A weekdoes not go by that I do not find several patients that have confused Botox with injectable fillers in terms of what it can do for in-office facial wrinkle and line reduction. I have heard many patients say “Can you fill up my lips with Botox’ or ‘I need a filler between my eyes to stop me from frowning’. The confusion is that some patients believe that all that comes out of a needle is the same. While such confusion is understandable due to the relative newness of these treatments, that is a little like saying that a scalpel does all the same surgeries. Injectable materials are treatments which have different mechanisms of action, even if the end result is often times similar. (wrinkle reduction)
To clear up the confusion, I often explain to patients the difference between static wrinkles and dynamic wrinkles. Dynamic wrinkles are those wrinkles and lines that appear when your face is moving or expressing. When we were younger, the only lines and wrinkles we had were dynamic. Our face was otherwise wrinkle-free when we weren’t expressing ourselves. Static wrinkles are those facial lines that are evident even when our face is still. All dynamic wrinkles, with age, will eventually lead to static wrinkles.
These two types of wrinkles are what separates Botox and any of the injectable fillers. Botox is for dynamic wrinkling. It is a muscle-paralyzing or muscle weakening agent so it will soften the wrinkles and lines that occur from a dynamic facial movement, such as between the brows with frowning….or the crow’s feet from smiling. Injectable fillers are for static wrinkling. They soften lines and larger wrinkles by plumping them out so they look less evident at rest. In some cases, the combination of Botox and fillers are used when the line or wrinkle is very deep and weakening the muscle action will help perserve the longevity of the filler material but not being ‘beaten on’ by muscle movement. This is most common in the furrows between the eyebrows. (’11 sign’)
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
Can Exercising Reduce Facial Wrinkles ??
One methods that has been touted for over fifty years to reduce facial wrinkling and aging is exercising the facial muscles. One of the original books on this subject was entitled Lift Up Your Face from the 1950s, which I actually have a copy in my plastic surgery library. The concept continues to be espoused and written about today, now even expanding the exercise theme to include yoga facelifts, acupuncture facelifts and electric stimulation devices that promise to tighten the face through ‘muscle build-up’.
Having a good knowledge of the facial muscles and the facial aging processe, I still cannot understand how most of these approaches have any hope of being effective. Short of the platysma muscle of the neck (which I actually think can be tightened), the rest of the facial muscles are quite small and would have little impact on keeping the face uplifted as they are responsible for facial expression and not tissue suspension. The face ages as ligaments to the skin become lax, which subsequently allows skin and fat to sag (with the exception of the lips and chin) The facial muscles cannot prevent this problem, no matter how ‘tight’ one tries to make them. In fact, exercising (making extreme facial expressions) is likely to increase facial aging by making skin wrinkles worse.
For real prevention or improvement in facial aging, stick to the tried and true methods, Botox, injectable fillers, skin resurfacing, and eventually skin excisions and lifting procedures.
Dr Barry Eppley
www.eppleyplasticsurgery.com
www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
Getting rid of those 11s!
Nothing makes yopu look more stressed or irritable than those vertical lines between the brows. Six different facial muscles converge in the area between the brows, and when making that classic scowl with straining or stress, creates two vertical lines in some patients, otherwise known as the 11s. If you frown enough, these 11s can become a permanent fixture of your face.
FDA-approved, specifically for this region, Botox injections can smooth these vertical lines so you can look stress-free for 4 to 6 months after treatment. In the event that these lines are still somewhat visible even after the muscles are relaxed, fillers such as Restylane, Juvaderm, or Radiesse can be used. They help fill in the indentations that left. This combination is particularly powerful at usually results in the best eradication of these lines. But not all patients will need both, however, If in doubt, do the Botox first, wait two weeks, and see if further line reduction is needed. The fillers can always be done later after the Botox.
Dr Barry Eppley
www.eppleyplasticsurgery.com
www.ologyspa.coom
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
A day does not go by that I find a patient that has confused Botox with an injectable filler in terms of what it can do for in-office facial rejuvenation procedures. I have heard patients say. “Fill my lips with Botox’ or ‘Use Restylane between my eyes to stop me from frowning’. Just because it is an injectable, doesn’t mean that what comes out of the end of the needle works the same.
To clear up the confusion, I often explain to patients the difference between static wrinkles and dynamic wrinkles. Dynamic wrinkles are those wrinkles and lines that appear when your face is moving or expressing. When we were younger, the only lines and wrinkles we had were dynamic. Our face was otherwise wrinkle-free when we weren’t expressing ourselves. Static wrinkles are those facial lines that are evident even when our face is still. All dynamic wrinkles, of course, eventually with age, lead to static wrinkles.
These two types of wrinkles are what separates Botox and any of the injectable fillers. Botox is for dynamic wrinkling. It is a muscle-paralyzing or muscle weakening agent so it will soften the wrinkle that occur from dynamic facial movement, such as between the brows with frowning. Injectable fillers are for static wrinkling. They soften lines and larger wrinkles by plumping them out so they look less evident at rest. In some cases, the combination of Botox and fillers are used when the line or wrinkle is very deep and weakening the muscle action will help perserve the longevity of the filler material but not being ‘beaten on’ by muscle movement. This is most common in the furrows between the eyebrows. (’11 sign’)
Dr Barry Eppley
www.eppleyplasticsurgery.com
www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis
