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.


Share this post:

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

Share this post:

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!
vConfidence Certified Provider Badge v1[1]

Can your Vagina Be Depressed?

It's time for women to focus on our lady parts. After all, men have many medications and treatments to help them achieve an erection. But when will women have their turn?

Well, our team is focused on the latest technologies. So we've decided to partner with VConfidence to introduce an awesome laser. This product improves many of the symptoms that women experience post-child birth and pre/post menopause. This post below is re-shared from the vconfidence site that our team partners with.
More and more women are empowered by vConfidence’s non-invasive, no downtime vaginal rejuvenation to address laxity to reclaim their sexuality. Often, younger women who have endured induced menopause as the result of medical treatment for cancer or other issues can suffer from vaginal dryness and painful urination or dysuria. These problematic symptoms can also plague post-partum and older post-menopausal women. When sex loses its enjoyment factor and intimacy becomes painful, expectations across every dimension of one’s quality of life can diminish. vConfidence resolves major medical symptoms and invigorates your confidence with treatments that re-balance pH, reduce or eliminate urine leakage, and restore your pleasure with neo-collagenesis-based solutions that rebuild mucosa linings of the vaginal wall to tighten and revitalize tissue with a more youthful density so your pleasure receptors and romantic life are made great again.
Utilizing the latest laser technology for improved patient outcomes, vConfidence represents the ultimate in transformative fractional CO2 laser treatments that improve the health of the mucosal lining by triggering the growth of new collagen. For too long, these types of symptoms and related issues of vaginal health and well-being have been too challenging for patients to even discuss with their physicians. vConfidence represents the next generation in self-empowerment for women. Now with vConfidence, our discretion, and privacy-focused approach allows you to address your issues non-invasively. And since all of our vConfidence Approved Providers are specialized on the craft of noninvasive laser treatments, with the goal of benefiting you with better feminine health, you can know that you are in great hands.Book your consultation with our team and check out for more information.Team RN Esthetics

Medical Grade Skin Care Must Haves

Medical Grade Skin Care is Essential.

Whether you're addressing pigmentation, acne, lines, wrinkles, or other age-related changes! This isn't the same a going to the mall and purchasing a product with the MD brand name on it. Medical grade skin care products are only available at physician and medical esthetic practices. Here are some top must-haves in your skin care line up. We'll let you know why they make a difference.


This is the top anti-aging product.  Prevention is key to block both UVA & UVB rays.  UVA rays are the longer rays in length. They penetrate deeper into skin. They reach and damage structures in the dermis. This causes inflammation.  UVB rays are shorter rays. They cause damage and inflammation in the surface of the skin.  Mineral based sunscreens must contain titanium dioxide and zinc oxide. This allows them to deflect sunlight and penetrate deep into skin.  A newer Super Screen from Skin Media, called Total Defense & Repair, also prevents Infrared penetration. That can cause aging and volume loss.


These products neutralize free radicals.  Common medical grade skin care antioxidants are Vitamin C&E, Coenzyme Q10 and green tea.  Vitamin C is also shown to increase collagen production.


As we age, epidermal cells and skin turn-over diminish.  This can contribute to lines, wrinkles, pigment and other age related changes. Retinoids will help increase cell turn-over, exfoliation, increase epidermal thickness, increase production of collagen and quality of elastin. Together they will result in smoother, more even toned skin. Retinoids are your skin's BFF.

Growth Factors

These are naturally occurring tissue proteins. They initiate tissue repair, stimulate collagen and elastin synthesis, and control inflammation.  Not all growth factors are equal.  They must be stable. They must contain high concentrations of human growth factors.  Our favorite medical grade skin care growth factor is TNS Essential Serum.  This all in one product is our staff fave. It's a must-have for all skin.


These are made up of Amino Acid Chains. They increase cell production of collagen.  Peptides improve clinical appearance of aged and photo-damaged skin.

Skin-Lightening Agents

Our team is not a fan of hydroquinone products. However, we do offer very limited courses. These are combined with peels or laser in deeply pigmented skin.  Lytera is a super power serum. It contains Niacinamide, vitamine B3 to promote skin lightening, licorice root for lightening, vitamin c, retinol and more.  This is a must-have for pigmented skin. It breaks up pigment on the surface. It also prevents deep pigment from coming to the surface.Come in and see our team of experts.  Let us work within your budget to get you on a few must-haves. Better yet, sign up for our 90 day North Shore Glow & Tell for a series of peels. You'll get 90 days of must-have products for the skin.Team RN Esthetics

Dermaplaning: The Cure for the Blonde Peach Fuzz.

I'm a blonde woman. The peach fuzz facial hair is always a challenge. Lasers don't work. And who wants to deal with waxing? Then I discovered the Dermaplaning. Life was simple again! Ever heard of Dermaplaning? This blog addresses this treatment option.

What is Dermaplaning?

Dermaplaning uses a scalpel to exfoliate skin. This gets rid of the blonde peach fuzzies. This method is taught in school to Estheticians. It's a great add-on to any skin care treatment.  Dermaplaning is a safe (provided the person performing it is properly trained) and highly effective physical exfoliation procedure. It requires the use of a sterile, surgical scalpel. The scalpel gently "shaves" the skin's surface. It removes the top-most layer of dead skin along with fine, vellus hair (aka peach fuzz).Many people hear the word dermaplaning and they associate it with dermabrasion. However, this is not the same procedure. Dermabrasion is a medical procedure to deeply abrade the skin. This procedure, often done under anesthesia, can be painful. It often leaves patients with complications.  Dermaplaning is a super-simple treatment leaving the skin soft, glowing, and fuzz free.  Here is the procedure and benefits:
  • Skin is cleansed deeply.  We prefer to add this to a Hydrafacial. This procedure will leave the skin clean and hydrated.
  • Using a scalpel or similar device, and of course a delicate touch, the provider simply abrades the surface of the skin using light feathering strokes.

Who Should Consider Dermaplaning?

This is an ideal treatment for those with vellus hair (thin baby like hair). This is because it often causes a build up of dirt and oils on skin surface. It's also great for people looking for an exfoliation, but do not wish to have peels performed (ie pregnancy).  It can help products penetrate deeper and even prep skin for peels and other treatments.

What Else Should I Know?

The hair does not grow back thicker and darker... this is an old wives’ tale!  As long as the hair is superficial vellus hair, it will grow back at the same rate and texture as before the treatment. This procedure can be performed every 4 weeks as necessary.Interested?  Book with one of our master estheticians in combination with our award-winning Hydrafacial. Be fuzz-free and glowing for October.