Injectables and Dermal Fillers

Injectables minimize facial wrinkling with wrinkle correction treatments, such as those listed on this site.


Botox® Cosmetic

What is Botox Cosmetic?

Botox is a purified natural protein toxin that, in small doses, blocks the nerve impulses to muscles and reduces frown lines caused by facial muscles pulling.

How does Botox Cosmetic work?

Frown lines are caused from facial muscle contraction causing the skin to bunch and creating a constant furrow, or frown line. Injecting Botox Cosmetic directly into the facial muscle weakens it and stops muscles from being able to draw the eyebrows together when an individual frowns. The action of frowning is stopped, the frown lines soften, relax and diminish, and give a more youthful appearance.

When does Botox Cosmetic start to work, and how long does it last?

The results of each Botox Cosmetic treatment begin to appear in three to four days. The effect will last three to four months, after which the treated muscles gradually regain their action and a simple repeat treatment is all that is necessary to maintain the desired results.

What are the other uses of Botox Cosmetic?

Botox Cosmetic effectively relaxes and softens wrinkles around the eyes, such as crow’s feet and forehead wrinkles. Botox Cosmetic can also reduce the appearance of lines that are caused by other facial muscles, such as nose creases, neck lines, neck bands and some of the lines on the upper lip.

In addition, Botox Cosmetic can dramatically reduce excessive underarm sweating, hypohydrosis, and is also effective in controlling marked sweating from the palms of the hands.

Who can perform Botox Cosmetic treatments?

Botox Cosmetic therapy should only be performed under the direction of a physician experienced and trained for its cosmetic use.

Has Botox Cosmetic been tested and approved?

There have been many scientific articles showing the positive effect of Botox Cosmetic on facial lines. In 2002, the FDA approved Botox Cosmetic for the cosmetic treatment of frown lines in the mid face, known as glabellar furrows.

Botox Cosmetic has also been used since 1980 for the treatment of strabismus (lazy eye) and blepharospasm (uncontrolled eye blinking). Since 1989, it has been used for hyperfunctional facial lines. 

What possible side effects can occur with Botox Cosmetic?

As with any injection, there can be temporary swelling, redness, bruising, headache or local discomfort. Rarely, clients have been reported to temporarily develop a slight lowering of the eyelid (ptosis), or slight lowering of the forehead, resolving within a few weeks. Some clients may have an uneven or incomplete response to treatment. Botox Cosmetic does not reduce the action of the muscles of facial expression distant from the site of treatment. Clients with neuromuscular disorders should inform their doctors before therapy. Botox Cosmetic treatment should not be used on pregnant women.

Dermal Fillers

What are dermal fillers?

Dermal fillers help to diminish facial lines and restore volume and fullness in the face.

With age, faces naturally lose fat under the skin. The facial muscles then work closer to the skin surface making smile lines and crow’s feet more apparent. The facial skin also stretches, adding to this loss of facial volume. Other factors that affect the facial skin include sun exposure, heredity and lifestyle.

What dermal fillers do:

  • Decrease or remove the shadow of the lower lids
  • Enhance shallow contours
  • Improve the appearance of recessed scars
  • Plump thin lips
  • Reconstruct contour deformities in the face
  • Soften facial creases and wrinkles

Dermal fillers can be very helpful in those with early signs of aging, or as a value-added part of facial rejuvenation surgery.

What dermal fillers cannot do:

For some clients, surgery, such as a facelift, browlift or eyelift, may be the best approach. Nonsurgical rejuvenation treatments, such as soft tissue fillers, cannot achieve the same results, but may help delay the time when consideration of a facelift becomes appropriate. It is important to remember that dermal fillers are temporary treatments for facial aging and that ongoing treatments are needed for long-term results.

Belotero Balance®

What is Belotero Balance?

Belotero Balance is an FDA-approved hyaluronic acid injectable filler used to temporarily smooth and fill moderate-to-severe folds or wrinkles from the side of the nose to the corner of the mouth.

What does Belotero Balance do?

Belotero Balance is a soft and cohesive gel that, once injected, instantly fills the skin to help smooth moderate-to-severe lines and wrinkles. It fills in areas within the skin to reduce the depth of wrinkles, lines and folds. The skin remains mobile and flexible, with a natural look, feel and movement.

How is Belotero Balance administered?

With a fine-gauge needle, a licensed professional injects Belotero Balance into the skin. Clients can either sit or recline during treatment. The aftercare is minimal.

Is Belotero Balance painful?

As with all injectable treatments, there may be discomfort associated with the procedure, but the professionals at Esteem can discuss effective options for managing discomfort during treatment.

Clients may experience injection site reactions. These reactions can include inflammation and usually last less than seven days.

How long do Belotero Balance results last?

Individual results vary, but Belotero Balance is said to last approximately six months and sometimes longer, depending on the amount of product used and the specific area where it is injected. For example, areas with more movement due to eating, talking and smiling, the product may not last as long as other less active areas.

What side effects can occur with Belotero Balance?

Just like any injection, clients may experience mild irritation, swelling, itching, redness, bruising or tenderness at the injection site. These side effects typically resolve themselves within a few days. If any side effects persist for more than seven days, the doctor should be contacted immediately.


What is Juvéderm?

Juvéderm is an injectable gel made of hyaluronic acid (HA). It is used by cosmetic dermatologists to restore volume creating a smooth, natural, youthful look. As we age, our face loses volume and we begin to see facial folds and wrinkles, better known as smile lines.

What does Juvéderm do?

Juvéderm temporarily adds new volume to sagging skin and fills in hollow spaces on the face, giving a fuller, smoother and more youthful appearance.

How is Juvéderm administered?

A cosmetic dermatologist uses a very fine needle to inject the Juvéderm into mid-to-deep layers of skin to correct moderate-to-severe facial wrinkles and folds. Once injected into the skin, HA helps to create new collagen and stops the breakdown of existing collagen.

Is Juvéderm painful?

Injections may cause some discomfort during and after the injection. Juvéderm’s gel consistency allows the doctor to administer it easily and smoothly. And, with a fine needle for minimal injection discomfort, Juvéderm is injected directly into the skin. Doctors may choose to numb (anesthetize) the treatment area to further minimize discomfort.

How long is the individual Juvéderm injection process?

The injection process takes only about 15 minutes. Clients should also allow time to consult with the doctor, prior to treatment.

How long do Juvéderm results last?

Juvéderm is the only FDA-approved HA filler that lasts up to a year. Touch-up injections, as well as repeat injections, are usually needed to maintain optimal corrections.

Can people with different skin tones and colors be treated with Juvéderm?

Yes. In fact, Juvéderm injectable gel is the first FDA-approved HA dermal filler that has proven its safety and effectiveness in persons of color. Studies with Juvéderm showed no increased risk of hyperpigmentation or hypertrophic scarring in clients of color.

What side effects can occur with Juvéderm injectable gel?

Most side effects are mild or moderate in nature. The duration is typically brief (seven days or fewer). The most common side effects include, but are not limited to, discoloration and temporary injections site reactions, such as redness, pain and tenderness, firmness, swelling, lumps and bumps, bruising or itching. As with all skin injection procedures, there is a risk of infection.

Juvéderm Voluma®

What is Juvéderm Voluma?

Voluma, from the Juvéderm family of products, is a dermal filler treatment  made of hyaluronic acid (HA), a substance naturally occurring in the body that aids in providing skin elasticity lost with age. What makes Voluma unique is that it is used specifically to restore volume loss in larger areas of the face than other fillers. Its thick gel consistency and unique formulation allow it to be injected deeply into hollow areas with a small needle. It is a smooth, pliable gel filler that produces even, consistent results. The results of Voluma injections are seen immediately and studies have indicated the results are long-lasting (up to 18 months with a treatment regimen).

Voluma is most commonly used for volume restoration in the following areas:

  • Cheeks
  • Cheekbones
  • Chin and jawline
  • Temples

Voluma offers non-surgical options for smooth chin and cheekbone augmentation results. Clients looking for stronger cheekbones or a more prominent chin can achieve natural-looking, temporary results with Voluma injections by an expert. Although the results are temporary, clients can return for touch-up injections to maintain their desired look.

How is Voluma different from other dermal fillers?

Voluma is the only dermal filler made specifically to address volume loss in the cheeks, chin and jawline. The HA works with collagen and elastin to produce smooth, plump results instantly, and has been shown to have long-lasting results.

Do Voluma injections hurt?

Dermal filler injections typically do not cause pain. Voluma, specifically, contains a small amount of lidocaine, which numbs the treatment area as it is injected. Each client should discuss any concerns and questions with the board-certified dermatologist who is performing the injection, beforehand. The doctor can also apply a topical numbing cream to the skin, prior to injection.

How long do Voluma results last?

All dermal filler treatment results vary from one client to the next. However, clients who have had Voluma treatments report that the results do last longer—up to 18 months for many clients who follow a treatment regimen.

Does Voluma address wrinkles?

Voluma is indicated for severe volume loss treatment and works best when injected deep under the skin to fill in hollow areas. Other dermal fillers, such as Restylane, Juvéderm and Belotero may be better options for minimizing the appearance of fine lines and wrinkles that are more superficial. The Esteem professionals can develop a liquid facelift treatment plan to best meet each client’s needs. The liquid facelift includes a combination of injectable treatments to address all problem areas.

What are the side effects associated with Voluma?

Although Voluma is well-tolerated by most individuals, as with any injectable treatment, there are potential side effects including, but not limited to, bruising, swelling, redness or itching after treatment. These should not last longer than a few days. For side effects lasting longer than a week, the doctor should be contacted for further evaluation.


What is Kybella (Deoxycholic acid) injection?

Say Goodbye to Your Double Chin for Good with Kybella

Kybella injection is the first and only FDA-approved injectable drug that contours and improves the appearance of a double chin, due to fat deposition beneath the chin. Kybella is a naturally occurring substance, deoxycholic acid, which aids in the breakdown and absorption of dietary fat. Kybella is indicated for improvement in the appearance of moderate-to-severe fullness associated with fat beneath the chin in adults.

What is a double chin and ‘submental’ fullness?

Fat deposits below the chin lead to the appearance of a “double chin,” which is a common, yet undertreated facial aesthetic condition. It can detract from an otherwise balanced and harmonious facial appearance, leading to an older and heavier look. It is not limited to people who are overweight.

This condition can impact men or women of average weight and can be caused by aging, genetics and weight gain. It is often resistant to diet and exercise alone.

How does Kybella work?

Kybella is a non-human and non-animal formulation of deoxycholic acid, a naturally-occurring molecule in the body that helps with the breakdown and absorption of dietary fat.

When injected into subcutaneous fat, Kybella causes the destruction of fat cells. Once destroyed, those cells cannot store or accumulate fat.

How is Kybella administered?

  • Kybella is injected into the fat under the chin.
  • Each in-office treatment session is typically 15-20 minutes.
  • Treatment with Kybella is customized by the physician to the client’s aesthetic goals for an improved chin profile.

What are the results of Kybella?

Many clients experience visible results in two to four treatments and have typically reported high satisfaction.

Is Kybella safe?

Kybella has been the focus of a global clinical development program involving more than 20 clinical studies and 2,600 clients worldwide. Kybella contains no human or animal-derived substances.

The safe and effective use of Kybella for the treatment of fat outside the chin region has not been established and is not recommended


What is Restylane?

Restylane is the world’s best-selling dermal filler, providing rejuvenating cosmetic beauty treatments for a natural, younger-looking face. It is well-tolerated, nonsurgical and long lasting (usually around six months).

Hyaluronic acid and how skin ages

Hyaluronic acid (HA) is a naturally occurring substance in skin that helps to provide fullness and elasticity. Over time, skin loses HA and, as a result, volume. When skin loses volume, it increases the chances for wrinkles and folds to appear. There’s no stopping it; skin changes with age. But the good news is, there’s something that can be done about it.

Here are the Facts:

  • Young skin is smooth and full.
  • Restylane is injected into the skin to restore volume to correct moderate-to-severe facial wrinkles and folds, such as the lines from the nose to the corners of your mouth (nasolabial folds).

Restylane gives natural-looking results by restoring skin’s fullness.

Sculptra Aesthetic®

What Is Sculptra Aesthetic?

Sculptra Aesthetic is an FDA-approved injectable that addresses the underlying cause of facial aging—lost collagen—not just the symptoms: smile lines between the nose and mouth, laugh lines surrounding the mouth; chin wrinkles. Sculptra Aesthetic helps gradually replace lost collagen for results that can last more than two years.*

Not all treatments or injectables are created the same, nor do they target the same areas of the face. Sculptra Aesthetic is more effective than collagen creams and dietary collagen, which are not well absorbed.

What are the results of Sculptra Aesthetic injections?

With Sculptra Aesthetic, results appear gradually over the treatment regime (typically three injections over the course of three to four months) and can last up to two years.*

*Individual results and treatment sessions may vary. Clinical trial ended at 25 months.

How does Sculptra Aesthetic work?

As a poly-L-lactic acid (PLLA) collagen stimulator, Sculptra Aesthetic works with the body, rather than topically, to help revitalize collagen production and help restore skin’s inner structure and volume. As Sculptra Aesthetic is absorbed, it stimulates collagen production. Rebuilt collagen strands gradually help to restore facial volume and the look of fullness to wrinkles and folds.

For a more youthful appearance — without any obvious or extreme appearance changes — Sculptra Aesthetic can provide another alternative to surgery.

How is it administered?

The specialist injects treatment within the deep dermis, where strands of collagen support the skin’s structure. Over time, Sculptra Aesthetic helps the body reproduce lost collagen. On average, three injection appointments over a period of a few months are necessary for maximum results. The number of injection appointments and the number of injections per appointment vary from person to person, depending on how much collagen has been lost.

Safety and side effects of Sculptra Aesthetic

Sculptra Aesthetic is FDA-approved in the U.S. and has been used worldwide since 1999. Though allergy testing is not required prior to treatment, individuals should not use Sculptra Aesthetic if they are allergic to any of its ingredients.

In addition, clients should not go through treatment if they have an active skin infection or inflammation in the treatment area, or with a history or susceptibility to keloid formation or hypertrophic scarring.

Sculptra Aesthetic should be injected into the deep dermis. Superficial injections may be associated with small bumps and larger lumps under the skin in the treated area. In a clinical study, a few clients reported these bumps and lumps, but none of these events were reported as serious adverse events by the investigator.

For complete details about safety, read the Full Prescribing Information for Sculptra Aesthetic and Patient’s Guide. This guide contains the results of a clinical trial and other specifics.

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