Pre- and Postoperative Gallery

Botox and Fillers

“Dr. Armstrong injected me with Botox and Juvéderm and I went straight back to work.”

Before the age of 30, some of us are beginning to notice creases around our eyes and loss of volume in our face. Lines may form between our eyebrows, at the corners of our eyes, and even across our forehead.  Our cheeks may become more hollow, our lips thinner and the shadows under our eyes more apparent. Injectable treatments and good skin care can slow the appearance of these early age-related changes.

If you are beginning to notice these changes, there are non-surgical treatments that may relax the muscles that cause wrinkles, and replace the lost volume. Muscle relaxation is usually accomplished with Botox or other neuromodulators, while volume is replaced with facial implants, injectable fillers, or fat grafts.

Botox and Neuromodulators

Botox is most commonly used in the upper face, especially for the glabellar “frown lines” between the eyes, and for the “crow’s feet” or “laugh lines” in the outer corner of the eyes.  Both of these indications are now FDA-approved for Botox Cosmetic.  Botox is also used (off-label) for horizontal forehead creases, for lip lines and for reshaping the mouth. Botox has been shown safe and effective for reducing migraine headaches, uncontrolled perspiration, and excessive salivation.  Competing brands include Dysport and Xeomin.

Read more about Botox and Neuromodulators

Fat, Fillers and Implants

Wouldn’t we love to use a little fat from our bellies to replace the baby fat in our lips and cheeks! In fact we can, but harvesting fat creates additional discomfort, and long-term results are unpredictable. Liquid silicone has been used to fill wrinkles and contour the face since the 1940′s, but occasionally created inflammatory reactions and deformities that were difficult to correct. Collagen was developed as a safer alternative to silicone, but required a skin test to avoid allergic reactions and lasted only three months. Nevertheless, many patients returned regularly for collagen injections to fine lines in the lips and face. Larger volumes were augmented by surgical implantation of solid silicone, Gortex and other plastics. Today’s treatment options include longer-lasting injectable fillers with different consistencies and intended uses. These can generally be grouped into shorter-acting hyaluronic acid fillers for superficial injections, and longer lasting fillers intended for deep injections.

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