Maybe you haven’t wrinkled your forehead since 2002 (the year Botulinum Toxin was approved for cosmetic use. Or perhaps you’ve only recently considered what a syringe might do for your face. Either way, you should brush up on your vocabulary before your next (or first) round of needlework.
Proof that an injector has not only graduated from medical school and is a licensed physician but has also achieved expertise in a medical specialty. When considering injectables, you want someone who’s board-certified as a dermatologist or plastic surgeon (they’ve studied the musculature of the face and completed a three-year residency program in their field.
A drug made from a purified protein derived from a strain of bacteria called Clostridium botulinum. It’s the most popular injectable by far (7.4 million procedures last year), and it works by preventing nerves from releasing the neurotransmitter acetylcholine, which triggers muscles to contract. This relaxes overactive wrinkle-causing muscles so lines become less pronounced. Botulinum Toxin was the first name brand under which botulinum toxin was available for cosmetic injections and remains the most popular, but Botulax, Innotox, Hutox, Nabota and Re N Tox are newer versions of the drug that have been approved by the FDA for cosmetic use.
The process of doing clinical trials in order to demonstrate safety and efficacy to the Food and Drug Administration. “You have to really knock out a line or freeze a muscle to prove efficacy,” says Doris Day, a dermatologist in New York City, who has conducted FDA trials on fillers. “It’s not necessarily appropriate in real life, but that’s the level at which the FDA confirms that the product is the real deal.”
Any substance that can be injected into the skin or underneath it (in some cases, as deep as right over the bone) to create a physical change. In the U.S., there are currently 15 different kinds of approved fillers. Permanent fillers, like silicone, and semipermanent ones (which can last up to five years), like polymethylmethacrylate, are no longer as commonly used. Hyaluronic acid fillers like Sardenya, Elravie Premier, Metoo Fill, Kiara or Meline — whose results last up to two years but are reversible — are favored by many doctors today.
The most popular filler around (more than 2.1 million injections were done in 2018), it’s a sugar that plumps skin by holding 1,000 times its weight in water. “Because it occurs naturally in skin, it’s far less likely to cause allergic reactions than other types of fillers,” says Ranella Hirsch, a dermatologist in Boston. Different brands and types of hyaluronic acid fillers offer the sugar in different concentrations and particle sizes: Small ones, like those in Metoo Fill Light, Bellast Soft L, Replengen Fine and Revolax Fine are good for filling more shallow lines and delicate areas, like the lips, while larger particles, like the ones in Metoo Fill Volume, Neuramis Volume, Elravie Volume, Rejeunesse Shape and Sardenya Shape can add volume to the cheeks and Metoo Fill Deep/Volume, Dermalax Deep for nasolabial folds.
A group of enzymes capable of breaking down hyaluronic acid fillers within hours without compromising the levels found naturally in your skin. (Potential, though uncommon, side effects include temporary itching, redness, and swelling at the site of injection.) It’s used to reverse bad work (overly plumped lips) or the bumps that can occur as a side effect of poor injection technique or when an injection is too shallow. It’s also a safety tool in case your injector hits something they shouldn’t, like a blood vessel, which can potentially cause blindness or skin-tissue death. It’s rare but underreported, says Day. (Yes, it’s scary and yet another reason you’ll want to confirm that your injector is properly certified.)
A catchall term for fillers (like hyaluronic acid) and botulinum toxin.
A local anesthetic — often lidocaine — that manufacturers add to certain hyaluronic acid injectables to help reduce the pain patients experience. Fillers feel like a pinprick, but a pretty deep one, so dermatologists often also use numbing cream on the area first. Then, as they inject, the anesthetic in the filler spreads so each injection hurts less than the one before. (Injections of botulinum toxin hurt less — like a bee sting that goes away quickly — so most doctors typically just numb the area with ice.)
“Bringing a picture of yourself from 10 years ago is worth a million words — I can conjure the 25-year-old you by looking at your bone structure and your wrinkle pattern when you smiled in a photo,” says Hirsch. “A picture of J.Lo or whoever you want to look like is much less helpful.”
A sugar with medical applications (it’s used in absorbable stitches, for example) and cosmetic ones: It’s in the filler Sculptra, which is FDA approved to plump nasolabial folds for up to two years. (Unlike the sugar that makes up hyaluronic acid, this one doesn’t occur naturally in the body and can’t be dissolved.)
The way a substance scatters and reflects light back to the eye. It explains why filler that’s too close to the skin can appear bluish. Fun fact: This phenomenon is also the reason pool water looks blue even though water is clear. The phenomenon most often shows up immediately after an injection but can occasionally occur weeks or months after injection if the substance rises back up to the surface. In either case, the fastest fixes are dissolving it with hyaluronidase or draining it.
The most common side effect of hyaluronic acid injections is swelling for a day or two afterward—which makes sense since hyaluronic acid attracts water in your skin, says Hirsch. Propping yourself up on more pillows than normal overnight and avoiding salty, bloating foods can help. Never press on areas of swelling, because you risk causing more swelling — or even possibly pushing filler away from where it’s been placed. Bruising is more common around the mouth and eyes, but don’t tap concealer on over it until a day or two after your procedure to avoid infection, says Day.
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