JUVÉDERM Ultra and Botox Cosmetic

This patient is 65 years old and came in with multiple complaints regarding her lower face. She had done filler in the past in the nasolabial folds and didn’t notice a difference. Her overlying concern was the heaviness in her lower face. So we talked extensively about how her midface (cheeks and around her eyes) has become hollow/sunken, all contributing to heaviness in lower face. To get a more youthful and natural look, she needs filler in those areas first, which ultimately pulls the face back up. Then we can go fix the remaining lines w/ success.

The patient also wanted Botox Cosmetic around the crows feet so we did the following over 2 visits:

1. 15 units total around the crows feet (eye area)
2. 3 syringes of Juvederm around the eyes and upper cheeks
3. 1 syringe in lower face/jaw to soften the jowl, vertical upper lip lines and marionettes

Next step: we are planning to do more filler in the marionettes and jowl area.