Like all procedures, in-office injectable filler treatments should have a full disclosure as part of the consent, which should be reviewed in detail before the injection session. While there are many different injectable fillers available, they are produce similar results and only fundamentally differ in how long they last and how much they cost. Important pre-treatment issues to know include what Type of filler is being used, what are the specific Treatment areas, what Outcome can be expected, Risks and Complications, and at what Cost.

Before you have any injection filler treatment to the face, know exactly what type of filler is going to be used…..and why. I find that many patients who have had injectable filler treatments before can not tell me what was used. While the scientific composition of the material is not really important to the patient, what was used and how did it work or how long it lasted is important for future injectable filler treatments, whether it is done by the same or different physician injector.

In general, the vast majority of injectable filler treatments are done in either the lips or the nasolabial folds (cheek-lip grooves). Unlike Botox® injections which is done over a broader surface area, injectable filler treatments are more specific to one area that is well-defined. Most patients do have a good recollection as to what areas were filled.

One of the best benefits of injectable filler treatments, and an expected outcome, is that the benefits of the injections (unlike Botox®) will be immediately seen. However, it is important to understand that no filling treatment is permanent. Injection treatments will have to be repeated based on the expected length of time the filler will last for the results to be maintained.

The most common adverse result from an injectable filler treatment, albeit it only temporary, is that the result may be over- or undercorrected or it may not be perfectly smooth and even. Injecting fillers is an art form and not an exact science. Also, there may occasionally be some bruising in a small area or two. Very rarely, it is possible that one may have a localized allergic reaction to the material which appears as redness and swelling. This may go away on its own or could require some steroid injections if it persists.

Lastly, each injectable filler is charged based on a full syringe cost. That is an easy number to know before treatment by asking…and it should be told to you without asking. Some practices charge you for a full syringe whether you use it or not. Others only charge by the amount of the syringe used. Ask what the practice policy is in advance.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

When you are considering Botox® injections (facial expression weakening/paralysis), consider the following issues which should be part of every procedure consent for this cosmetic treatment. These include issues of Treatment Areas, Outcome of the Procedure, Risk and Complications, and the all-important understanding of what the Costs will be.

What specific areas are going to be treated? While the forehead and the area between the brows(glabella) are by far the most common, other areas could include the crow’s feet (side of the eye), upper and lower lips, corner of the mouth, and neck areas.

What type of results can I expect? Usually the benefits of the injections may take up to a
full week to be seen. The results will not be immediate and the onset of the injections will start
in a few days. Understand clearly that Botox® is not permanent and that the treatments
will need to be repeated every 3 to 4 months for the results to be maintained. Also, there is some
slight variability between patients in terms of how much the expression will be weakened and
how much Botox®, in units, that it will take to achieve the best result. If you do not have enough expression weakening two weeks after the treatment, you may need more Botox® units.

Every cosmetic procedure has some risks and complications…Botox® is no different. Minor issues include the possibility of some mild injection site bruising and a headache (if done in the forehead) for a day or two. Every now and then I see a patient who does not get much muscle weakening from the treatment. This almost always is a reflection of the strength or age of the Botox and I, in my practice, repeat the injections for free. Usually, however, when a patient says they do not see a result….it turns out that they are not seeing as much result as they thought they would. Some patients expect total paralysis or freezing of the entire injection zone which may not be realistic given the number of units that were injected and for what they were willing to pay fofr the treatment. The most dreaded Botox® complication is that of drooping of the upper eyelid after treatment. This can occur if the injection were done too close to the eyebrow (where Botox® can drift down into the upper eyelid) or too much liquid volume was put close to the eyebrow area. This is a complication that I have never seen (nor do I want to!) as it will last for months until the effect wears off. The secret to avoiding it….don’t inject too close to the eyebrow!…stay high.

Lastly, know what you are going to pay in advance. There is no sense in ‘sticker shock’ when you get to the front desk after your injection session. Experienced Botox® injectors know in advance how many units they are going to inject for each area. They should share that with you, and you should know to ask, before you get the treatment. Botox® is charged by the unit so the price is predictable in advance, plus or minus twenty or thirty dollars either way.

Dr. Barry Eppley

http://www.eplpeyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis