Connecticut Maxillofacial Surgeons, llc

Aesthetic Facial Enhancements

What Are Aesthetic Facial Enhancements?

As with cosmetic surgery and other reconstructive surgeries involving the facial region, the oral and maxillofacial surgeon has taken an interest in providing a more comprehensive approach to treating the patient’s overall facial aesthetics. While for years the focus has been on more invasive procedures to achieve dramatic facial change, today many non-invasive and simple ambulatory techniques are available to make one’s facial appearance more pleasing. There is no question that our society has become more focused on their appearance than ever before. Much of this has been brought on by the ability to take very small, subtle and unobtrusive steps to simply “enhance” one’s appearance and create a greater feeling of self-confidence. Therefore, for lack of a more specific terminology, we have termed these minor interventions “Aesthetic Facial Enhancements.” You may also see the term “Injectables” used. The paragraphs that follow will address the more common procedures familiar to most of the general public, including Botox injections, dermal fillers and glycolic acid peels (chemical peels).

What Are Chemical Peels?

As previously reviewed in our section on Cosmetic Surgery, the chemical peel is a facial rejuvenation procedure (younger appearance) often done for the skin aging effects of the sun. Wrinkles and sun spots (actinic keratosis), as well as acne scarring can often be removed or made to look better with chemical peeling. The procedure consists of the application of certain solutions to the involved areas of the face which function by removing the superficial layers of the skin. The solutions are applied by the oral and maxillofacial surgeon and remain in place for only 1 to 2 minutes. Several applications are required over 10 to 12 weeks but most often involving only one application per week.

What is Botox®?

botox Without becoming overly scientific, BOTOX® Cosmetic (onabotulinumtoxinA) is a purified protein derived from the bacterium Clostridium botulinum, one such ‘Injectable’. A look back at history and our childhood would scare many of us with the age-old image of a terribly toxic poison derived from a bad can of tuna fish. However, like many things we thought to be harmful at one time, in an altered form the same thing can often become not only safe but useful to other areas of our lives. Botulinum toxin is one of those. Frown lines are caused by overactive glabellar (brow) muscles. BOTOX® Cosmetic actually blocks the release of a neurotransmitter called acetylcholine thereby inhibiting the contraction of muscles that are directly associated with those nerve endings. Just a few tiny injections of Botox® Cosmetic can act to inhibit the contraction of these muscles, thereby diminishing if not eliminating lines associated with overactive muscles of facial expression. BOTOX® Cosmetic was specifically developed and researched by Allergan Inc., and received FDA approval for the treatment of glabellar lines as early as 2002. The safety and efficacy of this product when used properly has been time tested and currently has seen over 11 million procedures since its introduction. However, you may have heard of other forms of botulinum toxin in use today with familiar names such as Dysport® and XEOMIN®. A more thorough discussion of how BOTOX® Cosmetic can help you take on a more pleasing appearance can be found in our broader web page section on Aesthetic Facial Enhancements (currently under construction).

frown lines befora & after

What Are Dermal Fillers?

There are many characteristics of the aging face that the concerned patient often finds objectionable. There is a generalized loss of muscle tone, a thinning of the skin and a loss of base collagen that typically gives the skin a firm and smooth look. If you combine all of that with the influence of gravity often times we see our faces taking on a droopy appearance with what seems to be one wrinkle after another. This can be further influenced by a history of sun exposure, smoking and other environmental factors some of which we have no control over. In any event, the aging face is virtually an archive of times past and often a road map to what is coming. Hence the introduction of dermal fillers as a minimally invasive technique to remap the future. When used in a comprehensive program combined with botulinum toxin, glycolic acid peels and proper skin care, an impressive change in many of these characteristics brought on by aging can often be made with very little invested time, risk and recovery.

Dermal fillers have been around for quite some time. However, it is only recently that they have become so generally well-known and popular when treating various facial imbalances and unwanted facial creases, wrinkles and folds. Furthermore, the science behind the materials used for these purposes have taken on a whole new dimension of predictability, allowing for the birth of practically a new art form in the hands of the skilled injector. Dermal fillers can be classified into three categories that include “permanent” (2 – 5 years), “semi-permanent” (12 – 18 mos.) and “temporary” (3 – 12 mos.). While there are subcategories of each that generally relate specifically to the filler material being used, for the sake of simplicity and patient understanding, we like to classify them on the basis of their permanency. Furthermore, while there are times when each category is useful, in this discussion we will stick to those that are most familiar to the public. It is obvious that the best type of dermal filler for you and your situation will result from a discussion with your physician.

dermal fillers Most of the more commonly known ‘Injectable’ fillers fall into the temporary to semi-permanent categories. Names like Juvaderm®, Restylane® and Radiesse® are often the first to come to the patient’s mind if they have either become interested in this form of treatment or have researched it. Materials such as human fat, collagen, calcium hydroxylapatite, hyaluronic acid and polylactic acid all have a role in the temporary filler category. However, among them the hyaluronic acid fillers are the most popular (Juvaderm®, Restylane®, Purlane® et al.) Hyaluronic acid is a natural substance in your body and actually is found in nearly every living thing. For that reason it is often a good choice for those searching for a treatment of this kind. It has a very low incidence of reactivity and is extremely well tolerated by most patients. The material presents itself and is delivered to the desired area in the form of a gel by injection. When injected properly within the dermis, it acts as a physical cushion to support the overlying tissues which have lost volume and elasticity due to the aging process. By the nature of its organic chemical structure it will not only add support to the tissues but is thought to promote collagen formation as well as bring moisture to the surface of the skin. Depending on the product and the area being treated, hyaluronic acid based fillers can provide a lasting effect often for up to 12 months.

before & after dermal filler

Why would you seek an oral and maxillofacial surgeon for aesthetic enhancements?

You may be asking yourself why you would choose the oral and maxillofacial surgeon for aesthetic enhancement procedures (BOTOX® and dermal fillers). Actually there are some very good reasons why that decision is a smart one. The oral and maxillofacial surgeon is a specialist that has focused his or her attention on this region since the beginning of their training. Most often commencing their training with dentistry the oral and maxillofacial surgeon moves forward from there to extensive and advanced training in surgeries and treatment of conditions involving the head and neck. In some cases they have been awarded two degrees to signify the breadth of their knowledge and understanding of this region of the human body. The specialty as a whole is specifically focused on the entire facial structure encompassing a unique knowledge of both its function as well as its appearance. We have spent years looking at structural facial balance while studying its impact on the overlying soft tissues. All of us have an in depth understanding of the muscles involving function as well as facial expression. We have surgically operated in this area of the human body for our entire career. Many of the other specialties offering treatments in aesthetic enhancements have come from a base of general surgery or general medicine and possibly have a watered down experience when it relates to the face and what makes pleasing form and proper function. Furthermore, the OMFS has some very unique abilities in the area of anesthesia. While most injections experienced during the use of botulinum toxin and dermal fillers are tolerable, many would rather not have to endure that discomfort simply with the idea that “without pain there is no gain.” Facial injections of dermal fillers can be made relatively painless, thereby allowing for a more meticulous outcome that is uninfluenced by patient burnout. We are noted by all medical specialties to be the first place to turn when performing regional local anesthetic blocks to the face as well as ambulatory anesthesia if that is something that the patient would prefer.

How can CTMAX help you in achieving your facial aesthetic goals?

All of the surgeons at Connecticut Maxillofacial Surgeons, LLC (CTMAX) are board certified in their specialty. While we feel as if we are entering this area of treatment late in the game, we also believe this is simply the right time for us and you. The long term studies looking seriously at the materials and pharmaceuticals involved in all aspects of minimally-invasive aesthetic facial enhancements have now proven themselves to be both safe and effective. As a result, the surgeons at CTMAX have now invested numerous hours in continuing education and hands-on training preparing to provide our patients with the best in this methodology of treatment. You can depend on our surgeons interfacing with you directly and providing all of your injectables personally. We will not use auxiliaries, PA’s or other ancillary staff to inject material or make decisions on your treatment. At the same time, all of our staff are enthusiastic about providing you with more information and many will be the first to share their own personal experience with these techniques. Yes, our trained staff are just as excited about their own ongoing treatments to achieve and maintain their aesthetic goals as you are. Feel free to contact us for a consultation appointment to discuss your wish list. Ask us about our complete line of facial skin care products and try a glycolic acid treatment on us. Moreover, don’t hesitate to ask us a question or two if you happen to be waiting for your son or daughter to undergo third molar surgery.

Cosmetic oral and maxillofacial surgery may be the most rapidly growing portion of our profession. Our society seems to entice people toward seeking a more youthful, healthy appearance. The procedures discussed above make this an achievable goal if desired. Please do not hesitate to call for a consultation appointment, or use this form to contact us.


The information listed above is the opinion of the doctors of Connecticut Maxillofacial Surgeons, L.L.C. and does not necessarily reflect the opinion of the specialty as a whole.


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