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Thanks for visiting the website!
I hope you will find this a good resource, but please call or email with your questions if that is easiest for you. The products I use have excellent records of safety and efficacy. There are rare instances of serious problems- at the bottom of this page you can read sample consent forms.
Check out the sites below for more information about Botox®, Restylane® and Perlane®, Juvederm® and Cosmoderm/Cosmoplast®. These sites tell you what products might be right for you. I will concentrate on practical questions so you know how to prepare for treatment and what to expect afterward.
www.Botox.com
www.RestylaneUSA.com
www.AllerganandInamed.com
www.JuvedermUSA.com
Preparation for treatment:
Bruising from the injection of filler materials, especially around the corners of the mouth and lower lip, is common. Occasionally it is difficult to cover a dark bruise (even with good makeup) for a week or so. Please schedule your filler injection with some recovery time to follow.
Because they increase bruising, aspirin, Ibuprofen (Advil® or Motrin®), and similar drugs should be avoided for a week or two UNLESS you are taking them for your cardiovascular health. Tylenol® is ok.
If you are planning to have injections of fillers around the lips and you have had cold sores or facial shingles in the past, you should start taking antiviral medication before treatment. It usually works if started on the day of treatment, but ideally, it is started one to three days before the injections. Call me for the prescription.
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Frequently asked questions:
I got a "surprised" look from Botox- my eyebrows arch up too high.
This is easy to fix- a tiny dose of Botox above your brow(s) will balance your forehead. In the future we'll try to get it right the first time, but sometimes a touch up is the only way to make it perfect. This kind of touch up is free.
I had Botox®, but I still have wrinkles!
Botox® takes 2-7 days to take effect. If you have waited 10 days and you still have muscle activity that creases the overlying skin, you may need a slightly higher dose. The dose that is effective for a certain area varies from person to person, and sometimes from treatment to treatment. I encourage follow up visits so that I can fine tune your treatment. Touch up treatments are usually under $100. Another reason for persistent wrinkles after botox is that they are too deep to resolve with botox alone. You can have the wrinkles filled with an injectable dermal filler to get more thorough and immediate results.
The effects have gone away faster than I expected.
Some people seem to go through products faster than others. Some get 4 months out of Cosmoderm®, some 4 weeks, and a few seem to chew it up literally overnight. Restylane® and Juvederm® are the most consistent. If your Botox® fades earlier than 2 1/2 to 3 months, we should increase the dose a bit.
I have a lump or bump.
Lumps that are felt and not seen don't need any treatment. If you can see the filler through the skin, I can usually help. Please give us a call.
What are the differences between the various filler products?
Restylane®, Perlane®, and Juvederm® are clear gels containing hyaluronate, a molecule natural to our body. The risk of allergy is low, and skin testing is not necessary. These products are FDA approved, and safe enough to be used medically for injection into arthritic joints. Cosmetic effects last approximately 4-8 months in the lips, 6-12 months in the nasolabial folds and marionette lines.
Cosmoderm® and Cosmoplast® are lab-generated human collagen, great for fine lines between the brows and in the “lipstick lines.” Cosmoderm® is perfect for acne scars. These products are often combined with Restylane® and/or Botox® for optimal correction. More frequent dosing is required around the mouth (every 1-3 months,) but the cost per session is modest.
Sculptra® is a substance similar to absorbable suture material (stitches). For clients in need of volume restoration in the cheeks or temples, it can be injected to stimulate the production of collagen. More than one treatment may be required. Please call or email for more information.
Wondering about a filler not listed here? That usually means I have decided not to use it for some reason (gets lumpy, can cause allergy, etc), but feel free to ask!
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Sample Botox® consent form
Being fully informed about your treatment will help you make the decision whether or not to undergo BOTOX® Cosmetic treatment. You are requesting that Dr. Foster attempt to improve your facial lines with BOTOX® Cosmetic. This is the Allergan Inc. trademark for Botulinum Toxin Type A. These injections have been used for more than a decade to improve spasm of the muscles around the eye, to correct double vision due to muscle imbalance, and for numerous other neurological uses. BOTOX® Cosmetic is now approved by the FDA to improve the appearance of the vertical lines between the brows. A few tiny injections of BOTOX® Cosmetic relax overactive muscles and soften those vertical lines. Injections in other areas to improve appearance of facial lines is common, but you should know that the FDA has not approved those uses. The results of BOTOX® Cosmetic are usually dramatic, although the practice of medicine is not an exact science and no guarantees can be or have been made concerning expected results.
The BOTOX® Cosmetic solution is injected with a tiny needle into the muscle; you should see the benefits develop over the next two to seven days. A decreased appearance of frowning or creasing of other lines will be the result of this treatment. The most common side effects are headache, temporary eyelid droop, and minor bruising. Uncommon side effects may include a large bruise, an infection or pimple at the injection site, facial asymmetry, and undesirable temporary changes in facial muscle activity. When used around the mouth, there is a chance of temporary difficulty speaking or sipping liquids.
I have been advised of the risks involved in such treatment, the expected benefits of such treatment, and alternative treatments, including no treatment at all. I understand that the results are temporary and several sessions may be needed for optimal results. I agree that this constitutes full disclosure. I have read and fully understand the above paragraphs, and have had sufficient opportunity for discussion and to ask questions. I consent to this and all subsequent treatments by Dr. Foster.
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Sample filler treatment consent form.
Disclosure and Consent – Treatment with Collagen (Cosmoderm®) and other Fillers including Restylane®, Juvederm®, and Perlane®.
You have the right to be informed about your skin condition and the recommended surgical, medical or diagnostic procedure to be used. You may make the decision whether or not to undergo the procedure after knowing the risks and hazards involved. This disclosure is not meant to alarm you; it is simply an effort to better inform you so that you may give or withhold your consent to the procedure. You are voluntarily requesting that Tammy Foster MD treat you with collagen or hyaluronate filler based on your individual needs. You understand that no guarantee has been made to me as to result or cure. There may be potential complications including lumpiness, allergic reaction, infection, bruising, or migration of the material to other sites. In rare instances, tissue damage and even blindness due to injection into a blood vessel has been reported. As with any injection, you may expect to experience a slight localized swelling accompanied by mild soreness and redness that may last for hours or days. This is a normal response. Persistent or increasing redness, swelling, or tenderness and/or persistent itching should be reported immediately. Some patients experience small broken capillaries at the injection sites. Because this is a relatively new procedure, the long-term prognosis has not yet been studied and although it is believed that there will be no adverse long-term results, that cannot be ruled out. Allegations have been made that certain serious connective tissue disorders (“autoimmune diseases”) may be related to injectable fillers; however, there is no verifiable or credible scientific evidence to support this idea. Collagen has a long record of safe use, and hyaluronic acid products such as Restylane® are actually used to treat arthritis by injection into joint spaces. However, as a responsible physician, it is my duty to warn you of the alleged relationship of collagen injection to these rare disorders. By signing below you agree that you have been given the opportunity to ask questions regarding treatment, and you have sufficient information to give this informed consent. You certify that you have read this form or have had it read to you and that you understand its contents. I consent to this and all subsequent treatments by Dr. Foster.
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