1. “I’m considering a facelift so I don’t have to do all the maintenance with Botox and fillers.”  A facelift will not substitute for Botox or loss of volume.  You will still have wrinkles if you don’t do Botox or Dysport after a facelift.  Also, loss of volume, a primary component of aging, is not corrected with a facelift.  Just go back 20 years and remember how everyone with a facelift looked like a skeleton?  Well, the concept of filling the face wasn’t understood at that time.  So if you do have a volume deficit, additional procedures are needed at the time of the facelift (liposuction to harvest fat and then fat grafting).  
  2. “I don’t want to start doing Botox because if I stop, the wrinkles are going to look even worse than if I didn’t do Botox.”   This is false.  When you stop doing Botox, the wrinkles which were corrected will reappear.  Keep in mind that they might look worse because you are now older and/or you forgot how they looked before Botox.
  3. “Rather than get repeated injections in my lips, I would like a permanent solution.”  There has never been a permanent filler or implant in the lips that has done well over time.  Malformed lips, abnormal firmness, bumps, and repeated surgeries have resulted.  The lips have too much movement and sensation to do well with implants.  Over time, repeated injections will stimulate collagen and the need for filler will decrease.   The HA fillers (Restylane, Belotero, Juvederm) are all completely reversible with an enzyme called hyaluronidase.  They are also much easier to fine tune and customize than implants.  Trying to remove old implants or permanent filler is nearly impossible to do without permanently misshaping the lips.
  4. “I can’t bother to use skin care products, I’ll just get the Fraxel to resurface my skin.”  Without skin care after laser resurfacing, your results will be suboptimal and won’t last as long.  Its very important to maintain results with skin care, and my preference is SkinMedica products.
  5. “Botox and filler parties seem like a great way to get treatments at a discount.”  I highly recommend against getting these treatments at any location other than a doctor’s office.  Often the lighting and positioning are suboptimal for the person administering the treatment.  Also, emergency medications and equipment are usually not available.  Often the injector is hard to get a hold of afterwards or is from far away, so post treatment care is difficult.  Most importantly, in Florida, a physician’s license is registered to a specific location so almost always this means that the physician is not licensed in that location.
  6. “I’m afraid to get my lips injected because everyone looks like a duck that does it.”  False.  The amount injected into the lips can range from minimal to Angelina Jolie.  It’s up to the skill of the injector as to control the size of the lips.  I prefer using the blunt cannulas in the lips because the bruising and swelling are minimized.  I consider everyone of my patients as a walking billboard for my work and I would never want anyone walking around with lips that look like Lisa Rinna.
  7. “I still have my frown lines, the Botox didn’t work.”  With very severe frown lines, one treatment with Botox will not make them go away.  Gradually over time with repeated regular treatments, you can expect better and better results.   Etched in lines (lines that are present even after stretching the skin) are actually scars and won’t improve with Botox in general.  Movement in the frown area is graded on a 1-4 scale.  Botox will help you go down 1-2 grades in general.  Also, wrinkles that are present at rest, particularly around the eyes, will not improve with Botox.  Botox helps the wrinkles which appear with movement.
  8. “I’ve read horror stories on the internet about this procedure, it doesn’t seem safe.”  The problem with the internet is that anyone can get on their soap box and discuss their poor (or perceived poor) outcomes.  In general, a person is going to be much more likely to write about a unsatisfactory result than a very happy client.  Rare side effects seem to be extremely frequent if you search the net.  Satisfaction rates for a given procedure are usually much less on the internet than reality.  Granted there is valuable information to be found on the net, but take everything with a “grain of salt”.
  9. “Sculptra patients seem to get a lot of nodules”  Sculptra has been FDA approved for over 8 years.  Indeed there were nodule problems in the beginning.  However, several changes have been made to reduce this risk to an acceptable level.  Deeper injections, massaging, greater dilution in the mixing of the Sculptra, mixing up the solution days or weeks before (rather than overnight) and not injecting close to the eyes and mouth have been implemented.  Dr. Weiner has been using Sculptra for over a year and some of his happiest clients have had Sculptra.

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