Though both Botox and Dysport are hugely popular non-surgical options for diminishing many facial lines and wrinkles, new alternatives are often being researched. This treatment, which is called cryoneuromodulation, “appears to have the same clinical efficacy and safety comparable to the existing techniques,” according to Francis Palmer, director of facial plastic surgery at the University of Southern California School of Medicine in Los Angeles, who co-authored the study.

Rather than paralyzing the underlying muscle to smooth out the wrinkle as Botox and Dysport do, this new method freezes specific nerves in the forehead using small needles. This stops the nerve from communicating with the muscle, which causes it to relax. The smoothing effect is almost immediate and lasts about as long as botulinum toxin-based methods—three to four months.

The procedure takes about 15 minutes to complete while the patient is under a local anesthetic. Patients said the level of discomfort was similar to that experienced with Botox.

Though you may want to jump at the chance to try this new wrinkle-fighting treatment, it is still in the early stages of trails and has only been tested on forehead wrinkles. In the meantime, Botox is known to beautifully treat forehead lines, frown lines and crow’s feet.

Today, are so many filler options available to consumers that it’s a wonder to some why pharmaceutical companies continue rolling out new injectables, especially when some existing products are already considered highly effective favorites in the aesthetic medical community and do not broker much room for competition.

But according to Dr. Gary Monheit, who commented on the topic in a recent Cosmetic Surgery Times article, unique new filler formulations and, to a lesser extent, new “me, too” products (fillers that closely resemble existing formulations) will still have a place in facial rejuvenation.

Despite the array of injectables available for wrinkle treatment, patients with fine lines around the eyes and mouth are still currently underserved, an issue which will likely be exacerbated by the fact that collagen injectables long used to treat superficial wrinkles (Zyderm, CosmoDerm) were recently discontinued by Allergan.

In addition, Dr. Monheit says patients are presently hard-pressed to find fillers that provide long-lasting results without a host of potential safety issues. Other than Sculptra and Radiesse, most fillers that can last longer than one year have generally proven problematic.

“To date, many long-lasting and permanent fillers, including both volumizing and structural products, have been associated with a number of problems. Reported complications include development of fibrotic nodules, granulomas and biofilm formation. These adverse events have not been reported with any filler materials approved by the FDA, but limited experience acquired in premarketing clinical trials may not be sufficient to fully understand product safety and biocompatibility issues,” Dr. Monheit says.

Joining the existing gamut of widely used hyaluronic acid (HA) injectable fillers, such as Restylane, Juvederm and Prevelle Silk are Juvederm Voluma (Allergan), Prevelle Lift (Genzyme/Mentor) and Belotero (Merz).

While Juvederm Voluma will primarily focus on chin and cheek augmentation and Prevelle Lift on correcting deep creases, Belotero is expected to be versatile, longer-lasting than many existing HA fillers and capable of correcting both deeper facial folds and superficial fine lines.

“In theory, this filler should be able to improve both superficial and deep lines. In patients enrolled in the clinical trial, effects lasted 6-12 months,” says Dr. Monheit, who serves as a consultant for Merz. “However, further evaluation of its benefits awaits use in clinical practice.”

As consumers eagerly await the latest and greatest fillers poised to enter the U.S. market, it is more important than ever to keep in mind that while the filler product certainly affects your facial rejuvenation results, the skill and expertise of your injector makes the biggest difference in the success (or failure) of your injectable filler experience.

Whether you’re seeking lip augmentation, wrinkle reduction or facial contouring, be sure to choose an experienced Lake Oswego plastic surgeon with a variety of FDA approved injectable fillers available to customize your facial rejuvenation treatment.

In fact, a recent study confirms this common sense notion and shows that people are more likely to make a positive first impression and be perceived as successful in various facets of life after improving their physical appearance with hyaluronic acid fillers to correct nasolabial folds (laugh lines).

Conducted by facial plastic surgeon Dr. Steve Dayan, the study concluded that full correction of the nasolabial folds with a soft-tissue filler made of hyaluronic acid, such as Juvederm or Restylane, “significantly and positively influences the first impression an individual projects.”

This determination was made after Dr. Dayan performed hyaluronic acid filler injections on 22 patients and included their images, alongside images of untreated patients, in a survey that asked more than 300 blinded participants to measure their overall first impressions and perceptions of the photographed individuals in the following categories:

• Social skills
• Academic performance
• Dating success
• Occupational success
• Attractiveness
• Financial success
• Relationship success
• Athletic success

The treated patients whose photographs were included in the survey were pictured 4 weeks after their initial filler injections, after optimal injectable filler results were achieved, and more than 5,776 first impressions were recorded.

Study findings show that the average first impression score improved significantly in all categories, including overall first impression, when photographed individuals who had nasolabial fold correction with hyaluronic acid fillers were evaluated by study participants.

If you’d like to make your first impression on others the best it can be and are thinking about correcting your laugh lines with a filler like Juvederm or Restylane, feel free to contact Dr. Michael Workman with your questions to learn more about this non- invasive, no downtime way to help you put your best face forward.

The new refinement technique, which essentially involves joining and rebuilding Botox molecules, may also improve the production process for Botox-based medicines, including the popular wrinkle relaxer Botox Cosmetic.

“It will now be possible to produce Botox-based medicines in a safer and more economical way,” said Bazbek Davletov, the leader of the study that uncovered the new refinement method.

The refining technique discovered by Davletov and his research team could allow scientists to create new and improved forms of the drug, expanding the practical medicinal uses for Botox, for instance as a long-term painkiller that could last four to six months.

“This is the first time we have been able to treat protein molecules like Lego building blocks, mixing and matching them to create the basis for treatments that would not previously have been possible,” Davletov said.

Although Botox has been used for years to smooth wrinkles, as well as treat problems like excessive sweating (hyperhidrosis), migraines, Parkinson’s, cerebral palsy and other diseases that cause spasms, tremors and chronic nerve pain, this latest scientific breakthrough will likely make the drug even more widely used.

It remains to be seen whether the “more economical” production process for Botox made possible with the new refinement technique will trickle down to doctors and consumers. It seems unlikely to decrease the cost of Botox injections, given the fact that the introduction of Botox-competitor Dysport to the cosmetic medicine marketplace didn’t lower the Botox cost.

Botox is currently FDA-approved to treat wrinkles, cervical dystonia and migraines, and Botox will likely become even more widely used as scientific advances continue to improve and expand its uses.

But does it work?

Eminent Philadelphia plastic surgeon Dr. Bruce Genter, is unconvinced. In a recent ABC News feature story, Dr. Genter pointed to the fact that no credible scientific evidence exists to support the claim that acupuncture can reduce wrinkles. Yet, there are those who claim it works for them. Are they seeing real change or is wishful thinking clouding the accuracy of their perceptions?

53-year old Julia Engstrom, a veteran of Botox and laser treatments, is convinced that acupuncture has improved the texture of her skin and reduced the appearance of wrinkles. Nearing the end of 10 treatments, she says her improvements have come from better sleep and relaxation. “I’ve noticed that my skin a lot smoother, [there’s] a lot less red pigment in there and the wrinkling seems to be a lot less,” Engstrom said. “I [also] have a lot less darkening under my eyes and I’ve been getting a lot of compliments.”

Acupuncture, in which tiny needles are placed strategically into the body, is said to bring improved health and well-being. In an article for Prevention, licensed acupuncturist and Traditional Chinese Medicine practitioner Phyllis Olson asserts that acupuncture can indeed lessen the appearance of wrinkles. She attributes this to a core premise of acupuncture – that health is reliant upon the healthy flow of chi (energy) in the body, which can be disrupted for a myriad of reasons. Acupuncture treatments are believed to break up energy blockages that prevent optimal blood flow to certain places in the body, improving circulation.

Beata Maslanka, acupuncturist and author of the “Art of Wellness” acknowledges that acupuncture doesn’t yield visible results that compare to Botox or other facial fillers, but claims that in some ways, “beauty comes from within.” When internal imbalances are healed, people will look better overall. Olson agrees, noting that the treatments foster relaxation of facial muscles, thereby reducing wrinkles. “Aside from the light, momentary stings, acupuncture is really quite relaxing,” she adds.

The results Engstrom points to are hard to discern from the video, and one can wonder about the salutary effects of relaxation and optimism, not to mention the natural human tendency to see (and believe) what we want to see.

It is also hard to imagine the results lasting for a long time. NYC dermatologic surgeon Barney Kenet, MD tells Prevention: “If acupuncture relaxes the muscles, it might reduce wrinkling temporarily. As for the increased blood flow, at most it will probably give you a temporary rosy complexion–something you don’t want if you have an inflammatory condition such as acne or rosacea,” he warns. “Otherwise, cosmetic acupuncture is relatively harmless.”

Maybe so, but then you may want to consider the cost. The average price of an acupuncture treatment for facial wrinkling could be as much as $60 to $100 per session, with 10 sessions recommended by Olson, followed by monthly maintenance procedures.

In contrast, the average Botox treatment in the US costs $472 and a single treatment will last 3-6 months. This makes acupuncture wrinkle treatments both an unproven and costly proposition.

Dr. Genter, whose patients are proof that Botox and other facial fillers visibly reduce the effects of aging on the face, says: ”If it increases your well-being that’s great, I just don’t know that it can make your face look younger.”