THE GIRLFRIEND’S GUIDE

INJECTABLES www.thederminstitute.com

ABOUT

DR. CHIU

Dr. Annie Chiu is a Board-Certified Dermatologist in Manhattan Beach who received her Medical Degree from Stanford University. She obtained her Bachelors of Science from UC Berkeley, where she graduated with top honors and was a University Medal finalist.

Dr. Chiu specializes in Aesthetic Dermatology, and is a nationally recognized Master Injector for Botox, Dysport, and all Fillers. She lectures both internationally and nationally on cutting edge, advanced cosmetic procedures and acts as both an advisory board member and National Trainer to teach other physicians expert Cosmetic Injectable techniques. She is the author of numerous publications, E-Books, book chapters, and review articles. Dr. Chiu currently acts as a consultant for all the injectable companies FDA approved in the US, including Allergan, Galderma, and Merz, as well as various skincare companies including La Roche Posay, SkinMedica, and Skinceuticals.

Frequently sought after as a media expert, in 2015, she was named a “Skin Genius” by Elle Magazine.

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OUR

PHILOSOPHY

Non-surgical rejuvenation is Dr. Chiu’s passion. A nationally renowned Master Injector and Advanced Trainer of other physicians, you will be in the best of hands as Dr. Chiu personally treats every patient. Whether it’s getting ready for a special event, or just maintenance of a more youthful appearance, we want our patients glowing, happy, and more confident when they leave our office.

Our practice welcomes anyone to discuss your unique needs and concerns. We are committed to a no-pressure atmosphere where we partner with you to achieve a rested, refreshed, and relaxed appearance. The improvements can be dramatic, yet subtle and natural-appearing. Our goal is for you to look better but not different.

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FIND THE

INJECTOR

Take your time thinking about who you want to trust with non-surgical medical rejuvenation. If you do not know where to start, ask your friends and family for referrals or search for providers in your area on the official site for the injectable you are interested in. Consider the following when researching potential injectors:

• Dermatology board-certification • Years of experience and training • Volume of cosmetic procedures in practice • Participation in cosmetic studies • Lectures and trains on injectables • Expertise in avoiding and treating possible

complications

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ASK THE

QUESTIONS

During your consultation, you should discuss all of your desires and concerns with your injector. Ask your provider the following questions:

• Do they have medical expertise in facial anatomy? For instance, are they licensed and trained in a field of aesthetic medicine, such as dermatology.

• How many years of experience do they have injecting neuromodulators and dermal fillers?

• How often do they treat patients with the injectables?

• Will they show you before-and-after pictures of other patients they have treated?

• What are the most common side effects they have seen in their clinical experience?

• What should you do if you experience any side effects?

• What do they need to know about your medical history? Be prepared to tell your specialist about any medical conditions, including any prescription medications, vitamins, or herbal supplements you are taking.

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INTRODUCTION

INJECTABLES Injectables are products that integrate with your own body’s collagen and are used to boost volume, lift, soften a fold, and contour the overall face and jawline. They work by replacing lost volume and fullness of the skin and restoring youthful contours. Recent studies show they may also induce neocollagenesis or new collagen by activating certain cells in the skin when injected. Most commonly treated areas with fillers include:

• Softening nasolabial folds (or smile lines that run from the nose to your mouth) • Correction of undereye hollowing (or dark circles) • Rounding out the temples • Filling in vertical lip lines (smoker’s lines) • Shape and plump the lips (in the most natural way!) • Enhance and/or lift the cheeks • Treat depressed scars • Soften horizontal neck lines or “necklace” lines • Lift the jowls • Lessen a heavy-lidded appearance of the eyes and lifting the brows • Smooth etched wrinkles on the face • Smooth the décolletage

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BOTOX | DYSPORT | XEOMIN

Botox®, Dysport®, and Xeomin® all injectable neuromodulators designed to soften lines and wrinkles typically formed by repeated expressions. This quick and easy procedure to smooth wrinkles is extremely popular in both men and women. The most commonly treated areas include:

• Glabella or the “angry” frown lines between your brows

• Crow’s feet

• Horizontal forehead lines

We take every precaution to balance a natural look where you still maintain expressiveness but appear more relaxed and rested.

These products can also be used to:

• Improve vertical neck bands

• Give a subtle lift to the jawline a.k.a. “the nefertitti lift”

• Smooth “bunny lines” or lines that show when you scrunch up your nose

• Lessen vertical lip lines or “smokers lines”

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BOTOX | DYSPORT | XEOMIN

Precise use of neuromodulators also can:

• Improve dimpling of the chin • Open up the eyes • Lift the brows • Lift the nose tip, which droops a bit with age • Upturn the corners of the mouth • Help treat a smile that shows too much gum • Tighten the lower face • Soften a squared off jawline or face • Reduce sweating

Botox, Dysport, and Xeomin are popular procedures because of the comfort, ease of treatment, and consistent high satisfaction among patients. There is no downtime to neuromodulator use other than a very low risk of bruising. Your results typically will last 3-4 months. Studies show consistent maintenance of treatments like Botox can eventually lead to longer lasting results up to 6 months.

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JUVEDERM | ULTRA | PLUS

Juvederm® fillers are composed of a hyaluronic acid gel that has almost no risk of allergy and are considered very safe. All hyaluronic acid based fillers restore volume, soften folds, shape or plump the lips, and contour the face by restoring the volume loss that occurs over time with collagen breakdown.

Juvederm Ultra and Juvederm Ultra Plus are most commonly used in the nasolabial folds (smile lines), the lips, cheeks, chin and the marionette lines. Juvederm Ultra Plus is the thicker of the two Juvederm products. It is used when deeper folds or more lift is needed.

At The Derm Institute, we only use the Juvederm XC line of products which are premixed with a numbing solution. Like all filler procedures, numbing cream is applied to areas being treated, making this a fairly comfortable procedure. The results are instant gratification! Sometimes bruising and swelling can occur that lasts 2-7 days.

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RESTYLANE | SILK | LYFT

Restylane®, Restylane Silk® and Restylane Lyft® are popular fillers used to replenish volume, contour the face, eliminate fine lines and soften wrinkles and folds. All are hyaluronic acid based products that are composed of a naturally occurring sugar in our skin that provides support and fullness. Over time, the collagen and elastin in our skin breakdown, resulting in volume loss or hollowing of the face. Our folds and jowls become more prominent as volume loss and gravity shifts the cheeks downward. Youthful faces are full (think less dramatic version of baby fat), and dermal fillers help restore the hollowing that occurs over time by restoring youthful contours in the cheeks, temples, or even earlobes.

Most commonly used areas include the nasolabial folds, lips, cheeks, and temples. One of our favorite areas to use Restylane is in the under-eye circles. It can be a dramatic instant effect that makes you look much more rested.

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RESTYLANE | SILK | LYFT

The difference between this family of fillers is based on particle size of the hyaluronic acid. Restylane Silk is the thinnest in this family of products. Composing of finer particles in a smoother gel, Restylane Silk is approved for the fine lines around the mouth area, often called “smoker’s lines”, and the lips themselves. Restylane is a mid-sized particle filler and is versatile for filling and lifting in all areas of the face. Restylane Lyft is the thicker of the two products, and is used when more lift or robust volume is needed to achieve desired results.

Restylane, Restylane Silk and Restylane Lyft all have numbing agents premixed. To insure maximal comfort, we also use numbing cream on the face prior to the procedure. Most clients find fillers to be a fairly comfortable procedure. Results are immediate! Uncommonly, you may have some swelling and bruising for 1-7 days after the procedure.

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JUVEDERM | ULTRA | PLUS

Like Restylane and Perlane, Juvederm® fillers are composed of a hyaluronic acid gel that has almost no risk of allergy and are considered very safe. All hyaluronic acid based fillers restore volume, soften folds, shape or plump the lips, and contour the face by restoring the volume loss that occurs over time with collagen breakdown.

Juvederm Ultra and Juvederm Ultra Plus are most commonly used in the nasolabial folds (smile lines), the lips, cheeks, and the marionette lines. Juvederm Ultra Plus is the thicker of the two Juvederm products. It is used when deeper folds or more lift is needed.

At The Derm Institute, we only use the Juvederm XC line of products which are premixed with a numbing solution. Like all filler procedures, numbing cream is applied to areas being treated, making this a fairly comfortable procedure. The results are instant gratification! Sometimes bruising and swelling can occur that lasts 2-7 days.

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BELOTERO BALANCE

Belotero Balance® is the newest of the hyaluronic acid fillers available on the market. It is approved to smooth moderate to severe wrinkles and folds. Belotero is a simple injectable procedure to instantly enhance your facial contours and make the skin appear more radiant. It smoothly integrates with your own collagen to modify wrinkles, volumize and enhance the youthful contours of the face. Because hyaluronic acid fillers attract water, after the treatment, your skin will appear more luminous and hydrated. It is a smoother, thinner gel product that doesn’t feel lumpy under the skin and can be used for fine lines and thin-skinned areas. It can also be used in the décolletage, to correct dry appearing crèpy skin on the chest.

Like all fillers, bruising and swelling may initially occur, but typically resolves in 2-7 days. The results are immediate, making you look refreshed and feeling more confident.

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PREVELLE SILK

Known as the “lunchtime filler”, Prevelle® Silk (another hyaluronic acid product) differs from Restylane and Juvederm in that it has a slightly “thinner” silkier consistency that we find works well in finer lines or thinner skinned areas such as the vertical lip lines or crow’s feet. With a 3-4 month duration, Prevelle Silk does not last as long as the other fillers. Because of its unique crosslinking, this product has less potential of swelling compared to the other hyaluronic acid based products and is a fairly comfortable and quick procedure. Prevelle Silk is a great choice for a first time filler patient, someone on a more limited budget, or simply because of less potential swelling which allows a patient to go to an event that same night.

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RADIESSE

Radiesse® is made of calcium-based microspheres suspended in a gel vehicle that is biodegradable over time. Studies have shown this filler is truly “volumizing” in that it stimulates natural collagen production when injected into the skin. We use Radiesse when there is a need to correct deeper lines in the nasolabial folds, create more lift through the cheeks, fill in hollows like the temples, or to rejuvenate the hands. Radiesse can provide more of a “lifting” effect compared to the softer hyaluronic acid fillers, and may last longer in some individuals. It also works beautifully to better define the chin or jawline, and can be used to sculpt out or straighten the nose in the right candidate. Radiesse creates a buttress under the skin, boosting the volume and allowing your own body to produce collagen around it.

At the Derm Institute, we always mix our Radiesse with a numbing agent to increase comfort of injection and find patients are comfortable throughout the procedure. If you are impatient, immediate improvement is seen! Like most fillers, swelling and bruising can occur, as well as a temporary feeling of firmness under the skin. These symptoms usually subside in 2-7 days.

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SCULPTRA AESTHETIC

Sculptra Aesthetic® is unique in that it is a true “volumnizer” and not just a filler. This is the celebrity procedure that seems to keep them looking “unaged” for years. Sculptra offers an incredibly natural improvement not just in volume but in skin quality as well. Dr. Chiu’s expertise with Sculptra allows the most natural and gradual improvement compared to all the other injectables.

Sculptra is a true bio-active product which stimulates collagen production gradually over time to renew volume and fullness, while improving skin texture and often giving the “Sculptra glow”. The effects are slightly slower to manifest than traditional fillers, as it is your own collagen being stimulated over time, but Sculptra provides the “wake-up” fibroblasts need to make new healthy collagen, resulting in lift, increased volume, and improved skin texture. Sculptra is made of poly-L-lactic acid, a safe bio-compatible and biodegradable material that has been in the medical field for decades. It is the longest lasting of the fillers at up to or greater than 2 years. Unlike the hyaluronic acid fillers, Sculptra does not give you instant results, but builds volume with 2-3 treatment sessions typically spaced about 6 weeks apart to gradually fill in hollows, boost volume, and contour a more youthful face over a period of months.

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SCULPTRA AESTHETIC

At TDI, Dr. Chiu will also use advanced techniques with Sculptra to improve décolleté texture, neck skin, upper arm laxity, and lower jaw lift. Sculptra is the BEST product to choose when the goal is to gradually rejuvenate the face in a subtle manner by softening deeper or even etched wrinkles, and improving the textural appearance of the skin without looking “overdone”.

Because of its very long lasting duration, Sculptra injection should only be done by very experienced cosmetic injectors. At The Derm Institute, Dr. Chiu will sculpt the face in a three-dimensional manner to give a natural, rejuvenated result. There can be tenderness, swelling, redness, and bruising in treated areas that typically resolve in 3-7 days.

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KYBELLA

Fullness or the presence of fat under the jawline, chin, and neck area that can appear as a “double chin” is one of the most common areas of concern that develops over time. Kybella is in late phase clinical studies with the FDA, and is poised to become the first non-surgical method decrease jawline, chin, and neck fullness. This procedure is administered through a series of simple injections spaced about one month apart. Kybella utilizes a naturally found compound called deoxycholic acid to break down fat cells. The result is not only a loss of fat cells in the area but induction of collagen that causes skin tightening around the chin and jawline.

Kybella is the first-in-class FDA-Approved injectable jawline contouring agent to reduce what is referred to as submental fat, which commonly presents as a double chin.

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TDI EFFORTLESS LIFT

Feel like you need facial rejuvenation, but not sure where to start? The TDI Effortless Lift is The Derm Institute’s Patented Liquid Lift Procedure. TDI Effortless Lift is an essential package dedicated to the natural lift and glow everyone desires and can achieve to give an “airbrushed” appearance. This is an exclusive personalized treatment package that caters to your individual skin beauty needs.

The Liquid Lift or TDI Effortless Lift refers to the subtle non-surgical facelift results that can be achieved with a combination of different dermal fillers in different areas along with a neuromodulator like Botox or Dysport. Taking advantage of the slightly different characteristics of different fillers and it’s layering effects, Dr. Chiu will sculpt, contour, lift, and volumnize the face. This is the best approach for a full facial rejuvenation, as it does not just focus on one problem area.

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TDI EFFORTLESS LIFT

Liquid Facelifts are completely non-surgical, requiring only local topical anesthesia. With a master injector such as Dr. Annie Chiu, downtime is minimal, and most patients can resume normal activities immediately.

The duration of a Liquid Facelift or TDI’s Effortless Lift Treatment varies based on the modalities that are utilized. Combination treatments with products such as Juvederm Voluma and Sculptra can give not only immediate improvement, but longer term collagen boosting and results lasting up to two years. We recommend periodic touch-ups for maintenance of your Effortless Lift.

The beauty and appeal of TDI’s Effortless Lift Treatment and Liquid Facelifts is that results can be seen immediately. Over the course of weeks, even more impact will be noticed as new collagen is stimulated and skin texture is improved.

Results from a Liquid Facelift or TDI’s Effortless Lift Treatment is a complete and customized skin rejuvenation that can be seen immediately. However, depending on the products and treatment choices that are personalized for the patient, some products do require up to 2-4 treatments to achieve the optimal benefit.

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OUR BEFORE & AFTER

PHOTO GALLERY

View before and after images of our patients to see examples of our excellent results and to help visualize what your injectable results can be like. Search through our before and after photo gallery for more images to help you visualize your desired results.

Botox Radiesse

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OTHER

RESOURCES

Our guide is only the beginning of your journey. If

you are interested in learning more about injectable

treatments, check out the following websites for more

detailed information and to connect with other

patients and providers:

• American Society for Aesthetic Plastic Surgery

• American Society of Plastic Surgeons

• RealSelf

• Smart Beauty Guide

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