Botox, Dysport or Fillers? It Depends on Your Wrinkles

If you’re looking in the mirror these days and wondering what you can do to smooth out some of those wrinkles, there are a wide array of products and procedures that can help. Knowing which ones are for you starts with getting to know your wrinkles a little bit better.

wrinklesDynamic Wrinkles

Botox and its newer competitor Dysport are made from the botulinum neurotoxin which blocks the action of nerves on muscles and are used to treat dynamic wrinkles, that is wrinkles that are caused by muscle activity.  Dynamic wrinkles are those that are seen when you animate your facial muscles, such as the ’11’ between your eyebrows when you frown, or the lines across your forehead when you try to look up or raise your eyebrows, and the smile lines in the corners of your eyes (crows feet).  These wrinkles can make you look tired and angry even when you are not.

The procedure involved to do a Botox treatment is quite simple. A very tiny needle is used to inject the Botox into the wrinkle-producing muscles. No anesthesia is required and the injections usually take only 10-15 minutes.  There is no recovery time or down time though you may see some temporary redness or bruising at the injection site. On average, it takes 3-5 days to start to see an effect and up to 3 weeks to see the maximum results from Botox.  Results usually last about 3 months.

Static Wrinkles

Fillers are complementary procedures – they are not the same thing as Botox and should not be thought of the same.  While Botox is used to treat dynamic wrinkles, fillers are used for static wrinkles and to enhance volume.  Static wrinkles or lines are those that can be seen even at rest, such as the nasolabial fold that runs from the side of the nose to the corner of the mouth on each side or marionette lines.  Fillers are used to ‘fill’ these static lines and folds.  It is important to note that these static wrinkles have multiple causes: loss of volume of the face as we age, sagging due to gravity, and some static wrinkles are accentuated by muscle activity (e.g., nasolabial folds deepen when smiling).  Fillers can also be used to plump or augment the lips and treat lipstick bleed lines.

Commonly used fillers include collagen (Cosmoderm, Cosmoplast) which is a natural substance known as a protein and is the main component in cartilage, teeth and bones; hyaluronic acid (Belotero, Captique, Perlane, Restylane and Juvederm) which is also a natural substance found in your body, high concentrations are found in soft connective tissue and in the fluid surrounding your eyes as well as in some cartilage and joint fluids, as well as skin tissue; calcium hydroxyl apatite (Radiesse) which is found naturally in human bones, and polylactic acid (Sculptra) which is a synthetic material that when injected, stimulates the body’s own production of collagen.

Filler injections usually require local or topical anesthesia and can take anywhere from 15 to 30 minutes or more depending on the area being filled.  You should stop any NSAIDS (aspirin, motrin, ibuprofen, naprosyn,  alleve, etc) for at least one week before the procedure to minimize bruising and swelling and avoid scheduling any important social events for at least several days after the injections. Fillers are temporary lasting anywhere from 6 months to over a year and need to be repeated to maintain your results.

Where to start

It is not uncommon for us to see patients who have a combination of static and dynamic lines, so often these two types of treatments are used together in facial rejuvenation. Dr. Green and Dr. Huang can examine you for both dynamic and static wrinkles and give you an opinion on which agent to use where. Call us at 360.823.0860 for a free consultation.