Portland Juvederm doctors

Oregon's policy as outlined on the Oregon Medical Board website can be found here:

(note: realself won't allow me to link it, so you can direct message me for the link, or search the oregon medical board site for botulinum toxin, 5th result down)

Professionals such as nurse practitioners (NPs), physician's assistants (PAs), and estheticians can perform injections. I can't speak for NPs, but in the case of PA and estheticians, they are required to be supervised by a physician with the physician being ultimately responsible for treatment results. If you do choose an non-physician, the level of supervision is key.

Often times you will see medispas that perform these services with a "ghost" physician or medical director who supervises in name only. You want to steer clear of these places. Furthermore, many of these places lure patients with deals, groupons, pretty waiting rooms, etc...Cheaper is not always better and sometimes (unfortunately) you get what you pay for.  For more information on choosing an injector you can visit injectablesafety dot org. It's put out by all of the societies represented on the realself site.

Good luck and have a nice day!

Michael Kim, MD

You are comparing apples and oranges when speaking about these two products.  Botox is a neuromuscular blocking agent and works best in the upper face (crow's face, glabellar and forehead) to decrease muscle movement. Juvederm is a hyaluronic acid based filler and works best in areas of volume loss, moderate to severe wrinkling and in the lips for augmentation.   Because filler is place between the different layers of the skin it does have the potential to create more swelling and/or bruising, so to minimize this potential we pre-ice the area and inject slowly as to decrease the trauma to the expanding tissues.

As for which product is the best... when treating  the laugh lines in the corners of the eyes, I use Botox or Dysport  to stop the crinkle movement and for the laugh lines around the mouth, I use Juvederm or Restylane to fill in the wrinkles but not alter the muscle movement of the smile.

Dermal fillers are used to restore volume to the skin as well as decrease the appearance of fine lines, wrinkles and depressions.  The most common area to fill are the Nasolabial creases that extend from the corner of the nose down to the corner of the lips.  Typically there is a depression that forms next to the nose and then as it gets closer to the lips it turns into a crease.  So more product is injected next to the nose to lift the depression and then small amounts, in thread form, are injected into the remaining crease.  Restylane, Perlane and Juvederm are hyaluronic based fillers and tend to have a softer more natural appearance.  Ultimately it is the skill of the injector that truly is in control of whether your outcome looks natural or overdone. 

Radiesse is a calcium based filler that I like to use primarily in the cheeks and along the jawline to add structure and restore volume.  It tends to feel a little more rigid initially but then softens to conform to the bony structures.  Due to the initial rigidity I do not feel that it is ideal for around the mouth as it can alter the smile for that 3 month period of time. 

When looking for a good injector, ask to look at before and after pictures.  If the pictures that they display look overdone and not so natural, it is a red flag that their vision of "natural" is different from yours.