Botox Cosmetic
Restylane
Juvéderm
Evolence
Radiesse
Sculptra
Autologous Fat
Preparing for Your Procedure
The Duke Difference

Volume loss in the face is one of the primary causes of facial aging. Replacement of facial volume loss in an artistic manner with injectable fillers creates a more youthful appearance with very little downtime. A short office procedure can take years off of your appearance in just a few minutes.

A variety of fillers including Restylane®, Juvéderm®, Evolence®, Radiesse®, and Sculptra™ are most often used.

Botox® Cosmetic

Botox has been used for medical therapies since the 1970’s, but it's cosmetic use was only approved in 2002. It is a purified protein that allows the muscles beneath the skin to relax, thus causing less dynamic wrinkles from repeated movements of the face (crow’s feet, forehead wrinkles, and the like).

Botox is most often used to treat wrinkles around the eyes and forehead. In addition to its cosmetic uses, Botox can also alleviate depression, migraine headaches, and some facial pain and can minimize hyperhydrosis (excessive sweating) of the hands or underarm.

Botox is not advisable for patients with myasthenia gravis or Eaton-Lambert syndrome.

You will begin to enjoy the effects of BOTOX in about five to seven days, and the effects usually last up to four months.

Restylane®

Restylane was FDA approved in 2003 for the treatment of depressed wrinkles of the face that remain apparent when the face is perfectly still. It is a volume-filler that allows immediate results which can last up to 18 months.

Restylane is a gel made of hyaluronic acid, a naturally occurring substance in the body which contributes significantly to cell growth and movement. The full term for the substance is NASHS (Non-Animal Stabilized Hyaluronic Acid). 

Restylane is extremely safe. The FDA does not require skin testing for this product, so you can achieve results on your initial visit. 

Juvéderm®

Juvéderm was introduced as another hyaluronic acid filler in 2006. Juvéderm is a smooth consistency gel made of hyaluronic acid -- a naturally occurring substance in your skin that helps to add volume and hydration.

Many patients enjoy the smooth, natural feel of Juvéderm and like that it comes in two different consistencies -- Juvéderm Ultra is thinner and Juvéderm Ultra Plus is the thicker. Your physician will help you decide which is best for your needs. 

The results from a Juvéderm treatment are immediate. 

A small amount of bruising and swelling are possible and may take a few days to resolve. An excellent quality of Juvéderm is that any noticeable lumps or bumps can be dissolved one to two weeks after the original procedure, should the patient desire. 

Evolence®

Evolence is a natural collagen-filler introduced in 2008 that mimics the collagen in your own skin. The makers of Evolence claim that it tends to bruise less than some of the other fillers. 

Radiesse®

Radiesse is a dermal-filler made of calcium-based microspheres suspended in a water-based gel that is best for deep facial contouring of the nasolabial folds and cheeks. The makers state that Radiesse stimulates your body to produce your own collagen surrounding the injected area, thus promoting a longer lasting effect.

A small amount of bruising and swelling is possible and may take a few days to resolve.

Sculptra™

Sculptra is made of poly-L-lactic acid. It is currently approved for filling deep hollow areas of the cheeks for patients infected with HIV. It does not require a skin pre-test, so you can achieve results on your initial visit. It is used for facial fat loss for many patients with cosmetic concerns that do not have HIV. 

Autologous Fat

Autologous fat injections were mainly used in the past for patients that were allergic to collagen. Now it is used only in cases where patients want large areas of volume replacement.

This is a larger surgical procedure and can be done if you and your physician decide that you are an ideal candidate. Fat injections are not good for fine lines around the mouth because the fat is too thick.

This procedure is done with a sterile surgical field in an operating room, not in an office environment like other injectables.

Preparing for Your Procedure

Before Your Procedure

Before your treatment, we recommend you stop taking aspirin, vitamin E, fish oil, and ginko for one week prior to the procedure with the permission of your physician.

A typical treatment involves a discussion with your doctor about your areas of concern, what you are hoping to achieve through the procedure, and what to expect during the surgery. 

During Your Procedure

Topical and injectable anesthetics may be used to decrease discomfort during the procedure and may take 15-20 minutes to take effect. The injection treatment may take another 15-20 minutes.  

After Your Procedure

Post-procedural care includes the following:

• Ice as tolerated for one day
• No heavy exercise for one day
• No alcohol for one day
• No hot baths or showers for one day
• Over the counter Arnica Montana may help bruising resolve if there is any

The Duke Difference

At Duke, there are no nurse injectors. All injections are performed by highly experienced physicians who will leave you with an improved and natural look.