MED SPA SERVICES
As one of Austin’s original medical spas, TOC Medical Spa provides expert personalized solutions for restoring and maintaining healthy skin. All of our treatments are provided by registered nurses under the supervision of our TOC physicians.
The term “Injectables” refers to three basic categories of nonsurgical, medical-grade products used for aesthetic correction or enhancement, usually in facial areas.
The first category, known as neuromodulators or neurotoxins, include injectable medications that reduce wrinkles or produce desired changes or improvement by relaxing selected muscles in specific areas. The most popular medications used for this in the United States are Botox® and Dysport®.
A completely separate category of nonsurgical injectable used for enhancement or correction is simply called “fillers.” Fillers, which are packaged in pre-filled individual syringes, are sterile, gel-based substances that can be artistically injected by a skilled nurse or doctor to restore diminishing volume, lift tissues back into a more youthful position, address issues with lines, wrinkles, and folds, and gently sculpt or re-sculpt facial contours. Most dermal fillers are composed of hyaluronic acid, a naturally-occurring fluid that bathes the cells of plants and animals. Some popular examples of these “H.A.” fillers are Juvederm® Voluma, Volbella, Vollure, Ultra Plus, and Ultra, or Restylane®, Restylane Lyft, Refyne, Defyne, and Kysse. Another popular filler, Radiesse®, works somewhat similarly but is composed of calcium hydroxylapetite, which stimulates the body’s own production of tissue in the area of application. Sculptra®, while not a filler in the traditional sense, creates or restores regional volume gradually over the months following injection by stimulating the production of collagen, and is composed of the same type of material used in the manufacture of absorbable sutures.
BOTOX & DYSPORT Q&A
Q: Who can benefit from a neuromodulator like Botox or Dysport?
A: Healthy adults who are interested in reducing those wrinkles associated with muscular movement are generally candidates for Botox, Dysport, etc. Your provider will ask questions and examine your facial movement and appearance in order to make sure you’re a candidate for a neuromodulator and get an idea of how much medication is appropriate to use in order to achieve your desired outcome. If a woman is or thinks she may be pregnant, or is breastfeeding, neuromodulator treatment should be postponed. There are a few other diagnoses that might rule out treatment, but these are very rare and your provider’s assessment will reveal that information should that be the case.
Q: How long do the results last?
A: Individual results vary quite a bit, but most patients find that neuromodulators’ effects last between three and six months. The length of effect seems to be stable for each individual, in most cases.
Q: When will I see results?
A: The onset of the medication’s effect varies with the individual, and to some degree, with the specific medication (Dysport typically takes effect a bit more quickly). However, any onset time between two and twelve days is considered within normal range. Most injectors feel that one should give the medication up to two weeks to evaluate the effectiveness of the treatment.
Q: Does it hurt?
A: Most people find the injections very tolerable. The injection needle is very fine, which minimizes discomfort. We also can use ice to help "numb" the area prior to injecting. There is no sensitivity immediately after injections.
Q: Does my face look worse after the neuromodulator wears off?
A: Once the neuromodulator’s effects are gone and all muscular movement has returned to normal, your facial appearance will simply return to its pre-injection state. These medications simply temporarily reduce the muscular activity where they are placed.
Q: Are there restrictions I should know about before or after Botox, etc?
A: For three or four hours after treatment, it’s best to avoid vigorous exercise. In addition, please don’t massage or allow any pressure to be put on the area of treatment, and please avoid bending or lying down during that time. There’s nothing you need to purposely do to make the medication “work” or “word better/ faster” like trying to make certain facial expressions or movements; instead, please simply avoid those activities listed above for the recommended three or four hours.
Q: How is cost determined?
A: At TOC MedSpa the cost of your medication is based on the amount of medication needed. This is determined by an established per-unit rate, so that each individual is charged only for the dosage they require. We offer a discount for pre-booking your next neuromodulator appointment at the time of your treatment, which is a popular option. In addition, both Allergan (manufacturer of Botox® and the Juvederm® family of fillers) and Galderma (manufacturer of Dysport®, Sculptra®, and the Restylane® family of fillers) offer rewards programs that give members points for treatments that translate to savings on subsequent treatments with their products. TOC Medical Spa is an approved provider for both rewards programs, and our friendly staff can help you with enrollment appropriately if you need assistance. Links for rewards system below.
Q: Who is a candidate for filler?
A: In general, any healthy adult who would like to enhance or rejuvenate their facial appearance might do well to consider receiving filler from a skilled injector. In consultation with your provider you’ll be asked about your health and medical history and your goals and appearance assessed for suitability of filler treatment. If a woman is or thinks she may be pregnant, or is breastfeeding, filler treatment should be postponed.
Q: How long do fillers last?
A: The longevity of fillers varies with the type and amount of filler as well as the age, anatomical characteristics, lifestyle, and metabolism of the individual client. Typically, most fillers last from ten to eighteen months but some can last longer with periodic touchups. Your provider can give you more information about the approximate length of time you can expect with your filler(s).
Q: What should I expect after my treatment session?
A: Immediately after your filler treatment, the area treated will usually be slightly pink, and typically will begin to experience some swelling, which will vary with the individual, amount of filler used, and area of treatment. Swelling with fillers usually peaks at around 24-36 hours and then diminishes, disappearing in two or three days on average. It’s not unusual to have some bruising at or near the site of injections. Reducing activity and gentle application of crushed ice can reduce aftereffects and speed recovery from treatment. Makeup can usually be worn after filler, but check with your provider for specifics.
Q: What kind of discomfort should be anticipated?
A: Most people experience little discomfort after filler treatments, but the use of gently applied ice helps with both discomfort and swelling. What discomfort there is generally results from the swelling associated with filler treatments, and acetaminophen (Tylenol) is very helpful if taken for the first 24 hours or so.
Q: Are there things to avoid before or after getting filler?
A: There are no universal restrictions to observe before filler treatment, but your provider might make some suggestions for the purpose of reducing the tendency to bruise or experience swelling, such as avoiding NSAIDS like ibuprofen, Omega 3/fish oil supplements, flaxseeds, and vitamin E for a few days, and avoiding alcohol for 24-48 hours before filler. After filler treatment, it’s preferred to avoid exercise for 48 hours, and avoid items on the preceding list for several days. It’s also important to try to avoid anything that places firm pressure on the area for a day or two. Your provider will go over specifics with you for your individual aftercare plan.
Q: How do I know which filler will work best or how much I need?
A: Because every filler has different properties such as viscosity, firmness, and spread, it’s best to ask your provider to help you understand which filler or fillers are likely to give you the results you’d like. Your provider can also assess the volume of filler needed to correct or enhance your area(s) of concern and explain this to you before any treatment is undertaken.
Q: Can filler be dissolved or reversed?
A: The majority of fillers (Juvederm, Restylane) are composed of hyaluronic acid, and as such can be reduced or dissolved with enzyme (hyaluronidase).
Q: Can fillers help with scars?
A: While it’s true that some scars can be improved by careful injection with filler, there are some types of scars such as certain acne scars that simply won’t respond favorably to filler. Once your provider has assessed the scar(s) fully, they will be better able to direct you as to whether filler will be helpful.
Q: What is the difference between Sculptra and fillers?
A: While both Sculptra and filler can add volume to tissues, they are very different in composition, longevity, and mechanism of action. Sculptra (injectable poly-L-lactic acid) works by stimulating the person’s own production of collagen to help provide more structure to the skin. This is particularly important because as we age our skin produces less and less collagen, resulting in weakening of the inner structure of the skin. As skin’s structure weakens, it is less able to function to maintain elasticity and moisture, and the loss of youthful support and skin volume also contribute to the development of lines, wrinkles, and folds. Sculptra requires multiple treatment sessions, which can be administered every 4-6 weeks, and produces improvements subtly and gradually over time.
Q: How do I know if I’m a good candidate for Sculptra/where would it be helpful?
A: Sculptra is often used for volume restoration in areas of diminished skin structure overlying age-related loss of supportive fat compartments. For example, Sculptra is popular for improving the appearance of cheeks, temples, and nasolabial folds. Your provider will help you determine whether Sculptra will be helpful for you as well as its amount and placement.
Q: Do the effects of Sculptra show immediately? How long do they last?
A: Sculptra is a material that works subtly and gradually. Once injected, it begins immediately to work deep within the skin to reinforce its inner structure and restore volume, and continues to do so for up to and often well beyond two years. Visible effects begin to appear within a few months after the initial treatment, and gradually increase over the course of the required several treatment sessions.
Q: What is the recovery like after Sculptra?
A: Once your provider has performed your injection, she will massage the treated area for a few minutes. This is something you must also do several times a day for the first five to seven days, according to your provider’s instructions. It’s helpful to apply an icepack for the first 24 hours to help with swelling. Acetominophen (Tylenol) may be taken if desired for the mild discomfort sometimes experienced, and makeup can be applied after a few hours if desired. It’s important to avoid sun and UV exposure for a few days.
Your provider will ask you about medications and supplements that you take regularly, and whether you are prone to facial cold sores. Discussing this in advance can help both of you determine the best approach and timing for treatment, as with any aesthetic treatment. Many people plan to arrive a half hour before their appointment time for filler so that they can apply our topical anesthetic cream to the area; this helps minimize any discomfort associated with treatments involving injectables.
Not sure what you need, but want to chat with a nurse provider? Give us a call at 512.533.7317 or by requesting a complimentary consultation below.
All injections are performed by Registered Nurses under direct supervision of TOC Eye and Face Physicians.