Monthly Archives: February 2015

Filler Facts

There is literally so much information I want to give you all about filler and I can’t fit it all into just one month! A one on one consultation is really priceless. Every person’s face is so different from the next. With that being said, I thought I would give some filler facts this week to end filler February with a bang (and information overload).

1. Your face is not 2 dimensional and that’s why filler looks so natural. Don’t look straight at your self in the mirror and analyze yourself. Look at all your angles. Put a mirror in front of you and look down, left and right very slowly. Filler can put your curves back where they used to be, bringing back a more youthful appearance.

2. Filler is adding volume to your face but makes you look slimmer. It’s kind of like getting breast implants makes your waist look smaller. When your curves are in the right spots it gives a beautiful, natural enhanced image not a pudgy look you may have previously feared.

3. Traditionally, Botox is the gateway drug to filler but this is all wrong. If you’re getting Botox you should probably be getting filler too. Think about years of Botox to your forehead preventing lines at rest and nothing to the lower half of your face. Eventually your upper face is not going to match your lower face(ie your forehead looks 30 and your lower face looks 50). To naturally enhance your image throughout the years you will likely need a combination of botox, filler, skin care, lasers and peels.

4.  Symmetry is beautiful. When you look in the mirror, is your left side flatter or wrinklier than your right side? Is your upper lip uneven from right to left? Is your right eyebrow lower than your left eyebrow? Filler is an awesome way to create symmetry.

5. Filler has complications. Don’t take filler lightly.  Filler can be injected into vessels or around blood vessels which then causes a blockage of blood flow which can then essentially cause your skin to die causing a wound. You want to make sure that whoever is injecting you A-has medical training of facial anatomy  and B-has the knowledge and capability to handle complications (able to get you prescription nitropaste, hyalurinadase, get you into a hyperbaric chamber). Basically, just let me inject you! Just kidding…… kinda. But seriously, my general rule is no needles should go in your body for any reason unless in a doctors office.

I hope you all enjoyed “Filler February” and the knowledge I have to share about fillers. With any luck you will all come see me in the clinic this week to say hello!

Now can we mention the Oscars? I mean there is some seriously good looking skin. Tim McGraw wins best male Botox for sure, did I inject him? And have you noticed how pale everyone is? I mean no one has a fake bake tan, obviously sunscreen has been used to get these flawless skin looks! I’m loving it! Bradley Cooper, will you marry me? Enjoy the Academy Awards with some hot cocoa tonight and stay warm!

Enjoy this snow! Have an awesome last week of February, talk at ya March 1!




How easy is filler?

I have a lot of patients who come to get filler injected and are not nervous about the results or what they will look like nearly as much as they fear the procedure of being injected. It really is so simple. Most people say, “that wasn’t bad”. I’ve never had anyone not get filler again because of the pain. These are my personal pre, during and post procedure tips to have the best experience possible once you take the plunge into the filler world.


1. Pick a date that won’t conflict with upcoming events. Chances are you won’t bruise or swell to a point that people will notice but some people are just more prone to bruising. Be prepared to have some bruising. If you don’t bruise, great! But if you do, you don’t have to worry about being in your biffle’s wedding two days later with bruises on your face.

2. Don’t stop your meds-If your doctor has you on blood thinners, it’s for an important reason. Don’t stop them, we can still inject you safely.

3. Take a selfie- Of course at Johnson Dermatology we take before and after pictures but it’s really fun to have your own on your phone. Remember, filler is immediate so you can take after pictures as you walk out to your car and see the difference before you get home!

4. Come as you are- We will wash your make-up off with a gentle cleanser. We then wash your face off with a surgical scrub. During the procedure we will use alcohol to keep the area clean.

During the procedure

1. Breathe- Don’t hold your breath, that’s how people pass out.

2. Talk to me- Tell me if you feel something weird and I will explain to you what is going on. For instance, sometimes when injecting the cheeks the numbing medicine will numb the lip because of nerves that start in the cheek and go to the lip, don’t freak out. I can talk you through most of the things you don’t expect. Conversation is distracting you from pain and makes it more fun for me too!

3. Pain prevention- We will ice you to numb the area with coolness. We can use numbing cream as well. We can do a dental block (shots in the gums like at the dentist) to numb your lips before injection. The fillers come with numbing medicine in them so after the first few sticks you start to feel numb. We tap you on the face to trick your nerves where to send pain signals which decreases the pain during injection. We use the smallest needle possible that is compatible with the filler particles.

4. Time- Usually you will be at the clinic for 30 minutes to an hour but the actual injection may only take about 15 minutes.


1. No strenuous activity the day of injection. This prevents/decreases bruising. No heavy lifting, no straining, no crossfit.

2. No rubbing, no massaging, no sleeping on your face. This is mostly precautionary. We don’t want you to move your filler which is fairly hard to do once we have injected it but better safe than sorry. For real though, don’t schedule a facial or massage the same day after you’re injected.

3. For bruising- Eat pineapple. Use Arnicare gel up to four times a day. This is a homeopathic gel used for swelling and bruising. Come to the clinic the next day and let us laser the bruises to make them go away much quicker.

4. Come back in two weeks- At two weeks most of your swelling and bruising should be resolved. We can look at your before and after pictures together which is the best part! We also can make sure we have you on a longterm plan because you’re always going to be getting older and we want to be preventing drooping, sagging, dull skin, brown spots, fine lines and wrinkles slowly over time.

Filler really is an easy procedure. Last time I was injected I threw some powder on and went and saw patients and no one even noticed I had just been injected. Want to see how easy it really is? This Thursday, February 19th at noon Johnson Dermatology is hosting a lunch and learn. You can come grab a bite to eat while watching me inject a patients lips with Juvederm Ultra Plus (my favorite lip filler!). You can ask me all the filler questions your heart desires. Live demonstrations are so much fun! I hope to see you ALL there. Just call or e-mail the clinic to reserve your spot, they fill up fast so hurry!

Hope your Valentines Day/Galentines Day/Single Awareness Day was full of lots of LOVE!

Stay LOVE-ly, Nina

Lovely Lustful Lips

Valentines day is just a week away. Valentines is full of chocolates, flowers, love and kisses. What everyone needs and wants for kissing is a perfect pair of smoochers. This week for filler February I want to celebrate filler in the lips. The filler choices for the lips are Restylane, Belotero, Juvederm Ultra and Juvederm Ultra Plus. There is a new very thin filler for fine lines coming out this month called Restylane Silk. Belotero and now Restylane Silk are more for etched in very fine lines on the surface of the skin than volume loss and deeper lines. Juvederm Ultra is similiar to Juvederm Ultra Plus only Ultra Plus has a little more va-va-voom. In my personal experience my favorite is Juvederm Ultra Plus. I feel like it has a little more longevity overall, less initial swelling, easiest to manipulate and easiest to inject. We inject all of the aforementioned fillers. Deciding which filler best meets your individual needs should be done during your consult.

There are lots of things you can do with fillers in the lips other than just making them bigger. As a matter of fact you can do a lot with the fillers to make your lips more youthful without even putting the filler into the actual lip area but putting it around your lips. Here are characteristics of the lips and the area around the lips that I like to improve with fillers.

1. Lines around the lips- Usually for lines around the lips a filler and Botox combination is prettiest.We can stretch lines around the mouth and lips with filler.

2. Border of the lip- In our youthful years most of us have a strong border around the lips. As we age, the lips and skin around them just kind of meld together. Some women try to improve this with lip liner. When we give you a border around your lip it redefines your lips and turns the pink part back to where it once was while stretching the lines around the lips as well.

3. Volume in the lips- If your lips are just made skinny or you are losing the volume in your lips as you mature you probably just want some plumping. We can do this with filler in a very natural way. One of my favorite things to do is give you that sexy pout back naturally making the lower lip bigger than the top lip. If your top lip disappears when you smile we can make it more of a natural beautiful lip that sticks around for photo ops.

4. Cupids Bow- Have you lost your cupids bow(also known as tubercle)? Is your top lip flat all the way across where you once had strong columns under your nose(also known as philtral columns)? I can inject filler to give those columns back to you and to give you your cupids bow just in time for Valentines Day!

5. Turn your frown upside down- Do the corners of your lips permanently turn down? We know you don’t feel sad inside so we will use filler to make your smiling inner spirit match your lips. We can put filler in/around your lips and the corners of your mouth to give you support back and make those corners go back to where they once were.

This is a good picture to try to visualize what I’m talking about.

Photo courtesy of Allergan, Inc.
Photo courtesy of Allergan, Inc.

If you get anything from this post then the take away should be that we can make your lips look very natural while using filler. Filler in lips doesn’t have to look done and fake. It can actually be done and no one even know what you had done.

Congratulations to everyone that ran in the Inaugural Fort Smith Marathon. You all have true grit! It was so inspiring to watch you all run by as my family enjoyed the beautiful weather.

Hope to see you all this week at the clinic with lots of love in the air!

Happy Valentines Day, XOXO, Nina

Oh the places filler will go!

I think in our society we associate fillers with big lips. Although lips, wrinkles, folds around the mouth and cheeks are areas commonly injected with fillers, there are other locations where we can do some very unique things with fillers. Let me enlighten you about the possibilities of fillers.  Make sure your injector is a highly trained core provider for safety because there are fillers that shouldn’t be used in certain places while others can be. Here are some of my favorite unique locations and tricks we can do with fillers.

1. The hands- If you don’t like the way the back of your hands are getting wrinkled or hollow looking then we can use Radiesse there.  We generally use one syringe per hand and it really smoothes out the back of the hand and gives a more youthful, natural appearance.

2. The nose- Is your nose bridge bumpy? Too wide without enough definition? We can use filler there to make a smoother, more defined nose.

3. The earlobes- Do your ears hang low? Do they wobble to and fro? No seriously, if you put your earrings in and there isn’t enough volume in the ear lobe to support the earring then your earrings could hang weird. We can put a very small amount of filler in the ear lobe to allow enough structure to support earrings again and give you that plumper, more youthful earlobe back.

4. The temples- Have your temples sunken in making your eye sockets protrude around the brows. This can age you drastically. We can fill the temples which can lift the brows and take away that aging sunken look. This is a very natural anti-aging trick.

5. Scars- Depending on multiple factors of the scar, such as age of the scar and characteristics of the scar, we can sometimes fill scars like we would a wrinkle to make the scar look better. If you have lost volume or there is a divot when you run your finger over the scar then you may be a good candidate to put filler in your scar and smooth that area back out.

Happy Filler February! If you aren’t already following Johnson Dermatology on FaceBook, now is the time to follow us. There are some exciting things coming with Filler February and that’s a really good place to be in the know.

Enjoy the Super Bowl, don’t let your blood pressure get too high cheering on your favorite team! And if you do get red faced, go read a couple posts back about facial redness treatments!

XOXO, Nina