Juvederm, Botox, Dysport, Sculptra, Restalyne: Understanding What’s What When it Comes to Injectables & Dermal Fillers

Dermal Fillers & InjectablesWhen it comes to dipping your toes in the pond of cosmetic injectables, the choices can be intimidating to say the least. Don’t worry, you’re not alone! Many patients enter into this arena with an understandable array of questions; hopefully the following explanation can help in understanding some of the available options.

The most common question asked at the Emory Aesthetic Center is often about the difference between “Botox©” and “fillers”. The simple answer is that injectables such as Botox©, Dysport© and Xeomin© (sometimes referred to as “neuromodulators”) work at the site of muscles to stop them from moving for a period of 3 – 4 months. These injectables are best used to treat areas where lines are formed due to repetitive motion: for example, the “frown lines” between the eyebrows, horizontal lines in the forehead, and “crows feet” around the sides of the eyes. Injections can be done in other places on the face, such as “lipstick lines” around the mouth, but these must be done by a surgeon well trained in the anatomy of this area as unintended (and unwanted!) consequences could result.

All three neuromodulators (Botox©, Dysport©, and Xeomin©,) work on the same principle and give similar results but are manufactured by different companies with their own proprietary methods. The choice of which injectable to use depends on the experience and comfort of your cosmetic surgeon as well as the possible subtle differences between them. Again, results last approximately 3 – 4 months in most areas, and take between 3 – 5 days for onset after injection.

It is important to understand that treatment with neuromodulators, like Botox©, does nothing to improve loss of facial volume, but is often a critical part of a well-crafted plan to enhance your overall appearance, improve and open up the eye area, and smooth the overall texture of the skin. Some studies have shown using these injections gives your brain positive feedback and improve your mood because of the inability to frown!

Dermal fillers, on the other hand, are ideally used in areas where lines or folds are seen at rest. Commonly treated areas include the cheeks, “smile lines” that run from the nose to the mouth, hollowing under the lower eyelids, sometimes the lips and even the temple area for loss of volume.

Starting in our 30s, skin has a tendency to lose collagen. Collagen contributes to the “plump” texture seen in the skin of most teens and young adults, but is damaged over time with sun exposure and naturally decreases with age. Along with other natural effects of facial bone loss, this can contribute to areas of hollowing in the eye area, folds around the cheeks and lips and possibly the early formation of jowls.

Juvederm, Restylane, Radiesse, Voluma and Sculptra are dermal fillers, and can counteract some of these changes by adding volume to these areas of loss. The decision regarding which fillers to use, and where, is often one that is guided by your facial or cosmetic surgeon. Preferences may be based on safety profiles for certain facial areas, or personal preferences based on experience and past results.

The longevity of these fillers can vary based on many factors: where the material is injected, and how deep the injections are performed. Some of these products have subtypes that have been formulated to be thinner or thicker based on the specific need. For example, an ultra thick form of a certain filler would be great to use in the cheek area, but not ideal for the subtle volume needed to fill a lipstick line. Sculptra or Radiesse would not be indicated for injection in under-eye areas or around the lips, so these are limited to cheeks, jowls, temples or cheekbones.

All of the injectables used at the Emory Aesthetic Center are FDA approved, however it is important for patients to understand that some of the facial areas listed above are non-FDA-approved areas for injection. Over time physicians have adapted these fillers for use in many areas of the face with good results. Because of this, seeking consultation and treatment with a cosmetic or facial plastic surgeon is not only preferred, but is the safest option. Practitioners who do not perform cosmetic surgery or do not understand the underlying anatomy can cause unnecessary risk, unneeded complication or adverse effects by “experimenting” in these areas.

Although the options seem endless and sometimes confusing, make sure you seek out professional advice from someone you trust, even if it requires more than one visit to feel comfortable. The best relationships will be ones maintained with cosmetic or facial surgeons who are able to address your particular concerns to your satisfaction. Here, at the Emory Aesthetic Center, our cosmetic surgeons have extensive experience and can explain the differences between all these treatments. We offer a full spectrum of options and will customize a plan that best fits your needs.

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