Injectables

Injectables work beneath the surface: relaxing the muscles that crease the skin, restoring volume where it has been lost, improving the quality of the skin itself, or dissolving fat or filler. Each is placed by anatomy rather than by trend, and every treatment is performed by Dr. Nawas herself.

The treatments

What each one does.

Relaxes expression lines

Botox and Dysport

Neurotoxin treatments

Relaxes the specific muscles that fold skin into lines, without flattening expression.

Treats
Frown lines, forehead lines, crow's feet, jaw clenching, sweating
Downtime
None
Typical cost
$16 per unit, most visits $500 to $1,400
Read the full guide

Restores volume and shape

Dermal fillers

Juvederm, Restylane and RHA fillers

Restores volume and structure where time has taken it, in the right plane and the right amount.

Treats
Cheeks, temples, tear troughs, lips, jawline, chin, hands
Downtime
Swelling, possible bruising, a few days
Typical cost
$800 to $1,250 per syringe
Read the full guide

Builds your own collagen

Sculptra

Poly-L-lactic acid biostimulator

Rebuilds volume gradually through your own collagen rather than filling it directly.

Treats
Overall volume loss, temples, cheeks, jawline, crepey skin
Downtime
1 to 2 days of swelling
Typical cost
$1,100 per vial, a first session is typically $2,200
Read the full guide

Dissolves fat under the chin

Kybella

Deoxycholic acid injections for fullness under the chin

Dissolves fat beneath the chin without surgery.

Treats
A double chin that does not respond to weight loss
Downtime
Swelling for several days to 2 weeks
Typical cost
$800 per session, usually 2 to 4 sessions
Read the full guide

Corrects filler

Filler dissolving and correction

Hyaluronidase (Hylenex)

Reverses hyaluronic acid filler that has migrated, accumulated, or gone further than intended.

Treats
Migrated or overfilled lips, puffy under-eyes, lumps, asymmetry
Downtime
Swelling for a few days
Typical cost
$500 per session
Read the full guide

Skin quality

Better skin, not only more volume.

Three treatments that work on the quality of the skin itself, alone or alongside filler.

Builds your own collagen

Sculptra

By Galderma

Poly-L-lactic acid placed deep beneath the skin prompts it to make new collagen. Volume returns gradually over a few months and lasts about two years.

Typical cost $1,100 per vial

Read the full guide

Smoother skin, cheeks and neck

SkinVive

By Allergan

Tiny droplets of hyaluronic acid placed in the skin smooth the cheeks and soften lines on the neck. On the cheeks, results last about six months.

Typical cost $600 per syringe

Ask Dr. Nawas at your consultation.

Lines around the mouth

RHA Redensity

By Revance

A soft, flexible hyaluronic acid filler for the lines around the mouth that deepen when you talk and smile.

Typical cost $1,200 per syringe

Ask Dr. Nawas at your consultation.

Our fillers

The fillers we use, and what each is for.

Each is a hyaluronic acid gel, made for a particular area and depth. Dr. Nawas chooses the product for the area and the result you want, so you do not need to choose one yourself.

Allergan

7 products
Juvederm Voluma XC
Volume in the cheeks and temples, and a better chin profile
Juvederm Volux XC
Definition along the jawline
Juvederm Vollure XC
Lines and folds, such as the folds from the nose to the mouth
Juvederm Volbella XC
The lips, lines around the mouth, and hollows under the eyes
Juvederm Ultra XC
Lines and folds, such as those from the nose to the mouth, and the lips
Juvederm Ultra Plus XC
Lines and folds, such as the folds from the nose to the mouth
SkinVive
Smoother skin on the cheeks, and softer lines on the neck

Galderma

8 products
Restylane-L
Lines and folds, such as those from the nose to the mouth, and the lips
Restylane Silk
The lips, and lines around the mouth
Restylane Lyft
Volume in the cheeks, chin and backs of the hands, and lines and folds
Restylane Contour
Cheek shape and midface contour, and hollow temples
Restylane Kysse
The lips, and the lines above the upper lip
Restylane Refyne
Lines and folds, such as the folds from the nose to the mouth
Restylane Defyne
Deep lines and folds, and a better chin profile
Restylane Eyelight
Hollows under the eyes

Revance

1 product
RHA Redensity
Moderate to deep lines around the mouth

Prices are on the dermal fillers page, and SkinVive's under Skin quality above.

How they work

Still from the animation: a cross-section of skin down to the muscle, where the neurotoxin blocks the nerve signal at its junction with the muscle, so the muscle relaxes
How Botox and other neurotoxins work One minute, no sound
Read the steps

Why expression lines form. Frown lines, forehead lines and crow's feet are creased into the skin by the small muscles beneath it, which contract thousands of times a day.

  1. Map and place. The muscles are mapped while you make expressions, then a few tiny injections are placed exactly where the pull comes from.
  2. Block. The neurotoxin works at the junction between nerve and muscle. It blocks the signal that tells the muscle to contract, so the muscle relaxes. Skin and sensation are unaffected.
  3. Smooth. With the muscle at rest, the skin above it stops creasing. The effect begins within a few days and is fully in by about two weeks.
  4. Renew. Movement returns gradually over 3 to 4 months as the nerve builds new connections. Botox and Dysport work the same way and differ mainly in how fast they take effect and how far they spread.
Still from the animation: a cross-section of skin down to the bone, with a blunt cannula placing hyaluronic acid gel deep on the bone beneath a fold
How dermal fillers restore volume One minute, no sound
Read the steps

What changes with time. With age, the fat pads under the skin deflate and shift, the bone beneath slowly recedes, and the skin loses its support. The result is hollows, folds and shadows.

  1. Plan. Treatment starts with anatomy: which structure has lost support, and in which layer the gel belongs. The goal is to restore, never to overfill.
  2. Place. Hyaluronic acid gel is placed in small amounts in the right plane: deep on the bone for lift, or closer to the surface for fine lines, using a needle or a blunt cannula.
  3. Support. Hyaluronic acid is a sugar your skin already makes. The gel holds water and rebuilds the support beneath the skin, so the surface lifts and the shadow softens right away.
  4. Last. The body gradually breaks the gel down over 9 to 18 months, depending on the product and the area. If it ever needs adjusting, it can be dissolved.
Still from the animation: a cross-section of skin down to the bone, with the tiny Sculptra particles placed deep above the bone, where new collagen forms around them
How Sculptra builds collagen One minute, no sound
Read the steps

How it differs from a filler. Sculptra is not a filler in the usual sense. It is made of poly-L-lactic acid, a material used in dissolvable stitches, and it works by prompting your skin to build its own collagen.

  1. Place. After numbing, the product is placed deep, under the skin and above the bone, in the areas that have lost volume. The treated area is then massaged.
  2. Respond. The tiny particles act as a scaffold. Over the following weeks, cells called fibroblasts gather around them and lay down new collagen fibers.
  3. Build. Volume returns gradually, from your own tissue, over 2 to 3 months. Because the change is slow, it looks natural rather than sudden.
  4. Last. The particles themselves dissolve over time while the collagen remains. A series of 2 to 3 sessions is typical, and results can last up to two years.
Still from the animation: a cross-section of skin with hyaluronidase injected into a lump of filler gel beneath the surface
How filler dissolving works One minute, no sound
Read the steps

When it is needed. Sometimes filler sits in the wrong place: too much, migrated beyond the lip border, lumpy, or placed years ago and still visible. It can be removed.

  1. Assess. The area is examined and mapped to find exactly where the gel sits. Only hyaluronic acid fillers can be dissolved this way.
  2. Inject. Hyaluronidase, an enzyme the body makes naturally, is injected directly into the filler, after a skin test when appropriate.
  3. Break down. The enzyme cuts the long hyaluronic acid chains into small fragments. The gel begins softening within hours, and the body clears the fragments over the next day or two.
  4. Reset. Some of the skin's own hyaluronic acid is affected too, so there can be a short-lived flatness that recovers. Once settled, the area can be re-treated correctly if desired.

Explore

Other treatments.

Lasers and energyFraxel FTX, Vbeam Pro, GentleMax ProRegenerative and resurfacingPlatelet-rich plasma, Acne scars, Subcision, Chemical peelsSurgical and medicalMohs micrographic surgery, Surgical excision, Skin biopsy, Cryotherapy, Electrodesiccation

Every procedure, explained in full