BOTOX

If you think it’s time to do something about those moderate to severe glabellar lines between your brows, then its time to contact us at Bangor Plastic and Hand Surgery. We can help you improve the way you look and feel! Botox is a common treatment for fine lines and wrinkles in men and women.

Many wrinkles are actually creases that have been worn into the skin by making the same expression thousands of times. Botox® Cosmetic injections smooth wrinkles by safely and selectively blocking the muscle from contracting. As a result, the muscle relaxes and the wrinkles gradually soften and disappear. Botox® has been researched and administered in the medical field for over twenty years. Approved for cosmetic use by the FDA in April 2002, it is used in minute quantities. Botox® is a sterile, purified protein which reduces the activity of the muscles that cause frown lines and crow’s feet to form over time. Botox® is also used to treat excessive sweating, migraine headaches, and neurological disorders.

After (7 days)
Before
Actual patients. Results may vary.


Photos taken at full smile before and after treatment with BOTOX® Cosmetic (onabotulinumtoxinA) at day 7. In two clinical studies, 26.1% and 20.3% of people had ≥ 2-grade improvement at day 30.1 In one of these studies, 67.9% of people had mild or no crow’s feet at day 30 after treatment.2


Photos taken at maximum frown before and after treatment with
BOTOX® Cosmetic (onabotulinumtoxinA) at day 7. In clinical studies, physicians assessed 80% of people had significant improvement at day 30.1


Photos taken at maximum frown and/or full smile before and after treatment with BOTOX® Cosmetic (onabotulinumtoxinA) at day 7. In two clinical studies for moderate to severe crow’s feet, 26.1% and 20.3% of people had ≥ 2-grade improvement at day 30.1 In one of these studies, 67.9% of people had mild or no crow’s feet at day 30 after treatment.2 In clinical studies for moderate to severe frown lines, physicians assessed 80% of people had significant improvement at day 30.1


Side effects associated with the injection include localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising.1




How does it work?

BOTOX® Cosmetic (onabotulinumtoxinA) targets one of the underlying causes of frown lines and crow’s feet—the repeated muscle contractions from frowning and squinting over the years. BOTOX® Cosmetic temporarily reduces this muscle activity so you’ll begin to notice a visible smoothing of these lines. For temporary improvement of moderate to severe crow’s feet, your doctor will inject BOTOX® Cosmetic into the muscle surrounding the sides of your eyes — called the orbicularis oculi muscles.

Will I look overdone?

BOTOX® Cosmetic (onabotulinumtoxinA) is a technique sensitive treatment. You should not lose the ability to show expression when you are treated by someone who is licensed, trained, and a medical expert in facial anatomy. It is important to talk to your provider about the results you want from treatment.

Does the treatment hurt?

Some patients report that being injected with BOTOX® Cosmetic feels like a pinch. Your provider may use ice to numb the treatment area. If you are concerned about discomfort, your provider may apply a topical numbing cream before administering your treatment.

How long does treatment take?

The treatment takes approximately 10 minutes and requires minimal downtime or recovery—it’s often called a lunchtime procedure.

What are the common side effects seen in clinical studies?

Three percent of patients experienced eyelid drooping in the frown lines and 1% of patients experienced eyelid swelling in the crow’s feet. Other possible side effects include: dry mouth; discomfort or pain at the injection site; tiredness; headache; neck pain; eye problems: double vision, blurred vision, decreased eyesight and dry eyes; and allergic reactions. These are not all of the possible serious side effects of BOTOX® Cosmetic. Please talk to your provider and see Important Safety Warnings.

Moderate to severe crow’s feet lines

Before

After (Day 7)

AREAS TREATED: Frown lines between the eyes, furrows and lines across the forehead and the crow’s feet around the eyes.

THE REMEDY: Injections of Botox Cosmetic into the muscles that create these wrinkle lines block the chemicals that normally signal these muscle groups to contract.

RESULTS: Treated areas are relaxed and softened.

EFFECTIVE SERIES OF TREATMENTS CONSIST OF: A single session of injections for each area generally lasts for 3 to 4 months and may last up to 6 months.

TREATMENT TIME: 15 to 20 minutes.

RECOVERY TIME: None. Immediately following treatment you may resume regular activities.

For additional Botox information visit: http://www.botoxcosmetic.com

Moderate to severe frown lines

Before

After (Day 7)

Results

moderate to severe frown lines

Frown Line Before and After
Frown Line Before and After
Frown Line Before and After
Frown Line Before and After
Frown Line Before and After
Frown Line Before and After

Results

moderate to severe crow’s feet

Crow's Feet Before and After
Crow's Feet Before and After
Crow's Feet Before and After
Crow's Feet Before and After
Crow's Feet Before and After
Crow's Feet Before and After

Important Safety Information Here

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55 Broadway
Bangor, ME   04401
207-947-5657

Founded by Dr. David Branch in 2000, Bangor Plastic and Hand Surgery provides state-of- the-art cosmetic and reconstructive surgery in an AAAASF accredited facility. We strive to create a warm, friendly environment in which our patients can pursue their cosmetic goals, explore new ideas about appearance and rejuvenation, or just heal following injury or illness.

“The information available on Bangor Plastic and Hand Surgery’s website is provided for informational purposes only. This information is not intended to replace a medical consultation where a physician’s judgment may advise you about specific disorders, conditions and or treatment options. The use of this website does not create a physician/patient relationship between you and Bangor Plastic and Hand Surgery. We hope the information will be useful for you to become more educated about your health care decisions. The images on this site are for aesthetic purposed unless otherwise noted. See before and after images for possible results. Individual results may vary.”

Website Content Copyright © 2018 Bangor Plastic & Hand Surgery | Sitemap

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JUVÉDERM® XC, JUVÉDERM® ULTRA XC, AND JUVÉDERM VOLUMA® XC IMPORTANT SAFETY INFORMATION

APPROVED USES

JUVÉDERM® XC injectable gel is for injection into the facial tissue for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds.

JUVÉDERM® Ultra XC is for injection into the lips and perioral area for lip augmentation in adults over 21.

JUVÉDERM VOLUMA® XC injectable gel is for deep injection in the cheek area to correct age-related volume loss in adults over 21.

IMPORTANT SAFETY INFORMATION

Are there any reasons why I should not receive any JUVÉDERM® injectable gel formulation?

Do not use these products if you have a history of multiple severe allergies or severe allergic reactions (anaphylaxis), or if you are allergic to lidocaine or the gram-positive bacterial proteins used in these products.

What precautions should my doctor advise me about?

Tell your doctor if you are pregnant or breastfeeding. The safety of these products for use during pregnancy or while breastfeeding has not been studied

The safety of JUVÉDERM® XC and JUVÉDERM® Ultra XC injectable gels in patients under 18 years, and the safety of JUVÉDERM VOLUMA® XC in patients under 35 years or over 65 years has not been studied

The safety and effectiveness of JUVÉDERM® XC for areas other than facial wrinkles and folds, and JUVÉDERM® Ultra XC for areas other than the lips and perioral area for lip augmentation, or facial wrinkles and folds, have not been established in clinical studies

The safety and effectiveness of JUVÉDERM VOLUMA® XC in areas other than the cheek area have not been established in clinical studies

Tell your doctor if you have a history of excessive scarring (eg, hypertrophic scarring and keloid formations) or pigmentation disorders, as use of these products may result in additional scars or changes in pigmentation

Tell your doctor if you are planning other laser treatments or a chemical peel, as there is a possible risk of inflammation at the treatment site if these procedures are performed after treatment

Patients who experience skin injury near the site of injection with these products may be at a higher risk for side effects

Tell your doctor if you are on immunosuppressive therapy used to decrease the body's immune response, as use of these products may result in an increased risk of infection

Tell your doctor if you are using medications that can prolong bleeding, such as aspirin, ibuprofen, or other blood thinners, as this may result in increased bruising or bleeding at the injection site

Minimize strenuous exercise, exposure to extensive sun or heat, and alcoholic beverages within the first 24 hours following treatment

What are possible side effects?

The most common side effects include tenderness, swelling, firmness, lumps/bumps, bruising, pain, redness, discoloration, and itching. With JUVÉDERM® XC and JUVÉDERM® Ultra XC injectable gels, most side effects are mild or moderate and last 14 days or less. For JUVÉDERM VOLUMA® XC, side effects are moderate (uncomfortable) and last 2 to 4 weeks.

One of the risks with using this product is unintentional injection into a blood vessel, and while rare, the complications can be serious and may be permanent. These complications, which have been reported for facial injections, can include vision abnormalities, blindness, stroke, temporary scabs, or permanent scarring.

As with all skin injection procedures, there is a risk of infection.

To report a side effect with JUVÉDERM® XC, JUVÉDERM® Ultra XC, or JUVÉDERM VOLUMA® XC, please call Allergan Product Surveillance at 1-800-624-4261.

For more information, please see Juvederm.com or call Allergan Medical Information at 1-800-433-8871.

Available by prescription only.

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INDICATION

RADIESSE® injectable implant is FDA-approved for subdermal implantation for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds.

IMPORTANT SAFETY INFORMATION FOR RADIESSE

Who should not use RADIESSE?

RADIESSE should not be used in people who have an allergy to any component of the product. You should not use RADIESSE if you are pregnant or breast feeding or if you are under 18 years of age.

What is the most important information I should know about RADIESSE?

As with all procedures that involve an injection through the skin, there is a risk of infection. Do not use RADIESSE if you have a skin infection until it has healed. The microspheres in RADIESSE can be seen in X-rays and CT Scans. It is very important that you tell your health care provider that you have had RADIESSE injected into your face.

If you have a history of herpes, you may experience a herpes breakout after receiving RADIESSE.

For approximately 24 hours after treatment:

  • Avoid significant movement or massage of the treated area
  • Do not apply makeup
  • Avoid extensive sun or heat exposure

What should I tell my doctor before being treated with RADIESSE?

Tell your health care provider if you are taking blood thinners or medicines that can interfere with the clotting of blood, such as aspirin or warfarin. These medicines might make it more likely that you have bruising or bleeding at the injection site.

What are the most common adverse events with RADIESSE?

The most common adverse events include bruising, redness, swelling, pain, tenderness and itching. These side effects generally last for a short time and are mild in nature.

These are not all of the possible side effects with RADIESSE. Tell your health care provider about any side effects that bother you or do not go away.

Important: For complete instructions for use, please visit www.Radiesse.com or call Merz Aesthetics Customer Service at 866-862-1211

Caution: Rx Only

References: 1. RADIESSE [instructions for use]. Franksville, WI: Merz North America, Inc.; 2013. 2. Berlin AL, Hussain M, Goldberg DJ. Calcium hydroxylapatite filler for facial rejuvenation: a histologic and immunohistochemical analysis. Dermatol Surg. 2008;34(suppl1):S64-S67. 3. Marmur ES, Phelps R, Goldberg DJ. Clinical histologic and electron microscopic findings after injection of a calcium hydroxylapatite filler. J Cosmet Laser Ther. 2004;6(4):223-226. 4. Moers-Carpi MM, Vogt S, Martinez Santos B, Planas J, Rovira Vallves S, Howell DJ. A multicenter, randomized trial Comparing calcium hydroxylapatite (RADIESSE®) to two hyaluronic acids (Juvéderm® and Perlane®) for treatment of nasolabial folds. 205 patients. Dermatol Surg. 2007;33:S144-S151.

Copyright © 2015 Merz North America, Inc. All rights reserved. MERZ AESTHETICS and the MERZ AESTHETICS logo are trademarks of Merz

Pharma GmbH & Co. KGaA. RADIESSE is a registered trademark of Merz North America, Inc. EM01321-00

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What is BELOTERO BALANCE?

BELOTERO BALANCE® is a prescription injection that is approved to temporarily smooth out and fill in moderate-to-severe nasolabial folds (the folds or wrinkles that go from the side of the nose to the corner of the mouth).

IMPORTANT SAFETY INFORMATION FOR BELOTERO BALANCE®

Who should not use BELOTERO BALANCE?

BELOTERO BALANCE should not be used in patients with a history of or presence of multiple or severe allergies, including those with a history of anaphylaxis. BELOTERO BALANCE should not be used in patients with allergies to gram-positive bacterial proteins.

What is the most important information I should know about BELOTERO BALANCE?

As with all events that involve an injection through the skin, there is a risk of infection. Laser treatments or chemical peels or any other treatments that affect the skin can increase the risk of infection. Do not use BELOTERO BALANCE if you have a skin inflammation or a skin infection. Do not use until the infection is healed.

Patients getting BELOTERO BALANCE may have an injection site reaction. These reactions can include inflammation and usually last less than seven days.

For approximately 24 hours after treatment, avoid:

  • strenuous activity
  • extensive sun or heat exposure
  • aspirin or non-steroidal anti-inflammatory drugs
  • alcoholic beverages

Exposure to any of the above can cause temporary redness, swelling, and/or itching at the injection site.

It is not known how BELOTERO BALANCE will work in areas of the face other than the smile lines.

It is not known how BELOTERO BALANCE will work in women who are pregnant or breastfeeding or people who are less than 21 years of age.

What should I tell my doctor before injections with BELOTERO BALANCE?

Tell your doctor if you are taking medicines that affect blood clotting, like aspirin, an NSAID or warfarin. These medicines may put you at an increased risk of bruising or bleeding at the treatment site.

Tell your doctor if you have a skin reaction like cold sores, cysts, pimples, rashes, hives, or an infection. Treatment with BELOTERO BALANCE should be delayed until the reaction goes away.

Tell your doctor if you are taking medicines that affect your immune system.

What are the most common adverse events seen with BELOTERO BALANCE?

The most common local side effects seen with BELOTERO BALANCE were swelling, bruising, redness, hardening of the skin, pain, altered color, or itching. Other side effects that have occurred with BELOTERO BALANCE include headache, swelling of the side of the nose, moderate cold sore, lip numbness, and lip dryness. Side effects were often mild to moderate and often resolved within 7 days.

Important: For full safety information and Instructions for Use, please visit www.belotero.com or call Merz Aesthetics Customer Service at 866-862-1211.

Caution: Rx Only

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2/27/15

BOTOX® Cosmetic Consumer Important Information

BOTOX® Cosmetic (onabotulinumtoxinA) Important Information

Approved Uses

BOTOX® Cosmetic is a prescription medicine that is injected into muscles and used to temporarily improve the look of both moderate to severe crow’s feet lines and frown lines between the eyebrows in adults.

IMPORTANT SAFETY INFORMATION

BOTOX® Cosmetic may cause serious side effects that can be life threatening. Call your doctor or get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX® Cosmetic:

  • Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months
  • Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, trouble swallowing. If this happens, do not drive a car, operate machinery, or do other dangerous activities

The dose of BOTOX® Cosmetic is not the same as, or comparable to, any other botulinum toxin product.

There has not been a confirmed serious case of spread of toxin effect when BOTOX® Cosmetic has been used at the recommended dose to treat frown lines, crow’s feet lines, or both at the same time.

Serious and/or immediate allergic reactions have been reported. They include: itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness or feeling faint. Tell your doctor or get medical help right away if you are wheezing or have asthma symptoms, or if you become dizzy or faint.

Do not take BOTOX® Cosmetic if you: are allergic to any of the ingredients in BOTOX® Cosmetic (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); have a skin infection at the planned injection site.

Tell your doctor about all your muscle or nerve conditions, such as amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), myasthenia gravis, or Lambert-Eaton syndrome, as you may be at increased risk of serious side effects including difficulty swallowing and difficulty breathing from typical doses of BOTOX® Cosmetic.

Tell your doctor about all your medical conditions, including: plans to have surgery; had surgery on your face; weakness of forehead muscles, such as trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® Cosmetic can harm your unborn baby); are breast-feeding or plan to breast-feed (it is not known if BOTOX® Cosmetic passes into breast milk).

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal products. Using BOTOX® Cosmetic with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received BOTOX® Cosmetic in the past.

Especially tell your doctor if you: have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin, such as Myobloc®, Dysport®, or Xeomin® in the past (be sure your doctor knows exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; take a sleep medicine; take aspirin-like products or blood thinners.

Other side effects of BOTOX® Cosmetic include: dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes.

For more information refer to the Medication Guide or talk with your doctor. To report a side effect, please call Allergan at 1-800-433-8871.

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Indication & Usage

XEOMIN® is a prescription medicine that is injected into muscles and used to improve the look of moderate to severe frown lines between the eyebrows (glabellar lines) in adults for a short period of time (temporary).

IMPORTANT SAFETY INFORMATION (CONTINUED)

Swallowing problems may last for several months. People who cannot swallow well may need a feeding tube to receive food and water. If swallowing problems are severe, food or liquids may go into your lungs. People who already have swallowing or breathing problems before receiving XEOMIN® have the highest risk of getting these problems.

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Spread of toxin effects. In some cases, the effect of botulinum toxin may affect areas of the body away from the injection site and cause symptoms of a serious condition called botulism.

The symptoms of botulism include:

  • loss of strength and muscle weakness all over the body
  • double vision
  • blurred vision and drooping eyelids
  • hoarseness or change of loss of voice
  • trouble saying words clearly
  • loss of bladder control
  • trouble breathing
  • trouble swallowing

These problems could make it unsafe for you to drive a car or do other dangerous activities.

Active Ingredient: incobotulinumtoxinA

Purpose: acts on nerve endings in muscles to prevent muscle fibers from contracting

Do not use XEOMIN if you are allergic to XEOMIN® or any of the ingredients in XEOMIN® (see the end of the Medication Guide for a list of ingredients in XEOMIN®), had an allergic reaction to any other botulinum toxin products such as rimabotulinumtoxinB (MYOBLOC®), onabotulinumtoxinA (BOTOX®, BOTOX® COSMETIC), or abobotulinumtoxinA (DYSPORT®) or have a skin infection at the planned injection site. Ask a doctor before use if you have a disease that affects your muscles and nerves (such as amyotrophic lateral sclerosis [ALS or Lou Gehrig's disease], myasthenia gravis or Lambert-Eaton syndrome)
  • have allergies to any botulinum toxin product
  • have had any side effect from any other botulinum toxin in the past
  • have a breathing problem, such as asthma or emphysema
  • have a history of swallowing problems or inhaling food or fluid into your lungs (aspiration)
  • have bleeding problems
  • have drooping eyelids
  • have plans to have surgery
  • have had surgery on your face
  • are pregnant or plan to become pregnant. It is not known if XEOMIN® can harm your unborn baby.
  • are breastfeeding or plan to breastfeed. It is not known if XEOMIN® passes into breast milk.

XEOMIN® is not recommended for use in children younger than 18 years of age.

Tell your doctor about all of your medical conditions and all of the medicines you take, including prescription and nonprescription medicines, vitamins and herbal supplements. Do not start any new medicines until you have told your doctor that you have received XEOMIN® in the past. Especially tell your doctor if you
  • have received any other botulinum toxin product in the last four months
  • have received injections of botulinum toxin such as rimabotulinumtoxinB (MYOBLOC®), onabotulinumtoxinA (BOTOX®, BOTOX® COSMETIC) and abobotulinumtoxinA (DYSPORT®) in the past. Be sure your doctor knows exactly which product you received. The dose of XEOMIN® may be different from other botulinum toxin products that you have received.
  • have recently received an antibiotic by injection
  • take muscle relaxants
  • take an allergy or cold medicine
  • take a sleep medicine
  • take a blood thinner medicine

Ask your doctor if you are not sure if your medicine is one that is listed above.

Possible Side Effects

XEOMIN can cause serious side effects that can be life threatening. See “Warnings.”

Headache was the most common side effect of XEOMIN for treatment of glabellar lines. Other possible side effects include:

  • dry mouth
  • discomfort or pain at the injection site
  • tiredness
  • neck pain
  • muscle weakness
  • eye problems, including: double vision, blurred vision, drooping eyelids, swelling of your eyelids, and dry eyes. Reduced blinking can also occur. Tell your doctor or get medical help right away if you have eye pain or irritation following treatment.

XEOMIN may cause other serious side effects including allergic reactions. Symptoms of an allergic reaction to XEOMIN® may include: itching, rash, redness, swelling, wheezing, asthma symptoms, or dizziness or feeling faint. Tell your doctor or get medical help right away if you get wheezing or asthma symptoms, or if you get dizzy or faint.

Tell your doctor if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of XEOMIN®. For more information, talk to your doctor.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Directions

XEOMIN® is a shot (injection) that your doctor will give you.
XEOMIN® is injected into your affected muscles.
Your doctor may change your dose of XEOMIN® until you and your doctor find the best dose for you.
Inactive Ingredients: human albumin and sucrose

Read the Medication Guide before you start receiving XEOMIN® and each time XEOMIN® is given to you as there may be new information. The risk information provided here is not comprehensive. To learn more:

Talk to your health care provider or pharmacist
Visit www.xeominaesthetic.com to obtain the FDA-approved product labeling
Call 1-866-862-1211
Please click here for XEOMIN® Full Prescribing Information and Medication Guide.

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Copyright © 2013 Merz Aesthetics, Inc. All rights reserved.
Merz Aesthetics and the Merz Aesthetics logo are trademarks, and XEOMIN is a registered trademark of Merz Pharma GmbH & Co. KGaA.
BOTOX is a registered trademark of Allergan, Inc. Dysport is a registered trademark of Ipsen Biopharm Limited Company.
MYOBLOC is a registered trademark of Solstice Neurosciences, Inc.
EM00741-00

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