Cosmetic Injectables

Cosmetic Injectables


Botulinum is an injectable medication used to treat dynamic facial lines or wrinkles (lines that appear when we move our facial muscles). The medication works by weakening the targeted muscles to prevent them from contracting and deepening existing, or forming new, facial lines. It is the most popular non-surgical intervention sought by men and women alike for cosmetic improvement. It is also sometimes used for non-cosmetic purposes to treat patients with severe migraines and/or muscle spasm.

Common areas for facial injection include the “eleven” lines between the eyebrows, horizontal forehead wrinkles, and the “crow’s feet” at the outer corner of the eyes. It can also be used to help shape the eyebrows, neck, jawline, and lips. Each patient’s needs and concerns are unique, and Dr. Chahal will cater your treatment to your specific concerns.

There are multiple brands of botulinum toxin that are commercially available US. These brands include Botox® , Dysport® , Xeomin®, and Jeuveau®. All are considered safe and effective, typically lasting 3-4 months in duration. These various forms of botulinum have been successfully used by oculofacial plastic surgeons for decades to treat facial aging.

The procedure itself is only mildly uncomfortable as the medication is injected with very small needles designed to minimize discomfort. Bruising can occur, but typically resolves within a few days. The medication begins working 3-4 days after injection and typically lasts 3-4 months.

Facial Fillers:

Facial fillers are also a popular alternative for nonsurgical facial rejuvenation.  They can be used alone, or in conjunction with botulinum. Unlike botulinum, filler does not work by weakening facial muscles. Instead, filler is injected under the skin to restore facial volume loss that happens over time.  This is sometimes described as “inflating” or “filling” sunken, shriveled, or hollow parts of the face. Fillers are routinely used to improve the shape and fullness of many regions including the lips, cheeks, temples, around the mouth, around the eyes, temples, earlobes, and even the back of the hands.

Most commercially available fillers are composed of hyaluronic acid, a common molecule in the human body. Popular brands of hyaluronic acid fillers include Restylane®, Juvederm®, and Belotero®.  These are advantageous to use as they can be readily dissolved if desired. There are also fillers based on materials other than hyaluronic acid, like Radiesse®, which offer their own advantages and disadvantages.

Dr. Chahal will address your specific concerns and help you select the appropriate filler(s) in accordance with your needs and budget. The filler market is changing rapidly as a result of technological advancement, and newer methods and products continually arise.

Dr. Chahal performs his injections with a needle or blunt-tip cannula, depending on where the procedure is being done. Most patients are treated with topical numbing cream prior to the procedure, and often with injections of local anesthetic as well. Bruising and swelling are common after filler injections, but typically resolve within a week. The results of the treatment are usually immediately visible and the duration of the facial improvement is highly variable, lasting anywhere from 6 to 18 months depending on the individual and the filler used.

Risks and complications:

While these treatments are considered very safe overall, no procedure is without risk. Bruising and swelling are common, and injections should be avoided 1-2 weeks prior to any major social events or travel. Bleeding and infection are rare, but injections should be postponed with any recent outbreak of shingles or cold sores, or any active skin infections. It is important to tell Dr. Chahal or his staff if you are taking blood-thinners as this increases your risk for bleeding complications. Botulinum injections may rarely result in temporary facial asymmetry, droopiness of the eyelid or eyebrow, or double vision. Serious complications of filler injection such as skin necrosis and loss of vision are extremely rare.

Dr. Chahal’s goal is always to help you look and feel your best. Because each individual is uniquely complex, however, there are many variables beyond Dr. Chahal’s control that may impact your results. As such, no guarantees or promises regarding outcome or patient satisfaction can be made. In the event of an undesirable outcome, additional treatments may be required. Our office is committed to addressing your concerns before, during, and after your procedure.