A day does not go in my Indianapolis plastic surgery practice 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
Indianapolis, Indiana