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Botox or Fillers?

I can’t tell you how many times I’ve seen patients in consultation for Botox, thinking it’s the panacea of cosmetic beauty. In fact, it is a very useful product. But most individuals over 40 require more than just Botox to restore youthful beauty. Setting aside, for the moment, treatments that are done primarily for the health of the skin, we generally have two injection treatments commonly performed for the sake of cosmetic beauty… Botox and fillers.

Strictly speaking, Botox is a brand name for onobotulinum toxin type A, in the class of chemical agents called neurotoxins. In North America we have two other, similar neurotoxins, Xeomin and Dysport (incobotulinum toxin type A and abobotulinum toxin type A). All three act to relax the muscles found just under the skin… resulting in a smoother surface.

Lines and Wrinkles Soften or Disappear
These products do a great job of reducing vertical creases between the eyebrows, horizontal creases across the forehead, and crow’s feet beside the eyes. Once the product is placed under the skin, it takes about 2 weeks for the full effects to settle in. By then, lines and wrinkles either soften or disappear.

Why Dermal Fillers?

But neurotoxins cannot treat a sagging face due to volume loss. As we age we lose the deep facial fat that is found above the brow, in the temples, under the eyes, mid-face, and around the mouth and chin. Without that deep fat, skin simply drapes over the remaining facial structure. At that point, another solution is necessary.

The solution for restoring youth and beauty lies with the strategic placement of dermal fillers. Currently, in the U.S., we have several categories of fillers that can do a great job, each with their own characteristics. They range from products that last several weeks to those that last years. Unfortunately, no matter the filler, we all continue to age, and nothing in today’s arsenal provides a permanent solution.

Even with a surgical facelift, achieving a natural look includes replacing deep fat volume. In the operating room, surgeons will typically use fat or fat mixed with platelet rich plasma. While fat is a beautiful filler, it too only lasts so long.

So… Botox or fillers?

Generally speaking, most people in their mid 20’s can get away with just Botox. But once your face has begun to sag, you’re going to need some form of dermal filler to restore the youthful appearance you remember.

Dr. Josie L. Tenore, M.D., M.Sc.,
is a board-certified family physician who became interested in aesthetics during medical school. As a result, most of her electives focused on dermatology and plastic surgery. Dr. Josie began her practice with family medicine because she enjoyed the challenge of delivering comprehensive health and well-being to people of all ages. This unique combination of family medicine and aesthetics led her to advocate a program of eating well, exercising and aesthetics for patients who want to have the best quality of life. Read full bio.

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595 Elm Place, Suite 208
Highland Park, IL 60035