Combination of Soft-tissue Filler and Neuromodulator Injections for Aging Skin

In this therapy, the doctor uses a combination of soft-tissue fillers (e.g., Juvederm, Radiesse, Restylane, Sculptra, Belotero) and neuromodulators injections (e.g., Botox, Dysport, Xeomin) to temporarily smooth wrinkles and improve skin appearance. The procedure is minimally invasive.

During the soft-tissue filler component of the therapy, your doctor will mark injection points on your face before cleansing it with an anti-bacterial agent. A topical numbing agent, ice or a local anesthesia is applied to keep you comfortable during the injections. The filler – usually a form of hyaluronic acid or a collagen-stimulating chemical – is injected with a very small needle. Some patients experience stinging or burning as the filler is injected.

During the neuromodulator injection, a minute amount is injected directly into the underlying muscle, causing it to relax and gradually smooth out the appearance of the overlying skin.

How to Prepare for the Procedure

Before the procedure, an ASDS dermatologist will review the patient’s medical history. This is the time for the doctor and patient to discuss expectations, potential risks and outcomes of the procedure. You should tell your doctor if you use or have recently taken:

  • Blood-thinning drugs
  • Previous neuromodulator injections
  • Antibiotics by injection
  • Muscle relaxants
  • Allergy or cold medicine
  • Sleep medicine
  • Any other prescription medicines
  • Any other over-the-counter medicines
  • Herbal supplements

Possible Risks

All medical procedures carry some risk. In the past, the most widely used soft-tissue fillers were based on collagen and sometimes required allergy testing prior to treatment. A newer class of hyaluronic acid fillers is based on a sugar found naturally in human skin. Allergic reaction is extremely rare for these fillers. Your ASDS dermatologist will discuss what filler would work best to fulfill your personal goals.

Neuromodulator injection risks include:

  • Soreness
  • Mild bruising
  • Temporary weakness of surrounding muscles
  • Headache

What to expect after the procedure

Patients may experience one or more of the following reactions at the injection sites:

  • Bruising, which may last up to a week
  • Swelling
  • Redness

Patients should take care not to rub areas treated with the neuromodulators, which could cause it to migrate to another area.

All neuromodulator and soft tissue filler therapies are temporary, lasting anywhere from six months to two years, depending on type of procedure and other factors. Some patients require maintenance treatments to achieve the best results.