An Introduction to Botox and Other Injectables

Michael C. Edwards, MD, FACS

Article by
Las Vegas Plastic Surgeon

Botox

Botox Cosmetic the brand name for botulinum toxin type A. It is the purified form of the toxin and when injected in small doses into specific muscles, blocks the chemical signals that cause muscles to contract. When the muscles can't tighten, the overlying skin appears smoother and less wrinkled.

The Food and Drug Administration (FDA) has approved Botox as a temporary treatment for moderate to severe frown lines between the eyebrows. But it can be used to treat other facial wrinkles as well as off label.

Not all facial wrinkles benefit from Botox Cosmetic injections and it won't reverse wrinkling caused by sun damage. Your skin type, skin thickness and degree of wrinkling all play a role in determining whether these injections are effective for you. The number of injections needed depends on many factors, including your facial features, the extent of the wrinkling and the specific area being treated.

Botox Cosmetic treatment requires no downtime and you can resume your normal daily activities almost immediately. You'll notice results within a few days, but the full effect takes about two weeks. Once the effect is seen, it takes three to six months for the affected muscles to begin functioning again.

To maintain your look, you need follow-up injections every few months. Botox must only be used under a doctor's care. It can cause adverse reactions if it's administered incorrectly. Look for a doctor who is board-certified and make sure of their experience with Botox.

 

Facial Fillers

Facial fillers are not all alike. Injectables and fillers include a variety of materials, which last for different lengths of time and have different effects and uses. With so many products on the market, finding the injectable filler most suitable for your condition can be confusing.

Juvederm: composed of hyaluronic acid (HA) which is a natural component of the cell walls in our bodies and is therefore not foreign. Juvederm is used for facial wrinkles and folds. The substance is biocompatible, and the body naturally absorbs it after about six to nine months. The effect may last as long as a year.

Restylane: another hyaluronic acid product, approved by the FDA in December 2003, that reduces facial wrinkles, particularly around the mouth and nose. Treatments can last six months or more. There is said to be more discomfort and post-procedure swelling with Restylane injection.

Radiesse: For filling wrinkles and folds, especially around the mouth and nose, Radiesse treatment may lasts two years or more. Radiesse, formerly Radience, is a compound of calcium hydroxyl apatite microspheres that are suspended in a carboxymethylcellulose gel. The gel contains an organic compound of carbon, hydrogen, and oxygen, as well as glycerin and sterile water. Thin connective tissue forms around the microspheres so that the microspheres act as a filler that remains permanently implanted at the site.

Sculptra: is a synthetic Poly-L-lactic acid material. The material has been commonly used in dissolvable stitches and soft tissue implants is a biocompatible injection that increases the thickness of the skin to treat skin folds and hollow or sunken areas of the face. It lasts about two years. This treatment was recently introduced in the United States.

Artefill: consists of synthetic microspheres suspended in bovine (cow) collagen. It is FDA-approved as a wrinkle filler for smile lines but is also used off-label for lip augmentation, acne scars, and more. One of ArteFill's main appeals is its permanency however it does currently require skin testing prior to use.

Collagen: may improve deep and fine wrinkles on the forehead, crow's feet, laugh lines, frown lines, scars, thin lips, naso-labial folds (deep folds produced by sagging skin that hangs from the nose to the mouth), vermilion border wrinkles (wrinkles that accumulate around the mouth), or depressed scars. The benefits are immediate and last about three months. Skin testing is required to avoid the risk of an allergic reaction.

Fat: can improve the appearance of an aging forehead and eyes, and reduce scars. Fat fillers can also plump up hollow cheeks, fill in stubborn facial lines, or change your lips from thin to supple. The filler consists of fat taken from one part of your body and moved into the area of your body to be treated.