The procedure involved to do a Botox treatment is quite simple. A very tiny needle is used to inject the Botox into the wrinkle-producing muscles. No anesthesia is required and the injections usually take only 10 to 15 minutes. There is no recovery time or down time though you may see some temporary redness or bruising at the injection site. On average, it takes three to five days to start to see an effect and up to 3 weeks to see the maximum results from Botox. Results usually last about three months.
Fillers are complementary procedures - they are not the same thing as Botox and should not be thought of the same. While Botox is used to treat dynamic wrinkles, fillers are used for static wrinkles and to enhance volume.
Static wrinkles or lines are those that can be seen even at rest, such as the nasolabial fold that runs from the side of the nose to the corner of the mouth on each side or marionette lines.
Fillers are used to fill these static lines and folds. It is necessary to note that these static wrinkles have multiple causes, as loss of volume of the face as we age or sagging due to gravity. Some static wrinkles are emphasized by muscle activity, such as when nasolabial folds deepen when smiling. Fillers can also be used to augment the lips and treat lipstick bleed lines.
Commonly used fillers include:
» Collagen: A natural substance known as a protein and is the main component in cartilage, teeth and bones. Brand names include Cosmoderm and Cosmoplast.
» Hyaluronic acid: Also a natural substance found in your body; high concentrations are found in soft connective tissue and in the fluid surrounding your eyes as well as in some cartilage and joint fluids, as well as skin tissue. Brand names include Captique, Perlane, Restylane and Juvederm.
» Calcium hydroxyl apatite: found naturally in human bones. Brand names include Radiesse.
» Polylactic acid: A synthetic material that when injected, stimulates the body’s own production of collagen. Brand names include Sculptra.
Filler injections usually require local or topical anesthesia and can take anywhere from 15 to 30 minutes or more depending on the area being filled. You should stop any NSAID pain relievers, including aspirin, Motrin, ibuprofen and Aleve, for at least one week before the procedure to minimize bruising and swelling and avoid scheduling any important social events for at least several days after the injections.
Fillers are temporary, lasting anywhere from six months to more than a year, and need to be repeated to maintain your results. It is not uncommon to see patients who have a combination of static and dynamic lines, so often Botox and filler treatments are used together in facial rejuvenation. Your plastic surgeon should be able to examine you for both dynamic and static wrinkles and give you an opinion on which agent to use where.