Some of the most frequent concerns we hear about Botox and fillers are: how to get a natural look and how to increase the longevity of your results.

At Reflections, we put the patient first and focus on how to get the most “bang for your buck” while providing amazingly natural results that everyone will notice, but won’t be noticeable as having been from injectables or any other treatment. Dr. Mitchell Chasin is widely regarded as one of the nation’s top physician injectors, who has been named one of the most prolific injectors of fillers and Botox, earning the top awards from the makers of Juvederm and Botox for over 7 years running.

Understanding Injectables with Dr. Mitchell Chasin

When talking to Dr. Chasin, cosmetic physician, founder and medical director of Reflections, he refers to injectables as “niche” products. What he means by this, is that each type of injectable product, whether a filler or neuromodulator, has its own specific qualities, and those qualities make each well-suited to specific treatment areas and specific patients, but not good at every concern that an injectable can be used for. For example, Voluma has great lifting properties and a firmer consistency than other hyaluronic acid fillers. Meanwhile, Restylane Silk flows very smoothly, almost like water. Both are useful for https://www.reflectionscenter.com/wrinkle-smoothing-restylane-may-now-be-used-as-a-lip-plumper/, and both may actually be used in the same patient, but one cannot achieve what the other can. Where Voluma is used in the lip to restore structure in the upper lip of an aging woman with deep vertical lip lines (“smokers lines”), Restylane Silk is used to smooth out the very fine line and wrinkles on the lips, without adding volume. The problem is, it takes time and effort to learn about these products in such detail, and then it also takes a lot of hands-on training and experience to get good at understanding the individual needs of a patient based on their own unique anatomy and aging pattern. And even after all of that, it requires time and patience to understand the patient’s real desires. And it is only then that an injector can truly create a natural result that makes the patient happy, and that makes the very most of these injectables.

Maximizing Your results

Since dermal fillers and neuromodulators are temporary, it’s important to understand how long they last and the maintenance necessary to maintain results. Botox has shown to be fully effective for 3 months in new patients and then tends to lengthen in the duration of result with continued use. As for dermal filler, the longevity of results varies by patient and depends on the dermal filler used for treatment. Results from dermal filler injections can last anywhere from 6 months to 2 years.

How do I make sure I’m getting a good price on my Botox and Filler treatments?

The following list will help you find the kind of providers that have the skill and expertise to make the most cost-effective use of Botox and fillers for you:

  • Seek a provider where cost is determined by what you use, especially with Botox For example, we just don’t use that much Botox to treat the forehead, so it should cost less than crow’s feet
  • Injectors that have experience because only with a lot of experience do you start to really understand when to use each different kind of filler and how, and how to perform the really advanced techniques with Botox, like “lip flips” and “neck bands.”
  • Practices that offer all of the fillers because each filler is different, and you can’t achieve the same results with a select few as you can with a wide variety. Many people will say that Lyft is the equivalent of Voluma, or that Restylane is the equivalent of Juvederm, but that’s simply not true – and if you don’t understand that on a deep level, then you really aren’t knowledgeable enough to be providing the kind of results patients deserve. Restylane products aren’t hydrophilic in the way Juvederm products are. This means the Juvederm family of products, including Lyft and Restylane, are more precise, but not as good at adding volume as Juvederm or Voluma. This is not inherently good or bad, it’s just a nuance that only the most skilled injectors understand how to make the most of.
  • Injectors who know how to mix Botox & Fillers to treat a specific area. Many times, the best result comes from first slowing down the repetitive motions that cause a wrinkle, and then filling that wrinkle with a dermal filler. The best injectors know how to layer and combine these products to create natural and longer-lasting results.

What can I do to increase the longevity of my results?

According to Dr. Chasin, it is best to have the next treatment before the effects of the last treatment wear off. Botox, for instance, timing your treatments right prevents the muscles from fully recovering and your smoother, more relaxed appearance will be maintained. This is how you get to the point where you need less Botox over time. Choosing the right fillers for the treatment area can also be a key factor in long-lasting results. For areas that are more expressive, using a filler with a more durable formulation such as Restylane Refyne® or Defyne® on the nasolabial folds. For areas that need more lift, a deeper placement of a cross-linked product, like Lyft or Voluma, allows the filler to be safely placed below the top layers of tissue which experience the most movement and stress during facial expressions. In the past, we used to tell patients that any filler in any area of high motion was not going to last as long, because the repeated motion was really hard on the hyaluronic acid, and would cause it to break down faster. But these new cohesive gel formulations, like Refyne and Defyne, act a bit like memory foam, allowing them to better “bounce back” after repeated motion, giving them a much longer duration. In addition to understanding injectables and how to space your treatments, Reflections likes to approach treatments in a more comprehensive way by combining treatment methods such as injectables and other facial rejuvenation procedures that target skin concerns and quality.

What habits or practices could prevent my injectables from lasting?

Something we see with across the aesthetic industry is the practice of over-injecting. Sometimes less Botox or filler is more. Heavy-handed injecting can lead not only to complications and poor (unnatural or weird-looking) results but also can mean a shorter duration of result and a higher cost in the end. Also, another practice that may be preventing your results from sticking around longer is solely relying on injectables to “fix” the skin. At Reflections, we use a variety of treatments to improve skin quality from the inside-out. Some of our favorite facial skin rejuvenation methods that can be used in conjunction with Injectables are:

  • Lasers and chemical peels to skin texture issues, such as sun damage & scars
  • Non-laser rejuvenation such as microneedling, nanofat, PRP & MicroRejuve to address skin quality
  • RF Microneedling and Non-Surgical Skin Tightening treatments, such as Ultherapy and Thermage, to ensure skin is firm and tightened.

If you really love your injectables and want to address skin texture and fine lines, MicroRejuve, which uses superficial microneedling to place fillers and Botox within the very top layers of the skin, can help create a hydrated, dewy complexion, similar to effects of a laser treatment. Adding in alternative skin rejuvenation methods helps to rebuild a stronger foundation to the skin.

What injectable methods can be done for more natural looking results?

Dr. Chasin is well known for his scientific approach to injections, which affords his patients the most natural-looking results. When injecting Botox, he likes to be conservative with the forehead in order to ensure the brow doesn’t drop. Instead, he often uses Botox to create a natural brow lift, with movement maintained, to ensure the result is natural, and not “frozen.”

Nurse Tracking Botox in Patient's Chart

To make sure each patient receives a customized treatment, Dr. Chasin looks through each patient’s chart to review historical treatments and results to build a custom plan at each visit. For thorough documentation, we use a specialized medical record system that allows us to document exactly how many units of Botox were placed in each individual injection, and how much of each syringe of filler is placed in each anatomical location. This incredibly detailed documentation, along with photos of the patient before and after, allow our physician injectors to study the exact effects of these treatments on your muscles and skin – so we can learn how your body uniquely reacts, and fine-tune your treatments to maximize them.

Schedule Your Comprehensive Consultation

If you want to start getting more out of your injectable treatments, we encourage you to schedule a consultation with Dr. Chasin or one of our other talented cosmetic physicians. Dr. Chasin has dedicated his professional life to the field of cosmetic medicine. Because of this, he is part of an exclusive group of physicians who have attained ‘BOTOX® Top 250 Status’ in the country for the past 7 years running.

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