Posts Tagged ‘injectables’


Ask beauty-conscious women over 40 for one of their favorite anti-aging tools and many will profess their love for Botox or other neuromodulator treatments such as Xeomin and Dysport. It seems health journals are routinely reporting new benefits from Botox use such as migraine relief, depression management and Hyperhidrosis treatment. With all of these new findings, it is easy to begin to categorize Botox as some sort of panacea.

While neuromdulators are long proven to smooth “11” lines, crow’s feet , neck cords and even subtly lift eyebrows, this magnificent emulsion does have its limitations. Here are three conditions Botox cannot effectively correct.

  1. Deep Lines

Yes, neuromodulators are great for preventing and addressing fine lines but only those caused by facial expressions. Botox works by relaxing those muscles responsible for dynamic wrinkles. Dynamic wrinkles are those lines formed as a result of frowning, squinting, laughing, smiling or scowling. With time, the habitual act of these expressions etch deeper lines into the skin. By relaxing such expressions, you prevent deeper etching of the lines and wrinkles. However, if deep lines persist even when muscles are relaxed, Botox alone will not remove the lines. If the wrinkling is still present after the application of a neuromodulator, you most likely will require an injectable filler to plump the skin and provide dermal volume to push the crease out. If you are experiencing wrinkling from sun damage, a dermal filler is better suited for your condition. Botox will not address this type of wrinkling.

  1. Skin Complexion

While neuromodulators can improve the appearance of the skin by smoothing out fine creases and lines, it has no effect on skin complexion. If you are looking to restore radiance to skin, treatments such as microdermabrasion, chemical peels and laser resurfacing will be better suited to your needs. A proper diet, sufficient water consumption, routine exfoliation and daily application of sunscreen are also great ways to ensure a glowing complexion. Keep in mind that exposure to sun and wind or tobacco use can wreak havoc on your skin.

  1. Sagging Skin

Sagging skin results as elasticity of the tissue is lost through aging and skin damage(often inflicted by sun exposure or weight fluctuation). Jowls and heavy eyelids are two popular expressions of this condition. While Botox can subtly lift the eyebrows and provide a slight improvement to eyelids, Botox is not equipped to address these issues. Although dermal fillers like Perlane, Restylane or Juvederm can provide a bit of relief, the most effective and proven way to lift sagging skin is through surgical removal or lifting of excess skin. A facelift is the best way to address jowls while blepharoplasty (eyelid lift) is ideal for correcting drooping eyelids.

While Botox is valuable for a number of conditions, it is definitely not a miraculous cure all. It is important for patients to have reasonable expectations before pursuing this treatment.

Our Board Certified Surgeons have years of experience with injectable neuromodulators. To schedule your complimentary consultation, call 423-648-4011.

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photo courtesy of Wikipedia.org

photo courtesy of Wikipedia.org

Like most of the patients we see, you have probably been careful to pamper your hands, face and neck by applying sunscreen daily, being faithful to your regimen of anti-wrinkle creams and perhaps even receiving some aesthetic intervention with laser treatments and injectables. Yet, you may have overlooked a tell-tale sign of aging- the earlobes.

Just like everything else on planet Earth, with age, earlobes fall victim to gravity and collagen loss. This causes the earlobes to appear long, droopy and aged. If you ever went through a fashion phase consisting of large hoop or chandelier earrings, chances are, your piercing holes have also been altered as the weight of the earring pulls and stretches the piercing site.

Depending on the specific problem, a treatment plan does exist. Whether it be earlobe repair by surgical intervention or earlobe rejuvenation by means of injectable, dermal fillers, you are not doomed to droopy, misshaped, thin or torn earlobes.

Earlobe Rejuvenation with Dermal Fillers
Dermal fillers such as Juvederm and Perlane are ideal for earlobes that appear floppy, saggy, thin or stretched. Injected through a syringe, the hyaluronic acid, a substance found naturally in the human body, provides volume to the earlobes-causing them to appear more youthful, plump and smaller. This treatment takes only about 30 minutes to complete and requires no downtime although bruising and swelling may temporarily result. The earlobes do not typically require much product and can generally be treated with 1 syringe which costs about $500. Results can last up to two years.

Earlobe Repair or Reduction Surgery
While many patients respond well to dermal filler therapy, some patients with tears or earlobes stretched to the extreme require surgery for alteration and repair.
When a simple tear occurs, the patient requires only a simple procedure. Using just a local anesthetic , the surgeon can reconnect the split earlobe with small sutures and restore the tissue back to its original shape. For patients needing an earlobe reduction, often common with those who have received ear gauges, the procedure is a bit more complex but still relatively straightforward and can be completed in an office surgical suite. The reduction is performed by surgically removing the excess tissue and augmenting the earlobe to a more visually pleasing shape. All branches of the military require earlobe correction prior to induction. Military uniform code states that ear piercings can not show light when the piercing jewelry is removed.

Upon healing, a thin white scar may be present but should fade over time. At our practice, we include laser scar treatment with the surgical cost for earlobe repair. Depending on the severity and complexity of the case, earlobe surgery ranges from $400 to $1500.

If you are interested in rejuvenating your thinning earlobes, reducing the size of your lobes or repairing a torn lobe, call 423-648-4011 and schedule a complimentary consultation with our Board Certified Surgeons.

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With less daylight and more time spent indoors lounging around, winter lends itself as an ideal opportunity for facial cosmetic surgery procedures. In this week’s Q&A , Dr. White answers some commonly asked facial rejuvenation concerns.

How can I fix the overlapping skin on my eye lid?

Blepharoplasty is a surgical procedure to remove overlapping skin of the upper eyelid. Sometimes medically necessary, it is also completed for cosmetic reasons. As with any surgery, do your homework. Look at online reviews . Ask other patients. Eyelid surgery is both art and science; but in order to achieve an aesthetically pleasing result, art is most important. Look at before and after images. Field of vision testing can determine if the procedure is cosmetic or medically necessary.

Is it true if you put human placenta on your face it gives an instant facelift?

There is a new cream, derived from stem cells of human placentas, posed to encourage faster regeneration of skin cells. Rather than using liquefied placentas, boiled to about 220 degrees (F), RNL Bio uses the active cells of natural placenta that are more efficient in stimulating the skin. The cream does not contain actual stem cells, only human proteins . However, no solid,scientific evidence exists at this point which supports human placenta as an effective rejuvenation technique.

What questions should I ask my surgeon about chin augmentation surgery?

You should ask your surgeon what type of implant will be used and if the implant will be fixed in position. Location of the incision is also crucial information. You may want to discuss possible risks like infection, nerve irritation [marginal mandibular nerve, mental nerve], bleeding, implant rejection and bone re-absorption by implant pressure.

Whats a good ,non-surgical treatment for facial wrinkles?

Your solution will ultimately depend on the location, amount and severity of wrinkles. There are various treatments for facial wrinkles. Topical retinoids can aid in the prevention of fine lines while neuromodulator treatments like Botox and Dysport can temporarily reduce the appearance of crow’s feet and frown lines. Hyaluronic acid fillers are effective in temporarily addressing smile lines or smoker’s lines by restoring volume. Chemical peels and laser skin resurfacing are also used to rejuvenate damaged skin.

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Zytaze Chattanooga, Tennessee
If you are like many of our Botox patients, you probably love the results associated with the botulinum toxin treatment but wish the effects lasted longer than a mere three months. Luckily, there is a new, nutritional supplement ,known as ZYTAZE®, which is intended to improve the effects of Botox and extend the duration of its results.

How Does ZYTAZE® work?

Botulinum toxins like Botox work by reducing the muscle activity responsible for fine lines and wrinkles like those present when we frown. In order for these toxins to be effective, however, each toxin molecule must bind with a zinc molecule. Without the presence of zinc, the otherwise powerful botulinum toxins are ineffective. Unfortunately, during the manufacturing process, the application of zinc molecules to the botulinum toxin solution are not feasible as this would decrease the potency of the solution. Therefore, the botulinum toxins must bind to zinc molecules found in human tissue during injection. Ultimately, if the patient is deficient in zinc, the effectiveness of the botulinum toxin injection will have only a moderate to small effect.

ZYTAZE® provides the zinc molecules necessary to optimize the effects of Botox. So, why not simply take an over-the-counter zinc supplement? Unfortunately, not all zinc is created equally. As a matter of fact, taking a low quality, hard to absorb form of zinc can compromise the absorption of higher quality zinc found in whole foods. This can actually be worse than taking no zinc at all. Formulated with a unique patent-pending combination of organic zinc and phytase to maximize zinc absorption ,ZYTAZE® enhances the effectiveness of botulinum toxin injections.

Recommended Dosage and Price

It is recommended that patients take two capsules daily for four days prior to and on the day of receiving botulinum toxin injections(Botox). A pack of ZYTAZE®, which contains10 tablets, can cost anywhere from $60-$80 and is available in the US by prescription only.

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liquid facelift in Chattanooga, TennesseeAlthough the skin appears tighter after facelifts, balance and youthfulness can be lacking due to volume loss. The goal of volume replacement is to help patients look more like they did 10-15 years ago, not to make them look like someone else. The term “liquid facelift” refers to treatments that can be performed using injectable therapies that require little or no downtime.

Neuromodulators work on the underlying muscles by relaxing them [Botox, Dysport, Xeomin], softening wrinkles [facial fillers] or appearing to lift a certain area of the face. Other therapies add volume [facial fillers, fat transfer].

As the face ages, it loses volume. This causes shifts in the youthful contours and prominent landmarks of the face. Loss of facial fat, muscle, bone and reduced skin elascity leads to folds, lines, jowls and wrinkles – the dreaded signs of age. Facelifts work to return facial structures to the original positions by shifting muscular structures, removing excess skin and re-drape of the skin to carry a more youthful contoured position. However, facelifts carry increased cost, downtime and surgical interventions. Many 40-50 year olds are looking for facial rejuvenation to tide them over until their facial aging mandates a formal surgical procedure.

Tissue Filler Injectables

Tissue fillers are another group of injectables used for liquid facelifts. The most commonly used are Restylane, Perlane, Juvederm and Radiesse. Not all products can be used just anywhere on the face. Depending on the patient’s appearance and the treatment location, one or a combination of these products can be used to reduce the appearance of wrinkles and provide plumping of various facial structures. Hollowing under the eyes, mid face droop, hollow temples and chin sag can dramatically improve with volume. Cheeks can be enhanced to return that heart-shaped, youthful face and to lift the nasolabial folds. Nasolabial folds and marionette lines can be treated with tissue fillers as an adjunct to mid face surgical lift procedures.

Sculptra and Selphyl exist in a category called collagen stimulators. They can be used to add volume to most areas of the face. Each work by stimulating the body’s natural collagen, which helps smooth out the lines and wrinkles. Selphyl uses platelet-rich plasma to trick the body to generate more collagen.


Neuromodulators relax dynamic muscles that create wrinkles as they contract. Areas that can be treated with Botox include crow’s feet. frown lines, forehead lines, neck lines and chin dimpling. Botox can elongate the appearance of the chin and elevate the corners of the lips, enhancing the patient’s smile. A small amount injected in the lip border reduces the appearance of lip lines and can help the lips appear more plump.

Botox injection is the most popular nonsurgical cosmetic procedure today. Improvement of the wrinkles may last up to four to six months. Until recently, Botox was the only botulinum toxin A preparation with a cosmetic indication. Dysport, the first competitor with similar indications was approved in April 2009. Xeomin has now entered the market with lower unit price than that of Botox and Dysport.

Facial balance can be returned using a combination of the products discussed- with little downtime and without major, invasive surgery. Facial injection is an art form and you must choose your artist well. Review before and after photographs and make sure you have appropriate expectations for non-surgical facial enhancement before you present for facial review. Make sure that your aesthetic ideal matches that of your cosmetic surgeon injection artist.

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