resume your day.

For more insight on what filler appointments are like, read THIS!

Is chin filler painful?

The chin filler procedure can be mildly uncomfortable but tolerable. The mentalis muscle (chin muscle) can be a bit tender, especially afterward because we move the chin so much to talk and eat. The quick pricks with a needle will feel mildly uncomfortable in some areas and sharper in others. Most fillers used for the chin have small amounts of lidocaine to help reduce the discomfort of the injections.

After your procedure, your chin may feel a bit sore and possibly heavier than it usually feels which may make things uncomfortable temporarily while it heals.

What types of filler are used for chin filler?

In general, injectors use a thicker filler for the jaw and chin area to add volume. In most cases, injectors will use a Hyaluronic Acid (HA) filler or a calcium hydroxylapatite (Radiesse) filler “off label” for the procedure. Some of the commonly used fillers are:

Restylane Lyft (HA)
Radiesse (calcium hydroxylapatite)
Juvederm Voluma (HA)

To learn more about these fillers, check out our guide on filler.

How long does chin filler last?

Depending on the type of filler injected, and how much was injected, chin filler can last quite a long time, between 10-24 months. At that point, patients will often have the procedure redone to maintain results. They may also come in at regular intervals for touch-ups to maintain the treatment.

What should you do to prepare for chin filler?

Talk to your injecting provider for a complete list of pre-care instructions and things to avoid. In general, it will likely be recommended that you:

Avoid over the counter blood-thinning medications and supplements like ibuprofen, fish oil, and aspirin (unless these are prescribed for a health condition).
Read this article on tips to avoid filler bruising and swelling HERE
Eat pineapple in the week leading up to your treatment if you are nervous about swelling. You can also take Bromelain tablets in the 24 hours before treatment to help reduce pain and swelling.
Consider taking arnica which will help limit bruising at the injection site.
Avoid drinking alcohol prior to your treatment. You’ll be unable to consent to the procedure and it may also make your recovery slower by increasing bleeding and bruising.
Consider limiting the amount of sodium you consume prior to your appointment. Sodium can cause your body to retain more water which will increase your swelling.
Talk to your injecting provider about any medical conditions or concerns that you may have.
Show up with a clean, makeup-free face.

What is chin filler aftercare like?

You’ll want to talk to your injector about specific aftercare instructions that may be specially geared to your situation. Most likely, you’ll be able to return to mild activity immediately following your procedure. In general, it will be recommended that you:

Consider applying an ice pack to the area injected to reduce swelling for the first 24 hours.
Avoid touching or massaging the area treated.
Take acetaminophen as directed to alleviate any pain or discomfort. Ibuprofen can delay the healing of bruises or make them worse if present.
Avoid any heat with the area (places like saunas and hot showers, as well as hot wax) unless instructed to use warm compresses for bruising after the first 24 hrs.
Consider taking arnica to help reduce any bruising or discomfort.
Avoid alcohol or exercise for 24 hours afterward to keep down the potential bruising.

If you’re worried about bruising and swelling from filler injections, read our article to learn about ways to reduce this side effect from filler injections, in general.

Is chin filler safe?

Dermal fillers like chin filler are generally very safe when injected by an experienced professional like Ali. Make sure you do your research and read reviews of different injectors before having your procedure done. That being said, any aesthetic procedure comes with inherent risks, talk to your injector about any concerns you may have.

What are the side effects of chin filler?

In the days following your procedure you may experience the following mild side effects from your chin filler injections:

Redness
Itchiness at the injection site
Mild bruising
Swelling in the area treated
Soreness
Possible bone resorption (see below)

If you’ve experienced previous chin filler, or any filler, that you are unhappy with, read how you can fix unwanted filler and start fresh here.

Can chin filler move?

Filler migration in the chin area is rare, but possible. Some injectors will massage filler after injecting it to prevent lumps and make sure that it has accurately treated the area. After your treatment, your injector will most likely advise that you do not touch the area treated and avoid certain activities that may cause it to migrate. Talk to your injecting provider about all possible side effects.

Can chin filler cause bone loss?

A recent study of 80 patients in Asia showed unexpected bone loss of the chin after injections of hyaluronic acid fillers. It was correlated with the amount of filler used. The more filler used, the more bone loss there was. However, there was no change in the aesthetic effect of the chin despite this side effect.

This phenomenon is not seen in other areas of the face like the cheeks or jawline, even when the filler is also injected directly on the bone. There are many theories on why this may happen. Talk to your injecting provider about his risk and all risks associated with aesthetic procedures. It is always best to have an initial consultation, with a provider like Ali, to learn/understand all of the risks and benefits.

Can chin filler fix a weak chin?

Yes, chin filler can be injected in a way that adds definition to the chin and makes it appear stronger. This procedure can help patients that have a small, weak, or receding chins achieve more balance and harmony of their facial profile.

Can filler get rid of a double chin?

Though chin filler will not remove tissue, sometimes the appearance of a double chin may come from the shape and structure of the chin. In these cases filler can be used to reshape the jawline and chin to give it a stronger look.

If there is significant submental fat (fat below the chin) causing the appearance of a “double” chin, then Kybella is a great treatment to do in combination with chin and jawline filler to reduce the extra tissue. See other alternatives below.

Client's before and after chin filler

What other procedures are an alternative to chin filler?

Chin implant

What is a chin implant: a chin implant is a surgical procedure where an implant of the desired shape and size is placed in the chin area to enhance this feature.

Cost: $3000-5000

Benefits: This is a permanent procedure where the exact shape and size of the chin can be determined.

Negatives: This procedure requires surgery which always comes with risks and is more expensive than other options.

As above, when an enhanced chin profile is desired it may also be necessary to slim and contour the jawline for best results. This can be accomplished in many different ways but a few treatments often done with chin filler include:

Kybella/Deoxycholic acid for submental fat or “double chin”. Learn more about Kybella here.
RF microneedling at deeper depths can tighten the skin and reduce fat. Learn more about RF Microneedling here.
Jawline and neck liposuction or “facetite” procedure done with a plastic surgeon to suction out versus melt fat along the jawline and below the chin

Is chin filler worth it?

Whether something is “worth it” or not is highly subjective, but we have had immensely positive feedback from all of our chin filler clients. It is one of those areas that is subtle but quite noticeable and can really enhance someone’s look while ensuring they still look like themselves.

If you live near Lone Tree, CO consider coming in for a consultation at Elite Medical & Aesthetics, link below. For more FAQ and Contact information about our practice, read more here.

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Learn more about your skin, and which treatment options would be best for you!

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Botox Brow Lifts

February 1, 2021 in Botox /by Ali Wagstaff

Almost all of us develop lines in between our brows as we age and our skin begins to lose elastin in that area. To soften these lines patients can undergo a surgical procedure called a brow lift or they can use a neuromodulator like Botox to raise the eyebrows. In this article we’ll explore what a Botox brow lift is, who may benefit from one, and how much it costs.

What is a Botox brow lift?

A Botox brow lift is a procedure that uses Botox to raise the eyebrows and eliminate the frown lines in between the eyes. The Botox injections relax the muscles creating the frown lines which allows the forehead to pull the brow upwards.

Small doses can also be placed under the eyebrow or at the tip of the eyebrow to release the pull from the orbicularis oculi, the circular muscle that goes all around the eye and also pulls the middle and outer brow down. See photo below.

What types of neuromodulators can you use for a brow lift?

Botox (onabotulinumtoxin-A)
Dysport (abobotulinumtoxin-A)
Xeomin (incobotulinumtoxin-A)

Some patients may find that they build resistance to Botox or Dysport due to a protein coating that they build antibodies to (more info on this can be found here). These patients are typically able to use a “Naked” Botulinum toxin like Xeomin to obtain the same results.

Who should get a Botox brow lift?

Almost everyone is a good candidate for glabellar Botulinum Toxin injections. Those with heavy lids, heavy brows, flat brows, or with 11’s lines will see the most benefit. To read more about general information about Botox read the article below.

Is a Botox brow lift safe?

Botox brow lifts are safe and fast when performed by trained injectors. To ensure that you’re getting the best results and the safest procedure make sure to find a trained injector like Ali from Elite Medical & Aesthetics. Keep reading to find out more about some of the potential side effects of this procedure.

What should I do to prepare for a Botox brow lift?

As with any procedure, talk to your injecting provider about what to expect and how to prepare for your appointment. In general though, some of the major things to do before your Botox brow lift might include:

Researching your injector thoroughly. Check out their reviews and their credentials prior to booking.
Tell your injector what medication you’re currently taking.
Consider taking zinc prior to your appointment. Zinc may help the Botox last longer.
Schedule your appointment for a good time when you can have a moment to recover without work or activities.
Consider icing the area prior to being injected if you’re nervous. It will make the procedure less painful and may reduce post injection bruising.

Some things to consider not doing before your appointment include:

Taking things that will thin your blood like aspirin, ibuprofin, omega-3, ginseng, and fish oil (unless prescribed for a health condition) as they can increase bleeding and bruising.
Smoking cigarettes, smoking impacts how long it takes for you to recover.
Drinking alcohol prior to your appointment. It has the potential to slow recovery time and make bruising worse. You also cannot legally consent to your procedure if under the influence of drugs or alcohol.
Using skincare products that could irritate your skin prior to your appointment.
Wearing makeup to your appointment. Your injector will need to easily see where they’re injecting.

For more info on what to do and what to avoid before getting Botox, check out our guide.

What is a Botox brow lift like?

A Botox brow lift is a very simple outpatient procedure that generally takes under an hour. The procedure itself may only be a few minutes. A good portion of the appointment will be a discussion with the injector and some prep. The injections themselves will be brief and shouldn’t be too painful, feeling like minor pricks. If you are worried about the pain involved, talk to your injecting provider about this, they may have solutions.

When will I see results from a Botox brow lift?

According to studies, and in office observations, we have found that results of Botox brow lifts generally show within a week of the injections. For some products, such as Xeomin, results may show within 24 hours for certain individuals.

What is Botox brow lift aftercare?

Most injectors will have specific aftercare instructions so be sure to follow your specific injectors instructions, but common consideration for aftercare treatment may include:

Avoiding lying down for 4 hours after your injections. This is a theoretical precaution to stop the medication from migrating.
Wait at least 8 hours before resuming strenuous exercise and preferably 24 hours. Exercise increases blood flow to the face which theoretically could also cause migration of the medication. Sweat may also irritate the injection sites.
Use a cold compress or ice pack on the area injected to reduce redness and swelling if you need it.

Is there any downtime after a Botox brow lift?

There is very little downtime for Botulinum Toxin injections. Following the aftercare instructions above, you should be able to get back to work or other light activities immediately after.

The most common after effects to plan for are small bumps that look like mosquito bites, those typically resolve within 30-45 minutes. Minor redness will resolve within this amount of time as well. Very rarely does bruising occur and it usually just looks like a tiny freckle, usually under the eyes.

What are the side effects of a Botox brow lift?

Mild side effects of Botox brow lifts can include:

Soreness
Headaches
Pain or swelling at injection site
Temporary Numbness
Mild bruising

Talk to your injector about all the potential side effects prior to receiving your treatment.

Can a botox brow lift help hooded eyes?

Hooded eyes occur when an extra portion of skin covers the crease of the eye. This gives the eyes the appearance of the eyelid being smaller. This can be genetic or occur with aging. When the muscles that pull the brows down are deactivated with Botox this allows the brows to lift, therefore lifting the extra “hooded” skin.

How much does a Botox brow lift cost?

A Botox brow lift can take anywhere from 20-40 units of Botox (or up to 120 if Dysport is used). This can cost anywhere from $200-$500+ depending on units and what your provider charges. For more on pricing click the pink button below.

How long does a Botox brow lift last?

Botulinum Toxin injections will last 3-4 months for most people between the brows in the 11’s area (the glabella). The small doses around the eyes to aid in the brow lift may only last 6-8 weeks because the dose is smaller and it’s a high movement area. For tips on how to make your Botox last longer, read the blog below.

How does a botox brow lift compare to a surgical brow lift?

A surgical brow lift will lift the brows permanently (until further aging occurs at least) whereas a Botox brow lift is only temporary. The Botox can also only do so much depending on each person’s unique anatomy.

For someone with heavy lids, they would likely need an eyelid surgery called a blepharoplasty. This surgery is also permanent (until further aging occurs). So a younger person, or someone looking for a mild change, could consider the Botox brow lift. An older person, or someone seeking a more drastic and permanent change, should consult with a board certified Plastic Surgeon to talk about surgical options.

Is a Botox brow lift worth it?

Aesthetic procedures like a Botox brow lift, are a personal choice that only you can decide on. A Botox brow lift may be the right answer for those with heavy lids, heavy brows, or 11’s lines. If you would like to learn more, and are located in the Lone Tree, CO ares, book a consult at Elite Medical & Aesthetics below.

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Everything You Need to Know About Baby Botox

January 25, 2021 in Botox /by Ali Wagstaff

Sometimes we like to dip our toes into the pool before diving in. When it comes to injectables, dipping our toes in can seem like it is entirely out of the question. But with baby Botox (smaller amounts of Botox) we can see some of the natural looking results of Botox without making a major leap into the injectable pool. In this article we’ll break down what baby Botox is, who it may be right for, and how much it costs.

What is baby Botox?

Baby Botox is extremely similar to regular Botox injections. It is simply injecting smaller amounts of Botox into areas prone to fine lines and wrinkles. The goal of baby Botox is to show the most natural results without completely relaxing the muscles. It is a great way for people worried about injectables to get an idea of what the effects would be like.

How does baby Botox work?

Just like regular Botox injections the goal is to decrease lines and wrinkles. “Baby Botox”, also trademarked “MicroTox”, is when a trained provider injects very superficial amounts of Botulinum Toxin under the top layer of skin with a goal of not quite reaching the muscle. These tiny doses will smooth and relax the skin while still allowing for more natural movement. However, even baby Botox can drift around 1cm so it’s always possible it will affect the muscle.

What areas can you get baby Botox injected?

Baby Botox is perfect for areas with fine lines and wrinkles where you would want a natural look (see photo below). It is used in many of the same areas that traditional Botox would be used, like:

Around the lips
Neck
Jaw area
Crow’s feet
Forehead wrinkles
Frown lines between brows

Who is a good candidate for baby Botox?

Baby Botox is best for younger clients or those with minimal lines and wrinkles because it’s going to be a modest effect compared to traditional injections. However, it can also be used strategically in clients with more severe lines and wrinkles to give natural appearing results in combination with full treatment. A good example is using this technique right above the eyebrows to allow for some lift of the brow while still smoothing the skin. For more on Botox brow lifts, read the article below.

What are the benefits of baby Botox?

Possibly a more natural appearance
Can diminish signs of aging like lines and wrinkles without disrupting facial movements
Can be used in combination of full treatments for more control over the final result

Is baby Botox safe?

It is important to note that all aesthetic procedures come with inherent risks. Baby Botox done by a trained injector with years of experience is generally very safe. It has been studied and may have even fewer side effects than traditional Botox because of its smaller doses.

What are the side effects of baby Botox?

Though baby Botox may have fewer side effects than traditional Botox, you may still run the risk of:

Bruising in the areas injected
Swelling around the injection site
Headaches
Potential for it to drift deeper leading to the same effect as regular injections

Always consult with your injector about the possible side effects before having a procedure done.

What is the difference between baby Botox and Botox?

Baby Botox and traditional Botox are extremely similar. They both utilize onabotulinumtoxin-A or another type of toxin to weaken muscles. This process weakens muscles and lessens lines and wrinkles. Baby Botox is focused on using less of the same toxin superficially to achieve more natural results. Using less produces less noticeable effects but can still help lessen wrinkles and lines. This makes it great for clients that have never tried Botox before. For more information on botox in general, read the article below.

How much does baby Botox cost?

Baby Botox prices are determined by the type of toxin (Botox, Dysport, Xeomin) used and the injector you choose. That being said, baby Botox procedures may require half as much toxin as a traditional Botox treatment. But the cost may be the same due to the advanced training of the clinician to perform this treatment and also the additional time it takes for all of the extra injection sites. For instance, a traditional forehead treatment might be 5-10 sites of a regular treatment and double or triple that for Baby Botox. Some of the costs might be:

Around the lips: $100+
Neck: $200+
Jaw area: $200+
Crow’s feet: $200+
Forehead wrinkles: $200+
Frown lines between brows: $200+

Click on the pink button below for Elite Medical and Aesthetic’s Pricing

How do you prepare for baby Botox?

For any medical procedure you’ll want to check with your injecting provider for a full list of instructions. In general most patients prepare for baby Botox the same way they would prepare for regular Botox procedures.

This may include: avoiding blood thinning medications and supplements (unless prescribed for health reasons), icing beforehand if needed, taking zinc, and showing up with a makeup clear face. For more information on what to do to prepare, check our Botox prep guide.

What is a baby Botox procedure like?

The baby Botox procedure is a very quick process that generally takes less than 30 minutes and up to 60 minutes for full face and neck.

The procedure will generally start with your injector talking to you about what will happen and asking you a few questions. After that they will wipe your face with a cleaning solution. Over the next few minutes the practitioner will inject Botox into the target areas. The injector will then explain aftercare treatment for you. From there, you’ll be on your way to continue on with your day.

What is baby Botox aftercare?

Talk to your injecting provider for a complete list of aftercare instructions. In general though, aftercare is fairly straightforward and may include:

Avoid rubbing or massaging the area treated. This could cause the toxin to move around and have unwanted effects. As well as increase risk for infection (hands are dirty!).
You may also consider not laying down for 4 hours after your treatment to make sure the toxin doesn’t move around.
Consider avoiding strenuous exercise after the procedure to avoid swelling and inflammation.
In some cases, icing the area can help reduce discomfort from the procedure since it’s a lot of pokes to spread the baby Botox around! You can ice for 5 minutes on and 5-10 minutes off as needed in most cases. Consider not wearing makeup immediately post-procedure to keep the injections site clean and to avoid rubbing and spreading the toxin. Always discuss aftercare with your injector to make sure you’re properly following their instructions.

What types of neuromodulators can be used for baby Botox?

Botox (onabotulinumtoxin-A)
Dysport (abobotulinumtoxin-A)
Xeomin (incobotulinumtoxin-A)

Some patients may find that they build resistance to Botox or Dysport due to a protein coating that they build antibodies to (more info on this can be found here). These patients are typically able to use a “Naked” Botulinum toxin like Xeomin to obtain the same results.

How long does baby Botox last?

Baby Botox typically lasts for 6-8 weeks depending on where it is injected. In higher movement areas, like the area around the mouth, it tends to have a shorter life. You’ll want to make sure you set up an appointment for another round of injections at this point to maintain the results.

Does baby Botox last as long as regular Botox?

Baby Botox generally does not last as long as regular Botox which can last for 4 months or longer. It doesn’t last as long because it is lower doses that are spread out more. For more information on how you can make your botox last longer, read the blog below!

Is baby Botox worth it?

Having any type of aesthetic procedure is a personal choice and you have to decide for yourself if it is worth it. If you’re newer to injectables or have never tried Botox, this may be an easy way to get a glimpse of what it would be like. If you are located in the Lone Tree, CO area, and would like to learn more or chat about this procedure, book a consult below.

All about under eye filler

January 14, 2021 in Fillers, Uncategorized /by Ali Wagstaff

Introduction: All about under-eye filler

Have you gotten tired of trying under-eye creams hoping that they would help you get rid of the dark sunken look under your eyes? For many clients this area is extremely frustrating, but the good news is that there is a solution. Under-eye (tear trough) filler can give the area under your eyes increased volume and reduce the appearance of dark hollows. In this article we’ll dive into what types of fillers are used, what the procedure is like, and what under-eye fillers cost.

For visual learners, watch this YouTube video that features NP, Ali Wagstaff, and her take on under-eye concerns and treatments to help.

What is under-eye filler?

Tear trough filler (aka under-eye filler) is a treatment where hyaluronic acid (HA) dermal fillers are injected using a needle or cannula into and around the dark hollows under the eyes. It can be done alone or in conjunction with cheek filler.

Why is under-eye filler sometimes done with cheek filler?

It’s important to address the whole face when treating this area for a natural and balanced look. Oftentimes under eye hollows can be from loss of volume in the cheeks. Always determine the underlying cause of the deficit before treating.

Also, it is crucial to go to an experienced provider, as this area can not only be dangerous to inject, but also difficult to inject in the correct plane (or level).

Below is a before and after photo of a patient who needed cheek support along with under eye correction. The two go hand-in-hand.

What types of filler can be used in the under-eye region?

Most of the softer, thinner HA (hyaluronic acid) fillers can be used in the under-eye area. Sometimes firmer HA’s can be used in severe cases, or when they are diluted. It is not advised to use non-HA fillers in this thin, sensitive area.

The most commonly used hyaluronic acid fillers for under-eyes are:

Other fillers such as collagen, Sculptra and Radiesse are NOT recommended in this area due to risk of overfilling, pain, reaction and nodules. This is a high movement area that needs a soft and gentle HA filler for best results.

For more information on fillers, check out our filler guide.

What does tear trough filler treat?

Our bodies naturally lose volume in our tear trough as we age. We also have separation of the fat pads under the eyes and the cheeks. This leaves an indentation, or dark hollowing, under the eye which can be softened with dermal fillers for a more refreshed “awake” appearance. Below are some before and after photos that help visualize tear trough filler.

Who is a good candidate for under-eye filler?

A good candidate is someone who:

Has always had dark under eye hollows genetically
Developed dark under eye hollows with aging
Has good skin quality & cheek support

A poor candidate is someone who:

Has large under eye bags rather than hollows
Has extremely thin or fragile skin that appears to be “see-through”
Has full face hollowing and requires full-face intervention prior to under eye filler

If you previously had a poor under eye filler treatment, and don’t know what to do, be sure to schedule a free consultation! In the mean time, read how you can reverse “bad” filler.

Are tear trough fillers safe?

Yes, under-eye fillers done by experienced medical providers can be done safely. It’s important to consult with your injecting provider, like our Nurse Practitioner Ali, to discuss the risks and benefits of any procedure. See below for risks

Are there risks involved with under eye filler?

All medical and aesthetic procedures come with risks. Some of these risks involved in tear trough filler include:

A poor result, usually over-filling with a puffy appearance
Prolonged swelling from poor product selection or placement
A blue tinge under the eyes (tyndall effect) from too much filler, filler placed too superficially or filler placed on a poor candidate
A vascular occlusion where dermal filler gets into the artery (angular artery) which can lead to severe complications.

What are the benefits of tear trough filler?

Tear trough filler can add volume to lessen the “hollowness” under the eyes
It can give you a more rested and youthful appearance
Filler will diminish under-eye bags (in certain cases)
It will eliminate or lessen dark circles under the eyes

How much does under-eye filler cost?

Under-eye filler varies in cost based on the type that you receive, where you have the procedure done, and who is performing the procedure. Below is a breakdown of the cost, on average.

Hyaluronic Acid Fillers like Juvederm, Belotero, and Restylane generally cost between $600-$1200 per treatment. This does not include any other filler that may be recommended. When combined with other facial fillers the cost for the under-eye portion may be lower.

For more on pricing

Check out Elite's pricing

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Pricing $

How do you prepare for under-eye filler?

Talk to your injecting provider for a complete list of instructions, but in general, it will likely be recommended to:

Avoid over the counter medications that may thin your blood like aspirin, ibuprofen, fish oil (unless prescribed)
Do not consume alcohol 24-48 hours before your procedure
Come to your appointment with a clean face and no make-up (if possible)

Some additional recommendations to help you prepare:

Taking arnica tablets help to prevent bruising/swelling, too (as with any supplement, talk to your provider before you take OTC medications or supplements)

Consider icing the under eyes for 10-20 minutes prior fo your procedure to decrease the risk of swelling/bruising

What is an under-eye filler treatment like?

Under-eye filler appointments are generally about 30-60 minutes. The actual procedure itself may only take about 5-minutes per side, but the preparation and discussions prior to the appointment will take up extra time. Your injector may also recommend injecting other areas first, such as the cheeks and mid-face, to support the tear trough area and for a better result which takes additional time.

If you are curious about what our filler appointments generally look like, read our blog here. The more you know, the more comfortable you can be (:

What is under-eye filler aftercare like?

Every injector will have their own specific aftercare instructions. Below are some of the general recommendations for under eye filler aftercare:

Try to avoid using concealer or other eye makeup for the first 24 hours.
Do not rub the treated area for at least 24-48 hours after your injections.
Avoid intense physical activity for 24-48 hours, if possible, as exercise may increase swelling to the area treated.
Consider avoiding alcohol for 48 hours after your treatment. Drinking could increase the swelling and bruising.
Use an ice pack to ice the area for 5-10 minutes off and on for the first 48 hours. This will help you reduce swelling quicker. It’s also a great reason to sit on the couch and relax.

For more tips and tricks on how to avoid swelling from filler, in general, read this.

When will I see results from tear trough filler?

Immediately after the procedure you will be able to see your results! For many people, there will also be some swelling immediately post-procedure. The swelling will start to go down in about 48 hours. You will be able to see the final results in 7 to 14 days in most cases but in rare cases, it may take longer, especially during allergy season.

How long do under-eye fillers last?

Over the years we have discovered that filler tends to last much longer in this area than in other high movement areas. Lasting even longer than the lips. The same filler brand that may only last 6-8 months in the lips may last 1-2 years under the eyes. More cross-linked fillers, such as the Juvederm family, can last 2-3 years, but this does come with an increased risk of reactions and late-onset nodules. Talk to your injecting provider about what dermal filler is best for you. Schedule a consultation HERE.

What is the best under-eye filler?

Hyaluronic acid fillers are the best fillers for under-eye treatments and we have tried almost all of the available brands on the U.S. market. Our favorites have been Belotero Balance and Restylane-L for most cases.

We also use other, firmer HA fillers or Radiesse in the cheeks prior to doing under-eye fillers to support the area and also give a more natural look.

For a full list on fillers and what areas they’re best for, READ THIS!

Is tear trough filler worth it?

Yes, tear trough filler is worth it. This is one of the procedures that we get excellent feedback on. It’s a subtle result that makes a huge impact for clients that feel like they constantly look tired. It also has minimal downtime and is not obvious to others that it was done.

Under eye filler before and after

Conslusion

If you are located in the Lone Tree, CO area, be sure to schedule a consultation with us, simply click the pink “book now” button below. Our licensed/trusted providers will ensure they are there for you, every step of the way! For more information on our company’s FAQs, read this!

Follow us on social media to see more about our treatments, team, and monthly specials!

All About Lip Flips

January 4, 2021 in Botox /by Ali Wagstaff

Introduction

Many patients seeking fuller lips are nervous to get lip filler and often opt to start with a lip flip. Some are also nervous about a ducky appearance and have heard that a lip flip can help with this!

In this article we’ll dive into what lip flips are, how much they cost, and why it may make sense for some patients to pair a Botox lip flip with traditional lip filler. We’ll also talk about who may be a candidate for a surgical lip lift if a lip flip is not enough.

What is a Botox lip flip?

A lip flip is an “off-label” procedure done by injecting Botulinum toxin into the border of the upper lip into the lower portion of the orbicularis oris muscle. This is the circular muscle that controls lip pursing (known as duck face).

By injecting botulinum toxin into the lower region the lower muscle is slightly deactivated. This allows the upper portion of the orbicularis oris to flip the top lip up a bit. It also helps with “smoker’s lines”around the lips.

The effect is a modest 1mm change to the upper lip that lasts around 2-months.

How much does a Botox lip flip cost?

Lip flips are generally for cosmetic purposes and are not covered by insurance. Pricing depends on how many units are needed, who is doing the procedure, and also if the procedure is done alone or with lip filler. Most patients use 4-10 units of Botox which can cost $100-$500. This is generally less expensive than getting a full set of lip fillers which can cost $500+.

Who is a good candidate for a Botox lip flip?

A Botox lip flip is the perfect procedure for:

People looking for a fuller appearing top lip without adding volume
Individuals hoping to get a more visible upper lip while smiling
Those that plan to get lip filler but have a longer philtrum column and don’t want to look ducky (more below)

A Botox lip flip should be avoided by:

Those allergic to botulinum toxin
Women that are pregnant
Patients with active infections or illnesses

Is a lip flip the same as lip filler?

No, they are actually quite different but patients can use both depending on the goals. A lip flip uses Botox and lip filler uses dermal fillers.

Lip filler is a non-surgical procedure where a gel-like substance is injected into the lip to enhance the shape, volume and contours of the lip. When done in a certain way it can flip up the top lip and shorten the philtrum column (distance between the bottom of the nose and top of the lip). See image above.

When necessary, patients can use it in combination with a lip flip to enhance the upper lip.

What are the benefits of a Botox lip flip compared to lip fillers?

One benefit of the lip flip over lip fillers is the cost. Most lip filler procedures cost between $600-800 whereas a lip flip might start out at $125.

Both the lip flip and lip filler can decrease lines in the lips called “smoker’s lines” or “kissing lines.” The lip filler will last longer on average though.

For someone with a long philtrum column (the distance between the bottom of the nose and top of the lip) the lip flip can be used with lip filler. This works to prevent a ducky appearance. In some other cases, if the distance is severely long, patients may need a surgical consult for a lip lift (see below).

Another major benefit of this procedure is that it can be a good intro into lip procedures, only lasting 2 months. Only lasting 2 months can also be a con when you consider lip filler lasts roughly 8-12 months. In the long run, the lip flip can be more expensive if done regularly.

What is a lip lift?

A lip lift is a surgical procedure where a plastic surgeon removes a small amount of skin from the philtrum column. This shortens the distance between the nose and the top lip. The goal is usually to have a few mm of top teeth showing when the mouth is relaxed but lips are slightly parted. The lip lift procedure costs on average between $2000 and $5000

What is the difference between a lip flip and a lip lift?

A lip flip is where Botox or another Botulinum toxin is injected into the top lip. This temporarily flips up the cupid’s bow and shortens the philtrum column (around 1mm).

A surgical lip lift is a permanent surgery to do the same thing. The difference is that the surgeon can measure exactly how much skin to take for each unique person. The average is around 3-7mm or 1/3rd of the distance depending on the person and their unique appearance.

What are the pros and cons of a lip flip versus a surgical lip lift?

The pros of the lip flip over a surgical lip lift is that the Botox lip flip is temporary, only lasting 2 months or so. It’s also cheaper in the short term. The cons are that it only lasts 2 months and that the change is very modest, around 1mm. So someone with a very long philtrum column the lip flip will not do much.

The pros of the surgical lip lift is that it’s permanent and the exact amount of change for the best aesthetic results can occur. The cons are that it is surgery which always comes with risks and it will leave a small scar. It is also permanent in the rare case the top lip has been shortened too much, though it does relax and “stretch” out over time.

Should I get a lip flip or lip lift?

One thing you can do at home to determine if you have a long philtrum column is look at yourself in the mirror with your face and lips still and neutral. Then open your mouth about 1-2 cms. Do your top teeth show at all or does your top lip cover them completely?

If your top teeth show then your best bet is likely lip filler with or without the lip flip depending if you have lip lines or how much top teeth show.

If your top teeth don’t show, then you should consider whether you would undergo surgery to enhance the appearance of your lips. If you would not, then make an appointment with an experienced injector and see what they think about lip filler with a lip flip. They may be able to do it, but in severe cases may recommend you have a surgical consultation with a surgeon. They usually have someone they trust that they can refer you to.

If you know you want a permanent change, do your research and get a few consults with well known, board certified plastic surgeons for a lip lift procedure.

Does a lip flip hurt?

In most cases, ice or numbing cream is used before the injections for a lip flip. The lips are very sensitive and because the needle is being injected deeper, into the muscle, this area can be quite tender. It is very quick though and most people tolerate it well.

Is a Botox lip flip safe?

Botox, and other neurotoxin treatments, are safe and highly researched. Due to the small amount of medication being injected, the risk is even smaller than many other procedures. That being said, you should always consult and book with a pro that has performed the procedure numerous times like Ali from EMA. The most expensive aesthetics procedures are the ones you have to have twice due to a poorly trained injector.

What are the side effects of a Botox lip flip?

Minor side effects of a Botox lip flip include:

Swelling
Bruising
Soreness in the area injected
Inability to fully purse lips or annunciate certain words

Talk to your injecting provider for a complete list of side effects and warnings to look out for after any procedure.

Does a lip flip change your smile?

A lip flip can make the top lip show a bit more when smiling but the effect is subtle. In rare cases, when the injection is not done correctly it can actually cause a crooked smile as well. Make sure you go to someone that has experience in lip flips before having this procedure done.

What is Lip Flip Aftercare?

Talk to your injecting provider and ensure that you are following all of their specific recommendations after any procedure. In general, aftercare is simple and usually involves keeping the site clean, avoiding massaging the area and avoiding intense exercise for 4-8 hours post procedure.

How long until I see results from my Botox lip flip?

Depending on which medication is used (Botox, Xeomin, Dysport, Jeuveau) results will likely start to show within 4-5 days with final results between 10-14 days.

How long will my Botox lip flip last?

Unfortunately, results only last up to 2-months in this high movement area. That means the procedure needs do be done again every 2 months.

Are lip flips worth it?

Having any type of aesthetic procedure is a personal choice and you have to decide for yourself if it is worth it.

We have done many lip flips at Elite and find that lip filler tends to have a more desirable and longer lasting effect, with or without the lip flip.

We’ve also found that many people look “ducky” from poorly placed or migrated filler done elsewhere and when we dissolve and redo it we get a great result.

In rare cases, we have also referred clients for plastic surgery consults. But for most clients we can give at least a subtle treatment to enhance their look.

If you want to learn more or chat about these procedures book a consult below to chat.

Read more about how to tell if you’ll look lucky ducky in this article.

About Ali Wagstaff

Entries by

Table of Contents

How to prevent bad filler and Botox

BAD BOTOX: What are my options?:

Can you make botox "wear off faster"?

High Stress

Lack of Zinc

Extraneous Exercise

Acupuncture

Can you temporarily fix bad Botox?

Possible Botox techniques to alter a case of "bad Botox"

Once I start Botox, can I stop?

BAD FILLER: what are my options?

Can you reverse dermal filler?

Can Hyaluronidase fix bad filler ASAP?

What fillers are HA?

Is there any scientific proof of dissolving filler?

Are there fillers that can't be dissolved?

Is it expensive to dissolve filler?

Does dissolving filler hurt?

Book your filler dissolving here:

Wrap it up!

By: Ali Wagstaff, NP

Becoming a RN Injector

Becoming a NP injector

Table of Contents

Ultimate Skincare Products

A quick note on diagnosing skin conditions

Basic Skincare Routine For Teen's

Teen skincare regime step-by-step

Best Skincare for Acne Prone Skin

Acne Prone Skin Summary:

What is the best skincare routine in your 20’s?

Skincare in 20's Summary:

What is the best skincare routine in your 30’s?

Skincare in 30's Summary:

What is the best skincare routine in your 40’s?

Skincare in 40's Summary:

What is the best skincare routine in your 50’s and 60's?

Skincare in 50's and 60's Summary:

Were do I start with skincare?

What are skincare essentials?

What is medical grade skincare?

What should I avoid to prevent aging?

Need help with your skincare routine?

Table of Contents

How do Botox and Dysport Work?

What are Botox and Dysport made from?

What is Botox made from?

What is Dysport made from?

Dysport and lactose intolerant allergy

Are Botox and Dysport the same?

How much does Botox and Dysport cost?

How much does Botox cost?

How much does Dysport cost?

Is Dysport cheaper than Botox?

What are Botox and Dysport used to treat?

What are Botox and Dysport used to treat?

Botox and Dysport before and after images

Does Botox have more uses than Dysport?

Is Botox or Dysport better than filler?

What are Botox and Dysport procedures like?

What are the side effects of Botox and Dysport?

Is Dysport less safe than Botox?

Is Dysport safe to use if you are a vegan?

What is aftercare like for Botox and Dysport?

When will the results of Botox and Dysport show?

When will the results of Botox show?

When will the results of Dysport show?

Does Botox have better results than Dysport?

Can Botox be reversed?

Does Botox or Dysport have longer lasting results?

Is Botox better than Dysport?

Table of Contents

What is laser skin tightening?

How does laser skin tightening work?

Who should get laser skin tightening?

What types of treatments are used for laser skin tightening?

IPL