Botox and Juvederm at the same time or later?

Thank you for the question.
You can combine injectables to personalize your treatment.  I perform this as part of a "Liquid Lift".  Neuromodulators like Botox can relax frown lines and hyaluronic acid injectables can lift the crease left behind.  Studies have shown that the results of hyaluronic acid injectables last longer when used in tandem with Botox.
As always, an in-person consultation with a board certified dermatologist with cosmetic training is the best way to assess your needs and provide medical advice. 

Many patients, when exploring
options in non-invasive cosmetic treatments, find the distinction between
toxins (i.e. Botox) and fillers (i.e. Juvederm) confusing. Toxins act to smooth
wrinkles that are caused by muscle action directly on the skin, such as the
area between the eyebrows (elevens) and the crow’s feet. When those little
muscles are paralyzed, they no longer pull on the skin and the skin’s surface
becomes smooth.



Dermal fillers (such as
Juvederm) occupy space under a different kind of wrinkle such as is present in
the nasolabial fold. This wrinkle is more of a crease; which is part of the
anatomic structure of the face. It is not really effected by muscle action
therefore Botox would have no affect in the area.



It is very common to use both
of these treatments to freshen the look of the entire face at a single visit.

Dermal fillers are required to correct nasal labial folds. Botox is not used for this purpose. Using a micro-cannula and 1/2 to 1 syringe per side of Juvederm or longer lasting Volift would provide aesthetic correction to this area. You may also want to consider using Voluma to augment and lift the cheek area as deep nasal labial folds are usually a symptom of volume loss in the cheeks. See your certified aesthetic injector for a face to face consult to discuss all your options.Best regards

Smile lines are best treated with facial filler such as Juvederm.  Smile lines are typically filled with a material such as Juvederm to lessen their appearance.Botox is a neuromodulator which can decrease muscular activity.  Since our smile is important, typically Botox is not injected in this area.

One of the main issues confusing many people who have never had a treatment with Botox or Juvederm, is what areas do each target? I usually tell people, think about it this way; Botox is used for the sides of the eyes and above on your face (between your eyes and forehead) and Juvederm is used for anything below the eyes. This is an oversimplification, however it is basically true. For the nasolabial folds, the best treatment is the filler, Juvederm. This is not an area that is targeted with botox as the wrinkle in this area is not due to abnormal muscle contraction (which Botox treats) it is due to the effect of gravity on your face. Fillers, do just that, they fill space. Typically, we inject some filler into your cheeks to help pull the fold apart slightly, then inject directly into the fold so it softens it. People can have dramatic results. I've posted a link to a more detailed editorial on the difference between Botox and Fillers. James P. Bonaparte, MD, MSc, FRCSCHead and Neck Surgerypracticing in Facial Plastic and Reconstructive SurgeryAssistant Professor, University of OttawaOttawa, Ontario, Canada

You would need a product like Juvederm injected into your nasolabial folds, not Botox.  Voluma can help the appearance of nasolabial folds also by increasing the volume in your cheeks. The average cost of Juvederm varies from city to city, in Utah it is usually around $600 per syringe for Juvederm and $900 per syringe of Voluma. 

While Botox and Juvederm are both injectable treatments, they do very different things. Botox is a neuromodulator that treats wrinkles and expression lines by relaxing the muscles that cause wrinkles. Therefore, Botox is not the right treatment for nasolabial folds. A dermal filler such as Juvederm is the better option since it will fill in deep folds and restore lost volume.