Sometimes having a refreshed and rejuvenated look doesn’t necessarily mean a trip to the operating room. We understand that a surgical procedure may require a recovery time that may not be available for everybody. For that reason, Dr. Couto also offers a variety of non-surgical alternatives for facial rejuvenation such as filler injections (Restylane® or Juvederm®) and neuromodulators (Botox®, Dysport®, Xeomin®).
See more LessBBL® HEROTM by Sciton® is a gentle, fast, safe, and non-invasive phototherapy that requires little to no recovery. This device offers several treatments that helps reverse signs of aging, corrects sun damage, treats active acne, offers hair removal, and treats other skin conditions. It improves the appearance of the skin by correcting issues like fine lines and wrinkles by revitalizing the skin at multiple layers with the stimulation of collagen formation, thus, improving skin elasticity and firmness, giving it a new tone and glow. This treatment is done in the office in less than 20 minutes. Requires little to no recovery, and you can return to your normal activities on the same day and wear make up the same day. The skin may appear red and swollen and have a mild sunburn sensation that can last from a few hours to several days after treatment. Post-treatment discomfort is typically minimal but if the area is very uncomfortable, oral pain relievers can be taken (Tylenol®, Advil®). Freckles and sunspots may turn slightly darker initially and then flake off within 7-14 days- this is a desired and normal reaction. There may be redness and slight swelling around the treated vessels for up to 7 days. Typically, 2-3 treatments are recommended spacing them 2-4 weeks apart. For optimal results BBL® HEROTM can be combined with other skin treatments like MOXITM, Microneedling, and/or PRP. Skin conditions treated with BBL® HEROTM:
Length of Treatment: 10-15 minutes (depends on the number of areas been treated)
Anesthesia: None or Topical Anesthesia
Office vs Surgical Treament: Office Treatment
Recovery: No Recovery, May Wear Makeup the Same Day.
Ancillary Treatments: MOXITM, Microneedling, and/or PRP.
BroadBand Light (BBL)®, also known as IPL (Intense Pulsed Light) or photofacial, delivers broad-spectrum visible and infrared light energy into the skin to regenerate skin cells, improve skin health, brighten skin, and treat several skin conditions. BBL (BroadBand Light)® HERO (High Energy Rapid Output)TM is the upgraded technology of BBL® which delivers 4x the speed, 3x peak power, and 2x the cooling as the original BBL®, which means more effective results and more comfortable treatments. It offers three different types of skin care treatments: Forever Young BBL® for skin rejuvenation, Forever Clear BBL® for acne, and Forever Bare BBL® for hair reduction.
The best candidates for BBL® HEROTM include:
The consultation is divided into five parts:
I. Health and Medical History Evaluation
A comprehensive evaluation of the patient’s health and medical history is performed. During this part of the consultation, we focus on identifying any potential risk factors for the treatment.
II. Learning Patient’s Goals
Dr. Couto has a deep discussion with the patient to learn what are the areas of concern and aesthetic goals. Listening to our patient’s interest is crucial, since it is our priority to determine if we can meet their expectations.
III. Physical Exam
A focused physical exam of the areas of interest is performed. In this part of the consultation, we will evaluate the patient’s skin type, skin conditions if any, and all the concerns the patient has. This comprehensive evaluation also includes a thorough skin analysis using our VISIA® Skin Analysis System, and will help us determine if this is the right choice for you and ensures that your treatment plan is tailored to meet your unique needs and expectations.
IV. Recommendations & Treatment Plan
Following the physical exam and the VISIA® Skin Analysis System, Dr. Couto develops a personalized treatment plan aimed to meet the patient’s expectations, achieve optimal aesthetic results, and maximize patient safety. During this time, Dr. Couto discusses with the patient if he/she is a candidate for a BBL® HEROTM treatment, and other possible ancillary treatments. Furthermore, we discuss in detail everything pertaining to each of the treatments and its recovery.
V. Pricing and Scheduling Information
Once the evaluation has been completed, our team will provide an individualized quote that is tailored to the treatment(s) discussed during the consultation and also discuss the steps involved to book the treatments with us. At Couto Plastic Surgery we believe in transparency and we will provide you with a detailed breakdown of costs during your private consultation. This ensures that you have a clear understanding of the investment involved in your BBL® HEROTM treatment. This includes the number of treatments needed, number of treatment areas, and if any added ancillary treatments like MOXITM, Microneedling, and/or PRP.
Preparing for the BBL® HEROTM treatment is important. In the 2 weeks leading up to the appointment, you should avoid:
Furthermore, avoid any topical products or medications, such as Hydroquinone that cause skin photosensitivity for 3 days before your treatment. Don’t worry if you’re not sure what products these might be; call our office, and we’ll personally instruct you before your treatment.
After the BBL® HEROTM treatment the skin may appear red and swollen and have a mild sunburn sensation- this is a normal reaction. It can last from a few hours to several days after treatment. Post-treatment discomfort is typically minimal but if the area is very uncomfortable, oral pain relievers can be taken (Tylenol®, Advil®). Freckles and sunspots may turn slightly darker initially and then flake off within 7-14 days- this is a desired and normal reaction. There may be redness and slight swelling around the treated vessels.
The skin may appear red of blotchy in the treated area for 1-2 days. Mineral makeup can be used the same day as long as the skin integrity has not been compromised. Starting on the morning after the patient can cleanse the treated area gently with a mild cleanser, apply a moisturizer, followed by a broad-spectrum UVA/UVB sunblock of at least SPF 30. Patient must strictly avoid any sun exposure to the treated area for a minimum of 2 weeks after the procedure. The treated area is more prone to sunburn and pigmentation changes. Any products containing active ingredients like Retinol (Retin-A, Tretinoin, Vitamin A), Glycolic Acid, Salicylic Acid, AHAs (Alpha-hydroxy acids), BHAs (Beta-hydroxy acids), LHAs (Lipo-hydroxy acids), Vitamin C, and Benzoyl Peroxide can be restarted 7 days after the treatment.
Additional treatment sessions are based upon your clinician’s recommendations. Typically, 2-3 sessions are needed and are done 2-4 weeks apart (depending if other ancillary treatments are done at the same time, i.e. MOXITM, Microneedling).
BBL® HEROTM is a straightforward treatment performed in the office following your consultation. Prior to undergoing the treatment, patients will undergo an objective and comprehensive evaluation of the skin using our high technology VISIA® Skin Analysis Imaging System. Although not necessary, the area to be treated can be numbed with topical anesthesia. Then, we remove all the makeup, and we clean and sterilize the area. Then we proceed to perform BBL® HEROTM treatment. The treatment usually takes 8-10 minutes. Afterward, the nurse will apply cold compression to the site and apply a medical skin grade moisturizer.
The MOXI® Laser by Sciton is the newest non-ablative fractional laser technology, which gently addresses superficial pigmentation and enhances skin tone and texture. Unlike more aggressive laser procedures, MOXI® requires minimal recovery and it is suitable for all skin types throughout the year, including summer. MOXI® corrects common signs of aging, sun damage, uneven pigmentation, fine lines and wrinkles, enlarged pores, and melasma, and is clinically proven to extend the results of more aggressive laser and light treatments to help maintain a radiant, healthy glow. Typically, 3-4 MOXI® sessions spaced 4 weeks apart are recommended for optimal results, followed by regular maintenance treatments 1-2 times per year. Downtime typically entails mild redness, swelling, and texture changes lasting 3-5 days, with the option to apply makeup after 24 hours.
Treatment Duration: 15-30 minutes (depends on the number of areas treated)
Anesthesia: Topical Anesthesia
Office Treatment vs. Surgical Room: Office Treatment
Recovery time: None
Auxiliary treatments: BBL HERO®, Microneedling, PRP, neuromodulators
MOXI® is a non-ablative and fractionated 1927nm laser that targets water within the cells to stimulate a natural healing process in the skin, which results in the production of collagen, elastin and hyaluronic acid, essential factors in skin rejuvenation. This produces an effective treatment with little-to-no recovery time.
The consultation is divided into five parts:
I. Health and Medical History Evaluation
A comprehensive evaluation of the patient’s health and medical history is performed. During this part of the consultation, we focus on identifying any potential risk factors for the treatment. Virtually all skin types are safe to have the MOXI® laser treatment.
II. Learning Patient’s Goals
Dr. Couto has a deep discussion with the patient to learn what are the areas of concern and aesthetic goals. Listening to our patient’s interest is crucial, since it is our priority to determine if we can meet their expectations.
III. Physical Exam
A focused physical exam of the areas of interest is performed. In this part of the consultation, we will evaluate the patient’s skin type, skin conditions if any, and all the concerns the patient has. This comprehensive evaluation also includes a thorough skin analysis using our VISIA® Skin Analysis System, and will help us determine if this is the right choice for you and ensures that your treatment plan is tailored to meet your unique needs and expectations.
IV. Recommendations & Treatment Plan
Following the physical exam, Dr. Couto develops a personalized treatment plan aimed to meet the patient’s expectations, achieve optimal aesthetic results, and maximize patient safety. During this time, Dr. Couto discusses with the patient if he/she is a candidate for the MOXI® laser treatment, and other possible ancillary treatments. Furthermore, we discuss in detail everything pertaining to each of the treatments and its recovery.
V. Pricing and Scheduling Information
Once the evaluation has been completed, our team will provide an individualized quote that is tailored to the treatments discussed during the consultation and also discuss the steps involved to book the treatments with us. At Couto Plastic we believe in transparency and will provide you with a detailed breakdown of costs during your private consultation. This ensures that you have a clear understanding of the investment involved in your MOXI® laser treatment. This includes the number of treatments, and number of treatment areas, and if any ancillary treatments like BBL HEROTM, Microneedling, and/or PRP.
Everyone! MOXI® can benefit both young and older patients. In the young population, MOXI® works as a “pre-rejuvenation” tool. Which helps delay age changes and maintains a rejuvenated skin. The benefit of MOXI® in older people is that it helps revitalize the skin, thus improving the texture, tone, and wrinkles that occur with the aging process. One of the things that sets MOXI® apart from its competition is that its technology can literally be used on every patient, regardless of skin age, type or pigmentation.
Preparing for your laser treatment is important. In the 2 weeks leading up to your appointment, you should avoid:
Furthermore, avoid any topical products or medications, such as Hydroquinone that cause skin photosensitivity for 3 days before your treatment. Don’t worry if you’re not sure what products these might be; call our office, and we’ll personally instruct you before your treatment.
We start all patients on a skincare regimen recommended by our treatment team. Be sure to use sunscreen daily to help prevent sun damage and burns before treatment. As stated above, we will recommend the appropriate sunscreen as part of your skincare package.
Patients who have a history of fever blisters, shingles, or herpes and who are taking Valtrex must take it 3 days before treatment, on the day of treatment, and 3 days after treatment.
After undergoing the MOXI® treatment you will experience redness on the treated area. The redness is comparable to a sunburn, and it typically lasts for 24-48 hours days. We recommend our patients to use gentle cleansers and keep your skin moisturized and out of the sun, which will allow your skin time to heal and limit further stress on your skin. The treated area may be warm for 1-2 hours after the treatment. Warmth may continue for 12-24 hours after the treatment. Cold compresses may provide comfort during this time. Also, a mineral water spray might provide some relief and much needed moisture to the skin. MENDs (microscopic epidermal necrotic debris) will appear on the 2nd or 3rd day after treatment as tiny dark spots and bronzed appearance to the treated skin. MENDs are part of the healing process where treated tissue is working its way out of your body as new fresh skin is regenerated. During this time, your skin will be very dry and feel like sandpaper before flaking and peeling off. Keep your skin well moisturized to support the healing process.
MOXI® is a straightforward treatment performed in the office following your consultation. Prior to undergoing the treatment, patients will undergo an objective and comprehensive evaluation of the skin using our high technology VISIA® Skin Analysis Imaging System. Then the area to be treated is numb with topical anesthesia. Once the skin is numb, we remove all the makeup, and we clean and sterilize the area. Then we proceed to perform MOXI® treatment. The treatment usually takes 8-10 minutes. Afterward, the nurse will apply cold compression to the site and apply a medical skin grade moisturizer.
VISIA® skin analysis is a high-tech imaging device that comprehensively and objectively evaluates the skin’s health and condition. This cutting-edge technology performs quantitative analysis and a visual assessment in different aspects of the skin that include texture, tone, and color. Thus, providing a valuable insights into the skin’s overall health, including wrinkles, age spots, pores, UV or sun damage, brown spots and facial redness. The benefit of this advanced technology is that it allows us to create an individualized treatment plan to each of our patients. Furthermore, it offers the revolutionary TruSkin AgeTM, a tool that uses the world’s largest skin feature database to compare a patient’s facial skin features to their peers to calculate their relative skin age. VISIA® skin analysis can detect various skin features, including:
The VISIA® Skin Analysis System works by capturing high-resolution images of the skin’s surface using highly advanced technology. The device uses specialized lighting to reveal details of the skin’s condition that are not visible to the naked eye. This includes a UV flash that mimics the path of UV light from the sun, exposing underlying skin damage not visible under regular lighting conditions.
VISIA® skin analysis offers several benefits:
Overall, the VISIA® skin analysis can help individuals take a proactive approach to treatments, skin care, prevent further damage, and achieve healthier skin.
During the analysis, the patient is positioned in front of the device while the camera captures facial images from three different angles. Subsequently, the software analyses the images and generates a comprehensive report on the skin’s condition. The report delineates various skin characteristics such as wrinkles, fine lines, pores, skin texture, facial redness, pigmentation irregularities, and UV damage caused by sun exposure. Uniquely, the results of each of the categories are scored as percentiles for future comparisons. Based on the analysis, the practitioner can develop a personalized treatment plan with focus on the areas of greater need. And last, but not least, we will use the TruSkin AgeTM tool to understand where the patient’s relative skin age stands compared to their peers.
Let’s be honest, skin wrinkles and fine lines on the face don’t help our image at all. If skin wrinkles are progressively getting worse and are bothering you, then neuromodulators, such as Botox®, may be the right treatment for you. Neuromodulator is an anti-aging treatment that helps soften those age-related facial skin lines. Its ability to not only soften skin wrinkles, but also to prevent or delay these unwanted facial skin lines has made neuromodulators a popular treatment across all age groups. No wonder Botox® is the most common non-surgical cosmetic procedure performed worldwide.
Dr. Couto is a board-certified, Cleveland Clinic trained plastic surgeon, and one of the few plastic surgeons in Latin America to have completed an American Society of Aesthetic Plastic Surgeon (ASAPS) endorsed subspecialty training in Aesthetic Surgery and Medicine.
Dr. Couto specializes in both surgical and non-surgical aesthetic treatments. Therefore, an objective and unbiased recommendation will always be provided during your consultation. The ability to know firsthand what can be accomplished non-surgically and when a surgical intervention is required is a unique and essential quality in the field of aesthetic surgery and aesthetic medicine.
Neuromodulators or neurotoxin is the name we give to botulinum toxin. There are numerous brands, such as Botox®, Dysport®, Xeomin®, Jeaveau®. Botox® is the most recognized brand, because they were the first neuromodulators to obtain FDA-approval for skin wrinkles in the face.
Although there are numerous medical indications for neuromodulators, it is most commonly used for the treatment and prevention of facial skin lines. Neuromodulators work by selectively weakening those facial muscles producing excessive skin wrinkles. The most common treated areas are usually the forehead, between the eyebrows, and on the lateral corner of the eyes, also known as the lateral crow’s feet. After its administration it usually takes 5-12 days to start seeing the effects. Neuromodulators approximately last 3-4 months. It is important to note that 5% of the population may develop antibodies to certain neuromodulators brand; thus, making the treatment ineffective. In those cases, the patient is treated with a different neuromodulator brand, one that has a lower risk of developing antibody resistance.
The real question is, who is not? Neuromodulators can benefit, both young and older patients. In the young population, neuromodulators help smoothen facial expression lines, but most importantly, it prevents or delays the development of unwanted facial skin lines. Dr. Couto has written on this topic in scientific journals. The benefit of neuromodulators in older individuals is that it actively softens facial skin wrinkles and prevents existing skin lines to worsen. In addition to its rejuvenative effect on the skin, neuromodulators can provide a cosmetic and functional benefit on patients suffering from teeth grinding during their sleep. Also, it helps reduce or eliminate excessive sweating of the axilla, hands, or feet.
Neuromodulators are commonly referred to as Botox®; however, Botox® is just one of many brands available in the market. Each brand has a specific type of botulinum toxin, and a unique effect. It is for that reason that selecting the type of neuromodulator to be used should be tailored to the patients needs and aesthetic goals.
Unfortunately, the number of commercially available neuromodulators has increased dramatically worldwide over the past decade. However, there are just a handful of neuromodulator brands that are approved by the US Food & Drug Administration (FDA). Knowing the type and brand of neuromodulator being used is crucial, since a non-medical grade neuromodulator can produce suboptimal results and potentially produce complications. In our practice, we only offer FDA approved neuromodulators, this includes:
Botox®
Dysport®
Xeomin®
Jeaveau®
The consultation is divided into five parts:
1) Health and Medical History Evaluation
A comprehensive evaluation of your medical history is performed. During this part of the consultation, we focus on identifying any potential risk factors for the treatment. It is important to tell Dr. Couto if you have recently taken blood thinning medications such as aspirin, ibuprofen, or anti-coagulants, as this can lead to greater bruising. Furthermore, it is important to specify if you have experienced any allergic reactions or complications to neuromodulators in the past.
2) Discuss with the Patient About Surgical Goals
Dr. Couto has a deep discussion with the patient to learn about their concerns and goals. Listening to our patient’s interest is crucial, since it is our priority to determine if we can meet their expectations.
3) Physical Exam
A complete systematic analysis of the face is performed. Dr. Couto treats the face and neck as whole, not by areas. A youthful appearance is marked by smooth transitions between different areas of the face and neck. Consequently, Dr. Couto not only examines the regions the patient is mainly concerned with, but also those surrounding areas and structures of the face that could help achieve a balanced and refreshing look.
4) Recommendations & Treatment Plan
Following the physical exam, Dr. Couto develops a personalized plan aimed to meet the patient’s expectations, achieve optimal aesthetic results, and maximize patient safety. During this time, Dr. Couto discusses with the patient if the desired aesthetic look by the patient can be achieved with the use of neuromodulators or if a surgical intervention is required.
5) Treatment
Once the treatment plan has been determined, we proceed to do the injection treatment. It usually takes 3 minutes complete the treatment.
Neuromodulator treatment is a straightforward and painless procedure that is usually performed in the office following your consultation. First, we examine and determine the areas where the neuromodulator will produce the highest benefit. Then we proceed to perform the injections, it usually takes a few minutes.When performing the injections, we use the thinnest needles Afterward, the nurse will apply cold compression to the site and help scheduling any follow-up appointments or treatments, as necessary.
In order to minimize bruising, we recommend our patients to avoid taking blood thinning medications such as aspirin, ibuprofen, or anti-coagulants, as this can lead to greater bruising.
Recovery time is not required! You can continue with your normal daily living activities following neuromodulator injection. After your treatment, we do recommend applying cold compression to the area to minimize swelling and bruising. We also encourage patients to use Arnica products, as this may help resolve unwanted bruising much faster.
Neurmodulator is only safe treatments when an experienced and certified injector is performing the procedure. With the increasing worldwide demand of injectables, we are observing a significant amount of uncredentialed personnel performing this procedure. As a result, every week we have patients showing up to our clinic with complications. Some patients have a bad aesthetic result, while others have complications, such as eyelid droopiness, descent of the brow, or smile deformities. The problem with these uncertified injectors is that they lack proper training. This lack of experience not only increases your risk of complications, but they are less likely to know what it needs to immediately do to treat these adverse events. Furthermore, many of these non-certified injectors do not have access to FDA-approved neuromodulators;instead, they commonly use non-medical grade botulinum toxin acquired through the black market.
We recommend to our patient to always do your research before undergoing a neuromodulator treatment. Enquire about the injector’s credentialing and experience doing neuromodulator. Also, ask about the origin of the product and ensure that FDA-approved neuromodulators are being used.
Neuromodulators are typically used to restore the shape by raising the tail of the eyebrows. Although it works beautifully to the great majority of patients, its brow lifting effect may be limited to individuals with advanced brow descent. In these cases, a browlift may be the indicated procedure.
The effect of neuromodulators usually last 3-4 months. That been said, everyone is different.
This could be due to several reasons. One reason maybe that the product that injecting you with is expired or is poor quality. The other reason may be that the injector is not treating the areas adequately or administering enough product. Alternatively, you may have developed resistance to a neuromodulator. Approximately, 5% of the population may develop antibodies to certain types of botulinum toxin. Thus affecting the effectivity of the treatment. The most common scenario for this is a patient that had a good response the first time she got treated, but minimal to no effect the following treatment sessions. When that occurs, the patient needs to be treated with an specific neuromodulator that is designed to lower the risk of developing antibody resistance.
Loss of facial volume is a common trait of aging. These changes produce loss of definition of the cheek, deflation of the lips, and pronunciation of skin lines and wrinkles. Luckily, these can be quickly treated in the office with the use of facial filler injections, also known as dermal fillers. The main objective of a dermal filler is to fill hollow and deflated areas of the face and body, and subsequently soften skin folds and wrinkles. Although dermal fillers are not a substitute for a surgical facial rejuvenation, it is an essential tool that helps individuals amplify or maintain their facial aesthetic beauty without the need undergoing surgery.
Dr. Couto is a board-certified, Cleveland Clinic trained plastic surgeon, and one of the few plastic surgeons in Latin America to have completed an American Society of Aesthetic Plastic Surgeon (ASAPS) endorsed subspecialty training in Aesthetic Surgery and Medicine.
Dr. Couto specializes in both surgical and non-surgical aesthetic treatments. Therefore, an objective and unbiased recommendation will always be provided during your consultation. The ability to know firsthand what can be accomplished non-surgically and when a surgical intervention is required is a unique and essential quality in the field of aesthetic surgery and aesthetic medicine.
Facial fillers or dermal filler injections is an office-based treatment designed to treat those areas of the face and body affected by the loss of volume associated with aging. In addition, some of these products have intrinsic capacity to stimulate collagen production and hydrate the skin & soft tissue.
Dermal fillers are made of biological synthetic materials that are present in our skin and soft tissue, and thus it is typically compatible with the human body. There are numerous classes of dermal fillers (e.g. hyaluronic acid, calcium hydroxyapatite, poly-L-lactic acid). However, hyaluronic acid-based fillers, such as Restylane® and Juvederm® are the most popular dermal fillers in the market. This is because it is a product that can be easily degraded with hyaluronidase and it blends well with the soft tissue.
Dermal fillers can benefit both, young and older patients. Dermal fillers are excellent for patients interested in enhancing the shape of certain parts of their body, such as the lips, chin, buttock. It is also indicated for individuals exhibiting early or advanced aging changes where volume restoration is required.
On the other hand, patients exhibiting gravitational changes, such as a saggy skin, prominent jowls, and loss of definitions of the jawline and neck, may require a surgical intervention. Facial rejuvenation surgery are procedures designed to specifically achieve those things that dermal fillers cannot: remove excess skin and lift descended soft tissue into an aesthetic pleasing position.
The number of commercially available injectable dermal fillers has increased dramatically worldwide over the past decade. However, there are just a handful of dermal fillers brands that are approved by the US Food & Drug Administration (FDA). Knowing the type and brand of dermal filler being used is crucial, since a non-medical grade dermal filler can result in catastrophic complications. In our practice, we only offer FDA approved dermal fillers, this includes:
Hyaluronic Acid-Based:
Restylane
Restylane Lyft
Restylane Defyne
Restylane Refyne
Restylane Contour
Restylane Kysse
Juvederm Ultra XC
Juvederm Ultra Plus
Juvederm Vollure
Juvederm Volbella
Juvederm Voluma
Calcium Hydroxylapatite Fillers:
Radiesse
Poly-L-Lactic Acid
Sculptra
The consultation is divided into five parts:
1) Health and Medical History Evaluation
A comprehensive evaluation of your medical history is performed. During this part of the consultation, we focus on identifying any potential risk factors for the treatment. It is important to tell Dr. Couto if you have recently taken blood thinning medications such as aspirin, ibuprofen, or anti-coagulants, as this can lead to greater bruising. Furthermore, it is important to specify if you have experienced any allergic reactions or complications to filler injections in the past.
2) Discuss with the Patient About Surgical Goals
Dr. Couto has a deep discussion with the patient to learn about their concerns and goals. Listening to our patient’s interest is crucial, since it is our priority to determine if we can meet their expectations. We focus on learning whether the patient is particularly interested in addressing an specific area of the face or if the patient is interested in a global face and neck rejuvenation.
3) Physical Exam
A complete systematic analysis of the face and neck is performed. Dr. Couto treats the face and neck as whole, not by areas. A youthful appearance is marked by harmonious transitions between different areas of the face. Consequently, Dr. Couto not only examines the regions the patient is mainly concerned with, but also those surrounding areas and structures of the face and neck that could help achieve a balanced and refreshing look.
4) Recommendations & Treatment Plan
Following the physical exam, Dr. Couto develops a personalized treatment plan aimed to meet the patient’s expectations, achieve optimal aesthetic results, and maximize patient safety. During this time, Dr. Couto discusses with the patient if she if dermal fillers will achieve the desired aesthetic looks or if a surgical procedure is required. Dr. Couto will explain in detail everything pertaining to the procedure and its recovery.
5) Pricing and Scheduling Information
Once the evaluation has been completed, our team will provide an individualized price quote that is tailored to the procedure(s) discussed during the consultation and review the steps involved to book the procedure with us.
Filler injection treatment is a straightforward and painless procedure that is usually performed in the office following your consultation. First, the area to be treated is numb with topical anesthesia. Once the skin is numb, we remove all the makeup and we clean and sterilize the area. Then we proceed to perform the injections. The entire procedure usually takes a few minutes. Afterward, the nurse will apply cold compression to the site and help scheduling any follow-up appointments or treatments, as necessary.
In order to minimize bruising, we recommend our patients to avoid taking blood thinning medications such as aspirin, ibuprofen, or anti-coagulants, as this can lead to greater bruising.
Recovery time is not required! You can continue with your normal daily living activities following dermal fillers injection. After your treatment, we do recommend applying cold compression to the area to minimize swelling and bruising. We also encourage patients to use Arnica products, as this may help resolve unwanted bruising much faster.
Facial filler injections is only a safe treatment when an experienced and certified injector is performing the procedure. With the increasing worldwide demand of dermal fillers, we are observing a significant amount of uncredentialed personnel performing this procedure. As a result, every week we have patients showing up to our clinic with complications. Some patients have a bad aesthetic result, while others have catastrophic complications, such as skin necrosis due to intravascular injections. The problem with these uncertified injectors is that they lack proper training. This lack of experience not only increases your risk of complications, but they are less likely to know what it needs to immediately do to treat these adverse events. Furthermore, many of these non-certified injectors do not have access to FDA-approved dermal fillers;instead, they commonly use non-medical grade filler materials acquired through the black market.
We recommend to our patient to always do your research before undergoing a dermal filler injection. Enquire about the injector’s credentialing and experience doing dermal fillers. Also, ask about the origin of the product and ensure that FDA-approved dermal fillers are being used.
This is a controversial topic in the field of facial aesthetics, since there is conflicting scientific data. Based on the existing scientific evidence, we can say that the main mechanism of action of a filler injection is to volumize those areas affected with age-related volume loss. Recent studies suggest that facial fillers might provide a minimal lifting effect when used on the lateral aspects of the face. However, it is important to note that this study emphasizes that this lifting effect is minimal and facial filler treatment should never be used to treat saggy, descended saggy skin.
Advantages:
1)Filler injection treatment does not require harvesting fat from your body; thus is a quick, non-invasive procedure that is performed in the office.
2) Recovery time is not required following filler injection treatment.
3) In case of an unwanted result, filler injections can be easily reversed with a degradation reagent called hyaluronidase.
Disadvantages:
1) Although filler injections are made of safe biological materials, these are synthetically produced. During facial fat transfer, fat harvested from your own body is being used to restore volume.
2) Fat is more cost-effective than facial fillers injections.3) Fat provides a permanent volume restoration. On the other hand, filler injections are temporary as they typically last 8-12 months.
4) Fat volume is readily available
