What’s the Difference Between Botox and Dermal Fillers?
For every person who sees the folds, ridges and creases on their face as evidence of a life well-lived, there’s another person who looks at them with dismay. Wrinkles and fine lines are an inevitable part of aging and getting older, but that doesn’t mean you have to like them!
While plastic surgery is an option, it’s expensive, invasive and can take a long time to heal. That’s why more and more people are turning to Botox® and dermal fillers to turn back the clock. But what are they exactly? And how can you tell which to get?
Here we will discuss neuromodulators, such as Botox as well as dermal fillers — what makes them different, what kinds of wrinkles they’re used to treat, and things to be aware of if you’re considering either procedure.
What is Botox and How Does it Work?
Botox is a neuromodulator. To be more precise, it’s a purified form of clostridium botulinum bacteria. In far higher doses, botulinum toxin causes botulism. But in small doses, the neurotoxin targets the nervous system, disrupting the nerve signaling processes that stimulate muscle contraction, effectively causing the muscles injected to weaken inducing temporary muscle paralysis.
In order for any muscle to contract, the nerves release a chemical messenger called acetylcholine at the junction where nerve endings meet muscle cells. Acetylcholine attaches to receptors on the muscle cells and causes the cells to contract or shorten.
Botox injections prevent the release of acetylcholine, which stops the muscle cells from contracting. In this way, the toxin helps the muscles to become less stiff.
There are actually several different brand-name injectable neuromodulators on the market including:
Botox® ()nabotulinumtoxin A).
Dysport® (Abobotulinumtoxin A).
Xeomin® (Incobotulinumtoxin A).
Jeauveau® (Prabotulinumtoxin A).
Daxxify® (Daxibotulinumtoxin A-lanm).
People casually use the term “Botox” to describe all of these products, though Botox is a registered trademark that one company owns.
Botox Cosmetic Uses
Botox is primarily used cosmetically to reduce the appearance of facial wrinkles.
According to the American Board of Cosmetic Surgery, Botox injections are the most popular cosmetic procedure nationwide. In 2016, over 7 million people had Botox treatments.
The effects are temporary, lasting 3–12 months, depending on the type of treatment.
People often request the injections in the following areas of the face:
• wrinkles between the eyebrows, called frown lines, glabellar lines, or elevens
• wrinkles around the eyes, known as crow’s feet
• horizontal creases in the forehead
• lines at the corners of the mouth
• “cobblestone” skin on the chin
Botox is also being used to improve the appearance of the hair, however, there is little evidence that this works.
Botox Medical Uses
While best known as a cosmetic procedure and the treatment of skin wrinkles, Botox injections can also ease pain and help correct issues caused by muscular disorders. It’s common, for example, to get Botox for migraines, eyelid and neck spasms, lazy eye, overactive bladder, excessive sweating, and pain caused by temporomandibular joint (TMJ) disorders.
Some people also have Botox injections for off-label, or unapproved, uses, including as treatments for:
• alopecia
• sialorrhea, which involves producing too much saliva
• psoriasis
• dyshidrotic eczema, which affects the palms of the hands and soles of the feet
• anismus, a dysfunction of the anal muscle
• post-herpetic neuralgia
• vulvodynia, pain and discomfort in the vagina without a clear cause
• Raynaud’s disease, which affects circulation
• achalasia, an issue with the throat that makes swallowing difficult
Other issues and medical conditions that may benefit from off-label Botox use include:
• facial redness and flushing, including during menopause
• keloids and scars from wound healing
• hidradenitis suppurativa, an inflammatory skin disease
• blistering lesions due to Hailey-Hailey disease, a rare genetic disorder
What are Dermal Fillers?
Dermal fillers, sometimes called soft tissue fillers, are substances designed to be injected beneath the surface of the skin to add volume and fullness. More specifically, dermal fillers plump up wrinkles, smooth lines and restore volume in your face. Your healthcare provider injects these substances just under your skin.
People choose to get dermal fillers to enhance their facial features or gain a more youthful appearance. This non-surgical, minimally invasive treatment usually takes less than half an hour, and recovery time is minimal. Results are seen right away and last months to years depending on the type of filler and the location.
There are several kinds of dermal fillers. Your provider will discuss your options with you. As with any cosmetic procedure, there are risks, including infection, bleeding and bruising. Health insurance plans generally don’t cover elective cosmetic procedures such as filler injections.
There are many types of dermal fillers each of which is designed to treat different signs of aging or other cosmetic issues. In addition to fillers that use synthetic (manmade materials) and substances that naturally occur in your body, providers can also use fat from your own body. Healthcare providers call this procedure “autologous fat grafting,” where they remove fat from one part of your body and inject it into your face.
The types of off-the-shelf fillers include:
• Hyaluronic acid (HA) – Hyaluronic acid is a naturally occurring acid in your skin. It gives your skin volume and keeps it hydrated. With age, your body stops making hyaluronic acid. Results from HA injections usually last six months to a year. Restylane® is a commonly used type of HA filler.
• Calcium hydroxylapatite (CaHA) – Calcium hydroxylapatite is a type of filler that consists of a substance you have in your bones. Results from these fillers typically last around a year. Healthcare providers usually use CaHA fillers for deeper wrinkles. Examples of CaHA fillers include Radiesse®.
• Polylactic acid (PLLA) – Known as a “collagen stimulator,” polylactic acid stimulates collagen production. It’s the same ingredient medical professionals use to heal wounds after dissolvable stitch insertion. This is a synthetic ingredient that’s also biodegradable. Providers usually use polylactic acid to smooth deep wrinkles on your face. The results can last two years or more. Types of PLLA fillers include Sculptra®.
• Polymethylmethacrylate (PMMA) – These fillers consist of collagen and very small balls that stay under your skin after your healthcare provider injects them. The balls give your skin volume and keep it firm. Bellafill® is one type of PMMA filler.
• Autologous Fat Injections – These come directly from fat in your body. Doctors use liposuction techniques to extract fat from a donor area, like the stomach. The doctor will then inject the fat into another area of your body that needs it. This is the only permanent dermal filler option.
Your provider will review the types of dermal fillers and discuss the right option for you. Speak to them about setting realistic goals and the results you can expect after getting injections.
Dermal Filler Cosmetic Uses
As you age, your body starts to lose collagen. Collagen is an important substance that exists all over your body, including in your skin, muscles, bones and connective tissues. Decreased amounts of collagen in your skin causes skin laxity (loose) and loss of volume. Skin becomes thinner, loses its elasticity and starts to sag. Your face can also lose some of the fat just beneath the surface of the skin. As a result, lines caused by facial muscles that perform repeated functions — such as frowning, laughing and smiling — become more visible. Smile lines, crow’s feet and furrowed brows appear, and skin can take on a hollow or sunken
In addition to general aging, lifestyle habits, as well as skin conditions and genetics can cause these subtle, and not so subtle changes to your face over time.
Injectable fillers can diminish some of these unwelcome effects. Dermal filler treatments use fine needles to strategically deliver dermal fillers, which are medical-grade solutions that plump up problem areas. Facial fillers add fullness and volume to give your face a younger, healthier look.
Different types of dermal fillers are designed to treat varying signs of aging. Depending on the filler selected, they may:
• plump up thinning lips
• enhance or fill in shallow areas on the face
• decrease or remove the shadow or wrinkle under the eyes caused by the lower eyelid
• fill in or soften the look of recessed scars
• fill in or soften static wrinkles, especially on the lower face
Static wrinkles include those around the mouth and along the cheeks. These wrinkles are usually a result of a loss of collagen and elasticity in the skin.
Unlike neuromodulators, which can have several uses, dermal fillers are strictly cosmetic.
Facial Fillers Can Be Used To:
• Add volume to sagging skin
• Make your facial features more symmetrical
• Add fullness to lips and cheeks
• Fill in shallow area of the face
• Diminish lines, creases and wrinkles
• Improve the appearance of recessed scars
• Reduce the shadow effect of lower eyelids
• Enhance facial contours and jawline
• Restore damaged tissues and features after illness or injury
• Treat facial wasting related to GLP-1 weight loss drugs
• Some medications prescribed to treat medical conditions such as HIV and AIDS can cause thinness in your face. Dermal fillers can be used to restore facial volume while or after taking these medications.
Difference Between Botox and Dermal Fillers
Botox and dermal fillers may seem similar at first glance, but they are actually completely different.
Again Botox is a neuromodulator that temporarily blocks specific chemical signals from nerves that cause muscle contractions, effectively causing the muscles injected to weaken thereby effectively relaxing wrinkles.
On the other hand, dermal fillers are effectively liquid implants that are injected into your skin (not your muscles) to plump and smooth your facial features. Different brands of fillers use different synthetic materials, from hyaluronic acid to polymethylmethacrylate (PMMA). How long the filler lasts depends on what material your provider uses.
When to Get Botox and When to Get Filler?
Botox and facial fillers are designed to do two different things, to understand the difference, you should know that there are two main types of facial wrinkles:
- Dynamic wrinkles are caused by muscle activity seen with motion (think crow’s feet at the corner of your eyes or the lines on your forehead when you raise your eyebrows). These types of wrinkles are from facial movement.
- Static wrinkles are lines or folds that can be seen when the face is relaxed (think laugh lines). These types of wrinkles are from the skin losing elasticity and collagen as we age.
Dynamic wrinkles are best treated with Botox or other neuromodulators. The three most common treatment areas are in the upper face around the eyes, between the brows, and the forehead.
Static wrinkles are often treated with both Botox and other neuromodulators, as well as dermal fillers. In these cases, neuromodulators like Botox treat the underlying muscle, while the fillers treat the lines at rest.
Dermal fillers are also used to treat volume loss in the lower face (like cheeks and smile lines). They can also be used to add fullness, like in sunken cheek bones or to plump up the lips.
In Summary
In summary, the differences between Botox and fillers are:
• Botox: This freezes muscles to stop creases and wrinkles caused by facial expressions. These are typically found in the upper face, such as the forehead and around the eyes.
• Dermal fillers: These use hyaluronic acid and similar substances to “fill in” or plump areas that have lost volume and smoothness. This includes wrinkles around the mouth, thin lips, and cheeks that have lost fullness. They may also be used on forehead wrinkles, scars, and other areas that need extra volume for a smoother look.
- Botox results last 3 to 12 months. Dermal filler results vary, depending on which filler is used.
Because Botox and fillers are different substances designed for different uses, they can sometimes be combined in one treatment. For instance, someone may use Botox to correct lines between the eyes and a filler to correct smile lines around the mouth.
PLEIJ Salon + Spa offers a range of injectable and facial filler services to address the complete range of skin-related concerns. We invite you to schedule a skin analysis and consultation appointment. During this service we will assess your skin’s precise condition, taking note of lifestyle factors to help us create a customized treatment program for your personal skin care needs.
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