Small and fine, a line tends to occur from repeated muscle movement that etches a slight mark into the skin.  Those who smile, frown or squint a lot develop fine lines earlier than those who don’t make these facial expressions as often.  When skin is young it snaps back into place, but as we get older it loses elasticity, so that ability to spring back becomes harder and less frequent, causing more premature lines.
Thicker and more dramatic in nature, wrinkles are noticeable folds, ridges and creases in skin.  Wrinkles can be caused by age, collagen and elastin breakdown, too much sun exposure, medications and dry, dehydrated skin.  Wrinkles are different from lines in that they are more diffuse throughout the face.
Different fillers are good for different people.  When there is a loss of volume from deterioration of the bone or fat pads, the skin loses its scaffolding and signs of aging such as sagging skin and wrinkles are created.  By using fillers early, we can slow down the aging process and maintain a natural, youthful appearance.  Fillers stimulate collagen and add volume to plum wrinkles.  Collagen-stimulating fillers such as Radiesse  and Juvederm work on thick folds and wrinkles.  Volumizing fillers are important in maintaining a youthful appearance.
Injectable Toxins:
Injectable toxins like Botox and Xeomin work to smooth out the skin’s surface by temporarily stopping the contraction of the muscles that are responsible for creating wrinkles.  Neuromodulators prevent muscles from allowing the movement that creates the fold, and over time, often reverse the lines that may already be present in the skin.  Botox and Xeomin are great for patients that start to see a trace of a wrinkle when the face is at rest.  This helps prevent the etched lines that are more difficult to treat.
Fractional Lasers:
Fractional resurfacing lasers can be used on wrinkled skin that’s the result of sun damage.  Lasers work to help lessen the appearance of wrinkles and lines by plumping skin, increasing collagen production and removing the rough, aged outer layer to create a more youthful appearance.
A facelift can help out the lines and wrinkles by excising any excess skin, which tightens and freshens the appearance.  Fillers, micro fat grafts and neurotoxins may further enhance the results.

en Español


Pequeño y fino, una línea tiende a ocurrir de movimiento muscular repetido que graba una ligera marca en la piel. Los que sonreír, fruncir el ceño o entrecerrar los ojos mucho desarrollar las líneas de expresión antes que aquellos que no hacen estas expresiones faciales tan a menudo. Cuando la piel es joven que encaje en su lugar, pero a medida que envejecemos, pierde elasticidad, por lo que la capacidad para saltar de nuevo se vuelve más difícil y menos frecuentes, causando líneas más prematuros.

Una arruga
Arrugas gruesas y más dramáticos en la naturaleza, son pliegues notables, crestas y pliegues en la piel. Las arrugas pueden ser causadas por la edad, el colágeno y la elastina desglose, demasiada exposición al sol, los medicamentos y la piel seca y deshidratada. Las arrugas son diferentes de las líneas en que son más difusa a lo largo de la cara.

Diferentes rellenos son buenos para diferentes personas. Cuando hay una pérdida de volumen de deterioro de las pastillas de los huesos y la grasa, la piel pierde su andamiaje y los signos de envejecimiento, como la flacidez de la piel y las arrugas se creó. Mediante el uso de materiales de relleno temprano, podemos ralentizar el proceso de envejecimiento y mantener una apariencia joven y natural. Rellenos estimulan el colágeno y aumentar el volumen de las arrugas de ciruela. Los rellenos de colágeno estimulante como Radiesse y Juvederm trabajan en gruesos pliegues y arrugas. Rellenos para dar volumen son importantes para mantener una apariencia juvenil.

Toxinas inyectables:
Toxinas inyectables como el Botox y el trabajo Xeomin para alisar la superficie de la piel por la interrupción temporal de la contracción de los músculos que son responsables de la creación de las arrugas. Neuromoduladores impiden músculos de permitir el movimiento que crea el pliegue, y con el tiempo, a menudo invierten las líneas que ya pueden estar presentes en la piel. Botox y Xeomin son grandes para los pacientes que comienzan a ver un rastro de una arruga cuando la cara está en reposo. Esto ayuda a prevenir las líneas grabadas que son más difíciles de tratar.

Los láseres fraccionales:
Láseres fraccionales de repavimentación se pueden utilizar en la piel arrugada que es el resultado de los daños del sol. Los láseres trabajan para ayudar a disminuir la aparición de arrugas y líneas de engordar la piel, aumentando la producción de colágeno y la eliminación de la capa externa áspera, envejecido a crear una apariencia más juvenil.

Cirugía estética:
Un estiramiento facial puede ayudar a las líneas y arrugas extirpando el exceso de piel, que se contrae y se refresca la apariencia. Rellenos, micro injertos de grasa y neurotoxinas pueden mejorar aún más los resultados.

What exactly is a liquid facelift? Well, it’s not a facelift, but a non-surgical reshaping and smoothing of the face using injectable facial, or dermal fillers. Injectable fillers have come a long way and products such as Juvéderm® Ultra Plus, Juvéderm® Voluma®, and Radiesse®, can be used alone or in combination to achieve real results without surgery. They are sometimes also used with a cosmetic toxin such as BOTOX® or Xeomin®. Together, we can help to reduce lines and wrinkles, restore plumpness, and even reshape areas — without surgery. 
By using a combination of injectable fillers and/or muscle immobilizing products such as Botox, lines can be minimized or erased, and sagging skin lifted and filled out.
With injectable products, you can dramatically improve appearances without the downtime of surgery. Ppeople who have mild jowls, volume loss, vertical lip lines, crow’s feet, lines along the side of the nose and chin — sometimes called marionette lines — can benefit greatly. Also, injectable products can correct asymmetries and even those bands in the neck below the chin that become prominent with age.

How drastic are the effects?

No one should be able to tell that you had a liquid facelift or any cosmetic work, essentially. You should simply enjoy comments from people such as, ‘Wow, you look fantastic, what did you do different?

Which product is right for you?

Some of the new fillers with hyaluronic acid — such as Juvederm — are popular and well-tolerated because the hyaluronic acid is a natural substance in the body, thus less likely to have allergy issues. Those fillers tend to be more expensive than a filler such as Radiesse, but both last eight to 10 months. Each product has a unique set of factors that might make one a better choice for you than another, so a consultation will determine which is the perfect option for you.
Is a liquid facelift for you? Call our offices in Mansfield and Southlake at (817) 473-2120.  You can also visit our website and


What are they?
Denevervating agents (onabotulinumtoxina), available as Botox and Xeomin work by temporarily reducing muscle activity to inhibit wrinkle formation, specifically between-brow lines that resemble the number 11. By decreasing forehead furrowing, they eliminate wrinkles and fine lines that currently exist and also prevent new ones from forming, making them favorites of patients of all ages.
In addition to cosmetic applications, many of which are considered off-label (see below), Botox is also FDA-approved for hyperhidrosis (excessive sweating). Xeomin is approved to treat abnormal spasms of the eyelids (blepharospasm) in adults who have had prior treatment with Botox. Xeomin is considered a more purified version of botulinum toxin type A than Botox because it does not have any protein additives. Some say this may help lower the risk of allergy to the product, as they believe the allergy risk is associated with these proteins. Xeomin is also the first denervating agent that does not need to be refrigerated before use.
Denervating agents have played a major part in the age of injectables, and doctors continue to find new and novel uses for them, as well as innovative ways to use them in conjunction with fillers.

  • Eliminating wrinkles and lines caused by movement
  • Excessive sweating (hyperhidrosis)
  • Creating wider-looking eyes *
  • Fixing scars *
  • Reducing pore size *
  • Lifting the top of the nose *
  • Lessening a gummy smile *
  • Treating migraines and TMJ *
  • Eliminating neck bands and cleavage wrinkles *
  • Temporarily improving the appearance of frown lines and crow’s-feet
  • Treating chronic migraines, defined as 15 or more headache days a month, each lasting 4 or more hours
(*indicates an off-label use)
Treatments and ResultsJust like injectable fillers, a topical anesthetic may be applied to make treatment more comfortable. Then, over roughly 10 minutes (depending on how many areas are being treated), your doctor will strategically place several injections. 
Although the overall experience is the same as with Botox and Xeomin, the main difference is that Dysport kicks in quicker—the results can usually be seen in a day or two, whereas Botox and Xeomin typically take three to five days. The results of both are believed to last about the same amount of time: on average, three months. However, after a series of injections, Dysport may last up to six months.
Side Effects and RisksYou may be red or bruised at the injection site for up to a few days, and in rare instances, patients have reported mild flu-like symptoms after treatment. 
Please call The Paragon Plastic Surgery and Med Spa for more information on Botox and Xeomin at (817) 473-2120


We all have varying degrees of fat in our faces and a multitude of factors can cause changes to these fatty compartments. Volume loss occurs because of gradual changes in the appearance of the fat. There is a loss both superficially and at a deeper level that comes along with aging.

1. Yo-Yo Dieting And Extreme Exercising
Keeping fat off your body is no easy task since the body can’t be told where to lose weight from and where to keep it. So even if you want to “spot-treat” a specific part of the body, you may end up reducing the amount of fat in your face as well. The ups and downs of recurrent dieting cause a stretching of the ligaments that support the tissues of the face. This can result in a loss of elasticity and volume, which promotes an aging effect.
2. Excessive Sun Exposure
Although fat loss is not directly dependent on UV rays, it is important to protect your skin from the sun. If you don’t wear SPF daily, the sun will accelerate the breakdown of collagen and elastin in the skin. When collagen and elastin levels are of poor quality, the condition of the skin is affected and the loss of fat can be accentuated.
3. Hormonal Changes
Female hormones, especially estrogen, are partially responsible for changes in the amount and quality of fat. As hormone levels begin to dip, fat can start to thin out.
4. Too Thin Of A Frame
It is possible to be too skinny. When that’s the case, the aging process will become even more of your enemy than your friend. The reason: A naturally thin face has little natural fat to begin with and over time the inherent amounts of fat begin to diminish, causing an extremely haggard look.
5. Receding Bones
With age, we naturally lose bone mass in the face. The muscles also begin to atrophy to some degree. These changes alter the underlying structure of the face and can cause the cheekbones and midface to look collapsed (the effects usually don’t take hold until later in life). It’s noticeable in the 70- to 80-year-old patient and while it’s highly variable, the majority of resorption happens around the nose and in the central face.
At the office of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa we provide a wide range of cosmetic procedures to help patients look and feel their best, including injectables and fillers. These procedures are designed to improve the appearance of volume loss through minimally invasive techniques. Minimally invasive procedures offer patients the results they desire without the hassle and lengthy downtime often associated with cosmetic surgery procedures. We offer patients Botox, Xeomin, Radiesse, Juvederm Ultra Plus XC and the NEW Juvederm Voluma to help reduce or eliminate the signs of aging on their face.  Please call our office to see which product would be best for you at (817) 473-2120 or visit our website at for more information on these.

Tweezers are a must for beautiful brows, but they can only do so much. Those seeking a more dramatic improvement in the overall look of their eyebrows can choose from a variety of injectables with a range of corrective effects.
For minimal tweaking-best suited for those without heavy eyelids-Botox is a good choice. By injecting Botox into the muscles that pull the eyebrows down, the muscles are weakened and consequently, the eyebrows are lifted. The goal is to train the muscles to reshape the brow over time.  Fillers such as Juvederm can also help lift the tail of the brow.
These noninvasive procedures can be refined over time as the patient ages.