Facial Injectables

What They Do

One of the most exciting advancements in cosmetic surgery for facial rejuvenation is the development and continued refinement of facial injectables. These substances allow your cosmetic surgeon to target areas on the face with pinpoint accuracy, helping to smooth frown lines, crows feet, and other problem areas with a long-lasting treatment. Although they are not intended to take the place of surgery, they can offer a much less invasive treatment with good and relatively long-lasting results. Facial injectables can also be used in conjunction with other surgical and non-surgical techniques.

Botulinum Toxin – Derived from purified bacteria, botulinum toxin is injected into very specific muscles of the face which weakens the muscles and smooths unwanted wrinkles. Commonly known by one of the more popular brand names, “Botox,” botulinum toxin can be used in conjunction with other facial procedures such as dermabrasion and chemical peels to increase its effectiveness.

Collagen Stimulators –Administered by injection, these water- or gel-based substances deliver particles to the deep tissues of the skin, initially plumping and smoothing the skin, but over time, stimulating the formation of new collagen to help correct facial lines and firm skin, especially in thicker areas such as the cheeks and neck. The active ingredient in some collagen stimulators is poly-L-lactic acid, which is naturally absorbed into the skin after treatment. Collagen stimulators require a series of injections given over several months, often a series of three treatments given at six to eight-week intervals.

Hyaluronic Acid – A substance found naturally in the human body, hyaluronic acid is used in cosmetic surgery as a “filler,” a gel that is injected under the skin to cushion and support the skin’s surface and smooth wrinkles. Hyaluronic acid is also proficient at bringing water to skin, keeping the treated area supple and more youthful looking.

Procedure Basics

Botulinum toxin should be administered by your doctor or a technician under your doctor’s supervision with a high degree of experience in placing the injections. Accuracy is critical in targeting the specific muscles that will be weakened and that will give the most effective result.  A very thin needle is used to administer the substance, a procedure that generally takes as little as 15 minutes, depending on the number of injections and areas to be treated. Anesthesia is usually not required, and the procedure is usually performed in your doctor’s treatment rooms.

Collagen stimulators are also administered by injection. Your doctor will map out the areas to receive the injections and after a cleansing, your skin may be rubbed with a topical anesthetic. The injection process is often fairly quick and can be done in the comfort of your doctor’s treatment rooms.

Similarly, hyaluronic acid injections are generally done in your doctor’s treatment room and no anesthesia is required. Generally, your face will be cleaned with an antibacterial agent, then your skin may be numbed with a topical anesthetic. The hyaluronic acid gel is injected with a very fine needle at injection sites mapped out by your doctor. The procedure may take only a few minutes and just seconds at each injection site.


There is little recovery time with facial injectables. You may experience facial redness or soreness that in most cases will fade within a few hours to a few days. Most patients find they can apply make-up and resume normal activities immediately. It is important to avoid pressing on or disturbing the injection sites for several hours – you might move the filler material or cause the botulinum toxin to migrate, causing numbness in areas of the face that were not treated.

The process is slightly different with collagen stimulators. There will be mild swelling following the treatment – you may need to use a cloth-wrapped ice pack to help reduce swelling for a few minutes several times during the day. You may also be advised to massage the injected areas for 5 minutes 5 times per day for 5 days following the treatment. As the swelling decreases, lines may return, but the process with collagen stimulators is a gradual one and over time, wrinkles will fade as new collagen is generated.

Additional Information

Facial injectables are not a replacement for facelift surgery or other facial procedures that are more permanent.  Depending on the type of injectable you are planning and the goals you have in mind, you may need to discuss planning more than one treatment with your doctor.

The effects of botulinum toxin, depending on your skin and physiology, can be expected to last about three to four months. Once the effects fade, muscle movement, as well as the wrinkles, will return.

Collagen stimulators require several treatments over several months for full effect. You’ll discuss with your doctor the best plan for your cosmetic goals. Generally, the results of collagen stimulators can be expected to last from several months to up to two years.

Depending on the type of hyaluronic acid your doctor uses, as well as your skin physiology and the type and depth of wrinkle being filled, the effects of treatment may last four to five months. As new developments and refinements are being made, longer effectiveness times may be possible.

Additional Resources

For more information on facial injectables, visit the Web page of the American Society of Plastic Surgeons (www.plasticsurgery.org) ; click on “Cosmetic” and choose from the list of procedures.

The American Society for Aesthetic Plastic Surgery, Inc. (www.surgery.org) also provides some information on facial injectables; choose “Procedures” for a list of topics.

To schedule a consultation to discuss possible treatments using facial injectables, please contact Dr. Christine Kelley at 317/575-0330.