Cosmetic Services

Botox® is a non-surgical treatment that helps temporarily improve moderate to severe wrinkles and frown lines in the forehead, eyes, and brow areas by relaxing the muscles that create lines. The results can last up to 3-4 months for moderate to severe lines.

Juvederm® is a line of 5 fillers that temporarily add volume to areas of the face, such as the lips, chin, nasolabial folds, and cheeks. The results vary by product. For example, Juvederm® Voluma™ XC can last up to one year in the chin with optimal treatment.

The biggest difference between the two products are the type of wrinkles they can temporarily improve. Botox® works best for expression lines. These are the lines and wrinkles that develop in the skin around the eyes and on the forehead from movement. For example, when you furrow your bow, squint your eyes, smile, laugh or frown.

Juvederm® is better suited for wrinkles and lines that are present when the face is relaxed and at rest. The filler helps replenish volume in the areas of the face where fullness have been lost due to age, sagginess, or other reasons.

Both treatments can be used for plumping and defining the lips.

At the free consultation, our certified providers will work with you to determine the best solution to help you achieve the results you are looking for.

Yes! Both Botox® and Juvederm® can be used together if the wrinkles being improved are in different areas. We can even schedule both injectable treatments to be performed at the same time.

Juvederm® can be used in adults over 21, and Botox® is approved for patients who are 18 years and older. Most experts agree that patients in their mid to late 20s and early 30s are at a good age for preventative treatments.

The results for both Botox® and Juvederm® vary depending on the patient. Typical results for Botox® can last up to 3-4 months, and Juvederm® results also depend on the formula used, for example, Juvederm® Voluma™ XC can last up to one year in the chin with optimal treatment.

At the consultation, our certified provider will discuss your areas of concerns, and walk you through the process of what to expect with the injections, and how many units we think it will take. We can then ether start the procedure of receiving your treatment, or we can schedule another appointment for the injections.

The appointment is about 20-30 minutes, and the injections take about 10 minutes of that time. Your provider will clean your face to remove excess makeup, oils and dirt, and then perform the injections.

We recommend staying upright for 4 hours after the procedure, not performing any moderate to excessive workouts, no touching of areas that were treated, and not washing/scrubbing the face. Your provider will discuss all of the steps with you and answer all of your questions at your appointment.

Yes, Botox®, in addition to temporarily reducing the appearance of fine lines and wrinkles, can be used to treat conditions such as:

• Chronic Migraines
• Hyperhidrosis (Excessive Sweating)
• Postherpetic Neuralgia (Shingles Rash Pain)
• Certain Sports Injuries
• Some Chronic Pain Conditions

Contact us to learn more about how insurance may be able to help cover the use of Botox® for the above treatments.

Dr. Katie Thelen performs cosmetic treatments with Botox® and Juvederm®.

You can call our clinic at 308-995-4431 to set up an appointment today!

To schedule an appointment, give our clinic a call at 308-995-4431 and ask to set-up a consultation!

Botox’s Website>

Juvederm’s Website>

BOTOX® Cosmetic (onabotulinumtoxinA) Important Information

Indications

BOTOX® Cosmetic (onabotulinumtoxinA) is indicated in adult patients for the temporary improvement in the appearance of: – Moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity – Moderate to severe lateral canthal lines associated with orbicularis oculi activity – Moderate to severe forehead lines associated with frontalis activity

IMPORTANT SAFETY INFORMATION, INCLUDING BOXED WARNING

WARNING: DISTANT SPREAD OF TOXIN EFFECT

Postmarketing reports indicate that the effects of BOTOX® Cosmetic and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity, but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have an underlying condition that would predispose them to these symptoms. In unapproved uses and approved indications, cases of spread of effect have been reported at doses comparable to those used to treat cervical dystonia and upper limb spasticity and at lower doses.

CONTRAINDICATIONS

BOTOX® Cosmetic is contraindicated in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation.

WARNINGS AND PRECAUTIONS

Lack of Interchangeability Between Botulinum Toxin Products The potency units of BOTOX® Cosmetic are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, units of biological activity of BOTOX® Cosmetic cannot be compared to nor converted into units of any other botulinum toxin products assessed with any other specific assay method.

Spread of Toxin Effect Please refer to Boxed Warning for Distant Spread of Toxin Effect.

No definitive serious adverse event reports of distant spread of toxin effect associated with dermatologic use of BOTOX® Cosmetic at the labeled dose of 20 Units (for glabellar lines), 24 Units (for lateral canthal lines), 40 Units (for forehead lines with glabellar lines), 44 Units (for simultaneous treatment of lateral canthal lines and glabellar lines), and 64 Units (for simultaneous treatment of lateral canthal lines, glabellar lines, and forehead lines) have been reported. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech, or respiratory disorders occur.

Serious Adverse Reactions With Unapproved Use Serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia, with some adverse reactions associated with fatal outcomes, have been reported in patients who received BOTOX® injections for unapproved uses. In these cases, the adverse reactions were not necessarily related to distant spread of toxin, but may have resulted from the administration of BOTOX® to the site of injection and/or adjacent structures. In several of the cases, patients had pre-existing dysphagia or other significant disabilities. There is insufficient information to identify factors associated with an increased risk for adverse reactions associated with the unapproved uses of BOTOX®. The safety and effectiveness of BOTOX® for unapproved uses have not been established.

Hypersensitivity Reactions Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such reactions occur, further injection of BOTOX® Cosmetic should be discontinued and appropriate medical therapy immediately instituted. One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent and, consequently, the causal agent cannot be reliably determined.

Cardiovascular System There have been reports following administration of BOTOX® of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors including pre-existing cardiovascular disease. Use caution when administering to patients with pre-existing cardiovascular disease.

Increased Risk of Clinically Significant Effects With Pre-existing Neuromuscular Disorders Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junction disorders (eg, myasthenia gravis or Lambert-Eaton syndrome) should be monitored when given botulinum toxin. Patients with neuromuscular disorders may be at increased risk of clinically significant effects including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia, and respiratory compromise from onabotulinumtoxinA (see Warnings and Precautions).

Dysphagia and Breathing Difficulties Treatment with BOTOX® (onabotulinumtoxinA) and other botulinum toxin products can result in swallowing or breathing difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or oropharyngeal muscles that control swallowing or breathing (see Boxed Warning).

Pre-existing Conditions at the Injection Site Caution should be used when BOTOX® Cosmetic treatment is used in the presence of inflammation at the proposed injection site(s) or when excessive weakness or atrophy is present in the target muscle(s).

Dry Eye in Patients Treated With BOTOX® Cosmetic There have been reports of dry eye associated with BOTOX® Cosmetic injection in or near the orbicularis oculi muscle. If symptoms of dry eye (eg, eye irritation, photophobia, or visual changes) persist, consider referring patients to an ophthalmologist.

Human Albumin and Transmission of Viral Diseases This product contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral disease and variant Creutzfeldt-Jakob disease (vCJD). There is a theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD), but if that risk actually exists, the risk of transmission would also be considered extremely remote. No cases of transmission of viral diseases, CJD or vCJD have ever been identified for licensed albumin or albumin contained in other licensed products.

ADVERSE REACTIONS

The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for glabellar lines were eyelid ptosis (3%), facial pain (1%), facial paresis (1%), and muscular weakness (1%).

The most frequently reported adverse reaction following injection of BOTOX® Cosmetic for lateral canthal lines was eyelid edema (1%).

The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for forehead lines with glabellar lines were headache (9%), brow ptosis (2%), and eyelid ptosis (2%).

DRUG INTERACTIONS

Co-administration of BOTOX® Cosmetic and aminoglycosides or other agents interfering with neuromuscular transmission (eg, curare-like compounds) should only be performed with caution as the effect of the toxin may be potentiated. Use of anticholinergic drugs after administration of BOTOX® Cosmetic may potentiate systemic anticholinergic effects.

The effect of administering different botulinum neurotoxin products at the same time or within several months of each other is unknown. Excessive neuromuscular weakness may be exacerbated by administration of another botulinum toxin prior to the resolution of the effects of a previously administered botulinum toxin.

Excessive weakness may also be exaggerated by administration of a muscle relaxant before or after administration of BOTOX® Cosmetic.

USE IN SPECIFIC POPULATIONS

There are no studies or adequate data from postmarketing surveillance on the developmental risk associated with use of BOTOX® Cosmetic in pregnant women. There are no data on the presence of BOTOX® Cosmetic in human or animal milk, the effects on the breastfed child, or the effects on milk production.

Please see accompanying BOTOX® Cosmetic full Prescribing Information including Boxed Warning and Medication Guide.

Before:

After (Day 30): 

Actual patient. Results may vary. By prescription only.
Photos taken at maximum eyebrow elevation before and 30 days after treatment with BOTOX® Cosmetic. In 2 clinical studies of healthy
adults, 61% and 46% had a ≥ 2-grade improvement at day 30.1,*
*Side effects associated with the injection include localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising.

Before:

After (Day 30): 

Actual patient. Results may vary. By prescription only.
Photos taken at full smile before and 30 days after treatment with BOTOX® Cosmetic. In 2 clinical studies, 26.1% and 20.3% of adults
had a ≥ 2-grade improvement at day 30. In one of these studies, 67.9% had mild or no crow’s feet lines at day 30 after treatment.1,*
*Side effects associated with the injection include localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising.

Before:

After (Day 30): 

Actual patient. Results may vary. By prescription only.
Photos taken at maximum eyebrow elevation before and 30 days after treatment with BOTOX® Cosmetic. In 2 clinical studies of healthy
adults, 61% and 46% had a ≥ 2-grade improvement at day 30.1,*
* Side effects associated with the injection include localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising.

Before:

After (Day 30): 

Actual patient. Results may vary. By prescription only.
Photos taken at full smile before and 30 days after treatment with BOTOX® Cosmetic. In 2 clinical studies, 26.1% and 20.3% of adults
had a ≥ 2-grade improvement at day 30. In one of these studies, 67.9% had mild or no crow’s feet lines at day 30 after treatment.1,*
* Side effects associated with the injection include localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising.

Before:

After (Day 7): 

Actual patient. Results may vary. By prescription only.
Photos taken at full smile before and 7 days after treatment with BOTOX® Cosmetic. In 2 clinical studies, 26.1% and 20.3% of adults had
a ≥ 2-grade improvement at day 30. In one of these studies, 67.9% had mild or no crow’s feet lines at day 30 after treatment.1,*
* Side effects associated with the injection include localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising.

Before:

After (Day 7): 

Actual patient. Results may vary. By prescription only.
Photos taken at maximum frown before and 7 days after treatment with BOTOX® Cosmetic. In clinical studies, physicians assessed 74%
of adults had significant improvement at day 7; and 80% had significant improvement at day 30.1,*
* Side effects associated with the injection include localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising.