Nonsurgical Procedures

Below are some of the nonsurgical procedures offered by Dr. Rothaus.  For more noninvasive procedures visit our Laser Procedures section.

Botox Cosmetic

Frown lines between the eyebrows, wrinkles along the forehead, and crow's feet next to the eyes can be significantly lessened with BOTOX®. The treatment takes minutes and lasts months. It is an effective, low risk procedure that remarkably rejuvenates the aging face. Unlike the popular misconception, when performed properly, a frozen or unnatural look should not be the result of BOTOX® injections.

BOTOX® is best used to treat dynamic wrinkles (those as a result of the action of the underlying muscles), examples of which are noted above. BOTOX® treatments do not require an anesthetic to be performed and the results are seen 4-7 days after the injections.

It is our experience, that the duration of the effects of the injections is directly related to the number of units of BOTOX®. As there is a permitted variation by the manufacturer in the amount of sterile saline used to prepare BOTOX®, the number of units in a single syringe will vary by practice. In addition, the duration of the BOTOX® effects may vary depending on the site into which it is injected. For example, BOTOX® injections into the crow’s feet may last longer than those into the glabellar region. Following this protocol of my practice, we find that the results last up to 6 months after the first treatment with BOTOX®. After repeated injections, however, the results last longer and can extend up to 8 – 10 months or more.

Patients should avoid aspirin and the NSAIDs, such as Motrin, Advil, and Naprosyn for the week before the injection. It is alright, however, to use acetaminophen products such as Tylenol.

Filler Agents

Filler agents can be used to fill in wrinkles, scars, depressed areas, and to fill out thinning areas, such as the aging lip or cheeks. These agents can be divided into those agents that are:

• Permanent (non-absorbable) – Silicone, Gortex
• Temporary (absorbable) – hyaluronic gels, collagen
  

Filler agents can also be classified by their origin:

• Autologous (come from the patient themselves-fat)
• Cadaver or Animal - collagen, alloderm
• Laboratory – hyaluronic gels
  

It is our opinion that at the current time the ideal filler is one that would have the following characteristics:

• Be absorbable
• Non-animal or human derived
• Last approximately two years
• Feel natural
• Be very non-reactive
  

Currently, the agent that is used most frequently in my practice is the hyaluronic gel Juvederm, which is manufactured by the Allergan Corporation. Juvederm is cross-linked hyaluronic acid, lasts up to 10 – 12 months, is lab derived, and feels very natural.

Juvederm injections are performed under a topical anesthetic. The entire procedure, including application of the anesthetic and injection, is performed in a 45-minute office visit. The results are almost immediate, although there is occasionally some swelling that can last overnight. Patients are advised to avoid aspirin or NSAIDs such as Motrin, Advil, and Naprosyn for a week prior to the treatment to avoid bruising.