Turning Back the Clock Without Surgery

By D.J. Verret, MD

The most common non-surgical facial rejuvenation procedures include dermal fillers and neuromodulators. Both are excellent at providing temporary facial rejuvenation. In some cases, these temporary solutions are the best options where no effective long term solution has been devised. It must be remembered that each product works in a different way and is used to address different problems.

When a physician talks of dermal fillers, they are talking of a class of medications which is injected into the deep layer of skin, the dermis, which provides volume to the skin. These medications are used to soften facial wrinkles and depressions. There are several on the market in the United States though most are temporary lasting 6 months to a year (though individual results will vary). There is currently only one United States approved product for permanent dermal filling. In general, dermal fillers are good at correcting lines which are created at rest, not during muscle motion. This means that if you look in the mirror without smiling and see a line that you want to fix, a dermal filler may be for you.

Because of the long track record of dermal fillers and their long safety record, some physicians have starting using them in off label ways as a non-surgical alternative to some common surgical procedures. Non surgical nosejob and non-surgical face lift procedures can be performed in the office setting without down time.

Neuromodulators, on the other hand, work well for wrinkles and fine lines created by muscle motion. The currently approved US neuromodulators are based on different formulations of purified botulinum toxin. The injection temporarily paralyzes the muscle which causes the wrinkles that a patient is concerned with. Unfortunately, the medication is non-selective and when used incorrectly can produce untoward results. The effect generally lasts about 3 months though results are variable.

There are risks with both neuromodulators and dermal fillers. Consultation with a trained and experienced surgeon is always necessary before undergoing either of these treatments. Having a physician nearby in case of complication can be lifesaving. - 30516

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