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No Down Time Facial Rejuvenation Frequently Asked Questions (FAQ)

BOTOX® Cosmetic FAQ

Injectable Fillers: Fillers, Restylane, Radiesse, Hyaloform, Hyaloform Plus, Captique, Fat Graphs

Does the use of a filler always produce "big lips"?

No. Fillers may be used in moderate amounts to produce a subtle but attractive fullness to the lips with correction of fine lines at the lip borders.

Can I receive fillers and BOTOX® at the same time?

Yes. These can both be used on different parts of the face to complement each other, with the correction to wrinkles of the forehead, around the eyes, lips, and nose.

If dark skinned, can I receive an injectable treatment?

Yes. Skin color poses no contradiction to the use of any of our no down time rejuvenation protocols. Fillers are a part of our minimal down time rejuvenation protocol and may be performed in conjunction with:

  • BOTOX®
  • Vein Therapy
  • Chemical Peels
  • Microdermabrasion
  • Lasers
  • Fat Injections

What fillers can be used in my lips; I want them fuller but not too large.

The size of the lips will depend on the volume of filler used, not so much on the type of filler. Restylane, Hyaloform, Hyaloform plus, and Captique can all be used in the lips. The hyaluronic acid type products typically last in the region of 6 months. Fat can also be injected into the lips for those patients that want to be all natural; this has a somewhat longer period of swelling and may require more than one session. Over filling the lips often distorts the natural anatomy resulting in a sausage like appearance. Your surgeon must understand lip anatomy and its highlights when performing lip augmentation.


How long do fat graphs last?

Fat is excellent filler; however, it does not always take in 1 session so multiple sessions may be required to achieve a final result. Dr. Spence usually waits approximately 12 weeks between fat grafting sessions. Once the final result is achieved the fat that takes is usually permanent. Fat grafts can be achieved under local anesthesia depending on the number of areas to be grafted


What is it meant by layering fillers?

Often times the best results from the use of fillers may require the layering of fillers. For example, the patient with deep nasolabial folds (crease from the base of the nose to the corner of the mouth) may benefit from the use of multiple fillers, e.g. Radiesse may be used deep in the tissue with Restylane layered closer to the skin. This will give a longer lasting effect.


Do all fillers need local anesthesia?

No. Some fillers already contin lidocaine (a local anesthetic) within the product, while others do not. To increase comfort for his skin care patients in Orlando, Dr. Spence has found the use of local anesthetic thereby greatly increasing the number of filler injections he performs. This has required the mastering of multiple injection techniques. When patients are comfortable they are able to stay still, allowing the precise injection of the fillers to achieve the best aesthetic result.


What filler can be used on the coarse frown lines between my eyes?

Restylane and Hyaloform plus may work in this area, depending on the depth of the furrow. Dr. Spence often injects BOTOX® along with the filler to prolong the effect of the filler. When the muscles are relaxed the furrows are less deep and the fillers last longer. Please note that the above are what are termed off the label uses of fillers; that is, they are not specifically approved for FDA use in that anatomic site but are used for cosmetic purposes and have been used safely elsewhere in the body.


Can I use a filler to build up my nose and chin?

Yes, fillers can be used to fill out the nose and chin, e.g. Radiesse and/or Restylane. This gives a patient a good understanding of what a chin implant or rhinoplasty will look like in the future. Some fillers will last as long as a year in these locations.


Can I use a filler on my jaw line?

Yes, the hollows created by sagging cheeks between the chin and jaw line can easily be filled out by fillers to create a smooth jaw line. This is an excellent location for the use of fillers such as Restylane and Radiesse, or a combination of both.


I have a scar on my lip with an indention in my upper lip; which fillers can be used to fix this?

Restylane or other Hyaloform products are excellent for lip scars.


I have a hollow beneath my eyelids. What filler can be used to correct this?

Restylane, along with other products such as Captique or Hyaloform plus, works well in the trough beneath the eyelids and usually only a small amount is necessary to make a significant difference. The Restylane is injected deep to produce a smooth transition from the cheeks to the lower eyelid.


What can be injected to help the lines around my eyes?

In general for more superficial lines the lighter (less viscous) fillers, e.g. Cosmoderm and Hyaloform, are preferable. For more superficial lines around the eyes these can be injected without being seen through the skin.


I have lost weight and a lot of cheek volume; how can this be restored?

Fat is an excellent filler in this case. However, if you have lost weight and do not have enough fat volume Radiesse works quite well to restore cheek volume, acting as a cheek implant, lasting between 9-14 months.


How can I prepare for my filler injection?

Be sure to notify your surgeon if you have any history of allergic reactions. Stop all blood thinning medications for several days before your injection, including Vitamin E and alcohol. If you are someone that becomes faint at the site of needles please let us know. Also, notify us if you bruise easily. Alcohol consumption the night before a filler can also promote bruising.


What can I expect after my filler injection?

A short period of swelling and soreness can occur for about 24-48 hours. This may be relieved with ice and some over the counter anti-inflammatory medications. For excessive swelling or bruising please notify us.


Can fillers be used to lift my eyebrows?

The combination of fillers and BOTOX® can be used to produce very full brows that are nicely arched, as full brows are often a sign of youth and can be lost with time. Talk with Dr. Spence about the shaping of your brows with the combination or fillers and BOTOX®.


Are fillers as good as a facelift?

Fillers are no substitute for the patient with a lot of excess skin and deep facial jowls; however, patients that have relatively good skin tone with deep lines and furrows can experience significant benefits from the use of fillers.


The corners of my mouth are turned down, giving me a sad look. What can be done to fix this?

A filler, such as Restylane or Radiesse, can be used to fill out and turn up the corners of the mouth. This will take away the sad appearance.

The responses to Frequently Asked Questions listed here are not intended to be medical advice, but are the practice of Dr. Spence and will vary from surgeon to surgeon and patient to patient.

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To schedule a consultation with Dr. Spence at Orlando Plastic Surgery, call 407-999-2585 or request a consultation online.