Procedures » Dermal Fillers

Since I began dermal fillers in 1994 the quality and number of choices of materials has grown exponentially. With improved products that have less risk of allergy, reactions, or pain and that last much longer I have expanded my usage to take care of all sorts of bothersome issues.

Dermal Fillers treatments

I was fortunate to be in on the ground level with both Restylane and Juvederm and participated as a clinical investigator for the FDA trials; giving me a very early and insightful experience from which to draw on. I also happened to begin my fellowship training just after the first ever report of Botox for cosmetic uses was published; again giving me a head start with this fantastic drug.

I researched and published the first-ever paper on using Botox for the purpose of elevating the eyebrow and subsequently became one of the world’s leading experts for this. All of my experiences have given me a comfort with these injections and helped me to address many subtle details and imperfections to provide for refined improvements.

When it comes to these injectables I want to emphasize that you, the patient, should merely articulate what bothers you and what you are hoping to achieve, and leave the decisions of exactly what needs to be utilized and how much up to me. Of course, once I decide on a game plan I will discuss it with you so that you understand my thought process.

Dermal Fillers | Beverly Hills, CA

When large volume is required for the purposes of rejuvenation I often consider using fat. However, there are many advantages to using the above fillers for volumization as well as for fine lines, wrinkles, changing the brow or corners of the mouth or even rejuvenating earlobes.

I can eliminate dimples in the chin or even increase chin projection with Botox or Dysport and often times provide for a stronger jaw line with Juvederm or Restylane. Often I can use fillers to stave off the need for surgery for several years and sometimes fillers and neurotoxins are necessary to enhance the results of an extensive surgery. There are times when some filler is helpful in the nose or when Dysport can help to shrink a large salivary gland that’s causing a bulge.

The main point here is that there are many things that can be creatively used for all types of purposes and that every individual requires careful analysis to determine what and how to go about reaching the established goal.

Real Patient Testimonial

  • Dr. Frankel, thank you so very much for something I've waited so long for. You were wonderful and so was the rest of your staff. I can' t express all my gratitude enough!

    • 5 stars
    • KD

FAQ’s about Aesthetic Injections

What are aesthetic injections?

Aesthetic injections are used to treat fine lines and wrinkles and/or add volume to various parts of the face. Dr. Frankel is a leading expert on utilizing Botox to elevate the eyebrows. Other uses for aesthetic injections include lifting the corners of the mouth, rejuvenating the earlobes, eliminating dimples in the chin, and treating some types of scars. Many people choose injectable fillers as an alternative to invasive plastic surgery, or in combination with other procedures to enhance their rejuvenation results.

Restylane, Juvederm, Botox, and Dysport are used at this practice. Fat transfer may also be appropriate in situations where a large amount of volume is required.

Who are candidates for aesthetic injections?

Anyone who is concerned with wrinkling, sagging skin, or loss of volume may be a candidate for anesthetic injections. They must be in good health with no active diseases or serious medical conditions that can cause complications. Your doctor will discuss the right course of treatment for you.

What happens during the aesthetic injection process?

The answer depends on the type of substance that is injected.

First the surgeon will evaluate your face and discuss with you what areas you see as problems. He will mark the points of injection on the face to act as a guide and clean the site thoroughly before the actual injection. A topical anesthetic may be used to numb the area if necessary, though when performed in the right hands the procedure can be painless. A thin needle will then be inserted into the site and the injection will be made.
If a fat transfer is performed, the patient’s own fat will be harvested from other areas of the body, such as the thighs or abdomen, through liposuction first. The doctor will then inject that fat into the new locations, typically overfilling the area to account for re-absorption that will take place. The fat will settle and you will experience the increased volume you have been looking for.

How long does the procedure take?

Aesthetic injections are a very quick procedure, taking mere minutes after the prep-work has been done. The number of injections will dictate the total time the procedure takes, though it is generally about 15 minutes.

What should I expect following an aesthetic injection?

Right after the injection, the guide marks can be washed off. Makeup can be applied, but patients are warned not to apply pressure to prevent movement of the filler. There may be some mild discomfort, which can easily be addressed with a cold compress. Any minor swelling or bruising will fade within a few days.

There is no downtime with aesthetic injections that are performed as standalone procedures.

Are aesthetic injections permanent?

Aesthetic injections are not permanent and will need to be “touched-up” at regular intervals. The do last longer today than they did years ago though.

Each person metabolizes injectable fillers at a different rate. Some last a few months, other can last a few years. The results of a Restylane injection can last for up to 1 year, Juvederm about 6 months, Botox and Dysport about 4-6 months.

Are all injectable substances the same?

No. The materials used for aesthetic injections very based on their composition and what they are used to treat. Restylane and Juvederm consist of hyaluronic acid. Other may be made of collagen, calcium hydroxylapatite, polylactic acid, or PMMA. Botox and Dysport are derived from botulinum toxin A. Dermal fillers are used to smooth static wrinkles and increase volume. Botox and Dysport block nerve signals, preventing muscles from contracting and causing dynamic wrinkles. The doctor will be able to tell you what product is right for you to address your concerns.

Are aesthetic injections safe?

Aesthetic injections are very safe when performed by a trained physician. Over the years since the practice of using injectables became popular, they have improved and the risk of allergy, adverse reactions, and pain has lessened. Many types of injectable fillers used, like Restylane and Juvederm, are composed of substances that can be found naturally in humans. Autologous fat injections eliminate the risk of allergy because the substance comes directly from the patient’s body.

Those concerned about Botox being poisonous due to its link with botulinum toxin should be aware that Botox is a purified derivative and used in very low concentrations, making it perfectly safe for use by experts.

What risks are associated with aesthetic injections?

Aside from the typical minor swelling and bruising that can occur, there are other risks when using aesthetic injections. These may include allergic reaction, rejection of the filler material, acne flare-ups, asymmetry of facial features, bleeding, infection, death of the skin, skin rash, migration of the material away from the injection site, temporary numbness and temporary paralysis of the facial muscles.

Additional complications may arise with the use of Botox, such as:

  • Headache
  • Flu-like symptoms
  • Nausea
  • Drooping or weakness in the face
  • Botulism-like symptoms are very rare. They include trouble breathing, difficulty swallowing, slurred speech, and muscle weakness.

Will my health insurance cover aesthetic injection procedures?

Most health insurance companies will not cover cosmetic procedures. Contact our office if you are unsure about what is covered by your insurance or if you would like to learn about available financing options.

What exactly is BOTOX?

BOTOX dates back to the 1950s when scientists found it was useful in treating muscle spasms. The FDA approved it for cosmetic use in 2002 as a tool for treating lines on the brow. The protein within BOTOX is a purified protein that blocks nerve impulses, leading to a temporary paralysis that helps relax muscles. This helps reduce the appearance of creases, fine lines, and wrinkles on the face and neck.

What should I expect during my appointment?

The doctor injects BOTOX into the affected area. The entire appointment usually takes less than 30 minutes. There is a sting as the injection occurs, but the discomfort is minor.

What can I expect after BOTOX injections?

Following your BOTOX injections, you can return to your usual routine. You do not need time to recover. Expect to see results after a few days.

Are there side effects or risks I should know about?

Side effects are not typical. Some people do report getting eyelids that droop temporarily, flu-like symptoms, headaches, nausea, and respiratory infection. You should not undergo BOTOX injections if you have an infection in the area where the injections will be administered. In rare occasions, people develop antibodies to BOTOX, making the treatments ineffective.

When will I need additional BOTOX injections?

BOTOX injections remain effective for up to four months. You should go for repeat injections every three or four months.

What qualities make a good candidate for BOTOX?

BOTOX is suitable for anyone between the ages of 18 and 65. It’s suitable for men and women who want to smooth creases, fine lines, and wrinkles on the face and neck.

How much does BOTOX cost?

It’s important to understand that BOTOX is a cosmetic treatment. Therefore, most insurance companies do not cover any portion of the cost. According to the American Society for Aesthetic Plastic Surgery, the average cost of BOTOX in 2011 was $328 per session.

Related procedures: Neck lift, Facelift, Midface Lift.