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A guide to injectables (Botox®, filler) in cosmetic dermatology A guide to injectables (Botox®, filler) in cosmetic dermatology
What is the difference between Botox® and fillers? Both of these products can effectively soften lines and rejuvenate or enhance your look. They are... A guide to injectables (Botox®, filler) in cosmetic dermatology

What is the difference between Botox® and fillers?

Both of these products can effectively soften lines and rejuvenate or enhance your look. They are complementary to each other but work in different ways.

Botox® is a neuromodulator, of which there are several different brands with slightly unique properties- Botox® (Allergan), Dysport® (Galderma), and Xeomin® (Merz). Neuromodulators temporarily relax the muscles of facial expression to soften dynamic lines- lines that appear when we are expressive, such as frown lines. Depending on the product and location, they take a few days to take effect. When done well, results look natural. You should expect people to tell you “you’re looking good”, or “you look rested”. Neuromodulators for cosmetic purposes last, on average, 3-4 months before their effects gradually and completely wear off. There is evidence, however, that repeated use of neuromodulators leads to increased collagen production, so in addition to preventing dynamic lines from becoming static lines (more on that below), there are benefits to regular use.

Fillers are injectable products that add volume, or “fill”. These target mainly static lines (lines that are present at rest) and volume loss. As we age, we lose volume in certain fat compartments in our faces, and our bone structure changes. As we age, we lose that volume, and filler is a way to restore it. Fillers can also enhance your look- give you slightly more volume in your cheekbones or lips, for example. Again, the goal here is a natural, better-rested appearance- you on your best day.

There are multiple different classes of filler, but the most commonly used fillers today are the hyaluronic acid fillers. Hyaluronic acid, “HA”, is a naturally occuring molecule in the layer of skin called the dermis. It has numerours appealing properties, including the fact that it can be dissolved- so we have on hand an “eraser” if we need it. Some other types of filler are semipermanent and these cannot be disolved.

How do Fillers and Neuromodulators work together?

As discussed above, neuromodulators like Botox® relax muscles of facial expression to soften dynamic lines and prevent static lines like the “11s” between the eyebrows from forming. Fillers restore volume and enhance facial proportions. Furthermore, when used together, they can help each other to last longer.

How do I know what is right for me?

This is where you need an expert opinion. When coming in for a cosmetic consultation, it is helpful if you can identify one or a few areas that bother you. Now, get ready for the tricky part- we rarely start by treating right where you are pointing! This may seem counterintuitive, but to get the best and the most natural-looking results, the face must be treated as a whole. Volume loss in the cheekbones affects the nasolabial folds, the “red show” of the lips, and loss of elasticity in the lower face. A well-trained injector can tell you what is needed and in what sequence, and explain why. An experienced injector can also tell you what you don’t need.

The array of products available, and new products that will be arriving soon to the market make this a very exciting time in cosmetic dermatology. I look forward to keeping you up to date on these developments.

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Alexandra Kuritzky

Dr. Alex Kuritzky is a board-certified dermatologist with a medical and cosmetic practice at Pacific Dermaesthetics in Vancouver. She also attends at St. Paul’s Hospital and is a Clinical Instructor at UBC. She grew up on the North Shore and is grateful to be living here once more with her husband and two very well sun-protected boys. To connect with Alex, visit the Pacific Dermaesthetics website.

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