Do I need Botox or Filler – Botox Vs. Fillers

Do I need Botox or Filler?

Many people see wrinkles, depressions, and uneven skin sagging and are not sure what to do or how to start rejuvenating.   Often, patients come in pointing at a spot asking for Botox, when in fact the area can only be repaired with a filler.

Rejuvenation is rejuvenation – what is the difference?

Botulinum toxin (BOTOX, Xeomin, Dysport and similar products) work to relax muscles in the face, which can temporarily decrease or even eradicate the appearance of wrinkles and fine lines.

Usually botulinum toxin works best on dynamic lines on the face, where dermal fillers are preferred for stationary folds and depressions.  Areas that respond well to botulinum toxin include the crow’s feet/wrinkles around the eyes, vertical wrinkles between the eyebrows, and horizontal “worry” wrinkles along the forehead.

In other instances, botulinum toxin can be used along the lateral arch of the eyebrows to widen the eyes, along the jawline to upturn the corners of the mouth, and in the chin to decrease dimples and indentations in the central chin.  Botulinum toxin is also used to treat medical conditions such as hyperhidrosis (excessive sweating) and migraines.

Does Botox Last Forever?

On average, botulinum toxin will last three to five months.  There is virtually no down time after treatment — you are able to return to normal activities on the day of treatment. Occasionally, patients may have very small bruises at the sites of injections but this is infrequent.

Patient with known muscular or neurological disorders or those who are pregnant/breastfeeding are not good candidates for these types of injections.  Always discuss the procedure, your expectations and any other concerns with your dermatologist before you begin treatment.

Ok, so botox is not the answer for me.

When natural depressions are augmented, this may be a time for fillers.  Dermal fillers (Juvederm, Voluma, and Volbella) best in more stationary depressions in the face as they replace volume loss — botulinum toxin cannot replace volume loss. Fillers are frequently employed to augment that appearance of the cheekbones and fill in deep lines such as the nasolabial folds.

Skilled providers can also use fillers to up turn the corners of the mouth and improve the contour of the jaw.

Dermal fillers come in a variety of formulations, which will determine where the filling material can be used and how long it will last. Fillers typically require more precision during injections as compared to botulinum toxin because your dermatologist needs to manipulate the filling material to lift and smooth the skin contours.

Fillers typically last a minimum of 6-7 months.  Some fillers can last 1-2 years depending on the type of product selected.  Unlike botulinum toxin, dermal fillers can also be used to temporarily repair sagging earlobes, fill acne scars, augment the size and shape of lips, and even restore a more youthful appearance to the dorsal hands.  Injection of dermal fillers can be complicated by temporary bruising and swelling.  Always discuss the procedure, your expectations and any other concerns with your dermatologist before you begin treatment.