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NEW YORK CENTER for FACIAL PLASTIC & LASER SURGERY
ANDREW A JACONO, MD, FACS
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BOTOX / RESTYLANE
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VIEW MORE PLASTIC SURGERY / RESULTS: Rhinoplasty / Nose Reshaping - Eyelid Lift - Mini-/Multiplanar Facelift - Endoscopic Brow / Midface Lift - Ear Reshaping - Lip Augmentation - Laser Resurfacing / Skin Peels - Chin Shaping / Neck Liposuction - Botox / Restylane - Fraxel Laser Resurfacing
 Facial Cocktails: Botox™, Juvederm™, Restylane™, Radiesse™ and Collagen
Although this frothy title might suggest an intoxicating mixed drink for a patient who has undergone the knife, these elixirs are not alcoholic. This cocktail is a combination of injectable treatments, which when performed at the same time can provide extremely rejuvenating results. They represent a gentler alternative to a face lift by using plumping fillers and Botox. Although their results are temporary and not as dramatic as a face lift, injection cocktails are sufficient for patients in their 30s, 40s and 50s.
It is important to use a combination of fillers at the same time, as different fillers (JUVEDERM™, Restylane™, Radiesse™) treat different surface wrinkles and folds depending upon their depth . Fillers are like spackle, they fill in lines. The type of injectable that is used is dependent upon how deep the lines and they atre described below.
One of the important components of the Facial Cocktail, is the use of Botox to lift portions of the face. The way to understand how Botox lifts the face is to understand that there is a constant tug of war going on in any section of the face. There are muscles that lift a portion of the face (for example the eyebrow) and opposing muscles that pull it down. If we inject Botox in the muscle that pulls things down, the muscle that lifts wins, and the results is that that portion of the face is lifted.
This also works when injecting Botox into the muscles that pull the corner of the mouth down, causing the marionette lines to flatten as the muscles that lift this area work unopposed. Another place where Botox is used is on the paired vertical bands in the neck that run from the chin to the chest. These bands are the platysma muscle of the neck, and they are apparent because this muscle pulls down when it is tensed. Generally speaking, a 40-50% improvement is obtained with the lifting affects of Botox.
The cocktail is the result of combining these lifting Botox injections with facial fillers.
You laugh, your frown, and you concentrate. And over time, those expressions leave their mark upon your face. Wrinkles around the eyes ("crow's feet"), between the eyebrows ("frown lines"), and forehead wrinkles are caused by contractions of delicate underlying facial muscles. Until today there wasn't a lot you could do about it. Today there's BOTOX® Cosmetic, a simple, nonsurgical procedure that can dramatically reduce even your toughest wrinkle within days by preventing these muscles from contracting. Dr. Jacono is a member of the BOTOX® Cosmetic Physician's Network.
| BOTOX® injection to the frown lines between the eyebrows. |  |  |
| BOTOX® injection to the "crows feet" around the eyes. |  |  |
Now FDA approved, BOTOX® Cosmetic is a unique aesthetic treatment to temporarily improve the appearance of forehead lines by targeting the muscles that cause them. BOTOX® Cosmetic is minimally invasive and localized, and no recuperation time is required.
Botox blocks the impulses from the nerves to tiny facial muscles that are related to expression lines. After treatment the muscles relax and the overlying skin remains smooth and unwrinkled. Untreated muscles still contract allowing for normal facial expression to be unaffected. Botox has been used for over ten years to treat many neurologic disorders and is safe and effective. Botox injections will last approximately 4-6 months, and must be repeated. For more permanent improvement of frown lines between the eyebrows Doctor Jacono may suggest a surgical procedures called an endoscopic browlift.
Doctor Jacono uses a tiny microneedle to precisely inject a very small amount of Botox into several locations of the face. Pain is minimal because the needle is so fine and small amounts are injected.
The photographs above are before and after photographs of one of Doctor Jacono's Botox patients. This is an actual result and has not been altered for presentation here.
| Juvederm™ Restylane™, Radiance and Collagen Injections. |  |  |
JUVÉDERM™ is the latest dermal filler advance from Allergan Inc. JUVÉDERM™ is a "next generation" smooth gel, non-animal dermal filler offering a natural look/feel and long-lasting results for up to six months or longer.
JUVÉDERM™ dermal filler lasts long because it's the only dermal filler currently available with the highest concentration of hyaluronic acid and a special formulation process. This process creates a smooth gel that flows easily into the skin, creating smooth, natural looks.
All other currently approved hyaluronic acid dermal fillers use a gel particle suspension formulation. These gel particles can be visibly seen as opposed to the smoother formulation used in JUVÉDERM™. The smooth consistency of JUVÉDERM™ dermal filler also may help to minimize the discomfort that can sometimes occur during the injection procedure.
As an expert injector, Doctor Jacono was part of the primary trial in the US called the JET trial to evaluate the efficacy of Juvederm. He is one of a few surgeons in the region who has vials of JUVEDERM available for treatment.
Restylane™ treatment is hyaluronic acid in the form of a crystal clear gel that adds contours and fills depressions to smooth facial wrinkles and folds. It lasts between 6 and 9 months, and no allergy testing is necessary.
Because Restylane is completely natural and contains no animal ingredients, pre-testing for possible allergic reactions is not necessary. Gaining the look you desire is as easy as it is quick. And the results are instantaneous.
Dr. Jacono ensures your comfort during treatment by administering a local anesthetic first, much like the kind dentists prefer. During JUVEDERM, Restylane, or Collagen treatment, the gel is injected into the skin in tiny amounts. The gel fills the skin’s wrinkles and depressions by plumping it with natural volume brings a rebirth of smoothness to the surface.
Radiesse™ is presently the newest and most promising long term soft tissue wrinkle filler, with results lasting 1 to 2 years, and no reported side effects or allergic reactions. Radiance consists of calcium hydroxylaptite, a primary component of teeth and bones, and is supplied in an injectable form which remains soft, pliable and non-calcified. FDA has approved such for use in the human vocal cord. Cost for a 1cc syringe is $1500.
Collagen injections attempt to replace the loss of collagen in the deeper layers of skin, called the dermis, that we acquire with age. Collagen injections will last between three and four months depending on how quickly your body metabolizes it.
Before undergoing collagen injection you will require a skin test. If after 30 days you have no reaction you can begin your treatment. The amount of collagen Doctor Jacono uses and timing of maintenance repeat injections will vary depending on your age and skin constitution.
How long do injectable treatments last? This depends on individual factors such as your age, skin type and lifestyle.
VIEW MORE PLASTIC SURGERY / RESULTS: Rhinoplasty / Nose Reshaping - Eyelid Lift - Mini-/Multiplanar Facelift - Endoscopic Brow / Midface Lift - Ear Reshaping - Lip Augmentation - Laser Resurfacing / Skin Peels - Chin Shaping / Neck Liposuction - Botox / Restylane - Fraxel Laser Resurfacing
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