Injection Perfection
by Theodora Malison; Photography Kim Billingsley

While looking younger has always been a priority in society, new advances in cosmetic surgery techniques have made wrinkle removal procedures even more desirable for both women and men. At present, there are a multitude of injectable substances on the market that are all geared at rejuvenating facial appearance and disguising the signs of aging. The main injectables being used in plastic surgery today include Botox, Juvederm, Dysport, Restylene, and Voluma. While each of these injectable products can help restore a youthful facial appearance, it is important to realize that the technique used to inject the wrinkle is as important as the substance being injected. According to Board Certified plastic surgeons Dr. Robert Skalicky and Dr. Michael Shafran, “The use of injectables in plastic surgery such as Botox or Juvederm can turn back the clock on the aging process and help put off the need for larger, more invasive procedures. However, the way that the injection is performed is critical to achieving a natural result as opposed to an artificial, overdone look.”

At Bucks County Plastic Surgery Center and Rinklefree Plastic Surgery and Dermatology, these injectables are performed by their expert injection team comprised of plastic surgeons, dermatologists, physician assistants and nurse injectors, all of whom have years of experience in both injection techniques and facial analysis. The process begins with an initial evaluation of the patient’s desires, needs, and expectations. As explained by nurse injector Michelle Petrillo, R.N., “One of the aspects that I value most about the injection process is the time spent with my patients during the initial consultation. I begin with an assessment of their facial anatomy and then, interactively with the patient, I discuss the benefits and outcomes of the treatment plan. It’s a great opportunity to discuss each of our perspectives and to formulate a plan of correction that will promote a more youthful appearance. It is the beginning of a comfortable future path between us that is based on trust.”

Many patients want to regain their youthful appearance from years gone by but fear the unnatural look that can occur if either too much filler is injected or it is not accurately placed. Kaitlyn Nelson, PA-C, further explains this point. “The more is better philosophy is not always the best approach when injecting facial lines and wrinkles. If too much product is put in, normal facial contours can be violated and give a very unnatural look. On the contrary, if the procedure is done properly, a beautiful, youthful appearance can easily be obtained. My goal is to educate patients on the changes they can accomplish and then devise a treatment plan to achieve the desired results.”

The trend today for many patients is to start earlier and do less so as to avoid the Hollywood overdone “plastic” look. Petrillo further explains, “The trend that I have seen evolve over the last 15 years is that patients are not looking for drastic changes but, rather, want subtle “tweaks” geared at prevention and maintenance. The key is to view the face as a whole, identify the areas in need of rejuvenation, choose the appropriate product for that particular area, and administer the procedure in a manner that is comfortable and safe. NEVER go for the home run in one sitting!”

So how does a patient assure that their injection will be performed the right way and result in a natural look? Dr. Skalicky emphasizes the need for each patient to have an initial consultation to outline specific goals and desires. This part of the process is extremely important to both discuss the pros and cons of each procedure being considered and also to make sure that the procedure will meet each patient’s specific expectations. At times, the requested procedure may not be able to give a patient the result that they want and, subsequently, may result in patient dissatisfaction. According to Dr. Skalicky, “I think that honesty from your surgeon is the most important quality to have when discussing treatment options to avoid unhappy outcomes resulting from false promises. I’d rather steer a patient toward another procedure that better addresses their concerns then have them spend money on a procedure or technique that falls short of their desired result.”

Many times other “minimally invasive” procedures may be discussed in a consultation that can also help rejuvenate facial appearance and sometimes be performed in conjunction with injectable products. These procedures include office based smaller surgeries such as mini facelifts, eyelid lifts, fat injections, or Fraxel laser resurfacing. Dr. Michael Shafran adds, “It is important for each patient to fully understand their options regarding facial rejuvenation so they can make the right choice for themselves. I like to educate the patient not only on the specifics of a particular procedure, but also, on how successful that procedure will be for their specific anatomy.”

While wrinkle reduction is always important to patients, the latest trends include facial augmentation to enhance facial features. These particular products, such as Voluma, Restylene Lyft, and Sculptra, are designed to restore facial fullness that has been lost with the aging process. According to board certified dermatologist Dr. Ivy DeRosa, “Elevating cheekbone volume or enhancing lip contour can beautify a woman’s appearance by balancing facial ratios. The technique, when done properly, results in enhanced facial beauty without detectability.”

While the effects of gravity are inevitable over time, there are many tools available to help fix aging related problems and restore beautiful, youthful facial appearance. What may be most important, however, is making sure the right tool and right provider are selected for the job.

Dr. Skalicky is president and founder of Bucks County Plastic Surgery Center and Rinklefree Plastic Surgery and Dermatology. In addition to Dr. Skalicky, the “dream team” of providers include Dr. Michael Shafran, Dr. Ivy DeRosa, Kaitlyn Nelson PA-C, and Michelle Petrillo, R.N. Consultations are complimentary. The offices are located at 104 Pheasant Run, Suite 123, Newtown and 4920 York Road, Buckingham. Our new King of Prussia location will open this summer. Call (215)860-9600 to schedule your consultation. Additional information provided at

Bucks County Plastic Surgery Center, Rinklefree Plastic Surgery and Dermatology
104 Pheasant Run, Suite 123 | Newtown
4920 York Road | Buckingham
(215) 860-9600

Published (and copyrighted) in Suburban Life Magazine, May, 2017.