Botox & Fillers


Naturally, our faces change as we age.


Full youthful faces can shrivel, wrinkles develop and lines appear, associated with the muscles of facial expression.


If you would like to decrease wrinkles and lines in the forehead, ‘crows feet' at the corners of the eyes (crow's feet), and between the eyebrows, then Botox^tm may be right for you. To restore fullness to lips or cheeks, or to soften facial creases and wrinkles of the face you may be interested in dermal fillers or fat grafting.






The most popular new muscle relaxing wrinkle remover, works similar to Botox but has less pain on injection, a more natural,blended look, and takes eect faster. In a study done called the DYSPORT CHALLENGE, over 97% of former Botox users who tried Dysport, Chose Dysport over Botox for their next treatment.



Botox is a therapeutic muscle relaxing agent which is used for the temporary relaxation of lines related to the muscles of facial expression. Botox Cosmetic injections block the nerve impulse and temporarily relax muscles which, over time, cause furrows and wrinkles to appear on the face. The location, size, and use of the facial muscles which cause wrinkles are slightly different for everyone. During your consultation Dr. Warfel will examine your facial muscles and wrinkles then determine where to administer, and the required dose of the injections. No anesthesia is required. At the Warfel Institute for Rejuvenation we find that an icepack applied to the face before the injections makes the procedure more comforatable. Dr. Warfel will then place several tiny injections of Botox directly into the facial muscles which cause furrows and wrinkles. There is no downtime involved and effects usually begin in about 3 days with the full effect taking about 2 weeks and lasting for as much as 6 months.



Xeomin Injections – Are You a Candidate?

Reviewed by Yael Halaas, MD edited by Dr W Mark Warfel

First there was Botox, then there was Dysport, and now there is Xeomin (incobotulinumtoxinA). The Food and Drug Administration (FDA) recently approved this new botulinum toxin type A product to treat severe frown lines or "11's" between the eyebrows. Xeomin was already FDA approved for use in adults with certain medical problems. Xeomin is manufactured by Merz Pharmaceuticals, and has been used by more than 84,000 people worldwide. It is now approved for use in 20 countries.

Like other drugs in this category, Xeomin works by relaxing wrinkles. It blocks the signals from the nerves to the muscles. As a result, the targeted muscle that causes wrinkles cannot contract.


Xeomin versus Botox and Dysport

Botox, Dysport and Xeomin have a lot in common, but they also have some important dierences. Xeomin is "naked." There are no additives — just botulinum toxin type A. This may lessen a patient's likelihood of developing antibodies to Xeomin. When your body senses a foreign invader, it responds by creating antibodies and launching an attack. If this were to occur with a neurotoxin such as botulinum toxin type A, it may not have its desired eects.

Xeomin is said to be more like Botox than Dysport. It takes about one week for the full eects of Xeomin injections to be realized, and once this occurs the results last from three to six months. Dysport, Xeomin and Botox should only be administered by skilled injectors such as plastic surgeons in sterile environments such as medi-spas or doctors’ oces.


Facial Fillers

Juvederm Ultra Plus is the most viscous(most highly cross-linked) form of Juvederm This compound is made of Hyaluronic acid- which is a natural substance already found in the skin the body. By injecting this filler beneath the skin, your can restore your face's volume and smooth away wrinkles, and restore a youthful balance to your facial features. It is the most common filler used to enlarge the lips.Radiesse This filler is composed of Calcium Hydroxy -Apetite ( naturally found in teeth and bones) Radiesse is used for deep sculptural injections to reshape facial contours. There is even a technique which is sometimes refered to as "The Injectable or Liquid Facelift" Hand Rejuvenation is done with Radiesse. It is painless with an instant result.



Bruising and swelling after any filler procedure are possible. Juviderm and Radiesse procedures usually calm down in a few days, although any bruising can persist longer.


Lipo-Sculpture Fat Grafting

The harvest and re-injection of your own fatty tissue is the gold standard of fillers.


Although a bit more complicated and expensive, the results are permenant and can rejuvenate the entire face. Grafted fat is rich in living stem cells which rejuvenate the skin and all the other tissues around them in a lasting way.


A common misconception is that fat grafting does not last. This is because many surgeons do not want to take the necessary time and care to do the procedure as described in the literature. Proper fat injection technique is pain-staking and time consuming. and takes a team of technitiions. When the technique is not followed or abbreviated, results are not reliable. At the Warfel Institute Fat grafting is done "by the book" and results are dramatic and long lasting.


Fat injections are associated with a longer recovery time. Bruising and swelling can be substantial, requiring a week or two or sometimes three to calm down.