Cosmetic Surgery, Dermal Fillers, and Botox for Men

Recently Yahoo! News published an article about Brazilian men and cosmetic surgery. The article stated that a study by the Brazilian Society of Plastic Surgery reports, “Plastic surgery quadrupled among men from 72,000 to 276,000 operations annually from 2009 to 2014.” According to the news article, that is approximately one cosmetic surgery every two minutes for Brazilian men.

Before and After Photo via

The number of US men having cosmetic surgery has not risen as dramatically as in Brazil, but it is certainly not uncommon for men to have a procedure done. At our Santa Barbara Cosmetic Surgery Center practice, we have quite a few male patients, some of whom are repeat clients. However, we have seen a lot of growth in men seeking minimally-invasive procedures such as Botox and fillers. This goes hand-in-hand with the 2014 Plastic Surgery Statistics published by the American Society of Plastic Surgeons that reported over 410,000 men had Botox or Dysport treatments in 2014 (up 337% from the year 2000).

Why are Botox and dermal fillers becoming more popular amongst men? There may be many different reasons why a person decides to use Botox and/or fillers but I will speak only from my experience as a Santa Barbara cosmetic surgeon who regularly treats both men and women with Botox, Dysport, and dermal fillers. While many women seek out these aesthetic treatments to look more youthful, men seem to be less concerned with looking young and more interested in looking “refreshed” or not looking tired or angry. Botox and Dysport will temporarily soften forehead frown lines and the “crow’s feet” around the eyes and the result will be a more approachable look. Dermal fillers can subtly add volume to areas where volume has been lost (cheekbones, eyebrows, under eyes, jawline). The result is a more defined appearance. There is a difference between how and where fillers are used in men and women so it is important to see a person who is experienced and educated in using fillers in men’s faces.

Botox and/or fillers are also easy to have done. Treatment time can take between half an hour to an hour and does not require any down time. Men and women can return to their normal routines right after their appointment. Men tend to share less about these treatments (and cosmetic surgery procedures) amongst friends, family, and colleagues, so having a Botox or dermal filler treatment can be easily be done without anyone else knowing about it.

I have been doing Botox and dermal filler injections for men and women for many years. I strive to have my patients look “naturally” rejuvenated so no one suspects they had anything “done”.

If you are a man or woman interested in having Botox, Dysport, or dermal fillers done, please call my Cosmetic Surgery Center office in Santa Barbara at (805) 563-0000 to schedule an appointment. 

Santa Barbara Cosmetic Surgery, Aesthetic Procedures Guide

As a Santa Barbara cosmetic surgeon, I have watched aesthetic procedures (like Botox and dermal fillers) rapidly evolve in the last decade that offer men and women anti-aging options that can be done in an office visit with little to no downtime. These procedures can complement or supplement cosmetic surgery procedures (such as Facelifts and Neck Lifts) but knowing what procedure may be right for a person, and when to have it done, can be confusing.

With the understanding that everyone ages differently, I will present a loose guideline of when a person may want to consider anti-aging treatments and/or cosmetic surgery to keep a youthful appearance and/or to rejuvenate their look.

The 30’s
Wrinkles on your forehead and/or around the eyes (crow’s feet) may suddenly be more prominent when a person hits their 30’s although facial volume has probably not diminished (at least visibly). The one aesthetic treatment to consider in the 30’s is Botox or Dysport. This treatment temporarily relaxes the frown lines and wrinkles to give you a more rejuvenated appearance. Cumulative use of Botox or Dysport may actually minimize muscle activity in the area, thereby slowing the onset of wrinkles and fine lines in future decades.

The 40’s and 50’s 
Visible signs of aging in the face, such as thinning and/or sagging skin, a hollowness under the eyes, and overall loss of plumpness really shows up in the 40’s. This happens because the rate of breakdown for collagen and elastin significantly increases after the age of 40. Dermal fillers, such as Juvederm, Restylane, and Radiesse, can effectively replace natural volume and fullness as well as correct skin imperfections like wrinkles, fine lines, and acne scares. A dermal filler treatment is an injectable treatment that shows immediate results and can last 6 to 12 months (depending upon the type of filler used).

Another issue that people notice in their late 40s is that the eyelids may start drooping, making the eyes look hooded which can make a person appear tired or angry. Bags and hollowness may become a permanent part of the under eye area. This is a good time to consider Eyelid Lift Surgery, which can be done on both the upper and lower lids (if need be), to remove excess skin and “re-open” the eyes to the world.

Sometimes, however, it is not the upper eyelids that are causing a heaviness. The forehead tissue may have relaxed so much that it is impacting the upper eyelids (and, hence, impacting the eyes). Forehead Lift surgery may be taken into consideration. This surgery repositions the forehead and brow upward to open up the eyes and smooth the brow area. Furthermore, frown lines can be minimized with the use of Botox or Dysport.

The 50s is when most people usually consider Facelift surgery.  The surgery addresses the skin laxity in the cheek and neck area. If the skin laxity does not warrant surgery (or the person is not interested in surgery at the time) there are non-invasive treatments such as Skin Tightening that use the latest technologies to tone, lift, and tighten the skin. The protocol for Total Tightening – a skin tightening treatment – is exclusive to my Santa Barbara medical spa.

The late 50’s and Beyond
By the late 50’s and beyond, many people are interested in addressing their neck contour. Sagging skin and fat accumulation can become very prominent and “age” a person dramatically. Neck Lift surgery will re-create long-lasting support for the neck area and give the person’s profile and appearance a boost. The  results will look natural and not “done”.

If a person has had a facelift or other facial rejuvenation surgeries, I recommend maintenance treatments such as Botox or Dysport, dermal fillers, and laser treatments to prolong the results.

If you are interested in any cosmetic surgery or aesthetic treatment, please call my Santa Barbara cosmetic surgery office to schedule a consultation (805) 563-0000.

More Men Giving Botox a Shot

Before and After Pictures from

Talk about Botox with your women friends and many will freely admit to doing it, having done it, or wanting to do it. The chance of a group of men having the same conversation is slim although the chance that a few of the men in the group are Botox-users is not. Botox for men is on the rise according to the American Society of Plastic Surgeons. Cosmetic surgeries, as a whole, rose 22% from 2000 to 2012 for men and minimally invasive procedures, including Botox, Dysport, and dermal fillers, rose 6% from 2011 to 2012 for men.

Why are more men turning to Botox? Speculation includes the idea of wanting to look how you feel (many men are in great shape and are healthy, they want their “look” to reflect that), having an “instant” fix without the downtime and cost of surgery, or enhancing their look for the job market. That’s right! Men who are seeking employment are finding it more difficult to compete with those who are one or two generations younger. An article in the Wall Street Journal that addressed this topic said that it takes men who are 55+ an average of 16 weeks longer to find employment than those who are under 55 (or appear under 55).

Forehead wrinkles plague both men and women, and the ability to “get rid of” them, even temporarily, can be life-altering. Forehead lines, and especially the scowl between the eyebrows (technically known as the glabellar lines), can make someone look angry, irritated or upset. In addition to that, wrinkles are often associated with age, so a person who has many facial wrinkles and folds may appear to look old or even older than they really are.  A short visit to a cosmetic surgeon or medical spa can change that! Botox is injected in small amounts to the areas where it is needed. It blocks the signals to the muscles that tell them to contract. Instead of the muscles contracting into a frown, the muscle will relax and the injected area will appear smooth. Botox can take up to seven days to set in and is effective for 3 to 4 months – long enough to go on several job interviews.

Get your Botox in Santa Barbara by Dr. Terry J. Perkins, a trusted Santa Barbara cosmetic surgeon. Call his office at 805-563-0000 to schedule a consultation. 

Restore a Youthful Appearance Non-Surgically with Radiesse Dermal Filler

Wrinkles come but, unfortunately, they don’t “go” away without some help. There are quite a few types of cosmetic surgeries that can help soften or eliminate wrinkles and bring back a more youthful appearance, but some of our Santa Barbara Cosmetic Surgery Center patients who are not ready to undergo surgery ask us, “What is the next best solution for appearing younger through non-surgical means?” The solution that we suggest is trying dermal fillers and/or Botox or Dysport for a temporary solution.

Although this article is primarily about Radiesse, a certain type of dermal filler, we will give you a quick overview of the difference between fillers and Botox/Dysport for those who may not be familiar with either. Dysport or Botox are neuromodulators that relax the muscles causing the wrinkles. They are primarily used in the top half of the face (crow’s feet, forehead wrinkles, frown lines). Dermal fillers are usually used in the lower half of the face and they add volume to the face by filling in depressions and wrinkles (for example, they can be used to fill in the nasolabial lines from the nose to the corners of the mouth to soften the deep grooves that make the face appear older).

How, exactly, can Radiesse bring back my youthful appearance?  

As we age, our appearance changes because the aging process causes loss of facial volume and a decline in skin elasticity. The result is facial sagging and deepening of lines and wrinkles, which can make a person look tired and older than they really are. Radiesse, an FDA-approved dermal filler that contains calcium-based microspheres, restores fullness in your face by adding volume and smoothing out lines and wrinkles. The increased volume and decrease in deep lines and wrinkles can turn back the clock dramatically.  An added benefit of Radiesse is that it has been clinically proven to stimulate production of your natural collagen for a longer lasting result. The average person sees results for 12 months, sometimes more.

Popular treatment areas for Radiesse are the oral commissures (corners of the mouth), jowl area, marionette lines, and nasolabial folds (although it can be used in other areas of the face).

There are several FDA-approved dermal fillers on the market today that we also use (Perlane, Restylane, Juvederm) and these are made from hyaluronic acid. Radiesse is the only calcium-based filler available and because it is longer-lasting, it may be a more affordable wrinkle correction option for patients.

What else do I need to know about Radiesse?

Radiesse is an injectable filler that is ideal for a broad range of patients and a great choice for those wishing to smooth out severe to moderate lines and folds. Radiesse has been FDA-approved to be mixed with lidocaine for a significantly more comfortable treatment. There is virtually no downtime with Radiesse although for best results it is recommended that no excessive sports are done after the treatment (it is okay to resume normal athletic activity the day after treatment). Radiesse is biocompatible and there is virtually no risk of an allergic reaction or rejection of Radiesse. There is the possibility of bruising, redness at the injection area, and swelling, but varies from patient to patient. To this date, over 4 million Radiesse treatments have been performed worldwide.

How do I schedule a Radiesse treatment?

Radiesse can be done by Dr. Perkins at his surgical practice, Cosmetic Surgery Center (805-563-0000), or at Evolutions Medical Spa (call for a complimentary consultation: 805-687-0212), both located in Santa Barbara. An aesthetic nurse practitioner at Evolutions Medical Spa can also perform your Radiesse treatment. All nurses at Evolutions have been extensively trained by Dr. Perkins.

Santa Barbara Medical Spa – Evolutions – Open House Event

Evolutions Medical Spa is celebrating six successful years with an Open House event! Dr. Perkins and Evolutions would like to invite their loyal clients and the community to celebrate this milestone event on Wednesday, January 25th, from 4:00 pm to 8:00 pm.

Guests will enjoy:
  • Complimentary Mini-Treatments
  • Free Coloresciene Mineral Make-up application
  • Games and raffles (with over $5000 worth of prizes)
  • Gift bags (for the first 50 guests)
  • Interactive skin care education
  • A *live demo* of Dr. Perkins doing Dysport injections on a client.
  • Products and services will be discounted too!
Thank you to the following companies for their generous contributions to make this event fun and fabulous: Revitalash, Neova Skin Care, AFA Amino Acid Skin Care, NuCelle Skin Care, Radiesse, Elure, VitaMedica, NanoPro Superfood, and many more!

Evolutions is located at 1309 State Street, the same block as the Arlington Theater, in downtown Santa Barbara.
We look forward to seeing you there!

Santa Barbara Botox: Botox FAQs Answered by Cosmetic Surgeon Dr. Terry J. Perkins

Santa Barbara cosmetic surgeon, Dr. Terry Perkins, was recently featured in an interview by The topic of discussion was Botox – the anti-wrinkle treatment that has become popular amongst women and men especially in their 40s and beyond – who seek an affordable, non-surgical anti-wrinkle treatment.

An excerpt from the interview follows:

Q. What is Botox?

A. Botox and Dysport, both of which are FDA-approved for cosmetic use of frown lines, are both natural, purified proteins used to treat overactive muscles and sweat glands. Botox and Dysport treat overactive muscles by blocking the signals that tell those muscles to contract. Botox or Dysport is usually injected between the eyebrows (the glabellar region), and have been used “off label” in other areas such as the lines across the forehead and around the outside of the eyes (“crows feet”). Both Botox and Dysport can also be used as a highly effective treatment for hyperhidrosis (excessive sweating).

Q. Who is the ideal candidate for BOTOX?

A. The ideal candidate for Botox is someone, man or woman, who is looking for a more natural, relaxed look. Most clients have frowns and/or forehead lines that are visible much of the time (regardless of what expression they are making) and often they say that when Botox / Dysport sets in, it makes them look “friendly” and
approachable instead of looking angry or irritated.

Q. How safe is Botox?

A. Botox is such a safe, quick (the procedure usually takes only 10-15 minutes), easy, effective, and relatively affordable wrinkle treatment, it is now easily the most popular medical cosmetic procedure in the country! As long as you receive true Botox (made exclusively by Allergan Inc) or Dysport (made by Ipsen Group, distributed in the U.S. by Medicis Inc) and have it administered by a well-trained clinician, then it is safe. Though Dysport is a relatively new treatment in the U.S. (it was FDA approved in May 2009), given its success in Europe over the last 20 years, it will likely be as popular as Botox within a short period of time.

Read the entire Botox interview here.

Watch a video of a client of Dr. Perkins receiving Dysport.

Botox, and Dsyport, are available in Santa Barbara at Dr. Perkins’ cosmetic surgery practice – Cosmetic Surgery Center – call 805.563.0000 for a consultation or to schedule an appointment. Also available at Evolutions Medical Spa, where Dr. Perkins is the founder and Medical Director. Reach Evolutions at 805.687.0212.

Santa Barbara Botox Users – Take the Dysport Challenge and Save!

Did you know that Santa Barbara cosmetic surgeon Dr. Terry Perkins was part of a select group of doctors who were chosen to conduct a study for the use of Botox as an anti-wrinkle treatment? This was more than 10 years ago and that study lead to the FDA-approval of Botox Cosmetic to treat wrinkles.

Since then, Dr. Perkins has been using Botox on patients at his Santa Barbara Cosmetic Surgery Center practice as well as at Evolutions Medical Spa for years. No other anti-wrinkle treatment compared . . . until the introduction of Dysport last year! Dysport just became FDA-approved (although it’s been used since the 1990s in Europe) and Dr. Perkins admits that now there is finally a real alternative to Botox.

Medicis Aesthetics, the distributor of Dysport, feels so strongly that you will like Dysport, that they are offering the Dysport Challenge. If you are a current Santa Barbara Botox user, or have been wanting to try Botox or Dysport, now is the time to try it and save $150!

Details of the Dysport Challenge:
  • Have a Dysport treatment of at least 35 units. Register at, download a Rebate Form, and mail in the completed form with itemized receipt within 14 days (no postmarks accepted after June 14, 2010). You will be mailed a $75 Rebate Check from Medicis Aesthetics, Inc.
  • Within 15-30 days after the Dysport treatment, return to and vote LOVE IT! and receive another $75 rebate after you next Dysport treatment or vote LEAVE IT! and receive a $75 rebate after you next Botox treatment.
  • Come back to see Dr. Perkins for your next Dysport or Botox treatment after three months (before October 1, 2010). Mail in your second rebate form and itemized receipt within 14 days and receive your second $75 rebate check (no postmarks accepted after October 14, 2010).
Schedule your Santa Barbara Dysport treatment today with Dr. Perkins at Cosmetic Surgery Center Santa Barbara. 805.563.0000.

Santa Barbara Cosmetic Surgeon Dr. Perkins Featured in Plastic Surgery Practice Magazine Talking About Botox and Dysport

Talk about anti-wrinkle treatments such as Botox Cosmetic and Dysport isn’t just limited to Santa Barbara and Los Angeles! With plastic surgery and cosmetic procedures constantly highlighted in today’s press (prime example, see Heidi Montag), many more people are interested in cosmetic procedures to keep themselves looking more youthful, often times to match how they feel on the inside!

These days, one of the most popular non-surgical treatments for wrinkles is the use of Botox Cosmetic, a neuromodulator that relaxes the muscles that cause frown lines. Dr. Perkins is very familiar with Botox, having been one of 16 doctors chosen by the FDA to study Botox and its use in the treatment of wrinkles, eventually leading to an FDA-approval of Botox for cosmetic purposes. Last summer, the FDA approved another neuromodulator called Dysport that is, in some opinions, just as effective as Botox, or perhaps even better! Since then, everyone is interested in Dysport, this new alternative to Botox, and articles and news pieces have been popping up all over about Botox versus Dysport.

For those of you who are interested in hearing the experts sound off about both anti-wrinkle treatments, pick up the January issue of Plastic Surgery Practice magazine (read by more than 12,000 plastic surgeons) which features viewpoints of several cosmetic surgeons, including our own Dr. Perkins, to iron out the wrinkles on Botox Cosmetic and Dysport! Read the entire article here.

Dysport and Botox by Santa Barbara plastic surgeon Terry Perkins, MD at his practice, Cosmetic Surgery Center (805-563-0000), or at Evolutions Medical Spa (805-687-0212). Call today to book your Botox or Dysport consultation!

Santa Barbara’s Evolutions Medical Spa Open House Event Happens this Wednesday!

Evolutions Medical Spa was founded by cosmetic surgeon Dr. Terry Perkins. Evolutions is celebrating it’s fourth year in Santa Barbara and is hosting an Open House on Wednesday, January 27th, 2010, from 4:00pm – 8:00 pm. A Press Release about the open house was issued last week – and you can read it below. Read all the Evolutions Open House details on the Evolutions blog.


Evolutions Medical Spa Celebrates 4 Years by Inviting the Public to an Open House on January 27th from 4pm-8pm

Santa Barbara’s Premier Medical Spa – winner of “Best Medical Spa 2009” in the Santa Barbara News-Press Readers Choice Awards and in the Santa Barbara Independent Readers Poll Awards – turns four years old this month and has many reasons to celebrate.
SANTA BARBARA, CA., JANUARY 19, 2010 – Evolutions Medical Spa’s website boasts that it is about “Advanced Solutions for Skin & Body”. Ask any of the Evolutions clientele, and they will tell you that it is much more than that. It is the combination of innovative skincare, the expertise of cosmetic surgeon Dr. Terry J. Perkins, the warmth of the staff, and the serene atmosphere that keeps customers returning — even in this tough economy.

Evolutions Medical Spa was founded by Santa Barbara cosmetic surgeon Terry J. Perkins, M.D. who had a vision of offering medically supervised non-invasive treatments to be safely administered in a luxurious atmosphere, similar to a day spa environment. The tranquil atmosphere at Evolutions is not just created by its beautiful décor and trickling fountains. Evolutions Medical Spa is a family business that is run by his son, Brian Perkins, the Spa’s Managing Partner, with a warm, genuine and highly trained staff that has been hand-picked by Dr. Perkins.

Dr. Perkins sees clients on a regular basis, many of whom he knows on a first name basis. He firmly believes in empowering his clients through education so that they feel comfortable making informed decisions about their choice of treatments. Some of the more popular Santa Barbara cosmetic services are FotoFacials, laser hair removal, chemical peels, Vibraderm, and rejuvenating facials; as well as, anti-wrinkle treatments such as Botox and Dysport, dermal fillers such as Restylane, Radiesse and Juvederm.

This month Evolutions celebrates four years as a medical spa in Santa Barbara at their Anniversary Open House event on Wednesday, January 27, 2010. The heart of this event is to celebrate what drives Evolutions to be the best: their clients. The Open House will feature representatives from many of the product lines carried at Evolutions, complimentary mini-treatments from favorite products such as the Clarisonic Cleansing System, and professional Colorescience Mineral Makeup application. Discounts and specials will be offered on all services including facials, chemical peels, injectables and laser treatments. There will be over $3000 in raffle items and the first 50 attendees will receive gift bags. Dr. Perkins and the Evolutions staff will be on hand for Q&A while guests enjoy refreshments and wine.

The Evolutions Medical Spa Open House is a free event and is open to the community. It will be held at Evolutions, which is located at 1309 State Street in Santa Barbara on Wednesday, January 27th, from 4:00pm-8:00pm. Please RSVP to Evolutions at 805-687-0212.

News from Dr. Perkins: Dysport and Botox in Santa Barbara are Similar for Treatment of Wrinkles

Recently released article by Santa Barbara cosmetic surgeon Dr. Terry Perkins discussing anti-wrinkle treatments from Botox Cosmetic and Dysport titled Santa Barbara Cosmetic Surgeon Calls Dysport A New, Real Alternative to Botoxfollows:

Botox has been used, and FDA approved, for neurological disorders since 1989, long before its use in the cosmetic field. Santa Barbara cosmetic surgeon, Dr. Terry Perkins, was one of only 16 doctors in the United States selected to conduct a study leading to the FDA approval of Botox (botulinum toxin type A) for cosmetic uses. Since Botox became FDA approved in 2002 to treat frown line wrinkles, Dr. Perkins has been using it on patients at his Santa Barbara-based practices, Cosmetic Surgery Center and Evolutions Medical Spa, to smooth forehead fine lines and wrinkles.

For the past seven years, Dr. Perkins and his patients have been happy with the results of Botox. When administered to the right muscles in the right doses, Botox is safe and works productively to treat wrinkles on the face. Dr. Perkins adds, “Until the introduction of Dysport, we had not seen any other wrinkle treatment as effective as Botox”. Dysport, also a form of botulinum toxin type A, was recently FDA approved to treat facial wrinkles, although it has been used in Europe since the early 1990s. Dysport, a smaller molecule than Botox, works faster – patients see results in one to three days versus four to seven days for Botox. Furthermore, Dysport has an FDA approval for a four month duration (versus three to four months for Botox).

“On patients that have tried Dysport, we are seeing virtually the same results as Botox, and patients are excited. This is truly the first anti-wrinkle option that is comparable, and a real alternative, to Botox,” Dr. Perkins commented. The cost differential between the two is small, with Dysport being a fraction less expensive. Asking one of Dr. Perkins patients, who recently was treated with Dysport, what she thought of the new product, she commented, “I just can’t even think of frowning!” Clearly, Dysport, just like Botox, works well to smooth out forehead lines and leave patients smiling, without the wrinkles!


Get Dysport or Botox in Santa Barbara from Dr. Perkins at Evolutions Medical Spa (805.687.0212) or Cosmetic Surgery Center (805.563.0000). Call either location to set up a consultation.