Botox & Fillers Overview
Am I a good candidate for Botox, Dysport & Fillers?
First no one needs Botox, Dysport or fillers. If someone wishes to keep lines and wrinkles on their face as a badge of aging, that’s great. For many others though, looking younger through use of Aesthetic Treatments such as Botox, Dysport, Fillers and Laser treatments to look & stay Forever Young is a great option.
As you will read below, the use of Botox, Dysport & Fillers are treatment options that corrects line/wrinkles in common areas of the face. Botox & Fillers are markedly different however and we explain below those differences and how they are used often in combination.
What is Botox, Dysport & how does it work?
Botox belongs to a class of neurotoxins called Botulinum Toxin A and there are currently three FDA approved versions in Botox, Dysport & Xeomin. We will use the term Botox in this article however both Dysport & Xeomin are the same class of drug & interchangeable. Many patients are surprised to learn there are three options and we will cover the differences later below. How all three work is exactly the same. When injected properly they simply “relax” opposing dynamic muscle groups that cause deep lines and wrinkles. Let’s look at some examples;
When you squint and bring your eyes together the wrinkles (Left Photo) that form are called the LL’s.
Left untreated the LL’s get deeper and wider until they become permanent even when resting or not making that expression.
Patients in Sun Belt states like Florida tend to develop very strong muscles in this area.
You can see the differences in the after photographs.
Now, let’s look at the forehead. When you furl or raise your brow you can see lines/wrinkles that form.
These muscles tend to get very strong over time and eventually, yes… they will become permanent unless treated.
In the top photo you can clearly see how defined or strong these muscles are. Next is one minute after without treatment you can still see the lines are beginning to set in & on their way to deepening and becoming permanent. The last slide is 10 days after treatment.
The 3rd area are called Crow’s Feet.
When smiling these lines form & through repetition these lines become more pronounced & eventually, permanent.
As you can see in all these before and after images, the results are more youthful, restful & very natural in appearance.
Are there any other areas that Botox is used in?
Three other often treated areas include as depicted in the photos below, Dimpled Chin, Gummy Smile & Eyebrow Treatments and those pictures are below.
What is the difference between Botox and Facial Fillers like Restylane & Juvederm?
As described above, Botox treatments treat dynamically caused lines/wrinkles by relaxing the muscles. Fillers serve an entirely different purpose as they replace the fat or volume lost during the aging process. Botox & Fillers are very often used together to provide outstanding clinical results.
To see how we lose fat please look at the chart to the left. At the far left at about age 35, a person’s face begins to lose volume or fat.
As we age further, the fat thins & separates, the laws of gravity cannot be denied & your face begins to sag. You look more tired, sadder & older than you did in your recent past.
Male patients describe this aging process as looking angry even when they’re not due to this loss of volume.
Looking at the Mother/Daughter picture to the left these changes can be clearly seen.
The Daughter’s face features high cheek bones, a rounder more youthful face and volume throughout the entire face.
The Mother has reduced volume especially in the mid & upper face which results in a more angular and less youthful appearance.
How do fillers work?
We have many tools in our tool chest when it comes to fillers that are used in different areas of the face, hands, chest and even buttock area to replace the volume of fat lost over time. Often different fillers are combined to achieve the best results. Fillers today includes; Restylane, Restylane Silk, Juvederm, Juvederm Ultra, Juvederm Voluma, Belotero, Restylane Lyft, Restylane Refine, Restylane Defyne, Radiesse, Volbella & Sculptra with more approved every year.
Let’s look at some before and after pictures.
At far left you can see loss of volume throughout her cheek and mid face & some jowelling taking place
By restoring that lost volume her entire area is lifted & refreshed. Her jaw line is more defined and she looks years younger.
Next is an early 30’s patient who frankly looks very good to the casual observer. On closer inspection you can see loss of volume in her mid and upper face.
The after pictures show a subtle, natural and jaw turning difference that occurs when properly and skillfully replacing the reduction volume or fat with facial fillers such as Sculptra.
As you can see in the before picture, this 47 year old patient lacks lower, mid and upper face volume & the after picture speaks for itself.
Men come in for different reason than women. Men are not as worried about looking their age. They want to look more relaxed, less angry or irritated and more rested.
If we’ve heard “I’m tired of looking so tired” once we’ve heard it 300 times!
As you can see in all the after pictures, once proper volume has been restored, the results can be truly amazing.
How many syringes of fillers will I need and how many units of Botox?
Every patient is unique so there is no way to tell without a proper & complimentary consultation. Generally speaking when it comes to fillers, a typical patient will need 1 syringe of filler for every decade of aging for mid and upper face revolumization (not including lips or tear troughs).
So.. a 30 year old would need about 3 syringes while a 60 year old would need at least 6 syringes for a proper correction. Other factors such as those who smoke, use excessive alcohol or excessive sun exposure often require more volume as well.
You might be thinking, six syringes sounds like a lot & you may be surprised to learn the answer to a question we often ask which is; how many syringes of filler will fit into one common household teaspoon?
Typically about 80% of patients will state one teaspoon and the rest may stretch it to two. There is actually room for 5 and half syringes of filler in just one teaspoon.
Now picture a teaspoon of product spread across someone’s entire face… On the subject of Botox it’s pretty much the same as no two patients opposing muscle groups are exactly the same strength.
This is also why when receiving Botox we ask you to make all those strange faces. We are actually analyzing the strength, length, location & depth of those muscles so we may target the specific areas more precisely. We don’t simply inject units of Botox. We specialize in Natural Look Aesthetic Medicine and provide the best results possible for our patients using tools like Botox & Fillers to accomplish them. The artistry & expertise required to achieve outstanding results cannot be understated.
Our policy with Botox is that we treat the areas rather than price per unit. We’ve seen Botox Groupon “deals” with ridiculously low per unit prices and we have retreated countless patients over the years from those types of offerings. Why? Because many centers who lower the cost per unit will over dilute their Botox and where an area calls for 20 units you are in fact receiving 5 units of Botox and 15 units of Saline.
At Forever Young Medpsa all we do each and every hour of every single day is Medical Aesthetics and we don’t cut corners on anything.
What’s the difference between Botox, Dysport & Xeomin?
As stated above they are all the same class of drug. Think of the brand Advil or the generic Ibuprofen. Same exact class of drug, one the original and the other a generic. For Botox class of drugs however there are some differences.
Botox & Xeomin inject unit for unit exactly the same while Dysport requires 2.5 times more units for the same result. Botox & Xeomin come in 100 unit vials and Dysport comes in 300 unit vials because again Dysport simply requires more units which for patients does not really matter as we take care of proper dosing.
The real difference is that both in studies and in our own practice, Dysport has a much faster onset of action (begins to work faster) then Botox or Xeomin and more studies have found a slightly longer duration. Combine this with Dysport costing on average about 10% less and that’s why over 90% of our patients have switched over to Dysport.
What about Xeomin? Well another good product with its own niche. Over time some patients develop a resistance to Botox or even Dysport. Not to the actual Botulinum Toxin A but rather to the proteins used as additives in both products. Xeomin in the purest form of Botulinum Toxin A and is used primarily on patients who have developed a resistance to Botox & Dysport or for patients who simply want the purest form available. Longevity is reported to be just a bit shorter then Botox.
I’m concerned about bruising, swelling & pain associated with needles!
First know that our Certified Aesthetic Nurse Practitioner Injectors are supremely qualified & certified on all our injectable procedures. That said no one “likes” injections especially on their face. Forever Young Medpsa is very proud that we’ve introduced some cutting edges pre-treatments that make the experience unique from other centers. It begins with a kind & gentle touch combined with the skillful art of having performed countless thousands of injections over the years combined with a prescription strength topical number cream.
Next, we use a vein imaging system that allows us to look under your skin and avoid all the major veins and larger vessels.
While bruising can still occur it’s typically minor & greatly minimized by using this vein imager.
We also offer for a slight additional fee the ProNox system that provides a 50/50 mix of oxygen and nitrous oxide. This takes the edge off & helps with anxiety especially for newer patients.
Many of our patients LOVE the ProNox experience. The effects are very quick to wear off and patients can resume normal activities in minutes.
You won’t find systems like these in most other centers in South Florida or the entire USA. Forever Young Medpsa has a long history (Since 2005) of excellence and market leadership.
Our patients appreciate that while price is always important, patient safety – results – technologies & practitioner qualifications matters most of all.
Besides Botox & Fillers what else should I have done?
That depends on what’s important to you and your budget. The great news is that we offer almost everything possible. Our most popular add on treatment is our Forever Young Protocol. A Stanford University 10 year study showed patients on this protocol looked 10 years younger, 10 years later so be sure to ask about it during your appointment.
Other typical add on treatments include; Skin Tightening Treatments, Age/Sun Spot Removal, Facial Vein Removal, Acne or Facial Scar Reduction, Monthly HydraFacials for Skin Health, Non-Surgical Body Shaping, PDO Thread Lifts, Chemical Peels, Platelet Rich Plasma (PRP) Treatments & much more.
We offer patient financing (for patients that qualify) & many of our Botox & Filler patients renew 12 month interest free financing every year so they can better budget those expenses each month rather than a lump sum payment.
Aging takes time and so does anti-aging… It’s a journey we go on together to get you looking and staying, Forever Young.