Can you look natural when getting Botox & Fillers?

Can you look natural when getting Botox & Dermal Fillers?
We hear this question on a daily basis in our practice, especially being in the North East. Lets face it, Hollywood has pushed the boundaries of what is refreshed and what is shockingly obvious that someone had work done. Many people in the North East are conservative and wish to have a refresher, without appearing as though they had Botox & Fillers. This blog addresses this concern.

As a clinical trainer and injector, I understand the balance between looking natural and refreshed vs overdone. My goal is to never have someone look frozen or over filled. So, why does this happen? Often, it is simply lack of an artistic eye. Many providers can be safe injectors who understand all of the principles, but they do not have an artists vision as to what an individual face needs. It can also be that the client has taken the drivers seat and is now dictation where the provider should inject. We hear this a lot, “fill my lines, get rid of this wrinkle”. Non-surgical enhancement is not about filling lines or freezing wrinkles, it is about correcting volume loss, softening certain muscle groups and enhancing your natural beauty.

Rule of thumb 101, if the deal is too good to be true, then beware! Think Groupon deals or home parties. Many providers are inexperienced and you are not going to get a beautiful, natural look. Rule 102, if the injector or the staff look like they have had work done, you are going to look that way too. I can’t tell you the number of times I have gone into a training and am taken back by how the provider and staff look over filled or frozen. If they do not look natural, chances are you will not either. Rule 103, it if not about the amount of Botox or Fillers that makes you look overdone, but where they are placed. For example, the other day I saw a beautiful women in her late 30s with some volume loss and enhanced her with 3 syringes of filler in strategic locations like her temple, lateral cheek, and chin. Every face is unique and a cookie cutter approach is not going to give you a natural look. We can not create Angelina lips to fit your face if your other features can not carry that lip style.

With Botox it is true that too much in the wrong places will make you look unnatural, for women, that is often being over treated in the forehead, which can drop the brow and create a masculine look. However, an ultra conservative Botox approach in the areas that strong muscles pull downward, like between the brows and around the eyes can actually still make you look unnatural. Many providers do not use Botox in the lower face and this should be a red flag. If you are just getting Botox in the upper face and fillers in the lower face, you can look like you have had work done.

Come see our team and have a 360 Consultation. Our goal is to enhance your best features and make you look refreshed.


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Ladies, lets talk about our Vs!

Why is it that women can not discuss their lady gardens with other women?  Our team is invested in women’s health and wellness and as a result, felt compelled to invest in the Geneveve treatment by Viveve when we learned more about it.  I don’t know about you, but when I see commercials about diapers for women and medications, I feel a bit red in the face knowing that there is an alternative that is not paid for by Pharmaceutical companies, thus you do not hear about it.  No, your insurance will not cover this treatment, but when you add the price for 1) not needing pads 2) not needing to take medications with side effects and 3) great vaginal health and improved libido, I would say the price tag of a few thousand is well worth it.  I mean, we spend more on a trip to Starbucks in a year than this.  This blog addresses the benefits of the Geneveve treatment.

The Geneveve uses Radio Frequency heat combined with surface cooling to create a controlled injury and healing effect in the vaginal area.  While there are many different laser treatments out there, this device had the advantage of being comfortable and effective with only 1 treatment as opposed to 3-4 treatments.  Did you know that Vaginal laxity effects over 50% of women?  Genetics, child birth, aging and hormonal factors will impact our vaginal health.  These symptoms often show up as urinary incontinence (stress incontinence like sneezing and peeing), decreased sensation, diminished libido or arousal, dryness and painful intercourse.

I don’t know about you, but after having three kids of my own, including twins, I began to experience many of these symptoms.  The one that was the most bothersome was stress incontinence.  I would be jumping on the trampoline or start sneezing and dribble.  Many of my friends and female colleagues have the same symptoms, but never speak about it.  Once I learned that there were Aesthetic treatments that could improve these symptoms, I was game.

The Geneveve takes 20-30 minutes.  Using a small transducer that looks like a sonicare brush head, the device is inserted into the vaginal canal.  Initially, it felt warm and cool at the same time.  I had a few areas of sensitivity, but after a few minutes, I was relaxed and game for the treatment.  Our team uses RNs to perform the treatment.  Our Nurse Practitioner (me) will ensure you are a good candidate for the treatment.  You can not have it if you have a pacemaker or metal IUD, history of STDs or vaginal cancers or irregular pap exams.

What are you waiting for?  Its time to love you lady garden again!

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Vampire Facials… not just for the Kardashians any more

I am sure your have heard about the various vampire treatments.  These treatment are patented for cosmetic purposes by Dr. Charles Runnels, of Alabama.  Historically, Platelet Rich Plasma, known as PRP, has been used by Orthopedic physicians for years to help with soft tissue healing and torn ligaments.

There is the Vampire Facelift which combines Dermal Fillers with platelet rich plasma in the same treatment.  This is a great treatment to volumize the face and improve tone/texture, color and areas where fillers are tricky, such as the under eye area.  The Vampire Facelift® combines HA Dermal Fillers (such as Voluma, Juvederm or Restylane) with growth factors derived from your blood. Together, they create a youthful outcome. This procedure contains two parts. The first part utilizes dermal fillers to begin sculpting specific areas of the face. These fillers act like a sponge. They hold water in the face, providing a basic shape. This initial injection of filler is the precursor to the ultimate desired form. The second is the polishing and refining step. It utilizes your body’s own natural healing process. A sample of your blood is obtained with a simple blood draw. Using a centrifuge, the growth factors in platelet rich plasma (PRP) are extracted from that blood sample. They’re then injected into specific areas of the face.

Then there is the Vampire Facial, which is not the same as the Vampire Facelift. This procedure does not involve using dermal fillers. Rather, it uses technology to create micro channels in the skin. It then topically infuses your own growth factors to signal healing. This procedure addresses fine lines and wrinkles. It also improves tone and texture of skin! We’ll numb your skin with a topical anesthetic for about 30 minutes. Then we draw your blood and it’s spun in a centrifuge. Finally, the PRP will be infused into your skin!

Here are benefits of the treatment;

  1. Super safe as it is using your own natural growth factors with no chance of allergic reaction
  2. Softening of lines and wrinkles and improvement in texture
  3. Improvement in skin color- giving you a youthful glow
  4. Great for under eye area where fillers can be tricky
  5. Quick treatment taking about 45 minutes with little to no discomfort

FYI: Many providers claim to offer Vampire Facelift Treatments. However, only those who have personally trained with Dr. Charles Runels, the inventor, are licensed and trained to provide these procedures.  Our Clinical Nurse Specialist, Linda Vecchione, personally trained with Dr. Runels. We feel fortunate to offer these treatments to our clients! Not all providers offer the same PRP treatments and results.  Our team has invested in the top PRP kits and centrifuge- pure spin, to give you true platelet rich plasma, not platelet poor plasma like in many systems.

RN Esthetics

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Our team’s top non-invasive treatments to improve your selfies.

With the rise in ‘selfies’, people are alway looking for ways to look and feel better.  Our team has come up with some of our clients favorite ways to feel great with little to no downtime and looking and feeling natural.  Here they are:

  1. The Hydrafacial MD.  This is an all time staff favorite treatment bar none.  We love it because it is fast and effective leaving you with healthy, glowing skin.  This is not your old school facial or microdermabrasion.  The Hydrafacial is a chemical and physical exfoliation that deeply cleans, removed impurities and toxins and infuses antioxidants and peptides.  It is great for men and women, as well as teens and even the most sensitive skin.  We recommend these treatments every 4-6 weeks.
  2. Baby Botox or Botox.  The goal of Botox is not to make you look like Lake Placid.  It is simply to soften lines and wrinkles and open up the eye area.  It makes us look more awake and refreshed.  Sure, we have all seen some bad Botox out there (sorry Nicole Kidman).. but our team is skilled in a conservative approach to make you look natural and great.
  3. Kybella.  Ever heard of it?  You will soon as this is a serious game changer that received FDA approval and launched in the US in 2015.  Kybella is a non-human, non-animal form of Deoxycholic acid that your body makes, which dissolves fat.  When this product is injected into the under chin area, it rids of of the stubborn fat and gives us a contoured jawline permanently… YES, permanently.  There is swelling associated with this treatment, but minimal downtime.  This wonder drug can also be used ‘off label’ for small areas of fat in the body (think ankles, knees, jowls, bra fat and more).  Kybella is safe and effective, giving a 90% response rate.  This treatment takes about 30 minutes in the office with an average of 2-3 treatments.  It is not a one and done treatment.
  4. Voluma.  The name ‘filler’ is really not accurate when talking about Voluma.  Voluma is a Dermal Filler which is unique as it is a form of Hyaluronic Acid that contours and lifts the cheek area.  When this product is injected by a skilled provider, it creates a beautiful lift and softening of the mid and lower face.  Not all fillers are created equally.  This one is a real game changer with up to 18-24 months duration.
  5. Ultherapy.  Ultherapy is really amazing and one of our most recommended treatments for our clients.  Why we love it… it is microfocused Ultrasound that creates a controlled injury to get our body to stimulate collagen and give us a foundation for the skin.  Most clients have this treatment done every 3 years (sooner if they are older and really need their collagen ramped up).  For younger clients, this is a great preventative treatment too.
  6. Medical Grade Products.  Our must have product is TNS Essential Serum- which contains growth factors and 7 antioxidants plus peptides (think protein smoothie).  Our second favorite product is HA5 from Skin Medica.  This is 5 types of Hyaluronic Acid (think water) for the skin.  This product hydrates from the inside.  SPF is another must have and both Skin Medica and Alastin make a fabulous tinted super sunscreen for everyday use.  Another BFF is Retinol… no, we are not talking about Retin A, which can be extremely irritating for the skin, but a medical grade retinol (we love Skin Medica and Alastin) that is encased with antioxidants and non-irritants, allowing you to actually use the product.
  7. Cool Sculpting.  We know you have heard of this treatment.  The most common question we get is does it work?  The answer is absolutely.. but you must be a good candidate for this treatment as it is not a weight loss tool, but rather a treatment for those stubborn areas of fat.  This technology dissolves fat permanently using cooling with no downtime and minimal discomfort.  Do your homework on this one.  You want a certified provider who has the newest Cool Advantage handpiece.  Our Nurses perform these treatments.

See You Soon!

RN Esthetics

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Team Based Medical Esthetics and Skin Care

What Sets Us Apart?

Want to know what makes RN Esthetics unique in the skin care business?  Sure, we have awesome staff and an adorable historic red building, but it is actually our Team Based approach to medical esthetics that sets us apart.  What does that mean?  Well, as Nurses, we have always been familiar with team based care.  We never received compensation for how sick our patients were or what procedures they were having.

It was a wakeup call when my partner, Linda Vecchione, and I opened RN Esthetics in 2011.  We had no idea about providers getting paid a commission to see clients or that it was all about a ‘me’ rather than ‘we’ mentality.  I was familiar with this in the hair industry… I mean one would feel like they were cheating on their stylist if they booked their next appointment at a time and date that worked for their schedule.  You get what I am saying, right?

A Team Approach to Medical Esthetics

Enter Strategies and its founder Neil Ducoff.  We first learned about this team approach to medical esthetics in 2012 and it just made sense to us.  Handpick your team, train them intensely and allow clients the opportunity to see any member of the team for appointments.  No commission.  Or overworked providers!  And no need to wait and see the same provider over and over.  The idea is simple, but really game changing in the spa industry.  As Strategies puts it, ‘team service in the world today is a unique point of difference.

A company that is truly engaged in team service just feels different … to the customers, the staff and the leadership.’   Yep.  We agree.  As a team based company, our goal is to have you meet every provider on our staff, to have a comprehensive plan that includes skin care and medical services, plus home care products.  And… to reward our staff ourselves for hitting those goals.  No tipping.  Or being locked in to see only one provider.  And no getting ‘upsold’ on services or products that you may not need simply to increase the providers commission.  We believe this is the point of difference with our team and is what makes us stand out in a crowded environment.

Michelle Doran
RN Esthetics

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Apes Don’t Have Nasal Labial Folds

Dermal Fillers in Your Nasal Labial Folds?

One of the most common complaints we hear from people when they come in for a consultation is that they do not like their Nasal Labial folds. These are the smile lines from the nose to the mouth.  We spend time educating people as to why injecting that area with Dermal Fillers does not look natural.  In fact, it can make them look like apes.  Here is the truth about looking natural while having dermal filler treatments.

The Truth About These Folds

Its all about making people look natural and refreshed.  When you look at little children, they actually have nasal labial folds and some flattening in their mid cheek area.  Children are full in the temple, lateral cheek area and lower face.  They also have a slight depression under their eyes (commonly known as the tear trough area).  As we age — beginning in our mid thirties — we start to lose collagen and hyaluronic acid. Fat pads in our mid and lower face diminish. We develop lines/wrinkles in motion (dynamic lines).

You Want to Look Natural, Right?

Skilled injectors understand age-related changes. We also know the subtle ways to augment the face to lift and volumize. Most importantly, we can do so while creating a natural look.  Simply placing dermal fillers in the lines and folds will make us look like apes — the only other species on two feet without nasal labial folds.

The most natural treatment plan is to focus on three areas:

  • Foundational treatment to stimulate collagen, such as Ultherapy (see previous blogs that address Ultherapy)
  • Volumization with dermal fillers and neurotoxins (Botox or Dysport). These create softening and relaxation of muscle contraction.  With Dermal Fillers, our team prefers Voluma and Juvederm products to lift and soften.  We start addressing the temple and brow area, lateral cheek and then lip area and lower face (chin, jaw line).
  • Our team will also focus on using Botox to open the eye area, give a medial brow lift, soften forehead lines when appropriate, and relax the lower face area.

Come in and let us create a treatment plan to make you feel and look your best!

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What do Popsicles and Cool Sculpting have in common?

Cool Sculpting and Popsicles?

Did you know that Cool Sculpting was developed by Harvard Physicians right here in Boston?  It started as an observation that when children were ill and sucked on popsicles for long periods of time, they had decreased fat (dimpling) in their face.  It was that notation observation that demonstrated there was something about the cold and fat that were connected and thus Cool Sculpt was created.  This blog addresses the most common questions about this device.

Does Cool Sculpting Work?

Yes, if you are a good candidate.  This is not a weight loss tool and the best candidates are fit and have stubborn areas of fat they cant exercise off.  It does not treat visceral fat (under the muscle and around organs), which can only be eliminated with diet and exercise.  It treats subcutaneous fat, pinchable fat in the abdomen, arms, legs, bra, flanks, thighs, chin and more.  Cool Sculpting uses FDA cleared cooling to kill fat cells permanently.  The fat does not come back, but if you gain weight, then the fat cells will enlarge.

How expensive is it?

It depends.  Every treatment is customized.  If you have a tiny stubborn area, then it can be as little as $1500… but that is the exception.  Most people looking for results need multiple cycles to get a treatment to transformation result.  It averages 6-8 cycles, but can be more or less.  Many people retreat an area after 3 months.  If you are comparing this technology to surgical intervention and lipo, it may be a bit less… but the key is that this is Non-invasive and no down time, not necessarily ‘cheaper’.

Do I need more than one treatment?

You may need a few treatments for the same area if you are looking for a surgical result and have a larger area to treat.  If you just have a small area, then one treatment may suffice.

Does it hurt?

Ok, here is the truth… yes and no.  Cool Sculpting used to hurt for the first 7-8 minutes with the older handpiece and amount of suction. However, with the Advanced handpiece, the device is colder and the suction is less intense. So, it is so much more comfortable (I know first hand).  The first 5 minutes can be a little uncomfortable, but then the area feels numb and you can catch up with your latest Netflix shows.

What does a a cycle consist of?

When we talk ‘cycles’ we are talking about a small area.  For example, an abdomen can be treated in 2-4 cycles, in as little as a few hours.

What makes is different than other devices out there?

Lasers and Radio Frequency use heat to try and destroy fat.  Cool Sculpting uses targeting cooling which causes fat cell death without injuring surrounding tissue.

How long does it take to notice the results?

Usually within a month, you will notice improvement.  However, it can take up to 3 months.  The fat cells die after the treatment and your lymphatic system flushes them out through your excretion.

What makes your team unique?

Well, a few things make us stand out.  First and foremost, we are Advanced Practice Nurses and RNs who primarily perform the treatments.  Our Nurses have advanced training and have attended Cool Sculpt University (yes there is such a thing).  We have two machines and can Dual Sculpt areas (2 cycles together) making your treatments faster.  We also have the newest Cool Advantage handpiece, with increased comfort and cooling.

Want to learn more?  Come to our Cool Sculpting party March 29th from 4-7pm!

RN Esthetics

cool sculpting

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A Rolex Doesn’t Go On Sale! A great blog by Adam Horoun shared by RN Esthetics

A Rolex Doesn’t Go On Sale: How So Many Aesthetic Providers Destroy Their Value & Tips To Avoid Being “That”​ Practice

A Blog that must be shared by Adam Haroun, Award-Winning Brand Marketing Strategist | Consultant to North America’s Most Innovative Aesthetic Practices

Did you hear about the blowout sale at the Rolex store recently?

For those of you who enjoy travel, were you able to scoop up a bargain when the Ritz-Carlton had it’s “all rooms must go!” deal?

If you’re an automotive aficionado, have you noticed that a Mercedes-Benz salesperson is always eager to slash away at a MSRP…so you will sign on the dotted line that day?

What about the “end of season” buy-one-get-one-free promotion at Louis Vuitton?

No! Of course not! The reason you’ve never heard about or seen any of the instances above is that they would simply never happen.

Many of the most prolific brands in the world recognize their value, and refuse to do anything that would ever diminish or take away from the cachet they have spent decades to build. To share two quick examples of how seriously the world’s most coveted brands will go to protect their value – Louis Vuitton literally burns unsold inventory each year, to avoid putting a lower price tag on their top-quality merchandise. Meanwhile, in the 1990s Burberry decided to abruptly stop manufacturing it’s ball caps after they gained popularity and became a cultural symbol among the street-gang youth crowd in the United Kingdom.

While these examples are extreme, the very same principles apply to your aesthetic practice. All too many surgeons and providers aim to drive business and attract new patients by doing the one thing they never should…destroying their value. Today, I’d like to share how many practices ruin the prestige and quality they work so hard to build, often without realizing it. I’d also like to share a number of action items your practice can take to avoid being one of the many that finds itself devaluing procedures.

Devaluation Culprit #1: Constant Use of Discounting/Group Buying Sites

While it’s one thing to use a promotional offer or loss leader to attract a long-term client relationship (in my experience, offering peels can be one of the best ways to leverage this strategy)…incessantly using discounts to get new patients into your practice is entirely another. Remember that from a patient’s very first interaction with your practice, you are “training” them on what to expect. A patient who comes to you through rampant discounting will expect discounts for the duration of their relationship with your practice. As for group buying sites, just say no.

Unless a client comes to BrandingMD in incredibly desperate financial circumstances, we do not permit them to use Groupon or similar sites to promote their services. There is frankly no faster way to position your practice as a commodity – the ultimate marketing “no-no”, as I explained in my previous article about why so many practices struggle. if a client comes to you over price, that is precisely why they will leave. Simply put, clients who are bargain-driven almost never have any sense of loyalty.

How To Fix The Problem: Use discounting and promotional offers sparingly, and only when paired with a campaign to further convert and engage both new and prospective patients. Ideally, any low-priced offer should be part of what we refer to as an “ascension model” – to upgrade them to progressively higher-value procedures that offer superior results. As an example, you may run a Facebook campaign for an attractively-priced peel. Once someone comes into the practice and receives the treatment, they are then entered into an e-mail nurturing and patient education campaign for laser resurfacing.

Devaluation Culprit #2: Failure to Invest In The Patient Experience

As I discussed at length in my article on patient loyalty, many practices believe that offering quality customer service is the same thing as patient loyalty. While both work hand-in-hand, they are in fact quite different. To summarize the difference, customer service is the ability of an organization to consistently meet or exceed the patient’s expectations. On the other hand, patient loyalty is the desire on behalf of the patient to continue to do business with a practice over time. Patient loyalty is rooted in an emotional connection with a practice, and driven by a consistent experience and interaction with people, products and processes. Whereas quality customer service is a requirement to do business (and further drives loyal clientele), patient loyalty is the foundation of sustained profitability and growth. The key to patient loyalty is delivering a remarkable patient experience

How To Fix The Problem: You’ll find that most patients have never received any kind of personalized communication from a doctor or aesthetic provider, ever. From a personal, unexpected phone call to your patient to having a member of your staff write hand-written thank-you card, imagine how enhanced appreciation of your patients would create word-of-mouth discussion about your practice While the sky is the limit, here are just a sampling of several simple (and very affordable) initiatives your practice can implement to create a memorable experience for your patients:

  • Handwritten letters – No list of patient appreciation suggestions would be complete without a call for handwritten letters; and for good reason – they work. Yes, they take some time, but consider doing one a day. Don’t be Hemingway, no novels – just a few lines saying thanks.
  • Train staff to learn (and use) first names – A person’s first name is the most important sound in the world. Saying it to someone shows they’re more than just a customer.
  • Share your own “amuse-bouche” – In fine dining restaurants, many chefs have an amuse-bouche, or a special bite (or small plate) specially created by their own hand, and often reserved for only the best customers. What can you give customers that is unique to your brand, or you personally?
  • Complimentary upgrades – If you add a new service or upgrade a product, consider giving it away to your best customers.
  • Post-transaction gifts – Give people something related to what they’ve purchased from you. The bigger the transaction, the more important this can be (consider the ever-present “free gift with purchase” at department store cosmetics counters!)

Devaluation Culprit #3: Driving Patient Action With Low Prices

All too many practices will do an incredible job of ‘building up’ the value and expertise of the surgeon or provider through their marketing, public relations, website, and consultation process – only to completely dismantle it at the moment that matters most. While it can be incredibly useful to use incentives to entice a patient to commit to a procedure on the day of consultation, I am of the opinion that offering substantial discounts is not the way to go about doing so. As we discussed above, discounting services from the outset “trains” your patients to expect reduced rates and negotiate with you for the duration of their relationship with the practice. What’s more, a price-based incentive to commit to a procedure at the time of consultation can create a “high-pressure”, automotive-sales type of environment which only further damages the value and quality you wish for your practice to exude.

How to Fix The Problem: The best incentives can prove to be “value adds” rather than discounts that leave a sense of desperation. From adding a non-invasive procedure at a low cost, to products that can enhance results and/or patient comfort post-procedure; there are numerous ways to drive your prospective patients to action that don’t involve “talking down” your price. An example I have seen work incredibly well for a practice that offers “mommy makeovers” is to offer a complimentary treatment with their feminine rejuvenation laser. In doing so, not only does the patient see immediate results to accompany their procedure, they often return to schedule a series of rejuvenation treatments. Not only is the patient driven to commit to their initial procedure, but the “incentive” drives another stream of revenue for the practice. If you currently use a price-discounting incentive for prospective patients, you may wish to trial a value-added incentive and compare the results – I am confident you will be pleasantly surprised.

Devaluation Culprit #4: Commodity Positioning

I saved the very best for last. As I discussed in my widely-shared article on the commoditization of aesthetic practices and procedures, while consumers may initially shop on price, what they are ultimately looking for is value. The formula to create value is simple – create an offering that is distinct in the marketplace, and serve the patient’s needs more effectively than the competition. As Theodore Levitt, the famous Harvard Business School economist, once said, “There is no such thing as a commodity. All goods and services are differentiable.” Although you may carry a generic product (as a very common example, let’s use Botox) your offered product – what you’re really selling – is the expertise, quality, skill, and distinct experience that accompanies each unit. Your execution is the differentiator here, and execution is by no means interchangeable.

How To Fix The Problem: When price becomes the primary influencing factor for purchasing a product or service, it means that the producer has failed to differentiate its services to the consumer. It means the consumer doesn’t find any more value in choosing one competitor over the other. Your practice is either perceived as a distinct brand, or as a commodity. Brands get the patient’s attention, while commodities are lost in a sea of obscurity. The more competitive your market, the more things rings true. Beginning today, I challenge you to rethink the way you approach your practice: as distinct, and never a commodity.

If you are ready to begin putting these steps into action, and maintain the value of your procedures, I’d love to share a valuable, complimentary resource that can help along the way…

For a limited time, you can download a complimentary digital edition of our popular book “Now The Patient Will See You”. With dozens of checklists, templates, and evaluation tools, this book will help you forge ahead more efficiently, confidently, and intelligently. You will be able to leverage the power of branding to enhance your existing marketing activity for maximum results. At the same time, it will accelerate your growth through a framework for market leadership that takes most practices years (if not decades) to understand and execute.

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Warning: Cookie Cutter Injecaibles Could Ruin Your Beautiful Face

The Problems with Cookie-Cutter Injectables

I have been thinking about this a lot lately. I seem to keep seeing the same faces over and over on Facebook, Instagram and in public... frozen foreheads, broad noses from too much botox, overfilled cheeks, and lips that do not fit the rest of the facial features. What is going on? I am beginning to wonder if injectors are aging people and taking beautiful faces and making them look like the same faces over and over. Here are my thoughts about why this is happening and what to look out for
As a trainer for Allergan, known as an ACE Traininer, I first began to notice this phenomenon at my own conferences that I was attended, filled with the top injectors (including Physicians, PAs, NPs, RNs).  As I was people watching, I kept seeing the same features over and over and wondered what was going on. Well, it only makes sense that if we are doing it to our own faces, the same would hold true for patients. Of course, there are so many skilled injectors out there who do not create such looks, but many do simply use injectables as though they're cookie-cutters. Here are my top 5 NO NOs:Shiny, frozen foreheads:The forehead is the only elevator in the upper face and many people complain about forehead lines with unrealistic expectations... NO movement.  So, what happens?  The frontalis is over treated with toxin creating a brow ptosis (heavy brows), diminishing the arch and masculinizing the face.


Brows should never be pulled too far apart in the center with Captain Spock peaks laterally.  This is usually a look created by a newbie who is over treating the glabellar complex (muscles in between brow) and the medial forehead area.  It also makes the bridge of the nose look wider and the eyes look smaller.  A dead give away that you have botox and an unskilled injector (Groupon anyone???).

Frozen Upper Face

Many injectors forget to use a pan facial approach to softening muscle movement with both the upper and lower face.  A little bit of neurotoxin in the chin, DAOs and perhaps lip lines can be a wonderful softening for an overall nice look.  The problem?  Once again it is the unskilled injector who often is only focused on the upper face with much too much toxin and nothing in the other half.

Over-Filled Lips.

We have all seen it and shockingly, many people want the look.  There is a fine balance, however, between giving you a full lip that looks proportioned to your face and giving you a look where you lips enter the room before you do.  Your injector should look at all of your features and create either a subtle or plump lip that fits your face.  It is also important how the filler is injected to avoid a 'joker mouth' when the corners are turned up too high and also a 'duck lip' when the lip sticks out.

Cheeks for Days

We have gone to the extreme now.  Many injectors used to fill lines and not cheeks, which did not look right.  Now we focus on cheeks and forget to assess all of the face to created softness and proportions.  This includes looking at the temples, fat pads in front of the ear area, lower face and cheeks.  Many providers over inject the cheeks, often medially, and cause the rest of the face to look off.  With such injections, often the lateral face is flattened, the temples are sunken and the eyes to look smaller.So, when you make an appointment about injectables, make sure your injector really does have an art for injecting.  They should be looking at your face, having you animate, and creating a plan that fits your individual facial features. Remember. It's about softening lines, gentle lifting and volumizing the face. Injectables should allow you to look refreshed and natural.  You want to see a provider who uses injectables all the time, has great reviews, and looks natural themselves.  If they look over filled or frozen, chances are you will come out looking the same way.

The Uplifting Anti-Aging Treatment Worth the Time and Money

We all want to look and feel great. The skin is the largest organ in the body. It protects us from the elements. But it also ages us. Sometimes, quicker than we care to admit. While investing in injectables and anti-aging skin care is great, however Ultherapy is the treatment that you really want. It will add to your arsenal of anti-aging skin care.  And this blog post will tell you why!

Where to Start

I first heard about Ultherapy 7 years ago. A  plastic surgeon clued me in, actually. And I happened to be affiliated with him. The concept made a lot of sense to me. Using ultrasound technology, you could create controlled injuries under the skin. Deep down in the dermis, you could stimulate collagen and elastin. Now, ultrasound has been around for 50+ years.  I knew that this was a great option, but the treatment was expensive. I also heard that it hurt.

Getting Re-acquainted

After trying to alternate it into our practice including Radiofrequency and Lasers, it was time to get reacquainted with Ultherapy.  After all, it has changed a lot in the past 7 years.  The amount of energy has been lowered, thus  it includes much less discomfort.  There are also more customizable treatments. These use various handpieces and advanced techniques. A LOT had changed since I first trained on this device!

FDA-Approved Anti-Aging

Now, Ultherapy is a non-invasive procedure FDA approved. It lifts skin on the neck, under the chin, the brow and the chest area. It can make your skin appear healthier. This happens thanks to the stimulation of collagen. There's really no downtime with this procedure. Many consider it a 'lunch time lift'. However, it does take more than a quick lunch. On average, you should allow 2-3 hours for a lower or full face. You only need 30 minutes for a brow though.

The Fine Print

You should know there will be some swelling post-treatment. Yellow bruising may also occur. However that can be easily covered.  Post-treatment, your face will feel sensitive to touch. It will also be a bit numb, due to cutaneous nerve swelling for a few weeks.  The procedure itself feels zingy. Almost like heat under the skin.  Many people will do the treatment with just Tylenol and Motrin pre treatment. However, we recommend some medication to take the edge off.  Our Nurse Practitioner prescribes this though.

What Else Should I Know?

The ideal age for Ultherapy is 40s-50s.  If you're older or have more laxity (loose skin), but are looking to avoid the scalpel, then it may take two treatments. These will need to occur 6 months apart for best results.  The results start to work at about 1 month. They then peak at 3 months.  This procedure is also great post-surgical procedure once healed.  Best of all, the results are natural.  We often hear people ask 'how long does it last?'.  The results are permanent. However, we keep aging. And we need to repeat the treatment every 3-5 years. This could be more frequent for older clients.

Why RN Esthetics for Anti-Aging?

Our practice is unique. Our RNs perform all of our anti-aging treatments. We have advanced certification in Ultherapy. And we've used many of the other ant-aging technologies out there. These include lasers and RF.  Ultherapy allows us to visualize the area we are treating. Then we ramp up your collagen and alastin.! We combine the treatments with our Alastin Kits for home.  We're advanced nurses, medical experts, and injectors.w We understand the anatomy. So we customize treatments to help you achieve your goals! So what are you waiting for?  Let us see you and customize a plan!