Services » Non-Surgical Alternatives


Injectables are a safe, effective and minimally invasive alternative to facial cosmetic surgery. They give reasonably good results with short recovery time and few after effects. When thoughtfully selected, non-surgical procedures can be valuable tool for enhancing one’s youthful appearance

However, most injectables need to be repeated to maintain their benefits and may prove unsatisfactory if skin laxity is so great that only a surgical procedure will provide significant improvement. Injectables can be a good choice for the person not yet ready for surgery.


Botox® is best used in the wrinkles between the eyebrows (glabellar region), the forehead and the “crow’s feet” around the eyes. It works by relaxing the muscles that create these lines and softening the wrinkles. It lasts four to six months and must be repeated to maintain effect.


Injections that add volume to the face or fill in the trough of a skin crease have been available for many years. Most of the products in use today last six to nine months; however, there are some in development that hold promise for longer duration.

Collagen has been available for many years, but is largely being replaced by newer and better products. Restylane®, Hylaform, Perlane®, and Juvederm™ are some of the frequently used fillers that are made from hyaluronic acid. Hyaluronic acid is found in all living tissues so there is no need to skin test for hypersensitivity. It lasts six to nine months and needs to be reinjected to maintain its fullness. Its primary use is in lips and the creases in the lower face.

Prevelle®, the Lightest Hyaluronic Acid Filler Available

Prevelle® is what I like to think of as  a “starter” filler. When you are looking for minimally invasive, effective, and safe approaches to lessen the affects of facial aging fillers can be a quick way to see  change. The fillers are used to soften facial features when lines develop and volume is lost.

Originally fillers were used in thin lips and in the smile lines from the nose to the chin. The uses have expanded quite a lot and so have the number of products available.

The fillers in use today are composed of hyaluronic acid, a substance that all living organisms have naturally in their cells, so it is very safe. Native hyaluronic acid only lasts 1-2 days. The process of cross-linking hyaluronic acid results in larger particle size and longer duration. The HAs that have the most cross-linking  are thicker and last longer. Less cross linking makes a more liquid filler with a shorter life span. The HAs in use now are naturally occurring, isolated from culture and then treated to create various viscoelastic properties.

Prevelle® was created to be softer and to have a shorter duration. These qualities are good if you want to try fillers for the first time and are uncertain you will like the result. If you do not like the effect it goes away in 4-6 months. If you do like it, you will want to go to a filler with longer duration on your next visit. Prevelle also costs about half what the usual fillers run so the experiment will not be so hard on your budget.

Prevelle® is a good place to start for non invasive cosmetic procedures.  I must warn you, however, that it might be habit forming.

Structural Fat Grafting (Lipostructure)

Lipostructure uses your own body’s fat to serve as filler or to restore volume loss. This is a completely biocompatible material. Fat grafting has been around for many years but newer methodologies are making it last longer, perhaps permanently. Unlike other injectables, lipostructure is really a surgical procedure that does involve bruising, swelling, and a somewhat lengthy recovery. It is best used when combined with a face lift or other facial surgery. Fat is harvested from some easily available site, often the abdomen, processed to remove extra fluid and injected into the area to be treated with multiple passages of a small blunt tip needle. Tiny droplets of fat the size of a piece of caviar are deposited one at a time. While it is entirely natural and the fat that “takes” may last a very long time, the amount of fat that “takes” can be highly variable.

Skin Quality: What’s the Value of a Chemical Peel?

Chemical peels are the second most frequently performed aesthetic procedure in the U.S. A chemical peel improves both the appearance and the health of your skin. There are many variations in what chemical agent is used, but  all peels involve the application of a solution that removes the upper layers of skin. The skin surface has more sun damage and more cells that are older. The damaged skin starts to separate from the deeper layer and peels off in a few days or weeks, depending on the depth of the peel. The resurfacing process takes advantage of the body’s healing capacity as fresh new skin from the deep layer replaces older damaged skin.

Light peels can be done by a cosmetician, but medium or deep peels require medical supervision.

Superficial peeling is repetitive. It might involve 3-5 peels over a 6 month period. These are the so-called “lunch time peels.”  The most commonly used peeling agent in this category is glycolic acid. After these the skin is brighter and some superficial skin growths can be removed. It is a subtle rejuvenescence. It is not particularly helpful for fine lines and pigmentation.

A medium peel creates brighter skin and can have greater effect on fine lines. TCA (trichloroacetic acid), salicylic acid  and Jessner’s solution are some of the commonly used agents for a medium peel. It can help to make more even coloring  by removing some of the darkened spots and mottling. Medium peels usually have 2-3 days of inflammation followed by peeling over 7-10 days. Medium peels can be helpful for removing the damaged upper layers of skin so that the skin not only looks better but is also cleared of new growths. Skin health is improved by removing some “at risk” cells that could be the precursors of skin cancer.

Deep peels are very selectively used for problem areas, like acne scarring. A peel that is too deep can overly bleach the color of skin and leave the texture leathery. They have largely been abandoned as a cosmetic procedure across the entire surface of the face.

Chemical peels remain the most frequently used, most versatile and efficacious way of resurfacing skin. As lasers, light therapies, and other devices fail to live up to their marketing claims, chemical peels are showing their usefulness both for the quality of skin appearance and for preventive maintenance of sun damaged areas.

Latisse (bimataprost opthalmic solution)

Latisse-eyelash-growthLatisse is a product that is very effective in increasing eyelash growth. the product is manufactured by Allergan, and was originally used for treatment of glaucoma. It was observed that glaucoma patients developed longer and darker eyelashes. It was not long before its use for cosmetic purposes evolved.

Latisse takes a number of weeks to become effective. It is applied to your upper lashes at bedtime after your makeup is removed. It is brushed on like liquid eyeliner. Only the upper lashes are treated because the medicine is carried through your tear film to the lower lashes.

After your lashes have grown out the length can be maintained by application every three to four days. Since your eyelashes arise from living hair follicles, it is necessary to keep up use of Latisse to maintain the effect.

Latisse can also be helpful for people with scant eyebrow hair.

Schedule a consult to see if Latisse is a good product for you.

Non-Surgical Alternatives FAQs

What side effects should I expect from Botox®?

Most people develop some redness, swelling, bruising, or tenderness at the injection sites which can be covered up by makeup. Most discomfort is minimal and brief and can be minimized with ice or a local anesthetic cream.

When will I see results and how long will the effects of Botox® last?

The Botox® will likely take between two and five days to work. The effects of Botox® will begin to gradually wear off three to four months after treatment. If you continue treatments on a regular basis, the results may last longer.

What side effects should I expect from Restylane®?

The most common side effects are temporary redness and swelling at the injection site which typically resolves in two to three days. Cold compresses can be used after treatment to reduce swelling. Discomfort may occur around the injection site. Dr. Peters may anesthetize the area to enhance comfort during the injection.

When will I see results and how long will the effects of Restylane® last?

You should see results within a few days of injection. The effect of Restylane® can last six months. A repeated injection before the product has dissipated is recommended to obtain a more lasting effect.


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