Non-Surgical Procedures

Botox Cosmetic™ (botulinum toxin) is a medicine that temporarily weakens the muscles when placed under the skin surface. It has a number of helpful applications in medicine including treating muscle spasticity, tremors, and voice disorders. It is most widely known, of course, for its ability to treat wrinkles and fine lines in the face. Botoxa™ is injected with a very fine needle under the skin in the office setting. The improvements in the wrinkles of the face begin to show around 3 days after the injection and achieve the maximal effect after about 7 days.
Botoxa™ is both a treatment and prevention. It will erase wrinkles that develop as a result of repeated facial expression- especially frowning and brow raising. The medicine relaxes the muscles and smoothes existing deep creases and wrinkles. It also prevents the development of architectural changes in the skin that eventually develop into permanent deep creases.

The forehead (worry lines), glabella (vertical frown lines between the brows), and the periorbital areas (crow’s feet or smile lines) are the most common areas treated with Botox™. Precise placement of the medicine in the brow will produce both relaxation and smoothing of wrinkles. Many people develop a slight ptosis or “drop” of the brow line with age, and Botoxa™ can provide a gentle lift. Treatment can be also focused on the outer aspect of the brow giving a gentle, natural “arch” to the outer brow. Botoxa™ is one of the few ways to smooth the periorbital “crow’s feet” and is commonly used in this area as well.
In some cases, Botoxa™ is injected into the areas of the upper lip or chin to treat vertical wrinkles that frequently appear in this area. Special care is required here to avoid interfering with the movement of the upper lip that patients need for everyday life. If you have questions about this area, speak with your doctor.

The medicine begins to take effect in the days immediately following placement. Patients should see the result about 5-7 days after the treatment. Although patients vary in response, most see the improvements persist for at least 3 to 4 months and in some cases longer. Everyone has an individual response.

The careful placement of Botox Cosmetic™ will ensure that you achieve the smoothest skin surface but will maintain movement that is critical for a natural appearance. The most experienced physician understands the location and function of the muscles and will help you achieve your desired result.

Patients decide when the time is right. In general, the medication works well for 3-4 months and then the movement returns gradually. This is the optimal time for a re-treatment. There is no advantage in getting an injection before the muscle movement has returned. Your doctor can help you assess the return of muscular function and will guide you on your decision.

Botox™ is very safe and has been used in the United States for years to treat a number of medical problems. Patients do not require allergy testing prior to treatment. Repeated injections are very safe and patients will not develop a resistance over time. Some patients anecdotally report that the medicine does work longer after a few injections. Patients can also decide to delay treatments or stop completely at any time.

Botox™ is injected in the office under sterile conditions. Precise placement of the medicine does require multiple injection sites. Patients are given cool compresses, ice, or topical local cream as needed. After the treatment, patients are asked to abstain from intense physical exercise until the following day. Otherwise, your normal routine can be resumed immediately. Because the needles used are so small, cosmetics may be reapplied immediately after the injection.

Botox™ can be placed in conjunction with most other facial plastic surgery procedures. Commonly, patients will undergo the placement of a Filler Material at the same time to achieve the optimal result. Please refer to the webpage on Filler Materials for more information.

There are so many options now for Botox™ injections and patients need to choose an experienced physician. Proper injection requires not only good training on technique but also a surgical anatomical knowledge of the exact location and function of the facial muscles. Only then can you truly take advantage of the tissue sculpting potential of the medicine you’re paying for. Our physicians at Hobgood Facial Plastic Surgery will perform a careful medical examination and will tailor a treatment plan that is unique to your goals. Our team is committed to providing you a truly exceptional experience.

Almost any area of the face can be improved with injectable fillers. The most common areas treated are the lips, cheeks and wrinkles of the forehead.

Some patients desire slightly fuller and more youthful lips. There are a number of very effective fillers that can be used to plump any part of the lip. In addition, placing fillers along the border of the lip allows material to enter into the fine vertical lines above and below the lip giving a dramatic improvement in this area as well. These vertical wrinkles can also be injected directly for improvement.

As we age, the cheeks tend to drop creating deeper grooves between the nose and mouth and at the corners of the mouth. We call these nasolabial folds,oral commissure grooves, and marionette lines. Fillers can be placed under the skin surface to soften these grooves producing a natural, rejuvenated appearance.

There are a number of options currently available. All provide safe and reliable results. The type of material selected by you and your doctor depend on the location that you are treating. Your doctor will help you select a product that is right for you. Most current filler substances use hyaluronic acid, or calcium hydroxylapatite. These products are available in Restylane™, Juvederm™, and Radiesse™. We utilize the most up-to-date fillers and continue to keep our patients informed on new products as they emerge.

Currently, Dr. Hobgood is not recommending any injections that are permanent. The safety of permanent agents has not been established. Of those that are currently available, the expected duration for cosmetic improvement for most facial filling materials is about one year.

All fillers are injected in the office and take only a few minutes to complete. We utilize a variety of medicines and techniques to maximize our patients’ comfort. All are placed directly under the skin using fine needles and gentle techniques. Botox™ is sometimes injected with the filler to increase the filler’s duration of action.

Patients can usually expect some minor swelling and redness in the area that lasts for one to two days. Cool compresses are immediately applied in the office before patients are discharged, and patients are encouraged to continue using compresses intermittently for around 24 hours. It is rare for patients to experience pain in the area, and bruising is usually minimal. Make-up can be applied immediately after the injection. There are no activity restrictions after having your procedure.

Achieving the best results requires selection of the right facial filler and proper placement techniques. Be sure that your surgeon is board certified by the American Board of Facial Plastic and Reconstructive Surgery and the facility is fully accredited. The team at the Hobgood Facial Plastic Surgery will work with you to help you make an informed decision.

As we age, there is a gradual loss in the elasticity of the skin. Fibers that once help the skin maintain its youthful tight appearance slowly begin to relax with repetitive movements. In addition oil gland production diminishes and the moisture is lost from the skin surface. The surface layers begin to pile up creating a thick and dry appearance. There is a decrease in melanin pigment production causing a more pale appearance. The end result is a loose, dry surface with a fine-wrinkled or “crepe” look.
Sun exposure plays a big role in the aging process as well. “Solar elastosis” is the process whereby the sun’s ultraviolet rays penetrate the skin surface weakening the elastic support fibers in the skin. Ultraviolet rays also cause disorganization in the collagen scaffolding upholding the skin’s supporting architecture. Most patients will also notice the accumulation of splotchy, irregular brown spots known as “hyperpigmentation” that occur with chronic sun exposure. Chronic sun exposure will definitely hasten the natural aging timeline.

There are a number of skin care products that can make improvements in the changes seen with the aging process. Certainly all patients should use cosmetics with sun protection in addition to a daily application of sun block with an SPF (Sun Protective Factor) of at least 20. Hobgood Facial Plastic Surgery has a complete line of scientifically proven skin care products and our team of physicians will advise you on what products will be the most effective for your individual skin type.

Skin resurfacing incorporates a number of different techniques that penetrate to various depths causing new skin to be regenerated. Collectively, these applications may reach the deepest layers of the skin and will rejuvenate the deepest wrinkles. Sunspots and irregular pigmentations are lifted out of the skin. These peels also are used to prevent the onset of skin cancer in patients with heavy sun exposure and significant changes in the skin texture.
A variety of different chemical peels and laser resurfacing techniques are available to your physician. Regardless of the approach taken, the principle of stimulating new skin turnover is the same for all techniques. Your doctor will help you to choose the approach that is right for your specific skin type.

The down-time is directly related to the depth of the peel. The deepest resurfacing techniques allow the most improvement but have the longest recovery period. Some superficial peels require only a few days for recovery and patients can begin applying cosmetics 2-3 days after the procedure. The deepest methods will heal over 10-14 days and most patients are able to cover areas after 2 weeks of healing. Sun block should be used regularly after the resurfacing procedure.

The most important aspect of resurfacing is surgeon experience. The healing period is very critical and your physician will follow you closely to make changes in your skin care regimen. Also, be sure that your physician understands and has experience using all varieties of chemical peels and laser resurfacing techniques. You should be sure that your doctor is a member of the American Academy of Facial Plastic and Reconstructive Surgery.