Botox injections are the best known of a group of medications that use various forms of botulinum toxin to temporarily paralyze muscle activity. Botox can be injected into humans in extremely small concentrations and is FDA approved to temporarily soften facial lines such as: frown lines (the “elevens”); crow’s feet (fine lines on the outside of your eyes); brow furrows.
Dermal fillers are substances that temporarily soften wrinkles when injected into your skin. How long the effect lasts depends on factors such as the type of wrinkle and filler used. Unlike Botox injections that relax the muscle under a wrinkle, injectable dermal fillers, contain a naturally derived or synthetic gel-like substance that sits beneath the skin to smooth out wrinkles or add volume to facial features. Dermal fillers can be used to moderate deep lines around the nose or mouth, enhance the lips and smooth out vertical lip lines and refine the results of facelift surgery without over-tightening the skin.
A chemical peel is a minimally invasive skin-resurfacing procedure in which solutions containing trichloroacetic acid or alphahydroxy acids are applied to the skin to remove the top layers. The skin that grows back after a chemical peel is smoother and younger looking. Chemical peels are used to treat wrinkles, skin discoloration and scars — typically on the face. A chemical peel can be done alone or in combination with other cosmetic procedures. Chemical peels can be done at different depths — light, medium or deep — depending on your desired results. Each type of chemical peel uses a different chemical solution. Deeper chemical peels produce more-dramatic results, but also involve longer recovery times.
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Diagnosis
Botox is predominantly used as a treatment to reduce the appearance of facial wrinkles and fine lines in older adults.
Dermal fillers are used for cosmetic reasons. In some cases, the use of fillers creates enough of an impact that surgical procedures can be postponed. Dermal fillers are usually used to treat static wrinkles on the mid to lower face, which have formed due to loss of facial volume and skin elasticity. Not all fillers are the same. Different products contain different ingredients and are intended to be used on different areas of the face. Dermal fillers sit in the deeper layers of the skin or on the bone and are gradually absorbed by the body over 6 to 24 months.
Chemical peels can be done on the face, neck, or hands. They can be used to reduce fine lines under the eyes and around the mouth; yreat wrinkles caused by sun damage and aging; improve the appearance of mild scars; treat certain types of acne; reduce age spots, freckles, and dark patches (melasma) due to pregnancy or taking birth control pills; improve the look and feel of skin.
Alphahydroxy acids are the mildest chemical peel formula and provide smoother, brighter skin with minimal recovery time. Trichloroacetic acids are commonly used for fine wrinkles, superficial blemishes, and dark pigment spots.
Treatment
Botox injections take approximately 10 to 15 minutes. Discomfort is very minimal; no anesthesia is required. Following treatment, some minimal bruising or swelling is normal but you can expect to resume your normal daily activities right after the procedure. Results are usually in full effect at two weeks after receiving BOTOX injections. Side effects from Botox are rare. You may experience a mild headache and some people also have soreness or bruising around the points where the needle went into your skin. Most side effects should go away within a few hours. Bruising may last a week. Tell your doctor about any problems that last longer. The wrinkle-reducing effects can last three months.
Filler –Injection of dermal filler is an outpatient cosmetic surgery procedure that temporarily softens wrinkles. For some fillers, your skin is first numbed with a local anesthetic then a cosmetic surgeon t uses a needle to inject the filler under the skin. A treatment session takes about 15 minutes to one hour. Some fillers are done in repeat sessions a couple of weeks apart. You may have mild discomfort, bruising and swelling for up to a week. After the swelling goes down, you may need a touch-up injection for best results.
A chemical peel is typically an office-based procedure room or may be done at an outpatient surgical facility. Pain relief isn’t typically needed for a light chemical peel. For a medium chemical peel, you a mild sedative and a painkiller may be recommended. If you’re having a deep chemical peel, your doctor will likely numb your skin with a local anesthetic and give you a sedative or local anesthetic.
There are three basic types of chemical peels:
Superficial or “lunchtime” peel: Alpha-hydroxy acid or another mild acid is used to penetrate only the outer layer of skin to gently exfoliate it. The treatment is used to improve the appearance of mild skin discoloration and rough skin as well as to refresh the face, neck, chest or hands.
Medium peel: Glycolic or trichloroacetic acid is applied to penetrate the out and middle layers of skin to remove damaged skin cells. your doctor will apply cool compresses to soothe treated skin. You might also be given a hand-held fan to cool your skin. You might feel stinging and burning for up to 20 minutes.
Deep peel: Tricholoracetic acid or phenol is applied to deeply penetrate the middle layer of skin to remove damaged skin cells. You will be given intravenous (IV) fluids, and your heart rate will be closely monitored. Your doctor will do the procedure in portions at about 15- minute intervals. A full-facial procedure might take about 90 minutes.
All peels require some follow-up care:
- Superficial peels require one to seven days to heal. Treated skin will initially be red and may scale. Lotion or cream should be applied until the skin heals, followed by daily use of sunscreen. Makeup can usually be worn the next day.
- Medium peels require seven to 14 days to heal. Treated skin will initially be red and swollen. Blisters may form and break and the skin crusts and peels off in seven to 14 days. Over-the-counter pain-relieving medication, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others), may help reduce any discomfort. A follow-up appointment will be necessary to monitor your healing.
- Deep peels require 14 to 21 days to heal. The treated area will be bandaged. Skin must be soaked four to six times daily, followed by ointment application for the first 14 days. Afterwards a thick moisturizer is applied for the next 14 days. Some patients prefer to remain at home while healing from a chemical peel. Once new skin completely covers the treated area in about two weeks, you can use cosmetics to conceal any redness. Typically several follow-up appointments are scheduled to monitor healing.
Being prepared will help you get the most out of your appointment. Please bring a list of medications you're currently taking and any pertinent test results—such as labs or imaging—to your appointment. Additionally, let your provider know of any drug allergies or medical conditions you have or for which you are being treated and if you've had any prior surgical procedures.