Facial injectables are dermal fillers that provide anti-aging effect and improve the appearance. Botox is the most widely used neurotoxin that adds fullness, creates volume, and contours to the face. The best-in-class plastic surgeon in Manhattan, NYC Dr. Gary Linkov uses dermal filler to create a natural, youthful appearance. At City Facial Plastics, a board-certified facial plastic surgeon, Dr. Gary Linkov, is specially trained in the aging process and can address your unique concerns.
What Are Facial Injectables?
Facial injectables are utilized in the anti-aging process to reduce and eliminate wrinkles, soften and relax folds, such as smile lines, improve the appearance of hollowing under the eyes, on the cheeks, and around the mouth and nose, and to contour and lift areas of the face, such as the jawline and the nose. There are several different types of facial injectables and injectable cosmetic procedures to improve each patient’s specific areas of concern.
See a summary of facial cosmetic injectables below:
|Injectable Name||Compound Material||Uses for Injectable|
|Radiesse||Calcium hydroxylapatite (CaHA)||
Juvederm Ultra Plus
|Hyaluronic acid (HA)||
|Sculptra||Poly-l-lactic acid (PLLA)||
|Botulinum toxin type A (neurotoxin)||
What Is Filler?
Facial fillers, sometimes called dermal fillers or soft tissue fillers, are substances that are injected into the skin to add fullness, create volume, plump the lips, smooth the skin, and contour to the face. Injectable fillers are compounds of polymethylmethacrylate, Poly-l-lactic-acid, hyaluronic acid, or calcium hydroxylapatite. They are FDA approved for facial injections and are very safe, provided you are being treated by a board certified physician. There are many fillers on the market. Not all injectable fillers treat all concerns. To address your unique concerns, many times your board certified facial plastic surgeon in UES, Manhattan, Dr. Gary Linkov, will use a combination of fillers to achieve your desired result.
What Is the History of Facial Filler?
The history of dermal fillers dates back to the 1800’s. Doctors and scientists were trying to improve the appearance of scarring and deformity caused by disease and infection. They used fat harvested from patients as well as different chemical agents. The first injectable filler was paraffin. While paraffin is used today in candles, cosmetic products, polishes, and various chemical compounds, it is no longer used as an injectable filler due to serious complications.
Silicone was also used as a filler agent. In the United States, silicone, used as a filler, has been banned by the FDA due to serious consequences ranging from infection to deformity and in rare instances, death. However, there are still some providers that use silicone so patients need to be careful. In 1981, the FDA approved the first facial filler, purified bovine collagen. As of 2020, the FDA had approved 21 dermal fillers for various indications.
What Areas Are Facial Fillers Used On?
Facial fillers are used all over the face to improve contour, remove wrinkles, smooth the skin, restore volume, soften expression, and plump lips. Injectable fillers can be placed in the temple area, under the eyes, along the cheeks, in the marionette lines around the mouth, in the lips, in the nasolabial folds, in the chin, along the jawline, and in acne scarring.
Facial fillers can also be used for:
- Non-surgical rhinoplasty (liquid rhinoplasty)
- Non-surgical facelift
- Non-surgical cheek lift
- Non-surgical eyelift
During your consultation at City Facial Plastics in New York, board certified facial plastic surgeon, Dr. Gary Linkov will discuss your specific areas of concern. Together, you will create a plan that will resolve your concerns and restore a refreshed, youthful appearance you desire.
What Will Fillers Do?
Some people naturally have full cheeks, smooth skin and plump lips. For others, dermal fillers can help patients:
- Experiencing the effects of aging
- Lacking contour in their faces
- Desire to enhance certain facial features
As people age, skin loses its elasticity. The fat in the face thins out and the muscles lose tone. The changes as we age result in the appearance of less volume, more wrinkles and skin that does not appear as smooth and hydrated. Today, hyaluronic acid, a natural compound, is used in the most common facial fillers.
Injectable fillers help to combat the signs of aging by:
- Restoring lost volume
- Smoothing out lines
- Adding plumpness
- Giving a hydrated appearance to the skin
Facial fillers are also wonderful options for people who have always wanted a little extra volume in their lips, definition around their jaw line, or a more contoured look to their face.
Which Filler Is Used and How Long Will It Last?
The type of facial filler needed depends on several factors:
- Location on face where filler will be placed
- Patient and doctor preference
The longevity of facial fillers can vary based on:
- Type of filler material used
- The area the filler was placed
- At what rate a person will metabolize the filler material
Once dermal fillers are placed and the desired results are achieved it is important to return for touch-ups to maintain the results. Approximately half way through the period a filler lasts, people may notice a decrease in volume. If this happens, it may be time for a touch up. Touch-ups will help to maintain your results much longer.
The longevity of a facial filler usually lasts between 6 to 12 months, with some lasting up to 2 to 5 years. As with any other procedure, an individual’s results will vary.
If a hyaluronic acid based filler is used and the results are unfavorable or a complication occurs, it can be reversed with hyaluronidase.
See the longevity chart below for most of the brands of facial fillers, including Restylane and Juvederm.
|Injectable Name||Longevity||Example Areas Used|
|Radiesse||12-18 months||Cheeks, jawline|
|Restylane-L||9-18 months||Eyes, nose, corners of mouth|
|Restylane Lyft||9-15 months||Cheeks, nose, chin|
|Restylane Silk||4-8 months||Lips|
|Voluma||9-18 months||Cheeks, chin|
Juvederm Ultra Plus
|6-12 months||Corners of mouth, lips|
|Belotero||4-8 months||Fine lines and wrinkles around mouth|
|Sculptra||12-24 months||Deep frown lines around nose, mouth, chin|
|Bellafill||Up to 60 months||Deep lines and wrinkles, facial contouring|
What Are Neurotoxins?
Another type of injectable, quite different from filler is neurotoxin. Neurotoxins work by paralyzing muscle and in doing so they reduce and in some cases eliminate wrinkles.
The most common types of neurotoxins include:
Botox is the original and most widely used neurotoxin but the others work in practically the same way. There are slight differences between how they are prepared and the exact effect, especially the “spread” of the injection. Based on this patients and doctors have their own preferences. Dr. Linkov prefers to use Jeuveau in his practice as it tends to have a quicker onset and lasts a bit longer. Dr. Linkov also carries Botox for patients who have grown accustomed to it over the years.
What Areas Are Neurotoxins Used In?
Neurotoxins can be used on different areas of the face, some of which are FDA approved and others that are not, including:
- Forehead – for the horizontal forehead lines
- Glabella – for the vertical “11’s” and the horizontal crease at the top of the nose
- Crow’s feet – for the radial lines on the side of the eye and to slightly lift the lateral eyebrow
- Masseter muscle – to improve TMJ and slim the lower face
- Base of nose – to improve excessive gum show and to reduce drooping of the nose with smile
- Mentalis (chin) – to reduce the appearance of wrinkles in the chin area
- Depressor anguli oris – to raise the corners of the mouth
What Will Neurotoxins Do in the Areas They Are Used?
Neurotoxins act on the connections between nerve and muscle. It reduces the release of a signaling message, called acetylcholine. This causes the muscles not to contract. These effects work locally where they are placed by the doctor.
How Long Will Neurotoxins Last?
You will first notice the effects of the neurotoxin after about 72 hours. The maximum (peak) effect of neurotoxins is at about 2 weeks. Neurotoxins, such as Botox, last about 3 months on average, though the range is closer to 2-6 months.
What Facial Injectables Are Offered by Dr. Gary Linkov?
Though there are many options on the market, the best-in-class plastic surgeon in Manhattan, NY Dr. Linkov uses the following facial injectables reliability in his practice:
- Restylane Silk
- Restylane Lyft
Dr. Linkov finds that he can consistently and safely treat his facial aesthetic patients with this selection of facial injectables.
Is There a Difference Between Botox and Jeuveau?
Botox and Jeuveau are made of a similar protein which is 90-100 kilodalton in size. Botox is made by a company called Allergan and Jeuvaeu is made by a company called Evolus. Botox has been on the market since 2002 for cosmetic use and Jeuveau since 2019. Jeuveau is strictly focused on the aesthetic market and has been FDA approved for the glabella. Some patients have a strong preference for one over the other, though there is truly very little difference in results.
How Much Do Facial Injectables in NYC Cost?
The cost of facial fillers vary depending on factors such as type of filler, location of the office, expertise of the injector, and the duration of the procedure. According to a national survey conducted by the American Board of Cosmetic Surgery, facial injectable filler ranges in price from $540 – $1680 per syringe. Depending on several factors, more than one syringe may be needed.
Neurotoxin injections range in price from $8 – $30 per unit or $250 – $850 per area. Some providers charge by the unit and others by the area. Plastic surgeon Dr. Linkov charges by the area and offers complementary touch-up injections at the 2 week time point, once full effect of the neurotoxin has been reached.
Talk to your provider about a possible discount on combination treatments when numerous areas and syringes are involved.
Are Facial Injectables Natural?
A common concern that patients have is whether or not facial injectables are natural. Some injectables are in fact synthetic (PMMA, PLLA, Silicone), while others are more natural or simulate natural compounds such as hyaluronic acid. Hyaluronic acid exists in every one of our cells already.
The neurotoxin that is used for aesthetic purposes is also “natural” in that it already exists in the natural world. Botulinum toxin is a neurotoxic protein produced by the bacterium Clostridium botulinum and related species. It is normally quite toxic, but in very small quantities it helps us look younger and more beautiful.
What Are Facial Injectables Risks and Complications?
The risks and complications of facial fillers include:
- Allergic reaction (hypersensitivity)
- Vascular occlusion
- Poor aesthetic outcome
- Chronic granuloma
- Herpes reactivation
The risks and complications of neurotoxins (such as botox) include:
- Poor aesthetic outcome
- Eyelid ptosis
- Allergic reaction
- Crooked smile
- Muscle weakness (diffuse)
Who Should Be Doing My Facial Injectables?
There are many types of providers that do dermal fillers. Sometimes this is done legally and sometimes illegally. Every state has different laws that govern who can and cannot do facial cosmetic injectables such as filler and Botox.
The general types of people who offer facial injectables across all states include:
- Nurse Practitioners
- Physician Assistants
Within the doctor category there are many different types of specialists who perform facial injectables. Arguably the best equipped doctors in the sense of understanding the anatomy and the broad range of aesthetic options and principles, include:
- Facial plastic surgeons
- Plastic surgeons
- Oculoplastic surgeons
Other types of medical specialists have sometimes gained significant experiences with facial injectables and may be a good fit for you. It is important to check the person’s licensure, board certification status, reviews, and prior work before choosing your provider. Also, make sure that they are ready and equipped to handle complications should they arise.
Who Is the Best Facial Injection Doctor in NYC?
Patients often search for the best, top-rated doctor for facial cosmetic injections such as filler and botox. Dr. Gary Linkov is a board-certified facial plastic surgeon in Manhattan’s Upper East Side specializing in non-surgical and surgical facial aesthetics. Dr. Linkov has taught facial injectables to many other doctors through courses in NYC under the face training centers organization in Chelsea. Dr. Linkov delivers safe, consistent, and natural results to each one of his facial injectable patients. You can view before and after photos of Dr. Linkov’s patients below:
Facial Injectables Before and After
Do you have any questions about injectables and fillers in New York City? Would you like to schedule an appointment with an experienced facial plastic surgeon in Midtown, Manhattan, Dr. Linkov? Please contact our City Facial Plastics office for a consultation.