How long can Aesthetic Facial Balancing (AFB) procedures really last and why are these filler procedures usually better aesthetically and financially than Botox and Dysport neuromodulators?

I want to start this blog by saying that I don’t think neuromodulators like Botox and Dysport are bad at all.  On the contrary, they are wonderful drugs that can have a place in aesthetic interventions!  I have been called Dr. No-tox many times in the past and this is because neuromodulators are usually not the first line of recommendation for “bang for the buck” in my practice.  Neuromodulators can have a nice subtle effect if administered properly and are relatively inexpensive up front.  However, their aesthetic effect is limited and their short course of action can make them obscenely expensive over a person’s lifetime.  Although I have placed 85 mL (syringes) of hyaluronic acid filler into my face, I have never injected a neuromodulator into my own face.

Some of my patients enjoy a little Botox as a “cherry on top” of their Aesthetic Facial Balancing procedure and there is nothing wrong with this, if this kind of extra maintenance is in the budget.  Patients have to be aware that with continued use, the frequency of treatment can approach two months which can get to be many thousands per year for a subtle tweak. The identical financial expenditure in AFB creates impressively significant results that are long lasting without the need for upkeep!

On that note I wanted to cover the lasting effects of HA based fillers in the way they are applied in AFB.  The substance itself is slowly cleaved by your body.  These fragments activate local tissue to grow, which explains the lasting effect.  It is very important however to understand that the aging process is not halted. The clock keeps ticking.  On that note, let’s consider my face, perhaps the best longitudinal example I have of the aging of AFB.  Below you will see pictures of me in 2012 right before I treated myself for the first time.

Left: Front View of Dr. Maercks’ before any treatment in 2012
Right: Front View of Dr. Maercks’ 2 years later in 2014

The above photos demonstrate my face pretreatment in 2012 on the left compared to results two years after treatment on the right.  It is evident that two years after the AFB treatment the results are present and very significant.  Now let’s examine what happens over the next four years from 2014 to 2018:

Left: Front View of Dr. Maercks’ after 2 year treatment in 2014.
Right: Front View of Dr. Maercks’ 2 years later in 2018.

There are obvious facial changes from the years, and of course building a solo practice as a young plastic surgeon with some pretty different ideas can speed up the aging! So it is obvious the aging clock continues.  Let’s now ask “has the AFB procedure worn off?” Could we say that the results are gone?  Now this may make your brain hurt: I know it’s hard for me to wrap my head around this being that it’s my own face, but the comparison of 2012 to 2018 is pretty telling:

Left: Dr. Maercks’ before any treatment in 2012
Right: Dr. Maercks’ treatment 6 years later in 2018.

Now the above pictures show my face in 2012 before any treatment and 6.5 years later on the right. It is clear that the changes delivered in the procedure have aged however are not gone.  Although there is a lot going on here most viewers rate the picture on the right, at 6.5 years older, as the younger picture.  So this is really confusing, right? From 2012-2014 it looks like I reverse aged, 2014 to 2018 looks like I aged but comparing 2012 to 2018 looks like slight reverse aging too.  Now your brain may be twisted over this, but all it demonstrates is that AFB works and lasts a long time but acts from a rejuvenation perspective as rewinding the clock a bit, not stopping it.  Results last for years, and in my case, more than six years before I felt compelled to retreat.  Make sense?

Ok, now that your head is wrapped around the older to younger to older to younger, let’s look what happened when I treated myself for the second time, about six months ago.

Left: Dr. Maercks’ treatment in 2018.
Right: Dr. Maercks’ treatment a few months later in 2019.

Above on the left is my face as it appeared last year, almost seven years after I first treated myself and immediately before I treated myself a second time and on the right we see my current appearance.  A harmonized and more balanced and youthful appearance is achieved. 

 Let’s now compare the pre-AFB face of mine seven years ago to current: 

Left: Dr. Maercks’ pre any treatment in 2012
Right: Dr. Maerck’s 6.5 years later in 2019

Even though I have aged seven years, my appearance is more balanced, healthy and youthful appearing compared to my naturally aging 36 year old face.  Although my weight and fitness is not much different, I appear slimmer and healthier seven years later at the age of 43.  Now to compare, a weird kind of “apples to apples”, let’s look at my AFB harmonized face from the first treatment in 2014 vs my current face after seven years of aging on the original AFB and a retreat:

Left: Dr. Maercks’ treatment in 2014
Right: Dr. Maercks’ current result in 2019

It’s hard to say which looks better, the 2014 picture on the left or the current 2019 picture on the right. Part of this is because I performed a much more extensive feature enhancement the second time.  My first treatment seven years ago used 35 mL of HA product and the second treatment about six months ago utilized 50 ML. More features were improved and touched on the second time which allows more harmony.  Harmony and balance are not strictly paired to rejuvenation and perception of age, but they are related.  A more harmonized face can really give the impression of youth, despite wrinkles, loose skin and other detractions.  This is why I commonly say that “rejuvenation” is really a side effect of what I do and not the primary target.  Well, that tangent is material for a whole new blog.

What I hope readers can take away from this short blog is a general understanding of Aesthetic Facial Balancing,and why it is the primary nonsurgical option we offer.  With this budget adjustable procedure, we are able to deliver serious aesthetic benefit that endures as well, or better than many common surgical procedures and has minimal downtime.

In short, the long-term financial cost to benefit ratio greatly exceeds Botox and other quick fix interventions as well. The goal is to create naturally, beautiful results non-surgically, create results that last a life time, and offer a lower financial cost longterm for my patients.