Cosmetic Injections

Mouth and Lip Augmentation

Lori Haney, RN, MEPC, LSO No Comments

If you’re considering dermal filler injections for mouth or lip augmentation, there are several important things you should know before your procedure. First and foremost, you can’t (or shouldn’t) take a photograph to your injector and say, “I want lips like these!”  Unlike haircuts where a certain one may look good on many different people, your facial features are distinctly yours! It’s impossible and just not aesthetically pleasing to simply recreate someone else’s lips, nose or otherwise on your face.

The goal of lip and mouth augmentation is to make you look like a better version of you. Whether that’s restoring lost volume in your lips or around your mouth, correcting/softening lines around your mouth, or restoring features that have changed or been lost over time in this area, the techniques used should help you look more youthful with soft and rounded features—not like a pouty, fish-lipped, obviously over-filled Hollywood celebrity!

At Celibre Medical, we use a combination of both dermal hyaluronic acid (HA) fillers like Restylane and Juvederm with Botox / Dysport to fill and shape the lips and mouth.

 

How Celibre Medical’s Approach is Different

We use HA fillers to add volume and definition to the lips. We can enhance and redefine the lip border with these products and reshape the mouth by carefully placing product just outside the corners, helping to turn them up and giving you just a hint of a smile. If your lips appear “deflated” with wrinkling, HA fillers can help restore soft, natural looking volume and soften those wrinkles.

The ideal lip proportion is the bottom lip just slightly larger than the top. If your lips have always been disproportionate or if they’ve simply just thinned out over time, HA fillers can restore or establish a more aesthetically pleasing proportion to your lips.

Aging can also trigger changes in facial boney structure and soft tissue which elongates the space between the base of your nose and your upper lip. It can also make your upper lip appear as if it’s turning inward or rolling towards your teeth. HA fillers can help restore your lip volume and return the appearance of the area around your mouth to what it was in your younger days.

One of the most common complaints from patients like you is those little vertical lines that appear around the edges of the mouth. Not so affectionately known as “smoker’s lines”, they can appear on someone who’s never smoked a day in their life! We’ve seen many women mistakenly take to removing all straws and bottles from their daily lives to prevent smoker’s lines, but we’re here to tell you that’s not why they happen either!

It is actually a combination of factors that create smoker’s lines. Number one, repeated contractions of the circular, purse-string-like muscle around the mouth is the underlying issue, but secondly, the loss of collagen and elastin in the skin just around the lips also contributes greatly.

Many injectors will simply try to place small amounts of filler in these lines, in an attempt to smooth them out. This may work for some, but for many, it just makes the lips look disproportionate and the top lip look heavy.

Here at Celibre Medical, we address the underlying muscular issue with Botox or Dysport. Subtle relaxation of the muscle will improve the appearance of the lines. We couple this with dermal fillers to redefine the border of the upper lip.  This helps to soften the appearance of these lines, without injecting them directly. Using these combined techniques over the years has also shown us that many patients get a subtle lip eversion. This means the upper lip gently rolls outward and upward. This helps the upper lip look even fuller and shortens that distance between the lip and base of the nose, a win-win!

As you can tell, there is a lot of artistry, skill and knowledge that goes into lip and mouth augmentation. Before you book and appointment with an injector, make sure that you look for some before and after photos that demonstrate their skill. Also, make sure you understand the benefits and limitations of this procedure, so that you’re pleased with your results. If you’d like to learn more about Celibre Medical’s philosophy on using injectables and lasers for facial rejuvenation, please visit our laser and injectables for wrinkles page.


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Steroid Injections for Acne

Lori Haney, RN, MEPC, LSO No Comments

We’ve all been there. You’ve got a big event, get together or a first date coming up and you get a painful, red, raised acne bump in the worst possible spot on your face! You hit panic mode and start piling on the acne treatment gels, rubbing alcohol or anything else you can think of to make it go away! Of course, these only make it look worse.  Instead, consider a  a quick fix that for the next time this happens to you: steroid injections.

Although these injections are not as quick as a magic wand, they contain a medication called Kenalog (triamcinolone) that is a powerful anti-inflammatory. Once injected into the cyst, it usually dramatically improves or resolves altogether in one to two days.

Steroid injections are not preventative for acne – they won’t keep acne from developing. They’re more of an emergency or once-in-awhile intervention. They should only be used on large, painful and inflamed cystic acne lesions. Never on small papules or pustules, and absolutely not on blackheads or whiteheads.

A steroid injection can dramatically clear up an acne cyst quick. Instead of waiting weeks for it to go away, you may just have to wait a couple of days! They aren’t a magic wand, but they really are the next best thing!


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Philtral Columns and Mouth Rejuvenation

Lori Haney, RN, MEPC, LSO No Comments

At Celibre Medical, when it comes to using filler in the lips and mouth, we believe that less is definitely more. Technique and knowledge of optimal lip structure and anatomy trumps “plumping and filling” the lips. This is one area of the face that takes finesse and skill to inject well. When done right, the results are amazing!

First, we want to ensure that any lip filler treatment leaves you with a symmetrical and natural-appearing mouth and lips. To accomplish this, we pay special attention to the philtral columns, the raised, vertical ridges that connect the bottom of the nose to the lips.  They are different for everyone—some people have more pronounced philtral columns and others less so. The key is adding just the right amount of structure to this important area with small amounts of filler to get the most natural, youthful appearance.

As we age, the area between the nose and upper lip elongates and flattens. This accentuates a natural flattening of the upper lip that happens over time (double whammy). By using a small touch of dermal filler such as Restylane or Juvederm, we carefully recreate youthful philtral columns that accentuate the border of the upper lip. Building these columns accentuates the natural “V” of the upper lip known as cupid’s bow. This gives your lips more shape and helps to lift and evert the upper lip (turn outward and upward).

Note that these techniques don’t involve filler in the actual lip itself, but still change the shape and appearance of it.  When an injector doesn’t understand these principles and techniques and just “fills” the lips, the duck-bill or trout-pout results.

If you’re considering lip or mouth injections with dermal filler, we encourage you to discuss what techniques your injector will use. Understand how dermal filler injections can accentuate or enhance your natural beauty—not just give you big lips! Remember it’s quality, not quantity that makes all the difference between being “treated” with dermal filler injections for the lips and mouth and being “filled”.


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How Can I Fix My Uneven Lips?

Lori Haney, RN, MEPC, LSO No Comments

In aesthetics, we know that symmetry is often equated with beauty. But if you look at a face, even the most beautiful of celebrities have a slight degree of asymmetry.  Instead of having “perfect” symmetry, we seek to balance asymmetry for our patients.

Many of us are just not lucky enough to have been blessed with beautiful symmetrical features, and one of the most common complaints we hear about is uneven, asymmetrical lips.

uneven lips after restylane
Restylane Before and After Photos

Dermal fillers, especially hyaluronic acid-based ones, can be a perfect remedy for this. We can add volume to make the corners of the lips more even, enhance the outer edge (the vermillion border), add volume to one side or another, and even create a more natural balance between the size of your upper and lower lips. The techniques for each of these corrections vary, but the result is a more symmetrical (but not perfect!) looking mouth and lips—which is beautiful!

Both the Restylane and Juvederm family of products can be used for this procedure and after you’ve discussed your concerns with and been evaluated by your injector, together, you can decide which specific product is the right choice for you.

We hear over and over from our female patients about their fears of looking “overfilled” with puffy, duck-billed lips.  We understand this fear, and are happy to explain our approach and show you some before and after pictures (like the ones here on this page) that demonstrate appropriate, conservative and individualized approach to correction of asymmetrical lips.

Our goal is to balance and enhance your natural features, making them more even and attractive to the eye—not make you into someone who doesn’t look like you!


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Restylane for the Inner Cheek

Lori Haney, RN, MEPC, LSO No Comments

Aging is inevitable and happens to everyone. But, some manage to age more gracefully than others. Before you assume that it’s all genetic, we’re her to tell you that “looking good” for your age often involves a secret weapon: a good aesthetic practitioner.

If you asked around, you’d be surprised at just how many people are using Botox and dermal filler treatments to look younger and feel better about the way they look. A good cosmetic practitioner has a “playbook” of minimally invasive techniques that yield big results with little to no downtime. Dermal filler injections are one them.

An example of an area that responds phenomenally to filler injection is the nasal alar area. This is the area of the inner cheek, just beside the outer edge of your nostril. It is the very top end of your nasolabial fold or “laugh line”.  As we age, this fold or crease becomes more noticeable due to structural changes and volume changes in the cheek itself. Combined with years and years of smiling and laughing (which is good!), this crease indents even further—which is bad! It can lead to a “heavy” look or like your cheek is folding in on itself.

Just a drop or two of a dermal filler product in the area next to the nose can make a big difference. Even if you aren’t bothered by too much “heaviness” in the nasolabial fold, treating this area with dermal filler can help improve your overall look by changing the topography. Without filler, it’s convex (like a bowl) which means that you’ll see a shadow in that area. Once filled, it becomes smooth which takes away the shadow effect and creates the visual effect of smoothness and fullness.

At Celibre, we like to use either Restylane or Juvederm for this area. It’s a small injection that can yield big time results. And it’s just one of many little “tricks of the trade” that Celibre’s skilled injectors use to help you look your very best.

 

los angeles restylane for laugh lines before and after pictures los angeles restylane for laugh lines before and after pictures
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Restylane before and after pictures

 

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Top 3 Areas for Botox

Lori Haney, RN, MEPC, LSO No Comments

We’re sure you’ve heard the expression “the eyes are the window to one’s soul.” At Celibre Medical, we have many patients tell us their eyes are making their soul look a lot older than it feels! We agree! Lines and wrinkling above, between and around the eyes, coupled with the natural downward gravitation of the eyebrows creates an unhappy, heavy and tired appearance our eyes as we age. But there is an answer: Botox and Dysport.

Using Botox (Dysport) in these areas is extremely common; in fact, we’d say these areas are probably the top three on the face where Botox is used. Here’s how Botox (& Dysport) can help each:

Between the Eyes (Glabella)

The medical term for the area between the eyes is the glabella. Beneath the skin in this area are three muscles: two, rectangular-shaped ones that pull the middle part of the brow towards the inner part (one on each side) and a shell-shaped one right in the middle that pulls the inner part of the brow down towards the nose. Known together as the “glabellar complex”, these muscles all contract simultaneously to produce a frown. Go ahead, make your “I don’t approve” face. See the lines that form between your eyebrows? As we get older, these lines tend to stay around…even when we’re not frowning! Another common term for them is “the elevens” since they look like the number itself, permanently etched between your brows. Whatever you call them, these lines make us look angry, sour and older than we feel.

Botox can be selectively injected into these three muscles relaxing them, preventing the proverbial “permanent scowl” from dominating our look. Another benefit? Since these muscles are brow “depressors”, meaning they pull downward on the brows, when relaxed, the brow elevator muscle works unopposed (think tug-of-war). The result is a brow lift without the surgery! The standard dose for the glabella is around 20 units.

Above the Eyes (Forehead)

Remember the brow “elevator” muscle we talked about above? That muscle is called frontalis and it is a large, sheet-like muscle that spans the length and width of the forehead. Frontalis is a tricky muscle because no two are exactly alike! Some are slightly V-shaped, while others are more rectangular. Some are narrow and others are wide. Why does all this matter? Because it can affect how your forehead lines look when you raise up your brows. It takes an experienced and skillful injector to understand the right dose of Botox for this muscle. Too much can mean your eyebrows drop (think Cro-Magnon brow). Too little or not enough to treat the whole muscle can mean uneven brows or “Dr. Spock” brows which just looks bad. The right dose (combined with proper treatment of the glabella) should leave your forehead smooth and your brows even and lifted, all at the same time.

For these reasons, there is no one, standard dose of Botox in this muscle. It may range from 10 to 20 units depending on your gender, the size and shape of your frontalis muscle and how strongly it contracts (single horizontal line or several).

Outer Eye (Crow’s Feet)

This last area is one that is different for everyone as well. Some people have pronounced lines that radiate outward from the edge of the eye when they squint or smile, while others may have hardly nothing at all. The reason Crow’s feet happen is from the contraction of a purse string-like muscle around the eye known as the orbicularis oculi. Treating orbicularis with Botox relaxes it, dramatically smoothing the skin around the eye both at rest and when smiling and squinting. The orbicularis oculi also pull down on the outer edge of the eyebrow so, if you remember about that downward/upward tug-of-war we talked about with the glabella, treating the crow’s feet can also lift the outer edge of the brow and eyelid which helps to open up the eye. Again, there is no one, single dose that works for everyone, but generally 10 to 15 units is standard.

Don’t think Botox can’t be used anywhere in the lower face as there are a few places where it can be helpful. But, far and away, using Botox in the glabella, forehead and outer eye is its bread and butter. When done right, Botox can lift and shape your brows, open up your eyes and give you a younger, more relaxed and refreshed appearance.

 


* Botox Before and After Pictures


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What Are the Best Fillers for Under-Eye Bags?

Kevin DiCerbo, RN, BSN, LSO No Comments

If you’re tired of looking tired under your eyes, maybe it’s time to do something about it. Surgery isn’t always the only option; in fact, for many people with under-eye hollowing or bags, treatment with injectable dermal fillers can provide dramatic and long-lasting improvement and may be a better choice.  Here’s why:

As we age, the delicate, thin skin around the eye thins even more. We lose precious collagen which triggers the changes of darkness and wrinkling. Time also causes the normal fat that surrounds the eyeball to push through the circular muscle that surrounds the eye, making the lower eyelids look swollen and puffy. Losing volume in the middle part of the face (the cheeks and cheekbones) can also cause the eyes to look aged by accentuating these changes and making the groove or tear trough beneath the eye more prominent.

Restylane is an excellent hyaluronic acid (HA) filler that can be used to correct and camouflage these unwanted changes. It stimulates the production of collagen in the skin, replaces volume for indentations and helps smooth the transition between a bulging fat pad in the lower lid and the cheek. At Celibre Medical, Restylane is our number one product to use for under-eye bags.

To give you a better idea of what Restylane can do for the eyes, please look at our patient’s photos below. This gentleman could have also chosen under eye surgery, as he has quite a bit of excess skin beneath his eyes. He opted instead for Restylane injections because he wanted immediate results and he didn’t mind the thought of re-treatment in the future. Restylane, coupled with the right injection techniques, gave him some very nice results that he was very pleased with. As you can see, it is possible to achieve dramatic change with a non-surgical approach.

Under Eye Bags Before PhotoUnder Eye Bags After Restylane Photo

Injection Technique Matters for Under Eye Injections

While the skill and technique of your injector is important regardless of the area being treated, we feel it is important to say that proper technique is essential when using dermal filler injections beneath the eyes. It can be the difference between you looking worse and looking amazing afterwards!

Injectors at Celibre are all highly trained and experienced in injection techniques that place the filler product “under the muscle” when treating the area beneath the eye. This technique ensures that your filler looks smooth and natural. When done improperly in the incorrect plane of tissue around the eye, dermal HA fillers can bruise severely and look uneven and lumpy.

Make sure to discuss the experience of your injector as well as the techniques that will be used for your under-eye filler before treatment. Before and after photos can help you gauge the skill of your injector as well as help you understand what this treatment can and can’t do for you.


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Using Dermal Fillers to Restore Volume to Hollow Cheeks

Kevin DiCerbo, RN, BSN, LSO No Comments

Have you noticed that your face is aging, but you just can’t put your finger on what’s changing? Maybe you’re a woman in your 40’s or 50’s and you’ve had dermal fillers in your laugh lines and/or nasolabial folds, but you still don’t see the youthful look that you want to. It’s possible that even though the lines around the nose and mouth are diminished, your injector is overlooking a major feature that often ages a woman’s face as she gets older: hollow cheeks.


Restylane before and after pictures

When dermal filler injections first became popular, injection techniques focused on filling individual lines, creases and wrinkles. Today, we’ve moved away from that mentality. Although we often still correct individual lines, we tend to view age-related changes as more of a global facial issue.

In today’s aesthetic industry, we often evaluate the face in thirds: the upper third (eyes, temples, forehead), the middle third (cheeks), and the lower third (mouth, chin and jaw). For middle-aged women, the middle third of the face is the area that is the most severely affected. Changes to and depletion of the underlying bone, muscle and fat lead to a flattening of the cheek, making it look hollow. Youthful cheeks are round and full, as are the cheekbones. Dermal filler injections – products such as Restylane, Restylane Lyft and Juvederm – are used to re-volumize the cheeks.  Cheek augmentation involves the placement of dermal fillers in areas of the cheek to restore softness, fullness and a more youthful shape.

Facial shaping with dermal fillers can be a complex process. Injectors must have a fundamental understanding of facial anatomy, as well as the ability to assess and analyze each patient’s individual features.  Finally, extensive knowledge is paramount to determining which dermal filler products will provide the best aesthetic outcome and long-lasting improvement.

If you’re not seeing the improvement you’d like from your dermal filler injections, it may be that your injector doesn’t have the knowledge or understanding of more recent advances in facial aging.  There is so much more the just injecting the products and this is one of the reasons that the cost of dermal filler injections can vary. The skill and knowledge level of your injector is the major factor when it comes to looking unnatural or looking amazing.

 

Read About All Celibre Medical’s Facial Shaping Techniques

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What is Restylane?

Kevin DiCerbo, RN, BSN, LSO No Comments

You’ve probably heard of Restylane or read about it in beauty magazines, but you may not know exactly what it is or what it does. We’ll give you the scoop on this amazing product and all the potential benefits of its use here.

Restylane is an FDA-approved injectable gel that is made up of hyaluronic acid (HA). It’s used to plump and fill areas of the face): lips, folds on the sides of the mouth, under eye dark circles, and cheeks are just a few examples of areas that can be treated with it.


Restylane injections before and after photos

If you think it sounds scary to inject something into your body, consider that HA is a natural part of our bodies to begin with. It a sugar-like molecule that can bind to and hold approximately 1,000 times its weight in water. This gives it amazing plumping and filling power! If you’re still skeptical, think of it another way.  A baby’s skin has a ton of HA compared to an adult’s. Over time, we lose the ability to make HA easily and we also lose what we have due to environmental exposure and aging. Look at your own baby picture. Wouldn’t it be nice to regain those plump, rounded cheeks and smooth-looking skin? HA fillers like Restylane can help you do just that!

The HA that’s in Restylane is non-animal based. There is no potential for an allergic reaction and no testing required before your treatment – pretty much anyone can enjoy the benefits of this HA-based filler.

Another bonus of Restylane treatment is that while it adds back volume and replenishes your skin’s HA stores that have been lost over time, it also helps stimulate your body to make more of its own collagen and elastin. The benefits of your treatment can last for an extended period of time and often get better with repeated treatments. This not only keeps you looking younger, it can even make you look better than you did years ago!  Call us today to learn more about the Restylane family of products.

Facial Shaping Techniques


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Why Cheap Botox is Not Necessarily Good Botox

Kevin DiCerbo, RN, BSN, LSO No Comments

We totally get it. You want to look and feel your best and you can’t break the bank at the same time. At Celibre Medical, we know and understand the importance of cost. We understand that your hard-earned dollars are important and that’s why we offer the highest level of care, expertise and technology at a fair price.

Often, we get calls from prospective patients that ask only one question – How much do you charge for Botox (Dysport)?  While we definitely agree that cost is an important factor, we also want to educate you on why the cheapest Botox might not be where you want to start your treatments.

We’ve included photos of a patient who came to us after years of getting very cheap Botox somewhere else. As you can see from her photos, she had a bit of a peculiar arch to her brows that gave her a bit of a “spock brow” appearance. She was not happy even though her pocketbook was! Despite knowing that it would cost more, she came to us for help.

Together, we discussed what she disliked and what the corrective steps would be to fix her problem. By changing how she was injected, we created a whole different look for her that was much more natural and appealing. Her forehead is smooth and her brows have a much more subtle arch. She is happy and we’re happy that she’s happy!

Remember, cheap Botox is not always good Botox. When you consider only price, you can easily overlook many factors that go into that number. The time, training and experience of your provider are figured into that price too! And these have value. In fact, they can be the difference between walking away a happy and satisfied patient or walking away wishing you’d gone somewhere else!

If you’re always searching for a Groupon for your next Botox treatment, ask yourself why these practices have to run specials on their Botox? Is it because patients don’t come back for repeat care? Or is it because they really can’t get anyone through their doors any other way? Whichever the reason, these practices simply might be missing the most important piece of the puzzle: a great injector!


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