Cosmetic Injections: 3 Tips from a Dermatologist

What you need to know before considering cosmetic treatments
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Cosmetic injections are the most popular minimally invasive cosmetic procedures performed in the U.S. According to data from the American Society of Plastic Surgeons, nearly 8 million cosmetic injections were performed in the U.S. in 2020, with higher numbers predicted for 2021. Here is what you need to know before deciding if these procedures are right for you.


Neuromodulators vs. fillers: What’s the difference?

Both neuromodulators and fillers address wrinkles and signs of aging, but they work very differently. Neuromodulators, aka botulinum toxins, work by relaxing muscles so that wrinkles made with movements do not set in over time. Botulinum toxin is used most commonly to treat frown lines, forehead wrinkles and crow’s feet. Injections have little to no downtime, take about two weeks to take full effect, and last three to four months.

Soft tissue fillers are injected to create or replace lost volume. There are a variety of materials used as fillers, with the most common being hyaluronic acid. Injectable hyaluronic acid is modeled after the natural substance in our skin that gives it its volume. Filler injections may have up to two weeks of downtime due to swelling or bruising, and may last 6–24 months or more, depending on the material used.



Cather McKay, MD, FAAD, Coastal Skin Surgery & Dermatology

Is it ever too early or to too late to start cosmetic treatments?

Patients frequently ask when to start seeking cosmetic treatments. Opinions differ on this subject. My general rule of thumb is that when frown lines or forehead lines begin to remain present at rest, you may consider starting neuromodulator treatment. In younger patients, small amounts are often needed and are viewed by many as preventative treatment.

Filler treatments may be considered more on a case-by-case basis depending on the natural anatomy of the face. For example, in patients with naturally thin lips or a small chin, filler injections can used to balance the face. Fillers can also be started at any point wrinkles or folds develop with aging.

While it’s never too late to start cosmetic injectables, there are some downsides to waiting. With time, skin becomes more lax and more volume is lost, resulting in deeper wrinkles and folds. Expectations are important. The volume in one syringe of filler is 1/5 of a teaspoon. Deeper folds and wrinkles will require more filler to correct. Additionally, areas with significant skin laxity may not benefit as much from neuromodulator. In patients with more advanced signs of aging, invasive surgical procedures, such as facelifts, may be necessary for full correction.


What is the most important factor when considering cosmetic treatments?

The most important factor regarding cosmetic procedures is the training of your injector. Board-certified dermatologists or plastic surgeons have the training necessary to not only perform the procedures, but also to handle any adverse events that may occur. No procedure is without risks. Before you consider any cosmetic procedure, know the credentials of your injector.

For more information, visit the American Academy of Dermatology (, the American Society of Dermatologic Surgery (, or the American Society of Plastic Surgeons (

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