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Aggressive New Dysport "Love it or Leave it" $150 Rebate Extended through September!
Dysport is an FDA-cleared anti-wrinkle injection that is the first real competition for Botox. As a way to entice patients to try their product, Dysport is running a “Love it or Leave it” challenge. When you have a Dysport treatment before the end of September, you'll receive a $75 rebate on your first visit. If you are happy with the results after 15 to 30 days, Dysport will provide you with an additional $75 rebate on your next Dysport injection. 
Here's what makes it interesting: If you don't like the results from Dysport and decide you are not happy with the product, Dysport will give you a $75 rebate on your next treatment even if you use Botox! Love it or Leave it.
Read Dr. Reath's blog post "Dysport: Six Months and Counting" for more information. Let us know which you like better in the comment section!
It's a great time to be over 30.
Never before have there been so many nonsurgical solutions for facial aging.
New scientific studies confirm that the combination of injectable Hyaluronic Acid Fillers (like Juvederm or Prevelle) with Botox produces a result that is far superior and longer lasting than either one alone. The latest research confirms the long-lasting results we are experiencing here in our Knoxville plastic surgery office.
This union of products allows us to treat wrinkles and folds over the entire face as well as adding shape and volume where needed.
 Breaking News!
(2/3/2010) We have our first supply of the FDA-cleared Juvederm XC, the newest hyaluronic acid injectable filler formulated with lidocaine for greater comfort. Studies show that 93% of the patients treated with Juvederm XC had less pain than when treated with the non-lidocaine formulation of Juvederm.
We did our own side-by-side study and here is what our patient had to say:
I recently got to try Juvederm XC and I must say that I am a believer in this product!
Jill first applied a topical anesthetic around the nasolabial folds
(creases that run from my nose to the corners of my mouth). She then
proceeded with a very small injection of the Juvederm XC, waited 2 or 3 seconds for the numbing agent to take effect, and then completed the
injection. Other than the initial needle stick (which is really quite
minimal), the whole process was painless. Compared to previous
procedures I was actually able to sit back and relax.
At the last minute, we decided to add some filler to the lower corners
of my mouth, where we had NOT applied a topical. Using the same process - a small injection, wait a few seconds, and then complete the injection - it was still a very comfortable process. I really believe that I could have done without the topical altogether, which will save me 20-30 minutes of "numbing time" on my next visit.
Post-treatment was also a much improved experience. I typically review a lot of paperwork during the work day, so I am constantly looking down. The XC formulation really made a difference, as I was so much more comfortable compared to previous treatments without XC.
My recommendation -- If you decide to use a filler, be sure to ask for
Juvederm XC!
Injectable Fillers are even better combined with Botox or Dysport!
As we have become more familiar with both Botox or Dysport and injectable fillers, we have several new options and areas that can now be treated. Below are some of the new applications for Botox/Dysport and wrinkle fillers together. We are learning more every day and travel frequently to bring the latest advances to our patients. So if it has been a while since you have been in to see us or if we previously weren't able to treat your area of concern, please schedule a free injectable consultation appointment with Dr. Reath. You'll be glad you did.
Eyes-
Botox works wonders in the Crow's Foot Area as you can see from the picture below.
Fillers are the treatment of choice for inherited or age-related hollowing under the eyes. OK, maybe the fact that this has been on Oprah six times in the past year has contributed to the number of patient requests we are getting. In this case the buzz is right.
Injectable hyaluronic fillers, especially Prevelle Silk, are proving to be a great option for correcting an area that previously has been very hard to treat. If you have a hollow area under the eyelid combined with a natural dark color in your skin, you know that it can produce a tired look that is very difficult to conceal with makeup. Adding volume with a filler improves the contour of the lower lid, which will give the appearance of being more youthful by eliminating the hollow and its shadows.
Below you can really see the difference under her eyes after her Prevelle Silk Treatment!
Here is a perfect example of dramatic improvements that can be made without surgery, recovery time and at a relatively low cost. She is 48 and was concerned with aging around the eyes. Nurse Injector Jill Maze used Dysport in her crow's feet and a tiny bit of Prevelle filler under the eyes. What a difference!
Forehead-
Botox is used to prevent the muscle activity, which causes wrinkles on the forehead.
Below are two patients in their early 40's who are pictured lifting their eyebrows before and after their Botox procedures. Both said they look at least five years younger now.
Brow Area-
The frown line in the area between the eyes (glabellar region) is treated with Botox to stop the muscle motion. Juvederm or other wrinkle fillers are added if you have more pronounced wrinkles here.
Nose-
Although "bunny-nose" wrinkles are cute for kids, they are not at all attractive once we get older. A bit of Botox makes them disappear. Wrinkle fillers are often used to contour the bridge of the nose, if that's a concern.
Mouth-
To Create A More Cheerful Expression
Botox can bring a real smile to your face! As you age the corners of your mouth can turn down. When you add a tiny bit of Botox to the DAO muscles that cause this, the effect is striking. The corners come up to a normal level, and lose that scowling downward turn. You look happier. Want even better news? Since it doesn't take very much Botox, treating the DAO area costs much less than treating any other area. (Now you're really smiling!)
Juvederm works beautifully to fill in the fold that runs between your nose and the side of your mouth (See the photo below). A tiny dose of Botox with the addition of Juvederm corrects pursed lip wrinkles above the mouth. Here is a 40-year-old patient before and after wrinkle fillers.
Lips-
Injectable fillers are the best way to restore full youthful lips. You can choose to create greater definition of the lip line, add volume to the lips and even lift the corners of the mouth to create a more cheerful expression.
Before and After: This is a 39 year old patient who was concerned about her lips and nasiolabial folds. She received one syringe of Juvaderm Ultra Plus to her lips and one syringe of Juvaderm Ultra to the nasiolabial folds. The patient had a great result and restored fullness in her lips.
You Pick Your Look-
One of the things everyone loves about injectable fillers is that you can choose to use a lot or a little depending on the look that you want to achieve. Use Juvederm to restore natural youthful looking lips like those pictured above, or use more Juvederm Ultra Plus for a voluptuous glamorous look like below. It's completely up to you!
Chin -
Again, BOTOX® can be used if muscle activity is creating wrinkles. In many cases Juvederm alone will give you the contouring correction you want.
Jaw Area-
Juvederm is used to contour the jaw line and is very effective when the laxity of the skin is minimal.
Other areas-
Because hyaluronic acid fillers mold so beautifully, they can be used to fill in depressed areas, contour irregularities, skin defects and acne scars all over the face.
Here is an interesting wrinkle: Dysport
Botox finally has competition. The "new" injectable Dysport, a form of botulinum type A, is available after being cleared by the FDA. Dysport is the first product to challenge Botox in the United States. You should know that it has been competing with Botox in Europe for over 20 years; yet, Botox dominates with an 83% market share throughout the continent.
There is a learning curve with any new product, but particularly so with Dysport. Because Dysport is diluted more than Botox, clinicians not adept at determining how many units to inject may be confused with the new product. It is important to understand that they are not interchangeable as it takes more units of Dysport than Botox to treat an area. Unlike other offices, we will use whatever is needed of either product to guarantee you get the results you want.
Clinical studies of Dysport report that it "spreads more" during injection. This can be both a good and a bad thing. It is good in large areas like the forehead or the armpits to treat excessive sweating. It is bad for an inexperienced injector without a good understanding of the more complex musculature (around the eyes, between the eyebrows). In this case, it may spread into unwanted areas causing side effects like droopy eyebrows.
It is too early to tell which product lasts longer so we are closely evaluating Dysport to determine it's effectiveness. Based on the European experience and a recent study in the Journal of the American Academy of Dermatology, we suspect that Botox has the advantage. On the other hand, Dysport does take effect quicker. If you are short on time before a big event, we do have Dysport available.
Our patients know and love Botox. We are very pleased that they have designed Brilliant Distinctions, an aggressive new loyalty program designed to keep Botox patients happy. (This can only be a good thing.)
Needless to say, things are heating up in the wrinkle-relaxing world. We expect Dysport will not be the only product to challenge Botox. PurTox, by Mentor Corporation, is in the process of obtaining FDA clearance and should also be available very soon.
* About Evolence-
There is a new filler made from pork collagen on the market called Evolence. It is being advertised here in Knoxville. We have decided not to carry Evolence in our office at this time. With the variety of new fillers on the market, it is important to understand that just because a product is new, doesn't mean that it is better. Evolence is not the first filler we have passed on. Recently we evaluated and decided not to carry Artefill, Sculptra and Elevess because we did not feel they brought value to our patients.
A benefit of collagen fillers versus hyaluronic acid fillers is that some patients may experience less swelling initially after the injection with collagen. However, Evolence is not approved to be used in the lips, the area most likely to swell.
In addition, there are reports of side effects not seen with Juvederm or Prevelle. These include the development of hard nodules: small areas of firmness under the skin at the treated sites that may be noticed when the areas are pressed upon.
There is a different form of Evolence that is used in Europe called EVOLENCE® BREEZE™. It has a more finely textured consistency and therefore should be able to be used in the lips. We will evaluate it if it becomes available in the United States. As Dr. Reath points out, "you can't go wrong with the gold standard- Juvederm".
Introducing Jill Maze, RN
Jill Maze is a welcome addition to our practice. Her patients attest to both her caring bedside manner and her skilled professionalism. Under the direct supervision of Dr. Reath, Jill’s extensive training and gentle touch is a winning combination. She is an active member of the American Society of Plastic Surgical Nurses.
Since the FDA’s approval of Juvederm and other fillers, Jill has been focused on training with the southeast’s most renowned experts in Cosmetic Injectables in both Atlanta and Boca Raton, Florida. This year she traveled to Las Vegas to be in the first class in the country to attend the Advanced Injector Competence Training Course designed by the American Society of Aesthetic Plastic Surgeons. In addition, she received specialized instruction on techniques for using Botox® for areas other than the upper face. She is also trained and experienced with the recently FDA-approved semi-permanent filler Radiesse.
This area requires a unique blend of artistry and science as well as the need to stay current, so Jill will continue to travel the U.S. to observe the leaders in her field. When she is not traveling and taking care of patients Jill likes to spend time with her husband and two teen-aged daughters camping in the great outdoors.
If you have questions about Botox, Restylane, Evolence, Dysport, Prevelle, Juvederm or Radiesse, email Nurse Injector Jill Maze at JillM@dbreath.com
BOTOX® is a registered trademark of Allergan, Inc., and JUVEDERMtm is a trademark owned by Corneal Industries SAS.
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