Injectables 101: What to know about facial injections

Ever considered getting facial injections but don’t know where to start or which injectables are best for you? Dr. Sunthosh Sivam, an expert in facial plastic and reconstructive surgery at Baylor College of Medicine, explains the different types of facial injections, who are the best candidates for them, what to expect and more.

Types of facial injections: neurotoxins vs. dermal fillers

The most popular types of facial injections are neurotoxins, such as Botox or Dysport and dermal fillers, such as RHA, Juvederm and Restylane.

Neurotoxins do well on all sorts of skin types and adults of all ages within reason. They are injected primarily into the upper part of the face, where fine lines may develop from expressions we can have frequently.

“Think about the lines between your eyebrows that you might see when someone is angry, the lines in your forehead when someone raises their eyebrows in surprise, or the lines you see around the eyes when you smile. It’s the repetitive muscle movements in these areas where neurotoxins have their biggest role,” said Sivam, assistant professor of facial plastic reconstruction and surgery and medical director in the Bobby R. Alford Department of Otolaryngology – Head and Neck Surgery.

For filler, there’s more of a role in the cheeks and lower face.

Specific uses for fillers tend to change with age. Older patients are more likely to seek fillers to regain volume in their cheeks or fill in areas where a line or depression has developed from where the cheek settled down onto the upper lips or chin. These areas are referred to as nasolabial folds and marionette lines.

Whereas younger adult patients may be more likely to seek lip fillers to add more volume to thin lips or create more definition in their lips.

Another sometimes overlooked area to use fillers is along the jawline. A little volume in the right spot can bring a lot more definition to the jaw which can create a more youthful appearing neck as well.

During injections

To minimize pain during facial injections, Sivam uses cold compresses to take the sting away, but this practice can vary depending on your injector.

“In general, a patient will feel several tiny pokes. The needle is super small, so the ice will help with that,” he said. “Sometimes, we have to go a little bit deeper with fillers than we would do for neurotoxins, which can be intimidating for patients. For this reason, we’ll use topical anesthetics or numbing ointments on the areas we will treat.”

Sivam mostly uses hyaluronic acid fillers that are combined with lidocaine, a numbing medication. When a patient undergoes a procedure, the numbing medicine will kick in, alleviating the pain while the procedure progresses.

After injections

After facial injections, Sivam encourages his patients not to drink alcohol or take ibuprofen because both can thin the blood and potentially cause more bruising and swelling.

“From an activity standpoint, what is worrisome is elevating your heart rate and blood pressure. What would have been little bruises will be bigger ones and possibly little hematomas or small blood collections. It doesn’t ruin your result, but it does make the recovery a bit longer,” Sivam said.

Finding a reputable injector

When searching for a reputable injector for your facial injections, it is important to note that injectors can come from a variety of different disciplines – plastic surgery, facial plastic surgery and dermatology, to name a few. Sivam suggests considering the injector’s training, their experience and exposure to the products you plan to get.

“I’m looking to see how long people have been in practice and definitely reading reviews,” he said. “Also, when you walk into a clinic, think about how much attention is given to cleanliness and preparing your skin. If you feel like shortcuts are being taken, then you definitely do not want to proceed with any injections.”

Learn more about Facial Plastic Surgery at Baylor Medicine.

By Taylor Barnes