As we all have approached the age of wrinkles (some knocking more loudly than others), we have also entered the age of “pick-me-up” medicine. That is to say, minor investments of time, money, and recovery for in-office facial beautification; bring sprigs of physical and emotional springtime into our wintry doldrums of aging. We call these treatments “pick-me-ups.” What is the right “pick-me-up” choice for you? Botox or fillers? Let’s learn a little bit about each.

Firstly, we need to think about the causes of facial lines. Facial lines or wrinkles may be dynamic, that is to say, caused by the activity of muscles. Examples of these would be forehead lines, crow’s feet, central brow furrows (the “11’s”), or parchment creases around the lips. In the early years of adulthood, taming the activities of these muscles can quiet the skin surface to a “Lake Placid” of smoothness. Botox-type agents (called “neurotoxins”) can be injected through a tiny needle strategically into these areas, and will percolate into the command-and-control portion of the muscle where normally nerve signals instruct the activity of the muscle, but this medicine effectively blocks the transmission of these signals. Voila! The muscle simply sits and waits for a signal, which won’t arrive until the Botox wears off in 6-9 months.

Lines not caused by repeated muscle activity, called static lines, usually are the result of weakening of the skin from sun, nicotine, age, or gravity. Botox does not help static lines. Fillers are safe chemical products, which are injected to nestle in the nooks and crannies of wrinkled skin, displacing adjacent tissues to provide a tenting outward of the skin. Introduced also with a fine needle this material rests in the deeper level of the skin, beneath the skin (such as nasolabial or marionette lines), or even down against the bone (e.g. to enhance cheek projection/fullness). Some popular agents include hyaluronic acid (Juvederm/Restylane/Voluma), and hydroxyapatite (Radiesse). Although not permanent they may last 6-24 months, depending on the agent and the location.

Interestingly, as we trudge through the chapters of aging, some of our dynamic wrinkles create a thinned “wear spot” in the skin, as a special type of wrinkle that persists even when the offending muscle is at rest. These special more stubborn wrinkles benefit from the tandem effects of Botox and filler.

If you would like to sit down with one of our skin care specialists to discuss your lines or other skin needs, please contact us at Sando Aker – My Plastic Surgery Group. 317-848-5512