Injectables are minimally invasive, non-surgical treatments for patients seeking correction of wrinkles, volume loss, spider veins of the legs and fat reduction.  Dermal filler is also used for augmentation of the cheeks or to increase the fullness of the lips.  We offer injectable treatments that are FDA approved, safe and effective.

Dr. Michalak performs all of the treatments we offer in the clinic and is considered to be an expert injector. He has very high standards for training and has personally trained injector’s Emily Nardiello, PA-C and Elizabeth Wood, PA-C. They also specialize in popular treatments like Botox, Restylane, and Juvederm.

What Injectable Treatments Do We Offer?

 Neuromodulators: Better recognized under the brand name’s Botox Cosmetic and Xeomin for the treatment of facial wrinkles. Injectables, Botox and Xeomin work by preventing small muscle contractions helping to relax areas that make us look prematurely older than we are or in some instances angry or sad when we are not. Common treatment areas are between the brows, forehead and crow’s feet.  Botox is also used for excessive sweating (hyperhidrosis). Treatment areas include under the arms and hands. Neuromodulators typically last 3 to 4 months.

Dermal Filler: Is used to restore volume loss or augment areas such as lips and cheeks to create a better-balanced face. It can also be used to improve volume in hands so they look more youthful with less visible veins.  Soft tissue augmentation has come a long way since its inception and there are a lot of choices to work with.  Some of the most recognizable ingredient’s used are hyaluronic acid (Restylane, Juvederm, calcium hydroxylapatite (Radiesse) and poly-L-lactic acid (Sculptra). Each brand has it’s unique point of difference and longevity. Hyaluronic acid is a great first time choice for patients new to filler and has the added benefit of being dissolved with the enzyme hyaluronidase if necessary.

Kybella: Bothered by a double chin? Kybella (deoxycholic acid) is the first FDA approved injectable for treatment of submental fullness and might be the solution for you.  Kybella destroys fat cells when injected and takes 3 or 4 treatments. For patients who do not want to do tumescent liposuction, Kybella can be a good second choice.

Sclerotherapy: Treats spider veins of the legs by injecting a sclerosing agent like Asclera so small veins collapse and are absorbed by the body. Treatments are comfortable and take around 30 to 40 minutes. Some veins require more than one treatment and only certain types and sizes of spider veins can be treated. Often patients have best results by combining sclerotherapy with a pulsed dye laser like the V-Beam.

How Do I Get Started?

Appointments for Injectable treatments can be made by calling our main number in Issaquah, 425-391-2500. You will need a consultation for Kybella and Sclerotherapy to determine if you are a good candidate for these procedures. if you have never had dermal filler, we also recommend starting with a consultation.  Be sure to check with your provider with what treatments they specialize in.


Injectable filler has grown to be a mainstay in today’s arsenal to fight aging or augment areas like cheeks and lips for better facial symmetry. Unlike years ago when collagen was the only option, we now have a wide variety of fillers available to treat specific areas, melding into the skin seamlessly. The outcomes are better and patients look more natural, making fillers a popular choice for rejuvenation. The longevity has also been improved upon with some brands lasting two years or longer. Dermal filler remains one of the top 3 ranking non-invasive procedures patients seek out and starting early has its benefits to improve the way our face ages without dramatically changing the way you look.

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Lip Augmentation

The size and shape of your lips can now be enhanced with procedures known as lip augmentation. This procedure typically requires injection(s) of dermal filler such as Restylane or Juvederm. Lip augmentation can provide fuller, more kissable lips, along with fewer wrinkles around the mouth area. We provide lip augmentation procedures using the latest FDA approved injectable products. Lip augmentation can be tailored to meet your cosmetic goals, whether you want to simply add volume or reduce lines and wrinkles.

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Lift your skin and restore your cheek fullness with this new volumizing and lifting hyaluronic acid product treatment.

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Juvederm and Restylane are widely used for the temporary correction of facial wrinkles and folds. Made with a special NASHA (non-animal stabilized hyaluronic acid) Restylane is injected beneath the skin to act as a hydrator and cushioning agent, effectively reducing the appearance of wrinkles for several months. The majority of patients who undergo this treatment desire a correction of the nasolabial folds, the distinct lines which travel from the sides of your nose to each side of your mouth. We may also recommend Restylane for treatment of marionette lines, lip lines, lip enhancement, and other facial wrinkles around the chin, cheeks, and temples.

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Radiesse is extremely versatile. Nearly any wrinkle can be treated, including facial wrinkles and folds. Radiesse injections for hands restores lost volume to aging hands, reducing the appearance of veins and tendons for smooth, natural-looking results. You may want to consider Radiesse injections if you exhibit wrinkles like nasolabial folds, marionette lines, flat or sunken cheeks, or scars. The correction should endure for about one year after your injectable treatment. Your body will slowly metabolize the filler and clear it away. Most patients return for a touch up after about 12–18 months.



Sclerotherapy is a common injectable treatment for spider veins in the legs. Treats spider veins through laser therapy as an alternative to the injectable solution. Both methods are effective for treating spider veins of the legs. After the quick treatment, you will be able to carry on with your day with no downtime required. Your doctor will instruct you to wear compression hosiery after your treatment. Walking is encouraged. The results from your sclerotherapy treatment are permanent.

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When you frown, you gather the tissue between your eyebrows into a fold. For some, this causes a chronic furrow. This produces a frustrated, discouraged, angry look on the face. Now you can eliminate these frown lines without surgery and without scars, through a simple injectable treatment using Botox® Cosmetic. A treatment takes only a few minutes and the Botox® injections take effect in three to four days. Gradually over three to five months the results will fade, and the muscle action will return. Cosmetic surgeons have also used Botox® injections for the treatment of crow's feet, forehead wrinkles, lip lines, and neck folds.

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For many men and women, excess fat along the neck and chin is a troublesome area as it is hard to target with diet and exercise. If you’ve been fighting to lose your double chin, Kybella injections may be the answer. We now offer the non-surgical fat melting procedure to help reduce excess fat below the chin. Kybella injection treatments will last about 15-20 minutes—many patients choose to come in for treatment during their lunch break and return to their schedules with little to no downtime. Slight bruising after injections is normal, but makeup can help hide some of these post-treatment signs.

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Sculptra is FDA-approved for treatment of facial folds and other contour depressions on the skin. There are many possible uses for Sculptra injections, but the most common indication is volume loss in the skin (facial lipoatrophy) that causes wrinkles and folds to appear. By injecting Sculptra into the skin, your doctor can provide a long-term correction of conditions such as nasolabial folds, sunken temples or cheeks, chin wrinkles, marionatte lines, and other unwanted contour depressions. Sculptra injections are not considered a “quick fix” like other wrinkle fillers; it takes time for the results to appear over a short series of injection treatments.

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Belotero® is the newest injectable wrinkle filler our office offers. Belotero injections can treat common problems like wrinkles, folds, and loss of tissue volume caused by aging. Made from hyaluronic acid, Belotero injections requires no allergy test and lasts six to 12 months. A typical Belotero treatment takes about 20 minutes. Patients in studies showed results lasting up to nine months after one Belotero treatment. Remember that once your results wear off, you can return to our office for a touch-up treatment.

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