I want to take a moment here to let you know, once again, that we are partners in any journey together that we take as patient and doctor.  When I started doing this in 2014, I was surprised at how much I enjoyed it because doing the Injectables stimulated my artistic and creative side.  So I do take my time in doing the fillers and the neuroomulators (Botox and Xeomin) because I promise to be mindful of everything that you are asking me to do.

What Benefits can you Expect From Injectables?

As we age, our faces begin to show the effects of gravity, sun exposure and years of facial muscle movement, such as smiling, chewing and squinting. The underlying tissues that keep our skin looking youthful and plumped up begin to break down, often leaving laugh lines, smile lines, crow’s feet or facial creases over the areas where this muscle movement occurs.

Dr. Wilkinson is happy to have a consultation with you in order to understand what concerns or needs that you may have.  She will work with you to decide what products are appropriate for you: Fillers, Neuromodulators or Kybella — so that we can obtain your desired results for the face, hands or that “double chin.

Soft-tissue fillers can help fill in these lines and creases, temporarily restoring a smoother, more youthful-looking appearance. Injectable fillers may be used alone or in conjunction with a resurfacing procedure, such as a laser or chemical peel treatment, or a recontouring procedure, such as a facelift. When injected beneath the skin, these fillers plump up creased and sunken areas of the face. They can also add fullness to the lips and cheeks. Injectable fillers may be used alone or in conjunction with a resurfacing procedure, such as a laser or chemical peel treatment, or a recontouring procedure, such as a facelift.

The Different Injectables You Can Choose From

Hyaluronic Acid Fillers

HA fillers are made from different amounts of hyaluronic acid and varying amounts of cross linking fibers that gives each product different characteristics.

Dr. Wilkinson recommends the newer Vycross HA technology if choosing from the Juvederm® family of fillers that also helps determine which product might be better or best depending on each person’s needs and what your individual physical exam shows.

Dr. Wilkinson uses this scientific information and combines it with the crucial physical examination (she may ask you to pull funny faces for her and move your head up and down or to the side for her) then she listens carefully to what You want and then she discusses what you need. Belotero®, Vollure®, Voluma®, Volbella®, as Vollure® Juvederm Ultra® and Juvederm Ultra Plus®

JUVÉDERM® Collection of Hyaluronic Fillers Important Information
There are 3 families of hyaluronic acid fillers: both families are made from hyaluronic acid is which is a hydophyllic (water loving) polysaccharide component of collagen that is found in all living cells.

The original family of HA fillers include Belotero®, Juvederm Ultra® and Juvederm Ultra Plus®. Each one has different amounts of HA and cross linking which determines how much water that product will attract which then in turn dictates where/when/why and how we decide to use the product based upon much water the product attracts and how long the product will likely last.
The newer Juvederm® Vycross HA technology class is different because they are made via tightly crossed HA chains so that they do not rely on attracting water like the original Juvederm products — this results in more predictable and longer lasting results because we are not depending upon how much water the product is attracting. The newer Juvederm® family of product names are Voluma XC, Vollure XC, and Volbella XC:

Finally there’s the”new kid on the block” which are the Revance® products: RHA2, RHA3, and RHA4. This newest innovation in hyaluronic acid dermal filler is from Switzerland and was developed by Madame Valerie Taupin, one of the co-creators of Juvederm. Revance® RHA daily of fillers are more resilient than other hyaluronic acid dermal fillers. It is known to be a more resilient HA filler because it was developed to work dynamically with the facial muscles.

RHA® is available for the first time in the United States in select practices like ours.

INDICATIONS (FDA Approved) but remember that we, in our doctor patient relationship can discuss and figure out the best places and ways to use the products available to us.
VOLUMA® XC is indicated for deep (subcutaneous and/or supraperiosteal) injection for cheek augmentation to correct age-related volume deficit in the mid-face and for augmentation of the chin region to improve the chin profile. Can last up to 2 years
VOLLURE® XC injectable gel is indicated for injection into the mid-to-deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds). Can last up to 18-24 months.
VOLBELLA® XC injectable gel is indicated for injection into the lips for lip augmentation and for correction of perioral rhytids in adults. Can last 12 months.
JUVÉDERM® Ultra XC injectable gel is indicated for injection into the lips and perioral area for lip augmentation in adults. Can last 6-12months
JUVÉDERM® Ultra Plus XC and JUVÉDERM® Ultra XC injectable gels are indicated for injection into the mid-to-deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds). Can last 6-12 months.

RHA Fillers

The RHA Collection currently includes 3 different types of filler—RHA 2, RHA 3, and RHA 4. Each of these fillers is specially formulated to treat different areas of the face:

RHA 2 is designed to treat surface lines and wrinkles including vertical lip lines, radial cheek lines (those that fan out from the mouth when you smile), glabellar lines (a.k.a. the “elevens”), and crow’s feet.

RHA 3 works best for treating deep wrinkles and creases, such as nasolabial folds (the deep lines that run vertically between the nose and mouth) and the corners of the mouth. It can also be used to volumize the lips and midface, and smooth the cheeks.

RHA 4 is designed to treat the deepest lines and folds, namely those along the lower face and jawline. It is also effective at contouring the cheeks to create the appearance of high cheekbones.


Radiesse® is calcium hydroxylapatite microspheres in a gel carrier. It is biocompatible, non-toxic and non-allergenic filler. Radiesse® is commonly used to reduce the appearance of facial wrinkles and folds occurring around the mouth and nose, such as the nasolabial folds and marionette lines. It may also be used to fill in some types of scars as well as to contour facial features like the chin, cheeks and jaw line. It has also been approved for the improvement of aging hands.

Radiesse® produces an initial plumping of the skin during the first three months after injection which is then followed by extended correction as new tissue regenerates. Radiesse cannot be called permanent, although it can last for up to 2 years.

Radiesse® is a safe injectable treatment, however as with any injectable treatment there are potential side effects. Minor swelling, discomfort or bruising may occur which generally clears up within a day or two. The formation of nodules is another rare but possible risk.


Neuromodulators- Botox® & Xeomin®

Botox and Xeomin injections are used to improve the appearance of dynamic lines, wrinkles and unwanted creases on your face. Dynamic wrinkles are caused by contractions of the underlying facial muscles as you smile, laugh or frown. We move our facial muscles in a repetitive way  which cause>s wrinkles and fine lines. . Neuromodulators have rapidly evolved into a popular treatment for reversing the visible signs of aging.

Botox and Xeomin can be used to improve:
  • Worry lines in your forehead
  • Lines between the eyebrows
  • Smile lines
  • Laugh lines from nose to mouth
  • Crow’s feet
How do neuromodulators work?

Neuromodulators block impulses from the nerve to the tiny facial muscles that cause these lines so the muscles do not contract. Untreated facial muscles contract in a normal fashion, allowing normal facial expression to be unaffected.

Is it safe?

Cosmetic denervation with Neuromodulators is a simple and safe procedure. Using a tiny needle, a very small amount of the neuromodulator is injected, very precisely, into several locations on the face. Because the needle is so fine and only a small amount of liquid is used, the pain associated with the injections is minimal. No anesthetic is required, and you can resume normal activities immediately. Some patients experience a slight temporary bruising at the injection site. This can easily be covered with make-up.

What benefit can I enjoy?

If dynamic wrinkles make you look older than you are, cosmetic denervation can smooth these out and give you a more youthful and rested appearance. Lines around the eyes and on the forehead, and upper lip, respond as well as horizontal neck lines. Neuromodulators can also be used in the neck region to improve the appearance of platysmal banding. These neuromodulators do not improve wrinkles due to aging and sun-damaged skin, as they are unrelated to facial muscle contractions. These injections will not improve sagging skin or replace the need for a facelift or brow lift.

What are the possible side effects?

While infrequent, mild temporary bruising is the most common side effect. In some cases, the medicine can migrate and cause a temporary weakness of nearby muscles. In rare cases, there can be a drooping of an eyelid or asymmetry of facial expression. The risk of any side effect depends on the muscles injected. Your doctor will discuss this with you in length before your treatment. Because the effects of neuromodulators are completely reversible, any side effects are temporary, lasting only a few weeks.

How long does Botox/Xeomin last?

The effects of the Botox/Xeomin injections last from about three to six months. The early clinical studies indicate that the duration of treatment benefits is increased over time so that you should require injections less frequently in the future.  Also, the duration of effect varies from patient to patient and may be less effective for those over 65 years of age.

If you would like to learn more about your cosmetic options, or find out if Botox/Xeomin treatments might work well for you, please call Dr. Heather and schedule a consultation.