A Question and Answer Session with Dr. Michael Bowman

This month we’ll answer a few questions that we hear frequently at River Region Facial Plastics (RRFP)


Q: I’ve been thinking about getting Botox, but I’ve never had it before…what can I expect?

A: Botox® Cosmetic is a neuromodulator, which is a class of medicines that includes Dysport® and Xeomin®.  It is our most common injectable treatment, and usually has no downtime.  These treatments are extremely safe, with over 3.7 million injections of neuromodulators (like Botox®) done in 2013.  These medicines work by relaxing the muscles that cause wrinkles.  The most common (and on-label) treatment sites are the crow’s feet and the glabella (in between the eyes).  The medicines can be used safely elsewhere in the face by experienced injectors.

The treatments are done with a tiny needle and take less than five minutes.  Small red bumps are common for an hour or two, but other reactions like bruising or swelling, while possible, are uncommon.  The medicine takes about five days to start working usually, but reaches its full effect by two weeks.  The wrinkles in your treated areas will soften as it starts to work.

Myself or Dr. Cawthon performs all injections, and we are Platinum Plus level injectors with Allergan, which means we are are in the top 2% of all of their accounts.


Q: My face is asymmetric, what can I do about it?

A: First of all, your concern about facial asymmetry is a common one.  As a facial plastic surgeon, I have to analyze faces everyday.  All of us have asymmetries in our appearance, ranging from small and subtle to more prominent.  Most of the time, everyone else does not notice those asymmetries, which appear so prominent to you.  We are certainly our own worst critics.  Therefore, I usually stress to patients that perfect symmetry is NOT attainable.  In addition, asymmetries, which are worse with smiling or facial motion, are the LEAST notable to other people because we only animate our face (smile, raise eyebrows, etc.) for a second or so at a time.

That being said, there may be some ways to enhance your appearance and bring your face into better overall aesthetic balance.  A face-to-face consultation is essential for determining what options may be best for you.  Come by to discuss your facial concerns… all consultations are complimentary!


Q: My lips are thin, what can I do about that?

A: Lip enhancement is a common procedure.  There are multiple options for enhancing the lips depending on your needs and desires.  People often ask about collagen injections, like Zyplast®.  Older collagen injectables like this have fallen out of favor because they require a skin test and don’t last long.  Juvederm® is my favorite product for lip enhancement.  A single treatment for injectable lip enhancement only takes around 20 minutes, and is usually painless because I use a modified dental block for anesthesia. Results generally last around a year or more.  For patients that want a more permanent option, I prefer SurgiSil™ silicone lip implants to silicone injections.  The silicone injections can’t be removed and other low quality silicone can cause acute or delayed problems.  The SurgiSil™ silicone implants look and feel natural and give a very nice result for those patients wanting a permanent enhancement of their lips.


Q: What is the safest filler?

A: We offer different options for volume replacement at RRFP including Juvederm®, Restylane®, Voluma®, Perlane®, Artefill® and Sculptra®.  We only use FDA approved products purchased directly from the manufacturer.  All of our fillers are safe and give us great results as qualified and trained injectors.   Which product will be best for you depends on the needs of your face, and I can make recommendations during your consultation.  We will review before and after pictures during your consultation to help you understand what results you can expect.

Remember, a nice pair of scissors can give either a great or an awful haircut…depending on who is holding them!  All of our fillers are safe and effective; so make sure you seek an injector with extensive experience.  I am excited to become a physician trainer for Galderma in the near future (maker of Restylane®, Perlane® and Sculptra®).  You can count on our expertise and quality results at RRFP.

Thank you for your interest and support, I hope we will see you very soon!



Yours in good health,
Dr. Michael Bowman
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