What No One Tells You About Injectables

Injectables can be a tricky topic, due in part to the fact that everyone has an opinion about them — and is willing to share it. (For proof, take a quick scroll through the comments section of just about any celeb Instagram selfie. Sigh.) But while the world is so quick to play the guessing game of "did she" or "didn't she" when it comes to others' cosmetic pursuits, we often shy away from discussing our own. Maybe it's because we want to keep our beauty secrets just that — secret. Or maybe it's because less than 40% of us are comfortable talking about our options with healthcare specialists in the first place. But we believe that you can do whatever you want with your face — after all, it's your face — and have the necessary conversations to make an informed decision about it.
While cosmetic tweaks are a very personal choice, it's important to get into the nitty-gritty with your doctor before taking the plunge. The world of wrinkle-fighting and plumping injectables can get overwhelming fast, especially if it's your first time considering going under the needle. So, we talked to experts to find out the most important questions to ask when you show up for the consultation. Whether you're interested in a between-the-brow, frown-line-relaxing neurotoxin, like Dysport*, or curious about plumping your lips, don't forget to ask the six questions ahead.
*Dysport is a prescription injection for temporary improvement in the look of moderate to severe frown lines between the eyebrows (glabellar lines) in adults less than 65 years of age. Please read full Important Safety Information, including Distant Spread of Toxin Effect Warning, here.
Important Safety Information is featured on the last slide of this slideshow.
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Depending on your state's law, you can go to a plastic surgeon, nurse practitioner, or dermatologist for injections. But not all of them are created equal. Some specialize in, say, skin cancer, while others focus on cosmetic procedures. Obviously, going to the latter (often called cosmetic or aesthetic dermatologists) is the right move for injections. “There are so many treatment options these days,” explains Dr. Frank. “Patients should go to someone who has experience in all the injectables out there.” And since practice makes perfect — clichéd but, in this case, totally true — finding a doc who uses injectables 24/7 ensures you get the most natural-looking result.

*Please see full Important Safety Information, including Distant Spread of Toxin Effect Boxed Warning, on first slide.
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We can get down with a budget — but now is not the time to score a great deal. Crazy discounts or buy-two-injections-get-one-free offers sound tempting, but there’s usually a reason they’re so cheap. Sometimes, the doctor in question may be less experienced or not even board-certified. Does that really matter? Yes, since you risk not getting the result you want, which is a big deal when your face is on the line. “There’s definitely an artistry behind the needles,” says Marina Peredo, MD, a dermatologist in Smithtown, NY. “Don’t chase the lower price.” Being board-certified is a standard qualification among dermatologists and an easy way to confirm that you’re in good hands.

*Please see full Important Safety Information, including Distant Spread of Toxin Effect Boxed Warning, on first slide.
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While some branded injections don’t require an introduction, there are a ton of perfectly good ones you might have never heard of before. Bottom line: It’s not like one type is better than the other, so ask your doctor about which injection is right for you. “There are so many options, but there’s no ‘best,’” says NYC-based cosmetic dermatologist Paul Jarrod Frank, MD. Different injections just offer different things, whether that’s the areas they treat or how long they last. There are also quite a few treatments that fall under the injectables category. Here’s what should be on your radar:

Botulinum toxin injections: Also known as a neurotoxin, these basically relax the muscles and facial expressions to soften the look of deep lines. Dysport, for instance, is botulinum toxin, and it softens the frown lines between your eyebrows. The result is smoother skin that looks natural, not frozen.

Hyaluronic acid filler: Its namesake is the star of this show, since hyaluronic acid can carry up to 1,000 times its weight in water to plump and smooth skin. These fillers can be used in the cheeks, around the mouth, and in the lips (where they even have a hydrating effect).

Polylactic acid filler: A type of filler known as a stimulator, polylactic acid kick-starts your body’s production of collagen to fill out laugh lines. Since it works by harnessing your body’s own collagen-creating process, the effects take longer to show than with other fillers.

*Please see full Important Safety Information, including Distant Spread of Toxin Effect Boxed Warning, on first slide.
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Like any other medical procedure, there are risks involved with injectables, like bruising, bleeding, and, more rarely, scarring. The odds are pretty slim, but they’re there. “Be cautious of doctors who promise too much,” warns Dr. Frank. That includes those who are quick to tell you that there’s no downtime. With injectables, you can be sure of three things, according to Dr. Frank: There are risks, there’s recovery involved, and there’s no treatment out there that instantly makes things disappear. Since the post-procedure care varies depending on the type of injection you received (botulinum toxin injections require minimal recovery, for example), be sure to get the full 411 from your doctor, first.

*Please see full Important Safety Information, including Distant Spread of Toxin Effect Boxed Warning, on first slide.
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We know, we know: We’re raining on your injectables parade. But insurance companies usually won’t cover them, so if you have a budget, it’s essential to get an estimate of the cost before making the appointment. In many cases, the standard pricing of injectables is by the unit, though some doctors price them according to the area of the face. The average cost of injectables ranges anywhere from $200 (for a small area) to $1,500 (complex fillers), depending on where you live and what you need. Is it an investment? Definitely. But is it worth it? That’s one question you’ll need to ask yourself.

*Please see full Important Safety Information, including Distant Spread of Toxin Effect Boxed Warning, on first slide.
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Here’s the thing: Unless you happen to be an injection wizard, you’re not going to have an expert understanding of which tweaks will have the most payoff. So even if the little crease near your right eye is driving you nuts, it may not necessarily be the top priority for your doctor. “I always ask my patients what they want — but I’m also going to tell them what I think they need,” says Dr. Frank. Obviously, you can (and should!) point out what’s bugging you, but it’s better to hold off until after the doc has offered his or her perspective.

*Please see full Important Safety Information, including Distant Spread of Toxin Effect Boxed Warning, on first slide.
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Dysport is a prescription injection for temporary improvement in the look of moderate to severe frown lines between the eyebrows (glabellar lines) in adults less than 65 years of age.

Important Safety Information

What is the most important information you should know about Dysport?

Spread of Toxin Effects: In some cases, the effects of Dysport and all botulinum toxin products may affect areas of the body away from the injection site. These effects can cause symptoms of a serious condition called botulism. Symptoms of botulism can happen hours to weeks after injection and may include swallowing and breathing problems, loss of strength and muscle weakness all over the body, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, or loss of bladder control. Swallowing and breathing problems can be life threatening and there have been reports of death.

The risk of symptoms is probably greatest in children treated for muscle spasms but symptoms can also occur in adults treated for muscle spasms and other conditions, particularly in those patients who have underlying conditions that would predispose them to these symptoms.

The toxic effects have been reported at doses similar to those used to treat muscle spasms in the neck. Lower doses, in both approved and unapproved uses, have also caused toxic effects. This includes treatment of children and adults for muscle spasms.

These effects could make it unsafe for you to drive a car, operate machinery, or do other dangerous activities.

Do not have Dysport treatment if you: are allergic to Dysport or any of its ingredients (see the end of the Medication Guide for a list of ingredients), are allergic to cow's milk protein, had an allergic reaction to any other botulinum toxin product, such as Myobloc® or Botox,® or have a skin infection at the planned injection site.

The dose of Dysport is not the same as the dose of any other botulinum toxin product. The dose of Dysport cannot be compared to the dose of any other botulinum toxin product you may have used.

Dysport may not be right for you if: you have surgical changes to your face, very weak muscles in the treatment area, your face looks very different from side to side, the injection site is inflamed, you have droopy eyelids or sagging eyelid folds, deep facial scars, thick oily skin, or if your wrinkles can't be smoothed by spreading them apart.

Tell your doctor about all your medical conditions, including if you have: a disease that affects your muscles and nerves (such as amyotrophic lateral sclerosis [ALS or Lou Gehrig's disease], myasthenia gravis, or Lambert-Eaton syndrome), allergies to any botulinum toxin product or had any side effect from any botulinum toxin product in the past, a breathing problem (such as asthma or emphysema), swallowing problems, bleeding problems, diabetes, or a slow heart beat or other problem with your heart rate or rhythm, plans to have surgery, had surgery on your face, weakness of your forehead muscles (such as trouble raising your eyebrows), drooping eyelids, or any other change in the way your face normally looks. Patients with a disease that affects muscles and nerves who are treated with typical doses of Dysport may have a higher risk of serious side effects, including severe swallowing and breathing problems.

Human Albumin
This product contains albumin taken from human plasma. Steps taken during donor screening and product manufacturing processes make the risk of spreading viral diseases extremely rare. In theory, there is also an extremely rare risk of contracting Creutzfeldt-Jakob disease (CJD). No cases of spread of viral diseases or CJD have ever been reported for albumin.

Allergic Reaction to Injecting in the Skin
It is not known if an allergic reaction can be caused by injecting Dysport into the skin. The safety of treating excessive sweating with Dysport is not known.

Common Side Effects
The most common side effects are nose and throat irritation, headache, injection site pain, injection site skin reaction, upper respiratory tract infection, eyelid swelling, eyelid drooping, sinus inflammation, and nausea.

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins and herbal and other natural products. Using Dysport with certain other medicines may cause serious side effects. Do not start any new medicines while taking Dysport without talking to your doctor first.

Especially tell your doctor if you: have received any other botulinum toxin product in the last four months, have received injections of botulinum toxin, such as Myobloc® (rimabotulinumtoxinB) or Botox® (onabotulinumtoxinA) in the past (be sure your doctor knows exactly which product you received), have recently received an antibiotic by injection, take muscle relaxants, take an allergy or cold medicine, or take a sleep medicine.

Use in Specific Populations
Dysport should not be used in children or in women who are pregnant or breastfeeding.

Ask your doctor if Dysport is right for you.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see Dysport Full Prescribing Information including Medication Guide.

The Dysport® trademark is used under license.

Important safety information.
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