Frequently asked questions

Are you interested in a little wrinkle relaxation but wondering what it will feel like on your bank balance? Well, I can give you some generalities, however we pride ourselves on individualizing every patient’s treatment to their own muscle activity so final determination is made at the time of your visit. There are currently 4 neurotoxins on the market (as of 5/1/2022) with another coming this fall. They have lots of similarities, but are not equivalent...so it isn't easy to compare one to the other, especially when their "unit" is a measure of personality and you have your own variables to take into account. Below is a snapshot of basic concepts for newbies. But even veterans should keep in mind every visit is a new session, and may require adjustment from the last. Men tend to have stronger muscle groups so should expect to need more than the ladies--up to twice as much! Sure, their dry cleaning is less expensive, but their tox budget is more! The area between your eyebrows, you know, the “angry 11’s” is a very strong muscle group which includes 3 – 5 muscles in total all wanting to pull down. I talk of this group as the “driver” for the muscle activity of the face—hitting it is priority 1! On average ladies receive 20 units as the sweet spot here, sometimes less, sometimes more. The forehead is generally a thin sheet of muscle that covers a lot of real-estate. Dosing here is tricky. The forehead’s job is to hold up the eyebrows, so putting too much in here has the risk of dropping it. Contrary to what you may think, there is no way to put toxin in the forehead to get your brows to go up. It is not physiologically possible. Usual dosing here is 8-16 units, most of it goes high near the hairline, a tiny amount can go lower—but too much low may drop your brows so living with that little rainbow wrinkle might be something you have to acclimate to. Crow’s feet, or professionally known as lateral canthus lines, are frustrating for some but others like to let their eyes smile. If the sphincter muscle around your eye is naturally pulling the corner of your brow down, sometimes we can get a bit of lift—but for some it has little effect. Treating the crow’s feet is typically 6 units on each side for a little softening, or 12 u each side for “closer to gone”. Of course, this is just a ballpark. There are other “off label” areas that we can treat with neurotoxin like bunny lines on the nose (6-10u), gummy smile reduction (2-4u), lip flip, chin dimpling (6-10u), and frown face around the mouth (6-10u). So how much you’ll need, really depends on your muscle and which areas you’d like to enhance! How much filler you’ll need is an entirely different question…

Absolutely! Neurotoxin works to disable the ability of a nerve to tell a muscle to contract temporarily. So if what you have is a wrinkle that occurs when you contract a muscle (make a face, smile, squint, pucker, etc) it may be amenable to softening with neurotoxin. If what you have is a wrinkle that is present even when your face is expressionless, or an area that has deflated with age (or weight loss) it might be better served with a filler. Most fillers are made of hyaluronic acid gel, but there are other types as well (those that stimulate your body to make its own collagen for instance). The final selection of which filler to use should be decided by your experienced injector and you--they know the details of each one, and you know what you're hoping for, if that suits your lifestyle and your pocketbook. When you pay for neurotoxin at RediscoverdU you pay by the unit--so each dose is crafted to what your anatomy presents on that day (20 botox equivalent unit per regular session). You'll see the "optimal" effect for that dose about 2-3 weeks later, at which time if you need a little more it can be added (again, paid for by the number of units needed) up until about a month out--then it's best to not add until your next cycle (3-4 months later). Remember, this is a drug people! When you invest in filler you are investing in a service which includes product, talent, education, and safety measures. Often we simplify that idea into a "price by syringe", but no doubt it's more than just the jelly...it's your FACE! HA fillers have a bit of an immediate effect, and will soften and settle 2-4 weeks after injection. Patience is a virtue here.

Wish your toxin would last longer? Step number one: talk to your injector about your dose! All 4 current manufacturers of neurotoxin approved for use in the US agree that the duration of effect is directly related to dose delivered for the area of treatment. And while all products are measured in units, the “math” involved in the equivalency of a onabotulinumtoxinA (Botoxâ) unit compared to an abobotulinumtoxinA (Dysportâ) unit can be tricky to explain. Add on top of the unit equivalency challenge the volume used to deliver the aid number of units may vary from injector to injector and even from area to area with the same injector. The math can be a mess! Bottom line, the number of units actually delivered per region is what is documented in the medical record, and what we use to measure our treatment on. Certain muscle groups are stronger than others (think glabella and masseter)—the bulkier the muscle the more medicine that’s required to put it to sleep for a spell. Some muscles are thinner but cover large regions (think forehead or platysma)—they need enough product to spread throughout the region. And yet other muscle areas we do not ever want to overdo (think lip flip—overtreating that can keep you from enunciating your words, or controlling your spit—yikes!). Underdosing an area or treating with a small amount generally means it will not retain its relaxed effect as long as a larger dose would, but there may be good reason to do just that. So, if you wish your toxin would last longer, the first thing is to evaluate whether or not you are receiving a dose sufficient for the muscle or the area. There are commonly accepted “usual” dosing for most areas, but every person is different, and dosing needs to be personalized. Consider too what product you are using, and what your expectations are. Movement is fine for most of us, we just don’t want to allow so much that the repetitive nature of the movement can contribute to etched in lines. And some wrinkles might be unloved but accepted because having the rainbow wrinkle above your brow is better than dropping your eyebrow and adding to upper eyelid hooding, eh?! Younger skin has healthy collagen and elastin stores, so wrinkles from movement may be better disguised than thinner, older, crepey skin. Your injector has a complex job—they manage pharmacological, anatomical, technical skills all while using their artistic ability to finesse your treatment to match your goals, anatomy and dosing. Developing a good relationship with your injector is critical!

Wow! That’s a great question, but there are so many more details are needed to come to a best guess on that question! First let’s keep in mind there are several different kinds of fillers to choose from, each with unique characteristics. You’ll find a few general guidelines below—but by no means does one answer fit every face! Most hyaluronic acid fillers come in syringes of 1 ml (or 1 cc). When comparing that to standard kitchen measure that’s 1/5 of a teaspoon; 1/10th of a standard ketchup packet, or 1/15th of a tablespoon. Estimates are that we naturally lose 3-5 cc of volume in our face every year after about 30 or so…but more if there has been weight loss or illness. The reduction volume comes from of a combination of things including shifting of fat pads, muscle atrophy, bony resorption to name a few. If you’re talking about lip filler—we provide up to one syringe at a time in our practice. Lip tissue does have the ability to stretch, but it should be a gentle process to reduce the potential reasons it tries to escape it’s vault. Afraid one syringe will make you look like a duck? Fear not! Opening a syringe for your lips does not mean it must all be placed there—we love to fill the lips until we think we are in your goal range, then find a perfect landing spot for the remainder, typically in the surrounding region to allow for facial balance. When you’re talking about cheek replacement (often the first place we recommend attention is placed even if your primary concern is nasolabial folds or marionette lines) then you’re probably talking about 2 syringes to start—one for each side. If you’re petite/small boned we can start with one but remember that only leaves 1/10th of a teaspoon for each side, so guard your expectations. Either marionette lines or nasolabial folds can initially be treated with a syringe, we spread it as far as we can but a finite amount of product has finite spread-ability. And if you’re talking pan facial HA filler placement, you’re probably talking 4+ syringes. If we shift to other fillers like poly-L-lactic acid a usual treatment is two vials followed by two more vials a few weeks later then maybe a touch up annually. More deficit, more product. With calcium hydroxyapatite it can be a few syringes whether used as is or hyper dilute, one for each side of the face, one for each jaw, one for the neck, one for the décolleté…it just depends. Confused? Talk to your injector!