Category Archives: Injections and Botox

Rejuvenating Your Face – What are the Options? Surgical and nonsurgical solutions

When you go to your high school reunion, do you want your classmates to squint at your name tag in confusion? No! Instead, you want them to instantly recognize you and think that you look well-rested and “good” for your age. Formerly there was only one way to resurrect your face: it took a scalpel, several weeks off from work and a nice chunk of change. But now, new nonsurgical options that promise to turn back the clock are proliferating at a rate that can make you dizzy.

It would be overwhelming to consider so many options on your own. Instead, schedule a consultation with a board-certified plastic surgeon, like Dr. Genter, who is experienced in traditional approaches, but also equipped with the latest and greatest nonsurgical innovations. Face-to-face a doctor can recommend to you procedures that offer the results you want. Both surgical and nonsurgical options definitely yield improvements but, as you may expect, the level of improvement will not be the same and the surgical option will result in more significant and longer lasting changes.

So you don’t go to your consultation totally “green,” here are, from hairline to the base of the neck, some of the surgical and nonsurgical approaches to the common facial problems that occur with aging:


Drooping Forehead

Surgical: A forehead lift involves hidden incisions in the hair-bearing scalp to rejuvenate the upper third of the face through lifting and weakening frown muscles.

Nonsurgical: Botox is injected into the forehead to soften frown lines. Botox and fillers may be injected together around brows to lift and add fullness.


Dark Circles, Eye Bags, Hooding of the Upper Eyelid

Surgical: Blepharoplasty removes fat deposits and tightens the skin and muscle of the eyelids to improve the appearance of the eyes.

Nonsurgical: Frown lines can be softened and crow’s feet minimized with injections of Botox; three times a year in both areas will do the trick. When injected above the eyebrows, Botox may also give a ten-degree lift to the arch and a slight lift to the tail. To get rid of bags under the eyes, a plastic surgeon can inject your own fat, which will last 2 years or more, or hyaluronic acid, which will last up to a year.


Sagging Cheeks

Surgical: With age, the distance between the eyes and cheeks increases. In the midface lift, the malar fat pad in the upper cheek is lifted to its former youthful position with either sutures or an absorbable implant, restoring your youthful, heart shaped face.

Nonsurgical: A doctor can restore high, full youthful cheeks using injectables such as Radiesse, Juvederm or other fillers. Injected over the cheekbones or in depressions, these fillers can add fullness to sunken or sagging cheeks for many months.


Droopy Nose

Surgical: With age, the tip of the nose may drop down and inwards towards the face. The drooping nasal tip may cause a slight hump on the bridge and appear to cover part of the upper lip, especially when you smile. A rhinoplasty procedure rejuvenates the nasal tip, which is re-supported with cartilage grafts. An added bonus is that re-elevation of the tip can improve nasal air flow and breathing.

Nonsurgical: If Botox is injected into the base of the nose by a skilled injector, slight nasal tip elevation may be achieved, resulting in a nose that turns upwards, rather than droops—even with big smiles. If your nose droops when your face is static, Botox will not help. Injections with fillers such as Radiesse or Juvederm may be used for nose shaping/augmenting purposes in a nonsurgical rhinoplasty.


Thinning upper lip and droopy mouth

Surgical: With age, the upper lip lengthens, sags and thins. An upper lip lift shortens the lip by removing a small ellipse of skin under the nose-lip junction, creating fuller mucosal show. The corner lift, removing a small triangle of skin above the corners of the mouth, elevates a downturned mouth, making you appear happier. 

Nonsurgical: Volumizers, such as Juvederm Ultra Plus, injected in the lips, can restore the ideal volume ratio of upper to lower lip, creating fuller plumped lips. “Smoker’s” or “lipstick bleed” lines can be treated every six months with Botox to soften them and micro droplets of fillers to plump them.  Lips may also be injected with collagen or your own fat harvested from another site. Both liquid collagen and fat are absorbed, so repeat treatments are necessary to maintain results.


Sagging jawline, redundant neck, prominent neck cords

Surgical: There are many different varieties of facelift approaches to smooth the face and neck skin, tighten the underlying loose tissues and muscle and remove excess skin.

Nonsurgical: To camouflage a sagging jawline, Juvederm or Radiesse may be injected, lasting up to 18 months. Botox and injections with fillers can be used to reduce the appearance of neck cords. Botox and fillers can smooth a pebbly chin. Fillers can be injected to reduce smile lines between the nose and mouth corners. Botox injections can make neck cords recede. Neckline appearance can be softened with mini doses of Juvederm combined with Botox.


Fine Facial Lines

Surgical: Fine facial lines can be treated surgically with dermabrasion, laser resurfacing, or deep chemical peels.  Although a facelift is useful for tightening the facial skin and deeper structures, it will not smooth fine facial lines on the skin’s surface.

Nonsurgical: New injection techniques have been developed to treat fine facial lines around the mouth, on the cheeks, etc. Dilute Juvederm is injected with very thin needles into these facial lines to smooth them, producing very successful results. Botox can supplement the effect. It is believed that new collagen growth in the skin is stimulated from these injections. 


Final advice: Get the best results by finding a plastic surgeon with the appropriate board certification. Wherever you go for treatment, be sure to ask how long and how often this doctor has been doing the procedure you desire. Dr. Genter is very experienced with these techniques.  In a tough economy, nonsurgical facial rejuvenation may seem to offer a cost-effective alternative for looking good. But, does it really? Ask your doctor how frequently you will need to repeat the nonsurgical procedure. Then consider your age and do the math. You may discover that a surgical procedure will be more economical in the long run…or you may not. Some investigators believe that fillers help skin regenerate natural collagen and neurotoxins like Botox can help retrain your muscles so the face creases less.

Be sure to schedule your surgical or nonsurgical procedure far enough in advance of an important event so you are healed and look your very best. 

Workout your skin!

Unless you’re lucky enough to move from one air-conditioned space to another this summer, you’re likely to have had some sweat-related skin problems. Add exercise or outdoor swimming into it, and you’re headed to the land of clogged pores, breakouts and aging from the sun.Shape Magazine has some helpful tips for exercising during the hot, sunny months where skin takes a beating, but this info can also be used all year round in warmer climates and at the gym. The main focus is to keep pores open, skin clean and SPF on whenever you’re outside.

  1. Clean before and after a workout: It’s important when you start sweating excessively that all that moisture and oil has somewhere to go. Clean your face with a cleansing wipe, makeup remover or a plain old face wash to make sure there’s no foundation or residual makeup clogging your pores. After a long sweat session, you want to remove the sweat and oil using the same means. Remember not to use anything too harsh to clean lest you strip off all your moisture.
  2. Keep it off your face: Pull back your hair and grab a towel so you won’t be tempted to touch your face. Hair has oils and products that might cause your skin to react, so tie it up and out of the way. Touching your face after touching weights, equipment or anything you might encounter outside is also not a great idea. Other than causing a breakout, it’s a great way to catch germs. Washing your hands should be the first thing you do after you’re done working out.
  3. Keep cool and fresh: When you’re exercising, it’s important to use the right equipment right? Same goes for your clothes – wear breathable outfits that keep you comfortable. Then, within half an hour after your workout, get in the shower and change your clothes. To avoid drying out or overproducing oil, use a gentle cleanser and moisturize after every shower. Gently exfoliating your face and body 2-3 times a week will make sure the dead skin cells are at bay.
  4. Protect yourself: The sun is the number one culprit for premature aging of the skin. It can cause sunspots, freckling, wrinkles, and for those at high risk, skin cancer. While natural foods and ingredients like carrot and coconut can boost SPF, it’s important to use sunscreen and reapply outside whether you’re exercising, at the pool or just enjoying a weekend barbeque. Try finding a tinted moisturizer with SPF for daily use.

These tips can help keep summer breakouts at bay, but to treat a more serious problem, please see a licensed skin professional associated with a board-certified plastic surgeon, like Dr. Genter, or a dermatologist. Large pores, oily skin, acne and constant breakouts might need a more aggressive skin regimen that might include micro-peels, laser skin resurfacing, skin tightening, chemical peels, and injectables.


Vampire Face Lift May Reverse Some Loss of Youth

vampire face liftsA new injection treatment called a vampire lift is gaining attention for the youth it may add to the face, according to

Patients who choose to undergo vampire face lifts may do so to combat signs of aging on the face. Even with proper skin care, time and gravity take hold and wrinkles can begin to appear in places like the nasolabial folds, or laugh lines.

While patients currently may choose injectable fillers to diminish the appearance of wrinkles and lines, some plastic surgeons are looking at vampire face lifts as a means to reverse some aging factors.

The way vampire face lifts work is not actually like a facelift surgery, but a procedure that uses components of the patient’s own blood. Platelets and fibrin in the blood has been shown to increase collagen production and strengthen connective tissues to repair some injuries.

Once the surgeon takes a sample of blood and has separated the platelets and fibrin, they are mixed with calcium chloride and prepared then injected into aged areas of the face.

Weeks after the procedure, it was found that at the treatment site, new collagen and blood vessels had developed. Researchers found that at ten weeks after patients underwent the vampire facelifts, the effects evened out, but should be long-lasting.

As vampire face lifts still must seek FDA approval, some plastic surgeons are skeptical of the benefits of the treatment.

Plastic surgeon and former AAPS president Phil Haeck told Los Angeles Daily News that more research should be done on the procedure. As Haeck says, plastic surgeons ensure that little to no blood is left behind in a traditional facelift, so he is unsure how placing blood under the skin achieves the desired result.

Haeck adds that his opinion on vampire face lifts could be changed, but that he needs to see further evidence of the procedure’s effects and safety.

To find out more about non-surgical treatments for aging on the face, we encourage you to email Philadelphia plastic surgeon Dr. Genter.