A week does 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
Indianapolis, Indiana