4 Myths About Injectable Fillers


Few aesthetic treatments are more popular these days than injectable fillers. But even as their popularity increases, misconceptions about fillers persist. For anyone looking for a cosmetic dermatologist in Houston, it’s important to separate fact from fiction regarding injectable fillers such as JUVÉDERM® and RESTYLANE®.

Before we tackle them, it’s helpful to understand what fillers are and how they work. A filler is an injectable gel-like substance that is designed to minimize certain lines and wrinkles by adding volume. Most fillers these days are made with hyaluronic acid, a substance that’s naturally found in the body which helps absorb water. BOTOX® Cosmetic, on the other hand, is not a filler. It’s a neuromodulator. It works by limiting the movement of tiny facial muscles which cause wrinkles to develop.

Now, on to those myths:

Myth 1: Anyone can perform cosmetic injections. The stories you may hear about disappointing results can often be traced back to an inexperienced or untrained injector. Choosing the right injector is crucial. Even though cosmetic injections seem like relatively simple procedures, they require precision and the ability to assess a patient’s individual needs based on facial anatomy. Injecting too much or too little of a filler can lead to unintended results, as can placing the injection in the wrong location.

Myth 2: Getting fillers is very painful. Years ago, filler injections could be fairly uncomfortable, depending on the patient’s pain tolerance. Now, however, virtually all fillers are formulated with an anesthetic called lidocaine, which takes away the sting of an injection. And topical numbing creams can be applied before the injections for anyone who wants an extra level of protection.

Myth 3: Your face will look fake after getting fillers. This is related to the first myth that anyone can perform filler injections. If your injector is inexperienced or ill-equipped to perform the treatments, then you may not be happy with the results. It may be that you don’t notice any difference — or you may look lumpy. Similarly, lip enhancement fillers require a delicate touch to avoid getting the dreaded “duck lips” that do appear unnatural. The goal of fillers is to create results that give your face a refreshed, but natural appearance, and that’s exactly what you’ll get in the care of an experienced injector.

Myth 4: The results are permanent. Fillers are lasting longer and longer. Certain products are approved by the FDA to last up to 2 years. But most fillers last between 6 months to a year, and they don’t produce permanent results. It’s also important to note that the results of hyaluronic acid-based fillers (which make up the vast majority of options) can be reversed. If a patient is unhappy with the outcome, a provider can inject hyaluronidase, an agent that dissolves the hyaluronic acid used in the filler.

Let’s close with a closer look at the results. In these before-and-after photos, you see a 55-year-old woman treated with JUVÉDERM to soften the “smile lines” or nasolabial folds:


3 Skincare Ingredients That Really Work

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3 Skincare Ingredients That Really Work! By Pauline Scott, MD

It can often times be confusing which ingredients to look for in skincare products as a myriad of products tout the latest and greatest ingredients for perfect skin. These claims are not always backed by sound scientific research. In addition, even if the product has a scientifically proven ingredient, it may not have been manufactured correctly or have enough of the active ingredient to deliver maximal results. As a board-certified dermatologist, there are several skincare ingredients I recommend to my patients based on their skin concerns. Below are three ingredients that I commonly recommend to patients.

Scott CutOut 2Vitamin C

Also known as ascorbic acid, this antioxidant helps protect the skin against UVA and UVB rays that contribute to skin aging. It also can improve the appearance of fine lines and wrinkles. My recommendation: SkinCeuticals® CE Ferulic


This Vitamin A derivative has been shown to promote collagen production and diminish the appearance of fine lines, wrinkles, and age spots resulting in a more even skin tone. My recommendation: SkinMedica® Retinol Complex

Zinc Oxide

This inert mineral is considered a physical sunscreen blocker because it sits on top of the skin and blocks both UVA and UVB rays. Wearing this sunscreen daily can protect against the damaging UV rays that cause both skin aging and skin cancer.My recommendation: EltaMD® UV Clear

Instantly Lift Cheeks with Sillouhette InstaLift™!

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Instantly Lift Cheeks with Sillouhette InstaLift™!
By Tracy Katz, MD

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Silhouette InstaLift is the newest and most exciting treatment that is sweeping the nation’s top cosmetic dermatologist’s offices this December. This procedure is designed to lift the deeper layers of facial skin in a short, non-invasive treatment that ultimately helps stimulate your own collagen for longer lasting results. It does this with the use of dissolving sutures and tiny cones made of Poly Lactic Acid (PLLA). Each suture has bidirectional cones (one set of cones point on way and another points the opposite way) that once inserted allow the dermatologist to reposition the deeper tissue onto the cones, thus providing re-contouring and lift. The PLLA then helps stimulate fibroblast activity, which basically means new collagen growth that then continues over the next 18 months. Instalift is a low to no downtime procedure that can instantly give you results!

Here is how the procedure takes place. First, we mark vectors on your face around your nasolabial fold and jowl. This basically means we are creating a map which shows us visually the areas that we are targeting to lift. Then, the areas where the needle will go in and out of are prepped and numbed with a small shot of lidocaine. This helps make the procedure more comfortable and pain-free. The InstaLift sutures are then inserted under the skin in the direction of vectors that will lift the tissue into the desired position. The excess suture material is then trimmed off the edge so nothing sticks out of the skin. As collages starts to build the sutures are then naturally absorbed, leaving a new structure of collagen that will continue to lift the skin.

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While we do see an instant change, over the next 2-4 months the outcome will only get better with the building collagen. Recently I treated Dr. Suzanne Bruce, and she is loving her results! Silhouette InstaLift can be an amazing procedure on its own, but we can really give you jaw dropping results when combined with fillers, toxins or resurfacing. Come in for a free consult to see if you may be a good candidate.

A Blogger’s Eye View of Dermal Fillers

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Our team recently had the pleasure of treating a patient named Meg (pictured above), a mom of 2 adorable daughters, a part-time junior high school theater teacher, and a popular blogger who documented her experience at our practice on YouTube. Meg, the blogger behind “Meg O on the Go,” wanted to find a dermatologist in Houston to help her navigate anti-aging treatments that would be appropriate for her such as filler and BOTOX® Cosmetic injections.

We were excited to partner with her on the project and help her followers get a glimpse into the world of real world of cosmetic dermatology. One of the myths we like to dispel is how cosmetic fillers and Botox can lead to an overdone and unnatural look. As a 33-year-old, Meg told Dr. Katz that even though she feels good about her overall appearance, she was concerned that the lines around her mouth were making her look 5 years older. Dr. Katz worked with Meg closely on what her expectations were and since she “vlogged” the whole experience, you can experience it right along with her!

Meg is a good example of the patients who come to Suzanne Bruce and Associates for nonsurgical facial rejuvenation. In her blog,

she wrote about breaking down the barriers to simply understand injectables: “I am hoping to get rid of some of the stigma behind these kinds of treatments, and I am also hoping to help you make an educated decision if it was something you are considering.” As you can see in the before-and-after photos at the end of her video, the combination of fillers and BOTOX injections provided the subtle improvements that she wanted. The results appear natural, with some of the lines softened and the smoothing of the nasolabial folds.

The cosmetic treatments offered at our practice include a wide range of procedures. We hope to have Meg back later on, when and if she decides to try something else!

As one of the leading dermatology practices in the nation, we remain at the forefront when it comes to providing breakthrough treatments. The most recent example is the introduction of JUVÉDERM VOLBELLA®, which we recently discussed in another blog post.

Interested in learning more about our treatments? Like us on Facebook, and you’ll be among the first to know about exclusive specials and upcoming events hosted at our practice. We also encourage patients to sign up for our newsletter for the latest in skincare news around here.

We hope you enjoy Meg’s story and feel inspired to stop by our practice for a skin care consultation.

Reducing Melenoma Risk by up to 18%

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April CutOutReducing Melenoma Risk by up to 18%! By April Harrison, MPAS, PA-C
A reduced chance of developing melanoma? That’s what one recent study said could happen if women use sunscreen at least SPF 15. In a recent article in the Journal of Clinical Oncology*, over 143,000 Norwegian women were followed for 11 years. Those who wore sunscreen with SPF 15 were 18% less likely to develop melanoma, the most deadly form of skin cancer.

The American Academy of Dermatology, and we at Suzanne Bruce and Associates, recommend using a broad spectrum sunscreen that protects against UVA and UVB rays. We recommend an SPF 30+ sunscreen be applied to all exposed areas – face, neck, chest, scalp, top of ears, arms and hands. It is also important to reapply after two hours or after swimming or sweating. Physical methods of sun protection such as broad-brimmed hats, sunglasses, and sun protective clothing, are also beneficial. Although this study followed women, the same conclusions could be drawn for men.

The bottom line? Wear your SPF 30+ sunscreen every day!


Bounce in Your Skin!


Bounce in Your Skin!  By April Harrison, MPAS, PA-C
We know Botox can reduce wrinkles, but new research* finds it may have long term benefits on the structure of the skin too. Forty-eight women who had never had Botox were treated between the brows and crow’s feet. Their skin was measured for elasticity and all areas showed increase in skin pliability and elastic recoil. The lead researcher of the study hypothesized that our skin may have receptors that interact with Botox causing the production of more collagen, elastin, and other substances that smooth and firm the skin.

After 11 years in clinic, I have observed this effect myself with smaller appearing pores and smoother forehead skin when this area is treated. This new information has long-reaching benefits as repeated botulinum toxin injections may improve the appearance of the skin in the long term. To learn more about Botox® Cosmetic or its competitor Dysport® visit our office for a consultation.

Get started by calling our office at (713)850-0240.




There’s a new filler in town, and it’s the latest from a name you trust. JUVÉDERM VOLBELLA is the newest addition to the JUVÉDERM family, and it’s meant specifically for your lips. And whether you’re coming in for dermal fillers, CoolSculpting®, or BOTOX®, my job as a dermatologist is to offer our Houston patients the best treatments. That’s why we’re so excited to add JUVÉDERM VOLBELLA to the list of treatments we offer.


Like regular JUVÉDERM, VOLBELLA is a gel formulation of hyaluronic acid that’s meant to be injected beneath the skin. VOLBELLA can be used to add volume, shape, and definition to lips, as well as reduce the look of lip lines. Developed with VYCROSS™ technology, VOLBELLA provides patients with natural-looking fullness for up to 1 year.

How is it different from other fillers?

Many fillers already use hyaluronic acid, because it’s a chemical that occurs naturally within the body. Smooth gel formulations of this chemical can be reconfigured to treat various wrinkles, from fine lines to deep creases. VOLBELLA’s lower concentration of hyaluronic acid particles makes it especially effective on the lips. Because the lips are a particularly delicate area of the face, it typically requires a light hand with fillers. VOLBELLA makes it easier to get great results.

Does treatment hurt?

Many patients report that VOLBELLA is more comfortable than some other injectable treatments, such as BOTOX Cosmetic. This is because VOLBELLA comes pre-formulated with a topical anesthetic called lidocaine. Because it’s already contained in the gel, you feel very little — both during and immediately after the procedure.

Who makes a good candidate?

VOLBELLA is an FDA-approved treatment for patients 21 years and older. Thin, undefined lips are often something that’s entirely independent of your age, VOLBELLA can offer improvements for women at all stages of life.

If you’ve been treated with a hyaluronic acid-based filler previously and experienced an adverse reaction, you may not be eligible for VOLBELLA. During your consultation, we’ll review some basic medical questions to make sure you get the very most from your procedure.

Committee Spotlight 2016 – Society of Dermatology Physician Assistants (SDPA)

This is a repost from the SDPA October 2016 Newsletter featuring Suzanne Bruce and Associates PA - April Harrison.

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April CutOutApril Harrison has been a practicing physician assistant since 2000 and has worked in dermatology since 2001. She received her Bachelor of Science in Physician Assistant Studies from the University of Texas Medical Branch at Galveston and her Master’s degree in Physician Assistant Studies from the University of Nebraska College of Medicine. She is certified by the National Commission on Certification of Physician Assistants and is a Society of Dermatology Physician Assistants (SDPA) Diplomate. In fact, April was the first PA to ever receive SDPA Diplomate status. She is a member of the Society of Dermatology Physician Assistants, Texas Academy of Physician Assistants and American Academy of Physician Assistants.

Previously, she worked in the Department of Dermatology at MD Anderson Cancer Center from 2001-2005. There she worked closely with Madeleine Duvic MD, an internationally known and respected expert in cutaneous T-cell Lymphoma. In 2005, she joined Suzanne Bruce and Associates, Houston’s largest dermatology practice, where she specializes in cosmetic dermatology including neuromodulators, dermal fillers, lasers, skin tightening treatments, and sclerotherapy.

What part of your work gives you the most pleasure? I enjoy all cosmetic procedures but what gives me most joy is dermal fillers. I like being able to take years off a patient’s face in a matter of minutes and it is especially gratifying when the patient is able to appreciate that too. We have so many versatile fillers now in dermatology that the possibilities are endless – from filling under eye hollows, to lifting the brows and filling in temples, replacing lost volume, and redefining the lower face and jawline due to aging.

Which patient had the most effect on your work? I had a patient who had just gotten through a terrible divorce and was feeling badly about herself. During consultation, we developed a game plan to ‘get herself back’. We started with Ultherapy for skin tightening, then a series of fractional resurfacing for lentigines and texture improvement. Lastly, we injected fillers for mid-face enhancement, under eye hollowing, temple hollowing, nasolabial folds and marionette lines, and revolumized her lips. She looked in the mirror afterward and started crying because she thought she would “never see that face again”. She was so happy to recognize her former, happy self again and I was happy to be a part of that.

What made you decide on a career in dermatology? In PA school, I was always the one student identifying skin rashes and skin cancers. It was an area that has always interested me. Initially, I thought I wanted to work in plastic surgery but eventually realized that dermatology was my true calling. I especially enjoy the visual nature of the field and being able to see improvement in our patients.

What is a typical day like for you? I have the best of both worlds – I get to spend time with my family and have a gratifying career. The day starts for my by dropping my kids off at school at 7:45am then going to the office and seeing my first patient by 8am. I have a mix of neuromodulator and/or filler appointments, IPL, Thermage or Ulthera patients scheduled. Some appointments like neuromodulators, take 15 minutes, others can take hours, such as Ulthera or fractionated CO2 laser resurfacing. I may have a study patient or two as I am involved in the clinical research arm of our practice too. My day ends at 3 pm when I leave to pick up my kids from school and start my second job – Mom!

My ultimate skin-care advice: Wear sunscreen SPF 30+ everyday, use a retinoid as many times a week as possible, and avoid the sun. I have been applying sunscreen to my children since they were babies, then I taught them how to apply it themselves when they were toddlers. I hope they will appreciate their beautiful skin when they are older.

Learn more about the Society of Dermatology Physician Assistants (SDPA) visit their website here.

Choosing an Injector for BOTOX® Cosmetic and Fillers

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With the ever-increasing popularity of nonsurgical cosmetic procedures, practitioners of all types are eager to expand their offerings, especially when it comes to injectables. But like everything else, it’s important to remember that experience counts. A BOTOX treatment session is quick, but it’s still a medical procedure — and your injector should have the experience and training needed to provide optimal results with products like dermal fillers or BOTOX. As a board-certified dermatologist in Houston, I understand what patients should look for when choosing an injector.

Check For Past Results

Viewing before-and-after photos of actual patients treated with the same procedure is the best way to get a sense of how your results may look.

Cost can be a factor for some patients, but it shouldn’t be the primary reason to select one injector over another. (Getting the best deal is fine when shopping for clothes, but not when it comes to your health. This is no time for Groupon.) What matters most is a proven record of successful results.

Look for subtle changes in before-and-after photos, like these. BOTOX Cosmetic, for example, should have a smoothing effect on facial wrinkles.

Review Their Qualifications

Next to actual photos, extensive training and experience is the best predictor of great results. So what’s the best way to check on an injector’s qualifications? There are various resources available online to help.

  • Credentials: Confirm that your provider is a board-certified dermatologist using the American Board of Dermatology website. Why does certification matter? It’s a signal of rigorous training and time devoted to developing expertise. To become a board-certified dermatologist, a practitioner needs to have graduated from medical school, completed a 1-year internship (minimum) along with a 3-year accredited dermatology residency program (minimum), and passed the written and oral examinations administered by the board.
  • Experience: Even board certification alone isn’t a signal of relevant experience. Some dermatologists have a stronger focus on other procedures and don’t have much experience performing injections. When looking for an injector, ask about the total number of procedures performed and how long injectables have been a part of the services offered at the practices. Millimeters can make a lot of difference when injecting BOTOX, and that level of precision comes with time. It’s important that the injector is not only trained but experienced.
  • Before & After photos: It’s impossible to stress this too much: If the injector doesn’t have photos of actual patients, consider that a red flag. These photos can help you choose an injector and provide a better idea of what to expect your results to look like.

Choosing an experienced, qualified injector is the best way to get the optimal results you want from aesthetic injections. At our practice, injectors skillfully combine fillers with BOTOX in a single procedure. That’s how we create the kind of comprehensive facial rejuvenation that gives our patients a real “wow” moment.

If you’d like to know more about our approach to injectables, please contact us and we’ll be happy to answer any additional questions.

Meet Dr. Pauline Scott

ScottWhere are you from & where did you grow up?
My family is originally from Burma (now called Myanmar), but I grew up in Muskogee, OK. I attended The University of Oklahoma where I earned my Bachelor of Science, MBA and my medical degree. I completed my dermatology residency at the University of Illinois at Chicago.

What is it about medicine that you love and why did you choose dermatology?
Practicing medicine is a way for me to combine my love for science with my passion for helping people. Dermatology is a remarkably diverse field of medicine. We see patients for general skin, hair and nail issues, do surgical and cosmetic procedures, and are involved in identifying and treating skin cancer. I love interacting daily with a diverse patient population and helping those who suffer from debilitating medical skin conditions. I also enjoy utilizing rapidly evolving, innovative technology to improve the quality of our patients’ lives.

How would you describe your style as a doctor?
I am cognizant of people’s time and try to be efficient while still providing the best care possible. I love helping people feel better about their skin. I also like to chat and catch up with my patients about their lives and families.

What issues do you feel passionate about?
I am passionate about patient advocacy, skin cancer prevention, positively impacting patients’ body image and self-esteem, and contributing to the field of dermatology.

What are some things that you love about Katy and Houston?
I love the genuinely friendly people here, the diversity of the area and the great food from different cultures! When deciding where to live in Houston, the Katy area stood out to me immediately. I was struck by the strong sense of community, the all-star school district and how friendly and inviting the Cinco Ranch area looked. My husband Nathanial and I decided to put down roots and just built a new home in Cinco Ranch. I have a strong desire to give back to the Katy and Houston communities. Suzanne Bruce, her husband Malcolm and the entire SBA team have always been very involved in the community, and it’s one of the reasons I decided to join this practice. Service and community are core company values at SBA. This year I can’t wait to represent us at our third annual YMCA Turkey Dash, the YMCA Healthy Kid’s Day, the Literary & Fine Arts Festival & Parade, and especially the Wild West Brewfest. SBA supports great causes, and every year they donate over $20,000 to local charities and I can’t wait to be a part of that. I look forward to getting involved and meeting everyone in this wonderful community.

What are your personal interests?
I’m passionate about my family and friends, great food, traveling the world, helping those in need, leisurely reading, and dogs!

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