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Botox and Fillers FAQ

No, it will usually take about 3-7 days to slowly see the effects of Botox, but it may take up to 2 weeks to see the full effect in all areas treated.

Botox results last approximately 3-4 months, but this can depend on the patient and the dosage used. Dosages can differ depending on the patient, the severity of the wrinkles, and the goal of the treatment.

Yes!!! The usual age reversal caused by Botox treatment is about 20 years

No, Dr. Cabanellas at The Wellington Institute believes in giving her patients a fresh and natural look that distinguishes her from most doctors performing this procedure.

No, most doctors will simply erase the lines and wrinkles around the forehead, frown, and crow’s feet. Dr. Cabanellas at The Wellington Institute will treat lines/wrinkles under the eyes, lines around the lips or “smoker’s lines”, contracted &/or “pebbly” chin, down turning corners of the mouth or “marionette lines”, “gummy smile”, nose “bunny lines”, and “neck bands”. At the same time, Dr. Cabanellas expertise can help you achieve the look you want by opening eyes for a more awaken look, increase brow arches, or make them flat.

Dr. Cabanellas at The Wellington Institute performs “Advanced Botox” in which expert injectors will perform more complicated procedures. Most doctors will simply erase the lines and wrinkles around the forehead, frown, and crow’s feet.
Because of her expertise in the anatomy of the face, Dr. Cabanellas will treat lines/wrinkles under the eyes, lines around the lips or “smoker’s lines”, contracted &/or “pebbly” chin, down turning corners of the mouth or “marionette lines”, “gummy smile”, nose “bunny lines”, and “neck bands”. This is “Advanced Botox”.

No, in fact my favorite part of a Botox treatment is causing the brow & eye area to enlarge and achieve the “awake look”.

Yes (see explanation about “Advanced Botox”)

Not significantly … in general, Botox injections feel like pin pricks, but every patient has a different pain threshold. At the Wellington Institute we use ice, vibrational therapy, and anesthetic creams to numb the areas of injection.

No. The “frozen face syndrome” has gotten much media attention and is generally due to “Overdone Botox” or a patient getting a larger dose of Botox than needed. In expert hands like Dr. Cabanellas, this has never happened. Less dosage is more often a better, more natural result.

***The ideal Botox dose erases the lines/wrinkles of expression when the face is at rest, while having these lines when making the different facial expressions.

Usually not!  People will often ask if you were on vacation or lost weight … they can see that you definitely have a more relaxed, youthful look, but cannot pinpoint why.

Like everything in life (hair, nails, skin, nutrition, exercise, bones, etc) maintenance is the key to preserving youth!

This myth continues because patients are not committed to the process. Reducing the aging process must be consistent and performed over a long span of time in order to continually reduce its effects. Getting one treatment will help you look younger, wrinkle free, and fresh for 3-4 months, before the natural aging process of your muscles start again. Botox has been proven in studies to combat facial lines and wrinkles over a long period of time with consistent treatments better than any other treatment. In other words, the muscles causing the wrinkles learn over time not to contract to the same degree because of the inhibiting action of Botox.

No, your face lines/wrinkles will return to your baseline after the Botox effect is gone. In other words, the lines/wrinkles stay the same as before the botox treatment … not worsened/deeper or increased in amount.

In general, approximately the same amount of Botox units are needed for each patient, but as the aging process progresses, the patient may need more units of Botox to achieve the same result.

No, but in approximately 1% of the population, the “Botox” brand will not have the effect that it used to and different Muscle Relaxers like “Xeomin” will work perfectly.

It has been proven in a number of clinical studies that patients that get “preventive” Botox in their 20’s and 30’s often can get ahead of their wrinkles with fewer treatments. Once wrinkles form, they are often harder to remove and require more units to treat.

No, sometimes very deep wrinkles will take a larger dose of Botox &/or 2-3 Botox sessions to erase the wrinkle completely.

Not at all!  I think men benefit from Botox treatments even more than women because they cannot hide imperfections and wrinkles with makeup.  The look I give men after a Botox treatment is a very different from women.  Many times involves softening lines and wrinkles giving a more youthful look, but conserving a more rugged, masculine look.

I always say that Botox treatments depend on lines and not age … as long as a line or wrinkle has developed, Botox will be the only treatment that works for this.

No, in fact those women that have had facial plastic surgery will need Botox as often as before (like everybody else every 3-4 months).

I like to wait 4 hours after Botox treatment in which I instruct the patient to stand or sit up straight; no bending over or laying down.

The procedure generally includes a local anesthetic and needle injections, therefore can have symptoms like mild irritation, swelling, redness, headaches, or itching. These symptoms can last up to 24 hours, but generally fade 1-2 hours after treatment.  If you experience pain, headaches, or discomfort after the procedure, over the counter pain medications like Tylenol / Aspirin / Ibuprofen / Motrin / Aleve are recommended.

There may be pin point dots or spots after the treatment which usually fade 1-2 hours after the procedure.

Avoid direct skin manipulation in the areas of the treatment; no facials or waxing of the treated areas for 24 hours.

Avoid exercise for 24 hours after a treatment

1-5% of patients will experience the possibility of a droopy eyelid, which is temporary, treatable while the Botox lasts, and chances are reduced when treatment is performed by an experienced clinician like Dr. Cabanellas.

There is a small percentage that the patient can experience bruising in one or more of the injected areas. Ice directly applied to the bruise in the first 24 hours will usually solve this issue.  Arnica and/or Bromelain in pill &/or cream forms will decrease the time of resolution of bruising and swelling.

Botox cannot be used in certain patients with specific neurologic diseases like Myasthenia Gravis and progressive degenerative motor neuropathies like ALS.

Botox comes in a dehydrated powder presentation which needs to be diluted in order to inject. It is hard to know first hand to know if the Botox is too diluted and charged the price for a certain amount of units but injected a lesser amount of units.  Bottomline the patient needs to have a relationship of trust with the doctor.  At The Wellington Institute we strive to act in a correct and fair way in every step of the way.

No, Xeomin and Dysport are also FDA approved in the USA and are used interchangeably with Botox.  At the Wellington Institute we only use FDA approved products & machines to ensure quality results 100% of the time and prevent adverse reactions.

No … after almost 40 years of international medical and cosmetic use, no cases of allergies have been reported for only FDA approved Muscle Relaxers which are Botox, Disport, and Xeomin.

No!!! There are many issues that are easily “touched up” or fixed.  Please call The Wellington Institute as soon as needed to make sure your result is 100% satisfactory to you.

Wait till you have Wrinkles! hahaha

***At any time after your treatment if you are not 100% satisfied with the results, you are always welcome to return to the Wellington Institute for a touch up session to ensure you get the results you want. 

***Any questions or concerns before or after treatment, you are always welcome to call the Wellington Institute or consult Dr. Cabanellas.

One of the first signs of aging is seen in our faces.  With aging, the skin of the face loses elasticity and has decreased cellular turnover.  This results in sallow and sunken features that are prone to wrinkles and creases.  In addition, expressions of laughing, smiling, and frowning can leave deep creases in the skin.  The loss of natural fullness in the cheeks and lips can leave the face looking aged.

Dermal fillers restore lost facial volume, decrease wrinkles and reduce the appearance of fine lines by filling and plumping needed areas.  Dermal fillers can provide age restoring outcomes without dramatically changing the appearance of the face.

Expected outcomes of a dermal filler depend on the area to be treated. In general, dermal fillers are used to “fill” needed areas on the face. These can include mild to severe wrinkles, creases and lines. In addition, sallow or sunken regions of the face and cheeks as well as for plumping thin lips.

As the aging process takes place, lines & grooves are formed in the face, gravity pulls down facial muscles, skin becomes flaccid, while at the same time the subdermal (under the skin) fat starts to disappear. All of these factors contribute to the somber look of aging. Dermal fillers provide a wonderful treatment that addresses all these factors.

Fillers are products injected under the skin in the different layers between the skin and the bone that can produce different effects in order to produce a youthful look.

In a variety of different ways:

Dermal Fillers fill the lines and grooves formed with the aging process.

They can also be used to create a “lifting” effect in those pulled down muscles and flaccid areas that occur with aging.

Lastly they replace the lost volume in the face or create a “voluminizing” effect which in turn causes tightening, lifting, and the disappearance of wrinkles/lines/grooves.

There are 3 types of fillers that are approved by the FDA in the USA:

  1. Hyaluronic Acid (HA) — Collagen and HA are the main components of skin.  The HA used in fillers have an identical molecular structure to the HA in our bodies, so the body will break it down as a normal part of its biochemical metabolism. They differ in molecular weight which           Examples are Restylane, Perlane, Juvederm, Belotero, and others
  2. Poly-L-Lactic Acid — The only example is Sculptra. This is an injectable that targets the underlying cause of facial aging by increasing the synthesis of lost collagen.  It works deep within the dermis layer, reinforcing the skin’s structure, and stimulating collagen.
    The reinforced collagen structure gives a foundation to restore facial fullness. Sculptra can be used in different ways. It can correct deep facial wrinkles & shallow facial regions as in HIV.  But it can also serve as an overall filler; it is injected in most areas of the face to give volume.The compound is a biocompatible and biodegradable so the body will know to how use and metabolize it in a natural way. Sculptra results in a subtle and gradual correction of facial lines & wrinkles and overall volume. The correction effect is usually seen in 2-3 months after the procedure and continues to improve up to 6 months later. A full treatment of Sculptra typically is 1-3 vials over the course of a few months depending on the patient’s response.This full treatment can deliver results that last over 2 years. Dr. Cabanellas typically uses traditional fillers to correct a particular line or wrinkle and afterwards uses Sculptra to give an overall “voluminizing” effect to the entire face.
  3. Calcium Hydroxylapatite — The only example is Radiesse. It is a dermal filler that is intended to smooth moderate to severe facial lines. It is used mostly for laugh lines, marionette lines, jowl/jawline area, chin area, and tear trough/cheek reconstruction. Radiesse immediately adds volume under the skin and with time, it naturally stimulates the body’s collagen production. Results last 1 year or more in most patients.
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