Considering facial fillers? Don’t forget your Chin!

 

Our chin is an area that we don’t often think about when we are talking about aesthetic injections like Botox® and filler but it should be.  As we age the mentalis muscle can become hyperactive creating a dimpled, pebbly, orange peel (peau d’orange) look to the chin. It can also begin to turn the chin downward.  Injecting Botox into the mentalis muscle relaxes the muscle smoothing out the skin on the chin and releasing the chin back upward for a more balanced look to the face.  

Some people just genetically have a “weak chin”.  This is when the lower jaw is either less developed or less projecting compared to the upper jaw.  This creates an unfavorable or unbalanced facial appearance. Injecting dermal fillers can really enhance the chin and change the overall appearance and balance to the face and jawline.  Juvederm Voluma® is a very cohesive filler that creates volume and lasts up to two years. It is a great choice for this area of the face.  

In some cases we cannot create enough volume to balance the appearance of the upper and lower jaw with filler.  For these people, surgery is an option. There are several silicone chin implants that can be permanently placed by Dr. Schenden or Dr. Elswick in our surgical suite.   This surgery is called genioplasty.  

Call to schedule a complimentary consultation with me to see which the right procedure is for you.   248-524-0620

Kristen Lotz, PA-C

Aesthetic Injector

What’s the new trend in Lip filler? 

In recent years when it comes to Lip filler, the request has been the bigger the better. With every trend comes a bandwagon and then it tempers. Although the volume and style injected has changed, the demand for Lip filler is not slowing down anytime soon.

Patients have been requesting a more natural result and lip injections is still one of the primary filler requests I receive.  My belief is to assess the patients face shape, other features in comparison, and definition as well as a full pout is important to most patients. 

The products I use and technique administered varies for each patient.   Different hyaluronic fillers produce different results. I’ll choose Restylane® if my patient wants more structure or has “smoker lines”.  For the patient that wants a pillowy pout, Juvederm® is my product of choice. 

Lip filler can last anywhere from 9-12 months but by 4-6 months, most of my patients feel they are deflating and require a refill.  Interested in learning more? Call today to schedule your complimentary consultation. 248-524-0620

 

Raquel Merlini

Registered Nurse and Aesthetician

Botox and Filler, learn how they are different.

Many people come into the office confused about the difference between neurotoxins like Botox® and Dysport® and fillers such as Juvederm® and Restylane®.   While these two treatments can be complementary to each other they are not the same thing.  

 

Botox/Dysport are used to reduce the activity of the muscles in the face that cause wrinkles.  They are often used for dynamic lines which are the lines/wrinkles you see when you animate your facial muscles. They are mainly, but not exclusively, used in the upper face.  Most common places are between the eyes (11’s), forehead, and crow’s feet. This treatment is quick procedure, typically 5-10 minutes, and is done by injecting a tiny needle into the muscle.  There is virtually no downtime.  You may see some temporary redness, swelling, and/or bruising at the injection site.  Results take about 4-7 days to take effect and results typically last around three months. The relaxation in the muscles smooths wrinkles and gives you a more youthful appearance.  

 

Fillers, on the other hand, are used for areas of the face that have lost volume and/or are in need of some overall plumping.  Some fillers are used to fill in an individual’s “trouble’” area with collagen or an agent that helps to stimulate collagen growth others use hyaluronic acid.  Fillers essentially plump and lift the skin.  They are used on wrinkles that can be seen on the face at rest. Some of the more common treatment areas are cheeks, nasolabial folds, marionette lines and lips, but they can also be used in other areas as well like your hands. Filler injections typically take anywhere from 15-30 minutes depending on areas being filled. Typically there is little to no downtime, however, there is a risk of redness, swelling and/or bruising at the injection site. With hyaluronic fillers results are seen immediately. They may last anywhere from 6 months to more than a year depending on product and area treated. The added volume and softened wrinkles also provide for a more youthful appearance.

 

While Botox/Dysport and filler treatments are very different, doing a combination of both can sometimes give optimal results depending on how the individual is aging.  Our goal is to give you a relaxed natural look and to not have you appear overdone. Working with a qualified injector is key. To find out which option is best for you, please schedule a free consultation with me by calling 248-524-0620 today!  I look forward to meeting you and figuring out a plan that is best for you!

 

Dr. Clarissa Kroese

Aesthetic Medicine

 

 

ALMI  the all natural alternative to aesthetic fillers.

I couldn’t be more excited to talk about our new ALMI procedure! ALMI = Autologous Lipocyte Micronized Injection.  In other words it means ALL YOU, ALL NATURAL REJUVENATION. ALMI is a simple outpatient rejuvenation procedure that takes about an hour, with minimal downtime and amazing results.  This treatment takes a few tablespoons of your own fat and blood platelets from one area and injects them into another. We can use it for facial or hand rejuvenation as well as to stimulate hair growth in men and women.

 

We start by numbing an area (usually abdomen) where we will extract the fat cells with small liposuction instruments.  The fat is then filtered according to what area we are treating and the desired outcome. The filtered consistency varies depending whether we are adding volume, improving tone and texture or simply adding a little finesse to the area.  We also extract blood platelets through a normal blood draw. The blood is also processed to separate the growth factors from the red and white cells. The separated platelets are also injected into the same area as the fat. They promote collagen growth, vascularity and improve the quality of skin texture. In the case of scalp injections they stimulate the hair follicles to promote growth.

 

This procedure is completed in our medical office. For downtime you can expect some mild to moderate bruising at the injection sites and some mild swelling for 1 to 2 weeks.  You may wear makeup the very next day to cover any bruising that may occur. The area of fat extraction may be tender for 3 to 4 days with mild swelling and bruising. Patients have reported being very comfortable during this procedure and rated a pain scale of 2-3 out of 10, which is very similar to traditional fillers.  

 

How is ALMI different from traditional hyaluronic acid derma fillers?  Traditional hyaluronic fillers do not have the ability to promote new collagen growth and blood supply, which leads to better texture, tone and glow of the skin.  Because we are using your own tissue and stem cells the results tend to last longer. Fat cells from the abdomen are programmed to remain or even increase with age unlike the fat cells of the face, which decrease with age.  These results should last for years as the collagen continues to regenerate.

 

Call to schedule your free consultation today 248-524-0620.  We will work with you to determine a treatment plan that works for you. .

 

Kristen Lotz, PA-C

Bellafill  -Making us smile!

 

I love my career and one of the main reasons is the consistent improvements made in the world of aesthetic injections.  There are so many options for my patients and I am confident there is a product that will work for you. I am excited to announce we are adding Bellafill® to our already comprehensive injectable product line.  Bellafill may be what you are looking for if you have deep smile lines or acne scars.

 

Bellafill is comprised of polymethyl methacrylate microspheres and bovine collagen. Sounds scientific I realize but easy to explain. These microspheres are building blocks for the skin and add volume. The spheres stimulate your natural collagen production. Which means you skin will continue to improve over time as the collagen rebuilds. Your smile lines can benefit with longer lasting results of up to five years. You will see immediate results due to PMMA (polymethyl methacrylate) microspheres.  Once injected the collagen gel immediately reduces the look of the smile lines. Over time the gel is gradually absorbed and replaced by natural collagen stimulated by the methacrylate microspheres.

 

Bellafill is also FDA approved to treat deep acne scars.  If you suffer from scars that appear pitted, Bellafill is a great treatment option. The indents or pitting of the skin is caused by a loss of collagen to the area.  Injecting Bellafill directly into the scar restarts the collagen building process and gives an immediate filled in/smooth look. The gel composition is 20% PMMA and 80% collagen gel.   As the gel is absorbed into the body the collagen is building giving you longer lasting results and a smoother skin.

 

Early risks associated with Bellafil are similar with other aesthetic injections with mild swelling and bruising at the injection site.  We offer complimentary consultations for all our injectable services. Together we will put together a treatment plan that is best for your skin and goals.  Schedule your appointment today and discover the exciting world of aesthetic injections. 248-524-0620.

 

Raquel Merlini, RN and Aesthetician

Before & After

Radiesse, an Alternative filler with natural looking results.

The exciting world of aesthetic injections is constantly growing and improving. This gives you options to be able to choose the product that you are most comfortable with and strive for the desired results.  

 

Are you feeling like your face is “falling” or maybe you’re just feeling like you need a little lift?! We have a variety of options to help you! We have several gel hyaluronic acid fillers such as the Juvederm and Restylane product lines.  These are great options to for those seeking immediate volume to the face. We also offer Sculptra which is a poly-L-lactic acid based treatment. This product works to stimulate the body’s own collagen production. Sculptra typically takes about 6-8 weeks to see results of the collagen building. This is perfect for the person looking for slower more natural improvement.   If you like the idea of a filler that promotes collagen growth but also want immediate volume we offer Radiesse.

 

How does Radiesse work? Radiesse works right away adding facial volume and diminishing the appearance of facial line and wrinkles.  Wrinkles form due to the natural loss of fat/volume and decreased levels of collagen over time. Radiesse is a smooth gel filled with tiny calcium hydroxylapatite microspheres. This gel, when it is injected, immediately lifts and adds volume to the face. Over the next few weeks these calcium hydroxylapatite microspheres stimulate the body to produce collagen. Your new collagen will surround the microspheres and eventually the microspheres and the gel are naturally metabolized by your body.  What you have left is newly formed natural collagen. Because of this, Radiesse produces a nice natural result. You will see a restored, lifted, more youthful appearance without looking overdone.

 

Typically areas of use for Radiesse are nasolabial folds, marionette lines, cheeks, down turning corners of the mouth, chin wrinkles, jowls and hands. Results have been shown to last a year or more in many patients. Radiesse is mixed with lidocaine to help make the injecting experience more comfortable. Like all fillers there is a risk of bruising, swelling, mild irritation, itching, redness or tenderness at the injection site. All of these reactions will typically resolve on their own.

 

We offer free consultations!! Call our office, located in Troy, MI, today to schedule yours! 248-524-0620 I will answer all your questions and together we will develop a treatment plan that works best for you! The world of aesthetic injections has lots of options and I would love the opportunity to work with you!

 

Clarissa Kroese, DO

Aesthetic Medicine

 

 

Want bigger lips but afraid of duck lips?

Want bigger lips but afraid of duck lips?  Don’t be! Filler in the lips can be subtle.

 

One of my favorite treatments is lip enhancement. This procedure can be done on my patients that are in their 20’s thru 60’s plus.  There isn’t a specific product that is best for every person which means there are options to help everyone achieve their desired goals. I am often confronted with concerns of looking “overdone” or having the dreaded “duck lips”.  I like to take a conservative approach keeping in mind my patient’s desired outcome. When I have a consultation with my patients about lip filler it isn’t always about size. We talk about the shape of the lips and giving them a natural, sexy appearance.

Let me address “duck lips”. Human-lips are fuller in the center, and taper off to the sides. This is not true of ducks, who have equal sized lips, top and bottom, nor do they taper to the sides. (Technically ducks have “bills” — not lips — but you know what we mean!). It is pivotal to understand the aesthetics of beautiful lip shapes and variations.  Cosmetic injections are a form of art, and it is important to discuss what will look great on your face. It’s important to make sure that you are placing your face into the care of someone who understands how to achieve natural, flattering looking results. Great injectors have both the medical knowledge to treat you safely, and the eye of an artist. Just having big lips isn’t beautiful they should be sculpted creating a cupids bow.  This creates youthful lips without a “fake” or “overdone” appearance.

 

There are several options for patients that want a very natural appearance to their lips. I offer a 1/2 or a full syringe option, we can always add more. Restylane Refyne will create a subtle augmentation to their lips.  Refyne may last up to a year giving patients a lasting result with a very soft and natural appearance.  Juvederm Ultra Plus and Restylane are my favorites for volume and structure. They have been on the market for years and my patients love them for adding volume and last approximately 6-months in the lips. Resylane Defyne and Juvederm Vollure both last approximately a year

 

Lip enhancement injections are a simple 30 minute procedure in the office.  Call today for your complimentary consultation. 248-524-0620   Let me put your worries to ease that you can have bigger lips without looking like a duck. —

 

Raquel Merlini

Registered Nurse & Aesthetician

The order in which you receive Aesthetic treatments is important

Botox before facials? Facials before lasers? In the world of aesthetics there are many types of treatments that range from noninvasive facials, aesthetic injections to comprehensive skin resurfacing lasers.  It’s important to receive these in the proper order to ensure the best aesthetic outcome.

Let’s start off with facials.  It is always best to receive your facial before any aesthetic injections. A facial involves massaging and rubbing of the face which can move the product to an area it was not intended for. Vigorous skin treatments such as microdermabrasion and microneedling could also cause the product to spread. If a neurotoxin, like Botox, disperses to a nearby muscle a side effect is droopy skin. This is commonly seen in the eyelid/brow area.  Therefore as a precautionary measure it is best to get the facial/vigorous treatment first or wait at least 2 weeks after receiving injections.

Lasers and treatments that are heat based are ideal before aesthetic injections. Most dermal fillers are made up of hyaluronic gel, which attract water and expand. Lasers that use heat may diminish the water content in the skin and the product, depending on the depth of the injection. Neurotoxin like Botox and Dysport are used to address wrinkles associated with facial animation. Heat causing treatments may cause swelling which could possibly diffuse the product to other areas. This means it is best to receive the laser treatment before any aesthetic injections.

 

The leading way to maintain a youthful face is to collaborate between non-surgical cosmetic procedures and the aesthetic treatment room. Knowledge is power and it is beneficial to know what sequence procedures are best performed in. This is something your Injector and Aesthetician can advise you on during a Skin Assessment/Skin Care Consultation. Our highly qualified team who will work with you to determine the best treatment plan for you. Call today to schedule your complimentary consultation. 248-524-0620.

Raquel Merlini, RN

 

 




How Injecting in the Jawline can Give you a Youthful Look

How injecting below the ear can give you a youthful jawline.

Where is that bright eyed and bushy tailed face that used to stare back at you in the mirror? Every birthday celebrated, vacation spent without sunblock, poor food choices and nights spent not removing your makeup have left their mark on your skin. Now you see fine lines and wrinkles, sagging skin and discoloration.

The skin needs attention regardless of your age.  Luckily today’s aesthetic industry can treat the damages caused from our past mistakes.  I want to address the fine lines and wrinkles with sagging skin along our jawline. When we are young our cheeks are full of volume with round apple cheeks.  The cruel part of aging is facial volume decreases and descends. As we age our body’s stop producing collagen, loss of muscle and bone remodeling occurs.

 What can we do?

Replace the lost volume and structure. I begin by evaluating my patient’s facial structure, needs and goals. Typical signs of a tired face are a heavy jowl area, flat cheek pads and sad marionette lines. With an aging face my primary goal is to replace lost structure and re-suspend the face with durable filler. This creates lifting, plumping, filling and smoothing. 

Jaw enhancement injections are a minimally invasive way to contour the look of your jawline and jowls. During the treatment small boluses of filler are injected at several angles along the jawline. This process changes the contours of the area by plumping up the skin from the inside out. The result is a jawline that has a crisp, contoured and well defined line. This draws the eye back up to your focal point, the center your face, creating a more youthful appearance.

Who is a suitable candidate?

If you feel that your jaw line lacks definition, or is sagging due to aging or weight loss, you may want to consider this treatment. This treatment doesn’t discriminate, both men and women alike benefit. Men wanting a more chiseled look and women who want a softer rounder face. Call our office today to schedule your free consultation, you don’t have to live with your past mistakes. Let us help! 248-524-0620

Blog Written by: Raquel Long, RN

Volbella® Filler

I often times have patients come in bothered by the vertical lines around their mouth or patients who just want a subtle volume enhancement to the lips.  There is now a product made just for these issues, Volbella® by Allergan. Volbella is temporary filler made of Hyaluronic Acid. The uniqueness is that it has a smaller particle size then Juvederm allowing us to fill more fine superficial lines without getting a “filled” look.  This also makes it a great filler for someone wanting just a slight enhancement to the lips and still maintain a natural appearance.

 

Volbella is made using Allergan’s patented Vycross technology.  This technology makes for a smooth gel consistency and should last approximately a year. The side effects are similar to using any other filler and include, swelling, bruising, tenderness and redness at the injection site. These side effects are temporary and vary by patient.  It is important to work with a highly trained medical professional for safety and to ensure you achieve the desired results.

 

If you struggle with perioral lines aka smoker’s lines around the mouth or just want to add a slight amount of volume to your lips, call our Troy office today to set up a free consultation. 248-524-0620. We will work together to see if Volbella could be the right product for you.

 

Dr. Clarissa Kroese

Aesthetic Medicine and Laser Specialist