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Adam G. Tattlebaum M.D.
syringe and vial

Injectables: Read This First

Injectables fall into two very different catagories and I find that some patients are confused about the differences. The catagories are:

1) Toxins: Botox, Dysport, Xeomin

These products selectively weaken muscles. Injected into the face they soften lines and wrinkles that are created by the facial muscles. They are commonly used in the forehand area to soften frown lines and beside the eyes to soften the lines called crows feet. Occasionally we use Botox or similar products to soften lines around the mouth and neck. Years ago I think people did too much of the products and looked over done. If the entire forehead is paralyzed patients don’t look normal. In my practice, I use these products to selectively soften facial areas and even elevate the outer eyebrow. These are injected awake in the office with topical anesthesia or no anesthesia. These products all have slightly different properties, but work in the same way. In my practice Botox cosmetic is the most popular because it is familiar to most of my patients. My patients also tend to stick with Botox because Allergan the company that makes it offers strong incentives to our patients through their “Brilliant Distinctions” program. Products that weaken facial muscles include: BOTOX COSMETIC DYSPORT XEOMIN


Before Botox
After Botox in VA

After (day 7)


Fillers are basically gels that are injected under the used to plump out depressions, or augment certain areas. Fillers can be used to enhance the volume of the lips or cheeks. They can strengthen a chin or the folds near the nose. Some fillers are thicker and last longer- these are used in deeper areas. Some are thinner and used more superficially like the depressions under the eyes. Collagen was the first filler, but it is rarely used anymore. People could be allergic to collagen. The new fillers are made of a jelly like clear substance known as hyaluronic acid (no its not acidic). This is a substance normally found in the body. There are other less popular fillers as well. Many fillers have local anesthesia built in to make injection more comfortable. They can be injected with no additional anesthesia or a topical anesthesia. In sensitive areas like the lips we block the nerves (like a dentist does before injection) Common fillers include: Juviderm ultra Juviderm ultra plus Voluma XC Bellatero Restylane Perlane Radiesse We offer all of these fillers, but by far the top 3 are the most popular and are part of our patients “Brilliant Distinctions” program.
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