One of the main things that patients are concerned about is an unnatural look following cosmetic treatments and injections, including Botox and fillers. For many, this risk appears to be a fear-inspiring black hole, and the concern about looking unnatural and overdone is widespread. Fortunately, skilled injectors understand what it is that makes a patient look unnatural, and more importantly are able to avoid it with some very specific techniques.
When it comes to treatment with botulinum toxins including Botox and Dysport, the primary culprit of an unnatural result is overdosing. When Botox was first introduced in the late 1990’s, many so-called experts used very high doses to achieve what they felt was an attractive, paralyzed and wrinkle-free appearance. However, the absence of wrinkles came with a price, which was the frozen look that has become so synonymous with Botox. Interestingly, many of us at SkinCare Physicians recognized early-on that this high dose treatment had its flaws. We have been working carefully for many years to optimize the proper dosing strategy, the result of which has been a natural looking and long lasting appearance for our patients. In fact, many of the dermatologists at SkinCare Physicians produce results that last significantly longer than the national average. And obviously, the fact that our patients look natural, rested, and not overdone is the hallmark of treatment at SkinCare Physicians.
The treatments that most often compliment the use of Botox/Dysport are filler injections, usually with one of a variety of products including Juvederm, Restylane, Sculptra, Radiesse, Belotero, and Voluma. Our dermatologists use these products like artists might use a color palette, carefully choosing the correct product to accurately match the specific wrinkle, crease, fold or hollow area that they want to treat. Again, the risk of looking overfilled, overdone, and unnatural is a major concern for our patients. Similar to Botox, technique is everything: once your physician understands what it is that makes a patient look unnatural, he/she can avoid overfilling, and create natural results reproducibly. One of the worst things a doctor can do to create an unnatural look is to overfill the central area of the face, particularly in the area directly under the eyes. It routinely surprises us when we see patients who have been treated elsewhere in the country, and the doctor has focused on the central face area. If you look at celebrities on television or in the movies, you will repeatedly see unnatural appearances which come from an aggressive filling of this central area of the face. While most of us would agree that replacing volume in a careful, thoughtful, and artistic way creates more youthful shapes, it remains a puzzle why some doctors would continue to inject so much material in this central face location.
At SkinCare Physicians, we use a comprehensive approach when treating the face. We work carefully not just to improve wrinkles, but also to improve the cheekbones, shape the temples, contour the jawline, using fillers and neuromodulators in balance to create a result that looks completely natural. It makes sense that overfilling, or filling preferentially in one area of the face will ultimately draw your eye to that area. One of the hallmarks of natural results is that your eye isn’t drawn to any one thing, but that the overall appearance looks improved and pleasing. Therefore, distributing product to several different areas on the face is the recipe for creating natural appearances, rather than focusing on one area in the central face. If you start to look at friends, co-workers, and celebrities, you may be able to pick out this overdone look of the mid-cheek and central face. Don’t even get us started on the topic of overdone lips!
Many of our patients find it comforting to know that the Boston dermatologists at SkinCare Physicians are keenly aware of the flawed treatment strategies that can lead to an unnatural appearance. By understanding and quantifying what the proper treatment approaches are, our doctors are able to predictably avoid unnatural results, and give our patients that subtle, refreshed and improved appearance that so many patients seek.