Recovery from Botox and Expected Results - Berman Cosmetic Surgery Blog

Recovery from Botox and Expected Results

In this video, I discuss what results you can expect following Botox injections, as well as what recovery looks like. I always like to share that I perform Botox injections in our office myself – it is quite rare to receive injections from a Board Certified plastic surgeon!

If you’d like to talk more about Botox, please do not hesitate to schedule a complimentary, private consultation with me calling our office at 703-406-2444.

Price of Beauty: Botox and Fillers - Berman Cosmetic Surgery Blog

Price of Beauty: Botox and Fillers

People still sometimes get confused about the difference between Botox and fillers. Botox works through muscle paralysis  to decrease facial motion and help eliminate fine lines. Fillers represent a wide range of products used to enhance facial volume.

What is Botox?
Botox, like Dysport and Xeomin, are neurotoxins, which means they are injected in order to weaken the muscle contracting. The most common place they are used is the glabellar area which is the area between the eyebrows – the famous “11’s”. The next most common area is the crow’s feet, which is the area lateral (to the side of) of the eyes. The third most common site is the forehead. This has the risk/benefit of altering the eyebrow position – either raising or lowering them or not changing them, depending on how much is injected and where. Less common areas to inject these are the chin and upper lip. They are also injected into the axillary region (armpits) to stop sweating (often lasts 6 months in this area). These agents take 4-10 days to work and last about 4 months, when used in the face.

How much does Botox cost?
There is some variation in the prices for Botox to be injected. Everyone is using the same Botox (or Dysport or Xeomin), with just  3 companies controlling the entire market. It is much more expensive for physicians to buy these from the company that makes them than people realize. Some places will charge by the area (eg injecting the glabellar area) but most places charge by the unit.

Factors that may affect the price:

  1. Who is doing the injecting and what is their experience doing this?  Is it a plastic surgeon? A doctor – family doctor or other doctor? A nurse? An Esthetician? A Medispa?I personally do all of my own injections and I always have. I presently charge $12 per unit. You certainly can find it for slightly less but if you pay less, you almost certainly will not be getting a board certified plastic surgeon doing your injection himself. The highest I have come across in the Northern Va area is $19/unit. The average cost seems to be about $15/unit.
  2. Geographic area: You will almost certainly pay more in certain areas such as Bethesda, McLean or Tysons Corner than you will pay in Sterling, Virginia (where my office is location). This is just a function of the rents being higher in those areas.
  3. Groupon and other deal websites: If you get your Botox through Groupon, you may be able to pay less. However, be wary since you have no control over who is injecting you. Frequently, the places offering Groupon for Botox are not making any money on their Botox, after they pay off Groupon.

How much do fillers cost? 
The same discussion above also pertains to fillers. We are all getting our fillers from the same major companies. They are ready to inject straight out of the box. No one can make the fillers, last a longer or shorter time. Depending on the filler, they will last in general from 1-2 years with the more dense fillers lasting longer (eg Voluma – closer to 2 years) and the thinner fillers (as used in the lips or under the eyes – eg Volbella) lasting more like 1 year.

There is skill in how they are placed by the injector -both the location and the comfort. The same concerns I expressed above – who is injecting your Botox, also applies to your fillers.

The cost of the fillers are going to depend on 4 things:

  1. Which filler is being used?
    Some fillers cost more for us to buy and this is being passed on to the patient
  2. The size of the syringe:
    Is it 0.5cc or 1.0cc or 2.0cc. Of course, the more filler being injected into you, the more it will cost.
  3. Who is injecting? Is is a plastic surgeon or dermatologist or personnel at a medispa or traditional spa? As with Botox, I do own injections! Once again, this is very uncommon for a plastic surgeon to do his own injections.
  4. Geographic area:
    Once again, you are going to pay more in Bethesda, McLean or Tyson’s Corner.

Pricing will vary as per above but for most 1 cc fillers, you should expect to pay between $600-900 per cc. Volbella, which comes as 0.55 cc will be about $375-550.

 

Have questions about Botox or facial fillers? Please call my office at 703-406-2444 to schedule a complimentary, private consultation.

Surgical Facelift Alternatives - Berman Cosmetic Surgery

Surgical Facelift Alternatives

People mistakenly believe that a facelift fixes your face and makes it perfect and instantly takes many years of aging off of your face. A facelift does certain things very well, but does not address many other aspects of aging.

What does a facelift do, exactly? A facelift is primarily designed to tighten the skin and underlying muscle of the neck and face. The most dramatic change occurs in those with a lot of loose neck skin. There is some improvement in the pre-jowl area and even less improvement in the naso-labial folds. Of course, one can add things like laser resurfacing, fillers or fat transfer and Botox, and a blepharoplasty. However, you can do these other things in the office, without paying for anesthesia or in an operating room facility.

So what are some surgical facelift alternatives?
Aging is multifactorial. This means that there is not one aspect of our face that shows our age. Just a few of the many things one can do to improve your face and delay for many, many years a facelift include:

  • Picosure laser:
    almost every women over the age of 35 will develop areas of irregular pigmentation – areas that are darker and lighter than the rest of the skin. The Picosure laser, with break-through technology, fires 1,000 times faster than any other laser. This means that you can get your face (and neck and chest and hands) resurfaced, with NO DOWN TIME! You need to plan for 3 treatments, each spaced a month apart. The Picosure laser can also help with fine lines and soften your skin. It can even help with acne scarring (although this will typically require 6 treatments). It will also dramatically improve age spots on the face.
  • Chemical Peels:
    We also offer an array of chemical peels such as the ViPeel, megapeels, and pharmaceutical skin grade products to further assist in this area.
  • Smartlipo to the submental area:
    Most people develop fullness and slight sagginess to the upper central neck area (submental area). This area usually responds very nicely to Smartlipo. This area is quite small and does not require any oral sedation, meaning you can be in and out of my office in just 30 minutes and can return to work the very next day.
  • Facial Fillers:
    As we age, we lose fat in our face and experience a deepening of the nasolabial folds. These respond very nicely to fillers such as Juvaderm, Voluma and Volbella.
  • Botox:
    Crowsfeet, glabellar and forehead lines in particular respond nicely to Botox. These lines are a result of movement.
  • Upper and Lower Blepharoplasty:
    The upper blepharoplasty is designed to decrease the redundant upper eyelid skin, while the lower lid blepharoplasty can help decrease the bulging and/or the redundant skin.

If you have any questions, please do not hesitate to call my office at 703-406-2444 to schedule a complimentary, private consultation with me.

Bridal Makeover: Plastic Surgery for the Bride-to-Be

It is almost universal that a woman would like to look her very best on her wedding day. However, from a plastic surgeon’s perspective, it takes careful planning. I’ve seen women who have requested fillers and Botox within a few days of their wedding. I’ve even seen women who have requested an upper lid blepharoplasty within 2 weeks of their wedding. And ditto for a breast augmentation. Quite frankly, all of these are terrible ideas. This topic covers a broad age group: many women are having their first marriages in their 20’s and 30’s and oftentimes a second or third in their 50’s. I’m also discussing others in the wedding party in the information below.  

Of course, each woman and her wedding situation can be different. However, I think as a general principle you should ideally do fillers and Botox six weeks before your wedding. I am being conservative here… 3-4 weeks before is probably fine, but I would lean towards six weeks to be certain. This allows any bruising that may occur to completely resolve and for any fine tuning that needs to be done. Even if you “never bruise,” there is always a first time, so I recommend allowing time for that possibility. A more minor point is to be careful using Botox on your forehead before your wedding. Although getting rid of all lines and wrinkles on your forehead is appealing, those same muscles allow your brow to elevate. Anyone who has Botox injected in their forehead (this does NOT include the glabella area or crows feet), can experience eyebrow descent. This is only correctable with time!

I personally would not do a breast augmentation closer than 4-6 weeks before a wedding, and perhaps much longer if a complicated lift is required at the same time. Three months before the wedding is a better timeframe. As I said previously, I have had women request a breast augmentation the week before their wedding. I’ve told them to enjoy their wedding and honeymoon and then get their augmentation. Remember it takes up to three months for your implants to drop fully into position – and sometimes longer with a vertical mastopexy. I would recommend the same minimum three-month timeframe for a tummy tuck as well. 

SmartLipo is fine three weeks before their wedding, though the more time in advance, the better, as improvements continue to take place over a six month time frame.  

Remember, you are likely your own worst critic. While the thought of looking your very best for your big day is appealing, you want to be sure you allow plenty of time to prevent having any issues or complications on your wedding day.