Cosmetic Plastic Surgery Articles

Already the most widely performed minimally-invasive cosmetic procedure in the United States, botulinum toxin (Botox, Jeuveau, Dysport, Xeomin) is forecast by industry insiders to become even more popular in the year ahead as more twentysomethings turn to it as a preventative treatment.

“Preventative Botox,” as it’s come to be known on beauty sites and across social media, may sound like overkill at first. Someone in their twenties who regularly thinks about their whispers of wrinkles is obsessed, not concerned, right? We are the harshest critics of ourselves. In other words, we’ve all been there, whether we choose to remember it and relate or not.

How it works

Personal motivations aside, there’s plenty of merit to preventative Botox. Frown lines, crow’s feet, and expression wrinkles result from the repetitive folding of the skin. It doesn’t happen overnight, but it does happen a lot sooner than many of us think it will.

We’ve come to realize that by injecting these areas earlier, we can keep these wrinkles from developing in the first place, instead of trying to diminish and delete them after they’ve developed. It’s a cumulative effect. With each subsequent treatment, we’re training these muscles—and, in turn, preventing the lines from developing until much later than they normally would.

One of the clearest examples of this are the downturned lines on the sides of the mouth, often referred to marionette lines. Once they form, they can be very difficult to treat. But by injecting the muscles at the mouth angles with botulinum toxin, we’re able to keep them from appearing in the first place.

When to start

Since the goal is prevention, when should treatment start? There is such a thing, of course, as being too young for preventative treatments. Botox is FDA-approved for patients 18 and older. Most begin around age 30. Some start as early as 25. Any younger than that and you likely haven’t developed enough lines to worry about.

When you start to notice frown or forehead lines, it’s reasonable to consult with a board-certified plastic surgeon about starting preventative treatments. Ideally, we want to prevent those lines from turning into larger folds.

It’s worth mentioning that while preventative Botox has been shown to be quite effective at staving off wrinkles, it’s also one part of a healthy skin-care regimen. Applying sunscreen on a daily basis, getting plenty of sleep, and keeping stress to a minimum with activities like yoga and meditation will all contribute to maintaining a youthful radiance.

As cosmetic injections have penetrated the mainstream in recent years, there’s been an increasing tendency by media outlets, bloggers, social media influencers, even some board-certified* plastic surgeons to use certain cosmetic-injection terms as though they’ve been part of our vocabulary all along. By doing so, the best-case scenario is you’re left in the dark. Worst-case, you’re misled. Whether you’re preparing for your next treatment or your first, think about taking a moment to brush up on your cosmetic-injection terms.

*Board Certification

Indicates that the injector has not only graduated from medical school and is a licensed physician but they’ve also completed a three-year residency program in plastic surgery. When you’re considering any sort of cosmetic injection, you want a board-certified plastic surgeon because they have extensive knowledge of the musculature of the face.

Botulinum Toxin

A drug made from a purified protein derived from a strain of protein called Clostridium botulinum. With 7.4 million procedures performed last year, it’s the most popular type of injectable by far. It works by preventing nerves from releasing the neurotransmitter acetylcholine, which triggers muscles to contract. In doing so, overactive, wrinkle-causing muscles become relaxed and lines they’ve etched become less pronounced. In 2002, Botox became the first brand under which botulinum toxin was available for cosmetic injections. Jeuveau, Dysport, and Xeomin are newer versions of the drug.

Filler

Refers to any substance that can be injected into the skin or underneath it to create a physical change. There are currently 15 different kinds of fillers approved by the Food and Drug Administration (FDA) for cosmetic use. In recent years, plastic surgeons have gradually drifted away from permanent and semi-permanent fillers, which can last up to five years, in favor of hyaluronic acid fillers, whose results can last up to two years but are reversible.

Hyaluronidase

Used to reverse poorly done procedures (overly plumped lips) or the bumps that can occur as a side effect of bad injection technique or when an injection is too shallow. Hyaluronidase is comprised of a group of enzymes that break down hyaluronic acid fillers within hours without compromising the hyaluronic acid that’s found naturally in your skin. (It cannot be used on permanent or semi-permanent fillers.)

Poly-L-Lactic Acid

A sugar with medical and cosmetic applications—it’s in the filler Sculptra, which is approved by the FDA to plump nasolabial folds for up to two years. But unlike the sugar that makes up hyaluronic acid fillers, this one doesn’t occur naturally in the body, and it can’t be reversed.

Hyaluronic Acid

A naturally-occurring sugar that plumps the skin by holding 1,000 times its weight in water. With more than 2.1 million injections done in 2018, hyaluronic acid-based fillers are the most popular types of fillers today. Different brands and types offer the sugar in different concentrations and particle sizes. Small particles, such as those in Juvéderm Volbella and Restylane Silk, are often used to fill in shallow lines and delicate areas, like the lips, while larger ones, such as those in Juvéderm Voluma XC and Restylane Lyft, are most appropriate for adding volume to the cheeks and smoothing nasolabial folds.