Lawrence A. Schiffman, D.O., FAOCD - Board Certified Dermatologist

Lawrence A. Schiffman, D.O., FAOCD - Board Certified Dermatologist


6 Life Changing Benefits of Laser Hair Removal

Published September 3rd, 2021 by Thepracticeagency


The Most Common Skin Care Procedures in 2021

Published August 5th, 2021 by Thepracticeagency

What Are Facial Fillers and Why Are They So Popular?

Published July 12th, 2021 by Thepracticeagency

Over the past three decades, facial fillers have become one of the most popular and widely sought-after cosmetic treatments. You've probably noticed the impossibly ageless influencers flooding your Instagram feed for years.

If you're considering jumping on the filler bandwagon, you'll be glad to know the stigma of facial injections is long gone. What you may not know is what types of fillers are right for you, your skin, and your budget.

You'll also want to be well-versed in the best (and worst) places to apply facial fillers. Whenever you're planning to inject something into your body, it's important to do your research first.

Luckily, we've done the research for you.

A Brief History of Fillers

If you want to understand the speedy rise in popularity of the facial filler, you'll need to start at the beginning.

The history of facial fillers begins in the early 1990s. The original facial filler ingredient was collagen taken from cows. It was injected via syringe and the results lasted for only a few months.

In the early years of facial fillers, the topic was quite taboo. Fillers were not subtle like they are today. They were used to alter appearances in a significant way.

In 2003, facial fillers as they are known today came onto the scene. The first hyaluronic acid injectable, Restylane, gained approval from the FDA. It wasn't until then that fillers became a commonplace topic in the cosmetic industry.

In 2004 poly-L-lactic acid arrived. People loved it because the effects of the injections lasted for years rather than months. In 2007 mixing lidocaine with facial fillers became a popular way to decrease the pain of injection.

By 2011 we had Belotero Balance, a hyaluronic acid filler so soft it resisted clumping or bumps. This made it possible to smooth even the shallow lines around eyes and lips.

In 2015 Kylie Jenner shared her lip filler journey with the world. After that, lip fillers became one of the most common cosmetic treatments. We were off to the races. Facial injections had officially gone from taboo to trendy.

What Do Facial Fillers Do?

Facial fillers are gelatinous substances injected underneath the skin by a licensed cosmetic dermatologist

The majority of clients seek out facial fillers to reduce signs of aging. As we get older, our facial tissues become thinner. We develop lines around our eyes, nose, and mouth. Our cheeks also tend to hollow out as we age.

Facial fillers fill in those smile lines, plump up your cheeks, and smooth out wrinkles. Basically, they return to us our youthful fullness, smoothness, and confidence.

Others use facial fillers to enhance the natural contours of their face.

Types of Facial Filler Injections

Every person's skin is different and every type of skin responds best to different things. When deciding what type of filler to get, make sure you choose what is right for you.

Poly-L-lactic Acid

Poly-L-lactic acid is a synthetic substance that is safe to use inside the body. It is the same substance used to make stitches that dissolve. Poly-L-lactic acid smoothes fine lines by regenerating the skin's natural collagen.

The results of poly-L-lactic acid can last over two years. It is great for filling in deep wrinkles. Sculptra is a popular brand of filler that uses poly-L-lactic acid.

Hyaluronic Acid

Hyaluronic acid is used in many of the most popular facial fillers because it is a natural sugar found in the body. It helps to moisturize the skin and give it more volume and elasticity.

The results of hyaluronic acid fillers last from six to 12 months. After that, the body's natural processes absorb the filler. The fillers Juvéderm and Restylane are made from hyaluronic acid.

Calcium Hydroxylapatite

Calcium hydroxyapatite also occurs naturally in the body. It is found mostly in the bones and helps to boost the body's production of collagen.

The results of using calcium hydroxyapatite last for about 12 months on average. Radiesse is a nonreversible filler made from calcium hydroxylapatite.

Autologous Fat Injections

Fat injections are a unique type of facial filler because they require a minor surgery. To create a facial filler from fat, a cosmetic surgeon harvests fat from another part of your body. 

They purify the fat and then inject it into the face to add volume and smooth out wrinkles.


Neurotoxins are not facial fillers. They are injectable forms of protein that help to relax the muscles of the face. When we contract our facial muscles, wrinkles form over time.

Neurotoxins relax and temporarily paralyze the muscles of the face, causing fine lines and wrinkles to smooth out. Botox is an example of a very common neurotoxin.

Best Spots to Apply Facial Fillers

Where you decide to apply facial fillers depends on your skin type and the results you want to achieve. The most traditional and effective areas to inject facial fillers are the lips, cheeks, and nose.

Fillers can also soften the lines at the corners of the mouth. Many people use facial fillers to reduce the appearance of smoker's lines or to fill in acne scars.

The following is a breakdown of the most common places to apply filler and which types of facial fillers are best for each area.

  • Smooth brow furrows, crow's feet, and frown lines (Botox or other neurotoxins)
  • Smooth under the eyes and tear troughs (Juvéderm, Restylane, fat injections)
  • Lift and plump cheeks (Restylane)
  • Smooth marionette lines (Juvéderm, Restylane)
  • Plump lips (Juvéderm, fat injections)
  • Soften nasolabial folds (Juvéderm, Restylane, Radiesse, Sculptura)
  • Smooth vertical lip lines (Juvéderm)
  • Smooth chin wrinkles (Juvéderm, Restylane, Radiesse)
  • Fill acne scars (Juvéderm, Radiesse)

What to Expect During Treatment

The first thing you will do is meet with a cosmetic dermatologist or cosmetic surgeon to discuss your facial filler treatment options and desired outcomes. This is called a pre-treatment consultation.

You'll also go over your medical history, allergies, concerns, medications, as well as your skin and neurological conditions with the dermatologist. This is important to determine what filler is best suited and safest for your skin.

During the treatment, the cosmetic surgeon will clean the area of your skin. They may also apply a topical ointment to make the area numb so you don't feel discomfort.

Then the cosmetic surgeon will inject the filler underneath your skin. You will likely see results right away. This can depend on the type of filler.

You may experience slight bruising and swelling over the next couple of days. Any reaction your skin has should be temporary.

You can expect to return to your regular activities immediately, but it's always best to take a day to rest.

Finding the Right Practitioner

When preparing for any treatment involving facial fillers, it is important to consult an experienced, licensed skincare professional. If you live in the Miami area, that trusted professional is the Miami Skin Dr.

Lawrence A. Schiffman, D.O., FAOCD is a board-certified dermatologist with over a decade of experience specializing in skin, hair, and nails. Book an appointment today at either the Aventura or Doral Miami Skin Dr. offices.

8 Things You Should Ask Dermatologists During Your Next Appointment

Published June 14th, 2021 by Thepracticeagency

Benefits of Botox for Skin Care

Published June 8th, 2021 by Thepracticeagency

Over 1 million Americans get Botox treatments every year. And that number is continuing to grow with each year.

No longer is Botox something that wealthy old women do to erase wrinkles and other signs of aging on their face. More and more people are discovering the benefits of Botox regardless of their age or the number of lines on their faces.

Chances are, someone that you know has uncovered the benefits of Botox and gets regular Botox injections.

This comprehensive guide will help to explain why Botox is so popular and why you should add Botox injections to your skincare routine.

What Is Botox?

Though most people have heard of Botox, you may be wondering what it actually is and how it works.

Botox injections are made of the neurotoxin onobotulinumtoxinA. This neurotoxin is produced by the microbe botulinum. This same microbe causes a serious type of food poisoning called botulism. 

Botox treatment uses a very small amount of neurotoxin, posing no risk to your health. It works by temporarily blocking the chemical signals from nerves so that the muscles near the injection site do not contract.

This relaxes the facial muscles around the eyes and mouth that cause wrinkles. This is why pop culture commonly parodies Botox as freezing the face. However, when properly administered, the result can be subtle and natural-looking.

There is no risk associated with the long-term use of Botox injections. Many people choose to get another treatment as soon as the results begin to wear off. In fact, this is the most effective way to prevent wrinkles and fine lines from appearing on your skin.

Benefits of Botox

Hearing that Botox paralyzes facial muscles can be a cause for concern in many people. It may leave you wondering why get Botox. However, Botox performed by a skilled doctor can give you the results you are looking for without leaving you with a face that doesn't move at all.

Though Botox is most commonly known as an anti-aging cosmetic procedure, there are many advantages of Botox that you might not be aware of. Read on to learn about some uses of Botox and discover why you need Botox.

Minimize Appearance of Fine Lines and Wrinkles

Botox is well known for its treatment of wrinkles and fine lines on the face. Common facial wrinkles and creases that Botox treats include:

  • Crow's feet
  • Forehead furrows
  • Frown lines

All of these wrinkles are caused by the contraction or movement of the surrounding muscles. For example, crow's feet often result from smiling. Botox relaxes those muscles so that the skin doesn't crease when the rest o the face moves to smile, talks, or frowns.

When these muscles are temporarily relaxed, lines and wrinkles are greatly reduced.

Maintain Skin Elasticity

Botox does more to slow the aging process than hiding wrinkles. A new study revealed that long-term use of Botox actually maintains skin elasticity even as you age.

Elasticity is one of the most fundamental reasons why youthful skin looks the way it does. The skin's elasticity naturally declines as you age, paving the way for wrinkles and fine lines to set in.

When used long-term, Botox can actually maintain the skin's elasticity for longer. Restricting muscle activity in the areas where Botox is used means that elasticity lasts for longer.

Preventative Botox

Botox is not simply something that older women do to reduce the appearance of existing wrinkles. Preventative Botox can actually prevent wrinkles from forming and has been rising in popularity.

According to the American Society of Plastic Surgeons, Botox treatments in people in their 20s have risen 28% in recent years. Botox relaxes the facial muscles where facial contractions generally cause wrinkles and lines. This can prevent those wrinkles from occurring.

When used in conjunction with other important anti-aging methods like slathering on the SPF, Botox can significantly reduce the effect of aging on the skin. This means that the skin stays youthful for longer and reduces the amount of Botox needed in the future.

Stops Excessive Sweating

When Botox paralyzes the nerves in the area of the injection site, it can also block the nerves that signal for your body to sweat. This is an especially useful treatment for those who suffer from excessive sweating, or hyperhidrosis. 

Regular antiperspirants cannot treat this condition. However, Botox can eliminate excess sweating at the injection site.

Treatment for Migraines and Muscle Spasms

In addition to well-documented and popular benefits for skincare, Botox injections also have a number of medical benefits in the treatment of certain conditions.  These conditions include chronic migraines, muscle spasms, lazy eyes, and an overactive bladder.

Botox can help to relax the muscles that trigger these conditions, either eliminating or greatly improving the symptoms. Sufferers of chronic migraines who were treated with Botox experienced 50-70% fewer headache days after treatment.

Tips for Botox

For the best results, you should get Botox treatment regularly. With regular treatment, existing wrinkles will remain hidden and new wrinkles will not be able to occur in the areas where you receive treatment.

The results are normally visible within 1 to 2 days after treatment and the effects usually last for three to four months after the injection. You may experience some bruising at the injection site, but this is far less common if you do not take any pain medications prior to treatment. 

Botox is not an excessively painful procedure and produces a pinching sensation. If you are concerned about pain from Botox, you can ask your provider for a numbing cream to help to relieve some of the discomfort.

Botox is generally a very safe and popular treatment. But, there are some risks involved if the person administering the Botox is not experienced. A licensed therapist can administer Botox to smoothen out wrinkles without changing your normal facial expressions.

Restore Youth to Your Skin Today

Whether you have smooth skin that you are hoping to keep that way or your face is etched with the evidence of a lifetime of laughter, Botox is a great solution for bringing youth back to your skin.

Miami Skin Dr. has the experience to deliver the benefits of Botox without any fear of negative consequences. Book an appointment today and give your skin a youthful glow.

For Patients