Both Botox® and Dysport® are used to target certain facial muscles, causing them to relax. This also reduces the appearance of fine lines and wrinkles. Botox® and Dysport® don’t paralyze muscles, but relax them by blocking the release of acetylcholine, a neurotransmitter that communicates nerve impulses to your muscles. Since the muscles do not receive the message to create an expression, they remain relaxed, and the skin remains smooth.

Both Botox® and Dysport® work in the same manner, have similar safety and efficacy profiles, and each have been used world-wide for over 20 years. Botox® and Dysport® were initially used to treat facial spasms, strabismus (crossed eyes) and other medical uses prior to being used as a cosmetic treatment. Your provider will discuss the minor differences between the two products, and help you decide which one is best for you. Typically, the effects of Dysport® may been seen more quickly than Botox®. The longevity of both products depends on the amount of product used (remember, this is a medication), the area of the face or body where it is placed, and individual patient differences. Both products tend to last 3-4 months, with patients requiring treatment 2-4 times annually to maintain optimal results.

Candidates for Botox® and Dysport® treatment have fine lines or wrinkles that are exacerbated by facial expressions. Most healthy individuals can have Botox® and Dysport® treatment. However if you are pregnant or breastfeeding, or have a history of certain neurological disorders, including myasthenia gravis and multiple sclerosis, you may not receive Botox® and Dysport® treatments.

Your provider will analyze your facial movements and the balance of various facial features, as well as discuss with you your expected outcomes and results. This allows them to create a customized treatment pattern that will address your specific concerns, and can be very conservative or more assertive based upon the results you wish to achieve. Often more than one treatment session may be required to achieve the results you desire. As the injections are placed, you may feel a slight stinging or “pinch” sensation. Treatments are typically well tolerated and patients are able to return to regular activities immediately. There may be some slight redness or minor swelling present that subsides within 30 minutes. Rarely, bruising may occur.

Typically, patient’s see some results beginning in 3-5 days after the treatment, however the full effect of Botox® and Dysport® is realized 3-4 weeks after treatment. If this is your first visit to the office, you will return for a follow up 3 weeks after your initial visit to evaluate the results. Most patients feel they need to return for subsequent visits every 3-6 months, depending on the results achieved, and the amount of residual movement desired.

Dermal fillers, such as Restylane®, Restylane® Lyft, Restylane® Silk, Juvéderm, and Voluma® can be used to augment and enhance facial features, replace facial volume that is lost over time, and improve the appearance of the hands by adding volume. They are comprised of hyaluronic acid, which is found naturally in your skin, eyes, and joints. Hyaluronic acid is a hydrophilic compound which attracts and holds water. This makes it optimal for dermal volume restoration, since the filler provides the initial volume, and it is maintained over time as the filler retains water at the treatment site. Fillers comprised of hyaluronic acid are quite safe, have a low risk of side effects, and can be reversed easily and rapidly if the desired results are not achieved.

Candidates for dermal fillers include individuals who desire to augment or enhance certain areas of the face, or who have lost facial volume over time. Most healthy individuals may receive dermal fillers, however there are some contraindications to treatment. Your provider will conduct a thorough review of your medical history to ascertain if you are a candidate. Women who are pregnant or breastfeeding cannot have dermal filler treatments.

Each dermal filler has unique properties that make it optimal for certain types of facial augmentation, or for certain areas of the face. Your provider will discuss your treatment options after a thorough evaluation of your unique facial features, and considering your specific treatment concerns and goals. A customized treatment plan that will provide you with the outcome you desire will be created. Often more than one treatment session may be required to achieve the results you desire. A topical anesthetic and ice are used to provide comfort during the procedure. Occasionally injectable anesthesia may be used for more sensitive areas. Additionally, the product contains an anesthetic, so patients are typically very comfortable during the procedure. You will feel a stinging sensation, and occasionally a “pinch” in certain areas.

Most patients have some swelling, redness, and mild bruising after the procedure. Many patients return to social activities right away, but it is best to schedule some social “downtime” with a lighter calendar. If you are preparing for an event in which photographs will be taken, we recommend scheduling your filler procedure two weeks in advance to allow the full effect of the treatment to be realized.

You will see some degree of results immediately after the treatment, however some swelling will be present as well. The treated area will initially feel swollen, appear pink and be tender to the touch. This subsides over the next week, and most patients are back to social activities with make-up after a day or so. Results may last 4-18 months, depending on the filler used, the area of the face or hands treated, and individual results.

During treatment, a saline-based solution called Asclera® (Polidocanol) is injected into unsightly leg veins, damaging the interior wall of the vessel and rendering it incapable of circulating blood. A tiny, fibrous clot is formed, and the vessel and clot are broken down by your body’s own healing mechanisms.

Candidates for sclerotherapy include individuals who have unwanted spider veins or varicose veins. Most healthy individuals may receive sclerotherapy treatment, however there are some contraindications to treatment. Your provider will conduct a thorough review of your medical history to ascertain if you are a candidate. Women who are pregnant or breastfeeding cannot have sclerotherapy treatments. During your consultation, your provider will thoroughly review your medical history and allergies to ensure that you are a candidate for treatment. Typically, the consultation and treatment are conducted on separate visits.

Some patients will require evaluation by a vascular specialist. We provide referrals to several excellent vascular specialists in the Bay Area when needed.

Your provider will examine your leg veins and determine the areas to be treated and techniques to be used during that session. Your skin is disinfected, and a tiny needle is used to cannulate each vein and instill the medication. You will feel a stinging sensation and a “pinch”, similar to a mosquito bite. Typically patients report the sensation is more annoying than painful. You may experience some mild and transient itching in the treatment areas. After the treatment, there may be dressings placed, and you will put on support stockings. You will wear the support stockings for approximately one week after each treatment session.

It is normal for the area to look worse before it looks better. Typically, bruising from the treatment may last 7-10 days, with the appearance of the legs continuing to improve over the course of the next 6-8 weeks. Full effect of the treatment may not be seen until 6-8 weeks after each treatment session. Results vary with each individual. Typically several treatments are required to achieve a desired outcome. Many patients will return for a “maintenance” session every 1-3 years, or whenever the veins recur.

Candidates for Mic B vitamin injections include individuals who are experiencing fatigue, those with a vitamin B deficiency, and patients undergoing a medically supervised weight loss program. Most healthy individuals may receive Mic B injections, however there are some contraindications to treatment. Your provider will conduct a thorough review of your medical history to ascertain if you are a candidate. Women who are pregnant or breastfeeding cannot have Mic B injections. During your consultation, your provider will thoroughly review your medical history and allergies to ensure that you are a candidate for treatment.

Your provider will review your medical history for changes and evaluate the results of your last treatment. Typically Mic B vitamin injections are placed in the gluteus medius or gluteus maximus, with rotation of the injection sites with each visit. You may feel a quick “pinch” sensation during the injection, but the medication does not burn or sting during infusion. You may resume activities immediately.

Some patients feel a mild energy boost shortly after the injection, but most patients carry on with regular activities without interruption. Some patients may benefit from repeated Mic B vitamin injections once weekly for one month, then returning once every 2-4 weeks for maintenance.