Fillers vs. Botulinum Toxin

Fillers are volume enhancers for the areas of concern.  They are used to plump the soft tissue to decrease the appearance of fine lines and wrinkles and volume loss.  The fillers can help improve collagen in the soft tissue over time.  The composition of the fillers available today are hyaluronic acid, poly-L-lactic acid, or Calcium Hydroxylapatite.  These are produced under different trade names.  Different fillers are used for different purposes.  The hyaluronic acid, produced under many trade names including Juvederm and Restylane, is reabsorbed by your body over time.  Sculptra or poly-L-lactic acid is a different volume enhancer that takes up to 2 months to show the final result.  Typically 3 treatments are needed spaced about 2-3 months apart for optimal results.  The result can last up to 2 years.  Radiesse or calcium hydroxylapatite is a subdermal filler that can help stimulate collagen production over time.

Botulinum toxin is used to decrease muscle contraction of facial muscles that causes facial wrinkles including forehead wrinkles, glabella wrinkles or “11” sign, crows feet or wrinkles around the eyes, bunny lines or wrinkles on the nose, wrinkles around the lips, and wrinkles around the neck.  Some of these locations are off label used.  It takes at least 5 days before the effect is seen.  There are different types of botulinum toxin and they are made under the trade name of Botox, Dysport, and Xeomin.

Both botulinum toxin and fillers have been used extensively and most often in combination to rejuvenate the face and restore its natural beauty.  Individual plans will be customized to your needs after a throughout evaluation.  (See before and after photos of fillers)

What is the procedure?

Your face will be numb with a cream first in the office to reduce discomfort during injection.  The injection is done with a small gauge needed.  There is no read downtime.  Although, bruising can occur but can be camouflage with make up and will resolve within 2 weeks.

What to expect after fillers?

Swelling after fillers is expected and will take about 2 weeks to resolve.  The most feared

What are possible complications?

Complication is accidental injection of the filler into a blood vessel causing blockage of the vessels that can lead to blindness or tissue necrosis/death.  Hence, injections must be done by experienced, well trained specialists that have a good understanding of the anatomy to reduce this risk.  If this occurs and is identified early on, hylenex or hyaluronidase can be injected into the area that might help reduce the amount of damage.  Hylenex only works for hyaluronic acid fillers.

What if I don’t like how hyaluronic acid filler looks after injection?

Hyaluronic acid fillers can be reversed with hylenex or hyaluronidase.


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