Dermal fillers like Restylane ® and Juvederm ® (both versions of hyaluronic acid) and muscle paralyzing agents like BOTOX ® Cosmetic and Dysport ® (both versions of botulinum neurotoxin) work the same way in Asians as they do in non-Asians.

Both classes of injectables can be used to modulate facial features without cutting or as an adjunct after surgery to refine or enhance the result. They are most often used in younger patients with mild changes seeking to avoid invasive procedures.

Dermal fillers can plump up superficial and deep skin depressions, while BOTOX can help wrinkling and reshape facial contours in subtle but temporary ways. There is hardly an area on the face (or much of the rest of the body, for that matter) where doctors have not applied injectable treatments.

By paralyzing nerve function, neurotoxins such as Botox and Dysport cause muscle to eventually shrink. In Asian plastic surgery, they are not uncommonly recommended for jaw and calf reduction.

Contrary to popular belief, injection treatment is not without risk, including infection, skin deformity, and, rarely, a range of serious problems.

KOKEN, a Japanese company, has developed several versions of new collagen fillers that show superior lasting power (12-18 months) compared to hyaluronic acid (6-8 months) and have a much lower rate of allergy compared to former brands of collagen that are now seldom used.

While popular in Asia, these fillers and other newer fillers are not available in the United States.