Injectable Facial Treatments
Putting Your Best Face Forward
Fillers & Biostimulators
Our Indianapolis-based Dawes Fretzin dermatologists and physician assistants are highly trained in performing safe and effective injections of fillers, biostimulants such as Sculptra, anti-wrinkle treatments like Botox, Xeomin, and Daxxify, as well as Kybella. We are dedicated to delivering natural-looking results while ensuring your comfort throughout the process. Whether you desire to restore lost volume, reduce fine lines and wrinkles, or achieve a more youthful appearance, our personalized approach and state-of-the-art techniques guarantee exceptional outcomes.
Our expert injectors at Dawes Fretzin will consult with you about aesthetic concerns related to facial expression lines or volume loss and recommend the treatment and approach best suited to your needs.
Not sure where to start? Begin with a consultation with one of our injector physicians or PAs. If your primary concerns involve skin quality or skincare products, you may want to begin with a consultation with one of our licensed estheticians.
Injectable treatments include:
- Anti-Wrinkle Injections / Neurotoxins
- Volumization Procedures
- Hyaluronic Acid Fillers
- Radiesse
- Sculptra
- Selphyl PRFM
- Kybella
Anti-Wrinkle Injections/Neurotoxins
Over time, lines can become imprinted in the skin as a result of repeated movement of the underlying muscles. Common areas include between the eyebrows (the so-called “11s”), across the forehead, around the eyes (crow’s feet), and around the mouth (vertical lip lines). Try making a variety of facial expressions at yourself in the mirror—best done in private to avoid stares—and you’ll see what we mean!
When injected selectively into the muscles of facial expression, neurotoxins such as Botox, Xeomin, or Daxxify block chemical signals from the nerves that cause muscle movement. This temporarily relaxes the targeted muscles, allowing lines to soften. With careful technique and a thorough understanding of facial dynamics, natural-looking results can be achieved without creating an overly “frozen” appearance.
Before treatment, your injector will discuss your goals and priorities with you to develop an approach designed to achieve a result you’ll be happy with. Occasionally, a touch-up may be recommended approximately two weeks after the initial treatment to optimize your results.
Anti-wrinkle injections generally take less than 10 minutes and typically do not require numbing. There is little to no downtime, although bruising can occasionally occur. Results develop gradually, with maximum effect typically reached around two weeks after injection. Visible lines will begin to soften as muscle movement diminishes consistently over the following days or weeks, depending on how deeply established the lines are.
Muscle movement will gradually return over time, depending on the dose administered and individual factors. Treatments are generally recommended every 3–4 months in most cases.
Immediately after treatment, patients are generally advised to move their facial muscles normally, avoid lying down for 4–6 hours, avoid massaging the treated areas, and avoid intense exercise for 24–48 hours.
At Dawes Fretzin Indianapolis and Westfield, we offer the following trusted brands of anti-wrinkle injections:
Volumization Procedures
As we age, we lose bone mass and fat in certain areas of the face, which can cause the face to appear more bottom-heavy or less youthful. Some people are also born with insufficient facial volume in certain areas, such as the tear troughs, cheeks, or chin. In either case, volume can be thoughtfully and effectively restored through fillers and/or collagen stimulators.
“But I don’t want to look like an overdone Real Housewife!” you say. Never fear—we don’t want that for you either. In fact, we’ll reel you in if you start to get carried away. Natural-looking results come from expert facial analysis and injection, with careful attention to the key areas of volume loss—not always where you might expect them to be. Treating these areas in balance and harmony with the entire face helps preserve and enhance your natural features.
Unnatural results can occur when too much focus is placed on a single area without balancing volume elsewhere. One common example is overly enlarged lips that aren’t supported by the proportions of the rest of the face. Results can also look unnatural when trying to force a particular aesthetic that isn’t suited to an individual’s unique features. See some examples of Dr. Shrift’s work below for examples of beautifully balanced, natural-looking results.
At Dawes Fretzin, we primarily rely on the Juvederm family of hyaluronic acid (HA) fillers, Radiesse—which has both filling and biostimulatory properties—and Sculptra, as well as Selphyl platelet-rich fibrin matrix (PRFM) for appropriate patients
Juvederm
In the United States, six different HA fillers are available within the Juvéderm portfolio. While all are made from hyaluronic acid (HA), each product is cross-linked differently, giving it distinct properties and making it better suited to certain applications.
Juvéderm Volux and Voluma, for example, are firmer and better suited for supporting facial structure in areas such as the jawline and cheekbones. Juvéderm Ultra and Ultra Plus tend to attract more water into the tissue, making them well suited for plumping. Juvéderm Vollure and Volbella are ideal for more subtle enhancement, refinement, and definition of structures such as the lip border.
Radiesse
This injectable gel is composed of calcium hydroxylapatite (CaHA) and provides immediate volume, similar to Juvéderm. As the gel carrier gradually breaks down, the CaHA microspheres stimulate your own tissues to produce collagen, helping strengthen the skin’s structure and improve overall skin quality.
Radiesse can be used at various dilutions in the face, as well as in the neck, chest, and hands.
Sculptra
Sculptra is a poly-L-lactic acid (PLLA) powder that is suspended in saline and injected beneath the skin to stimulate your body’s natural collagen production. It is typically administered over 3–4 initial sessions, approximately 2–3 months apart.
While Sculptra takes more time to produce visible results—your body can only make new collagen so quickly!—it is an ideal treatment for those seeking gradual, global facial volumization along with improved skin quality and radiance. It accomplishes both by stimulating your body’s own collagen production.
Sculptra can also be a great option for those who are uncomfortable with traditional HA fillers, as it works by harnessing your body’s natural regenerative and collagen-producing processes rather than providing traditional filler volume.
Selphyl PRFM
Platelet-rich fibrin matrix (PRFM) is one of the newer regenerative approaches to facial rejuvenation, with exciting potential for the right patient. This injectable gel is similar to a filler, but it is made from your own blood.
First, your blood is drawn in the usual fashion and spun in a centrifuge to separate the platelet-rich plasma (PRP) layer. The plasma is then activated and placed in a heater, where it forms a gel that can be injected much like a traditional filler.
PRFM is particularly well suited for patients seeking under-eye rejuvenation who may not be good candidates for traditional filler in this area. It can also be injected in many of the same areas where fillers are used.
While the volumizing effects of PRFM typically do not last as long as those of an HA filler and may require repeat treatment after 2–3 months, the growth factors released by the platelets may stimulate additional collagen production, potentially providing longer-term benefits to the treated tissue.
What To Expect
Patients seeking volumization are scheduled for a filler appointment that allows at least one hour in the procedure room. Numbing cream will be applied as soon as possible to maximize its effect, and your injector will confirm and finalize the treatment plan with you.
After thoroughly cleansing the face with an antiseptic, injections will be performed using a combination of a needle and cannula, as appropriate. While some discomfort is expected even with numbing cream, most patients are able to tolerate the procedure with minimal discomfort. Before-and-after photos are standard and are always fun to look at together afterward!
Mild bruising or swelling may occur after treatment, but most patients experience minimal downtime. To help minimize bruising, we recommend avoiding NSAIDs, aspirin, alcohol, vitamin E, ginkgo biloba, fish oil, and bromelain for several days before your appointment, when medically appropriate.
After your injections, bromelain supplements and Alastin Post-Injection Serum may help reduce bruising and swelling. Please avoid dental appointments, including routine cleanings, for two weeks before and after your injections.
Discover the range of Fillers we offer:
Kybella
Occasionally rather than adding volume, we wish to instead decrease volume, especially when it comes to double chins! Kybella is an FDA-approved synthetic version of naturally occurring deoxycholic acid that targets and breaks down fat cells. This treatment is most effective for individuals with good skin tone and elasticity in the neck, as Kybella reduces fullness but does not typically tighten the skin. It is therefore NOT a good option if the primary problem is a saggy neck. Optimal results typically require 2-4 treatment sessions, spaced about 2 months apart. Swelling, bruising, numbness, or a feeling of lumpiness beneath the skin are common but temporary side effects. Unlike other treatments, maintenance sessions are not necessary as the destroyed fat cells do not return.
During the procedure, patients may experience a burning sensation shortly after the injection. However, the area is numbed before and after the treatment using ice to minimize discomfort. The injections only take a few minutes once the area is numbed, and most swelling resolves within 3-5 days. A consultation with our physician will determine if you are a good candidate for Kybella.
Fillers & Injections F.A.Q.s
Approximately 94% of millennials have considered Botox treatment. One of the most commonly treated areas is the glabella, commonly known as the “11s” between the brows.
Patients of different ages may consider Botox for different reasons:
- In your 20s: You may consider Botox if you’re interested in minimizing the development of expression lines over time.
- In your 30s: Dynamic lines and wrinkles may become more noticeable, making this a common time to consider treating facial expression lines.
- In your 40s and beyond: Botox may be used to soften established expression lines and create a more refreshed, youthful appearance.
Botox has an excellent safety record, particularly when administered by a trained and experienced medical professional. While every cosmetic procedure carries some inherent risks, most side effects associated with Botox are temporary. Potential side effects include:
- Redness: Mild redness may occur from pinpoint swelling at the injection sites or from the application of ice packs. This typically resolves within about 30 minutes.
- Swelling: Mild swelling may appear as small, raised bumps resembling bug bites. These typically resolve on their own within 15–30 minutes.
- Bruising: Bruising can occur at the injection sites and, in rare cases, may persist for about a week. Patients taking blood thinners or aspirin, or certain vitamins and supplements, may be at increased risk. Alcohol, particularly red wine, consumed within 24–48 hours of treatment may also increase the likelihood of bruising. Prescription medications should not be discontinued solely for the purpose of receiving Botox unless directed by your prescribing physician.
- Asymmetry: Mild asymmetry can occur and may be most apparent approximately two weeks after treatment. Follow-up appointments may be scheduled at this time to assess your results and address any asymmetry with a touch-up, if appropriate.
- Brow drop: A temporary lowering of the brow can occur when too much Botox is injected into the forehead or when injections are placed too low on the forehead. Brow drop is more common in men due to differences in brow anatomy. It typically resolves as the Botox wears off, usually within 4–6 weeks. In some cases, your injector may be able to treat muscles that pull the brows downward with additional Botox to help improve the appearance while the effect resolves.
- Ptosis: Ptosis, or eyelid drooping, is a rare side effect that can occur if Botox spreads to nearby muscles around the eye. It may also occur if injections are placed at an inappropriate depth. Medicated eye drops may provide some improvement, but the condition generally resolves on its own as the Botox wears off, typically within a few weeks to a few months. Avoiding massage or pressure on the injection sites following treatment may help minimize the risk.
- Headaches: Some patients experience a headache within 24 hours of treatment. This is typically temporary and may be treated with acetaminophen (Tylenol), if appropriate.
Two to three million dermal filler injections are performed in the United States each year, and serious complications are relatively uncommon. While some swelling and bruising are expected after treatment, less common side effects can include inflammation or infection around the injected filler. Very rarely, filler can block an artery supplying the face or eye, which can result in serious complications.
We use the safest techniques possible when injecting, including thorough skin antisepsis before the procedure, cautious injection techniques, and the use of cannulas when appropriate. In addition, most hyaluronic acid (HA) fillers can be dissolved with an injection of hyaluronidase in the event of a serious or persistent complication.
We also recommend avoiding filler treatment within two weeks of dental procedures or other invasive procedures that may introduce bacteria into the bloodstream.
We’ve all seen images of cosmetic procedures that intentionally exaggerate certain facial features, such as the lips. While this may be a desirable aesthetic for some, others prefer a more natural result—one that simply restores volume to levels more typical of a younger age or adds volume where it may have been lacking due to individual anatomy, such as genetically deep under-eye hollows, flatter cheeks, or very thin lips.
The degree of volumization is ultimately up to you and depends on the amount of filler used and where it is placed. It is absolutely possible to achieve a natural-looking result, and we make that our priority when a subtle, balanced appearance is what you’re looking for.
No, injectable treatments do not disrupt the skin surface or make you more sun sensitive, so no additional sun avoidance is required.
Treatment Pricing
Botox treatments average $200-300 for per treatment area. Treatment with fillers can range from about $500-2000 depending on how many syringes are injected. Discuss your budget with your injector at the time of consult.