Hi Dr. Kelly:

My girlfriend had three different facial products injected during her last dermatology visit. She looks great, but isn’t that too much for one setting?

Dr. Kelly. I’m glad your girlfriend looks great. It sounds like she saw a good physician who injected appropriately. The science of injectables is a rapidly changing field. In the old days, we only had injectable collagen, which didn’t last very long, and then we got Botox. Those were our only non-invasive injectable options.

As we have come to understand the aging process, more products and techniques have become available to improve many different areas of the face. There are now four Botox-like products we can use in the US (many more are available in Europe).

At last count, there were 23 different hyaluronic acid fillers available in the US. Each of these products are very different with regards to how long they last and where they are best utilized. The choice of filler can be firm, medium or soft. Firmer filler should be used deeper and softer fillers work better more superficially. Botox (and other neurotoxins) can be injected in many different ways, and in many different strengths, depending on what the cosmetic goals are.

In the patient photographed here, facial rejuvenation was achieved in one session using three different products. Botox was used to smooth the forehead, soften the lines above the nose, lift the corner of the brows and soften the crow’s feet outside the eyes. Voluma was used to fill the sunken cheeks. Juvederm was used to fill the folds between nose and mouth. It was also used to fill the marionette area and jawline.

It is fine to use multiple products for facial rejuvenation. The art of injection, however, requires it to be done skillfully, choosing the right product and having the judgement to know where and how it should be injected.


About Dr. Kelly

Dr. Kelly is a board-certified Plastic Surgeon and partner in both Miami Plastic Surgery and MPS MedSpa. He has been in practice over 25 years and has been recognized by his peers both nationally and internationally as one of the best plastic surgeons in the United States. In addition to being an expert on Cosmetic Surgery, his practice encompasses the entire spectrum of non-invasive treatments such as Botox, fillers, CoolSculpting, ultrasound, lasers and radio-frequency.

He also believes in giving back to our community, having served on the Village Council for eight years and volunteering as a coach for our youth sports programs. You can email him questions at mkelly@miamiplasticsurgery.com

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