Depending on when you start your filler and botulinum (e.g. Botox™) journey will determine what maintenance looks like. The idea is to turn back the clock, get you to a happy place, and then keep you there going forward. How much effort it will take to keep you there will vary based upon your age, history of skincare, and health. For someone in their 20’s the Botox and filler maintenance will look different than someone in their 40’s, 50’s, and beyond.

Let’s start with someone in their mid-20’s to mid-30s, a member of Gen Z. In your 20’s and 30’s may be when you notice the first signs of aging, such as hollowness under the eyes or in the temples. You may feel like your lower eyelids are getting longer or looser. Or, you may not be happy with your nose but can’t take the time off from work or family for a rhinoplasty. A little bump on the nose or a widened nose can be greatly improved through camouflage with filler treatment. (For others’ nose concerns the solution may be using filler for a little nose tip flip or adding volume to the chin to balance the nose projection.) Many Gen-Zers also want fuller plumper lips, and what better way to get it done than with hyaluronic acid filler like Restylane®, RHA®, or Revanesse Versa® or Lips®. Lip fillers, botulinum, and skin treatments are done by our experts in our Newton office every day.

For Gen Z’ers a little filler can go a long way, which keeps both cost and treatment times low. Once we’ve achieved the appearance you’ve been dreaming of, maintenance can mean as little as one syringe of hyaluronic acid filler every 6 months to a year depending on how much correction you had done and how quickly you metabolize the filler. For wrinkle prevention or reduction with botulinum (e.g. Botox), most people in their 20’s and 30’s are not going to need as much as older persons. Here the treatment is largely to stop aging – as a prophylactic treatment to prevent line and wrinkle formation. Botulinum maintenance for Gen Z may mean re-treatment with a little botulinum as infrequently as every 6 months to keep up the results you’ve achieved and ensure the muscles stay relaxed and you keep the smooth silky skin appearance that you got with your Botox treatment.

In your 20s and 30s may also be the time you start to notice fullness under the chin. We call it submental fullness, but you may say a “double chin”. Fat freezing may be the perfect solution for that, to give you the snatched jaw you’ve always wanted, or used to have. But, if you never had a snatched jaw and don’t have a double chin, fillers to the jaw can be the perfect treatment for a more defined jawline and the maintenance may be just one filler syringe to the jaw every 6 -12 months. Not bad for such a big change!

For those in their mid 30’s and 40’s, otherwise known as Millennials, who may be just starting with filler and botulinum treatment, maintenance will look similar to that of Gen Z’ers. Millennials are concerned with the same issues as Gen Zs, hollowness under the eyes and the temples, a bump on the nose or a slightly widened nose, keeping sexy lips, achieving balanced facial proportions, chin projection that matches the nose, as well as maintaining a snatched jaw. Millennials are also looking for a prophylactic treatment to prevent forehead lines and the 11s, but, there may be some lines that are starting to be there even without movement. This is the time to target those before they get out of control or will require more extensive treatment. This group may opt to have their maintenance botulinum done every 4 to 6 months and filler every 6 months to a year. This age group is also likely to start benefiting from some skin-tightening procedures like IPL or Morpheus8 radiofrequency microneedling to maintain and keep youthful skin.

Those in their mid-40s to mid-50s by now will most likely have done some aesthetic treatment like botulinum, filler, and skin tightening to renew their appearance and maintain their youth. At this point, maintenance should likely include some bio-stimulating fillers like Radiesse® or Sculptra® to add more volume to the face, tighten the skin, treat horizontal neck bands and undo the hollowness in the temples, nasolabial folds, and jowls. These fillers can be distributed thinly and diluted underneath the skin to generally thicken and improve skin quality.

At this point, people will also start to notice their upper lips’ length as the lip distance between the nose and lip elongates. Other treatments may be needed like lip lift or FaceTite/Embrace to tighten the jowls and under chin area. This is also the time to start with botulinum treatment to the neck bands, otherwise known as platysma bands. Botulinum for this age group typically gets done two to three times a year, and you will likely do one or two filler syringes to keep your results each year.

In the late 50s and beyond filler and Botox are easily maintained once you’ve done some skin tightening with energy devices like Morpheus, or a combination of IPL and Morpheus. Typically, this age group does maintenance to keep up their results about three times a year and they will do multiple layers of maintenance from Botox to fillers, introducing bio-stimulating fillers like Sculptra® and Radiesse® as well as energy-based treatments like the InMode Morpheus 8, FaceTite/Embrace. If you are in this age group you may choose to get small, but powerful, office procedures like an eye lift (also known as a blepharoplasty), lip lift, or neck lift to keep things tight and bright.

In short, keeping your good looks, or obtaining your best look, can easily be achieved and maintained if you follow these simple guidelines. For fillers, get yourself evaluated by one of our expert TSC doctors every four to six months for a little touch-up. A rule of thumb is that once you are happy, you’ll need about half of what was used the first time. Remember that in some locations these fillers last about a year. But, in certain areas, like under the eyes and the upper lip, fillers may last much longer than a year, and touch-up maintenance is minimal or unlikely to be needed. Some other areas like the temples, cheeks, and lower lip may require a bit more touch-up depending upon your metabolism.

Looking good is not a one-and-done process. You’ll develop a strong relationship with your doctor at The Spiegel Center and you can feel confident that we will do the most advanced and precise treatments to keep you looking great. Trust us to place just tiny little aliquots of filler where they are needed to maintain your results. We will also likely layer different fillers, like hyaluronic acid fillers such as Juvéderm®, Rastylane®, RHA® or Revanesse Versa® on top of bio-stimulating fillers like Radiesse® or Sculptra® and visa versa.

For botulinum like Botox ®, Dysport®, Jeuveau®, and Xeomin®, treatment starts every three to four months in the beginning, to initially relax those muscles and shrink them down. After that, you can go four to five months – it’s up to you at which point you are happy with your results. There’s a little bit of maintenance, but it’s really not much.

Meet Our Doctors

Dr. Jeffrey Spiegel

Dr. Jeffrey Spiegel

With special expertise in all aspects of facial plastic surgery, and a particular skill for revision surgery, it’s clear why Dr. Spiegel is one of the most celebrated facial plastic surgeons in the world. If you are seeking the best possible results, or have a uniquely challenging problem, you’ve found the right doctor.

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Dr. Onir L. Spiegel

Dr. Onir L. Spiegel

Dr. Onir (pronounced “oh-near”) has years of experience in facial aesthetics and treats some of the most recognizable and famous faces. Dr. Onir started her career in oral health, earning doctorate degrees from both New York University and Boston University. She has been the recipient of numerous awards for her cutting-edge medical research as well as her technical skills in dentistry.

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Dr. Jacob Tower

Dr. Jacob Tower

A board-certified specialist in facial plastic surgery, Dr. Jacob Tower brings a thoughtful approach and an artistic eye to New England’s premier plastic surgery practice, The Spiegel Center in Newton, Massachusetts. In addition to being an in-demand surgeon, Dr. Tower is an assistant professor at the Boston University School of Medicine, a sought-after lecturer, and an expert in facial plastic surgery.

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