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Category Archives: Fillers

The New FDA-approved Way to Plump up Your Cheeks: Restylane Lyft


There is a new product available that some of you may be reading about called Restylane Lyft. This is a product in the Restylane family of fillers by Galderma. Restylane Lyft is specifically designed to treat mid-face volume loss.

If you are familiar with the Restylane family of products, you know Restylane and Restylane Silk are the thinner of the products, while Perlane was the thicker product. Each of these products is hyaluronic acid derived.

Restylane Lyft is the thicker product, Perlane renamed and used in the cheeks to give a lift. It improves the nasolabial folds in the middle by lifting the cheeks laterally.

Hyaluronic acid fillers are very safe and have been used for more than 10 years to treat lines on the face. Restylane Lyft is now FDA approved for placement in the cheeks to help some of the volume loss in this area and provide a lift to the face, decreasing the prominence of the nasolabial fold. It lasts about one year, and side effects of the injections usually include bruising and swelling, along with some other more rare side effects.

In the studies, people received between two and four syringes to achieve a lift. Each syringe costs between $500 and $700, depending on which thickness you select and how many syringes you purchase.

For a consultation regarding Restylane Lyft, or any other fillers please call 775-398–4600 and make an appointment with Dr. Jennifer Janiga or Melanie Buckley.

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How Young is Too Young for Cosmetic Surgery Procedures?

There’s been a lot of hype and interest in some of the young starlets having cosmetic procedures performed at very young ages; sometimes even younger than 18-years-old. While each situation is unique – and there are specific times where cosmetic surgery can be performed for patients younger than 18 – my general rule is usually 21 or older.

Let’s first discuss some of the special circumstances that might allow someone under 21 to have a cosmetic procedure. First and foremost, parental consent is required for patients younger than 18, except those who are emancipated adults. If that consent has been obtained, some special circumstances that might allow cosmetic procedures for people under 21-years-old would include genetic abnormalities of the chest wall, hypoplastic (underdeveloped) breasts, abnormalities of the jaw bones that would impede normal chewing and development, deviated septum in the nose preventing breathing, disfiguring scars after an accident, or other abnormalities that prevent normal growth and development or are psychologically damaging.


Interestingly, the FDA will not allow silicone breast implants to be placed in anyone younger than 22, even if they are born with genetic abnormalities or disfiguring medical conditions. Fillers such as Restylane and Juvéderm are not approved for anyone under 22. Botox and Dysport are approved for 18 and older. All of the above factors need to be considered in addition to a young person’s mental health, parental involvement and long-term safety.

For adults older than 21, some factors are less complicated. When you’re 18, you are considered a legal adult and can consent to surgery. The FDA will allow fillers and silicone implants for adults over 21, so those issues are removed from the equation. But, whenever I am considering an operation on a young person – whether it be for strictly cosmetic purposes or for developmental abnormalities – there are many factors to take into consideration.

Please make an appointment with me, Dr. Timothy Janiga, so we can discuss both your personal situation and what is most appropriate for you.

~ Dr. Timothy Janiga

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What Causes Eye Bags and How to Treat Them

One of the most common reasons that men and women visit to my office is to find out what can be done about the bags under their eyes. Some people experience darkness almost a purple like discoloration, while other people have excess tissue and or swelling. Usually they report that people tell them they look tired or ask them if they have been crying a lot recently.

So what causes under eye bags? There are a few things…

If you have what appears as darkness under the eye, it is possible that this could be from allergies or seasonal allergies.  There is a sinus cavity underneath that area that can cause some reflection of darkness and even some swelling in people with allergies (even if you do not have other symptoms of allergies).

If you have swelling under your eyes, it is possibly caused by the fat shifting. There is a collection of fat under the surface of the skin that can herniate or change position as we age. We can develop fine lines and wrinkles from years of movement and sun damage in this area.  Additionally, as we age some of the changes that occur in the bone structure, as well as gravity, contribute to the prominence in this area.

So, what can be done to improve these deficiencies to make the under eye look better?

First, I recommend a great eye cream that builds collagen and helps with sun damage. My favorite is the TNS Eye Repair from Skin Medica, which we have available to our patients in the office. This is the one I personally use and love.

No matter what treatment protocol we use in the office, maintenance with an under eye cream is almost always appropriate.

Once we have the eye cream started the next step is to decide how to help you and your situation specifically. There are a couple of different options including eye bag surgery in Reno, Botox, and filler. Let’s discuss each briefly.

If the area is very severe with fat herniation and extra skin I will have Dr. Timothy Janiga perform a lower lid blepharoplasty (eye bag surgery) to adjust the fat herniated tissue to place it back in its correct position and remove any excess skin in this area.

Other than surgery, we can address under eye bag removal in the Reno Dermatology office in a variety of ways. If there is a hollowing in the under eye area, filler can be placed to improve this volume loss and rebuild the bone structure.

If fine lines are a problem, Botox can be placed laterally and underneath in small amounts to decrease that tissue paper-like look and fine lines. We also may use laser resurfacing to decrease fine lines and wrinkles as well as tighten the surrounding tissue.

Of course each person is different and may need a combination of two or more of these options to achieve an eye bag remedy. Come in for a consultation to see which of these options are best suited for you and we will tailor your treatment. Call us at 775-398-4600.

~ Dr. Jennifer Janiga

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Why Voluma is our New Favorite Product – Plus 15% Off!

Janiga MDs is going to feature one product with a discount each quarter that we know you are going to love.  Each time we have a new product to feature, we’ll write a bit about it here on the blog,  keeping it both fun and educational.

The first product we’ve chosen is an Allergan product called Voluma.  Voluma is the newest filler available in the United States.  For those of you who swear by Juvederm Ultra and Juvederm Ultra Plus, you are going to be excited to hear about the newest version.  For those of you who were not familiar with these products, Voluma is a great way to be introduced.

Voluma packagin

Juvederm and Voluma are hyaluronic acid filler products.  Hyaluronic acid is a normal product of human skin and can be injected under the skin in order to fill in fine lines and wrinkles and improve volume in the face.  Since it is a normal product of the skin, you will not have to have a skin test prior to having Juvederm or Voluma, which makes this product convenient and fast.

For years we have been using the Juvederm family of products to improve the appearance of the nasolabial folds, fine lines around the mouth, bags under the eyes, and volume loss in the cheeks.  Voluma is specifically designed to give volume back to the mid face and cheek bone area.  It is the first filler to be FDA approved for this purpose.

The best news of all is that while Juvederm Ultra and Juvederm Ultra Plus can last up to a year, Voluma can last up to two years.  Voluma should not be used in the lips or in fine lines as it is too thick of a product, but it is great for giving the cheekbones back their youthful appearance.  If you’re interested in plumping up those cheeks and redefining your cheekbones, Voluma might be the right product for you.

Voluma is my new favorite product, as I’ve seen it do amazing things for patients. We are excited to offer Voluma at Janiga MDs. Just look at some of these patient before/after photos from the Voluma website.

Voluma before and after photo Voluma Filler

Voluma is the first featured product for Janiga MDs, and to celebrate, we will be offering 15% off each syringe of  Voluma for the months of April 1 – June 30th.  Call today and make your appointment for consultation or treatment.

Have questions about Voluma? Leave a comment on this blog and I’ll get back to you

~ Dr. Jennifer Janiga

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Perlane: Ideal for Deeper Wrinkles & Facial Contouring

Perlane Adds More Volume and Lasts Longer

In earlier blogs, we’ve discussed Hyaluronic Acid dermal fillers like Juvederm, so it only seems fitting that we now cover Perlane. Perlane is an injectable sub-dermal filler which allows a skilled, Board Certified Dermatologist, like Dr. Jennifer Janiga, to address and correct the deeper, almost structural skin issues which can be the visible signs of aging. Perlane is often used to support or fill larger areas of the face, which may require a greater degree of contouring.

Because Perlane is composed of larger gel particles than Restylane, and is injected further below the surface, it is an invaluable weapon in Janiga MD’s repertoire of available solutions in the battle against wrinkles and other visible signs of aging, here in the Reno/Tahoe region.

Perlane Attracts and Binds to the Water Already In Your Skin

One of the key benefits Perlane brings to the table is that it actually attracts and binds to the moisture content already in your skin, supporting and encouraging it to build up in the areas the product has been injected. Beyond the initial benefits of smoother looking skin, this also means that Perlane can last up to a year, and its effects are cumulative. Meaning that subsequent applications can require less and less of the product as you continue to avail yourself of the procedure.

Perlane Treatments Take Very Little Time

For the lasting benefits a patient can receive from Perlane injections, the procedure itself is relatively quick and relatively painless. Depending on the number of sites requiring treatment, a visit to our Reno office location should take no longer than an hour or so. Though, as with any procedure where injections will be made into the skin of the face, some discomfort is to be expected, topical numbing medication is applied prior to the actual procedure – which deals quite nicely with the initial “pinch” – and Perlane itself is formulated with a small amount of additional numbing agent in the gel itself.

You may experience some bruising at the injection sites, which should fade completely within two weeks. Cold compresses and Acetaminophen should serve to help with any subsequent discomfort you may experience after you return home.

Unlike Most Cosmetic Procedures, Perlane Treatments Work Right Away

Other than the potential bruising or very minor swelling which can be associated with any sub-dermal Hyaluronic Acid injection, the supporting benefits of Perlane are immediate and measurable. Deep lines and wrinkles in the skin are literally wiped away by the injections. Then the cumulative hydrophilic (water attracting and binding) properties continue to build up the underlying structure of the skin over time, greatly diminishing the signs of aging and augmenting the initial contouring the gel itself produced.

If you would like the opportunity to speak with Dermatologist Dr. Jennifer Janiga personally, we would love to schedule a complimentary consultation for you at our Reno/Tahoe Dermatology office. Contact us right now, so we can schedule a convenient appointment.

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Restylane: Reverse Signs of Aging, From Lips to Laugh Lines

Restylane Minimizes Wrinkles and Restores Facial Features

Restylane, a leader in the fight against aging lips and wrinkles, has proven to be one of the best forms of Injectable Hyaluronic Acid Gels available to dermatologists today. Restylane has actually been proven to help create new collagen subcutaneously, while simultaneously inhibiting the further breakdown of existing collagen. By “stretching” the skin’s fibroblasts and allowing them to once again release collagen into the lips and skin, Restylane works to reduce the wrinkles and smile lines associated with an older looking face.

Fuller, smoother lips, with fewer smile lines or frown lines, can seem to erase countless years off of your face. And the effects of Restylane are more than simply cosmetic; your lips and skin actually are smoother, fuller and have greater moister content. And they will remain that way for many months.

Restylane is Especially Helpful in Northern Nevada’s Sometimes Harsh Climate

There are a great number of reasons why the skin of the lips and surrounding tissues can lose elasticity here in our Northern Nevada climates: UV damage from the Sun, dehydration from the wind & cold or even just too much time spent swimming in Lake Tahoe or the Truckee River. Our environment plays a key role in the aging processes. But today, with a Restylane treatment, thinning lips, deep lines and wrinkles are no longer something you have to live with.

Fuller, Younger Looking Lips after Just One Treatment

Another key advantage to Restylane is that you can reap all the benefits of fuller, softer, smoother, younger looking lips, with just a single treatment at Janiga MDs. Soon after you arrive on the day of your scheduled treatment, a topical numbing agent will be applied directly to the area where the injections will be placed. After allowing 30 minutes for the anesthetic to fully take hold – to reduce discomfort – our Board Certified Dermatologist, Dr. Jennifer J. Janiga, MD, FAAD, will personally administer the gel injections in precisely the correct areas and amounts. You should only expect to be in our Reno office for about an hour, after which you can look forward to anywhere from six to nine months of continuing benefits.

If you would like the opportunity to discuss your options and gather more information, we would invite you to contact us right now, so we can arrange a personal, complimentary consultation between you and Dr. Janiga. We look forward to hearing from you.

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Juvederm: Instantly Smooth Away Wrinkles and Skin Folds

Juvederm Turns Back the Clock

Recently we discussed the many faces of Hyaluronic Acid treatments, which are available and very useful for erasing wrinkles and folds in the skin of the face. Today we’re going to focus in on Juvederm, a product which is specifically crafted to eliminate years of accumulated lines and wrinkles, almost immediately. Juvederm has proven to be particularly effective when applied to the deeper lines and folds found around the mouth, which are most often associated with smiling.

Juvederm injections have enjoyed approval from the FDA since June of 2006, which has allowed dermatologists like Dr. Jennifer J. Janiga, MD, FAAD, to easily and safely deal with the visible signs of aging without resorting to full-up plastic surgery.

Juvederm Can Work with Just One Treatment

Juvederm injections have proven to be so effective in the battle against signs of aging, that very often a single appointment is all that’s necessary to enjoy smoother, more youthful looking skin, for as long as six to 18 months after the treatment.

Juvederm Injections: What to Expect

Of course, any time something is going to be injected into your skin, you should expect some mild discomfort. When you arrive at our Reno office location for your Juvederm treatment, part of your prep will include a topical numbing agent, which will serve to eliminate that discomfort. We allow a full 30 minutes for the effects of the topical agent to fully sink in. Also, Juvederm itself has additional anesthetizing ingredients contained within the gel itself, which act to further reduce any potential discomfort you might feel.

Initial Consultation is Always Complimentary

Janiga MDs has established an enviable reputation with the people of Northern Nevada, as one of the most inviting and personable Dermatology/Plastic Surgery offices in the Reno/Tahoe area. We would love the opportunity to show you why that is. Please contact us today, so we can arrange a personal meeting for you with Dr. Janiga, at your earliest convenience.

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Bringing The Happy Back to Your Face

I consult with a number of patients every week about their facial aging. A frequent thread to the discussion centers around a patient looking “tired” or “angry,” but not feeling that way. She wants her facial expression to better reflect her true feelings of happiness and contentment.

What Causes Facial Aging?

There are a number of factors at play in facial aging, but key to the discussion is the loss of volume to the face as we age. To illustrate the example, I point out that if you look at the back of your hand and compare it to a baby’s, 20-year-old’s, 50-year-old’s, and a 90-year-old hand, the noticeable difference will be the obvious loss of volume that occurs, as we grow older.

As we age, we lose the fatty-layer that lies underneath the skin. It’s that fatty layer that gives our skin a smooth, supple, healthy appearance. As the layer recedes, you begin to notice the underlying bony structures in the face and hands. Add the affects of gravity and you can understand why people feel like they look tired or angry when they see themselves in the mirror.

How Can I Add Volume Back to My Face?

Adding volume back to the face with fillers such as Juvederm or Restylane, or with fat grafting has significantly improved my patients’ results when it comes to cosmetic facial surgery.

In fact, when I perform facelifts the majority of time I will graft fat from my patient’s hips or abdomen and place it into their cheeks, nasolabial folds, lips and any area that is lacking volume. The addition of fat grafting to traditional face and neck lifting has produced superior outcomes compared to simply removing excess skin alone.

The thing to keep in mind is that every patient has distinct features –your face is unlike any other. So I would need to spend some time with you discussing what would be optimal for your particular features. In addition to your clinical evaluation we can use our 3D imaging system to simulate your post-surgical outcome.  If you would like to see some face lift before and after photos, please click here.

Where Can I Learn More?

Review this section for more detail about the procedure. When you’re ready to talk in person, let’s schedule a consultation about the treatment and procedure and the kind of results you can expect. Call our office at (775) 398-4600.

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5 Tips for Looking Your Very Best This Holiday Season

The holidays are around the corner and here are a few ideas for freshening your look in preparation for friends and family, or stepping under the mistletoe.

Tip 1: Try a Fast, Temporary Fix

Botox, Dysport and Xeomin, the newest competitor, take effect in about one week and help soften forehead lines and creases around the eye and mouth by preventing the muscles in these areas from contracting. Be sure to schedule your appointment about 5-7 days in advance of the special event or occasion.

Tip 2: A Softer, More Even and Natural Option

Or consider a Janiga MD signature facial. It evens skin tone, improves texture and gives your face a softer, more supple appearance. This delightful refresher with one of our estheticians takes about 75 minutes.

Tip 3: Laser Therapy is an in-office Solution

Laser therapy is another highly effective, in-office treatment. You’ll immediately see fine lines and wrinkles lightened, brown spots diminished, decreased redness, and obvious blood vessels reduced. Best yet, results are apparent soon as the treatment is complete, which greatly adds to its popularity.

Tip 4: Use a Filler to Remove those Lines!

Fillers such as Juvederm, Restylane, and Perlane can also be administered in-office at Janiga MDs, under topical anesthesia. These very effective products treat the deeper lines around the mouth and restore volume to the area surrounding the eyes. They can even increase fullness in cheekbone and lip zones. The procedure takes about an hour and produces minimal, short-term swelling.

Tip 5: Use a Pharmaceutical Grade Moisturizer!

Finally, dry skin on the face can often add prominence to facial lines. One of the easiest solutions is to treat your face with a pharmaceutical grade moisturizer. The high quality moisturizers you’ll find at Janiga MDs help flatten fine lines and lessen skin flaking within 5 days. Your newly nourished skin will provide a softer base for applying make-up during the holidays and will look great, whether you’re out shopping, bustling around the kitchen or enjoying time spend with friends and family.

For more information and to schedule an appointment for these treatments and procedures, please contact our office at (775) 398-4600.

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Botox vs. Dysport: Is One Wrinkle Reducer Better Than The Other?

The short answer is not really.

Botox and Dysport are similar in many ways.  The purpose of the medications is to relax the muscles that contract and cause wrinkles, like those found on the forehead and around the eyes.  The end result should give the face a softer and less-angry look that develops as a result of aging and sun damage.  They are both botulism-toxin type A (the generic names are onabotulinumtoxin A and abobotulinumtoxin A, respectively).  Botox is made by Allergan, while Dysport is made by Medicis.  Thankfully, the two medications are both produced by reputable companies, each with excellent track records.  The results for either last between three and four months and have very few side effects when used in cosmetic doses.

The differences in effect are fairly similar, and oftentimes the choice comes down to patient preference.  Botox has been on the market in the United States longer than Dysport; this is most likely why Botox maintains better brand recognition.  The medications are also dosed differently, with a Dysport dose being two-and-a-half to four times what is required for Botox.  In most practices you can be treated with Dysport for slightly less cost than Botox.  So, if cost is a determining factor, Dysport may be your best bet.  In some cases, I will encourage one medication over the other.  For example, those with smaller foreheads or those who have a naturally flat eyebrow I usually prefer botox while in some patients I prefer Dysport around the eyes for more extensive crows feet.

Regardless, be sure to consult your physician prior to receiving treatment for either.  You may find you want to try both medications, as one may be suit you better.  Overall, they are both great medications, and I treat patients with both on a daily basis.  If you’d like to learn more, please email me and I’ll be glad to offer greater detail once I have a chance to learn about your particular needs.



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