Understanding Your Non-Surgical Facial Rejuvenation Options

Next to facial plastic surgery, nothing makes as big a difference in my patient’s facial appearance as injectables.

What are injectables? They come in three categories: (1) Muscle Relaxers, like Botox®; (2) Wrinkle Fillers, such as Juvéderm, Volbella, Vollure and Voluma; and (3) Kybella, which melts fat to eliminate a double chin.

What are they made of, what do they do, and how long do they last? I’m glad you asked! I present to you: Injectables 101.

southwest michigan botox and face fillers


Botox, technically known as BOTOX Cosmetic®, was originally created by scientists to treat eye spasm. Once it was discovered to relax the muscles that create wrinkles, it became a cosmetic classic.

What Is Botox® Made Of?

Botox® is made from a highly purified, cosmetic form of botulinum toxin, a neurotoxic protein produced by bacteria. Injecting it into the muscles beneath your facial wrinkles will cause those muscles to relax, creating a smoother skin surface. These two products are most frequently used around the eyes, forehead or mouth. Because they are very thin liquids, a very tiny needle can be used. Most people experience little to no discomfort from the treatment, but those who express any concern are pre-treated with numbing cream. It lasts 4-6 months.

How Long Do The Results of Botox® Last?

Although it varies from patient to patient, results last from 3-6 months, on average. Of note, however, is this: the longer you use injectable relaxants, the less frequently you need them. In other words, once the muscle becomes “used to” being relaxed, it tends to remain relaxed.

Three Times Not To Get Botox®

  1. You are pregnant or nursing. Although there have not been any documented cases of damage caused by BOTOX® Cosmetic injections during pregnancy, better safe than sorry, right?
  2. Right before a big event: you won’t look better (yet) but you may have visible injection spots or even some slight swelling. Not a good look.
  3. You have sagging skin and/or volume loss. Without fillers, you’ll still have them after the Botox® injections.


Maximum improvement is achieved when Botox® is used in conjunction with a filler, so that the Botox can relax the muscle that created the wrinkle and the filler can soften its appearance. It’s a match made in Heaven, you might say!

Volbella, Vollure, Voluma and Juvéderm are hyaluronic acid fillers used to plump wrinkles throughout the face, including the nasolabial folds (the lines that run diagonally from the nose to the mouth), the glabellar lines (between the eyebrows) and the wrinkles around the lips and around the eyes. These fillers are composed of a laboratory-created protein called hyaluronic acid, similar to the natural hyaluronic acid in your skin that contributes to youthful skin’s volume and fullness. The lab-created hyaluronic acid in these products has been modified slightly to last longer than your own hyaluronic acid. The differences in the products have largely to do with how long they last.

Hyaluronic acid is hydrophilic, which means it’s "water loving," and as such, it attracts many times its own weight in water. Even as the hyaluronic acid begins to disappear, each molecule attaches to more water, which means it will maintain its volume and effect for between four and six months. Numbing creams are applied to minimize pain, and fortunately, the products can also be mixed with a bit of Lidocaine to minimize discomfort during the injection.

Juvéderm is a soft gel made of hyaluronic acid, used to restore your skin's volume and smooth away facial wrinkles and folds, like your “smile lines” or the creases that run from the bottom of your nose to the corners of your mouth. It’s also been found extremely effective for plumping lips. It can last up to about 12 months.

Voluma is another hyaluronic filler, most often used to fill the mid-face, particularly the cheeks, giving a lovely “lifting” effect that lasts up to two years!

Vollure helps add volume and treat nasal labial folds and marionette lines and lasts up to 18 months.

Volbella treats lips and peri-oral lines (lines around the mouth) and lasts up to one year! It’s especially popular for the lines above the mouth, commonly called “smoker’s lines” even if the patient isn’t a smoker.

I know it can feel confusing with all these products to choose from. The biggest difference between the “V” injectables (Vollure, Voluma and Volbella) is the amount of hyaluronic acid included in each one. Rest assured, I’ll make the right choice to correct your facial concerns!

How It's Done

Filler injections take only about fifteen minutes to half an hour, and the results of fillers appear immediately. The final results of BOTOX® injections generally occur after 48 hours, with the majority of the improvement found in about a week.


After injecting, we apply a cold compress. Some redness may be present for the first few hours, and you may have slight swelling around the injection sites themselves.  However, this fades quickly, and by the time you leave the office, you will be unlikely to have any discomfort.

After receiving BOTOX®, you should not lay flat for four hours to avoid “spreading” the botulinum toxin beyond the desired area(s). You might have a slight redness around the injection site for the first two hours. The results of BOTOX® injections usually last about 4 months. It will be obvious to you when you should come in for another treatment, as the wrinkles will begin to reappear.

Because our office is very busy, we suggest that you make the appointment for your next treatment after each treatment, spacing the next appointment at the interval I recommend.

If you have concerns about wrinkles, contact one of my two plastic surgery locations for a consultation to discuss all the alternatives. You can phone us at 269-743-3290 or complete this online consultation request form.

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