Often, patients interested in facial rejuvenation will ask us, “Do I need Botox® Cosmetic or fillers?”
Most of the time, we consider the symbiotic relationship between Botox® Cosmetic and the array of fillers available, and suggest combining them.
It is important to understand the difference between Botox® Cosmetic, a muscle relaxer, and Restylane, Juvederm Injectable Gel, Radiesse, and other fillers. If someone has a line that is apparent only when making an expression, Botox® Cosmetic is often all that is necessary to correct it. Botox® Cosmetic can be used to treat such lines on the forehead, around the eyes, around the mouth, and the chin area. Fillers are used to fill deep creases in the skin that remain even when the face is at rest. They also can be used to improve or enhance facial structures such as cheekbones, lips, noses, hollows under the eyes, jaw lines, acne scars, or to improve balance in the face. As we age, we experience a loss of volume in the face, particularly apparent in thin people and those who spend a lot of time working out. This becomes a catch-22, in the sense that the people who have spent the most time taking care of their bodies often look older in the face than those who are more sedentary.
Many times, if creases have already been softened with Botox® Cosmetic, smaller amounts of filler can be used, such as in the area between the eyebrows. When Botox® Cosmetic accompanies filler in the lips, many people find their filler has a longer duration. We frequently have patients who complain of dark circles or hollows under the eyes. This is caused by loss of the fat layer due to a natural downward pull of the cheeks as we age, and can be remedied by the precise placement of an appropriate filler. Addition of filler in the midface area not only instantly refreshes the face; it can replace the mid-facelift giving a much more natural look. This is not to say that injections can always replace surgery. There will always be cases that require a full facelift to give the desired outcome.
Combination therapies can yield amazing results, literally taking 10 or more years off a person’s face instantly. These treatments are always individualized, depending on natural facial structure, skin elasticity, and the patient’s own wishes. In the hands of an experienced injector, thoughtful combinations of Botox® Cosmetic, Juvederm Injectable Gel, Radiesse, Restylane, Prevelle Silk, and Evolence can be used to take ten years off of your appearance in a matter of an hour. This approach to facial rejuvenation is deserving of the term “Liquid Facelift” as it addresses the signs of aging before you need the knife!