Botox and Fillers

Botox and fillers are available for temporary wrinkle management and volume augmentation. I’ve used Botox for cosmetic and functional purposes for 16 years, and fillers over the last ten, and have come to think of them in a broader context – that of the lifetime of the individual.

Neurotoxins like botulinum are safe and effective when administered correctly, but it is important to be conservative. They can be overdone. If a muscle is kept inactive it will atrophy and that will interfere with normal facial expression as well as contribute to a loss of volume, producing a “flatness” of natural contours.  It is important that the longer they are used, the less frequently they are given, in order that the muscle have a chance to recover.  I do not believe in “preventive Botox”.

For fillers, I use only those without particles and I do not use silicone.  Collagens and hyaluronic molecules (such as Restylane) are found everywhere in the connective tissues of the body and so are very unlikely to cause problems, both for this reason and because they are temporary.  I use them primarily to give people an idea of what volume enhancement can do for their appearance before considering a permanent solution such as FAMI. 

In my view, autologous fat is currently the ideal permanent filler.

Brow Lift, Blepharoplasty, and Cheek Lift

People often develop enophthalmos –– an eye that shrinks back into the orbit –– after having a prosthetic eye placed, or after trauma to the area.

This volume deficit can be corrected by injecting fat behind the eye in the same way that the fat is used to enhance facial volumes.It is an extension of the FAMI technique and involves no cutting or sutures.