Answered before you have to ask

A consultation is a medical appointment, not a sales meeting. We take a history, ask what medications and supplements you take, look at how your face moves rather than only how it sits still, and assess proportion across the whole face - not just the area you came in thinking about.

You leave with a written plan: which areas, which product, roughly how much, in what order, and what it costs. The $100 is for that assessment and plan, whether or not you ever book a treatment. Virtual and in-person consultations are the same price.

One of two people. Tahjeira Lewis is a Registered Nurse (RN, BSN) and licensed cosmetologist with over five years of nursing experience, more than eight years in the beauty industry, and over four years specializing in aesthetic injections. Jeanette Romos is a cosmetic injector with four years of experience specializing in facial balancing.

Both pursue advanced aesthetic training in facial anatomy, injection technique, treatment planning, and patient safety. The person who assesses you is the person who treats you.

This is the most useful question on this page, so here is the honest answer: an overfilled look is more often a placement decision than a product problem. Most of the time it comes back to the plan.

Four things go wrong most often:

• Chasing one area in isolation. Lips get filled repeatedly because the lips are what someone dislikes, when the actual issue is chin projection or midface support. Treat the lips alone and they keep looking bigger without ever looking balanced.
• Volume used instead of structure. Filler is not one substance. Firmer gels are made to sit deep and act like scaffolding on bone; softer gels are made for tissue like lips. Use a soft product where structure is needed and you get puffiness rather than definition.
• Placement in the wrong plane. Product placed too superficially can look lumpy, or cast a bluish tint through thin skin - the Tyndall effect. In lips, repeated superficial placement over years is a common cause of filler migration above the lip border.
• Never stopping. Hyaluronic acid filler softens gradually rather than vanishing on a fixed date. Treating on a calendar rather than on assessment layers new product onto product that has not gone yet.

Our stated philosophy is refinement rather than transformation, and it is the reason facial balancing is planned across the whole face rather than sold by the syringe. If the honest answer at your consultation is that you need less than you asked for, or nothing yet, we will say so.

They do opposite jobs. A wrinkle relaxer is a botulinum toxin type A product. It temporarily interrupts the chemical signal - acetylcholine - between a nerve and a muscle, so that muscle contracts less strongly. It adds no volume to your face at all.

Filler is a gel that occupies space, restoring or creating volume and structure. Relaxers soften lines caused by movement; filler addresses lines and hollows caused by lost volume or bone structure. Many plans use both, because most faces have both problems.

Both are botulinum toxin type A, and both are FDA-approved. They differ in formulation.

• Xeomin (incobotulinumtoxinA) is a purified formulation carrying no accessory proteins around the active molecule. Because there is less foreign protein present, it is often chosen for people concerned about developing resistance over years of treatment.
• Daxxify (daxibotulinumtoxinA) is stabilized with a peptide rather than human serum albumin, and in its clinical trials, effects lasted a median of about six months - which is why it is priced higher per unit at $14 against Xeomin's $12.

Which one suits you is a clinical decision made at consultation based on your muscle strength, your treatment history, and how your face has responded to neuromodulators before.

Because muscles are not the same size or strength from one person to the next. A strong frown muscle needs meaningfully more product than a light one, and a masseter needs more again.

Per-area pricing means someone with light muscle activity subsidizes someone with heavy activity, and it gives the clinic a reason to under-dose you to protect its margin. Per-unit means you pay for exactly the dose your anatomy calls for. Your consultation gives you the estimated unit count in writing before anything is scheduled.

Onset is not immediate. Most people notice softening between day three and day seven, with the full effect settled by about two weeks. Judging your result before then is judging an incomplete one, which is why any adjustment is assessed at a two-week review rather than on day four.

Duration typically runs three to four months for conventional products, and often longer with Daxxify. It wears off gradually as nerve signalling recovers - there is nothing to remove and nothing that accumulates.

Not if the dose and placement respect how your face works. The forehead muscle is the only thing that lifts your brows, so relaxing it too aggressively - particularly in someone who unconsciously uses it to hold heavy lids up - is what produces brow heaviness. Treating the frown complex without accounting for its interaction with the forehead is what produces an over-arched, quizzical brow.

This is a dosing and mapping problem, and it is usually avoidable with careful placement. Conservative first dosing with a two-week review is safer than a large first dose, because product can be added and cannot be taken away.

Forehead lines, and the lines at the outer corners of the eyes, are treated off-label with the two products on our menu; the frown lines between the brows are the approved area.

All three use a wrinkle relaxer rather than filler, in small, specifically placed doses.

• Lip flip ($150) (used off-label) relaxes the muscle ringing the mouth so the upper lip rolls slightly outward and shows more when you smile. It adds no volume, so it is subtle, and it is shorter-lived than most relaxer treatments - typically six to eight weeks.
• Brow lift ($250) (used off-label) relaxes the muscles that pull the brow downward, letting the muscles that lift it work with less opposition. The result is a small lift and a more open eye, not a surgical change.
• Masseter treatment ($500) (used off-label) reduces activity in the large chewing muscle at the jaw angle. Over repeated treatment the muscle reduces in bulk, softening the appearance of a wide lower face. People who clench or grind often report symptom relief as well, though that is a clinical discussion for your consultation rather than a promise made here.

The fillers used for the treatments on our menu are hyaluronic acid - a sugar molecule your body already produces, which is what allows skin to hold water. In a filler it is cross-linked into a gel so that it holds shape and resists breaking down for months rather than hours.

Two things follow from that, and both matter. It is not permanent: your body metabolizes it gradually. And it is reversible, because an enzyme called hyaluronidase breaks hyaluronic acid down on demand - which is not true of every filler on the market.

Facial balancing evaluates the face as a whole and treats the areas that will most improve overall proportion - which are frequently not the area you arrived focused on.

A common example: someone asks for lip filler because their lips look small in profile. Assessed as a whole face, the lips are proportionate and the chin is under-projected, so the profile reads as it does. Filling the lips makes the imbalance more obvious. Supporting the chin resolves it, and the lips may need nothing.

That is why packages are sold by volume - 2 mL through 6 mL, $1,350 to $3,750 - with the distribution decided by your anatomy rather than fixed in advance. The volume is the starting point, not the plan.

It depends on the product's firmness and how much the area moves. Mobile, soft-tissue areas metabolize filler faster than structural ones sitting against bone.

As a general guide: lips are the shortest-lived, commonly six to twelve months. Cheeks, chin, and jawline typically run twelve to eighteen months or longer. Non-surgical nose enhancement often lasts a year or more, as the area barely moves. Your own metabolism, exercise levels, and the specific product all shift these figures, so treat them as ranges rather than dates.

Yes, and this is the single most reassuring fact about hyaluronic acid filler. Hyaluronidase - the same enzyme your body uses on its own hyaluronic acid - dissolves it. Filler dissolving is $200 on our menu.

It is used in three situations: when you simply dislike a result, when old product needs clearing before a new plan can be built properly, and urgently in the rare event of a vascular complication. Any injector working with hyaluronic acid filler should keep hyaluronidase on hand for that third reason - it is worth asking any clinic you are considering whether they do.

It is worth knowing what it will not dissolve. Collagen-stimulating products, and permanent or semi-permanent fillers, are not hyaluronic acid and do not respond to it. That is a reason to be cautious about what is placed in your face in the first place.

The common side effects are minor and expected: swelling, bruising, tenderness, small lumps that settle, and occasional asymmetry that is corrected at review.

The serious risk with filler is vascular occlusion - filler entering a blood vessel and blocking blood supply to the tissue it feeds. It is rare, but it is real, and it is the reason injector training matters more than product branding. Untreated it can cause skin breakdown, and in the rare case of vessels connected to the eye's blood supply, visual loss.

What reduces the risk is anatomical knowledge of where vessels run, careful technique, injecting slowly at low pressure, appropriate use of a blunt cannula rather than a needle in higher-risk areas, and recognizing the early signs immediately - disproportionate pain, blanching of the skin, or mottled discoloration. It is treated urgently with hyaluronidase, which is why it must be in the building.

With wrinkle relaxers, the risks are different and more forgiving: the product can spread slightly beyond the intended muscle, producing temporary eyelid or brow droop. It is uncommon, it is not permanent, and it resolves as the product wears off.

As with every botulinum toxin, there is a rare risk of the effect spreading beyond the treated area; we will go through the full warning list at your consultation.

Some of this is absolute and some is a conversation, which is what the medical history at consultation is for.

• Pregnancy and breastfeeding. Neither filler nor neuromodulators are used.
• Active infection or inflamed skin at the injection site, including an active cold sore near the lips. Treatment is deferred, not refused.
• Known hypersensitivity to a product or its components, including lidocaine where a filler contains it.
• Certain neuromuscular conditions - myasthenia gravis and Lambert-Eaton syndrome among them - which make neuromodulators inappropriate.
• Blood thinners and some supplements do not rule treatment out, but they raise bruising risk considerably and change how a visit is timed and planned.
• Body dysmorphic concerns. If the result someone wants is not achievable by injection, saying so is the correct clinical answer, and more treatment is not the kind thing to offer.

Filler swells, and lips swell the most - occasionally dramatically for the first twenty-four to forty-eight hours. Most settles within three to seven days, and the result you actually keep is visible at around four weeks, once swelling has fully resolved and the product has integrated with your tissue.

Bruising is possible anywhere but more likely in lips and around the nose, and it can take up to two weeks to clear fully. If you have an event, book at least three weeks ahead of it, not three days.

Wrinkle relaxers do not swell meaningfully - small raised bumps at the injection points settle within an hour. Judge the result at two weeks.

You will be given written aftercare specific to your treatment. The general shape of it:

• After filler: no strenuous exercise for twenty-four hours; avoid saunas, steam, and prolonged heat for a couple of days; sleep with your head elevated on the first night; avoid pressure or massage over the treated area unless you have been told to massage it; and defer non-urgent dental work for around two weeks.
• After a wrinkle relaxer: stay upright for roughly four hours, do not rub or massage the treated area, and skip strenuous exercise for the rest of the day.
• Both: some people find arnica and cool compresses helpful. Call the practice - do not wait - if you have pain out of proportion to the treatment, skin that looks white or mottled, or vision changes.

Filler adds volume on the day. Regenerative treatments instead prompt your own tissue to do the work, so their results build over months rather than appearing immediately.

PRP uses platelet-rich plasma drawn from your own blood and concentrated to isolate the growth factors within it, which are then reintroduced to support skin quality or hair restoration. Biostimulatory products work by stimulating your body's own collagen production over a series of weeks.

Because these are personalized to your goals and medical evaluation, they are quoted at consultation rather than priced on the menu. Which treatment suits you, and whether it suits you at all, is decided there.