Botox & Fillers

More and more patients are taking advantage of non-invasive treatments that allow a person to return to their daily activities without downtime. Botox or injectable fillers such as Juvederm, Radiesse or Artefil, give immediate results usually without bruising or swelling or any visible sign. Understanding each product will help you make an educated decision about which product is right for you.

Patients are often confused by the many terms and product names that bombard them from the media and other sources. Adding to the confusion, many of the same substances are being made by different companies and marketed with different brand names. For example, Restylane the first hyaluronic acid (HA) filler, made by Medicis Aesthetics, lasts 4-6 months. Demand for longer lasting products led Medicis Aesthetics to develop a new filler they named Perlane. Still composed of hyaluronic acid, Perlane particles are larger thus it takes the body longer to dissolve and the filler last longer. Now multiple companies make a hyaluronic acid filler; Inamed offers Juvederm, and Mentor offers Puragen and more will follow.

Injectable fillers are made of differing substances that effect how long they last. The hyaluronic acid fillers mentioned previously are the shortest acting. Perlane and Juvederm Ultra Plus, typically last 8 months to one year. Hyaluronic acid fillers are FDA approved for injection into the nasolabial folds (parenthesis lines around the mouth). Hyaluronic acid fillers are soft enough to be used in the lips, although use in the lips is not FDA approved or considered an “off label” use.

Radiesse, another common injectable filler, is made of calcium hydroxyapatite and lasts 18 months to two years. Radiesse received FDA approval for facial wrinkles around the mouth, facial lipoatrophy (facial fat loss from medications or sickness), and even for plumping the vocal cords in cases of chronic hoarseness. Radiesse is not recommended for lip injection even as an off label use. This is a longer acting alternative for facial wrinkle treatment or adding volume when needed.

A recent addition to the filler market is Artefill a permanent filler composed of polymethylmethacrylate (PMMA) and collagen. Although the collagen gets re-absorbed, the PMMA is permanent. This means life-long improvement of those unwanted facial wrinkles is possible. Artefill requires a skin test three weeks prior to injection to determine if you are allergic to the collagen component of the injection.

Botox works differently than fillers; however, in some locations the combination of the two products gives better results than either will individually. Botox works by decreasing muscle movement. Muscle movement is usually responsible for creating many of the wrinkles and creases that tell our age. When the muscles stop moving, the skin memory fades over the course of weeks to months and wrinkles become less apparent or if used preventatively never form. Botox’s effect on the muscles lasts three to six months. After an injection, you will begin to notice less muscle movement after one week. The inability to make scowl lines not only makes you look happier, but seems to actually make you happier.