Fillers vs. BOTOX®, or Fillers with BOTOX®? New Jersey Dermatologist Dr. Robin Levin Highlights Panfacial Rejuvenation
Have you ever thought BOTOX® and filler were the same thing? While they can both treat lines and wrinkles, Dr. Robin Levin, a board-certified dermatologist and founder of South Jersey Skin Care & Laser Center, explains how different the two injectables really are, and how they can be used in conjunction for overall, or “panfacial”, rejuvenation.
For the past decade, non-surgical injectable treatments have been surging in popularity. While the most popular choice is still BOTOX®, New Jersey dermatologist Dr. Robin Levin notes that dermal fillers are steadily becoming more popular.
During consultations, patients often confuse the two injectables, asking whether dermal fillers are better than BOTOX®, or vice-versa. The truth is that while both may be used to rejuvenate the face, the way they function and the specific issues they target are quite different.
BOTOX® is Allergan’s brand of botulinum toxin type A, a neurotoxic protein that works by blocking the neurotransmitter acetylcholine (ACh), which signals muscles to contract. If the neurotransmitter signals are effectively blocked, the muscles stay relaxed.
Dermal fillers are liquid or gel substances that quite literally “fill” in areas to add volume. The most commonly used substance in fillers today is a synthesized, gel version of the hyaluronic acid that is naturally found in our bodies. Hyaluronic acid is like a sponge that keeps the skin moisturized, but as we age, its production in the body diminishes.
An easy way to understand the difference between the two is to consider the types of wrinkles we might see as we age. A broad way to categorize them is into static wrinkles and dynamic wrinkles. As their names indicate, “dynamic” wrinkles occur during facial expression, while “static” wrinkles are those that occur even when the face is at rest.
Because BOTOX® targets muscle contraction, it is used to treat dynamic wrinkles – such as the frown lines between the eyebrows and horizontal lines on the forehead – as well as other aesthetic concerns caused by contracted muscles, such as platysmal bands at the neck or bunny lines on the nose.
BOTOX® is ineffective on static wrinkles or other aesthetic concerns where muscle movement isn’t involved. Additionally, it may also have limited effects if the dynamic wrinkles are more deeply set and show even when the face is at rest (i.e. they become static) – this occurs over time with the loss of elasticity and volume in the skin.
Static wrinkles occur over time as the skin loses its elasticity and volume, as well as when fat pads diminish and move down the face. The most common manifestations of these effects are nasolabial folds (sometimes called laugh or smile lines) between the nose and outer corners of the mouth.
Filler can add volume that smooths the skin out to correct static wrinkles. It can also fill in other areas that might benefit from a volume boost, such as thin lips, hollowed cheeks and temples, or recessed scars.
A responsible injector will never use one as a substitute for the other. In fact, one who has that has extensive experience using both BOTOX® and fillers might strategically use the two in conjunction to achieve specific effects.
Consider lip augmentation, which has become particularly popular in recent years with both younger and mature patients. Dermal fillers can quite literally fill the lips to make them larger, and the gel-like consistency allows for manual massage to shape lips. In contrast, BOTOX® can relax muscles around the mouth, making the lips flip or roll out for a more accentuated pout (which is especially beneficial for patients who might want relatively subtle augmentation).
The most common scenario in which BOTOX® and filler might be used on the same patient is what many physicians dub the “liquid facelift” or “panfacial rejuvenation”. Using both at strategic points of the face, a skilled injector may be able to address a range of age-related concerns from crow’s feet to deflated cheeks, leaving a patient looking refreshed and youthful, yet still natural and expressive.
If you would like to learn more about BOTOX®, fillers, or both, you can contact Dr. Levin’s office online or by phone at (856) 810-9888 to request a consultation with her.