christina monaco

The one thing everyone seems to be talking about is fillers- from Kylie Jenners Juvederm plump that has built an empire ( who doesn’t envy her perfect pout?) to older celebs who you can’t help but look at and wonder – “what has she had done”?! A recent study said 4 in 10 (36%) of women surveyed plan on using their tax refund this year on cosmetic procedures, specifically noninvasive procedures like Botox, injectable fillers and non-surgical weight loss procedures such as CoolSculpting. This is up from 13% last year, so our MyTopFace Beauty Experts knew we had to learn more about these procedures. To get the first-hand experience on this increasingly popular trend we turned to the best in the biz, Cristina Monaco PA-C. She is an experienced Physicians Assistant with years experience in getting her patients the look of their dreams. She is also the mastermind behind The Derm Diva blog. We sat down with her to get a few procedures and chat more about her work!

MTF Beauty Expert: Cristina, tell us more about what inspired you to get into Dermatology! Also, tell us a little more about you!

Cristina:  About 3 years into my undergrad I applied to PA school. After graduating from my PA program I found a job that wasn’t in dermatology and wasn’t finding it fulfilling as I had hoped. I had always had a major interest in beauty, injectables, and cosmetic surgery. I got into dermatology with Schweiger Group in 2014, and I found something I love. In late 2016 I started The Derm Diva to launch my practice and I have been doing work with bloggers and others in the industry! It has been taking off quickly and I couldn’t be any happier with what I do! I would love to be able to represent beauty solutions I believe in as a brand rep while still getting to work with all my Derm Divas on injections!

MTF Beauty Expert: What is the most rewarding part of your job?

Cristina: For me, my entire job is so rewarding. People come to me for a boost in confidence and to love the way they look- I enjoy being able to give them that. Fillers are a favorite of mine to give clients a bit of self-confidence and pep in their step where they might have been lacking. It’s also interesting to me because, with fillers, clients get about 80% of their results immediately. It is so exciting to see them with that boost in their self-esteem so instantly.

I am also extremely passionate about acne and getting to work with clients who are in need of a skin care plan to tackle those issues. It is rewarding to get to see patients go through the process and see their skin at all the milestones. It takes 12 weeks for 80% acne to be treated, so when people are really compliant with their regimen they see their complexion really change. That can radiate through their entire lives and have such an ego boost! Trust in your doctor and being religious with your care is everything. When my clients do this and see results I couldn’t be happier to do what I do!

MTF Beauty Expert: Can you talk about the differences between the brands of fillers?

Cristina: The differences between fillers are basically the same as the differences between soda brands, they are all very similar formulas, just with different names. They are really all great and I love to work with each of them! They are all hyaluronic acids that draw water or volume to the injected area. Upon injection, they bring that lost volume to the area.

The one that is really different is Radiesse as it lasts over a year and is a bit of a harsher product giving more volume than the other products. Voluma lasts about a year if used properly.  Juvederm and Restylane will last about 9 months.

MTF Beauty Expert: What is the down time for the cheek procedure and for the lips?

Cristina: I always tell my patients not to have anything planned for 3-5 days after injections. Some people will have bruises that might be visible, so it is important to be aware of that if you’re someone who won’t want to go out with bruising. Also taking Arnica tablets and eating pineapple for about 5 days prior to your appointment can help shorten the bruising time.

MTF Beauty Expert: What are your thoughts on prevention vs corrective procedures?

Cristina: Prevention is always the best policy! This starts with always washing your face before bed and wearing sunscreen at a young age. If we protect our skin we will need fewer things done down the road. The younger you can get on a skin care regime the better.

As far as injectables go, if you are shooting for prevention at a young age you don’t need a lot of product. Solutions such as Botox and Dysport are neuromodulators that help relax the muscles in the face. Getting a neuromodulator 2 times a year should slow down aging and make your process easier in the long term. These are great for preventing those deep lines from becoming static and more permanent thus harder to correct.

Fillers such as Juvederm, Voluma, and Restylane are made of hyaluronic acid that is a naturally occurring complement of skin that aids in re-inflation. If you are looking for plumpness and not a wrinkle fill these products might be a better fit for you and can be added into your preventive care.

When talking about correction, the most important thing to note is that when working within a budget the patient has to be realistic about what can be expected. If you are someone with deep set lines these can not be corrected with a single syringe of Botox! Talk with your doctor about finding out what you will need to get the results you are looking for and what you are comfortable with budget wise.

the derm diva

MTF Beauty Expert: Speaking of correction V prevention, what procedures are you seeing become popular with the different age groups?

Cristina: The 20’s I am seeing a lot of clients wanting lips and cheeks done with fillers, 30’s we start to see clients for their smile lines and crows feet treated with botox. From 40’s to 50’s we start to see people come in for deeper fillers using products like Radiesse to fill deeper lines in their faces that have come from longer term damage or those patients who are just maintaining their previous injections. 50’s and up we are talking about more intensive restorative processes.

MTF Beauty Expert: What pain levels would you expect for someone who is just starting with these procedures?

Cristina: The great thing about injectables is that they have Lidocaine ( a numbing agent ) inside of the syringes. After a few pricks of the needle, you should be feeling less and less pain. The lips are a more painful area than the cheeks as there are a lot more nerve endings in the lips.

MTF Beauty Expert: Tell us about some products you are loving right now? What are you must haves?

Cristina:  My most important piece of advice for anyone is to make sure you are always using sunscreen! Having a foundation with SPF is not enough, sun damage causes premature aging and wrinkles so it’s important to be proactive. Use an SPF before you put on other makeup no matter the season. Sun damage can get to you during any season! I highly recommend EltaMD UV Clear 46, it is lightweight enough to wear under your makeup and is great for sensitive skin!

Another favorite product of mine is Revision Vitamin C 30 lotion 15%. This is such a great completion brightening product and has tons of antioxidants that improve your complexion.

Our Experience 

A little more from us on the actual injections and the process. Cristina made us feel so comfortable and at home with her. Our MTF Beauty expert had never had any kind of injectables or cosmetic procedures so she had a lot of questions and concerns. Cristina took the time to explain everything that would happen! We started with the lips- Cristina warned that this would be the more painful procedure of our two. After the topical lidocaine numbed our lips a bit we were ready to start. Our first few injections did hurt a bit since the skin around the lips is sensitive. However, after a few minutes, we couldn’t really feel the injections and it was relatively painless from that point forward due to the lidocaine in the Juvederm formula. The plumping effects were immediate. Right after Cristina put our last of the 1 syringe of Juvederm used during our session we looked in the mirror and loved what we saw. Our pout was plumed but not at all changed in shape. Our lips weren’t sticking out in a way that looked like we had just had injections. The look was totally natural. What more could we ask for?!

lips augmentation

Next came our cheeks with Voluma. This is an increasingly popular procedure to give patients the contoured look without all the bronzer! Cristina preps our skin with a more cleansing skin prep called hibacleanse. This is an important measure as these injections are going right to the bone. We have to say this set of injections did not hurt at all! After one poke we were started and didn’t feel a thing. There was a bit of a weird sensation as we could hear the Voluma going into our bone. But the results are certainly worth it. Days later we have higher cheekbones and some of the lines under our eyes are diminished! Cristina used a syringe on each side of our face for the perfect contoured look!

cheek and lips augmentation

All in all – we see why this craze has taken off. Our new look has given us a natural but amazing new confidence. Our friends have complimented our makeup but can’t put a finger on what is different about our look. We had minimal bruising and even were able to attend a black-tie gala the evening of our injections. The after photos here were taken 4 days after injections.

Cristina is a MASTER of making fillers look natural and we can’t wait to explore more of these produces with her!


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