The popularity of injectables is on the rise and has been for over a decade. While Botox is still number one, dermal fillers are quickly encroaching on that spot. Either way, the more pressing issue is selecting the right option for your skin, if you choose to give these treatments a try. Knowing the differences between all of your options is a job for the pros, so we called in New York City board-certified plastic surgeon Dr. Matthew Schulman and asked him to give us all the details.
Keep reading to find out when, where, and why to use each and every treatment!
First things first: Dr. Schulman points out that Botox is the brand name of a specific botulinum neurotoxin. “There are three FDA-approved neurotoxins available in the United States—Botox, Dysport, and Xeomin,” Dr. Schulman says. All three work by paralyzing the muscles and preventing muscle contractions. “Fillers can be of a variety of temporary or permanent materials and are used to fill lines.” Hyaluronic acid fillers like Restylane, Juvederm, and Belotero and calcium fillers like Radiesse are the most common.
“While both botulinum toxin and fillers are commonly used together, they work differently and are used on different lines.”
The simple rule? “Lines of expression need botulinum toxin. Lines at rest need filler.” Dr. Schulman says that while Botox is a great choice for hitting those “crease points” where muscles contract, fillers are best for deep lines that are present even when facial muscles are not contracting. Hyaluronic acid fillers, which come in a variety of thicknesses so that the right one can be chosen for each particular skin type, last nine to 12 months. “There are other fillers composed of calcium (like Radiesse), which are better for deep filling and can last 12 to14 months,” Dr. Schulman says.
Botox typically wears off around the four-month mark.
Dr. Schulman says hyaluronic acid fillers are great for lines of the face and filling lips. “Filling the deeper lines of the face, such as the marionette lines or nasolabial lines (i.e., laugh lines) is best accomplished with a hyaluronic acid filler.” For even deeper filling power—think sleep wrinkles on the cheeks and chin—he says to choose a calcium-based filler. “Botulinum toxin is best used in areas of facial expression such as the frown lines, crow's feet, and ‘11s’ between the eyebrows.”
“The best thing to do is to see a board-certified plastic surgeon or a dermatologist,” Dr. Schulman says. “They will be able to evaluate your skin and help you select the best treatment for your skin, desires, and pocketbook.”
Do you have any other Botox- or filler-related questions? Let us know in the comments!