Hyaluronic Acid Injection (Temples, Midcheek Groove, Lips, Nasolabial Folds: Juvederm VOLUMA XC, Juvederm VOLBELLA, Juvederm VOLITE / SKINVIVE), Botox Injection (Philtrum Shortening, Chin, Corners of the Mouth, Forehead, Glabella: Coretox)

Treatment details: Hyaluronic Acid Injection (Temples, Midcheek Groove, Lips, Nasolabial Folds: Juvederm VOLUMA XC, Juvederm VOLBELLA, Juvederm VOLITE / SKINVIVE), Botox Injection (Philtrum Shortening, Chin, Corners of the Mouth, Forehead, Glabella: Coretox)

Nine points were treated across filler and botulinum toxin in one session. The filler restores the structural loss at the temples and midcheek, while the toxin addresses movement in the philtrum, chin, mouth corners, forehead and glabella. Treating volume and movement separately is deliberate: filler placed into an area that is being pulled by muscle tends to migrate. The two week photograph is taken once the toxin has taken full effect. Coretox was used for the toxin component. The philtrum and the corners of the mouth take a small dose placed precisely, since overtreatment in this area affects speech and changes the shape of the smile.

Swelling is heaviest in the lips, where firmness and uneven contour can persist for several days and cold sores may be reactivated in carriers of the virus. Deep injection at the temple bruises easily and can ache when chewing. In the nasolabial folds and midcheek groove the product may look fuller than expected at first, and lumps or asymmetry sometimes need adjustment. Vascular occlusion is rare but serious and calls for prompt hyaluronidase. Filler in these areas absorbs over six to twelve months.

Botulinum toxin softens movement gradually over one to two weeks. Forehead treatment can leave the brow feeling heavy or sitting lower, and glabellar injection may rarely cause temporary drooping of the eyelid. Reducing the philtrum can make the upper lip feel stiff and awkward when speaking, whistling, or drinking through a straw for a few weeks. The mouth corners and chin may move asymmetrically at first. Small bruises appear at injection points, and the effect wears off over three to six months.