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Answer:
There are some benefits to using filler to shape the nose, as opposed to rhinoplasty surgery. The average downtime with having filler injected is 1 – 2 days of mild swelling and bruising versus approximately 10 days of downtime after a rhinoplasty. Another advantage of using filler, is this can help to show what results might be achieved with a rhinoplasty without undergoing the actual surgery. Filler is temporary, and generally lasts about a year, after which it would need to be repeated. If you decided to have a rhinoplasty after seeing the results of filler injections, you would need to wait about a year in order to give time for the filler to dissipate.

Answer:
The most common treatment option for lip enhancement is the use of fillers. Usually hyaluronic based fillers are used for this, such as Juvederm Ultra. One of the main reasons for using fillers is the minimal downtime, which is basically 1 – 2 days of mild swelling and possible bruising, as opposed to several days of downtime for surgical options.

In fact we no longer use collagen for lip augmentation, or in the folds. We are now using products preferentially based on hyaluronic acid such as Juvederm, Restylane or Perlane. The other preferential filler being used is Radiesse, to augment the nasolabial folds, the cheeks and other parts of the face such as the temporal area, the cheeks, the mid-cheeks and the chin. We classify the fillers as thick fillers and thinner fillers. The thick fillers are basically Radiesse and Juvederm Ultra Plus, and are used for lifting tissue or increasing volume, especially in the cheeks, the cheekbones and the eye area. The thinner fillers, such as Restylane and Juvederm Ultra are used to augment the lips, and to plump up and help erase fine wrinkles around the eyes or in the cheeks. Thinner fillers can last between four to six months, while the thicker fillers can last up to one year.

For the nasolabial folds, I do prefer the thicker fillers such as Radiesse and Juvederm Ultra Plus over the thinner fillers. The reason is, with the thicker fillers we get a better lift and plumping up of the folds. Also, the Radiesse will last about 8 months before the first touch-up is needed, and about 6 months with the Juvederm Ultra Plus which is longer than with the thinner fillers. Everybody is different and everybody absorbs the product differently, but for the Radiesse touch-ups generally only about half the amount of filler used at the initial treatment is needed. Interestingly, after the first touch-up at 8 months or so, the next touch-up is not generally needed for about a year or so afterwards. For Juvederm Ultra Plus, the first touch-up is usually around 6 months after the initial treatment and the next touch up is about 10 months after that.

Regarding the difference between Dysport and Botox, it is first important to know that they are the same type of product in that they are both Botulin toxin. However, Dysport does seem to take effect more quickly than Botox after the injections. Botox usually starts taking effect within 5 days, with full results showing after 10 days. With Dysport, results usually start within 2 days with the full effect showing by 5 days. I prefer starting with Botox, and reserving the Dysport for patients who do not have a complete dissolution of their wrinkles from the Botox. Usually they both last about 3-1/2 to 4 months.