Facial plastic surgery and chemical or laser peels cannot improve every skin problem. The crease between your nose and corner of your mouth might be too deep. You might have a small crease between the corner of your mouth and chin, which makes you look angry or unhappy all the time. Or maybe crow's feet (squint lines) or vertical lines between your eyebrows (frown lines) are the problem. Although certain operations can improve these, you may not be quite ready for the time or expense of plastic surgery. A reasonable alternative might be an injection.

BOTOX:
This is not a filler like collagen or Cymetra ( micronized alloderm). Instead, Botox works by weakening the muscles that pull on the skin and form a wrinkle. It is superior to collagen for improving deep vertical creases between the eyebrows (frown lines), horizontal furrows on the forehead (surprise lines), and crow's feet (squint lines) to the side of the eyes. As Botox does not cause allergic reactions, no test dose is needed.

Botox is botulinum toxin A, an FDA-approved injectable solution used to reduce frown lines, furrows in the forehead, and laugh lines.

It only takes a few seconds to inject each area of the face.

Botox treatments last approximately three months on average. Some patients state it lasts two to three months, and some up to six months.

The amount of effect is proportional to the amount of Botox administered, i.e., the number of units.

The average number of units given per site, i.e., in the frown lines, would be 25 units, which is one syringe; in the laugh lines 25 units, again one syringe but divided into one-half per side. The forehead can range from one to two or even three syringes, depending on how many lines and furrows in the forehead which, therefore, would be anywhere from 25 to 75 units.

It is important not to rub the areas that were injected with Botox for one week. Washing the face or patting it dry and applying makeup gently are acceptable.

There is usually no bruising and the effects are noticed anywhere from three to seven days.

Collagen:
Injected either into the skin or just beneath it to plump up any unwanted crease or wrinkle. Collagen is prepared from calf hide and is highly purified. As a small percentage of the population has an allergy to collagen, a test dose injected into the forearm is necessary to ensure that it is safe for you. Injectable collagen is similar in structure to human collagen, therefore, the body breaks it down in three to six months. As this happens, the wrinkle will reappear, and more collagen is needed to maintain the improvement. We will review the process with you during our consultation.

Cymetra (Micronized Alloderm):
Cymetra is a another injectable product but it is derived from human cells, not calf hide. This technique greatly lowers the risk of allergic reactions or rejection and Cymetra lasts longer than other skin augmentation techniques. It is injected beneath the skin and replenishes the very substance that aging depletes. Furthermore, it stimulates ones own tissues/cells to regenerate into the injected "scaffolding". It is as if one is injecting a blueprint beneath the skin directing your own body to repair the skin damaged from aging and the sun. Similar to collagen, cymetra often requires several injections to reach a desired result and will require periodic maintenance injections