Botox Blog
Please feel free to use the blog below to share information about Botox, or to ask Dr. Ringpfeil a question that might be of interest to others.
The Philadelphia Center for Dermatology and Cosmetic Surgery
Call 610.525.5250
rad@ringpfeildermatology.com
Uncompromised quality through
unmatched experience | focus on patient satisfaction | advanced technology
Botox, Fillers, and Laser for Wrinkle Reduction
| Treatment Comparison | Botox | CO2 Laser | fillers | ActiveFX | TCA Peel | Fractional Laser |
| Results | +++ | +++ | +++ | ++ | ++ | + |
| Dynamic lines | Yes | No | No | No | No | No |
| Static lines | No | Yes | Yes | Yes | Yes | Yes |
| Downtime(days) | None | 7-14 | 1-3 | 3-6 | 5-7 | 1-6 |
| # Treatments | 1 | 1 | 1 | 1 | 1 | 4-8 |
| Lasting results | 4-6 months | 10 years | 6-9 months | 10 Years | 2 Years | Unknown |
| Avg. total cost | $15/unit | $3000 | See below | $3000 | $500 | $7000 |
Next available appointment
for Botox injection Mon, Mar 19 9:30AM
Click here to book it! find other appointments here or call us 610.525.5250
Click here to book it! find other appointments here or call us 610.525.5250
Botox and Filler Events - 20% off
Botox Events: the last Tuesday of odd months
Filler Events: the last Tuesday of even months
Limited availablity, call for details.
Filler Events: the last Tuesday of even months
Limited availablity, call for details.
Definitions
Static Lines Lines/wrinkles visible at rest.
Dynamic Lines Lines visible only with forceful movement of muscles.
To achieve best results and a natural look all cosmetic injections are performed by Dr. Ringpfeil.
Facial wrinkles treatment by fillers and Botox
| price / syringe | lasts (months) | # treatments | |
| Botox | $15 / unit | 4-6 | 1 |
| Artefill | $900 (0.8 ml) | Permanent | 1-2 |
| Sculptra | $750 (1.0 vial) | 24+ | 2-3 |
| Radiesse | $600 (1.5 ml) | 12-18 | 1 |
| Juvederm | $500 (0.8 ml) | 6-12 | 1 |
| Restylane | $500 (1.0 ml) | 6-9 | 1 |
| Prevelle | $250 (1.0 ml) | 3 | 1 |
Purchase of a full syringe is required. When only a partial syringe is needed, the remainder can be injected to another area.
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Marionette lines – Radiesse / Juvederm / Restylane / Prevelle- 1-2 syringes will fill in the longer grooves that extend to the jaw line.
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Note: Sculptra and Artefill can be used in place of Radiesse. Usually, several treatments are necessary to achieve desired volume correction. Their upfront cost is substantially higher, yet, fewer treatments are needed in the long run.
Some static lines are a result of long time repetition of dynamic lines. Those lines are used for facial expression (angry - frown lines, surprised - forhead lines, or happy - crows feet).
Other static lines are formed by a volume shift on the face due to intrinsic aging, and because of exogenous factors such as sun exposure or cigarette smoking.
Botox is best for dynamic lines and mild static lines on the upper face. It can also decrease a pebbly chin, vertical lip lines, as well as vertical bands that form on some aging necks. It lasts between 3-6 months and the number of units needed is determined by the strength of the muscle to be weakened.
Moderate and severe static lines need several sequential botox treatments to melt away.
Fillers are a good option to smooth those lines until serial Botox treatments are taking effect.
Static lines can be corrected with a variety of injectable fillers and volumizers. The area to be treated determines which filler is suitable.
TCA peels and fractional lasers treat fine and medium depth wrinkles, whereas a complete CO2 laser resurfacing may even eradicate deep lines.
Treating Wrinkles with DeepFX Laser
26 Responses to “Botox”
Leave a Comment or a Question
Ringpfeil Advanced Dermatology | 569 W. Lancaster Avenue | Haverford, PA 19041 | rad@ringpfeildermatology.com | 610.525.5250
Copyright 2006-2012 © Ringpfeil Advanced Dermatology | Committed to best dermatology and best cosmetic surgery | All Rights Reserved.
I am interested in getting botox but I am worried about the pain and swelling at the injection site. I have heard Ouchless Needles are less time consuming then numbing creams and they reduce the patients pain. Do you use Ouchless Needles?
Most people who get botulinum toxin (Botox or Dysport) do not consider the procedure painful. Therefore we never had to use numbing medicine but we use ice in those who have a strong bruising tendency. The needle stick does not typically cause a very intense sensation as we use very fine needles, however some experience a mild stinging injection when Botox/Dysport flows into the skin.
The swelling at the injection site lasts only 15 minutes. Most will have no visible mark by the time they leave the office.
I have several planar warts on both of my feet. I have had one of them for 10+ years. I’ve been to different doctors who have tried freezing and topical treatments but they continue to grow and last year they started spreading (there are 7 total). When I was a kid, the first one I had was burned off by my family doctor and it never came back. I was told that this type of treatment is no longer done. The doctors I have seen lately seem to think that the warts are not a big deal, but they are very embarrassing to me and I’d like to have them removed permanently, even if that means there would be a scar left behind. What type of treatment could you perform and what costs would be associated with those? Thank you.
Warts are caused by human papilloma virus. They are benign and most will resolve on their own after several years. They can be transmitted to others through frictional skin to skin contact. Treatment is indicated when warts cause symptoms or are actively growing or spreading. There is no effective treatment for warts. In office and at home procedures are tailored to encourage the immune system to fight the human papilloma virus from the inside. In areas of thickened skin such as on fingers, toes, palms, soles, elbows and knees several treatments are usually needed to remove a wart. We often combine at home treatments including nutritional supplements and prescription topicals with in-office treatments in recalcitrant warts and many options are available. Burning or cutting is no longer performed on hands or feet by most dermatologists not because a scar occurs but because warts can persist within the scar and then become impossible to treat.
Dr. Ringpfiel-
When considering a non permanent filler for fine to very moderate smile lines. Do you prefer, one filler over another. Restylane, Juvederm, Elevess etc? Thank you.
The texture may play a minor role when considering between Restylane and Juvederm but they are very similar. I no longer use Elevess but instead Prevelle when shorter lasting results are desired.
Does Dr. Ringpfeil administer all Botox and filler injections?
Yes, I am the only provider who injects Botox and fillers
Hi-I have an undifferentiated connective tissue disease and my eyelids are sort of purple all of the time. I have tested positive for Sjogrens(sp?). My lids are thin and a bit dry but are not as irritated as they once were since my disease is well managed. I was prescribed Desonate gel 0.05% and used that on them when they seem more sensitive. I have a few questions. First-how often can i used the desonate and can it be used if i become pregnant? Also, would any eye cream like lumiere help make my eyelids less wrinkled? I realize you may need to see me to make a better judgement but i thought i would ask you here first. Thank you!
Lumiere eye cream would work well for dry eyelid skin. Also apply a warm compress to your eyelids at bedtime for about 10 minutes, take it off and immediately after apply petrolatum on the damp skin. Lumiere should be applied in the morning. Please understand that medical questions such as the use of a steroid on the eyelids must be directed to your treating physician/dermatologist. They cannot be handled in a blog.
I’ve already had a bilateral Blepharoplasty, I have lines on my lower eyes which my doc said could be removed using a laser. Which laser is best for this application, the CO2 or the Fractional? Why is the Fractional laser more than twice the cost of the CO2 laser treatment? Can either treatment be used to correct this issue? Thank you.
The difference in price is due to the number of treatments needed.
CO2 laser treatment(”traditional” CO2 as well as fractional CO2) is more efficient than fractional Erbium glass or FRAXEL laser treatments when you have fair skin. This means that the results are present after one CO2 laser treatment whereas it will take 4-8 fractional (Erbium glass/FRAXEL)) laser treatments to get to the end results. When you have fair skin, the CO2 laser can be used in its maximal capacity where it tightens the surface as well as the skin underneath and will provide superior results on the lower lids. If you have darker skin (Mediterranean, Asian, Indian or black skin), both lasers give you about the same results but are limited to tightening the skin in the deeper layers only. Please notice, CO2 laser is nowadays used almost always in a fractional mode. As other fractionated laser technologies it leaves a grid of non targeted skin area to help the skin to heal faster.
I have ‘creppy’ folds under my eyes that creams do not help. I am in my earlyb 30’s and though the creases are not too deep they really bother me. I have inquired into botox and fillers for this area, but I have been advised that laser is my only option. I cannot afford the downtime of the C02 laser; I also have light skin and cannot afford the months (or year) of redness. I am interested in fraxel (fractional, not sure?) laser treament for this area. What is the pre/post procedure process? How much does each treatment generally cost for the eye area?
I appreciate your help. Thanks!
Fine crepiness under the eyes can be corrected by laser treatment. The best results on the eyelids are achieved with a fractional CO2 laser; which is an ablative laser. However, both ablative (injuring the surface of the skin) and non-ablative (not injuring the surface of the skin ) lasers can be used for treatment.
The term fractional technology applies to both ablative laser and non-ablative laser. Fractional lasers skip minute areas of skin from which healing is generated rapidly, which means time to healing is much shorter.
There is a significant difference between the results after a fractional ablative laser versus a non ablative laser treatment. In general, a fractional ablative laser typically requires a small number of treatments. In fact, crepiness can resolve after one treatment with fractional CO2 technology. A non ablative laser requires several treatments to reduce crepiness and its end results may not be as good as after fractional ablative laser treatment. Typically, the skin around the eyes heals so quickly that most people who decide to treat crepiness on their eyelids do not consider the inferior non-ablative technology. Swelling is the same with both FRAXEL, a fractional non ablative laser that you mentioned, and CO2 and typically takes one week to resolve. During this time any crusting from CO2 resolves as well. Redness may persist for up to 3 months after fractional CO2 laser treatment but in my experience, eyelids often heal faster than that. In addition, redness can easily be covered by make up. The lighter your skin, the faster redness resolves after ablative laser treatment. If redness is still a concern, CO2 laser treatments can be reduced in intensity. This will reduce post laser redness but requires repeat treatments in 4 weekly intervals. End results are typically superior to a series of non ablative treatments.
Hi Dr. Ringpfeil:
Could Artefill work on a ice pick scar on the nose (I caused this scar to happen myself and I have learned my lesson). I have a deep scar that looks like a very large pore. I (due to heredity) have large pores on my nose already and my nose tends to be oily. I have done internet searches on this matter and some people suggest at home TCA-stiching(?) but I have no desire to try and use a needle to apply acid and possibly stich myself up to and hope for a smoothly healed/looking nose. I am just not sure if there are options for this. Please let me know.
Thanks!
Scars are notoriously difficult to treat. However, Artefill is usually not the choice for a single ice pick scar on the nose. TCA treatments are possible and were the standard for many years until CO2 laser technology was further refined. while CO2 laser spot treatment and TCA treatment may not work in all situations, when they do work, they improve these ice pick scars significantly. Several treatments as well as downtime with scabbing and redness is expected with both treatment types.
how many syringes of restalyne do you estimate you would use for minor Nasolabial folds? I’m in my early 20s
In a young person, nasolabial folds are not expected to be very deep. On average, one 1 ml syringe of Restylane is sufficient for both sides.
Is there anything you can do to improve the bags under the eyes without surgery?
Loose skin under the eye is a concern for many. Treatment options depend on the degree of laxity which can be assessed on examination. They include a customized eyelid care regimen, laser treatment and/or surgery.
I am interested in using facial fillers for volume restoration in my jaw and cheeks and perhaps around m nose. Is this able to be done, is it safe and have you done many procedures like this? Is one syringe usually enough or do you often use many more? Thank you.
The areas you indicated can easily and very safely be restored using a number of facial fillers and these procedures are performed in our office daily. The volume needed depends on the depth of the lines or volume loss to be corrected. Just to give you an idea, most people will require one syringe for the nasolabial fold alone and another syringe for the jaw. Evaluation is crucial for an estimate on the number of syringes required.
I am looking for a package that includes Botox & Artefil. I had some Artefil about 5 years ago, but the effect has diminished. I am hoping you offer a combination package.
I need forehead frown lines Botoxed; a line just above each brow Botoxed & filled; glabellar lines Botoxed & filled; Botox & some additional Artefil in the nasalabial area; Botox & filler in the corners of my mouth. Most important to me is the area below my mouth. I had a mini face lift known as the LifeStyle Lift about 6 years ago. As a result, I have areas on both sides of my face, under my mouth that are sunken in & need filler to add volume. Of course, finances are a concern, so if you could let me know approximately how many units/syringes of each product you estimate I would need & an estimated cost I would appreciate it. Thanking you in advance. J
Botox and/or fillers including Artefill in the areas described are very reasonable and can be performed as you outlined. However, a description does not allow to estimate the amount of filler or Botox needed to achieve your desired goals for facial volume restoration and rejuvenation. A consultation in the office provides you discussion about types of fillers suitable for the areas in question, assessment of units/syringes needed for your goals including a price quote. We customize all our treatments and charge only for the units/syringes actually used. Our pricing structure rewards those who have multiple procedures performed during the same visit.
I am interested in a Botox treatment for my frown lines. What is your fee for this procedure? Thank you.
We charge $15 per unit (As of July 2009, price might change in the future). The number of units required varies. Everybody’s muscle tone is different and therefore an examination in the relaxed and animated state is necessary to determine the number of units needed to relax dynamic frown lines. The number of units needed is directly related to the years the muscles had to create these lines. Women often require a lesser number of units than men. E.g., the average dose in the area between the eyes (glabella) of a 30 year old woman is approximately 15, whereas a man in the same age often requires 20 units to relax the muscle complex. If glabellar lines are no longer dynamic (very deep lines that are present in the relaxed state), a filler may be needed to help achieve the look you are aiming at. The forehead frown lines require between 8-15 units in a woman or 10-18 units in a man, and rarely require the use of a filler.