What are Wrinkle Relaxers aka “Toxins”?

Although Botox is the most well-known wrinkle relaxer, there are a total of four FDA approved brands in the U.S.: Botox, Dysport, Xeomin, and Jeuveau. To make things simpler for this blog, I will now refer to all of these brands collectively as “wrinkle relaxers”. Although they are somewhat different in shape and size, all of these brands are derived from a toxin produced by the bacteria clostridium botulinum. They also all work through the same mechanism shown below. These wrinkle relaxers actually prevent contraction of the targeted muscle. Without the target muscle contraction, you no longer make the wrinkles form in the skin. Over time, less folding of the skin allows the wrinkles to improve. Most of these wrinkle relaxers last 3-4 months so best results are with 3-4 treatments per year.

Which Wrinkle Relaxers do I use most?

Although I am comfortable with and have patients request all U.S. brands, I use more Botox and Dysport in my practice. Most of my patients get very similar results with all of the brands but in my experience the key difference is duration. One brand may work slightly better or last longer in a particular patient. Most patients get 3-4 months duration, but this can vary from patient to patient.

What are Fillers?

Fillers are prescription medications used for the treatment of volume loss and wrinkles/folds of the face. The vast majority of fillers are made of hyaluronic acid (aka HA). However, the size, shape, and linkage of the molecules varies between brands and indications. There are three common brands of HA fillers in the U.S.: Juvederm (Allergan makes Juvederm fillers and Botox), Restylane (Galderma makes Restylane fillers and Dysport), Belotero, and Versa. There are other types of fillers less commonly used. Radiesse, which is made from calcium hydroxyapatite a chemical found in your teeth and bones, is used in the chin, cheeks and hands mostly. Sculptra is made from Poly-L Lactic Acid and stimulates your body to produce more collagen at the site of injection. Sculptra is mostly used in the cheeks.

Which Fillers do I prefer?

This question is much more difficult to answer than my favorite wrinkle relaxer. My filler choice varies too much based on where I am injecting the filler as well as patient specific qualities such as age, degree of volume loss, prior history, treatment goals, and budget. I honestly carry most every major type of filler in my clinic as they each have advantages and disadvantages. For instance, I use seven different fillers in the lips and seven different fillers in the cheeks.

What is the difference between Fillers and Wrinkle Relaxers?

Fillers are used to improve or restore volume of the targeted area. Wrinkle relaxers prevent wrinkles caused by muscle contraction. One good analogy is to think of your face as a bed with the sheet being the skin and the mattress representing the underlying structures such as collagen, fat, muscle, and bone. Wrinkle relaxers keep the sheet from folding by relaxing muscles whereas fillers plump the mattress by adding volume.

Where are the wrinkle relaxers used? Where are fillers used?

**This image is over simplified as a skilled injector can also use wrinkle relaxers and fillers in other areas. These medications are used in various places of the body for different treatment goals. Some of these locations are “off-label”, meaning that the FDA has not specifically approved their use in that particular area. However, almost every injector uses filler in some off-label capacity.

Wrinkle relaxers can also be used to:
1) Forehead, Crow’s feet, Glabella (frown lines between the eyes)
2) Reduce lines around the mouth commonly referred to as “smokers lines”
3) Reduce lines of the neck called “platysma bands”
4) Reduce tension and size of the masseter muscle of the jaw to create a more feminine jaw line or to help jaw pain,
5) Reduce dimpling of the chin
6) Reduce frequency of migraine headaches
7) Reduce sweating of underarms, hands, feet, and scalp
8) Reduce acne- these medications can be used to reduce oil production in the face, therefore reducing acne

Fillers can be used to:
1) Improve the volume of lips, cheeks, nasolabial folds
2) Reduce tear troughs and dark rings around the eyes
3) Improve hollow appearing temples
4) Enhance the jaw line
5) Treat wrinkles of MOST any location on the face
6) Improve the appearance of the hands (volume loss)
7) Increase the girth of the penis (yes you read that right)

When should I get Wrinkle Relaxer, Filler or Both?

This is specific to each patient. Many patients do not need wrinkle relaxer treatments until their mid or late 30s, but I have patients in their early 20s who regularly get filler for their lips. The best way (and really the only way) to determine a specific treatment plan for you is to have a consult with a skilled injector. We offer free consults at Rejuvenated Medical Spa to help create a plan for your goals and budget. We pride ourselves on taking an interest in your specific goals and giving you the time you deserve.

How much do Fillers and Wrinkle Relaxers cost?

While we can give you general estimates (such as filler cost per syringe or wrinkle relaxer cost per unit) over the phone, it is much more accurate to have a free consultation so that we can give you the actual cost of your specific treatment plan.