The US Food and Drug Administration (FDA) has approved use of onabotulinumtoxinA (Botox Cosmetic, Allergan) for temporary improvement in the appearance of moderate to severe lateral canthal lines, also known as crow’s feet, in adults. Botox Cosmetic is currently the only FDA-approved drug treatment option for lateral canthal lines, the FDA said today.
The agency approved Botox Cosmetic in 2002 for the temporary improvement of glabellar lines (frown lines) in adults. Botox Cosmetic works by keeping muscles from tightening, so wrinkles are less prominent.
Botox Cosmetic is administered via intramuscular injections. Treatment for both frown lines and crow’s feet can be given at the same time, the FDA said.
Boxed Warnings
The approval of Botox Cosmetic for treating lateral canthal lines was based on 2 clinical efficacy and safety studies involving 833 adults with moderate to severe lateral canthal lines who were randomly assigned to receive either Botox Cosmetic or placebo.
The results showed that those treated with Botox Cosmetic had greater improvement compared with placebo in the appearance of lateral canthal lines, the FDA said.
BOTOX® is a prescription medicine that is injected into muscles and also used for the following:

  • to treat overactive bladder symptoms such as a strong need to urinate with leaking or wetting accidents (urge urinary incontinence), a strong need to urinate right away (urgency), and urinating often (frequency) in adults 18 years and older when another type of medicine (anticholinergic) does not work well enough or cannot be taken.
  • to prevent headaches in adults with chronic migraine who have 15 or more days each month with headache lasting 4 or more hours each day in people 18 years or older
  • to treat increased muscle stiffness in elbow, wrist, and finger muscles in people 18 years and older with upper limb spasticity
  • to treat the abnormal head position and neck pain that happens with cervical dystonia (CD) in people 16 years and older
  • to treat certain types of eye muscle problems (strabismus) or abnormal spasm of the eyelids (blepharospasm) in people 12 years and older
  • to treat the symptoms of severe underarm sweating (severe primary axillary hyperhidrosis) when medicines used on the skin (topical) do not work well enough in people 18 years and older
This news is brought to you courtesy of Dr. Mark Bishara and The Paragon Med Spa
Dr. Mark Bishara provides a wide range of cosmetic procedures, including Botox and fillers, to help patients look and feel their best. All injections are performed by Dr. Bishara in our office. Please call our office to schedule an appointment at (817) 473-2120.
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In the quest for youth—or at least a more youthful appearance—women and men are seeking treatments to minimize laugh lines, crow’s feet, and forehead furrows. A popular treatment involves injecting cosmetic wrinkle fillers into the face.  At Dr. Mark Bishara’s office in Mansfield and Southlake- we offer injectables for our patients.
Injectable cosmetic wrinkle fillers are soft tissue fillers approved as medical devices by the Food and Drug Administration (FDA). These devices are injected into the skin to help fill in facial wrinkles, restoring a smoother appearance. Most of these wrinkle fillers are temporary because they are eventually absorbed by the body.
Some people may need more than one injection to achieve the wrinkle-smoothing effect. The effect lasts for about six months or longer.
Successful results depend on:

  • health of the skin
  • skill of the doctor
  • type of filler used

Uses

FDA has approved absorbable injectable cosmetic wrinkle fillers for correcting soft tissue contour defects, such as moderate and severe wrinkles and folds. Some absorbable fillers are approved for restoring or correcting the signs of facial fat loss in people with human immunodeficiency virus (HIV).
FDA has also approved two absorbable injectable wrinkle fillers for lip augmentation in patients over the age of 21.
The only non-absorbable FDA-approved injectable cosmetic wrinkle filler is for correcting facial tissue around the mouth.
FDA-approved cosmetic wrinkle fillers should not be used for

  • increasing breast size (breast augmentation)
  • implanting into bone, tendon, ligament, or muscle
  • implanting into blood vessels

Filler Materials

Wrinkle fillers are made of various types of materials, and some include a combination of products. Some products also contain lidocaine, which numbs the skin at the injection site.
The materials used in injectable cosmetic wrinkle fillers include
Temporary (absorbable) fillers

  • Collagen injections are made of highly purified cow or human collagen. Collagen is a natural protein that is a major component of skin and other tissues in the body.
  • Hyaluronic acid gel is a protective lubricating gel, produced naturally by the body, that binds with water to plump the skin.
  • Calcium hydroxylapatite is a mineral that is a major component of bone. Calcium hydroxylapatite is a well-matched (biocompatible) material that dissolves in the body (biodegradable) and is implanted in the form of a gel.
  • Poly-L-lactic acid (PLLA) is a biodegradable, biocompatible, synthetic material from the alpha-hydroxy-acid family that has been widely used for many years in dissolvable stitches and bone screws.

Permanent (non-absorbable) filler

  • Polymethylmethacrylate beads (PMMA microspheres) are tiny round, smooth plastic particles that have been tested to be biocompatible. They are not absorbed by the body.

Risks

Getting injected with cosmetic wrinkle fillers is an elective procedure. As with any medical procedure, it poses risks. Most side effects occur shortly after injection and go away within seven days.
You should not use cosmetic wrinkle fillers if any of the following applies to you:

  • severe allergies marked by a history of anaphylactic shock
  • allergy to cow collagen or eggs
  • allergy to lidocaine
  • inflamed or infected skin
  • prone to form excessive scarring (keloid) or thick scarring (hypertrophic scars)
  • bleeding disorder
  • active inflammatory condition (cysts, pimples, rashes or hives) or infection; you should postpone treatment until the condition is controlled.

Tips for Consumers

Before deciding to get injected with a cosmetic wrinkle filler:

  • Be aware that the safety of these products is unknown for use in pregnant or breastfeeding women or in patients under 18 years of age.
  • Be aware that the safety is unknown when these products are used with Botox or other wrinkle therapies.
  • Be aware that the safety of these fillers has only been studied when used in the face.
  • Know the type of product that will be injected and all of its possible side effects.
  • Discuss fillers with a doctor who can refer you to a specialist in the fields of dermatology and aesthetic plastic surgery.
  • Select a doctor who is trained to do the procedure.
  • Have realistic expectations about the benefits you want to achieve and discuss them with your doctor.

What About Botox?

Botox Cosmetic is an injectable drug, but it is not a wrinkle filler. Instead of filling the wrinkle, it keeps muscles from tightening so the wrinkles don’t show as much. FDA has approved Botox Cosmetic only to treat wrinkles between the eyebrows.
At the office of Dr. Bishara and The Paragon Med Spa we offer both injectables, such as Botox, as well as fillers.  Dr. Bishara is a cosmetic surgeon and also performs the injections for all patients.  Please call our office to schedule an appointment at (817) 473-2120.
 

Good Skin Care in Your 20’s, 30’s and 40+

20’s: The Issue- Dullness

In-Office Fixes: Microdermabrasion and Chemical Peels
When you’re young skin cells turn over, exfoliating every 28 days.  But as you move into your mid to late 20’s, that process starts to slow, and a natural decrease in skins sloughing ability. You’re left with a layer of dead skin that doesn’t evenly reflect light. Lunchtime procedures like microdermabrasion and chemical peels take less than and hour and leave behind only mild redness. During a microdermabrasion treatment, an aesthetician buffs away the top layer of skin.  For maximum results, consider a series of 3 treatments, spaced apart- followed by a chemical peel. Microdermabrasion removes any build up and then the chemical peel makes skin look brighter and more toned evening out skin discoloration and tightening pores.


30’s: The Issues- Fine Lines, Redness and Sun Spots

In-Office Fixes for Fine Lines: Injectables such as Botox
Those little lines that used to disappear as soon as you stopped smiling or frowning are suddenly here to stay.  Movements that cause skin to repeatedly crease in the same place eventually wear down the underlying collagen, creating lines that remain after muscles relax. Injectable muscle relaxers containing botulinum toxin A, such as BotoxDysport and Xeomin, temporarily paralyze muscles so you can’t make those wrinkle-causing movements. Expect smoother skin 72 hours post-injection and results last 3-4 months on average.  If you have no lines to speak of yet, these injections can be used as a preventative measure.  Small doses can prevent muscle action so you’ll never get the creases to begin with.
**6.1 million people had Botox treatments performed in 2012**


In-Office Fixes for Redness and Sun Spots: Laser Procedures
A rosy glow can be a sign of good health, but a constant ruddy complexion is a red flag. For some it’s a sign of sun damage. Excessive UV exposure weakens blood vessels until they no longer constrict after dilating.  For others redness stems for rosacea, a condition marked by flushing, broken blood vessels and acne-like bumps. Other issues like brown spots are a sign of chronic sun damage triggered by overexposure of UV rays. Unlike freckles these marks don’t fade after reduced sun exposure- but they will get darker with even more.
An IPL-Fotofacial will target and treat unwanted discoloration, pigmentation, broken capillaries, age spots and sun damage.  It also lessens the appearance of rosacea, fine lines and wrinkles. At The Paragon Med Spa our medical microdermabrasion also includes a chemical peel. Our Laser 360 treatment offer 3 technologies in 1 visit.  The Laser 360 is meant to be done in a series of 3 treatments and produces optimal results.  During this treatment a fotofacial, skin tightening and laser skin resurfacing are combined to offer the most comprehensive correction and rejuvenation.  Bonus:  Your skin will look tighter and feel smoother.

40+: The Issues- Sagging, Deep Creases and Hollowed Cheeks

Genetics and the effects of sun damage really start to show in this decade, as skin’s elasticity takes a nosedive.  Sagging skin and crow’s feet that showed up in your 30s are probably more pronounced now. And due to natural volume loss, you may be noticing new wrinkles especially around the lips and in between the nose and corners of your mouth. With age, skin loses fat, exposing folds and creases.
In-Office Fixes for Sagging and Deep Creases
Fillers such as Juvederm instantly plump indentations.  JUVÉDERM® Ultra Plus is used to treat deeper and more severe wrinkles and folds, and provides results that last up to one year. Injections take about 15 minutes to administer and do not require any anesthesia. Patients should avoid strenuous exercise and excessive sun exposure for the first 24 hours after treatment, but can otherwise resume normal activities right away.
In-Office Fixes for Hollowed Cheeks
Injectables such as Radiesse, reign supreme here too.  Thicker fillers are ideal for filling out hollowed cheeks. Radiesse is a stiff material, so it’s good for replacing volume as well as lifting the skin.  Radiesse provides an immediate fill plus long-term collagen stimulation for 18 months to two years.
Dr. Bishara provides a wide range of cosmetic procedures to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance. Please call our office to schedule an appointment at (817) 473-2120 or click on the button below.

 

People always seem to be seeking treatment to reduce or eliminate the signs of aging on their face, hands and body. Minimally invasive procedures offer patients the results they desire without the hassle and lengthy downtime often associated with cosmetic surgery procedures. These treatments are designed to provide subtle enhancements that can improve your targeted problem areas, while allowing you to return to work and your regular activities the very same day.

Dr. Mark Bishara is proud to offer a wide range of dermal fillers and other enhancing, minimally invasive procedures in his Mansfield and Southlake offices.
Out of all minimally invasive procedures, BOTOX® Cosmetic is still the No. 1 non-surgical treatment performed in the U.S. after so many years. Why is this……because BOTOX works.
In our offices, patients are getting BOTOX treatments in record numbers. They want to look younger, healthier, and more vibrant. BOTOX can help patients achieve this at a reasonable price. These treatments work on patients of any age and with any skin type and have no downtime after treatment.
BOTOX can be used to relax the muscles of the face, temporarily erasing wrinkles on the forehead, between the brows, and around the lips, as well as laugh lines around the eyes. What’s more, studies show that when BOTOX is administered to younger patients, lines and wrinkles in those areas may be prevented altogether. There is definetely a trend of more BOTOX patients coming in their early and mid-20s.
The bottom line? New and improved treatments may come and go, but only a few will stand the test of time.

Sticking to a Schedule

It is important to stick to a schedule if patients want to get the most out of their Botox treatments. BOTOX can be great for quick rejuvenation if you decide that’s all you want, but its effects can also last longer if you maintain them.
There are many misconceptions regarding the most effective use of this injectable treatment. BOTOX is a great solution for women and men who may not be ready for facial cosmetic surgery and just want a little natural freshening. Even people who do proceed with actual cosmetic surgery benefit by BOTOX treatments afterwards to maintain the great results they got and make them last longer. At Dr. Bishara’s office you will receive a treatment plan based on your exact needs.
On average, the results of BOTOX appear within the first few days of treatment and last 3 to 4 months. The key to maximizing your results is planning in advance for your treatment sessions to occur every 3 to 4 months, just as the results are beginning to dissipate.
Injectable dermal filler treatments are also helpful as part of a patients’ personalized rejuvenation plans. Options such as JUVÉDERM® and RADIESSE® can enhance facial volume in key areas where we lose it with age, and thus restore youthful contours for a year, and they complement the results achieved with BOTOX.

We offer Botox weekly specials:

Wrinkle-FREE Wednesdays in our Mansfield office from 9am-5pm- Botox $10/unit
Wrinkle-FREE Rush Hour Thursdays in Southlake from 12pm-7pm- Botox $10/unit
At the offices of Dr. Mark Bishara and The Paragon Med Spa we would love to answer any questions you have regarding Botox and other fillers.  To schedule an appointment with Dr. Bishara, please contact our office directly at (817) 473-2120.

How To Defeat Aging!!

We are all struggling against the effects of aging. The more weapons we have to fight the monster of aging the better. Here are some weapons everyone should keep in her anti-aging arsenal. At the office Dr. Mark Bishara and The Paragon Med Spa- our main focus is to help patients restore or achieve their ideal appearance in order to feel confident about the way they look. Dr. Bishara and his staff are ecstatic to welcome you personally to our office and look forward to helping you very soon!

Our Paragon Med Spa has many different procedures that we offer which can be done as quickly over a lunch time with little or no down time such as our Lunch-Hour Facelifts, Fotofacial, skin tightening, and small areas for laser hair removal. Our aesthetician also offers many other services that can be done over a longer scheduled amount of time such as a Laser 360, tattoo removals, and bigger laser hair removal areas (legs, brazilian, back, etc.) Through the many options that are offered from our Paragon Med Spa we always have a solution for what you are wanting to achieve.
Please contact a member of our staff to see how we can help you fight aging signs with the following treatments:
  • Combine Botox and Fillers: Most of us have tried Botox. You don’t have to stop there, add some fillers too. Botox will soften dynamic wrinkles that occur as a result of continual muscular contraction. Fillers will restore volume and support. The combination is dramatic!
  • Invest in some laser treatments: The laser 360 is your best option. It combines three treatments in one procedure. The first step, Fotofacial, will remove unwanted skin discolorations such as pigmentation and blood vessels. The second step, NIR Skin Tightening will stimulate the production of brand new collagen and elastin. The final step is iPixel Laser Resurfacing restoring smooth texture All parts and layers of the skin are treated. The results are unmatched.
  • Stop the Abuse: Smoking, drinking alcohol, caffeine and drugs are not good for your skin or your body. They all accelerate the aging process. Stop!
  • Use skincare at home: Your at home skincare routine will help you maintain your skin as well as any treatments you may invest in. In addition to the basics (cleanser and moisturizer) everyone should be using an antioxidant, an exfoliant and an eye cream.
  • Wear sunscreen every single day: We know UV radiation causes cancer. It doesn’t stop there. When UV radiation is absorbed by the skin, it activates the body’s own natural substance MMP-1. This substance digests collagen. This means that when you are in the sun unprotected, you are digesting your own collagen! This is very bad!
  • Use Mineral Based Makeups: Try to find 100% quality mineral based make-up- especially after a LASER 360 or a chemical peel. Your skin has to breath for proper healing to take place, and most foundations and powders coat the skin, and trap oxygen from getting in. This can lead to many problems, if fact if you have tiny bumps under your skin, its probably do to your daily make-up routine. One ingredient to avoid is Talc, which clogs the pores, and irritants sensitive skin.
Dr. Bishara and The Paragon Med Spa’s unique treatments offer patients effective results through the most minimally invasive techniques. For more information about Dr. Bishara and his practice, feel free to explore our website at markbisharamd.com, or call the office today at 817.473.2120 to schedule a consultation with Dr. Bishara.