Hyaluronidase; Just In Case: injectables for beginners.

15 Jun

I’m so good at rhyme. I’m just saying.

One in 5 women has interest in doing Botox, but has a billion questions, and it’s overwhelming. The inability to find the answers leaves this grey area of fear that supports a misguided rumor-mill of what Botox actually is. You can’t believe everything you read, and you certainly can’t believe everything you hear (unless I wrote it or said it. Then it is pretty much a fact).

‘The oldest and strongest emotion of mankind is fear,

and the oldest and strongest kind of fear is fear of the unknown.

-H.P. Lovecraft ( ßI wonder if his parents are from Amherst… strange name… but good quote none-the-less).

New to the World of Injectables?

Usually, the first place we go to is the internet, but when it comes to health-related issues, this is not the best place to sift through to find information without training in How To Read A Medical Article (this is an ENTIRE class, and it is REALLY hard). And unless your best friend is me… there is a lot of misinformation going around via word of mouth.

To those readers who have never done a procedure, it is all the same. It’s ALL called Botox. (That’s NOT Botox..)

 

It’s Not All Botox!

There are a lot of injectable products on the market, and the world of Botox and Fillers is doing nothing but growing. Every person has a different face and different goals with aesthetics. So it needs to be the right product for the right problem, and really only an expert can decide what that is. Since I love making charts, I made a chart of the basic differences between Botox and Fillers. That’s important to know.

***Super Important Information Chart*** for lack of a better title.

Botox (or Onobotulinum Toxin A)

Fillers

Injected into the muscle.

Injected into folds.

Causes temporary “relaxing” of the muscles into which it is injected.

Causes temporary fill of folds into which it is injected.

Does not give any volume to the face.

Gives varying degrees of volume depending on the product used, the amount of product used, and the area being treated

Goes into lines that are a result of muscle movement.

Goes into folds that are a result of gravity and bone remodeling.

Botulinum Toxin family includes Dysport, Xeomin, Reloxolin, but they all basically do the same thing (but are not interchangeable in dosage) and are injected the same way into the same place.

No one uses collagen anymore. These products are way more advanced. We’re talking Hyaluronic acid (Juvéderm, Restalyne) and Calcium Hydroxylapatite (Radiesse). Sculptra (although technically a biostimulator) is in this family as well.

Lasts 3-6 months.

Lasts 4 months – 2 years depending on the product.

Is a thin liquid when injected.

Ranges from a thick gel (Radiesse) to a thick liquid (Sculptra).

Usually doesn’t bruise.

May bruise, depending on things like the technique used for injection, the amount of product injected, the size of the needle used.

Pinches, but requires no anesthetic.

Requires both topical and local anesthetic. And even then isn’t always completely painless (depends on the area you are injecting).

As we can conclude from my awesome chart, Botox and Fillers are very different products. The left side of the chart is pretty straight forward. If the line is a result of muscle movement you can inject Botox to improve it. The Botulinum Toxin family has the same properties and effects for the most part… and 99.9% of the time you’ll be receiving Botox. It’s a household name.

Fillers on the other hand… way more confusing to the novice patient. To anyone who has never undergone an injectable procedure, they are all called “doing Botox.” But, once the decision has been made to investigate what all the hype is about, there is a very VERY steep learning curve. So where should you start then?

The Hyaluronic Acid Family

There’s a few different kinds of HA’s. Restylane, Juvéderm, and Perlene are all examples of products in the Hyaluronic Acid family. They are all very different as well. They can last from 4 months to a year (Juvéderm lasts the longest… and is currently the #1 seller of HA’s).

Hyaluronic Acid is a sugar that your body naturally makes that attracts water molecules. Everything your body naturally makes, your body also naturally breaks down. One of the best things about trying Botox and Fillers is that they don’t last, so if you decide you don’t like the result of a treatment, the good news is, it isn’t forever. Unfortunately, that is also the bad news. But for a beginner, there literally is a product that can dissolve any HA injection that is not to your liking. This is a huge positive for people who are new to fillers.

Fortunately for me, I’ve never had to use Vitrase. My policy on filler removal has always been to wait two weeks post injection and to re-evaluate the area. Swelling can last about two weeks, and I like to take this into consideration as well as the initial “shock factor” some people can experience.

Hyaluronidase is an enzyme that acts at the site of injection (i.e. does not travel systemically) to break down and hydrolyze hyaluronic acid. Tissue permeability is increased. There is a temporary decrease in the viscosity of the HA, promoting diffusion of the injected product and facilitating the absorption of the fluid carrier.

It appears from the case studies I’ve read that this product can be injected anytime after misplacement of HA’s has occurred. From immediately, to up to five months post injection. It takes 24 hours for a majority of the HA to dissolve post hyaluronidase injection.

****Why not always use HA’s? …because they’re more expensive. But remember: Right product, Right place, Right person.

The world of Fillers is expanding. There’s a handful of products out there, and they’re all formulated just a teeny tiny bit different. It’s not all Botox, and it’s not all the same. If you need a starting off point, because you just don’t feel comfortable with the information overload, HA’s are definitely the safest bet. Because they can easily be dissolved if you don’t like the result… but I’ll put money on the opposite happening. J

XOXO

LK

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One Response to “Hyaluronidase; Just In Case: injectables for beginners.”

Trackbacks/Pingbacks

  1. More Belotero! | bostonbeautyblog - February 27, 2013

    […] Juvéderm and Restylane are also in the HA family, but have a hydrophilic effect. This means the product will take on water molecules after it is injected, giving the area treated more correction over the next few days to weeks. Great for your lips and cheeks. Not great in the ultra thin skin under the eye. When this area is over treated you will see a bump or a bluish hue from the product. It’s not pretty. But it can be dissolved!  Hyaluronidase; Just In Case: injectables for beginners.. […]

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