Botox and Filler are two of our most common consultation request we see at Charlottesville Plastic Surgery, so we thought an August blog explaining how the two work would be a great summertime read. Although Botox and Filler have some overlap in what they treat, we often noticed there is some confusion between what exactly Botox and fillers treat. The most common request we hear from first time Botox patients are – “I don’t want to look frozen” or “over injected,” and we feel that this is a common misconception of how botox and filler will alter your facial appearance. Below, we will breakdown how Botox and filler work, where they are commonly injected on the face, and exactly what wrinkles and effects you can expect from each treatment.
To preface, injectable treatments offer a safe and non-invasive option that can easily meet the anti-aging needs of both men and women with no downtime for recovery, minimal discomfort, and take only a few minutes to administer. Dermal fillers and Botox have become the mainstays of “youthful maintenance therapy” and have become so commonplace, that we, as plastic surgeons, are seeing fewer and fewer older patients needing more invasive surgical therapy.
Botox is derived from the botulinum toxin and acts by paralyzing targeted muscles. Did you know that Botox is actually a trade name? Botox has become such a household name, that many people do not realize that there are many neurotoxins on the market that are just as effective and act in the same way. Although Botox was the first to get FDA approval for facial wrinkles, and it’s name has become a catch-all for all neurotoxins, there are equally as effective brands, such as Dysport and Xeomin, that target the same dynamic wrinkles.
The most common areas treated with Botox is the mid-upper face, and include forehead lines, frown lines, and crows’ feet. Although there are targeted areas below the mid-face that can be treated with Botox, wrinkles from the nose down are typically reserved for filler.
Dynamic wrinkles are lines in your face that appear, or form over time, from repeated muscle movement. When you are not raising your eyebrows, or scowling, the wrinkles may soften or disappear completely. These are the best wrinkles to treat with Botox because when you paralyze the muscles that form these wrinkles, your skin relaxes and the wrinkles dissipate. If you have severe, deep wrinkles of the upper face, Botox will certainly help soften the appearance, but might not totally eliminate the lines. This is because the skin construct has changed overtime and these wrinkles have become static wrinkles. We will discuss how to treat these in our next section covering fillers.
Botox only acts on moving muscles, so unless you constantly are wrinkling your forehead, or scowling at people, then people will not know that you had Botox injections to these areas. Your forehead and brow will appear calm and relaxed. You will still have all of the muscles of facial expression around your mid and lower face, which is 90% of facial expression.
In regards to recovery, you will start to see the effects of Botox in the fist 4-7 days, and most patients can expect to see full results within two weeks of treatment. If you think you need any touch up injections, we often tell patients to wait the full two weeks to allow the Botox to fully take hold before coming back in for any fine-tuning. Injections are often needed every 3 to 6 months to maintain their results. Some patients prefer to preschedule maintenance appointments, and others choose to wait to see how long the product lasts for them.
Dermal fillers address the loss of youthful fullness and volume in the face as we age. Hollowness in the face, sagging skin, fine lines, and wrinkles develop over time and can become a permanent fixture on the face – these are called “static wrinkles” and do not go away with cessation of facial movement. These are the best wrinkles to treat with filler, as they are present even if you are not moving your facial muscles. Wrinkles on the lower face and around the mouth that only appear with smiling or laughing are not ideal for filler, as they disappear when your face is at rest. Injecting the fillers into the problem areas plumps the skin to smooth wrinkles, fill the indentations or volume loss, and make the skin firmer and tighter. The most common areas for filler injections are the tear troughs (depressions under the lower lids), the nasolabial folds (the crease from the side of your nose to the corner of your mouth), the marrionette lines (lines from the corner of your mouth to the jawline), the cheeks and cheekbones, temporal hollowing, jawline, and pre-jowl sulcus (the depression directly in front of your jowls on the jawline). Targeted injections can also enhance the lips fullness and dehydrated appearance. The results of filler are immediate and will continue to improve over the following few weeks.
Filler can also be used for other, less common areas of the body, including the back of the hands to restore a fuller, more youthful look, the neck, and upper chest area. A non-surgical Brazilian Butt Lift can also be performed to improve contour, fullness, and to fill in the “hip dips” with various fillers.
Like Botox, dermal fillers are only a temporary solution. Follow-up injections are needed to maintain results and patients should expect to the filler to last anywhere from 8 months to 2 years, depending on the type of filler. A consultation before the treatment can give each person a reasonable expectation of when they should schedule their maintenance injections.
Many people choose to use Botox and dermal fillers at the same time. Since each product subtly addresses different skin concerns, using injectable fillers and Botox together provides more of a youthful boost. The combination can produce noticeable anti-aging results.
Botox and dermal fillers have similar aftercare instructions and recovery processes. Both products may cause redness, mild swelling, or tenderness around the injection site. There is always an inherent risk of very mild bruising. There is no downtime needed, though patients should avoid direct sunlight, swimming, alcohol consumption, and strenuous exercise for a day or two after treatment.
Looking youthful does not need to require surgery, stitches, and long recovery periods. Injectables are a faster and more affordable option. Contact Charlottesville Plastic Surgery on the phone or online to schedule a consultation. Don’t miss out on our limited-time injectable specials this summer when you book with our new nurse injector, Amy Falls, RN.Back to Blogs