What’s Best For Your Treatment Plan: Botox Or Fillers?

Aesthetics is a wonderful world… if you know your way around your injectables, that is.

Granted, your physician is the true expert and if you’ve chosen one with professionalism, experience and qualifications on their side, you don’t really need to know the exact differences between Restylane and Radiesse, or Botox and Belotero Balance. However, when it comes to needles and our faces, we don’t know about you, but we’d rather not walk into the consultation room completely blind. We want to know what our skin needs. And why.

So, how do you know if neurotoxins like Botox, Dysport and Xeomin are what the skin doctor ordered, or whether your concerns would benefit better from dermal fillers such as Juvéderm or Restylane? Well, first up, you need to know the difference between the two, then, and only then can you make a judgement…

What Are Neourotoxins?

Neurotoxins are used primarily to temporarily soften active facial lines like crow’s feet and frown lines before they become deeper wrinkles. (They’re also used to treat excessive sweating, migraine and all manner of other concerns, but that’s a whole other story).

Botulinum toxin type A is the most widely used neurotoxin in non-invasive cosmetic procedures and is made from a purified toxin derived from bacterium clostridium botulinum. This toxin is diluted and injected into specific facial muscles where, within seconds, it paralyzes them by blocking the nerve impulses that control movement. This, in turn, prevents repetitive motions that cause fine lines.

The main contenders are Botox, Dysport and Xeomin, and while Botox is the most commonly known, they each have their own benefits.

“Neurotoxins are roughly the same,” explains HintMD partner Dr. Steven Swengel, CEO and Medical Director of Refined Dermatology in Los Gatos, CA.

“Botox is my silver bullet and great for nailing specific muscles and hitting certain lines, whereas Dysport tends to spread a little bit more, so is great for flat muscles such as those on the forehead and around the eyes,” he adds.

And Xeomin? Well, studies have yet to determine reliable data on long-term efficacy, but many aestheticians find that Xeomin works better on patients who’ve built up antibodies to Botox or Dysport.

Who Are Neurotoxins Best For?

Neurotoxins are most effective for patients looking to treat expression lines around the mouth and eyes, on the forehead or between the eyebrows (bye-bye resting bitch face). They can also help smooth bands around the neck, but will neither plump the skin, nor work on deep wrinkles that have been etched into the skin over a long period of time.

There’s also very little downtime associated with neurotoxins, so they’re perfect for anyone wanting to nip out in their lunch break and be back at their desk with very few questions asked.

What Are Dermal Fillers?

Unlike neurotoxins, fillers have no paralyzing effect. Instead, as their name suggests, they temporarily ‘fill’ or bulk up the tissues underneath your skin to replace proteins that have been lost in the aging process.

Skin aging usually begins in your 20s (gasp) when the structure of your skin starts to lose collagen and elastin and consequently the ability to maintain suppleness, strength, volume and youthfulness.

Fillers come in a variety of forms to replace this loss of volume, but these days, the most popular are hyaluronic acid-based. Hyaluronic acid (HA), or hyaluronan, is a type of polymer found naturally in the body. Composed partly of sugars, it’s found in abundance in the skin’s structure where it acts as a powerful humectant – meaning it holds moisture to keep the skin soft, firm, plump and hydrated.

HA levels deplete with age which is why injectable hyaluronic acid fillers like Restylane and Juvéderm are so popular and effective. Typically lasting from four to 12 months, hyaluronic acid fillers are injected deep into the skin to immediately replace lost HA and temporarily restore moisture and fullness to the face.

Treatment involves injecting a tiny needle into the target area – a quick and relatively painless procedure – and as with injectable toxins, results are immediately gratifying and there is very little downtime.

Who Are Fillers Best For?

Dermal fillers are great for anyone concerned with thin, sagging skin and/or deep wrinkles that have been hanging around a little longer than liked. They’re primarly used in the cheeks, lips or jowl area, but can also add volume to those painful balls of the feet (known in the fashion world as a ‘loub job,’ fyi) and to thin, aging hands.

“Radiesse, for example, is a wonderful, natural way to reduce the appearance of lines, veins and bony hands,” explains HintMD partner and board-certified cosmetic and plastic surgeon Dr. Barbara Persons, MD FACS, owner of Persons Plastic Surgery in Lafayette, CA.

“We often use it for hand rejuvenation as it delivers hyaluronic acid and a natural calcium derivative underneath the superficial fascia of the hand, turning old skin into youthful-looking skin with a simple, two-minute injection and a short massage.”