INJECTION / FILLERS

Why Does Skin Age?

Aging skin and wrinkles result from a combination of many factors. It’s not just about cellular changes, collagen depletion, hormone loss, or damage caused by free radicals. The 11s – those vertical lines that appear between your brows – result from muscle contractions. When you concentrate, squint, or frown, the muscles between your brows contract, causing your skin to furrow and fold. After years of frequent contraction, those wrinkles can linger even after the muscles are at rest.

Figure 1: Relaxed glabellum muscles.

Figure 2: Contracted glabellum muscles.

 

BOTOX® Cosmetic works by blocking nerve impulses to the injected muscles. This reduces muscle activity that causes the persistent lines to form between the brows.

BOTOX® Cosmetic is a prescription medicine that is injected into muscles and used to improve the look of moderate-to-severe frown lines between the brows in people 18 to 65 years of age for a short period of time (temporary).

BOTOX® Cosmetic is administered by a healthcare professional as a simple, nonsurgical treatment that is injected directly into the muscles between the brows. It works by blocking nerve impulses to the injected muscles. This reduces muscle activity that causes moderate to severe lines to form between the brows.

 

 


 

 

DYSPORT – L (MEDICIS)

What causes frown lines?

Over time, repeated movement of the facial skin by the forehead muscles forms lines between the eyebrows. Frown lines are "dynamic"—they happen because of the way a person's face moves.

Are they always related to age?

No. Because frown lines are created by facial movements, such as frowning or squinting, they may develop even in younger adults. Prescription Dysport temporarily improves the look of your frown lines without changing the look of your whole face. Untreated facial muscles still work normally.

What is DYSPORT?

Prescription Dysport is an injection used to temporarily improve the look of your moderate to severe frown lines without changing the look of your whole face. The untreated facial muscles still work normally, allowing you to freely show facial expressions, such as smiling, in untreated areas.

Dysport is a formulation that has been shown to deliver temporary improvement in moderate to severe frown lines, even with repeat treatments. So, the effect of repeat treatment with Dysport may be comparable to your first use.

How does DYSPORT  work?

With just 1 injection into each of 5 points between and over the eyebrows, Dysport blocks the signal from the nerve to the muscles, ultimately resulting in a reduction of muscle activity and temporarily preventing contraction of the muscles that cause frown lines. You should not be treated with Dysport more frequently than every 90 days.

Treatment with prescription Dysport can temporarily improve the look of your moderate to severe frown lines. Treatment generally takes just 10 to 20 minutes.

The most common side effects of Dysport treatment are nose and throat irritation, headache, injection site pain, injection site skin reaction, upper respiratory tract infection, eyelid swelling, eyelid drooping, sinus inflammation, and nausea. You should wait at least 90 days between Dysport treatments.

Clinically proven results with 1 treatment

In 3 clinical studies of people whose frown lines were rated "moderate" or "severe" by a doctor before their treatment with Dysport*:

  • • 30 days after treatment, the majority (88%, 85%, and 86% in each of the 3 studies) had their frown lines rated by a doctor as "mild" or "moderate" at maximum frown. For example, a patient could improve from "severe" to "moderate" or from "moderate" to "mild".
  • •30 days after treatment, the majority (74%, 79%, and 82% in each of the 3 studies) rated their own frown lines as "mild" or "moderate" at maximum frown. For example, a patient could improve from "severe" to "moderate" or from "moderate" to "mild".

Used worldwide

Dysport is used for aesthetic purposes in 47 countries.† In the United States, Dysport was studied for safety in more than 2,400 U.S. patients, and today over 200,000 women and men have been treated with Dysport.

Demonstrated results

Improvement at every time point

A 5-month, single-dose, double-blind, multicenter, randomized, placebo-controlled study (N=300) to assess the safety and efficacy of 50 Units of Dysport vs placebo in subjects with moderate to severe glabellar lines at maximum frown1

Improvement demonstrated for up to 4 months3
(also see study GL-3 results above)

A 6-month, single-dose, double-blind, multicenter, randomized, placebo-controlled study (N=158) to assess the safety and efficacy of 50 Units of Dysport vs placebo in subjects with moderate to severe glabellar lines at maximum frown1

 

 


 

 

XEOMIN (MERZ AESTHETICS)

 

 

 

 

 

 

Understanding XEOMIN®.

“What is XEOMIN?”

XEOMIN is a botulinum toxin that is used to treat adults with cervical dystonia and blepharospasm. It has been used around the world since 2005 and was introduced to the US market in 2010 by Merz Pharmaceuticals, LLC.

XEOMIN is a prescription medicine that is injected into muscles and used:

  • • To treat adults with cervical dystonia to decrease the severity of abnormal head position and neck pain
  • •To treat abnormal spasm of the eyelids (blepharospasm) in adults who have had prior treatment with onabotulinumtoxinA (Botox®)

“What is botulinum toxin?”

Botulinum toxin is a naturally occurring protein produced by the bacteria Clostridium botulinum. Botulinum toxin type A—the active ingredient in XEOMIN—is produced commercially from C. botulinum serotype A.

“How does XEOMIN work?”

XEOMIN is injected into muscles to decrease their activity. XEOMIN blocks the release of a chemical messenger—acetylcholine—that conveys the signal from nerve terminals and causes muscle fibers to contract. Not all terminals are affected by botulinum toxin, so the muscles can still contract, just less forcefully. This allows the muscles to contract more normally.

“Are all botulinum toxin products the same?”

Not all botulinum toxin products are the same. This is reflected in the unique names for each product. The dose of XEOMIN may be different from other botulinum toxin products.

“How is XEOMIN made?”

In nature, C. botulinum produces the toxin in association with accessory proteins (toxin complex). Merz takes the toxin complex and employs a proprietary manufacturing process that isolates the therapeutic component and removes the accessory proteins to produce XEOMIN.

What to expect

“How is XEOMIN® administered?”

XEOMIN is injected directly into the affected muscles. The injection plan varies from person to person, depending on the number of muscles involved and the extent of their involvement.

“How many XEOMIN shots will I need for treatment?”

This also varies from person to person. Your doctor will decide how many sites to inject and the total dose per muscle based on your condition.

“How often will I need treatment with XEOMIN?”

Everyone is different. However, clinical studies suggest that it generally takes 7 days before most people begin to feel improvement. The effect generally lasts up to 12 weeks, but the effect in individual patients may be significantly longer or shorter.

“What are the most common side effects of XEOMIN?”

In the treatment of blepharospasm, the 5 most common side effects were drooping eyelid, dry eye, dry mouth, diarrhea, and headache.

In the treatment of cervical dystonia, the 5 most common side effects were difficulty swallowing, neck pain, muscle weakness, injection site pain, and muscle/joint pain.

XEOMIN can also cause serious side effects that can be life threatening.


 


 

 

RADIESSE (MERZ AESTHETICS)

How It Works

Collagen is what gives volume, flexibility and strength to healthy, young skin. As a part of the aging process, your own natural collagen breaks down, diminishing facial volume and elasticity. This loss of elasticity and volume results in wrinkles, facial lines and skin laxity – all of which rob your skin of its youthful, fresh appearance.

Replenish Volume. Restore Collagen. Refresh You.

Ideal wrinkle reduction is achieved by replenishing your skin's lost volume. Upon injection, RADIESSE® Volumizing Filler immediately provides the volume and lift needed to diminish the signs of aging because of the calcium-based microspheres and gel that comprise the product. But what's unique about RADIESSE Volumizing Filler is that it acts as a scaffold under the skin, providing structure and stimulating your own natural collagen to grow.1 This process continues for several months, which extends the initial effect of RADIESSE Volumizing Filler. Best of all, the natural results are clinically proven to last a year or more in many patients, which is why more and more cosmetic surgeons, dermatologists, and other medical professionals are choosing RADIESSE Volumizing Filler to achieve long-lasting facial rejuvenation.2

Why choose RADIESSE Volumizing Filler?

  • • It is the only filler that immediately replenishes lost volume and stimulates the production of your own natural collagen for long-lasting results
  • • It is clinically proven to last a year or more in many patients
  • •RADIESSE patients are significantly more satisfied than patients treated with other leading wrinkle fillers3,4
  • •It is FDA approved to mix with lidocaine to significantly reduce injection related pain5

Treatment with RADIESSE Volumizing Filler is quick, comfortable and convenient, with immediately visible, long-lasting results. Experience what millions worldwide have and begin your journey towards a naturally, more refreshed you today.

To discover what RADIESSE Volumizing Filler can do for you, call to make an appointment today.

 


 

 

JUVEDERM (ALLERGEN)

You can experience JUVÉDERM® XC injectable gel with a quick, in-office procedure and minimal downtime. During treatment, your healthcare provider will ease JUVÉDERM® XC under your skin to smooth out the moderate to severe facial wrinkles and folds (such as nasolabial folds). You’ll see the difference instantly!


 

 


 

 

RESTYLANE – L (MEDICIS) / PERLANE – L (MEDICIS)

 

 

 

 

 

 

 

The Restylane family of products includes Restylane, Restylane-L, Perlane, and Perlane-L. These products can be used to add volume and fullness to the skin to correct moderate to severe facial wrinkles and folds, such as the lines from your nose to the corners of your mouth (nasolabial folds). Restylane may also be used for lip enhancement in patients over 21 years. Ask your doctor which is right for you.

Get a more comfortable lift with Restylane-L and Perlane-L*

If you want a more youthful appearance, but you’re concerned about the potential discomfort from treatment, you can get beautiful results and a more comfortable Restylane or Perlane experience. By combining lidocaine with Restylane® and Perlane®, Restylane-L and Perlane-L help reduce discomfort during and after treatment. In clinical studies evaluating the Restylane family of products:

  • • 72% of patients reported significantly less pain during treatment with Restylane-L vs. Restylane
  • • 95% of patients reported significantly less pain during treatment with Perlane-L vs. Perlane
  • • Patients continued to experience less discomfort for up to one hour after treatment

Restylane-L and Perlane-L can be used to add volume and fullness to the skin to correct moderate to severe facial wrinkles and folds, such as the lines from your nose to the corners of your mouth (nasolabial folds). These products are not approved for use in lip enhancement.

Restylane-L and Perlane-L should not be used by anyone with a known allergy to lidocaine.

 


 

 

BELOTERO (MERZ AESTHETICS)

 

DESCRIPTION OF DEVICE

BELOTERO BALANCE is a hyaluronic acid gel. It has no color.

INDICATIONS/INTENDED USE

BELOTERO BALANCE is used to smooth out and fill in the fold or wrinkle that goes from the side of the nose to the corner of the mouth (nasolabial fold) as shown in figure 1 below.

Figure 1. Facial Nasolabial Fold

HOW IS BELOTERO BALANCE ADMINISTERED?

Your doctor will inject a small amount of BELOTERO BALANCE into the skin using a small needle. The doctor may first inject a local anesthetic such as lidocaine to numb the area. A “touch up” injection is often given 2 weeks after the first injection to get the optimal smoothing and rounding of skin or to make the effect last longer. You and your doctor will decide whether a second “touch up” injection is needed later on. In one study, 67 out of 93 subjects had a second injection of BELOTERO BALANCE. In another study, 103 out of 118 subjects were given a second injection.

CLINICAL TRIALS WITH BELOTERO BALANCE

Three clinical trials were conducted in the United States which evaluated the safety and effectiveness of BELOTERO BALANCE for a period of 24 weeks, in a total of 211 adult subjects, 18 to 75 years of age. The subjects consisted of both light and dark skin types and approximately 9 out of 10 subjects were female. In these studies an optional “touch-up” injection of a lesser volume of BELOTERO BALANCE was given to almost all subjects about 2 weeks after the first treatment.

The results indicated that BELOTERO BALANCE when injected into the skin, was clinically effective for filling and smoothing the nasolabial folds on the face. The smoothing and filling effects of BELOTERO BALANCE on the nasolabial fold were similar in light skin and dark skin type subjects. The only adverse events or side effects that were related to injection of BELOTERO BALANCE were skin reactions at the injection site. These occurred in one-third to one-half of all subjects. None was serious and most were gone in 1 to 2 weeks

Figure 2. Gradation of Facial Nasolabial Fold Appearance from Absent, #0 (Far Left) to Extreme, #4 on the Far Right