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I often have patients come into my office for a consult seeking a more youthful appearance (aren’t we all?). They start pointing to areas of concern starting in their upper face, forehead, and around the eyes and slowly move down to the lower face. Inevitably everyone starts asking the same thing: can I put botox down here as well? Patients are often pointing to their nasolabial folds or laugh lines which are deeper wrinkles around the mouth. Or, they may start pulling back on the skin in front of their ears creating a “tighter” appearance. I am going to break down the difference between botox and dermal fillers.

The group of medications that include Botox, Dysport, and Xeomin, are all classified as neurotoxins. Just hearing the word “toxin” in there can make them sound scary, but these are perfectly safe. They differ in their chemical structure or formulation, which influences how much of the product is used, how quickly you can see results, and how far the the product spreads within the muscle. Neurotoxins are injected directly into the muscle, and they work by preventing the muscle from contracting. These muscles are responsible for facial expressions, and so by softening the expression, the muscle is no longer able to contract and crease the overlying skin. Bye bye wrinkle! Now, we’re not talking about a frozen face - and this is exactly where the science of medicine intersects with the art of injecting. Experienced injectors know how to subtly soften the appearance of wrinkles in a subtle and natural way, without looking overdone or frozen.

What are dermal fillers? There are many different types of dermal fillers (recognizable names include Juvederm, Restylane, Sculptra, and Radiesse among others), however, all dermal fillers are used to fill volume loss, or in some cases enhance already existing volume. Deeper lines and wrinkles in the lower face (under the eyes, cheeks, nasolabial folds or laugh lines and marionettes) are typically a result of volume loss due to the aging process. Dermal fillers will add volume to flatten out creases and folds in the face (under eye filler, for example, called “tear trough” filler is a good example), in areas that have lost fat and collagen due to the natural aging process.

Not all filler injections are equal. There is no one-size-fits-all filler. When choosing your injector trust that he or she has done their research and has an in-depth knowledge of each product, will take a thorough history, understand your specific goals, evaluate your individual anatomy, in order to ultimately decide what procedure is right for you. These are the elements of my driving philosophy - only after a holistic and individual consultation can I deliver you the results you’re looking to achieve.

What questions do you have about injectables? I’d love to hear from you. Leave a comment below and I’d be happy to answer!

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