Articles Written by Bruce G. Freund, D.D.S.

Great question! TV and print media are inundating the world today with products and procedures to make us look younger. There are creams and lotions that promise to reduce the signs of aging. Others promise to correct skin damage or protect you from further damage that has occurred through the normal aging process, through sun exposure or by poor health or diet. 

The truth is there are many good products out there that will help. Some are available over the counter, but the ones that will generally help the most are the products that are available through healthcare professionals. This is due to the fact that the ingredients in these products are stronger and, therefore, more effective. The big part of the question then remains: “What do you do when products just aren’t helping?” 

At one time the only thing you could do to look younger was to have surgery. Many people found this an unpleasant choice. They were afraid of surgery and the possibility of post surgical complications; there was a considerable financial investment, the results were permanent, and they needed time to heal so there was considerable “downtime.” 

The cosmetic pharmaceutical companies stepped in and began to manufacture injectable products that—although temporary—could give you back a youthful look by reducing lines, wrinkles and facial folds. 

These are the products we hear so much about today: 

Botox is probably the most familiar of the injectable cosmetics. It is a neurotoxin that relaxes the muscles, which in turn eliminates the lines that can often make people look angry or tired. It is typically used between the eyebrows, around the eyes and on the forehead. Patients are often confused and ask for Botox to fill wrinkles and folds. Botox is not a filler; it cannot fill wrinkles and folds, or replace lost volume. Botox usually takes three to five days to show results, but changes can occur as quickly as one day or take as long as two weeks. Results will generally last from three to five months. 

Restylane, Perlane and Juvederm are hylauronic acid gels that are clear in color. They are injected below the skin to fill in a wrinkle or a fold or to replace lost and desired volume. These fillers are injected into different areas of the face, for example, the lips (lip augmentation), the nasal-labial folds (those lines that go from the sides of your nose toward your mouth), the marionette lines (the lines from the corners of your mouth that go toward your chin), the cheeks (cheek augmentation), the jaw line and even the nose, to correct slight imperfections. All of these lines/folds and loss of volume tend to cause us to look older than we feel. Results are instantaneous and can last from four months up to more than a year. 

Radiesse is a calcium-based material that also falls into the dermal filler category. Radiesse dermal filler is made from a biocompatible substance that’s identical to what is naturally found in the body. It is white in color so it is not used in the lips. As with all the fillers mentioned, Radiesse has virtually no risk of allergic reaction, and there have been very few side effects reported in clinical trials and actual use. Each product can/will last a different amount of time on different people, but with any of the products chosen you will have a result that will truly diminish lines and wrinkles and make you look younger. 

That’s easy; you need to choose someone whose ability you trust and who has been well trained in administering injections. There are many fine injectors out there. Not every medical professional was taught to administer facial injectables as part of his or her medical training. Many practitioners that are injecting were taught by taking continuing education courses and then by practicing their craft. At one time, facial injections were done primarily by dermatologists and plastic surgeons. Now many other medical professionals are performing these procedures. But as with anything else, there are some healthcare professionals who are just better injectors than others, some just by virtue of the fact that they were trained to inject as part of their professional training. 

As a dentist, and one trained in dental cosmetic procedures, I found that I had to use my artistic skills, and so providing this service to my patients was a natural progression. They wanted beautiful teeth and smiles and they asked me to do it. Dentists are trained to administer anesthesia as well as perform the dental procedure. This means that by nature of their profession, dentists have to be very good injectors. Patients trusted my judgment and ability and they were already comfortable with me giving them injections since I always worked in their facial area and had given them injections as part of their dental procedures. You need or should feel this level of comfort and trust in the person you choose to inject your facial injectables. 

Now although these are non-surgical procedures, they are not without some discomfort. Botox injections are quick and relatively painless. Filler injections, especially those in the lips, can be quite uncomfortable, but the fact is, when the injection is over, so is most of the discomfort. Dentists, and some other healthcare professionals, are able to reduce most of the pain by giving you an anesthetic block, which will numb the area to be injected. Dentists give intraoral (in the mouth) injections every day, and by giving injectable fillers in this manner, there is a reduced chance of any bruising or swelling as compared to injections that are given externally. Intraoral injections allow you to return to your normal activities immediately with minimal evidence that any procedure was performed. 

Experienced injectors with advanced training can use many of these products interchangeably or in conjunction and in various other ways to enhance the outcome. Whatever procedure you decide you need/want should be done in conjunction with a consultation with the healthcare provider you have chosen. You need to be verbal in expressing what it is that bothers you so that together you can come up with the best treatment plan. Your ideas may not be what will yield you the result you desire so be open to the doctor’s suggestions about what procedures/ products may be best for you. He/she should be well versed in the products and should guide you in choosing the product that will produce the best results for the area in need of the correction. 

The beauty of these injectable procedures is that you are always in control of how you look and how much you want to spend. It can be something you just want to try once and may decide not to do again but more than likely the results are something you will love and you will want to continue as needed.