Dysport® / Botox®

Which is best - Botox or Dysport?

Dr. Kirn's experience has been that for most patients, the two medications work equally well and there is no difference between them. While this is true in the majority of patients, some patients do seem to respond better to either Dysport or Botox. Because of this, we offer both medications and it is left to the patient's preference. Generally, Dysport is slightly less expensive than Botox, but periodic specials offered by the manufacturers may affect the bottom line cost. Always be sure to check the "Specials" page or ask if there are any specials when you are in the office for treatment.

How long do Botox and Dysport last?

Most patients are ready for repeat injection 3 to 6 months after the treatment. The best results are obtained by re-treating patients before the muscle activity returns to normal. By doing so, the wrinkles do not have time to re-form. Also, it is best to look the same all the time rather than looking like you just had a treatment. It's very similar to getting a haircut - if you let the hair grow long and then get it cut, people will notice that you look different. If you get your haircut more frequently, you will look the same all the time, and people will not notice a significant difference.

What areas are treated with Botox / Dysport?

The most common areas for treatment are the forehead, between the eyebrows, and around the eyes. We also treat muscle bands in the neck. We have numerous patients who have been treated in our practice for many years. Usually, over time, we develop customized treatment patterns which suit their individual needs. No two faces are alike and therefore, a standardized injection pattern represents a starting point only.

Is it dangerous to have a toxin injected into my body?

Botulinum toxin is a naturally occurring compound. The botulinum toxin in Botox and Dysport is grown in a lab, the same way many pharmaceuticals are made. The toxin is injected in very small quantities and remains within a few millimeters of the site of injection. Your body dissolves the toxin away completely within a few months. We have patients who have been using Botox every three of four months for well over ten years now, and the only long term effect on them has been that they haven't made wrinkles in the treated areas.

What are the side effects of Botox/Dysport?

The most common side effect is bruising. This is not due to the neurotoxin, but rather the injection process. Some areas are more prone to bruising than others. Around the eyes in the smile lines / crow's feet is more likely to bruise, for example.

Will I bruise with Botox/Dysport treatment?

Usually not, but some folks are more prone to bruising than others and some areas are more prone to bruising. We use a dermal chiller which cools the skin immediately before the injection as needed to decrease the risk of bruising. This causes the blood vessels in the area to constrict making bruising less likely.

Who will perform the Botox/Dysport treatment?

Dr. Kirn and the nurse-injectors perform neurotoxin treatments. You have the choice of who will treat you at the time of scheduling. All of them have performed thousands of successful injections. We use a standardized charting system within the practice so that treatments remain consistent regardless of who is performing them. This allows us to accommodate patient's scheduling requirements easier, while maintaining a consistent treatment approach.

Will a Botox/Dysport treatment hurt?

The needles used for both neurotoxin and dermal filler injections are very small. Most patients do not require any additional pain blocking method for neurotoxin injections. However, if desired, we use a dermal chiller which cools the skin at the site of injection immediately prior to the injection thereby providing a temporary numbing effect.

Dermal Fillers

How long do dermal fillers last?

We use many different fillers and each has a different longevity. In addition, the area in which the filler is placed significantly effects longevity. That said, some averages to keep in mind are that Restylane and Juvederm typically last around 6 months or so. Voluma usually lasts 1-2 years and Sculptra lasts around 2 years. Note that these are averages and are based on our experience in our own patients. There can be substantial differences from patient to patient and area to area. We have many patients who experience longevity greatly exceeding these averages.

Which filler should I use?

Selection of filler is made based on the area being treated, the depth of the wrinkle, the patient's skin quality, the patient's goals, and other factors. Therefore, this choice is made mutually by the patient and Dr. Kirn or Nurse Carey.

What are the side effects of dermal filler treatment?

The most common side effect is bruising. We take every effort to avoid bruising, but it still happens occasionally. Just as with neurotoxin injection, some areas are more prone to bruising than others. There is usually some swelling with the treatment so we provide each patient with an ice pack to use after the treatment. Swelling is usually resolved within a day or two of the treatment, and is typically minor.

Will I need additional dermal filler treatments?

If you like the effect dermal fillers generate, you will need additional treatments to maintain it. With the exception of fat grafting, all of the dermal fillers eventually wear off.

Are dermal fillers safe?

All of the fillers we use are FDA approved and have been extensively safety tested. Collectively, Dr. Kirn and the nurse injectors have performed thousands of successful treatments.

What are the best areas for dermal filler treatment?

The most common areas for treatment are smile lines, lines at the corner of the mouth, lip lines, and tear trough lines. We also use fillers to enlarge the lips or restore lost lip volume. Many other areas are also suitable, but less common. Consultation prior to treatment allows the patient and injector to develop a customized plan.

Who will perform the dermal filler treatment?

Dr. Kirn and the nurse-injectors perform dermal filler treatments. You have the choice of who will treat you at the time of scheduling. Collectively, they have performed thousands of injections successfully. We use a standardized charting system within the practice so that treatments remain consistent regardless of who is performing them. This allows us to accommodate patient's scheduling requirements easier, yet maintain a consistent treatment approach.

Will dermal filler treatment hurt?

All of the commercially available fillers are injected with a very small needle. Many of them have a numbing medicine mixed in with them and for others; we will mix in a numbing medicine. In addition, we usually use a dermal chiller device which creates a temporary numbness of the skin at the site of injection by cooling the skin. Some patients prefer a topical numbing cream which is also available. Dr. Kirn may also perform a nerve block - just the same as the dentist uses before working on your teeth.

VersaPulse® Laser

What does the VersaPulse laser treat?

The VersaPulse laser treats small blood vessels and red spots on the face and body. It also treats brown spots on the face or body as well as brown skin discoloration on the face. It can be used for non-invasive skin rejuvenation (collagen remodeling), but this requires several treatment sessions.

Does VersaPulse treatment hurt?

Most patients say the laser feels like a pinprick or being snapped with a rubber band. But, pain tolerance varies dramatically from patient to patient. For most folks, no numbing medicine is required. But, it is available for patients who wish to use it.

When will I look normal after VersaPulse treatment?

There is usually some swelling and increased skin redness after the treatment. Because of this, almost all VersaPulse treatments are performed on a Friday, so that most, if not all, of these changes have resolved by Monday.

Will multiple VersaPulse treatments be necessary?

Generally speaking, the laser does not remove every brown spot or vessel. So, for patients who have many brown spots or red vessels, multiple treatments are usually necessary. If you only have a few, then one session may be sufficient. Sometimes particular brown spots or vessels need to be re-treated. Multiple treatments are always used for collagen remodeling.


What is sclerotherapy?

Sclerotherapy is a treatment where a sclerosant medication is injected into an undesired blood vessel to clot the vessel. After the vessel has clotted, the body will eliminate it. Mostly, sclerotherapy is used for small leg veins.

What medication is used for sclerotherapy?

Kirn Plastic Surgery only uses Asclera (polidocanol) which is FDA approved for sclerotherapy. Other medications have been used for this purpose in the past, but Asclera is the only FDA approved product and it is the only one which we have found to be safe, effective, and minimally painful.

Does sclerotherapy hurt?

Although a tiny needle is used to inject the Asclera, most patients do not find the sclerotherapy treatment to be painful. The legs are not a very sensitive area and the needles used for the treatment are very small.

How many sclerotherapy treatments will be needed?

Multiple treatment sessions are usually necessary to achieve a good result with sclerotherapy. This is because most patients have more vessels to be treated than can be addressed in a single session. Also, not every vessel which is injected will go away the first time.

How long does it take for the treated vessels to go away after sclerotherapy?

Sclerotherapy sessions are usually performed every 4-6 weeks. Most of the time, the vessels which are going to go away will have done so during that interval.

When is the best time to do sclerotherapy?

We generally advise patients to start sclerotherapy in the fall after the weather is too cool to wear shorts or short dresses. The treated vessels look worse and more noticeable before they look better. It takes 4-6 weeks for the treated vessels to go away and, since multiple sessions are usually required, it is best to start the process early so that it will be finished well before spring time.

Should I have sclerotherapy or laser for my leg veins?

Most of the time, we find sclerotherapy to be better for leg veins and laser (VersaPulse) to be better for facial veins.

Is sclerotherapy used on the face?

Yes, on occasion for vessels that fail to respond to laser, sclerotherapy can be used. Most of the time however, laser is the best treatment for vessels on the face and neck.

Skin Rejuvenation

What treatments do you offer for skin rejuvenation?

Dr. Kirn offers laser resurfacing, non-ablative laser resurfacing (collagen remodeling), and chemical peels for skin rejuvenation. A broad range of other less invasive treatments are offered through our affiliate practice, Aesthetic Skin Care Center LLC which is located in our office.

Chemical Peels

What kind of peels do you offer?

Dr. Kirn performs TCA peels including the Obagi Blue Peel. These are physician strength peels which are effective treatments for sun damaged skin, skin color irregularities, and fine wrinkles. Many different lighter peels are offered through our affiliate practice, Aesthetic Skin Care Center LLC.

How is a chemical peel different from laser resurfacing?

Actually, the two are more similar than different. Both involve removing the top layers of skin, and then the new skin which grows to replace it is more youthful and healthy. The amount (depth) of skin which is removed, either by the laser or chemical, determines the recovery time as well as how much change results. The deeper the wrinkles or problem being treated, the deeper the laser or peel must penetrate to be effective.

Laser Resurfacing

What types of laser resurfacing do you offer?

Dr. Kirn performs CO2 laser resurfacing as well as non-ablative resurfacing using the VersaPulse. The latter involves painting the laser beam over the face and neck to tighten the collagen and is performed over several treatment sessions. The advantage to this method is that there is little to no downtime after the treatment. CO2 resurfacing is one of the best wrinkle treatment methods ever developed, but is does come with a significant recovery time for healing.

What type of resurfacing is right for me?

The selection of treatment is as individual as the patient being treated. Our goal is always to achieve the desired outcome by the least invasive means possible. We have found that many folks who present interested in laser resurfacing can be effectively treated using dermal fillers, neurotoxins, light chemical peels and a quality skin care regimen.