David B. Reath, MD
Knoxville, TN (865) 450-9253
HKB Knoxville Staff

The Latest in Injectable Wrinkle Treatments

For the 7th edition of Your Beauty Magazine, we sat down with our nurse injector and asked her to share some of her patient photos, along with the secrets of what goes on behind her closed door. Here’s what we found out.

What are you doing now that’s different from when you started?

Well, back in the day, people would want to work on the nasolabial folds, the smile lines, and just fill them up. We don’t want to do that anymore because it doesn’t look natural. It’s a much more natural look when you lift your smile lines by replacing volume in the cheeks. We’re going for the inverted triangle look with most of the volume up top on the cheeks instead of at the bottom of the face.

So Voluma is super-popular right now.

Yes. I do a lot of cheeks.

What advice do you give those patients?

People worry about their cheeks. They have seen the movie stars and are afraid that they are going to have these big ole cheeks. But you can get your cheeks done and have them look natural. An average amount would be two to four syringes, and most people use two or three. We can always do a couple of syringes and have you come back in a couple of weeks to look at it and see if you want to add more. There is a way to get the cheeks looking beautiful and natural and kind of give you that heart-shaped face without making you look fake with the big, puffy cheeks.

I’m glad you mentioned celebrities. Do you figure it’s because they think, “Oh, gosh, I just had this great result. Since a little bit is good, a lot will make me look even younger.” And they just do too much?

They just keep going…and do too much.

What can folks do to keep that from happening?

It’s helpful to an injector if you bring in a photo from the past because I’ve had a lot of people do that. I might be thinking, “Well, that might be a little bit too much cheek for you.” But then they bring in their photo, and I see, well, that’s what they’ve always had.

Good idea.

That’s what they’re used to, and it’s how people know them, so on those people, we’d go a little bit larger in the cheeks and feel more comfortable with it.

Anything else you suggest to achieve natural-looking results?

There is a way to make you just look refreshed, and more rested, without giving you a fake look. We can go with the fillers at your own pace. You tell me how you want it to look, and I can work with that. You can get the Botox to look natural as well. We can leave it, so you have a little bit of movement, and if you prefer not to have any movement at all, we can do that too. It’s a process that we work together on. Then it’s in your chart, and we have a perfect plan for your Botox just how you like it.

Besides Voluma in the cheeks, what other trends are you seeing?

Lately, I have been doing a lot of lips. They are kind of making a comeback, but now people are more into the natural-looking lips. They don’t want them too big. Where I used to use two syringes on someone, now it is usually just one. I’m also using a lot of Volbella, which is very thin and just gives a border and a little definition. The natural-looking lip is “in.”


A lot of people come in requesting only to have the upper lip done with filler. A natural lip is a ratio of 40 percent on the top, and 60 percent on the bottom. However, it all comes down to personal preference. But when you do put filler in the lips, they become smoother. So, it is a good idea if you only want one lip done to put a little bit in the other lip so you can get the smoothing effect on both lips.

So it matches?

Yes, so you don’t have one wrinkly lip and one not wrinkly.

Good to know. Haha.

Another thing that’s good to know is how much improvement patients have when they combine a skin care procedure like a RealPeel or a series of Diamond Glow treatments with injectables. That’s where we see the “wow results.”

Let’s talk Botox. What do patients need to know?

Some people think that you can only do Botox in the upper face, which is not true. You can also do it in some areas in the lower face, like the upper lip. There seems to be a lot of people asking for the lip-flip recently.

The lip-flip?

Yes, you can do that with Botox. It just takes a few units. You’re not going to get any fullness with the lip-flip from Botox, but you can get your upper lip to turn up a little bit.

I had no idea.

The neck is also an excellent spot for Botox. The results are maybe not as dramatic as in the upper face, but it does help to soften the lines of the platysmal bands in the neck. A lot of people don’t know that you can do this to improve the appearance of the neck, but you sure can.

You can do Botox in the corners of the mouth to kind of brighten up your smile and lift your smile a little bit and also use it to correct an “orange-peel” chin.

What else am I missing?

Let’s see. Another area that Botox can treat is the armpits for sweating, and it works great. I’ve had people tell me it’s changed their lives.

You can put fillers in the earlobes. It’s not going to fix a torn hole, but it’s going to plump your earlobes up and makes your earrings look perkier.

A lot of people don’t realize that you can create symmetry with fillers and Botox. Yes, many people have more aging on the left side of the face, so we can add filler to their left mid-face to even things up. Also, with Botox, we can create symmetry. It is not uncommon for people to have uneven brows. We just adjust the Botox a little bit, and there ya go…even brows!

That makes a big difference.


Botox and fillers aren’t permanent. What do you tell people who wonder what happens when they wear off?

You’ll just return to normal, except better because the injectables slow down the aging process. Botox prevents new wrinkles from forming, and fillers stimulate new collagen growth. It’s totally fine to start and stop injectables, but with something this fabulous, why would you?


You can read more about injectable wrinkle treatments in the 7th edition of Your Beauty Magazine. To get your free copy, just fill out the form here, and we’ll pop it in the mail to you right away.

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