When should I start injectables?

We often get asked when is the “right” time to start injectables, and while there is no “right age”, there are some signs and age milestones that might signal the time is now!

Think of it this way- when you buy a new car, you don’t wait until it’s falling apart to take it to the shop. Instead, you perform regular maintenance and routine care on it so it stays in good condition as time goes on. Your skin is no different! The best way to age gracefully is to perform regular preventative maintenance and take care of any problems as they arise rather than waiting until you are “falling apart”.


What signs should I look for?

We look at our faces every day, so sometimes it is difficult for us to see small problems as they arise. A good rule of thumb is that if you notice even the faintest lines between your eyebrows, on your forehead, or around your eyes while your face is in a neutral position, it’s probably time for an injectable neuromodulator (neurotoxin) like Dysport, Botox, or Jeuveau. Neuromodulators are the definition of a preventative treatment- they relax a target muscle so as to prevent the movement causing the fine lines you see at rest.

Our bodies typically lose 1% of collagen production per year after age 20, and bone loss begins around age 25. As a result, the skin becomes thinner and more fragile with each passing year. Most people will begin to notice faint fine lines/wrinkles at rest in their mid to late 20s, so that is typically a good time to start neuromodulators if not sooner (before the lines ever even arise!).


What about biostimulating injectables such as Sculptra or Hyper-dilute Radiesse?

Biostimulating injectables like Sculptra or Hyper-dilute Radiesse (HDR) are another good preventative treatment that can be started truly at any age. These act like liquid fertilizers for your skin, increasing production of collagen and elastin to help preserve healthy skin thickness, elasticity, and volume. Remember- collagen loss starts as early as 20 years old so it is best to stay on top of that with these “pre-juvenation” procedures!

What about dermal fillers?

Dermal fillers have a broad range of use. They can be used at any age to plump up lips, help give lift by adding volume to the cheeks or temples, and can help correct volume deficits or darkness to areas such as the under eyes. Aside from spot treating at any age, the rule of thumb for fillers to combat signs of agining is around 1 syringe for every decade of life- so if you are 50 you will typically require 5 syringes, if you are 60 you will require 6, etc. Fillers vary in longevity, but most need to be re-done every ~ 9-15 months.

The bottom line is this: there’s no right age to start injectables. You should start when you’re ready, but as the old saying goes, an ounce of prevention is worth a pound of cure. So the sooner you start, the easier it will be to maintain a youthful, radiant appearance as you grow older!

The importance of “Prejuvenation”

Skin Rejuvenation Treatments

“Prejuvenation” is just a fun word we use to describe preventative, skin rejuvenation treatments/procedures. It is truly never too early to start preventing a problem. Think about your car- you take it in routinely for maintenance and care to keep it running longer, and your face is no different! Consistent prevention early on can help you maintain a naturally youthful appearance for longer without the need for more invasive or corrective procedures. At the most basic level, prevention starts with home care. A high quality SPF, antioxidant like vitamin C, and a retinol are the absolute must haves for everyone at ANY age.

After good home care, there are a few in office procedures and treatments that we recommend for good “prejuvenation” at any age.

    skin rejuvenation treatments
    • Neurotoxins/neuromodulators (Botox, Dysport, Jeuveau, etc)- these relax the targeted muscles to help prevent the formation of fine lines and wrinkles from dynamic movements. The most common areas we treat include “11s”, upper forehead, around the eyes (crow’s feet), upper lip, DAOs (the muscles on the corner of your mouth that contribute to marionette lines), and platysmal bands (the band like muscles in your neck that give a “turkey neck” appearance. Dosage will vary from person to person depending on age and how you use your face! The best time to start neurotox is BEFORE you ever get a line! Neurotox is truly preventative- it’s purpose is to prevent the motions that cause static lines to form. To some extent you can expect to see some correction of existing fine lines and wrinkles with neurotox, but once a line is deep enough at rest it will never go away with neurotox alone.
    • Biostimulating InjectablesCollagen and elastin are 2 components that contribute to youthful, glowing, tight/firm skin. Sadly, we start to lose around 1% of collagen per year after our mid 20s, so it is never too early to start replenishing/maintaining those collagen and elastin stores. Sculptra, Hyperdilute Radiesse, Microneedling or Radiofrequency Microneedling, Ultherapy, and Platelet Rich Fibrin (PRF), are just a few of the options that can help achieve this. These “biostimulating” (aka collagen stimulating) procedures all work in various different ways to induce collagen synthesis in the skin, which helps combat the annual collagen loss we experience naturally! The results from these procedures look incredibly natural- you look better without being able to pinpoint that you had something done!
    skin rejuvenation treatments
    skin rejuvenation treatments
    skin rejuvenation treatments


    skin rejuvenation treatments
    skin rejuvenation treatments

    If you’re still not sure where to start, but ready to start somewhere, schedule a consult and we will discuss the best plan for you!

    What’s the difference between all of the “Botox” brands?

    types of botox

    Different Types of Botox

    At this point most people have heard of Botox, but did you know that this is just one of many different types of botox brands we call neuromodulators or neurotoxins?

    Neuromodulators are the umbrella term for any product that utilizes botulinum toxin to temporarily relax a target muscle in order to prevent and sometimes treat fine lines and wrinkles. Botox has come to be the household name for neuromodulators, but other common brands include Dysport, Jeuveau, and Xeomin. What’s the difference between all of the brands or types of botox and which one is right for you?


    The biggest difference between brands is the form of botulinum toxin that is used- Botox is made of onabotulinumtoxinA, Dysport is abobotulinumtoxinA, Jeuveau is another form of botulinum toxin type A, and Xeomin is incobotulinumtoxinA. At the end of the day, all of these forms are effective in relaxing muscular contraction, so all will help to reduce the appearance of fine lines and wrinkles. However, there are some slight nuances that arise due to the different formulations.

    Onset and Duration

    According to the International Association for Physicians in Aesthetic Medicine (IAPAM), the average onset of Dysport is 3 hours, Botox is 72 hours, and Xeomin is 96 hours. In practice, most people notice the results of Dysport and Jeuveau within 3-7 days post injection, while Botox and Xeomin are typically noticeable after 1-2 weeks. For all products, dose = duration, meaning that the higher the dosage used, the longer the results can be expected to last (within reason). The average duration for most people is between 2-5 months.


    While rare, some people may develop a tolerance or resistance to neurotoxins due to the creation of antibodies. A person’s immune system may identify the ingredients used in these injections as being a foreign invader, so it responds by producing antibodies that neutralize their effect. While resistance can occur with any of these four types of injections, it’s most common with Botox and Dysport. Botox and Dysport contain additives that can “irritate” the immune system and, thus, trigger the creation of antibodies.

    Xeomin, on the other hand, consists solely of botulinum toxin, so it’s less likely to cause resistance than its counterparts, however there still have been reported cases of tolerance to xeomin. This has led researchers to believe that it might be the actual botulinum toxin causing antibody formation instead of, or possibly in addition to the additives, however the jury is still out on that. All in all, only about 1 in 100 people who receive a neurotox injection will develop a resistance to it.

    Dosage and Pricing

    Dosage will vary from person to person, however you can typically expect that you will need 2-3 times the number of units of Dysport as you would with Botox, Xeomin, and Jeuveau. Botox is usually the most expensive per unit as you are paying for the brand, and Jeuveau is usually the most cost effective. Evolus, the company that produces Jeuveau, was able to achieve a lower price by focusing its FDA approval specifically on cosmetic applications for its product, whereas Botox is approved for both medical and cosmetic purposes.

    At the end of the day, all four products are FDA approved and all work well to help reduce and prevent fine lines and wrinkles. Come in for a consult today to help decide which brand could be the right fit for you! types of botox types of botox types of botox types of botox

    Myths about dissolving filler

    I’m sure you have heard that dissolving filler is an option if you don’t like it, and while that is partially true there are a lot of myths surrounding that!

    What are Fillers?

    Hyaluronic acid (HA) fillers are sterile gels consisting of non-animal stabilized hyaluronic acid for injection into the skin to correct facial lines, wrinkles and folds, for lip enhancement, shaping facial contours, etc.

    Why Would Someone Have to Consider Dissolving Filler?

    The worst case scenario with any filler procedure is what’s called vascular occlusion- basically when filler is injected inadvertently into a blood vessel, blocking blood supply to its target tissue, ultimately leading to tissue death and necrosis if not corrected quickly. That is where hyaluronidase comes in. Hyaluronidase (hyalenex) is an enzyme that breaks up hyaluronic acid and essentially aids in dissolving filler. We always keep it on hand in the worst case event that we experience a vascular occlusion. Flooding the affected area with hyaluronidase is the best bet to restoring blood flow to the tissues.

    Aside from vascular occlusions, occasionally fillers produce unwanted aesthetic outcomes, as no cosmetic procedure has guaranteed results. In rare cases, these undesirable effects can be treated with hyaluronidase, however this does carry risks of its own.

    We have HA in our body naturally, and hyaluronidase is not selective when it comes to what HA it dissolves- it just dissolves everything in its path. So, while we may only try to dissolve a small bump of filler, there is no guarantee that the hyaluronidase won’t dissolve the native HA in your surrounding tissues. This can leave you with an unwanted deficit or even skin laxity in or around the treated area.


    dissolving filler

    Patience is Key

    The best bet to treating an unwanted outcome is patience- over time (usually 6 months to 2 years depending on the product), your body will absorb the HA filler and the unwanted effects will go away, but on the flip side there is no guarantee that over time your body’s natural HA will be regenerated if a deficit is created from using hyaluronidase.

    So yes, HA fillers are reversible, but not without consequence. Our hope is that you are pleased from the get go with your cosmetic outcomes, however no result is ever guaranteed, and there are risks associated with “dissolving filler”. Our advice is to know the risks of filler beforehand, be ok with those risks, and have patience if something does not look exactly how you had hoped. Sometimes doing too much to try to “fix” things just makes the problem worse or creates new problems, and we are left chasing our tails. Of course, our team will always do everything we can to make you pleased with your appearance and loving the skin you’re in! dissolving filler dissolving filler

    Everything You Need to Know About Sculptra

    As we get older, our face loses both bone structure and fat pad volume, which leads to a sagging, aging face rather than a lifted, youthful face. Hyaluronic acid fillers help to rebuild some of that lost volume and structure, however collagen stimulating therapies such as Sculptra Aesthetic are another popular and very natural looking option.

    What is Sculptra?

    Sculptra Aesthetic is a safe, synthetic, biocompatible material made of poly-L-lactic microspheres that is injected below the surface of the skin to stimulate collagen production. Think of this as fertilizer for your skin- it can be used for global volume restoration and to spot treat specific areas depending on the placement and amount of product used.

    Sculptra Results

    As with any biostimulating therapy, the results of Sculptra Aesthetic are not immediate. At your first treatment visit, it may appear that Sculptra Aesthetic worked immediately because of swelling from the injections and the water used to dilute the product. A few days following the treatment, when the swelling goes down and the water is absorbed by your body, you may appear similar to as you did before your treatment. Sculptra takes time, up to 6 months, to see full results. Results have been studied out for 2 years, but likely last even longer than that especially if you keep up with maintenance therapy (recommended 1-2 vials per year after initial series).


    At your consult, we will discuss your specific goals to get a better idea of how many vials and sessions you may need. Up to 2 vials may be used per session, and most clients need on average 3 sessions about 6 weeks apart for best results.

    After your injections, your face may appear a bit swollen/puffy and you can expect some bruising at the injection site. You will be instructed to massage the treated areas for 5 minutes, 5 times per day, for 5 days following the procedure- this is to prevent nodules from forming under the skin and to ensure even distribution of this “skin fertilizer”. You will likely be a little sore as the lidocaine used to mix the sculptra wears off after the treatment.

    We will continue to assess and treat as needed until the desired results are achieved. Schedule your consult today to see if Sculptra Aesthetic is right for you!