It has become increasingly clear to me that people often use the terms “Botox” and “dermal filler” interchangeably, thinking that they are either one and the same or that they perform essentially the same function. Since that is not at all the case, let us talk about each one individually.

Botox and Xeomin

Botox is a chemical that paralyzes any section of the muscle into which it is injected. Since it acts only locally – at the injection site – it is often necessary to perform a number of individual injections in order to weaken or paralyze the entire muscle. The number of the injections depends on the size of the muscle. Once a Botox molecule attaches itself to the muscle, our body’s immune system begins to destroy it. Thus, the length of time when Botox is active depends directly on the strength of our immune system.

Traditionally, the areas best suited for Botox treatments were the forehead, the frown lines and the laugh lines around the eyes. More recently, Botox was used on the upper lip to reduce the vertical wrinkles and in the neck to reduce prominent muscle bands. I also started using Botox in the temple and jaw area to ease the TMJ pain, or to produce narrrowing of the face for people who feel their faces are too wide. Botox is also used now to help people with migraine headaches.

You can expect Botox treatment to last about three to four months initially, but with continued use this interval can be extended for up to six months.

Dermal Fillers

Dermal fillers are either naturally occuring substances such as hyaluronic acids – Juvederm, Restylane and Prevelle – or synthetic compounds – Radiesse – which can be injected under the folds and wrinkles to reduce or even eliminate their appearance. Fillers have no effect on the muscles. Traditionally, fillers are used to fill in nasolabial folds – folds which run fron the nose to the corners of the lips – the marionette lines – lines from the corners of the lips to the chin – and to plump up thin lips. Radiesse cannot be used in the lips and is reserved for deeper lines.

Our body’s immune system destroys dermal fillers. The time that they last in the face depends on the strength of the immune system. Juvederm and Restylane can last up to nine months and Radiesse can last for over a year.

Both Botox and dermal fillers are distinct but equally important tools in facial rejuvenation.